1.5　Conclusion

The pain mechanisms in chronic pancreatitis are heterogeneous and multifaceted，and likely often overlap and co-exist in the individual patient.Whereas the focus of pain treatment previously targeted abnormal anatomical findings such as strictures and stones in the main pancreatic duct there is little evidence to support that this is the reason for pain.Rather，neuronal changes in the peripheral and central nervous system are the main reasons for pain in most patients and often complicated further by cognitive and emotional distress.Therefore，the treatment should be multidisciplinary and based on a thorough workup of the pain system and in some cases combined with a psychological evaluation.It is mandatory to exclude secondary causes of pain，including side effects to treatment，as they are often reversible and easy to treat.As the combination of pain mechanisms in each patient is unique with distinct causes of pain and response to treatment，personalised treatment based on biomarkers that reflects the pain processing is an unmet need that invariably will be the focus for future studies.(https://www.daowen.com)