Can pancreatitis cause post-prandial back pain?

Hello doctor,

I have a long-standing diagnosis of GERD. Around six months back, an upper endoscopy rendered a diagnosis of gastritis, which had occurred several times over the years. I have been taking Omeprazole, Carafate, and Pepcid for six months. These have helped to a limited degree.

There is also moderate pain in the pancreas (apparently), especially after eating. The pain is usually in the back (right side, under the rib cage), but sometimes it is in front under the right rib cage. Occasionally, the pain is in the side, under the rib cage. And, at times, it is in the center of the back. But, again, this occurs almost immediately after eating. Other symptoms include a daily upset stomach, bloating, frequent gas, frequent bowel movements, occasional nausea, and night sweats. A recent X-ray suggested some constipation, and a recent EUS indicated hyper and hypoechoic foci in the pancreas. Some EUS images are appended here. My doctor said very little besides not to worry.

We are very concerned about malignancy or something that might develop into a malignancy. My symptoms persist daily. Are these symptoms related to the images? Is there a suggestion for pancreatitis? Is there evidence of a cyst or something else?

Hello doctor,

The local gastroenterologist referred to the lesions as hyper and hypoechoic foci. We had the impression that meant they were cysts. Did you see the lesions in the EUS images? I am very concerned about what they might mean.

Hello doctor,

I will see my physician in a few days. But meanwhile, the back pain, mainly post-prandial, continues and worsens. Also, we wonder if there is a beginning of diabetes. My urine has been mostly clear for several weeks, and my urination is frequent (roughly every hour, but in small amounts). For a while, we disregarded this because of past prostate problems and, of course, my age. Still, this makes us think of diabetes induced by pancreatic disease. And further, there are occasional moments of chills during the day.

Also, there is often a burning, kidney-type pain in the lower back at night. This is almost nightly while in bed. My wife has read of EUS inaccuracies due to a diffusely hyperechoic pancreas due to fatty infiltration. Do my images suggest such infiltration? My apparent fear is of needless delay if the EUS missed a significant or sinister lesion.