Diagnosis

There is no single test that can be used to diagnose chronic pancreatitis. If you have chronic abdominal pain or signs that your food is not being properly absorbed (such as weight loss or greasy stools) then your doctor will ask you about alcohol use and other risk factors for chronic pancreatitis, and other problems of the digestive organs.

Tests that may be done include:

• Blood tests to check for high levels of two pancreatic enzymes, amylase and lipase. These enzymes typically are elevated in people with acute pancreatitis and in many people with chronic pancreatitis, especially during a flare-up of symptoms

• A computed tomography (CT) scan , magnetic resonance imaging (MRI), or ultrasound can detect inflammation, scarring, and possible tumors of the pancreas

• A test called endoscopic retrograde cholangiopancreatography (ERCP), in which the patient swallows a small tube with a camera at the end, which passes through the stomach and into the small intestine. At the site where the bile and pancreatic ducts empty into the small intestine, dye is injected through a small tube into the ducts, which then light up on X-ray. This technique allows your physician to evaluate for blockages or damage to the ducts. In chronic pancreatitis, the pancreatic duct can appear a certain way during ERCP.

• A non-invasive imaging test called magnetic resonance cholangiopancreatography (MRCP), which evaluates the ducts without requiring an endoscope or contrast material. However, it is not as accurate a test as the ERCP.

If there are no signs of cancer or other problems that could explain your symptoms, and your history and test results point to scarring and damage to the pancreas, you will be diagnosed with chronic pancreatitis.

Expected Duration

Once the cells of the pancreas have been destroyed, they do not easily regenerate. For this reason, diabetes and other problems that are associated with chronic pancreatitis require longstanding treatment. It is unclear why pain develops with chronic pancreatitis, but once chronic pain develops, it tends to be longstanding or even lifelong. Many patients require chronic medications for pain.