Medications for the treatment of pancreas withchronic pancreatitis

Update: November 2018

Pancreatitis is an inflammation of the pancreas. Disease
may occur in both acute and chronic form.
Accompanied by pain and dysfunction, and not only
pancreas, but also closely related organs:
liver, gallbladder, intestines.

In acute pancreatitis, the clinical picture is always bright.
severe, and the treatment is only inpatient. Aggravation
chronic process also sometimes requires hospitalization. But
The main group of patients with chronic pancreatitis is treated at home.
It is important to know the main groups and specific medications for
pancreas, for what they are assigned and how to properly
take.

Is it possible to treat the pancreas independently?

Mild and moderate exacerbation of chronic pancreatitis
can be treated at home in the following cases:

  • You have been fully examined in the last 1-2 years and others.
    diseases excluded (for example, tumors, gallbladder stones,
    peptic ulcer disease).
  • Similar symptoms of exacerbation are well known to you and nothing
    different from the past.
  • You have previous doctor recommendations.
  • Aggravation нетяжелое, без рвоты, без выраженной диареи.
  • Within a few days of treatment, note improvement.

Principles of treatment of chronic pancreatitis

  1. Diet with the exception of fatty foods, smoked, rich
    broths, canned food. Such a restriction in diseases of the pancreas
    glands are respected for life. When exacerbated by several days
    hunger is prescribed, and then low-fat diets
    inflammation.
  2. Waiver of alcohol and smoking.
  3. Уменьшение pains.
  4. Reduced secretion of digestive juices during exacerbation
    pancreas.
  5. Reception of enzymes in tablets to support the processes
    digestion.
  6. Removal of spasms and normalization of intestinal motility.
  7. Reception of vitamins and minerals, as their absorption from food at
    pancreatitis is disturbed.
  8. Medicines to restore the intestinal flora.
  9. Treatment of diabetes, which can be a complication
    острого или хронического pancreatitis.

See Symptoms of Pancreatitis, What You Can Eat with Pancreatitis,
Панкреонекроз поджелудочной железы, Причины развития
pancreatitis

Treatment of pancreatitis is complex, depends on the symptoms. Not
universal “good pills from the pancreas.” Disease
may proceed in different ways. One will have pain and he needs
pain medicine, another has impaired absorption and
digestion, and he needs more enzyme preparations. Someone
both pain and diarrhea are possible, against this background – losing weight and
exhaustion.

The main groups of drugs used for pancreatitis

Pain relievers

The main symptom that torments a person during exacerbation
pancreatitis – это боль. What pills to take if it hurts
pancreas?

  • The main anesthetic drug that can be taken with
    воспалении этого органа – Paracetamol (он наименее
    safe for gastric mucosa). Paracetamol
    1-2 tablets are taken 3-4 times a day 30 minutes before taking
    food. However, it is carefully prescribed with concomitant
    liver pathology.
  • It is also possible to use short courses and other
    ненаркотических анальгетиков –  Спазган, Баралгин,
    Ketanov, Ibuprofen, Nimesulide.
    There are studies
    confirming the increased analgesic effect of these drugs in
    sharing them with multivitamin complexes, as well as with
    антидепрессантами (амитриптиллином).

Pain medication should not be taken more than 10
days 

  • Применяются также спазмолитики – But-шпа, Бускопан,
    Mebeverin, Duspatalin, Papaverin.
    They relieve spasm
    bile ducts, intestines, thereby reducing the pressure in
    просвете кишки.
  • The more acidic content enters the stomach from the 12-pinta
    the gut, the more activated the secretion in the pancreas.
    Accordingly, drugs that inhibit the secretion of hydrochloric acid,
    indirectly also relieve pain. These drugs include
    блокаторы Н2-рецепторов Ранитидин, Фамотидин, а
    также ингибиторы протонной помпы Омепразол (Омез, Лосек,
    Ультоп), Рабепразол (Париет), Пантопразол (Butльпаза, Контралок),
    Esomeprazole (Nexium).
  • Sometimes used antisecretory drug
    Даларгин для внутримышечного или внутривенного
    введения.
  • Антацидные средства – Фосфалюгель, Маалокс
    also reduce the acidity of gastric juice. Apply them after 40
    minutes after meals and before bedtime.

Enzymes

The pancreas is the most active gland of ours.
organism. It produces 1.5-2 liters of pancreatic per day.
juice with a content of 10-20 grams of digestive enzymes.
Chronic inflammation almost always leads to a decrease in
their quantity, which affects the digestion of food (mainly
fat).

Undigested food residues are not absorbed in the intestines, cause
it is fermented, bloated, diarrhea (malabsorption syndrome). Swollen
bowel loops further aggravate abdominal pain, impaired
absorption leads to weight loss, anemia and hypovitaminosis.

Therefore, the main drugs for pancreatitis during exacerbation –
these are enzymes that help normal digestion and
absorption of food. Indirectly they also reduce pain,
normalize stools, prevent exhaustion and promote absorption
vitamins and minerals in the intestines.

Ферментные препараты  выпускаются как в виде таблеток, так
and in the form of capsules. Each form has its advantages and disadvantages.
A list of pills that contain digestive enzymes,
big. They all contain amylase, lipase and protease in various
dosages, plus other additives.

  • The cheapest enzyme preparation is our domestic
    Pancreatin. But with a stretch it can be called
    cure for pancreatitis since it has a low concentration
    active enzymes (in terms of lipase – about 3 thousand U). Him
    more used with errors in the diet. Of the benefits – low
    cost (starting from 30 rubles).
  • Аналог панкреатина – Мезим. Activity – about
    3500 МЕ липазы. Cost – about 100 rubles per
    pack of 20 tablets.
  • Пензитал (около 6000 ЕД липазы). Price – from 170
    rubles.
  • Энзистал П (3500 ЕД). Цена от 70 rubles.
  • Панзим форте (3500 ЕД). Price from 160 rubles for
    20 tablets.

If we talk about the right treatment, then when it hurts
pancreas, medication must be chosen with greater
enzyme concentration. Orientation is mainly content
lipase. For normal replacement therapy you need at least
25,000-40000 IU of lipase at the main meal and about 10 thousand IU per
extra snacks.

  • The most famous pancreas tablets with enhanced
    активностью – это Мезим–форте 10,000, 20000. Цены
    these drugs start at 200 rubles per pack of 20
    pills.

The most effective enzyme drugs today
day are considered drugs of pancreatin in the form of microtablets,
minimicrospheres or microplates enclosed in a gelatin capsule
(IV generation). The diameter of the pancreatin particles in such a capsule is not
more than 2 mm. The shell itself is not dissolved in the stomach, but in
duodenum, the particles are evenly mixed with food,
The effect of this form of application of enzymes is maximum.

The most popular capsulated pancreatin preparations and their
cost:

Tradename Lipase activity, IU

Price per pack of 20 capsules

(average)

Price per 10 thousand units of lipase
Creon 10,000 300 r 15 r
Creon 25,000 600 r 12 r
Hermital 10,000 175 r 8.75 p
Hermital 25,000 325 r 6.5 r
Panzinorm Forte 10,000 125 r 6.25 p
Mikrasim 10,000 250 r 12.5 p
Mikrasim 25,000 460 r 9,2 r

Самым дорогим препаратом из этой серии является Creon, самым
cheap – Panzinorm.

When the pancreas hurts, pancreatin preparations
taken during or immediately after a meal. The course of treatment is from 1 to
3 months. In the future, you can drink pills for any violations.
diets. Often medication is given for life.

It should be noted that when pancreatitis is NOT
ПРИНИМАЮТСЯ ферментные препараты, содержащие компоненты желчи
– Festal, Digestal, Enzistal, as they can cause an increase
pains.

Approximate scheme of treatment of exacerbation of pancreatitis

  1. Diet with pancreatitis. Waiver of alcohol and smoking.
  2. Creon 25,000 Х 3 раза в день на основной прием пищи, 10,000 Х 3
    times for snack 12 weeks.
  3. Omeprazole 20 mgX2 times a day for 4 weeks, then 20 mg in the morning 2
    of the week.
  4. Mebeverin 200 mgX2 times a day for 6 weeks.
  5. When pain – Paracetamol 500 – 1000 mg X3 times a day for 30
    minutes to eat 7 days.

Preparations for the restoration of intestinal microflora

Violation of the ratio of normal and pathogenic bacteria in
intestines observed in almost all patients with chronic
pancreatitis. This is explained by the lack of secretion of enzymes,
increased fermentation processes, which creates a favorable environment for
reproduction of pathogenic microflora.

To eliminate this phenomenon, sometimes appointed:

  • Кишечные антибиотики: Энтерофурил
    (Стоп-диар), Рифаксимин (Альфанормикс).
    Или Ципрофлоксацин, курсом до 7 days
  • Then – probiotics and prebiotics, containing normal beneficial
    bacteria. К ним относятся: Бактистатин, Энтерол,
    Линекс, Бифиформ, Флористин, Butрмобакт
    и пр. Принимаются
    during or after meals with courses up to 3 weeks.

Treatment of acute pancreatitis

If the pancreas is acutely inflamed, medications for
ingestion will not help. It is necessary inpatient treatment.
The patient will be assigned to:

  • Intravenous infusion of saline solutions.
  • Pain relief up to narcotic analgesics.
  • Proteolytic enzyme blockers – Gordox, Contrycal.
  • Octreotide is a medicine for suppressing gland secretion.
  • Antibiotics.
  • Antiemetics.
  • Operation if conservative measures turn out to be
    ineffective.

Phytotherapy pancreatitis

It is known that some plants contain ingredients that help
in the treatment of many diseases. Diseases of the gastrointestinal tract
Since ancient times they have been treated with folk drugs, and healers sought
quite good success. With the rapid development of chemical pharmacology
interest in traditional medicine has faded somewhat. But let’s not forget
that the healing properties of plants have not gone away, and herbal remedies
may be of great help in the treatment of gastrointestinal ailments, including
including and pancreatitis.

Herbal broths can hardly cure exacerbation
pancreas, but here’s a decrease in the number taken
medications they can.

The main properties of medicinal plants required in the treatment
pancreatitis:

  • Antispasmodic (mint, calamus, marjoram).
  • Anti-inflammatory (calendula, plantain, yarrow,
    chamomile, aloe).
  • Improving digestion (chicory, immortelle, tansy, leaves
    birch).
  • Enveloping and protecting the mucous membrane (flax seeds, decoction
    oats).

An example of the most versatile herbal collection used in
acute period:

  • Смешать в равных частях  ромашку, мяту, зверобой, репешок
    (grass) plantain.
  • 1 tablespoon of the mixture pour 0.5 liter of boiling water, hold on
    water bath.
  • Drink 1/4 cup every hour for 2 days, then –
    1/3 cup 3 times 15 minutes before meals. The course is 10 days.

In chronic pancreatitis:

  • Then you can take calamus, immortelle, St. John’s wort, calendula, sheet
    burdock, yarrow, raspberry leaf, mint, plantain. Infusion
    cooked like the previous one. Take half a cup three times a
    the day before meals and overnight.
  • 2 tablespoons chopped dry chicory herb pour 500 ml
    water, bring to a boil, strain. Drink ½ cup 3 times a
    day month.
  • Non-melted natural honey contains many natural enzymes.
    It is useful to add a teaspoon of honey in a non-hot infusion of herbs, so
    as in hot water (above 40 degrees) the enzymes are inactivated.
  • In the period of exacerbation it is useful to drink blueberry or green tea,
    dogrose infusion, decoction of the leaves of the beans.

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