How to treat pancreatin during an exacerbation. Symptoms and treatment for exacerbation of pancreatitis

Pancreatitis is 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 relieve 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 consumption of alcoholic beverages. Even in small quantities, alcohol is in 1st place. After, in order of importance:

1. Lack of protein intake.
2. Psycho-emotional experiences, stressful situations.
3. Use of medications (hormonal drugs, aspirin, certain antibiotics, chemical medications for the treatment of cancer).
4. Acute form of cholecystitis and cholelithiasis, cholangitis.
5. 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.

Symptoms of exacerbation

Exacerbation of pancreatitis is a serious problem that can harm the health and life of the patient. Therapy is carried out only in a hospital setting, since there is a risk that the patient will die without timely assistance from a specialist. For most, exacerbation of pancreatitis occurs without any symptoms. Sometimes loose stools or pain near the left hypochondrium give discomfort. Signs of acute pancreatitis cannot go unnoticed.

General signs

This condition is characterized by the following symptoms:

All of the above symptoms appear both individually and collectively. When the pain is very severe, a dyspeptic disorder probably occurs, during which a sudden deterioration in the condition can be observed. In some patients, an exacerbation occurs with a less pronounced pathology: dull pain appears, nausea appears from time to time, constipation alternates with diarrhea, and appetite decreases. A person can remain in this state for weeks. Severe dyspepsia, a 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

When pancreatitis worsens, the following symptoms may occur:

Since such symptoms accompany not only pancreatitis, but also other pathological processes in the gastrointestinal tract, a specialist must diagnose the problem and prescribe treatment. This can only be done based on diagnostic indications.

Diagnosis of the disease

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

First aid

When pancreatitis worsens, it is important to provide first aid in a timely manner, since failure to follow 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 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 goals of treatment for this pancreatic disease are:

• relieve pain;
• restore fluid content inside the body;
• unload the pancreas, preventing pathological processes from further developing.

When the patient first contacts a specialist, non-steroidal drugs are prescribed. In many cases, they make it possible to significantly reduce the severity of symptoms of the disease. When treating, 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 inflammatory processes in the pancreas is liver pathology. If the expected result is not achieved, the patient is prescribed narcotic analgesics. Tramadol is often chosen. 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 with strict fat restriction or fasting for several days;
• limiting alcoholic beverages and smoking;
• Octreotide is a drug that is an analogue of the pancreatic hormone somatostatin.

The same signs that appear in acute and chronic pancreatitis are sharp, severe pain near the peritoneum. The pain is localized in the area of ​​the pancreas that is inflamed. The pain syndrome during exacerbation of the pancreas is the most severe. It occurs near the abdomen or hypochondrium, radiating to the back, under the shoulder blade and behind the sternum. If a patient experiences characteristic signs of an exacerbation of the disease, it is important to immediately contact a specialist. Recovery processes and the likelihood of complications depend on timely treatment.

When the pancreas becomes inflamed, the patient experiences recurrent pain that deprives him of sleep and rest. Acute pancreatitis is a serious disease that is difficult to treat conservatively. In the relapse stage, the probability of death is high, so it is necessary to treat the first symptoms of the pathological process. It is important to know which medications are allowed to be taken during exacerbation of chronic pancreatitis in order to ensure and extend the period of remission as soon as possible. Self-medication is excluded; it is life-threatening.

Causes of exacerbation of pancreatitis

Consuming alcoholic beverages and fatty (fried) foods with a weak pancreas contributes to exacerbation of pancreatitis, so the basis of any therapy becomes a therapeutic diet with a selective list of foods. In addition to alcohol consumption, the causes of this disease are presented in the following list:

• limited portions of protein foods;
• nervous shocks, stressful situations;
• acute infectious diseases;
• hereditary factor;
• smoking and other bad habits;
• consequence of drug therapy;
• relapses of cholecystitis, cholelithiasis, cholangitis;
• exposure to toxic, toxic substances;
• systematic overeating (excessive food load);
• chronic diseases of the liver, duodenum;
• old age;
• complications after surgery;
• autoimmune diseases;
• mechanical abdominal injuries.

Relapse begins with acute pain in the abdominal area, the localization of which is difficult to determine. In the absence of timely conservative therapy, the unpleasant feeling of pain only intensifies, the same thing happens after eating food and systematic overeating. To correctly differentiate exacerbation of pancreatitis, it is important to know its clinical manifestations:

• nausea, prolonged bouts of vomiting;
• vague feeling of pain, severe heartburn;
• rumbling, bloating, flatulence;
• severe signs of dyspepsia (weak stools, diarrhea);
• disruption of the endocrine system;
• increased body temperature, fever;
• dryness, bitterness in the mouth;
• lack of appetite, sudden weight loss;
• depression of the nervous system;
• nagging pain in the back of uncertain localization.

Diagnostics

When the first symptoms of acute pancreatitis appear, you must immediately contact a gastroenterologist, undergo a full examination of the body, and begin conservative treatment in a timely manner. The most informative diagnostic methods are presented below:

• collecting medical history data is necessary for the specialist’s first understanding of the prevailing health problem;
• a general blood and urine test is required for the timely detection of an inflammatory and infectious process;
• a biochemical blood test is needed to study the levels of hormones, trypsin, amylase, antitrypsin, lipase (hyperglycemia and glycosuria, leukocytosis cannot be excluded);
• coprogram, identifying pieces of undigested food in biological material, as one of the main signs of acute pancreatitis;
• X-ray, ultrasound of the abdominal cavity for visual examination and detailed study of the presumably affected organ, identifying calcification of organ tissue, swelling;
• endoscopic retrograde cholangiopancreatography for a real assessment of the condition and capacity of the biliary tract;
• The LUNDT test is necessary for laboratory testing of pancreatic juice by introducing a special liquid;
• secretin-pancreozymin study, in which a hormonal drug to assess the quality of pancreatic juice is administered only by injection;
• CT, MRI (as recommended by the attending physician) to identify or exclude the level of pancreatic fibrosis.

Treatment of exacerbation of pancreatitis

The disease is difficult and takes a long time to treat with medications; it requires an integrated approach to the health problem. The main goal of treatment is to relieve pain, restore the concentration of pancreatic juice, relieve the pancreas and prolong the period of remission. To achieve the desired result, you must strictly adhere to these valuable expert recommendations:

1. It is important to provide the patient with complete rest and reduce physical and emotional stress, especially during the next exacerbation.
2. Strictly adhere to a therapeutic diet with strict limitation of fatty, fried, salty, smoked and spicy foods.
3. The first two days of the exacerbation stage require you to completely stop eating and choose therapeutic fasting.
4. Cold must be applied to the suspected affected area to ease general well-being and get rid of unbearable pain.
5. It is important to control the flow of fluid into the body, regularly take medications such as Bourget's mixture for heartburn, Almagel, Gordox, Contrical against inflammation.
6. Regular intake of natural vitamins or full-course multivitamin complexes is encouraged.

Drug therapy

In the event of an attack of acute pain, action must be taken immediately. Oral intake of antispasmodics, analgesics, enzyme preparations, prokinetics, non-narcotic analgesics is encouraged on the individual recommendation of the attending physician (depending on the severity of symptoms in a specific clinical picture). Other medications are especially popular for exacerbation of pancreatitis, which should be taken in full course:

• H2-histamine blockers: Ranitidine, Famotidine;
• proton pump inhibitors: Omeprazole, Rabeprazole;
• to suppress pancreatic secretion: Somatostatin and Octreotide;
• anti-enzyme drugs: Kontrikal, Gordox.
• pancreatic enzymes: Creon, Pangrol;
• prokinetics: Motilium, Cisapride;
• anticholinergics: Atropine, Metacin, Platiphylline;
• antispasmodics: Drotaverine, No-shpa, Papaverine;
• non-narcotic analgesics: Metamizole sodium, Analgin, Paracetamol, Ketorolac;
• opioid analgesics: Tramadol, Promedol, Meperidine.

The above medications can only be prescribed by your doctor. Unauthorized choice of a complex treatment regimen can provoke an exacerbation of another disease of the digestive system (in addition to pancreatitis), side effects, acute signs of intoxication, and the risk of drug interactions. In addition to the pharmacological groups presented, it is important not to forget about the benefits of vitamin therapy and a therapeutic diet.

Surgery

Exacerbation of chronic pancreatitis does not always respond to successful conservative treatment; in some clinical situations, doctors insist on urgent surgery. It is first necessary to undergo a detailed diagnosis of the body to exclude potential health complications. After surgery, a rehabilitation period for pancreatitis is required, lasting from 3 to 6 months with the participation of drug therapy. Surgical methods are presented below:

1. Straight. Provides definitive removal of stones, pancreatic resection and drainage of pseudocysts.
2. Indirect. Surgical intervention is performed directly on the gastrointestinal tract and bile ducts, after which the condition of the pancreas improves significantly.

Conservative or surgical treatment of the disease must be timely and correctly selected. If you ignore the pronounced symptoms of exacerbation of pancreatitis or self-medicate for a long time, you can provoke serious health complications, sometimes incompatible with the patient’s life (for some patients they can result in death). Potential pathologies are presented in the following comprehensive list:

• internal bleeding;
• icteric cholestasis;
• thrombosis of the splenic veins;
• formation of pseudocysts;
• hypovolemic shock;
• infectious lesions of the body (abscesses);
• distress syndrome;
• renal failure;
• encephalopathy;
• pancreas cancer.

Prevention of exacerbation of pancreatitis

It is recommended to prevent the disease in a timely manner, and to do this, take preventive measures. This is especially true for patients at risk, the elderly. Otherwise, treatment of chronic pancreatitis in the acute stage is very complicated, does not give the patient the most pleasant sensations, and an acute attack of pain is difficult to stop. Here are the generally available preventive measures we are talking about:

• give up smoking, drinking alcohol, and other bad habits forever;
• It wouldn’t hurt to play sports or take long walks in the fresh air;
• normalize the functioning of the digestive system (cure constipation or diarrhea);
• control body weight, avoid the development of obesity and frequent overeating;
• take vitamin complexes several courses per year;
• for prevention purposes, use multienzyme drugs for 6 months after an exacerbation;
• adhere to a therapeutic diet (limit consumption of fatty, fried, spicy foods);
• drink only mineral water;
• avoid stressful situations;
• reduce the risk of mechanical injuries;
• strengthen local immunity.

By adhering to such simple recommendations, you can exclude exacerbation of pancreatitis for an indefinite period of time. Keeping your problem in mind, preventive measures should become the norm of everyday life for the patient. Otherwise, effective treatment of exacerbation of chronic pancreatitis takes a lot of effort and significantly undermines the general condition of the nervous system.

Video

Attention! The information presented in the article is for informational purposes only. The materials in the article do not encourage self-treatment. Only a qualified doctor can make a diagnosis and give treatment recommendations based on the individual characteristics of a particular patient.

Found an error in the text? Select it, press Ctrl + Enter and we will fix everything!

Discuss

Exacerbation of pancreatitis - symptoms and treatment

Chronic pancreatitis is considered a progressive inflammatory damage to the pancreas, which provokes disruptions 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 symptoms in a timely manner and follow the timely and adequate treatment prescribed by the doctor.

What is chronic pancreatitis?

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

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

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

Causes

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 disruption of its structure, as a result of which pancreatic enzymes easily penetrate into its own tissue, destroying its cells (autolysis) and the development of a chronic inflammatory process

It may take 10-15 years before 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 drinking.
• 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
Lightweight	At this time, adults begin to suffer from 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.
Average	Stage of development of permanent clinical symptoms. Patients develop signs of endocrine and exocrine insufficiency. People eat very little and complain of abdominal pain. There are 3-4 exacerbations per year. They last longer than with a mild course. In sick people, body weight decreases. The exocrine function of the pancreas is moderately reduced, and pancreatic hyperenzymemia is observed.
Heavy	Regular and prolonged attacks (more than 5 times during the year) with intense unpleasant sensations and pronounced symptoms. Weight drops significantly to the point of emaciation, a sign of which is diarrhea. Sometimes adverse consequences can be added - stenosis of the duodenum.

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, the pathological disorders are already quite significant.

Chronic pancreatitis is a condition accompanied by:

• Painful discomfort, and the degree of intensity may be different. Location: epigastric region and left hypochondrium. The pain is either constant or appears intermittently. After the patient eats something, the symptom gets worse.
• Dyspeptic disorders– nausea, urge to vomit, feeling of heaviness in the stomach, unpleasant taste in the mouth, . The patient may develop an aversion to fatty foods, and sometimes lose appetite.
• For many years, the patient may complain of unpleasant symptoms in the form of short-term pain that bothers him 15 minutes after eating. The discomfort lasts from one hour to 3-5 days. The place where they are concentrated is the upper abdomen; sometimes pain is felt near the heart or to the left of the chest or lumbar region. In certain situations it is girdling. You can reduce its strength by bending forward or squatting.
• The patient's skin becomes an indistinct yellow color. The same applies to sclera. The yellowness of the skin goes away from time to time.
• Due to a lack of pancreatic enzymes the process of breaking down 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 increased nutrition can be accompanied by a decrease in body weight, a lack of vitamins in the body, dry skin, brittle nails, a 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;
• increasing the volume of gland secretion;
• pancreatic ischemia;
• inflammation of the surrounding fiber;
• changes in nerve endings;
• compression of nearby organs.

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

Exacerbation

Chronic pancreatitis can worsen for two most common reasons:

• taking large doses of alcohol;
• dysfunction of the biliary tract.

There are also a lot of reasons that are of less importance, but significantly increase the frequency of exacerbations of chronic pancreatitis:

• regular intake of small doses of alcohol;
• tendency to overeat;
• smoking;
• overweight;
• eating unhealthy amounts of fat;
• taking medications;
• infectious diseases;
• frequent stress.

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

• Often the pain is atypical, disguised as other diseases, is most pronounced in the upper back, and spreads across the abdomen.
• Sometimes the pain radiates to the chest, to the side, felt deep in the body, which is typical for exacerbation of pancreatitis.

Characteristic signs of exacerbation of chronic pancreatitis:

1. Severe pain, which can be dull or sharp in the abdominal cavity without clear localization, worsens after eating and radiates to the back.
2. Frequent diarrhea mixed with fatty particles in the stool.
3. Feeling of bitterness in the mouth.
4. Vomiting interspersed with bile, difficult to eliminate with medications.
5. Severe nausea.
6. Loss of appetite.
7. White coating on the tongue.

All of the above signs can appear either as a whole bunch or individually. If a person suffers from severe, sharp pain, then dyspeptic syndrome may occur, in which the patient’s well-being rapidly deteriorates.

Complications

If you do not carry out competent and complete treatment of chronic pancreatitis in a timely manner, then the following complications will begin to actively progress against its background:

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

Diagnostics

Treatment of chronic pancreatitis can be carried out by both a therapist and a gastroenterologist. If endocrine insufficiency develops, consultation with an endocrinologist is indicated; if there is compression of surrounding organs, consultation with a surgeon.

A diagnosis can be made only after implementing the following research methods:

• changes in the content of elastase in urine are the main method of clinical examination of a patient;
• detection of steatorrhea - the presence of undigested fat in the stool;
• carrying out a research test for gland stimulation;
• CT scan according to indications;
• performing a blood glucose test and undergoing glucose sensitivity testing.

How to treat chronic pancreatitis?

When describing a plan for upcoming treatment to a patient, the doctor sets very specific goals. Necessary:

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

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

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

Medications

For chronic pancreatitis, the following medications may be prescribed:

1. Enzyme-containing products. Aimed at reducing the load on the pancreas and accelerating the process of tissue regeneration. Digestive enzymes facilitate the process of digestion and absorption of food, and facilitate the functioning of the gastrointestinal tract. With their constant use, nausea disappears and appetite appears. Enzyme-containing drugs include: Creon, Pancreatin, etc.
2. Antacids, reducing acidity. According to the principle of action, they are divided into: absorbable (Rennie) and non-absorbable (Almagel,). Suction provides quick but short-term relief. The action of non-absorbable drugs is longer, the effect occurs some time after administration.
3. Analgesics are aimed at relieving pain that occurs with pancreatitis during an exacerbation. Antispasmodics (No-shpa, Papaverine) are prescribed to relieve spasms of the main pancreatic duct.
4. Antisecretory drugs(Famotidine, Omeprazole) are prescribed to neutralize the acid.
5. Anti-inflammatory drugs(Diclofenac) reduce pain by reducing inflammation in the pancreas.
6. 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.
7. Prokinetics (Motilium, Cerucal) are used to suppress nausea and vomiting during exacerbation.

Treatment for exacerbation of chronic pancreatitis

Features of the treatment of a severe attack consist of strict adherence to bed rest, diet and taking appropriate medications only in a hospital setting, 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, relapse of the disease does not exceed 7 days.

Auxiliary drugs for pain relief:

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

To unload the pancreas, use:

• a diet with severe fat restriction or complete fasting for several days;
• complete exclusion of alcohol and smoking;
• Octreotide is a drug that 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 pancreatic ducts with stone obstruction;
• opening and sanitation of purulent foci (abscesses, phlegmons, cysts);
• pancrectomy (complete or partial);
• vasectomy, splanchectomy (operations of excision of 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 on the main pancreatic ducts (virsungoduodenostomy, etc.).

Diet and nutrition principles

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

Basic principles of nutrition for chronic pancreatitis:

1. Diet No. 5p for chronic pancreatitis involves introducing more protein foods into the diet by eliminating fatty foods and carbohydrates. It is also necessary to avoid coarse plant fibers and fatty meats.
2. Fried foods are not allowed. It is recommended to cook food in a double boiler, stew and bake in its own juice.
3. All foods that cause dyspepsia and enhance the production of enzymes are also excluded from the menu.
4. When a patient is on a chronic pancreatitis diet, food should be balanced in composition; dishes should be served warm and semi-liquid.
5. Meals are fractional, consisting of 5-6 meals, with small portions.
6. A complete ban on the consumption of alcoholic beverages eliminates the main danger factor for the pancreas.
7. New foods should be introduced into the diet carefully, in small portions.
8. at the slightest discomfort, you should refuse until the functioning of the pancreas is more completely stabilized;
9. The recommendation to chew food thoroughly is also appropriate for a healthy body, but if you have a disease of the pancreas, this rule should be observed especially carefully, even if puree soup is served.

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

• lean meat and poultry;
• boiled lean fish;
• vegetarian pureed vegetable soups;
• vegetarian soups with rice, noodles, buckwheat, semolina, oatmeal;
• boiled pureed vegetables (potatoes, carrots, zucchini, cauliflower, pumpkin);
• omelettes 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;
• moderate amount of butter and vegetable oil;
• porridge prepared with water and milk in a 1:1 ratio;
• boiled pasta;
• sugar-free cookies and homemade wheat bread crackers.

Patients are contraindicated in dishes with a juice effect:

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

It is fundamentally important to avoid alcoholic beverages, since they are strong stimulants of pancreatic secretion.

During remission The list of products is expanded and the inclusion of vegetables and fruits in raw form is shown. Vegetables are used in salads, side dishes, vinaigrettes and as independent dishes. In addition to porridges, you can make pilaf with dried fruits and boiled meat, pasta, and cereals. Soups are prepared without puree and beetroot soup, borscht and cabbage soup are carefully introduced. Homemade sauces and spices are used to improve the taste.

For chronic pancreatitis, a therapeutic course of mineral water is often prescribed. To achieve the effect, water is drunk not to quench thirst, but according to the recommendations for intake, certain types and according to the specified system.

A course of taking water of the Essentuki No. 4, Borjomi and Smirnovskaya brands, which have a special effect on the pancreas, is prescribed:

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

Prevention

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

• to give up smoking;
• avoiding the consumption of alcoholic beverages;
• diet;
• Regular preventive examinations by 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.

People rarely pay attention to what they eat and how much. Poor nutrition, accompanied by stress, overexertion or emotional stress, leads to the body responding with inflammatory processes. In this case, the pancreas suffers more often than others; a disease called pancreatitis occurs. It is important to remember that if treatment is not carried out, the disease will develop into a chronic one. In order to take timely measures to combat the disease, you should know how exacerbation of chronic pancreatitis manifests itself - symptoms, treatment prescribed by a doctor will help you choose the right therapy.

Signs of exacerbation of pancreatitis

The disease, including pancreatitis, does not occur without a reason. The main signs of exacerbation of chronic pancreatitis are:

• presence of cholelithiasis;
• diagnosed cholecystitis;
• there are stressful situations or constant worries;
• violation of diet and treatment in acute forms of the disease;
• excessive drinking of alcohol;
• unhealthy diet (predominance of spicy, fatty and salty foods in the diet).

Symptoms of exacerbation of chronic pancreatitis

Exacerbation of pancreatitis symptoms, which manifests itself in the form of sharp pain, indicate that it is necessary to undergo a course of rehabilitation therapy. Additional signs that changes are occurring in the pancreas that require attention include:

• back pain;
• pain in the area of ​​the shoulder blades and between them;
• pain in the left hypochondrium;
• nausea;
• vomit;
• bitterness in the mouth;
• dryness;
• weakness;
• lack of appetite;
• constant urge to defecate;
• diarrhea;
• headache;
• heart failure;
• increased body temperature (on average up to 38.5);
• bile secretion;
• hard belly;
• Bad mood;
• weight loss;
• there is bloating;
• drowsy state.

An attack can last from 1 to 7-8 days. In addition, the symptoms of chronic pancreatitis in the acute stage may not go away - pain and nausea are constantly present. If the pain is constant but mild, it can last up to 1-2 months - the course of the acute stage is sluggish, but requires attention. It is also noted that at night the pain may intensify.

Important! The symptoms of exacerbation of pancreatitis indicate that the problem already exists and requires treatment. That is why immediate consultation with a doctor (general practitioner and gastroenterologist) is necessary.

Phases of the disease

In case of exacerbation of the pancreas, treatment is prescribed based on the phase of the process. Each of them has special manifestations and symptoms. So in the first phase, inflammation forms - a source of pain. It lasts up to 5 days. During this period, pain manifestations may be unnoticeable, there is a deterioration in health, a pulling sensation in the abdomen, and stool disturbances.

The second phase is characterized by increasing severity - the symptoms of exacerbation of chronic pancreatitis become pronounced. Consultation with a doctor is necessary, since many manifestations of the disease are similar to the symptoms of other diseases, for example, poisoning. An accurate diagnosis can be made by a doctor based on the diagnostics performed. This will eliminate all errors and prescribe effective therapy.

Diagnosis of the disease in the acute phase

If a person notices signs of exacerbation of pancreatitis, then he needs to undergo diagnostics. It includes:

• blood test (biochemistry);
• stool analysis;
• blood test (sugar);
• urine test (general);
• ultrasound of the peritoneum;
• X-ray;
• gastroscopy;
• Passing functional tests.

Additionally, the doctor feels the abdomen and interviews the patient to determine the duration of the attack and the symptoms that are present at a given time.

Treatment of exacerbation of chronic pancreatitis

Exacerbation of the pancreas requires treatment. It is assigned based on the survey data obtained. Therapy includes:

• drug treatment;
• use of traditional medicine;
• diet;
• prevention.

for exacerbation of the pancreas treatment

In order to relieve the main symptoms, it is important to know how to calm the pancreas during an exacerbation. The main advice is fasting, as it is necessary to relieve the load on the pancreas and the gastrointestinal tract in general.

Dietary nutrition is an integral part of the recovery process. In addition to dietary restrictions, you need to know what to drink during an exacerbation of pancreatitis. The table for symptoms of acute pancreatitis should consist of low-fat foods, baked goods, sweets and spicy foods are completely excluded. Salt and marinades also remain prohibited until complete recovery.

Symptoms of exacerbation of the pancreas - pain require a person to refuse to eat at all in the first 2-3 days or, if this is not possible, to eat in minimal quantities. In addition, from the 4th to the 10th day of the diet, it is gradually allowed to eat porridge - semolina, oatmeal, rice, and also include vegetable purees and meat, which should be lean, in the diet. Baked apples and a little honey are allowed as desserts. You can drink rosehip decoctions, juices diluted with water (except banana and grape), green tea.

In order not to provoke another attack of pancreatitis, it is recommended to adhere to fractional meals, and also eat up to 7 times a day in small portions so as not to burden the stomach. At the same time, medications should be taken to produce a sufficient amount of enzymes.

Disease prevention

After the signs of exacerbation of the pancreas disappear, a course of restorative therapy is carried out and good indicators of repeated tests are achieved, prophylaxis will be required. It includes:

• continuation of dietary nutrition (relaxed restrictions);
• taking a course of medications;
• folk remedies.

All this will allow you to relieve negative feelings at home if they appear again. Signs of exacerbation of chronic pancreatitis will allow you to remove traditional medicine prescriptions. Decoctions and infusions prepared from medicinal plants will help effectively solve the problem of recurrence of pain.

Traditional medicine recipes

Effective recipes that help support pancreatic health are very easy to prepare. You need to take:

• corn silk – 20 g;
• celandine -20 g (dry);
• dandelion root – 10 g;
• anise seeds – 10 g;
• knotweed - 10 g;
• tricolor violet (flowers) – 10 g.

All ingredients need to be poured into 2 glasses of water and boiled. After boiling, cook for another 7 minutes, reducing the heat to minimum. After this, strain the resulting decoction and take 3-4 ml 30 minutes before meals for 14 days.

Another recipe that can be used for both treatment and prevention:

• dill seeds – 2 tbsp;
• chamomile flowers (dry) -20 g;
• immortelle flowers - 2 tbsp;
• hawthorn fruits – 10 g (chopped).

The ingredients are poured into 4 glasses of water and brought to a boil. Afterwards, they must be removed from the heat and wrapped in a container until the broth has cooled completely. Strain the resulting liquid and drink 85 ml after each meal. Use for at least 5 days or until symptoms of exacerbation of chronic pancreatitis completely disappear.

Another simple and good recipe:

• golden mustache - 3 leaves (freshly cut);
• water – 3 glasses.

The ingredients should be mixed and heated, and then boiled. After boiling, leave on low heat for another 15 minutes, then remove from heat and strain until only liquid remains. Start taking with 1 tablespoon, the maximum amount is 125 ml (the volume increases gradually). Course up to 10-14 days.

Thus, you can cure an attack of exacerbation of chronic pancreatitis by knowing its symptoms. Therapy should be carried out in a complex - the measures are consistent. It is recommended to reduce physical activity and general activity during this time, and strictly adhere to the rules of taking medications and diet. Subsequent prevention is the key to success and good health.

A person who suffers from chronic pancreatitis does not suffer from his disease most of the time. Symptoms during remission are either mild or absent. Treatment in most cases comes down to diet and pancreatitis in case of pancreatic insufficiency. But during an exacerbation, the patient’s condition sharply worsens, so he requires drug therapy, and often hospitalization in a surgical or gastroenterology department.

General principles of treatment

In this case, symptoms can increase very quickly, over several hours. And in order to stop the inflammatory process in the pancreas, as well as improve the patient’s condition, he often requires emergency drug therapy. On the first day after a person’s admission to the hospital, the doctor’s tasks are as follows:

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

In the future, the person is prescribed a diet, enzyme replacement therapy, and drugs that reduce the activity of the pancreas. You should also combat the consequences of exacerbation of the inflammatory process. More often they can be dealt with using conservative methods. Sometimes it is necessary to use surgical methods of treatment.

In the first hours after a person is admitted to the hospital, his stomach is washed. This measure is necessary to reduce production by 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, when treating exacerbation of chronic pancreatitis, fasting is prescribed for 1-2 days. In a severe exacerbation, a person may be on zero diet for a week or more. In this case, he is shown feeding through a tube or administering nutrient solutions into a vein.

After the severity of clinical symptoms has decreased, when pancreatic function 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 animal products;
• the diet is based on plant foods;
• a fractional diet is established up to 7 times a day;
• Preference is given to dishes with a uniform consistency.

Pain relief

Relieving pain is the first thing a doctor should do when a patient with abdominal pain is admitted to his department. At the initial stage, for pain relief during exacerbation of pancreatitis, the following is prescribed:

• antispasmodics (platiphylline, 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 (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 the painkillers are canceled or their doses are reduced. In addition to the analgesic effect, the above drugs also have other effects:

• paracetamol helps reduce swelling of the pancreas;
• drotaverine relaxes the pancreatic ducts and normalizes the evacuation of pancreatic juice;
• according to the feedback principle, their activity is inhibited.

Fighting intoxication

When digestive enzymes enter the blood, a pronounced intoxication syndrome is observed. It is also present in the case of jaundice, which is a consequence of blockage 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 injecting colloid and crystalloid solutions into a vein.

The method of forced diuresis is often used. It involves the additional use of diuretics. Most often, loop diuretics such as torsemide 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 functioning of the heart, it is necessary to additionally prescribe potassium chloride to the patient.

Occasionally, a patient with intoxication syndrome is prescribed:

• proteolytic enzyme inhibitors;
• plasmapheresis;
• hemosorption;
• lymphosorption.

These methods and medications do not bring the desired effect, so they are gradually losing popularity among doctors. Less and less often in new books on the treatment of pancreatitis, authors indicate the need to use Contrikal, Gordox and other drugs that inhibit the activity of pancreatic proteases.

Antibacterial treatment

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