Helpful Hints
How to treat acute pancreatitis. Chronic pancreatitis: symptoms, treatment, diagnosis

How to treat acute pancreatitis. Chronic pancreatitis: symptoms, treatment, diagnosis

Pancreatitis is an inflammation of the pancreas. The acute form of the disease is provoked by the most insignificant factors. It is very important to identify symptoms as soon as possible.

Symptoms of exacerbation of pancreatitis are complicated by the fact that the pain syndrome is difficult to stop even with the help of medications. To alleviate the pathology and improve the general condition, immediate therapy is necessary.

Causes of exacerbation

The main cause of exacerbation is a significant violation of dietary nutrition and the intake of alcoholic beverages. Even in small quantities, alcohol is in 1st place. After, in order of importance:

Lack of protein intake.
Psycho-emotional experiences, stressful situations.
The use of medications (hormonal drugs, aspirin, certain antibiotics, chemical drugs for the treatment of cancer).
Acute form of cholecystitis and cholelithiasis, cholangitis.
Poisoning and acute infectious diseases.

During exacerbations, the activity of pancreatic enzymes increases significantly, the pancreatic tissue can be irritated under their influence, swelling appears, the large pancreatic duct is compressed, and the blood supply to the gland decreases.

Exacerbation symptoms

Exacerbation of pancreatitis is a serious problem that can harm the health and life of the patient. Therapy is carried out only in stationary conditions, since there is a risk that the patient will die without timely assistance from a specialist. For most, exacerbation of pancreatitis occurs with no symptoms. Sometimes it gives discomfort loose stools or pain near the left hypochondrium. Signs of acute pancreatitis cannot go unnoticed.

General signs

This condition is characterized by the following symptoms:

All of the above symptoms appear both singly and in combination. When the pain is very pronounced, then a dyspeptic disorder probably occurs, during which a sudden deterioration in the condition can be observed. In some patients, the exacerbation proceeds with a less pronounced pathology: pain sensations of a dull nature appear, nausea appears from time to time, constipation alternates with diarrhea, and appetite decreases. In this state, a person can stay for weeks. Pronounced dyspepsia, gag reflex and loss of appetite lead to a significant and rather sudden decrease in body weight - in 1-2 weeks the patient will lose up to 8 kg. In such situations, when increased appetite is noted, diabetes mellitus occurs.

Other symptoms of acute pancreatitis

With an exacerbation of pancreatitis, the following symptoms may occur:

Since such symptoms accompany not only pancreatitis, but also other pathological processes in the organs of the gastrointestinal tract, a specialist should diagnose the problem and prescribe treatment. It is possible to carry out this only based on the indications of diagnostics.

Diagnosis of the disease

In general, diagnosing an exacerbation of pancreatitis is not a difficult task; in order to prevent the development of adverse effects, the required tests should be done in time and specialized diagnostic methods should be carried out:

First aid

With an exacerbation of pancreatitis, it is important to provide first aid in a timely manner, since non-compliance with the rules can only aggravate the situation:

An ambulance should be called even when the patient does not know that he has an exacerbation of pancreatitis. After all, such pathological processes are dangerous because they can subside for a certain period of time, and then suddenly give a relapse.

Treatment of the disease

In many situations, exacerbation of pancreatitis lasts no more than a week and does not cause significant harm to the patient's health. The primary objectives of treatment for this disease of the pancreas:

relieve pain;
restore the fluid content inside the body;
unload the pancreas, preventing further development of pathological processes.

During the first treatment of the patient to a specialist, non-steroidal drugs are prescribed. In many cases, they make it possible to significantly reduce the severity of the symptoms of the disease. In treatment, preference is given to paracetamol, since it has the least negative effect on the gastric mucosa. It is undesirable to use this remedy when the cause of the inflammatory processes of the pancreas is a pathology of the liver. If there is no expected result, then the patient is prescribed narcotic analgesics. Often choose Tramadol. Additional remedies for the treatment of pancreatitis in the pancreas and relief of symptoms:

enzymes;
antispasmodics;
proton pump inhibitors.

To unload the pancreas use:

diet food with severe fat restriction or fasting for several days;
restriction of alcoholic beverages and tobacco smoking;
Octreotide is an analogue of the pancreatic hormone somatostatin.

The same signs that appear in acute and chronic pancreatitis are sharp, pronounced pain near the peritoneum. The pain is localized in that part of the pancreas, which is covered by inflammation. Pain syndrome during exacerbation of the pancreas is the strongest. It occurs near the abdomen or hypochondrium, radiates to the back, under the shoulder blade and behind the sternum. If a patient has characteristic signs of an exacerbation of the disease, it is important to contact a specialist without delay. Recovery processes and the likelihood of complications depend on timely treatment.

Let's figure out how to relieve an exacerbation of pancreatitis, how long does it last and what to do to avoid it? The answers to these questions are important for patients with a chronic form of the disease.

How long does an exacerbation last?

The acute phase can last from several hours to seven days, sometimes longer. How long the exacerbation of pancreatitis lasts depends on the length of the disease and the aggressiveness of the provoking factor. A simple violation of the diet causes a short-term deterioration in well-being, and taking a large amount of alcohol, a long course of antibiotics, cytostatics, or an exacerbation of cholelithiasis lead to long-lasting symptoms.

If the experience of the disease is small, the exacerbation of the process with severe pain can last a week or more. In patients with a long history of the disease, the intensity and duration of the pain component of the exacerbation decrease, the remaining symptoms persist for a long time, but are not so pronounced.

The duration of the exacerbation also depends on the age of the patient, the presence of concomitant diseases. Usually, treatment lasts for a month, and maintenance therapy lasts at least 6 months.

Signs of exacerbation of pancreatitis

In the early stages, signs of exacerbation of pancreatitis resemble the clinic of an acute form of the disease that occurs with severe pain. As a rule, the pain decreases when bending forward, squats.

In addition to abdominal pain, the patient complains of the following:

belching with air or food eaten, heartburn;
rumbling in the abdomen, increased gas formation;
unstable stool with a tendency to diarrhea;
the presence of undigested food particles, impurities of mucus, blood in the feces;
nausea, vomiting with an admixture of bile, which does not bring relief;
fever, muscle pain, chills;
fatigue, lack of appetite, irritability.

If the process is long, the pain syndrome is no longer leading. In adult patients, complaints of icterus of the skin and sclera come to the fore. Light stools and dark urine may appear.

Symptoms

Symptoms of exacerbation of pancreatitis in patients with a short duration of the disease are very similar to an acute attack. The main symptom in the clinical picture is severe and prolonged pain.

There are several types of pain syndrome, depending on its nature and localization:

Ulcerative pains. Night and hungry pains in the epigastric region are characteristic, which requires differential diagnosis with a stomach ulcer.
Pain resembling left-sided renal colic. Localized in the left side and lumbar region on the left.
Pain simulating exacerbation of cholecystitis or acute appendicitis. They are localized in the right hypochondrium and in every 2-3 patients are accompanied by the appearance of yellowness of the skin and sclera. When jaundice occurs, it is necessary to exclude the tumor process.
Pain accompanied by impaired intestinal motility (belching, nausea and vomiting after eating make them look like manifestations of intestinal dyskinesia).
Intense pain without a specific localization, as in the picture of an acute abdomen with the development of peritonitis.

On examination: the skin is pale, dry, there is a whitish coating on the tongue, with a long course of the disease, atrophy of the taste buds is possible. On palpation of the abdomen, the doctor can determine the dense, enlarged and painful head of the pancreas. The abdomen is swollen, painful in the epigastric region and left hypochondrium.

With exacerbation of pancreatitis in patients suffering from this disease for many years, abdominal pain is less pronounced, disturbing for a short time. This is due to progressive pancreatic insufficiency due to fibrotic changes in its tissues.

The following manifestations of pathology become dominant:

Intermittent jaundice of varying severity.
Steatorrhea (frequent, offensive, greasy stools).
Malabsorption syndrome with severe weight loss.
Diabetes mellitus with high levels of glucose in the blood, resistant to correction with sugar-lowering drugs.

Even a chronic process that proceeds in an erased form with a mild exacerbation clinic is dangerous, as it leads to a gradual degeneration of the pancreas.

Exacerbation during pregnancy

Chronic pancreatitis may worsen during pregnancy. During this period, the body experiences overload, as a result of which there is a risk of activation of any inflammatory process.

Deterioration of pancreatic function during pregnancy can also be triggered by unbalanced nutrition, dietary disorders due to a woman's altered taste preferences.

What to do with an exacerbation?

What to do with exacerbation of pancreatitis? First of all, you need to call an ambulance.

If symptoms of pancreatitis appear, first aid for an exacerbation includes the following steps:

complete exclusion of food and liquid intake;
observance of rest, you need to lie in bed on your back, with vomiting, you can take a position lying on your side with your knees pressed to your stomach;
using an ice pack as a cold compress on the abdomen.

After delivery to the hospital, the patient will be examined, based on the results obtained, the doctor will choose the most effective therapeutic tactics. It is forbidden to independently prescribe pills and administer medications during exacerbation of pancreatitis.

If the exacerbation of a chronic process is limited to nausea after eating, the appearance of diarrhea, abdominal discomfort, you still need to contact a specialist for advice to avoid complications. After the examination, the doctor will decide where it is necessary to undergo a course of treatment - in an inpatient or outpatient setting.

Is it possible to remove the exacerbation at home?

Aggravated pancreatitis always carries a potential threat of the development of necrotic changes in the gland tissue. Pancreatic necrosis requires urgent medical care in a surgical hospital, as it can lead to death in the shortest possible time.

Many patients with exacerbation of pancreatitis are interested in how to relieve pain. But it is important to remember that at home, while waiting for doctors, the patient should never take painkillers. They will not have the desired effect, but they can distort the clinical picture. An antispasmodic tablet (No-shpa, Papaverine) will alleviate the patient's condition.

If the degree of exacerbation of the chronic inflammatory process allows you to be treated at home, you must strictly follow all the doctor's recommendations. In this case, the main therapeutic method is diet, drinking regimen and taking prescribed drugs.

Treatment Methods

If pancreatitis is in the acute stage, treatment is aimed at suppressing the production of proteolytic enzymes by the gland, which destroy its own tissue. Complex therapy should be used against the background of a protective regime with the complete exclusion of any loads. The main role is given to drug therapy.

Medicines for exacerbation of pancreatitis in adults are the following:

solutions for detoxification infusion therapy;
anesthetics;
antacids;
protease inhibitors;
antispasmodics;
pancreatic enzymes;
anticholinergics;
antibiotics;
sedatives.

Which drug from different groups is optimal is always decided on an individual basis. In the phase of inflammation subsidence, confirmed by laboratory and instrumental methods, exercise therapy, physiotherapy (electro- and phonophoresis with anesthetics and antispasmodics, mud therapy, magnetotherapy) are added to the treatment.

How and how to treat an exacerbation of pancreatitis, if conservative methods do not help, pain persists, and there is a threat of complications? All these circumstances make urgent surgical intervention necessary.

Folk remedies

How to relieve an exacerbation of pancreatitis at home with the help of folk remedies? With an exacerbation, resorting to the use of folk recipes is not only useless, but also dangerous. Various infusions and decoctions of medicinal plants are widely used in the chronic form of the disease in remission. Their choice should be agreed with the gastroenterologist.

Trying treatment with folk remedies, you can lose valuable time and create a serious threat to life. In a hospital, after the inflammatory phenomena subside, if the attending specialist allows, the patient can take herbal and vitamin teas, decoctions, infusions.

Cholagogue herbs are effective in exacerbation of pancreatitis, but their use is possible only in the absence of gallstones. The collection should contain corn stigmas, tansy, rose hips, St. John's wort, chamomile, immortelle, mint. You should mix dry medicinal raw materials, prepare an infusion and take it warm before meals 3 times a day for a month.

A decoction made from chicory root also has a good effect. It should be taken between meals 3 times a day, 100 ml.

You can mix in equal parts the following dried medicinal herbs: St. John's wort, sage, chamomile, calendula, wormwood. Then prepare a decoction in a water bath and take half a glass before meals for a month.

Diet for exacerbation of pancreatitis

The diet, frequency of food intake and its volume are regulated by the attending specialist.

1 day - fasting;
Day 2 - drinking alkaline mineral water, rosehip broth;
on the 3-5th day, liquid cereal porridges on the water are allowed.

Then there is a gradual expansion of the diet: the use of vegetable soups, lean meats and fish is allowed. Proper nutrition is the basis for the treatment of inflammation of the pancreas and its prevention.

Food should be boiled or steamed. You need to eat often, take food in a warm form and in small volumes. Fried, spicy foods, carbonated drinks, canned food are strictly prohibited. It is important that the mineral water used for acute pancreatitis is degassed.

Prevention

To avoid the progression of pathology, you need to know why the disease can worsen, and avoid the influence of negative factors.

The following preventive measures must be taken:

strict adherence to diet number 5a;
refusal of alcohol;
compliance with the regime of work and rest with the exception of physical and nervous overload;
dispensary observation by a gastroenterologist with the passage of prescribed tests and examinations at least twice a year;
course intake of pancreatic enzymes prescribed by a specialist;
control of cholesterol and blood sugar levels;
courses of drugs that normalize the motility of the stomach and intestines, several times a year;
therapy of concomitant chronic diseases of the gastrointestinal tract;
exclusion of toxic effects on the body - uncontrolled medication, occupational hazards;
treatment in sanatoriums of the corresponding profile.

Chronic pancreatitis is an insidious and dangerous disease, exacerbations of which significantly reduce the quality of life and cause serious damage to health. To avoid them, you need to be regularly observed by a gastroenterologist, take supportive therapy, and lead a proper lifestyle. A complete recovery is impossible, but the main task of the patient is to live and be treated in such a way as to make exacerbations rare and not dangerous to health.

Useful video about chronic pancreatitis

Chronic pancreatitis is considered to be a progressive damage to the pancreas of an inflammatory nature, which provokes failures of exocrine and intrasecretory functions. This, in turn, leads to a decrease in the production of enzymes involved in digestion, important hormones (for example, insulin) and a number of biologically active substances. Therefore, all patients need to identify the symptoms in time and follow the timely and adequate treatment prescribed by the doctor.

What is chronic pancreatitis?

Chronic pancreatitis is an inflammatory disease of the pancreas of a long relapsing course, characterized by a gradual pathological change in its cellular structure and the development of functional insufficiency.

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

Most often, the disease occurs due to alcohol abuse for a long time. In men, chronic pancreatitis of the pancreas can develop if they drink for more than 15 years, in women with alcohol abuse for more than 10 years.

The reasons

The main mechanism for the development of chronic pancreatitis is an increase in pressure in the pancreatic duct and stagnation of pancreatic juice in it. Prolonged stagnation in the duct leads to a violation of its structure, as a result of which pancreatic enzymes easily penetrate into their own tissue, destroying its cells (autolysis) and the development of a chronic inflammatory process

It may take 10-15 years when the signs of chronic pancreatitis become so obvious that there will be no doubt about the diagnosis. The disease may occur due to:

Cholecystitis, or chronic form.
or duodenum.
Infectious lesions -, typhoid or typhus, viral.
Excessive consumption of alcoholic beverages.
Unregulated diet.
Atherosclerotic disease.
Penetration into the body.
Intoxication with harmful substances - arsenic, phosphorus, mercury, lead.

Stages of development of the chronic form

Stage of pancreatitis
Light	Adults at this time begin to suffer the first symptoms of the disease. The duration of the stage can be several years. In some cases, the disease progresses very quickly. Number of exacerbations 1-2 times a year.
Medium	The stage of development of permanent clinical symptoms. Patients develop signs of endocrine and exocrine insufficiency. People eat very little, complain of pain in the abdomen. There are 3-4 exacerbations per year. They are longer than with a mild course. In sick people, body weight decreases. The exocrine function of the pancreas moderately decreases, pancreatic hyperenzymemia is observed.
heavy	Regular and prolonged attacks (more than 5 times during the year) with intense hostility and pronounced symptoms. Weight is significantly reduced to exhaustion, a sign of which is diarrhea. Sometimes adverse effects can be added - duodenal stenosis.

Symptoms of chronic pancreatitis

Often, the initial pathological changes in the tissues of the gland during the development of chronic pancreatitis occur without symptoms. Or the symptoms are mild and nonspecific. When the first pronounced exacerbation occurs, pathological disorders are already quite significant.

Chronic pancreatitis is a condition accompanied by:

Pain discomfort, and the degree of intensity can be different. The place of localization is the epigastric region and the left hypochondrium. The pain is present either constantly or comes on paroxysmal. After the patient eats something, the symptom will increase.
Dyspeptic disorders- nausea, urge to vomit, sensations of heaviness in the abdomen, an unpleasant aftertaste in the oral cavity,. The patient may have an aversion to fatty foods, and sometimes the appetite disappears.
For many years, the patient may complain about unpleasant symptoms in the form of short-term pain sensations that bother him after 15 minutes after eating. The discomfort lasts from one hour to 3-5 days. The place of their concentration is the upper abdomen, sometimes pain is felt near the heart or to the left of the chest or lumbar. In certain situations, it is encircling. You can reduce its strength if you lean forward or squat.
The patient's skin becomes an unexpressed yellow color. The same applies to the sclera. The yellowness of the skin from time to time passes.
Due to lack of pancreatic enzymes the process of splitting the complex molecules of the food we consume into smaller ones that can be absorbed in the intestines is disrupted. In connection with this circumstance, with pancreatitis, even enhanced nutrition may be accompanied by weight loss, lack of vitamins in the body, dry skin, brittle nails, lack of iron in the body () and other symptoms.

With chronic pancreatitis, pain occurs as a result of:

problems with the outflow of pancreatic juice;
increase in the volume of secretion of the gland;
pancreatic ischemia;
inflammation located around the fiber;
changes in nerve endings;
squeezing nearby organs.

With the development of the disease exacerbation frequency usually increases. Chronic inflammation of the pancreas can lead to damage to both the gland itself and adjacent tissues. However, it may take years before clinical manifestations of the disease (symptoms) appear.

Aggravation

Chronic pancreatitis can worsen for two of the most common reasons:

taking large doses of alcohol;
violation of the function of the biliary tract.

There are also many reasons that are less important, but significantly increase the incidence of exacerbations of chronic pancreatitis:

regular intake of small doses of alcohol;
tendency to overeat;
smoking;
overweight;
the use of a sick amount of fat;
taking medications;
infectious diseases;
frequent stress.

In most cases, the signs of exacerbation of chronic pancreatitis are manifested in the form of constant, acute and severe pain felt under the ribs, reflected in the back.

Often the pain is atypical, disguises itself as other diseases, is most pronounced in the upper back, and is blurred over the stomach.
Sometimes the pain radiates to the chest, to the side, felt in the depths of the body, which is typical for exacerbation of pancreatitis.

Characteristic signs of exacerbation of chronic pancreatitis:

Severe pain, which can be dull or sharp in the abdominal cavity without a clear localization, worse after eating and radiating to the back.
Frequent diarrhea with an admixture of fatty particles in the stools.
Feeling of bitterness in the mouth.
Vomiting, interspersed with bile, difficult to eliminate with drugs.
Strong nausea.
Loss of appetite.
White coating on the tongue.

All of the above signs can appear as a whole bouquet, or one by one. If a person suffers from severe sharp pain, then dyspeptic syndrome can be observed, in which the patient's well-being is rapidly deteriorating.

Complications

If competent and complete treatment of chronic pancreatitis is not carried out in time, then the following complications will actively progress against its background:

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

Diagnostics

Treatment of chronic pancreatitis can be carried out by both a general practitioner and a gastroenterologist. With the development of endocrine insufficiency, a consultation with an endocrinologist is indicated, with compression of surrounding organs - a surgeon.

The diagnosis can be made only after the implementation of such research methods:

changes in the content of elastase in urine - the main method of clinical examination of the patient;
detection of steatorrhea - the presence of undigested fat in the feces;
implementation of a research test for stimulation of the gland;
CT according to indications;
taking a blood glucose test and undergoing a glucose sensitivity test.

How to treat chronic pancreatitis?

When describing the patient's plan for the upcoming treatment, the doctor sets quite specific goals. Necessary:

eliminate pain;
provide the pancreas with rest;
reduce its secretory activity;
compensate for the deficiency of pancreatic enzymes;
to correct the disturbed metabolism of carbohydrates (if necessary).

To achieve these goals in the non-surgical treatment of patients with all types of chronic pancreatitis, different methods should be applied.

The complex effect of various therapeutic factors (diet therapy, medications, physiotherapy, etc.) is more effective.

Medications

In chronic pancreatitis, the following medications may be prescribed:

Enzyme-containing products. They are aimed at reducing the load on the pancreas and accelerating the process of tissue regeneration. Digestive enzymes facilitate the process of digestion and assimilation of food, facilitate the work of the gastrointestinal tract. With their constant intake, nausea disappears, appetite appears. Enzyme-containing preparations include: Creon, Pancreatin, etc.
Antacids reducing acidity. According to the principle of action, they are divided into: absorbable (Renny) and non-absorbable (Almagel,). Suctions provide quick but short-term relief. The action of non-absorbable is longer, the effect occurs some time after ingestion.
Analgesics are aimed at getting rid of the pain that occurs with pancreatitis during an exacerbation. Antispasmodics (No-shpa, Papaverine) are prescribed to relieve spasms of the main pancreatic duct.
Antisecretory drugs(Famotidine, Omeprazole) are prescribed to neutralize the acid.
Anti-inflammatory drugs(Diclofenac) reduce pain by reducing inflammation in the pancreas.
Decreased active secretion of the gland, drugs (Octreotide, Sandostatin) are used for exacerbation of chronic pancreatitis, with severe pain that is not relieved by antispasmodics.
Prokinetics (Motilium, Cerucal) are used to suppress nausea and vomiting during an exacerbation.

Treatment for exacerbation of chronic pancreatitis

Features of the treatment of a severe attack consists of strict adherence to bed rest, diet and taking appropriate medications only in a hospital, since there is a real threat not only to health, but also to human life. Before the ambulance arrives, the patient should be given first aid:

Absolute hunger.
Apply cold to the pancreas area.
Complete rest and bed rest.

Many patients would like to clarify how long an exacerbation of chronic pancreatitis can last? Doctors emphasize that in most episodes, the recurrence of the disease does not exceed 7 days.

Auxiliary drugs for the relief of pain:

enzymes (Creon or Pangrol);
antispasmodics (drotaverine or papaverine);
proton pump inhibitors (lansoprazole, rabeprazole).

In order to unload the pancreas, apply:

a diet with severe fat restriction or complete fasting for several days;
complete exclusion of alcohol and smoking;
Octreotide is an analogue of the pancreatic hormone somatostatin.

Operation

Surgical operations for chronic pancreatitis:

sphincterotomy for blockage of the sphincter of Oddi;
excision of stones in the ducts of the pancreas with calculus obturation;
opening and sanitation of purulent foci (abscesses, phlegmon, cysts);
pancreectomy (full or partial);
vasectomy, splanchectomy (operations for excision of the nerves that regulate the secretion of the gland), partial
excision of the stomach (resection);
removal of the gallbladder in case of complications from the large bile duct and gallbladder;
techniques for creating circumferential bile outflows to relieve the load from the main pancreatic ducts (wirsungoduodenostomy, etc.).

Diet and principles of nutrition

In adults, the disease becomes chronic, which means that due attention should be paid to nutrition, since it can prevent exacerbations. Each exacerbation entails the replacement of a normally functioning glandular tissue with a fibrous one. Therefore, over the years, the patient develops insufficiency of the gland, exocrine and intrasecretory.

The basic principles of nutrition in chronic pancreatitis:

Diet No. 5p for chronic pancreatitis provides for the introduction of more protein foods into the diet due to the exclusion of fatty and carbohydrates. It is also necessary to abandon coarse vegetable fibers and fatty meats.
Fried foods are not allowed. It is recommended to cook food in a double boiler, stew and bake in its own juice.
All products that cause dyspepsia and increase the production of enzymes are also excluded from the menu.
Food with a patient's diet for chronic pancreatitis should be balanced in composition, dishes are served in a warm and semi-liquid form.
The food is fractional, consists of 5-6 meals, while portions of a small volume.
A complete ban on the use of alcoholic beverages eliminates the main risk factor for the pancreas.
New foods in the diet should be introduced carefully, in small portions.
at the slightest indisposition, it should be abandoned until the pancreas is more fully stabilized;
The recommendation for thorough chewing of food is also appropriate for a healthy body, but with a disease of the pancreas, this rule should be observed especially carefully, even if pureed soup is served.

The diet during exacerbation of chronic pancreatitis, despite the restrictions, is very diverse. It is allowed to include in the diet:

meat and poultry of low-fat varieties;
lean fish in boiled form;
vegetarian vegetable pureed soups;
vegetarian soups with rice, pasta, buckwheat, semolina, oatmeal;
boiled pureed vegetables (potatoes, carrots, zucchini, cauliflower, pumpkin);
omelets from 2 eggs;
low-fat dairy products, non-acidic and low-fat cottage cheese, sour cream and cream in moderation, fermented milk products;
ripe fruits with low acidity, pureed berries, baked apples;
compotes and weak tea with lemon;
a moderate amount of butter and vegetable oil;
cereals cooked in water and milk in a ratio of 1: 1;
boiled pasta;
sugar-free cookies and homemade wheat bread crackers.

Dishes with juice action are contraindicated for patients:

meat,
bone,
mushroom and fish broths,
fried foods.

Of fundamental importance is the rejection of alcoholic beverages, since they are strong stimulants of pancreatic secretion.

During the period of remission the list of products is expanding and the inclusion of vegetables and fruits already in raw form is shown. Vegetables are used in salads, side dishes, vinaigrettes and as independent dishes. In addition to cereals, you can make pilaf with dried fruits and boiled meat, pasta, cereals. Soups are cooked not pureed and beetroot, borscht and cabbage soup are carefully introduced. Homemade sauces and spices are used to improve the taste.

In chronic pancreatitis, a treatment course of taking mineral water is often prescribed. To achieve the effect, they drink water not to quench their thirst, but according to the recommendations of the reception, certain types of it and according to the specified system.

Assign a course of water intake of brands Essentuki No. 4, Borjomi and Smirnovskaya, which have a special effect on the pancreas:

prevent stagnant processes in the bile ducts, in the pancreas itself;
reduce the risk of inflammatory processes;
normalize the work of the stomach and intestines.

Prevention

In order not to learn how to treat chronic pancreatitis, it is necessary to take timely action to prevent the disease, which includes:

to give up smoking;
exclusion of the use of alcoholic beverages;
dieting;
regular preventive examinations by narrow specialists.

Chronic pancreatitis should be treated under the supervision of a gastroenterologist. When the first signs described in the article appear, be sure to undergo diagnostics to make an accurate diagnosis.

A person who suffers from chronic pancreatitis most of the time does not suffer from his disease. Symptoms during remission are either mild or absent. Treatment in most cases is reduced to the appointment of a diet and pancreatitis in case of pancreatic insufficiency. But during the period of exacerbation, the patient's condition deteriorates sharply, so he needs drug therapy, and often hospitalization in a surgical or gastroenterological department.

General principles of treatment

In the case, the symptoms can increase very quickly, within a few hours. And in order to stop the inflammatory process in the pancreas, as well as improve the patient's condition, he often needs emergency drug therapy. On the first day after a person enters the hospital, the tasks of the doctor are as follows:

maximum unloading of pancreatic function;
relief of pain;
fight against intoxication of the body;
prevention of complications.

In the future, a person is prescribed a diet, enzyme replacement therapy, as well as drugs that reduce the activity of the pancreas. It is also necessary to deal with the consequences of an exacerbation of the inflammatory process. More often they can be dealt with by conservative methods. Sometimes you have to use surgical methods of treatment.

In the first hours after a person enters the hospital, his stomach is washed. This measure is necessary to reduce the production of the pancreas. For the same purpose, the patient is prescribed bed rest. Some doctors recommend putting ice on a person's stomach to reduce the activity of the pancreas.

In order to reduce the load on the organ affected by the pathological process, the patient is prescribed fasting. Its duration varies, depending on the patient's condition. On average, in the treatment of exacerbation of chronic pancreatitis, hunger is prescribed for 1-2 days. In a severe exacerbation, a person may be on a zero diet for a week or more. In this case, he is shown feeding through a tube or introducing nutrient solutions into a vein.

After a decrease in the severity of clinical symptoms, when the function of the pancreas begins to gradually recover, the patient is prescribed a diet. Its features:

too sour or salty foods are prohibited;
alcohol is prohibited;
fatty foods are prohibited;
limited products of animal origin;
the basis of the diet is plant foods;
a fractional diet is set up to 7 times a day;
preference is given to dishes of a uniform consistency.

Relief of pain

Relieve the pain - this is the first thing the doctor should do, to the department of which the patient was admitted with abdominal. At the initial stage, for analgesic treatment for exacerbation of pancreatitis, the following is prescribed:

antispasmodics (platifillin, drotaverine);
non-steroidal anti-inflammatory drugs (paracetamol);
in case of ineffectiveness of NSAIDs - narcotic analgesics (tramadol, promedol);
percutaneous blockade of the celiac plexus with lidocaine (an invasive and therefore rarely used method of pain treatment);
large doses of pancreatin (Pangrol, Creon).

As a rule, the intensity of pain decreases a few days after the onset of an exacerbation. Then painkillers are canceled or their doses are reduced. In addition to the analgesic effect, the above drugs have other effects:

paracetamol can reduce swelling of the pancreas;
drotaverine relaxes the pancreatic ducts and normalizes the evacuation of pancreatic juice;
on the principle of feedback inhibit its activity.

Fight against intoxication

When digestive enzymes enter the bloodstream, a pronounced intoxication syndrome is observed. It is also present in the case of jaundice, which is a consequence of the obstruction of the bile ducts. Then one of the elements of treatment for exacerbation of chronic pancreatitis will be detoxification therapy, which is carried out by introducing colloid and crystalloid solutions into the vein.

Often used the method of forced diuresis. It involves the additional use of diuretics. Most often, loop diuretics, such as torasemide or furosemide, are prescribed for this purpose. But it should be borne in mind that they remove potassium from the body. Therefore, in order not to provoke muscle cramps and interruptions in the work of the heart, it is necessary to additionally prescribe potassium chloride to the patient.

Occasionally, a patient with an intoxication syndrome is prescribed:

inhibitors of proteolytic enzymes;
plasmapheresis;
hemosorption;
lymphosorption.

These methods and drugs do not bring the desired effect, so they are gradually losing popularity among doctors. Increasingly, in new books on the treatment of pancreatitis, the authors point to the need for the use of Kontrykal, Gordox and other drugs that inhibit the activity of pancreatic proteases.

Antibacterial treatment

With an exacerbation of pancreatitis, there is a threat of a bacterial infection. Regardless of whether the presence of microbes in the pancreas is confirmed, in severe exacerbations of the disease, doctors prescribe broad-spectrum antibiotics to the patient. They do it because:
it is very difficult to identify an infection against the background of an intoxication syndrome by clinical signs, therefore, in