Pancreatitis: Symptoms, treatment, diet. Than to treat pancreatitis

Pancreatitis - a name of a group of diseases and symptoms in which there is inflammation of the pancreas. If such a process is shown, the enzymes produced by the pancreas, are not subject to the duodenum. Consequently, they are beginning to act is in the pancreas gradually destroying her.

Thus, there is a so-called self-digestion process. Such pathology is fraught with subsequent infection of other organs, since by gradual destruction of the pancreas is released toxins and enzymes. In turn, they may be in the bloodstream and damage other organs. Therefore acute pancreatitis be treated immediately after diagnosis. With this condition, the treatment is carried out mainly in the hospital.

What it is?

Pancreatitis - a group of diseases and syndromes in which there is inflammation of the pancreas.

When inflammation of the pancreatic enzymes secreted by the gland is not released into the duodenum and activated in the most gland and begin to destroy its (self-digestion). Enzymes and toxins that at the same time stand out, is often discharged into the bloodstream and can seriously damage other organs such as the brain, lungs, heart, kidneys and liver.

Causes of

The main causes of acute pancreatitis:

• Genetic predisposition.
• Alcoholism and alcohol abuse (70%).
• Cholelithiasis.
• Autoimmune problems (when the immune system attacks its own cells)
• vermin, such as roundwormCan also cause blockage of the pancreas.
• Blockage of the pancreatic duct or the common bile duct e.g. gallstone.
• Damage and pancreatic ducts during operation.
• complications cystic Fibrosis.
• Kawasaki disease.
• Reye's syndrome.
• Hemolytic uremic syndrome.
• Hyperparathyroidism.
• High blood fats - triglycerides (hypertriglyceridemia).
• Violation of the pancreas circulation.
• The trauma of the pancreas in an accident.
• Viral infections, including mumps, mycoplasma, pneumoniaAnd Campylobacter, hepatitis C.
• Duodenal disease, small and large bowel, accompanied by constipation, such as peptic ulcer, Enteritis, colitis, Enterocolitis, diverticulitis.
• The use of some medications (especially estrogens, corticosteroids, thiazide diuretics, and azathioprine).

Chronic pancreatitis often develops in people who are aged 30 - 40 years and is most often caused by alcohol abuse for years, and men predominate over women. Repeated episodes of acute pancreatitis can lead to chronic pancreatitis. In some cases, genetics may be a factor in its development. 10-15 In cases of chronic pancreatitis, the cause is not known.

Other factors are also associated with chronic pancreatitis:

• Autoimmune problems;
• Using estrogens, corticosteroids, thiazide diuretics, and azathioprine;
• Blockage of the flow of the pancreas or common bile duct;
• Hypercalcemia - high levels of calcium in the blood;
• Hyperlipidemia or hypertriglyceridemia - high fat levels in the blood;
• Metabolic disorders, especially fat, associated with over-eating;
• Complications of cystic fibrosis, the most common hereditary disorder where the secrets that allocated to different bodies have very high viscosity and density.

Due to the chronic inflammation occurs scarring of the pancreas, the body becomes unable to produce the right amount of digestive enzymes. As a result, the body may not be able to digest fat, and other important components of the food. Damage to parts of the pancreas to produce insulin, may lead to diabetes.

symptoms of pancreatitis

Pain in acute pancreatitis (inflammation of the pancreas) are considered one of the most powerful. Sharp, acute pain occurs in the stomach, in the upper quadrant, in most cases extending to the shoulder blades, the back or behind the breastbone.

The main symptoms of acute pancreatitis in adults are listed below:

1. Painful sensations in the right or left hypochondria, also possible herpes character, depending on the degree of occurrence of inflammation and the affected area of ​​the pancreas;
2. Change the color of the skin: sallow complexion, bluish spots around the navel and on the back, jaundice due to sclerosing pancreatitis;
3. Deterioration of general well-being, a significant increase in body temperature, there is a weakness, malaise, blood pressure change in the upward or downward;
4. A feeling of dryness in the mouth, long concerned about the hiccups, belching rotten egg, nausea and repeated vomiting, not bringing relief to the patient;
5. Disorders stool as diarrhea or constipation;
6. Shortness of breath, excessive sweating.

Chronic pancreatitis has a non-aggressive shape for accompanied by reduction of appetite and body weight. The main symptoms of chronic pancreatitis:

1. Pain syndrome - is typical for this kind of fighting symptoms, usually after meals or alcoholic beverages, constant discomfort in the upper abdomen.
2. Asymptomatic (latent stage) - the disease can last for years slowly destroying the pancreas, the patient is almost It feels discomfort or it all comes down simple discomfort which give different simple reasons, such as overeating.
3. Psevdoopuholevy view - rarely found at all similar to the symptoms of cancer. Symptoms of pancreatic cancer - is the yellowness of the body and sclera eyes. Head of the pancreas is affected. It increases in size due to its replacement by fibrous tissue.
4. Expressed dyspeptic intestinal disorders (dyspepsia), diarrhea or constipation, bloating, weight loss unfounded.

Quite often, chronic pancreatitis, contributes to the development of diabetes. The manifestation of symptoms of the disease affects the percolation stage, as well as whether the patient took the treatment, compliance with the regulations on food intake, the patient's age and general physical condition.

objective symptoms

In pancreatitis has its objective symptoms:

• Symptom Musso George's - positive frenikus - a symptom of the left.
• Symptom Gubergrits-Skulsky - painful palpation of the line connecting the head and tail.
• Symptom Grotta - to the left of the navel in the pancreas projection defined hypotrophic change subcutaneous fat.
• Symptom Desjardins - determined tenderness in pankreticheskoy point Desjardins (projection head pancreas), located 4-6 cm from the navel on the line connecting the right axilla with navel.
• Symptom Tuzhilin - when viewed on the skin of the patient with chronic pancreatitis can be seen hemorrhagic lesions as droplets purple color up to 1-4 mm. This point angioma arising from proteolysis - destructive action on capillary pancreatic enzymes in the blood ejection process during exacerbation.
• Symptom Mayo-Robson - pain determined at Mayo-Robson, pancreatic tail projection, for between the middle and outer thirds of the line segment drawn through the stomach, and the arc edged left axilla left. In this pain can be determined in Mayo-Robson area left costal-vertebral angle.
• Symptom Chauffard - reveal tenderness in Chauffard area (projection head of the pancreas), located 5-6 cm above the navel to the right angle between the bisector and the umbilical midline body.
• Symptom Kacha - a symptom of pancreatitis, in which painful to palpation projection right transverse processes T1H-TH1 and left TVIII-TIX thoracic vertebrae.
• Symptom Resurrection - in the projection of the pancreas is not determined by the pulsation of the abdominal aorta.

Diagnostics

In order to identify the development of chronic pancreatitis should consult a doctor-gastroenterologist. Inspect, collect complaints, disease history analysis. On this basis, appointed by the conduct of diagnostic procedures:

• renting assays for determining blood levels of urine amylase and diastase;
• biochemistry and complete blood count;
• general urine analysis;
• Ultrasound of the pancreas - one of the leading methods of research that can help determine whether there are pathological changes of the pancreas;
• gastroscopy;
• radiography of the abdominal cavity;
• functional tests;
• endoscopic retrograde cholangiopancreatography.

If you have symptoms of acute pancreatitis requires urgent hospitalization of the patient and conduct examination and treatment in a hospital. The main objective: to stabilize the patient's condition, the relief of acute symptoms and eliminate the possibility of the development of pancreatic necrosis.

Treatment of acute pancreatitis

In acute pancreatitis must be treated in a hospital and under close supervision of specialists, such as the condition of the body is considered to be dangerous. If there is suspicion of an acute human pancreatitis need to be hospitalized as soon as possible.

If the attack of pancreatitis caught you at home, the following items are recommended actions to the ambulance:

1. The patient should be in bed and in complete peace. This will reduce the flow of blood to the patient body, and thus reduce inflammation.
2. On the epigastric region applied cold - it helps reduce the intensity of pain, a little remove swelling and inflammation. It is best if the ice will be used instead of heater filled with cold water.
3. It is forbidden to take any food. And should refrain from eating for 3 days. This must be done to stop the production of enzymes that enhance the inflammatory response and pain. You can drink water without gas and additives.
4. Permitted medications for self-acceptance - Drotaverinum, Spazmalgon, No-spa and maksigan. They can have a drink before the arrival of ambulance crews. Meanwhile, it is necessary to call a doctor, even if the patient is not sure that he had an attack of acute pancreatitis. Because this pathology is dangerous because at some time can calm down, and then promptly recur.
5. With the rapid development of disease apply surgical treatment of pancreatitis: removing a portion of pancreas, peritoneal lavage (rinsing of the abdominal cavity), etc.

The three main words in the treatment of patients with acute pancreatitis - a calm, cold and hunger. They are the rules of first aid in a fit.

After the hungry days of the week is assigned a diet №5p by Pevsner. Fractional power up to 8 times a day, no more than 300g portions. Food boiled, steamed, in a semi-liquid form, puree. The temperature of food - 20-52˚S. The daily amount of protein - 80 g, fats - 60g, carbohydrates - 280g.

Recommended: mucous porridges on water, crackers, soaked in tea, mashed potatoes, pumpkin, zucchini, carrots, jelly, pudding.

All other products and treatment options are excluded.

After achieving the positive dynamics and pain relief, prescribed diet advanced option for three months. The daily amount of nutrients: up to 120g protein, 70g fat, up to 400g of carbohydrates.

Recommended: lean meats and fish, birds, two eggs per day, sour cream, cottage cheese, oatmeal on the water, vegetables, jellies and compotes fruit, tea, broth hips, butter in the form of additives in ready meals up to 20g per day, oil - up to 15g day.

All of these products should be handled for a couple, baked or boiled.

Treatment of chronic pancreatitis

Chronic pancreatitis can be bright or mild symptoms. More often than not, at the time of exacerbation of chronic pancreatitis patient hospitalization and therapy, similar to the acute process.

The patient should be on a lifelong diet and take medications from the group of muscle relaxants and drugs, normalizing the secretory function of the organ. Especially useful twice a year undergo spa treatment in appropriate institutions of Stavropol edge (Kislovodsk, Zheleznovodsk, Pyatigorsk), wherein the treatment is carried out using the natural mineral water.

Diet

If exacerbation of chronic pancreatitis seriously enough and is accompanied by severe pain, persistent vomiting, significant changes in laboratory samples, the patients need hunger. Its duration depends on the particular clinical case, but usually is from 1 to 3 days. Sometimes in the "hungry" stage may be drinking a decoction of rose hips, alkaline mineral water, weak tea.

Then assigned a special low-calorie diet (2200 kcal) with normal quota protein. It is designed to maximize spare the pancreas and other digestive organs.

The features of this diet for pancreatitis include:

• prohibition of fatty foods (lamb, pork, cream, lard, etc.) and alcohol;
• fractionality food consumption (up to 6 times);
• restriction of salt;
• meals are exclusively in the form of heat;
• milling or wiping products used;
• wide application mucous cereal soup, vegetable soup, boiled mashed with added meat, souffles, omelettes protein, fish and meat quenelle, steam cutlets, meatballs, baked apples, vegetable purees, jelly, mousse, the dried white bread, fat-free yogurt, jelly;
• exclusion of all foods with a high content of extractives and essential oils (fish, meat broths, cocoa, coffee, etc.), fresh fruits, vegetables, herbs, fruits, fruit, acidic juices, carbonated beverages, marinades.

Provided clinical and laboratory improvement food expand, increasing its caloric content and quantity of proteins necessary for speedy recovery. Although the set of allowed products is very similar to the already mentioned diet, but the list of dishes on the menu is increased (resolution baking). If pancreatitis is associated with the development of diabetes, the forbidden food list add white porridge, potatoes, honey, sweets and cakes.

medication

When a diet is much less pain makes itself felt, but it's worth a little bit away from it, afford fatty or fried and all - need painkillers.

1. When intense pain doctor can be assigned antispasmodics - No-Spa, Drotaverinum that reduce inflammation in the pancreas and thus reduce pain.
2. To date, the doctor may also prescribe mebeverin (Duspatalin, Spareks) - antispasmodic, myotropic action eliminates gastrointestinal spasms.
3. You can assign a short course of antisecretory (omeprazole diakarb or a tablet for three days under the guise asparkama the edematous form).
4. Octreotide is also used, a drug that suppresses the hormone gland, because they stimulate it and thus cause pain. This medicine is prescribed only in hospitals.

With long-term course of chronic pancreatitis is a replacement of normal body cells by connective tissue. Thus, the functionality of the body is disturbed, can develop diabetes, and digestive problems. In order to reduce pain and to rest the pancreas, pancreatic enzymes should be taken:

1. Festal - it should drink 3 p / day 1 tablet during the meal, it is usually combined with histamine blockers to reduce the acidity in the stomach - famotidine, cimetidine.
2. "Pancreatin" ( "enzistal", "Gastenorm", "bios", "Mezim", "Mikrazim", "Pangrol", "Panzinorm", "Penzital", "Creon", "Ermital") - is pancreatic enzymes, which should be taken as the "Festal", the best alkaline mineral drink preparation water. They contribute to better break down proteins, carbohydrates and fats.
3. Speaking of enzymes, we must remember about their activity 10 000 units of lipase (mezim forte tablet) three times a day - a standard requirement for substitution therapy. The original mezim is not very pleasant smell, if the smell is not - it is a fake (crushed chalk).

In the presence of chronic pancreatitis symptoms may occur for a long time, respectively, reduced insulin levels, which can eventually lead to the development of diabetes. In the case of diagnosis of this disease the patient should consult an endocrinologist for the development of treatment regimens and diets coordination.

Physiotherapy

Physiotherapy after limited use for decreasing inflammation activity.

When intense pain appoint electrophoresis with novocaine or dalargin, ultrasound, diadynamic currents. To combat the inflammation of the remaining recommended laser and ultraviolet blood irradiation, an alternating magnetic field.

Folk remedies

To treat pancreatitis using these traditional medicines:

1. Gathering herbs. To prepare the collection is taken in a series of equal amounts, cudweed, horsetail, chamomile flowers and marigold, St. John's Wort, sage and tarragon. Herbs mixed and ground. Then the infusion was prepared (tablespoon is taken to collect glass boiled water for an hour, filtered). Infusion consumed three times a day, half a cup half an hour before a meal.
2. Two sheets golden whiskers poured 0.5 liters of boiling water, put on low heat and boil for 15 minutes. Then the mixture was cooled for 8 hours. Before use, the infusion is heated to a warm state in a water bath and drink before a meal (half an hour). On the day you need to drink three tablespoons of the infusion.
3. In equal quantities take burdock root, elecampane and dandelion, ground and mixed them. The resulting mixture is placed in boiling water (Dessert spoon mixture into a glass of water), boiled for 15 minutes, then for an hour insist. After this infusion of strain and drink before eating a tablespoon three times a day.
4. Juice of carrots and potatoes. Take two carrots and two potatoes, squeeze the juice from them, and drink on an empty stomach in the morning during the week.
5. The infusion of Leonurus, Immortelle and calendula. Take one tablespoon of the above herbs, stirred and poured liter of boiling water. The resulting mixture was covered with a cloth soaked in for an hour, then filtered. Take the resulting broth is necessary to 6 times a day, half a cup.
6. It takes the bark of barberry, crushed. Then, barberry bark crushed added to boiling water (teaspoon cortex glass of water), boiled for 15 minutes, after which the resulting broth is cooled and consumed before a meal, a tablespoon, thrice day.
7. Take cumin seeds (2 teaspoons), pour the hot water glass and insist 2 hour. The mixture is then filtered and taken three times a day, before meals, half a cup.

It should be remembered that the traditional remedies can be used in the treatment of pancreatitis only as add-on therapy, and only with the doctor's permission.

Forecast

Strict adherence to diet and diet, abstinence from alcohol, strict adherence to the recommendations of the drug treatment significantly reduces the frequency of exacerbations, transfer process variant rare relapsing slow progression. Some patients may achieve visible and sustained remission.

Chronic pancreatitis is characterized by progressive course, but the impact of the termination of the causal factors and adequate therapy to slow the progression of the disease, significantly improve the quality of life of patients and forecast.