Pancreatitis - how does it manifest itself? What to do with an attack of pancreatitis and its exacerbation?

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Pancreatitis - how does it manifest itself? What to do with an attack of pancreatitis and its exacerbation?
Pancreatitis - how does it manifest itself? What to do with an attack of pancreatitis and its exacerbation?
Anonim

What is pancreatitis?

Pancreatitis is an inflammation of the pancreas. The cause of pancreatitis is the blockage of the duct of the gland by stones from the gallbladder, a tumor or a cyst. In such a situation, the outflow of digestive juices with enzymes into the small intestine fails. These pancreatic enzymes accumulate over time and begin to affect the tissues of the gland itself. And the result is that the pancreas digests itself.

Such enzymes can destroy not only all tissues of the gland, but also nearby blood vessels and other organs. Death can result.

Causes of pancreatitis

pancreatitis
pancreatitis

The gland is influenced by both the diet of a person and his lifestyle in general. In order for carbohydrates, fats and proteins to be absorbed by the body, certain enzymes must be present in it, for example, lipase for the ability to absorb fats, trypsin for the absorption of proteins. When a person introduces into his diet products in which harmful substances predominate, or when he abuses alcohol, or when he is undergoing therapy with certain drugs, the work of the pancreas is disrupted. Such a slowdown leads to the fact that stagnation of juice occurs in the organ and in its ducts. The process of digestion of food fails, as a result, a person begins to suffer from inflammation of the gland - acute pancreatitis. It can be provoked by poisoning, overeating, trauma.

Inflammation of the pancreas alone is an extremely rare phenomenon, almost always other digestive organs are involved in this pathological process. The complexity of diagnosing her condition lies in the fact that it is located deep in the body and has a small size.

Scientists have identified a number of factors leading to the development of pancreatitis:

  • Diseases of the gallbladder and biliary tract. This is the most common cause of inflammation. The fact is that with the formed obstruction of the biliary tract and with the reflux of bile, the pancreas gives a pathological chemical reaction. It accumulates substances that stimulate the work of produced enzymes against the tissues of the organ itself. There is a gradual destruction of blood vessels, gland tissues swell strongly, hemorrhages appear in it. According to available data, pancreatitis due to disruption of the gallbladder and its pathways develops in 70% of cases (if we exclude the alcoholic nature of the disease). Other causes of inflammation of the gland, scientists refer to as idiopathic, that is, those that cannot be established.
  • Diseases of the duodenum and stomach. The release of intestinal contents into the ducts of the gland can occur with insufficiency of the sphincter of Oddi. This occurs in diseases such as: gastritis and ulcers, decreased motor activity of the duodenum or its inflammation.
  • Intoxication of various etiologies. Poisoning by alcohol, chemicals, food and even infection with worms - all this can lead to the formation of pancreatitis. In addition, the regular consumption of fruits and vegetables with pesticides, the inclusion of foods rich in chemical additives in the menu are harmful.
  • Increased blood pressure, arteriosclerosis, gestation period, diabetes mellitus. Any disease that leads to circulatory disorders causes it to fail in the pancreas. As a result, there is a violation of its nutrition and the formation of inflammation. During the bearing of a child, a lack of blood circulation occurs due to the pressure of the uterus on the vessels of the organs, contributing to the development of its ischemia. Therefore, all pregnant women are at increased risk for the development of pancreatitis.
  • Overeating. If the balance of fat metabolism is disturbed in the body, iron begins to produce enzymes in greater quantities. If disorders of fat metabolism become chronic, then the risk of developing inflammation of the organ increases significantly. It is especially dangerous to include fried and fatty foods in the menu.
  • Therapy and taking certain medications for this reason. The following drugs can negatively affect the work of the pancreas: Metronidazole, Furosemide, Azathioprine, Tetracycline, Estrogens, Glucocorticosteroids, Cholinesterase inhibitors, Thiazide diuretics, Sulfonamides and NSAIDs.
  • Injury to the organ. Operations on the duodenum and gallbladder, blunt abdominal trauma, and wounds can lead to inflammation.
  • Allergy. Some types of pancreatitis can be triggered by allergic reactions of the body. It begins to produce antibodies that are prone to auto-aggression. Similar processes occur with pancreatitis, when the gland destroys itself on its own. (Read also: Causes, symptoms and treatment of allergies)
  • Infections. Chicken pox, chronic tonsillitis, liver failure, hepatitis, mumps, inflammation of a purulent nature, with localization in the peritoneal cavity and outside it, dysentery and intestinal sepsis - all these infections can cause inflammation of the pancreas.
  • Genetic predisposition. Possible genetic disorders that provoke the development of the disease in early childhood.

Statistics of pancreatitis by causes of occurrence

  • 40% of all patients with pancreatic inflammation are alcoholics. They most often reveal either organ necrosis or its destructive disorders.
  • 30% of patients are patients with a history of cholelithiasis.
  • 20% of patients are obese patients. (See also: obesity: degrees of obesity and its causes)
  • 5% of patients are patients who have suffered an organ injury or intoxication of the body, taking medications.
  • Less than 5% of patients are patients with a hereditary predisposition to the formation of inflammation, or suffering from congenital defects in the development of the organ.

How does pancreatitis manifest?

How does pancreatitis manifest?
How does pancreatitis manifest?

Inflammation of the organ is accompanied by symptoms that echo those of serious poisoning. Enzymes, with pancreatitis, remain in the pancreatic ducts or in the organ itself and destroy it from the inside. In addition, they are absorbed into the blood, which leads to the development of intoxication of the body.

So, how does pancreatitis manifest itself? The following signs can be distinguished:

  • Severe pain always accompanies inflammation of the gland. They torment the patient on an ongoing basis, their character is cutting or dull. The pain can be so severe that it can provoke pain shock. The place of their localization is the right hypochondrium or the left hypochondrium, or an area located slightly below the median edge of the sternum. The exact location of the pain depends on which part of the organ is inflamed. If the entire gland is inflamed, then the pains are girdle.
  • Increase in body temperature, drop or increase in pressure. The more intense the inflammation, the worse the patient will feel. Body temperature rises to high values, blood pressure jumps are possible.
  • Change in skin color on the face. First, the facial features of the patient are sharpened. Secondly, the skin turns pale, and then completely becomes earthy gray.
  • The occurrence of vomiting. After the vomit comes out, the patient does not experience a feeling of relief. The masses themselves contain undigested food, and subsequently bile masses. In this regard, fasting is an important point in the treatment of inflammation, which lays the foundation for further successful recovery.
  • Nausea and hiccups. You may also experience belching and dry mouth.
  • The formation of constipation or the development of diarrhea. Most often, the acute phase is accompanied by the appearance of frothy, fetid stools, in which food particles are present. Constipation is often the first sign of the development of inflammation, in parallel, the patient experiences hardening of the abdominal muscles and bloating.
  • The appearance of shortness of breath. This symptom is formed due to the loss of electrolytes during vomiting. A person has sticky sweat, a large amount of yellow plaque forms on the tongue.
  • Bloating. Stopping the work of the intestines and stomach leads to bloating, which is diagnosed by the doctor when performing palpation.
  • The appearance of bluish spots. They occur mainly on the lower back and near the navel. At the same time, the skin seems to be marbled, and in the groin area it can turn blue-green. The reason for this condition is the penetration of blood from the inflamed organ under the skin.
  • Yellowing of the skin and sclera of the eyes. If sclerosing pancreatitis occurs, the patient develops obstructive jaundice. It is formed against the background of bile duct clamping by an inflamed organ.

If a patient shows signs of acute pancreatitis, his condition will deteriorate rapidly. Therefore, it is so important to seek medical help immediately.

The same signs that appear both in acute and in chronic (during exacerbations) forms of pancreatitis are acute, severe pain in the abdomen. Localization depends on which part of the pancreas is covered by the inflammatory process.

The main components of the pancreas are: head, body and tail. If the process began in the head of the gland, then acute pain occurs in the right hypochondrium, if the body is affected, then pain is noted in the epigastric region, and pain in the left hypochondrium indicates the development of inflammation in the tail. If the process covers the entire gland, then the pain syndrome is girdle in nature, it can radiate to the back, behind the sternum, to the shoulder blade.

Pain syndrome in acute inflammation of the pancreas is considered one of the strongest. Acute, sharp pain that occurs in the abdomen or in the hypochondrium tends to spread to the back, to the area of the shoulder blades and behind the sternum.

In the acute form, as a rule, stool disorders from diarrhea to constipation are noted. Most often, patients note mushy stools with impurities of undigested food, which has an unpleasant odor.

How does chronic pancreatitis manifest?

How does chronic pancreatitis manifest?
How does chronic pancreatitis manifest?

Chronic pancreatitis is accompanied not only by inflammation of the organ, but also by structural changes in its tissue. Experts argue that the most significant difference between the chronic form of the disease and the acute one is the progression of pathological changes in the organ even after the provocative factor has been eliminated. As a result, the patient experiences exogenous and endogenous insufficiency of the gland.

The initial period of chronic inflammation of the organ lasts, as a rule, up to several years. At the same time, the symptoms of the disease appear and disappear. The second period starts from the moment when the symptoms of the disease begin to haunt the person constantly.

  • For several decades, the patient can complain only of periodic pain that bothers him after a quarter of an hour from eating. The pain can last from an hour to several days. The place of their localization is the upper abdomen, sometimes pains are felt in the heart, or in the left side of the sternum or lower back. In some cases, the pain is excruciating in nature. You can reduce their intensity by leaning forward or sitting down.
  • Pain often does not occur spontaneously, but is the result of eating fatty, fried foods or alcohol. Chocolate or coffee can provoke an attack. If you eat several potentially dangerous foods at the same time, the pain can become unbearable. This is due to the fact that iron is not able to cope with various types of carbohydrates, fats and proteins at once. Therefore, those people who eat separately are less likely to suffer from pancreatitis.
  • A pain attack may be accompanied by diarrhea, nausea, vomiting, flatulence, a person may begin to lose weight. However, these symptoms do not always bother the patient, and even if you receive symptomatic therapy, you can quickly get rid of dyspeptic disorders and continue to lead a normal life, but until the next attack.
  • When pancreatitis becomes chronic and a person does not receive proper treatment, the structures of the organ are destroyed. There are signs of enzymatic and hormonal deficiency. Moreover, such people may not suffer from pain at all. The symptomatology of dyspeptic disorders prevails more often.
  • The skin of the patient becomes unexpressed yellowness. The same applies to the sclera. Yellowing of the skin periodically passes.
  • When an organ atrophies completely, a person develops diabetes mellitus. (Read also: Causes, signs and symptoms of diabetes)

The following types of chronic inflammation of the pancreas are based on the symptoms from which the patient suffers:

  • Asymptomatic inflammation - for years the patient does not even suspect that he has a problem;
  • Dyspeptic inflammation - the patient comes to the fore diarrhea, flatulence, weight loss;
  • Painful inflammation - the patient suffers from severe pain that occurs after eating and drinking alcohol;
  • Pseudotumor inflammation - symptoms are similar to those of pancreatic cancer, while the patient's skin and sclera turn yellow.

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What to do if you suspect chronic pancreatitis?

Passing through a full examination after visiting a gastroenterologist is the right thing to do for a person with suspected chronic inflammation of the organ.

Diagnosis is made after the following diagnostic procedures:

  • Change in the amount of elastase in the urine is the main method of laboratory examination of the patient;
  • Detection of steatorrhea - the presence of undigested fats in the feces;
  • Performing a diagnostic organ stimulation test;
  • Ultrasound;
  • Carrying out computed tomography according to indications;
  • Performing a blood glucose test and taking a glucose tolerance test.

If only ultrasound diagnostic data is used to make a diagnosis, it may be unreliable. Often, pancreatitis does not give any specific signs, and the specialist conducting the examination can detect only minor diffuse changes, or swelling of the organ. Although even these indicators are visible on ultrasound only with an exacerbation of the disease.

Diagnosis

Gastroenterologists are involved in the diagnosis of pancreatitis. The patient is examined, his complaints are listened to, the anamnesis is studied. During the initial appointment, blood pressure must be measured. With inflammation of the pancreas, it is often reduced, and the heartbeat, on the contrary, quickens.

To confirm the diagnosis, the patient is prescribed the following tests and procedures:

  • Complete blood test. With pancreatitis, all signs of an inflammatory reaction are found: ESR accelerates, the level of leukocytes rises.
  • Blood donation for biochemical analysis. This will reveal an increase in pancreatic enzymes such as lipase and amylase. Hyperglycemia and hypocalcemia are common.
  • Urine delivery to determine amylase activity in it.
  • Ultrasound of the pancreas is a fairly informative method in terms of detecting the disease. With its help, it will be possible to visualize the organ itself, the state of its parenchyma, and the size of the gland. In parallel, other organs of the digestive system (gall bladder, liver, spleen) are examined, which makes it possible to identify the cause of the development of pancreatitis.
  • If a detailed examination is required, the patient is referred for CT or MRI. As a rule, such a complex diagnosis is prescribed for patients with complicated pancreatitis.
  • Endoscopic retrograde cholangiopancreatography (ERCP) is prescribed for biliary-dependent pancreatitis. At the same time, a probe is inserted into the main bile duct, through which a contrast agent is supplied. Then take a picture on x-ray equipment. This technique allows assessing the patency of the smallest ducts, identifying stones in them, as well as other obstacles: strictures, kinks, adhesions.

Sometimes the symptoms of pancreatitis resemble those of other abdominal diseases.

Therefore, it is important to differentiate between disorders such as:

  • Appendicitis and cholecystitis in the acute phase.
  • Perforation of the intestine or stomach against the background of an ulcerative process.
  • Intestinal obstruction.
  • Internal bleeding.
  • Abdominal ischemic disease.

In general, the diagnosis of pancreatitis is not difficult, often the doctor can assume inflammation of the pancreas in a patient at the stage of questioning and examination.

Attack of pancreatitis - what to do?

Exacerbation of organ inflammation is a serious problem that can endanger not only he alth, but also the life of the patient. Treatment is carried out strictly in a hospital, as a person can die without timely received qualified assistance.

Pain and other symptoms of an attack of pancreatitis

An attack of pancreatitis
An attack of pancreatitis

The pain is intense, never ending. Appears in the abdomen, but can radiate to the back, lower back, under the shoulder blade. The nature of the sensations is dull or cutting.

Such a high intensity of pain is due to the abundance of nerve endings in the pancreas, which, when it becomes inflamed, are involved in the pathological process. A person during an attack can even experience pain shock.

Sharp dagger-like pain is a sign of destructive inflammation. Irritation of the peritoneum during stroking indicates its involvement in the process of inflammation. In this case, the pain recedes somewhat with pressure on the abdomen and intensifies when released. A person succeeds in lowering the pain threshold if he pulls his legs up to his stomach.

Loss of consciousness is the result of unbearable pain. If it does not tend to decline, and continues to grow, then this is an extremely dangerous symptom that indicates the manifestation of the process of destruction of the organ.

  • Pain occurs against the background of vomiting (first food, and then bile), flatulence and a complete lack of appetite.
  • Diarrhea has a fetid odor, undigested food is found in the masses. The stool is poorly washed off, as it contains a lot of fat. Constipation and diarrhea alternate, sometimes there may be no stool for a long time.
  • In the prone position, the pain gets worse. The forced posture of a patient with an attack is sitting, tilting forward.
  • Belching, hiccups, dry mouth.
  • Temperature rises, shortness of breath and chills appear.
  • The patient's tongue is coated with a whitish coating. After two days, the skin loses its elasticity, signs of beriberi develop, and weight loss occurs.
  • Blood pressure drops, skin becomes gray, severe weakness appears.

Since such symptoms can accompany not only pancreatitis, but also other pathologies of the digestive tract, the doctor should determine the problem. This can only be done on the basis of diagnostic data.

What to do with an attack of pancreatitis?

  • It is forbidden to take any food. And you should refrain from eating for 3 days. This must be done to stop the production of enzymes that increase the inflammatory response and pain. You can drink water without gas and additives.
  • Cold is applied to the epigastric region - this allows you to reduce the intensity of pain, slightly remove swelling and inflammation. It is best if a heating pad filled with cold water is used instead of ice.
  • The patient should be in bed and at rest. This will reduce blood flow to the diseased organ, which means it will reduce inflammation.
  • Allowed drugs for self-administration – No-shpa. You can drink before the ambulance arrives. Meanwhile, it is necessary to call doctors even if the patient is not sure that he has an attack of acute pancreatitis. After all, this pathology is dangerous because it can subside for a while, and then rapidly recur.

Especially often a rapid relapse occurs with organ necrosis. Therefore, it is so important for relatives that the patient (even despite his protests) undergo a comprehensive examination.

The three main words in the treatment of a patient with acute pancreatitis are Rest, cold and hunger. They are the rules of first aid for an attack.

The intake of any digestive enzymes can only intensify the pathological process. Proton pump blockers, in particular Rabeprazole and Omeprazole, can alleviate the condition.

If it is known that the patient was exposed to at least one of the inflammation provoking factors (alcohol intake, overeating, trauma, etc.) before the attack, then an ambulance should be called without delay.

Treatment methods

Medicated treatment

If you follow a strict diet, pain in the pancreas is practically not a concern, but if you just break it a little, you can’t do without painkillers.

  1. In case of severe pain in the area of the pancreas, the doctor may prescribe antispasmodics, they reduce inflammation and eliminate pain in the gland.
  2. If it is necessary to relieve not severe pain, then the doctor may prescribe antisecretory drugs for a short course.
  3. In addition, in the hospital, the doctor may prescribe a drug that inhibits the production of pancreatic hormones. Thanks to this drug, hormones stop stimulating the pancreas and the pain goes away.

If pancreatitis becomes chronic, normal gland cells are replaced by connective tissue. In this case, the functions of the pancreas are disrupted, and as a result, digestive problems will begin, up to diabetes mellitus.

! To relieve stress on the pancreas and reduce pain, you must definitely take digestive enzymes.

If pancreatitis has entered the chronic stage, then problems with the pancreas will be observed for a very long time. And then there is a risk of developing diabetes. If the patient has already been diagnosed with this disease, then you need to consult an endocrinologist for a diet and treatment.

Acute attack of pancreatitis is treated exclusively in a hospital setting. The patient is completely limited in food for several days. When a person is in the hospital, recovery is faster, as doctors have full control over what he eats and what medications he takes. If the patient feels sick or vomits, then a probe is inserted to remove air and fluid from the stomach. In case of deterioration of he alth, the patient will be provided with emergency assistance.

Treatment of chronic pancreatitis

In chronic pancreatitis during the remission of the disease, the patient is prescribed pancreatic drugs (pancreatin), which is unable to cope with its function in full.

Drugs are selected based on the data that will be obtained after a comprehensive examination of the patient. It is imperative that such patients carry out regular sampling of blood, feces and urine.

In addition to enzymes, the patient is shown taking drugs to normalize digestive processes, to enhance intestinal motility, to stabilize the acid-base balance in the stomach.

Be sure the patient is prescribed courses of vitamins A, C, K, E, D and group B, lipoic acid, cocarboxylase and other drugs.

The patient must follow a diet that involves the rejection of fatty and spicy foods, under a strict ban on any alcohol. When chronic pancreatitis worsens, the patient will have to fast for 1-2 days. He is allowed to drink water in small sips, or weak tea.

As a rule, after a course of treatment, the symptoms of pancreatitis disappear, but this does not mean that a person has completely got rid of the disease. The diet will always need to be observed in order to prevent a re-exacerbation of the pathology.

Prevention of pancreatitis

tablets
tablets

Treatment of an acute attack of pancreatitis is carried out only in a hospital, as the patient may require surgery. Several attacks of acute pancreatitis can lead to the manifestation of the chronic form of the disease. In this case, the diseased organ gradually destroys itself.

So preventing pancreatitis is the best way to avoid serious he alth problems:

  • Excessive physical activity, such as: exercising in the gym, running and jumping, visiting a bath, sauna - all this can lead to an exacerbation of the disease. The best option for physical activity is to perform therapeutic and breathing exercises and undergo massage courses.
  • Giving up bad habits (alcohol and smoking) will make it possible to reduce the burden on the body, which will achieve a stable remission.
  • Timely treatment of the pathology of the gallbladder and biliary tract. When stones have already formed in the bladder, they need to be removed as soon as possible.
  • You need to eat right, portions should not be large, but it is better to make approaches to the table more often. You should not use a lot of different foods at a time - the principle of fractional nutrition greatly facilitates the work of the body. It is necessary to avoid mixing carbohydrates and proteins - this is the most difficult combination for the gland. Unloading days will benefit the body. Useful simple food, cottage cheese and cereals.
  • Overeating is prohibited. In order not to load your body with excess food, just listen to it while eating.
  • Coffee is the unloved drink of the problem organ. It is better to either refuse to take it at all, or drink no more than a cup a day. A person inflicts particular harm on himself by taking a drink on an empty stomach. The real iron kick is instant coffee.
  • Sick body does not like foods containing coarse fiber, so vegetables are best baked or stewed. It is important to refuse not only fatty and fried foods, but also limit the intake of canned, s alty and smoked foods as much as possible. Citrus fruits are also subject to the restriction. It is useful to drink mineral water, include seafood and dairy products with a small percentage of fat in the menu.

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