Pain that occurs at night | Pancreatic pain

Pain that occurs at night

Pain that occurs mainly at night and increases in intensity over weeks and months can usually indicate a pancreatic tumor. As there are no early symptoms or signs, symptoms only occur after some time, although pain is not initially a symptom. In the early stages, the tumour is more likely to manifest itself as a painless icterus (yellowing of the skin).

Non-specific symptoms such as weight loss, night sweats or even fever can occur. Other symptoms may include inflammation of superficial veins (so-called thrombophlebitis), and depressive moods may also occur. Only in the further course of the disease does the typical “occlusive secterus” occur, in which the bile ducts leading away from the pancreas are squeezed by the tumour located in the pancreatic head.

Muffled, belt-like pain develops in the upper abdomen, which can radiate into the back. Over time, the intensity of the pain increases, it remains dull and belt-shaped, but becomes increasingly painful and occurs mainly at night. The pain is caused by the tumour growing into a nerve plexus (the so-called solar plexus) in the direction of the back, which causes the pain typical of the tumour disease.

This situation is usually also the reason to consult a doctor. This pain is very distressing for the patient and often has to be treated with high-dose morphine preparations. In accordance with the step-by-step scheme for pain therapy of the World Health Organization (WHO), the pain can be treated in an orienting manner and adapted according to cause and strength.

The pain is caused by the tumour growing into nerves such as the solar plexus or adjacent areas, but can also be caused by metastases of the actual tumour, for example in the liver (liver capsule expansion pain) or bones. These can be treated well with the step-by-step plan. If the pain therapy with medication is not sufficient, there is the possibility of radiation therapy to relieve the pain.

Further possibilities are the introduction of morphine by injecting the medication into the spinal cord or blocking the nerves that transport the pain information from the pancreas. There are different ways in which pancreatic disorders can make themselves felt. Back pain often occurs in connection with diseases of the pancreas.

A typical characteristic risk of back pain is that it is often located in the upper abdomen, can form a belt around the body and radiate into the back. Depending on the character of the pain, the examining doctor can already draw initial conclusions as to the most likely cause. Further examinations, such as diagnostic procedures, imaging, as well as blood sampling or the performance of an ultrasound, then enable the definitive diagnosis to be made.

In acute pancreatitis, the pain is sudden and radiates into the back from the upper abdomen. The pain may be accompanied by flatulence, nausea and vomiting, and may also be accompanied by fever or even shock. It is also typical for this disease that the pain starts mainly after eating and becomes weaker when the patient is on a dietary leave (no food is eaten).

They can increase in intensity over weeks and months, but also occur mainly at night, for example. The symptoms of chronic pancreatitis are comparable to those of acute pancreatitis. In this case there is also belt-shaped dull and cutting pain in the upper abdomen, which can radiate backwards into the back.

The difference between chronic pancreatitis and acute pancreatitis is that in acute inflammation the pain is new and occurs for the first time. People with chronic pancreatitis have these typical symptoms often and repeatedly. They are usually familiar with these symptoms.

The duration of the pain usually ranges from hours to several days. A malignant disease in the context of a degeneration of the pancreas is most likely to occur asymptomatically. The typical pain as in acute or chronic pancreatitis is not found in this form in a pancreatic tumour (pancreatic cancer). In this case, even painlessness is more likely to be effective, because typical symptoms of a pancreatic tumor are painless icterus (yellowing of the skin) and a newly occurring, previously unknown, diabetes mellitus (diabetes).