Chronic pancreatitis: symptoms and treatment


Chronic pancreatitis is a pathological condition that occurs after an episode of acute pancreatitis. It is characterized by irreversible pathological changes in the gland tissues. Due to the fact that the inflammatory process is constantly present in this gland, it may wrinkle in some areas. Gradually, areas with proliferative fibrosis are formed.

Chronic pancreatitis is a fairly common pathology of the gastrointestinal tract. It is worth noting that the pancreas plays one of the important roles in the process of digestion, and its damage affects the condition of the whole organism. The disease is more often diagnosed in the elderly, but its development in people of working age is not ruled out. In children, pathology is rarely diagnosed.

As a result of the progression of such a disease, the secretion of enzymes — trypsin and lipase — decreases in the gland. Because of this, the blood circulation of the organ significantly worsens, connective tissue grows, and specific scars, areas with sclerosis are formed.

Etiology

Such a disease often occurs in conjunction with other ailments, such as enteritis, gastritis, cholecystitis, hepatitis and the like. Often, this pathology affects people who do not adhere to a diet, do not consume the necessary amount of nutrients, minerals and vitamins, as well as those who abuse fatty, high-carb and poor-quality food.

The main reasons for the progression of chronic pancreatitis are as follows:


  • Unbalanced meals
  • regular consumption of alcoholic beverages in large quantities
  • hepatitis
  • helminthiases;
  • stomach ulcers and duodenal ulcers
  • tumors of the gland of benign and malignant nature
  • intoxication with various chemical and biological substances
  • cholelithiasis
  • heredity;
  • persistent stress.

Classification

Depending on the morphological changes:


  1. Inductive. In the gland tissues there are infiltrated sites
  2. pseudocystic. Characterized by the formation of pathological cysts in the parenchyma of the gland
  3. pseudotumorous. As the pathology progresses, an increase in the gland’s head is observed. This, in turn, creates an obstacle for a complete outflow of bile from the gallbladder (an enlarged head presses on it). As a result, a person experiences mechanical jaundice
  4. calcining. Calcium salts accumulate in the excretory ducts of the pancreas.

Forms


  • Chronic relapsing. Usually, it develops after the acute form of the pathology. It is characterized by alternation of periods of exacerbation and remission;
  • Primary chronic. It flows without significant symptoms.

Symptoms

Symptoms of chronic pancreatitis are due to the stage of the disease. With an exacerbation of chronic pancreatitis, all symptoms of an acute form of the disease are observed:


  1. pain syndrome in the abdomen. The patient can not clearly identify the site of pain localization
  2. nausea and vomiting
  3. bloating
  4. blood pressure reduction
  5. loose stools
  6. temperature increase;
  7. jaundice of the skin;
  8. Renal failure may occur.

Symptoms of chronic pancreatitis are less pronounced during the remission phase. Pathology may not manifest itself at all. With an exacerbation of chronic pancreatitis, such symptom-complexes appear:


  • pain syndrome
  • dyspeptic syndrome: nausea and vomiting, bitter taste in the mouth, heartburn
  • A sick person has diarrhea. As the pathology progresses, there is a loss of taste;
  • weakness;
  • because of a dysfunction of the gland, pancreatogenic diabetes begins to develop;
  • jaundice (mechanical type).

Diagnostic measures

Chronic pancreatitis can successfully mask for other pathologies over a long period of time. Symptoms that indicate an exacerbation of chronic pancreatitis are quite similar to those of peptic ulcer, cholelithiasis and others. Therefore, it is important to conduct a thorough diagnosis.

Standard Diagnostic Plan:


  1. Inspection. In the eyes immediately rushes that the patient is very thin. A severe pain syndrome forces the victim to assume the position of the embryo on the bed. In case of progression of the pseudotumorous form, changes in the color of the skin are observed — it becomes icteric;
  2. palpation
  3. A clinical blood test
  4. blood biochemistry
  5. analysis to determine the activity of enzymes that produce pancreatic;
  6. coprogram (excrements can reveal excess undigested fats)
  7. Ultrasound;
  8. CT;
  9. MRI.

Complications

If in time not to conduct a competent and full-fledged treatment of chronic pancreatitis, then against its background, the following complications will progressively progress:


  • pancreatic ascites
  • pancreatogenic type of diabetes;
  • abscess;
  • formation of phlegmon in retroperitoneal space
  • inflammatory process in the excretory ducts
  • duodenal obstruction in chronic form
  • B12-deficiency anemia
  • portal hypertension
  • gastrointestinal bleeding may occur due to rupture of pseudocysts
  • formation of malignant tumors

Treatment

Treatment of chronic pancreatitis is carried out under stationary conditions and under the constant supervision of specialists. The doctor determines the method of treatment proceeding from the severity of the course of the disease. Possible complications are also taken into account. During the treatment it is required to follow a special diet. Nutrition for chronic pancreatitis should be balanced. Completely excluded sour, smoked, fatty and spicy food. It is also important to drink at least 2 liters per day.





Conservative treatment:


  1. analgesic therapy
  2. detoxification of the body
  3. Elimination of the symptoms of an illness
  4. Normalization of the digestive tract
  5. taking anti-inflammatory drugs
  6. diet therapy. The necessary menu is made by a dietician, taking into account the severity of the pathology and characteristics of the patient’s body
  7. taking cholagogue medicines that normalize the outflow of pancreatic juice
  8. medicines. Containing active substances, reduce the secretion of gastric juice.

Surgical methods of treatment of pathology are used in case of ineffectiveness of conservative therapy, as well as in the presence of obstruction of the bile ducts, purulent foci, sphincter stenosis, cyst formation, etc.

Types of interventions:


  • pancrectomy;
  • sphincterotomy
  • opening of abscesses with their subsequent sanation
  • excision of formed conglomerates localized in the pancreatic ducts
  • vasectomy
  • virsung-duodenostomy
  • In case of severe illness, the gallbladder is completely removed.

After carrying out any type of surgery, the patient still remains in the hospital for some time under the supervision of doctors (until complete stabilization). In the postoperative period it is shown to adhere to a diet, to limit physical activities. If necessary, the doctor prescribes medications that reduce pain and normalize the functioning of the digestive tract.

Diet therapy

The diet must be observed, as the use of «dangerous» foods can trigger a new attack of pancreatitis. Diet for pancreatitis excludes use:


  1. caffeine;
  2. alcohol;
  3. fatty foods
  4. red meat
  5. rich stock;
  6. Sugar
  7. Sweets
  8. carbonated beverages
  9. canned food
  10. smoked products
  11. spicy dishes and stuff.

If you follow a diet in the diet, you can include fruits, vegetables, cereals, low-fat dairy products, low-fat fish. The diet for chronic pancreatitis is as follows:


  • food is taken in small portions;
  • be sure to consume enough water
  • meals should be taken 4-5 times a day.

If you follow a diet, it is important to consume vegetables in a baked or boiled form. It is better to give preference to beets, courgettes, cauliflower, peas, carrots. Fruits should preferably be sweet and fully ripe.

The diet is observed not only during treatment, but also after it (not to provoke an exacerbation).

Prevention

In order not to learn how to treat chronic pancreatitis, it is necessary to do timely prevention of the disease, which includes:


  1. Quitting smoking
  2. excluding the use of alcoholic beverages;
  3. dieting
  4. the regular passage of preventive examinations for narrow specialists