Stanislava Sergeevna Kashevarova, a gastroenterologist at Olympus Clinics, told all about the disease and its treatment.
There are two forms of this disease: acute and chronic pancreatitis.
Acute pancreatitis
Inflammation develops in a short period of time, always requires hospitalization in a surgical hospital. Complications up to a fatal outcome are possible.
Symptoms of acute pancreatitis
Acute intense uncompressed epigastric pain with irradiation to the back or shingles
Vomiting
Dry mouth
Bloating
Muscle tension in the upper half of the abdomen
An increase in body temperature
The most common cause of acute pancreatitis is alcohol abuse and the presence of gallstone disease.
Chronic pancreatitis
Chronic pancreatitis, unlike acute, develops for a long time and is manifested by irreversible changes in the tissue and ducts of the organ.
Symptoms of chronic pancreatitis
Pain in the upper abdomen radiating into the back, increasing after eating. Episodes of pain may alternate with pain-free periods. In some cases, the pain may be permanent
Oily loose stools and weight loss occur only with a decrease in the functional activity of the pancreas by 90% or more
How do I know if you have pancreatitis?
The diagnosis consists of a number of anamnestic and clinical diagnostic signs. We will give some of the signs by which you can suspect the presence of pancreatitis in yourself.
Factors that can cause the disease.
Alcohol abuse
Gallstone disease
Hereditary predisposition
Increased levels of immunoglobulin IgG4
High levels of triglycerides in the blood
Smoking
Typical symptoms:
Stomach pain
Pancreatitis is characterized by debilitating abdominal pain (in the epigastric region or shingles), which often radiates to the back. The sensations are unstable, there may be both constant aching pain and repeated attacks of pain. Even antispasmodic and enzyme preparations are not able to reduce pain. Often the pain worsens after meals.
Digestive disorders
In chronic pancreatitis, the pancreas produces fewer enzymes. This leads to the fact that digestion worsens, the stool becomes liquid, oily, and the person loses weight. Since fewer enzymes are produced, the body also loses the necessary vitamins and minerals that enter the body with food. The patient begins to lose weight, the body is exhausted. There may be problems with the production of insulin, which leads to the development of diabetes mellitus.
Diagnosis of pancreatitis.
An accurate diagnosis can only be made in the clinic. The main role in the diagnosis of pancreatitis is played by ultrasound and / or CT of the abdominal cavity, a number of analyzes.
Characteristic changes in acute pancreatitis:
Several times increased levels of amylase and lipase in the blood (in chronic pancreatitis, measurements of these enzymes do not play a significant diagnostic role)
Increased size, swelling of the pancreas, dilation of its duct, the presence of free fluid in the abdominal cavity in acute pancreatitis
Chronic pancreatitis is characterized by:
the presence of calcifications, pseudocysts in the pancreas according to ultrasound or CT of the abdominal cavity (CT with contrast is the most accurate diagnostic method for chronic pancreatitis)
, a decrease in the level of fecal elastase
Thus, an accurate diagnosis of pancreatitis requires not only the presence of symptoms, but also a combination of laboratory and diagnostic procedures.
Treatment of pancreatitis
Treatment of acute pancreatitis occurs only in a hospital. In chronic pancreatitis, the patient may be monitored on an outpatient basis.
Therapeutic tactics include:
Exclusion of alcohol and smoking.
Constant intake of enzyme preparations to improve digestion.
The appointment of painkillers, including analgesics, antidepressants, anticonvulsants (pain in chronic pancreatitis is not stopped by antispasmodics), proton pump inhibitors (PPIs) to reduce the secretion of hydrochloric acid
The use of additional enteral nutrition if necessary
Treatment of pathologies and complications (diabetes mellitus, bacterial overgrowth syndrome (SIBR), malabsorption, etc.) in their presence.
Surgical treatment of cholelithiasis