Chronic pancreatitis – treatment of disease. Symptoms and prevention of diseases of chronic pancreatitis

Хронический панкреатит – что это за болезнь? Chronic pancreatitis is a progressive inflammatory destructive lesion of pancreas, inconsistent with its outwardly- and vnutrisekretornoj functions.

Хронический панкреатит – Причины возникновения

In the same way as in the case of acute pancreatitis, the main causes of chronic inflammation of the pancreas are alcohol and cholelithiasis.

Alcohol is directly toxic to the gland parenchyma factor. When gallstones inflammation becomes the result of the transition from infection of the bile duct in gland on vessels of the lymphatic system, development of hypertension of biliary tract, either directly railings bile in the pancreas.

Other factors, contribute to the development of chronic pancreatitis:

• strong increase of calcium ions in the blood;
• mukovystsydoz;
• gipertriglicerinjemija;
• use of drugs (corticosteroids, Estrogens, thiazide diuretics, azathioprine);
• long stasis of secretions of the pancreas (occlusion of the sphincter of Oddi due to scarring duodenal papilla);
• Autoimmune pancreatitis;
• genetically-caused pancreatitis;
• diopaticheskij pancreatitis (unclear etiology).

Хронический панкреатит – Симптомы

Often the initial pathological changes in the tissues of glands developing chronic pancreatitis occur without symptoms. Or symptoms not so remarkable and the nespecifichna. When the first expressed aggravation, pathological violations already quite substantial.

The main complaint of an exacerbation of chronic pancreatitis is often pain in upper abdomen, in the left upper quadrant, that can acquire Herpes nature. Pain or expressed constant, or is colicky in nature. Pain can irradiirovat' in the area of the projection of the heart. Pain may be accompanied by a dyspeptic (nausea, vomiting, heartburn, abdominal distention, flatulence). Vomiting at exacerbation of chronic pancreatitis can be frequent, exhausting, not facilitate the. Chair can be unsustainable, diarrhea alternating with constipation. Decreased appetite and digestion disorder help reduce body weight.

Хронический панкреатит – Диагностика

To confirm chronic pancreatitis study enzymes of the digestive gland, US, CPGRE, biopsy of the pancreas.

Хронический панкреатит – Виды заболевания

Chronic pancreatitis class

• by origin: primary (alcoholic, toxic, etc.) and secondary (Biliary and etc.);
• on clinical manifestations: pain (recurrent and persistent), psevdotumoroznyj (cholestatic, with portal hypertension, with partial duodenal obstruction), latent (ulterior clinic) and match (several expressed clinical symptoms);
• on the morphological picture (kal'cificirujushhij, obstructive, inflammatory (infiltrative anti-fibrotic), indurativnyj (Fibro-sclerotic atrophy);
• on the functional picture (giperfermentnyj, gipofermentnyj), by the nature of functional disorders may emit gipersekretornyj, giposekretornyj, obturazionny, duktuljarnyj (secretory insufficiency are also divided on the severity of the light, medium and heavy), giperinsulinizm, gipoinsulinizm (pancreatic diabetes);
• Chronic pancreatitis are distinguished by gravity flow and structural violations (heavy, moderate and easy). In the course of the disease, emit the acute stage, remission and nonstable remission.

Хронический панкреатит – Действия пациента

If you experience the symptoms described, consult a doctor.

Хронический панкреатит – Лечение

Treatment of chronic pancreatitis is done conservatively or surgically, depending on the severity of the disease, as well as the presence of or developing complications.

Conservative treatment includes the following components.

Diet therapy. Patients with chronic pancreatitis during heavy aggravation of recommended to refrain from Enteral nutrition, While prescribed diet stuhanii # 5b. In chronic pancreatitis drinking alcohol is strictly forbidden, from your diet clean sharp, fatty, acidic foods, pickles. When pancreatitis, complicated with diabetes mellitus, -control of sugar-containing products.

Exacerbation of chronic pancreatitis are treated the same way, as acute pancreatitis (simptomaticheskaya therapy, anesthesia, detoxification, removal of inflammation, restoring digestive function by using enzymatic preparations, such as Creon).

For pancreatitis of alcoholic origin refusal of using alcohol-containing products was a key factor in treatment, in mild cases leading to alleviate symptoms.

The indications for surgical treatment of chronic pancreatitis may become purulent complications (abscess and cellulitis), obturation biliary and pancreatic ducts, sphincter of Oddi stenosis, expressed severe changes in the tissues of the prostate gland (sclerosis, calcifications), cysts and pancreatic pseudocyst, severe course, nepoddajushheesja conservative therapy.

Surgical treatment in chronic pancreatitis:

• sfinkterotomija when a blockage of the sphincter of Oddi;
• excision of stones in the ducts of the pancreas with konkrementnoj for covering;
• an autopsy and sanation of purulent foci (abscesses, phlegmons, cysts);
• pankrjektomija (full or partial);
• vasectomy, splanhjektomija (excision of nerves, regulating the secretion of the gland), partial excision of stomach (resection);
• gallbladder removal complications by the large bile duct and gallbladder;
• technology of establishing district bile outflows to relieve tension on the main pancreatic duct (virsungoduodenostomija, etc.).

Хронический панкреатит – Осложнения

If there is a violation of the diet, taking alcohol, tobacco smoking and inadequate treatment of progressing Dystrophic processes in the tissue and glands develop severe complications, many of whom require surgery and may cause fatal.

Хронический панкреатит – Профилактика

For the prevention of exacerbations of chronic gastritis, you must comply with all the doctor's advice on diet and lifestyle, regularly (at least 2 times a year) pass survey. An important role in extending the remission and improvement in the quality of life of patients with chronic pancreatitis plays sanatorium-and-spa treatment.