Ask Dr. H | Why pancreas pain is felt in the back

Question: I had a recent bout of pancreatitis due to gallstones. Can you tell me why it caused me to have back pain?

Answer: The pancreas, when injured by gallstone blockage or alcohol, leaks powerful enzymes that digest fats, protein and carbohydrates - and pancreatic tissue. In pancreatitis, these potent enzymes attack the gland that produces and secretes them.

The back pain you describe has to do with where the pancreas is located. It is a large, tongue-shaped organ that can be thought of in three parts: It originates with a "head" section attaching to the duodenum (food moves from the stomach to the duodenum) on the right side of the abdomen, just behind the stomach. The "body" of the pancreas runs from right to left across the abdomen, coursing deep inside the abdominal cavity toward the back. A "tail" section reaches to the spleen in the left upper abdomen. That's why you experienced a gnawing pain that radiated into your back.

A diagnosis of pancreatitis requires at least two of three criteria to be present: abdominal pain typical of acute pancreatitis; blood levels of the pancreatic enzymes amylase and/or lipase at least three times the upper limit of normal; and characteristic findings of pancreatitis on an abdominal CT scan.