Diet with pancreatic pancreatitis: what can and can not eat - causes, diagnosis and treatment
Posted On 19.03.2021
What is pancreatitis
Pancreatitis is an acute or chronic inflammation of one of the main organs of the endocrine system of our body - the pancreas. The work of the entire gastrointestinal tract and the process of digestion of food depends on the normal functioning of this body.
Pancreas is located in close proximity to the liver right behind the stomach. It performs many functions, the main of which is the synthesis of hormones, in particular, insulin. It also produces digestive enzymes that ensure the processes of splitting and assimilation of fats, proteins and carbohydrates. Food digestion occurs under the action of pancreatic juice coming directly into the duodenum.
Enzymes and pancreatic juice begin to be produced immediately after receipt of any food or beverages in the stomach. Enzymes perform different tasks:
lipase - splits fats;
lactase, amylase, maltase and invertase convert carbohydrates in monosahara - glucose, galactose and fructose;
TRIPSIN - ensures assimilation by the body of proteins.
In fact, pancreatitis is the self-defining of the pancreas tissue produced by it enzymes. Inflammation begins with excessive development of some enzymes in combination with high pressure in gland ducts. Extra enzymes fall into the overall bloodstream, negatively affecting the work of the brain, kidneys and other internal organs.
Causes of inflammation of the pancreas:
Alcohol abuse. More than half of the observations (p.36-47) pancreatitis is associated with regular consumption of large doses of alcohol.
Pancreatitis is often developing with bricken disease, abdominal injuries, the formation of a cyst in bile ducts, malignant formations in the gland.
The disease can be a side effect of the reception of some drugs, such as diuretics.
The risk group includes diabetics, people with other endocrine pathologies and hepatitis B or C. Sometimes pancreatitis develops against the background of pregnancy or after kidney transplant.
How alcohol affects the work of the pancreas
Alcohol in the body disintegrates with the formation of acetaldehydes, which are toxic to humans. Pancreatic cells are especially susceptible to their destructive effects. In addition, the use of alcoholic beverages can cause spasms and the narrowing of pancreatic ducts, which leads to the accumulation of pancreatic juice in it. As a result, digestive enzymes begin to process the gland itself, causing inflammation. Over time, if the disease is not treated, the cells of the glands die (pancreonenecosis) and are replaced by a scar tissue, the body loses the ability to function as before.
It is important to understand that the type of beverage and its quality in this case does not matter. If the drink contains alcohol, it is harmful. Especially negatively at the work of the pancreas can affect the use of alcohol together with fatty food or food with a high glycemic index, since these products create an additional load on the organ.
Types of pancreatitis
The most common classification of pancreatitis relies on the nature of the course of the disease: acute attack or long-term chronic pancreatitis with periodic recurrences. These two forms differ in terms of the severity of symptoms and require different approaches to treatment.
The inflammatory process in acute pancreatitis develops very quickly and is always accompanied by severe pain. In most cases, the disease occurs against the background of abuse of alcoholic beverages or after receiving a large amount of oily food. Sometimes the exacerbation is preceded by an attack of acute liver colic.
Symptoms of acute pancreatitis:
Strong pain in the left hypochondrium, which gives to other organs. The pain attack lasts about half an hour. Especially very pain is felt in the position lying on the back. The attack is enhanced after meals, especially fried and acute, and any alcoholic beverages.
Vomiting, often indomitable with an admixture of bile and bitter flavor. Permanent nausea, not passing after vomiting.
Subfebrile or high temperature.
Sometimes due to the violation of the outflow of bile, the yellowed of eye proteins is observed, very rarely yellow skin shade.
In some cases, pain syndrome is accompanied by heartburn and bloating.
With an attack of acute pancreatitis, immediate medical care is required. Anesthetic drugs bring only temporary relief, but do not affect the cause of inflammation. In the absence of qualified assistance, the risk of severe complications increases rapidly: infections to inflamed tissues, necrosis and abscesses.
Acute pancreatitis in severe stage can lead to shock and polyorgan deficiency.
If, after the attack of acute pancreatitis, a person does not comply with the recommendations of the doctors and continues to use alcoholic beverages and do not eat, the disease with a high share of probability goes into a chronic stage. Chronic pancreatitis develops with a significant nature of the pancreas damage during the first episode of the disease.
The disease is characterized by gradual pathological changes in the structure of the pancreas cells. Over time, it begins to lose its main function - the production of enzymes needed to digest food. Surrendor deficiency manifests itself:
By changing the nature of the forces mass - they acquire a sticky consistency due to a large amount of fat in them and poorly washed away from the walls of the toilet.
Chronic pancreatitis can leak asymptomatic: acute pain appears when significant pathological changes have already occurred in the pancreas. During the attack, chronic pancreatitis is manifested by the same symptoms as acute:
Strong hazing pain
Violations in the intestine.
The diagnosis is made on the basis of ultrasound research, computer or magnetic resonance tomography. During the study, narrowed pancreatic ducts are usually discovered due to the formation of stones in them - calcinates. Hardware techniques can also detect cysts at the site of atrophied tissue. Laboratory blood tests in chronic pancreatitis are little informative.
The insufficiency of the pancreas function is determined by the analysis of the carts. In the presence of a specific enzyme - pancreatic elastase - the diagnosis of "chronic pancreatitis" is made.
The importance of enzymes during digestion
The functioning of the human body is ensured by a complex system of interrelated and interdependent biochemical reactions. Thanks to special protein compounds - enzymes or enzymes - all these reactions are accelerated by providing quick metabolism. The effect of enzymes is very selectively: each of them is capable of initiating, accelerating or slowing down only one reaction.
The digestive process is based on the work of digestive enzymes. Their main task is to make the process of absorbing energy rapid and efficient. Enzymes split the components of food (proteins, fats and carbohydrates) on suction substance suitable for suction. At the same time, the amount of enzyme produced depends on the amount and quality of the eaten.
Digestion of food begins in the oral cavity. The chopped with teeth on small pieces of food is mixed with the saliva, which contains an alpha-amylase enzyme. The better we chew food, the easier it is that the enzyme of the salivary glands turn the starch molecules into soluble sugars and facilitate the process of further processing.
After primary processing, food in the esophage is entered into the stomach, where the gastric enzyme pepsin and hydrochloric acid begin work. These substances create gastric juice, which:
Provides antibacterial protection of the body;
stimulates the production of pancreatic hormones;
regulates the motorcy of the stomach;
Splits fats and performs a number of other functions.
In addition to pepsin responsible for splitting large protein molecules, other enzymes are also produced in the stomach, for example:
gelatinis - collagen solvent, gelatin and other connective tissue proteins;
Lipasa is an enzyme that cleaves some fat molecules to fatty acids and monoglycerides;
Hymosine - launches milk protein digestion process.
A significant role in the process of digestion is playing bile. It includes bile acids that stimulate the production of pancreatic secretions.
The stomach of the food lump is evacuated to the duodenum, where the main process of digesting food occurs. It provides more than 20 pancreas enzymes. Enzymes are contained in pancreatic juice, which is produced by iron in the amount of about two liters per day.
Pancreatic enzyme functions:
proteases - splitting proteins to amino acids;
Nucleases - affect DNA nucleic acids;
amylase - splits starch on simple sugar;
Lipases - decompose fats for higher fatty acids and glycerin.
The process of digestion under the action of fountal intestinal enzymes and beneficial bacteria living in the intestines is completed. In the intestine there is absorption of recycled food into the body (Fig. 1).
In violation of the functioning of the enzymes, the organs of the digestive system, especially the pancreas, there is a declaration of the whole organism. Such an imbalance entails nausea, diarrhea, meteorism with subsequent anemia and exhaustion.
What to take during meals with a shortage of pancreatic enzymes
In case of pancreatitis, the process of producing pancreas of digestive enzymes is broken, as a result of which a person suffers from discomfort and pain in the stomach. In this case, replacement therapy may be appointed after a complete examination.
The task of treatment with enzyme preparations is to fill their flaw in the body, while reducing the load on the damaged organ. In some cases, such therapy is appointed for life.
Important! The action of all enzyme preparations begins 20-30 minutes after eating, so drinking them is needed strictly before meals in the appointed doctor of the dosage!
Modern pharmacology offers a large number of different enzyme preparations of animal and plant origin. Some of them are directed only to the replenishment of a lack of some single enzyme, for example, splitting lactose or fats. There are also means of integrated effects appointed with a shortage of several enzymes in various organs of the digestive system.
Pancreatic enzymes are obtained from organs of cows or pigs. The composition of drugs includes basic pancreatic enzymes - amylase, lipase and tripsis. Paric acids, adsorbents or other enzymes may include, adsorbents or other enzymes. All drugs are selected strictly individually taking into account the nature of the course of the disease and the severity of symptoms.
What do you need a diet with pancreatitis
In the process of treatment of pancreatitis, nutrition plays a no less role than drugs. The main goal of the appointed diet is the restoration of the pancreas functions and the normalization of the process of producing digestive enzymes.
Heavy products for processing increase the load on the inflamed organ. After an abundant feast with fat fried pancreasses, the pancreas begins to produce enzymes to digestively. If the gland duces are narrowed, produced in extreme mode, pancreatic juice accumulates in the gland, exacerbating the development of the disease - the affected pancreas begins to digest itself.
The signals that iron works in reinforced mode include:
gravity in stomach after meals,
Attacks of pain in the area of the stomach.
Of course, constantly sticking to a strict diet is not easy, especially at home. People with strict restrictions in nutrition are forced to prepare themselves separately and hold from the temptations to eat something roasted or sharp.
It is important to understand that one violation of the diet can cause a acute attack of pancreatitis with all the ensuing consequences: severe pain, nausea, vomiting and diarrhea. The only breakdown may not be reduced to all efforts to maintain long-term remission.
Rules diet number 5: What can and what can not be with pancreatitis
Diet with pancreatitis has many restrictions and for permitted products, and according to the method of their preparation. Especially for people experiencing problems with pancreas, one of the founders of domestic dietology and gastroenterology professor I.I. Peusner was developed by dietary table No. 5.
But, before meeting the specific provisions of this diet, it is necessary to take into account the general nutrition principles in Pancreatitute:
It is necessary to eat 5 times a day in small portions;
eliminate fried and marinated products;
Under the acute stage of the disease, food is needed to grind or wipe;
An animal protein should prevail in the diet;
The number of fats per day should not exceed 50 g;
Sugar also falls under a strict restriction - no more than 30 g per day;
Under the prohibition of products that increase the meteorism - sweet carbonated drinks, any legumes, sweet apples and grapes, sweet duff and some others;
Salt consumption is reduced to a minimum - no more than three to five grams.
Important! With pancreatitis, it is possible to eat slow carbohydrates, while it is necessary to monitor the ratio of nutrients in dishes. It is not necessary to deceive that sugar can be replaced with honey, its consumption should also be controlled. At first, it will necessarily need a calculator. It is necessary to immediately calculate the calorie rate per day and the balance of proteins, fats and carbohydrates based on the body mass index. This information is easy to find on the Internet on sites on proper nutrition and a healthy lifestyle. To count calories and the number of nutrients there are various mobile applications.
All listed principles are taken into account in Diet No. 5, which exists in basic and expanded versions.
The basic variant is shown in recurrences of chronic pancreatitis and in the acute nature of the disease. In the acute phase, the diet is more strict with many limitations. It is aimed at unloading the pancreas and the removal of symptoms of acute inflammation. In the first 3 days of the acute stage, the patient recommends starvation for the pancreas leisure. Next, for 3-7 days, powered by carbohydrate products with small portions with small intervals is allowed. The calorie content of the diet these days should be reduced, and food is used only in a rubber or semi-liquid form.
Important! It is common that with any problems with digestion, the boiling broth helps well, especially chicken. In pancreatitis, diseases of the gallbladder and other pathologies of the gastrointestinal gastrointestinal ribric broths are categorically contraindicated! An excessive amount of animal fat significantly increases the load on the pancreas and prevents the normalization of the state.
The diet includes porridges on water and vegetable soups with various croups, except for breast and corn, boiled or cooked with a pair of rubber vegetables. Sustained tea, kissel, compote from dried fruits are allowed from drinks. The bread is allowed only white and slightly snapped, you can eat crackers and biscuits like Galet.
On the third day of carbohydrate diet, protein products are gradually introduced:
Soup from lean meat, it is advisable to cook broth from veal, turkey or chicken breast, meat from the broth should be skipped through a meat grinder or crushed in a blender;
Omelet, cooked for a pair or eggs sick;
steam cutlets from lean meat or low-fat fish;
Curd casseled and souffle of cottage cheese with minimal fat.
Diet number 5 is recognized as to spare the pancreas, which in the aggravation stage needs a complete peace. Allowed and prohibited products for the basic diet are shown in Table 1.
Important! The predominance of protein food in the diet can lead to constipation. In this case, you need to add more raw vegetables and fruits from the allowed list. When gave preference is given to proteins of plant origin or sea fish.
Table 1. Allowed and prohibited products according to the basic version of diet No. 5.
It is impossible
Sustained tea with lemon adding and small sugar
Decoration of Ryshovnika
Water diluted vegetable and fruit juices
Compote and fresh fruit compotes without sugar
Chocolate and cocoa
Any alcohol including beer
Soups (base diet)
Vegetable soups without roasted
Cruel soups or noodle soup
Borsch on the broth from lean meat without roasted
Classic borsch with roasted vegetables
Shattered soup or spinach soup
Occard on kefir, kvass or serum
Cereal and products from croup
Buckwheat, oat, rice porridge on water or dilute milk
Pilaf with dried fruit
Casseroles and puddings from croup
Any of the solid wheat varieties
Pasta with meat additives and sharp sauces, for example, carbonara paste
Meat and fish
Turkey and chicken without leather, preferably white meat
Seafood - in limited quantities
Sea fish (2-3 times a week)
Dairy sausages - very limited
Fat river fish
Canned fish and meat
Meat semi-finished products
Bread with bran
Any sweet pastries
Double Test Products
Roasted Patties With Any Stuffing
Low fat dairy products
Natural yogurts without additives
10% sour cream
Fat milk products
Strong salted brine cheeses
Vegetables (better consuming seasonal)
Tomatoes (only in the remission stage and in small quantities)
Canned and pickled
Corn, asparagus, eggplants, radish and radishes
White white cabbage
Berries and fruits
Bananas in limited quantities
Watermelon (no more than 200 g)
Any fresh berries
Creamy - 30 g per day
Steam or cooked Omelet, preferably protein
Cool or ski
Fried eggs with tomatoes
Omelet in a frying pan
Salads and snacks
Canned vegetables and snacks
Sweets and desserts
Walnut desserts - Kozinaki and others
After removing the symptoms of acute pancreatitis, the diet is expanding, and other products are added to it, the amount of protein in the diet and the overall caloric content of nutrition increases. At the same time, the gentle principle is maintained for a long time to minimize the risks of recurrence of the disease. All dishes should be cooked or cooked for a couple, too hot or cold products can not be. At the first signs of exacerbation, it is necessary to immediately switch to the first version of the diet with less calirage and large restrictions.
Important! Pancreatitis is especially harmful: alcohol, chocolate, coffee, carbonated drinks.
Diet with pancreatitis balanced and rational, all its components are easily absorbed. Despite significant restrictions, delicious and nutritious dishes can be prepared from the permitted products.
Partially limited products
With the second version of the diet, sometimes you can pamper yourself with marshmallow and dissolved in tea jam. Parsley and other greens are better used only for decorating dishes. Melon and pineapples can be eaten in a dried form, but in small quantities.
Approximate menu with pancreatitis for a week
Strict recommendations for the daily menu with diet number 5 is not. For a reference, you can use the menu in Figure 2, replacing dishes at your discretion, taking into account the preservation of the balance of proteins, fats and carbohydrates and general calorie content.
Figure 2 - menu for a week with chronic pancreatitis (diet number 5P). Source: Medportal
Replacing dishes in the menu, you need to adhere to the recommendations for the preparation method: products can only be cooking, bake or cook for a pair. The diet for the acute stage of the disease will always be more strict than for chronic pancreatitis in the remission stage (Fig. 3).
Dietary dishes recipes with pancreatitis
In Figure 4, we collected several simple recipes from the allowed products. More recipes for people with chronic pancreatic diseases can be found in the book "Chronic Pancreatitis Cookbook", published on the website of the American National Foundation for Support Patients with Pancreatitis. Please note that recipes in this book are not fully consistent with Table No. 5.
Figure 4. Recipes dishes for people with pancreatic diseases. Source: Medportal
What herbs can drink
To facilitate the state after consulting with a doctor, you can drink champs of medicinal herbs.
"Elan" is a finished collection of Altai herbs sold in pharmacies. It has anti-inflammatory action. Prepare a decoction must be prepared on the packaging.
Parsley has a pronounced anti-inflammatory and antioxidant effect, stimulates the secretion of the stomach. In chronic pancreatitis, the infusion of fresh crushed parsley takes 2-3 times day half an hour before meals.
Herbal fee number 213
The collection includes a number of useful plants useful with inflammation: the chamomile pharmacy, wormwood bitter, horsetail and other herbs. Ramars based on a collection prepare on the recommendations on the package.
Diet for children
In children under 14, chronic pancreatitis is detected extremely rarely. When diagnosing an acute form of disease, food is organized in the same way as in adults.
Diet for pregnant women
Pregnant women are often faced with problems associated with the work of the gastrointestinal tract. Pancreatitis can develop due to the abuse of vitamin complexes or due to excessive pressure on the pancreas on the side of the uterus.
The principles of a diet for pregnant women are not different from a common diet with pancreatitis. However, during pregnancy it is extremely important to provide a full-fledged diet necessary for the development of the fetus. As part of food in sufficient quantities must be present:
proteins (low-fat meat and fish, dairy products, eggs, legumes),
Complex carbohydrates (cereals, pasta, fruits and vegetables),
Fats (vegetable oils),
Vitamins and minerals.
Compliance with a strict diet with pancreatitis - the basis of successful therapy. The effectiveness of diet number 5 is confirmed by many years of clinical practice. Proper nutrition is the same important component of treatment, as well as drugs, so the recommendations of the attending physician in no case should be neglected.
Guberngritz N. B., Krylova E.A., Gaidar Yu.A., Burka A.A. Features of pathogenesis, progression and structure of pancreatic fibrosis during chronic pancreatitis. Medical alphabet. 2019; 3 (20): 11-15.
Pancreatitis is the inflammation of the tissues of the pancreas (PZh) with a violation of the outflow of its secrets. The disease is caused by poor passability of withdrawing ducts against the background of increased activity of enzyme systems. At the same time, the highlighted juices do not have time to go out into the lumen of the duodenum, but they accumulate and begin to digest their own gland tissues.
Over the past 10 years, the "popularity" of the disease increased 3 times and became a characteristic phenomenon not only for adults, but also for the younger generation. The most frequent causes are a disruption of the diet and the absence of a proper culture of alcoholic beverage consumption.
Causes of the disease
The main reasons for the development of pancreatitis:
Long and non-valid alcohol consumption. Ethyl alcohol increases the saturation of pancreatic juices and provokes a sphincter spasm that regulates their receipt to the duodenum. Statistics: 40% of patients with pancreatitis are sick alcoholism; 70% - periodically abuse alcohol.
Gallgamed disease - the biliary concretion is able to cause the blockage of the incoming ducts and cause inflammation of the iron tissue. Statistics: 30% of patients have a history of the stones in the gallbladder.
The violation of lipid metabolism associated with overeating and obesity leads to increased development of enzymes, which provokes the risk of inflammation. Statistics: 20% of cases are accompanied by overweight and lipid metabolic diseases.
Viral infections, including hepatitis, tuberculosis, chickenpox, vapotitis, corte, abdominal typhoids, etc.
Disturbance of calcium metabolism - hypercalcemia. Leads to sclerotization (hardening) of tissues of the gland with a violation of secretory function and spasp of ducts.
Autoimmune diseases - some types of allergies can provoke autoimmune antibodies to their own PJ cells.
Parasitic invasions - the accumulation of large parasites, for example, Askarid, can overlap the governing devices of the organ.
Damage to the ducts during injuries and during operations.
Poisoning or intoxication of the body - leads to overloading enzyme systems with excessive production of digestive juices.
Endocrine diseases - directly or indirectly affect the work of all glands of internal and external secretion. Particularly adversely affect the PJ disorders of the thyroid gland and diabetes.
The pathology of the structures of the digestive system - enterocolitis, colitis, duodenitis, diverticulitis, ulcerative disease, Reee syndrome (liver fatty).
Prolonged reception of some drugs - steroid preparations, certain types of diuretic products, antibiotics, sulfanimamides.
Vascular pathologies (arterial hypertension, atherosclerosis) with circulatory impairment in the pancreas area, as well as complications during pregnancy in women.
Hemolytic diseases - including hemolytic-uremic syndrome.
Hereditary pathologies (most often fibrousosis). The associated thickening of internal secrets, including pancreatic juices, leads to a violation of their outflow.
Causes of pancreatitis causes can manifest themselves independently or in the complex. This determines not only the etiology of the disease, but also the degree of its manifestation, the severity of the flow and therapeutic forecast.
Repeated attacks of acute pancreatitis provoke the transition of the disease into a chronic form. Because of the frequent inflammation, the organ is covered with a scar cloth (fibrous rebirth) and loses the ability to produce the desired amount of enzymes. If areas produce insulin (Langerhans islands) are damaged by damage, an insulin-dependent form of diabetes is developed.
How Pancreatitis is manifested: symptoms and signs
The main list of symptoms at acute form:
pronounced pain in the hypochondrium - taking into account the causes of the disease and accompanying pathologies may be concerning, right- or left-hand;
reactions from the digestive tract - Icota, belching with an unpleasant odor, nausea and multiple seizures of vomiting, constipation or diarrhea;
The general deterioration of the state is dehydration of the body, the feeling of dryness in the mouth, weakness, increase or decrease in blood pressure, shortness of breath, reinforced sweating, high temperature;
External manifestations - dim, earthy skin, blue, or brownish spots in the lower back area and the obsequency zone, can mechanical jaundice.
Attention! Acute form requires urgent hospitalization with subsequent hospital treatment.
In chronic form, the sign of pancreatitis is less pronounced:
pain is manifested only after receiving fried and fatty food or alcohol; The rest of the time in the field of hypochondriums may be observed light discomfort;
The reactions from the digestive system are manifested only during dyspeptic form in the form of meteorism, diarrhea or constipation;
External skin manifestations in the form of light yellowness; With a long lack of treatment, weighing loss, anemia, 2-type diabetes mellitus are observed.
In the latent stage, the disease proceeds asymptomatic; When fibrous form, the scar tissue can grow with the formation of pseudo-pumping structures.
Important! Pancreatic pancreatitis Rarely manifests as an independent disease. Usually, the pathological process combines several digestive organs, involving hepatobiliary system in it (liver, gallbladder and ducts), duodenum, stomach. This fact requires the diagnosis of the entire human digestive system.
How to examine
Diagnosis and treatment of pancreatitis are within the competence of the gastroenterologist. To make a diagnosis, the doctor collects history, conducts inspection and assigns diagnostic procedures.
The procedure includes an assessment of the condition of the skin, eye scool, language, the operation of the salivary glands. The patient is then placed on the couch and carry palpation and the awake to identify objective symptoms of pancreatitis:
The symptom of Mussi-Georgievsky, or Frainian-symptom - painful sensations when pressing the tips of the fingers in the region over the left clavicle - where the diaphragmal nerve is passed between the legs of the municipal muscles;
Sensitivity in the Zone of Shoffhara - in the area of projection of the pancreas head, 5-6 cm above and the right of the navel;
The symptom of the governor-Sculiansky - pain is manifested in the zone of the body of the pancreas body, a little left of the Soffara zone;
The pain in the Meio-Robson zone is the left edge-vertebral angle - the area of the attitude of the pancreas tail;
Symptom of dezharden - sensitivity at a point located on 5-6 cm above the navel of the line connecting the navel and the axillary depression; Like the Soffara zone, the point is the projection of the pancreas head;
The hypotrophic sign of Grotta is a lack of subcutaneous fatty fiber in the area of the projection of the gland;
The hemorrhagic symptom of Thalilina, or the symptom of "red droplets", is manifested in the form of fine burgundy rashes or brown pigmentation over the area of the gland;
The symptom of kaches is pain in palpation at the output of nerve processes at the level of breast vertebrae: 8-9th - left, 9-11 - right.
The symptom of Voskresensky - with an increase in the pancreas with an edema of the tag, the pulse of the abdominal aorta is not forgiven.
Together with the poll, the palpation allows you to determine the presence of dyspeptic phenomena from the digestive tract: meteorism, belching, nausea, diarrhea, constipation.
Attention! A sign of chronic pancreatitis can be a pronounced weight loss. It develops due to a violation of the food digestion process against the background of a decrease in the secretory function of the gland and the shortage of enzymes. Accompanied by increased dry skin, anemia, dizziness.
Laboratory diagnostic methods:
Common blood test identifies signs of inflammation - a high level of leukocytes, reduced ESO;
Biochemical blood test determines the level of pancreatic enzymes - amylases, alkaline phosphatase, as well as bilirubin pigment;
urine analysis shows the residual content of amylase enzymes and diastases;
DOG DIAGNOSTICS Estimates the activity of the digestive process by introducing substrates for pancreatic enzymes, followed by tracking their assimilation;
An analysis of the feces on the parasites is carried out as needed.
Ultrasound - determines the form and size of the organ, the presence of seals and fibrous sections;
Gastroscopy - assesses the degree of inflammation of the walls of the stomach and duodenum;
X-ray and its type - endoscopic retrograde cholangiopancatography - help to detect the clusters of clusters of clusters or stones causing blockage;
Protecting methods for determining the outer-generating function of the gland - the secretine-panoposimine test, the Lund test;
CT or MRI allows you to estimate the degree of tissue necrosis in heavy patients;
Laparoscopy is used in difficult cases for visual assessment and tissue biopsy.
How to treat pancreatic pancreatitis
Three rules for the treatment of this pathology - peace, cold and hunger:
Peace slows down blood circulation and reduces blood flow to the patient;
Cold compresses on the region of hypochondrium lower the temperature of inflammation and the severity of pain syndrome;
Fasting for 1-6 days suspends the production of enzymes causing inflammation.
Additionally, conservative treatment with the use of medicines, physiotherapy and phytotherapy is prescribed.
spasmolitics and NSAIDs to eliminate gastrointestinal spasms and inflamed pancreas;
antibiotics - with an active infectious process;
antisecretory preparations - to suppress external (enzyme) and internal (hormone) secretion;
Pancreatic enzymes - to maintain healthy digestion during the treatment period, as well as with a significant degeneration of the tissues of the gland;
Insulin preparations - when damaged hormone production zones.
Physiotherapy is connected to treatment after removing the acute phase of inflammation. The most effective techniques:
Electrophoresis with painkillers and anti-inflammatory drugs increases the intensity of their action, better relieves pain and inflammation;
Ultrasounds are used as an anesthetic with a sickening pain syndrome;
Laser and UV irradiation of blood remove inflammation, improve microcirculation of liquid media and tissue regeneration;
A variable magnetic field successfully helps to eliminate swelling and inflammation.
Fitotherapy is used as accompanying treatment - to enhance the effect of drugs and eliminate possible "sides". To this end, plants with anti-inflammatory, detoxification, antispasmodic, soothing effects are used. These include chamomile, calendula, St. John's wort, wormwood, dandelion, burdock, golden mustache, mother-in-law, immortelle, barbaris, cumin and a number of other herbs that are used as a one, and as part of comprehensive fees.
In severe cases, when conservative treatment methods do not help, resort to surgical removal of the organ or its part, followed by the appointment of substitution enzyme therapy on an ongoing basis. Indications: Full disintegration of the organ, the presence of cyst, necrosis, tumors, abscesses, fistula, resistant blockage of duct stones.
After removing acute inflammation, special diet food is prescribed. In chronic pancreatitis or in the case of surgical treatment of the gland, it must be lifelong.
Diet number 5 under pancreatitis
With iron pancreatitis, it is not able to cope with a large set of diverse food, so the best way out is fractional separation. Fully exclude products that stimulate increased secretion: fat, salty, fried, smoked, spices, chocolate, coffee, sturdy tea, meat, fish, mushroom broths, coarse fiber in the form of fresh fruits and vegetables, as well as any alcoholic beverages.
Strict diet number 5P (according to Pevznera) is relevant in the first days after exacerbations. Features:
fractional food with minor portions 8 times a day; The size of the one-time portion is not more than 300 g.;
Food structure - thermally processed, crushed in Cashitz products: mashed potatoes, kisins, puddings, mucous porridges on water, softened in chimneys;
Food composition - boiled in water or a pair of vegetables (carrots, potatoes, zucchini, pumpkin), low-fat meat and fish, low-fat dairy products, chicken squirrels, vegetable broths, pasta, cereals, semi-sweet berries and fruits; emphasis should be made on protein food with a reduced content of fats and carbohydrates;
Salt consumption is not more than 10 g per day; Instead of sugar, it is desirable to use a sugar substitute;
The food must be warm - a temperature of 20-52 degrees; Hot and cold is impossible!
When remission reaching, the diet requires a little softened:
The number of food meals are reduced to 5 times a day with increasing portions;
It is allowed to use non-grinding products, stewed and baked dishes, milk kas;
You can increase the amount of carbohydrates.
Attention! Of great importance is the disclaimer of smoking, especially if the disease is triggered by the poor state of the vessels.
A single case of acute pancreatitis with timely and high-quality treatment may pass without consequences for the body. When moving the disease in chronic form, the full recovery of the PZ is impossible. However, when compliance with strict diet and recommendations on drug treatment, you can achieve a resistant remission with a significant improvement in the quality of life.
Painful sensations in the pancreas area may be signs of very formidable diseases. These sensations often can be confused with pain in neighboring organs. It is very important to know how the pancreas hurts and what to do with these symptoms.
Where is the organ
It is necessary to know the exact location of the pancreas. It is behind the stomach in the area of the epigastrium and the left grab. Iron takes the top and middle part of the abdominal cavity on the left. This organ crosses the Addison plane and is at one height with the first and second lumbar vertebrae.
Where pain is felt
The structure of the pancreas will help to understand why pain can be given to other parts of the body. This body weighs about 70-80 g. It is allocated head, body and tail. In an adult, this body grows up to 14-22 cm. The width of the gland in the head is 3-9 cm. Its structure is extremely complex: it contains many ducts, alveoli, ganglia, nerves and vessels. The main function of this organ is the development of vital enzymes, secrets and hormones.
The pain can be felt at the top of the abdomen and proceed as if from the depth. It often gives to the left shoulder and back, it happens to be grooming. By character, pain can be a rodent, novel or swath.
If neighboring organs hurt
From all sides, the pancreas is closely closed by other bodies, so their diseases and pathologies can be confused. This happens for diseases of many organs:
Destinating the location and character of pain is extremely important to start competent treatment in time, which will save life.
With acute or chronic inflammation of the stomach, pain often appear in the left upper stomach. A burning or ricking pain can become sharper during a meal or because of hunger. Similar sensations arise with the stomach and duodenal ulcer.
If stones were formed in the bustling bubble, the painful colic may occur periodically. Intense sharp pain lasts about 2 hours. If the attack lasts longer, this indicates a cholecystitis (inflammation of the gallbladder) or cholangitis (diseases of bile ducts). Breast disease is often accompanied by cholecystitis. Bile (liver) colic appears with a sharp pain in the top of the abdomen and occasionally occur. Depending on the severity of the state, they can appear often or rarely. Fat food provokes pain attacks in diseases of the gallbladder and pancreas.
When the abdominal wall hurts, the painful sensations arise closer to the surface of the belly, and not from the depth. Nevertheless, such a state may be observed at the beginning of an attack of pain in the pancreas.
Pain due to the rupture of the abdominal organ
Through damage, caming or gap of any organ located in the abdominal cavity causes painful pain. The patient begins peritonitis, musculature is strained, nausea and vomiting occurs, the temperature rises. The contents of the affected organ enters the abdominal cavity.
Pain with heart attack
The pain with such a threatening life of the state, as a myocardial infarction, can move to the epigastrium and disguised as pain in the pancreas. The patient always make ECG to raise the right diagnosis.
Why hurts pancreas
A person can feel small unpleasant symptoms or, on the contrary, painful pain. Painful sensations arise with a variety of pancreas diseases. It can hurt constantly or periodically, but almost always becomes stronger after receiving food. Symptoms of diseases are the same in men and women. The most common diseases are cancer and pancreatitis. They require serious and complex treatment.
Most often, the pancreas hurts with acute inflammation - pancreatitis. Strong, incessant pain begins sharply and suddenly and lasts longer than a day. It is localized in the epigastrium and left under the ribs, but often gives back and left shoulder. If you lean a little forward or curl up, it will become a little easier. On the contrary, it is not worth standing or lying, stretching out, it aggravates the pain.
Other symptoms of acute pancreatitis:
Due to tachycardia and fainting, pancreatitis is often confused with a heart attack. In any case, it is necessary to immediately call "ambulance". Acute pancreatitis proceeds rapidly and can lead to necrosis. Then the patient dies within 1-2 days. According to statistics, about 30% of patients die. If a patient has serious complications, then death is almost inevitable.
Pain is often repeated in chronic pancreatitis. In the launched cases, it accompanies a person constantly. But some patients do not arise any pain. Additional symptoms of disease - diarrhea, steatheree (fatty chair), yellow skin and mucous color, sharp decline in body weight. Progressing, the disease causes irreversible violations in the work of the pancreas. In this case, the disease must be observed a strict diet and take appointed medicines.
Oncological diseases of the pancreas show themselves the same symptoms as pancreatitis, so it is difficult to immediately damage the correct diagnosis.
painful rodent or taking pain;
gravity in the stomach;
nausea, vomiting, lack of appetite;
Strong jaundice - yellowing the whole body;
Most often, the tumor occurs in the head of the gland and rapidly grow. Metastases to other organs quickly germinate.
Pancreas Cancer is a very insidious and difficult disease. It is difficult to diagnose on time. It often happens that the correct diagnosis is raised when the precious time is missed, and the treatment will not help. In the initial stages it can be found randomly during the planned ultrasound or MRI.
After diagnosis, patients do not live longer than 1.5 years. If the diagnosis was delivered at the late stage, patients live about 7 months or less.
What to do
It is necessary to contact the doctor as soon as possible - first to the therapist, and then to the gastroenterologist or oncologist. If the pain is impossible to endure, it is necessary to call "ambulance". It is impossible to eat, drink and take any painkillers. It is forbidden to lay the heating on the stomach, because it can accelerate the injection of infection into the blood and aggravate the inflammatory process.
Diagnosis and treatment
The gastroenterologist will send a patient for several studies that need to go through as soon as possible:
According to the results of inspection and research, the patient prescribe medications and a strict diet. If the disease is dangerous, the patient is urgently sent to the operation.
We will help with the choice of drugs in pancreatitis
Which pills can be used in pancreatitis
Blockers receptors and proton pumps
Analgesics and antispasmodics
How to choose the drug with pancreatitis
Pancreatitis is inflammation of the pancreas that can flow in acute or chronic form. The disease is accompanied by a violation of the outflow of the secret from the authority, as a result of which the enzymes begin to destroy the cells of the gland, and the digestion of food in the intestine almost stops. To stop this process, experts practice the treatment of pancreatitis by medicines with various properties: to eliminate symptoms, neutralization of enzymes in the gland or replenishing their lack of intestines. Special attention is paid to lifestyle and diet.
From how correct the choice of drugs, not only the result of therapy, but also the life of a person depends on. Incorrectly chosen preparations for pancreatitis are able to reduce the efforts of doctors to save the life of the patient. As a result of improper treatment, necrosis of the pancreas, diabetes can develop. There are often cases when an abscess is formed in the authority, the breakthrough of which leads to peritonitis, the formation of fistulas between the pancreas and located near the authorities. All these diseases are dangerous to the high risk of fatal outcome or a significant deterioration in the quality of the patient's life.
Which pills can be used in pancreatitis
In case of disease, pill pancreatitis is selected taking into account the available symptoms, and the main purpose of their reception is to unload the pancreas and reducing its activity. Suspend the synthesis of digestive enzymes of organs helps the drugs of the following groups:
Blockers of proton pumps and inhibitors of H2-histamine receptors;
enzyme preparations with pancreatin;
This set of funds is sufficient to eliminate the inflammatory process and restoring the functions of the pancreas. Preparations of other groups (enterosorbents, funds that save from heartburn, antibiotics, etc.) are prescribed if necessary or complications.
Blockers receptors and proton pumps
This group of medicines does not affect the gland directly on the gland, but partially or completely stops the extraction of hydrochloric acid in the stomach. As a result of the reduction in its synthesis, the pancreas receives a signal that the body does not need digestive secretion. The slowdown in the body leads to a more rapid restoration of its functionality, and the risk of complications is reduced.
When choosing funds to reduce the secretion of hydrochloric acid, it is possible to make a choice in favor of drugs that block H2-histamine receptors or inhibitory proton pumps.
N2-histamine receptor blockers (Roxatidine, Ranitidine, Famotidine and Lafutidine) suspend only one mechanism for the production of hydrochloric acid in the stomach (on garbage and acetylcholine receptors such drugs do not affect), there are short time, have side effects and cause addictive.
Proton pump inhibitors ("omeprazole", "Pantoprazole", "Rabeprazole" and others) are more efficient and safe, do not cause side effects and addiction, there are long and suspend the formation and separation of hydrochloric acid, acting on the shelter cells of the stomach walls. Reviews of the effectiveness of these drugs in most cases are positive.
Enzymes - indispensable drugs for pancreatitis that allow you to restore the process of digestion and unload the pancreas. Drugs for pancreatitis of this group are represented by pills with pancreatin, including plant origin ("Pancreatin", "Mesim Forte", "Pepfaz", "Wobenzyme") and acid-resistant capsules with microgranules of the programmed release ("Creon", "Ermal", "Micrazim ").
When choosing enzyme preparations, the role plays not only the dosage of actors. Specialists pay attention to the course of the disease, the causes of its occurrence, the presence of concomitant diseases or intolerance to individual components.
Important! Tablets with a bile, turmeric extract and simeticone with pancreatitis are contraindicated, since they not only reimburse the lack of enzymes, but also enhance their synthesis in the pancreas, provoking inflammation.
The most efficient and safe drugs suitable for the treatment of pancreatitis, gastroenterologists call:
The listed drugs are used in chronic pancreatitis, as well as in power errors to prevent exacerbations. Reviews of them in most cases are positive, but the likelihood of side effects during their reception is not excluded.
Analgesics and antispasmodics
In acute inflammation of the pancreas or the exacerbation of the chronic process, it is important to eliminate pain syndrome. For this use analgesics and antispasmodics. The first is well coped with discomfort, which occurred during primary inflammation. Antispasmodics are also recommended to use with pain syndrome caused by the pressure of cyst, pseudokist and stones on the gland ductures.
Recommended to use analgesics in pancreatitis:
Paracetamol is an efficient and safe drug that does not irritate the gastric mucosa and helps reduce inflammation.
Analgin is a potent drug that is used independently or in a complex with spasmolitics.
Baralgin is similar in composition and action with analgic agent.
Preparations with anesthetic effect are not devoid of flaws. They can irritate the mucous membranes, cause allergies and affect the work of the cardiovascular system, liver and kidney. Therefore, they are prescribed, taking into account the individual characteristics of the patient. Nevertheless, the reviews about these painkillers are more often positive than negative.
If sharp pains appeared due to an increase in pressure in pancreatic ducts, analgesics will be ineffective. To eliminate symptoms, it is better to use antispasmodics:
Papaverin is a means based on the connection of the same name, which effectively relaxes the smooth muscles, from which the PJ dlys consist.
DROTAVERIN - Miotropic spasmolitic, which contributes to the restoration of pancreatic ducts under their spasme. It has a weakly pronounced anti-inflammatory effect.
Mebavverin (Duspatalin) is a drug with a pronounced and long effect, but acts mainly on the smooth muscles of the stomach, intestines and bile ducts. Its use is especially useful in secondary pancreatitis, arising against the background of the pathologies of the gallbladder.
Each of the listed drugs is positively assessed by patients. In rare cases, the reviews contain negative, and often it is caused by non-quality of drugs, but their high cost.
Experts note that antispasmodics require strict dosage, as they affect smooth muscles throughout the body, including myocardium, vascular walls, bladder. They are not prescribed patients with reduced arterial pressure, some types of arrhythmias, a bowel atony.
In addition to enzyme preparations and painkillers for pancreatitis, prebiotics based on soluble food fibers are recommended. They are needed to restore intestinal microflora and protect the pancreas from excessive load.
If the fibers and glucose, which stimulate the PZ stimulate the digestive secret and insulin are absorbed into the fiber digestive tract. Thanks to this, iron functions due to its capabilities, which allows it to recover faster. In addition, the soluble fiber is a good nutrient medium for useful microflora, as a result of which the absorption of the main nutrients in the thick intestine is improved.
The source of soluble fibers can be all kinds of cabbage, citrus, apples, beans and pumpkin, zucchini and carrots, oat groats, prunes and whole grain bread. Unfortunately, most of the products listed during exacerbation are prohibited for receiving, as they cause bloating and violation of the chair. Replace them with rye bran or husky plantain. A more convenient and safe option is the "Smart Fireber" additive. The fiber in it has a powder structure, which is dissolved without a trace in any food and beverages, without changing the taste, color and consistency of the dish. On a day, it is enough to use one spoonful tool to cover the daily need for food fibers and get rid of the unpleasant feelings in the abdomen.
How to choose the drug with pancreatitis
Make the right choice in the treatment of pancreatitis pills and soberly appreciate which one is better, can only the attending physician. Even the most expensive and modern medicine may not be suitable for a number of reasons: due to concomitant diseases, intolerance, the characteristics of the body.
A tool that helped a neighbor, a relative or friend can lead to serious complications. The lack of effect is less, which can happen when taking an incorrectly selected drug. The symptoms of pancreatitis may well join the problems with the heart, the brain, the blood system. Therefore, the choice of funds can only be entrusted with a gastroenterologist.
To reduce all sorts of risks, you need to tell the doctor about all diseases, intolerance to drugs and allergies (if any), recently transferred or existing diseases. It is also worth telling about which drugs are constantly being accepted, even if it is vitamins or biologically active food additives. This information will help you choose effective and secure funds in the desired dosage.
Chronic pancreatitis is a pancreatic disease associated with constant damage to its tissues under inflammation.
Chronic pancreatitis can meet in people of different ages, but men are most often sick of 45-54 years. The prevalence of chronic pancreatitis among the Russian adult population is 3-5 cases per 10,000 people.
The most characteristic symptom of chronic pancreatitis are repeated pain in the abdomen, which may be intensive. Other signs of chronic pancreatitis depend on the degree of damage to the pancreas and in time increase. One of these symptoms is the formation of a chair with a greasy, greasy shine and a flicker smell.
If the inflammation of the gland is short-term, they talk about acute pancreatitis. Repeated cases of acute pancreatitis associated with the use of alcohol can sooner or later lead to the development of chronic pancreatitis.
Alcohol abuse is the cause of 7 out of 10 cases of chronic pancreatitis. This is due to the fact that alcoholism for many years has a multiple damaging effect on the pancreas.
Less common reasons:
smoking that increases the risk associated with pancreatitis alcohol;
problems with the immune system, when it attacks its own pancreatic cells;
Genetic mutation due to which the pancreas functions are violated, which can be inherited.
Approximately 2 cases out of 10 causes of chronic pancreatitis cannot be determined.
The pancreas is a small organ, in the form of a taller, located behind the stomach below the chest. It performs 2 important features:
The formation of digestive enzymes that are used in the intestine to digest food;
The production of hormones, the main of which is insulin, regulating the level of sugar (glucose) in the blood.
Treatment is mainly aimed at changing lifestyle (see below) and pain relief. If strong long-term pains are bothering, which are not removed by the reception of drugs, surgery may be required. It is noted that people who do not smoke and avoid alcohol, as a rule, feel less pain and live longer those who failed to get rid of these harmful habits after diagnosis.
In half patients with chronic pancreatitis, the pancreas is damaged so much that insulin cannot produce insulin, which leads to the development of diabetes. Patients with chronic pancreatitis refer to a group of increased risk of developing pancreatic cancer. Always contact the doctor if you are experiencing a strong abdominal pain - this is an important sign that something is wrong.
Symptoms of chronic pancreatitis
Repeated attacks of stomach pain are the most characteristic symptom of chronic pancreatitis. The pain usually arises in the center of the abdomen or in its left half and can spread (give) in the back. Most of the patients describe their pain as stupid and at the same time very strong. Pain lasts a few hours, and sometimes days. Pain occurs after meals, more often - for no reason.
The described attacks may be accompanied by nausea and vomiting. As the chronic pancreatitis, the attacks become heavier and frequent. In some cases, the pain remains between the attacks, only changing the character on light or moderate. It happens more often in people with pancreatitis, which cannot refuse alcohol despite their diagnosis. On the contrary, people who refuse alcohol and smoking can observe the decrease in the severity and frequency of episodes of pain. Progressive chronic pancreatitis
Over time, with chronic pancreatitis, the pancreas loses the ability to produce digestive juices, which are necessary for sprouting of food in the intestine. As a rule, it occurs years of years from the first manifestations of the disease. In the absence of digestive juice, fats and certain proteins are poorly digested, which leads to the appearance of a fetus chair with a fatty glitter, which is poorly washed off when the water is drained in the toilet. Other symptoms are observed:
loss of appetite;
jaundice (yellowing of the skin and scool);
Thirst, frequent urination, weakness, - symptoms of joining diabetes.
Always contact the doctor if you are experiencing a strong pain - this is an important sign that something is wrong. Doctor's help will need if you have jaundice. In addition to pancreatitis, jaundice has many other reasons, however, in any case, this is a sign of improper operation of the digestive system. You should also refer to the doctor in the event of constant (indomitable) vomiting.
Causes of chronic pancreatitis
A lot of causes of chronic pancreatitis have been studied, however, no more than 2 cases find them out of 10. The most frequent factors leading to the development of chronic pancreatitis are discussed below.
At least in 7 out of 10 cases, the development of pancreatitis is associated with the intake of alcohol, especially with long-term abuse of alcoholic beverages. Acceptance of alcohol causes episodes of acute pancreatitis. Acute pancreatitis usually goes quickly, but repeating time after time, under the action of permanent admission of alcohol, causes irreparable damage to the pancreas. Frequent inflammatory processes in the gland, in the end, cause the development of chronic pancreatitis.
Regular use of alcohol carries an increased risk of developing chronic pancreatitis, however, fortunately, the disease develops only in a few.
In rare cases, the occurrence of chronic pancreatitis is associated with a disease of the immune system, in which the immunity attacks its own pancreatic tissues. This disease is known as autoimmune pancreatitis, its reasons until late are not studied.
An autoimmune pancreatitis is often combined with other diseases when immune cells damage healthy fabrics. For example, Crohn's disease or ulcerative colitis that are associated with inflammation in the digestive system.
Sometimes chronic pancreatitis is inherited. It is believed that the cause of the hereditary forms of the disease are mutations (changes) in a number of genes, including PRSS1 and SPINK-1 genes. These mutations violate the normal operation of the pancreas. There is evidence that in some people, under the action of genetic mutations, pancreatic cells are becoming more vulnerable to alcohol.
Other, more rare causes of chronic pancreatitis are installed:
blockage or narrowing of output pancreatic ducts;
Radiation therapy of the abdomen.
Diagnosis of chronic pancreatitis
The final diagnosis of chronic pancreatitis can only be installed after the instrumental studies. But first, the doctor asks about complaints and conducts a simple inspection. If, according to the results of the inspection, it suspects chronic pancreatitis, an additional study is assigned to confirm the diagnosis.
Research that you can assign:
Ultrasonic research (ultrasound), during which, using sound waves, a picture of the inner structure of the pancreas is created;
Computed tomography (CT) - with this study, with a series of X-ray shots, a more accurate, three-dimensional image of the organ is created; Endoscopic ultrasonography (see below);
Magnetic resonance cholangiopancratography or MRHPG (see below).
During endoscopic ultrasonography in the stomach through the mouth, a flexible telescopic tube (endoscope) is carried out, at the end of which the ultrasonic sensor is located. Being in the immediate vicinity of the pancreas, the sensor allows you to create a high-precision image of the organ and its structure. During the procedure, as a rule, give a sedative (sedative) drug to help relax.
To get a clearer image of the pancreas and nearby organs, such as the liver and a gallbladder, an introduction of a contrast agent must be administered to the MRHP. To create detailed images of the internal organs, the magnetic resonance tomograph uses the magnetic field energy and radio waves. MRHPG makes it possible to estimate whether the causes of chronic pancreatitis stones in the gallbladder were caused.
Sometimes the symptoms of chronic pancreatitis and pancreatic cancer are very similar. Therefore, with the appearance of jaundice (yellow color of the skin and eye proteins) and weight loss to eliminate malignant neoplasm in the gland, biopsy is prescribed. Biopsy is the take of small samples of the pancreas cells and send them to the laboratory, where the material obtained is studied under a microscope in search of cancer cells.
To take biopsy, use a long thin needle, which is injected into the place of the intended tumor through the abdominal wall. To control the accuracy of the needle introduction use ultrasound examination or computed tomography. Alternatively, biopsy is possible during the endospopic ultosonography procedure (see above).
Treatment of chronic pancreatitis
Healing chronic pancreatitis is not possible, but with the help of treatment it is possible to control the course of the disease and reduce the severity of symptoms. If you were diagnosed with chronic pancreatitis, some lifestyle changes are recommended.
The most important thing you can do is to exclude alcoholic drinks from your life, even if alcohol is not the cause of your pancreatitis. This will prevent further damage to the pancreas and reduce the severity of pain. The continued intake of alcohol increases the likelihood of painful pain and the risk of death from complications of chronic pancreatitis.
People with alcohol addiction requires additional help and support to throw drinking. If this applies to you, talk to your doctor to help you find a way to combat alcoholism. For the treatment of alcoholism use:
Individual consultation of the psychologist;
Participation in mutual assistance groups, such as society "Anonymous Alcoholics";
The use of drugs that reduce the thrust to alcohol.
Read more about the common myths about alcohol and their exposure.
If you are subject to this bad habit, try to quit smoking. Smoking worsens the course of chronic pancreatitis, accelerating the violation of the pancreas function. The doctor may recommend antitabachic treatment, for example, replacement therapy with funds containing nicotine (NZT) or drugs that reduce craving for cigarettes. People who use drug therapy are easier to quit smoking than those who count only on their own power.
Since chronic pancreatitis leads to a disruption of food digestion, you may need to change the nature of nutrition, for example, limit the amount of fats in the diet. Your doctor will give you relevant recommendations for changing the diet, and if necessary, will send to a nutritionist.
Medicinal treatment of chronic pancreatitis
Enzyme preparations containing artificial analogs of pancreas enzymes are used to improve digestion. Side effects may include diarrhea, constipation, nausea, vomiting and stomach pain. When developing side effects, tell us about this to your attending doctor, as you may need a dose correction of an enzyme preparation.
Treatment with steroid (corticosteroid) hormones which reduce inflammation, damaging the structure of the pancreas, is appointed in cases where the cause of chronic pancreatitis has become problems with the immune system. However, the reception of corticosteroids for a long time can lead to the development of complications, such as: osteoporosis (bone fragility) and weight gain.
Package. An important component of treatment with chronic pancreatitis is anesthesia. First, weak painkillers are prescribed. If they do not help, stronger preparations have to use.
In most cases, a paracetamol or a drug from a group of non-steroidal anti-inflammatory agents (NSAIDs), for example, ibuprofen is prescribed the first anesthetic drug. Long-term reception of the NSAID increases the risk of ulcers in the stomach, in connection with which you can additionally assign a proton pump inhibitors that protect from it.
If the NSAIDs or paracetamol does not sufficiently reduce the pain, it will be assigned opioid (narcotic) painkillers, for example, codewayin or tramadol. The side effects of this group of drugs include constipation, nausea, vomiting and drowsiness.
Publishers are particularly transported against the background of long-term treatment with opioid painkillers. In such cases, you can help the reception of laxatives. Read more about the treatment of constipation. If you feel drowsiness after taking opioid analgesics, avoid control of the machine or complex mechanisms.
If you are experiencing an attack of strongest pain, you may need even stronger drug, for example, morphine. Its side effects are similar to those of the above-mentioned opioid painkillers. Long-term techniques are not recommended for strong drug painkillers, as it can cause physical dependence on drugs. Therefore, if you are constantly experiencing severe pain, you will be offered surgical treatment.
In some cases, amitriptyline is prescribed as additional treatment. This drug was originally created for the treatment of depression, but some people helps to alleviate pain.
If the treatment is not effective, severe pain can be removed using the nervous blockade. This procedure helps facilitate a few weeks or months. The nervous blockade is an injection (injection), stopping the pains of pain that the pancreas sends.
In case of a sudden strengthening of inflammation in the pancreas, hospitalization is needed to the hospital for a short time. Hospital treatment will include the introduction of liquids into a vein, nutritional support using the probe (tube) and an additional suspension of oxygen to the nose on a special tube.
Surgical treatment of chronic pancreatitis
A surgical operation can be used to treat strong pain in chronic pancreatitis. The choice of surgical technique in each case depends the cause of the disease. Some of them are described below.
Endoscopic intervention. If pancreatitis is associated with the blockage of the withdrawal ducts of the pancreas with gap bubble stones, it is possible to carry out endoscopic treatment with lithotripsis. Lithotripsy is to destroy the stones using shock waves into smaller parts, which are then extracted using an endoscope (long thin tube, equipped with a light source, video camera and mini-tools at one end). This type of treatment to some extent makes it easier for pain, but the effect of the operation may be non-permanent.
Pancreatic resection. In cases where individual parts of the pancreas are inflamed and cause severe pain, they can be surgically removed. This type of operation is called pancreatic resection. Recreation is used when endoscopic treatment is inefficient. The resection technique depends on which parts of the pancreas are subject to removal. For example, some operations include simultaneous removal of part of the pancreas and gallbladder.
As a rule, all types of resection have approximately the same efficacy in terms of reducing pain and preserve the pancreatic function. However, the higher the complexity of the operation, the most likely the risk of complications, such as inner bleeding or infection, and a longer period of recovery after intervention. Discuss all the advantages and disadvantages of methods with your doctors before making a decision on the operation.
Total pankettectomy (complete removal of the pancreas). In the most severe cases of chronic pancreatitis, when most of the pancreas is damaged, it may be necessary to remove the entire organ. This operation is called total pancreatomy (complete removal of the pancreas). This is a very effective way to get rid of pain syndrome. However, after removal of the pancreas, your body will no longer be able to produce a vital hormone insulin. To cope with this situation, a new technique called Autogenous cell transplantation of the island of Langerhans is developed.
It lies in the fact that even before removing the pancreas, the cells of the Islands of Langerhans are extracted, which are responsible for the production of insulin. The cells are then mixed with a special solution and entered into your liver. In case of success, islet cells are coming out in the tissues of the liver and begin to produce insulin there. For a short time, transplantation is effective, but you may need to treat insulin preparations in the future.
Complications of chronic pancreatitis
Damage to the pancreas in chronic pancreatitis often leads to the development of complications in the future.
Approximately 50% of cases, chronic pancreatitis leads to the development of diabetes. This complication develops years after the diagnosis of pancreatitis (usually passes about 20 years before diabetes mellitus).
Diabetes occurs when the pancreas cells are no longer capable of synthesize insulin - a hormone, which is necessary for glucose cleavage in order to obtain energy. Main symptoms of diabetes:
If diabetes develops against chronic pancreatitis, you will need regular injections (injections) insulin to compensate for its absence in the body.
Any chronic disease, especially associated with constant pain, can have a negative effect on emotional and mental health. In the course of the study of patients with chronic pancreatitis, they found out that one of 7 people developed psychological and emotional problems: stress, anxiety or depression.
Another frequent complication of chronic pancreatitis are pseudokists are cavities (bubbles) filled with liquid on the surface of the pancreas. Pseudokists are formed in each fourth patient chronic pancreatitis. In most cases, pseudokists do not cause any symptoms and are a random find when CT-study (computed tomography). However, some people have pseudocysts:
Stomach abdominal pain.
If the pseudokists of small sizes and do not cause any symptoms, then there is no need for treatment. They usually disappear independently. Pseudokists are subject to treatment more than 6 cm in diameter causing anxiety. In such cases, the risk of breaking cysts, internal bleeding or attachment infection.
The treatment of pseudokists is to remove fluid from it using the needle entered through the skin. An alternative is endoscopic drainage when through the mouth to the digestive system is carried out a thin flexible tube - an endoscope. The removal of the fluid is performed using special microinstructions.
Sometimes pseudokists are treated, removing part of the pancreas using a low-alignment operation - laparoscopic distal resection of the pancreas.
Chronic pancreatitis is associated with an increased risk of pancreatic cancer. However, in general, this risk is not great. It is believed that the pancreas cancer will only have 1-2 people from 100 patients with chronic pancreatitis. The most common initial manifestations of pancreatic cancer are almost the same as in pancreatitis. They include jaundice, pain in the stomach and weight loss.
What doctor to apply for chronic pancreatitis?
With the help of the service, you can find a good gastroenterologist who is engaged in the treatment of chronic pancreatitis. If there is no possibility to contact a specialist, find a wide profile doctor, such as the therapist or family doctor.
The aggravation of chronic pancreatitis is usually treated on the basis of gastroenterological departments of hospitals and specialized gastroenterological clinics. After reading the reviews, you can choose them yourself by clicking on the links.
If the operation takes place, find a good clinic of abdominal surgery or general surgery.
Pancreatitis is inflammation of the pancreas (the body responsible for the production of digestive juice).
The pancreas in the human body performs a very important function: produces enzymes, which, falling into a small intestine, are activated and involved in digesting proteins, fats and carbohydrates. The organ produces hormone insulin, which regulates blood glucose levels.
Acute - characterized by an acute sling of pain in the top of the abdomen. Often pain appears after consuming oily food or alcohol. An unpleasant feeling can be both barely noticeable and unbearable with irradiation in a blade or sternum. There is nausea, vomiting, stool violation. Because of the difficult outflow of bile, the skin takes a yellowish color.
Chronic - the main localization of pain is located on the top of the abdominal wall with irradiation in the back, chest (left part), the lower part of the abdomen. An unpleasant sensation occurs after taking oily heavy foods, alcoholic beverages, constant stress.
The development of chronic pancreatitis is characterized by nausea, loss of appetite, bloating, stool violation, sometimes vomiting.
The chronic form of pathology differs from acute periods of remission and exacerbation. Over the course of the disease, the exacerbation periods become increasingly, the development of intestinal disorders, violations of normal digestion, a decrease in body weight is possible.
Chronic pancreatitis often gives complications (gastric bleeding, cancer, cysts and abscesses, liver damage, diabetes, enterocolitis). That is why the disease should be treated seriously and with the slightest suspicion of the development of inflammation, consult a doctor.
Causes of pancreatitis development
The disease is developing due to the damage to the pancreas tissues. This happens for the following reasons:
Alcohol and Tobacco Abuse
Belly injuries, surgical interventions
Uncontrollable and long-term reception of medicines: antibiotics, hormonal drugs, corticosteroids, some diuretics
Incicacy of food products, chemicals
Incorrect diet with a predominance of acute and greasy meals and with large interruptions between meals
Symptoms of pancreatitis
The manifestations of pathology differ depending on the form - acute or chronic pancreatitis. In acute pancreatitis, there are:
The pain is intense, constant, the nature of pain is described by patients as cutting, stupid.
High body temperature, high or low pressure - the patient's well-being is worse rapidly due to the rapid development of the inflammatory process.
Pale or yellowish faces.
Nausea and vomiting - dryness appears in the mouth and white rings, the attacks of vomiting do not bring relief. The most correct step at this point is to starve, any reception can only worsen the situation.
Diarrhea or constipation - a chair in acute pancreatitis most often foamy, frequent with a mowing smell, with particles not digestible food. There are both the opposite, bloating, hardening the abdominal muscles, which may be the very first signal of a starting acute attack of pancreatitis.
The bloating of the stomach and the intestines during the attack are not reduced.
Dyspnea - appears due to the loss of electrolytes during vomiting.
Chronic pancreatitis is characterized by the following features:
Abdominal pain - can be encircling or have a clear localization with irradiation in the back. Appears after eating.
Intoxication of the body - a general weakness appear, a decrease in appetite, tachycardia, an increase in body temperature, decrease in blood pressure.
Endocrine disorders - ketoacidosis, diabetes, tendency to hypoglycemia. Bright red spots in the area of the abdomen, back, chest, which are not disappeared upon pressing, may also appear.
With a long-term course of the disease, the patient gradually arises anemia, loss of body weight, dry skin, hair and nail fragility, avitaminosis symptoms, increased fatigue.
First aid in the attack of pancreatitis
To reduce pain, you can use a heap filled with cold water. It must be applied to the abdomen area, namely, to the epigastric area (area under a mildo-shaped process, corresponding to the projection of the stomach on the front abdominal wall). This reduces the intensity of pain, remove swelling and inflammation.
The patient must be observed the hospital mode. This will reduce blood flow to the organ, which means reduce inflammation.
It is forbidden to eat. The digestion process may cause stronger pain, nausea and vomiting appear. A diet will reduce the production of enzymes that enhance the inflammatory response and pain. Adheres to starvation you need 3 days. You can drink clean water without gases.
It is necessary to call a doctor for inspection, even if the patient is definitely not sure that it is an attack of acute pancreatitis. As we already know, this pathology can sink, and then rapidly recur. At this time, you can drink an anesthetic drug to reduce unpleasant sensations.
Diagnosis of the disease to the Private Medical Clinic "Medunion"
Diagnose this disease is not difficult, since the first signs speak for themselves. However, to assign adequate treatment, it is necessary to determine the form of the disease. For this, the doctor conducts laparoscopy - a method that allows you to examine the abdominal cavity from the inside with the help of a special tool.
In suspected acute pancreatitis, laboratory tests are carried out:
General blood analysis
Analysis of urine
Analysis of Cala
Ultrasound, MRI or radiography of abdominal organs
Computer tomography on testimony
In chronic form, the same studies are carried out, but it is better to take tests during the exacerbation of the disease.
Treatment of acute pancreatitis
When discovering acute patient pancreatitis, it is necessary to immediately hospitalize. Treatment should be held in the hospital, as this condition is very dangerous.
Antispasmodics are taken to remove pain, in difficult cases, the contents of the stomach content for removing the load on the gland are pumped.
With the exacerbation of pancreatitis, patients need hospitalization with daily over the first week by the control of blood parameters, water balance, leukocyte numbers, serum enzymes. In the first 1-3 days, hunger is recommended, alkaline solutions receiving every 2 hours.
During the exacerbation of chronic pancreatitis, the patient shows therapy similar to the acute process. The patient should abide by the diet throughout the life and take drugs from the group of spasmolitics and drugs that normalize the secretory function of the organ.
The most important thing in the chronic form of the disease to maintain a diet, which implies an exception from the diet of greasy and fried foods. With the slightest violation of the regime in the patient, unpleasant sensations and nausea can begin. With intense pain, the doctor prescribes antispasmodics. Antisecretory therapy can be used short course.
Diet with pancreatitis
With any form of the disease, the patient is assigned a strict diet "Table No. 5P", according to which it is forbidden to eat acute and fried food. All dishes are prepared for a pair, boiled or baked. Alcohol and smoking are also prohibited.
It is also necessary to limit the consumption of salt, to eat in small portions 6 times a day. Dishes should always be fed in warm form. It is necessary to eliminate all products with a high content of extractive substances or essential oils (fish, meat broths, cocoa, coffee, etc.), fresh berries, vegetables, greens, fruits, fruits, acidic juices, carbonated drinks, marinades.
Where to pass the treatment of pancreatitis in Krasnoyarsk?
If you or your loved ones suffer from inflammation of the pancreas, seek help in Medunication Medical Center. We are engaged in the diagnosis and treatment of any diseases in Krasnoyarsk. Powerful equipment for conducting CT, MRI and X-ray, experienced doctors who, if necessary, hold the primary inspection at home, are waiting for you to "Medunion". To find out the details or make an appointment, call 201-03-03.