What they are, how they’re evaluated, treatment options, and what to do next
What is the pancreas—and what can go wrong?
The pancreas is a gland behind the stomach. It makes digestive enzymes that help break down food and hormones, including insulin, that help regulate blood sugar. “Pancreatic disease” is a broad term for conditions that affect one or both of these functions. [1]
Examples include:
- Pancreatitis: Inflammation of the pancreas. Acute pancreatitis begins suddenly; chronic pancreatitis involves lasting inflammation and damage. Common causes include gallstones and alcohol use. Other causes can include certain medicines, high blood fats, genetic conditions, and blockages. Sometimes no cause is identified. [1, 2]
- Exocrine pancreatic insufficiency (EPI): The pancreas does not provide enough digestive enzymes for the small intestine to digest food properly. It can occur with chronic pancreatitis and other pancreatic conditions. [3]
- Pancreatic cysts and fluid collections: Fluid-filled areas may be found during imaging. Some arise in connection with pancreatitis; others need assessment to determine what they are and whether monitoring or treatment is appropriate. [2, 4]
- Pancreatic cancer: Cancer can develop in the cells that make digestive juices or in hormone-producing cells. Many other conditions can cause similar symptoms, so concerning symptoms need evaluation rather than self-diagnosis. [5]
What symptoms can occur?
Symptoms depend on the condition. Some pancreatic conditions may cause no noticeable symptoms at first.
Possible symptoms include:
- Pain in the upper abdomen, sometimes spreading to the back
- Nausea or vomiting
- Pain that worsens after eating
- Diarrhea, greasy or foul-smelling stools, or difficulty digesting food
- Unintentional weight loss
- New or worsening blood-sugar problems
- Yellowing of the skin or eyes (jaundice), dark urine, or pale stools [2, 3, 5]
These symptoms can have causes other than pancreatic disease. A healthcare professional can help determine what evaluation is appropriate.
How are pancreatic diseases found?
Your provider will ask about symptoms, medical and family history, alcohol and tobacco use, medicines and supplements, and prior episodes of pancreatitis or gallstones. The evaluation may include:
- Blood tests: These may check pancreatic enzymes such as lipase, blood sugar, blood fats, liver-related tests, or other measures chosen for your situation. A blood test alone may not identify the cause or severity.
- Stool tests: A stool elastase test may help assess pancreatic enzyme production. Other stool testing may be used when malabsorption is suspected.
- Imaging: Ultrasound, CT, or MRI/MRCP can help examine the pancreas, nearby organs, and bile or pancreatic ducts.
- Endoscopic ultrasound (EUS): A flexible endoscope with an ultrasound probe can produce detailed images of the pancreas. In selected cases, a small tissue or fluid sample can be collected.
- Other procedures or tests: ERCP may be used to treat certain blockages or duct problems. If cancer is suspected, imaging and sometimes a biopsy are used to establish the diagnosis and guide treatment. [4, 5, 6]
Not everyone needs every test. Your provider will choose based on your symptoms, initial results, and health history. There is no recommended routine pancreatic-cancer screening test for everyone; evaluation is guided by symptoms and individual risk. [5]
How are pancreatic diseases treated?
Treatment depends on the specific diagnosis, its cause, and whether complications are present.
Acute pancreatitis
- Often requires prompt medical assessment and may require hospital care, fluids, pain control, and nutrition support.
- Treatment may address the cause—for example, gallbladder treatment if gallstones caused the episode, or an endoscopic procedure if a duct is blocked.
- Antibiotics are used when an infection is present, not automatically for every case. [6]
Chronic pancreatitis
- Care may focus on pain, nutrition, and preventing or treating complications.
- Treatment may include pancreatic enzyme replacement when digestion is affected, vitamin support when needed, and procedures for selected duct blockages or fluid collections.
- Avoiding alcohol and stopping smoking are important steps for people with pancreatitis. If you may be dependent on alcohol, ask a healthcare professional for help stopping safely. [6]
Exocrine pancreatic insufficiency
- Prescription pancreatic enzyme replacement therapy (PERT) is commonly used to help digest food. It is taken with meals and snacks as directed by the prescriber.
- A clinician or dietitian may help with nutrition and evaluate for vitamin or nutrient deficiencies. Treatment of the underlying cause may also be needed. [3]
Pancreatic cysts or cancer
- Management depends on the type, size, location, test findings, and symptoms. Some cysts may need follow-up imaging; others may require additional testing or a specialist review.
- If cancer is diagnosed, care is planned by a cancer-care team. Depending on the type and stage, options may include surgery, chemotherapy, radiation, targeted treatment, or care to relieve symptoms. [4, 5, 7]
Do not start “pancreas cleanses,” stop prescribed medicines, or change enzyme doses without discussing it with your healthcare professional.
What are the next steps?
- Seek urgent care for severe or rapidly worsening symptoms. Do not wait for a routine appointment if you may be having acute pancreatitis or another emergency.
- Arrange an appointment for recurring upper-abdominal pain, unexplained weight loss, greasy stools, jaundice, or abnormal pancreatic test or imaging results.
- Bring relevant records: lab and imaging results, previous procedure reports, and a list of prescriptions, over-the-counter medicines, vitamins, and supplements.
- Write down your symptoms: when they began, where pain occurs, whether it spreads to your back, how it relates to meals, and changes in stool, appetite, or weight.
- Ask your provider: What condition is suspected? What do the results show? Do I need more testing or specialist care? What symptoms should prompt urgent care? When should I follow up?
- Follow the care plan and contact the office if symptoms worsen or you have questions about medicines or nutrition.
When to seek emergency care
Get emergency medical care now for severe or worsening upper-abdominal pain—especially with repeated vomiting, fever or chills, a rapid heartbeat, shortness of breath, or yellowing of the skin or eyes. These can be signs of severe pancreatitis or a blocked or infected bile or pancreatic duct. [2]
Also seek urgent evaluation for vomiting blood, black tarry stools, fainting, or new confusion. Call 911 for a medical emergency.
Set up an appointment
Call Digestive Healthcare of Georgia to set up an appointment with a provider. Contact the office serving your area:
- Atlanta: (404) 355-3200
- Cartersville or Jasper: (706) 253-7340
- Fayetteville: (770) 719-3240
- Newnan: (678) 326-4812
- Ellijay: (706) 253-5514
- Woodstock, Marietta, or Canton: (404) 425-5570
When you call, confirm the appropriate location and appointment availability. [8]
Sources
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Definition & Facts for Pancreatitis.
https://www.niddk.nih.gov/health-information/digestive-diseases/pancreatitis/definition-facts - NIDDK. Symptoms & Causes of Pancreatitis.
https://www.niddk.nih.gov/health-information/digestive-diseases/pancreatitis/symptoms-causes - NIDDK. Exocrine Pancreatic Insufficiency (EPI).
https://www.niddk.nih.gov/health-information/digestive-diseases/exocrine-pancreatic-insufficiency - NIDDK. Diagnosis of Pancreatitis.
https://www.niddk.nih.gov/health-information/digestive-diseases/pancreatitis/diagnosis - National Cancer Institute (NCI). Pancreatic Cancer: Symptoms; Testing & Diagnosis.
https://www.cancer.gov/types/pancreatic/symptoms
https://www.cancer.gov/types/pancreatic/diagnosis - NIDDK. Treatment for Pancreatitis.
https://www.niddk.nih.gov/health-information/digestive-diseases/pancreatitis/treatment - NCI. Pancreatic Cancer Treatment.
https://www.cancer.gov/types/pancreatic/treatment - Digestive Healthcare of Georgia. Office Locations.
https://digestivehealthcare.net/contact-locations/
This information is for general education and does not replace medical advice, diagnosis, or treatment. Your provider can recommend care based on your symptoms, test results, and health history.
