Pancreatitis - Causes, Symptoms and Treatment .MF .
Pancreatitis - a progressive disease of the pancreas, which is based on an inflammatory process leading to damage and changes in the external and endocrine functions, leading to serious metabolic disorders.
1 - esophagus;
2 - stomach;
3 - the duodenum;
4 - small intestine;
5 - colon;
6 - liver;
7 - the gall bladder;
8 - spleen;
9 - pancreas
pancreas - an organ of the digestive system, which provides an efficient process of digestion and the regulation of carbohydrate metabolism in the body.It produces pancreatic juice (exocrine function) and synthesizes hormones (endocrine function), in particular, insulin - the main hormone responsible for the maintenance of normal blood glucose levels.pancreatic juice contains a unique set of enzymes (protease, lipase, amylase) - substances that cleave basic food components: proteins, fats and carbohydrates.The hormone insulin regulates carbohydrate metabolism.Due pancreatic provided as the normal digestion and absorption of food and nutrition of tiss
frequency pancreatitis and other pancreatic disease is increasing worldwide.Primarily this is due to poor diet, alcohol abuse, environmental degradation.There are acute and chronic pancreatitis.
main causes of pancreatitis:
- alcohol abuse;
- constant use of large amounts of fatty, fried, smoked, spicy food;
- pathology of the hepatobiliary system (cholelithiasis, cholecystitis, hepatitis);
- diseases of the stomach and duodenum (peptic ulcer, gastritis, tumors);
- viral infections (mumps, hepatitis B);
- endocrine disorders (hyperparathyroidism);
- pancreatic trauma, including surgery;
- severe food allergy;
- medication (tetracyclines, sulfonamides, cytostatics);
- cystic fibrosis;
- hereditary pancreatitis.
Chronic pancreatitis may occur even for a number of reasons for this in the article "Chronic pancreatitis."
symptoms of pancreatitis.
Constipation, bloating, indigestion, heaviness after eating, stomach discomfort - this is the first bells in which you must pay attention to the stomach and pancreas.
Symptoms of acute pancreatitis
Acute pancreatitis is an infringement of the free outflow of pancreatic juice, leading to self-digestion gland own enzymes.This disease is characterized by a sharp pain.The pain of acute pancreatitis occur in the left side of the abdomen, after a while gets shingles character, accompanied by nausea, vomiting.As a result of intoxication, dehydration (frequent vomiting) patients condition can quickly become severe: falling blood pressure, impaired consciousness.May develop collapse and shock.This disease is considered to be urgent conditions in surgery, and it requires urgent inspection of the surgeon and the hospital in the surgical hospital.
detailed symptoms of acute pancreatitis & gt; & gt;
At the same time easy to fit the patient can "endure", which, of course, should not be done, because without treatment it can go in chronic pancreatitis, and it is incurable.
Symptoms of chronic pancreatitis
During chronic pancreatitis distinguish two periods: the initial period and expressed pancreatic damage.In the initial stage (lasts about 10 years), the main symptom of pain appears.The pain is localized mainly in the upper and middle part of the abdomen, the left half of the chest, around the heart (such as coronary heart disease) in the left lumbar region (reminiscent of renal colic), can be spread on the circumference of the body, to be encircling, decrease in the sitting position, withtorso forward, often occurs in 15-20 minutes after eating.The attack in a patient with chronic pancreatitis is classified as acute pancreatitis.
provoke excessive pain, fatty, fried, smoked food, intake of alcoholic and carbonated beverages, chocolate, coffee, cocoa.The pain of pancreatitis is accompanied by dyspeptic symptoms - prolonged nausea, vomiting, not bringing relief, bloating, loose stools.Dyspeptic symptoms occur not always have a companion character, easily stoped in the treatment.Pancreatic exocrine function usually remains intact.
With long-term existence of chronic pancreatitis occurs restructuring pancreatic tissue, decreases its ability to produce enzymes and hormones, formed secretory failure.Pains become less pronounced, and more likely to be absent.The clinical picture is dominated dyspeptic syndrome develop exocrine pancreatic insufficiency, malabsorption syndromes, and manifesting maldigestion.
maldigestion - a violation of the digestion of food to the required suction components. malabsorption - a violation of the suction mechanism in the small intestine.The main symptom is a mushy stools 2-3 times a day or more, the "big pancreatic chair" (profuse, fetid, greasy).Characteristically bloating resulting gas accumulation in the intestine.There is a loss of body weight.There are signs of hypovitaminosis: reduced vision in the twilight, pigmentation disorders (lack of vitamin A), bleeding gums (lack of vitamins K and C), conjunctivitis, stomatitis, itchy skin (lack of B vitamins), anemia (vitamin deficiencies of B12 and folic acid).Violation of calcium intake leads to cramps, pain in the bones (osteoporosis).Develops endocrine pancreatic insufficiency.There are episodes of hypoglycemia (low blood sugar level) with characteristic weakness, nervous and mental excitement, cold sweat, trembling in the body.Later pancreatogenic developing diabetes.There dryness, thirst.
One of the most common combination in the practice of the gastroenterologist is a combination of chronic pancreatitis, and gastroesophageal reflux disease (GERD), and it also puts their symptoms, often the combination takes place against the background of obesity.
First aid in cases of suspected acute pancreatitis
If you suspect an attack of pancreatitis as first aid - rest, sitting position with pressed to his chest knees, strict fasting with taking a quarter cup of water every 30 minutes - an hour, on the area of the pancreas from theback to put an ice pack.Pverhnostnoe breathing will help alleviate the attack.
Painkillers and anti-inflammatory drugs should not be taken, it is much more difficult diagnosis.Enzyme preparations also contraindicated.To facilitate the patient's condition will 0.8mg but shpy or Drotaverinum hydrochloride in a similar dosage, if possible better to intramuscular injection of papaverine solution 2 ml, can be replaced by a drug solution but shpy.And nitroglycerin under the tongue, well, maybe it does not pancreatitis and myocardial infarction.
diagnosis of pancreatitis.
When abdominal pain is required to call a doctor.Acute pancreatitis can be confused with other life-threatening diseases, and he himself in severe deadly.
instrumental confirmation of pathological changes in the pancreas:
1. Transabdominal ultrasonography (US).Defines the increase in pancreas size, calcifications in tissues, blurred and uneven contours, heterogeneity of structure, change of echogenicity, presence of cysts, duct expansion.The sensitivity of ultrasonography in the diagnosis of pancreatitis is 80-85%.Therefore, in all cases sonografichnyh changes should be compared with laboratory data, as ultrasound results are not sufficiently specific.
2. Computed tomography (CT) and magnetic resonance imaging (MRI) - reveal an increase in the pancreas reveal calcification, pseudocyst, determines the expansion ducts, detected lesions adjacent organs, malignant neoplasm.
3. ERPHPG - endoscopic retrograde cholangiopancreatography.He currently plays a leading role in the diagnosis of pancreatitis.The sensitivity of this method is 93 to 100%.
Laboratory diagnosis of pancreatitis.
1. Determination of fecal pancreatic elastase-1.This method is defined only by the human elastase, so the test results are not influenced by conducting enzymatic replacement therapy.Is the "gold standard" for diagnosis of chronic pancreatitis.
2. Complete blood count - there are signs of inflammation, anemia.
3. Alpha - amylase of blood and urine - increased during exacerbations.But the sensitivity of the test does not exceed 30%.
4. The level of sugar in the blood - for detection of diabetes.
5. Urinalysis - to rule out kidney disease.
6. ECG and echocardiography - to avoid heart disease.
in the diagnosis of pancreatitis leading role belongs to the expert - to the doctor or therapist gastroenterologist.Only they are able to select the diagnostic methods, their sequence of each individual patient to quickly, accurately and cost-effectively establish the correct diagnosis.
1. Gastroenterology, for a choice of tactics of treatment.
2. surgery, duration of the current pain syndrome, the development of complications.
3. endocrinology, with the development of diabetes.
4. cardiologist, to eliminate the disease of the cardiovascular system.
treatment of pancreatitis.
The causes of pancreatitis are varied and in some cases with their elimination decreases and symptoms of inflammation.
necessary to refuse alcohol consumption, a diet low in animal fat, eliminate medication that may have a damaging effect on the pancreas, it is extremely important to treat diseases of the gastrointestinal tract, food allergy.
main goal of treatment is to eliminate pain, correction of pancreatic function, prevention and treatment of complications.
To eliminate the pain using non-narcotic and narcotic analgesics.analgesic dose chooses doctor, starting with the lowest effective dose.Apply myotropic antispasmodics (mebeverin, no-spa, spazmolgon).
For pain relief is used pancreatic enzymes with sufficient lipase, at least 10 000 thousand. Units.(Creon panzinorm) in combination with proton pump inhibitors (PPIs - omeprazole, pantoprazole, rabeprazole, esomeprazole) both to protect enzymes from degradation by gastric fluid, and for creating pancreatic physiological dormancy.These drugs show only a moderate exacerbations of chronic pancreatitis.The choice of drug, its dosage, dosing frequency carries only the doctor.
In the absence of effect of conservative treatment is carried out rapid disease correction.Surgical treatment helps prolong the life of these patients and improve their quality.
Read more about the treatment of acute pancreatitis & gt; & gt;
polyenzyme replacement therapy is the development of exocrine insufficiency.The indications for its implementation is the progressive loss of body weight, persistent diarrheal (loose stools) syndrome.Its purpose is to provide sufficient lipase activity in the duodenum.When properly chosen dose of the enzyme preparation patient noted an increase in body weight, stool normalization, reducing the symptoms of pain, bloating.Application
polifermentativnyh pancreatin preparations, especially in conventional dosages and enzyme preparations of plant origin is practically useless.Polifermentativnaya therapy is prescribed depending on the level of exocrine insufficiency, according to the elastase test.With the development of diabetes pancreatogenic - dieting and supervision of the endocrinologist.Select the desired treatment regimen can only be a specialist - a gastroenterologist or internist doctor, using an individual approach to each case.
pretty well-proven treatment for chronic pancreatitis by means of herbal medicine.About herbs and fees for treatment, as well as how to make and accept what dozirokami article Treatment of Pancreatitis herbs & gt; & gt;
Diet for pancreatitis.
In acute pancreatitis food intake is contraindicated until further notice of your doctor.
basic principle of diet therapy in the recovery period, and in chronic pancreatitis - consumption of food, sparing the stomach, pancreas and liver.
During exacerbation of chronic pancreatitis, in the first 1-2 days appoint hunger.Allow only 1.0-1.5 liters of fluid intake per day (200ml 5-6 times a day).This alkaline mineral water without gas at room temperature, broth hips (1-2 glasses), weak tea.With the improvement of the general condition of the patient is transferred to the first limited and then on good nutrition.When expanding diet strictly observed gradual principle as regards the amount and caloric intake, and with respect to the inclusion of certain foods and food products.There should be slowly, chewing food thoroughly, 5 times a day.Modern approaches to diet therapy does not provide for exceptions to the diet of any products.Exclusion or significant limitation (especially during an exacerbation) Individual intolerance of products and foods that cause the deterioration of the disease.
|Category food||Products unfavorable for patients with chronic pancreatitis|
|Bakery||Fresh bread, pastry products pastry, fried pies, pancakes, pizza|
|Cereals, porridge||Millet, barley, barley, corn cereals, legumes|
|meat, meat products||Fatty meats: lamb, pork, duck meat products;sausage, canned food.|
|Soups||fatty broths and soups, borscht, prepared on the basis of their|
|Sauces and condiments||tomato gravy and sauces, frying.|
|Fats||margarine, chicken, goose, mutton, pork fat.|
|Drinks||Strong tea and coffee, juices (orange, grapefruit, apple, grape, pomegranate), carbonated drinks, alcohol.|
Patients in remission encouraged to adhere to work and rest.Prohibited smoking and drinking.Spa treatment - only when stable remission, and the absence of symptoms.Showing spa resorts with hydrocarbonate waters of small and medium mineralization.It Essentuki, Truskavets, Morshyn, Zheleznovodsk, Borjomi.It is necessary to carefully treat and physiotherapy, to hold them only when stable remission.
In acute pancreatitis temporary disability is often delayed.It depends not only on the patient's state of health, how much of the total disappearance of local pathological (palpable, sonographic, and others.) And laboratory symptoms.In some cases, a subsequent temporary or permanent employment on the WCC line.Contraindicated work associated with significant physical stress, the body shaking, traumatization of the abdomen, the contact with poisons, and the work that prevents compliance with the dietary regime.
In severe, chronic, form of acute pancreatitis without surgery there is long-term disability, leading to disability group II or III.
complications of pancreatitis:
2. Pancreatic cancer.
3. Mechanical jaundice.
4. Pancreatic coma.
5. Cysts and pseudocysts of the pancreas.
6. pancreatic abscess.
7. Reactive hepatitis.
8. Jet pleurisy.