The occurrence of acute pancreatitis is due to the powerful development of the inflammatory process in the tissues of the pancreas. The aggressive effect of their own enzyme substances, which are activated directly in the body and trigger the mechanism of digestion of their own tissues, is the basis of pathology. Among the clinical manifestations, vomiting, pain, nausea, fever, lack of appetite, discoloration of the skin and more are distinguished in acute pancreatitis.
general information
The severity of acute pancreatitis is distinguished:
- Light - a weak lesion of the gland. It is quickly cured, the prognosis is favorable.
- Severe - severe clinical picture, extensive organ damage. Often complications join.
Provocateurs of the inflammatory process are:
- frequent use of alcohol;
- malnutrition - abuse of spicy, fried, fatty foods;
- organ injury;
- the presence of viral and bacterial diseases;
- congenital malformations;
- genetic ailments;
- burdened heredity;
- taking certain medications in high doses;
- gastrointestinal diseases;
- endocrine diseases;
- failure of pancreatic function during surgical interventions.
Pharmacotherapy of acute pancreatic inflammation
The treatment of acute pancreatitis with medicines of the following pharmacological groups is carried out:
- Proteolysis inhibitors (Aprotinin) - neutralize the action of enzymes that have an aggressive effect on the function of the gland.
- Water-electrolyte balance regulators - “Touring”.
- Antispasmodics - Mebeverin, Drotaverin, Papaverine.
- The proton pump blockers are Omeprazole, Lansoprazole.
- H2-histamine receptor blocker - Ranitidine, Famotidine.
- Antacids - "Fosfalugel", "Almagel", "Maalox".
- Diuretics - "Furosemide", "Acetazolamide".
- Anticholinergics - Atropine, Platyphyllin.
- Hepatoprotectors - Essentiale, Carsil, Gepabene.
- Antibiotics are groups of fluoroquinolones, cephalosporins and macrolides.
- Vitamin complexes - "Viitrum", "Duovit".
- Enzymes - "Festal", "Pancreatin", "Creon", "Mezim".
Factors affecting the appearance of the gag reflex
Causes of vomiting in acute pancreatitis:
- Emotional state - an individual develops fear due to a strong pain syndrome, which provokes the appearance of vomiting.
- Intoxication of the body - the vomiting center located in the medulla oblongata activates a high concentration of toxins.
- Diseases of the biliary tract in both acute and chronic stages.
- Existing gastrointestinal diseases and a decrease in the level of pancreatic enzymes.
- Bowel obstruction resulting from inflammation.
Complications of vomiting with pancreatic inflammation
The consequences of vomiting in acute pancreatitis can cause the following disorders:
- Electrolyte - recognized as the most difficult. Vomiting attacks wash out sodium, calcium and chlorine ions from the individual’s body, which contributes to a malfunction of the muscles and a decrease in nervous regulation. As a result, the individual is disturbed in consciousness, vomit enters the respiratory tract. In some patients, respiratory arrest is observed.
- Frequent vomiting in acute hemorrhagic pancreatitis. At the same time, vomiting acts provoke an overflow of intestinal contents. As a result of aggressive action, erosive and ulcerative lesions are formed, which can lead to the development of Mallory-Weiss syndrome (damage to the mucous membrane of the esophagus).
- Hypovolemic shock, in which the patient has the following symptoms: decreased pressure, impaired consciousness, hypoxia. In this case, urgent medical attention is required.
In order to avoid serious complications, pancreatitis should be treated at an early stage.
What is vomiting in acute pancreatitis?
The first ailment that arose with the course is quite severe. An individual suddenly has acute pain in the left hypochondrium, which rapidly spreads throughout the abdomen and gives it to the back. An attack of nausea is associated with pain. After a short period of time, vomiting occurs, caused by intoxication and inflammation in the pancreas. Moreover, it is painful, repeated many times and does not bring relief. Nausea in the intervals between seizures does not stop.
It should be noted that vomiting in acute pancreatitis, edematous or hemorrhagic is different. In the first case, it is multiple and with a large number of vomit. They contain the remains of undigested food, bile, mucus. After several sips of water, vomiting intensifies. In rare cases, vomit resembles coffee grounds. The reason for this phenomenon is bleeding from the eroded vessels of the organ. About the third day there is relief, vomiting stops after the appointment of the necessary treatment and partial removal of edema.
In the second case, vomiting is continuous and plentiful. Vomit with a smell of alcohol, gruel-like consistency, consisting of undigested food, bile and blood.
Characteristics of vomiting. Medicines to eliminate it
In acute attacks of the disease, a feeling of nausea and vomiting is present in more than ninety percent of patients. The nature of vomiting in acute pancreatitis is reflex, that is, a signal to it is laid in the pancreas. He promptly reaches the vomiting center located in the medulla oblongata, and the act of vomiting directly follows. In addition, the reflex mechanism is able to start in the presence of complications such as mechanical bowel obstruction. In this case, intoxication caused by the decay products of pancreatic tissue provokes the occurrence of central vomiting.
Drugs for nausea and vomiting are blockers of the following receptors:
- Dofaminov - "Raglan", "Tserukal", "Torekan", "Motilium".
- Histamines - Bonin.
- Serotonin - “Navoban”, “Zofran”.
The influence of the above medicines on the body of an individual is different. When taking them, you should definitely familiarize yourself with the contraindications. The right choice can only be made by the attending doctor. The most popular drugs for nausea and vomiting are Cerucal and Motilium.
What to do if vomiting occurs?
If an attack occurs:
- Calm the individual and provide him with peace.
- Remove or unfasten tight clothing so that it does not constrain breathing and movement.
- To help the patient to take a comfortable position to reduce pain. To convince him not to take sharp and deep breaths.
In addition, medications are shown that contribute to the replenishment of the electrolyte balance and fluid in the patient's body:
- Infusion solutions.
- Analgesics (as prescribed by the doctor). Self-administration is prohibited.
- Antispasmodics.
- Antiemetics - they are used for incessant vomiting, even against the background of ongoing therapy. Most often, the following medications are used that are injected: Osetron, Domperidone, Metoclopramide. Tablets from vomiting in acute pancreatitis are ineffective, since they do not have time to be absorbed.
Emergency care of doctors is of paramount importance, since inflammation of the pancreas in acute form threatens the life of the individual.
Diet food
With the help of a diet that should be followed with acute pancreatitis, conditions are created under which secretion is temporarily weakened and the pancreas is in a state of functional rest. In other words, the food taken should reduce the activity of digestive enzymes and ensure a normal outflow of pancreatic juice. It is the failure of the latter that contributes to the occurrence of acute inflammation of the pancreas. After a diagnosis is made for a period of three to five days, complete fasting is recommended, and then the use of sparing food. Consider the basic rules of the diet:
- Eating up to eight times a day. Five later.
- The introduction of products that activate digestion, as well as increasing calories up to 2500 per day, is carried out gradually.
- The food is steamed, boiled, baked or stewed.
- For the preparation of soups, second or third broths are used.
- Stale bread.
- Food temperature should be average.
- Meat, poultry and fish are pre-cooked, and then various dishes are prepared from them.
- Within three days after the attack, the reception of warm liquid in small volumes is shown - decoctions of currants, rose hips, tea and kefir drinks, mineral alkaline water without gas. Further, the volume of daily fluid intake is gradually brought up to two liters.
- The composition of the diet - a limited amount of carbohydrates and fats, increased - proteins.
A strict diet is followed from a week to a month and a half, then it is allowed to switch to an extended one. The doctor determines the duration of its compliance individually, depending on the severity of the course of the disease.
Regardless of the variant of the disease, the following products are prohibited for use:
- alcohol-containing, coffee, carbonated drinks;
- fatty varieties of poultry, meat and fish;
- bakery products - muffin, fresh pastries;
- smoked and raw smoked sausages;
- chocolate;
- sweets;
- marinades;
- fried foods;
- strong meat and vegetable broths;
- legumes;
- fresh vegetables and fruits;
- animal fats;
- butter;
- milk;
- sour cream;
- spices.
What to eat with acute pancreatitis? The following products are allowed for use:
- Rabbit, turkey, chicken, lean beef and pork, pollock, cod, pike perch, etc.
- After heat treatment - pumpkin, beets, carrots, potatoes.
- Groats - buckwheat, oatmeal, barley, rice.
- Wheat bread baked the day before.
- Pasta.
- Olive, sunflower and butter, as well as milk and sour cream (for cooking only).
- Sour milk - kefir, cottage cheese, cheese with a low percentage of fat.
- Non-acidic and unsweetened jelly, fruit compotes, mineral water without gas, broth of wild rose or blackcurrant, weak tea.
Strict adherence to the diet after the attack not only promotes a speedy recovery, but also significantly reduces the risk of relapse and the flow of the disease into the chronic stage.
The drug "Domperidone" and analogues
In the pharmacy network, the drug is presented under various trade names: "Motilium", "Motilak", "Motonium" and others.
It has a combined therapeutic effect. Unlike other antiemetic drugs, it to a greater extent blocks peripheral dopamine receptors, increases the motor and transport activity of the stomach, and also removes the delaying effect of dopamine on the motor function of the gastrointestinal tract. As a result of his intake, the patient eliminates nausea, stops vomiting, and in addition, the manifestations of digestive upset are reduced. Analogs of Domperidon:
- Prokinetic: “Trimedat” - relieves the symptoms of irritable bowel syndrome and flatulence.
- Complete - Metoclopramide, which is completely similar to Domperidone.
- Antiemetic: Ondansetron - effective for the treatment of vomiting.
Enzyme preparations for pancreatitis
Due to the violation of the synthesis of enzymes arising from this pathology, food processing is carried out poorly, fat splitting processes fail, and soreness appears in the epigastric region. Therefore, the composition of complex treatment includes the intake of enzyme substances. The instructions for use with "Creon" (the price and reviews of this drug are in the article) detail the rules for its administration. It helps to compensate for the lack of pancreatic enzymes, and is also necessary to support digestion in the chronic stage of the disease. The composition of the active substance is close to human and is represented by amylase, protease and lipase. The tool, subject to the rules of administration and the recommended dose, is well tolerated. It is forbidden to take it with exacerbation of acute pancreatitis. The reason is that in this condition there is an active development of inflammation, and taking "Creon" will contribute to the appearance of undesirable reactions. Most often, they are represented by diarrhea or constipation, general weakness, pain in the stomach, vomiting, nausea and allergic manifestations.
You can return to taking the medicine after two weeks, when the process of inflammation and the pain syndrome subside. It is important to remember that prolonged intake of enzyme preparations is undesirable, so as not to completely suppress the production of your own secret. In order to avoid complications, do not use the drug without consulting the attending doctor - this warning is also available in the official instructions for use of "Creon".
About the price and reviews should be told separately. Depending on the form of release, the price for packaging is from 330 to 1590 rubles. As patients say, it’s not so expensive. You can buy the drug at any pharmacy without a prescription. In addition, this medicine is on the list of prescription drugs. Reviews about the drug are only positive: to achieve the result, you should strictly adhere to the dose prescribed by the doctor. "Creon" is allowed to give children. The drug is safe and effective.