Pancreatitis is a disease that develops against a background of pancreatic dysfunction. The reason for this is the penetration into the organ of bacteria from the duodenum, blood, biliary tract, and also as a result of the negative influence of provoking factors from the outside. One of the common types of pathology is parenchymal pancreatitis. This is a chronic form of the disease, the development of which is caused by damage to the organ parenchyma with progressive factors, which in the absence of treatment leads to its atrophy.
Parenchymal form of pancreatitis - what is it?
This form of the disease is characterized by a sluggish inflammatory process, the cause of which is a violation of the synthesis of enzymes produced by the pancreas. Excessive enzyme concentration provokes self-digestion of parenchyma tissue with subsequent scarring and wrinkling.
As a result of this, diffuse changes in the organ occur. This is expressed in the gradual replacement of the affected areas of tissue with connective segments, followed by a loss of pancreas functionality. As a result, the synthesis of digestive enzymes in the body is reduced.
In medicine, there are two types of inflammatory process of the parenchyma:
- diffuse (extensive) - affects most;
- limited - partially affects the head or tail.
The danger of parenchymal pancreatitis is that it is difficult to diagnose at the initial stage of development. This is due to the fact that the disease does not have pronounced symptoms and only sometimes manifests itself in minor periods of exacerbation. As a result, the disease gradually progresses and in the absence of adequate therapy can lead to pancreatic atrophy.
Main forms
Parenchymal pancreatitis is divided into three main forms. Each of them is characterized by certain clinical signs and the course of the pathological process:
- Edematous. This form develops due to excessive accumulation of fluid in the tissues of the organ. Errors in nutrition act as a provoking factor, which is exacerbated by alcohol. In rare cases, the edematous form develops as a complication of pathologies of the digestive tract. Clinical signs are expressed due to severe intoxication. Treatment does not require surgical intervention and is characterized by a favorable prognosis.
- Sclerosing. It develops against the background of blockage of the glandular ducts, less often due to concomitant diseases of the digestive system. This form is characterized by the formation of sclerotic changes in the organ, which leads to a significant expansion of its ducts. Common symptoms of damage: pain in the left hypochondrium, the presence of glucose in the urine, frequent urination, thirst. 5% of diagnosed cases develop completely asymptomatically. For treatment, traditional methods of treatment are used.
- Calculous. It is characterized by the deposition of insoluble calcium salts in the glandular ducts, which can provoke a complete blockage of the lumen. This form significantly progresses and can provoke the formation of a malignant tumor.
Subspecies with exocrine insufficiency
In addition to morphological forms of the disease, specialists distinguish two subspecies. Each of them is characterized by certain pathological changes that lead to a partial or complete loss of pancreas functionality.
The diagnosis of parenchymal pancreatitis with exocrine insufficiency is established with a decrease in the synthesis of digestive enzymes. As a result of the lesion, the body is not able to produce the necessary enzymes in sufficient quantities. This provokes their deficiency in the body, which negatively affects the work of the digestive system.
Laboratory and hardware studies, which are confirmed by patient complaints, help to identify a subtype of pathology.
Chronic parenchymal biliary-dependent pancreatitis - what is it?
Another common subspecies is biliary dependent, which needs close attention. It makes up 50% of the detected cases of pancreatitis. The development of parenchymal biliary-dependent pancreatitis is a consequence of hepatobiliary disorders of a different nature.
The disease is closely associated with sluggish inflammation of the pancreas, which develops against the background of congenital and acquired pathologies of the organ.
Chronic parenchymal biliary-dependent pancreatitis - what is it? This disease is characterized by a partial or complete decrease in the efficiency of the gland for the production of digestive enzymes and hormones.
With biliary-type pancreatitis, the outflow of bile from the duodenum occurs back into the pancreatic ducts. This ultimately leads to a change in the structure of tissues. This subspecies is characterized by constant relapses that threaten serious health complications. A characteristic sign of pathology is a constant or frequent feeling of bitterness in the mouth.
Possible complications due to the development of parenchymal biliary-dependent pancreatitis:
- blockage of the bile ducts;
- diabetes;
- further spread of the inflammatory process to adjacent organs and tissues;
- deficiency of enzymes, which leads to a malfunction of all digestive organs.
With biliary-dependent pancreatitis, a critical decrease in the functionality of the pancreas is possible up to 70%.
Anxiety symptoms
Pathological signs of the disease are often difficult to recognize, since they are similar to many diseases of the digestive tract. At the same time, the symptoms are not bright, which many people simply do not pay attention to.
Symptoms of parenchymal pancreatitis:
- Dull pain in the left hypochondrium with irradiation in the back is most often felt after eating spicy and fatty foods, alcohol and as a result of overeating.
- Nausea with frequent bouts of vomiting.
- Stool disorder, with constipation alternating with diarrhea, feces are characterized by a fetid odor, have a mushy consistency and undigested food residues.
- Excessive flatulence.
- Constant drowsiness, distracted attention, which makes it impossible to concentrate on work.
- Significant weight loss that occurs as a result of a lack of digestive enzymes, so many nutrients are not able to be absorbed by the body and transit in exit.
- Increased dry skin, red spots in the abdomen, due to hypertrophic changes in the subcutaneous fat layer.
The appearance of two or more pathological signs is an occasion to consult a doctor and undergo an examination. Do not immediately think up a diagnosis for yourself, since these symptoms are characteristic of many pathologies. And only an experienced specialist is able to identify the causes of their appearance.
Development reasons
Chronic parenchymal pancreatitis develops under the influence of certain provoking factors.
The most common ones are:
- cholecestitis, as a result of excessive deposition of cholesterol on the walls, the gall bladder becomes inflamed and swells, which leads to a decrease in acid outflow and its reflux into the bile ducts
- urolithiasis, as a result of which the pathways of acid outflow are partially or completely blocked;
- the formation of tumors of benign and malignant properties;
- decreased motility of the biliary tract;
- excessive consumption of alcohol, as well as fatty and salty foods;
- deficiency in the diet of proteins and vitamins;
- regular stress;
- malfunction of the thyroid gland;
- uncontrolled medication;
- regular frostbite or heat stroke;
- organ trauma;
- chronic diseases of the digestive system.
In some cases, parenchymal pancreatitis develops as a complication after the transferred flu, scarlet fever, tonsillitis.
Diagnostics
To identify pathology, the doctor first conducts a patient survey for the presence of characteristic signs. In addition, an examination with palpation and percussion is used, which allows you to identify a painful area in the left hypochondrium.
To confirm the diagnosis, the following types of tests and studies are prescribed:
- a blood test to determine the level of red blood cells, white blood cells, the concentration of enzymes, as well as to detect levels of calcium, sodium and potassium;
- a study of feces for the content of certain enzymes and fragments of undigested food;
- urinalysis to detect microhematuria, proteinuria, cylindruria;
- Ultrasound is the most informative method to detect diffuse changes in the pancreas;
- CT scan with contrast pigment allows you to accurately determine the presence of stones in the bile ducts.
How to treat?
Treatment of chronic parenchymal pancreatitis is carried out in accordance with the identified stage of pathology. At the initial stage, it is enough to carry out the prescribed course of drug therapy and subsequently adhere to a certain diet in order to fully restore health.
If the pathology is neglected, which has led to irreversible consequences for the pancreas, a surgical operation is performed to cut off the affected area in order to prevent further deterioration of the situation.
Drug treatment
The selection of necessary drugs is carried out by the attending physician based on the severity of the identified pathology. Their dosage and course of administration are prescribed taking into account the individual characteristics of the patient.
The main types of medications that are used to treat parenchymal pancreatitis:
- drugs that reduce the production of gastric juice (Omeprazole, Esameprazole);
- antispasmodics for pain relief (No-Shpa, Papaverin);
- prokinetics that improve intestinal motility and facilitate the rapid passage of the food lump (Domperidone, Metoclopravid);
- replacement drugs that make up the resulting deficiency of enzymes.
Special diet
How to treat chronic parenchymal pancreatitis with a diet? It will not be possible to get rid of the pathology without an appropriate dietary adjustment. Therefore, it is recommended to adhere to the following rules in food:
- Refuse alcohol, smoking, as well as fatty, salty, smoked, fried and spicy foods.
- Minimize sugar and salt intake.
- All food should be boiled and steamed, while it should be crushed to a puree consistency.
- With exacerbation, it is recommended to drink more jelly and stewed fruit.
- Porridge should be cooked on the water.
- Food should not be cold or hot.
- Almost all fruits can be consumed, but they should not be acidic.
- It is forbidden to eat fresh bread. It is better to replace it with crackers, bread, crackers.
- Meat and fish should be lean. They should be boiled.
- Dairy products should have a fat content of less than 2%, the use of curd with a high content of sugar and palm oil is not allowed.
- It is recommended to adhere to a fractional diet, eating food in small portions 5-6 times a day.
- Dishes should be prepared from a small number of components.
A strict diet with parenchymal pancreatitis should be followed within 1-2 months after a course of drug therapy.
Herbal Therapy
Herbal medicine is also an effective treatment for this disease. Medicinal herbs are used in remission to prevent relapse of the pathology. It is impossible to cure the pathology by purely medicinal fees, since they are not able to replace the main treatment.
You can buy ready-made mixtures of medicinal herbs in a pharmacy. But also, if necessary, you can cook them yourself. To do this, mix the components in equal proportions.
Valid Dosage Options:
- wormwood, motherwort, St. John's wort, mint;
- Sausage, wormwood, St. John's wort, chamomile, yarrow;
- dill, mint, immortelle, hawthorn, chamomile;
- St. John's wort, wormwood, sage, elecampane, burdock root, calendula, horsetail.
To prepare the broth, pour 30 g of the herbal mixture with 250 ml of boiling water. Insist 40 minutes, clear. Drink the drink throughout the day in equal portions. Full course - 3 weeks.
Exercise as prevention of exacerbations
Physiotherapy exercises also help a person forget about pathology and return to their usual way of life. The most effective exercises are prescribed by the attending physician in accordance with the individual characteristics of the patient.
But there are several recommendations that should be followed:
- More physical activity, so it is better to give preference to walking, an exercise bike, simple physical exercises.
- Do not use breathing exercises: squats, leg presses.
- It is forbidden to use tightening belts during training.
- Meal should be taken 60-90 minutes before exercise.
Conclusion
Parenchymal pancreatitis is a serious disease that requires timely and adequate treatment. Ignoring doctor's prescriptions or self-medication threatens serious health complications. It should also be understood that tablets cannot solve the problem without adjusting the diet and giving up bad habits. Only complex therapy is able to prevent recurrence.