Is the pain an indication of a dangerous disease?

On the one hand, pancreatitis can occur acutely or manifest itself as a chronic disease pattern. The most common cause of an acute inflammation is the obstruction of the outflow of digestive juices by a gallstone, whereas the chronic form develops mainly in connection with years of alcohol abuse. A certain potential danger emanates from the released digestive juices, which on the one hand attack the pancreas itself and on the other hand damage surrounding structures.

In the presence of acute inflammation, the permeability of the tissue barriers within the pancreas increases significantly, which leads to the leakage of large amounts of fluid 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, rapid heartbeat, fatigue or even headaches. In addition, the increasing destruction of the organ releases large amounts of inflammatory substances, which can secondarily cause a systemic inflammation (sepsis) and consequently a life-threatening clinical picture.

If chronic pancreatitis is present, deficiencies occur more frequently as a result of insufficient fat digestion and absorption, and secondary vitamin deficiency. With increasing loss of tissue, the so-called endogenous pancreatic functions in the context of sugar metabolism also fail (occurs when more than 90% of tissue is lost). Furthermore, it represents a relevant risk factor for the development of pancreatic cancer.

Common symptoms

Depending on the disease of the pancreas, other symptoms can occur in addition to the pain that often occurs in the middle or left upper abdomen and can radiate in a belt-shaped manner into the back. The nature of the pain can vary depending on the condition. In most cases, the pain is not colicky (as it would be with a gallstone, for example), but is rather described by affected persons as stabbing or dull.

The stomach is also very sensitive to pressure. 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 of the back. In contrast, other diseases of the organ, such as a pancreatic cyst or a tumour of the pancreas, are completely painless, depending on their size. Since the type of pain in pancreatic diseases cannot be definitely assigned to any disease, imaging diagnostics and the determination of specific blood values are absolutely necessary to prove the presence of a disease of the organ. However, the relatively specific localisation of the pain can be an indication of suspected pancreatic disease.

Where does the pain occur?

Pain that comes from the pancreas can radiate into different areas of the abdomen. Pain originating from the pancreas is considered relatively typical if it is primarily located in the upper abdomen (epigastrium) and radiates in a belt shape to one or both sides, often extending sideways into the back. In the case of acute processes in the pancreas, for example in the context of acute inflammation of the pancreas (acute pancreatitis), the examiner can often trigger a pressure pain, which is usually also localised in the epigastric region.

Another relatively typical symptom of acute inflammation is the so-called “rubber belly”, which is caused by a combination of defensive tension and bloating (meteorism) due to increased gas accumulation in the gastrointestinal tract. While pain in acute inflammation of the pancreas is usually relatively sudden and severe, in chronic pancreatitis it is more recurrent, dull and persistent for days. Left-sided pain: The pancreas extends from the area of the duodenum on the right side of the spinal column to the left upper abdomen, with the greater part being located in the area on the left side of the spinal column.

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 in the pancreatic tissue, such as acute or chronic inflammation of the pancreas (pancreatitis), often cause pain. These are usually described by the patient as being localised in the upper abdomen, from where they typically radiate in a belt-like manner to the left and/or right up to the back.

Typical in an inflammation of the pancreas is therefore less the side on which the pain is localised than the belt-shaped radiation into the back and the “rubber belly” which is often palpable in acute pancreatitis: a mixture of defensive tension due to the spread of the inflammation from the pancreas to the peritoneum in combination with excessive gas accumulation in the gastrointestinal tract (meteorism). Right-sided pain: The pancreas lies almost horizontally in the upper abdomen behind the stomach and in front of the spine. The head of the pancreas lies on the right side of the spinal column while the body of the pancreas crosses the spinal column and runs out into the tail of the pancreas on the left side.

The pancreas lies in the area of the first and second lumbar vertebrae. Pain originating from the pancreas is often found in the area of the upper abdomen. From there it can radiate to the left and/or right, the pain often reaches the back in a belt shape.

Pain that is indicative of a process in the pancreas is therefore not characteristically localised on either the left or right side, but rather typically radiates from one or both sides in the form of a belt into the back and the “rubber belly”. This is the term used to describe the more than normal tension of the abdominal wall during palpation of the abdomen, which is caused by a mixture of defensive tension due to inflammation of the peritoneum in the context of pancreatitis and excessive accumulation of gas in the gastrointestinal tract (meteorism). Back pain: The pancreas lies behind the stomach and in front of the spine.

It extends from the duodenum, which lies on the right side of the spine, far into the left upper abdomen, where it runs at the level of the first and second lumbar vertebrae. Due to its location, an inflammation of the pancreas is often accompanied by relatively characteristic symptoms: The pain is primarily located in the upper abdomen (epigastrium) and radiates to the right and/or left up to the back. Back pain can therefore often be an indication of a process in the pancreas. Significantly more often, however, musculoskeletal complaints, for example those of the intervertebral discs in the context of incorrect loading of the spinal column, are possible causes for back pain.