Pancreatitis – is a degenerative inflammatory process in the pancreas. Each year number of people suffering from pancreatitis increases. Symptoms and treatment of this disease are directly dependent on the severity of inflammation, the severity of lesions of the pancreas.
The main victims of pancreatitis are often people who are prone to overeating, fatty food and alcohol. Under the influence of certain provoking factors the development of proteolytic enzymes that causes inflammation is activated in the pancreas.
- Reasons causing pancreatitis
- The symptoms of acute pancreatitis
- Treatment of acute pancreatitis
- Symptoms and signs of chronic pancreatitis
- Therapy of chronic pancreatitis
1Reasons causing pancreatitis
In most cases, there are several factors causing development of pancreatitis in a person, which should be identified and eliminated if possible. In 98% of cases acute pancreatitis is caused either by the abuse of alcohol or by the formation of gallstones.
2The symptoms of acute pancreatitis
Pancreas is not a very big organ though it performs major functions in a human body, the most important of which is secretion of food enzymes for normal digestion and production of insulin, the deficiency of which leads to such a serious disease as diabetes. But what really happens when a gland inflames? During the period of pancreatitis the symptoms are developing the same way as with a strong poisoning. The enzymes produced by the pancreas are trapped in it or its ducts and begin to destroy the gland itself and getting into the blood causing symptoms of general intoxication:
- Pain. It is the most distinct symptom. Pain in pancreatitis is usually very intense, constant, it is described by patients either as cutting pain or dull pain. If medical treatment is delayed the patient might have a pain shock. The pain in the stomach is localized either in the left or in the right side of the upper quadrant. It all depends on the place of lesion of the gland. In case when the entire organ is inflamed, the pain is characterized as a girdle one.
- Either low, or on the contrary high temperature, blood pressure. With the rapid development of the inflammatory process, the patient’s state of health is deteriorating rapidly, body temperature may rise very high, or blood pressure may become low as well as high.
- Color of the face. Patient’s face gets sharpened features with pancreatitis, first of all skin gets pale, and patient’s face acquires earthy shade of gray.
- Hiccups, nausea. Also pancreatitis is characterized by such symptoms as dry mouth, hiccups, belching and nausea.
- Vomiting. Vomiting the bile does not bring relief to the patient. Therefore, in the beginning of the acute period eating any kind of food is unacceptable, and starvation in the case of acute pancreatitis is the main condition for the successful further treatment.
- Diarrhea or constipation. Patient’s stool in acute pancreatitis is often frothy, often with fetid odor, with particles of undigested food. Vomit may be with undigested food (when vomiting with stomach content at the beginning of spasm) then comes bile from duodenum. However, on the contrary, constipation may occur along with abdominal distention, hardening of the muscles of the abdomen, which may be the first signal of incipient acute attack of pancreatitis.
- Dyspnea. Shortness of breath is also caused by the loss of electrolytes in vomiting. Patient is concerned about constant shortness of breath, clammy sweat, there is rich yellow coating on the tongue. Fast food – is one of the main enemies of the pancreas.
- Bloating. The stomach and intestines do not contract during the spasm, that’s why at the time of examination a doctor defines strong swelling of a stomach, during palpation no muscle tension is determined.
- Cyanosis of the skin. Bluish spots may appear around the navel or in the lower back, giving skin a marble shade. In the groin area the color of the skin may also acquire a blue-green shade. This is because blood can penetrate from the inflamed gland into the skin of the abdomen.
- Yellowness of the sclera and skin. Mechanical yellowness may occur with a sclera making form of pancreatitis, which occurs as a result of compression of the common bile duct with the hardened tissue of the gland. At such symptoms of pancreatitis, person’s state of health is getting worse every single minute and it is strongly recommended to call an ambulance immediately.
3Treatment of acute pancreatitis
Acute pancreatitis treatment is possible only in a hospital under the supervision of qualified professionals, it is considered to be a very dangerous condition. If acute pancreatitis is suspected, you should immediately call an ambulance and a person should be urgently hospitalized. Sometimes the failure to provide medical care can cost a person his life.
First aid, which can be provided to a person who suffers a fit of pancreatitis, symptoms of which are obvious, is putting some cold on his abdomen as well as taking antispasmodic medicine, and the last, but not the least – is to refuse to eat any kind of food and to have a bed rest until an ambulance comes.
There are three basic points of treatment of pancreatitis. They are: Hunger, Cold and Rest.
Vitamin therapy is also included in the comprehensive maintenance of a weakened organism, vitamin C and B are very essential. The patient is prescribed to the famine and drinking warm water without gases for 4-5 days. In severe pancreatitis, when patients are starving for weeks the parenteral nutrition (intravenous protein hydrolyzates and fat emulsions when blood cholesterol is normal) is prescribed. Only after this time, the patient is allowed to have some food, patients can only drink yogurt at first, gradually adding cheese on the menu and after 3-4 days the patient can gradually adopt a diet food for special diets 5P.
Surgical treatment is indicated for suspected destructive pancreatitis and signs of peritoneal inflammation, as well as the ineffectiveness of a conservative therapy. Besides this a laparoscopy is prescribed in case of suspected abdominal fluid or signs of peritonitis. Also, it is performed for the differential diagnosis of acute pancreatitis with other diseases. Laparotomy (a surgical approach with an incision from the sternum to the groin) is conducted at previously performed surgical procedures in the abdomen, ventral hernias, unstable circulation (shock).
4Symptoms and signs of chronic pancreatitis
Chronic pancreatitis, is considered to be an inflammatory disease of the pancreas, where there are structural changes in the tissue of the inflamed organ. Most researchers believe that the distinctive feature of chronic pancreatitis is that after the removal of action provoking factors, pathological changes in the gland are not only retained, but also continue to progress and there are functional as well as morphological disruptions of the gland. This forms the exogenous and endogenous insufficiency of this organ.
In the event of chronic pancreatitis two periods are determined, an initial – which can take years to show itself and either to calm down, or to come out, and the period when the damage to the pancreas worries the patient constantly. In the period of onset of the disease, which usually lasts for decades, a person experiences only recurrent pain occurring 15 minutes after eating and lasts from a few hours to several days.
The pain is localized mostly in the upper abdomen and sometimes in the heart, the left side of the thorax, the left lumbar region, or even may be characterized as girdle pain. Its intensity decreases when a person leans forward or while sitting. In general, the appearance of characteristic pain is provoked by excessive consumption of fatty, fried food, alcohol, or an abundance of carbonated beverages, as well as chocolate, coffee.
If a person ate a large number of different dishes simultaneously, he would feel worst of all. Pancreas has difficulties to cope with different types of proteins, fats and carbohydrates.
That’s why those people who follow the principles of having different meals separately are less prone to diseases of the pancreas. When the patient feels pain, he can also have dyspeptic disorders such as vomiting, nausea, chronic diarrhea, bloating, or loss of weight.
However, this does not always happen, and the pain as well as dyspepsia with an adequate symptomatic treatment passes, gland function of developing enzymes is not much disturbed and the patient continues his peaceful life, until the next overeating or failure.
In case of long-term existence of chronic pancreatitis the structure of the gland tissue begins to break down, decreasing the production of enzymes and hormones, secretory disorder is gradually forming.
At this, the pain syndrome may be absent at all or be poorly defined, and dyspepsia on the contrary, becomes the predominant symptom of chronic pancreatitis with secretory insufficiency.
Also chronic pancreatitis is characterized by a slight yellowness of the skin, sclera, it may happen not with every patient and may also periodically disappear. In the later stages of pancreatitis, when the gland begins to atrophy, diabetes may develop.
Taking into consideration various symptomatic complexes which are experienced by patients with chronic pancreatitis, several types of diseases are identified:
- Dyspeptic type – in this form of pancreatitis, the patient suffers from chronic diarrhea, bloating, weight loss.
- Asymptomatic type – this form is the strangest, since pancreatitis shows no signs of itself with any symptoms for years, and the person does not know about the ongoing disorders in his body.
- Pseudotumor type – this form of pancreatitis resembles pancreatic cancer by its flow and symptoms. The main symptom of this disease – is the yellowness of the skin, sclera, etc.
- Painful type – it is clear from the name that it is characterized by a painful syndrome that happens very often after meals, and especially alcohol.
What should you do in case if you suspect chronic pancreatitis?
Of course, in cases of suspected chronic pancreatitis one should seek for a comprehensive diagnosis at the gastroenterologist.
On the basis of a patient’s complaints, his medical history, and the following diagnostic measures, a doctor establishes an accurate diagnosis: Laboratory diagnosis of chronic pancreatitis – is change in the level of elastase in patient’s feces.
The analysis of feces can determine whether there is steatorrhea, that is, the content of undigested fat in the stool, which will indicate the malfunction of the gland.
A test with special preparations for stimulation of the pancreas. Ultrasound can also help to establish the correct diagnosis.
CT may also help in case of doubt or for greater certainty of diagnosis. It is necessary to take a blood test for glucose, for the detection of diabetes and also the patient may be tested for glucose tolerance.
Any diagnosis based only on the results of ultrasound data is not reliable, because there are no specific signs, and only minor changes may be found in the structure as well as edema in the acute period. Most often, there are no general ultrasound manifestations.
5Therapy of chronic pancreatitis
Symptoms of chronic pancreatitis may be weakly and clearly marked. As a rule, when an escalation of chronic pancreatitis is diagnosed, hospitalization and similar treatment as for the acute process is strongly recommended. The patient must keep to a diet for the rest of his life, take medicine as well as antispasmodics if he has secretory pancreatic insufficiency. It is very useful to visit a special resort 2 times a year.
The basic principles of treatment is to keep to a diet in chronic pancreatitis (this is the most difficult principle of treatment to fulfill, since the diet in pancreatitis excludes all the delicious meals that everyone likes- barbecues, chocolate, sweets, mushrooms, spicy, fried food, fast food)
All the products up to fruit and vegetables should be grinded, cooked and baked only. Meals should be frequent and in small servings, it means that the patient should eat every 3 hours, it is desirable not to mix different types of protein, fat or carbohydrates in one meal.
How to eliminate pain in chronic pancreatitis
Alcohol –is the worst enemy of the pancreas. When a person keeps to a diet less pain makes itself felt, but just try to neglect the diet and let yourself eat some fried or fatty food and you will need painkillers again. When the pain is intense, a doctor may prescribe antispasmodics which reduce inflammation of the pancreas and hence reduce pain.
Pancreatic enzymes to correct malfunctions of the pancreas
At the prolonged flow of chronic pancreatitis a replacement of normal tissue of the organ both with loss of its normal function takes place, hence there is diabetes and disordered digestion.
In order to give rest to the pancreas and reduce pain in patients they are prescribed to take some additional pancreatic enzymes. During the meal it is desirable to drink alkaline mineral water. Ferments help to break down fats, carbohydrates, proteins.
In chronic pancreatitis, when the symptoms are observed for a very long time – the level of insulin is reduced, which sooner or later leads to the development of diabetes. In case of its diagnosis, the patient should consult an endocrinologist.
At the end of this article we would like to wish you to stay healthy, not to abuse drinking alcohol beverages and to eat more natural food.