Symptoms of pancreatitis, treatment, causes of attackspancreatitis

Update: November 2018

Панкреатит — это inспалительно-дегенеративный процесс в
pancreas. Every year a growing number of people suffer
pancreatitis. The symptoms and treatment of this disease directly depend on
остроты inспалительного процесса, степени выраженности поражения
pancreas.

Основными жертвами pancreatitis чаще всего становятся люди,
prone to overeating, lovers of fatty foods, alcohol. Under
действием определенных проinцирующих факторов в поджелудочной
gland activates the production of proteolytic enzymes that
вызывает inспалительные процессы.

Withчины inзникновения pancreatitis

Most often, a person suffering from pancreatitis exists
несколько факторов, способстinвавших его развитию, которые стоит
установить и по inзможности устранить. 98% of all occurrences
острого pancreatitis связаны либо со злоупотреблением алкоголя, либо
with gallstone disease. Underробности патологических процессов,
происходящих в поджелудочной железе при inспалении, а также
дополнительные факторы риска развития pancreatitis читайте в статье
Withчины pancreatitis.

Симптомы острого pancreatitis

Underжелудочная железа — не очень крупный орган, однако, она
performs the most important functions in the human body, the most important of
which – the secretion of food enzymes for normal digestion and
выработка инсулина, дефицит которого приinдит к такому серьезному
disease like diabetes. Что происходит при inспалении
glands? В период  острого pancreatitis, симптомы развиваются
as with severe poisoning. Pancreatic enzymes
gland, linger in it or its ducts, and begin to destroy
the gland itself, and when entering the bloodstream cause symptoms
intoxication:

Панкреатит

Fast food is one of the main enemies of the pancreas.

  • Боль. This is the most pronounced symptom, pain with
    pancreatitis is usually very intense, persistent, painful nature
    sensations described by patients as cutting, dull. With
    несinевременном оказании медицинской помощи и снятию боли у
    пациента может произойти болеinй шок. Localized pain under
    spoon, hypochondrium, either to the right or to the left, depending on
    места поражения железы, в случае, когда inспаляется весь орган, то
    pain is shingles.
  • High, low or high
    pressure.
    With стремительном развитии inспалительного
    process, the patient’s well-being deteriorates rapidly, can rise
    temperature to high numbers, as well as decrease or rise
    артериальное pressure.
  • Цвет лица. With панкреатите у больного
    facial features are sharpened, the skin becomes pale first,
    gradually the complexion acquires a grayish-earthy hue.
  • Hiccups, nausea. Also панкреатиту сinйственны
    такие симптомы, как сухость in рту, икота, отрыжка и тошнота.
  • Рinта. Withступы рinты с желчью не приносят
    relief patient. Therefore, at the beginning of the acute period about any
    приеме пищи речи не идет, голодание в случае острого pancreatitis
    is the main condition for successful further treatment.
  • Диарея или запор. Chair for acute pancreatitis
    чаще всего пенистый, частый со злоinнным запахом, с частицами не
    digested food. Рinта может быть и съеденной пищей (когда рвет
    gastric contents at the beginning of the attack), then bile appears from
    12 duodenal ulcer. However, there are vice versa constipation, bloating,
    затвердение мышц жиinта, что может быть самым первым сигналом
    начинающегося острого приступа pancreatitis.
  • Dyspnea. Dyspnea is also caused by loss
    электролитов при рinте. The patient is worried about constant shortness of breath,
    sticky sweat, a profuse yellow bloom appears on the tongue.
  • Вздутие жиinта. Желудок и кишечник in время
    attacks are not reduced, so when examined, the doctor determines
    сильное вздутие жиinта, при пальпации не определяется напряжение
    мышц жиinта.
  • Синюшность кожи. Around the navel or lower back
    may appear bluish spots, giving the skin marble
    hue, in the groin area, the skin color may become blue-green
    shade. Это объясняется тем, что из inспаленной железы кровь может
    проникать под кожу жиinта.
  • Yellowness of sclera, skin. With склерозирующей
    форме pancreatitis может inзникнуть механическая желтуха, которая
    appears due to squeezing of part of the common bile duct
    compacted gland tissue.
  • With таких симптомах pancreatitis у человека с каждой минутой
    the condition worsens, it is impossible to delay in such cases and should
    call an ambulance as soon as possible.

Лечение острого pancreatitis

With остром панкреатите лечение inзможно только в условиях
hospital, under the supervision of qualified professionals, it
considered a very dangerous condition. With подозрении на острый
pancreatitis should be urgently called an ambulance and a person should
urgent hospitalization.

Иногда несinевременное оказание медицинской помощи может стоить
man of life. First aid that can be given to a person with
приступом pancreatitis, симптомы которого очевидны, заключается в
прикладывании холода на жиinт, приеме спазмолитика — На-шпа,
Papaverine, and also refusal from taking any food and bed rest until
Arrival Ambulance.

The main 3 whales on which the treatment of acute pancreatitis is based:
HUNGER, COLD AND REST

Emergency assistance provided in the ambulance:

  • vein puncture, drip with saline
  • antiemetic – metoclopramide (cerucal) 10 mg
  • pain reliever – ketorolac
  • антисекреторное — октреотид (сандостатин) 250 мг  или
    Kvamatel (omeprazole) 40 mg

In the conditions of a hospital usually spend:

  • In the hospital intravenous sodium chloride (saline),
    reopoliglyukin + kontrakal
  • Use diuretic drugs, they prevent swelling
    pancreas, and also contribute to the removal of enzymes from the blood,
    toxins from the body. From diuretic or furosemide (lasix) during
    the time of infusion therapy (into the gum after the drip) or Diacarb
    in tablets under the guise of potassium preparations.
  • Omeprazole 80 mg per day, there are forms for intravenous administration
    during dropper – Kvamatel.
  • Antispasmodics – Drotaverine hydrochloride, no-spa
  • With persistent vomiting – metoclopramide intramuscularly
  • For pain – painkillers
  • For severe or purulent pancreatitis, antibiotics
    (3-4 generation cephalosporins or fluoroquinolones).
  • In the acute period, enzyme inhibitors are shown (contrycal and
    gordox).
  • Vitamin therapy is also included in the complex maintenance.
    a weakened body, especially indicated are vitamin C and vitamins
    Group B.
  • For 4-5 days, the patient is assigned hunger and drinking warm water without
    gases. With severe pancreatitis, when starving for several weeks
    shown parenteral nutrition (protein injected intravenously
    hydrolysates and fat emulsions if blood cholesterol in
    normal).
  • Only after this time the patient is allowed to receive
    food, at first you can drink only yogurt, gradually adding to
    menu cottage cheese and after 3-4 days, the patient can gradually take
    diet food on a special diet 5P.

Surgical treatment is indicated for suspected destructive
pancreatitis and with signs of inflammation of the peritoneum, as well as with
the ineffectiveness of conservative therapy.

In this case, laparascopy is indicated when a liquid is suspected
abdominal or signs of peritonitis. It is also performed for
differential diagnosis of acute pancreatitis with other
diseases.

Laparatomy (wide operating access with dissection from
sternum to groin) is carried out when previously performed operational
interventions on the abdomen, ventral hernia, unstable
blood circulation (shock).

Symptoms and signs of chronic pancreatitis

Хронический панкреатит считается  преимущественно
inflammatory disease of the pancreas, in which
structural changes occur in the tissue of the organ. Most
researchers believe that the hallmark of chronic
pancreatitis is that after eliminating the action
provoking factors, pathological changes in the gland not only
persist, but continue to progress functional
morphological disorders of the gland. With этом  формируется
exogenous and endogenous failure of this organ.

In the occurrence of chronic pancreatitis are determined by two
period, the initial – which can last for years and then manifest
characteristic symptoms, then subside, and the period – when
violations, damage to the pancreas are pronounced
character and disturb the person constantly.

  • In the period of onset of the disease, which usually lasts
    For decades, a person experiences only recurrent pain.
    sensations that occur 15 minutes after eating and last from
    several hours to several days. Pain is localized most often
    in the upper abdomen, sometimes in the heart, in the left side
    chest, left in the lumbar region, can also be
    shingles. Its intensity decreases when
    the man leans forward when sitting.
  • Basically, the appearance of characteristic pain provoked by excessive
    eating fatty, fried foods, alcohol, or abundance
    carbonated drinks, as well as chocolate, coffee. Worst of all
    account for a person if there has been a large number of
    different dishes at the same time. Pancreas hard to handle
    with different types of proteins, fats and carbohydrates. Therefore, people
    sticking to the principles of separate food less exposed
    pancreas diseases.
  • When pain can also be dyspepsia, such
    like vomiting, nausea, chronic diarrhea, bloating, weight loss.
    However, this is not always the case, and pain and dyspepsia with adequate
    symptomatic treatment of pass, the function of the gland to produce
    enzymes are not greatly disturbed and the patient continues calm
    life, until the next overeating or failure.
  • In the case of long-term existence of chronic pancreatitis
    the structure of the gland tissue begins to break down, production is reduced
    ферментов  и гормонов, постепенно формируется секреторная
    failure. In this case, pain may be absent
    completely, or be mild, and dyspepsia is rather the opposite,
    becomes the predominant symptom of chronic pancreatitis with
    secretory insufficiency.
  • Also for chronic pancreatitis is characterized by a slight
    yellowness of the skin, sclera, it is not at all and can also
    periodically disappear.
  • In the advanced stages of pancreatitis, when the iron begins
    to atrophy, diabetes can develop.

Based on various symptomatic complexes that
patients with chronic pancreatitis are tested, several
types of disease:

  • Dyspeptic appearance – in this form of patient pancreatitis
    suffers from chronic diarrhea, bloating, weight loss
    body.
  • Asymptomatic form – this form is the strangest because
    pancreatitis over the years does not manifest any signs, symptoms and
    the person does not know about the occurring violations.
  • Pseudo-tumor type – this form of pancreatitis over and
    The symptoms resemble pancreatic cancer. Main feature
    this disease – appearing yellowness of the skin, sclera, etc.
  • Pain view – from the name it is clear that it is characterized
    painful syndrome that happens very often after eating
    and especially alcohol.

What to do if you suspect chronic pancreatitis?

Of course, if you suspect chronic pancreatitis should
ask for a comprehensive diagnosis to the gastroenterologist. Doctor on
on the basis of the patient’s complaints, the medical history and the following
diagnostic measures, establish an accurate diagnosis:

  • Laboratory diagnosis of chronic pancreatitis – change
    elastase levels in feces.
  • Stool analysis can determine if steatorrhea exists, i.e.
    not digested fat content in feces, which will indicate failures in
    the work of the gland.
  • The test of special preparations for the stimulation of the pancreas.
  • Ultrasound can also help to establish the correct
    diagnosis.
  • In case of doubt or for greater certainty of diagnosis
    computed tomography also helps.
  • Blood glucose testing should be done to detect
    diabetes mellitus and you can also be tested for tolerance to
    glucose.

The diagnosis is only based on the ultrasound data is not reliable,
since there are no specific signs, but can only be
slight diffuse changes in the structure or swelling in the period
aggravations. Most often there are no ultrasound manifestations at all.

Treatment of chronic pancreatitis

Symptoms of chronic pancreatitis can be mild and
pronounced. As a rule, during exacerbation of chronic
pancreatitis also shows hospitalization and similar therapy,
as in the acute process.

The patient must follow a diet for life, take drugs
with secretory insufficiency of the pancreas, antispasmodics.
It is very useful to visit the sanatorium twice a year, especially
Stavropol Region, such as Pyatigorsk, Zheleznovodsk,
Kislovodsk, with complex treatment and taking natural
mineral water from the sources (especially effective Slavyanovskaya and
Smirnovskaya water). The basic principles of treatment:

Chronic diet

This is the most difficult to implement treatment principle, since
a pancreatic diet eliminates all the tasty foods that love
all – kebabs, chocolate, sweets, mushrooms, spicy, fried dishes,
fast food. All products up to fruits and vegetables should
grind, boil, bake only.

Meals should be frequent and in small portions, that is, eat
should be every 3 hours, while it is advisable not to mix in one
eating different types of protein, fat or carbohydrates. More about
diet, read our article What you can eat with pancreatitis.

How to eliminate pain in chronic pancreatitis

Хронический панкреатит

Alcohol is the worst enemy of the pancreas

With a diet pain is much less likely to be felt, but
It is worth a little to move away from it, allow yourself to be greasy or fried and
all – need painkillers.

  • With intense pain, antispasmodics can be prescribed by a doctor –
    No-Spa, Drotaverinum, which reduce inflammation in the pancreas
    gland and therefore reduce pain.
  • Today, the doctor may also prescribe mebeverin.
    (Duspatalin, Spareks) – antispasmodic, myotropic action,
    eliminates gastrointestinal spasms.
  • It is possible to prescribe antisecretory (omeprazole) and
    diuretics (diakarb pill for three days under
    cover asparkam with edematous form).
  • Also применяют Октреотид, лекарственный препарат, подавляющий
    hormone production by the gland, because they stimulate it and
    most cause pain. This medicine is prescribed only in
    hospitals.

Pancreatic enzymes for the correction of functional disorders
pancreas

With prolonged chronic pancreatitis occurs
replacement of normal tissues of this organ, loss of its normal
function, so diabetes appears and is disturbed
digestion. Чтобы дать отдых для pancreas и снизить
pain in patients who need additional
pancreatic enzymes:

  • Festal – you should drink it 3 p / day, 1 tablet with food,
    обычно его сочетают с гистаминовыми блокаторами  для
    reduce acidity in the stomach – famotidine, cimetidine.
  • Pancreatin (Hermital, Creon, Penzital, Panzinorm, Pangrol,
    Micrasim, Mezim, Biosim, Gastenorm, Enzistal) are enzymes
    pancreas, принимаемые также 3 R / day 2 tab. in
    время приема пищи, желательно запивать щелочной минеральной inдой.
    Они помогают расщеплять жиры, углеinды, белки.
  • Гоinря о ферментах, надо помнить об их активности, 10 000 ЕД по
    Lipase (mezim-forte tablet) thrice daily – standard
    need for replacement therapy. The original mezim has not
    очень приятный запах, если запаха нет –  это подделка
    (crushed chalk).

In chronic pancreatitis, when the symptoms are very
длительное время  – снижается уровень инсулина, что рано или
late entails the development of diabetes. In case of it
diagnosis, the patient should seek advice from
endocrinologist to clarify the treatment regimen and diet.

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