The pancreas is one of the most important glands in our body. It belongs to the group of glands of mixed secretion. This means that it simultaneously produces hormones that are secreted into the blood (internal secretion), and synthesizes enzymes that are necessary for digestion in the intestines (external secretion). Therefore, it is very important to have an idea of what problems with the pancreas can occur in a person, how they manifest themselves, and also how to deal with them.
The importance of the pancreas in the body
To understand why there are certain signs of problems with the pancreas, you need to understand what is the importance of this organ in the body and what functions it performs.
As noted above, the pancreas is an organ of mixed secretion. Performing the function of the endocrine gland, it secretes three main hormones:
- insulin - reduces the concentration of glucose in the blood, facilitates its utilization by cells, increases protein synthesis and reduces the breakdown of fats;
- glucagon - the exact opposite of insulin, increases glucose levels, increases the breakdown of proteins and fats, therefore glucagon is also called contra-hormonal hormone;
- somatostatin - inhibits the synthesis of pituitary hormones (somatotropic and thyrotropic).
External pancreatic secretion is characterized by the production of the following enzymes:
- amylase - necessary for the absorption of carbohydrates, breaks down polysaccharides to monosaccharides (glucose and fructose);
- trypsin - breaks down proteins to amino acids;
- lipase - necessary for the absorption of fats.
From the above basic functions of the pancreas, it follows that problems with it in the first place will lead to digestive disorders. And with a longer course of the disease, a violation of protein and carbohydrate metabolism also joins.
Possible diseases
The most common causes of pancreatic problems are presented below:
- Pancreatitis - inflammation of the gland tissue, can be acute and chronic. Most common in adults, rarely seen in children.
- Neoplasms are benign and malignant tumors.
- Diabetes mellitus is the destruction of pancreatic cells involved in the synthesis of insulin, or a violation of the sensitivity of tissues to insulin.
- Functional disorders of the gland - a violation of the function of the organ in the absence of anatomical changes.
- Anomalies in the structure are a common cause of pancreatic problems in a child.
Common signs of pancreatic disease
Despite the diversity of the origin of diseases of this organ, a number of basic signs that are characteristic of any pancreatic problem can be distinguished:
- Pain in the left hypochondrium, often having a girdling character and extending to the back. The intensity of pain increases with a violation of the diet, palpation of the abdomen. Depending on the pathology, they can be of varying intensity, constant or cramping. Pain is the main symptom of pancreatic problems in adults, which makes the patient seek medical help.
- Dyspeptic manifestations. This group of symptoms develops with insufficiency of the external secretion of the pancreas, manifests itself as constipation and diarrhea, nausea and vomiting.
- Decreased appetite, and as a result of losing weight and exhaustion of the body.
The remaining symptoms are more specific, therefore, they will be considered in the context of individual diseases of this organ.
It is also worth noting that the signs of diseases may differ depending on the severity of the pathology, its causes, but they do not depend on gender. The symptoms of pancreatic problems in women and men are the same.
Pancreatitis: general concepts
Pancreatic inflammation or pancreatitis is a common problem in digestive disorders in adults. This pathology can occur acutely or chronically. Acute pancreatitis in adults occurs due to alcohol abuse, a violation of the diet. However, this problem can also occur in children. Most often, in childhood, the pancreas becomes inflamed due to viral infections (mumps), congenital pathologies (cystic fibrosis), and damage to the gland with certain medications.
Chronic pancreatitis is most often the result of untreated acute. It occurs when the patient fails to contact the doctor for medical care, patient non-compliance with the diet and unfair medication.
Inflammatory processes in the gland arise due to obstruction of the ducts, which leads to an increase in pressure in their channels. After a certain time, the ducts are damaged, and their contents, together with enzymes, enter the bloodstream, injuring the pancreatic cells. There is the death of the gland (pancreatic necrosis). In the blood, enzymes accumulate in excess (fermentemia), which has a toxic effect on internal organs.
Pancreatitis: Symptoms
What are the most common symptoms of pancreatic problems in adults? All the above clinical manifestations are true: pain in the hypochondrium, dyspeptic manifestations, decreased appetite and weight loss.
It is worth noting that with acute pancreatitis, the pain is extremely pronounced. It occurs acutely with malnutrition (the use of alcohol, a large amount of fatty and fried foods). The pain covers the entire upper abdomen, giving back. It is facilitated in a sitting position, with legs lowered. Painful sensations are accompanied by a difficult general condition of the patient: a decrease in blood pressure, increased heart rate, sweating and weakness.
In chronic pancreatitis, the pain is not so intense, it acquires a pulling or pressing character. Here, the phenomena of dyspepsia come first: diarrhea, alternating with constipation, nausea and vomiting. Characteristic is the appearance of oily stool, which is difficult to wash off. These symptoms occur due to impaired digestion of proteins, fats and carbohydrates. Untreated nutrients come out with feces.
Also, in the chronic course of the disease, alternation of periods of exacerbation with remission is characteristic. In remission, the patient's condition is satisfactory, there are no pains and dyspeptic manifestations.
Pancreatitis: diagnosis
The symptoms listed above should make the patient suspect a problem with the pancreas, which requires immediate medical attention and, possibly, further hospitalization.
In the diagnosis of pancreatitis, the reference method is the laboratory determination of fecal elastase-1, an enzyme produced by the pancreas. A reduced concentration of this substance in the feces indicates an external pancreatic insufficiency. In addition, methods for visualizing this organ are performed. Used ultrasound diagnostics, computed tomography, magnetic resonance imaging.
Pancreatitis: treatment
The treatment and symptoms of pancreatic problems are inextricably linked. Indeed, the relief of pain and the reduction of dyspeptic manifestations is task No. 1 in the treatment of pancreatitis.
To reduce pain, antispasmodics ("Drotaverin", "Papaverine"), analgesics ("Analgin", "Baralgin") are used. The use of narcotic analgesics for pancreatitis ("Morphine") is strictly prohibited, since they cause a spasm of the pancreatic ducts, which further prevents the outflow of secretion from the gland into the intestines.
It is also necessary to compensate for those enzymes whose synthesis is impaired in the pancreas. For this, substitution enzyme therapy is used. This is a separate group of drugs containing pancreatic enzymes (lipase, amylase, trypsin). These include Creon, Pancreatin.
Another link in the treatment of pancreatic problems is the inhibition of the activity of enzymes that enter the bloodstream. For this, the drug "Contrical" is used.
Particular attention should also be paid to nutrition in diseases of the pancreas, however, it will be discussed in the appropriate section.
Diseases in children
Pancreatic problems in children can be either congenital or acquired.
Among congenital diseases, the following pathologies are distinguished:
- ectopia of the gland;
- bifurcation of the pancreas;
- annular (ring-shaped) gland;
- congenital decrease in lipase activity (Sheldon-Rey syndrome);
- congenital amylase deficiency;
- an isolated decrease in trypsinogen activity;
- generalized pancreatic insufficiency.
Among the acquired problems with the pancreas, there are:
- viral acute pancreatitis;
- cystic fibrosis;
- drug pancreatitis;
- traumatic pancreatitis;
- pancreatitis with Shenlein-Genoch disease;
- pancreatitis with excessive nutrition.
The clinical manifestations and treatment of childhood pancreatitis do not fundamentally differ from those in adulthood. The main thing in this case is to determine the cause of pancreatic inflammation and its elimination.
Therefore, below we will analyze those pancreatic problems that are specific to childhood.
Cystic fibrosis: general concepts
Cystic fibrosis is a hereditary disease that can occur immediately after the birth of a child, or after several years, which depends on the severity of the disease. With this pathology, almost all organs and systems of the body are affected.
It occurs due to a violation of the exchange of chlorine between cells and the space around them, which leads to an increase in the viscosity of the secretion secreted by the gland. This secret accumulates and clogs the ducts of the pancreas, causing inflammation. This leads to severe exocrine insufficiency.
Cystic fibrosis: diagnosis and treatment
Diagnosis of the disease consists in the determination of sweat chlorides (their increase is characteristic), ultrasound examination of the pancreas. Now more and more widespread is a genetic examination.
Symptoms of pancreatic problems and treatment are directly related to this disease. Enzyme replacement therapy and diet therapy, like pancreatitis in adults, play a big role.
Isolated enzyme deficiency
Pancreatic problems in children can occur due to isolated failure of one of three enzymes: lipase, trypsin, or amylase.
Lipase deficiency is characterized by the presence of diarrhea and stool. When diagnosing with a coprogram, a large amount of undigested fat in the feces is determined (steatorrhea). The amount of fecal elastase-1 is also reduced.
An isolated violation of amylase production is possible, which is characterized by the presence of diarrhea with undigested starch (amylorrhea). Trypsin deficiency is also possible, in which diarrhea occurs with protein inclusions (creatorrhea). Impaired absorption of protein leads to a decrease in its amount in the body (hypoproteinemia), which contributes to the development of massive edema.
This pathology, fortunately, is quite rare, but it is worth knowing and remembering it when diagnosing pancreatic problems in children.
Diet therapy
Special attention should be paid to diet in the treatment of pancreatic diseases. In the treatment of diseases of this organ, patients are recommended to use the following dishes:
- White bread;
- light soups on vegetable broth;
- low-fat types of meat: rabbit, chicken, turkey, low-fat pieces of beef, steamed, boiled or baked;
- any kind of vegetables, except fried;
- dairy products;
- vegetable fats - vegetable oil, a small amount of butter is allowed;
- no more than one egg per day;
- among sweets, only the use of fruits, compote, honey is allowed;
- among drinks should give preference to tea, a decoction of rose hips.
When correcting nutrition for problems with the pancreas, the use of such products is prohibited:
- fatty meat and fish;
- fried foods;
- smoked dishes;
- smoked meats and spices;
- pastries, sweets, chocolate;
- alcohol.
Compliance with this diet in combination with medication will help get rid of pancreatic problems!