1 Pancreas functions

The pancreas is the organ that performs endocrine and exocrine functions. The exocrine function of the pancreas consists in the release of pancreatic juice containing enzymes: lipase and amylase. They participate in the digestion of fats and sugar. Pancreatic juice is secreted into the duodenum, i.e., into the first segment of the small intestine.

The endocrine function is to release this body of hormones, such as glucagon and insulin. Glucagon causes an increase in blood sugar, and insulin causes it to decrease.

If a long time in the pancreas is an inflammatory process, then this can lead to fibrosis of its parenchyma.

Chronic pancreatitis is a chronic, often long-lasting inflammatory process that occurs in the pancreatic parenchyma. Chronic pancreatitis leads to irreversible changes in the structure and function of this organ. Inflammation is most often the result of repeated acute inflammation of the pancreas.

2 Causes of

The most common cause of exacerbation of chronic pancreatitis( about 80% of cases) is alcohol abuse. In addition to alcohol, smoking is also an important factor contributing to the emergence and development of a chronic disease.

Symptoms of exacerbation of chronic pancreatitis appear when consuming high-calorie dishes with a high content of carbohydrates and fats.

In 20% of cases of chronic pancreatitis there is idiopathic pancreatitis. When the disease is idiopathic, it means that the cause of the disease is unknown, or it has no explanation. Most cases of idiopathic chronic inflammation of the pancreas develop between 10 and 20 years of life and in people older than 50 years.

It is not known exactly why idiopathic pancreatitis does not apply to people of other age groups( other than those listed).Approximately half of patients with idiopathic pancreatitis have a mutation in the genes, which can affect the weakening of the pancreas.

Factors contributing to the onset of a disease such as chronic pancreatitis are autoimmune diseases in which the patient's own immune system attacks the pancreas. These are diseases such as Sjogren's syndrome, Crohn's disease, ulcerative colitis, primary biliary cirrhosis.

3 Clinical picture of

In most patients, the symptoms of exacerbation of chronic pancreatitis are manifested in the form of persistent, severe pain localized directly under the ribs, which can spread and be felt also in the back area. She reacts weakly to typical general anesthetics. Appears after drinking alcohol and after eating. The pain can be soft at first, and then become acute.

Exacerbation of pancreatitis may accompany the following symptoms:

• bloating;

• feeling of overflow;

• pulse acceleration;

• lowering blood pressure;

• impaired consciousness;

• diarrhea with fat.

The amount of food taken is reduced because of pain after taking it, and digestive disorders cause weight loss.

Symptom associated with endocrine pancreatic dysfunction is diabetes mellitus. It is a consequence of the destruction of the parenchyma of the pancreas, in which special cells produce insulin. Initially, this can be expressed by the body's need to receive more than normal amounts of fluid. However, chronic pancreatitis is not a common cause of diabetes.

Another symptom of chronic pancreatitis may be jaundice. It appears when the pancreas enlarged as a result of edema inhibits the conductivity of the common bile duct. During the disease, the production of pancreatic enzymes is reduced, which is necessary, in particular, for digesting the fat contained in the food. Undigested fats from food can spread in the intestines and cause diarrhea with fat, which is characterized by a bright color.

If the exacerbation of chronic pancreatitis is caused by alcohol, the pain of the pancreas grows gradually, within a few days. Patients, as a rule, take a sitting position, leaning forward, which brings them a slight relief. Cough, movement or deep breathing causes an exacerbation of feelings of discomfort.

5 Nutrition

In pancreatic diseases, a properly chosen diet plays an important role in the treatment process.

The ideal diet for people with chronic pancreatitis is an individually selected diet. In view of the development of the disease, it is necessary to limit only those products that aggravate the symptoms of the disease. However, here are some general recommendations that are appropriate for each patient:

• absolute elimination of alcohol;

• restriction of fats - however, the size of this restriction depends on the patient's condition;

• fiber restriction - and here too much depends on individual patient tolerance;

• should be eaten more often, but in smaller quantities( eating large amounts of food can lead to increased pain).

In old dietary guidelines for chronic pancreatitis, the amount of fat in food was very limited( about 15-18%, that is, not more than 50 g per day).However, at the same time, such a restriction does not improve the patient's condition at all and is only required for people with severe exacerbations.

The source of fats should be foods that are easily digestible, and these include:

• butter;

• oily fish: salmon, trout boiled or baked in foil;

• vegetable oils( 1 tsp per day, not more);

• walnuts, flaxseed( if well tolerated)

Protein is a nutrient that reduces inflammation. But consuming it in too much is undesirable for the patient, as for the normal digestion of the protein, enzymes of the pancreas are needed.

From products rich in proteins, choose low-fat types:

• milk and milk drinks( kefir, yogurt) 1,5-2% fat;

• low-fat cottage cheese;

• lean meat and fish;

• egg protein.

Patients with chronic pancreatitis should consume more carbohydrates, but this should be complex carbohydrates( oat flakes), rather than simple( sugar, sweets).The situation is slightly complicated when symptoms are associated with glucose intolerance or diabetes. Then the diet is selected individually for the patient. However, always( even with diabetes) you can use:

• stale bread and rolls;

• crackers;

• small grains: barley, semolina, starch;

• noodles without eggs;

• white rice;

• boiled potatoes( mashed potatoes with milk).

In chronic pancreatitis, some people mistakenly limit the consumption of fruits and vegetables. Then the patient's body is deprived of the necessary vitamins and minerals. Vegetables and fruits that can be consumed in chronic pancreatitis:

• carrots, beets, spinach, pumpkin, canned celery, parsley - cooked or grinded;

• tomatoes without skins and pits;

• dill;

• asparagus, canned cucumber without skin;

• citrus fruits( lemons, oranges, grapefruits, tangerines);

• berry( raspberry, strawberry) - only in the form of puree;

• apples, peaches, pitted apricots;

• grapes - without skins and bones.

Do not forget about herbs. The pancreas always leads to loss of appetite. In such a situation, it is worthwhile to raise the flavoring qualities of food with condiments. Use:

• fragrant pepper and bay leaf, they will add flavor to any soup;

• ginger, nutmeg, sweet paprika, marjoram, thyme, tarragon, basil and savory are perfect for meat, fish;Dill and green parsley

• is a wonderful and fragrant source of vitamin C;

• vanilla, lemon juice, cinnamon, cloves, lemon and orange peel will decorate your desserts.

It is important to understand that chronic pancreatitis should be treated only in a complex manner. Diet, reduction in physical activity, taking medicines and decoctions of medicinal plants - all these methods will help to quickly stop symptoms and improve the patient's condition.

4 Diagnostics and treatment measures

For the diagnosis of chronic pancreatitis, such kinds of visualization as ultrasound and computed tomography of the abdominal cavity are used. It is very important to collect an anamnesis from the patient regarding the regimen of life and the medications used by him. Laboratory blood tests can determine the severity of the disease and damage to the pancreas.

Until now, there is no specific, unambiguous method of treating exacerbation of pancreatitis. If the damage to the pancreas is serious, a surgical or endoscopic operation is performed with partial or complete removal of this organ. Treatment of exacerbation of chronic pancreatitis caused by the use of alcoholic beverages is usually carried out by the introduction of abstinence from alcohol intake. In practice, this is difficult to implement, as many patients depend on alcohol. In addition, symptomatic therapy is used, the fight against pain comes to the fore. It is recommended to use supplementary therapy with drugs containing pancreatic enzymes, if necessary, the supply of insulin.

According to medical data, about 4% of patients with chronic pancreatitis, continuing to 20 years, develop pancreatic cancer. In this case, the unfavorable course of the disease causes high mortality. It is worth taking care of the prevention of pancreatic cancer by changing the way of life. Therefore, it is necessary to refrain from smoking cigarettes, and obese patients - to reduce body weight, among other things, it can prevent the development of type 2 diabetes.