How can I recognize a pancreatic disease myself?

There is no sure sign to detect a disease of the pancreas itself, but there are more or less clear indications. If severe pain occurs, which is localised in the upper abdomen and radiates to the back and which persists, this can be an indication of an inflammation of the pancreas. Repeated dull pain in the upper abdomen and back can also be an indication, usually of chronic inflammation.

A common reason for an inflammation is prolonged alcohol consumption, but an acute inflammation is most often triggered by gallstones. If the above-mentioned pain occurs and either regular alcohol consumption is present or gallstones are known, pancreatitis may be present. If there are symptoms such as significant unwanted weight loss, heavy night sweats, fever and recurring pains in the stomach and back, a doctor should always be consulted as soon as possible, as these can be indications of a malignant disease in the area of the pancreas (pancreatic carcinoma).

Diagnosis and therapy

The diagnosis of pancreatic disease is usually made on the basis of the symptoms described, a blood test and imaging in the form of an ultrasound or CT/MRI examination. The therapy for all pancreatic diseases consists of a sufficiently strong pain therapy. Opiode can also be used; for lighter pain, tramadol is often chosen, while for stronger pain, pethidine or buprenorphine is also used.

Morphine is rarely or not administered at all if pancreatitis is suspected, as a possible side effect of morphine is a blockage in the pancreatic duct. However, the morphine derivatives are considered harmless with regard to this side effect. In acute inflammation of the pancreas, a sufficient fluid intake is also very important, as much fluid is lost through the inflammation. In chronic inflammation, on the other hand, the substitution of enzymes and insulin is more important.

Causes of pancreatic disease

A distinction is made between acute and chronic inflammation of the pancreas (pancreatitis). The acute form of pancreatitis causes severe, sudden pain in the upper abdomen, which can also radiate to the back. A typical symptom is the so-called “rubber belly”.

Here the abdomen has a bulging elastic consistency. Many patients complain of nausea and vomiting as well as a high accumulation of gas in the intestine. A brown-greenish discoloration of the skin on the flanks and around the navel can also occur.

These discolorations often indicate a severe course of the disease. A possible yellow discoloration of the skin and the conjunctiva is another symptom of acute pancreatitis. Some patients also complain of an increase in the abdominal fluid, i.e. ascites.

The causes of acute inflammation are often gallstone disease (cholelitihiasis), as is regular alcohol consumption. It can also happen that the pancreas becomes inflamed without a recognisable cause, in which case it is called idiopathic pancreatitis. Less common causes are inflammation after surgical or diagnostic procedures, such as endoscopic retrograde cholangiopancreatography (ERCP), or infections such as HIV, mumps or viral hepatitis.

The chronic inflammation of the pancreas is mainly caused by regular alcohol abuse. The chronic inflammation is characterized by severe, belt-like pain, this pain is recurrent and can last for several days. The chronic inflammation can lead to a loss of function, first of all of the exocrine and later of the endocrine pancreas.

The symptoms are usually unintentional weight loss and yellowing of the skin (icterus). This can also lead to a diabetic metabolic condition, which means that not enough insulin can be produced to transport the sugar ingested with food from the bloodstream into the body cells. Chronic pancreatitis also favours the development of pancreatic cancer (pancreatic carcinoma), blood clots in the spleen (splenic vein thrombosis) and a narrowing of the excretory ducts of the pancreas and gall bladder.

You can read more information on this topic here: PancreatitisThis rare disease is inherited autosomal recessively (i.e. both parents must pass on the defective gene even if they are healthy themselves). These symptoms are caused by defects in a (chloride) ion channel that occurs in the most important glands of our body (sweat glands, bronchial glands (glands of the pulmonary ducts), liver, intestine and pancreas, but also in sexual organs such as the testicles). The result is an increase in the saline content (containing chloride) in the sweat and the formation of thick, viscous mucus in many glands of the body, which leads to shortness of breath, coughing and recurrent pneumonia in the lungs.

In the pancreas, too, the mucus cannot flow off properly and is enclosed by connective tissue blisters as a compensatory attempt by the body. In the long run, the entire organ is destroyed and eventually scars. The consequences range from digestive problems (maldigestion) to diabetes mellitus.