Chronic pancreatitis. Symptoms, treatment, diet, medical history, exacerbation of clinical recommendations

Chronic pancreatitis - an inflammatory disease of the pancreas, which leads to tissue destruction body. Important time to detect disease symptoms to avoid complications.

types of diseases

There are several types of classification of chronic pancreatitis depending on the reasons that influenced its development:

classical	of MI cousin	International
1. Toxic-metabolic (arises from the effects of alcohol and drugs). 2. Idiopathic (develops for no reason). 3. Hereditary (if in the family there were cases of chronic or acute pancreatitis). 4. Autoimmune (the result of an autoimmune malfunction in the body when the immune system perceives pancreatic cells as foreign and starts "attack" them). insta story viewer 5. Recurrent (different duration periods of remission alternate with acute phases). 6. Obstructive (developed with or by displacement obstruction (clogging) pancreatic ducts). 7. Primary (there own). 8. Secondary (manifested as a complication of other gastrointestinal pathology).	Primary: manifested as a result of metabolic diseases due to the action of alcohol, drugs, for unknown reasons.	In origin or risk factor.
Posttraumatic: after surgical manipulation, ERCP, or on the basis of pancreatic injury (acute or obtuse).	According to the clinical stage.
Secondary: occurs against a background of other diseases, in particular, after suffering acute pancreatitis.	According to the severity of the disease (grading system).

Stage and grade

Chronic pancreatitis, symptoms of which depend on the extent of the disease has 3 stages of development:

1. First stage. The main manifestation of chronic pancreatitis is pain and burning sensation in the left upper quadrant, digestive disturbances. The initial phase lasts on average 1-5 years.

   

2. Within 5-10 years manifested disorders pancreatic functions (secretory failure, low activity produce enzymes) that lead to diabetes, hypo- and giperglimekii.
3. 7-15 years after the onset of symptoms of pancreatitis observed subsidence (subject to treatment). In 1/3 of patients develop severe complications.

Stop the progression of the disease at an early stage is possible with careful observance therapy. If the patient refuses to alcohol and to observe the principles of healthy eating, the frequency of symptoms is reduced even without taking medication.

symptoms

Chronic pancreatitis, unlike acute, manifested by recurrent symptoms from time to time. The most common symptom of the disease - pain in the left upper quadrant, which can be moved to the right side, the area of ​​the heart, back. When tilting downwards or squatting position discomfort diminish or disappear altogether.

Also, patients with chronic pancreatitis are concerned the following symptoms:

1. Persistent abdominal distention, flatulence, nausea after eating.
2. Frequent diarrhea; cal fat and oily, there types of undigested food residue.
3. The feeling of bitterness in the mouth, white or gray plaque on the tongue.
4. Loss of appetite and weight loss; due to a lack of nutrients the patient is deteriorating condition of the skin, nails and hair, showing signs of beriberi, there is fatigue.

Some symptoms accompany a person all the time, and some are manifested at an aggravation of pathology. Can provoke an aggravation of reception of alcohol, unhealthy diet (prevalence in the diet of oily and spicy food), prolonged stress. Aggravation of continues from 3 to 14 days.

The main clinical manifestation of the disease is pancreatic exocrine insufficiency, which is the body's inability to synthesize the required number of enzymes for proper digestion food.

Hence the incomplete digestion of food entering the body (visible remnants of food in the stool), disorders of protein metabolism, fats and carbohydrates, and internal poisoning of the body is not fully digested food residues that are beginning to rot in gut.

Approximately 10-15% of patients are completely absent pain, while there are signs of malabsorption (malabsorption of nutrients): underweight, flatulence, presence fat in the feces.

Causes of

The most common cause of chronic pancreatitis is to maintain an unhealthy lifestyle. If a person is constantly overeat heavy and fatty foods, smoking and alcohol abuse, it is likely he will arise inflammation of the pancreas and other digestive diseases.

Also for the development of pancreatitis may affect:

• peptic ulcer, or enteritis (inflammation of the intestinal mucosa difficult to isolate pancreatic juice, which contains the enzymes necessary for digestion);
• cholelithiasis (stones obstruct the bile duct, which leads to inflammation of the surrounding organs);
• prolonged intoxication (some drugs, parasitic diseases);
• metabolic disorders;
• viral diseases;
• surgery on the gastrointestinal tract;
• stress and nervous tension;
• abdominal trauma;
• infectious diseases;
• congenital abnormalities of pancreatic structure, gallbladder and bile ducts;
• genetic predisposition to the development of pancreatitis.

Diagnostics

For an accurate diagnosis requires a comprehensive medical examination:

1. Visual inspection of the patient's body. The doctor looks at the language of flowers (plaque present or not), color and elasticity of the skin, general. Also carried palpation and epigastric infracostal areas to determine the pain sensations with pressure, which is also one of the symptoms of pancreatitis.
2. General blood analysisBy which to detect inflammation in the body (the presence of inflammation indicates increasing amounts of leukocytes and erythrocyte sedimentation rate).
3. Analysis of blood biochemistry (High levels of enzymes are found in any form of pancreatitis in the blood).
4. Analysis of urine (If elevated amylase enzyme indicator, which indicates the pancreatic pathology).
5. analysis of feces (Invisible to determine neperevarivshihsya food debris and parasites).
6. ultrasound that can be used to detect changes in the structure of the pancreas. The study can be performed from within the stomach or duodenum, which improves its accuracy.
7. Computed tomography (CT). Appointed to determine the complications of chronic pancreatitis associated with the seal body tissues.

For suspected impaired circulation in an organ used angiography, which can be used are well view pancreatic vessels. During the study may reveal changes in body size, the presence of proliferation of blood vessels and blood flow obstruction of splenic vein.

This method of diagnosis of pancreatic diseases such as ERPHG is fairly efficient, since it allows to investigate the body through the endoscope duct, filled with radiopaque material.

However ERPHG often results in damage to the pancreas and other organs studied (in particular, there have been cases of acute pancreatitis after the procedure), so his medical practice use seldom.

When to see a doctor

Chronic pancreatitis, symptoms of which most often appear frequent pain on the left side of the stomach and nausea after food, can lead to dangerous consequences, so you should immediately visit the appearance of these signs Physician.

He will prescribe the necessary tests and a referral to a gastroenterologist who treats digestive diseases. If chronic pancreatitis complicated by diabetes, the patient should also be observed at the endocrinologist.

prevention

Prevention of relapse and chronic pancreatitis include:

1. The dominance of the diet of healthy food and non-robustness and compliance with diet.
2. Restriction or complete abstinence from alcohol and smoking (found that in smokers the risk of pancreatitis by 75% higher than non-smokers).
3. Early treatment of infectious and viral diseases of the body.
4. Limiting stress.
5. A visit to the doctor for any discomfort in the area of ​​the pancreas.

People at risk (with congenital anomalies of the pancreas structure, genetic predisposition and other gastrointestinal diseases) must be 1-2 times a year to visit gastroenterologist for exclude the diagnosis.

Patients with chronic pancreatitis should be observed medical diet, taking enzymes and regularly attending gastroenterologist. they are also encouraged to take annual rate of spa treatments, including medications reception, mineral water and therapeutic procedures to prevent a recurrence.

therapies

First, you need to give up bad habits, which significantly reduces the risk of relapse. Rejection of alcohol reduces pain in approximately 50% of patients.

Chronic pancreatitis, which gives patients the symptoms of a large number of nuisance calls combined treatment, which necessarily involves reception of drugs and compliance diet.

Medications

the following types of drugs used for the treatment of chronic pancreatitis:

1. analgesics (Cropped soreness) and spasmolytics (relieve spasms). To do this, use drugs such as: "No-spa," "Drotaverinum", "Spazmonet", which have the same effect. In no case can not use NSAIDs ( "aspirin", "Nise", "Nimesulide", etc.)., Because they irritate the mucous membranes of the digestive tract and increase the risk of bleeding.
2. If pancreatitis is used hypersecretion proton pump inhibitors, which inhibit the secretion of the pancreas. Prescribed the drug "Omeprazole" "Omez", "Oprazol".
3. enzyme preparationsTo facilitate the digestion process and reduces the burden on the pancreas. Such preparations contain a complex of enzymes that are released under the title: "Creon", "Mezim", "Festal" and "Pancreatin". The amount of enzyme (from 5,000 to 50,000 units.) Depending on the pathology severity.
4. Antibiotic therapy with antibiotics Ampicillin type used in infectious lesion of the pancreas.
5. In case of severe violations of water-electrolyte balance (after prolonged diarrhea or vomiting during acute) used saline solutions as droppers.

Traditional methods

People's therapy is very good for various pathologies of the digestive tract, including pancreatitis. Such methods reduce inflammation, improve digestion and pancreas.

Oatmeal with pancreatitis

Oatmeal and jelly shown in gastritis, peptic ulcer, pancreatitis and other pathological conditions of the gastrointestinal tract. Substances contained in oats, reduce inflammation and mildly envelop the mucous membranes of the digestive system, thereby protecting them from damage.

Oatmeal also helps to regulate blood sugar, which is very important for pancreatitis complicated by diabetes, and increases the overall body tone.

Pancreatitis is necessary oatmeal in water, without salt or sugar and to use oat extract: 500 g of this grain need to rinse and fill with 1 liter of hot water and leave to infuse for 40 min. After that filter and take half a cup 3 times a day. The course of treatment - at least 3 weeks.

Herbal №1

For the preparation of medical collection is necessary to take 1 tbsp. l. the following herbs:

• chamomile;
• fennel;
• Helichrysum;
• hawthorn.

Chopped grass mix, pour hot water and let stand for 30 minutes. Infusion cool and strain. Take half a cup 2-3 times a day for 30 minutes. before meals. The course of treatment - at least 2 weeks. This drink will help to clear the gastric tract and normalize the functioning of the pancreas.

Herbal №2

Ingredients for collecting: 50 g of leaves of Leonurus, mint and hypericum.

Recipe:

1. A mixture of herbs pour 500 ml hot water and let set for 20 min.
2. Infusion put on low heat and bring to a hot state again.
3. Remove the broth from the heat, cover and wrap a towel for 15 minutes.

Broth should be taken daily for 2 weeks, 0.5 cups of fasting. Next, you need to take a break for 1 week and repeat the course.

Sagebrush

Wormwood is used in various diseases of the gastrointestinal tract, due to its beneficial properties:

• It enhances the flow of bile from the pancreas organ improves performance and prevents attacks pancreatitis;
• anti-inflammatory and antibacterial action;
• improves appetite and dissolve gallstones.

The plant is contraindicated in the acute phase of pancreatitis (drink teas from it can only be out of phase exacerbations) and people who have an increased acidity of the stomach. Wormwood prepare a decoction and infusion.

Recipe broth: Pour 1 tbsp. l. Artemisia hot water and put on a slow fire for 20 min. After this decoction should drain and cool. Take 20-30 minutes. before meals for 1-2 tablespoons.

Recipe tincture: 1 tbsp. l. Artemisia pour hot water and let set for 1 hour. under the hood. Then filter and take the above scheme.

Blueberry tea

Tea leaves and blueberries helps to reduce inflammation and irritation of the pancreas tissues in acute. Preparing tea is very simple - the need to fill in 2 hours. l. shredded leaf cup of hot water and let stand for 5 minutes. Taking this tea should not be more than 2 times per day (in parts can be taken). The course of treatment - 2 weeks.

You can also cook blueberry and cranberry drink:

1. Stir 2 h. l. bilberry leaf 2 hours. l. blueberries and 1 hour. l. lingonberry leaves.
2. Fill them with hot water and infuse 1 hour.
3. Take tincture 3 times a day for 14 days.

Diet

Chronic pancreatitis, symptoms which may occur after ingestion of fatty foods, can not be cured without dieting. Proper nutrition is one of the main factors of treatment.

Chronic pancreatitis patients must adhere to the following rules:

1. You need to eat 5-6 times a day in small equal portions. This contributes to a better assimilation of food.
2. Replace soft roughage: soups, mashed potatoes, peretortymi vegetables and fruits, cereals.
3. To limit fried, salty and spicy food, store sausages, convenience foods, sweets, pastries, spices and seasonings. It is also recommended to eliminate products that can provoke a recurrence of the disease, coffee, soda, acid berries, cabbage and beans (due to their content of crude fiber).

All dishes should be boiled or baked, instead of fried. The diet should prevail boiled porridge, omelettes made of protein, vegetable ragout and mashed potatoes, low-fat dairy products, and meats and fish.

Fresh bread is excluded. From drinks are recommended rather weak tea, broth hips, herbal infusions (in consultation with your doctor), mineral water. For the treatment of chronic pancreatitis used mineral water "Narzan" and "essentuki" №4 and №17.

Surgery

Surgical treatment is used in the event that other methods do not help or resistant to medicines pain. Also, the operation is carried out at a pseudocysts complications.

Pseudocyst is a pathological cavity in pancreatic tissue, which contains a liquid - pancreatic secretion. To remove a little traumatic pseudocyst used methods - often puncture drainage through the skin. During the procedure of the abnormal area is evacuated liquid contents and conduct decompression to nearby tissues.

When forming a fistula in pancreatic tissue puncture performed drainage or surgical intervention, depending on indications. During the operation, the fistula is excised or scrape.

Also the operation shown in this complication pancreatitis as biliary obstruction.

Starvation

In the early days of relapse used fasting, during which you can not use anything other than mineral water without gas. Fasting for 1-5 days (if indicated) will help cleanse the body, improve zhelchevyvedenie and make less pronounced inflammation. Also, not eating helps unload the pancreas.

After a few days of fasting should gradually begin to eat light food and follow the basics of the diet.

possible complications

If you do not follow doctor's instructions and do not treat the inflammation that may develop serious consequences:

1. Diabetes mellitus develops due to lack of the pancreas (in particular, the reduction of insulin).
2. Cholestasis.
3. Liver failure.
4. Purulent processes in the pancreas and surrounding tissues due to rupture of the pancreatic duct.
5. Formation of pseudocysts in the body tissues.
6. Development of gall bladder and ducts, ulcers duodenum.
7. Jaundice occurring due to compression and biliary obstructions.
8. Arterial pseudoaneurysms (expansion vessel wall tissue to rupture, but no hemorrhage) near pancreatic pseudocysts.
9. Splenic vein thrombosis (which leads to gastric varices).
10. Adenocarcinoma of the pancreas.

The most severe consequence of chronic pancreatitis is fatal. Most often dying patients who abuse alcohol and smoking.

The chronic form of pancreatitis accompanies human life. It can not be cured, but with the help of prescribed therapy can reduce the frequency of symptoms and relapse. Proper diet, abstinence from alcohol and taking medication - the main components of the treatment.

Registration of the article: Vladimir the Great

Video of pancreatitis

Malyshev will speak about chronic pancreatitis: