Reactive pancreatitis: symptoms and treatment in adults

Acute aseptic inflammation of the pancreas, which develops along with the pathology of the entire gastrointestinal tract, is called reactive pancreatitis.

It is characterized by a sharp worsening of symptoms, an increase in girdle pain in all abdominal abductions, the appearance of fever and indicators of general poisoning.

Reactive pancreatitis is diagnosed by taking anamnesis, physical examination of the patient, X-ray examination, ultrasound and EGDS.

Therapy is supposed to be conservative, based on diet No. 5-p, with the intake of anesthetic drugs, analgesics, and enzyme preparations.

Reactive pancreatitis

Reactive pancreatitis is a characteristic pancreatic response to any pathology of the digestive tract.

With sharp, sharp pains, the pancreas reacts to sudden changes in the diet, food poisoning, and stomach overload.

Half of the recorded cases of a high reactive state of the pancreas are due to cholelithiasis.

Statistics note that representatives of the female half of humanity are often sick. Reactive pancreatitis is a secondary lesion of the pancreas, it is formed due to a disease of the gastrointestinal tract, their systemic diseases, and general poisoning.

A distinctive feature of this disease is the abrupt onset of the disease after penetration into the body. factor provocateur, and a rapid decline in symptoms immediately with the start of therapy, with the transition to a strict diet food.

Reactive pancreatitis causes

The causes of reactive pancreatitis are diseases of the organs and pathways of the gastrointestinal tract, calculous cholecystitis, chronic gastritis, dyskinesias of the systems, infections in the intestines, helminthic invasions.

The basis of pathogenesis is the early activation of the enzymatic synthesis of the pancreas, which damages the tissues of the parenchyma.

Cholelithiasis becomes a common cause of stagnation of pancreatic secretion in the pancreatic ducts. With the formation of stones less than 4 mm, they irritate the tissues of the walls, cause spasm of the smooth muscles of the duct.

If spasm occurs constantly, strictures develop on the tissues of the common bile duct, stenosis of all tissues is formed. Often this process leads to complete obturation of the ducts with large stones, then a complicated stagnation of secretion is formed.

The risks of the formation of reactive pancreatitis significantly increase if a person has previously been diagnosed with cholelithiasis, gastroduodenitis, and stomach ulcers.

With an ulcer of the duodenal ulcer, a reflex throw of intestinal juices into the pancreatic ducts occurs, due to which the fermentation of the pancreas is untimely activated, and it eats away the tissues of the parenchyma with its own juices.

Against this background, biochemical processes are activated that regulate the resistance to inflammation, but elements of decomposition of enzymes and juices penetrate into the blood, which is why processes develop in the pancreas intoxication.

Specialists are interested in reactive pancreatitis, the symptoms and treatment of which will give a positive trend, an effective result.

Manifestation of reactive pancreatitis

The clinical picture of reactive pancreatitis is rapidly heading towards deterioration.

In a few hours from contact with a provoking etiological agent in the human body, a sharp deterioration develops.

Since pancreatitis is often only a secondary pathology, the symptoms of the main disease are sharply exacerbated.

Main manifestation:

• pain of the shingles type, begins on top of the abdomen, goes into the hypochondrium, spreads to the back, under the shoulder blades;
• flatulence increases;
• painful heartburn, belching appear;
• manifestations of dyspepsia.

Vomit usually contains mucus and bile impurities. Vomiting causes high intra-abdominal and intraductal pressure, due to which the painful symptoms after vomiting do not diminish, but intensify.

Reactive pancreatitis, symptoms and treatment are already well known to gastroenterologists, amenable to medication at an early stage, if the patient comes to the doctor in a timely manner.

From an attack to an attack, the symptoms become more complicated, become more difficult, and then it will be much more difficult for both specialists and the patient to cure pancreatitis of reactive etiology.

A person's well-being worsens due to the massive penetration of enzymatic elements into the bloodstream.

It is from this that symptoms of general intoxication appear, the temperature can rise to subfebrile values, the skin turns pale, the pulse and blood pressure increase.

Hospitalization is recommended for a person with acute pancreatitis.

Diagnostic measures for reactive pancreatitis

When the first signs of reactive pancreatitis appear, a thorough examination is required.

Diagnostics includes:

• analyzes of a clinical and biochemical nature;
• coagulogram;
• checking the indicators of the presence of enzyme particles in the blood and urine;
• study of indicators of elastase in the blood.

Usually, in this state, in the analyzes of a person, the norms of amylase, trypsin, and blood elastase are exceeded.

These indicators hold for the first few days of illness. At this stage, a physical examination of the patient is indicative, where the doctor sees tachycardia, increased blood pressure, pasty skin.

On palpation, the abdomen responds with increased pain in its upper part, especially in the corner under the left rib. A slight swelling is visible, but the abdomen is palpable, does not show irritation of the peritoneum.

A survey ultrasound of the abdominal cavity is carried out, the state of the pancreas and the biliary tract is specifically studied. Ultrasound today is the safest and most informative diagnostic method.

Ultrasound shows small stones, sand in the bile duct, edema, an increase in the anatomical parameters of the pancreas.

Endoscopic cholangiopancreatography is used when indicated, when a previous examination confirms that the ducts are blocked by calculi.

The endoscope in its design has an illumination, a recording camera, a working channel.

Through the working channel, the doctor introduces the necessary instruments into the examined organ in order to take pieces of tissue for biopsy and remove stagnant fluid.

Fibroesophagogastroduodenoscopy is performed using local or general anesthesia to determine the degree of tissue damage by inflammation. At the same time, the issue of the need for a biopsy is being resolved.

To clarify the diagnosis, to visualize in detail the focus of the pathology, an overview study of the abdominal cavity is carried out on radiography, on CT.

Intravenous administration of a contrast agent improves the CT image. MSCT of the abdominal organs is performed.

If these examination methods prove that there is an obstruction of the common bile duct with calculi, this is a strict indication for endoscopic RCP and choledochoscopy.

When using the ERCP method, the patient is injected with a contrast agent, which gives a clearer picture on X-rays.

Today, these complex examinations are successfully replaced by MRI of the pancreas and bile ducts. It visualizes calculi in several projections, determines their size, position in the duct.

Celiac trunk angiography is required to confirm increased vascularization of pancreatic tissue.

The acute period requires all patients to undergo esophagogastroduodenoscopy, it shows the presence of concomitant pathologies.

When diagnostic measures are difficult, the doctor conducts a laparoscopic examination.

After diagnosis, and sometimes at the same time, doctors already prescribe treatment for reactive pancreatitis.

Reactive pancreatitis treatment

The purpose of medical prescriptions is to stop pain in the first place, relieve swelling in inflammatory processes in the pancreas.

It is important to quickly remove the symptoms of general poisoning, restore the secretion of pancreatin. Therapeutic measures are successfully carried out when the factor of the etiology of the underlying disease is first eliminated. Treatment of reactive pancreatitis in adults is determined by doctors according to the intensity of the course of pancreatic pathology.

The acute stage of reactive pancreatitis requires therapeutic fasting for 1-2 days. On these days you can drink water and herbal infusions.

The mild course of the disease does not require fasting, but it is important to follow a diet number 5-p, saturated with carbohydrates, with the exception of protein and fat.

The purpose of the diet is to create complete rest of the pancreas, so that the synthesis of pancreatic secretion is significantly reduced.

Food is required fractional, with chopped food, in small portions. To remove the intoxication of the body, it is important to drink a lot.

The duration of adherence to the diet is assessed according to the individual course of the disease in each patient.

The doctor assesses the level of organ damage, the patient's well-being. In specific situations, the diet will need to be followed for a lifetime.

Drinking alcohol and smoking for patients after recovering from a disease of reactive pancreatitis is prohibited forever.

In accordance with the symptoms manifested in adults, the doctor will prescribe treatment for reactive pancreatitis.

These will be Pancreatin, Festal, Mezim, Creon - enzyme substitutes, if necessary, anesthetic medicine in injections will be prescribed.

The severe course of the disease requires the use of narcotic analgesics to eliminate severe spastic pain.

In inpatient treatment, Tramalgon, Baralgin, Ibuprofen are used. Intravenous drips are given to relieve signs of intoxication.

In a specific course of the disease, a course of antibiotic is prescribed, usually Gentamicin.

The mild course of the disease allows you to relieve spasms with non-steroidal anti-inflammatory antispasmodics, these are Drotaverin, Spazmalgin, Platifillin, No-Shpa, Nise.

According to the testimony, funds are prescribed that reduce flatulence, Espumisan. If the acute course of reactive pancreatitis is complicated by the presence of cholelithiasis, a specialist will carry out endoscopic removal of calculi.

As a drug therapy, proton pump blockers are used. This is necessary if there are concomitant diseases associated with hypersecretion. Here doctors use Emaneru, Omez, Nolpazu.

These are drugs that slow down the synthesis of hydrochloric acid, reducing the load on the pancreas.

When the main diagnosis is a stomach ulcer, antibacterial drugs are necessarily prescribed, stimulating the restoration of the internal mucous membranes, which have a rather complex structure.

Severe development of pathology requires immediate surgical intervention.

Surgical treatment is also used in a situation where additional pathology appears, a complication of the underlying disease, which sharply worsens the patient's condition.

If calculous cholecystitis, provoked by pancreatitis of reactive etiology, is diagnosed, surgeons remove the organ.

If it is proven by diagnostics that calculi are blocking the ducts, specialists also choose surgical treatment.

Possible complications

When the patient does not adhere to the recommendations of the gastroenterologist, complications develop.

The acute course of the disease is fraught with serious complications, often fatal.

Dangerous complications:

• endotoxin-type shock;
• inflammation of the abdominal cavity;
• abscesses, phlegmon;
• fistulas in the pancreatic ducts and common bile duct;
• necrosis on adjacent organs.

Therefore, when diagnosing "inflammation of the pancreas", doctors tend to immediately begin therapeutic measures. Without treatment, inflammation causes irreversible changes in tissues.

Possibility of treatment with traditional medicine

There are many alternative treatments for reactive inflammation of the pancreas. They, like general therapeutic practice, are aimed at relieving the pain symptom, getting rid of inflammatory processes, and restoring the normal functions of the organ.

Each of the traditional medicines must be approved by a physician for use.

Most used tools:

• Pharmacy fee number 1. It contains herbs of chamomile, mint, hawthorn berries, dill seeds. Method of preparation: pour 10 g of collection into 1 stack. boiling water, keep boiling for a couple of ½ hour, cover the dishes, wrap warm with towels, leave to cool naturally. Then strain, drink 100 ml 2 r. a day, strictly before meals. Do not leave for tomorrow, prepare a fresh broth every day.
• Pharmacy fee number 2. It contains grass St. John's wort, knotweed, birch leaves, corn stigmas in a ratio of 1: 1: 2: 2. Method of preparation: pour 20 g of the collection into 400 ml of boiling water, keep it simmering for another ½ hour, cover the dishes tightly, wrap warmly. Allow to cool naturally. Then strain, drink 100 ml 4 r. a day, always before meals.
• A mixture of fresh juices. Method of preparation: mix freshly squeezed juice of carrots and potatoes in equal volumes, add 5 ml of olive oil, drink 4 r. a day, prepare fresh juice each time.
• Chamomile tea. Cooking method. For 500 ml of boiling water, take 1 tbsp. l. dry chamomile. Brew like tea, drink 3 r. a day as tea. It reduces inflammation, relieves pain.
• Water infusion of propolis. It soothes the pancreas, should be taken on an empty stomach, ½ hour before breakfast. Drink only in the absence of acute pain.
• Oatmeal jelly. Relieves inflammation in the pancreas. Method of preparation: 50 g of oatmeal, pour 300 ml of cold filtered water. Leave to infuse overnight. In the morning, eat instead of the first breakfast.

The duration of taking medicinal herbal medicines depends on the patient's well-being. If folk remedies help the patient, it can be repeated in courses, as prescribed by the doctor, as a treatment, and as a prevention of the correct functioning of the pancreas.

Useful video