Pancreatitis

Treatment of chronic pancreatitis in adults

For many people, periodic pain in the abdomen seems like a trifle not worthy of attention. And basically this is the case. However, sometimes these pains may be hidden treacherous enemy - chronic pancreatic pancreatitis (pancreas). Depending on the country of residence, the percentage of incidence may vary from 0.4 to 5%. Therefore, you need to consider this disease in more detail.

What is chronic pancreatitis?

Chronic pancreatitis (CP), or Pancreatitis Chronica (in Latin), - This is a disease resulting from inflammatory processes in the pancreas. The natural functional tissue of the organ is replaced by connective, irreversible changes in the ducts occur, and the functionality of the pancreas is steadily declining. Also due to inflammation occur:

  • cysts
  • calculi inside the affected organ.

In the International Classification of Diseases, ICD 10 is located under the numbers:

  • K86.0,
  • K86.1.
Classification

Causes and forms of pancreatic inflammation

The causes of this ailment lie in the fact that when the human body is exposed to certain negative factors, the production of sufficiently aggressive digestive enzymes by the pancreas is activated. In the case when for some reason their free movement along the duct to the duodenum ceases, they begin to digest the cells of their own organ, that is, the gland digests itself.

A recurring form of pathology is characterized by the fact that when a sick person assumes nutritional disorders in the prescribed preventive course, he may experience a repeated inflammatory process, which takes longer to get rid of. The main risk factors for the development of an exacerbation of this disease lie in the excessive consumption of fatty foods or large amounts of alcohol by a person, requiring increased production of digestive enzymes. Also, the immediate causes of chronic pancreatitis can be the following:

  • injury to an organ as a result of any medical manipulation on it or postcholecystectomy syndrome that occurs after removal of the gallbladder,
  • atherosclerosis or thromboembolism developing directly in the vessels of the pancreas,
  • poisoning by toxic or chemical substances,
  • constant nervous strain and frequent stresses.

In addition, chronic pancreatitis, which occurs with constant exacerbations, can provoke diseases of the duodenum, liver, or gall bladder.

Types of disease

If we consider this pathology of the pancreas from the point of view of the development of the disease, depending on the reasons that provoked it, then we can distinguish two forms of this destructive-inflammatory disease:

  • Chronic calcifying pancreatitis, which is characterized by the presence in the duct connecting this digestive organ directly with the duodenum 12, calculi, that is, calcareous stones that interfere with the passage of digestive enzymes through it. Their sizes determine the degree of blockage of the passage, and, accordingly, the severity of the course of the disease.
  • Chronic obstructive pancreatitis is also caused by blockage of the duct, but for organic reasons - the formation of scars on the tissues of the organ or the development of a tumor in it.

Both forms of pathology are reversible, since if the precondition that provoked obstruction in the duct connecting the pancreas with duodenum is eliminated, the normal functioning of the digestive organ is restored and the secretory imbalance provoked by these varieties is normalized.

The situation is worse when a person develops chronic atrophic pancreatitis, which always occurs with exocrine insufficiency. This kind of ailment is irreversible and leads to the fact that in place of dead pancreatic cells, connective tissue develops, which is devoid of digestive glands and is not able to produce the necessary enzymes.

Post-traumatic

  1. Open and dull pancreatic injuries.
  2. The consequences of operations.
  3. Due to endoscopic retrograde pancreatocholangiography.

Often this disease is a consequence of diseases:

  • GIT (gastrointestinal tract),
  • abdominal aorta
  • cholecystitis, etc.

Stages of Chronic Pancreatitis

Chronic pancreatitis is accompanied by an alternation of attenuation and manifestation of the symptoms of the disease. The disease itself develops in three stages:

  • initial - the pancreas is functioning normally, despite the presence of symptoms of the disease,
  • stage of intrasecretory insufficiency - there are problems with digestion,
  • complications stage - bacteriological and viral infections, cysts appear, endocrine pancreatic insufficiency develops.

Causes of chronic pancreatitis

For the occurrence of pancreatitis, several factors are necessary. These are:

  • consequences of acute pancreatitis - fibrosis of the pancreatic tissue, duct obstruction,
  • prolonged alcohol abuse,
  • tobacco smoking
  • the presence in the diet of food with a lot of fats and proteins. Such food contributes to the excessive production of pancreatic juice, as a result of which the ducts are damaged,
  • diseases of the gallbladder and biliary tract, mainly in women,
  • diseases of the duodenum
  • hereditary factors based on the mutation of certain genes.

What does the pancreas look like in chronic pancreatitis?

The internal organ produces special enzymes responsible for the breakdown of food into useful components. However, in the chronic form of the disease, they do not have time to get into the intestines, but accumulate in the pancreas. This leads to the fact that enzymes corrode the walls of the internal organ. Normal tissue is replaced by connective tissue and calcifications.

At the last stage of the disease, changes occur in the body: not only the pancreas, but also organs adjacent to it are destroyed.

The destructive effect of enzymes is expressed in the chronic form of the disease. Both death and tissue edema occur. With relapse, whole necrotic areas, false cysts, and lime deposits form. Bile ducts are characterized by deformation.

Most often, chronic pancreatitis is associated with disturbances in the digestive system, which are caused by improper diet and overeating. The use of spicy, fried or fatty foods in large quantities negatively affects the functioning of the digestive system of the human body. This also applies to alcohol, which has a devastating effect on internal organs.

Alcohol abuse and malnutrition are the most common causes of pancreatitis, which, without proper treatment or due to a slow inflammatory process, becomes chronic. However, other factors are also able to cause changes in pancreatic tissues and provoke chronic pathology.

The physiological causes of the disease include:

  • disorders of blood circulation and fat metabolism in the pancreas,
  • gallstone disease, which contributes to the inflammatory process in the bile ducts,
  • the presence of gastritis or ulcers of the stomach and duodenum,
  • poisoning by food, drugs, intoxication with chemicals,
  • gastrointestinal infections
  • trauma to the internal organs of the abdominal cavity,
  • the presence of cystic fibrosis,
  • genetic predisposition.

Injuries to the internal organs of the abdominal cavity can lead to the development of pancreatitis.

The psychological causes leading to impaired pancreatic function include:

  • frequent stress, depression, nervous strain,
  • regular lack of sleep,
  • lack of good rest.

In 8 cases out of 10, the deposition of stones in the gallbladder leads to chronic pancreatitis and obstructive jaundice due to the fact that the bile ducts and pancreatic ducts pass side by side. At the entrance to the duodenum, they are combined by a common duct with the muscle ring - the sphincter of Oddi.

To prevent the development of dangerous pathologies, with the formation of stones and a severe course of the disease, the patient gall bladder is removed. However, pancreatitis caused by gallstone disease can also develop after removal of the gallbladder. This happens due to diseases of the liver and other organs of the digestive system or medical errors during surgery.

Frequent stress, depression, nervous strain exerts a negative effect on the pancreas.

Classification

According to the Marseille-Roman classification, there are 4 forms of CP:

  • Calcifying.
  • Obstructive.
  • Inflammatory.
  • Cystic.

Regular sleep deprivation can cause pancreatitis.

The M-ANNHEIM classification divides pancreatitis into primary and secondary, as well as the following phases:

  • Subclinical.
  • Without failure with pain syndromes without exacerbations.
  • With exocrine insufficiency.
  • With exocrine insufficiency.
  • With excretory and secretory insufficiency.

The classification of V.T. Ivashkin is in demand, which divided pancreatitis into fibrous, atrophic, dysmetabolic and other types.

Symptoms of chronic pancreatitis are bouts of pain that are localized in the left hypochondrium.

Symptoms of chronic pancreatitis in women and men are bouts of pain, which are localized in the left hypochondrium, but can give into the projection of the upper abdominal cavity, back and lower back. The pain syndrome manifests itself after taking heavy food, alcoholic or carbonated drinks. However, painful sensations vary in intensity, duration and frequency of occurrence. It depends on the severity of the pathology and the presence of concomitant diseases. Often, pathology develops slowly and does not manifest itself for years.

The chronic form of the disease is characterized by a sharp decrease in body weight. Most patients have dyspeptic syndrome - an upset stomach, a change in the nature of the stool, nausea and vomiting, which does not bring relief. Problems with the process of nutrition and digestion - another characteristic syndrome is observed in chronic pancreatitis. Frequent constipation or diarrhea, increased gas formation, decreased appetite, constant belching, sounds in the abdomen - companions of potology in both men and women.

The chronic form of the disease is characterized by a sharp decrease in body weight.

Long-term development of the disease leads to the destruction of the pancreas. The patient is worried about hormonal changes leading to secretory insufficiency. The skin turns yellow, a person feels weakness and constant fatigue. There is a frequent increase in temperature, aversion to food, lowering blood pressure, headaches bother. However, an echo sign is a decrease in body temperature with diarrhea and excessive loss of fluid, which leads to rapid weight loss.

What pains can be with pancreatitis and how to remove them? Read about it here.

In some patients with a suspected chronic form, indirect signs of pathology are found such as a white coating on the tongue, dryness, itching and peeling of the skin, bad breath, hair loss, and brittle nails. The inflammatory process in the pancreas leads to a decrease in the production of saliva, which causes dryness and a taste of bitterness in the mouth.

Frequent headaches are a symptom of chronic pancreatitis.

Diagnostics

If chronic pancreatitis is suspected, the patient is referred for feces, urine and blood tests. Determination of pancreatic lesions occurs on an ultrasound or radiography. In adult patients, computed tomography is mandatory.

In order to distinguish the chronic form from other pathologies of the digestive system, an ultrasound scan, pancreatoangioentgenography, and radioisotope scanning are performed. After examination, the patient is diagnosed. An example of the diagnosis is as follows: chronic pancreatitis with severe pain, latent, moderate.

In adult patients with pancreatitis, computed tomography is mandatory.

For the treatment of the chronic form, conservative drug therapy is used. If the patient complains of pain, the doctor prescribes antispasmodics. With inflammation in the elderly, increased gastric acidity is often observed. To reduce it, histamine blockers are prescribed.

Surgical intervention is performed with a severe form of the disease.

With pancreatitis, it is important to follow a diet with the exception of fatty foods, fried and spicy foods. In addition, the rejection of alcoholic and carbonated drinks is necessary.

To restore the normal functioning of the pancreas, the diet must include fish, poultry, beef, dairy products, cereals. Fatty fish, whole milk, spicy cheese, legumes, sauces and marinades are excluded. It is better to cook steamed dishes, rather than in a pan. Do not overeat during the day and before bedtime. Food should be taken in small portions 5-6 times a day at equal intervals.

If the patient complains of pain, the doctor prescribes antispasmodics.

What is the danger of chronic pancreatitis?

The danger of pancreatic pathology lies in its destructive activity. If treatment is not started in time and risk factors are not excluded, then the internal organ will cease to function, which will adversely affect the digestive process, without which a normal life is impossible.

How many people with chronic pancreatitis live and how to live with such a diagnosis? Read more in the article.

The statistics of diseases of the chronic form in Russia are disappointing. The number of cases increases every year. For 10,000 people, about 50 are ill. The number of deaths is 6-8%.

Following a diet for pancreatitis is an essential condition for recovery.

Complications

Complications of pathology include:

  • Violation of the outflow of bile. The result of this dysfunction is obstructive jaundice.
  • Pancreatic abscesses. They are characterized by purulent formations in the tissues and intoxication of the organ.
  • Duodenal stenosis. Disrupted patency of food into the intestines.
  • False aneurysms of arterial vessels of an organ.
  • Cysts of the internal organ. The reason for their formation is most often a blockage in the ducts.
  • Diabetes. It develops due to damage to the cells responsible for the production of insulin.
  • Oncology.

Pancreatitis diabetes develops due to damage to the cells responsible for the production of insulin.

Can it go to cancer?

The fact that people suffering from a chronic form of pancreatitis can develop oncology is proved by doctors. About 8% of patients with chronic pathology fall ill with oncology. Cancer affects the pancreas, less often the colon and stomach. The tumor can metastasize to the retroperitoneal lymph nodes, lungs, liver, kidneys and bones.

Most often, a chronic form with active calcification degenerates into an oncological disease.The situation is aggravated by the lack of proper treatment, an unhealthy lifestyle, smoking and drinking. These factors do not allow the inflammatory process to subside inside the body and have a harmful carcinogenic effect on the pancreas.

Oksana, 34 years old, Balashikha

Five years ago she underwent abdominal surgery, and then complications began. From the doctors did not go. Pain began in the left side, diagnosed with chronic pancreatitis. Now I'm sitting on a strict diet without flour, fat, spicy, sweet. No carbonated drinks and alcohol. Even on holidays you have to limit yourself.

Anton, 43 years old, Saratov

Do not despair those who have problems with the pancreas. When I was diagnosed with a chronic form, I turned to the best doctor in the city. The course of treatment, herbal decoctions, diet and illness receded. Now I allow myself to drink on holidays, eat without strict restrictions, but I did not quit smoking.

Ekaterina, 40 years old, Perm

The diagnosis of chronic pathology was made at 36 years old. Often there were girdle pains in the abdominal region. Somehow I was relaxing in the summer with a friend in the village. I ate organic foods, fresh vegetables, fruits, herbs, drank fresh milk and well water. The pains began to recede. Now they arise only when you go too far with alcohol or eat at night.

Initial signs of pathology

Any person needs to know how chronic pancreatitis manifests itself, since no one is safe from the development of this disease of the digestive tract, which is of a destructive and inflammatory nature.

Based on medical practice, experts note the factor that in most cases the primary pathological changes in the gland do not have a pronounced manifestation, so patients usually do not focus on them. But, despite this, it is necessary to know the possible symptoms and signs of chronic pancreatitis that can occur with this ailment. Such awareness will help not to miss the disease that has begun to develop, to undergo the necessary diagnostic tests and begin timely treatment. Among the warning signs that experts recommend paying direct attention to, the following can be distinguished:

  • The main manifestation of the pathology is discomfort and pain of varying degrees of intensity, localized in the epigastric region and intensified after eating.
  • Constantly occurring dyspeptic disorders (diarrhea accompanied by flatulence, discomfort and heaviness in the abdominal cavity, constant nausea, sometimes ending with the appearance of vomiting and an unpleasant aftertaste in the mouth).
  • In addition, when a person develops this ailment that proceeds according to a chronic type, an aversion to fatty and meaty foods or a complete loss of appetite may occur. The manifestation of the pathological condition can also be expressed in a strong weight loss of the patient, the formation on his skin of small angiomas (tumors formed from lymphatic or blood vessels), and the development of diabetes mellitus. Such negative symptoms correspond to the period of exacerbation of the disease, and pancreatitis in the stage of remission occurs without any negative signs.

Pain characteristic

Soreness, as already mentioned, is the main sign indicating the development of inflammation in the pancreas. In the painful form of chronic pancreatitis in a patient with this kind of pathology, unpleasant thrills prevail that are localized on the left side of the abdomen and have a pronounced character. Very often, the pain accompanying the disease is girdle-like and radiates to the back or region of the heart. In the latter case, they imitate angina pectoris.

Chronic inflammation of the pancreas, which for the most part characterizes the appearance of severe pain, can occur as a result of the appearance of the following immediate premises:

  • significant compression of organs adjacent to the gland and a change in its nerve endings,
  • the occurrence of mechanical or organic obstacles to the outflow of pancreatic juice, provoking its stagnation,
  • an increase for any reason in the amount of digestive enzymes produced by the pancreas,
  • the development of the inflammatory process on the fiber located around this enzymatic organ,
  • pancreatic ischemic disease.

The nature of the pain can be various, both crushing and drilling, cutting or burning. This pain syndrome occurs at completely different times both on an empty stomach and a few hours after eating.

The basic methods needed to detect a disease

In order to diagnose chronic recurrent pancreatitis, it is necessary to conduct a comprehensive full examination, which allows you to most accurately differentiate the disease with other inflammatory pathologies of the digestive organs that have similar symptoms. For this purpose, both instrumental and laboratory studies are used. Thanks to the full diagnostic complex, the specialist has the opportunity to accurately diagnose chronic pancreatitis. Typically, gastroenterologists use the following research methods:

  • General, immunological and biochemical analysis of blood, as well as tumor markers, allowing to identify both pathological inflammation in the pancreas and its malignancy.
  • A coprogram that gives an idea of ​​the digesting ability of the digestive tract, as well as the presence in them of helminths and simple pathogenic microorganisms.
  • Ultrasound shows not only the chronic course of inflammation in the pancreas, but also the pathology of the gallbladder or its ducts, as well as the liver.
  • According to certain indications, such studies as computed tomography and FGDS can be carried out. In the event that all of them have confirmed the alleged differential diagnosis, the specialist selects a specific therapeutic protocol for each patient according to which the treatment of chronic pancreatitis will take place without any complications.

Treatment and consequences

Patients with this pathology of the enzymatic digestive organ should be interested in asking their doctor about how to treat chronic pancreatitis.

Only the attending physician can answer all questions of interest to a person, and also give him the necessary recommendations for the treatment of pathology.

Typically, the symptoms and treatment of chronic pancreatitis are interconnected. The purpose of therapeutic measures largely depends on what signs accompany the pathology. The following therapeutic measures are usually used:

  • An ailment occurring with secretory insufficiency requires the use of replacement therapy, which consists in the use of enzymatic preparations made on the basis of pancreatin.
  • Treatment of chronic pancreatitis that occurs with the formation of pseudocysts is carried out by minimally invasive percutaneous drainage.
  • Obstruction of the duct connecting the pancreas with duodenum requires surgical intervention.

But the main method of treatment for any form of pathology is the appropriate diet, which should be selected by a specialist.

Prognosis and complications

A specialist should also be interested in how to cure chronic pancreatitis so that there is no danger of serious complications. Only he can give the necessary advice on preventing the development of pathological conditions provoked by the course of the inflammatory process in the pancreas. In chronic pancreatitis, the prognosis will be more or less favorable if any ailment of a systemic nature does not develop (functional insufficiency of systems and various internal organs, encephalopathy, multi-organ pathologies, DIC), which significantly complicates the recurrent course of the pathology.

The main recommendations of specialists, allowing a person with a chronic type of illness to protect themselves from the occurrence of complications of chronic pancreatitis, are a complete rejection of addictions and maintaining a healthy lifestyle.

Only rigorous implementation of the prescribed preventive measures and adherence to all the advice of a doctor will help prevent the disease, which repeats every autumn and spring, with its severe manifestations, for a very long time.

Drug treatment

Medicines are prescribed for such purposes:

  • analgesics and antispasmodics - to eliminate pain,
  • antihistamines - to suppress the pancreas,
  • inhibitors - to reduce the secretion of the pancreas and stomach,
  • antacids - to neutralize stomach acid,
  • prokinetics - for the treatment of disorders in the motility of the gastrointestinal tract,
  • enzymes - to compensate for the lost functions of the pancreas. As a rule, they have to take a lifetime.

Traditional treatment

For the treatment of folk methods use:

  • Kriefe tincture - normalization of acid balance, improvement of pancreatic secretory functions, stimulation of the production of insulin and enzymes,
  • black cumin - the fight against inflammatory processes,
  • triple tincture of onions, walnut leaves and grass cuffs,
  • Kvass on the celandine according to Bolotov - anti-inflammatory and cleansing effect,
  • Brussels sprout juice - a means to restore the secretory functions of the pancreas,
  • flax seeds - normalization of acidity and detoxification,
  • Hericium Mushroom
  • royal jelly.

Diet for chronic pancreatitis

With CP, a medical medical diet No. 5 is prescribed, which includes the following recommendations and limitations:

  • dairy products: cheese, cottage cheese, kefir. However, you can’t eat ice cream, fermented baked milk and sour cream,
  • fresh baked goods, brown bread, pastry,
  • you can eat almost all cereals, with the exception of millet,
  • lean soups are recommended from the first courses, and decoctions of meat, mushrooms and fish are contraindicated,
  • lean meats can be consumed if steamed or baked. But fried and greasy is not allowed,
  • alcohol and soda are contraindicated for drinks,
  • fish, like meat, should not be fried, not oily and properly cooked,
  • you can’t eat cabbage, radish and sorrel from vegetables, and it’s better not to eat raw fruits at all,
  • various seasonings, hot sauces and canned foods are contraindicated.

Prevention of chronic pancreatitis

To prevent the development of CP, you should abandon what causes this disease. First of all, from harmful products and habits for healthy liver and pancreas, such as:

It is also useful to engage in physical education and hard physical labor.

Secondary prophylaxis is already used in the event of chronic pancreatitis (CP), and its goal is to avoid exacerbations.

It is also advisable to take enzyme preparations, constantly follow a diet and immediately treat in case of exacerbations.

Causes, risk factors

Inflammatory processes in the pancreas are manifested in diseases, one of the most common is pancreatitis. Violation of the normal functioning of the body, causing inflammation, explains the causes of chronic pancreatitis.

They can be grouped: internal and external.

  • toxins and toxic elements: smoking, alcohol, calcium and lipids (fats) in the blood above normal, promiscuous intake
  • medicines
  • a genetic predisposition that has its roots in the family tree,
  • poorly selected food menu, overeating,
  • nervous disorders, mental injuries, stressful situations,
  • viral, chronic diseases and gastrointestinal tract,
  • peritoneal injury due to operations and endoscopic procedures,
  • loss of immunity by the body, low protective barrier.

There are other possible causes; they are thrown up by the modern pace of life.

Signs and mechanism of occurrence

In the structure of the gland there is an exocrine system responsible for the production of pancreatic juice - an enzyme that processes food. Chronic pancreatitis appears when this system fails. There is a lack of digestive enzymes.

Participating in the breakdown of food, they must get into the duodenum and activate their work. But due to the reasons causing an abnormality in the body, enzymes begin to work within the gland, processing native tissues, causing its inflammation.

Symptoms of chronic pancreatitis are expressed sluggishly. The process quietly destroys the organ. Its course is distinguished in 2 phases:

The initial period can last up to 10 years. Signs of chronic pancreatitis in this phase are manifested by pain in the upper abdomen, after eating after a certain time up to 1 hour. Pain can cause bloating, nausea, sometimes vomiting, belching, diarrhea.

Symptoms of chronic pancreatitis change with the duration of the disease. Pain is less of a concern, or is generally absent. The patient's skin turns pale, dries, fatigue appears. This is evidence of hypovitaminosis.

A striking symptom in weight loss, despite the appetite and normal nutrition, flatulence. In chronic pancreatitis, the manifestation of these signs indicates a severe form of a progressive disease. This is expressed in the replacement of healthy gland tissue with fibrous tissue. Her weight remains the same, and functionality drops, which immediately affects the body.

Severe consequences accompany the development of diffuse changes in the pancreas:

  • suppuration of the passageways of iron elements and bile,
  • sepsis, bleeding,
  • the occurrence of ulcers and erosion of the stomach, esophagus, intestines,
  • duodenal obstruction,
  • cysts, cancer, fistulas,
  • accumulation of fluid in the peritoneum,
  • a distinct drop in blood sugar,
  • Thrombosis of the veins providing blood flow to the spleen, liver,
  • Changes in the shape of the gland, blocking the passage of food.

Lab tests

  • blood biochemistry
  • general blood analysis,
  • general urine analysis,
  • urine biochemistry,
  • general analysis of feces,
  • cerulein test.
  • Instrumental research:
  • CT scan,
  • Ultrasound
  • endoscopic ultrasonography,
  • X-ray examination
  • magnetic resonance imaging (MRI),
  • endoscopic retrograde cholangiopancreatography.

If necessary, an endocrinologist, a nutritionist, an immunologist, an infectious disease specialist, a psychotherapist, and a surgeon join the diagnosis. The work of such a circle of specialists will make it possible to detect all pancreatic defects and outline measures on how to treat chronic pancreatitis.

A long process that combines all types of therapy, treatment of pancreatitis. The severity of the disease, determined by diagnosis, will answer the question of how to treat chronic pancreatitis.

The conservative method is aimed at preventing signs of the disease:

  • drug treatment consists of replacement therapy. It is aimed at compensating for the oppressed or lost - excretory function of the pancreas. This is expressed in the unsatisfactory production of pancreatic juice. Therefore, substitution therapy uses drugs consisting of elements related to enzymes, the purpose of which is to help break down carbohydrates, proteins, fats,
  • analgesics, antiemetic drugs are used for nausea, pain, vomiting in order to alleviate the patient’s condition,
  • drugs aimed at maintaining optimal blood glucose.

Surgery - surgical intervention for resection of burdened lesions of the organ:

  • operable cysts that have a wall, a cavity filled with liquid, which give growth,
  • abscesses that created a capsule in the pancreatic tissue, filled with purulent secretion,
  • fistulas that form pathological passages,
  • blockage or obstruction of the passage of pancreatic juice,
  • malignant tumors.

The treatment of chronic pancreatitis has the general principles listed above. But according to the classification, each chronic pancreatitis has its own causes, symptoms and treatment:

  1. A definite answer to the manifestation of the hereditary nature of pancreatitis. The genetics of violations, presumably, consists in transferring them on an autosomal dominant basis, i.e., the mutant gene is enough to inherit from one of the parents. Symptoms of the disease can occur in children and adults. Often the disease proceeds easily without causing serious disturbances. Occasionally, it proceeds with severe complications. The prognosis of healing is favorable, despite the causes of exacerbation of chronic pancreatitis.
  2. A characteristic feature of recurrent pancreatitis is a more frequent manifestation of pain than in other forms. The causes of exacerbation of chronic pancreatitis do not always have severe symptoms. However, miscalculations in cure will lead to the progress of the disease. The nature of recurrent seizures causes pain no more than 2 times a year. If the disease is not treated when the pain subsides, then they return, increasing up to 4 times a month. The duration of the attacks increases from a few minutes at an early stage to a countdown in days. Recurrent pancreatitis is accompanied by characteristic symptoms: flatulence, diarrhea, constipation, belching, nausea, weakness, rapid salivation. Recurrent chronic pancreatitis is treated as usual, following all its instructions.
  3. Idiopathic pancreatitis is allocated in a separate group due to the severity of complications. It is not possible to establish the causes of idiopathic chronic pancreatitis until the time of diagnosis. The essence of the disease is to replace the healthy tissue of the gland fat. This entails a weakening or complete loss of secretion in the body. Factors - provocateurs are the same as in general principles.
  4. In general, a rather unique disease is autoimmune pancreatitis. It is dangerous for damage to the pancreas and nearby organs. An illness has its own mechanism. As you know, immunity is designed to protect the body from the penetration of bacteria and infection. In this case, he begins to fight with his native cells, causing disruptions in various organs, occurs during a prolonged, more than six months, course of the disease.
  5. When obstruction occurs in the main pancreatic duct, inflammation occurs in the form of obstructive pancreatitis. Risks of the disease are violations in passing the secretion of the gland along its path due to the appearance of mechanical or traumatic foci. Against the background of all diseases of the pancreas, a form of obstructive pancreatitis is distinguished. obstruction-narrowing of the ducts due to spasms or swelling, less often the presence of stones. Treatment of chronic pancreatitis is successful in eradicating its manifestation. In this case, diffuse changes are reversible, which will restore the function of the organ.
  6. The first lesions of the gland for the reasons described in this article, is in the form of primary pancreatitis.
  7. Secondary pancreatitis - causes inflammation of the pancreas due to ailments of nearby organs. To detect pathologies, patients undergo a thorough medical examination.

Chronic pancreatitis, symptoms, treatment involve the docking of knowledge and a combination of all known principles: medical, psychological, and nutritional in nature. The attending physician is responsible for healing the patient. For the latter, the word “healing” is both dogma and taboo. Minimizing the manifestations of the causes of chronic pancreatitis is the key to the success of healing.

An integral part of the treatment of chronic pancreatitis is the diet. It is designed so that the patient is full, and satiety does not injure the gland. In different phases, diet food is selected individually for each sick person. The general principle of using table No. 5 is boiled, steam, mashed food from acceptable products. The effective cooperation of the doctor with the patient is the key to reducing the consequences of the disease.

What is a pathology?

The disease "chronic pancreatitis" is an inflammation in the pancreas of a progressive type, which remains even after eliminating the root cause. If it is not treated, then the tissues of the organ are replaced by connective, which negatively affects the general condition.

Interesting! Doctors around the world have confirmed a twofold increase in the number of patients with this pathology over the past 35 years.

In our country, over the same period, among the adult population, the growth has tripled. Moreover, if earlier people from 50 years old mostly suffered from it, now - from 38 years old. In adolescents, the frequency of detection of pathology increased 4 times. Due to adult alcoholism, this disease is diagnosed in 65% of all cases.

Why is it developing

The most common causes of both chronic and acute pancreatitis are alcohol gallstone disease. Ethyl alcohol acts on the organ parenchyma as a strong toxin. Pathology provokes an infectious infection of the pancreas through its ducts or by throwing bile into the body.

Among other factors leading to chronic pancreatitis can be identified:

  • excess calcium ions in the blood,
  • pancreatic obstruction through the sphincter of Oddi,
  • long-term therapy with a number of drugs,
  • hypertriglyceridemia and cystic fibrosis,
  • autoimmune pancreatitis of unknown genesis,
  • heredity.

By chronic pancreatitis it is worth understanding not one disease, but a whole series. Classic types:

  • metabolic toxicity, provoked by drugs or alcoholic beverages,
  • autoimmune, when the body’s immune system itself attacks an organ,
  • idiopathic, arising for no reason,
  • genetic, inherited and resulting from a malfunction in DNA,
  • recurrent, in which prolonged remission and brief exacerbations always alternate,
  • obstructive, when the ducts of an organ are blocked or squeezed,
  • primary, arising without a previous pathology,
  • secondary, which has become a complication of another disease.

The clinical picture of chronic pancreatitis

The initial stage of the pathology is characterized by an asymptomatic course. Less commonly, mild or nonspecific symptoms. When the first serious attack occurs, dangerous changes have already occurred in the organ. It begins with a strong girdle pain under the left rib, which can be constant or paroxysmal.

Sometimes pain passes into the heart, which is quite dangerous, because it can only be distinguished by a doctor. Joins the pain:

  • nausea and vomiting, the latter is often, exhausting the body and does not provide relief,
  • heartburn, bloating, elevated gases,
  • unstable bowel movements, where constipation alternates with severe diarrhea,
  • decreased appetite, which leads to weight loss.

The more the disease progresses, the brighter the clinical picture. If chronic pancreatitis is not treated, the inflammatory process will destroy not only the organ itself, but also adjacent tissues. Sometimes you can live with him for years, until at one moment there is a serious attack.

The onset of chronic pancreatitis in a neglected form is manifested in the biliaryity of the skin and eye sclera. The epidermis becomes dry, and the chest and abdomen may become covered with small red spots.

Disease Description

Chronic pancreatitis is a commonly diagnosed disease today. The pancreas plays an important role in digestion. With its defeat, serious complications arise that affect the whole body.

Mostly the disease affects the elderly, although in recent years, chronic pancreatitis has been diagnosed in people aged 35-40. Often affects the disease of men who abuse alcohol. Chronic pancreatitis can be primary, secondary, and concomitant. The latter type proceeds along with other pathologies.

Causes of the disease

The chronic form of pancreatitis develops under the influence of the following factors:

  1. Alcohol consumption.
  2. Diseases of the biliary system. This includes dyskinesia, cholecystitis.
  3. Improper nutrition. The development of chronic cholecystitis is observed if there is not enough fat and protein in the diet.
  4. Hereditary factor. If there is a congenital metabolic disorder of part of the amino acids, then family pancreatitis is observed.
  5. The effect of toxins and drugs on the pancreas.
  6. An abnormal increase in the amount of fat in the blood.
  7. Prolonged hypercalcemia.
  8. Infectious diseases.
  9. Mechanical damage to the pancreas.

Strong pain

The most pronounced sign of the disease remains a strong pain cider. Moreover, it is both blunt and cutting in nature. If time does not reduce the severity of pain, then there will be a pain shock.

The concentration of pain is observed under the spoon, on the left or right side of the hypochondrium. If there is extensive inflammation of the organ, then the pain becomes girdling.

Non-medication

As soon as the patient is admitted to the hospital, he is prescribed gastric lavage. This is a necessary measure, due to which the production of digestive enzymes by the affected organ is reduced. You can also apply live ice to your stomach to reduce pancreatic activity.

It is possible to reduce the load on the affected organ by fasting. Its duration varies depending on the condition of the patient. Most often, fasting lasts 1-2 days. In severe exacerbations, the patient will be on a zero diet for 7 days or more. Then food is introduced to him through a probe or nutrient solutions are applied into a vein.

When it was possible to reduce the severity of symptoms, and the pancreas is restored, the patient is prescribed a diet. She suggests:

  • rejection of very acidic and salty foods,
  • giving up alcohol
  • the prohibition of fatty foods,
  • limited consumption of animal products,
  • diet should be based on plant foods,
  • you need to eat fractionally up to 7 times a day,
  • it is worth eating dishes of a uniform consistency.

Pain reduction

The first step in exacerbating chronic pancreatitis is to stop the pain syndrome. In this case, such drugs can be prescribed:

  1. Antispasmodics - Drotaverinum, Platifillin.
  2. NSAIDs - Paracetamol,
  3. Narcotic painkillers - Tramadol, Promedol. They are prescribed for the ineffectiveness of NSAIDs.
  4. A large dosage of pancreatin - Creon, Pangrol.

It is possible to stop the pain within a couple of days from the moment of exacerbation. Then the doctor cancels the administration of analgesics.

Elimination of infection

When digestive enzymes enter the bloodstream, severe intoxication occurs. In this case, detoxification therapy will be introduced into the treatment regimen. It involves the introduction into the vein of colloidal and crystalline solutions.

They can also use the method of formed diuresis. Its essence is that diuretics are used. These include Furosemide or Torasemide. It should be borne in mind that they are able to remove potassium from the body. In order not to provoke muscle cramps and malfunctions of the heart, potassium chloride must be included in the treatment regimen.

Antibiotics

With exacerbation of chronic pancreatitis, there is a threat of bacterial infection. In this case, the doctor may prescribe broad-based antibiotics. Infectious complications often have severe complications for the patient. So empirical antibiotic therapy in this case is considered justified. Then they can prescribe antibiotics from the group of fluoroquinols and cephalosporins. Very rarely used carbapenems.

Drug treatment

The essence of drug therapy of chronic pancreatitis is the use of the following drugs:

  1. Cholinergic and antispasmodic drugs. These include Atropine, Platifillin, No-shpu and Papaverin. Use in a medium dosage inside and under the skin to reduce pain.
  2. Antacids. This group should include Almagel, Phosphalugel and other liquid alkaline mixtures. Antacids today can be produced in various forms, but it is preferable to choose gels or suspensions. The fact is that they are distributed over a larger surface of the esophagus and stomach, enhancing the neutralizing and absorbing ability.
  3. Antibiotics. Ampioks, Fetsobid, Aksetin, Zinacef, Doxycycline are prescribed. Thanks to antibiotics, it is possible to prevent the attachment of a bacterial infection and the occurrence of serious complications. If, with a pronounced form of pancreatitis, antibiotic therapy did not have the desired effect, then this indicates the presence of chlamydia. Then the treatment will include Sumamed or Abactal.

Folk methods

To use unconventional methods of treatment for chronic pancreatitis is to alleviate the general symptoms. You can get the maximum effectiveness from therapy only if the alternative methods are combined with the medication. The following recipes are considered effective:

  1. Kissel from sprouted oats. It can be used in the chronic form of the disease and its concomitant cholecystitis. It is necessary to rinse oat grains, soak and set in a warm place for several days. Grind the sprouted grains, add water and set on the stove. To languish for several minutes. Filter the resulting drink, wait 20 minutes, and then drink it, but only freshly brewed.
  2. Tincture of calendula. This remedy should be used by those patients in whom chronic pancreatitis is accompanied by acute pain. It is enough to consume 10 ml of this drug per day.
  3. Tincture of Echinacea. It should be taken to prevent attacks. The required dosage is 10 ml per day.
  4. Barberry root This tool effectively copes with pain. You need to take 100 g of finely chopped barberry root, pour it with 1 liter of vodka and wait a few weeks. With its use, it is possible not only to stop the pain, but also to prevent its further appearance.
  5. Leaves of high ash. Take the leaves and grind into powder. Add boiling water and wait 30 minutes. Filtered broth take 20 ml per day.
  6. A decoction of burdock. This remedy is very effective in the treatment of chronic pancreatitis. It is necessary to take raw materials in an amount of 40 g, add 1 liter of boiling water. Insist 3 hours in an enameled container. Then send to the fire, simmer for 10 minutes. Filter and take 100 ml once a day.
  7. Calamus root. This plant improves the general condition in chronic pancreatitis. You need to take 20 g of raw materials, finely ground, add 200 ml of boiling water. Cool, filter and take 10 ml 3 times a day. Drink broth centaury.
  8. Barberry bark. It is necessary to grind it, take in the amount of 20 g and pour 200 ml of boiling water. Simmer on fire for 15 minutes. Wait until it cools down, and then consume 20 ml 3 times a day.
  9. Chicory root. Take it in an amount of 20 g, chop finely, add 200 ml of boiling water. Simmer on fire for 5-6 minutes, then cool, filter and take throughout the day in small sips.

Using these folk remedies, you must first condemn everything with your doctor. In the case of self-administration of alternative medicines, various side effects may occur, including allergies.

Diagnostic Methods

There are over 85 laboratory tests to detect chronic pancreatitis.Basically, they reveal an already running pathology. Diagnostic error happens often and this is due to the fact that the pathology is multisymptomatic with the phase nature of the clinical picture. Therefore, a comprehensive examination consisting of:

  • general clinical blood test, which will show the presence of inflammation in white blood cells, ESR, etc.,
  • a biochemical blood test that establish the level of enzymes in the body,
  • urine tests showing amylase levels,
  • studies of stool for undigested fiber,
  • Ultrasound
  • gastroscopy
  • X-ray
  • endoscopic retrograde cholangiopancreatography,
  • functional tests after glucose loads to drugs.

Important! A number of tests are not suitable for chronic pancreatitis during pregnancy.

Depending on the severity of the attack, chronic pancreatitis can be treated in a hospital or on an outpatient basis. The heavier the case, the greater the chance that it will be inpatient therapy. Extract is possible only after the onset of complete remission.

Conservative

It is built on:

  1. Diet therapy, which in the early days of exacerbation of chronic pathology implies a complete rejection of food, and after a gradual transition to dietary table No. 5B. You can not drink alcohol and eat all the food that can aggravate inflammation. If the pathology is complicated by diabetes, then you need to refuse or minimize the use of sugar and its derivatives.
  2. Similar therapy as in the acute form of pathology: elimination of symptoms, pain medication, elimination of toxins, drugs for inflammation and enzymes.
  3. A complete rejection of alcohol if it caused a pathology.

Surgical

Such therapy is indicated for:

  • complicated form, which is accompanied by obstructive jaundice,
  • acute pains that do not reduce any drugs and methods,
  • cyst.

Surgical intervention for chronic pancreatitis is carried out:

  • sphincterotomy, when the sphincter of Oddi is clogged,
  • removal of stones in the ducts of an organ,
  • sanitation and opening of foci with pus with an abscess, cyst or phlegmon,
  • full or partial pancreatomy,
  • removal of nerves responsible for secretion,
  • resection of the stomach, gall bladder,
  • conducting circulating ducts.

To improve the excretion of bile

Relapse of pancreatic and gallbladder inflammation can be prevented using the following herbal preparations:

  1. Maggot, St. John's wort, violet, corn stigmas, dandelion root, fennel, coriander, taken in equal parts. For a liter of pure boiling water you need only 4 tbsp. l collection. Infusion is taken in a glass four times a day.
  2. Peppermint tea with an extract of corn stigmas, which are mixed in equal parts and brewed in a teaspoon in a glass of boiling water. Take every time before eating.

For pain relief

In phytoreceptions, the role of excellent painkillers and anti-inflammatory drugs lies on decoctions of:

  • hypericum and dandelion root,
  • leaves of a three-leafed and dried immortelle sandy watch.

Brew charges for 2 tbsp. l half a liter of boiling water. Take 150-200 ml 3 times a day. Before taking these decoctions, you need to consult a specialist to determine if there is an allergy.

If an allergic reaction occurs in chronic pancreatitis, then this is a serious health risk. Such a tandem can end in shock, which often leads to a coma or death of the patient.

Exacerbation of chronic pancreatitis

If untreated, the prognosis for the patient will be disappointing. The exacerbation phase most often occurs when the patient ceases to adhere to a diet and eats food prohibited for him or drinks alcohol.

It all starts with severe pain in the peritoneum, which may be sharp, sharp or dull. This usually occurs half an hour after eating. There are cases when the pain came within 1-5 hours after eating, causing spasm and pressure, leading to swelling of the organ.

In addition to this, the clinical picture begins characteristic of the pathology from nausea to toilet problems. Frequent loose stools - a signal of failure in the pancreas.

The Importance of Diet

Who, faced with pancreatitis in any form, knows what he can eat and what not. Failure to comply with the diet threatens to complications and deterioration of the pancreas and the whole organism. Pancreatic necrosis is the most dangerous in this case, and it is already diagnosed by a pathologist, since they do not live long with this pathology. Therefore, build your diet on:

  • rejection of prohibited products,
  • physiology of the right diet,
  • timeliness of food intake,
  • fractional nutrition
  • refusal to overeat.

Consequences of the disease

The most dangerous and main consequences of chronic pancreatitis are:

  • peritonitis,
  • purulent cholangitis,
  • infectious lesion
  • bleeding,
  • cholestasis
  • blood clot in the veins
  • crisis
  • crayfish,
  • diabetes.

Is a full recovery possible?

There are ailments that cannot be completely eliminated. And this is not due to the fact that the doctor lacks qualifications or for other factors. These are the specifics of the pathologies themselves, and chronic pancreatitis refers to such diseases. However, you do not need to be upset, because you can stop the pathology and live without attacks.

To do this, you will have to make serious adjustments to life and nutrition will be in the first place. Following medical recommendations, it will be possible to live for many years without bouts of chronic pancreatitis.

The main difficulties are that it is extremely difficult to resist the stereotypes imposed by advertising and some life positions. When a person advertises fried chicken wings of fast food or an elementary lack of time for proper nutrition, it is difficult to resist.

A snack with chips, shawarma and other tasty, but not healthy products will end in a relapse of the pathology. And the feasts accepted in our country for holidays with alcohol are not only stress for the whole organism, but also a serious blow to the pancreas.

Preventive measures

To minimize the complications of chronic pancreatitis and the severity of the pathology itself, a consultation with an endocrinologist is needed, who will prescribe therapy and give recommendations on measures that improve the patient's condition. Prevention of chronic pancreatitis is based on:

  • balanced and fractional nutrition,
  • refusal of alcoholic beverages,
  • physical activity.

Do not ignore the last point. Sport in moderate amounts forms immunity, makes the body stronger, which means it is easier for him to resist various pathologies. Even if chronic pancreatitis has arisen, it will be easier for the doctor to cure the patient, because his body is healthier and stronger, which makes therapy more effective.

Watch the video: Easing the Pain of Chronic Pancreatitis (November 2019).

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