Manage pain in chronic pancreatitis by initially offering paracetamol or a nonsteroidal anti-inflammatory drug (NSAID) for mild-to-moderate pain, considering contraindications and adverse effects NICE CKS.
For severe pain, consider adding a weak opioid such as codeine phosphate, with caution regarding dependency and adverse effects NICE CKS.
Consider the addition of drugs such as amitriptyline or gabapentin for neuropathic pain, depending on clinical judgement NICE CKS.
Be aware that pain mechanisms are multifactorial, involving duct obstruction, nerve damage, inflammation, and central sensitization, which may influence treatment choices NICE CKS.
Use neuropathic pain drugs as indicated, especially if no clear cause for pain is identified, to reduce reliance on opioids NICE CKS.