Diagnosis of pancreatitis, its methods. Symptoms and treatment of the disease

Pancreatic inflammation is an unpleasant and dangerous condition. In medicine, it is called pancreatitis. In this disease, the enzymes produced in the pancreas remain in it, begin to destroy its tissues. Treatment should be timely. Otherwise, the inflammation becomes chronic. What are the ways to identify the acute form of the disease? How is differential diagnosis of chronic pancreatitis carried out? These issues should be examined in detail.

Essence of the disease

The pancreas is a small but important organ of the digestive system. It lies behind the stomach and extends from the duodenum to the spleen. The pancreas has a lobed structure. Each lobule has a duct. In the organ, all ducts are connected and form the main pancreatic duct. There is also a second (incremental) duct. Each of them flows into the duodenum.

Iron in the human body performs two functions:

1. Exocrine (exocrine). Juice secreted from the gland into the duodenum contains enzymes. They are involved in the digestion of protein, carbohydrate and fatty foods.
2. Endocrine (intrasecretory). The pancreas secretes polypeptide hormones into the blood. They regulate the metabolic processes occurring in the body.

With inflammation, the functions of the pancreas are impaired. This is confirmed by the diagnosis of pancreatitis. The secret is not secreted from the organ into the duodenum. In this regard, the process of self-digestion of the gland sections begins. Part of the enzymes and toxins in this case is released into the blood vessels, spreads throughout the body and damages other organs (liver, kidneys, lungs, heart, and even the brain).

The disease occurs in people for various reasons. Statistics show that 50% of people suffer from pancreatic inflammation due to alcohol abuse. In 20% of cases, the diagnosis of pancreatitis in adults shows that the disease develops due to gallstone disease. Other causes of pancreatic inflammation include:

• infectious, viral and parasitic diseases;
• fungal lesions;
• injuries and poisoning;
• endoscopic manipulations and operations.

Pancreatitis Classification

By the nature of the course, the disease can be acute (OD) and chronic (CP). The first form of the disease means an inflammatory process that occurs in the pancreas and passes on to other tissues and organs. The disease develops suddenly due to the intake of alcohol, spicy or fatty foods. In some cases, the onset of the disease is associated with eating large amounts of food after prolonged fasting.

Acute pancreatitis experts classify as follows:

1. Acute severe pancreatitis. With this form, the internal organs do not function properly. Dif Diagnosis of pancreatitis reveals serious violations.
2. Sharp light form. With this type of disease, organ function is minimally disturbed.
3. Acute severe pancreatitis, complicated by parapancreatic infiltrate, peritonitis, purulent abscesses, sepsis, bleeding.

Chronic pancreatitis occurs in people after suffering an acute form of pancreatic inflammation. Depending on the severity, specialists distinguish:

1. Severe form. Pancreatitis is characterized by a continuously recurring course. Periods of remission are rare and short-lived.
2. The course of the disease is moderate. Exacerbations of inflammation of the pancreas occur 3-4 times a year. Pain abdominal syndrome is quite long.
3. The mild course of the disease. Exacerbations are short and rare. They occur 1-2 times a year.

Signs of acute inflammation

Epigastric pain is a symptom indicating acute pancreatitis. Differential diagnosis in the presence of this symptom is carried out immediately, because the pain is often so strong that people can not lie and sit quietly. Only after a diagnosis and an accurate diagnosis are made, specialists can take any measures to alleviate the condition of patients.

Another common sign of acute inflammation of the pancreas is vomiting, which is repeated in most cases. It does not bring relief to sick people. Their condition due to vomiting only worsens. Other symptoms of acute pancreatitis include:

• pallor of the skin, acrocyanosis (acquisition of bluish-colored skin);
• bloating;
• gas retention, stool;
• sharp weakness.

Symptoms of Chronic Pancreatitis

The signs characteristic of CP are different during periods of exacerbations and remissions. They depend on a number of factors: stage, clinical form of the course of the disease. Despite this, several main symptoms of chronic pancreatitis can be distinguished:

1. Indigestion. It is manifested by an increase in the volume and frequency of the stool. In chronic pancreatitis, feces have a grayish color and a fetid odor. It often contains leftover food that has not been digested. The above symptoms occur due to a decrease in the mass of a functioning exocrine parenchyma and a violation of the secretion of the gland into the duodenum.
2. Weakness, trembling throughout the body, hunger, cramps, involuntary bowel movements and urination, loss of consciousness. These symptoms of CP are associated with a violation of the intracecretory function of the pancreas.
3. Pain abdominal syndrome. The pain does not have a clear localization. It can occur in the middle or upper abdomen and take on herpes zoster. In some cases, pain is not observed.

Diagnosis of acute pancreatitis

To confirm the diagnosis, doctors prescribe an examination for their patients. Diagnosis of pancreatitis includes blood tests to determine the amount of enzymes produced in the pancreas. A common serum amylase test is common. The level of this enzyme exceeds the norm several times in those people who have acute pancreatitis.

Diagnostic methods also include urinalysis. According to the results of the analysis in patients revealed:

• proteinuria (protein content in the urine);
• microhematuria (the presence of blood in the urine in excess of the physiological norm);
• cylindruria (the appearance in the urine of cylindrical bodies formed from blood cells, coagulated protein, renal tubule epithelium).

A reliable method for the diagnosis of acute pancreatitis is computed tomography (CT). It allows you to get an image of the pancreas, surrounding tissues and internal organs, identify complications of the disease, assess the scale and nature of pancreatic lesions in pancreatic necrosis.

Diagnosis and treatment of acute pancreatitis can be carried out thanks to laparoscopy. Using it, doctors with a high degree of certainty determine the form of the disease, identify and eliminate some complications of the disease.

The most common, informative, simple and safe method for detecting a disease is ultrasound diagnosis of acute pancreatitis (ultrasound). When it is carried out, dimensions, contours, shape, internal structure, echogenicity of the pancreas, and the condition of the ductal system are evaluated.

Diagnosis of a chronic form

Diagnosis of pancreatitis in adults includes primarily ultrasound and CT. Sick people are also assigned endoscopic retrograde cholangiopancreatography. This research method is a combination of endoscopy and fluoroscopy.

Diagnosis of chronic pancreatitis also includes the determination of exocrine pancreatic function. It is for this purpose that specialists conduct a coprogram - a laboratory study that allows you to detect the remains of undigested food in feces.

Exocrine pancreatic function can also be assessed using C-breath tests. Their main advantage is non-invasiveness (lack of need to violate the integrity of the body’s natural external barriers). Such a diagnosis of pancreatitis also makes it possible to determine the effectiveness of enzyme replacement therapy.

Treatments for acute pancreatitis

If symptoms occur that indicate the development of OP, a sick person needs to be provided with first aid:

• prohibit eating and drinking for several days;
• apply a heating pad with cold water or an ice bubble to the epigastric region ;
• give antispasmodics (due to the use of "No-shpa" or "Papaverine" the production of enzymes will decrease).

After first aid, you must immediately call a doctor. A person must be hospitalized in a hospital. An ultrasound diagnosis of acute pancreatitis is immediately performed at the hospital . After establishing an accurate diagnosis, analgesics are prescribed (Baralgin, Analgin) in order to suppress pain.

Solutions of amino acids and glucose are also used in the treatment. They make up for the plastic and energy needs of the human body. Antibiotics are also prescribed. These drugs are necessary for the treatment and prevention of purulent complications.

A few days after the start of treatment, a thin probe is installed in the small intestine. It is necessary for the application of enteral nutrition techniques. When bowel function is restored, the patient is allowed to eat naturally. The diet should consist of cereals, boiled vegetables, compotes.

Conservative treatment in 87% of cases is successful. The remaining 13% of sick people need surgical intervention. It is carried out when the diagnosis of pancreatitis reveals serious complications. The goals of surgical treatment are as follows:

1. Decrease in endotoxemia. For this, drainage and decompression of the bile ducts, drainage and rehabilitation of the abdominal cavity are prescribed. During the operation, enzymes, toxins and other biologically active substances are removed from the body.
2. Treatment of infectious and necrotic complications of pancreatic necrosis (abscesses, fistulas, cysts, peritonitis). To accomplish this, specialists perform an autopsy and drainage of post-necrotic, purulent cavities, resection and sequestrectomy of the pancreas.

Chronic inflammation treatment

If the diagnosis of pancreatitis revealed a chronic form of the disease, then various drugs can be prescribed to patients: enzyme preparations based on pancreatin (Mezim, Festal, Creon), antibiotics (Abaktal, Amoksiklav, Sumamed) and others. In some cases (for example, with a formed pseudocyst) minimally invasive (percutaneous) drainage or surgery is required.

An important role is played by nutrition. With an exacerbation of the disease on the 1-2nd day, patients are forbidden to eat anything. You can only drink liquid (1-1.5 liters per day): weak tea, alkaline mineral water without gas, a rosehip broth (1-2 glasses). On the 2-3rd day, food is allowed. Mucous soups, liquid mashed milk cats, mashed vegetables, fruit juice jelly are allowed.

During periods of remission, you must adhere to the following tips:

1. Cook steamed, mashed or bake in the oven. Exclude pure fats from the diet and limit salt to 6 g per day.
2. Eat small meals 5-6 times a day. The recommended temperature of hot dishes is not higher than 57−62 degrees, cold - not less than 15−17 degrees.
3. Exclude from the diet acidic, spicy, spicy and canned foods, peas and beans, mushrooms, carbonated and alcoholic drinks, kvass, sour fruit juices, and rich bakery products. Cream and sour cream are allowed in small quantities in dishes.

Alternative treatment methods

In the acute form of inflammation of the pancreas, the only right solution is to see a doctor. It is not worth experimenting with folk remedies for this type of disease. If the symptoms and diagnosis of pancreatitis indicate a chronic form of the disease, then you can try the treatment methods offered by alternative medicine.

A positive effect in most cases gives herbal medicine. The use of herbal preparations can significantly improve the condition of people suffering from chronic pancreatitis. Here is the recipe for one traditional medicine:

• mix in equal parts corn stigmas, chamomile and calendula flowers, plantain leaves and mint grass;
• take 1 tsp. from the mixture and pour 2 cups boiling water;
• put the broth in a water bath for 15 minutes;
• infuse the finished product for 45 minutes and strain.

It is recommended to drink the broth three times a day for 15 minutes before eating food, 0.4 cups, previously diluting with warm water to the volume of a cup. You can store the product in the refrigerator for up to 5 days.

Pancreatitis Prevention

It is quite possible to prevent the development of pancreatitis. First of all, you need to monitor your health. Some diseases of the biliary tract and gall bladder, diseases of the gastrointestinal tract cause inflammation of the pancreas. If you feel unwell and the appearance of suspicious symptoms, you should immediately consult a doctor, take the necessary tests and undergo the prescribed examinations.

Another important preventative measure is to reduce alcohol consumption. Experts advise even absolutely healthy people not to drink alcohol in large quantities. In diseases of the gastrointestinal tract, alcohol should be completely abandoned.

In conclusion, it is worth noting that pancreatitis (clinic, diagnosis, treatment of this disease) is an urgent medical topic. If symptoms occur that indicate inflammation of the pancreas, you should consult a doctor. Running a disease can lead to serious life-threatening complications.