Diagnosis of chronic pancreatitis

diagnosis of chronic pancreatitisDiagnosis of chronic pancreatitis is usually made based on testing of its function and visualization of its structure.

The following methods are usually used to diagnose chronic pancreatitis:

  • Secretin stimulation test – measures the response of the pancreas to injection of secretin. Secretin is a hormone that is produced by the small intestine as a response to food. The test is conducted by inserting a tube through the nose of the patient into the stomach and then into duodenum. Then secretin is injected intravenously. The material that is released by pancreas as a response to secretin is aspirated through the tube for a period of 1-2 hours. Though this test is very reliable and considered to be “gold standard” it is not very frequently performed.
  • Fecal elastase test – elastase is one of the pancreatic enzymes that hydrolyzes elastin along with many other proteins. Fecal elastase test determines the amount of elastase-3B enzyme in fecal matter using ELISA (enzyme-linked immunosorbent assay). This method is more preferable than the secretin-cholecystokinin test, since it is less expensive and less invasive.
  • Serum trypsinogen – the levels of trypsinogen are determined using a blood test. High levels can indicate cystic fibrosis and acute pancreatitis. Levels of trypsinogen also rise when there is a relapse in chronic pancreatitis.
  • Computer tomography, MRI, and ultrasound – can identify things such as fibrosis, calcification, and other structural anomalies of the pancreas.
  • X-ray – pancreatic calcification can easily be viewed using plain X-rays.
  • Alkaline phosphate and serum bilirubin can be raised if the common bile duct has been obstructed by fibrosis, edema, or cancer of the pancreas.
  • Chronic pancreatitis caused by autoimmune aggression can lead to the rise in rheumatoid factor, IgG4, anti-nuclear antibodies, erythrocyte sedimentation rate, and anti-smooth muscle antibodies.


Prognosis


Regretfully, current methods of treatment of chronic pancreatitis cannot cure it entirely. Chronic pancreatitis irreversibly alters the structure and function of the pancreas. Thus, a patient that suffers from chronic pancreatitis has to keep on receiving medical treatment and remain on a strict diet for the rest of his or her life. Even a single occasion of eating or drinking something forbidden can cause a relapse in chronic pancreatitis, greatly reducing the quality of life of a patient.





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