Evaluation of pain patterns in idiopathic chronic pancreatitis patients in the background of central sensitization

Pain in chronic pancreatitis (CP) is most common and difficult aspects to manage. About 90% of patients with CP suffer from abdominal pain which remains primary cause of hospitalization. Pain in CP results from complex interplay of morphological (increased parenchymal pressure, pancreatic duct hypertension, pancreatic complications) and neural mechanisms (peripheral and central sensitization). Neuroplasticity is an emerging theory to understand mechanism of pain in CP characterized by peripheral and central pain sensitization, and brain reorganization. It manifests clinically as allodynia and hyperalgesia and perceived as one of the driving reasons of pain in CP. Currently available conventional medical and surgical treatments majorly target morphological aspect of pain mechanism which leads to inadequate pain management. Further research in neuroplasticity and identifying brain regions involved pain sensitization can help in understanding and managing pain in CP in a comprehensive fashion. In this study, we will investigate association between clinical pain patterns with central sensitization and brain reorganization using Pancreatic-Quantitative Sensory Testing (P-QST), functional MRI (fMRI), EEG and serum biomarkers.