Pancreatitis is a serious inflammatory disease of the pancreas. Nowadays, the number of people affected by this disease is steadily growing. Why? What are the causes of pancreatitis? What symptoms indicate its development? And how to treat this disease? This and much more will now be discussed.
Pathogenesis
Most often, the cause of pancreatitis lies in the human diet and in his lifestyle. In order for the proteins, fats and carbohydrates to be absorbed by the body, the presence of enzymes such as trypsin, lipase, etc. is necessary. But if a person is fond of junk food, abuse alcohol or actively takes certain drugs, the work of his pancreas is disrupted.
As a result, juice stagnates. This leads to disruption of the digestion of food. After another overeating, injury or poisoning, the iron becomes inflamed.
Pancreatitis is now more common. If 5-10 years ago this pathology affected people whose age exceeded 30 years, now it is diagnosed even in adolescents.
At risk are people prone to abuse of fatty foods, overeating and alcohol. These are the provoking factors that activate the production of specific enzymes in the pancreas. And this process becomes the cause of the development of inflammation.
Predisposing factors
They should also be listed. Since it is they who determine the cause of pancreatitis. All common predisposing factors can be identified in the following list:
- Damage to the peritoneal organs of a mechanical nature. Usually result from injuries.
- Alcohol abuse, especially low-quality. Intoxication is the leading cause of pancreatitis.
- Ailments of the biliary tract and liver.
- The use of estrogens, diuretics and antibiotics.
- Surgery.
- Exposure to industrial, food and household toxins.
- Overweight.
- Infectious or viral diseases.
- Problems of the cardiovascular system.
- Worms.
- Poisoning.
- Malignant neoplasms, narrowing of channels and other developmental abnormalities.
- Eating disorders (overeating, starvation, irregular regimen).
- Changes in the hormonal background.
- Hyperparathyroidism and other endocrine pathologies.
- Genetic predisposition.
It is important to make a reservation that in 25-35% of cases it is not possible to determine the cause of the onset of pancreatitis in patients.
Some statistics
All known factors provoking the onset of the disease were listed above. And here is what the statistics look like, taking into account the causes of the disease pancreatitis:
- 40% of patients suffer from alcoholism. In addition to the disease, they often reveal destructive disorders of the pancreas or its necrosis.
- 30% of patients previously suffered from gallstone disease.
- 20% of people are obese.
- 5% of patients had a history of intoxication, pancreatic injury, or long-term use of any drugs.
- Slightly less than 5% of people have a hereditary predisposition or some kind of congenital defect in the development of the organ.
Stages of development
They should also be considered, since we are talking about the causes of pancreatitis in women and men. It is customary to distinguish four stages:
- Pancreatic edema.
- Hemorrhagic phase.
- Pacreonecrosis.
- Cholecystitopancreatitis.
But this is not the only classification. There is still the principle of an owl. According to him, there are four phases, each of which lasts a certain time. These include:
- Enzymatic stage (3-5 days).
- Reactive (6-14 days).
- Sequestration stage (from 15 days).
- The outcome of the disease (over six months).
There is also a classification of Tolstoy A.D. It is based on pancreatic necrosis and its volume. Four stages are also distinguished:
- Interstitial or edematous pancreatitis. It is characterized by a mild course.
- Small focal fat necrosis. It is moderate in severity.
- Common necrosis with large foci and hemorrhagic syndrome. It’s hard.
- Subtotal and total pancreatic necrosis. At this stage, a large number of deaths are recorded.
Course of the disease
It is important to pay a little attention to this topic, since we are talking about the causes of pancreatitis in adults. The basis of the disease, as already could be understood, is the digestion of the pancreas itself, which is associated with excessive activity of phospholipase and lipase enzymes.
The development of the disease begins with edema. The pancreas is increasing in size. There is no pancreatic necrosis in the tissues, but cellular already appears. As a rule, girdle pain occurs in the right and left hypochondrium, as well as in the epigastric region.
When a person suffers from acute pancreatitis, the causes of which were described above, the discomfort becomes so unbearable that even loss of consciousness is possible. To reduce pain, some patients involuntarily tighten their legs to the stomach.
Indomitable vomiting also appears, which does not bring relief. And the field of emptying from the remnants of the consumed food leaves mucus, periodic with an admixture of bile and blood. Also mucous membranes, integuments turn pale. Sometimes cyanosis occurs. Gradually, tachycardia develops.
Often, patients are diagnosed with leukocytosis. Blood becomes thicker, an increased amount of amylase is observed.
Specific symptoms
In the early stage of chronic pancreatitis, the cause of which is one of the previously mentioned factors, there is a strong bloating. If you feel it, then the patient will have pain in the stomach. And the abdominal muscles will be tense at that moment.
Weakening of peristalsis is also noted. Approximately 50% of patients develop a Mayo-Robson symptom, characterized by pain that is localized in the region of the left rib-diaphragmatic angle.
At the 4th stage, the inflammatory process spreads to other tissues and organs. The following complications appear:
- Diseases of the cardiovascular system.
- Atelectasis of the lungs, respiratory failure, pleurisy.
- Toxic hepatitis.
- Hepatic and renal failure.
- Abscesses in the retroperitoneal region, peritonitis.
- Fistulas of the intestines, bleeding.
The release of enzymes accompanies necrosis of the omentum. Due to the entry of pancreatic juice into the bloodstream, blood pressure drops sharply. Even collapse is possible.
Chronic form
Something has already been said about the causes of the disease "pancreatitis", as well as the symptoms of the disease. It is necessary to make a reservation that its chronic form has features. And they deserve special attention. Here are three main signs characteristic of chronic pancreatitis:
- Change of stages of remission and exacerbation.
- Violations of the thyroid gland.
- Progressive course.
As a rule, the chronic form develops due to previous pancreatic necrosis. The ailment can be of the following forms:
- Cystic. It is accompanied by the formation of a pseudocyst.
- Fibrosclerotic or inductive. It is characterized by a gradual decrease in gland function.
- Fistulous. With this form, fistulas form in the tail, body, or head of the gland.
- Calculous. It is characterized by deposition of calcium salts in the tissue.
The chronic form of the disease is indicated by constantly increasing pain in the epigastric region, jaundice, fever, bloating, and diarrhea, which are replaced by constipation.
When a person's condition improves, remission sets in. But this is a very unstable stage. Exacerbation occurs as a result of any, even minor malnutrition. However, if you follow a diet and follow medical recommendations, remission will last for months, even years.
Diagnostics
Talking about the symptoms and causes of pancreatitis in adults, it is also necessary to tell how the diagnosis is made.
First of all, a gastroenterologist collects an anamnesis and takes into account the patient's complaints. Upon examination, the doctor pays attention to the skin, the appearance of the mucous membranes, and also necessarily palpates the abdomen. As a rule, the following deviations are observed:
- Pulsation of the abdominal aorta is absent.
- Frenicus is a positive symptom.
- Subcutaneous fat is thinned.
An analysis is also carried out to determine the presence of pancreatic enzymes, functional tests, biochemical studies of urine and blood. Of the instrumental techniques, ultrasound of the abdominal cavity is prescribed. CT scans can be given if complications occur.
Therapy
Having studied the symptoms and causes of pancreatitis, you can pay attention to the topic of treatment. The medication is prescribed by the doctor individually, this must be remembered. To relieve pain, for example, one of the following may be prescribed:
- H2 blockers. Help with persistent pain. This may be Famotidine or Ranitidine.
- M-anticholinergics. The best drugs are Chlorosil, Atropine, Metapin and Gastocepin.
- Antispasmodics. Medicines in this category include Sparex, Drotaverin, Spazmalgon, Maksigan, Fenikaberan, No-Shpa, and Duspatalin.
In addition, antienzyme therapy is prescribed, the purpose of which is to stop processes that destroy the pancreas. The drugs of this group include “Contrical”, “Gordox”, “Trazilol”, “Pantripin”, “Amidopyrine”, “Omez”, “Rabelok”, “Nexium”, “Omeprazole”.
To reduce the load on the pancreas, pancreatic enzymes are prescribed. Usually it is “Festal”, “Hermitage”, “Biozim”, “Penzital”, “Vigeratin”, “Pancreatin”, “Gastenorm”, “Mezim”, “Creon”. Taking these drugs also helps eliminate bloating, nausea, and upset stools.
Surgery
It is indicated if a person has pancreatitis in an advanced or severe stage. The operation is usually performed using laparoscopy.
After the intervention, the person will have to undergo antibiotic therapy. He is also prescribed other drugs, the purpose of which is to stop inflammatory processes.
If the doctor considers it necessary, then the intake of enzymatic medicines and dehydration therapy are prescribed.
Sanatorium treatment
It is highly recommended. At least 1-2 times a year, a person should visit sanatoriums and resorts where they treat the gastrointestinal tract.
The most popular type of therapy is the use of non-carbonated mineral water. As a rule, people suffering from pancreatitis visit the sanatoriums Truskavets, Morshin, Zheleznovodsk, Pyatigorsk and Kislovodsk.
Diet
It is also necessary to talk about proper nutrition, since we are talking about symptoms, causes and methods of treating pancreatitis.
Diet is the most important, main component of therapy. It aims to stop the production of pancreatic juice. Here are the basics of good nutrition:
- Dishes should be boiled, wiped and chopped.
- It is necessary to increase the amount of protein and carbohydrates consumed. Fats are introduced gradually, and not more than 70 g / day.
- Fiber and extractives must be removed from the diet. Because the meat is boiled in pieces of 100 grams, be sure to drain the first water.
- Salt should be a minimum (up to 6 g / day).
- You need to eat 5-6 times a day, fractionally, in small portions.
- Dishes with sokogonnym action (mushroom, fish, bone, meat broths) to exclude. Fried, spicy, salty, too greasy too.
- We must abandon alcohol, soda, coffee, cocoa. During remission, saline water is allowed.
What can I eat? Mucous soups, boiled cereals (oat, rice, semolina), mashed cereals, white crackers, compotes, vegetable juices, low-fat boiled meat and fish, some dairy products, boiled vegetables. The diet is strict, but the body will receive all the substances and vitamins necessary for it. A nutritionist will definitely give detailed recommendations and suggest an approximate diet.