Chronic Pancreatitis

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Diagnosis

Tests and procedures used to diagnose pancreatitis include:


Blood tests to look for elevated levels of pancreatic enzymes, along with white blood cells, kidney function and liver enzymes

Abdominal ultrasound to look for gallstones and pancreas inflammation

Computerized tomography (CT) scan to look for gallstones and assess the extent of pancreas inflammation

Magnetic resonance imaging (MRI) to look for abnormalities in the gallbladder, pancreas and ducts

Endoscopic ultrasound to look for inflammation and blockages in the pancreatic duct or bile duct

Stool tests in chronic pancreatitis to measure levels of fat that could suggest your digestive system isn't absorbing nutrients adequately

Your doctor may recommend other tests, depending on your particular situation.


Treatment

Initial treatments in the hospital may include:


Early eating. Old data suggested to stop eating for a couple of days in the hospital in order to give your pancreas a chance to recover. This is no longer practiced. Newer data have suggested that eating as soon as you tolerate food helps heal the pancreas.


As the inflammation in your pancreas improves and pain symptoms improve, you should begin drinking clear liquids and eating bland foods. With time, you can go back to your normal diet.


If your pancreatitis symptoms persist and you still experience pain when eating, your doctor may recommend a feeding tube to help you get nutrition.


Pain medications. Pancreatitis can cause severe pain. Your health care team will give you medications to help control the pain.

Intravenous (IV) fluids. As your body devotes energy and fluids to repairing your pancreas, you may become dehydrated. For this reason, you'll receive extra fluids through a vein in your arm during your hospital stay.

Once your pancreatitis is under control, your health care team will evaluate and treat the underlying cause of your pancreatitis. Depending on the cause of your pancreatitis, treatment may include:


ERCP procedure

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Procedures to remove bile duct obstructions. Pancreatitis caused by a narrowed or blocked bile duct may require procedures to open or widen the bile duct.


A procedure called endoscopic retrograde cholangiopancreatography (ERCP) uses a long tube with a camera on the end to examine your pancreas and bile ducts. The tube is passed down your throat, and the camera sends pictures of your digestive system to a monitor. Anesthesia is used for this procedure.


ERCP can aid in diagnosing problems in the bile duct and pancreatic duct and in removing obstructions, such as gallstones. In some people, however, ERCP can also lead to acute pancreatitis.


Gallbladder surgery. If gallstones caused your pancreatitis, your doctor will recommend surgery to remove your gallbladder (cholecystectomy).

Pancreas procedures. Endoscopic procedures may be necessary to drain fluid from your pancreas or to remove diseased tissue.

Treatment for alcohol dependence. Drinking several drinks a day over many years can cause pancreatitis. If this is the cause of your pancreatitis, your doctor may recommend you enter a treatment program for alcohol addiction. Continuing to drink alcohol would worsen your pancreatitis and lead to serious complications.

Medication changes: If a medication is deemed to be a cause of acute pancreatitis, your doctor may stop the medication and work with you to find alternative options.