What Causes Chronic Pain On Upper Back And Nausea?

Posted on Wed, 26 Mar 2014

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Wed, 26 Mar 2014 Answered on

Mon, 14 Apr 2014 Last reviewed on

Question : I have hereditary chronic pancreatitis. I have had 80percent of my pancreas removed along with my spleen and a bowel reconstruction. I did get a secondary infection almost died. 1year later I had to ha e a large amount of scar tissue removed and ten plus herniated repaired with mesh basically wrapping my tummy together. I continue struggling with chronic co pain from my upper left and right to the back with lots of nausea. It has gotten worse and every day it starts in by 3or4 to the point I can hardly tolerate it. I take pain meds morphine 30mg 2times a day and fill in with loratab 10s for break through pain along with creon at meals. I feel as though it has really progressed. I lost33 lbs in a month for no reason. Is this a sign of the progression?

Answered by Dr. Ashish Verma (2 hours later)

Brief Answer: it can be Detailed Answer: Hi, Thanks for writing to HCM. Your pain can be due to various reasons, first and most likely is a flare up of your pancreatitis, and to confirm that you need to get a repeat serum lipase levels done. Other causes may be due to a nerve entrapment in the mesh or even gastritis due to drug entake. I would advice you to revist your gastro for a full evaluation, as pain radiating to the back is highly suggestive of pancreatitis. And loosing weight is not a good sign either. Hope that i have answered to all your queries. If you have further queries, i will be glad to answer them. Regards Dr. Ashish Verma

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Ashish Verma (12 hours later)

when you say loosing weight is not a good sign either can you explain? i do feel more tired and stamina is much less but i relate everything to fighting pain all the time.

Answered by Dr. Ashish Verma (26 minutes later)

Brief Answer: can be malabsorption or even malignancy Detailed Answer: Hi, Rapid weight loss, 33 lbs in a month, which is quite a significant amount, in your case can be mostly due to two reasons. First and most likely is malabsorption due to 80% of your pancreas removed and the remaining being affected by the disease. But if this is there then your stools might be foamy and floating on the water. Second possibility is that of the chronic diseased pancreas turning malignant. This can easily be screened by doing levels of tumor marker CEA and CA 19-9. But for these, you need to consult your treating doctor first, as these are not 100% diagnostic, as they are raised in pancreatitis also. So, better to see him for a physical examination and a delailed evaluation as he may feel necessary. Regards Dr. Ashish Verma

Above answer was peer-reviewed by : Dr. Yogesh D