What causes pancreatitis. What causes pancreatitis: why it appears and develops

It plays an important role in the human body. She is a participant in energy metabolism, as well as the process of digestion.

Pancreatitis is a disease in which an inflammatory process occurs in the pancreas. The disease can be acute or chronic.

Pancreatitis occurs with frequent alcohol use.

The causes of pancreatitis can be varied. Most often, this disease occurs with the regular use of alcoholic beverages in large quantities.

With cholelithiasis, the development of this pathological condition can also be observed. may occur as a result of trauma or injury to the abdomen.

Quite often, this disease is diagnosed with endoscopic retrograde cholangiopancreatography.

As a result of diseases of the duodenum, many patients develop pancreatitis. In many patients, the inflammatory process develops against the background. With peptic ulcers, doctors often diagnose pancreatitis.

During the period of taking certain medications, the development of this disease is observed. Pancreatitis is most often observed while taking antibiotics, sulfonamides, furasemide, estrogens, etc.

With a hereditary predisposition, this disease can also be observed. A fairly common cause of pathology are, namely, roundworms.

Pancreatitis can be diagnosed against the background of infectious diseases - viral hepatitis, mumps. In vascular diseases, inflammation of the pancreas is often diagnosed. This pathological process can be observed against the background of anatomical anomalies of the organ duct.

With metabolic disorders, the patient may be diagnosed with pancreatitis. If the patient has changes in the hormonal background, then this can lead to the onset of the disease.

Inflammation of the pancreas is observed in patients against the background of various diseases. That is why, when diagnosing pancreatitis, it is necessary to determine the causes in order to direct treatment to eliminate them.

Symptoms of the disease

Acute pancreatitis is accompanied by diarrhea.

Despite the fact that the pancreas is small in size, it performs quite important functions.

That is why, with inflammation of this organ, a large number of symptoms appear. Most often, the disease manifests itself in the form of:

• Soreness. It is one of the most pronounced symptoms. The pain has a cutting and dull character and is characterized by constancy. Localization of pain is observed under the ribs on the right or left side. With inflammation of the entire pancreas, the soreness has a surrounding character.
• An increase in body temperature or blood pressure. This symptomatology is observed if the disease has a rapid development.
• . After leaving the digestive tract of food, along with bile, the patient notes relief. In most cases, this symptom is observed in the acute period of the disease. That is why the patient refuses to eat.
• Change in complexion. Pancreatitis leads to the fact that the complexion becomes gray-earthy. The patient's features are sharply sharpened, which is explained by a decrease in his body weight.
• Nausea and hiccups. Many patients also complain of dry mouth.
• Constipation or. Acute pancreatitis in most cases is accompanied by foamy stools. Many patients note its fetid odor. There are particles of food in the stool that have not been digested. Constipation is very often accompanied by bloating and hardening of the muscles. These symptoms indicate that the patient is developing acute pancreatitis.
• . In many patients, when this disease occurs, flatulence and bloating are observed. This is due to the absence of contractions of the intestines and stomach during the attack. It is impossible to determine muscle tension by palpation.
• Breathlessness. During vomiting, the human body loses electrolytes, which leads to shortness of breath. Patients complain not only of this symptom, but also of the appearance of a profuse yellow coating on the tongue and sticky sweat.
• Blueness of the skin. With pancreatitis, the patient's skin becomes pale. Many patients note the appearance of cyanosis in the lumbar region and. During the period of palpation, doctors note that the patient's abdominal muscles are tense.
• Jaundice of the sclera. The sclerosing form of the disease is often accompanied by obstructive jaundice. This is due to the fact that the compacted tissue of the gland compresses part of the common bile duct.

Pancreatitis is characterized by pronounced symptoms, which allows the patient to independently suspect the disease. Despite this, to confirm the diagnosis, the patient must go to see a doctor.

The video will tell about chronic pancreatitis:

Diagnosis of pancreatitis

A gastroenterologist can help diagnose pancreatitis.

It is difficult to make a diagnosis of chronic pancreatitis.

That is why, when symptoms appear, the patient should be examined.

Initially, he evaluates the clinical picture of the disease and makes a preliminary diagnosis.

To confirm it, laboratory tests and instrumental diagnostic methods are used.

The patient is required to make a general appointment.

It can be used to detect signs of inflammation. In order to detect an increased level of enzymes, a biochemical blood test is carried out.

If all of the above methods have not brought results, then the use of surgical intervention is carried out. Initially, the patient is washed.

In order to carry out this procedure, hollow tubes are inserted into the abdominal cavity. They carry out the outflow of fluid accumulated in the cavity. A necrectomy is used to remove the destroyed tissues of the organ.

This surgical intervention is quite complicated and therefore it is used in extremely rare cases. In some cases, after the passage of the acute period, the patient is removed with the help of surgery.

If the patient has a chronic form of the disease, then he needs to follow a diet. At the same time, spicy and fatty foods are completely excluded from the diet. The patient is strictly prohibited from drinking alcoholic beverages.

In order to improve the patient's condition, he is prescribed painkillers. Also, with pancreatitis, enzyme replacement therapy is prescribed. Quite effective in this case are Creon and other medicines.

During the treatment of pancreatitis, the patient must take vitamin complexes. If the patient has diabetes mellitus or other endocrine disorders, then it is recommended to treat them. Gallstone disease should also be cured in a timely manner.

Pancreatitis is a group of diseases in combination with their accompanying syndromes, the course of which is accompanied by a common factor for them, which is inflammation of the pancreas. Pancreatitis, the symptoms of which are manifested due to the fact that there is no release of enzymes secreted by the gland into the duodenum, proceeds with the activation of these enzymes directly in the gland, due to which its gradual destruction occurs, in other words, self-digestion.

general description

It should be noted right away that the described specificity of the processes that is relevant for pancreatitis is very serious, because both toxins and enzymes, the active release of which occurs in this case, are often sent directly to the bloodstream, and this, in turn, can cause serious damage. a number of organs, such as the liver, heart, brain, kidneys, lungs. With the development against this background of hemorrhage in the area of ​​the pancreas, the possibility of a lethal outcome is not excluded.

By itself, the pancreas, if you go into its anatomical features, is a fairly long organ (actually the gland), covered by the duodenum 12. This gland is directly involved in the processes associated with digestion, contributes to the regulation of metabolic processes, etc. The course of pancreatitis, in addition to its existing classification, is possible in two main forms, namely, in the form of acute or in the form of chronic. Due to the enzymes stored in the gland and due to which the development of a pathological condition occurs in this case, in general, assistance is provided in the digestion of fats, proteins and carbohydrates by the intestines, but the hormones of this gland (such as insulin, etc.) are responsible for the regulation blood glucose levels.

Anatomical location of the melanoma gland

Pancreatitis: causes

When considering the factors that contribute to the development of pancreatitis, it can be said that disorders associated with the outflow of bile, as well as dietary habits (for example, consumption of fatty and rich meat foods, stress, hereditary predisposition, alcohol, etc.) can lead to the development of pancreatitis. ).

Various diseases, such as influenza, appendicitis, herpes, gastritis, allergies (food), etc., can also provoke pancreatitis. Considering the peculiarity that the gland is deep enough, diagnosing a disease directly related to it is somewhat complicated. Provoke the development of the inflammatory process in the pancreas, for example, trauma (getting into the stomach with a ball, etc.).

In a special risk group for predisposition to pancreatitis are, first of all, men who do not deny themselves the use of alcohol and overeating, in addition to them, the risk group includes women during pregnancy and in the early postpartum period. In general, pancreatitis occurs in children, young people and adults, regardless of age and other specific features.

As we have already noted, pancreatitis can be acute or chronic, while the development of its chronic form is possible against the background of the previous acute form of this disease. In addition, the chronic form of pancreatitis can develop due to atherosclerosis, liver disease, ulcerative colitis, thyroid disease, etc.

Classification

Pancreatitis is considered in various sources in their own distinct classifications. The first of these classifications appeared in early 1946, in particular, it was focused on highlighting the clinical features that accompany the course of the chronic form of pancreatitis against the background of patients drinking alcohol. Later, in 1963, a new version of the classification was created, which includes a description of the etiological factors and morphological characteristics in combination with the rationale for the relevance of the relationship that exists between them. After that, the originally indicated variants of classifications with additions and corrections began to appear.

The most “fresh” version of the classification was the classification created in 2007, in which, depending on the nature of the course of pancreatitis, the following forms are distinguished:

• acute pancreatitis;
• acute recurrent pancreatitis;
• chronic pancreatitis;
• chronic pancreatitis in an aggravated form of the course.

As we have already noted, chronic pancreatitis can develop from previous acute pancreatitis, and it is in this variant, as a rule, that this disease manifests itself, that is, the transition from one form to another. The gradation (sequence, increase) between the acute relapsing form of the disease and the exacerbation of the chronic form is very arbitrary. The occurrence of a pancreatic syndrome in a patient (including pain syndrome, lipasemia and amylasemia) within less than six months from the onset of the onset of pancreatitis is usually defined as a recurrence of its acute form, but if we are talking about a period of more than six months, then an exacerbation of the chronic form of the disease is already considered here .

In accordance with the characteristics of the lesion of the gland, in which the volume of this lesion indicates the size of the site of its necrosis, the following forms of pancreatitis are distinguished:

• The edematous form (in this variant, the necrosis of single pancreatocytes is considered, in which characteristic islands of necrosis do not form);
• Pancreatic necrosis (or a destructive form of the disease), which, in turn, may correspond to the following variants of forms according to the nature of the lesion:
• pancreatic necrosis small focal;
• pancreatic necrosis mid-focal;
• macrofocal pancreatic necrosis;
• pancreatic necrosis total-subtotal.

The specified definition, "pancreatic necrosis", is more pathoanatomical than clinical, for this reason, accordingly, it is incorrect to define it as a diagnosis. Total-subtotal pancreatic necrosis defines this kind of destructive processes in the gland, in which all its departments are affected, that is, the tail, body and head. An exclusively total form of pancreatic necrosis does not occur in practice.

There are certain phases of pancreatitis, which are considered as part of its acute form:

• enzymatic phase (within three to five days);
• reactive phase (ranging from 6 to 14 days);
• sequestration phase (from 15 days);
• phase of the outcome (from six months or more from the onset of the onset of pancreatitis).

The actual moment in the course of this disease is the lethality, which also determines the corresponding positions in the classification for it, there are only two of them:

• early lethality - occurs as a result of the development of multiple organ failure;
• late mortality - occurs as a result of the development of purulent-septic forms of complications that manifest themselves in destructive pancreatitis (purulent-necrotic parapancreatitis).

Remarkably, the statistics indicate that about 50% of patients with destructive pancreatitis or pancreatic necrosis abuse alcohol, which, as we have already identified, is a serious background for the development of the disease. In addition, it is known, again, based on statistical data, that 20% of patients developed pancreatitis as a complication of gallstone disease.

Acute pancreatitis: symptoms

Acute pancreatitis by itself means, respectively, an acute form of manifestation of aseptic inflammation to which the pancreas is exposed. The basis of the disease is necrobiosis of pancreatocytes in combination with enzymatic autoaggression, as a result of which necrosis of the gland and its dystrophy subsequently develop, in addition to this, a secondary purulent infection also joins the process.

The disease in this form, despite the fact that modern variants of methods are used in its treatment, based on the implementation of measures of conservative treatment and surgical treatment, is characterized, nevertheless, by a fairly high degree of mortality. So, in general terms, it is about 7-15%, and in the case of the development of destructive forms of pancreatitis, it can reach 40-70%.

Focusing specifically on the symptoms of this form, we note that acute pancreatitis does not have a clear clinic, and therefore its diagnosis implies the need for a number of studies.

Patients complain of the appearance of acute pain in the abdomen, which is accompanied by nausea and vomiting without relief (vomiting - in the form of duodenal contents, which, in turn, implies the presence of digestive juices, mucus, bile, digested food, saliva, etc.). There is also bloating, dry mouth, and belching. Against the background of intoxication with concomitant vomiting, patients experience a violation of the water and electrolyte balance, and dehydration occurs. Bluish spots often appear on the left side wall of the abdomen, in some cases they have a yellowish tint (this symptom is defined as Gray Turner's symptom). Spots may also appear in the area near the navel.

The progressive course of the acute form of pancreatitis may be accompanied by a rapid deterioration in the general condition of the patient, which is accompanied by increased heart rate, fever, lower blood pressure, pallor of the skin (it may change to an earthy gray tint), the face may acquire a characteristic sharpening of the features.

Examination determines bloating, the appearance of signs indicating paresis of the stomach and intestines (which is manifested in the absence of contractions). Complications of acute pancreatitis can manifest themselves in complications both from those organs that are in the peritoneal region, and from organs concentrated in other areas, that is, outside it. The main group of complications includes suppuration of the stuffing box, intraperitoneal complications, gastrointestinal ulcers, peritonitis, pulmonary pneumonia and lung abscesses, exudative pleurisy (in which fluid accumulates in the pleural cavity). Often, acute pancreatitis is also accompanied by hepatitis and disturbances in carbohydrate metabolism, which manifests itself in the form of a disturbance in the blood sugar level, as well as in its appearance in the urine.

In any case, the basis of the symptoms of pancreatitis is the pain that occurs due to the processes relevant to it in terms of the outflow of secretion by the gland. This is expressed in the form of a tense state of the capsule of the gland, as well as in the form of an increase in pressure in the area of ​​the solar plexus. An exceptional condition for the appearance of a pain syndrome is the fact that many nerve endings involved in the whole process are concentrated in the pancreas. The duration of the manifestation of pain can be as much as several hours, and up to two days (prolongation of this period is not excluded). As for the intensity of actual pain, it is determined by the severity of the actual inflammation in the gland. With its swelling, the pain may appear in an intense sharp form. In some cases, the course of the disease, the symptoms of pancreatitis can manifest themselves in the form of pain, extending to the area of ​​​​the heart and chest. Diagnosis of pancreatitis in this case should take into account a similar option.

Also, pancreatitis may be accompanied by the following symptoms:

• weight loss;
• flatulence;
• the appearance of a white coating on the tongue;
• symptoms of hypovitaminosis (appearance of "jam" in the corners of the mouth, brittle hair, peeling and dry skin, etc.);
• nausea and vomiting;
• the appearance of "ruby droplets" localized in the abdomen and chest.

The listed symptoms are not necessarily combined with each other, moreover, they do not always indicate pancreatitis, but their appearance in any case should not be ignored.

We have already noted that the chronic form of pancreatitis can develop against the background of the acute form, but the option is not excluded in which acute pancreatitis develops against the background of its chronic form, and in any case, acute pancreatitis is in no way connected with the concept of exacerbation of the chronic form of pancreatitis.

After patients have suffered acute pancreatitis, pseudocysts appear in their pancreas, which, in turn, due to their own increase in size and accumulation of pathological fluid in the cavities, as well as due to the compression of organs that are in close proximity to them, thus produced, can cause pain. In addition, the process of food advancement in the stomach and duodenum may be disrupted, and the possibility of suppuration of pseudocysts is not excluded.

In some cases, swelling or sclerosis that has appeared in the area of ​​​​anatomical concentration in the pancreas of its head causes a clinical picture similar to compression of the bile ducts, as well as the pancreatic duct. This type of picture is characteristic of the development of a head tumor, on the basis of which this form of pancreatitis is defined as a pseudotumorous form. Due to the relevance of the violation in such a flow of bile outflow, obstructive jaundice often develops.

Predominantly, the death of patients with acute pancreatitis during the first days from the moment of its occurrence occurs due to endogenous intoxication, which, in turn, is accompanied by the development of hypovolemic shock, acute renal failure and cerebral edema.

Chronic pancreatitis: symptoms

Chronic pancreatitis is a fairly common disease, its main manifestations are reduced to the appearance of periodic or constant pain, as well as the manifestation of signs of endocrine and exocrine insufficiency. In terms of actual processes, pathological changes in the parenchyma of an irreversible nature occur in the pancreas, which consists in its wrinkling, proliferative fibrosis, with the disappearance of acini in some places. In addition, there is a stricture of the duct (that is, its organic narrowing occurs), the formation of stones (dense formations, stones) in it or in the tissues of the gland occurs.

Pancreatitis is manifested with a minimum of clinical manifestations, and in some cases this form of pancreatitis is masked under other diseases that occur in the abdominal organs (for example, diaphragms, biliary dyskinesia, chronic cholecystitis, duodenal ulcer or biliary tract, etc.). ). Given the similar nature of the course of this disease, it is impossible in principle to establish the true frequency of its occurrence.

Chronic pancreatitis has its own classification, it distinguishes the following forms:

• toxic-metabolic pancreatitis;
• idiopathic pancreatitis;
• hereditary pancreatitis;
• autoimmune pancreatitis;
• obstructive pancreatitis;
• recurrent pancreatitis;
• primary and secondary pancreatitis.

Primary pancreatitis, in accordance with the classification used by M. I. Kuzin, may be alcoholic, resulting from malnutrition, against the background of metabolic disturbances. In addition, in this form, chronic pancreatitis manifests itself as drug-induced pancreatitis (respectively, due to the intake of certain drugs that provoke it), as well as pancreatitis of an unknown origin.

In accordance with the same classification, pancreatitis is classified as secondary and post-traumatic. Post-traumatic pancreatitis occurs against the background of blunt trauma of the pancreas, its open trauma, as well as against the background of previous intraoperative injuries, examination of the pancreatic ducts and bile ducts when they are filled with a contrast agent for subsequent observation by using an X-ray unit (ERCPG method). As for secondary pancreatitis, cholangiogenic pancreatitis is distinguished here, incl. lymphogenous cholecystopancreatitis (occurring against the background of papillostenosis, choledocholithiasis), pancreatitis developing against the background of gastrointestinal diseases, endocrinopathies, occlusions of the branches of the abdominal aorta, as well as other factors of an etiological scale.

As for the part that is of particular interest to us, which consists in the symptoms of chronic pancreatitis, here, as a rule, exocrine insufficiency acts as the main clinical sign of the disease. Such insufficiency is manifested by the inability to produce the required amount of enzymes by the gland. Often, against the background of the transfer of an acute form of the disease, pseudocysts are formed, which, due to their increase in size and the accumulation of pathological fluid, lead to compression of the organs surrounding them. This, in turn, leads to the appearance of pain, as well as to a violation of movement in the duodenum and in the stomach of food. The possibility of suppuration against this background of pseudocysts is also not excluded.

In some cases, as a result of sclerotic processes occurring in the head of the pancreas, a clinic appears that is similar to the clinic when the ducts of the bile ducts are compressed with the pancreatic duct. The specified variant of the course is relevant in the development of tumors in the head of the gland, therefore this form of the course of pancreatitis is defined as a pseudotumorous form. Due to the actual violation of the outflow of bile with a similar course of pancreatitis, obstructive jaundice may develop. With obstructive jaundice, the skin becomes yellow, and the sclera and mucous membranes are also affected in a similar way. Due to the development of this form of jaundice, the condition of patients undergoes a significant deterioration, which, accordingly, aggravates the course of the underlying disease, which is, in fact, chronic pancreatitis. The symptoms of this form of pancreatitis can also determine the transition to its acute form, but it is not considered as an exacerbation of pancreatitis due to inconsistency with this condition.

Chronic pancreatitis is a slowly progressive inflammatory process, inflammation, as we have already noted, is subject to stages of regression, that is, it periodically exacerbates, then subsides. Ultimately, organ atrophy occurs, fibrosis or its calcification, the course of the disease eventually leads to the replacement of tissues in the gland (normal tissue in it is replaced by scar tissue).

Attack of pancreatitis: symptoms

An attack of pancreatitis is accompanied by symptoms in the form of pain that arises from the upper half of the abdomen and radiates to the back. These pains appear after eating, can last for many hours, but in some cases the duration of their manifestation reaches a period of several days. Often the state of an attack of pancreatitis is accompanied by nausea and vomiting, the development of jaundice. The prolonged course of the attack leads to the appearance of copious stools with a characteristic greasy sheen, as well as to weight loss in patients.

When an attack of pancreatitis occurs, urgent hospitalization is necessary, because otherwise the patient may develop a number of complications directly related to this organ, one of them is the necrosis of its part.

Alcoholic pancreatitis: symptoms

Alcoholic pancreatitis is a chronic form of the disease, it appears in patients who abuse alcohol. The symptomatology manifests itself in particular after eating acidic and spicy foods, as well as after eating fresh vegetables and fruits. Sometimes the signs of the disease can manifest themselves similarly to the signs of biliary colic in quite pronounced manifestations in the form of pain in the right hypochondrium (with its spread to the back), as well as with the appearance of vomiting, in which an admixture of bile is found.

The early stages of the disease are accompanied by the appearance of constipation, which is combined with a hypomotor form of dyskinesia. Gradually, the chair becomes unstable, there is an alternation of diarrhea with constipation. Diarrhea (diarrhea) is the main "companion" of patients with alcoholic pancreatitis.

Reactive pancreatitis: symptoms

Reactive pancreatitis, like pancreatitis in general, develops against the background of a malfunctioning pancreas, which, in turn, is due to its inflammation. At the initial stage, the reactive form of pancreatitis is accompanied by constant heartburn, frequent bloating, and belching. Patients have an aversion to fatty foods, there is an acute intolerance to the smells characteristic of them.

If these signs appear, you should seek medical help. In itself, the disease in this form is not dangerous, but with the exclusion of going to the doctor as necessary, it will begin to progress, moving on to an even more serious form. This form of pancreatitis is considered as the first reaction on the part of the body to malnutrition. In most cases, pancreatitis develops in adult men, which is associated with frequent neglect of the food consumed, as well as with the periodic use of alcoholic beverages.

Given the increase in pressure exerted in this case on the gallbladder and duodenum, the outflow of pancreatic juice is blocked, which, in turn, causes the progression of the disease. As in other forms, reactive pancreatitis is often the cause of other diseases already present in a sick person (liver cirrhosis, cholelithiasis, gastritis, hepatitis, etc.). It can also occur as a result of a blow, due to tissue rupture, which also leads to the impossibility of passing the enzymes produced by the stomach to the duodenum. This causes self-digestion of the stomach and, as a result, the destruction of gland tissues.

Signs of reactive pancreatitis are the appearance of severe cutting pain that occurs under the ribs, as well as the appearance of regular hiccups and incessant constant vomiting. Pain sensations can also change in the area of ​​​​their localization, which is determined based on the specific area of ​​​​inflammation. So, inflammation of the bottom of the organ is indicated by pain in the region of the right hypochondrium, inflammation of the body of the organ is indicated by pain in the region under the scapula, and inflammation of its neck is indicated by pain in the region of the right hypochondrium.

In addition to the above symptoms, the patient may experience problems with appetite (loss of appetite up to the appearance of aversion to food), in a more advanced version of the course of the disease, increased salivation, periodic attacks of nausea, and bloating are noted. Reactive pancreatitis in children is often accompanied by diarrhea (it has a permanent manifestation), fever and, again, loss of appetite.

Diagnosis

Diagnosis of pancreatitis involves the following methods:

• analysis of blood and feces;
• coprogram (allows you to determine the features of the digestive functions of the gastrointestinal tract, as well as to identify the actual insufficiency of the digestion of carbohydrates, proteins and fats);
• Ultrasound (the areas of the gallbladder, liver, bile ducts, and, in fact, the pancreas) are examined;
• CT (computed tomography, which examines the whole organs concentrated in the abdominal cavity).

Treatment of pancreatitis

Treatment of pancreatitis depends on the severity of its characteristic course. In the absence of complications (with damage to the lungs, kidneys), acute pancreatitis disappears. The basis of its treatment is to provide the patient with conditions of rest, in particular, it means rest for the affected organ, which is ensured by fasting for a period of several days. Also, in determining treatment measures, they are based on the goal of maintaining vital functions characteristic of the body, while preventing the development of complications. Hospitalization may be required if a specific type of drug is needed.

The formation of false cysts may be the reason for an operation to remove them.

A stone blocking the bile duct or gland duct can lead to an acute attack lasting several days. With advanced or complicated form of pancreatitis, treatment may require the provision of intravenous nutrition lasting within 3-6 weeks (a specific period is determined by the patient's condition, taking into account the restoration of the normal state of the organ). Mild cases of the course of the disease do not require such manipulations; it is enough to limit oneself to an appropriate diet. The diet for pancreatitis is used No. 5, it exists in two versions, designed for use as part of the exacerbation stage or in remission.

In chronic pancreatitis, treatment is focused on relieving pain, then planning an appropriate diet while limiting the intake of foods rich in fats and carbohydrates. Additionally, pancreatic enzymes can be prescribed, used as a measure of replacement therapy, as well as to lower the level of enzyme production and to calm down the functioning of the pancreatic organ.

In any of the variants of the forms of pancreatitis, the use of alcohol is excluded.

If symptoms appear that indicate the possible presence of pancreatitis, it is necessary to contact a gastroenterologist.

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Pathologies of the digestive system and even oncology. To prevent a threat, you need to know about its primary sources.

Causes of pancreatitis

pancreatitis causes

Pancreatic disease is an inflammatory process that is localized in.

According to medical statistics, in more than 70% of cases, the cause of such organ damage is alcohol abuse. However, despite the fact that the remaining 30% are divided among themselves by other factors (malnutrition, hereditary predisposition, etc.), this does not make pancreatitis a rare occurrence.

what causes pancreatitis

Moreover, disorders in the digestive system and the occurrence of pancreatic disease are increasingly attacking younger people and even children. Although before the risk group fell on the elderly aged 50 years of both sexes.

• Alcoholic products are what causes pancreatitis. Enzymes contained in pancreatic juice, when drinking alcoholic beverages, significantly increase in concentration. Drinking slows down the flow of juice and can trigger its activation before it reaches the intestines, as it should be normal. It is not uncommon for a spasm of the sphincter to occur, which is responsible for skipping enzymes and blocking incoming food. It is located between the duodenum and the gland. Alcohol becomes the culprit of a malfunction in its functioning, for example, the sphincter does not open in a timely manner, so the juice accumulates in the pancreatic ducts.

causes of pancreatitis

• An abundance of spicy and fatty foods are the next most popular causes of pancreatitis. It is no secret that fats and spices adversely affect the state of the digestive system. The greatest threat is the use of spicy and fatty foods on an empty stomach, and if with all this you also drink alcohol during the meal, pain and seizures cannot be avoided. The statistics are relentless: most often, acute pancreatitis occurs on holidays, when, having eaten from the belly of the most harmful food (richly seasoned with mayonnaise, fried with spices, etc.), they finish off the diet with alcoholic beverages - a truly explosive mixture. Such attractive and tasty causes of acute pancreatitis can eventually even lead to death.

• Another cause of pancreatitis is through a complication of cholelithiasis. It accounts for 1 case out of 5. The ducts of bile and pancreas merge before entering the intestine. If the stone gets into this "channel", naturally it can block the way, and then the enzymes will not get to their destination. This will cause inflammation in the gland and result in a number of negative consequences: indigestion, pain, diarrhea, etc.

• Injuries to the abdomen can also cause pancreatitis, which can cause characteristic symptoms such as pain, nausea, vomiting, and fever. This factor also includes inflammatory processes of the internal organs of the peritoneum, and not just bruises and penetrating wounds in the gland.

• Viral hepatitis, as a rule, becomes the fault of the fact that. The causes of inflammation can also be hidden under the complications of the same flu or other infectious diseases.

As you can see, there are many factors that cause pancreatitis. Pictures illustrating inflammation clearly show what the pancreas experiences with pathological changes. In order not to start the situation in a timely manner, contact a specialist for a complete examination, and the following symptoms will be the impetus for action:

causes of acute pancreatitis

1. Pain that radiates to the back and mainly to the left side of the hypochondrium.
2. The nature of pain sensations is closer to girdle, however, it can be replaced by aching and acute pain.
3. The body temperature may rise, as well as the heart rate.
4. An upset of the gastrointestinal tract is manifested by violations of peristalsis: flatulence, bloating, diarrhea, constipation, heartburn, nausea, hiccups, vomiting, etc.
5. A state of weakness and lethargy that covers even after a long rest and sleep.

Be vigilant, because health is the most precious thing we have!

Pancreatitis - what is it

Signs of pancreatitis: symptoms, where it hurts, treatment and types of inflammation
Acute pancreatitis: symptoms and treatment in adults and children

When the pancreas becomes inflamed, this is a very common phenomenon in medicine. Symptoms of pancreatitis in women, according to statistics, are not as common as in men, since the male sex is more prone to the development of this disease. In the article we will talk in detail about the symptoms and treatment of pancreatitis disease.

If there is a problem with the pancreas, this is very serious, since its pathologies can disrupt the functioning of the entire human body. Therefore, doctors recommend paying more attention to the prevention of pancreatitis.

What it is?

Pancreatitis is a kind of inflammation of the pancreas. Its main functions:

• Release enzymes to break down beneficial substances that were obtained with food in the small intestine.
• Carry out the fermentation of insulin and glucagon in the blood. These are hormones that regulate the storage and consumption of energy that comes from food.

In the case when the enzymes themselves are activated and do not go into the intestine, the organ suffers and "self-digestion" is formed. And also the tissue of the gland is destroyed, edema appears, and bleeding is possible.

But you need to understand that the violation occurs not only in the tissues of the gland, but also in the blood vessel. Only adults suffer from this disease. In childhood, pancreatitis as a congenital pathology. Doctors identify a certain number of factors that cause the disease to develop. They have differences among themselves, it all depends on the gender of the person.

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Causes of pancreatitis

Doctors described a list of reasons why pancreatitis develops. Here is some of them:

• Frequent alcohol abuse;
• gallbladder disease;
• The presence of inflammatory diseases of the gastrointestinal tract, such as peptic ulcer, duodenitis;
• Postponed operations on the abdomen;
• Due to mechanical damage to the abdomen: wounds, blows, bruises;
• Due to the constant use of hormonal drugs;
• With chronic liver disease;
• In the presence of infectious diseases: mumps, hepatitis B and C, scarlet fever;
• Worms;
• Features with the pancreas - a tumor or a certain structure;
• Due to hormonal failure;
• Heredity.

Experts have found that 20% of people who fall ill with pancreatitis do not have a well-established cause.

Acute pancreatitis in adults

It is very easy to determine the form of pancreatitis. If you have very sharp intense pain in the left side of the abdomen, then this is a disease.

Pain in the right side of the abdomen is also possible, it all depends on the location of the organ that is affected. It is important to provide first aid to the patient in time, since the development of a painful shock in a person is possible.

But there is still a list of symptoms by which pancreatitis can be determined. These include:

• fever
• sudden changes in blood pressure;
• the appearance of cold sticky sweat;
• pallor of the skin;
• the appearance of bluish spots in the navel and lower back;
• rarely icterus of the sclera and skin;
• nausea, belching, hiccups;
• bouts of vomiting with bile;
• frequent bowel movements;
• bloating, constipation, tension in the muscles of the peritoneum;
• loss of consciousness.

If you find one of the symptoms of pancreatitis disease, you urgently need to be hospitalized.

Chronic form of pancreatitis

It is often difficult to distinguish the symptoms of a particular problem. So pancreatitis has very similar symptoms with diseases such as gastritis and biliary dyskinesia.

But, both in the acute and in the chronic form of the disease, the patient begins to experience severe pain. Usually, these are pains in approximately one area, the so-called "pituitary".

Painful urges can be given to the left or right side, and back. Often the pain is diffuse or shingles. If you take the position lying on your back, the pain will only intensify. When you sit more and you can tilt your body forward slightly, the pain will seem much easier.

In the chronic form, the pain appears and becomes more frequent after you have eaten. If you drank alcohol, then the pain may make itself felt after a while. There were cases when the pain syndrome reached the heart. You can deal with such pain with the help of angina pectoris.

In addition to all of the above, an adult may have such symptoms of chronic pancreatitis:

• lost appetite, as well as aversion to any food;
• naivety of dyspeptic phenomena (belching, hiccups, salivation, bouts of nausea, vomiting);
• diarrhea profuse or oily;
• frequent swelling and rumbling between meals;
• if the disease has already lasted a long time, then the person loses a lot of weight;
• a slight increase in temperature is possible;
• irritability;
• chronic fatigue;
• sleep is disturbed.

Types of pancreatitis

Based on the symptoms, several types of pancreatitis can be distinguished:

Diagnostics

It goes through several stages:

1. Asking a patient about a problem. The patient needs to tell the story of the whole disease to the maximum. In what period of time did the pain begin, its strength and frequency, etc.;
2. The doctor feels the person's stomach. This is a kind of diagnostic test to believe the stimulation of the organs;
3. Ultrasound of the pancreas is performed;
4. If necessary, computed tomography is done;
5. To determine the level of ESR, leukocytes and bilirubin, you need to take blood tests: clinical and biochemical;
6. The next one is a blood glucose test;
7. To determine the level of elastase and undigested fats, a fecal analysis is needed in the main laboratory method.

The appearance of pancreatitis in men

The development of pancreatitis in males is usually manifested due to excessive alcohol intake. Approximately 50% of men who have pancreatitis drink alcohol frequently.

But in other cases, the disease progresses due to:

1. Gallstone disease. One of the most common factors after alcoholic beverages.
2. Complications of infectious, viral diseases.
3. Postoperative complications, side effects of some medications.
4. Trauma
5. hereditary disposition.

The appearance of pancreatitis in women

A woman is inherently much more emotional than a man. A woman takes everything to heart and is often nervous over trifles.

In addition to the nervous system, the causes may lie in the following:

• malnutrition;
• self-medication (reaction to drugs);
• cholelithiasis;
• infectious injury.

Treatment

To treat pancreatitis in an adult means to direct actions to eliminate pain and inflammation, to prevent exacerbations. Usually, a gastroenterologist prescribes painkillers, as well as medications that can reduce the action of gland enzymes.

If dehydration occurs due to vomiting, fluid should be given intravenously. As practice shows, pancreatitis cannot be cured quickly, long-term treatment is required.

Medical therapy

• To eliminate the inflammatory process, you need to take antibiotics ("Amoxicillin", "Ampicillin", etc.);
• If you have frequent vomiting, drugs are prescribed to restore the water-salt balance ("Sodium chloride solution");
• To restore the work of the gastrointestinal tract, you need to take drugs that the pancreas: "Pancreatin", "", "".
• In order to eliminate pain, you need to use antispasmodics: "Papaverine", "".
• To restore the level of vitamins and trace elements in the body, you need to drink multivitamin medicines.
• If there is a need, then the doctor prescribes drugs: choleretic, sedative, and hormonal.

Photo of preparations:

2. Neuroimmune theory
It says that in the body under the influence of allergens (with allergies), antibodies appear against pancreatic tissues.

The antibodies destroy various structures in the pancreas, causing chronic inflammation. Inflammation leads to increased formation of pancreatic fibrosis.

3. The theory of the appearance of the disease at the level of narrow channels
The meaning of this theory is the formation of stones that close the channels that remove pancreatic juice. There is an accumulation of juice in the excretory tubules and activation of enzymes, which leads to the destruction of the normal structure of the pancreas and the development of fibrosis.

Symptoms of chronic pancreatitis

1. Pain
It is localized in the epigastrium (upper abdomen), sometimes girdle pain, which radiates to the lower back, left arm. Appears after eating fatty foods, sweets or drinking alcohol.

The nature of the pain: pressing, dull or aching, lasting from several hours to several days. Pain attacks usually recur several times a day.

Causes of pain in pancreatitis

Blockage of the outlet channels (increased pressure inside the channels)

Neurogenic. Appears due to inflammation of the nerve bundles that innervate the pancreas.

ischemic pain. Pain due to reduced blood supply to the pancreas. As a result, the tissues lack oxygen and nutrients.

Malabsorption syndrome (poor absorption)
It is manifested by a reduced ability to absorb proteins, fats, carbohydrates at the level of the small intestine. This syndrome appears due to a significant decrease in the production of pancreatic juice by the gland.

Due to the decrease in blood proteins, microelements, the body begins to use its own proteins, microelements from various tissues - muscle weakness appears.

Cause of weight loss in pancreatitis
Occurs due to malabsorption.
The body uses its own fat reserves. The consequence of this is a decrease in the amount of vitamins (A, D, E, K) in the blood.
- Asthenia (lack of strength, general weakness)
- Sleep disturbance (insomnia, superficial sleep)
- Adynamia (decreased motor activity)

Dyspeptic syndrome - many symptoms associated with the process of nutrition
- Decreased appetite
- Belching with air
- Nausea
- Vomiting that does not bring relief
- Flatulence - bloating. It occurs due to the accumulation of a large amount of gases in the intestines.
- Violations of the stool - the allocation of a large amount of feces (polyfaeces), with undigested food residues.

endocrine syndrome
It develops some time (several years) after the onset of the disease. There is a decrease in insulin production. This leads to the development of diabetes.

allergic syndrome
Includes allergies to various medications, food.

The course of chronic pancreatitis.
The nature of the flow depends on the scale of irreversible morphological (fibrosis) changes in the gland. The larger the area of ​​fibrosis, the more severe the course of the disease.

Also, the course depends on the presence or absence of such complications as diabetes mellitus. If diabetes mellitus is present, the course of the disease is much more complicated.

Diagnosis of chronic pancreatitis

Conversation with a doctor

The doctor will first ask you about your complaints. He will dwell in particular on dietary issues (what do you like to eat most of all?). The doctor will inquire about whether this disease was before the moment of seeking medical help and for how long.

Examination of the patient

1. Examination of the patient.
The skin is dry, elasticity and turgor are reduced, which indicates a progressive course (weight loss and muscle dystrophy).

The tongue - dry, white with a coating, the papillae of the tongue are atrophied - indicates the presence of a chronic disease of the gastrointestinal tract.

The abdomen is swollen due to the presence of a large amount of gas in the intestines (flatulence).

2. Palpation (palpation of the abdomen)
With superficial palpation in the epigastric region and the left subcostal part of the abdomen, the appearance of pain is noted.
With deep palpation, you can feel the pancreas (normally, the pancreas is not palpable). The gland is enlarged in size, hard consistency.

After the interview, the doctor will prescribe several tests.

Tests for pancreatitis

1. Complete blood count- a slight increase in leukocytes (an indicator of the inflammatory process), an increase in the erythrocyte sedimentation rate, also as a sign of inflammation.

2. Determination of pancreatic enzymes in the blood.
An increase in the level of blood enzymes is characteristic of a relapse (exacerbation) of chronic pancreatitis.

Alpha amylase begins to grow in the blood 2 hours after the onset of relapse.

The maximum level of this enzyme is observed 24 hours after the exacerbation.
On day 4, the amount of the enzyme is normalized.

Lipase- reaches its maximum values ​​on the 2-4th day from the onset of exacerbation. Keeps increased 10-12 days. The presence of lipase in the blood indicates the severity of the process, the necrosis (destruction) of pancreatic cells.

trypsin- an increase in trypsin in the blood is characteristic only for damage to the pancreas.

3. Test of indirect stimulation of the excretory function of the pancreas
The test is based on stimulation of the excretory function of the pancreas by ingesting 300 grams of food in liquid form.
This food mixture contains 5% proteins, 6% lipids and 15% carbohydrates. Within 2 hours, 4 samples are taken (with an interval of 30 minutes) of the contents of the duodenum and the activity of pancreatic enzymes is determined.

4. Direct functional test
The test is based on duodenal intubation and subsequent stimulation of enzyme secretion.

5. Coprological analysis (stool analysis)
In the feces we find steatorrhea (the presence of lipids in the feces).

6. Test to determine the endocrine function of the pancreas
The test is based on the ingestion of 75 grams of glucose. Normally, after 2 hours, the blood glucose level should be between 8 and 11 mmol/liter. If the blood sugar figure is above 11, then the test is considered positive (there is a violation of the endocrine function).

Instrumental examinations

X-ray of the abdomen
Chronic pancreatitis is characterized by the presence of calcifications (formations consisting of connective tissue and calcium salts) in the pancreas.

Ultrasound of the pancreas
Ultrasound visualizes:
- an increase in the size of the pancreas
- uneven contours
- various deformations of the tubules of the pancreas
- calcifications
- Expansion of the pancreatic duct > 3 millimeters

CT scan
You can determine the accompanying pathologies of the pancreas: cysts, tumors.

Selective retrograde angiography
This study is carried out to determine the quality of the blood supply to the pancreas: hypervascularization of the gland, as well as impaired blood circulation through the splenic vein, which leads to portal hypertension (increased pressure in the portal vein).

Relaxation duodenography
The study is carried out to determine the increase in the head of the pancreas and changes in the major duodenal papilla.

Complications of chronic pancreatitis

1. Violation of the outflow of bile - appears with a significant increase in the head of the pancreas. As a result, mechanical jaundice appears.

2. Duodenal stenosis - or narrowing of the duodenum, which leads to debilitating frequent vomiting due to the impossibility of the normal passage of food through the intestinal tract.

3. Pancreatic abscesses - limited purulent inflammation of the tissues of the pancreas with the formation of a cavity with pus. Manifested by a sharp pain in the pancreas, fever, chills, high body temperature of 38.5 - 40 degrees Celsius.

4. Pancreatic cysts - are formed either due to necrosis (cell death) of the pancreas, or due to blockage of the ducts.

5. Endocrine insufficiency or, more simply, diabetes mellitus - with the destruction of insulin-producing cells

6. Pancreatic cancer - the probability of cancer in patients with complicated chronic pancreatitis increases tenfold.

Treatment of pancreatitis

Medical prescriptions

Treatment always begins with the exclusion of contact between the patient and the causative factor.
1. Eliminate alcohol
2. No smoking
3. Stopping taking drugs that have a toxic effect on the pancreas (furosemide, aspirin, glucocorticosteroids)
4. Elimination of blockage of the excretory ducts.

Correct and successful treatment during an exacerbation is possible only in a hospital in the department of gastrology!

During the period of exacerbation of chronic pancreatitis, bed rest until the patient's condition improves. During the period of relative remission, the normal regimen

Diet for pancreatitis

Meals during the day should be divided into 4-5 meals and in small portions.

In the period of incomplete remission
1. Products that should be excluded from the diet.
- rye and fresh bread, puff and pastry products
- ice cream
- coffee, cocoa
- carbonated and cold drinks
- fresh and canned juices
- high-fat dairy products
- fried, smoked, salted fish
- any kind of canned food, as well as smoked meats and salinity
- boiled and fried eggs
- soups with fatty meat and fish, okroshka, cabbage soup
- fatty meats: duck, goose, pork
- bean dishes
- radish, turnip, radish, garlic, sorrel, mushrooms
- raw fruits and berries (grapes, banana, dates, figs and others)
- any spices

2. Foods to eat in chronic pancreatitis
- wheat bread from flour of the 1st and 2nd grade, necessarily dried
- pureed soups from potatoes, carrots, zucchini
- boiled rice, buckwheat, oatmeal, vermicelli
- meat of non-fat varieties (beef, veal, rabbit, turkey, chickens) boiled, minced (cutlets, beef stroganoff and other types of dishes)
- boiled or baked vegetables (potatoes, carrots)
- lean fish (boiled)
- low-fat dairy products (fresh non-acidic cottage cheese), various puddings
- ripe non-acidic fruits and berries, pureed raw or baked
- weak tea with lemon, rosehip broth
- butter (30 grams), sunflower oil (10-15 ml) - in dishes

During the period of exacerbation
- Starvation diet 1-2 days with a constant intake of mineral water (every 2 hours)
- Then gradually include foods like vegetable puree or pureed porridge

Medical treatment

1. Painkillers
Usually they start with non-steroidal anti-inflammatory drugs (paracetamol, diclofenac, nimesulide). Paracetamol is prescribed at a dose of 650 milligrams. In case of severe pain, tramadol 50-100 mg is prescribed. Every 6 hours. Baralgin is also used.

For very severe pain, narcotic painkillers are used.
Promedol 1% - 1ml. intramuscularly.

Often the pain is spastic in nature (pain due to spasm), then antispasmodics (drugs that relieve spasm) are effective - Papaverine, Drotaverine 200 mg. 2 times a day.

2. Decrease in secretion of pancreatic juice and decrease in internal pancreatic pressure
Octreotide or Sandostatin is used to reduce exocrine secretion. Dosage 100 micrograms subcutaneously 3 times a day. Or another drug is prescribed

Famotidine (H2 blocker of histamine receptors) - 20 mg. 3 times a day.
Rabeprazole (proton pump inhibitor) - 10 - 20 mg. 2 times a day.

Drugs that reduce acidity: Maalox, Almagel - used to maintain acidity in the stomach more than 4 and to destroy bile acids in the duodenum.

3. Enzyme therapy - used for the replacement treatment of exocrine insufficiency.
Such drugs are used as: Pancreatin, Trienzyme, Creon. It is taken after every meal.

4. Antioxidant treatment (used to reduce the level of oxygen and hydrogen radicals, which are very toxic to the body)
Vitamins of group E, C, beta-carotene.

5. Antibiotic therapy. Very often recurrence of pancreatitis is accompanied by infection, especially if stones or stasis are present.
Penicillins or cephalosporins 5-7 days.

6. Drugs that reduce toxicity
Various solutions: Ringer's solution, Hemodez, Phys. solution. These drugs are administered intravenously.

If various narrowings (stenoses), stones or tumors are present, surgical treatment is recommended.

Endoscopic operations are performed using a special endoscope. With stenosis of the major papilla, expansion is performed. Stones from the ducts are removed with an endoscope with a hook-like nozzle.

In case of presence of pancreatic juice in the abdominal cavity, drainage is performed (placement of special tubes that help in removing pancreatic juice from the abdominal cavity).

Prevention of pancreatitis

In the first place is the correction of risk factors: alcoholism, various metabolic disorders. It is necessary to constantly adhere to a diet. It also requires constant adjustment of treatment. To do this, it is recommended to visit a gastrologist 2 times a year in the absence of relapses. In case of relapse, you should immediately consult a doctor.

Is it possible to drink kefir with pancreatitis?

Diet for pancreatitis is one of the main therapeutic and preventive measures. During an exacerbation of chronic pancreatitis, as well as during acute pancreatitis, it is recommended to refrain from taking any food, as this can provoke an increase in the level of production of digestive enzymes of the pancreas, which can aggravate the course of the disease. During these periods, the use of kefir is highly undesirable. However, during periods of remission of chronic pancreatitis ( weakening or disappearance of symptoms) you can drink kefir, and in some cases its use is even recommended.

Pancreatitis is an inflammation of the pancreas. In this case, acute pancreatitis occurs under the influence of a number of adverse factors and is accompanied by self-destruction of the gland tissues under the action of its own digestive enzymes. Chronic pancreatitis, which in most cases develops as a consequence of acute, is a situation in which some part of the gland ceases to function normally, and its microscopic structure is significantly impaired. In this case, there are significant changes in the level of digestive enzymes produced, which imposes some restrictions on the daily diet.

In chronic pancreatitis, a low-fat diet is recommended, since the function of enzymes that break down fats is primarily affected in this disease. The degree of restriction depends on the severity of the disease, but in most cases it is not recommended to exceed the limit of twenty grams of fat per day. In the presence of digestive disorders against the background of compliance with this restriction, you should consult a doctor who can prescribe adequate replacement therapy. Usually, in these cases, medications are prescribed that contain ready-made pancreatic enzymes, the artificial replacement of which makes it possible to compensate for the existing deficiency. The amount of protein consumed in most cases is recommended to be increased. The carbohydrate diet as a whole depends on the endocrine function of the pancreas, that is, on its ability to produce insulin. If this process is disturbed, the amount of carbohydrates should be strictly controlled. However, with normal endocrine function, the amount of carbohydrates consumed can be slightly increased.

Kefir is a fermented milk product that contains a fairly high amount of beneficial microorganisms that can normalize the intestinal microflora. This allows you to stabilize many processes in the digestive tract, and also contributes to the normal formation of stool. For this reason, kefir is recommended for patients who suffer from constipation against the background of pancreatitis. However, you should not drink more than two hundred - three hundred grams of kefir per day.

Is it possible to eat fresh vegetables with pancreatitis?

The use of fresh vegetables for pancreatitis is not recommended, since these products increase fermentation processes in the intestines, which can cause a number of unpleasant symptoms and even provoke some serious complications.

In chronic pancreatitis, a serious violation of the function of the pancreas occurs with a change in the amount and composition of the digestive juice produced by it. As a result, the process of digestion of a number of nutrients is disrupted. This causes changes in both the general condition of the patient ( due to malabsorption of nutrients, general malnutrition can occur), and a change in the internal balance of the intestine. Due to a shift in the internal environment of the intestine, the vital activity of its normal microflora is disturbed ( microorganisms living in the intestinal lumen that contribute to normal digestion), which provokes fermentation processes.

Fresh vegetables, despite their undeniable benefits for healthy people and a high content of vitamins, in chronic pancreatitis can provoke an increase in fermentation processes. When this occurs, bloating develops, discomfort occurs, diarrhea develops, or, in more rare cases, constipation.

In addition, fresh vegetables have a pronounced stimulating effect on pancreatic tissue, thereby increasing the amount of digestive juice produced. Although at first glance this effect may seem favorable, in fact it is not. The fact is that against the background of the altered structure of the pancreas, its reserve capabilities are also violated, that is, excessive stimulation does not lead to an improvement in the functioning of the pancreas, but to a deterioration or exacerbation of the disease. Therefore, the exclusion of fresh vegetables and their juices is extremely important for pancreatitis.

It should be noted that in acute pancreatitis, as well as in exacerbation of chronic pancreatitis, it is recommended to avoid not only fresh vegetables and fruits, but in general any enteral nutrition ( food that enters the gastrointestinal tract through the mouth and stomach).

What is acute pancreatitis?

Pancreatitis is an inflammatory disease of the pancreas that can occur in both chronic and acute forms. At the same time, acute pancreatitis differs in its course, clinical manifestations and prognosis from chronic. This disease is quite common among the population, and its frequency is approximately 40 cases per hundred thousand of the population.

Acute pancreatitis occurs when the factors involved in maintaining the normal functioning of the cells and structures of the pancreas are suddenly outweighed by aggressive factors of a different nature.

The main factor of aggression in the development of acute pancreatitis are digestive enzymes produced by the pancreas itself. At a sufficient concentration, these enzymes are able to independently activate, which ultimately leads to the self-destruction of the gland ( therefore, treatment is based on measures aimed at reducing the production of pancreatic enzymes).

There are the following possible causes of acute pancreatitis:

• Alcohol consumption. Alcohol consumption is considered as one of the main causes of acute pancreatitis, which occurs in at least 35% of cases. At the same time, the amount of alcohol consumed on the eve of the onset of an acute inflammatory reaction can vary significantly in different people and be quite small. Pancreatitis occurs due to the fact that under the influence of ethyl alcohol the permeability of the internal pancreatic ducts increases, which allows extremely aggressive enzymes to reach tissues with the development of cell damage. In addition, alcohol increases the concentration of proteins in the composition of pancreatic juice, due to which protein plugs are formed in small ducts, which greatly complicates the outflow of secretions.
• Stones in the bile ducts. Gallstone disease is one of the most common causes of acute pancreatitis. With this disease, due to a shift in balance during the formation of bile in the gallbladder, calculi of various sizes can form and accumulate ( stones). The migration of these stones through the bile ducts can cause their blockage with stagnation of bile and the development of the so-called obstructive jaundice. However, when stones migrate to the area of ​​the common bile duct and pancreas, acute pancreatitis may also occur. The development of an acute inflammatory reaction in this case is associated with an increase in pressure in the pancreatic ducts and the accumulation of enzymes that are activated and begin to have an aggressive effect on the cells of the organ.
• Injuries. Closed and open injuries of the abdominal cavity can cause a significant increase in the level of pancreatic enzymes in the blood due to the development of an acute inflammatory reaction that occurs against the background of damage to both the cellular structures of the gland and its ducts.
• Retrograde cholangiopancreatography ( RKHPG) is a minimally invasive procedure in which, using a flexible endoscope ( a tube equipped with lighting devices, with which you can perform a series of manipulations) stones are removed from the bile ducts. Since the hole through which bile enters the duodenum is common to the pancreas, damage or swelling can cause an acute inflammatory reaction.
• The use of a number of drugs. Drug-induced pancreatitis is rare, even among populations taking potentially toxic drugs. In most cases, this disease occurs in a mild form.

Rare causes of pancreatitis are the following pathologies:

• congenital pancreatitis;
• excessively elevated levels of calcium in the blood;
• various disorders in the structure of the pancreas;
• excessively high levels of triglycerides in the blood;
• tumors;
• action of toxins;
• surgical procedures;
• vascular anomalies;
• autoimmune processes.

Acute pancreatitis is characterized by a pronounced clinical picture with a violent onset and significant discomfort. The symptoms are based on severe pain, which, however, is accompanied by other signs. It should be noted that despite the rather characteristic clinical picture, additional examinations or consultation with an experienced specialist are necessary to confirm the diagnosis.

Acute pancreatitis is characterized by the following symptoms:

• Pain. The pain is usually of high intensity, located in the upper abdomen, sometimes with some emphasis on the left or right side. Often the pain is excruciating. In some cases, the pain is relieved by lying on the back. The duration of pain is different, but usually - more than one day.
• Nausea and vomiting. Nausea and vomiting may be accompanied by a complete lack of appetite. In some cases, diarrhea occurs.
• Fever and palpitations. They occur in more than half of the cases. May be accompanied by a decrease in blood pressure with the development of appropriate symptoms ( decreased urine production, dizziness, weakness).

The treatment of acute pancreatitis is based on the replacement of lost fluids and the stabilization of fluid and electrolyte balance, as well as balanced energy support. To reduce the production of pancreatic enzymes, normal nutrition is excluded. In some cases antibiotics are prescribed for both treatment and prevention). If necessary, resort to surgical intervention.

What are the symptoms of acute pancreatitis?

Acute pancreatitis is a serious disease of the pancreas in which the tissues of the organ become inflamed and damaged due to digestive enzymes produced by the pancreas itself. This disease is accompanied by a number of pronounced symptoms that develop quite quickly.

Acute pancreatitis is manifested by the following symptoms:

• Abdominal pain. Abdominal pain in acute pancreatitis is the dominant symptom that causes the greatest discomfort to the patient. The pain is usually dull, aching and prolonged. Usually the pain comes on suddenly and gradually increases in intensity until it reaches its maximum. In most cases, the pain is localized in the upper middle part of the abdomen, however, in some situations, it may be more felt on the left or right side ( depending on the area of ​​the pancreas that has undergone the greatest damage). The pain spreads back to the lumbar region in the form of a belt. Typically, the pain sensation increases with exercise and decreases at rest and in the supine position. The duration of this symptom may vary depending on the course of the disease, but in most cases it is more than one day.
• Nausea and vomiting. Nausea and vomiting occur in most cases. At the same time, nausea is not associated with eating, and vomiting does not bring significant relief. In some cases, there is a disorder of the stool by the type of diarrhea.
• Heat. The occurrence of heat is associated with the release of biologically active substances into the blood, which are formed at the site of the development of the inflammatory reaction. Fever occurs in more than two-thirds of patients. Usually the fever does not exceed 38 degrees, however, with the infectious nature of pancreatitis, this figure may be higher.
• Cardiopalmus. Increased heart rate is due to several factors. First, an increase in temperature reflexively causes an increase in heart rate by an average of 10 beats per minute for every one degree above normal. Secondly, exposure of pro-inflammatory substances to the cardiovascular system can cause an immediate change in the work of the heart. Thirdly, under the influence of both pancreatic enzymes released into the blood, and some other factors, a decrease in blood pressure may occur, which reflexively causes an increase in heart rate, as this allows you to maintain adequate blood supply to the internal organs even against the background of reduced pressure.
• Tension of the abdominal muscles. Under the action of pancreatic enzymes, irritation of the sheets of the peritoneum may occur ( a membrane that covers most of the organs of the abdominal cavity and its walls) with the development of a reflex defense mechanism, manifested by tension in the muscles of the anterior abdominal wall.
• Bloating, lack of peristalsis. Irritation of the peritoneum and the impact of biologically active substances on the intestine causes a violation of its work with a decrease or complete elimination of peristalsis ( rhythmic contractions of the intestines aimed at mixing and moving the contents). The result is bloating ( no gas transit), constipation develops. Due to the accumulation of toxic intestinal contents, intoxication syndrome may develop.
• Respiratory failure. In acute pancreatitis, respiratory dysfunction is often noted, which is associated with irritation of the diaphragm ( main respiratory muscle) an inflamed pancreas, as well as due to the accumulation of fluid in the pleural cavity.

Separately, mention should be made of biliary colic, which is not a symptom of acute pancreatitis, but often precedes it. This colic is manifested by periodic and severe pain in the right hypochondrium, which may be accompanied by vomiting, nausea, and bloating. In addition, during the migration of stones from the gallbladder, obstructive jaundice often occurs, which is characterized by fever, pain in the right hypochondrium and yellowing of the sclera and skin. This condition can provoke pancreatitis, since a small stone in the bile ducts can block the common pancreatic duct with them.

How to treat acute pancreatitis?

Treatment of acute pancreatitis largely depends on the severity of the disease. In most cases, with a relatively mild and uncomplicated course of the disease, treatment is carried out in therapeutic departments. With the development of unfavorable evolution, the development of complications or pancreatic necrosis ( death of pancreatic tissue) patients are admitted to intensive care units for adequate treatment.


The treatment of acute pancreatitis with uncomplicated course is based on the following principles:

• unloading of the pancreas;
• correction of water and electrolyte disorders;
• energy support;
• elimination of the original cause if possible);
• symptomatic treatment.

Reducing the load on the pancreas and reducing its synthetic activity is an extremely important principle for two reasons. Firstly, with a decrease in the activity of the gland, the production of digestive enzymes decreases, which have an adverse effect on its tissues, splitting it. Secondly, reducing the load contributes to faster and more complete regeneration of damaged structures and cells.

Removing the load from the pancreas is carried out in the following ways:

• Diet. The entry of food into the stomach is one of the main factors that stimulate the external secretion of the pancreas. Eliminate this by cutting off the power ( old principle of treatment - hunger, cold and rest) can significantly reduce the level of digestive enzymes. If it is necessary to continue enteral nutrition ( i.e. nutrition using the gastrointestinal tract) a special probe can be placed in the area after the duodenum, through which special nutrient mixtures can be supplied.
• Medications. Some medications ( somatostatin, octreotide) have an inhibitory effect on pancreatic cells, reducing their secretory activity.

Correction of water and electrolyte disorders is carried out by intravenous infusion of fluids. The composition of the fluids can be different and is selected depending on the type of disorder, as well as on the dominant symptoms and the general condition of the patient. The most commonly used saline solution is a sterile 0.9% NaCl solution in water. This drug allows you to effectively replace the lost volumes of fluid, and also replenishes the chloride ions lost along with the vomit. Often, a glucose solution is used, as it allows you to replenish the energy losses of the body ( which, against the background of hunger, fever and general malaise, increase significantly). Other fluids are included as needed.

The infusion of large volumes of intravenous solutions can reduce the degree of intoxication by "washing out" toxins from the body. In addition, these fluids stabilize blood circulation in large and small vessels, improve the functioning of internal organs. The main indicator of normal water and electrolyte balance is adequate urine production.

Energy support is carried out by intravenous administration of special preparations containing nutrient particles of a certain composition and type. The main energy-rich product is glucose solution. However, if necessary, amino acid solutions and fat emulsions are included in the diet. As soon as possible, when the functions of the pancreas are stabilized, patients are transferred to a normal diet, which is more natural.

The initial cause can be eliminated by the following measures:

• The use of antibiotics. In some cases, pancreatitis is caused by infectious agents that can be destroyed with the right antibiotics. However, in most cases, antibiotics are prescribed to prevent infectious complications that can develop against the background of impaired bowel function.
• Retrograde cholangiopancreatography. Retrograde cholangiopancreatography is a minimally invasive procedure ( not associated with massive tissue damage), during which, with the help of a special tool, stones or other objects that caused blockage of the pancreatic duct are removed.
• Surgical intervention. In some situations, surgery is necessary to resolve acute pancreatitis or to correct its original cause. In this case, they are performed as laparoscopic interventions ( insertion of small manipulators through 3 small incisions), and laparotomy ( wide incision of the anterior abdominal wall). The choice of surgical technique depends on the type of lesion and the degree of inflammation of the pancreas. If complications develop or pancreatic necrosis occurs ( death of gland tissue) requires wide access to damaged organs.

Symptomatic treatment is aimed at eliminating pain and other clinical manifestations of the disease that disturb the patient. The measures that form the basis of this treatment do not have or have very little effect on the inflammatory process in the pancreas itself and do not contribute to the elimination of the original cause of the disease.

Is it possible to treat pancreatitis with folk remedies?

Pancreatitis is a rather serious pathology, which is difficult to cope with without the use of modern pharmacological preparations. In principle, recovery even with acute pancreatitis can occur spontaneously. However, inaction is fraught with possible destruction of tissues and death of gland cells ( pancreatic necrosis). Folk remedies for exacerbation of pancreatitis can rarely drastically change the situation and improve the patient's condition. Their use is justified mainly during the period of remission of the disease ( with chronic pancreatitis) when there are no acute manifestations.

The therapeutic effect of folk remedies is aimed at improving the outflow of juice from the pancreas. Often, the exacerbation is explained precisely by its delay in the ducts of the organ. Some drugs help relax smooth muscles and dilate the ducts. This reduces the chance of an exacerbation. In addition, a number of agents increase the protective properties of organ cells. This weakens the destructive action of pancreatic enzymes.

From folk remedies, the following recipes have a certain effect in the treatment of chronic pancreatitis:

• decoction of oats. Young grains of oats are soaked in boiled water and placed in a warm place. On the second or third day when they germinate) they are ground ( or just grind). The resulting flour is poured with boiling water and continue to boil for a few more minutes. After that, the broth should cool for 15 - 30 minutes. The resulting jelly is drunk freshly prepared. It is possible to prepare sprouted grains in advance, but jelly should only be drunk fresh.
• Hypericum infusion. For 1 tablespoon of collecting dry grass, you need 2 cups of boiling water. Infusion lasts several hours until the infusion cools to room temperature. After that, it is drunk half a glass three times a day 30 minutes before meals. In some patients, this drug may cause increased pain. In this case, it should be abandoned.
• Burdock root and chamomile. Dried burdock root and chamomile flowers are mixed in equal proportions and poured with boiling water. For 10 g of the mixture you need 300 - 400 ml of boiling water. Infusion lasts 4 - 6 hours in a dark place, after which the infusion is drunk twice a day before meals, 150 ml each. It soothes pain and improves the functioning of the pancreas.

It should be noted that in the event of acute pain ( exacerbation of pancreatitis) resort to the above folk remedies should not be. They cannot solve the problem if a pronounced inflammatory process or destruction of the tissues of the organ has already begun. At the same time, they can remove or reduce some of the symptoms and manifestations of the disease ( nausea, vomiting, severe pain). This will make it harder for doctors to make a correct diagnosis. Qualified treatment will be started late, which will endanger the life of the patient.

Therefore, the use of folk remedies in the treatment of pancreatitis is best discussed in advance with your doctor. He will be able to adequately assess the patient's condition and warn against the use of those means that will worsen his condition ( provoke an aggravation).

What is an approximate menu for chronic pancreatitis?

Pancreas This is the digestive organ that secretes special enzymes and hormones that help digest food and absorb nutrients.

The purpose of the diet for chronic pancreatitis:

• Reduce irritation of the pancreas;
• Eliminate the symptoms of the disease (pain, bloating, nausea, loose stools, etc.);
• Provide the body with essential nutrients.

In chronic inflammation of the pancreas, the ability to digest and absorb fats first of all decreases, which is manifested by abdominal pain and loose stools. Concerning basic principle when compiling the menu is low fat content in the daily diet of no more than 50 grams of fat per day.

A diet low in fat and optimal in protein and carbohydrates reduces stress on the pancreas, reduces inflammation and prevents further damage.

When compiling the menu, a number of basic principles must be observed:

What foods to prefer for chronic pancreatitis?

Daily menu with 50 grams of fat

Important! Above were the general principles of nutrition for chronic pancreatitis suitable for most people suffering from this disease. However, it is worth noting that each organism is individual, gender, age, race, genetics, stress, concomitant diseases, etc., so menu preparation is a particularly individual matter. First of all, you should listen to your body in order to choose for yourself a diet that your body best perceives. Everything needs a reasonable approach and a golden mean. Be sure to consult with your doctor!

How to help yourself with an attack of pancreatitis?

The best way to help yourself is to see a qualified specialist, as many diseases can have similar symptoms.

But if this is not the first time you have these symptoms and you already know the diagnosis, you can do the following steps that should help with an attack of chronic pancreatitis and do no harm.

The above methods of assistance are designed for attacks of exacerbation of mild to moderate chronic pancreatitis. However, if after applying these methods the symptoms do not decrease, but progress even more, you should immediately call an ambulance. Acute and progressive pain in the abdomen is always a formidable call, which should be immediately responded to.

How to relieve pain during exacerbation of chronic pancreatitis?

Eliminating pain in chronic pancreatitis is not an easy task, because so far scientists have not found the main mechanism of its occurrence. Therefore, often different methods of treatment are not so effective. We will try to comprehensively approach the solution of this problem. In the world there are two leading theories of pain in hr. neurogenic pancreatitis and the theory of excess pressure inside the ducts and pancreatic tissue. In this regard, the main modern principles of treatment are directed precisely at the elimination of these mechanisms. The World Health Organization offers a stepwise approach to the management of chronic pain. pancreatitis. The principle is to gradually prescribe drugs from the least analgesic ability to the desired effect. Example: first paracetamol is prescribed, if there is no effect, then they give a stronger substance like codeine, then tramadol, and so in case of failure, it comes to powerful narcotic drugs like morphine.

There are also surgical methods for the treatment of pain, which are used in cases where pharmacological methods do not work.

How to help yourself at home, relieve pain while not harming the body. First of all, you must be sure that this is definitely an exacerbation of chronic pancreatitis, otherwise you can erase the clinic of another disease and lose precious time. If you are not sure, do not self-medicate. If you have been diagnosed and this is not the first case, then you can use this recommendation.

Consider the main steps:

In case of progression of symptoms, do not hesitate, consult a specialist or call an ambulance.

What is reactive pancreatitis?

Reactive pancreatitis is an acute inflammation of the pancreas that occurs against the background of an exacerbation of chronic diseases of the digestive tract.

The most common causes: cholelithiasis, biliary dyskinesia, cholecystitis, chronic hepatitis, cirrhosis of the liver, inflammation of the duodenum, gastritis, stomach and duodenal ulcers. Also, reactive pancreatitis can develop after surgery, trauma, endoscopic examination (example: retrograde pancreatography).

Reactive pancreatitis is a form of acute pancreatitis, so the symptoms are the same. Diagnosis and treatment also do not differ much from the basic principles of managing patients with acute pancreatitis.

Why does diabetes develop after pancreatitis?

The pancreas is an organ with 2 main functions:

1. Exocrine (production and secretion of digestive enzymes);

2. Endocrine (production of hormones, insulin, glucagon, etc.).

For the production of hormones in the pancreas, special areas called the islets of Langerhans are responsible, they occupy only 1-2% of the entire gland. The islets contain specific beta-cells responsible for the production of insulin. And insulin is the main hormone responsible for the penetration of glucose (sugar) from the blood into cells. If it is not there, then all the sugar remains in the blood, leading to damage to blood vessels, nerves and organs, this is how diabetes manifests itself.

Pancreatitis is an inflammation of the pancreas that can lead to damage to the cells responsible for the production of digestive enzymes and beta cells responsible for the production of insulin. Diabetes that develops after pancreatitis is called pancreatogenic. Thus, diabetes can be classified into:

• Pancreatogenic diabetes - caused by disease of the pancreas (low level of insulin in the blood).
• Type I diabetes - caused by an autoimmune disorder, when cells of the body's own immune defenses damage the beta cells of the pancreas (low insulin levels in the blood).
• Type II diabetes, caused by metabolic disorders, the body's cell receptors lose sensitivity to insulin (high levels of insulin in the blood).

Diabetes can develop as after acute pancreatitis if much of the pancreatic tissue has been damaged. So it is against the background of long-term progressive (5-10 years) chronic pancreatitis, in which functional tissue is replaced by non-functional (fibrous, calcium deposits). However, this gland has a high compensatory capacity, and its function disorders begin to appear only when more than 90% of the cells are damaged.

Why is pancreatitis often combined with cholecystitis?

The main reason lies in the anatomical relationship of the pancreas and gallbladder. Two systems for excretion of digestive enzymes are combined into one and open into the intestinal cavity. The common bile duct joins with the common pancreatic duct to form the common excretory duct, which opens into the intestinal cavity at the level of the duodenum. This close relationship explains the frequent combination of pathologies of these two organs. However, they are connected not only anatomically, but also functionally, performing a single function of splitting the food bolus. Many pancreatic enzymes are simply not active without bile components. Example: The pancreatic enzyme lipase, which breaks down fats, simply won't work without the action of bile. Likewise, the functionality of the gallbladder is not fully manifested without the normal functioning of the pancreas. For example, the release of bicarbonate by the pancreas can reduce the acidity in the duodenum 12, this is a necessary condition for the activation of enzymes, both the pancreas and the normal functioning of bile acids.

The main cause of acute pancreatitis worldwide is gallbladder stones, which form against the background of a long-term inflammatory process (chronic cholecystitis). The stone, getting into the common duct, creates conditions for increasing pressure in the ducts, the pancreas, this leads to the fact that the pancreatic juice with all its enzymes returns back to the gland, where they are activated. This leads to damage to the tissues of the gland and the development of an acute inflammatory process.

The close relationship of the two organs, both anatomically and functionally, determines the approach to the treatment of one or another organ. Often, treatment is ineffective, only because their relationship is not taken into account. The normal operation of one organ cannot take place without the normal operation of another, if they are components of one system.