Targeted pain treatment for abdominal pain | gastric pain

Celiac plexus Intervention

Celiac plexus intervention is commonly used to treat abdominal pain / gastric pain / stomach pain because of cancer in intestine, colon, stomach (gastric cancer), Gall bladder, pancreas, liver, GE junction, food pipe (oesophagus) or pancreatitis. This intervention provides relief from severe pain, without any major complications and high-dose narcotic pain killer medication can be reduced or stopped.

What is a Celiac Plexus Intervention treatment?

This is amazing technique to control pain due to the spread of cancer in the organs of the upper abdomen as well as lower abdomen. The celiac plexus is a group of pain nerves coming from the intestine, colon, pancreas, stomach, liver, and part of the bowels. It is located in the center of the abdomen, below the diaphragm.  This intervention inhibits the ability of nerves carrying pain signal from tumour in abdomen to the brain. As a result, patients experience significant pain relief for months or more at a stretch.

What is a test before celiac plexus intervention treatment?

For the diagnostic celiac plexus step / test step we will use only numbing medicine (known as celiac plexus block). This will prove us if this intervention will relieve at least 70 percent of your pain eventually. If this test step helps to relieve much of your pain for few hours, we then will perform the longer lasting neurolyis or laser like RF ablation of celiac plexus.

What is a neurolytic celiac plexus intervention?

For the neurolytic celiac plexus intervention, we will use a concentrated medicated neurolytic medicine mixed with some numbing medicine. In contrast to the numbing medicine this neurolytic medicine will actually destroy the pain nerves. These selectively damaged pain nerves will not be able to let you feel the pain for a much longer time. It is very important to understand here that, this procedure does not affect the other normal roles of nerves or other nerves.

How is the celiac plexus interventional procedure done?

For the celiac plexus intervention you will lie on your stomach. The Interventional Pain Specialist doctor will numb a small area in the middle of your back. Doctor will then put in needle like instrument to the area between the spine and the big abdominal blood vessel through numb skin. Mixture of medicines is given through the instrument.  It is always done with the help of fluoroscopy (special X-rays) or ultrasound (USG). During the procedure you might feel a slight burning sensation.

 How long will pain relief last?

The diagnostic intervention will give you good pain relief for six to 24 hours. The neurolytic celiac plexus intervention will usually give you pain relief for months or more.

Will I need to take pain medication after the procedure?

You might need to continue taking some of your pain medications after the neurolytic celiac plexus intervention. If you were taking a lot of pain medications, or for a long period of time prior to the neurolytic celiac plexus procedure, it should not be stopped suddenly. We will discuss all this with you in detail before the procedure.

When is a celiac plexus intervention required?

A patient is advised to go for celiac plexus intervention when the oral pills and other methods of treatment fail to stop abdominal pain or when one wants to get rid of strong pain killer pills. The best time to get this treatment is early stage of advancement of cancer. Earlier the intervention is done, longer will be its effect.

How beneficial is celiac plexus intervention?

Celiac plexus intervention is found to provide pain relief between a few weeks and a year subject to patient condition and spread of the cancer. And usually it is the only method left to provide pain relief (except pain implant) when other commonly used methods fail. Most important criteria for the better outcome is the timing of the procedure. Earlier the procedure is done, better is the results.

The procedure significantly reduces the dependence on pain medication while improving the quality of life.

When will I have pain relief?

Pain relief can be felt immediately and celiac plexus intervention benefits are most visible in a day or two to five days.

Click on Liver cancer, Gall bladder cancer, Pancreas cancer, food pipe cancer, Intestinal cancer to know the various sign and symptoms of early and advanced stages of cancer.

What is a Radiofrequency Ablation of Nerve?

Radiofrequency ablation of nerve or radio frequency lesion is a procedure using a specialized machine to interrupt the pain signals on a semi-permanent basis.

The basic principle of radio-frequency treatment is placement of an insulated electrode probe into the target tissue or pain nerves and release RF waves.

When is the radiofrequency ablation of nerve used?

Radiofrequency ablation of nerve is generally used for patients when all forms of commonly used pain medications are not giving satisfactorily pain relief. That means common methods of pain relief have failed.

Radiofrequency ablation of splanchnic nerve is generally advised for patients experiencing one of the below listed medical conditions:

Abdominal pain / gastric pain / stomach pain because of cancer in the intestine, colon, stomach (gastric cancer). Gall bladder, pancreas, liver, GE junction and food pipe (oesophagus) or pancreatitis

In addition, to be a right candidate for radiofrequency ablation of splanchnic nerve, you must have responded well to the local anesthetic test block. ie before doing an RFA procedure, numbing medicine is given in the target pain nerves and if you get more than 50% pain relief immediately, it’s an indication to proceed for the radiofrequency ablation procedure. These two steps may be done on the same day or on different days, depending upon the patient’s condition and requirement.

What is the procedure?

The radiofrequency nerve ablation uses radio waves to produce heat directed at a specific pain nerve. The heat destroys the nerve and thus relieves pain. These damaged pain nerves will not be able to let you feel the pain for a much longer time. This procedure does not affect the other normal roles of nerves.

The patient is required to lie on the stomach during the procedure.

In this procedur, two needle like instruments are inserted. Ultrasound (USG) or fluoroscopic (X-ray) guidance is used to correctly position each instrument, known as cannula. Once done, the radiofrequency ‘radio waves’ are directed through each cannula.

What are the benefits of Radiofrequency Ablation of Splanchnic Nerve?

The radiofrequency ablation of splanchnic nerve has a series of benefits as compared to the other forms of pain relief. Here we list the main benefits:

• The target nerves can be accurately controlled, thus allowing lesioning of small nerves without damaging nearby other nerves.
• Pain relief is rapid and usually side effects are negligible, allowing the patient to return to normal activity very soon or may be same day.
• Nerve destruction is usually long lasting and heals without any complication..
• The rate of side effects and complications is relatively low.
• When pain recurs, nerve lesion can be repeated as necessary.

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In advanced stage of cancer, if cancer spreads to multiple places and patient has many pain spots; or if the above mentioned treatment fails to control the pain in few patients; Pain implant is used to treat the pain.