DEAR DR. DONOHUE: I have a granddaughter who has a boyfriend who lives in fear for his pancreas. He believes that his having been born prematurely puts him at risk for pancreas problems.

Will you comment on this? – M.M.

ANSWER: The pancreas lies below the stomach, next to the duodenum (the first part of the small intestine). It extends leftward to the spleen in the upper part of the abdominal cavity.

The pancreas has two major functions. It produces digestive enzymes that break down foods into microscopic components so they can pass through the intestinal wall, enter the blood and be transported to body sites in need of nourishment.

Its second and equally important job is the production of insulin for regulation of blood sugar.

One common pancreatic illness is acute pancreatitis, inflammation of the organ. The pain of an inflamed pancreas is intense, constant and usually felt in the center of the stomach, often penetrating to the back.

Along with pain, body temperature rises. Inflammation leads to body-fluid depletion, which speeds up the heart and lowers blood pressure.

In more than 80 percent of pancreatitis cases, the illness resolves with no complications. In some with severe pancreatitis, death is a possibility, but even in severe inflammations, 90 percent recover.

The causes of pancreatitis include excessive alcohol intake, gallstones blocking the duct that drains the pancreas and gallbladder, very high blood triglycerides, some medicines and a few viral infections.

Tell your granddaughter’s friend that premature birth is not a cause.

If the young man worries about pancreatic cancer, that’s something that doesn’t usually make an appearance until the 60s or 70s. Prematurity doesn’t enter the picture here, either.

This fellow is going to drive himself and your granddaughter crazy if he doesn’t stop worrying about his pancreas when there is no reason to do so.

DEAR DR. DONOHUE: I am a 34-year-old female in good health. I have one problem: pain in the back of my neck and on both sides of my head.

They diagnosed me as having occipital neuralgia, and I had a nerve block without getting any relief. I have had MRIs and X-rays, which are normal. Could I be misdiagnosed? – Anon.

ANSWER: The occipital nerve is on the back of the head. Irritation of the nerve can bring on aching, throbbing or piercing pain in that general area.

Even if only one nerve is affected, the pain can be on both sides.

If the nerve block doesn’t bring relief, the possibility of another cause should be entertained.

Have you gone back to the doctor and reported that you’re still in pain? Do so.

DEAR DR. DONOHUE: Do I have to get on my knees to get an answer from you?

Some years ago, a long white worm crawled out of my rectum.

I was too embarrassed to tell anyone. As a young kid, my mother used to give us coal oil with sugar on a spoon for pinworms. This thing I had was no pinworm.

Now lately I have woken in the middle of the night with the lower part of my belly feeling like there is a baby in there moving around. I am a nervous wreck for fear that it might be a big worm. What medicine can I take to get rid of worms? – D.R.

ANSWER: You don’t have to get on both knees to get an answer. One would be a nice gesture, though.

I’m having trouble answering your question because there are many different intestinal worms, and one medicine doesn’t fit all.

However, your episode is a bit strange. One large worm rarely exists by itself, and no worm I know of crawls away. It stays pretty much where it lands.

Today intestinal worms are not frequent, with the exception of pinworms. The movement you feel in your abdomen can’t be worms; that’s not a symptom of them.

The whole matter can be resolved and you can stop worrying by submitting a stool sample to your doctor. The doctor or a laboratory can look for worm remnants or worm eggs.

If none is found, you must look for another cause of the abdominal sensation that’s waking you.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com