Chronic pancreatitis of the pancreas. How does pancreatitis manifest? What to do during an attack? How to relieve exacerbation of pancreatitis

Pancreatitis is inflammation of the pancreas. The acute form of the disease is provoked by the most insignificant factors. It is very important to identify symptoms as soon as possible.

Symptoms of exacerbation of pancreatitis are complicated by the fact that the pain syndrome is difficult to relieve even with the help of medications. To alleviate the pathology and improve the general condition, immediate therapy is necessary.

Causes of exacerbation

The main cause of exacerbation is a significant violation of dietary nutrition and intake alcoholic drinks. Even in small quantities, alcohol is in 1st place. After, in order of importance:

1. Lack of protein intake.
2. Psycho-emotional experiences, stressful situations.
3. Use of medications (hormonal drugs, aspirin, certain antibiotics, chemical medications for the treatment of cancer).
4. Acute form of cholecystitis and cholelithiasis, cholangitis.
5. Poisoning and acute infectious diseases.

During exacerbations, the activity of pancreatic enzymes increases significantly, the pancreatic tissue can be irritated under their influence, swelling appears, the large pancreatic duct is compressed, and the blood supply to the gland decreases.

Symptoms of exacerbation

Exacerbation of pancreatitis is a serious problem that can harm the health and life of the patient. Therapy is carried out only in a hospital setting, since there is a risk that the patient will die without timely assistance from a specialist. For most, exacerbation of pancreatitis occurs without any symptoms. Sometimes loose stools or pain near the left hypochondrium give discomfort. Signs of acute pancreatitis cannot go unnoticed.

General signs

This condition is characterized by the following symptoms:

All of the above symptoms appear both individually and collectively. When the pain is very severe, a dyspeptic disorder probably occurs, during which a sudden deterioration in the condition can be observed. In some patients, an exacerbation occurs with a less pronounced pathology: dull pain appears, nausea appears from time to time, constipation alternates with diarrhea, and appetite decreases. A person can remain in this state for weeks. Severe dyspepsia, a gag reflex and loss of appetite lead to a significant and rather sudden decrease in body weight - in 1–2 weeks the patient will lose up to 8 kg. In such situations, when increased appetite is noted, diabetes mellitus occurs.

Other symptoms of acute pancreatitis

When pancreatitis worsens, the following symptoms may occur:

Since such symptoms accompany not only pancreatitis, but also other pathological processes in the gastrointestinal tract, a specialist must diagnose the problem and prescribe treatment. This can only be done based on diagnostic indications.

Diagnosis of the disease

In general, diagnosing an exacerbation of pancreatitis is not a difficult task; in order to prevent the development of adverse consequences, the required tests should be performed in a timely manner and specialized diagnostic methods should be carried out:

First aid

When pancreatitis worsens, it is important to provide first aid in a timely manner, since failure to follow the rules can only aggravate the situation:

An ambulance should be called even when the patient does not know that he has an exacerbation of pancreatitis. After all, such pathological processes are dangerous because they can subside for a certain period of time, and then suddenly relapse.

Treatment of the disease

In many situations, exacerbation of pancreatitis lasts no more than a week and does not cause significant harm to the patient’s health. The primary goals of treatment for this pancreatic disease are:

• relieve pain;
• restore fluid content inside the body;
• relieve the pancreas, preventing pathological processes from developing further.

When the patient first contacts a specialist, non-steroidal drugs are prescribed. In many cases, they make it possible to significantly reduce the severity of symptoms of the disease. When treating, preference is given to paracetamol, since it has the least negative effect on the gastric mucosa. It is undesirable to use this remedy when the cause of inflammatory processes in the pancreas is liver pathology. If the expected result is not achieved, the patient is prescribed narcotic analgesics. Tramadol is often chosen. Additional funds for the treatment of pancreatitis in the pancreas and relief of symptoms:

• enzymes;
• antispasmodics;
• proton pump inhibitors.

To unload the pancreas use:

• dietary food with strict fat restriction or fasting for several days;
• limiting alcoholic beverages and smoking;
• Octreotide is a drug that is an analogue of the pancreatic hormone somatostatin.

The same signs that appear in acute and chronic pancreatitis are sharp, severe pain near the peritoneum. The pain is localized in the area of ​​the pancreas that is inflamed. The pain syndrome during exacerbation of the pancreas is the most severe. It occurs near the abdomen or hypochondrium, radiating to the back, under the shoulder blade and behind the sternum. If a patient experiences characteristic signs of an exacerbation of the disease, it is important to immediately contact a specialist. Recovery processes and the likelihood of complications depend on timely treatment.

Exacerbation of chronic pancreatitis - symptoms and treatment

In most cases, exacerbation of the disease does not require mandatory surgical intervention, but neglecting conservative treatment, there is a risk of serious complications in the form of problems with the digestive process and absorption of substances in the body.

What is it?

Chronic pancreatitis is an inflammatory process in the tissues of the pancreas that lasts more than six months. The disease is characterized by an undulating course - periods of remission are followed by periods when it worsens.

Causes of exacerbation

The main cause of exacerbation of chronic pancreatitis is alcohol abuse.

Other causes of exacerbation of the disease:

1. Mechanical abdominal injuries.
2. Complications after surgical operations.
3. Diets that involve a minimum of protein.
4. Autoimmune diseases.
5. Infectious diseases of the body.
6. Excessive consumption of fatty and fried foods.
7. Hereditary factors.
8. High loads on nervous system, frequent stress.
9. Senile age (lack of enzymes in the body).
10. Taking toxic medications.
11. Smoking, especially if you are overweight.
12. Chronic diseases of the liver, duodenum and gall bladder.

During an exacerbation, the activity of pancreatic enzymes sharply increases, the tissue of the pancreas is irritated under their influence, swelling occurs, compression of the large pancreatic duct occurs, the blood supply to the gland worsens - the clinical picture resembles acute pancreatitis and, in fact, is not much different from it.

Symptoms of exacerbation of chronic pancreatitis

As a rule, symptoms of exacerbation of chronic pancreatitis develop quite quickly. Already on the first day, a person’s condition deteriorates sharply, as a result of which he has to take medications or seek help from a doctor.

A patient may suspect exacerbations of chronic pancreatitis based on the following clinical signs:

• frequent and loose stools, fat in the stool;
• abdominal pain with vague localization, radiating to the back, worsening after eating;
• , vomiting of bile, which does not bring relief and is difficult to control with medications.

All these clinical signs are not characteristic only of chronic pancreatitis. But if a person has had an exacerbation of this disease not for the first time, he already knows that it was the inflammation of the pancreas that caused the appearance of all the symptoms.

What should be done if abdominal pain and dyspeptic symptoms occur? It is advisable to consult a doctor. If the pain is severe and vomiting cannot be eliminated, you should call ambulance immediately transport the patient to the intensive care unit for correction of water and electrolyte metabolism. Such conditions are life-threatening, so you should not delay seeing a doctor. Exacerbation of pancreatitis may well lead to partial destruction of the pancreas, which may require surgical treatment.

How long does the attack last?

Chronic pancreatitis in the acute phase can be accompanied by severe pain and a significant deterioration in health. However, not all patients experience such severe pain, but instead suffer from other symptoms: lack of appetite, high temperature, vomiting, diarrhea, etc.

But how long does the acute phase last? Doctors do not give a definite answer, since the duration of the attack is influenced by many factors, for example, the reasons that led to the development of this pathology or the presence of concomitant ailments. On average, during an exacerbation of pancreatitis, an attack lasts 1-2 hours or more than a day.

What to do in case of exacerbation?

First of all, you need to call an ambulance. If symptoms of pancreatitis appear, first aid for an exacerbation includes the following steps:

• complete exclusion of food and liquid intake;
• maintaining rest, you need to lie in bed on your back; if you are vomiting, you can take a position lying on your side with your knees pressed to your stomach;
• using an ice pack as a cold compress on the abdominal area.

After delivery to the hospital, the patient will be examined, and based on the results obtained, the doctor will choose the most effective therapeutic tactics. Self-prescribe pills and administer medicines in case of exacerbation of pancreatitis, it is prohibited.

If the exacerbation of a chronic process is limited to nausea after eating, the appearance of diarrhea, and abdominal discomfort, you still need to consult a specialist to avoid complications. After the examination, the doctor will decide where it is necessary to undergo treatment - inpatient or outpatient.

Diagnostics

After determining the symptoms and etiology of the disease, the specialist doctor prescribes tests. Usually this is:

• general and biochemical blood tests;
• urine test;
• fecal biochemistry;
• saliva tests to determine amylase levels.

Additional abdominal examinations may be required for an accurate diagnosis, such as computed tomography, MRI, x-ray of organs, ultrasound or endoscopy.

How to treat exacerbation of pancreatitis?

Comprehensive treatment of exacerbation consists of regimen, diet and drug therapy. In cases of severe pain, bed rest is prescribed and patients are unable to work.

Drug treatment

Treatment of pancreatitis during an exacerbation should begin immediately and always under the supervision of a specialist. Only a gastroenterologist can prescribe the correct treatment aimed at quickly relieving the exacerbation of the disease and preventing possible complications.

First of all, drug treatment is used:

1. Vitamin therapy: fat-soluble A, E, K, D and B vitamins.
2. Pancreatic enzymes: Pancreatin, Creon, Panzinorm with lipase at least 10 thousand.
3. Drugs aimed at reducing the secretory function of the gland: Esomeprazole, Octreotide, Pantoprazole, Omeprazole.
4. Drugs that relieve concomitant pain syndrome. These are antispasmodics: Drotaverine, Mebeverine, Spazmalgon, No-shpa. And also non-steroidal anti-inflammatory drugs: Tramadol, Ketoprofen.

It is worth noting that drug treatment of patients is individual. Only a doctor should select medications after carefully studying the symptoms of the disease. You cannot give injections or take pills without consulting a specialist. This can lead to serious consequences.

Nutrition and diet

In the first few days, fasting is necessary; you can only drink water - purified without gas, or boiled. In the future, the diet is gradually expanded, table No. 1a is prescribed, as in case of exacerbation of gastric ulcer. Protein-rich foods are allowed - lean meat - beef, rabbit, turkey, in the form of steamed meatballs or soufflé, boiled lean fish, steamed protein omelet, low-fat cottage cheese, pureed viscous porridge. Drinks you can drink include tea, rosehip infusion, and blackcurrant compote.

All dishes are prepared either steamed or boiled, carefully chopped or pureed. Portions are small, not exceeding the amount that fits in one handful. The number of meals is from 6 to 8 times a day.

Extractive substances that enhance secretion - strong broths, mushrooms, coffee, cocoa, chocolate, marinades, smoked meats - are excluded from the menu. All foods that require effort from the pancreas - fatty, fried, salty, spicy, seasonings and spices, canned food, cream, sour cream, fatty cottage cheese, lard - will have to be put aside. You can't eat fast food, soda, colorful candies and chocolate bars, chips, crackers, nuts - everything we're used to snacking on on the go. An unconditional, categorical, non-discussable taboo on alcohol. And for beer. And for non-alcoholic drinks, too.

Typically, diet solves about 70% of the problems that arise during exacerbation of chronic pancreatitis. Once you give the gland rest, the inflammation will begin to subside. The main thing is to take the necessary time and not “break down” when everything starts to get better and stops hurting.

Prevention

Of course, the best treatment is prevention. Chronic pancreatitis can worsen and throw up “surprises” that the patient is not even aware of. This may be hyperglycemia and hypoglycemia, severe vitamin deficiency, processes leading to atrophic gastritis, liver dysfunction and nervous and physical exhaustion.

The basic rule of prevention is very simple. If you want to be healthy, “pass through your head” what gets into your mouth. Before you swallow anything, you need to think about whether it will harm your digestion.

Alcohol should be strictly avoided. In conditions of insulin deficiency, it can lead to hypoglycemia and the development of a serious condition, and if you are “lucky” and a pleasant intoxication develops, then the person “without brakes” gorges on junk food. Therefore, complete abstinence from drinking, smoking (swallowing tobacco saliva irritates the digestive tract) and food temptations will allow you to avoid this disease.

General information about the disease

From time to time, the pathology begins to recur if nutrition is disrupted or there are other associated factors. In this case, an exacerbation of chronic pancreatitis begins.

Main reasons

1. As a rule, exacerbation of chronic pancreatitis develops with prolonged or improper use of powerful drugs that are used to treat various pathologies.
2. Injuries.
3. Cystic fibrosis.
4. Ischemic disease.
5. Autoimmune pancreatitis.
6. Viral diseases.

Classification

There is no general classification for chronic pancreatitis, but in medicine a convenient division of pathology is used, which was created in 1980. It is divided into pathology according to clinical manifestation and origin. In the first case, there are:

Main symptoms

1. Pain syndrome.

Pain syndrome

The localization of pain is deep in the abdominal cavity and constantly moves up and down, then to the sides.

Dyspeptic disorders

1. Heartburn.
2. Nausea.
3. Belching.
4. Loss of body weight.
5. Bloating and gases.

1. Decreased appetite.

Diagnosis

Additionally, a coprogram is done to identify fats in the stool, which will be in excess, due to this, enzyme deficiency can be determined.

Other research options include:

1. Duodenoradiography.
2. CT and MRI.

1. Diet food.
2. Use of medications.
3. Taking folk remedies.
4. Surgical treatment.

Medicines

Treatment of the chronic form in the acute stage is carried out by analogy with acute pancreatitis. For this purpose, drugs are used that can eliminate the symptoms of the disease.

In addition to this, remedies are used to relieve pain, improve the functioning of the digestive system, eliminate intoxication and inflammatory processes.

Surgical treatment

1. Purulent processes.
2. Sphincter stenosis.
3. Cysts.

Folk remedies

Possible complications

1. High blood pressure.

1. Encephalopathy.
2. DIC syndrome.

Prevention

1. Stop smoking.

It is important to follow the basic rules indicated by the doctor. A routine examination for pathology should be carried out every six months. I recommend

Diseases of the digestive system in medicine are often diagnosed in people of different ages.

Patients often present with characteristic symptoms of pathology, which indicate an exacerbation of chronic pancreatitis.

It is important to understand what the disease is, what the causes and signs of exacerbation are, as well as methods for treating and relieving the main symptoms.

General information about the disease

Chronic pancreatitis is an inflammatory process that occurs over a long period of time in the pancreas.

The disease gradually changes the structure of cells, organ failure appears, and therefore functions are impaired. A certain number of people are at risk, including:

1. Fans of junk food, namely fatty and fried foods.
2. Women who have cholelithiasis.
3. Patients with chronic inflammation of the gallbladder.
4. People who frequently drink alcohol.

According to statistics, the chronic form of the disease appears in 5-10% of all cases, among possible diseases of the digestive system.

From time to time, the pathology begins to recur if nutrition is disrupted or there are other associated factors. In this case, an exacerbation of chronic pancreatitis begins.

Main reasons

Among the main reasons why an exacerbation of the disease may occur are:

1. Alcohol. Such drinks are the main cause of the development of pancreatitis in the chronic phase. The disease appears in 40-95% of people who abuse alcohol and suffer from the disease, and in almost half of the patients the pathology is chronic. Alcohol directly affects the cells and tissues of the pancreas; pancreatic juice appears, which settles in the ducts in the form of plugs. Due to this, secretory ability is impaired.
2. Gallstone disease. An equally common cause of the disease, which provokes the problem in 40% of cases. The condition worsens especially if stones appear in the gallbladder and its ducts. As a rule, such a diagnosis causes an acute course of pancreatitis.
3. Cigarette abuse. Smoking may increase the risk of developing the disease compared to people who do not smoke.
4. Hyperlipidemia. This condition indicates an increased level of fats in the blood, which negatively affects the functioning of the pancreas.
5. Injuries.
6. Cystic fibrosis.
7. Ischemic disease.
8. Genetic predisposition.
9. Poisoning of the body with strong toxic substances and even food.
10. Long-term stagnation of pancreatic secretions.
11. Autoimmune pancreatitis.
12. Surgical interventions on the gastrointestinal tract or endoscopic diagnostic method.
13. Viral diseases.
14. Psychogenic factors. These include frequent stress, psychological trauma, emotional stress, which causes disruption in the functioning of blood vessels and ducts.

Only a doctor can determine the exact causes of exacerbation of the chronic phase of the disease, based on certain tests and a person’s symptoms.

Classification

There is no general classification for chronic pancreatitis, but in medicine a convenient division of pathology is used, which was created in 1980.

It is divided into pathology according to clinical manifestation and origin. In the first case, there are:

1. A recurrent form, in which periods with sharp pain change to remission.
2. Painful appearance, which is accompanied by constant pain.
3. Pseudotumoral is chronic pancreatitis, which has obstructive jaundice.
4. Latent form, which does not manifest itself with characteristic symptoms.
5. The sclerosing type, as a rule, does not develop on its own, but is considered the cause of other types of chronic pancreatitis. Accompanied by obvious pancreatic insufficiency.

Based on its origin, the disease is classified into primary, which occurs due to alcohol abuse, poor diet or toxic poisoning, and secondary or biliary form, which develops against the background of other diseases.

Main symptoms

As a rule, at the beginning of the development of chronic pancreatitis there will be no characteristic signs or the overall clinical picture is very weak and may resemble diseases of other internal organs.

Chronic pancreatitis in the acute stage has pronounced symptoms that are difficult to ignore. Among them there are 4 main types of signs:

1. Pain syndrome.
2. Dyspeptic disorders that are associated with the gastrointestinal tract and digestion.
3. Exocrine insufficiency of the affected organ, which is caused by a lack of enzymes secreted by the pancreas. In this case, food cannot be digested as needed, and a disorder begins. Absorption is impaired useful substances in the intestines.
4. Intrasecretory insufficiency, which is accompanied by a lack of insulin, as well as substances that participate in metabolic processes.

Pain syndrome

As a rule, at the beginning of the pathology, 30% of people have almost no characteristic signs, but this does not apply to exacerbations.

After some time of development of the pathology, pain appears in the upper part of the abdominal cavity, which for a long time may be the only symptom.

During exacerbations, pain may persist for several years. After about 3-10 years, exocrine insufficiency appears, as well as characteristic symptoms.

Before the appearance this violation Some patients may experience impaired carbohydrate absorption.

The pain under the left rib is quite strong and encircling. In addition, the symptom may flow under the right rib.

The localization of pain will be deep in the abdominal cavity and constantly moves up and down, then to the sides.

The symptom will develop approximately an hour after the meal if fatty foods were consumed during the meal.

The sign persists for 1.5-3 hours. There may also be sphincteric pain, which begins due to changes in the sphincter itself.

The syndrome appears on the right under the ribs, often starting in the morning after a meal. The nature of the symptom is acute, appears after carbonated drinks, alcohol and spicy foods.

Dyspeptic disorders

This type of disorder is a normal condition in pancreatitis. A person experiences malfunctions in the functioning of the gastrointestinal tract; the digestive process itself will be difficult and often causes pain.

Among the main disorders that are classified as dyspeptic are:

1. Vomiting that does not go away for a long time, and after it there is no improvement in the condition.
2. Heartburn.
3. Nausea.
4. Belching.
5. Abnormal stool in the form of diarrhea.
6. Loss of body weight.
7. Bloating and gases.

Many disorders are caused by damage to the gastrointestinal tract, in particular the pancreas. Patients often develop flatulence, which is caused by problems with the digestive system.

Diarrhea often changes to constipation, and with the development of external secretory insufficiency, the stool becomes fatty.

There is a late symptom that may not always appear, which is called true pancreatic diarrhea. Failure begins in cases where 90% of the organ is already affected.

It takes more than 10 years of pathology for this disorder to appear. Classic diarrhea appears in the chronic form of the disease from 2 to 6 times a day, the average weight of feces is about 500 grams, but it can be more, based on the diet.

In the feces, patients may notice undigested pieces of food, fats, and in color, the feces will be gray and oily, with a sharp unpleasant odor. The symptom often appears within an hour after eating.

With an exacerbation of the chronic form of pancreatitis, many people experience a loss of body weight, the problem begins due to the following reasons:

1. Fear of food, because after it unpleasant symptoms and pain begin to appear.
2. Decreased appetite.
3. Malabsorption useful elements in the intestines, metabolic failures.
4. Loss of calories due to diabetes.

Very rarely, people develop a lack of vitamins, which results in hemorrhage under the skin, bone pain, and blurred vision.

Other signs of exacerbation include obstructive jaundice, which can be identified by changes in skin color, dark urine, and lightening of stool.

Symptoms such as dry mouth and thirst appear when endocrine insufficiency occurs.

The main signs appear quite late, about 15 years after the onset of chronic pancreatitis.

Diagnosis

For selection proper treatment and determining the severity of the chronic form of pancreatitis in the acute phase will require a qualitative diagnosis.

Doctors collect tests, and blood results may indicate nonspecific inflammation. Tests are also carried out for the activity of pancreatic enzymes.

Additionally, a coprogram is done to identify fats in the stool, which will be in excess, due to this, enzyme deficiency can be determined. Other research options include:

1. Duodenoradiography.
2. Ultrasound of the abdominal cavity and pancreas.
3. CT and MRI.

In addition, doctors may use radiography. Based on the results of the examination, treatment is prescribed.

Features of treatment for exacerbations

The standard treatment regimen for the disease in the acute phase can be carried out using medications, which refers to conservative therapy or surgical methods of treatment.

The selection of the method depends on the severity of the pathology, as well as on possible complications that exist.

The main features of treatment for chronic pancreatitis include several rules:

1. Diet food.
2. Use of medications.
3. Taking folk remedies.
4. Surgical treatment.

Nutrition is very important for pancreatitis and the rule is mandatory; patients need to monitor their diet and completely avoid foods that can irritate the pancreas.

It is recommended to use the Pevzner dietary table No. 5p. In the chronic phase of the disease, if it worsens, it is strictly forbidden to drink alcoholic beverages, as well as eat spicy, fatty, sour and salty foods.

If pancreatitis is accompanied by diabetes mellitus, then the diet should be adjusted by the attending physician; it is important to monitor foods that contain sugar.

Medicines

Treatment of the chronic form in the acute stage is carried out by analogy with acute pancreatitis.

For this purpose, drugs are used that can eliminate the symptoms of the disease. In addition to this, remedies are used to relieve pain, improve the functioning of the digestive system, eliminate intoxication and inflammatory processes.

Among the main medications that can be identified:

1. Antispasmodic drugs. This group includes No-shpa, Papaverine or Platiphylline.
2. Medicines to reduce gastric secretion. Good results gives the medicine Omez and its analogues. You can use proton pump inhibitors, for example, Rabeprazole, Lanzal, Nolpaza. If enzyme activity is very high and sharp, then medications are administered through a vein.
3. For dehydration due to severe vomiting or diarrhea, doctors use Ringer's solution and other medications that are administered through a vein.

Enzyme medications during exacerbation are strictly prohibited for treatment. Only after a certain period of time can they be used, when the inflammatory process passes.

As studies have shown, Pancreatin can be used to help with the functioning of the digestive system in the dosage and regimen indicated by the treating doctor.

Surgical treatment

Main indications for surgical treatment:

1. Purulent processes.
2. Obstruction of the duct for the secretion of the gallbladder or pancreas.
3. Sphincter stenosis.
4. Changes in pancreatic tissue.
5. Cysts.
6. Ineffectiveness of conservative treatment.

After surgery, patients will need to fast for 1-3 days, as well as use medications that will help the body function normally and cope with basic digestive tasks.

Folk remedies

In addition to any treatment regimen, you can use traditional medicine based on medicinal herbs, from which decoctions or infusions are made.

They are used as an additional measure that can relieve some symptoms, improve appetite, and also allow for faster recovery.

Among the effective recipes are:

1. Mix 1 tsp. corn silk, celandine, dandelion root, violet and anise seeds. 500 ml of water is added to the mixture and everything is sent to cook over low heat for about 10 minutes. Leave the drink to brew, cool, and after filtering, drink 100 ml before your meal. Take this medicine until the pain goes away completely; in addition, the decoction improves the function and condition of the pancreas.
2. Grind 3 leaves of golden mustache and add 750 ml of water. Let the plant cook for a quarter of an hour. After cooling completely, filter the liquid and drink 1 tbsp. Gradually the dosage should be increased to 150 ml per single dose.

Treatment of exacerbations of chronic pancreatitis is carried out only in combination. To quickly achieve results you need to use proper nutrition, medicinal and folk remedies, excluding loads.

Possible complications

Complications of chronic pancreatitis may include different types. Early forms include:

1. Bleeding inside the body, which occurs due to rupture or cracks of the hollow parts of the gastrointestinal tract.
2. Jaundice, which begins when the outflow of bile is disrupted.
3. High blood pressure.
4. Infectious infection of the body.

Systemic complications include:

1. Encephalopathy.
2. Kidney, lung or liver failure.
3. DIC syndrome.

As the pathology progresses, there may be other types of complications, for example, diabetes, cancerous tumors in the pancreas, bleeding of the esophagus.

Prevention

Among the main preventive measures that help prevent exacerbation of an already developed disease are:

1. Refusal or minimal consumption of alcohol.
2. Control your diet, it should be balanced, you should eat small portions, try to give up harmful foods.
3. Stop smoking.
4. Monitor your drinking regime, drinking at least 1.5 liters of liquid per day.
5. Drink vitamin complexes to maintain the body.
6. Get diagnosed by a doctor in a timely manner in order to identify disturbances in the functioning of the gastrointestinal tract and other systems, and also take timely measures to eliminate possible problems.

It is important to follow the basic rules indicated by the doctor. A routine examination for pathology should be carried out every six months.

Useful video

This disease is one of the complications of acute pancreatitis, which was not cured in time. If such signs of pancreatic syndrome as amylasemia, lipasemia and pain occur within six months after diagnosis of the disease, we are talking about an attack of acute pancreatitis; after this period, an exacerbation of chronic pancreatitis occurs.

Facts about the disease:

• Among all officially diagnosed gastroenterological diseases, chronic pancreatitis has a share of 9%, among all clinical diseases - up to 1%.
• Mortality from exacerbations of this disease is about 10% in the first 10 years after diagnosis and 50% in the next 20 years.
• The frequency of detection of the disease is 10-15 people for every 100 thousand population of the Russian Federation.
• In the 21st century, the age at which the risk of contracting the disease is greatest has decreased from 50 to 39 years.
• The disease mainly affects men, especially those with an unhealthy craving for alcoholic beverages.
• In the last few years, the number of detections of the disease in women has increased to 30%.
• The proportion of exacerbations of chronic pancreatitis caused by alcohol abuse is about 70-75%.

REASONS

The main cause of exacerbation of chronic pancreatitis is alcohol abuse.

Other causes of exacerbation of the disease:

• Chronic diseases of the liver, duodenum and gall bladder.
• Mechanical abdominal injuries.
• Infectious diseases of the body.
• Excessive consumption of fatty and fried foods.
• Hereditary factors.
• Senile age (lack of enzymes in the body).
• Taking toxic medications.
• Smoking, especially if you are overweight.
• Complications after surgical operations.
• Diets that involve a minimum of protein.
• Autoimmune diseases.
• High stress on the nervous system, frequent stress.

CLASSIFICATION

Chronic pancreatitis is characterized by the following characteristics.

For reasons of occurrence:

Primary:

• drug;
• due to malnutrition;
• due to impaired metabolic mechanisms;
• alcoholic;
• atypical.

Post-traumatic.

Secondary:

• due to malfunctions of the gastrointestinal tract;
• lymphogenous;
• cholangiogenic;
• due to blockage of one of the branches of the peritoneal aorta;
• endocrinopathic;
• unidentified.

By manifestation:

• Painful.
• Dyspeptic – manifests itself in the form of digestive function disorders.
• False tumor – accompanied by Gospel disease (jaundice).
• Asymptomatic.

Depending on the form of the disease, the symptoms and treatment of exacerbation of chronic pancreatitis may differ slightly.

SYMPTOMS

Symptoms during exacerbation of chronic pancreatitis are very pronounced and clearly differentiate the disease from pancreatitis in its acute form.

Clinical manifestations:

• sharp pain in the abdomen;
• digestive dysfunction;
• disruptions of the endocrine system (for example, diabetes);
• nausea, severe vomiting;
• heartburn;
• rumbling in the stomach, flatulence;
• lack of appetite;
• high body temperature;
• febrile phenomena;
• severe weakness of the body;
• dryness and bitter taste on the tongue;
• rapid weight loss;
• depressed state.

DIAGNOSTICS

In most cases, making a diagnosis does not cause difficulties for a gastroenterologist, since in the acute stage the symptoms of chronic pancreatitis appear quite clearly.

Diagnostic methods:

• Collecting a primary medical history by interviewing the patient.
• Blood and urine analysis.
• A coprogram reveals undigested pieces of food, which is a sign of disturbances in the functioning of the pancreas.
• Ultrasound of the abdominal cavity.
• Radiography.
• Examination of the peritoneal organs using computed tomography.
• Gastroscopy.
• Endoscopic retrograde cholangiopancreatography is a method based on identifying the area in the duodenum where the pancreatic ducts and bile ducts converge to assess their patency.
• LUNDT test – injected into the body special liquid, promoting accelerated secretion of duodenal hormones. As a result, pancreatic fluid is produced, which is examined after collection.
• Secretin-pancreozymin study - differs from the previous method in that hormones (secretin and pancreozymin) are administered by injection.

In total, about 90 methods for diagnosing chronic pancreatitis are known, but most of them cannot detect the disease on early stage, especially in its asymptomatic form.

TREATMENT

If symptoms occur, treatment of an acute form of chronic pancreatitis is carried out only in a hospital setting and involves the comprehensive use of therapeutic measures that are designed to bring the functioning of the pancreas to normal levels.

Complex treatment:

Medication:

• drugs based on drotaverine that help eliminate pain;
• omeprazole-based inhibitors that suppress the secretion of pancreatic secretions;
• pancreatin enzymes, which take on a replacement function in the work of the pancreas when it is unloaded;
• antibacterial agents to prevent infectious lesions of the gastrointestinal tract;
• physiological solutions to restore electrolyte balance.

Dietary:

• avoidance of fatty, spicy and fried foods;
• complete abstinence from alcohol;
• minimal fat intake;
• predominance of animal proteins in the diet;
• moderate consumption of carbohydrates and table salt;
• regular intake of mineral waters.

Surgical:

• direct method - removal of stones, resection of the pancreas and drainage of pseudocysts;
• indirect method - surgical operations on the gastrointestinal tract and bile ducts.

Non-medicinal:

• applying cold to the pancreas area;
• therapeutic fasting in the first 2 days after an exacerbation;
• decrease in physical activity.

Simultaneously with the restoration of pancreatic function, treatment of exacerbation of chronic pancreatitis should be aimed at preventing its severe complications and complete rehabilitation of the patient.

COMPLICATIONS

Symptoms and treatment of exacerbation of chronic pancreatitis ignored by the patient often lead to extremely severe complications and deaths.

Most often, chronic pancreatitis leads to pancreatic cancer, which is severe, difficult to treat and can cause the death of the patient.

Other dangerous complications:

• internal bleeding;
• icteric cholestasis;
• infectious lesions of the body (abscesses, inflammatory processes in the bile ducts);
• formation of pseudocysts;
• renal failure;
• hypovolemic shock;
• distress syndrome;
• thrombosis of the splenic veins;
• encephalopathy.

PREVENTION

When preventing exacerbations of chronic pancreatitis, it should be remembered that giving up alcoholic beverages is the main task for the patient.

Other preventive measures:

• balanced diet;
• moderate consumption of fried and spicy foods;
• quitting smoking;
• body weight control;
• consumption of mineral waters (up to 1.5 liters per day);
• taking vitamin complexes;
• timely treatment of the digestive system;
• regular consultations with a treating gastroenterologist;
• following the rules of maintenance therapy throughout the year;
• taking multienzyme drugs in the first 6 months after remission (sometimes for life);
• careful use of medications (strictly according to the prescription and taking into account all contraindications);
• regular exercise, walks in the fresh air;
• avoiding stressful situations and nervous tension;
• reducing the risk of mechanical injuries (strict adherence to labor safety rules at work);
• support protective functions body at a sufficient level.

PROGNOSIS FOR RECOVERY

Symptoms after treatment of exacerbation of chronic pancreatitis often appear in cases where the patient ignores preventive measures and abuses alcohol.

Treatment takes up to 30 days. After this time, the patient’s strength fully returns, and performance is restored gradually, depending on the patient’s general condition.

The period of remission can last quite a long time, but, unfortunately, the risks of exacerbation of chronic pancreatitis remain high.

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All about chronic pancreatitis

Chronic pancreatitis is a disease of the digestive tract that is characterized by progressive inflammation of the pancreas tissue. As a result of the pathological process, a gradual...

Pancreatitis is a group of diseases characterized by inflammation of the pancreas in adults and children. Pancreatic enzymes are not released into the duodenum, but remain and self-digest. After digestion, toxins are released: once they enter the blood, they are transferred to other organs and harm them. How an exacerbation of chronic pancreatitis occurs, symptoms and treatment, as well as what to do, is described below.

Inflammation can occur in:

• acute form;
• acute form of relapse;
• chronic form;
• as an exacerbation of chronic pancreatitis.

Symptoms of exacerbation of pancreatitis manifest themselves as:

1. Dull, sharp pain under the ribs, spreading to the scapula area, the entire back.
2. Bitterness in the mouth, dryness, white plaque on the tongue.
3. Nausea, loss of appetite, weight loss, sometimes vomiting. The latter will be present even in the complete absence of food: the patient vomits bile.
4. Diarrhea, the feces have a greasy sheen and particles of undigested food. Sometimes there is an alternation of diarrhea with constipation.
5. Possible temperatures up to 38 degrees, chills, signs of vitamin deficiency.
6. Weakness, poor health, drowsiness, shortness of breath, low blood pressure, and “gray” skin are noted.
7. In a horizontal position, symptoms may intensify - it becomes easier if you sit and lean forward.

An attack can last up to a week, while the symptoms will be pronounced, and the pain and nausea will be constant. If they are not clearly expressed, the attack can last a long time - up to 1-2 months.

Also, the pain may not have a clear location (for example, spread to the entire back or lumbar region) and intensify after eating or at night.

Position of the pancreas

Making a diagnosis

Since the problem already exists, you cannot delay a visit to the doctor: since attacks negatively affect the digestion process, and toxins poison the entire body.

Any treatment for exacerbation of chronic pancreatitis begins with confirmation of the diagnosis, since similar symptoms appear in other diseases.

The patient will have to undergo:

• blood test: biochemical, for sugar content;
• stool analysis;
• general urinalysis;
• X-ray, ultrasound of the peritoneum;
• gastroscopy;

Additionally, a survey is conducted. With its help, they determine how long an attack can last and the causes of the pathology.

Read more about tests for pancreatitis and other pancreatic pathologies in

Treatment

Treatment of the pancreas during exacerbation of pancreatitis:

• taking medications;
• diet;
• prevention of re-exacerbation.

Medicines and diet are prescribed only by a doctor after examination and taking into account the patient’s concomitant pathology. If the drugs provide analgesic and anti-inflammatory effects and eliminate unpleasant symptoms of the disease, then the diet provides functional rest to the glands.

Traditional medicine can only be taken outside of an exacerbation. In the acute period, they are more likely to cause harm.

After stopping an exacerbation of pancreatitis, the following measures may be recommended to the patient:

1. Prevention in sanatorium-resort institutions: Mineralnye Vody, Kislovodsk and Zheleznovodsk, Truskavets (Ukraine), Karlovy Vary (Czech Republic).
2. Treatment of diseases that indirectly affect the condition of the pancreas (cholecystitis, gastroduodenitis, cholelithiasis).

Medicines

Mild and moderate exacerbations can be treated at home, after undergoing tests and consulting with a doctor. Patients with severe illness should be admitted to hospital.

Medicines for the treatment of exacerbation of chronic pancreatitis:

• analgesics and antispasmodics for pain relief (Duspatalin, No-shpa, Buscopan);
• prokinetics to normalize the motor function of the gastrointestinal tract, relieve nausea and vomiting (domperidone, Cerucal, Ondansetron);
• antisecretory agents to ensure functional rest of the pancreas, reduce the acidity of gastric juice (Omeprazole, Rabeprazole, Ranitidine, Almagel A, T);
• antibiotics are used only in the presence of bacterial complications;
• proteolysis inhibitors (Gordox) and somatostatin analogues (Octreotide) have high efficiency in relation to pancreatitis, they are prescribed for severe pathology.

Any medications must be prescribed by a doctor, since he takes into account not only the patient’s condition, but also other chronic diseases he has, which will determine the duration of treatment.

It is important to know that synthetic pancreatic enzymes (Creon, Pancreatin, Micrasim) are contraindicated in acute pancreatitis and exacerbation of chronic

Diet

The diet includes:

1. 2-3-day fasting: reduces the activity of enzyme production, calms the gland. Only drink should enter the stomach: warm still water, weak tea, rosehip decoction, additional nutrients are administered intravenously or through a gastric tube. Allowed 1.5-2 liters of drink per day - 50 ml hourly or 200 ml 6 times a day. Alkaline water is allowed (Narzan, Essentuki-17, Borjomi) - a sip several times a day. Avoid water in case of vomiting or nausea.
2. Fractional meals - small portions up to 7 times pureed, liquid food rich in carbohydrates, which least stimulate the pancreas. Shown are milk oat soups and porridges without oil, sugar, rice water, carrot, mashed potatoes, sugar-free apple jelly, low-fat fermented milk products. Serving sizes should be 2-3 tablespoons.
3. Over the next 14 days, portions are gradually increased to 200-300 grams of food. Food is prepared without salt, sugar, in liquid, pureed form.
4. The patient is transferred to diet No. 5p. It consists of boiled, stewed, baked food.

In the acute stage, it should be accompanied by the exclusion of foods that cause copious discharge gastric juice: pickles, marinades, spices, spicy, fried and fatty foods, as well as strong broths. Pork, lamb, goose and duck are excluded, all fats except light ones vegetable oils– corn and olive.

Traditional medicine

These can be plant decoctions and herbs, alcohol tinctures containing sage, wormwood, immortelle, horsetail, oats, St. John's wort and other herbs.

It's important to remember traditional medicine– is not a panacea: it can help improve the condition, but not cure it. Any use of herbs should be approved by a physician and used only in conjunction with medications and diet.

Prevention

It includes:

• dieting and maintaining a healthy weight;
• refusal bad habits: smoking and alcohol;
• regularly taking medications prescribed by a doctor;
• visiting resorts and healing waters on the advice of a doctor.

These actions will help avoid another exacerbation.

First aid

If pancreatitis has worsened, correctly provided first aid will slow down the development and alleviate the condition.

Help lies in:

What is prohibited to do at home:

• Apply cold, as this will lead to vasoconstriction and spasm.
• Give painkillers (for example, Analgin, Spazmalgon), as their effect will complicate the diagnosis.
• Give enzymes (for example, Mezim, Festal), as they will only worsen the situation.
• Flush the stomach yourself. It is only allowed to induce vomiting if the patient is very nauseous.

Exacerbation of pancreatitis is an extremely dangerous condition characterized by pain and poisoning of the body with toxins. IN such a case It is necessary to consult a doctor as soon as possible and begin treatment, and before that apply first aid.