Diagnosis and treatment of pancreatitis


Health And Medical Video: Acute Pancreatitis - Causes, Symptoms, Diagnosis, Treatment, Pathology (August 2018).



Pancreatitis is a serious illness in which pancreatic inflammation occurs, and is affected by its own enzymes.

A pancreatic gland is called a long gland that is under the stomach and which covers the duodenum. It produces special enzymes that help the process of digestion of carbohydrates, proteins and fats in the intestines. Pancreas hormones, such as insulin, are regulators of glucose, and the disorder of the function of the gland is manifested in a chronic and acute form.

During acute pancreatitis, the whole gland or part of it is inflamed. It can also be manifested in the form of decay of the tissues of the pancreas, which can cause festering, abscess formation and hemorrhage.

Acute cholecystitis in combination with pancreatitis is called cholecystopancreatitis.

During chronic pancreatitis, there is a process of inflammation of the pancreas. The process of inflammation is alternating: it subsides, then it occurs again. The inflammatory process leads to atrophy, glandular calcification and fibrosis, and normal tissues, from which the pancreas forms, eventually turn into scarring.

Modern medicine distinguishes two types of chronic pancreatitis: primary, secondary, which is also called concomitant.

During the primary form of chronic pancreatitis, the process of inflammation is localized in the gland itself. Secondary pancreatitis begins to develop against the background of other diseases of the digestive system, such as stomach ulcer, gastroenterocolitis and others.

Aggravation of diseases of the stomach, intestines, liver and gall bladder provoke an attack of acute pancreatitis, which in this case is called reactive pancreatitis.

The outflow of bile, consumption of abundant meat and fatty foods, the use of alcohol, stress and hereditary predisposition - all this can be the cause of pancreatitis.

Pain distress in the back at the level of the upper abdomen, accompanied by attacks of pancreatitis. Basically, they arise after eating and can last for several hours, and sometimes for a few days. Attacks are also accompanied by nausea and vomiting, jaundice, weight loss. If the attack lasts for a long time, the disease manifests itself in abundant chairs and weight loss.

An attack on pancreatitis requires the intervention of doctors, as it can lead to various complications, for example: pancreatic necrosis. Digestive enzymes that produce the gland are inactive until they enter the small intestine to ease the process of digestion. But in the case of pancreatitis, they are activated already in the very pancreas and begin to corrode its tissue.

Most often, pancreatitis occurs in men who are prone to overeating and consuming a large amount of alcohol, as well as in pregnant women and those who are in the early postpartum period.

This disease is equally dangerous for all ages.

Causes of pancreatitis

Below are the most common causes of pancreatitis:

  • Alcohol intoxication, alcohol abuse and chronic alcoholism;
  • Injuries in the abdomen;
  • Connective tissue disease;
  • Diseases of the gall bladder and biliary tract, as well as biliary outflow disorders;
  • Diseases of the duodenum;
  • Infectious diseases transmitted;
  • Cardiovascular diseases;
  • Non-compliance with the prescribed diet;
  • heredity;
  • Taking antibiotics, sulfanilamides, indirect anticoagulants, indometacin, brufen, paracetamol, estrogens;
  • diabetes;
  • Cirrhosis;
  • Postponed endoscopic manipulation and surgery;
  • Allergies;
  • Parasitic diseases.

Acute pancreatitis can cross into the chronic form of the disease. Ulcerative colitis, hemochromatosis, atherosclerosis, as well as liver and thyroid disease can also be the cause of pancreatitis.

Symptoms of pancreatitis

The main symptoms of pancreatitis are:

  • Pain attacks in the upper abdomen or left hypochondrium, which often occur after eating;
  • Swelling of the stomach and flatulence;
  • Weight loss;
  • Whitish plaque on the tongue;
  • Skin flaccidity;
  • Symptoms of hypovitaminosis, which can manifest in the form of cracks in the corners of the mouth, dryness and peeling of the skin, fragility of hair and nails. Formation of "ruby droplets" on the skin in the region of the chest and abdomen;
  • Nausea and vomiting;

It should be noted that not always listed above symptoms of pancreatitis are combined with each other.

Diagnosis of pancreatitis

Diagnosis of pancreatitis includes blood tests, feces analysis, including the presence of dysbiosis, coprogram.

The coprogram allows you to find out about the ability of digestion of proteins, fats and carbohydrates in the gastrointestinal tract, since inadequate digestion of substances can be found in patients with pathology of the liver, pancreas and biliary tract.

In addition to the tests, ultrasound examination of the liver, gall bladder and bile ducts should be performed. It is also recommended to carry out a computer tomography of organs located in the abdominal cavity.

Consequences of pancreatitis

Usually, the onset of acute pancreatitis occurs suddenly and lasts a rather short time. Toxins that arise during the inflammation of the pancreas can get into the bloodstream and damage other organs such as the liver, heart and lungs. The appearance of hemorrhages in the gland can lead to a fatal case.

By itself, chronic pancreatitis is not cured and slowly destroys the pancreas.

Chronic pancreatitis may have the following complications:

  • Infectious seals in the gland;
  • Inflammation of the duct of the pancreas and bile ducts, often accompanied by pus;
  • Erosion in the esophagus;
  • Stomach and intestine ulcer;
  • The appearance of malignant tumors in the pancreas;
  • Lowering the level of sugar in the blood, also called hypoglycemia;
  • The emergence of false cysts in the pancreas;
  • Fistulas that appear in the abdominal cavity in the pancreas;
  • sepsis;
  • Neuropsychiatric disorders.

In addition, chronic pancreatitis is able to change the shape of the pancreas in such a way that it begins to press into the 12th-rectum, and this fact can cause its obstruction and surgical intervention will be necessary.

Treatment of acute and chronic pancreatitis

Treatment of acute pancreatitis is usually carried out conservatively, with the help of drugs. During therapy they eliminate pain, purify blood, prescribe a diet and carry out treatment.

As a result of a severe diet, the pancreas receives the necessary calm. Currently only drinking water is allowed. Nutrient substances in the body come from nutrient solutions that are administered intravenously within 3-6 days, after which the patient can be given a small amount of liquid food.

Due to infusion therapy, a large volume of solutions that dilute blood and reduce the concentration of enzymes synthesized in the pancreas are poured into the interior. Among such preparations - contrikal, raszilol and others.

Symptomatic treatment includes taking anti-vomiting drugs, eliminating heart failure, raising blood levels of calcium, etc.

For prevention, antibiotics are sometimes prescribed so that the damaged organs are not infected. If a week after the conservative treatment began, the patient will not get better, carry out laparotomy - an operation in the abdominal cavity, during which dead cells of the pancreas are removed.

Without complications on the lungs and kidneys, acute pancreatitis passes easily. If you have breathing problems, hypoxia, then prescribe forced ventilation of the lungs. If refusals of the kidneys, a person cleans blood artificially (hemodialysis).

If the patient has chronic pancreatitis, then they eliminate pain, prescribe a diet, correct the functioning of the pancreas.

If there is an exacerbation of chronic pancreatitis, the patient is placed under the supervision of a doctor, usually in a hospital.

Patient with chronic pancreatitis should not eat roasted, pepper, salty, greasy, eat white bread, mushroom soups, smoked meat, coffee, chocolate, alcohol and carbonated drinks.

The menu can include porridges, cooked vegetables, macaroni, low-fat fish and meat, vegetable soups, tea and fruits. In chronic pancreatitis, fractional nutrition is prescribed, up to 6 times a day, but in small portions.

The diet weakens the pain, but if it is not enough, prescribe painkillers: diclofenac, aspirin, which reduce pain and inflammation.

If the pain is severe, prescribe a special drug octreotide, which is used to treat chronic pancreatitis. Medications suppress the synthesis of hormones that stimulate the pancreas.

In the chronic form of pancreatitis, instead of normal tissues, scarring is formed, which results in the loss of the pancreas of its usual function.

Patients should receive enzymes such as mesim, festal, pancreatin, and others to adjust the digestion that accompanies chronic pancreatitis and to reduce the pain due to stress on the pancreas.

If pancreatitis is accompanied by diabetes, the patient should consult an endocrinologist and receive a treatment regimen.

Operations in chronic pancreatitis are usually not carried out, but if the pain is expressed and the medication does not help, use sphincteromy - surgical intervention, when they dissect and extend the outflow opening in the pancreas duct.

In some equipped clinics and sanatoria, additional treatment for pancreatitis is carried out with the help of a magnetic field.

Popular methods of treating pancreatitis

The method of treatment of pancreatitis by folk methods consists of diet, gymnastics and the use of medicinal herbs. Medicinal plants can be used in combination with other drugs, after consulting with a specialist.

It should be remembered that the treatment of pancreatitis should be started immediately. Timely treatment increases the likelihood of restoring function and structure of the pancreas. Therapies are strictly individual for each patient.

Prevention of pancreatitis

The main measures of prevention of pancreatitis are healthy and high-grade nutrition, as well as timely treatment of diseases of the stomach and intestinal tract. Minimizing the use of alcohol and consuming fat and abundant food will minimize the risk of pancreatitis. In addition, it is desirable to give up smoking.

Gymnastics exercises with pancreatitis

When pancreatitis, it is recommended to perform respiratory gymnastics, which gives the effect of massage of the internal organs. Performance of gymnastic exercises is recommended two - three times a day, in positions sitting, lying or standing.

Start exercising can be from a small number (3-4) repetitions per day, bring them gradually up to 9 times a day. Gymnastics should be performed after an attack on pancreatitis.

Exercise 1 Inhalation, exhalation, respiratory depression. Smoothly, but at the same time, strongly pull in a stomach, count up to 3, then relax the muscles of the press.

Exercise 2 Inhalation, exhalation, respiratory depression. During a pause, stomach inflate as much as possible and count up to three. Relax with exhalation.

Exercise 3 Smash halfway and hold your breath for a few seconds, then continue to sigh, directing air into the abdomen and pulling out the abdominal cavity. After blowing up the abdomen, at the end of breath hold your breath and count up to 3. Then pull the abdominal wall and count to 6. At the end of the exercise exhale and relax the abdominal muscles.

Exercise 4 Exhale strongly pull the stomach. Hold your breath for a couple of seconds, then relax the muscles of the abdominal cavity. Strongly inflate the stomach on the inhalation and pull it out when exhaling.

Diagnosis and treatment of pancreatitis

Category Of Medical Issues: Diseases