What are the indications for referral to a specialist in cases of chro

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Referral to a specialist in cases of chronic pancreatitis should be considered if there are:

Uncontrolled or recurrent symptoms, including pain or other complications, that require further assessment and management, such as imaging or intervention, depending on clinical judgement .
Persistent or worsening pain, or if symptoms change or new symptoms develop, warranting further investigation with imaging like CT or MRI .
Evidence of complications such as pancreatic exocrine insufficiency with malabsorption or malnutrition, especially if symptoms persist despite pancreatic enzyme replacement therapy .
Ongoing symptoms of pancreatic exocrine insufficiency despite treatment, requiring specialist pancreatic function testing .
Suspected pancreatic cancer, which requires urgent referral via a 2-week wait pathway .
Presence of complications such as pseudocysts, pancreatic duct obstruction, or pseudocyst-related pressure effects, which may need invasive management .
Persistent or worsening pain that may benefit from specialist pain management, including pain clinic referral .
Pancreatic ascites or pleural effusion, which should be managed in a specialist pancreatic centre .
Type 3c diabetes, which should be assessed every 6 months and may require specialist endocrine management .

What are the indications for referral to a specialist in cases of chronic pancreatitis?