Self-Reported Measures of Nociplastic Pain are Associated With Reduced Response to Endoscopic Retrograde Cholangiopancreatography in Chronic Pancreatitis.

BACKGROUND

Endoscopic retrograde cholangiopancreatography (ERCP) provides inadequate pain relief in nearly half of patients with chronic pancreatitis (CP). With no reliable predictors for ERCP response, patient-reported outcome measures (PROMs) of nociplastic pain, which have demonstrated predictive value in other chronic pain conditions, are appealing but remain unexamined in CP. This study assessed whether PROMs of nociplastic pain are associated with analgesic response to ERCP in CP.

METHODS

Between October and November 2025, we conducted an electronic survey of patients with definite CP who had undergone technically successful pancreatic ERCP during 2019-2025. Treatment response was defined by a Patient Global Impression of Change rating of "very much improved" or "much improved." Evaluated PROMs included: (A) Michigan Body Map (MBM); (B) Fibromyalgia Survey Questionnaire (FSQ); (C) Generalized Sensory Sensitivity (GSS); and (D) Central Sensitization Inventory (CSI).

RESULTS

Of 53 participants, 47% responded to ERCP. Using the MBM, the odds of treatment response to ERCP was lower in participants with a greater number of painful body sites (OR=0.82; 95% CI: 0.64-0.98; P =0.029) and regions (OR=0.73; 95% CI: 0.49-0.99; P =0.06). Similarly, the odds of responding to ERCP was lower in those with higher FSQ (OR: 0.85; 95% CI: 0.73-0.97; P =0.05) and higher GSS (OR: 0.79; 95% CI: 0.61-0.99; P =0.05). Treatment response was not associated with the CSI.

CONCLUSION

Simple PROMs, such as a body map, FSQ, and GSS, can identify patients with CP who have less pain relief from ERCP. Prospective studies are needed to confirm the predictive value of these tools.