Brief, factual descriptions of conditions that may be discussed during a gastroenterology consultation.
Hong Kong gastroenterology and hepatology information from Dr Paul Ng. Consultations in Central and Tsim Sha Tsui are by appointment; assessment and care are individual.
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Pancreatic conditions
Chronic pancreatitis
Chronic pancreatitis involves persistent inflammation and scarring of the pancreas. Some people have recurrent upper abdominal pain, sometimes extending to the back. Over time, digestion or blood-sugar control may be affected, but symptoms and progression vary.
Causes and risk factors include alcohol, smoking, recurrent acute pancreatitis, genetic factors and other pancreatic disorders; it should not automatically be attributed to alcohol. Diagnosis considers the history and imaging, often CT or MRI, with specialist tests when needed. Abdominal pain alone or a single blood enzyme result cannot establish the diagnosis. Care may address the cause, stopping smoking, alcohol avoidance, nutrition, pain and diabetes. Pancreatic enzyme replacement is used when digestive enzyme insufficiency is present, not automatically for every patient. Endoscopic or surgical treatment is reserved for selected problems after specialist assessment. Chronic pancreatitis is not pancreatic cancer, although it can increase future risk; surveillance is not the same for everyone.
For discussion in consultation
Discuss persistent pain, oily stools, weight loss or changes in blood sugar. Sudden severe pain, persistent vomiting, fever or new jaundice requires urgent assessment rather than being assumed to be a usual flare.
Related procedure information
These links are general information, not a recommendation for an examination or treatment.
PEI occurs when pancreatic digestive enzyme activity in the intestine is insufficient for normal digestion. It can result in poor absorption of fat and other nutrients, sometimes causing bulky, oily or difficult-to-flush stools, diarrhoea, weight loss or nutritional deficiencies. Symptoms are not specific to PEI and can have other pancreatic, intestinal or dietary causes.
Faecal elastase is a commonly used indirect measure of pancreatic enzyme output, but very watery samples can give misleadingly low values and test results need to fit the clinical picture. Imaging can investigate structural pancreatic disease but cannot establish whether digestion is adequate; nutritional markers and alternative causes of malabsorption may also be reviewed.
For discussion in consultation
Assessment considers pancreatic disease or surgery history, symptoms, weight and nutritional status. A stool elastase test is often used, but watery stool can affect the result and a normal result does not answer every clinical question. Imaging can help identify pancreatic disease but does not itself measure digestion; clinicians interpret tests alongside the history and other findings.
Related procedure information
These links are general information, not a recommendation for an examination or treatment.
Pancreatic cysts are fluid-filled spaces in or beside the pancreas and are often discovered incidentally on a scan. Some follow inflammation, while others arise from pancreatic ducts or cyst-forming growths; their future behaviour varies. Many remain stable, but certain types can develop concerning changes, so “cyst” is not one single diagnosis or risk category.
The type of cyst is often inferred from its location and connection to pancreatic ducts, but imaging may not settle the diagnosis completely. MRI/MRCP can show the ducts and cyst over time; endoscopic ultrasound can provide closer images and sometimes a fluid sample, but is not needed for every incidental finding. Concerning features, growth, symptoms such as pancreatitis, age, general health and the ability to benefit from intervention all affect decisions. Surveillance can involve repeat imaging over time, and a specialist can explain why a particular interval or test is proposed. The purpose of monitoring is to notice meaningful changes while avoiding tests that are unlikely to alter care. Keep earlier scan reports available, because a comparison can be more informative than a single measurement and may help avoid unnecessary repeat assessment. The wording of a scan report can identify duct communication or other features that narrow the likely cyst type, but it may not be definitive. A specialist can explain the balance between surveillance and additional procedures in light of age, health and the cyst findings.
For discussion in consultation
Assessment may compare prior scans and consider cyst size, growth, connection to the pancreatic duct, duct widening, nodules or solid components, symptoms and overall health. MRI/MRCP is often useful; endoscopic ultrasound with fluid sampling is reserved for selected cases when results could affect decisions. Surveillance, further testing or intervention depends on the specific features, and finding a cyst alone does not mean surgery is needed.
Related procedure information
These links are general information, not a recommendation for an examination or treatment.
These summaries are for general information only. They cannot establish a diagnosis or determine whether you need tests, surveillance or treatment. Your own results, risks and options must be reviewed in an actual consultation with a qualified clinician. Do not start, stop or change treatment based on this page.
References are provided for background reading; they do not replace a consultation.
Questions about a finding on your scan, blood test or endoscopy report? Discuss the full report and your history in a consultation.
About this information
This is general educational information, not a diagnosis, a personalised recommendation or consent for a procedure. Whether to investigate or treat, the alternatives (including no procedure), benefits and risks require individual clinical assessment and discussion.