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Celiac plexus block (CPB) in patients with unresectable pancreatic cancer‐related pain

Abdominal pain is a major symptom in patients with inoperable pancreatic cancer and is often difficult to treat. Celiac plexus block (CPB) is a safe and effective method for reducing this pain. It involves the chemical destruction of the nerve fibres that convey pain from the abdomen to the brain. We searched for studies comparing CPB with standard analgesic therapy in patients with inoperable pancreatic cancer. We were interested in the primary outcome of pain, measured on a visual analogue scale (VAS). We also looked at the amount of opioid (morphine‐like drugs) patients took (opioid consumption) and adverse effects of the treatment. Six studies (358 participants) comparing CPB with standard therapy (painkillers) met our inclusion criteria. At four weeks pain scores were significantly lower in the CPB group. Opioid consumption was also significantly lower than in the control group. The main adverse effects were diarrhoea or constipation (this symptom was significantly more likely in the control group, where opioid consumption was higher). Endoscopic ultrasonography (EUS)‐guided CPB is becoming popular as a minimally invasive technique that has fewer risks, but we were not able to find any RCTs assessing this method (current medical literature on this subject is limited to studies without control groups). Although the data on EUS‐guided CPB and pain control are promising, we await rigorously designed RCTs that may validate these findings. We conclude that, although statistical evidence is minimal for the superiority of pain relief over analgesic therapy, the fact that CPB causes fewer adverse effects than opioids is important for patients.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Causes and diagnosis of lactose intolerance

Some people have digestive problems after drinking milk or eating dairy products. They may only tolerate very small amounts of lactose because their bowel has trouble breaking it down.Lactose is the main carbohydrate in milk produced by cows and other animals. Human breast milk also contains lactose. It is not present in vegetable products like soy milk. Lactose consists of two sugars: glucose and galactose. An enzyme in our small intestine called lactase quickly breaks down the lactose into its two parts. Only after the two sugars have been separated can they be absorbed by our bowel.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: June 17, 2015

Irritable bowel syndrome: Overview

The typical symptoms of irritable bowel syndrome (IBS) include abdominal pain, constipation and diarrhea. Although IBS is not dangerous, the symptoms can be very painful and bothersome. Here you can find information on the various treatment options and what you can expect from them.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: October 20, 2016

Small Intestine Cancer Treatment (PDQ®): Patient Version

Expert-reviewed information summary about the treatment of small intestine cancer.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: June 30, 2016

Adult Non-Hodgkin Lymphoma Treatment (PDQ®): Patient Version

Expert-reviewed information summary about the treatment of adult non-Hodgkin lymphoma.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: August 3, 2016

Pancreatic Cancer Treatment (PDQ®): Patient Version

Expert-reviewed information summary about the treatment of pancreatic cancer.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: June 30, 2016

Systematic Reviews in PubMed

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