Acute pancreatitis: symptoms and treatment in adults of acute pancreatitis

Pancreatitis is an inflammation of the pancreas, accompanied by spasms of the ducts, a violation of their conduction.

As a result of digestion, the juices of the pancreatic gland must enter the small intestine.

But due to the blockage of the passages, the juices accumulate in the gland, and it digests itself.

Many factors affect the malfunction of the pancreas in adults. First of all, unbalanced nutrition and bad habits should be called among the most important.

In general, they negatively affect general well-being, and in particular, they form pancreatic dysfunction.

ICD-10 pancreatitis

In ICD-10, pancreatitis is classified by codes K00-K93, K80-K87. Among them, acute pancreatitis class K85 stands out. ICD-10 includes types of pancreatitis of different courses:

• recurrent;
• hemorrhagic;
• subacute;
• purulent.

So that the juices of the pancreatic gland could normally participate in the digestive process and be absorbed in certain parts of the tract, normal synthesis of pancreatin, lipase, trypsin is needed.

In case of disturbance in the functions of the pancreas, and especially in case of damage to its ducts, the produced enzymes do not enter the digestion process, but accumulate in the capsules of the gland. Because of this, its inflammation develops.

It is caused in adults for the following reasons:

• food or alcohol poisoning;
• constant overeating, overloading the digestive tract;
• eating fatty and spicy foods.

Significant factors in the development of inflammation of the pancreas are trauma to the anterior wall of the peritoneum, bruises of internal organs.

Acute pancreatitis rarely develops in the form of an independent pathology, it often accompanies damage to other organs of the gastrointestinal tract.

It is difficult to make an accurate diagnosis, because the pancreas is located deep in the peritoneum and is small in size.

Inflammation of the organ is accompanied by symptoms similar to the manifestation of other pathologies.

The contributing factors provoking the development of pancreatitis:

• accumulation of calculi in the gland, which block the bile ducts;
• accumulation of substances that stimulate the synthesis of enzymes; but they start to work against the tissues of the gland;
• swelling of the gland due to the accumulation of excess enzymes leads to damage to the blood vessels, which causes internal hemorrhage.

Diseases of the duodenum, stomach cause a reverse reflux from the stomach into the pancreatic passages, this is an obvious factor in the onset of acute inflammation in the gland.

These phenomena accompany gastritis, ulcers, gastroduodenitis. The danger of the disease threatens with possible complications:

• the development of purulent inflammation;
• blockage of the ducts of the gland;
• stenosis of the sphincter of Oddi;
• the development of a postnecrotic cyst;
• violation of the portal blood supply to the liver;
• the development of diabetes;
• pancreatic necrosis.

One has only to think about the possibility of developing pancreatic necrosis, as it becomes clear that the pancreas should be treated in a timely manner.

Otherwise, inflammation leads to severe dysfunctions of the pancreas, the rapid death of organ cells.

After such changes, the pancreas, which is subject to tissue destruction, is unable to perform its tasks.

Pancreatic necrosis is considered one of the complicated stages of acute pancreatitis, when the clinical picture of the disease progresses rapidly and becomes the most severe.

Signs of pancreatitis in adults

Without qualified diagnostics, it is difficult for even an experienced doctor to immediately identify signs of acute pancreatitis, since it is accompanied by symptoms very similar to ordinary poisoning.

The condition of an unexpectedly sick person is determined by:

• severe pain in the epigastric region of the abdomen; pains are girdle in nature, spread to the lower back, kidneys;
• high fever, jumps in blood pressure, tachycardia, a general deterioration in the condition of a sick person, confusion;
• indomitable vomiting, after the stomach is emptied, nausea and vomiting persist, and do not bring relief, vomiting attacks are repeated several times;
• after vomiting, heartburn suffers, the stomach swells, a red rash appears;
• the onset of foamy diarrhea, green in color, with remnants of undigested food;
• pallor of the skin, shortness of breath.

The acute form of pancreatitis is characterized by the rapid progress of the disease, a sharp deterioration in human well-being.

If the symptoms of acute pancreatitis in adults begin to appear at home, then time should not be delayed, and it is necessary urgently call an ambulance to provide first aid and identify a sick person to a stationary branch.

Before the ambulance arrives, no medicine, water, or food should be given to the sick person. This can blur the picture of the disease, increase vomiting.

Dagger pains, indomitable vomiting indicate an acute condition in which immediate surgical intervention is required.

The specific structure of the pancreas causes different symptoms. The gland consists of a head, body, and tail. Symptoms appear in different ways from the site of inflammation:

• inflammation of the head of the gland gives off pain under the right hypochondrium;
• inflammation in the body; pain is localized in the epigastric zone;
• inflammation of the tail gives off pain under the left hypochondrium.

When the inflammation covers the entire gland, the patient complains of acute girdle pains. If the inflammation becomes chronic, the manifestations of the disease also change.

Now this is not only inflammation of an organ with damaged tissues, but also concomitant pathologies of the digestive tract.

Chronic pancreatitis in adults is characterized by a sharp exacerbation of symptoms, and their gradual subsiding, gradually pain in the pancreas becomes permanent, acute, with clinical symptoms:

• dagger pains in the epigastric zone, with a tendency to girdle the whole body;
• indomitable vomiting without signs of relief;
• diarrhea with a high content of fatty components;
• an increase in signs of intoxication;
• drop in blood pressure.

The sick person cannot lie down, in the lying position the pain intensifies sharply, because of this, the person sits with an inclination forward, with his stomach clamped with his hands.

Symptoms of acute pancreatitis in adults cannot be missed, it is dangerous to develop painful shock, fatal in the absence of medical care.

Pancreatitis in adults is diagnosed on the basis of complaints, examination by a doctor, a series of tests and examinations:

• urinalysis shows a change in elastase indicators;
• urinalysis for the determination of trypsinogen-2, which clearly confirms the specificity of acute pancreatitis;
• analysis of feces shows the presence of steatorrhea - undigested fats and parts of food;
• tests for the ability to stimulate organ function;
• ECG;
• Ultrasound of the gland and internal organs;
• blood test - glucose tolerance test;
• study of water and electrolyte balance;
• test for the presence of gland enzymes in the blood;
• X-ray in the supine and standing position;
• MRI or CT.

Ultrasound and CT are not highly indicative in the diagnosis of pancreatitis, but they are used to assess abdominal pain.

An ultrasound scan is performed to determine cholelithiasis. At the same time, dilatation of the bile ducts can be seen, confirming the obstruction of the biliary tract.

Pancreatic edema can be visualized only if the examination of the organ is not interfered with by gases in the intestine that obscure the pancreas.

The tests and examination performed give the doctor the opportunity to suggest the degree of damage to the pancreas in order to justify the prescribed treatment.

The main indicator is symptoms and treatment in adults is mainly based on their removal. In severe cases, endoscopy, laparoscopy are performed. Their use is justified by the patient's condition and the decision of specialists.

Treatment of pancreatitis in adults

The main principle of the treatment of acute pancreatitis is fasting. Exacerbation of the disease requires excluding food and water for 1-2 days.

To avoid dehydration, the patient is prescribed an intravenous rehydration infusion of saline solutions, glucose with vitamins.

Droppers help relieve bouts of vomiting, cure diarrhea. A heating pad with ice is placed on the area of ​​acute pain, the cold reduces pain, relieves swelling of the gland.

The patient is prescribed bed rest to create complete rest for the whole body.

In these ways, doctors seek to reduce acute inflammation, and only when the pain subsides, when stable indicators of improving well-being, the patient is prescribed a strict diet against the background of medication treatment.

The main drugs used in the acute stage of the disease are enzymes, antispasmodics, probiotics.

The diet is based on cereal and vegetable dishes, which are prepared by boiling, stewing, with a small addition of vegetable oil.

Together with food, the patient is advised to take enzymes to facilitate the work of the pancreas, to improve the digestion process. Usually these are enzymes:

• Festal;
• Creon;
• Pancreatin;
• Mezim forte.

Acute pancreatitis is usually accompanied by diarrhea, therefore, drugs that restore the intestinal microflora are required.

For this purpose, the doctor prescribes the intake of probiotics:

• Linex;
• Biogaya;
• Lactofiltrum;
• Beefi-form.

There are many similar drugs in the arsenal of doctors, they are selected in accordance with the analysis of feces for microflora, so that the drug is most effective.

The acute form of pancreatitis in adult patients is treated in a hospital setting. Traditional drug therapy includes:

• intravenous administration of saline solutions, plasma substitutes, these are Reopolyglucin, Reosorbilact;
• relief of pain attacks with antispasmodics, these are No-shpa, Ketanov, Papaverin, Platyphyllin together with Papaverine;
• removal of gland edema with diuretics - Lasix, Diacarb, Furosemide; when prescribing Diakarb, it is recommended to take calcium-containing preparations in parallel;
• stopping vomiting by intramuscular administration of Cerucal, Metoclopramide;
• restoration of the enzymatic balance by the appointment of inhibitors, these are Trasilol, Contrivan;
• restoration of secretory functions is achieved by taking Kvamatel, Omeprazole.

In addition, supportive vitamin therapy is provided. According to the signs of acute pancreatitis in adults, the doctor regulates the diet of each patient.

In severe cases, a hunger strike is recommended for 4-5 days of illness, in extreme cases - up to 2 weeks.

At this time, patients are injected drip fat emulsions, hydrolysates of protein compounds.

The first products that will be allowed to the patient are kefir, cottage cheese. Gradually, the patient is transferred to the dietary table No. 5.

When conservative therapy does not give the expected effect, doctors choose surgery.

Treatment of chronic pancreatitis in adult patients, depending on their condition, is limited to adherence to a diet with a minimum inclusion of fats and carbohydrates.

Undoubtedly, one should permanently stop smoking and drinking alcohol, including beer.

In case of violation of the doctor's prescriptions, exacerbations are inevitable. In this case, the doctor prescribes:

• the antibiotic Amoxicillin, to quickly stop the incipient inflammation;
• strong analgesics, antispasmodics to relieve pain, these are Tramadol, Papaverine, Drotaverin;
• enzymes for the normalization of digestion - Mezim, Pancreatin, Festal;
• preparations for normalizing acidity - Almagel, Maalox, Rennie.

And again - a hungry diet, to which you have to return with an exacerbation of chronic pancreatitis.

It is allowed to drink a little mineral still water. Proper nutrition in small portions with a minimum of fat is the mainstay of treatment for exacerbations.

Patients should forever forget about spicy, sweet, fried foods. Their diet is now composed of:

• boiled or steamed vegetables, excluding tomatoes;
• fruits with a neutral taste - apricots, pears;
• lean steamed or boiled fish;
• chicken, rabbit, veal meat;
• limited quantities of pasta;
• kefir;
• cereals;
• low-fat cottage cheese;
• herbal teas, still water.

A fairly extensive diet, from which you can make interesting and nutritious menus for every day.

In addition to a strict diet, nutritionists recommend consulting a phytotherapist and introducing folk remedies based on medicinal herbs into the course of treatment.

Traditional medicine against pancreatitis

For the treatment of pancreatitis in adults, doctors recommend including alternative recipes in the therapy plan.

Which of them can be used by each patient, should be consulted with specialists.

The most common means are:

• Kissel from sprouted oat grains. Method of preparation: oats should be carefully sorted out, soaked, left in a warm, bright place. After 48 hours, the grains have time to germinate, they should be rinsed with clean water, dried in a shaded place, and ground into flour. The resulting mass in the amount of 2 tbsp. l. pour 2 cups of cold water, bring to a boil, cook for 2-3 minutes, stirring constantly. Then remove from heat, cover the dishes, wrap warmly with towels. Insist for 20 minutes. Then you need to strain the mass from the grains of flour to drink. For the future, jelly is not prepared, you only need to drink a freshly prepared mixture. The course of treatment is 30 days. In case of positive dynamics, it is necessary to take a break for 2 weeks and repeat the course of treatment.
• Rosehip infusion. Method of preparation: insist in a thermos, pour in half a thermos of wild rose berries. Pour boiling water over, cover tightly. Insist for 20 minutes. You can leave the thermos overnight, then the infusion will be more saturated, and it can be slightly diluted with boiled water. Adults with acute pancreatitis should have a rosehip drink in their daily diet. For treatment, you need to drink 0.4 liters during the day. The symptoms of the disease go away quickly, within 10 days. You can drink rose hips all the time, but do not forget about its diuretic effect, and reduce the volume of the evening drink you drink.
• Flaxseed decoction. Method of preparation: pour 1 liter of water into an enamel pot, pour 80 g of flaxseed into the water. Simmer for 2 hours under a closed lid. After natural cooling, the broth should be filtered, drunk 3 times daily before meals. The course of treatment is 2 months. With positive dynamics, take a break for 2 weeks and repeat the course of treatment.
• Potato and carrot juice. Method of preparation: take 2 raw potatoes, 1 carrot, pass them through a juicer. Drink freshly squeezed ½ hour before meals, 2 times a day. The course of treatment is a week, no more. The juice relieves abdominal pain, normalizes digestion. With positive dynamics, take a break for 1 week and repeat the course of treatment.
• Tincture of barberry root. Method of preparation: 100 grams of pre-prepared, crushed and dried root should be poured into 1.5 liters of vodka, put in a dark place for a month. Stir the contents of the dishes occasionally during this time. After that, the tincture should be drained, drink 1 tbsp. l. before eating. The duration of treatment is from 2 to 4 weeks. Using this tool, you need to think carefully about how useful it will be, and how much the alcohol contained in it will bring probable harm.

All folk remedies, when included in the general treatment regimen, should be discussed with a therapist.

It is not recommended to take folk recipes on your own, as you can harm yourself.

Useful video