Pancreatitis

Diagnosis

Your healthcare professional will ask you questions about your health history and symptoms, give you a general physical, and check for pain or tenderness in your belly.

Tests and procedures that may be used include the following.

• 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.
• Computerized tomography (CT) scan show gallstones and the extent of inflammation.
• Magnetic resonance imaging (MRI) to 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 digestive system. It can show inflammation, gallstones, cancer, and blockages in the pancreatic duct or bile duct.
• Stool tests can measure levels of fat that could suggest your digestive system isn't absorbing nutrients as it should.

Your doctor 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. These include:

• Pain medicines. Pancreatitis can cause severe pain. Your healthcare team will give you medicines to help control the pain.
• Intravenous (IV) fluids. You will receive fluids through a vein in your arm to keep you hydrated.
• Nutrition. You will 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:

• Procedures to open bile ducts. A procedure called endoscopic retrograde cholangiopancreatography (ERCP) is used to locate and remove a gallstone. 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 stone and clear the bile duct. ERCP may itself trigger acute pancreatitis, but research about risk factors have helped improve outcomes.
• 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 alcohol dependence. If excessive alcohol use has caused pancreatitis, a treatment program for alcohol addiction is recommended. Continuing to drink alcohol worsens pancreatitis and leads to serious complications.
• Changes in medicines. If a medicine is the likely cause of acute pancreatitis, your healthcare professional will work with you to find other options.

Additional treatments for chronic pancreatitis

Chronic pancreatitis may require additional treatments, including:

• Pain management. Chronic pancreatitis often causes severe, long-term pain. In addition to prescribing medicine, your healthcare professional will look 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. Taken with each meal, these enzyme supplements help your body break down and use the nutrients in food.
• Changes to your diet. Your doctor may refer you to a dietitian who can help you plan low-fat meals that are high in nutrients.

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 doctor for help. Your doctor 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 doctor for help. Medicines and counseling can help you quit smoking.
• Choose a low-fat diet. Choose a diet that limits fat and emphasizes 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.

Alternative medicine

Alternative therapies can't treat pancreatitis, but some may help you cope with the pain from chronic pancreatitis. These include:

• Meditation.
• Relaxation exercises.
• Yoga.
• Acupuncture.

Preparing for your appointment

You'll likely see your primary care professional first. You may be referred to a specialist in the digestive system called a gastroenterologist.

Because appointments can be brief, and because there's often a lot to discuss, it's a good idea to be well prepared. Here's some information to help you get ready and know what to expect from your doctor.

What you can do

• Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there's anything you need to do in advance, such as restrict your diet.
• Write down any symptoms you're experiencing, including any that may seem unrelated to the reason you scheduled the appointment.
• Write down key personal information, including any major stresses or recent life changes.
• Make a list of all medications, vitamins, supplements or herbal remedies you're taking.
• Take a family member or friend along. Sometimes it can be difficult to keep track of all the information during an appointment. Someone going with you may remember something that you missed or forgot.
• Write down questions to ask your doctor.

Questions you may have at a first visit or follow-up visit after a diagnosis may include:

• What is likely causing my symptoms or condition?
• What are other possible causes for 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?

In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask other questions.

What to expect from your doctor

Your doctor is likely to ask you several questions. Being ready to answer them may allow more time to cover points you want to address. Your doctor may ask:

• When did you first begin experiencing symptoms?
• Have your symptoms been off-and-on or constant?
• 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?
• Is there a family history of any pancreas disease?