Treatment of exacerbation of chronic pancreatitis: drugs and enzymes used, prognosis
Chronic pancreatitis - is a progressive inflammatoryDisease of the pancreas, with the development of its fibrosis and as a consequence, - secretory insufficiency.
More often the disease occurs at the age of 35-40 years, mainly in women. Chronic pancreatitis proceeds for a long time, with periodic exacerbations.
Causes of the disease
To highlight the main factor that caused the disease is difficult, since chronic pancreatitis is a multifactorial disease. The development of pancreatitis can provoke the intake of alcohol, swelling of the gland or drug intoxication.
Exacerbation of the disease can cause the ingestion of fatty fried foods, alcohol consumption, viral infections or stress.
Symptoms of pancreatitis
In the initial stages, pancreatitis may not have clinical manifestations. Secretory cells are able to compensate for the loss of up to 80% of the pancreas. The exacerbation of the disease has bright characteristic symptoms:
- Acute pain in the upper abdomen, in the region of the left hypochondrium. In some cases, the pain is shrouded like a "hoop".
- Dyspeptic manifestations - lack of appetite, nausea, vomiting, heartburn, bloating, upset of the stool( by type of diarrhea or constipation).
- Change in general condition - jaundice of the skin and mucous membranes, weakness, weight loss and headache.
Complications of the disease
Lack of therapy or improperly selected treatment can lead to complications. There are systemic complications - renal, hepatic insufficiency, syndrome of dissiminated vascular coagulation, and local complications - abscess of pancreas, cholangitis, phlegmon of retroperitoneal tissue.
Treatment measures
Chronic pancreatitis in the acute stage requires mandatory hospitalization in the hospital. Depending on the severity of the general condition and the presence of concomitant pathology, pancreatitis is treated with conservative or surgical methods. Conservative treatment includes a sparing regimen, a diet with the exception of fatty, smoked, roasted and symptomatic therapy. It is recommended to use mineral alkaline still water. A bubble with ice is placed on the abdomen. With alcoholic genesis of pancreatitis, it is important to exclude the use of alcohol.
Exacerbation of chronic pancreatitis requires the use of analgesics, detoxification, enzyme and anti-inflammatory drugs. In the hospital, a powerful infusion therapy is performed, using saline solution, Ringer's solution, Rheosorbylact. The infusion of a large volume of liquid helps to reduce the concentration of proteolytic enzymes in the blood.
Treatment with enzyme preparations prevents weight loss and normalizes digestion in general. They use Creon, Mezim, Pancreatin, Pancreasim. Enzymes are used during each meal. Calculation of the dosage of the drug depends on the severity of pancreatitis. It is important that the food is warm, as in the hot environment, lipase and protease are destroyed.
Also used are drugs that neutralize the toxic effects of proteases - countertrial and tracerol. They are administered parenterally for 10 days. A good effect has blockers of H2-receptors - famotidine, ranitidine. They reduce the secretory activity of the pancreas.
For the relief of pain, injections of promedol, omepon or morphine are used. In severe pain syndrome, paranephric and paravertebral blockades are used. Such treatment can significantly alleviate the condition of the patient.
With the development of suppurative complications, violation of bile outflow, formation of cysts, inefficiency of drug therapy - surgical treatment is indicated. Types of surgical intervention: pancrectomy, gallbladder removal, dissection of the sphincter of Oddi, creation of bypass ways of outflow of bile. Treatment of fistula pancreas can be minimally invasive puncture.
Forecast
With this disease you can live a lifetime, if you follow all the recommendations of a doctor. If you do not follow the treatment, pancreatitis is steadily progressing and can lead to fatal consequences.
