Pancreatitis is an acute or chronic inflammation of the pancreas caused by an etiological factor. The disease can occur in acute or chronic form. Acute conditions are a surgical pathology requiring hospitalization of the patient. The chronic form of the disease lends itself to conservative therapy. So, what is pancreatitis, symptoms and treatment in adults? What are the predictions for this disease?
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Causes of adult pancreatitis
The causes of the disease in men and women are not different. Separate etiological factors are more common among female representatives, while others - among representatives of the male population. However, this does not mean that the “female” factor in the development of pancreatitis cannot occur in men and vice versa.
Pancreatitis in men
The main cause of chronic pancreatitis in men is alcoholism. The number of cases of alcoholic genesis disease reaches 50% of the total number of registered patients. It is known that with daily use of 80 or more ml of pure ethanol, pancreatitis in a chronic form develops after 3-4 years. The process is accelerated if the patient smokes.
Chronic pancreatitis occurs for other reasons, which include:
- restriction of proteins and fats in the diet;
- hyperlipidemia;
- infectious diseases;
- hypercalcemia;
- hereditary disorders of amino acid metabolism;
- diseases of the zone of the large duodenal papilla;
- hereditary predisposition.
Eating large amounts of fat, fatty foods, alcohol or other "heavy" foods contribute to the development of the disease. Acute forms of pancreatitis usually develop due to exposure to certain toxicants, as well as in case of pancreatic injuries or received during surgery.
Occurrence in women
In women, the disease often develops with the following conditions and diseases:
- pathology of biliary structures (cholecystitis, dyskinesia);
- vascular disease (atherosclerosis);
- stressful situations;
- pregnancy;
- helminthic infestations.
Acute pancreatitis in women develops for the same reasons as in men (operations, toxic substances consumed in food).
Note: most of the above reasons become a catalyst for the pancreatic enzyme activation process. Normally, they are produced in an inactive form, enter the intestines, and then are activated. In violation of this process, activation occurs in the tissues of the gland, after which it begins to be split by its own enzymes.
The main symptoms of pancreatitis
Symptoms of pancreatitis directly depend on the form and intensity of the pathological process. Major differences are present between chronic and acute forms of inflammation.
Manifestation of acute pancreatitis
The main symptom of acute pancreatitis is pain, which is a dagger in nature, is extremely intense and intensifies when the patient is on his back. Some weakening of the pain syndrome occurs when the patient sits down, slightly tilting the body forward. Other symptoms of the disease occur 1.5-2 hours after the onset of pain. These include:
- hyperthermia (38˚C and higher);
- tachycardia;
- pallor;
- sweating (cold, sticky sweat);
- hypotension;
- flatulence;
- bloating;
- diarrhea;
- repeated vomiting, which does not bring relief, but not related to the symptoms of brain damage.
With the development of such a serious complication as pancreatic necrosis, all the symptoms present are multiplied. In addition to this, the patient has severe intoxication, often manifested in the form of encephalopathy. Dark or blue spots may be present on the lateral surfaces of the abdomen, which are evidence of the presence of internal hematomas.
It is curious that severe common pain with pancreatic necrosis is a positive sign, and their weakening is negative. The fact is that the subsidence of the pain syndrome indicates the spread of the necrotic process over a large area with the defeat of sensitive nerve endings. This is relevant only for the necrotic form of pancreatitis.
It is also necessary to say about the atypical form of pain. In some cases, sensations can be localized in the left half of the chest, resembling coronary pain, or in the lumbar region. In the latter case, patients believe that they have renal colic. Given this, you should seek medical help when there are colic or angina attacks, when the usual treatment does not have the expected result.
Signs of chronic pancreatitis
Pain is one of the first manifestations of chronic pancreatitis. However, in this case, it has a dull, oppressive character, occurs mainly 35-40 minutes after eating, if the patient has violated the diet (ban on fried, salted, spicy dishes). The localization of sensations depends on where the affected area of the gland is. So, in the presence of a pathological focus in the tail of the organ, patients refer to unpleasant sensations in the left side, if the affected gland body pains are shifted to the epigastric zone. With inflammation in the head region, pancreatalgia occurs in the Shoffar zone (an anatomical region limited to 45˚ to the right of the midline of the abdomen). With total organ damage, the pain becomes girdle.
Chronic inflammation in the gland leads to the development of dyspeptic syndrome (bloating, diarrhea, nausea, etc.). There are also phenomena of endocrine insufficiency (diabetes mellitus). Possible phenomena associated with a lack of vitamins and nutrients, since their absorption in the intestine with pancreatitis is impaired. In addition, the patient may have all the symptoms characteristic of the acute form of the disease, although their severity is lower.
Diagnostics
Diagnosis of pancreatic inflammation is based on an anamnesis and clinical presentation, laboratory and instrumental studies. The purpose of the examination of the patient is not only to identify the fact of inflammation, but also to determine the level of its intensity, as well as differential diagnosis with diseases such as:
- cholecystitis;
- colitis;
- enteritis;
- ischemic syndrome;
- pancreas cancer.
An anamnesis and an objective examination are carried out by the doctor immediately after the hospitalization of the patient. At the same time, he manages to identify the symptoms of pancreatitis described above. As a rule, the patient reports the recent use of irritating food or alcohol, complains of pain, takes a forced position (sitting, leaning forward).
Laboratory studies (general and biochemical blood tests) indicate an increase in ESR, leukocytosis and other signs of the inflammatory process. A study of the secretion of pancreatic enzymes confirms changes in this indicator to a smaller or greater side (perulein test, lund test). Examination of feces for 3 days allows you to detect polyphase (the study is not carried out with diarrhea).
Note: for patients with chronic pancreatitis, a blood test for sugar is necessarily prescribed. In this case, the biomaterial is taken every 3 hours, during the day. The two-humped glycemic curve indicates endocrine insufficiency characteristic of diabetes mellitus.
Treatment of pancreatitis in adults
Pancreatitis treatment is carried out in a hospital.
In this case, therapy has the following goals:
- decreased pancreatic secretion;
- pain relief;
- prevention of complications;
- enzyme replacement therapy.
Treatment consists of two important components: pharmacological correction of the condition and diet. As an auxiliary technique, it is permissible to use recipes of alternative medicine.
Drugs for treatment
The following drugs are used for treatment:
| Pharmacological group | Name | Dosage and Administration | Expected Pharmacological Action |
|---|---|---|---|
| Histamine H2 receptor blockers | Ranitidine | 150 mg / 2 times a day, course up to 4 weeks | Decreased hydrochloric acid secretion in the stomach |
| Famotidine | 40 mg / 2 times a day, course up to 4 weeks | ||
| Proteolysis inhibitors | Proudox | 100 000 units / day 1 week | Pancreatic enzyme suppression |
| Contrikal | 40 000 units / day 1 week | ||
| Non-steroidal anti-inflammatory | Analgin | 1 t / 3 times a day, until severe pain disappears | Anesthetic effect, reducing the release of inflammatory mediators |
| Ketorol | 1 t / 3 times a day, until severe pain disappears | ||
| Enzyme preparations | Lipase | 30,000 units after each meal. Lifelong course | Steatorrhea correction, participation in the digestive process |
| Pancreatin | 4 capsules per day, 1 after each meal. The course is lifelong. |
According to the indications, the patient can be prescribed drugs from the group of antispasmodics (no-spa, papaverine), antiemetics (cerucal), hemostatic drugs (aminocaproic acid).
Folk remedies
To reduce pain, as well as to accelerate recovery processes, the following recipes of alternative medicine can be used:
- Potato and carrot juice: 3 potatoes and 2 carrots are washed, peeled and passed through a juicer.The resulting juice is drunk immediately, it can not be stored. The tool is taken in courses of one week. The total number of courses reaches 3, a break between them is a week. Drink juice should be half an hour before meals.
- Tincture of barberry root: 100 grams of root is poured into one and a half liters of vodka, insist in a dark place for a month. After preparation, the medicine is filtered through a fine sieve, taken in a tablespoon before meals. The course of treatment is 2-4 weeks.
- Oat broth: a glass of cereal is crushed using a meat grinder or coffee grinder. After this, the raw material is poured with a liter of water. The mixture is boiled for 10 minutes, cooled and drunk half a glass before each meal. The course of treatment is until the symptoms of the disease disappear.
Do not forget that the basis for the treatment of pancreatitis is the medication prescribed by the doctor and diet. The use of these recipes should be carried out only after consulting a doctor.
Diet for chronic and acute pancreatic pancreatitis in adults
An important condition for the nutrition of patients with acute or chronic pancreatitis is that the products should not stimulate the secretion of gastric juice. In severe exacerbations and acute forms of the disease, patients are prescribed hunger for 3-5 days. During this time, parenteral nutrition methods may be used, but food should not enter the stomach. In the future, the patient is allowed to eat normally.
A patient with pancreatitis is strictly contraindicated in alcohol, spicy, sour, salty, fried, stewed dishes. It is not recommended to take fats and foods rich in calcium. The patient's diet should include boiled meat, eggs, cereals and mucous soups, dried bread or dry biscuit. The total amount of proteins, fats and carbohydrates should be 120: 80: 400 grams, respectively.
Nutrition of patients is carried out fractionally: food is taken 5-6 times in small portions, accompanying each trip to the dining room with the use of an enzymatic drug prescribed by a doctor. If the condition worsens after consuming a particular product, it should be excluded from the diet.
Possible complications
In clinical practice, the following types of complications of pancreatitis are most common:
- An abscess of the pancreas is an accumulation of pus in the tissues. It develops in the presence of necrotic phenomena and the attachment of infection, more often in the second week of the disease.
- Ascites is the result of the entry of pancreatic juice rich in enzymes into the small omentum of the intestine and abdominal cavity, where a large amount of exudate accumulates.
- Narrowing of the common bile duct - is a consequence of swelling of the head of the pancreas, leading to the appearance of jaundice of a mechanical nature.
- Gastrointestinal bleeding - develop with rupture of pancreatic cysts, as well as with exacerbation of diseases associated with pancreatitis. They lead to the appearance of a clinic of internal bleeding and require surgical intervention.
Other complications may occur, however, the above list includes those conditions most commonly experienced by practitioners.
Pancreatitis Prevention
Prevention of pancreatitis is consistent with the general principles of a healthy lifestyle.
To avoid pancreatic inflammation, you must:
- give up alcohol and smoking;
- Use healthy foods
- reduce the consumption of spicy, fried, sour or salty foods;
- exclude energy drinks;
- do sport.
Pancreatitis is a serious disease, from the complications of which more than 20% of the total number of patients seeking help die. The risk of complications is lower the sooner the patient seeks help. Therefore, at the first signs of pancreatitis, you should abandon attempts to self-medicate and consult a doctor for examination and prescribe competent drug therapy.
