Scheme of treatment of chronic pancreatitis and cholecystitis: drugs, diet, medication and surgical intervention

Chronic pancreatitis is a disease characterized by a disorderThe term inflammatory process in the pancreas.

Usually, pathology is a consequence of cholelithiasis or excessive alcohol consumption. Sometimes this disease leads to gastritis, cholecystitis, colitis, hepatitis, etc. The scheme of treatment of chronic pancreatitis in each case is selected individually when the patient is examined by a surgeon and gastroenterologist.

Pathology is usually diagnosed in middle or old age, and in most cases it affects women. Isolate primary and secondary pancreatitis, which leads to chronic enteritis, gastritis, cholecystitis.

How does chronic pancreatitis develop?

This disease has a rather complicated course, it is not fully understood, but the basic mechanisms are already known. Due to the influence of various factors that affect the body, an inflammatory process occurs in the pancreas. It is observed almost constantly - with periods of exacerbations and remissions. However, the bottom line is that negative factors influence the healthy tissue of the gland. Over time, it begins to gradually die, replacing the connective tissue, which harms the body.

As the amount of healthy tissue decreases, pancreatic function also decreases. In severe cases, they completely disappear. Each subsequent aggravation leads to complications, which makes the process irreversible.

Causes of

There are quite a few factors that affect the appearance of chronic pancreatitis. These include:

1. The use of excessive amounts of alcoholic beverages.
2. Smoking.
3. Traumatic injury.
4. Pathologies of the liver, duodenum, gallbladder - cholecystitis, ulcer, the presence of stones, cirrhosis, etc.
5. Hepatitis B and C.
6. Parotitis. High level of fats in the blood.
7. .
8. The use of toxic drugs.

Symptoms and signs

The main manifestation of chronic pancreatitis are severe pain sensations. Their location depends on the area of ​​the pancreas. Often pain syndrome occurs in the left or right hypochondrium, and discomfort can also be felt under the ribs in the middle.

As a rule, discomfort occurs about an hour after eating, especially if the food was very oily or acute. Pain in the supine position increases, in addition, it can give to the lower abdomen, heart or shoulder. Often the patient has to take a forced position - sitting, leaning forward.

As the digestive enzymes are reduced in the work of this organ, changes occur in the functioning of all digestive organs. This is why chronic pancreatitis is often accompanied by symptoms such as:

• nausea and vomiting;
• belching;
• heartburn;
• appetite impairment.

It should be noted that pain is not always accompanied by chronic pancreatitis. Usually it is typical for those people who systematically overeat, which causes pancreatic edema. In addition, the signs may include additional manifestations characteristic of pathologies such as cholecystitis, ulcers, gastritis.

What happens during pregnancy

Pancreatitis in the period of bearing a child may be due to the fact that an increasing uterus compresses the pancreas. Often, pregnant women complain about changes in taste preferences, overeating, toxicosis, which also negatively affects their health. The cause of pancreatitis in this period may be the use of vitamin preparations, cholecystitis, gastritis, enteritis and other diseases.

To identify chronic pancreatitis during pregnancy, it is worth paying attention to the following symptoms:

• bloating, nausea and vomiting;
• dysbiosis;
• weight loss;
• appetite impairment;
• food allergy;
• pain in the upper abdomen.

To improve the condition of a pregnant woman, it is necessary to choose the optimal treatment regimen for chronic pancreatitis, which includes:

1. Restriction of medicines.
2. Application of digestive enzymes.
3. Improving the digestive tract.
4. Application of herbal preparations.
5. Special diet.

All medicines should be prescribed exclusively by a doctor, since self-medication can lead to negative consequences. If there are other pathologies, such as gastritis, cholecystitis, enteritis, it is also very important to treat them.

Diagnosis

In order to detect chronic pancreatitis, in addition to the standard examination, it is necessary to determine the exocrine function of the pancreas. This is done with the help of a coprogram, which consists in analyzing undigested remains of food in the stool.

In addition, for the diagnosis of chronic pancreatitis, instrumental methods of research can be used - computer tomography or ultrasound of the abdominal cavity. Thanks to this, it is possible to establish the causes of the development of pathology - cholecystitis, peptic ulcer, dyskinesia, etc.

Assess the work of the pancreas will help C-respiratory tests. They have non-invasive character and allow to reliably determine the exocrine function of this organ.

Treatment methods

Patients can be treated in a therapeutic or surgical hospital - it all depends on the characteristics of the course of the disease. Medical treatment is applied in the event that a person does not have complications that require surgical intervention. These include stones in the duct of the gland, cysts, narrowing of the duct, etc. If the disease is secondary, it is very important to choose a comprehensive treatment that will eliminate the root cause of its development - gastritis, cholecystitis, etc.

Diet

During remission, a special diet is prescribed to a person - table number 5. She assumes the exclusion from the diet of alcoholic beverages, fatty, sharp, fried foods. In this diet should include many proteins in the form of low-fat meat, fish, cottage cheese and cheese.

Pain control

To eliminate spasm of smooth muscles of the gastrointestinal tract, antispasmodics are used - no-spa, spasmalgon, ketans.

A nasogastric tube can be used to decompress the patient. If there is severe pain syndrome, pain medication can be used.

Correction of impaired pancreatic function

Therapy of chronic pancreatitis directly depends on the condition of the patient. With an exacerbation, it is no different from the ways of helping with acute pancreatitis. In the first hours, people are forbidden to eat and intravenously drip the fluid in large volumes - saline, glucose. These measures are aimed at reducing the intoxication of the body.

To block the activity of the enzymes of the gland juice, drugs that reduce activity and release of enzymes are used. They include sandostatin, countercracker, etc. To avoid the spread of infection, antibacterial drugs can be used. In this case, you must check the sensitivity to them.

Medical standards also include substitution treatment, in which enzyme preparations - creon, mezim - are prescribed. If a patient develops diabetes, he should receive insulin injections. Also in this situation, medicinal preparations that reduce the level of sugar are used.

Surgical intervention

Surgical treatment of chronic pancreatitis is required in case of serious complications. In this case, the features depend on the reason for the operation. If a person has cysts as a result of chronic pancreatitis, interventions are performed to open and empty their cavity. Also, treatment consists in removing the affected part of the gland, draining the cyst, laparoscopic fenestration.

If a person has an enlargement of the gland duct and the formation of stones, this pathology should be treated by removing pebbles from the duct and ensuring the outflow of juice into the intestine. With inflammation of the gland's head, surgical treatment of chronic pancreatitis consists in normalizing the outflow of bile to the intestine.

Recently, chronic pancreatitis has been treated with minimally invasive procedures. Standards of therapy in this case include the implementation of laparoscopy. Instead of the usual incision of the abdominal cavity, several small punctures of not more than 1 cm are made. A camera is inserted through them and an operation is performed with the help of precision instruments.

After surgery, a person should be under the supervision of doctors. In the development of diabetes, endocrinologists who control the blood sugar level should be treated.

In addition, a strict diet is prescribed, which eliminates the consumption of fatty and fried foods, as well as large amounts of food. Under no circumstances should you drink alcoholic beverages.

Treating folk remedies

Some people use folk recipes to treat chronic pancreatitis. For this purpose, juice of sauerkraut, potatoes, carrots will suit. No less effective and herbal treatment - actively used celandine, birdwort, dandelion, chamomile, three-color violet.

In any case, before treating the disease with traditional medicine, it is worth consulting a doctor. In some situations, the therapy of chronic pancreatitis with herbs can only aggravate the situation.

Forecast

If you follow the recommendations for the prevention of exacerbations, the disease is mild and has a favorable prognosis. If you break the rules of the diet, drink alcohol, smoke and do not take medication, serious complications develop. Many of them require surgical intervention and can result in death.

Chronic pancreatitis is a serious enough disease that can be caused by a variety of factors. Most often, its appearance is influenced by excessive consumption of alcohol and systematic overeating, although sometimes it arises because of various diseases - it can be gastritis, cholecystitis, enteritis, etc.

To prevent the development of serious complications, treat the pathology immediately after the onset of the first symptoms. For this, medical and surgical methods of care are used. Of special importance is a special diet. The earlier it will be possible to begin therapy of a chronic pancreatitis, the better the results will be.

Useful video about chronic pancreatitis