To diagnose chronic pancreatitis, abdominal X-rays may show whether the pancreas is calcified. Your doctor will take blood samples and check the stool for excess fat, a sign that the pancreas is no longer producing enough enzymes to process fat. You may be given a stimulation test called a pancreatic function test to see how well the pancreas releases digestive enzymes. You may also be screened for diabetes.
Initial treatment of acute pancreatitis includes pain control, hydration, and nutritional support. If you have an attack of acute pancreatitis, your doctor will feed and hydrate you intraveneously. You may receive strong drugs for pain. You may have to have your stomach drained with a tube placed through the nose.
If your pancreatitis is caused by gallstones or an obstructed bile or pancreatic duct, you may need surgery or have an endoscopic retrograde cholangiopancreatography (ERCP) done once your symptoms have subsided. An ERCP is a procedure that involves the insertion of a tube down your throat into the stomach and upper intestines to the place where the bile duct and pancreatic duct drain. A small incision is made to remove stones in the bile duct or a plastic tube called a stent is inserted into the ducts to relieve the obstruction.
If you have chronic pancreatitis, the doctor will focus on treating pain -- guarding against possible addiction to prescription painkillers -- and watching for complications that affect digestion. You may be placed on a pancreatic enzyme replacement therapy to restore the digestive tract's ability to digest nutrients; this will also likely reduce the frequency of new attacks.
You may have to avoid fatty foods and will have to abstain from drinking alcohol. Injection of anesthetics into the nerves near the spine may give pain relief. If the pain does not respond to medication or nerve blocks, the damaged pancreatic tissue may be surgically removed, but only as a last resort.