Sometimes we have stomach pains that don't go away with a simple pill. Especially in cases like pancreatic cancer or pancreatitis, the pain is very difficult to bear. So today we are going to talk about a special treatment method used to control such severe pains.
What is Celiac Plexus Block?
Simply put, this is an injection that is given to control pain. Inside our stomach, in the upper part, there is a place called the 'celiac plexus' where a lot of nerves are gathered. It's like a nerve message center in our stomach. Pain signals coming from organs like our liver, stomach, pancreas, gallbladder, intestines go to the brain through this nerve cluster.
So, in a `Celiac Plexus Block`, a drug is injected into this nerve bundle, temporarily or permanently stopping the pain signals from going to the brain. It's like 'cutting' a phone call about pain. This is a `nerve block` treatment.
What organ is this nerve bundle connected to?
- The gallbladder
- Intestines
- Liver
- Pancreas
- Stomach
When something goes wrong with these organs and these nerves are compressed, severe pain occurs.
What are the uses of this treatment?
This treatment is often used for severe, persistent abdominal pain that is difficult to control with other painkillers.
| Medical condition | How treatment helps |
|---|---|
| Pancreatic cancer | Cancerous tumors can press on that nerve bundle. This treatment can reduce the severe pain that occurs. |
| Pancreatitis | This treatment helps relieve severe pain in the upper abdomen and back caused by pancreatitis. |
Many people who are diagnosed with pancreatic cancer are already in severe pain. Doctors prescribe strong painkillers for this. But these medications can cause side effects like memory loss, constipation, and nausea . Sometimes, even after taking these medications, the pain does not go away completely. In such cases, the `Celiac Plexus Block` can be very useful.
How should you prepare for this?
Your doctor will advise you on the things you need to do before this treatment. They will usually say things like:
- Stopping certain medications: Some medications, such as blood thinners, may require you to stop taking them a few days before your treatment. However, never stop taking them without your doctor's advice.
- Avoiding food and drink: You will be asked to stop eating and drinking for a few hours before the treatment. It is safest to have an empty stomach during anesthesia.
- Avoid smoking: If you are a smoker, it is best to quit, as it can increase the risk of complications.
- Getting a vehicle ready: This is an outpatient procedure. This means you can go home the same day. However, since you will not be able to drive after the procedure, you will need to bring someone to drive you home.
What happens during treatment?
The following steps are followed during this treatment:
1. First, to calm you down, a small amount of medicine (sedative) will be given into a vein in your arm. This will make you feel relaxed, but will not put you completely to sleep.
2. You will then be made to lie on your stomach on a table. A pillow will be placed under your hips. If you are uncomfortable lying that way, you may be made to lie on your back.
3. The injection site is thoroughly cleaned with an antiseptic solution.
4. Next, a small injection of local anesthetic is given. At this point, you may feel a small prick.
5. Then, a needle is inserted and a special dye (contrast dye) is injected. This dye can be seen on an X-ray, CT scan, or endoscopic ultrasound. This allows the doctor to see exactly where to inject the medicine.
6. Once the exact location is found, a painkiller or steroid is injected into the nerve bundle.
7. Sometimes, if you want to stop the pain for a long time, a chemical called alcohol or phenol is injected to deactivate some of the nerves. This is called a `neurolytic procedure`.
The entire procedure usually takes about an hour. However, the injection itself only takes a few minutes. There is time to prepare beforehand and about 30 minutes of observation after the treatment.
What happens after treatment? And what are the benefits?
You may start to feel some relief within 30 minutes of the treatment. You will be monitored for at least 30 minutes before being sent home. You will be able to go home in about an hour. However, please remember to have someone else drive you.
This treatment can reduce the amount of painkillers you need to take continuously, which also reduces the side effects of those medications.
The main benefits of this are:
- Controlling persistent severe abdominal pain.
- Reduction in breakthrough pain.
- Reducing the amount of oral painkillers.
Are there any side effects?
Serious complications from this treatment are rare . However, some minor side effects may occur. Your doctor will inform you about all of these before treatment.
| Type of side effect | Things that could happen |
|---|---|
| Commonly seen side effects | |
| The injection site | Bruising, swelling, or soreness |
| Other | Diarrhea (abdominal pain), low blood pressure, vomiting |
| Serious conditions that can occur very rarely | |
| Reactions and damage | Allergy to anesthetic or dye, nerve damage, kidney or other organ damage, decreased blood flow to the spinal cord, delayed emptying of food from the stomach (gastroparesis) |
| Other serious conditions | Paralysis (due to spinal cord damage), seizures |
How long will it take to recover? How long can I be pain-free?
You can return to normal activities within 24 to 48 hours after treatment. However, do not drive, exercise, or lift heavy objects for the first 24 hours. You can eat and drink normally.
The amount of time it takes to be pain-free varies from person to person.
- A combination of painkillers and steroids can provide pain relief for three to six months . Another injection may be needed in the future.
- But if you use the `neurolytic` method (injecting something like alcohol), the pain relief can last much longer , perhaps even permanently.
If you have these symptoms, call your doctor immediately.
If you experience any of the following symptoms after treatment, contact your doctor without delay.
- Symptoms of low blood pressure such as dizziness, fainting, and excessive thirst.
- Difficulty breathing .
- Signs of infection, such as redness, pus, or fever at the injection site.
- Numbness, tingling, or numbness in the legs .
Pain is a life-threatening condition. You may not be able to get out of bed or spend time with your loved ones because of the pain. Even if you take painkillers, you may not feel well due to the side effects. So if your pain is interfering with your daily life, talk to your doctor about new treatments like the Celiac Plexus Block.
Take-Home Message
- Celiac Plexus Block is a special injection treatment used to control severe abdominal pain caused by conditions such as pancreatic cancer or inflammation.
- This blocks the transmission of pain signals to the brain, providing pain relief.
- This is usually a safe procedure and can be done without a hospital stay.
- Serious side effects are very rare, but if you experience symptoms such as dizziness, difficulty breathing, or numbness in your legs, tell your doctor immediately.
- This treatment can significantly improve quality of life and reduce the use of painkillers.
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