Stomach pain, is it really stomach pain?
The 60-year-old Uncle Li started to have a dull pain in his upper abdomen half a year ago. At that time, he didn’t think about it.
Uncle Li, who had done a “diagnosis” for himself, went to the pharmacy to buy stomach medicine and came back. After taking it for a long time, there was no improvement. Uncle Li was used to saving money, but he just didn’t want to “spend a lot of money” in the hospital, so he reluctantly endured it.
Until the last half month, Uncle Li’s stomach pain has developed very seriously, sometimes even the back pain, and the whole person has lost a lot of weight. According to the family, Uncle Li was willing to go to the hospital for an examination. After taking a picture, it was found that Uncle Li had a 5 cm tumor in his pancreas, which was pancreatic cancer.
I believe that many people have “stomach pain”, but few people think about pancreatic cancer. However, more than 60% of pancreatic cancer patients are clinically misdiagnosed as stomach disease, chronic cholecystitis and other diseases.
1. The stomach pain you think is not necessarily the stomach pain
Stomach pain is in life It is a very common symptom, but sometimes what you think is stomach pain is not necessarily stomach pain. There are many organs next to the stomach, such as the duodenum, liver, gallbladder, part of the small intestine, transverse colon, Spleen, pancreas, kidneys and adrenal glands. The nerves distributed in the internal organs of the human body actually cross, and there are fewer pain receptors on the internal organs, so it is difficult to determine which organ is suffering from abdominal pain.
Professor Wang Xiaoyan from the Department of Gastroenterology, the Third Xiangya Hospital of Central South University introduced that about 80%~90% of upper abdominal pain comes from the stomach, esophagus and duodenum; 10% of the pain is caused by intestinal lesions, liver lesions, gallbladder lesions and so on.
1. Pancreas
Anatomically, the stomach is located in the middle and left of the upper abdomen, while the pancreas is long and narrow, hidden deep in the upper abdomen The anatomical position of the pancreas and stomach is the same in the posterior and inferior position of the stomach, even in the projection of the abdominal dissection surface, so when there is a disease in the stomach or pancreas, epigastric pain will occur.
2. Liver
If there is pain in the right rib, especially in patients with liver cirrhosis or viral hepatitis, it is necessary to be alert to liver cancer possible. Liver cancer pain is usually distending or dull pain. Because the location of left lobe liver cancer is very close to the stomach, the pain it causes is easily mistaken for stomach pain.
3. Gallbladder
Pain in the right rib cage may also be caused by lesions of the gallbladder. For example, common gallstones usually manifest as colic; Biliary ascariasis usually presents with episodic, piercing pain.
4. Duodenum
Peptic ulcers can also present with symptoms of stomach pain, including gastric and duodenal ulcers, which appear as prickles Pain, dull pain, burning pain, easy to recur. However, there is a difference between gastric ulcers and duodenal ulcers. Gastric ulcers are usually painful after eating, and are more common in middle-aged and elderly people; duodenal ulcers are usually painful before eating or at night, and are common in irregular diet, staying up late, Stressed young man.
Second, when these kinds of “stomach pains” appear, special attention should be paid to pancreatic cancer
pancreatic cancer It is the “king of cancer”. Due to the special location of the pancreas, it is easy to be confused with gastric diseases, resulting in many patients at an advanced stage when they are diagnosed. Abdominal pain caused by pancreatic cancer has the following characteristics:
1. Epigastric pain
Regardless of whether the tumor of pancreatic cancer is located in the body, tail or head of the pancreas , there will be symptoms of pain, about 60% to 80% of patients with upper abdominal pain.
2. Not related to diet, more and more pain, various manifestations
Pain caused by pancreatic cancer is usually not related to diet, and most symptoms are mild at first , The pain will be continuous and gradually aggravated. Due to the different pain mechanism and the location of the cancer, the abdominal pain will also show various manifestations, ranging from dull pain, fullness discomfort or severe pain.
3. Often radiating pain
The abdominal pain caused by pancreatic cancer is usually a dull pain in the upper abdomen, and the pain may radiate to the back
strong>, pancreatic head cancer usually radiates to the right side, and most body and tail cancers radiate to the left side.
In addition, pancreatic cancer may also cause jaundice, loss of appetite, nausea, vomiting, diarrhea or constipation, weight loss, fatigue, abdominal mass, diabetes, poor mental symptoms, partial limb edema, lymphadenopathy, etc. symptom.
Third, “stomach pain”, how can I know if it is a real stomach problem?
If there is “stomach pain”, you can judge whether it is stomach disease by the following two aspects:
On the one hand, whether the pain time is related to eating. Since most stomach pains are closely related to eating, they can be identified according to the time, type, and habit of eating. Observe whether the stomach pain occurs before or after a meal? Does it happen after eating certain foods? Does it happen when you are too hungry or too full? If so, it may be stomach pain caused by stomach problems.
On the other hand, symptoms can be observed. Generally, there are no symptoms of jaundice, fever, hiccups, etc. There are many symptoms associated with stomach disease, such as nausea, vomiting, flatulence, chest tightness, diarrhea, etc. However, if there are symptoms such as jaundice, fever, hiccups, etc., it may not be related to stomach disease or stomach, but may be related to gallbladder, liver, pancreas, etc. Wait until there is a problem.
If you cannot tell what is causing the pain or the pain is severe, you must seek medical attention in time to avoid delaying the treatment.
Fourth, high-risk groups should be more careful about “stomach pain”!
“Stomach pain” does not necessarily mean stomach pain, especially People at high risk of pancreatic cancer should be more vigilant when they have stomach pain.Chief physician and professor of the Pancreatic Center of the Second Affiliated Hospital of Nanjing Medical University, said Qian Zhuyin, Age over 40 years old, meet one of the following The population of this item belongs to the high-risk group of pancreatic cancer.
1. Has a family history of pancreatic cancer
According to epidemiological studies, pancreatic cancer has familial aggregation About 10%~20% of pancreatic cancers have a family history. If there is one pancreatic cancer patient in the family, the risk of other family members getting pancreatic cancer is 4 times that of the general population. The risk increases to 12-18-fold if there are 2 patients in the family, and up to 40-fold if there are 3 patients.
In addition, pancreatic cancer is associated with genetic syndromes, especially It is a family with multiple atypical collicoid melanomas, and it is easy to cause malignant transformation of pancreatic cells with cell gene mutation.
2. Patients with chronic pancreatitis
Recurrent episodes of chronic pancreatitis continue to destroy pancreatic tissue, leading to pancreatic fibrosis and cancer. Therefore, recurrent episodes of chronic pancreatitis, calculous pancreatitis, or pancreatic duct stones may be the cause of pancreatic fibrosis. Precancerous lesions of cancer, it is best to carry out standardized treatment and management.
3. People with recent diabetes mellitus
with mucinous cystic glands Pancreatic cancer, primary pancreatic duct-type myxopapillary tumor, solid pseudopapillary tumor, and new-onset diabetes mellitus without family history should also be alerted to pancreatic cancer.
4. Long-term Chemical Exposures
Men who work in beta-naphthylamine and benzene-related workplaces are at increased risk of pancreatic cancer, researchers suggest
5. People with bad habits
People who drink, smoke or have a long-term high-protein, high-fat diet, such as those who like to eat high-salt , high-calorie, high-fat and fried, pickled, smoked food, people are prone to pancreatic cancer. Among them, the carcinogens contained in tobacco can easily lead to pancreatic duct epithelial cancer, the length of smoking, the amount of smoking per day, the pancreatic cancer Cancer incidence is positively correlated.
Although abdominal pain is very common, we must learn to distinguish If it is stomach pain or pain caused by other diseases, if you can’t judge by yourself, it is best to go to the hospital for examination in time.
References:
[1]Wang Xiaoyan: Is upper abdominal pain just stomach pain? .The Third Xiangya Hospital of Central South University. 2021.07.28
[2] Li Jing. Pay attention to high-risk groups and danger signals, and there is a chance to encounter the “cancer king” – interview with the director of the Pancreas Center of the Second Affiliated Hospital of Nanjing Medical University Physician and professor Qian Zhuyin[J].Jiangsu Health Care, 2021(12):6-7.
[3] Ten early symptoms of pancreatic cancer”. Department of Pancreatic Oncology, Tianjin Medical University Cancer Hospital .2022-05-07