Pancreatic Pain: Where It Hurts and How It Manifests

Pain in the upper abdomen can have various causes, and the pancreas is only one possible source. Below are the signs characteristic of diseases of this organ and the tests that help make an accurate diagnosis.

Can the pancreas hurt, and where is it located

The pancreas is located behind the stomach and in front of the spine. It secretes digestive juice that breaks down food and hormones that regulate blood glucose levels, including insulin (a hormone that lowers blood sugar). It can hurt: in chronic pancreatitis (long-term inflammation with scarring of the tissue), abdominal pain is the main symptom. The mechanism is described as follows: the organ's own digestive enzymes begin to digest the tissue of the gland itself.

Where the pancreas hurts and what the pain is like

The location and character of pain in chronic pancreatitis vary. The pain can be:

• in the upper abdomen, just below the ribs;
• on one side of the abdomen or throughout the abdomen;
• constant or recurring in attacks;
• severe or aching, dull — what people describe as "aching";
• eases in a sitting position leaning forward and worsens after eating.

The symptoms of chronic pancreatitis can resemble irritable bowel syndrome or gallstone disease, so the doctor first rules out other causes.

What causes pancreatic pain: main causes

The most common cause of chronic pancreatitis is alcohol: it causes short-term inflammation (acute pancreatitis), and with repeated episodes the tissue of the gland gradually scars. Besides alcohol, causes also include smoking, heredity (including the gene that causes cystic fibrosis — the most common cause in children), an attack by the immune system on the gland itself, a congenital malformation of the organ, and certain medications, including some antibiotics and drugs for treating diabetes. Sometimes the cause cannot be established. Chronic pancreatitis occurs predominantly in adults and more often in people who drink and smoke heavily.

Other symptoms in pancreatic diseases

In addition to pain, there can be nausea and vomiting, diarrhea, very foul-smelling floating stool that is hard to flush, bloating and increased gas formation, thirst and frequent urination, and effortless weight loss. Scarring of the tissue leads to impaired absorption of nutrients with weight loss and weakened bones, to type 3c diabetes (associated with damage to the gland), to cysts that can become infected, bleed, or compress neighboring organs, to blockage of the pancreatic ducts and bile ducts with inflammation of the gallbladder. The risk of pancreatic cancer is higher in chronic pancreatitis.

How the pancreas is examined and when to see a doctor

There is no single test that confirms chronic pancreatitis: other causes of the symptoms are ruled out first. The doctor palpates the abdomen, checks for yellowing of the skin and eyes, weighs the patient, orders blood tests and stool tests, and asks about relatives with pancreatitis. Further, a specialist consultation, computed tomography or ultrasound, gastroscopy (examination of the stomach through a thin tube with a camera), and ERCP — an endoscopic examination of the ducts — may be possible. The tests used include, in particular, measurement of amylase and lipase in the blood, and elastase and chymotrypsin in the stool.

People see a doctor if chronic pancreatitis is suspected. Sudden severe abdominal pain requires emergency care.

Abdominal pain alone is not a reason to call an ambulance. You should call 103 or 112 if the pain came on suddenly and is severe: this may be a sign of acute pancreatitis or another condition requiring hospital treatment.

This material is for reference purposes: it describes signs and tests but does not replace a doctor's consultation.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer