How is pancreatitis diagnosed?

Acute pancreatitis is primarily suspected when a patient has the symptoms mentioned above and has risk factors such as heavy alcohol use or gallstone disease. Confirmation of pancreatitis is done by measuring levels of the two digestive enzymes, amylase and lipase, in the blood. High levels of these two enzymes strongly suggest acute pancreatitis. As the patient recovers, the digestive enzyme levels decrease to normal.

Chronic pancreatitis is generally suspected when a patient has the symptoms mentioned above and has risk factors such as a heavy alcohol use. Diagnosis can be difficult but is aided by such techniques as pancreatic function tests and radiographic imaging of the pancreas. In more advanced stages of the disease, when poor absorption or diabetes are present, the doctor can use blood, urine, and stool tests to monitor the progression of the disease.

Diagnostic tests include:

  • Pancreatic function test, in which the pancreatic function is measured by determining if the pancreas is producing the appropriate levels of digestive enzymes
  • Glucose tolerance test to measure damage to the cells in the pancreas that make insulin
  • Ultrasound, which can produce images of the pancreas so that abnormalities may be seen
  • Computed axial tomography scan (CAT scan), which can produce images of the pancreas so that abnormalities may be detected
  • ERCP (endoscopic retrograde cholangiopancreatography), an exam that shows the size and shape of the pancreas and its connections leading to the intestine
  • Esophagogastroduodenoscopy with ultrasound (EUS), an examination in which images of the pancreas are obtained from inside the stomach and intestine using sound waves

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