The location of the pancreas makes diagnosing pancreatitis difficult. It may be diagnosed by a physician during a physical examination that includes a medical history and list of medications. Patients may also be referred to a gastroenterologist (a physician who specializes in the function and disorders of the gastrointestinal [GI] tract).

During a typical examination, a physician touches the abdomen and may use a stethoscope to listen for sounds in the intestines. A physician may ask a patient about patterns of alcohol use.

If a physician suspects that a patient has pancreatitis, blood tests may be performed. Blood tests can evaluate pancreatic function and may detect abnormalities such as:

• High levels of amylase and lipase, which are enzymes in the pancreas
  
  
• High levels of urinary trypsinogen-2
  
  
• High levels of white blood cells
  
  
• High levels of liver enzymes and bilirubin (substance formed from the breakdown of red blood cells)
  
  
• High blood sugar levels (hyperglycemia)
  
  
• Low calcium levels (hypocalcemia)

If a physician suspects that a patient has chronic pancreatitis, a stool test may also be performed. Patients often have elevated levels of fat in the stool because the fat is not digested and absorbed normally. A pancreatic function test may also be conducted. These tests measure the ability of the pancreas to secrete enzymes and other substances necessary for digestion.

Many cases of pancreatitis cannot be diagnosed with blood and stool tests alone. Imaging tests may be performed to detect abnormalities (such as gallstones) in the pancreas or pancreatic duct. These may include:

• X-rays. An image may be taken of the abdomen or chest on film paper or fluorescent screens. It is produced by using low doses of radiation.
  
  
• Ultrasound. An imaging technology that uses sound waves to produce images of the shape and outline of various tissues and organs of the body. An endoscopic ultrasound may be performed because it provides better images of the pancreas and pancreatic ducts than a standard ultrasound.
  
  
• Computed axial tomography (CAT) scan. A test that allows for multiple x-rays to be taken from different angles around the patient. It creates images of organs and bones within the body. This is the most important diagnostic test as it helps visualize the pancreas very well.
  
  
• Endoscopic retrograde cholangiopancreatography (ERCP). An endoscope (lighted tube) is inserted through the mouth to the small intestine. A dye is passed through a thin flexible tube (catheter) inside the endoscope before x-rays are taken. ERCP is usually performed stones are thought to be present in the common bile duct.
  
  
• Magnetic resonance cholangiopancreatography (MRCP). A test that uses magnetic resonance imaging to produce detailed images of the body.