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DIGESTIVE SERVICES

Diagnosis & Treatment

Pancreatitis

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How is Pancreatitis Diagnosed?

Diagnosis

Pancreatitis is diagnosed using testing, imaging, and various specialized techniques. There is no at-home test for pancreatitis, and some diagnostic methods are not widely available. NewYork-Presbyterian offers the latest diagnostic approaches administered by expert our pancreatic care specialists. In addition to standard imaging tests such as CT, MRI, and abdominal ultrasound, we use:

  • Endoscopic ultrasound (EUS). An interventional endoscopist uses a special endoscope with high-energy sound waves to see your pancreas and the pancreatic duct.
  • Endoscopic retrograde cholangiopancreatography (ERCP). This technique combines endoscopy and x-rays to provide a clear image of the structure of your pancreas and the ducts and can show any abnormalities, as well as identify if gallstones or other blockages are causing your pancreatitis. NewYork-Presbyterian’s interventional endoscopists routinely perform this procedure and are highly regarded experts in its use.
  • Pancreatic function test. We use this endoscopic test to assess the bicarbonate concentration in pancreatic juice. Low levels of bicarbonate in the fluids produced by the pancreas indicate that the pancreas is not making sufficient digestive enzymes. Additional diagnostic testing for pancreatitis may include blood work and stool sample testing. Blood glucose levels can be checked to see if the pancreas is functioning correctly, while stool may be tested to check for digestion of key proteins.

Additional diagnostic testing for pancreatitis may include blood work and stool sample testing. Blood glucose levels can be checked to see if the pancreas is functioning correctly, while stool may be tested to check for digestion of key proteins.

How is Pancreatitis Treated?

Treatment

At NewYork-Presbyterian, our pancreatitis care team tailors your treatment to your medical needs. Your treatment depends on your acute or chronic pancreatitis and its severity.

  • Medications
    • Antibiotics, enzyme supplements, and oral medications may be used to help manage pancreatitis symptoms.
    • Neurolysis, or EUS-guided celiac plexus block, is an injection that blocks pain signals to the nerves used to relieve chronic pancreatitis pain.
    • Pain pumps, implanted in the spine to control chronic pain by pain medicine specialists, may be recommended as part of a custom pain management plan.
  • Surgery
    • ERCP to insert a stent (small tube) to open a blocked bile or pancreatic duct; perform sphincterotomy (a tiny cut to enlarge a duct opening); perform balloon dilatation (insertion of a balloon to open a narrowed duct); or remove or destroy a gallstone or pancreatic duct stone using laser or shock wave lithotripsy. Our doctors can also remove dead pancreatic tissue endoscopically.
    • Total pancreatectomy and pancreas removal is a procedure reserved only for those with pancreatitis with severe pain and debilitating symptoms. This is offered only when all other treatments have failed. Removing the pancreas will induce type 1 diabetes requiring insulin.
    • Islet cell transplantation is a procedure that involves removing your own insulin-producing islet cells and reinjecting them into your liver after a pancreatectomy. This treatment may allow you to retain some of your insulin-producing function and avoid diabetes. A third of patients can maintain normal blood sugar levels without needing insulin therapy, while another third can significantly reduce their dependence on insulin injections.
  • Supportive services
    • Intravenous hydration, a temporary IV of fluid to prevent hydration, may be given to allow your pancreas to recover and prevent damage and irritation.
    • Nutrition support, if regular food cannot be eaten, you may receive "enteral" nutrition through a feeding tube. We may also recommend a low-fat, nutritious diet and prescribe enzyme supplements.

FAQs

FAQs

The length of recovery time depends upon the severity and type of pancreatitis, and whether there are complications from the disorder.

Acute pancreatitis: There is no organ failure or complications in most people with mild acute pancreatitis. Inflammation may clear within a few days or up to one to two weeks.

For those with moderate to severe acute pancreatitis: organ failure, complications, and associated diseases lengthen the recovery time. Some individuals with acute pancreatitis may go on to develop chronic pancreatitis.

Chronic pancreatitis: There is no cure or reversal of chronic pancreatitis. This disease may cause a range of complications, including diabetes and pancreatic insufficiency. Patient care may involve surgery, medication management, nutritional support, and routine monitoring by a specialist.

If mild or moderate acute pancreatitis is detected and treated early, symptoms may go away and the condition may clear. Severe acute pancreatitis, recurrent pancreatitis, or chronic pancreatitis often require ongoing care. Routine management of pancreatitis by an expert doctor, called a gastroenterologist, provides the best health outcomes for patients with the disease.

Your healthcare provider may have a feeding tube inserted at first, so that the pancreas has time to heal. Once you begin eating and drinking again, your doctor may suggest eating small, frequent meals that are low in fat, and to avoid caffeine and alcohol, which can raise your risk of severe disease.

 

This content has been reviewed by the following medical editors.

Allison Yang, MD, MPH

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Trust NewYork-Presbyterian for Pancreatitis Treatment

Pancreatitis can become severe and therefore requires a team of experts to diagnose it and treat it successfully and accurately. We also host a special support group for patients who are currently being treated for pancreatitis.

NewYork-Presbyterian provides high-quality care for pancreatitis and uses a range of specialized treatment options. Understand the symptoms, risk factors, and causes of pancreatitis, and find the right course of treatment. Contact us to make an appointment now.