Among the diseases of the digestive system, the leaders in the prevalence and frequency of detection are chronic pancreatitis and chronic cholecystitis. The physiological processes involving the pancreas and the hepatobiliary system are interconnected, therefore, these two ailments in most clinical cases accompany each other. Moreover, they have similar symptoms. Treatment of chronic pancreatitis and cholecystitis is carried out simultaneously.
Why does two diseases arise at once?
Most often, the primary of these two ailments is precisely inflammation of the gallbladder. The development of cholecystitis, as a rule, is promoted by cholelithiasis, as a result of which bile ducts are clogged and an obstacle to the normal outflow of bile is created. Its stagnation causes inflammation. A complication of cholecystitis can lead to the development of hepatic hepatosis.
The likelihood that pancreatic inflammation will occur against the background of cholecystitis is quite high, especially if no measures are taken to treat this disease. In addition, the risk of pancreatic cancer is increased in the presence of a history of diseases such as:
- gastritis;
- colitis;
- duodenitis and gastroduodenitis;
- hepatitis;
- diabetes.
In a predominant number of cases, the development of acute and chronic inflammation of the pancreas occurs against the background of existing cholecystitis. The essence of this phenomenon is as follows: bile is thrown into the organ parenchyma, which provokes a violation of the blood circulation processes, promotes swelling, and in severe cases leads to purulent lesion and necrosis of the gland tissue.
If chronic pancreatitis and chronic cholecystitis develop simultaneously, then inflammation of the pancreas is called biliary-dependent. Calcinates, which are formed during cholelithiasis, lead to the calculous stage of pancreatitis, which is an indication for surgical treatment.
Causes of pathologies of the digestive system
There are several factors that play an important role in the formation of chronic cholecystitis and chronic pancreatitis, as an associated pathology. As a rule, these diseases develop against the background of:
- endocrine system dysfunctions;
- hormonal adjustment;
- hereditary predisposition;
- sedentary lifestyle, sedentary work;
- unbalanced diet and improper diet;
- the prevalence of fatty, spicy foods, smoked meats, spices, sweets in the diet;
- alcohol abuse.
Problems with the pancreas and bile often occur in pregnant women for no apparent reason. In addition, symptoms of chronic pancreatitis and cholecystitis can be observed after a severe infectious disease.
Clinical picture
As already noted above, the main symptom of chronic cholecystitis and pancreatitis is pain in the abdomen, which can radiate under the scapula, in the lumbar region, in the epigastrium. In addition, other diseases are characteristic of these diseases:
- frequent flatulence;
- stool disorder, manifested by constipation or diarrhea;
- frequent burping after eating;
- nausea and vomiting;
- fever.
Despite the fact that most often these two diseases occur simultaneously, it makes sense to familiarize yourself with the symptoms characteristic of each of them. So, for example, for chronic pancreatic inflammation at the stage of exacerbation, the following manifestations are typical:
- acute girdle pain on the left side under the rib;
- severe nausea with intense vomiting, after which there is no relief and vomiting does not stop;
- heart rhythm disturbance, tachycardia;
- stool contains pieces of undigested food;
- severe bloating, flatulence;
- increase in blood pressure;
- dry mouth;
- high body temperature;
- pale bluish skin integument;
- diarrhea, alternating with constipation.
Specific symptoms of gallbladder inflammation include frequent pain in the right hypochondrium of a cramping nature. With exacerbation of cholecystitis, body temperature can also rise, a taste of bitterness or metal in the mouth may occur. If the patient develops vomiting, the masses contain impurities of bile. Patients suffering from chronic cholecystitis complain of constant bloating, constipation or diarrhea, the appearance of a tendency to allergic reactions. In complicated forms of the disease, appetite worsens and body weight decreases.
Similarities and differences between diseases
With exacerbation, chronic cholecystitis and pancreatitis have many similar symptoms. It is impossible to independently determine which of these two diseases takes place, or they occur parallel to each other. In addition, even experienced gastroenterologists will not be able to make an accurate diagnosis without having the results of a preliminary examination of the patient. Common signs of chronic pancreatitis and cholecystitis during relapse are:
- nausea and vomiting;
- severe pain syndrome;
- high body temperature;
- intense sweating.
The difference between these two diseases is the localization of pain. On the right side, it often hurts with chronic cholecystitis. Exacerbation of pancreatitis is manifested by girdle or severe pain on the left. Another distinguishing feature is how these two pathologies are reflected in the state of the oral cavity. With inflammation of the pancreas, patients note the presence of constant dry mouth, and with cholecystitis, the patient often has an aftertaste of bitterness.
A person who does not have a specialized medical education is not always able to objectively assess the whole danger of the symptoms that appear and the degree of possible complications. If the above symptoms have become permanent, you should consult a doctor. The gastroenterologist will determine which of the diseases or both of them are taking place, give a referral for an appropriate examination, make a diagnosis and prescribe treatment.
Diagnostic Features
The joint course of pancreatic disease and cholecystitis is called by doctors as cholecystopancreatitis. To make an accurate diagnosis, the patient is prescribed several laboratory tests and functional studies, of which the primary ones are:
- Ultrasound of the abdominal cavity is the simplest and most affordable method of non-invasive imaging of the pancreas and gall bladder. Screening allows you to evaluate the structure of the organ parenchyma and determine if calculi are present in the cavity of the bladder and biliary tract.
- Laparoscopy is a type of endoscopic surgical procedure that allows, with minimal invasiveness, to determine the degree of damage to the abdominal organs.
In addition, differential diagnosis of chronic pancreatitis and chronic cholecystitis will be required to exclude other gastrointestinal diseases. For this, the patient passes:
- general and biochemical blood tests;
- general analysis of urine and sugar;
- fecal examination for coprology.
You will also need to undergo esophagogastroduodenoscopy, necessary to assess the condition of the mucous membranes of the upper gastrointestinal tract. Other diagnostic procedures are also possible, which depends on the severity of the disease, the individual characteristics of the body.
Tactics of combined treatment of pancreatitis and cholecystitis
Since the pancreas and gall bladder are interrelated organs of the digestive system, the treatment of chronic pancreatitis and cholecystitis with drugs is carried out comprehensively. In addition to medicines, patients who are diagnosed with these diseases are also recommended to undergo a course of physiotherapy and maintain the performance of diseased organs during remission with folk remedies.
The main role in the treatment of these diseases belongs to a properly composed diet. Without a special diet, neither medicines, nor home medicines, nor physiotherapy will bring long-awaited relief. The treatment for exacerbation of chronic pancreatitis and cholecystitis is based on complete rest and hunger for several days.
In case of a relapsed relapse of the disease, patients may require emergency surgical intervention. With the manifestation of severe pain, uncontrolled vomiting with bile, it is urgent to call an ambulance, and not wait until the relief comes on its own.
Effective drugs
As already mentioned, the selection of medications should be carried out by the attending physician. Self-medication can lead to serious and irreversible consequences, aggravate the overall picture of the disease and worsen the patient's condition. With exacerbation of inflammation of the pancreas and gall bladder, patients are prescribed:
- Antibacterial drugs. They are used to reduce the risk of developing septic complications with bile congestion (Ampicillin, Oxamp, Cefazolin, Kefzol, Ciprofloxacin, Metronidazole).
- Inhibitors of proteolytic enzymes. They are necessary for improving the functioning of the pancreas (Contrikal, Gordoks).
- Proton pump inhibitors to reduce gastric secretion (Omeprazole, Cimetin, Pantoprazole, Omez, Nolpaza).
- Preparations for the restoration of metabolic processes (Pentoxyl, Methyluracil).
- Antispasmodics and painkillers (No-shpa, Meteospasmil, Papaverin, Spazmalgon, Galidor, Buskopan).
- Enzyme-containing drugs to improve digestive processes (Pancreatin, Festal).
A spa stay during the period of disease remission will be especially useful for patients. In chronic pancreatitis and chronic cholecystitis, it is recommended to undergo a preventive examination and a course of maintenance therapy annually in order to prevent relapse.
Healing procedures
Before treating chronic cholecystitis and pancreatitis with physiotherapy, you need to make sure that there are no contraindications. Typically, such procedures are not prescribed to patients who have suffered serious cardiovascular and neurological diseases. Among the types of physiotherapy that are actively used in the treatment of chronic cholecystitis and pancreatitis, it is worth noting:
- electrophoresis;
- shock wave therapy.
The course of procedures contributes to the speedy relief and achievement of remission. It is impossible to eliminate the diseases in question forever, but thanks to physiotherapy, patients feel better by increasing the efficiency of the affected organs, in particular:
- there is an increase in the volume of produced bile;
- blood circulation is normalized;
- pains subside;
- general inflammation is removed;
- formation of calcifications is prevented.
Many physiotherapists note that therapeutic mud can bring great benefits to patients with these diseases.
Power Features
As already noted, it is impossible to stop the development of the inflammatory process without following a special diet. Proper nutrition in chronic pancreatitis and cholecystitis is the key to the longest possible remission and prevention of exacerbation. In order to establish digestive processes and achieve improvement in their own well-being, patients should follow a few simple rules.
First, you need to eat fractionally. During the first week of treatment, food should be taken in small portions (no more than 200-300 g) every 2 hours. Secondly, in case of chronic pancreatitis and cholecystitis, the menu should not include the following products:
- canned food;
- sausages;
- fast food and convenience foods;
- smoked meats;
- alcohol;
- fried and fatty dishes.
You need to drink as much liquid as possible (about 2 liters per day), with preference being given to non-carbonated or mineral water “Borjomi”, “Essentuki”, green tea or herbal decoctions of chamomile and rosehip, kissel, but it is better to refuse black tea and coffee . Spices, spices, spicy foods will not benefit. A permanent place in the daily menu of a person who suffers from chronic pancreatitis or cholecystitis should be occupied by baked vegetables, apples, dairy products, cereal cereals, soups on light meat broth.
When is surgery necessary?
The decision to conduct surgery is made by the doctor only if there are good reasons. The reason for surgical treatment is the accumulation of calculi in the cavity of the gallbladder, which cannot be split or removed by a conservative method. If the study confirmed that calcifications blocked the bile ducts or the patient developed a purulent necrotic process in the pancreatic parenchyma, the patient is urgently prepared for surgery.
Folk remedies in the treatment of chronic diseases
The use of alternative therapy methods will not help the patient who is indicated for the operation, but on the other hand, natural remedies can serve as a good basis for the prevention of exacerbations of pancreatitis and cholecystitis. Among the recipes that are popular with users, it is worth noting several of the most effective:
- Gruel from fresh cabbage leaf - has a choleretic effect, helps to improve intestinal motility.
- Celandine tincture - 10-15 drops of tincture are required for half a glass of water. Helps relieve inflammation and pain, helps restore digestive tract tissue.
- A decoction of oats - relieves general inflammation and normalizes metabolic processes in the body.
Anti-inflammatory effect is also exerted by tinctures from propolis, mint, calendula, yarrow, wormwood. The possibility of using folk remedies should consult a doctor.