Condition after treatment of acute pancreatitis. Pseudocysts of the pancreas

Pancreatitis is based on an inflammatory process that occurs in the tissues of the pancreas. As a result, the harmful influence leads to damage and correction of internal and external secretory functions. This process contributes to metabolic disorders.

Due to pancreatitis, the enzymes that are by default produced by the pancreas to digest food do not begin their work in the lumen of the duodenum, but in the pancreas itself.

As a result, the gland begins to digest itself, thereby giving rise to the symptoms of pancreatitis. Enzymes produced are released into circulatory system, and are carried throughout the body of an adult - causing abundant intoxication of the body.

The number of people suffering from pancreatitis is growing every year. People who are prone to overeating, lovers of fatty foods and alcohol are in the danger zone, and are prone to pancreatitis.

Causes of pancreatitis

Gallstones and alcoholism account for almost 90% of hospital admissions for acute pancreatitis. According to some reports, over 40% of all patients are alcoholics with pancreatic necrosis or destructive pancreatitis.

If a person has a tendency to chronic overeating, the risk of pancreatitis increases significantly, especially with the abuse of fatty, fried foods. Also, herpes, food allergy, .

As for risk factors, people who have these habits or diseases are most susceptible to pancreatitis:

• alcoholism and smoking;
• abdominal trauma;
• vascular diseases;
• violation of the outflow of bile;
• constant consumption of a large amount of fatty, fried, smoked, spicy foods;
• connective tissue diseases;
• diseases of the stomach and duodenum (, gastritis, tumors);
• hereditary predisposition;
• taking certain medications (tetracyclines, sulfonamides, cytostatics);

After the postponed acute pancreatitis a chronic form may develop, and this is already fraught with development and other serious consequences up to pancreatic cancer.

Symptoms of pancreatitis

Pancreatitis and its symptoms will depend on the form of the disease; acute and chronic pancreatitis are distinguished in total.

During the period acute pancreatitis symptoms develop as severe poisoning. First of all, this is the strongest pain in the upper abdomen (pit of the stomach, right or left hypochondrium), usually of an encircling nature. After taking painkillers or antispasmodics, the pain does not subside. With untimely provision of medical care and removal of pain, the patient may experience pain shock.

Also characteristic is mushy, frothy stools with bad smell containing particles of undigested food. In most cases, nausea, repeated vomiting occur, sometimes it can be without gastric contents. The patient has a characteristic appearance: he is exhausted and covered with sweat, the pulse is rapid, breathing is shallow, frequent. Due to intoxication, dehydration of the body, blood pressure drops, consciousness is disturbed. Collapse and shock may develop.

Acute pancreatitis develops suddenly and usually continues short period time. With the above symptoms of pancreatitis in a person, the condition worsens every minute, it is impossible to delay in such cases and you should call an ambulance as soon as possible.

Concerning chronic form diseases, then pain syndrome less pronounced.

Symptoms of chronic pancreatitis

When chronic pancreatitis symptoms of gastrointestinal disturbances come to the fore endocrine function glands. may take some time without visible symptoms or disguised as other diseases of the abdominal cavity.

During chronic pancreatitis, two periods are distinguished, the initial one - which can last for years and then manifest itself with specific symptoms, then subside, and the period - when violations, damage in the pancreas are pronounced and bother a person regularly.

In the initial period, the main manifestation is pain. Pain (less intense than in the acute form of the disease) of a girdle character, localized in the upper abdomen. Pain may be encircling, decrease in the sitting position, when the torso is tilted forward, more often occur 20-40 minutes after eating.

Also, chronic pancreatitis is characterized by dyspeptic disorders of the body: loss of appetite, belching, diarrhea, nausea, vomiting, constant rumbling in the abdomen. The person loses his appetite and quickly loses weight. Basically, the appearance of characteristic pains is provoked by excessive consumption of fatty, fried foods, alcohol or an abundance of carbonated drinks, as well as chocolate, coffee.

Based on the various symptomatic complexes experienced by patients with chronic pancreatitis, several types of the disease are distinguished, each of which has its own clinical symptoms.

1. Dyspeptic - there is bloating, diarrhea, weight loss.
2. Asymptomatic - may not show itself for years.
3. pseudotumor- the main symptom is yellowness of the skin, sclera and others.
4. Painful - after eating and especially alcohol, pain occurs.

As a result of chronic pancreatitis, the shape of the pancreas can change so much that it begins to put pressure on duodenum and interfere with the passage of food, in addition, its ability to produce enzymes and hormones decreases, secretory insufficiency is formed.

In chronic pancreatitis, Tuzhilin's symptom can be observed - the appearance of bright red spots in the abdomen, back, chest, which are aneurysms and do not disappear with pressure.

Treatment of pancreatitis

Patients suffering from acute pancreatitis are subject to immediate hospitalization in the intensive care unit, where they are examined on an emergency basis and prescribed the necessary treatment.

The main goal of treatment is to eliminate pain, correct pancreatic dysfunction, prevent and treat complications. Medications for pancreatitis are prescribed for relief inflammatory process, elimination of pathogenic factors, reduction of pain, normalization of digestion in the small intestine.

In the first few days of the development of severe acute pancreatitis, the question of surgery may arise. Surgical treatment is indicated for suspected destructive pancreatitis and for signs of inflammation of the peritoneum, as well as for the ineffectiveness of conservative therapy.

Severe pancreatitis caused by is treated endoscopically or surgically. Surgical intervention consists in the removal of the gallbladder and sanitation (cleaning) of the ducts.

How to treat pancreatitis folk remedies

It is important to understand that folk remedies can be used in the treatment of pancreatitis at home only as an additional therapy with the permission of the attending physician.

1. It is necessary to take one tablespoon of infusion of motherwort, immortelle and calendula. All this mix and pour boiling water. Infuse for 60 minutes, then strain and drink 5-6 times a day. The volume of a single serving is 125 ml.
2. Grind and mix the infusion of iris and wormwood in equal proportions. Dial a tablespoon of the resulting mixture and pour boiling water. After 50 minutes, you can drink, after straining the broth. Take 20 minutes before meals 1/3 cup three times a day.
3. An extensive decoction of herbs. This will require such components in equal proportions - string, cudweed, horsetail, chamomile and calendula flowers, St. John's wort, wormwood and sage. Chop and mix everything. Prepare in the same way as the above recipe. Drink should be 3 times a day, 125 ml, 30 minutes before meals.
4. Multi-component decoction, which consists of burdock roots, elecampane roots, chamomile flowers, calendula flowers, wormwood herb, St. Pour two tablespoons of the collection with 2 cups of boiling water, insist in a closed thermos for 3-4 hours. Strain. Take 1/3-1/2 cup of infusion 30 minutes before meals 3 times a day.
5. On an empty stomach for a week, you can drink freshly squeezed juice from carrots and potatoes.
6. Two teaspoons of cumin seeds, pour a glass of boiling water and leave for 120 minutes. Strain and you can drink 2-3 times a day for 1/2 cup, before meals.

In general, alternative treatment for pancreatitis includes diet, fees from medicinal plants and gymnastics.

Diet for pancreatitis

The main principle of diet therapy is the use of food that spares the stomach, pancreas and liver. And so, what can you eat with pancreatitis, as well as detailed list products are listed below:

1. Boiled or baked vegetables - zucchini, beets, carrots, potatoes, cauliflower, broccoli, cucumbers (in the form of mashed potatoes).
2. Dairy products are considered the most suitable dairy products like kefir, but drinking milk itself is not recommended. You can eat 5-7% cottage cheese. Of the cheeses, mozzarella, Adyghe, and gouda are allowed to eat.
3. The meat is only boiled, lean. The same criteria applies to fish.
4. You can pineapples, sweet apples, bananas, strawberries, avocados.
5. Various cereals are recommended - buckwheat, oatmeal, rice, semolina.
6. You need to eat slowly, chewing food thoroughly, 4-6 times a day.

In the period of exacerbation of chronic pancreatitis, in the first 1-2 days, hunger is prescribed. Only liquids are allowed - rosehip broth, weak tea, and alkaline mineral water without gas.

Prevention

These rules should be followed healthy lifestyle life:

• moderate alcohol consumption;
• adherence to the basics of proper nutrition;
• timely diagnosis and treatment of gallstone disease.

The goal of prevention is to stop the progression of inflammation, to prevent the development of complications.

Gymnastics for pancreatitis

1. Inhale, exhale and hold your breath. Smoothly, but at the same time, pull in the stomach strongly enough and count to three, then relax the abdominal muscles.
2. Inhale, exhale and hold your breath. During the respiratory pause, "inflate" the stomach as much as possible, count to three. Exhaling - relax.
3. In the middle of inhalation, hold your breath for 1-2 seconds and continue to inhale further, as if directing air into the stomach and at the same time protruding the abdominal wall. At the end of inhalation with an inflated belly, hold your breath again, count to three. Continuing to count to six, begin to slowly draw in the abdominal wall. Exhale and relax your abdominal muscles.
4. Pull your stomach in strongly as you exhale. Holding your breath for a few seconds, relax your muscles abdominals. While inhaling, actively inflate the stomach, and while exhaling, draw it in again.

To avoid the appearance unpleasant symptoms pancreatitis, you should thoroughly reconsider your lifestyle, limiting alcohol intake and refusing too fatty foods. Go in for sports, keep a balanced diet, carry out timely prevention of gallstone disease, and in this case, pancreatitis will not bother you.

Acute pancreatitis is an inflammation of the pancreas. The symptoms of pathology primarily include unbearable sharp pain in the abdomen. The localization of pain will depend on which part of the gland is inflamed. So, pain can be localized in the epigastric region, in the left or right hypochondrium.

There are options when the pain is girdle in nature. Chronic pancreatitis is accompanied by symptoms such as loss of appetite, indigestion, acute pain that occurs after drinking alcohol, spicy or fatty foods.

In this article, we consider the complications of acute pancreatitis.

Description of the disease

Pancreatitis is a disease that is characterized by the occurrence and development of inflammatory processes affecting the tissues of the pancreas. Pancreatitis can be classified according to the nature of its course into chronic and acute. At the same time, acute pancreatitis is the third in the ranking of the most common requiring treatment in a hospital setting. In first and second place, respectively, are acute appendicitis and acute cholecystitis. Complications of acute pancreatitis can be very serious.

Statistical data

World statistics show that every year up to 800 people out of a million fall ill with such an ailment as acute pancreatitis. Men suffer from this type of pancreatitis much more often than women. The age of the diseased has a fairly wide range, and this is directly related to the reasons why acute pancreatitis arose. If acute pancreatitis arose and developed against the background of excessive alcohol consumption, then the average age of patients is 39 years. If the cause of this disease was cholelithiasis, then the average age of patients is at around 69 years.

Pathogenesis and etiology of acute pancreatitis

A variety of factors can contribute to the occurrence of a disease such as acute pancreatitis. Among them:

• Cholelithiasis.
• Bad eating habits.
• Abuse of alcoholic beverages.
• Viral infections, such as the Coxsackievirus.
• Bacterial infection, for example, campylobacter or mycoplasma.
• Injury to the pancreas.

• Taking drugs that contain estrogens, corticosteroids, thiazide diuretics, azathioprine. That is, those medicines that have a pathological effect on the pancreas. Such pancreatitis is drug-induced.
• Surgical interventions that were aimed at treating other diseases of the pancreas and biliary tract.
• Cystic fibrosis.
• genetic predisposition.
• A congenital anomaly that affected the development of the pancreas.
• Diseases of the gastrointestinal tract of an inflammatory nature, including cholecystitis, gastroduodenitis, hepatitis.

Complications of acute pancreatitis can be prevented if pathology is detected in a timely manner.

Provoking factor

In accordance with the most common theory about the causes of pancreatitis, the main factor provoking the development of this disease is cell damage, which is caused by prematurely activated enzymes. If the conditions are normal, then the pancreas produces the enzymes involved in digestion in a reactive state. Their activation occurs directly in the digestive tract. In the event that internal pathological factors are present or have an impact external factors, then the activation of enzymes occurs out of time, in the tissues of the pancreas. The consequence of this is the digestion of the tissues of the pancreas itself. As a result, swelling of the tissues develops, and the vessels of the parenchyma of the gland are damaged. The medical history (acute pancreatitis) is known to all specialists.

If pancreatitis has an acute form, then a similar pathological process can affect tissues located in the immediate vicinity of the gland itself, for example, retroperitoneal tissue, omental sac, peritoneum, omentum, intestinal mesentery, liver ligaments may be affected. If acute pancreatitis proceeds in a severe form, then the level of various biologically active substances in the blood increases sharply. active substances. This leads to severe disturbances in the functioning of the body. Secondary inflammatory processes, disorders of the dystrophic nature of various organs and tissues, for example, the heart, kidneys, lungs, and liver, may occur.

These manifestations are complications of acute pancreatitis.

Disease classification

Acute pancreatitis can be classified according to the severity of its course:

1. Pancreatitis occurring in mild form causes minimal damage to tissues and organs. It is expressed mainly by interstitial edema of the pancreas itself. Therapy lends itself quite easily, the prognosis is very favorable, implying a quick and complete recovery.
2. Acute pancreatitis, which occurs in severe form, causes significant and severe pronounced violations tissues and organs. It is also characteristic local complications, which include tissue necrosis, infection, abscesses, cysts.

Acute liver failure in severe form may be accompanied by:

• Acute accumulation of fluid in the tissues of the gland or in the peripancreatic space that does not have granulation or fibrous walls.
• Acute pseudocyst, which is an accumulation of pancreatic juice, which is surrounded by a fibrous wall or granulations and resulting from an attack of the disease. The development of such a cyst occurs over four to six weeks.
• Pancreatic abscess, which is a collection of pus in the tissues of the pancreas and tissues that are in close proximity to it.
• Pancreatic necrosis leading to tissue infection. There is a diffuse or limited area of ​​the parenchyma, which begins to die. If an infection occurs and purulent pancreatitis begins to develop, the likelihood of death increases significantly.

Below we will talk about the history of acute pancreatitis in more detail.

Symptoms

To characteristic symptoms acute pancreatitis can include:

• Pain syndrome. Pain sensations may have epigastric localization, may be observed in the left hypochondrium, be girdle in nature, it is possible to radiate under left shoulder blade. Pain in acute pancreatitis is pronounced and permanent. If the patient is in the supine position, the pain increases significantly. The pain also increases after taking spicy, fatty or fried foods, after drinking alcohol.
• Feeling of nausea, vomiting. In this case, vomiting is most often indomitable in nature, contains a large number of bile, does not bring relief.
• Jaundice of the sclera. It is expressed most often moderately. In rare cases, jaundice may appear on the skin.

In addition, acute pancreatitis may be accompanied by dyspeptic symptoms. These include flatulence, bloating, heartburn. Manifestations on the skin are not excluded, for example, hemorrhages located in the navel, spots on the body that have a bluish color.

How is acute liver failure diagnosed in a person?

Diagnosis of the disease

Gastroenterologists carry out the procedure for diagnosing pancreatitis, based on the patient's complaints and physical examination. The latter makes it possible to identify specific symptoms.

What tests are done for pancreatitis?

During the procedure for measuring the pulse and blood pressure tachycardia and hypotension are found. To confirm the diagnosis, various laboratory tests urine and blood, ultrasound of organs located in the abdominal cavity, MSCT, MRI of the pancreas.

In case of acute edematous pancreatitis during a blood test general analysis shows signs of an inflammatory process (ESR accelerates, the level of leukocytes rises). detects increased activity of pancreatic-type enzymes (lipase and amylase). Hypocalcemia and hyperglycemia are not excluded. In addition, the level of concentration of enzyme compounds in the patient's urine should be determined. Possible manifestations of bilirubinemia, increased activity liver enzymes.

Biochemistry of urine allows you to determine the activity of amylase in the urine.

It is necessary to conduct a visual examination of the pancreas, as well as organs in the immediate vicinity. A similar study is carried out through CT, ultrasound, MRI. It allows you to detect a pathological change in the parenchyma, cysts, abscesses, stones in the ducts, an increase in the gland.

Treatment

If acute pancreatitis is detected, the patient is hospitalized, followed by bed rest. The main goal of treatment is to eliminate the pain syndrome, stimulate the processes of self-healing, reduce the load that falls on the pancreas.

To treatment therapeutic methods can be attributed:

• novocaine and antispasmodic blockade, the main purpose of which is to relieve too pronounced pain syndrome;
• the use of deactivators of pancreatic enzymes (inhibitors of proteolysis);
• conducting detoxification therapy;
• the use of antibiotic therapy to prevent complications of an infectious type; most often used drugs that have a wide spectrum of action, but in large dosages;
• fasting, applying ice to the area where the gland is located in order to create local hyperthermia.

Surgical treatment is prescribed in the following cases:

• in the presence of ;
• accumulation of fluid around the gland or in it;
• the occurrence of cysts, necrosis, abscesses.

In acute pancreatitis, endoscopic drainage, cystogastrostomy, and marsupialization of the cyst may be indicated. If necrosis has formed, then, depending on its size, the doctor may prescribe a necrectomy or an operation to resect the pancreas. Stones can cause duct surgery.

Possible Complications

Acute pancreatitis is dangerous for its possible consequences and complications. If there is an infection of the tissue that is inflamed, then the occurrence of necrosis and abscesses is not excluded. If you do not carry out timely treatment, then a fatal outcome is possible.

If the disease is severe, it is possible to develop state of shock with pancreatitis and multiple organ failure.

The result of the development of acute pancreatitis may be the formation of pseudocysts, the rupture of which is fraught with the occurrence of ascites.

Diet for pancreatitis: menu for the week

With an exacerbation of pancreatitis in the first day or two, you need to follow a starvation diet, two glasses of rosehip broth are allowed, up to 1 liter of alkaline mineral water. In severe cases, nutrition is only drip intravenously.

With pancreatitis, diet No. 5p is shown, which consists of several options.

Below we give sample menu for a week with pancreatitis of the pancreas.

• For breakfast, you can eat meat (chicken or beef), steamed. Drink rosehip broth or weak tea.
• For a second breakfast, oatmeal with milk is served, washed down with a decoction or infusion of wild rose.
• For lunch - soup-puree of carrots and potatoes. You can eat steamed fish. Dried fruits compote.
• For an afternoon snack - fruit puree (apple or pear).
• Dinner should include a piece of boiled chicken, vegetable stew and weak tea.
• Before going to bed, drink a glass of kefir.

Inflammatory processes in the tissues of the pancreas lead to the development of pancreatitis, which can have both acute and chronic course. The disease develops as a result of an excessive accumulation of enzymes in the ducts of the gland, which destroy the tissues of the organ, disrupt its functionality, thereby causing inflammation. The clinic of acute pancreatitis is always pronounced, and the patient himself often needs immediate medical attention. An integral part of therapeutic therapy is drug treatment, which consists of taking several groups of drugs with a diverse mechanism of action. Preparations for the treatment of acute pancreatitis can improve the functioning of the organ, relieve inflammation, stop the symptoms of the disease, reduce the risk of various complications, and improve the general condition of the patient.

Treatment of acute pancreatitis is often carried out in a hospital, where the patient is provided with emergency medical care. With a slight attack of the disease, therapy can be carried out on an outpatient basis. Conservative treatment consists of taking medicines, rest, and compliance strict diet. The effectiveness of therapeutic therapy directly depends on the condition of the patient, the stage and type of the disease. Before treating acute pancreatitis, it is necessary to distinguish it from other diseases of the gastrointestinal tract. intestinal tract who may have similar symptoms.

How to recognize the symptoms of acute pancreatitis?

Acute pancreatitis has severe symptoms that most often appear suddenly after alcohol abuse, food poisoning, against the background of cholelithiasis and other provoking factors. An acute attack most often occurs as a result of blockage of the bile ducts by stones. But in such cases, the doctor prescribes surgical treatment to remove the gallbladder or restore the patency of the bile ducts.

The main symptom of the disease is severe pain in the epigastric region of the upper abdomen, left or right hypochondrium. The pains are often girdle in nature, can be stabbing, cutting, accompanied by nausea, vomiting, dry mouth. Vomiting in acute pancreatitis with an admixture of bile, while it does not bring relief. In addition to the main symptoms of the disease, the patient's condition can deteriorate sharply, accompanied by an additional clinic:

1. Increase in body temperature up to 40 degrees.
2. Rapid pulse.
3. Violation of the heart rhythm.
4. Breathlessness.
5. Decreased blood pressure.
6. Paleness, cyanosis of the skin.
7. Bloating.

Strong and pronounced pain in acute pancreatitis is explained by the fact that the pancreas has many nerve endings, which provoke acute pain of varying intensity. The pain syndrome can last for several hours or days, so it is very important to recognize the disease in time, to take all the necessary therapeutic measures to eliminate the symptoms.

How to treat acute pancreatitis?

Treatment of acute pancreatitis should be carried out at the first signs of the disease. Considering that some forms and stages can lead to lethal outcome need to call an ambulance as soon as possible. Before the arrival of a team of doctors, the patient must be provided with peace. As an anesthetic, you can drink the antispasmodic drug No-shpa or Drotaverin, which will help reduce pain, improve your well-being for a while.

Therapy for acute pancreatitis consists of taking several groups of drugs that are administered orally, intravenously or intramuscularly. The treatment regimen, as well as the dose of drugs, the duration of administration is set by the doctor individually for each patient. Treatment of acute pancreatitis is aimed at eliminating pain, reducing the amount of pancreatic enzymes, suppressing infection, restoring or improving the functionality of the organ.

Drug therapy is determined by a gastroenterologist and only after the results of all laboratory and instrumental research. If the doctor is sure that the patient does not require hospitalization, treatment is prescribed on an outpatient basis, including taking several drugs, each of which will have a certain effect on the pancreas. In a hospital setting, all drugs are administered intravenously or intramuscularly and only under the close supervision of medical specialists.

In addition to the medications used in an attack of acute pancreatitis, the doctor prescribes a "hungry" diet, which must be followed for 3 days.

At severe course acute pancreatitis, the patient is placed in the ward intensive care where all the necessary therapeutic measures are taken to eliminate the inflammatory process, as well as reduce the risk of complications. In cases where conservative treatment does not bring the expected result or the disease is advanced, the doctor prescribes a laparoscopic operation, which refers to minimally invasive techniques, has a short postoperative period. After the operation, a person must also take a number of medications to normalize the work of the pancreas.

Drug groups

Therapy of pancreatitis in the acute phase of the disease consists of taking several medications, each of which has a certain effect on the functioning of the pancreas and digestive system generally.

1. Enzymes (enzymes) - replacement therapy drugs that allow you to stimulate the production of pancreatic enzymes: Creon, Mezim, Pancreatin.
2. Anti-enzyme drugs - neutralize the action of enzymes that have an aggressive effect on the pancreas: Gordox, Ingitril, Pantripin, Kontrykal.
3. Antispasmodics and analgesics - relieve pain, eliminate spasms: Papaverine, No-shpa, Gastrocepin and others.
4. Antacids - neutralize hydrochloric acid: Maalox, Phosphalugel, Almagel.
5. Antisecretory drugs - reduce the intensity of production gastric juice: Lansoprazole, Omeprazole, Ranitidine.
6. Herbal medicines are herbal preparations that allow you to eliminate the symptoms of pancreatitis, supplement the main treatment with medicines: Gastrolit, Duspatalin, Festal.
7. Diuretic drugs - reduce swelling of the pancreas, stimulate the excretion of enzymes, toxins from the blood: Lasix, Furosemide, Diakarb.
8. Vitamins - maintenance therapy for the main treatment: Vitrum, Duovit.
9. Cholinolytics - block the mediator acetylcholine: Atropine, Chlorosine, Platifillin.
10. Lytic mixtures - a complex of drugs that eliminate the general symptoms, have an anti-inflammatory, antipyretic effect: Tavegil + Diphenhydramine + Papaverine.
11. H2 blockers - reduce production of hydrochloric acid: Famotidine, Nizatidine.
12. Hepatoprotectors - drugs for the restoration and protection of the liver, which often disrupts its work when exposed to pancreatic enzymes: Gepabene, Essentiale, Urochol, Karsil.
13. Antibiotics - suppress aggressiveness pathogenic microorganisms, bacteria that can infect the pancreas. Most often, drugs from the group of Cephalosporins, Macrolides, Fluoroquinolones are used.

All the above drugs issued in different pharmacological forms. In severe cases, the patient is prescribed the introduction of infusion solutions in combination with drugs.

Any of the drugs used to treat acute pancreatitis must be prescribed by a doctor. Only a specialist can draw up a treatment regimen, give useful recommendations.

Overview of effective drugs

In a hospital setting, drugs such as Kontrykal are often prescribed, which is an artificial plasma substitute that allows you to suppress the activity of proteolytic enzymes that are involved in the formation of the inflammatory process in the tissues of the pancreas.

At repeated vomiting, the patient is prescribed drugs of metoclopramide - Cyrucal, Metoclopramide, which are administered intramuscularly. Such drugs allow you to normalize intestinal motility, improve the digestion process. In the first days of the acute period, painkillers, antispasmodic drugs are used, the use of warm mineral water without gas, a "hungry" diet, and the elimination of contact with any provoking factor are also recommended.

To eliminate spasm and relieve pain, No-shpu is most often used. At home, you can take tablets (80 mg twice a day), and in the hospital, the drug is administered intramuscularly.

In the presence of an inflammatory process that is caused by pathogenic bacteria, a course is prescribed antibiotic therapy. The antibiotic is administered intravenously or intramuscularly. The treatment course is up to 10 days. Together with antimicrobial therapy, enzyme preparations are used (Creon, Mezin, Panzinorm), as well as probiotics (Linex, Hilak forte, Laktovit).

With swelling of the pancreatic tissues, an anti-enzymatic drug is used - Trasysol - intravenously, slowly.

AT acute period Your doctor may prescribe the medicine Octreotide, which is an artificial analogue of the hormone somatostatin. This drug suppresses the secretion of the stomach and pancreas, thereby reducing the symptoms of the disease, normalizes the functioning of the organ.

Therapy of acute pancreatitis can take from 5 to 10 days in the hospital. For outpatient treatment after discharge, the doctor also prescribes a number of drugs for oral use, which the patient will take for several weeks or months.

For the treatment of acute pancreatitis, both systemic and symptomatic drugs are used, but their choice should always be left to the attending physician.

Acute pancreatitis is a serious and very dangerous disease, which requires competent treatment under the supervision of doctors. Acute pancreatitis cannot be self-treated because uncontrolled reception any drug can provoke complex and sometimes irreversible processes in the tissues of the organ. It is known that if the wrong untimely treatment disease, it can acquire a chronic course, for which a characteristic period of remission and exacerbation. If you have a history of acute pancreatitis, it is very important to follow some rules:

1. In the acute period, it is forbidden to wash the stomach or use a hot heating pad on the stomach.
2. In case of nausea, it is forbidden to induce artificial vomiting.
3. It is forbidden to use folk methods treatment.
4. Medicines should be selected in conjunction with the attending physician.
5. With pancreatitis, all medicines are taken according to a special scheme.
6. After the initial intake of an antispasmodic and the pain subsides, you need to seek medical help, as the pain can return with renewed vigor.
7. Strictly observe the recommended doses of medication.
8. Drug treatment of pancreatitis in adults should always be combined with a therapeutic diet.

Acute pancreatitis should be treated in a hospital, where every adult will receive the appropriate medical care which will help to exclude complications of the disease. If you treat the disease at the first symptoms, follow all the doctor's recommendations, remove acute attack diseases can be already 2 days after admission to the hospital. However, the healing process itself can take several weeks or months. The prognosis for acute pancreatitis directly depends on the degree of damage to the organ, the age of the patient, concomitant diseases and other features of the body of an adult.

Treatment of acute pancreatitis in adults is highly Long procces, requiring a person's attention to their health. This is especially true for nutrition and lifestyle. Persons who have been ill with this disease for the rest of their lives must follow a diet, since any errors in nutrition increase the risk of developing a second attack.

Sudden inflammation of the pancreas, which is one of the most severe surgical diseases leading to necrosis of pancreatic tissue.

In acute pancreatitis, the gland tissue is damaged by the gland's own enzymes, which are activated under the influence of one or another factor, then penetrating into the glandular tissue and destroying it. Active enzymes circulating in the blood lead to dysfunction of all organs and systems of the body.

The main symptoms of acute pancreatitis are: acute pain in the upper abdomen, nausea and vomiting. Diagnosis of acute pancreatitis is based on determining the level of pancreatic enzymes (amylase and lipase) in the blood.

Treatment of acute pancreatitis is conservative and consists in following a diet, cleansing the blood of pancreatic enzymes, and also in symptomatic treatment. In the case of a progressive deterioration of the condition, an operation may be performed to remove dead tissue from the pancreas.

Causes of acute pancreatitis

The greatest importance in the occurrence and development of this disease belongs to the abuse of alcohol, the abuse of juice and choleretic foods (for example, fatty meat fried foods).

Also important are injuries of the pancreas, diseases of the digestive system (liver, biliary tract, duodenum), various vascular diseases.

Besides:

Attack of acute pancreatitis

An attack of acute pancreatitis usually develops suddenly, after eating or drinking.

The main symptoms of an attack of acute pancreatitis include:

First aid for an attack of acute pancreatitis

Important: with an attack of pancreatitis, you should immediately call a doctor, because. any delay can lead to serious complications and even death of the patient.

Before his arrival, you can not eat anything, and to reduce the secretion of the gland, you can put an ice pack on your stomach.

You should not take analgesics that are available without prescriptions. They will not bring relief, but they can make it difficult clinical picture pancreatitis. You can take the following drugs:

• "No-shpa";
• "Baralgin";
• "Papaverine" in combination with "Platifillin".

It should be noted that the first strong dose should not exceed two tablets, and next move should be done in two hours.

Important: with unbearable pain, the patient is injected potent drugs that protect against necrosis of the pancreas.

Symptoms of acute pancreatitis

The disease begins with severe girdle pain in the upper abdomen. Sometimes strong attack pains precede initial symptoms acute pancreatitis - a state of discomfort, short-term fuzzy pain in the abdomen, loose stools.

The position on the back exacerbates the pain. With the onset of necrosis of the pancreatic tissue, pain may decrease due to the fact that necrosis has also affected the nerve endings. Mandatory symptoms of acute pancreatitis are also nausea, vomiting and bloating.

Vomiting is excruciating, persistent, sometimes indomitable and never brings relief. Increasing bloating due to the accumulation of gases disrupts motor activity intestines.

When enzymes enter the blood, its circulation in small blood vessels is disturbed, stagnation leads to the appearance of small pinpoint hemorrhages on the skin in the navel and buttocks.

The skin of such patients becomes pale, with a bluish tinge. General intoxication of the body with enzymes and products of the breakdown of the pancreas affects the activity of all organs.

acute pain

Acute pain, encircling nature, localized in the right and left hypochondrium, epigastric (pit of the stomach). Pain radiates (radiates) to left side body: in the area of ​​the shoulder, shoulder blade, lower ribs from the back. Intense pain, constant, even in the background drug treatment may continue for another day. The cause of pain is necrosis (death) of tissue and nerve endings of the pancreas.

Lack of appetite

Lack of appetite, aversion to food develops, is the result of a lack of excretion of pancreatic enzymes into the intestines.

Nausea with vomiting

Nausea with vomiting, provoked as a result of eating, is the result of a lack of enzymes in the intestines necessary for normal digestion. Indomitable, profuse vomiting of stomach contents or bile, which does not bring relief.

Symptoms of intoxication

Symptoms of intoxication develop with the development of purulent foci in the pancreas:

• body temperature rises above 38C with chills;
• pulse quickens above 90 beats / min;
• the skin becomes cold and damp;
• quickening of breathing.

Shock

Signs of shock appear as a result of severe pain and loss of fluid by the body, due to indomitable vomiting: a decrease in pressure below 90 mm / Hg.

Bloating

Bloating of the upper abdomen and a feeling of fullness, as a result of indigestion associated with a lack of enzymes and a violation of transit through the intestines.

Diarrhea

Frequent loose stools, due to indigestion, as a result of a lack of pancreatic enzymes in the intestines.

The skin is pale with a dark tint

Acute pancreatitis is characterized by specific symptoms of cyanosis, which develop as a result of sharp violation microcirculation, due to a decrease in the volume of circulating blood, as a result of profuse vomiting. Cyanotic spots are formed on different parts of the body (in the face and neck, lateral parts of the abdomen, navel).

Stomach tension

The abdominal wall of the abdomen is tense to the left below the costal arch.

Descriptions of symptoms of acute pancreatitis

Complications of acute pancreatitis

Acute pancreatitis can be complicated by the formation of abscesses (abscesses limited to the capsule), as well as the transition of inflammation to other organs gastrointestinal tract such as the bile ducts and gallbladder.

If the wall of the blood vessel is broken, acute gastrointestinal bleeding can begin.

In the process of destruction of pancreatic tissue, various substances, which can lead to complications in the form sharp decline blood pressure (collapse), impaired renal function, as well as various complications from other internal organs.

In addition, blood poisoning (sepsis) can begin.

Diagnosis of acute pancreatitis

Acute pancreatitis is very characteristics. Diagnosis is confirmed with laboratory research. So, in the very first hours after the onset of the disease in the urine appears high content the pancreatic enzyme amylase.

When the pancreatic tissue is destroyed, the amount of amylase, on the contrary, decreases, or may be completely absent. The amount of amylase and another enzyme, lipase, in the blood also increases.

In the blood of a patient with acute pancreatitis, signs of an inflammatory process are found: a large number of leukocytes and an accelerated ESR (erythrocyte sedimentation rate).

To clarify the diagnosis, the following studies are sometimes carried out:

Treatment of acute pancreatitis

Patients with acute pancreatitis are primarily in need of hospitalization, pain medication, and intravenous infusions solutions for recovery water-salt balance.

Approximately one in five acute pancreatitis occurs in severe form requires close monitoring under conditions intensive care unit or an intensive care unit (ICU), as pancreatitis can damage the heart, lungs, or kidneys.

Some cases of pancreatitis can lead to necrosis of pancreatic tissue (pancreatic necrosis). In these cases, or if there is a secondary infection, surgery may be required to remove the damaged tissue.

Which doctors to contact for acute pancreatitis

Surgical treatment of acute pancreatitis

An acute attack of pancreatitis caused by a blockage of the bile duct by a stone may require removal of the gallbladder or a much less traumatic restoration of the patency of the bile ducts using an endoscope.

Once the gallstones are removed and the inflammation subsides, the pancreas usually returns to normal fairly quickly. Operation on the pancreas and gallbladder It can be performed both with a wide section and with a laparoscopic, or "minimally invasive" method.

During laparoscopic surgery, a small (usually 5-10 mm) incision is made on the abdominal wall, through which a laparoscope is inserted into the abdominal cavity and itself surgical instrument. The surgeon during the operation is guided by the image of the internal organs transmitted from the laparoscope camera to the monitor.

Benefits of laparoscopic surgery include reduced risk of infection, more fast recovery, minimum cosmetic defect, low risk of postoperative adhesions and much less painful postoperative period.

Diet for acute pancreatitis

important healing factor with all forms of acute pancreatitis is a diet:

Questions and answers on the topic "Acute pancreatitis"

Pancreatitis is an inflammatory disease of the pancreas. The main reason is a violation of the outflow of digestive juice and other enzymes produced by the pancreas, in small intestine(duodenum). The incidence of pancreatitis and other pancreatic diseases is increasing worldwide. First of all, this is due to irrational nutrition, alcohol abuse, environmental degradation.

In the article, we will consider in detail: what it is, what are the main causes, the first signs and symptoms, as well as what treatment is prescribed for pancreatitis in adults, and what you need to know if an attack occurs.

What is pancreatitis?

Pancreatitis is an inflammatory and degenerative process in the pancreas. If such a process manifests itself, then the enzymes produced by the pancreas do not enter the duodenum. Consequently, they begin to actively act already in the pancreas, gradually destroying it.

This process is called autolysis, which, translated from Latin, is called "self-digestion". Now you know the most in general terms about acute pancreatitis, what is it. This is just a chemical attack, and the transformation of the gland "on its own" into a semi-digested mass.

The pancreas is one of the most complex organs human body which is practically unrepairable. The efficiency of this gland regulates metabolism, normal digestion.

Its main functions are:

• Isolation of enzymes for cleavage useful substances obtained from food in the small intestine.
• Fermentation of insulin and glucagon in the blood - hormones that regulate the storage and consumption of energy obtained from food.

The reasons

Pancreatitis in adults is a fairly common problem that anyone can face. Violations associated with the outflow of bile, as well as dietary habits (for example, the consumption of fatty and rich meat foods, stress, hereditary predisposition, alcohol, etc.) can lead to development.

Therefore, more high risk the development of pancreatitis is in those people who constantly abuse alcohol. According to statistics, it often develops in pregnant women and in young mothers in postpartum period. The key to preventing the development of pancreatitis is the correct approach to the formation of the diet.

Doctors allocate the following types diseases:

Acute pancreatitis

Acute pancreatitis by itself means, respectively, an acute form of manifestation of aseptic inflammation to which the pancreas is exposed. Most often develops in the following cases:

• when taking alcohol - up to 70% of all cases of the disease (mainly in young and mature men),
• in the presence of cholelithiasis - up to 25% or 30% (more often in women),
• operations on the stomach or other abdominal organs - about 4% or a little more.

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 moment of the onset of the appearance).

Chronic form of pancreatitis

What it is? - This is a form of the disease in which inflammation progresses slowly, while the functions of the pancreas are gradually impaired. As a result, fibrosis of the pancreatic tissue or its calcification may occur. It is most often found in older women.

According to the predominant cause of the development of inflammation, chronic pancreatitis is distinguished:

• toxic-metabolic (including alcohol),
• idiopathic,
• hereditary,
• autoimmune,
• recurrent,
• obstructive.

It is possible to distinguish the primary chronic form of pancreatitis, the secondary one, which develops due to diseases of the digestive system - cholecystitis, chronic, enteritis.

The first signs of an attack

If the patient has signs of acute pancreatitis, his condition will deteriorate rapidly. That is why it is so important to seek medical help immediately.

• In the acute form of the disease, pains are localized under the pit of the stomach in the upper part, left and right hypochondrium, if the entire gland is affected, then the pains are girdle.
• Also, the patient has vomiting with an admixture of bile, which does not bring him relief, dry mouth, hiccups, nausea and belching.

The same signs that manifest themselves in both acute and chronic (during exacerbations) forms of pancreatitis are acute, severe pain in the abdomen. Localization depends on which part of the pancreas is covered by the inflammatory process.

Symptoms of pancreatitis in adults

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.

The acute form of pancreatitis is accompanied by the following symptoms:

• Severe pain in the left hypochondrium, radiating to the back or girdle.
• Nausea, vomiting, flatulence. Malfunction of the digestive tract.
• Increase in body temperature.
• Dry mouth, thick white coating in the language.
• Headache, sweating. The skin becomes pale.
• Increased blood pressure, palpitations, shock.

In the presence of such symptoms, the patient's condition worsens every minute, so you can not hesitate. At the first suspicion, you should immediately call an ambulance.

In chronic pancreatitis:

• Permanent or temporary abdominal pain. Appears after drinking alcohol and fatty foods.
• Pain in the upper abdomen radiates to the back.
• Rumbling in the abdomen, nausea, vomiting.
• Loss of appetite, upset stool, chronic diarrhea.
• Dehydration. As a result, the body weight of the patient is reduced.
• The skin and mucous membrane of the oral cavity acquire a yellow tint.
• On the last stage disease occurs diabetes mellitus.

With relatively no severe pain the period of exacerbation can last quite a long time (up to several months). This period is characterized by a decrease in appetite, general weakness, and a decrease in mood.

Complications

Complications of pancreatitis can be:

• gland abscess;
• Pancreatic necrosis (necrosis of pancreatic tissue);
• Formation of a false cyst;
• Pancreatogenic ascites;
• Pulmonary complications;
• Diabetes;
• Fatal outcome.

With complications, the habitual nature of the disease changes: the nature, localization and intensity of pain changes, it can become permanent.

Diagnostics

The sooner the patient receives qualified assistance, the less time the treatment will take and it will be more effective. But just early diagnosis this disease is the main problem.

The most reliable method for detecting pancreatitis and its forms is achieved using complete examination sick. In the diagnosis of the disease, the following stages are distinguished:

• assessment of clinical symptoms;
• study of biochemical parameters;
• carrying out enzymatic tests;
• instrumental studies in the diagnosis of the disease.

Blood tests:

• General (KLA) will reveal, show the erythrocyte sedimentation rate (ESR) and the volume of pancreatic enzymes, and help identify inflammation. The number of leukocytes more than 8.8 thousand / ml or ESR from 15 mm / h are bad signs.
• Biochemical analysis will reveal the level of glucose (it is dangerous to increase the concentration of "sugar" to 6.5 mmol / l and 106 mg / dl - hyperglycemia), cholesterol (should not be less than 3 mmol / l) and pancreatic enzymes: amylase (with pancreatitis increases by tens of times, up to 1000 U / l and above), α2-globulins (should not be less than 7%), trypsin (should not be above 4 μmol / ml.min), lipase (should not exceed 190 U / l), etc.

Instrumental diagnostics:

1. Ultrasound of the abdominal organs can detect an increase in the pancreas and the presence of stones in the ducts.
2. X-ray diagnostics establish paresis of the intestine (impaired contractility), visible subsidence of the lungs (atelectasis) and the presence of effusion in the pleural cavity.
3. The gastroduodenoscopic method reveals an edematous stomach and duodenum 12.
4. Examination of blood vessels - angiography, allows you to see deformed and displaced arterial vessels, accumulation contrast agent in them due to congestion.

If only ultrasound diagnostic data is used to make a diagnosis, then it may be unreliable. Often pancreatitis does not give any specific signs and the specialist conducting the examination can detect only minor diffuse changes or swelling of the body. Although even these indicators are visible on ultrasound only with an exacerbation of the disease.

Treatment of pancreatitis

In acute pancreatitis, treatment is possible only in a hospital, under supervision qualified specialists, it is considered very dangerous state. Therefore, when the first signs appear, call an ambulance.

First aid

If you suspect an attack of pancreatitis as a first aid - rest, sitting position with your knees pressed to your chest, strict fasting with a quarter glass of water every 30 minutes - an hour, put an ice pack on the pancreas from the back. Shallow breathing will help relieve the attack.

Painkillers and anti-inflammatory drugs should not be taken, this will greatly complicate the diagnosis.

If the pain is intense, the doctor may prescribe antispasmodics (No-shpa, Drotaverine). With their help, inflammation in the pancreas decreases and, as a result, pain subsides.

In the hospital for the treatment of pancreatitis acute form are used conservative methods therapy. In particular, various solutions are introduced into the bloodstream - saline solutions, protein preparations, glucose, with the help of which intoxication and pain are overcome. The acid-base balance is also normalized.

Medicines for pancreatitis

• With frequent vomiting, drugs are used to restore the water-salt balance, for example, "Sodium chloride solution".
• To restore the work of the gastrointestinal tract, enzyme preparations are taken that replace the pancreatic enzymes that are absent during the illness: "Creon", "Pancreatin", "".
• Vitamin therapy. In the treatment of chronic pancreatitis, an additional intake of vitamins is prescribed - A, E, C, D, K and vitamins of group B. In addition, a reception is prescribed - lipoic acid, cocarboxylase.
• parenteral nutrition. In severe digestive disorders and poor absorption of food by the intestines, parenteral nutrition is prescribed.

As parenteral nutrition, by drip intravenously, usually administered:

• Mixtures of essential amino acids (250-400 ml each): "Alveein", "Alvezin", "Aminosol";
• Electrolyte solutions: 10% potassium chloride solution (10-15 ml) and 10% calcium gluconate solution (10 ml).

Treatment of chronic pancreatitis involves: diet, pain medication, vitamins, replacement therapy enzymes, treatment diabetes and others endocrine disorders, timely treatment cholelithiasis.

Surgery

Surgical treatment is indicated in case of diffuse inflammation of the peritoneum, purulent complications, increasing obstructive jaundice and destruction of the gallbladder and ducts.

Operations can be assigned as follows:

• Emergency. They are carried out at the very beginning of the development of the disease. It can be the first hours and days. Patients with enzyme-induced and acute pancreatitis, which began due to blockage of the duodenum, are operated on urgently.
• Planned. The surgeon begins to operate on the patient only when acute inflammation stopped in the pancreas. Before the operation, the patient is carefully examined so that the recurrence of the attack does not begin.

Diet

The basis of successful therapeutic correction of this disease is following a diet. diet daily nutrition corrected in this way: the level of fats is reduced and carbohydrate products in the diet and increased protein intake. Appointed vitamin preparations. The number of meals should be 5-6 in one day.

In acute pancreatitis, in the first 2-3 days it is necessary to completely refuse food intake, only plentiful drink- mineral water, rosehip broth or, in extreme cases, ordinary water.

When the exacerbation of pancreatitis has passed, you need to adhere to such nutritional rules as:

1. The diet should contain lipids, proteins and carbohydrates.
2. Eat water-soluble and fat-soluble vitamin complexes.
3. Avoid products that contain chemical substances because they can strongly irritate the intestinal mucosa.
4. Cannot be consumed spices, smoked meats, spicy.
5. It is best to cook food by steaming, pre-chopping it, you may need to grind it.
6. Food should be consumed warm, but not hot.

After the symptoms of acute pancreatitis are completely gone, you need to eat soup, lean meat, fish, low-fat cottage cheese, different types cereals, vegetables, you can drink fruit juice, with sweets, give preference to honey, jam and pudding.

Folk remedies

Below, we have collected effective folk remedies for pancreatitis, but be sure to consult your doctor before using them.

1. Golden mustache . one big leaf(length 25 cm) or two small ones are crushed and pour 700 ml of water. On medium heat, the broth languish for 15-20 minutes, then it is infused for several hours in the body (you can leave it overnight). You need to use the infusion in a warm form of 25 ml (before meals).
2. Potato-carrot juice. Pass 2 potatoes and 1 carrot through a juicer. Use 2 times a day 30 minutes before meals, the course of treatment for adults will be 7 days, the method helps to normalize digestion, eliminate pain symptoms.
3. Herbs for the pancreas are used in collections and one of them should consist of yarrow herb, calendula flowers and chamomile. All components are taken in a tablespoon and brewed in a ladle with boiling water. After half an hour, you can drink the first portion (100 ml), and 40 minutes after that, eat. It is necessary to drink the medicine at least 4 times a day, only before meals.
4. For a recipe for pancreatitis, you will need immortelle flowers, motherwort, St. John's wort, pour 200 ml of boiling water over everything, leave for 30 minutes, drink up to three times a day before meals.
5. Instead of regular tea, use tea with mint and honey. Mint has a choleretic effect and promotes the release of enzymes from the pancreas.
6. Propolis. Small pieces are chewed thoroughly between meals, the method is a prime example effective modern homeopathy and excludes pain attacks normalizing the work of digestion.
7. Rowan . Excellent cholagogue, which is used both in the treatment and prevention of pancreatitis. Rowan fruits can be consumed fresh or dried for future use.
8. For 10 days, you need to take 1 teaspoon of rosehip oil. Take two months off and take the course again. Recommended for chronic pathology.
9. Pour a glass of oats with a liter of water, insist for 12 hours. Bring the broth to a boil and boil under the lid for half an hour. Wrap the container with the broth, leave for 12 hours, then strain and add water to a volume of one liter. Adults take a decoction three times a day for 100 - 150 ml half an hour before meals. The course of treatment is a month.
10. Rose hip . In the chronic course of pancreatitis, rose hips can be drunk on an ongoing basis - up to 400 ml per day. Rose hips are poured with hot water (the number of berries is equal to the amount of liquid). In a thermos, the infusion is left for a couple of hours, after which the drink can be consumed.

Prevention

Prevention methods:

• In the first place is the correction of risk factors: alcoholism, various metabolic disorders.
• It is necessary to constantly adhere to a diet. Try to always be indifferent to what you eat, as this will not play into your hands in the future. As often as possible, eat vegetables and fruits that will enrich your body with vitamins. Such prevention will protect you not only from pancreatitis, but also from other diseases.
• It also requires constant adjustment of treatment. For this, it is recommended to visit a gastroenterologist 2 times a year in the absence of relapses. In case of relapse, you should immediately consult a doctor.

Now, you know what kind of disease it is and how it proceeds in adults. Remember that timely treatment can avoid the chronic form of pancreatitis and reduce the risk of complications. Be healthy and take care of your health!