Pancreatitis

Diagnosis and testing

Pancreatitis diagnosis often begins with a review of your health history and symptoms. Your healthcare professional may do a physical exam to check for pain or tenderness in your belly.

Tests and procedures used to diagnose pancreatitis may include:

• Blood tests can give clues about how the immune system, pancreas and related organs are working.
• Ultrasound images can show gallstones in the gallbladder or inflammation of the pancreas.
• CT scan can show gallstones and the extent of inflammation.
• MRI can look for irregular tissues or structures in the gallbladder, pancreas and bile ducts.
• Endoscopic ultrasound is an ultrasound device on a small tube fed through the mouth and into the upper digestive system. It can show inflammation, gallstones, cancer, and blockages in the pancreatic duct or bile duct.
• Endoscopic retrograde cholangiopancreatography (ERCP) combines endoscopy and X-ray images to look at the bile and pancreatic ducts.
• Stool tests can measure levels of fat that could suggest your digestive system isn't absorbing nutrients as it should.
• Pancreatic function tests can be done on fluid collected from the pancreas during an endoscopy. This can show how well the pancreas is working.

Your healthcare professional may recommend other tests depending on your symptoms or other conditions you may have.

Treatment

There is no specific medicine to treat pancreatitis. Treatment begins with a hospital stay to manage symptoms and complications. This includes:

• Pain medicines. Pancreatitis can cause severe pain. Your healthcare team may give you medicines to help manage the pain.
• Intravenous (IV) fluids. You may receive fluids through a vein in your arm to keep you hydrated.
• Nutrition. You may begin eating again when you can do so without vomiting or pain. In some cases, a feeding tube is used.

When the symptoms and complications are under control, other treatments are used to treat underlying causes. These may include:

Endoscopic retrograde cholangiopancreatography Enlarge image

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Endoscopic retrograde cholangiopancreatography

Endoscopic retrograde cholangiopancreatography

Endoscopic retrograde cholangiopancreatography (ERCP) uses a dye to highlight the bile ducts on X-ray images. A thin, flexible tube with a camera on the end, called an endoscope, goes through the throat and into the small intestine. The dye enters the ducts through a small hollow tube, called a catheter, passed through the endoscope. Tiny tools passed through the catheter also can be used to remove gallstones.

• Procedures to open bile ducts. A procedure called endoscopic retrograde cholangiopancreatography (ERCP) is used to locate and remove gallstones. A long tube with a camera is fed through the mouth and digestive system to the bile duct. This tube also is used to get tiny tools to the site to remove the stones and clear the bile duct. ERCP may trigger acute pancreatitis, so it may not be for everyone.
• Gallbladder surgery. If gallstones caused the pancreatitis, surgery to remove the gallbladder may be recommended. This procedure is called a cholecystectomy.
• Pancreas procedures. Procedures with an endoscopic camera and tools may be used to drain fluid from the pancreas or remove diseased tissue.
• Treatment for excessive alcohol use or cigarette smoking. If excessive alcohol use or cigarette smoking has caused pancreatitis, your healthcare professional may recommend a treatment program. Continuing to drink alcohol or smoke cigarettes worsens pancreatitis and leads to serious complications.
• Treatment for high triglyceride levels. If triglyceride levels are high, your healthcare professional may recommend medicines to lower the levels. Continuous high levels of triglycerides can cause pancreatitis to come back in the future.
• Changes in medicines. If a medicine is the likely cause of acute pancreatitis, your healthcare professional works with you to find other options.

Additional treatments for chronic pancreatitis

Chronic pancreatitis may need additional treatments, including:

• Pain management. Chronic pancreatitis often causes severe, long-term pain. In addition to prescribing medicine, your healthcare professional looks for causes or complications of chronic pancreatitis that cause pain. Treatments may include procedures to improve drainage from the pancreas or injections to block nerve signals from the pancreas to the brain. You may be referred to a pain specialist.
• Enzymes to improve digestion. When chronic pancreatitis causes diarrhea or weight loss, you may take pancreatic enzyme supplements. When taken with each meal, these enzyme supplements help your body break down and use the nutrients in food.
• Changes to your diet. Your healthcare professional may refer you to a dietitian who can help you plan meals that are high in nutrients.
• Surgery. Surgery may be used when chronic pancreatitis does not respond to other treatments. Surgery may involve bypassing the blocked pancreatic duct or, rarely, removing the pancreas.

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Lifestyle and home remedies

Once you leave the hospital, you can take steps to continue your recovery from pancreatitis, such as:

• Stop drinking alcohol. Even if alcohol was not the likely cause of pancreatitis, it is best to stop drinking alcohol while recovering. If it was the expected cause, stop drinking. If you're unable to stop drinking alcohol on your own, ask your healthcare professional for help. They can refer you to local programs to help you stop drinking.
• Stop smoking. If you smoke, quit. If you can't quit on your own, ask your healthcare professional for help. Medicines and counseling can help you quit smoking.
• Choose a balanced diet. Choose a balanced diet that includes fresh fruits and vegetables, whole grains, and lean protein.
• Drink more fluids. Pancreatitis can cause dehydration, so drink more fluids throughout the day. It may help to keep a water bottle or glass of water with you.

Preparing for your appointment

If you're experiencing symptoms, you might start by seeing your primary healthcare professional. This person may refer you to a specialist in the digestive system, called a gastroenterologist.

What you can do

Here's some information to help you get ready for your appointment.

• Be aware of anything you need to do ahead of time. When you make an appointment, be sure to ask if there's anything you need to do in advance, such as restrict your diet.
• Write down symptoms you have, including any that may not seem related to the reason for which you scheduled the appointment.
• Write down important personal information, including major stresses or recent life changes.
• Make a list of all medicines, vitamins and supplements you're taking and the doses.
• Take a family member or friend along. It can be hard to remember all the information you get during an appointment. Someone who goes with you may remember something that you missed or forgot.
• Write down questions to ask your healthcare team.

For pancreatitis, some questions to ask might include:

• What is likely causing my symptoms or condition?
• What are other possible causes of my symptoms or condition?
• What kinds of tests do I need?
• Is my condition likely temporary or chronic?
• What is the best course of action?
• What are the alternatives to the primary approach that you're suggesting?
• I have other health conditions. How can I best manage pancreatitis along with these conditions?
• Should I see a specialist? How can I learn if my insurance covers a specialist?
• Is there a generic option for the medicine you're prescribing?
• Are there any brochures or other printed material that I can take with me? What websites do you recommend?
• Should I schedule a follow-up visit?

Don't hesitate to ask other questions.

What to expect from your doctor

Your healthcare professional is likely to ask you several questions, such as:

• When did you begin experiencing symptoms?
• Have your symptoms come and gone or stayed steady?
• How severe are your symptoms?
• Does anything improve your symptoms?
• Does anything worsen your symptoms?
• Have you had these symptoms before?
• Have you been diagnosed with pancreatitis in the past?
• Do you drink alcohol? If so, how much and how often do you drink?
• Did you start any new medicines before your symptoms began?
• Does anyone in your family have a history of any pancreas condition?