Pancreas pain
introduction
There are various diseases of the pancreas (pancreas) which lead to pain in the abdomen.
However, the pain is often not limited directly to the pancreas but is indicated in other parts of the body.
However, most and most common diseases of the pancreas are pain-free.
Diseases of the pancreas
A very serious disease of the pancreas is acute inflammation of the pancreas (acute pancreatitis).
This is accompanied by acute, severe pain in the upper abdomen. This pain often radiates into the back in a belt shape.
It is also characterized by a very painful abdomen on the physical examination and a so-called rubber belly.
Furthermore, pain in the lower area of the thoracic spine can occur, which initially resembles a slight lumbago.
However, this pain changes and develops into a character of "getting pierced" from the back to the area of the head of the pancreas on the front of the abdomen.
The chronic inflammation of the pancreas, on the other hand, leads to recurrent pain in the area of the left upper abdomen, which is not colic-like.
This pain can radiate to both sides and also pull into the back in a belt shape.
Often the late stage of chronic pancreatitis is painless again.
Find out more about the Inflammation of the pancreas
A tumor disease of the pancreas, on the other hand, leads to pain very late and is therefore often recognized and treated too late.
The pain is rather dull and also radiates into the back like a belt.
However, the main symptom is the increasing yellowing of the skin without the occurrence of pain (painless jaundice).
More information can be found here: Pancreatic cancer and end-stage pancreatic cancer
A pancreatic cyst can also cause pain in the upper abdomen. These too often radiate into the back.
Depending on the size of the cyst, it can also cause colic-like pain.
However, in most cases, pancreatic cysts remain asymptomatic.
Alcohol abuse can also lead to pain in the pancreas, because alcohol is one of the most common causes of acute inflammation of the pancreas (acute pancreatitis) and the most common cause of chronic pancreatitis, along with gallstones, which prevent the pancreatic secretion from draining through the pancreatic duct.
The pain associated with the acute inflammation usually occurs suddenly and is often localized in the upper abdomen (epigastrium). Relatively typical for an inflammation of the pancreas is a belt-shaped radiating of pain from the upper abdomen to the right and / or left to the back.
The examination often reveals tenderness on pressure with deep palpation in the upper abdomen, and a so-called "rubber belly" is not uncommon, which arises due to a mixture of defensive tension caused by irritation of the peritoneum as part of pancreatitis and gas accumulation in the gastrointestinal tract (meteorism).
Even with chronic pancreatitis, the most common cause of which is alcohol abuse for years, patients often complain of pain in the upper abdomen and with a belt-like radiation to the back, but the pain often does not appear as suddenly as with an acute inflammation but is rather dull and recurring.
Illustration of the pancreas
- Body of
Pancreas -
Corpus pancreatis - Tail of
Pancreas -
Cauda pancreatisauda - Pancreatic duct
(Main execution course) -
Pancreatic duct - Duodenum lower part -
Duodenum, inferior pars - Head of the pancreas -
Caput pancreatis - Additional
Pancreatic duct -
Pancreatic duct
accessorius - Main bile duct -
Common bile duct - Gallbladder - Vesica biliaris
- Right kidney - Ren dexter
- Liver - Hepar
- Stomach - Guest
- Diaphragm - Diaphragm
- Spleen - Sink
- Jejunum - Jejunum
- Small intestine -
Intestine tenue - Colon, ascending part -
Ascending colon - Pericardium - Pericardium
You can find an overview of all Dr-Gumpert images at: medical illustrations
Does the pain indicate a dangerous illness?
Inflammation of the pancreas can occur acutely on the one hand or manifest itself as a chronic disease on the other hand. The most common cause of acute inflammation is obstruction of the outflow of digestive juices by a gallstone, whereas the chronic form develops mainly in connection with years of alcohol abuse.
The released digestive juices, which attack the pancreas itself or damage the surrounding structures, pose a certain risk. When the acute inflammation is present, the permeability of the tissue barriers within the pancreas increases significantly, which leads to large amounts of fluid escaping from the vessels into the inflamed pancreatic parenchyma and surrounding tissue. This results in a lack of fluid within the vessels, which causes typical side effects such as low blood pressure, fast heartbeat, fatigue or even headaches.
In addition, the increasing destruction of the organ releases large amounts of inflammatory substances, which are secondary to systemic inflammation (sepsis) and as a result can cause a life-threatening clinical picture.
If chronic pancreatitis is present, deficiencies occur more frequently as a result of insufficient fat digestion and absorption, as well as secondary vitamin deficiencies. With increasing loss of tissue, the so-called endogenous pancreatic functions within the framework of the sugar metabolism also fail (occurs with more than 90% tissue loss). Furthermore, it represents a relevant risk factor for the development of cancer of the pancreas.
Common symptoms
Depending on the disease of the pancreas, in addition to the pain, which often occurs in the middle or left upper abdomen and can radiate into the back in a belt shape, there are others Symptoms occur. The type of pain can vary depending on the illness. In most cases they are Pain not colicky (as it would be with a gallstone, for example), but are more likely than piercing or dull designated. The belly is also great pressure sensitive. The pain in the back can sometimes be in the foreground, which is why a disease of the pancreas can sometimes be confused with a problem in the back area.
Other diseases of the organ, such as a Pancreatic cyst or a tumor of the pancreas are completely painless, depending on their size.
Since the type of pain in diseases of the pancreas cannot definitely be assigned to a disease, is one imaging diagnostics as well as the Determination of specific blood values absolutely necessary for the proof of the presence of a disease of the organ. However, the relatively specific localization of the pain can be an indication of a suspected disease of the pancreas.
Where does the pain occur?
Pain caused by the pancreas (pancreas) can radiate into different areas of the abdomen (abdominal region).
As relative typical for pain caused by the pancreas those that are primarily in the area of Upper abdomen (Epigastrium) are localized and belt-shaped radiate to one or both sides, often pulling sideways into the move inside.
For acute processes in the area of the pancreas, for example in the context of an acute Inflammation of the pancreas (acute Pancreatitis) is often let in by the examiner Tenderness trigger, which is usually also localized in the area of the epigastrium.
The so-called inflammation is also relatively typical for acute inflammation "Rubber belly"made by a combination of Defense tension and Bloated stomach (Meteorism) is caused by increased gas accumulation in the gastrointestinal tract.
While the pain in acute inflammation of the pancreas is mostly relatively suddenly and occur violently, in a chronic form of pancreatitis they tend to be recurring, dull and persistent for days.
Left side pain:
The pancreas extends from the area of the Duodenum on the right side of the Spine up to the left upper abdomen, with the larger part lying in the area to the left of the spine.
The pancreas lies behind the stomach and in front of the spine and runs at the level of the first and second lumbar vertebrae.
Pathological processes that originate from the pancreatic tissue, such as an acute or chronic one Inflammation of the pancreas (Pancreatitis), often cause pain.
These are usually described by the patient as being localized in the upper abdomen, from where they typically radiate belt-shaped to the left and / or right to the move out. In the case of an inflammation of the pancreas, the side on which the pain is localized is less typical than the belt-shaped radiation to the back and that which is often palpable in acute pancreatitis "Rubber belly": A mixture of defensive tension due to the inflammation spreading from the pancreas to the peritoneum in combination with excessive gas accumulation in the gastrointestinal tract (meteorism).
Right side pain:
The pancreas lies almost horizontally in the upper abdomen behind the stomach and in front of the spine.
The head of the pancreas is on the right Spine while the body of the pancreas crosses the spine and ends on the left side in the tail of the pancreas. The pancreas lies in the area of the first and second lumbar vertebrae.
Pain emanating from the pancreas can often be found in the area of the upper abdomen. From there they can radiate to the left and / or right, the pain often extends in a belt-shaped manner into the move. Pain that indicates a process in the pancreas is therefore neither localized in a characteristic way on the left nor on the right, typical is more the belt-shaped radiation to one or both sides to the back and the "Rubber belly". This is the name given to the more tense than normal abdominal wall when palpating the abdomen, which is caused by a mixture of defensive tension due to inflammation of the peritoneum as part of pancreatitis and excessive gas accumulation in the gastrointestinal tract (meteorism).
Back pain:
The pancreas lies behind the stomach and before the Spine. It pulls from Duodenum the right side of the spine extends far into the left upper abdomen and runs at the level of the first and second lumbar vertebrae.
Because of the location, a Inflammation of the pancreas often associated with relatively characteristic complaints: The pain is primarily localized in the upper abdomen (epigastrium) and radiates to the right and / or left to the back. Back pain can often be an indication of a process in the pancreas.
However, they come much more frequently musculoskeletal complaints, for example those of the Band washers in the context of incorrect loading of the spine, as a cause of back pain in question.
left side pain
In addition to a number of abdominal disorders which cause pain left upper abdomen Certain pancreatic disorders can typically cause pain in this area. The pancreas lies across the upper abdomen, which is why it is in different places unspecific symptoms may have. Especially at Inflammation of the pancreas pain can occur, which then occurs in the left upper abdomen, among other places. A pain that occurs in the left upper abdomen, is belt-shaped and radiates towards the back is typical for diseases of the pancreas. If this pain occurs for a long time without strain, a doctor should be consulted to clarify the symptoms.
Pain in the left upper abdominal area does not necessarily have to be associated with a disease of the pancreas. Other organs can provide a reason for the present symptoms. So can Diseases of the stomach, esophagus and kidneys cause a problem of the back in this area pain.
Pain after biliary surgery
Pain in the middle or left upper abdomen may indicate pancreatic disease. If gallbladder surgery preceded these symptoms, it is entirely possible that the person's pancreas is inflamed, as gallbladder surgery can cause such inflammation.
The reason for this is that the gallbladder and the pancreas share a common outlet into the duodenum. If the gallbladder is now removed or gallstones removed, damage to the pancreas and subsequent inflammation of the gland cannot always be prevented. However, the removal of the gallstones is absolutely necessary, since even if the stones persist, inflammation of the pancreas can result. It must be prevented that the digestive juices of the pancreas build up and thus attack the gland itself.
So if there is pain in the upper abdomen after gallbladder surgery, it is strongly recommended to inform a doctor about the symptoms so that he can determine the cause of the pain and, if necessary, confirm that the pancreas is involved and initiate therapy.
You might also be interested in this topic: Pain after biliary surgery
Pain after eating
The pancreas represents an essential part of the Digestive system of man. It produces Digestive juicesthat can break down certain components of food and thus make them available for the body. In the case of a disease of the pancreas, this production and release of digestive juices may no longer function optimally.
Especially with one inflammation the gland (Pancreatitis), but also at Tumor diseases pain in the pancreas can worsen significantly after eating. The pain is very strong, belt-shaped radiating in the upper abdomen and can pull backwards into the back. They occur either continuously or repeatedly. Especially with very high-fat food the typical symptoms occur.
Furthermore, the pain can be caused by other symptoms such as nausea and Vomit to be accompanied. Most of the time, they develop while eating, are aggravated by it, or occur afterwards. Because of this recurring, very unpleasant, Pain after eating those affected avoid eating and often lose weight as the disease progresses.
It is important that, unlike with a disease of the gallbladder or biliary tract, the pain only occurs when a little longer time (about 20-30 minutes) after a meal, whereas the pain occurs in, for example, one Gallstoneappear very shortly after eating. High-fat food in particular can significantly increase the pain caused by inflammation of the pancreas, which is why the people affected low-fat diet recommended becomes.
At a chronic pancreatitis it comes to one in the course of the disease Breakdown of cells. The gland burns out, so to speak. This process takes several years, but it can also take decades. The initial severe discomfort and pain in the upper abdomen then gradually subside. Especially at the beginning of the disease, the damage to the pancreas can be reversed. Over time there is an increase in the complaints, many years later the full picture can be Pancreatic weakness (Pancreatic insufficiency) develop. An existing one Alcohol addiction can make the symptoms worse. It is not uncommon for people with this type of pain to develop one improper use of pain medication.
Pain that occurs at night
If pain occurs primarily at night and increases in intensity over weeks and months, this can usually be an indication of a Pancreatic tumor give. Because it no early symptoms or signs there are symptoms only after a while, although pain is not one of them initially. Of the tumor in the early stages it is rather painless Jaundice (Yellowing of the skin). There can be non-specific symptoms like Weight loss, night sweats or fever occur.
More symptoms can be Inflammation of superficial veins be (so-called Thrombophlebitis), it can too depressive moods come. Only in the further course of the disease does the typical "Obstructive jaundice“Where the laxative Biliary tract through the im Tumor located in the head of the pancreas be pulled. It evolves dull, belt-like pain in the area of the upper abdomen, which can radiate into the back.
Over time, the pain intensifies, it continues dull and belt-shaped, however, become more and more painful and kick mainly at night on. The pain arises because the tumor is in a back direction Nerve plexus (the so-called solar plexus) grows into it, this creates these for the Tumor disease typical pain. This situation is mostly the reason to see a doctor. This pain is very excruciating for the patient and often has to be treated with high doses Morphine preparations be treated.
Based on that Level scheme for the Pain therapy of the World Health Organization (WHO) the pain can be treated based on the cause and severity. The pain is caused by the tumor growing into nerves like the solar plexus or adjacent areas, but can also go through Metastases of the actual tumor, for example in liver (Liver capsule stretch pain) or bone arise. These can be handled well using the step-by-step plan.
Is that enough Pain management with medication not off, there is a possibility one Irradiation to perform for pain relief. Further possibilities are the introduction of Morphine by injecting the drug into the Spinal space or one Blockage of the nerves, those who Pancreatic pain information move on.
Pancreatic pain and back pain
There are different ways that a Pancreatic disease can make noticeable. Back pain are often associated with diseases of the pancreas. A typical characteristic of the pain is that it is often in the area of the Upper abdomen are located, belt-shaped around the body pull and radiate into the back.
Depending on Pain character the examining doctor can already draw initial conclusions as to the most likely cause. Further research on how diagnostic procedures, Imaging, such as Blood draws or performing one Ultrasound, then enable the definitive diagnosis.
In the acute pancreatitis is the pain occurring suddenly and radiate into the back, starting from the upper abdomen. The pain can be from Gas, nausea and vomiting can also be accompanied fever or even to shock come. It is also typical of this disease that the Pain primarily after eating use and at Food leave (no food is consumed) weaken. They can increase in intensity over weeks and months, but also for example mainly at night occur.
In the chronic pancreatitis the symptoms are comparable to those of acute pancreatitis. Here it comes too Belt-shaped dull and cutting pains in the area of the upper abdomen, which can radiate back into the back. The difference between chronic inflammation of the pancreas and acute inflammation of the pancreas is that in acute inflammation the pain is new and occurs for the first time. People with chronic pancreatitis have these typical symptoms frequently and always recurring. You are mostly familiar with these symptoms. The duration of the pain is usually in the range of Hours to several days.
A malignant disease as part of a Degeneration of the pancreas usually occurs most likely unsymptomatic on. The typical pain as in acute or chronic pancreatitis is in this form in one Pancreatic tumor (Pancreatic cancer) not to be found. Here is even the painlessness rather effective, because typical symptoms of a pancreatic tumor are the painless jaundice (Yellowing of the skin) and a new, previously unknown, Diabetes mellitus (diabetes).
therapy
Persistent pain should always be considered a warning sign serve and, if persisted, entail a presentation to the attending physician.
If the pain is primarily localized in the upper abdomen and if it radiates in a belt-like manner to the left and / or right into the back, this can indicate a disease in the area of the pancreas be, for example an inflammation (Pancreatitis).
Depending on the cause of this inflammation, the treating doctor will take various measures. An acute one Pancreatitis often requires one hospitalized with restricted food intake (Food leave) and more comprehensive Hydration through an intravenous line.
Also will mostly Painkiller (Analgesics) used to relieve pain. Nowadays more and more descendants from the group of Opioids, like for example Tramadol or Piritramide, for use.
Home remedies for pancreatic pain
First of all, it is important that the Risk factors for the development of a disease of the pancreas are kept small. If the symptoms are present, you should not drink alcohol, as well as that Smoke can be set. It should also be on fatty food be waived.
Since the people affected often do not know that it is a disease of the pancreas, which should definitely be treated by a doctor, home remedies that lead to a Relief of symptoms should lead.There are a number of home remedies that are specifically designed to help with diseases of the pancreas.
These home remedies include special ones, for example Teas, Hip baths, or Oil massages. For none of the home remedies used, which are supposed to help with a disease of the pancreas, there are medical studies that could prove their effectiveness. Because of this, the application of the existing home remedies Recommended only with reservations. Therapy for a disease of the pancreas should never consist of home remedies alone, but only as supportive measures medical, medically supervised therapy. The attending physician should also be informed about the home remedies used, as some active ingredients in the existing home remedies may influence other medications.
Summary
The painful nature of diseases of the pancreas is usually a dull or colic-like pain, which radiates into the back in a belt shape. Inflammation of the pancreas in particular leads to the most severe characteristic pain.
Whereas the very lethal tumor of the pancreas leads to pain very late and is therefore usually treated too late.
Most pancreatic diseases, such as diabetes mellitus or a Malfunction of the pancreas (Pancreatic insufficiency), on the other hand, lead to completely different symptoms and are painless.
