Chronic Pancreatitis Symptoms and Diagnosis
Symptoms of chronic pancreatitis
Most people with chronic pancreatitis experience upper abdominal pain, although some people have no pain at all. The pain may spread to the back, feel worse when eating or drinking, and become constant and disabling. In some cases, abdominal pain goes away as the condition worsens, most likely because the pancreas is no longer making digestive enzymes.
Other chronic pancreatitis symptoms include:
- nausea
- vomiting
- weight loss
- diarrhea
- oily stools
People with chronic pancreatitis often lose weight, even when their appetite and eating habits are normal. The weight loss occurs because the body does not secrete enough pancreatic enzymes to digest food, so nutrients are not absorbed normally. Poor digestion leads to malnutrition due to excretion of fat in the stool.
Diagnosis of chronic pancreatitis
Chronic pancreatitis is classically diagnosed with a tissue specimen that shows evidence of injury. Since gathering tissue to prove the diagnosis is difficult without causing substantial risk, we often try to make the diagnosis of chronic pancreatitis through history, physical exam, imaging, and function tests.
Advanced Diagnostic Tools
Common imaging methods we use to make a diagnosis of chronic pancreatitis include Computed Tomography (CT) scanning, Magnetic Resonance Imaging (MRI) and Ultrasound (US).
Stanford’s Benign Pancreas Program also utilizes advanced diagnostic methods including the following:
- Dedicated CT protocol to studying the pancreas
- Dedicated MRI protocol that can inclue secretin stimulation to better study the pancreas
- Endoscopic imaging with Endoscopic Retrograde Cholangio-Pancreatography (ERCP), and Endoscopic Ultrasound (EUS).
- Function testing: This involves measuring the amount and concentration of digestive juice secreted by the pancreas when stimulated by certain hormones.
These tests, particularly EUS, are considered more sensitive to catch early disease when changes in the pancreas are subtle.
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In more advanced stages of pancreatitis, when malabsorption and diabetes can occur, we may order blood, urine, and stool tests to help diagnose chronic pancreatitis and monitor its progression.