Chronic pancreatitis is a progressive inflammatory and destructive disease of the pancreas. It leads to a violation of the function of the organ. With exacerbation of chronic pancreatitis, pain occurs in the left hypochondrium, dyspeptic disorders appear in the form of nausea, vomiting. In order for the doctor to be able to accurately make a diagnosis, an ultrasound scan is performed, an RCP and other diagnostic examinations are performed. As soon as the exacerbation of chronic pancreatitis is confirmed, a therapy is prescribed that includes various types of medications and a diet. With their ineffectiveness, surgical treatment of the disease is carried out.
Chronic pancreatitis
Chronic pancreatitis is a disease of the pancreas that develops over time and is characterized by gradual pathological changes at the cellular level. As a result of the disease, functional failure develops. Among all types of gastrointestinal tract pathologies, pancreatitis is diagnosed in eight out of a hundred people. Moreover, before, mainly people aged fifty years and above suffered from it, and now they are thirty years old.
Men suffer from pancreatitis more often than women. Over the past few years, against the background of alcohol consumption, the risk of developing an ailment has grown to eighty percent. Also, various pancreatic neoplasms that arise due to chronic pathology have become more often diagnosed.
The causes of the disease
Exacerbation of chronic pancreatitis occurs for various reasons, but most often due to alcohol abuse, cholelithiasis.
Alcohol is a toxic factor for the parenchyma. In cholelithiasis, inflammation is the result of the passage of infection from the bile ducts through the lymphatic system or due to the casting of bile into the pancreas.
Exacerbation of chronic pancreatitis can occur for other reasons. These include:
- cystic fibrosis;
- high content of calcium ions in the blood;
- the use of certain drugs;
- other types of pancreatitis that have not been cured or treated incorrectly.
Types of chronic inflammation
The classification of the chronic type of pancreatitis is as follows:
- By origin. Pancreatitis can be primary and secondary.
- According to clinical manifestations. Pathology can be painful, pseudotumorous, latent, combined.
- According to the morphological picture. Pancreatitis can be obstructive, calcifying, fibro-sclerotic, infiltrative-fibrous.
- By the nature of the disorders, hyposecretory, obstructive, hypersecretory, ductular, hypo - and hyperinsulinic pancreatitis are distinguished.
Symptoms of exacerbation of chronic pancreatitis indicate the severity of the disease and structural disorders. According to this indicator, the disease is divided into mild, severe and moderate severity.
Clinical manifestations
Usually, the onset of the pathology occurs without any clinical manifestations or the symptoms are mild. The first acute symptoms of exacerbation of chronic pancreatitis are already observed with significant violations.
The main complaint of patients is pain in the upper abdomen in the left hypochondrium. It has a girdle character. The pain can be constant or paroxysmal. Sometimes she gives to the area of the heart. Chronic pancreatitis in the acute stage is accompanied by dyspeptic disorders in the form of nausea, vomiting. During an exacerbation, vomiting can be frequent, debilitating, it does not bring relief. The nature of the stool also changes: it becomes unstable, constipation alternates with diarrhea. Appetite is disturbed, digestion is upset, due to which body weight is reduced.
With the development of the disease, the frequency of exacerbations increases. Chronic disease of the gland leads not only to damage to the pancreas, but also to adjacent organs. However, before a person visits a doctor for treatment of exacerbation of chronic pancreatitis, the ailment will proceed in a latent form, not reminding himself. Such a process can go on for many years.
Visual inspection
During the examination, the doctor assesses the condition of the skin and sclera. This is an important clinical criterion by which pancreatitis can be assumed. During exacerbation, patients have yellowness of the skin and sclera. Sometimes the shade becomes brownish. Blanching of the skin, dry skin - all these are symptoms of exacerbation. Also, red spots may appear on the chest and abdomen, which remain after pressing on them.
Palpation
To prescribe the correct treatment for exacerbation of chronic hepatitis, the doctor must carry out palpation of the abdomen. During this procedure, there is moderate swelling in the epigastric region, atrophy of subcutaneous fat.
On palpation, soreness can be observed in the upper abdomen, around the navel, as well as in the left hypochondrium, in the rib-vertebral corner. In some cases, pancreatitis is accompanied by splenomegaly and hepatomegaly.
Diagnostics
To clarify the diagnosis, a gastroenterologist prescribes various diagnostic methods, including a general blood test, blood sugar, fecal analysis.
A general blood test determines non-specific inflammation. For differential diagnosis, samples are taken for the activity of gland enzymes in the blood. Radioimmune analysis shows an increased activity of elastase, trypsin. The coprogram determines a large amount of fat, which helps to suggest enzymatic organ failure.
If the diagnosis is confirmed, then a diet with exacerbation of chronic pancreatitis is necessary, without it, treatment will be inconclusive.
For a more accurate diagnosis, an ultrasound of the organ is required. It shows changes in the parenchyma and structure. According to indications, CT, MRI and endoscopy are performed. The latter method allows you to see the organ from the inside, evaluate the tissue of the gland.
With pancreatitis, retrograde pancreatocholangiography can be performed, during which a radiopaque substance is injected into the duodenal papilla and the result is examined.
To assess the ability of the gland to produce enzymes, prescribe functional tests with stimulation of secretion.
Complications of Pancreatitis
The diet and treatment of exacerbation of chronic pancreatitis are selected according to the symptoms, do not neglect the recommendations of the doctor, in order to avoid complications. In the early stages, obstructive jaundice is observed, which appears due to a violation of the outflow of bile. Internal bleeding, hypertension may also occur.
Less common are systemic complications in the form of multi-organ pathologies, functional insufficiency of organs and systems, and DIC. As the disease develops, pancreatitis can be complicated by bleeding of the esophagus, diabetes, the occurrence of neoplasms.
Treatment methods
The main thing in the treatment of chronic pancreatitis is a diet that is selected in each case of the disease individually. An important role is played by drug therapy.
The treatment regimen for the disease is as follows:
- Diet therapy. In the treatment of symptoms of exacerbation of chronic pancreatitis, diet plays an important role. During a period of severe exacerbation, it is recommended to refrain from enteral nutrition, and when calming down, table No. 5B is appointed. A strict ban includes alcohol, spicy, fatty, fried foods, as well as pickles and sour foods. If there is diabetes mellitus, then sugar-containing products must be controlled.
- Treatment of chronic pancreatitis is carried out in the same way as acute form therapy. Anesthetics, anti-inflammatory drugs, as well as medications that restore digestive function, are necessarily prescribed.
If pancreatitis is caused by alcohol, then you should abandon its consumption completely. This factor is the key to the success of pancreatitis therapy.
In cases of purulent complications, as well as obstruction of the bile and / or pancreatic ducts, sphincter stenosis, the presence of a cyst, in severe cases of the disease, surgical treatment is prescribed.
Diet
Diet for exacerbation of chronic pancreatitis is very important. In the first three days, it is important to endure a hunger period. After this, you must follow a diet for several weeks.
- Fractional nutrition. Meals should be gentle. To do this, you need to divide the daily ration into six or eight doses. Food is taken only boiled or steam in a mashed state. In this form, iron will not experience heavy load.
- Food selection. The ideal option is the choice of mainly protein foods. In this case, it is recommended to eat mashed beef, low-fat varieties of fish. It is important to take a lot of vitamins. A good effect gives a decoction of currants or rose hips.
Strong broths, salty foods, fresh muffins, sweets, smoked meats, and canned foods should be excluded from the diet. Do not use sour cream.
Each additional product is introduced into the diet with care, so as not to provoke pain.
Symptoms and treatment of chronic pancreatitis are two inseparable concepts. Therapy is carried out not only to improve organ function, but also in accordance with the clinical picture. For example, to relieve pain, painkillers are selected, and antispasmodics are used to relieve spasms.
The symptoms and diagnostic data indicate what is the best treatment for exacerbation of chronic pancreatitis. In some cases, patients are indicated for surgery.
Patients with chronic pancreatitis during remission are recommended to adhere to a diet with a restriction of fats. It’s best to add protein-rich foods to the menu. From the diet it is also worth forever excluding carbonated, sour drinks, spicy, coffee, alcohol. But mineral waters, such as Essentuki, Smirnovskaya and others should be included in the daily diet.