Abdominal pain may be caused by a wide range of problems. "Attacks" of pain in the right upper abdomen lasting for several hours may be due to gallstones...


The pancreas lies in the upper abdomen closely associated with the duodenum (the small bowel immediately following the stomach). The common bile duct - the connection between the liver and duodenum for flow of bile - runs through the pancreas
The pancreatic duct and the bile duct empty into the duodenum (small bowel just past the stomach) through the same opening
Cancer develops mostly in the head of the pancreas. This commonly leads to blockage of both the pancreatic duct and bile duct

The pancreas is well known for making insulin but it also has a major role in digestion. The pancreas secretes 1.5 litres of fluid into the duodenum – the first part of the small bowel. This contains enzymes for digestion of carbohydrates, fats and proteins as well as bicarbonate (HCO3) which is important to balance the hydrochloric acid secreted into the stomach.

The hormone producing part of the pancreas can be damaged without affecting digestion. This leads to diabetes.

The pancreas can be damaged by inflammation that is sudden and often severe – this is called acute pancreatitis. This can be caused by gallstones lodging in the bile duct, by the direct toxic effect of alcohol or as a side-effect of some drugs.

Repeated episodes of pancreatitis can lead to chronic pancreatitis - this means the pancreas is severely damaged and unable to recover. The pancreas is unable to secrete the enzymes required for digestion and there may be failure to absorb important nutrients and weight loss.  This is often caused by excess alcohol intake over a long period of time.

Cancer of the pancreas has no definite cause and is a very serious diagnosis. The diagnosis is often made late and surgery is not possible.

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