Pancreatitis

Diagnosis

Pancreatitis diagnosis often starts with a review of your health history and symptoms. A healthcare professional may do a physical exam to check for pain or tenderness in the belly. Based on the findings, several tests and procedures may be recommended to help understand the cause and severity of inflammation.

Tests commonly used to diagnose pancreatitis include:

• Blood tests that provide information about how the immune system, pancreas, and related organs are functioning.

• Ultrasound imaging to detect gallstones or signs of pancreatic inflammation.

• CT scan to show gallstones and measure the extent of swelling or damage.

• MRI to examine tissues and structures of the gallbladder, pancreas, and bile ducts.

• Endoscopic ultrasound, which uses an ultrasound device on a thin tube passed through the mouth to view the upper digestive system. This can identify inflammation, stones, blockage, and tumors.

• Endoscopic retrograde cholangiopancreatography (ERCP), a combination of endoscopy and X-ray imaging used to examine the bile and pancreatic ducts.

• Stool tests that measure fat content to determine whether nutrients are being properly absorbed.

• Pancreatic function tests, done using fluid collected during an endoscopy, to evaluate how well the pancreas is working.

Additional tests may be recommended based on symptoms, underlying conditions, or findings from initial evaluations.

Treatment

There is no specific medicine that cures pancreatitis, so treatment focuses on managing symptoms and preventing complications. Most people begin treatment in the hospital, where the healthcare team monitors the condition closely and provides supportive care.

Treatment during the early stage often includes:

• Pain medicines to relieve discomfort caused by inflammation.

• Intravenous fluids to maintain hydration and support organ function.

• A nutrition plan that may involve starting with clear liquids or using a feeding tube if eating is not yet possible.

After symptoms are controlled, treatment shifts to managing the underlying cause of pancreatitis. Options may include procedures, lifestyle changes, or medicines depending on the diagnosis.

Procedures to treat underlying issues include:

• ERCP to open blocked bile ducts and remove gallstones. A tube with a camera is guided through the digestive system, allowing tools to remove stones or clear blockages. Because ERCP can sometimes trigger acute pancreatitis, it is used only when necessary.

• Gallbladder surgery to remove the gallbladder when gallstones are responsible for the condition.

• Pancreas procedures using endoscopic tools to drain fluid collections or remove damaged tissue.

If pancreatitis is linked to alcohol use or smoking, a treatment program may be recommended. Ongoing use of alcohol or tobacco increases the risk of complications and repeated episodes. When high triglycerides are the cause, medicines to lower levels may be advised. If a specific medication is suspected of triggering pancreatitis, alternatives may be recommended.

Additional treatments for chronic pancreatitis

Chronic pancreatitis may require ongoing therapy to manage symptoms and support digestion. Pain is often long-term, and treatment may include medicines, procedures to improve drainage from the pancreas, or nerve-blocking injections. Referral to a pain specialist may be necessary.

Digestive support may involve pancreatic enzyme supplements taken with meals to help break down food, especially when diarrhea or weight loss occurs. A dietitian may help create a nutrient-rich eating plan.

Surgery may be considered when chronic pancreatitis does not respond to other treatments. Surgical options can include bypassing blocked ducts or, in rare cases, removing the pancreas when symptoms cannot be controlled.