Pancreas pain

Location of pancreas pain: Where is pancreas pain felt?

location of pancreas pain
where is pancreas pain felt?

To understand pancreatic pain, you need to know where your pancreas is located. Pancreas is an elongated gland and it sits deep inside your belly. When measured from the surface of your body, your pancreas location is closer to your upper back than your front abdomen. Your pancreas can be divided into 4 different parts. The location of these parts of your pancreas can help you make sense of your pancreatic pain.

“Head of pancreas” location: Most of your pancreas is located to the left of your body. However, the head of your pancreas crosses the midline and is located slightly to the right. It wraps around the upper part of your small intestine.

“Neck of pancreas” location: The pancreatic neck is the somewhat constricted part of your pancreas. The pancreatic neck connects the pancreatic head on the right with the pancreatic body on the left of your midline. Your pancreas curves towards your left from here on.

“Body of pancreas” location: The pancreatic body connects the pancreatic neck to the pancreatic tail. It curves upwards and to the left. It looks somewhat triangular when viewed from below.

“Tail of pancreas” location: The tail of the pancreas is it’s thin tip. Tail of your pancreas is the leftmost part of your pancreas. It has a slight forward curve and it goes all the way left to touch your spleen.

Pancreas location and its relation to pancreatic pain

Pancreatic pain feels like it is coming from deep inside your abdomen because of the deep location of your pancreas. Pain is usually felt in the middle or left of your midline. It can also occur on your right but that is less common. You can see that pancreas pain corresponds to your pancreas location. As you recall, most of your pancreas is in your midline and left ,and that is where you feel the pain most of the times. A part of the pancreas crosses to your right and you can sometimes feel the pain in that location too. Because your pancreas is an elongated organ, pancreas pain can feel stretched out like a band. Your pain may radiate out in a band-like fashion and go all the way to your back.

Acute pancreatitis symptoms: What is pancreatitis? What does pancreas pain feel like?

Acute pancreatitis definition:

Acute pancreatitis is the inflammation of pancreas that develops quickly.

Your pancreas has many important functions in your body. Producing digestive juice is only a part of your pancreas function. However, these digestive juices play an important role in the inflammation of pancreas. Symptoms of acute pancreatitis are caused by this inflammation. They also play the main role in causing many of the other acute pancreatitis symptoms listed below.

Let us look at the list first and I will explain how digestive juices and inflammation of pancreas leads to those pancreatitis symptoms.

List of acute pancreatitis symptoms

  1. Abdominal pain (Pancreatic pain)
  2. Burning and swelling of abdomen
  3. Nausea and vomiting
  4. Fever
  5. Weakness and lightheadedness
  6. Chest pain with inspiration
  7. Shortness of breath

Pancreatic juice contains enzymes designed to digest nutrients in your food. Pancreatic juice is very corrosive because it is designed to breakdown tough organic materials including protein and fat. It is so strong that it can digest your own organ tissues. It is not surprising because our organ tissues are mainly made up of protein and fat. The production and use of these enzymes is normally highly regulated. These enzymes only flow in special ducts and have no contact with your organ tissues. They are only released inside your intestines to act on your food and not on your internal organs.

When something disrupts the flow of that corrosive juice, it initiates a series of events leading to acute pancreatitis. As soon as the corrosive juice leaks out in the open, it starts to digest your own tissue. The protein and fat inside your abdominal organs get exposed to this corrosive pancreatic juice and they start to dissolve. You feel this burning pancreas pain.

At first, your pancreatitis pain location may vary, but it is usually somewhere in the upper mid abdomen. As the corrosion progresses, your pancreatitis pain location starts to expand. You may feel a tight band like area of severe pain spreading from side to side in the your mid upper abdomen. This type of severe pancreatitis pain may radiate all the way to your back. The corrosion of your organ tissues caused by spilling of pancreatic juice causes wide spread inflammation. This inflammation causes fevers and chills throughout your body.

When this inflammation spreads to your stomach, you may have severe unrelenting nausea and vomiting that may last for hours.

You may have pain with inspiration as your diaphragm gets inflamed. When you have severe acute pancreatitis symptoms, your inflammation continues to spread outwards and may go all the way up to your lungs. Your pancreatitis pain location may expand to include your chest. When your lungs get inflamed, you start to have shortness of breath. Lung inflammation caused by severe acute pancreatitis may interfere with your breathing and your body may not get enough oxygen.

The widespread inflammation resulting from severe acute pancreatitis may push your body towards a state of shock. Increased flow of blood to your inflamed organs may result in reduction of blood flowing to the rest of your body. This may result in low blood pressure. You may feel weak and dizzy when your blood pressure starts to go down. When the symptoms of your acute pancreatitis get this severe, it becomes a life threatening condition. Treatment for pancreatitis requires close monitoring in ICU when symptoms are severe.

Acute pancreatitis diagnosis: How is pancreatitis diagnosed?

Acute pancreatitis diagnosis is established by measuring the levels of pancreatic enzymes in your blood. In severe acute pancreatitis, the enzyme levels are significantly elevated. Among pancreatitis diagnosis blood tests, the levels of two pancreatic enzymes called amylase and lipase are very helpful. CT scan of the abdomen may show the inflammation surrounding your pancreas. CT is also helpful to look for possible complications.

Acute pancreatitis diet

Acute pancreatitis treatment diet starts with a complete NPO (nothing by mouth) diet. The goal of initial pancreatitis diet plan is to avoid any stimulation of the pancreas at all. Any food or drink passing to the stomach can stimulate pancreas to make more digestive juice and that can worsen pancreatitis pain. Once the pain gets better and your inflammation starts to go down, best diet for pancreatitis recovery is clear liquid diet, at least for the first few days of recovery.

An example of clear liquid acute pancreatitis diet food list would be:

  1. Coffee (no cream, but sugar is OK)
  2. Fat-free chicken broth
  3. Fat free vegetable broth
  4. Flavored water
  5. Gatorade
  6. Gelatin without any fruit or solids added to it
  7. Hard candies
  8. Lemonade (no pulp)
  9. Soft drinks ( Ginger ale, 7 UP, Coke, Pepsi, Sprite)
  10. Strained fruit juice without pulp
  11. Strained tomato or vegetable juice
  12. Sugar or honey
  13. Tea (no cream, but sugar is OK)
  14. Popsicles without fruits, ice cream, or sherbet
  15. Water

In the past, doctors used to avoid any food or drink for a long time during recovery from a severe acute pancreatitis. They even recommended feeding by intravenous solution to meet the nutritional need while patient was on a NPO diet. However, the recent trend is to start clear liquid diet as soon as patients can tolerate it. Even when they don’t tolerate oral diet, it is now recommended to start tube feeding rather than feeding with intravenous solution. Tube feeding for acute pancreatitis treatment diet is started by placing a tube that goes all the way to lower stomach or intestine. A nutrient dense feeding solution is then slowly passed through the tube as tolerated. An optimal rate of infusion is maintained based on tolerance and nutritional needs.

Best diet for pancreatitis recovery after being discharged from the hospital depends on the state of recovery at that time. If your pain has completely resolved and your appetite is normal, you can slowly advance your diet as tolerated and start eating normal balanced diet. If you still have occasional pain, it may be a good idea to stick to clear liquid diet for a few more days. You can then slowly advance to low fat diet. After a few days without pain, you can slowly advance your diet to normal healthy balanced diet.

Chronic pancreatitis symptoms

Pancreas pain in chronic pancreatitis comes and goes. It is a recurrent condition. Pancreatitis pain location in chronic pancreatitis is similar to the pancreatitis pain location in acute pancreatitis. However, chronic pancreatitis symptoms do not usually spread up to the chest.

Here is a list of common chronic pancreatitis symptoms

  1. Pancreatic pain (Abdominal pain) on and off for a long time
  2. Nausea and vomiting
  3. Weight loss
  4. Diarrhea on and off
  5. Loss of appetite
  6. Malnutrition
  7. Indigestion with undigested fat and other food particles in stool

Chronic pancreatitis symptoms are debilitating and hard to control. Pancreatitis pain relief is the main goal of treatment in patients with chronic pancreatitis symptoms.

Chronic pancreatitis diet

Chronic pancreatitis diet is somewhat different from acute pancreatitis diet. There is no need to prescribe NPO diet in chronic pancreatitis. In fact, many patients with chronic pancreatitis are malnourished and need a balanced diet to meet their nutritional needs. Other than alcohol and high fat foods, there are no chronic pancreatitis foods to avoid. All normal healthy balanced diet foods are chronic pancreatitis safe foods. You don’t need to follow any specific chronic pancreatitis diet recipes.

Pancreatitis causes: What causes pancreatitis in most patients?

Here are the 2 important causes of pancreatitis:

1. Alcohol

Drinking too much alcohol is the most common cause of chronic pancreatitis. It is the second most common cause of acute pancreatitis. The only effective treatment for pancreatitis from alcohol use is cessation of drinking.

2. Gallstones

Gallstones are the number one cause of acute pancreatitis. If you want to learn more details about gallbladder symptoms, you can follow this link. Gallbladder symptoms may progress into acute gallstone pancreatitis when the gallstones move out of gallbladder and obstruct the flow of pancreatic juice. The common bile duct connects pancreatic duct with the duct coming out of the gallbladder. Treatment for gallstone pancreatitis requires cleaning of this duct to make sure pancreatic juice has a passage to flow freely.

What causes pancreatitis in other patients?

Here are some other causes of acute pancreatitis:

  1. Trauma to the abdomen
  2. Certain medications
  3. Certain surgical procedure
  4. Very high blood triglycerides (visit this link if you want to learn about high triglycerides symptoms)
  5. Certain infections
  6. High blood calcium levels
  7. Certain immune diseases
  8. Certain tumors
  9. Certain autoimmune diseases
  10. Certain toxins
  11. Certain genetic conditions such as cystic fibrosis
  12. Certain bodily stress
  13. Due to repeated episodes of acute pancreatitis

Pancreatitis treatment: How is pancreatitis treated?

Pancreatitis treatment depends on whether you have acute pancreatitis or chronic pancreatitis. It also depends on the severity of disease.

Mild acute pancreatitis treatment

The main treatment for mild acute pancreatitis is supportive care. You may need hospitalization for observation. You will be kept NPO until your pain and inflammation start to go down. For mild acute pancreatitis, it is usually 24 to 48 hours. After that, you will be started on clear liquid diet. If you tolerate that, you can go home and slowly advance your diet to normal in a few days.

Severe acute pancreatitis treatment

Severe acute pancreatitis can be a life threatening condition. You may need resuscitative treatment in ICU with close monitoring of vital signs. You may need to be NPO for several days with IV fluids. You may need oxygen or respiratory support if your lungs are involved. You will most likely need tube feeds before oral feeding can be started. You may need multiple CT scans to look for complications such as infection and abscess formation. You may even need CT guided drainage if you have too much fluid in your abdomen. You may need IV antibiotics if you develop infection. Severe acute pancreatitis treatment is complicated and it may need a team of doctors to coordinate and develop individualized care.

Surgical treatment for acute pancreatitis: Pancreatitis cholecystectomy

In patients with acute pancreatitis caused by gallbladder stones, cholecystectomy or surgical removal of gallbladder is needed. It is recommended to get tested for possible gallstone pancreatitis in most patients hospitalized for acute pancreatitis. Once the diagnosis of gallstone pancreatitis is confirmed, cholecystectomy is advised, preferably during the same hospitalization.

Chronic pancreatitis treatment

Chronic pancreatitis treatment is mainly based on lifestyle modification, pain control and supportive care. Alcohol and tobacco cessation are the most important parts of chronic pancreatitis treatment and some patients may need substance abuse counseling and rehabilitation. Some patients with chronic pancreatitis lack pancreatic enzymes and may have problems with digestion and absorption of nutrients. They may need pancreatic enzyme supplementation. It is also important to check chronic pancreatitis patients for diabetes because long term damage to pancreas can destroy the insulin producing capabilities of pancreas.

Pancreas pain related to pancreatic cancer

Pancreas cancer symptoms can be hard to diagnose in the early stages. In the early phase, pancreas cancer symptoms are very non-specific. You may have mild pancreas pain in your stomach and you may feel tired and generally weak. You may also have decreased appetite. Pancreas pain from pancreatic cancer may be mild initially, but it is usually relentless. Unlike pancreas pain from acute pancreatitis, pancreas pain from pancreatic cancer does not fluctuate with meals. If you have relentless pancreas pain with unintended weight loss, you need to think about pancreas cancer and get tested. Early detection of pancreas cancer has significant positive impact on pancreatic cancer survival rate. If detected early, surgical resection of the pancreas may be curative in some patients. Unfortunately, pancreatic cancer treatment is mostly palliative in majority of patients. Pancreatic cancer life expectancy is poor in patients with advanced disease. Overall pancreatic cancer survival rate is about 10-20% within 5 years of diagnosis.