Pancreas: disease symptoms, medication, diagnosis, nutrition

Among the diseases that occur in about three out of a hundred people over the age of 30, doctors call pancreatitis. In the overwhelming majority of cases (about 70%), the cause of this diagnosis is alcohol, smoking and the consumption of fatty foods.

Diseases of the pancreas cause acute pain, digestive disorders, which can greatly complicate the patient's life, and in some cases, provoke death.

Acute forms of pancreatitis respond well to treatment, chronic ones require constant monitoring, adherence to a lifelong diet. If any symptoms of pancreatic disease occur, medication is used in conjunction with a strict diet.

Functions and diseases of the pancreas

The pancreas consists of two parts with different structures and functions. One part of it produces enzymes (amylase, protease, lipids), which are involved in the digestion of food in the intestine, and the second produces hormones: insulin, somatostatin, glucagon.

Among the diseases of the pancreas, most often (about 80% of cases), doctors diagnose non-infectious inflammatory processes - pancreatitis.

Pancreatitis occurs as a result of the action of enzymes produced by the gland on the walls of the organ. Normally, the enzymes produced move along the bile ducts, enter the intestines, where they carry out the main processing of the food lump, decompose proteins, fats and carbohydrates.

If, for some reason, enzymes stagnate in the gland, then they begin to break down the tissues of the gland itself. In this case, the main symptom of pancreatitis arises - acute severe pain.

Pancreatitis can be of two types - acute and chronic. The acute form is divided into several more:

• edematous (interstitial);
• hemorrhagic;
• purulent (phlegmonous);
• pancreatic necrosis (total or partial tissue death).

About the reasons

Doctors diagnose primary acute pancreatitis in people aged 35–45 years (28–40 cases per 1000 people). In older age groups, the percentage of cases increases, which suggests a direct dependence of the disease on the patient's age.

According to statistics, pancreatitis is provoked by the following factors:

1. Excessive alcohol addiction. According to various estimates, people with excessive alcohol consumption account for 65–80% of all patients suffering from chronic forms of pancreatitis. Alcohol increases the production of enzymes many times over.
2. Backflow of bile (reflux) as a result of narrowing or squeezing, blocking of the bile ducts with gallstone disease, tumors, cysts of the gland.
3. High concentration of fats in the blood with obesity, unhealthy diet. Fats provoke enhanced enzyme production.
4. Viral infections, intoxication. As a result of their exposure, chronic pancreatitis occurs more often.
5. Mechanical damage to the bile ducts. It occurs as a result of mechanical injuries, operations in the abdominal cavity.
6. Diabetes.
7. Hereditary predisposition.

For further identification of pancreatic diseases, the primary manifestations of pancreatitis are important. The presence of characteristic symptoms is of particular importance for the diagnosis. Diseases of the pancreas have a number of common characteristic symptoms inherent in pancreatitis.

Pancreatic inflammation symptoms

In acute pancreatitis, the symptoms are pronounced. Chronic forms have a washed-out clinical picture and a weak severity of symptoms.

Among the recognizable, mandatory symptoms of pancreatitis will be:

Symptoms	In acute forms	With chronic pancreatitis
Pain	The pain is severe, localized in the left hypochondrium, it is acute or dull, pulling. Often takes on a shingles character, It can give to the region of the heart, back. Painful sensations are so strong that they can cause painful shock and require urgent localization	The pains become dull in nature, the localization of pain is in the intestinal region, often painful sensations take on a girdle character and are given to the spine. The pain becomes less noticeable, it persists almost around the clock during periods of exacerbation
Nausea	Occurs immediately after eating or after a while, in 8 cases out of 10 ends in vomiting	It is permanent, occurs regardless of food intake. Increases after eating, induces vomiting
Vomit	Fountain-shaped, disposable, observed after eating	Vomit has a bitter taste; with cholecystitis, bile contents are present. Observed after ingestion of fatty, spicy foods
Defecation disorders	Flatulence, constipation or diarrhea, stools have a characteristic oily shade, lighter in color	Constipation alternates with diarrhea, there is a constant loosening of the stool. Frequent urination is recorded after eating. Feces have an oily sheen, they lighten
Dehydration	Weight loss, pallor, weakness is observed with frequent diarrhea and vomiting, can threaten the patient's life with rates over 9%	It is mild, manifested by weight loss, general weakness, lethargy, impotence, decreased blood pressure
Depression	Lethargy, apathy, lack of appetite	Frequent depressive conditions, lethargy, apathy occur

Among the nonspecific manifestations are possible:

1. Increased body temperature. Occurs with infectious inflammation and intoxication.
2. Skin rash, severe itching. Typical for tumor processes, compression of the bile ducts.
3. Jaundice (yellow color of the skin and whites of the eyes). Appears with a complete or partial cessation of the outflow of bile from the gland.
4. Strong headache. It occurs as a result of intoxication.

Manifestations of other diseases

Some other diseases of the pancreas appear already at the initial stage of pancreatitis. They complement the general picture of the disease with nonspecific symptoms:

1. With gallstone disease, vomiting with bile, a characteristic taste in the mouth, is observed. At the initial stages, there is a pallor of the skin, their yellowish tint, a rapid increase in jaundice is characteristic when the bile ducts are squeezed. Acute pain in the hypochondrium, which radiates to the stomach, covers the back (spine).
2. When an infection joins the inflammation, the body temperature and blood pressure rise significantly. The pain occurs as an acute prolonged attack, acquires a shingles in nature.
3. With tumor processes, the abdomen increases, the lower blood pressure levels rise, jaundice gradually increases, and itchy skin occurs. Diabetes mellitus is diagnosed.

Video - Signs of pancreatic disease

About diagnostics

The symptoms of pancreatitis are so extensive that in most cases it is possible to establish an accurate diagnosis only after a series of studies. An experienced surgeon will detect acute pancreatitis after examination and questioning of the patient - to establish the type of disease, it is possible to clarify the presence of concomitant pathologies, other diseases only after a detailed analysis of the results research.

Among the tests that the doctor will prescribe will be:

1. General blood analysis.
2. Biochemical studies of blood plasma and urine.
3. Ultrasound of the pancreas, if necessary, the liver, bile ducts.
4. X-ray.
5. Angiography.
6. Laparoscopy.
7. Endoscopy of the upper gastrointestinal tract (if acute pancreatitis is suspected).
8. Fibrogastroduodenoscopy (for chronic pancreatitis).
9. Cholangiopancreatography (MRI), tumor markers (if cancer is suspected).

Treatment

Therapy for diseases of the pancreas always contains dietary restrictions. Other activities are added to the diet:

1. In acute pancreatitis, pain relief comes to the fore. In difficult cases of infection, antibiotics are used. Be sure to take measures to detoxify the body.
2. Chronic forms are treated with enzymes.
3. Surgical intervention, laparoscopy are used for cholelithiasis, in emergency cases (blockage of ducts with stones), with the formation of large cysts, compression of the ducts by tumors.
4. Treatment of tumors will be especially difficult. It involves the use of enzyme preparations, chemotherapy, and the use of surgical treatment.

In the initial stage of treatment, a special diet is required, involving fasting. Acute severe attacks may require a diet of up to 7 days; with an exacerbation of lower intensity, the fasting period is 2 to 4 days.

During this period, measures are taken to localize the pain. At home (minor colic), antispasmodics can be used:

1. No-Shpu, 2 tab. after 4 hours, can be used from 6 years old (maximum 2 tablets / day in two doses, for children 6-12 years old 3 tablets / day in three doses).
2. Papaverine, Drotaverine: adults and children from 12 years old 1-2 tables. after 8 hours, but not more than 6 tab. per day.
3. Mebeverine: 1 caps. after 12 hours. The drug is not prescribed during pregnancy.
4. Meteospazmil: 1 caps. after 8-12 hours for children from 14 years old and adults. Not prescribed for pregnant women.
5. Buscopan 1–2 tab. after 3-4 hours for children from 6 years old and adults.

To relieve acute pain at home, analgesics are used:

1. Baralgin (250-500 mg no more than 3 times a day). Do not use during pregnancy, children under 6 years of age.
2. Pentalgin (500 mg up to 3 times / day, max. 2 g / day). Contraindicated for children under 12 years of age, during pregnancy, hepatitis B.
3. Trigan-D (1 tab. up to 3 times / day) Use for children from 15 years old and adults. Do not use during pregnancy, HB, children are treated under the supervision of a pediatrician.

In the absence of stomach diseases, bleeding and allergy to NSAIDs, drugs from a number of non-steroidal anti-inflammatory drugs are used: Voltaren, Aspirin (acetylsalicylic acid), Movalis, Indomethacin take 1-2 tablets every 4-6 hours, no more than 6 tablets / day.

When carrying out medical measures in a hospital, novocaine is administered through a dropper, in the most difficult cases, opiates are used.

Important! Treatment of pancreatitis includes measures to detoxify the body; at home, the simplest method would be to consume a large amount of pure non-carbonated water.

If pancreatitis is diagnosed, pancreatic disease symptoms are present. Medication treatment always includes taking enzyme preparations. The drugs break down fats, proteins and carbohydrates, do not require the production of enzymes by the gland itself, and make it possible to recover damaged tissues of the pancreas.

Enzyme preparations are produced under a huge number of trade names:

• Ajizim;
• Eurobiol;
• Zentaze;
• Innosim;
• Creazim;
• Creon;
• Mezim;
• Micrasim;
• Panzinorm;
• Pancreasim;
• Pancreatin;
• Pancitrate;
• Pentasil;
• Fermentium;
• Festal;
• Enzibene;
• Hermital;

The composition of medicines, regardless of the name, includes enzymes from pork liver. The preparations contain the amount of enzymes that is a multiple of this number:

• lipase - 3500 ED;
• amylase - 4200 ED;
• proteases - 250 units

Enzymes in medicines are packed in a special enteric coating (tablet or capsule coating), which is absorbed only in the intestine.

The funds have a different amount of substance - from 10 thousand. UNITS up to 35 thousand UNITS

The amount of enzymes is prescribed depending on the degree of their deficiency in the body. Dosages vary:

1. In the complete absence of enzyme production (removal of the pancreas, gallbladder, gastric resection), enzymes are prescribed for life. Doses range from 35 thousand IU at a time with each meal.
2. For partial replacement, use the same drugs, but in smaller doses (from 10 thousand. IU three times a day).
3. In acute attacks of pancreatitis, courses of treatment are prescribed from 2 to 8 months.

Advice. Take tablets or capsules with meals or immediately after meals without chewing. Wash down with a large amount (from 200 ml) of clean water without gas. Juices must not be used. If the patient cannot swallow the capsule, it is allowed to mix its contents with unsweetened applesauce. The composition is taken with meals. You cannot crush tablets.

With pancreatitis, treatment takes a long time. To cure the acute form, it will take from 4 to 8 months, during which the patient adheres to a diet and takes enzyme preparations.

In chronic forms, the diet is less rigid, but is constantly observed. Enzyme preparations are taken in courses, on the recommendation of a doctor.

Video - Acute pancreatitis

The special importance of diet

Along with taking enzyme preparations, diet is one of two important components of the treatment of pancreatitis.

In the acute period, fasting is always present, after which the patient is introduced to table No. 5p. This is one of the toughest diets.

It is a fractional meal 6-7 times a day. A single serving should contain no more than 200-350 g of food, and the fat content should not exceed 10 g. The diet includes a minimum amount of salt (7 g / day), sugar (10 g / day), sweets (15–20 g / day). In limited quantities, the patient should eat lean meat, low-fat fish, skim milk, eggs (1/5 of the total daily food intake).

The basis of food is slimy porridge on water with milk, bread, supplemented with permitted vegetables and fruits.

All food is prepared in pureed or chopped form, served warm.

Spicy, fatty, fried foods, fast foods are prohibited. With pancreatitis, carbonated drinks, kvass, beer are strictly prohibited.

Quitting alcohol and smoking

Treatment for pancreatic disease includes avoiding alcohol altogether. A small dose of alcohol will cause increased production of enzymes and their delay in the pancreas, which will provoke an attack of acute colic.

Doctors recommend minimizing the ingress of tobacco smoke into the body as a result of active or passive smoking - it also helps to increase the production of enzymes.

When pathologies of the pancreas, symptoms of the disease are detected, treatment with medicines should be combined with adherence to a strict medical diet and maintaining a healthy lifestyle.

The course of treatment for acute pancreatitis is long, taking at least 4 months. In case of complex disorders of the functioning of an organ, resection, cysts, tumors, enzyme replacement therapy is prescribed for life.

Doses and duration of the course of treatment are determined by the therapist, based on the individual characteristics of the patient's body, concomitant diseases, age.