Pain usually precedes symptoms of exocrine and endocrine malfunction by several years. Early symptoms include intermittent epigastric or nonspecific abdominal pain that can radiate to the back, be relieved by leaning forward, occur after eating a large meal, and increase in severity following alcohol intake. Over time, abdominal pain may be continuous and most intense in the upper abdomen, and may worsen after eating or drinking any liquids. Weight loss, diarrhea, vomiting, anorexia, jaundice, flatulence, constipation, fatty or oily stools, pale or clay-colored stools, and epigastric tenderness might also be present.