Inflammation of the pancreas: symptoms and treatment. Diseases of the pancreas: symptoms treatment Inflamed pancreas than to treat

Pancreatitis is an inflammation of the pancreas, the symptoms and treatment of which directly depend on the form of the disease. Pathology can be acute as well as chronic. It is important to notice the signs of the disease in time and seek help, since ignoring the signals of the body can lead to unpleasant consequences, even death.

According to statistics, the two main causes of inflammation in the gland are excessive alcohol consumption or gallstone disease.

In 70% of cases, pancreatitis occurs due to alcoholism, in 20% due to blockage of the duct by a calculus, and several trigger factors fall on the remaining 10%:

• frequent food poisoning;
• abdominal trauma in the pancreas (left hypochondrium);
• infectious or viral diseases of the gastrointestinal tract;
• malfunctions of the sphincter located in the gland;
• fungal diseases.

In addition, the disease can develop as a complication after surgery in the abdominal cavity or after endoscopic manipulations.

Symptoms and signs of the disease

The nature of the manifestations of the disease depends on the form of the course of pancreatitis, the individual sensitivity of the patient, and also on the area of ​​the affected area. Symptoms of inflammation of the pancreas in women are important to distinguish from problems with the ovary, when pain can only radiate under the left rib. And in children, similar symptoms can occur during banal poisoning.

Chronic pancreatitis is characterized by a latent course, often, patients are not even aware of the presence of the disease until the first serious exacerbation. The acute form of pathology, on the contrary, has a pronounced symptomatology. During an attack, the patient necessarily requires qualified medical care.

Acute form of pancreatitis

The pancreas is a small organ, but it performs the most important functions in the body - it produces insulin, which is needed to maintain normal blood sugar levels, as well as digestive enzymes that help break down food that has entered the intestines. During inflammation, all organ functions are disrupted, and serious damage can lead to such a chronic disease as diabetes mellitus.

To avoid this, you need to recognize the symptoms in time and help the patient:

• girdle pain, which is localized in the hypochondrium, often more on the left. Painful sensations are intense, not relieved by the use of medicines, provoke nausea, vomiting. In severe cases, pain shock may develop and, against this background, death may occur;
• aversion to any food, the presence of bile inclusions in the vomit;
• a change in the main indicators - an increase in temperature, an increase in heart rate, frequent breathing, a decrease in blood pressure;
• severe heartburn and a feeling of dry mouth;
• frequent belching, hiccups;
• bloating of the upper abdomen due to digestive dysfunction;
• stool disorder - carrying, constipation, the presence of particles of undigested food in the feces.

The general health of the patient is gradually deteriorating. Particular attention should be paid to the type of skin. White or bluish skin tone appears most often, it is not as dangerous as a yellowish color. Jaundice speaks of a reactive (the most dangerous) form of pancreatitis, it occurs due to compression of the gallbladder and its duct by a greatly enlarged pancreas.

At the slightest yellowing of the sclera or skin, you need to urgently seek medical help.

Chronic inflammation of the pancreas

Chronic pancreatitis has a latent course and makes itself felt only during an exacerbation of the process. An attack of pain can provoke a violation of the diet, alcohol intake, severe stress, and so on.

The clinical picture of exacerbation is similar to the acute form of inflammation:

• localization of pain - the upper abdomen, in the hypochondria. The sensations are girdle in nature and may radiate to the shoulder blade, back or sternum;
• violation of the digestive tract - nausea, belching, vomiting, bloating, loose stools, constipation;
• changes in pulse, pressure, temperature.

During the period of remission of the disease, the symptoms fade away, but pancreatitis still makes itself felt. The patient complains of constant constipation or diarrhea, which occur as a result of insufficient digestion of food in the intestines, flatulence. Also, there is fragility of hair and nail plates, dryness and peeling of the skin, rapid onset of fatigue.

Diagnostic measures

To diagnose acute or aggravated pancreatitis, a clinical picture and anamnesis are usually sufficient, and an examination of the body will be needed to reveal latent inflammation.

Upon admission to the hospital, the patient is prescribed the following studies:

• a routine blood test - shows general signs of inflammation in the body (increased erythrocyte sedimentation rate, increased concentration of leukocytes);
• determining the level of glycemia (glucose) in the bloodstream - is carried out to exclude the development of diabetes or a pre-diabetic state due to damage to the islets of Langerhans - areas of the pancreas in which insulin is produced;
• blood biochemistry - they do not conduct a detailed study, but determine exclusively gland enzymes (trypsin, amylase, lipase);
• ultrasound of the organs in the abdominal cavity;
• Esophagofibrogastroduodenoscopy - allows using a thin tube with a small camera to examine the gastrointestinal tract from the inside;
• X-ray examination of the abdominal organs;
• general analysis of feces and urine.

In unclear cases, the patient may also be prescribed computed tomography, but it is rarely resorted to due to the high cost of the procedure and long queues.

Treatment of inflammation of the pancreas

To maintain remission of chronic pancreatitis, it is usually sufficient to follow a diet and take enzyme preparations. The tactics of treating exacerbation and acute inflammation are no different. The patient is necessarily hospitalized, detoxification therapy is carried out, and the work of the pancreas is stabilized.

Medications

To alleviate the patient's condition and eliminate inflammation, the following medications are used:

• antispasmodics (No-shpa, Baralgin);
• anticholinergics (Atropine, Metacin);
• H2 blockers (Famotidine);
• pancreatic enzymes (Festal, Mezim);
• adsorbents (Sorbeks, Enterosgel);
• antibiotics;
• eubiotics.

On the first day, the patient should starve, it is allowed to drink plain water. Starting from the second day, various products are gradually introduced, but a person can return to his usual diet only after a few months.

Folk remedies

Treatment of inflammation of the pancreas with folk remedies can be started only after the acute stage has subsided. Non-traditional methods should be used only simultaneously with conventional medicine and only after consultation with the attending physician. Being engaged in self-medication, a person can cause irreparable harm to his health.

Potato juice has proven itself well as a cure for pancreatitis. It should be drunk 100-150 ml before meals, 1-2 times a day is enough. It is important that each serving of juice is squeezed immediately before drinking.

Also, traditional medicine often resorts to herbal preparations:

• yarrow, chamomile, calendula: 15 g of dried herbs pour 200 ml of boiling water, let cool. Drink 70-100 ml of infusion half an hour before meals.
• bark bark: add a large spoonful of chopped bark to a glass of boiling water, cool. Take a tablespoon before each meal.
• immortelle, wormwood, chamomile (flowers): mix these herbs in a ratio of 3:1:2, five tbsp. spoons pour 1.5 cups of boiling water and let cool. Drink 100 ml three times a day.

Nutrition and Diet - What to Eat and What Not to Eat?

Diet for inflammation of the pancreas plays a big role in the treatment process. During acute pancreatitis, the patient is forbidden to eat any food for up to 2 days, then foods are gradually introduced into the diet. At first, you can eat thin cereals strictly on water, without adding salt, sugar, milk, and other things. With a good course, after a week it is allowed to eat vegetable soups, boiled fish and dietary meat little by little. The patient must be on a diet for several months.

In the remission stage, it is important to exclude foods that load the pancreas and can provoke a new attack:

• alcohol;
• chocolate;
• smoked meats;
• fatty food;
• fried foods;
• dairy products from high-fat milk;
• legumes, cabbage;
• Tea coffee.

You need to eat little and often, observe the temperature regime of food (about 50 degrees), select foods that have a beneficial effect on digestion.

Possible Complications

Both acute and chronic pancreatitis can lead to complications. Moreover, the latent form of leakage often provokes unpleasant consequences, since the gradual destruction of tissues is almost asymptomatic.

Possible complications:

• impaired glucose tolerance, diabetes mellitus;
• gland abscess;
• damage to other organs of the gastrointestinal tract;
• cysts in glandular tissues;
• mechanical yellowness of the skin.

In advanced cases, pancreatitis leads to severe intoxication of the body and death.

Prevention of exacerbations

To prevent exacerbations, it is enough not to violate the rules of the diet and take the drugs prescribed by the attending physician. In addition, it is recommended to periodically undergo examinations, take tests and do an ultrasound of the abdominal cavity. You also need to avoid stress, maintain immunity at the proper level, exclude or drastically limit glucose intake.

Pancreatitis is an inflammatory disease of the pancreas. Depending on the clinical picture, acute and chronic pancreatitis are distinguished. These two forms of pancreatitis differ both in the mechanism of occurrence, the etiology of pancreatitis, and in the choice of primary therapy and recovery prognosis.

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What is pancreatitis?

Pancreatitis is an inflammatory process that affects the tissues of the pancreas, an organ of intra- and exocrine function. The pancreas itself is located behind the stomach, in the retroperitoneal region, adjacent to the duodenum. The name "pancreas" was given because of its location closer to the back, thus, when examined lying down, it is "under the stomach".

The main purpose of this organ is the production of pancreatic juice with enzymes and bicarbonates that take part in the process of digestion of the body. When waiting for food and when it enters the stomach, enzymes and juices begin to be transported from the pancreas through the connective duct to the small intestine, providing the process of enzymatic processing of nutrients, participating in metabolism, facilitating the absorption of nutrients through the walls of the small intestine.

Pancreatic fluid neutralizes the acidic environment of gastric juice directly in the intestine, where digestive enzymes are activated and begin to perform their functions of splitting and processing substances.
The main digestive enzymes produced by the pancreas are:

• amylase, which promotes the processing of starch into sugars;
• lipase, an enzyme that breaks down fats;
• trypsin, chymotrypsin - enzymes involved in the breakdown of proteins;
• insulin, polypeptide, glucagon and others.

The causes of pancreatitis are in violation of the outflow of pancreatic (digestive) juice from the pancreas to the duodenum. Lingering inside the gland with partial or complete blockage of the ducts, as well as when intestinal contents are thrown into the ducts, the enzymes are activated ahead of time and begin to process, digest the surrounding tissues.

The retention of juice and enzymes that occurs during inflammation of the pancreas has a destructive effect on the tissues of the pancreas in the first place, however, with prolonged exposure, the negative effect of accumulating pancreatic enzymes and pancreatic juice also extends to nearby tissues, organs, and blood vessels. Destroying cells increase the activity of digestive enzymes, involving an increasingly large area in the traumatic process. In severe cases, accompanied by necrosis of the pancreas, pancreatitis can be fatal.

The maximum amount of digestive juice and enzymes is required to process carbohydrate foods. Excessive consumption of fatty foods, especially rich in spices, as well as alcohol abuse contribute to the retention of enzymes in the pancreas. The reasons for the delay of digestive enzymes and juices can be other factors.

The development of pancreatitis in adults

Statistical data on the prevalence of the disease in adults fluctuate significantly depending on the climate, the dietary habits adopted in different countries, and the traditions of drinking alcoholic beverages. There is also a significant difference in the incidence of female and male, both in terms of the mechanism of the disease, and for the reasons that cause it.
The main risk group for the development of pancreatitis consists of the adult population, due to the frequency of alcohol consumption, an unbalanced diet and the addition of concomitant diseases.

Causes of the development of the disease in men

The "trigger" in male patients with primary pancreatitis with a high frequency is the intake of alcohol (the so-called alcoholic pancreatitis) and the predominance of fatty foods, semi-finished products. Also, a distinctive feature of pancreatitis in men is the chronic form, ignoring the characteristic symptoms and exacerbations, "neglected" pancreatitis due to a late visit to a gastroenterologist.

Etiology of pancreatitis in women

The most common causes of pancreatitis in women are:

• cholelithiasis, causing the development of pancreatitis and cholecystitis;
• hormonal fluctuations and disorders that cause inflammation of the pancreas: pregnancy, menopause, taking hormone-containing contraceptives;
• starvation, adherence to diets that are unbalanced in the composition of food that are harmful to health.

Causes of the reactive form of the disease in adults

Secondary, or reactive pancreatitis develops against the background of existing diseases and the consequences of injuries of the abdominal organs, surgery, etc. The most common factors contributing to the development of reactive pancreatitis are diseases of the digestive system, such as:

• non-infectious hepatitis;
• cholelithiasis;
• gastritis;
• cirrhosis of the liver;
• biliary dyskinesia;
• intestinal infections.

Causes of pancreatitis in children

The definition of the cause of the development of pancreatitis in a child is carried out by a specialist - a pediatric gastroenterologist. Due to childhood, the etiology of inflammatory processes in the pancreas differs from the adult mechanisms of the onset of the disease.
Most often, pancreatitis in children is the result of trauma, surgery, resulting in damage to the pancreatic ducts and / or its tissues. Hereditary predisposition to excessive production of digestive juice, cystic fibrosis (intestinal, pulmonary, mixed form), as well as food allergies, chronic inflammatory processes in the body, the effects of parotitis and other diseases and disorders of digestion and other functions cause the development of pancreatitis in children and adolescents.

Classification and causes of pancreatitis

Symptoms of pancreatitis, the mechanism of the development of the disease, methods of diagnosis and therapy have been the object of study by specialists for several centuries. In the process of improving diagnostic methods, research capabilities and the accumulation of experience, several types of classification of pancreatitis were proposed, based on the characteristics of clinical symptoms, the nature of tissue damage, the causes of occurrence, and so on.
At the moment, there are varieties of pancreatitis according to the etiology of the disease, the form and characteristics of the course of the disease.

Classification of the disease by cause

For the reasons for the development of the disease, primary and secondary, reactive pancreatitis are distinguished.
The primary form of the disease develops against the background of damage to the tissues of the pancreas itself. Among the main causes of destructive processes are the following:

• abuse of alcohol-containing drinks (from 40 to 70% of cases depending on the region), nicotine smoking;
• damage to the pancreas due to abdominal trauma, surgical interventions and certain diagnostic procedures, in particular, such consequences are possible during endoscopy (retrograde pancreatocholangiography and endoscopic papillosphincterotomy);
• long-term, especially uncontrolled use of medications that aggressively affect the pancreas (some groups of antibiotics (tetracyclines), estrogen-containing drugs, glucocorticosteroids, acetylsalicylic acid (Aspirin), sulfanilamide drugs, some diuretics, etc.);
• food poisoning, chemicals;
• eating large amounts of food with synthetic additives, treated with pesticides and other chemicals;
• genetic predisposition to diseases of the digestive system, congenital pathologies of the development of the pancreas;
• an unbalanced diet with an excess of fatty and spicy foods, especially with long breaks between meals.

The primary form of the disease can develop at any age. Timely diagnosis and therapy allows you to stop or slow down the destructive processes in the tissues of the pancreas, restore the lost functions of the organ and avoid serious complications.
They say about secondary, reactive pancreatitis, when in the etiology of the disease it is possible to diagnose the main cause in the form of diseases of other organs of the gastrointestinal tract and the digestive system as a whole (statistically, cholelithiasis is considered the most common cause of reactive pancreatitis), as well as with the provocative action of infectious diseases (more often total - viral hepatitis, as well as dysentery, sepsis, chronic foci of inflammation, for example, with tonsillitis); diabetes; hereditary diseases, in particular, cystic fibrosis or Crohn's disease; diseases of the cardiovascular system; helminthic invasions in the biliary tract and so on. Diagnosing the cause of pancreatitis can be difficult. However, the success of therapy mainly depends on the elimination of the factors that caused the onset of the disease and the prevention of exacerbations.

Classification of pancreatitis according to the form and characteristics of the course of the disease

The inflammatory process leads to partial or complete loss of the main functions of the pancreas. The destruction of the cells of this glandular organ threatens with irreversible processes. In the human body there is no backup organ that can replace the pancreas.
Depending on the symptoms and the form of the course of the disease, acute and chronic pancreatitis are distinguished. The forms of the disease differ in the clinical picture, methods of therapy and health consequences.
Acute pancreatitis is a rapidly developing inflammatory disease, accompanied by the threat of irreversible changes in the tissues and structure of the pancreas, destruction, partial or complete, of other organs, and even death. In the acute form, pancreatic juice, stagnating in the gland, is activated and destroys its cells.
With this course of the disease, significant damage to the cells of the organ, accompanied by edema, is observed. The main risk group is adults in the age period of 30-60 years, although acute pancreatitis can also occur in children as a result of such negative factors as:

• lack of food intake;
• the predominance in the diet of fatty and spicy foods, semi-finished products, fast food;
• blunt abdominal trauma;
• helminthic invasion of the digestive system;
• congenital anomalies in the development of the gallbladder, its ducts, duodenum, pancreatic ducts;
• hereditary tendencies and disorders, infectious diseases, etc.

In the childhood period, the acute form of pancreatitis, as a rule, has less pronounced symptoms. The clinical picture of the disease, diagnostic methods and principles of therapy differ from acute destructive pancreatitis in adult patients.

Features of chronic inflammation of the pancreas

Pancreatitis in a chronic form is said to occur when the disease proceeds with periods of exacerbations and remissions. As the progression progresses, pancreatic insufficiency develops: the glandular tissue of the organ undergoes changes and is replaced by connective tissue, which is not capable of producing digestive enzymes and pancreatic juice. The lack of enzymes causes disturbances in the functioning of the digestive system.
This form of the disease is observed in patients of different ages. Recently, experts have noted a trend towards an increase in the diagnosis of recurrent pancreatitis occurring in a chronic form, which is provoked by the popularization and availability of semi-finished products, fast food, junk food, as well as alcoholization of the population.
There are two stages of chronic disease. The initial stage is expressed by minor symptoms and can last for several years, depending on the lifestyle and general health of the person. The initial stage is followed by a period in which deviations and disturbances in the functioning of the pancreas become more and more pronounced and disturb almost constantly. Exacerbation of the chronic form mainly provokes the use of spicy, fatty or fried foods, carbonated drinks and alcohol, especially on an empty stomach.

Symptoms of pancreatitis

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The symptoms of acute and chronic forms of pancreatitis differ, as well as the features of their course and possible complications of the disease. The symptoms of chronic pancreatitis are most often mild, but the signs of the disease in an acute form are pronounced. With a clinical picture of an acute form, it is important to urgently consult a specialist not only for treatment, but also for differential diagnosis from acute cholecystitis, appendicitis, which can cause similar symptoms.

Symptoms of the acute stage

In acute pancreatitis, being activated directly in the pancreas, digestive juice enzymes affect its cells. So, the action of the enzyme lipase, which breaks down fats, leads to fatty tissue degeneration. Trypsin, which promotes the digestion of proteins, provokes various chemical reactions, causing swelling of the pancreatic tissues and necrosis (death) of cells.
At the first stage of destruction, necrosis is aseptic, local, but without urgent treatment it covers nearby organs, joining infections cause the formation of new foci of inflammation, purulent complications.
Common symptoms of acute pancreatitis include:

• girdle pain, with localization in the region of the right or left hypochondrium. Pain symptoms are intense and are not eliminated by medications even with the timely start of treatment at the first attack. The pain syndrome is so pronounced that it can provoke the onset of a painful shock, loss of consciousness, and cause death. The duration of the attack can be from one hour to several days;
• complete lack of appetite, nausea, bouts of vomiting that do not improve well-being. In the vomit, the contents of the stomach with bile inclusions are observed;
• hyperthermia of the body (more than 38 ° C), increased heart rate (over 90 beats / min.), respiration, lowering blood pressure (less than 90 mm / hg);
• heartburn, hiccups, belching, dry mouth;
• the appearance of a white or yellowish coating on the tongue;
• tension of the abdominal wall;
• bloating in the upper peritoneum, which is caused by dysfunctions of the digestive systems;
• bouts of diarrhea, constipation, inclusions in the feces in the form of undigested food debris;
• discoloration of the skin: pallor, cyanosis, yellow tint of the skin and sclera as a result of the development of obstructive jaundice in reactive acute pancreatitis of the sclerosing form, provoked by cholelithiasis or causing compression of the bile ducts due to enlargement and swelling of the pancreas;
• change in blood pressure - an increase or decrease in its indicators;
• a general significant deterioration in well-being, rapid weight loss, bouts of sweating.

Signs of exacerbation of the chronic form of the disease

Pain attacks during exacerbations of chronic pancreatitis are localized in the same place as in acute pancreatitis, and, depending on the characteristics of the disease, are felt in the right or left hypochondrium, the pain radiates to the back, is of a girdle character, can spread to the area of ​​the scapula, sternum, depending from the site of the inflammatory process and the stage of the disease. Alcohol intake, fatty, spicy food can provoke exacerbations of chronic pancreatitis.

Pain during exacerbations of the disease occurs against the background of the development of an inflammatory process that affects the nerve endings of the pancreas, as well as with swelling and enlargement of the organ, involving the nerve endings in the surrounding tissues. Soreness can occur after a violation of the diet, last from several minutes to several days. A decrease in pain syndrome is noted with downward bending, squatting.

In addition to severe pain, exacerbation of chronic pancreatitis is also accompanied by the following symptoms:

• bloating, belching, diarrhea, nausea, vomiting due to disruption of the digestive system due to enzyme deficiency;
• weight loss, deterioration in general well-being. Dry skin, fragility of the nail plates, anemia, symptoms of vitamin deficiency, increased fatigue, etc. are also observed as a result of metabolic disorders of protein, carbohydrates, fats, as well as chronic intoxication of the body with decay products of undigested food;
• increased gas formation, stool disorders, chronic diarrhea, prolonged constipation due to insufficient digestion of food, activation and reproduction of bacteria that negatively affect the intestinal microflora.

The clinical picture of a pronounced exacerbation of chronic pancreatitis is similar to the acute form. With a sudden exacerbation of the disease, pancreatic tissue necrosis can also develop, causing acute pain attacks and requiring urgent medical intervention and hospitalization of the patient.

Complications of pancreatitis

Almost any form of pancreatitis, therapy for which is started in a timely manner, is capable, if not of a complete cure, then of a significant reduction in probable complications and slowing down the processes of destruction of one of the most important organs of the human digestive system.
Complications of acute pancreatitis or exacerbation of the chronic form can develop into extremely compressed juices and cause significant damage to health, even death.
At the same time, chronic pancreatitis, even in an erased form with an unexpressed clinical picture, is also dangerous. As the cells are damaged, the glandular tissue is replaced by the connective pancreas gradually loses the ability to function.
The main complications of chronic pancreatitis include:

• diabetes mellitus, which develops as a result of pancreatic insufficiency, a decrease in the production of the hormone insulin;
• general exhaustion, chronic intoxication of the body;
• abscess of the pancreas;
• pulmonary complications;
• development of pancreatogenic ascites;
• diseases and dysfunctions of other organs of the gastrointestinal tract (cholecystitis, duodenal ulcer);
• cystic formations in the tissues of the glandular organ;
• obstructive jaundice as a result of compression of the bile ducts;
• fatal outcome.

With exacerbations of inflammation, infectious processes can develop, both in the tissues of the pancreas and in adjacent organs and tissues. The localization of the pancreas near the large aorta contributes to the rapid spread of inflammation, associated infections, and general intoxication with the decay products of necrotic tissues. In the absence of the necessary therapy, strict adherence to the rules of nutrition in pancreatitis, abscesses can form, bleeding can begin.

Early and late consequences of acute pancreatitis

In acute pancreatitis, complications may appear immediately or have long-term consequences. Early complications that develop at the onset of an attack include:

• hypovolemic shock, leading to a lack of oxygen in the tissues of all organs of the gastrointestinal tract;
• liver, kidney failure, provoked by the toxic effects of digestive enzymes;
• peritonitis, aseptic or purulent, developing against the background of infection joining the inflammatory process;
• cardiovascular, respiratory failure and other complications.

The development of late complications in acute pancreatitis occurs mainly against the background of infections. The most common late complications of pancreatitis include sepsis, abdominal abscesses, the formation of fistulas in the organs of the digestive system, purulent inflammation, the formation of pancreatic pseudocysts, internal bleeding, etc. High statistical mortality rate from advanced forms of pancreatitis - according to various sources, from 15 to 90%, especially due to alcohol intoxication, indicates the need for timely therapy and preventive measures to prevent the development of this disease.

Methods for diagnosing pancreatitis

A timely diagnostic study, the establishment of the causes of pancreatitis, the initiation of treatment help to avoid the development of severe and numerous consequences. Acute forms and exacerbations of a chronic disease require immediate medical attention. However, with the initial signs of the disease: discomfort during or after eating, sensations of bloating, disorders of the digestive system, it is also necessary to consult a gastroenterologist before the onset of more pronounced clinical signs of pancreatitis.
Diagnostic procedures include an external examination of the skin, evaluating dryness, elasticity, discoloration, the patient's tongue (with pancreatitis, a whitish coating and atrophy of the taste buds are noted on the surface). Superficial and deep palpation of the epigastric region and the left hypochondrium allows you to determine the presence of pain when pressed, which is also a clinical sign in pancreatitis.

After examination and history taking, laboratory and instrumental methods for diagnosing pancreatitis can be prescribed. These include general, biochemical blood tests, stool and urine tests.

Early laboratory diagnosis makes it possible to determine an increase in the level of amylase in the blood and urine, which manifests itself in the first hours of an exacerbation of the disease. The amount of lipase increases by 2-3 days from the onset of a pronounced inflammatory process, and its elevated level indicates a prolonged exacerbation. The enzyme trypsin, determined in the patient's blood, indicates the onset of damage to the tissues of the organ.
During an exacerbation, an increased value of bilirubin and sugar is also noted, and the presence of partially split, underdigested fats, proteins, and carbohydrates in the feces indicates pancreatic insufficiency.
A complete blood count is not so informative, however, without indicating enzymes and the consequences of their deficiency, it demonstrates the number of leukocytes and the erythrocyte sedimentation rate. Both indicators increase with pancreatitis.

Methods of instrumental diagnostics

Instrumental diagnostics allows you to determine the size of the affected organ, the presence of inclusions, cystic formations in it, the structure of tissues, glandular, connective or with signs of necrosis, involvement in the inflammatory process of surrounding organs, their general condition.
The methods of instrumental diagnostics for pancreatitis include ultrasound examination (ultrasound) of the abdominal organs, radiographic examination, esophagogastroduodenoscopy (EGDS), endoscopic retrograde cholangiopancreatography (ERCP), computed, magnetic resonance imaging, laparoscopy. The choice of method is based on the severity of symptoms and the overall clinical picture of the disease.
If the presence of pronounced tissue necrosis is established, they can resort to the method of percutaneous puncture to extract biopsy material for the purpose of bacteriological examination, identifying the nature of necrosis, and the sensitivity of the infectious agent to groups of drugs.

Features of the treatment of acute and chronic pancreatitis

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Methods of therapy for acute and chronic forms of pancreatitis differ depending on the clinical symptoms, severity of pancreatitis, etiology, the presence of concomitant diseases, the general health of the patient and his age period.
Treatment of acute pancreatitis is carried out exclusively in stationary conditions. The first appointment for acute pancreatitis is complete fasting for several days without exception. Staying in a surgical hospital allows not only to control the diet and prescribe appropriate medication, but also, if necessary, to urgently or routinely use surgical methods in case of a severe course of the disease and a threat to the patient's life.
The methods of surgical treatment for pancreatitis include the removal of areas of necrotic tissue, the installation of a drainage system.

Drugs used in the acute stage of the disease

Drug therapy for the acute form of the disease includes courses of targeted drugs. These include the following groups of medicines:

• cytostatics to block inflammatory processes;
• painkillers, antispasmodics, anticholinergics, in acute pain attacks, drugs of the narcotic group can be used;
• antisecretory drugs, blockers of the production of pancreatic enzymes are used to reduce the likelihood of complications, necrotization of organ tissues;
• with the spread of the inflammatory process, the attachment of infection, the development of purulent foci, antibiotics are prescribed;
• the introduction of solutions of drugs aimed at reducing the level of intoxication of the body, provoked by the circulation of digestive enzymes in the blood, parenteral nutrition, the introduction of electrolyte solutions, essential amino acids intravenously.

Drug treatment of the chronic form of the disease

In chronic recurrent pancreatitis during remission, preparations of pancreatic enzymes are prescribed, which do not perform their functions effectively enough. The choice of what doctors prescribe to a patient with pancreatitis and at what dosage is based on the results of laboratory tests of blood, urine and feces. The course of drug therapy with enzyme preparations is supplemented with drugs to normalize digestion processes, enhance intestinal motility, and restore acid-base balance. Vitamin therapy is used: medicines and medicines with vitamins A, C, D, K, E and group B, prescribe lipoic acid, cocarboxylase, and so on according to indications.

An important component of treatment is a diet with the strict exception of fatty, spicy foods, alcohol is strictly prohibited. With an exacerbation of the chronic form, complete fasting for one to two days is recommended. Eliminating the symptoms of pancreatitis does not mean a complete cure and is not a reason to include prohibited foods in the diet.

First aid for acute pancreatitis

The appearance of the first signs of an acute form of the disease is the reason for the immediate call of a team of ambulance specialists. Before they appear, the following rules must be observed:

• it is absolutely impossible to eat and drink anything, as this provokes the production of pancreatic juice and can significantly aggravate the situation and increase the area of ​​​​damage to the pancreas, involve other organs in the inflammatory process;
• take a horizontal position (with bouts of vomiting - lie on your side), you can press your knees to your stomach if this relieves pain;
• try to relax the muscles of the abdomen, abdominals;
• put a cold object on the stomach: ice in a bag and a towel, a plastic bottle, a heating pad, etc., which will reduce the rate of inflammation.

It is highly not recommended to use drugs to relieve pain, firstly, at the beginning of an attack, they are ineffective, and secondly, such medications can reduce the information content of the clinical picture and make it difficult to diagnose. If necessary, you can use antispasmodic drugs to reduce the strength of spasm: drotaverine (Drotaverine, No-Shpa), Spasmalgon. It is necessary to inform specialists about taking medications.

With an exacerbation of chronic pancreatitis, the general rule of the first day is expressed in three words: cold, hunger and rest. This helps to reduce the development of inflammation, returning to a state of remission. However, in acute pancreatitis, treatment should take place exclusively in stationary conditions under the supervision of specialists.

Nutrition for pancreatitis

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Compliance with the prescribed diet for pancreatitis is the basis of therapy. It is impossible to both cure pancreatitis and slow down its development without following the rules of nutrition.
With the help of diet, it is possible to correct the functioning of the pancreas for the most part, to control how the disease proceeds. The diet is prescribed at the stage of remission, at the end of the period of exacerbation of pancreatitis. The chronic form of pancreatitis requires lifelong compliance with the rules of nutrition.

An attack of pancreatitis, depending on the severity of the course, requires strict fasting from 2 to 5 days. From the second day, you can begin to take warm alkaline water that reduces acidity, a weak decoction of rose hips, clean water. If there are improvements for 3-6 days, you can start using liquid cereal cereals without the addition of milk, sugar, butter and other taste improvers.

On the sixth day from the onset of an attack, the diet can be expanded to include low-fat broths, vegetarian vegetable soups, lean fish, weak tea, and other foods on the recommendation of a doctor. Next, a general diet is prescribed for pancreatitis, depending on the stage of the disease.
So, in chronic pancreatitis in remission, the diet is adjusted based on the analysis of the digestive system functioning under conditions of enzyme deficiency.

Diet during remission

The general rules of nutrition for chronic pancreatitis during remission include the following:

• the total amount of food consumed per day is divided into 5-6 small approximately equivalent parts to facilitate the functioning of the digestive system;
• food temperature should approximately correspond to body temperature and in no case exceed 60 ° C, the use of hot and cold dishes is excluded;
• the maximum restriction of the volume of fatty, spicy, fried foods, sausages, smoked meats, canned food, semi-finished products, seasonings and spices that can provoke an exacerbation of the disease, the exclusion of foods rich in coarse fiber (white cabbage, legumes, etc.), caffeinated and carbonated drinks, alcohol, chocolate, sweets with oily, fatty creams, and so on;
• replacement of rough food with soft ones: boiled or steamed grated vegetables and fruits, mashed soups, etc .;
• adhere to the daily intake of fats (no more than 60 g in total), proteins (60-120 g depending on body weight, age, physical activity, stage and characteristics of pancreatitis), carbohydrates (300-400 g).

The following foods should be included in the diet for chronic pancreatitis:

• slightly dried wheat bread made from flour of the first or second grade (fresh pastries are excluded);
• chopped vegetable puree soups;
• boiled cereals, cereals: rice, buckwheat, small pasta, oats;
• lean meats, fish, chicken, turkey, cooked by boiling or steaming;
• steamed or baked protein omelettes;
• boiled, baked vegetables (potatoes, pumpkin, beets, carrots, zucchini, squash);
• fresh natural dairy products with a low percentage of fat without dyes and preservatives, with low acidity (cottage cheese, yogurt, kefir), low-fat and non-spicy cheese, milk with a reduced percentage of fat (limited, only when added to dishes or tea);
• butter and sunflower oil in limited quantities;
• fruits and berries with a low level of acidity, sugar content, preferably non-acidic apples;
• honey, jam, jam, fruit and berry jellies, mousses and so on.

Prohibited foods and the principle of food processing

It is not recommended for patients at any stage of pancreatitis such types of products as pork, lamb, goose meat, ducks, mushrooms, garlic, sorrel, pickles and marinades in any form, radish, legumes, fresh cabbage, grapes and grape juice, margarine, coffee , cocoa, cinnamon, bananas, ice cream and sherbets. For any form of pancreatitis, the consumption of alcoholic beverages must be forgotten.

The correct methods of preparation and choice of products contribute to the remission of all forms of pancreatitis and reduce the likelihood of exacerbations and relapses in chronic pancreatitis or a single episode of the disease in history. A wide selection of culinary recipes allows you to diversify the diet, not experience the consequences of the restrictive principles of dietary nutrition, and avoid breakdowns.
With exacerbations of chronic forms of pancreatitis, complete fasting is prescribed on the first day, supplementing it as the severity of symptoms decreases with the use of heated alkaline water every two hours in small doses.
After the end of the stage of exacerbation of pancreatitis, they return to a sparing diet, starting with pureed liquid cereals, vegetable purees, low-fat varieties of fish.
With pancreatitis, it is not recommended to mix different types of protein during one meal, for example, eat fish and cheese, beef and chicken, etc.

The preferred method of cooking when heat treatment is required is to grind the product, followed by boiling, baking or steaming. On demand, grinding, pureeing is done twice, before cooking and after.

Prevention of pancreatitis

Pancreatitis is a disease that is easier to prevent than to cure. Prevention of inflammatory diseases of the pancreas includes the correct diet and diet, limiting or eliminating factors that contribute to disorders in the digestive system, other systems and organs, prevention of infectious diseases, a healthy lifestyle, as well as a timely visit to the doctor in case of any discomfort or pain.

The prevention of exacerbations in chronic pancreatitis in remission includes not only taking prescribed medications and dieting, but also spa treatment, as well as examination by a gastroenterologist at least twice a year.

pancreatitis- inflammation of the pancreas. The pancreas is the second largest gland in our body. It performs important secretory functions: the intrasecretory function is to produce the hormones insulin, lipocaine and glucagon, the exocrine function is expressed in the release of pancreatic juice into the duodenum, which neutralizes the acidic content of the stomach and participates in the digestion process.

An internal duct passes through the gland, opening into the duodenum, and the bile duct also opens there. Together they form a common ampoule. In a healthy state of the gland, the pressure in the pancreatic duct is higher than in the bile duct in order to prevent the reflux of bile and intestinal contents. If the pressure difference is violated, the outflow of pancreatic juice is difficult, which causes a number of disorders, leading to the fact that the gland begins to digest itself. This causes inflammation or pancreatitis.

Reasons for the development of pancreatitis

• Alcohol intoxication of the body
• Diseases of the gallbladder and its ducts
• Diseases of the duodenum
• Internal trauma
• Long-term use of drugs such as antibiotics, indirect anticoagulants, immunosuppressants, sulfonamides, Brufen, paracetamol, indomethacin, estrogens, and glucocosteroid hormones
• Past infections (hepatitis B and C, mumps, etc.)
• Hyperlipidemia
• hyperparathyroidism
• Vascular diseases
• connective tissue inflammation
• Stones in the excretory duct of the gland

There are two types of pancreatitis:

• Spicy
• Chronic

Acute pancreatitis

Acute pancreatitis- This is an inflammatory process, expressed in enzymatic autolysis (self-digestion) of the pancreas. In severe and advanced forms, necrosis of part of the tissues of the gland and tissues of nearby organs and vessels may occur, as well as the occurrence of secondary infections at the site of inflammation.

There are 5 forms of acute pancreatitis:

1. Interstitial form- Severe swelling of the pancreas itself.
2. Hemorrhagic form- hemorrhage in the tissue of the gland.
3. Pancreatic necrosis in acute form- the appearance of foci of decay on the compacted gland.
4. Cholecystopancreatitis in acute form- simultaneous acute inflammation of the pancreas and gallbladder.
5. Purulent pancreatitis- the presence of foci of purulent fusion in the gland.

Symptoms of acute pancreatitis

The first symptom is severe pain in the abdomen, the pain can be localized in different parts of the abdomen. With inflammation of the head of the pancreas, it hurts in the right hypochondrium, with inflammation of the body of the gland, the pain radiates to the epigastric region, if the inflammation began in the tail of the gland, the pain will be in the left hypochondrium. If extensive inflammation of the entire gland has occurred, the pain may be girdle. In rare cases, pain may radiate to the back or behind the sternum, to the region of the left shoulder blade.

The second chain of symptoms can be dry mouth, belching, hiccups, nausea, or even severe vomiting. In addition, in rare cases, jaundice is observed. The temperature rises, the tongue is covered with copious bloom, profuse sweat appears, the skin becomes very pale.

Treatment of acute pancreatitis

First of all, rapid hospitalization is required, since timely treatment can prevent tissue necrosis. The first four days require strict bed rest, food intake should be kept to a minimum. Drinking is preferably alkaline, such as a solution of soda or Borjomi mineral water. In the hospital, gastric lavage is done through a tube, as well as injections with drugs to treat the gland and antibiotics to prevent the development of a secondary infection. If stones in the duct became the cause of inflammation, then surgical intervention is required to remove them.

Chronic pancreatitis

Chronic pancreatitis most often develops at the site of an acute form that has not been fully treated. It can also be a consequence of inflammation in other organs of the digestive tract. Chronic pancreatitis can also provoke alcoholism. The chronic form is expressed in a progressive inflammation of the pancreas, which leads to a slow replacement of the gland tissues with tissues that are unable to perform their function. Inflammation can cover both the entire gland and its individual parts.

There are 4 forms of chronic pancreatitis:

1. Asymptomatic- inflammation does not make itself felt.
2. pain- is expressed by constant, not severe pain in the upper abdomen, with an exacerbation of pain, it sharply intensifies.
3. recurrent- acute pains appear only at the time of exacerbations.
4. Pseudotumor This form is extremely rare. In this case, the head of the gland grows with fibrous tissue and increases in size.

Symptoms of chronic pancreatitis

Appetite worsens greatly, belching, nausea and vomiting appear, as a result, the patient loses weight significantly. There is increased salivation and gas formation in the intestines, the work of the digestive tract is disrupted. Frequent stool disturbances, food comes out partially undigested, diarrhea is not uncommon.

Pain in the upper abdomen and back, depending on which part of the gland is inflamed. From fatty, spicy foods or alcohol, exacerbations of the course of the disease in the form of burning or boring pain are possible.

Treatment of chronic pancreatitis

In the treatment of chronic pancreatitis, efforts are directed at relieving pain and preventing destruction of the pancreas. Replacement enzymatic and antibacterial therapies are used. The disease is not completely curable. The patient must take medication all his life, otherwise the inflammatory process will begin to progress again.

Diet for pancreatitis

The most important task in acute pancreatitis is to reduce the load on the inflamed gland and give it maximum rest. Since the pancreas plays a crucial role in the process of digestion and is activated at every meal, the most effective way to keep it calm at the time of exacerbation is fasting.

During the period of refusal to eat, the patient should drink at least one and a half liters of liquid. You can drink water, mineral water without gas, decoctions of wild rose or herbs, weak tea. The liquid should be taken in small portions. The beginning of a meal after fasting is very individual and depends on the general condition of the patient and the data of laboratory and instrumental indications.

Treatment chronic pancreatitis is complex. One of the most important components of treatment is diet. The exacerbation of the disease most often occurs at times when the patient violates the diet or takes alcohol. Diet is a continuous effect on the pancreas and the best prophylactic against exacerbations. It is important to remember that pancreatitis is an incurable disease and the diet must be continuous.

Food should be balanced, but low in calories. It is advisable to consume more liquid or semi-liquid food, boiled or steamed. Eat small meals 5-6 times a day.

It is very important to eat enough protein foods. When preparing meat dishes, be sure to first boil it until half cooked, then you can bake or steam it. Be sure to eat fresh cottage cheese. From vegetables boiled carrots and a pumpkin are most useful. Porridge is recommended. You can eat stews, casseroles, lean pies, soups and baked vegetables and fruits. Seaweed is useful, it contains cobalt, which normalizes the work of the pancreas.

Prohibited everything is fatty, sour, spicy and fried. Do not eat fast food and products with a high content of non-natural components. Alcohol is also completely banned.

Not recommended eat mushrooms, offal, canned food, a large number of eggs (the norm is one or two eggs per week). Avoid frequent use of vegetable and animal oils, no more than 50 g per day. Minimize the use of spinach, rhubarb, sorrel and radish. Do not abuse legumes and foods rich in fiber. It is advisable to exclude marinades and carbonated drinks.

Sugar and sweets can be consumed if diabetes has not developed. But try not to abuse it, because insulin, which breaks down sugars, is produced by the diseased organ in insufficient quantities. From seasonings, you can use vanilla, dill, cinnamon and cumin.

A healthy drink will be fresh fruit compotes and jelly. You can drink juices with everything except citrus fruits.

Folk remedies

The intake of herbal infusions restores the undermined forces of the body, helps it to restrain the disease from progressing. But he does not cancel doctor's appointments. In addition, in order to avoid exacerbations of the disease, it is important to follow a diet. If the exacerbation nevertheless began, it is worth switching to fasting and increasing the amount of infusions drunk.

• Collection of herbs. Mix equal parts dill seeds, St. John's wort, yarrow and horsetail, bean pods, rose hips and galangal roots. Add half of the celandine herb, it is poisonous, so there should be a little of it. Pour two tablespoons of the collection with half a liter of boiling water and let it brew for eight hours. Take a third cup three times a day half an hour before meals. The course of treatment is 6-8 weeks, then a break for at least a week. During the period of exacerbation, three tablespoons of the collection should be brewed.
• Collection for partial restoration of gland tissue. Mix two full tablespoons of dill seeds, as well as two tablespoons of immortelle flowers and crushed hawthorn fruits, add a tablespoon of chamomile flowers. Pour the collection with three glasses of water, bring to a boil over low heat and turn off. Cool, strain. Take half a glass after each meal. Course up to two months.
• Golden mustache. Take 3 leaves of a golden mustache, each leaf should be at least 20 cm long. Cut the leaves and boil in three glasses of water for 20 minutes. Strain. Reception to begin with a tablespoon of decoction gradually, bringing the dose to 150 ml per day.
• Zubchatka late. The plant restores even dying tissue. To prepare the infusion, pour one dessert spoon of the clove with a glass of boiling water and let it brew for an hour. Take a quarter cup three times a day half an hour before meals. The course is a month, then a break for a week.
• Lemons. Take a kilogram of lemons with peel, but without stones and 300 g of parsley and garlic. Grind the ingredients in a saucepan and leave to infuse in a cool place for a week. Take a teaspoon before meals.
• potato juice. Rinse 3 potatoes and 2 carrots thoroughly. Cut out the eyes from the potatoes. Pass through the juicer. Half an hour before meals, drink 200 g of juice, a course of treatment for a week, then a break for 7 days. There are three courses in total.
• Sauerkraut juice. This juice contains a substance that has a beneficial effect on the function of the pancreas. You can drink it as much as you can, it is advisable to drink at least two tablespoons before each meal.
• oatmeal jelly. Take oats and soak them in water for a few days until they germinate. Then dry the sprouted grains and grind into flour. Boil fresh jelly from flour once a day.
• Collection to improve the functioning of the biliary system. Take equal proportions of anise fruits, highlander grass, St. John's wort, corn stigmas, dandelion roots, violet tricolor herb and celandine. Pour three tablespoons of the collection with three cups of boiling water and cook for 10 minutes over low heat. Strain. Take the decoction before meals in a glass three times a day.
• Pain reliever, antispasmodic and antimicrobial collection. Grind and mix equal parts of elecampane roots, hawthorn fruits, peppermint and chamomile. Prepare a decoction of them, which is taken warm three times a day, two-thirds of a glass before meals.
• Cholagogue collection. The collection includes the following herbs: elecampane tall, St. John's wort, calendula, chamomile, burdock roots, wormwood herb, marsh cudweed grass, horsetail, tripartite string and sage. Take all components in equal parts, grind and mix. Pour a tablespoon of the collection with a large glass of boiling water and let it brew for an hour. Strain. Take the infusion half an hour before meals, a third of a glass three times a day.
• Alcohol infusion of herbs. Take a tablespoon each of immortelle, chicory and mullein herbs. Mix the herbs and fill them with a bottle of vodka. Let it brew for three days. Take 10 drops per 100 ml of water three times a day before meals.
• Collection of herbs. Take three tablespoons of St. John's wort and motherwort herbs and six tablespoons of immortelle flowers. Pour a tablespoon of the collection with a glass of boiling water and let it brew for an hour. Strain. Take half a glass three times a day half an hour before meals.
• Collection of herbs. The collection includes three parts of calendula flowers, immortelle flowers, flax seeds, buckthorn bark and thyme herb, five parts of agrimony grass, four parts of mint leaves and rose hips, two parts of chamomile flowers and dill fruits. Grind all ingredients and mix. Pour two tablespoons of the collection with half a liter of boiling water and leave to infuse overnight. Strain in the morning. Take three times a day for a third of a glass half an hour before meals. The course of treatment is six to eight weeks. Then a break for a week.

Pancreas- the most important organ of the human digestive and endocrine systems, which produces digestive enzymes and hormones (insulin and glucagon).

The pancreas has two important functions: digestive and endocrine. The first is necessary for the digestion of proteins, fats, carbohydrates. With the help of the endocrine system, the vital hormone insulin, which regulates carbohydrate metabolism, is released into the blood. Even the slightest violation of one of these functions can lead to illness, then the body, as it were, begins to digest itself as food.

Inflammation of the pancreas (pancreatitis) is a severe attack that usually resolves in a few days or a week, but it poses a risk of life-threatening complications, including shock and infection of the fluid around the pancreas (pseudocyst). Chronic pancreatitis, resulting in permanent damage to the pancreas, may follow recurring attacks of acute pancreatitis or result from persistent inflammation. Possible long-term complications include inadequate absorption of nutrients and diabetes mellitus.

The reasons

Symptoms

Diagnostics

Treatment

Enzyme preparations

More than 150 years have passed since the Dutch doctor D. Flesh cured the inflamed pancreas of a patient with an aqueous extract from the pancreas of calves. And so far, for these purposes, the drug pancreatin, made from the pancreas of cattle or pigs, is widely used. The enzymes lipase, amylase and protease that are part of pancreatin facilitate the digestion of fats, carbohydrates and proteins, which contributes to their more complete absorption in the small intestine. The reason for the popularity of enzyme drugs is simple: the inflamed pancreas needs rest. It is provided by tablets and capsules, which take on part of the work of digesting food and relieve pain.

At the pharmacy, you may be offered a choice of several preparations containing healing enzymes. It can be pancreatin concentrate, pancreazim, pank-renorm, pancitrate, penzital, panzinorm forte, now popular creon and others. Some patients, waving their hands and not going into details, buy the first thing that the pharmacist called. Well, there is still such a prejudice: supposedly, the less the patient knows about medicines, the more he believes in them, and therefore, the better they help him. Most likely, this is just a convenient position that allows the doctor to know less himself and not explain anything to the patient.

For the good of the cause, we suggest that you still understand the features of the composition and use of the main enzyme preparations. Let's start with the mildest pancreatic dysfunction correctors - this is mezim forte, which practically does not give side effects and is prescribed for children from a very young age and pregnant women. And all of the above drugs contain pancreatin in its pure form.

Since inflammatory diseases of the pancreas are often accompanied by a dysfunction of other organs (liver, stomach, intestines, biliary tract), additional components are introduced into the preparations along with pancreatin, which normalize the intestinal microflora, absorption, bile secretion and other indicators. Such medicines include digestal, digestal forte, festal, uni-festal, enzistal, panzinorm forte.

As you can see, there are quite a lot of enzyme preparations today. And in order not to get confused in boxes with unfamiliar names, before going to the pharmacy, do not be too lazy to consult a gastroenterologist.

Perhaps the doctor will tell you that approaches to the use of enzymes have changed in recent years. Previously, it was believed that they should be used when the exacerbation of pancreatitis subsides, that is, a week and a half or two from the moment of exacerbation. Now enzymes are prescribed almost immediately, as soon as a person begins to eat. On average - from the fourth day of illness.

This became possible because in the last decade highly active drugs have appeared in Russia in a special form, for example, Creon. Creon's gelatin capsule contains many tiny microspheres with pancreatin. When it enters the stomach, the gelatinous layer of the capsule dissolves quickly. And the baby tablets are evenly mixed with food, enter the duodenum and there they immediately get down to business. Therefore, Creon and its analogues are currently widely used in the treatment of pancreatitis. Creon is a drug with an easily adjustable dose and a quick positive effect. A patient taking Creon may not be on a very strict diet.

Now there is also a lot of talk about plant enzymes - papain and bromelain, which are included in many modern preparations: Wobenzym, Phlogenzym, Unienzyme. These drugs help a lot with the digestion of carbohydrate foods rich in fiber, but in terms of their effectiveness, of course, they cannot be compared with traditional medicines. Therefore, with pancreatitis, herbal preparations can be recommended only as part of complex treatment. And not during an exacerbation.

In chronic pancreatitis, enzyme drugs are taken in long courses. And if the pancreas has suffered significantly - sometimes for life. Digestive enzymes are usually taken after meals, but if you prefer processed or ground foods, you can take the tablets with meals. Keep in mind that all preparations containing enzymes should be stored in a cool place. Keep tablets and liquids in the refrigerator, and powders and capsules in a cool, dry place.

It would seem that the issue with enzymes has been resolved: the drugs facilitate the work of our pancreas - and now we can not be afraid of exacerbations. But it turns out that there is a downside to the coin - some people, under the influence of advertising, now simply do not sit down at the table without mezim and similar drugs. Be careful with enzymes, because without “training” your pancreas will become lazy and stop producing digestive substances on its own. As a result, in a year a stronger drug will be required, then an even stronger one, and then it will suddenly turn out that even semolina cannot be digested without pancreatin. So rely on enzymes, but don't make a mistake yourself - do not forget about the diet, use enzyme preparations only as prescribed by the doctor and if you cannot do without them.

Laser therapy

In the treatment of pathologies of the pancreas, physiotherapy procedures are widely used. One of these methods is laser treatment. Laser therapy is usually prescribed immediately after the operation on the pancreas. Physiotherapy procedures in this case are carried out in two stages:

1) first, patients undergo transcutaneous electrical neurostimulation of certain areas of the pancreas (duration of the procedure - 5-10 minutes);

2) then laser therapy itself is carried out - a postoperative wound is scanned with a beam from a distance of 1 cm.

The duration of laser scanning is 10 min. The course of treatment is 10-15 daily procedures, starting from the first day after the operation.

What is the effectiveness of this method? First, there is a rapid healing of the postoperative wound. In addition, the laser beam relieves pain and inflammation.

Magnetotherapy

In the treatment of chronic pancreatitis, the properties of a low-frequency alternating magnetic field are successfully used, which, unlike high-frequency electromagnetic fields, does not have a thermal effect. Clinical studies have shown that magnetic therapy has many advantages - this procedure has a moderate anti-inflammatory effect, relieves pain, stimulates the immune system. In the process of treatment, blood counts improve, microcirculation in tissues increases. This method is especially effective in combination with medicinal coniferous baths. Baths are prescribed every other day, the water temperature is 36-37 ° C. The course of treatment is 8-10 baths.

Mud treatment

A good effect in the treatment of chronic pancreatitis is given by pelotherapy, that is, treatment with mud with an effect on reflexogenic zones. Studies have shown that mud applications stimulate regenerative processes and eliminate microcirculatory disorders in the pancreas. It is recommended to apply mud applications on the collar zone, on the upper and lower extremities in the form of high gloves and socks. Mud applications are applied every other day (temperature - 38-39 ° C, course of treatment - 8-10 procedures).

Mud therapy with an effect on reflexogenic zones activates the body's defenses, regulates the functions of the organs of the gastrointestinal tract. Experts suggest that this method of physiotherapy be combined with other methods of treating chronic pancreatitis - dietary nutrition (table No. 5P) and therapeutic coniferous baths every other day (water temperature - 36-37 ° C, course of treatment - 8-10 baths).

Applications of ozocerite

Ozokerite, which is sometimes figuratively called frozen tears of the earth, has been known to people for as long as, for example, oil. Previously, it was mainly used to make candles and some medicines. This amazing natural substance consists of high molecular weight paraffins and ceresins with the addition of liquid oils and asphalt-resinous substances.

In medicine, ozokerite is used as an anti-inflammatory and analgesic agent, with its help they increase blood circulation in a diseased organ, which also has an antiseptic effect. In chronic pancreatitis in remission, applications of ozocerite are prescribed to the projection area of ​​the pancreas. A good effect is given by the so-called cuvette method of ozocerite applications. The melted product is poured into a tin cuvette 20 x 40 cm in size and 3-5 cm high, lined with oilcloth. After the ozokerite cools down to a temperature of 45-50 ° C, it is applied together with an oilcloth to the area of ​​the diseased organ.

The thermal conductivity of ozokerite is extremely low, and therefore its applications do not burn the skin even at a temperature of 60-70 °C. In addition, immediately after application, ozokerite hardens, thus protecting the skin from the next, hotter layers.

One of the most famous resorts where ozocerite is treated is located in Truskavets. The most widely used there was medical ozocerite, consisting of ore petrolatum and paraffin. In the early 80s of the XX century, new preparations appeared - ozoceramin, ozocerafin, ozocerafin, ozocerafin napkin. Ozokerafine, as well as medical ozokerite, are usually used for applications on the skin and are applied using a cuvette-application or napkin method.

Before the procedure, ozokerite is heated to 100 °C for sterilization purposes and kept at this temperature for 30-40 minutes. As a rule, it is applied to the skin using a compress or lozenge. To make a cake from ozocerite, it is poured into a cuvette in molten form and allowed to thicken. The thicker such a cake, the longer it retains heat.

The compress is made using a thick gauze pad, which is lowered into a vessel with a hot product, squeezed out, spread on an oilcloth and waited for the compress to cool to the desired temperature. After that, it is applied to the sore spot. Ozokerite compresses are used when, for medical reasons, the patient is prescribed more intense heat.

An ozocerite compress or a flat cake is usually placed for 40-60 minutes. After the procedure, ozokerite particles adhering to the skin are removed with a cotton swab with petroleum jelly. Usually procedures are prescribed daily or every other day. After the procedure, the patient should rest for 30-40 minutes. The general course of treatment, as a rule, is 20-25 procedures.

Mineral water

Well help with chronic pancreatitis and mineral water. The therapeutic effect is achieved due to the fact that mineral water is drunk not just like that, from time to time, but according to science: a certain amount of water is consumed at regular intervals for a long period recommended by the doctor.

The specificity of the action of mineral waters depends on their chemical composition. So, the hydrocarbonate waters of the resorts of Borjomi, Essentuki, Zheleznovodsk, Morshin regulate the secretory and motor functions of the stomach, reduce spasms of the stomach and intestines. Chloride waters increase the secretion of gastric juice and increase its acidity.

Sulfide waters, such as "Batalinskaya" (Pyatigorsk), reduce gastric secretion, have a choleretic and laxative effect. Low-mineralized waters containing organic substances, such as "Naftusya", "Arkhyz", improve metabolic processes in the body, normalize the functional activity of the liver and pancreas. It is important to remember that drinking mineral water for medicinal purposes is indicated for chronic pancreatitis only in remission.

Waters such as "Slavyanovskaya", "Essentuki No. 17" have a beneficial effect on various parts of the digestive system. With their help, pathologies of the intestines, liver, stomach, pancreas are treated. When ingested, mineral water has a chemical effect due to the trace elements, salts, gases contained in it.

It is most useful to take mineral water at a source - a drinking pump room. At the same time, all its natural properties are preserved. Drink water slowly, in small sips. The duration of the drinking course is from 3-4 to 5-6 weeks. Usually they take mineral water 3 times a day - before breakfast, lunch and dinner, less often - after meals.

In addition to drinking, mineral waters are used for gastric lavage using a thick tube, duodenal drainage (tubage), irrigation of the oral mucosa, rectal procedures (enemas, intestinal irrigation). If in diseases of the pancreas the intake of mineral waters is combined with a complex of rehabilitation treatment, this usually leads to a stable remission of the disease and a significant improvement in well-being.

When not to avoid the surgeon's scalpel

What diseases of the pancreas are treated surgically? Most often, operations are resorted to in acute destructive pancreatitis, with frequent exacerbation of chronic pancreatitis, in the event of pancreatic necrosis, tumors, injuries, and for the treatment of chronic pancreatic cysts. The difficulty for surgeons lies in the fact that the pancreas is located in a very uncomfortable place: retroperitoneally and in close proximity to vital organs - the aorta, superior vena cava, superior mesenteric veins and arteries, kidneys. The pancreas consists of a very fragile parenchymal tissue that is easily damaged. During operations, it is difficult to suture it. The fragility of the tissue often leads to bleeding and fistula formation.

It is better, of course, not to bring matters to an operation, but there are cases when surgical intervention cannot be avoided. Indications for surgical treatment of acute pancreatitis in the first 10 days from the onset of the disease are as follows:

Increase in clinical manifestations of peritonitis; . development of acute cardiovascular insufficiency, which is not amenable to drug therapy; . decreased urine output (less than 1000 ml per day); . increase in jaundice.

Since the pancreas is in close proximity to the biliary tract and duodenum, it suffers if any problems occur in this area. It happens that in acute pancreatitis, a small stone enters the gallbladder into the pancreatic duct. The pebble temporarily blocks the duct where it joins the common bile duct at the point where it enters the duodenum. Most patients with this diagnosis recover fairly quickly, but some develop acute inflammation that requires surgery. Since biliary pancreatitis almost always recurs, as soon as the patient recovers from an acute attack, he is offered cholecystectomy - removal of the gallbladder.

An attack of acute pancreatitis caused by gallstones or alcohol may be accompanied by the entry of enzyme-rich fluid from the duodenum into the pancreatic tissue. The fluid accumulates, and the so-called pseudo-or false cyst is formed, which differs from the true one in that it does not have a shell. Pseudocysts also require surgical treatment.

Operating surgeons often do not know how the pancreas will behave during surgery. Cases of the development of acute pancreatitis are described when operations were performed that were not directly related to the pancreas, but in the immediate vicinity of it or even at a considerable distance (for example, on the heart). Given all these features, it is easy to understand why even an experienced surgeon operates with the greatest care on the pancreas.

We remind you once again: operations on the pancreas are complex and are performed only for health reasons. After them, the period of recovery and recovery, or, as doctors say, rehabilitation is quite long.

Previously, it was believed that without the pancreas, human life is impossible. The first operations for the complete removal of this organ were carried out at the beginning of the 20th century and ended in death after the operation or after a short time. Modern medicine has solved this problem. Today, people with a removed pancreas live on substitution therapy - enzyme preparations, lipotropic agents and insulin.

To overcome the disease, it is in your interest to learn as much as possible about diseases of the pancreas from books, medical guides, radio and television programs. But only a doctor can give you qualified answers to a number of questions. And the success of treatment largely depends on how the relationship between the doctor and the patient develops.

The trouble is, just as there are no perfect doctors, there are no perfect patients. We all have weakness, laziness and irresponsibility to some extent. Not everyone, for example, is able to give up habits such as smoking, drinking alcohol, a cup of coffee in the morning, even knowing that the pancreas will definitely react to this.

The most preferred option is when the doctor and the patient become comrades in the fight against pancreatitis or diabetes. With the eternal lack of time with doctors, try to still find a doctor who will listen to you carefully and try to resolve all your questions. At the same time, do not forget that communication is always a two-way process. The doctor can only react to the information you give him. Therefore, it is very important to accurately and clearly describe how certain symptoms manifest themselves and what bothers you.

You can also write on a piece of paper the questions you would like to ask the doctor. How often do we remember what we wanted to ask when we have already left the doctor's office!

Here are examples of typical questions you may have.

What causes my symptoms? Is it due to pancreatic disease or something else? . How can you relieve stomach pain and other unpleasant symptoms? . What are the pros and cons of the proposed treatment? . How long will I need to be treated? . How much will the treatment cost? . Are there any other treatments? . Will I have to go to the hospital or will I be treated as an outpatient? . What examination do I need to pass? . Do I need advice from other specialists and which ones?

THERAPEUTIC NUTRITION

Do you think about what you eat? What do the products brought from the store consist of, and how will your pancreas perceive them? The pancreas is unique and irreplaceable, it cannot be removed like an appendix. So, you need to adapt: ​​fatty is not allowed, fried - in no case, cold, spicy and sour are also not allowed, sweet is sharply limited ... As soon as the ban is violated, the disease immediately punishes with pain in the abdomen, nausea. The inflamed pancreas is forced to speak the language of pain, it cannot warn you of the danger that threatens you in a different way.

In chronic pancreatitis in domestic medicine, the so-called diet No. 5p according to M. I. Pevzner is successfully used. This Soviet nutritionist once developed a set of diets for the treatment of major diseases. Diets are called tables. For example, the first table is used for stomach ulcers, the fourth - for intestinal diseases, the ninth - for diabetes, and so on.

The main goal of the 5p diet is to limit the release of pancreatic enzymes in order to reduce the load on the pancreas. To do this, it is recommended to exclude strong broths, fatty, spicy and sour dishes, sausages, sausages, sausages, offal (liver, kidneys and others), smoked meats and pickles (primarily sauerkraut), canned food, caviar and fatty fish from the diet - stellate sturgeon, sturgeon, halibut, mullet, catfish, carp.

Also banned are nuts, mushrooms, legumes and black bread (they have too coarse fiber), millet (due to poorly digested cell membranes), fresh pastries, cakes, pastries and caramel, ice cream, chewing gum, kvass, coffee, cocoa, chocolate, citrus, carbonated drinks.

Do not get too carried away with fresh fruit, which is usually fed to a sick family member by caring relatives. There is no doubt that the vitamins contained in them are very necessary for the body, but the strong juice effect of raw vegetables (especially cabbage, radish, turnip and swede), herbs (sorrel, spinach, lettuce) and fruits is not good for the pancreas. 1-2 bananas or sweet ripe apples without peel, of course, will not harm your health, but sour fruits are categorically contraindicated. But it is not forbidden to feast on baked apples, boiled and stewed vegetables.

Do not succumb to the persuasion of loved ones to eat more in order to regain the strength eroded by the disease. Focus on your appetite: while it is reduced, limit yourself to the appropriate portions. The food you eat should be boiled or steamed. Here are some dishes that will be useful for you.

For the first: cereal soups with milk or liquid vegetarian soups with well-boiled vegetables (except cabbage, onion and garlic). For the second: lean meat, poultry and fish - boiled or in the form of steam cutlets, meatballs; boiled vegetable and cereal side dishes; milk porridge, steam curd casserole or scrambled eggs. On the third: liquid jelly, compote or weak tea, slightly alkaline mineral water without gas (“Essentuki” No. 4 and 17, “Slavyanovskaya”, “Moskovskaya”), juice diluted with half boiled water. For dessert: dry biscuits, biscuits, marshmallows, marshmallows, marmalade (no more than 2-3 pieces per day), honey and jam (1-2 tablespoons).

To make it easier for you to choose dishes, we bring to your attention a three-day diet for chronic pancreatitis, designed for 1 person. Portion sizes are approximate - you can decrease or increase them depending on how you feel.

Breakfast. Crackers - 2 pcs., mashed potatoes - 100 g, mineral water without gas - 200 ml. Lunch. Omelet from 2 eggs, steam cutlet - 150 g, white bread - 1 slice, apricot - 1 pc., milk - 200 ml. Dinner. Chicken soup - 250 ml, boiled fish - 100 g, boiled zucchini - 100 g, white bread - 1 slice, raisins - 30 g, tomato juice - 200 ml. afternoon tea. Kissel - 200 ml, fruit jelly - 150 g, mineral water without gas - 200 ml. Dinner. Oatmeal porridge - 150 g, steam cutlet - 100 g, carrot puree - 100 g, white bread - 1 slice, tea with milk - 200 ml.

Breakfast. Oatmeal porridge - 100 g, boiled beef - 100 g, white bread - 1 slice, mineral water without gas - 200 ml. Lunch. Cottage cheese pudding - 100 g, white bread - 1 slice, apple puree - 100 g, tea without sugar - 200 ml. Dinner. Vegetable soup - 300 ml, steamed fish cutlet - 100 g, pumpkin porridge with sugar - 100 g, white bread - 1 slice, cottage cheese - 100 g, tea with milk - 200 ml. afternoon tea. Meatballs - 100 g, carrot puree - 150 g, apple puree - 100 g, yogurt - 100 g. Dinner. Meat roll - 150 g, mashed potatoes - 150 g, cottage cheese pudding - 100 g, white bread - 1 slice, fruit jelly - 100 ml, tea without sugar - 200 ml.

Breakfast. Omelet from 2 eggs, white bread - 1 slice, milk - 200 ml. Lunch. Boiled fish - 100 g, buckwheat porridge - 150 g, white bread - 1 slice, apple puree - 100 g, tea with milk - 200 ml. Dinner. Milk soup - 250 ml, meat roll - 100 g, oatmeal - 150 g, white bread - 1 slice, vegetable puree - 100 g, dried apricots (soaked in water) - 5 pieces, tea with sugar - 200 ml. afternoon tea. Steam cutlet - 100 g, boiled rice - 100 g, white bread - 1 slice, kefir - 200 ml. Dinner. Zucchini stewed with potatoes - 150 g, meatballs - 100 g, cottage cheese pudding - 100 g, white bread - 1 slice, tea with sugar - 200 ml.

The pancreas loves animal proteins: they strengthen it. The diet of patients with chronic pancreatitis, both in the acute stage and in remission, should contain at least 130 g of protein per day. For cooking, choose the best varieties of meat: lean beef, veal, as well as chicken, turkey and rabbit meat in the form of fillets. White meat is digested and absorbed more easily. From fish, cod, pollock, pike perch, carp, perch are preferred. Ice fish is out of competition - it is very tasty and tender. From time to time you can buy pollock, blue whiting, navaga.

The proteins of chicken eggs are similar in amino acid composition to the proteins of our body and therefore are easily digested without overloading the pancreas. Every day you can eat one soft-boiled egg. And an airy steam omelette is a real pleasure for this organ.

Speaking of omelets. Some doctors believe that they should be prepared only from proteins, others say that sometimes it is possible from whole eggs. Who is right? Oddly enough, both are right. A protein omelet is prescribed for exacerbations of pancreatitis or for a deterioration in well-being. Doctors working in a hospital are faced with just such cases. Without exacerbation, it is quite possible to cook a full-fledged omelette from a whole egg or even a soft-boiled egg, but it should be cooked according to all the rules. A chicken egg is immersed in hot water and boiled for 2-3 minutes at a low boil. In this case, the protein turns out to be slightly thickened and opaque, and the yolk is semi-liquid.

The parade of protein dishes continues with cottage cheese. It turns out very tasty if you mix dietary cottage cheese bought in a store with homemade unleavened cottage cheese. To prepare unleavened cottage cheese, boil 1 liter of milk, remove from heat, pour in 1/2 liter of kefir. Throw the cooled curdled milk on a sieve. You can fill the finished cottage cheese with a tablespoon of Aktimel sweet drink. Curd puddings or juicy casseroles with the addition of carrots, sweet pumpkin, apricots, pears, sweet apples diversify the menu. Dishes from cottage cheese and pasta can be sprinkled with grated low-fat cheese: Dutch or any soft.

According to diet No. 5p, 60-70 g of fat is allowed per day. If you have cooked porridge, it is allowed to fill it with butter, but not more than 1 teaspoon per serving. It is better to buy oil in small packs packed in foil. The oil must be fresh, of the highest grade (without the addition of vegetable fats). It is better to put oil in a plate with hot mashed potatoes, porridge or boiled vegetables. The same amount on a sandwich is worse tolerated. With an exacerbation of the disease, even a slight one, oil is temporarily excluded from the menu.

Avoid vegetable oils. When the painful phenomena completely subside, you can add a little olive oil or refined sunflower oil.

Regarding carbohydrates, nutritionists are now of the opinion that patients with chronic pancreatitis should slightly reduce the amount of carbohydrates, since the pancreas is also an endocrine gland responsible for insulin. And if it is involved in the pathological process, then the development of diabetes is possible. Therefore, the amount of carbohydrates in the diet for chronic pancreatitis is reduced to 350 g, the emphasis is on poorly soluble carbohydrates.

Porridges are boiled in milk in half with water. What kind of porridge to treat the patient? Offer him a choice of semolina, buckwheat, oatmeal, oatmeal or rice. Diversifies the menu homemade noodles, vermicelli. Refrain from millet: it contains indigestible polysaccharides.

As you can see, the list of products available to you turned out to be no less than the list of products that do not suit you. Show a little imagination, cook with love, and soon you will realize that diet food can be very tasty and varied.

Diet for cholecystopancreatitis

You already know that, as a rule, pancreatitis “does not walk alone”, it is often accompanied by cholelithiasis. If cholecystopancreatitis develops, then changes in the gallbladder are taken into account when prescribing a diet. The optimal amount of protein in the diet for this disease is 110-120 g per day. The source of complete animal protein is lean meats, fish, poultry, dairy products, eggs. Since egg yolk is a pronounced stimulant for the separation of bile and pancreatic juice, during an exacerbation of the disease it is better to make protein omelettes (proteins of no more than 2 eggs).

Vegetable proteins are part of vegetables, fruits, berries, bread and other flour products. Vegetables and fruits are the main suppliers of many vitamins and mineral salts; without them, the diet will be incomplete.

Due to the deterioration of the secretory function of the pancreas and bile secretion in cholecystopancreatitis, as a rule, the absorption of fats is impaired. Therefore, the amount of fat in the diet should not exceed the lower limit of the physiological norm (70-80 g). Eliminate pure fat altogether. Use unsalted butter in small quantities (up to 30 g) for cooking, and 10-15 g of refined vegetable oil, with good tolerance, can be added to ready-made dishes. Vegetable oil should not be subjected to heat treatment: it will lose its valuable properties. Occasionally, you can fill the salad with a spoonful of sour cream.

Recent studies have established that an excess of simple sugars in the diet leads to a deterioration in the composition of bile and a violation of bile secretion, and also requires hard work of the pancreas. Therefore, limit carbohydrates to 300-350 g. This includes pasta, bread, cereals, sugar, honey, jam. Pure sugar is recommended no more than 4 pieces per day (30 g).

Excess salt in food supports the inflammatory process. Therefore, table salt (no more than 8 g) is used only for salting ready meals. The total weight of the daily diet for cholecystopancreatitis is 2.5-3 kg, the volume of liquid is 1.5-2 liters, the calorie content is 2500-2800 kilocalories.

Food preparation is of great importance. Dishes are steamed or boiled; allowed and baked in the oven. It is impossible to fry, because in this case substances are formed that irritate the mucous membrane of the stomach and intestines, reflexively increase the excitability of the gallbladder and pancreas.

During an exacerbation, it is recommended to eat chopped or pureed food, which is easier to digest and assimilate by the body. However, long-term nutrition of pureed food is undesirable; this negatively affects the psycho-emotional state of patients, leads to a decrease in appetite, the occurrence of constipation.

What to eat if you have had surgery

Some diseases of the pancreas are treated only with the help of surgical operations (pancreatic necrosis, tumors, cysts, fistulas, etc.). After the operation, the doctor will prescribe a special strict diet for such cases for some time. Food should be supplied only in liquid form in very small portions every 1.5-2 hours. This is weak tea, fruit and berry sweet kissels, compotes (strained from dried fruits), you can eat some fruit jelly or soufflé, you can also drink meat broths and decoctions rice and oatmeal with butter (1 teaspoon). Food must be warm. If necessary, artificial nutrition is used through a tube or ready-made nutrient solutions are administered intravenously.

After removal of the gallbladder, a strict diet is not required if the patients did not follow it before the operation. They can eat normal food, limiting only the intake of indigestible animal fats - lard, brisket, roast lamb. Those patients who adhered to a strict diet can gradually expand their diet.

Reducing the possibility of re-formation of stones - this time in the bile ducts - helps to exclude from the diet foods containing a large amount of cholesterol: brains, egg yolks, fatty meats and fish, concentrated broths, spicy and fried foods. Alcoholic beverages, including beer, are also not recommended. They complicate the work of the liver and pancreas. Obese patients should eat less bread, potatoes, sugar, muffins, confectionery and other foods rich in carbohydrates.

In general, for patients with diseases of the pancreas, it is very important to observe regular rhythmic nutrition with uniform intervals between meals. The break between them should not exceed 5 hours during the daytime, and between the last evening and the first morning - 10-11 hours. The most optimal is four meals a day, as it favors the rhythmic excitation of the food center and the release of digestive juices. The daily diet of most patients is 3-3.5 kg. During the day, it is distributed as follows: first breakfast - 25-30% of total calories, second breakfast - 10-15%, lunch - 40-45%, dinner - 15-20%.

With peptic ulcer of the stomach and duodenum in the acute stage, exacerbation of chronic pancreatitis, in which strict mechanical sparing is necessary, the daily amount of food is reduced to 2.5 kg and is divided into 5-6, and sometimes even 8-10 doses.

Of great importance is the temperature of the dishes that are served to the patient. Contrasting temperatures have a stimulating effect on the liver and pancreas. Dishes with temperatures above 60 ° C have an irritating effect on the mucous membrane of the esophagus, stomach, duodenum. The most preferred are dishes whose temperature is close to 36-37 ° C, as in the stomach.

If you can't, but you really want to...

Food is one of the main, and for many, even the main joy of life. Of course, it is hardly worth calling people with an open ulcer, exacerbation of cholecystitis or pancreatitis to the common table. They need diet food. But for owners of chronic diseases of the digestive system, the well-known “recipe” is quite acceptable: you can’t, but you can, if you really want to.

For example, in order to diversify the table somewhat, you can sometimes eat a piece of soaked herring, and lightly fry boiled meat or fish in a pan. If you can’t live a day without sweets, then don’t deny yourself this pleasure at all. All the same, rarely anyone succeeds, so in the “calm” period of your illness, you can afford some sweets for morning tea, but for dinner, limit yourself to a low-calorie vegetable or cottage cheese dish.

Many people love chocolate, but consider it too fat. In fact, cocoa is a low-calorie product, and additives (milk, butter, nuts, caramel, sugar) make it fat. It is better to buy dark chocolate without fillings, it is the most dietary.

It’s not easy to completely revise your eating habits, so it’s hardly worth chopping off your shoulder. Try to reduce the amount of "harmful" delicacies gradually, buy them occasionally and in small amounts so that they do not lie in the refrigerator and tease you.

The situation is more complicated on holidays, when interesting communication, alcohol and food changes dull the feeling of satiety and many tend to get carried away. But holidays do not happen every day, and it is not so difficult to prepare for them. First, half an hour before the feast, drink a glass of water - plain or mineral. This will dull the feeling of hunger, and the stomach, pancreas and liver will be very grateful for a sip of water before hard work. Second, chew your food slowly and very thoroughly. They took one piece and put the fork back on the plate - so you learn to eat in small portions. Between hot meals, it would be good to have a cup of green tea without sugar. It is better not to take bread at all, so as not to stuff the stomach and intestines with it.

Replace lemons and marinades with salted and sour foods. But spicy snacks and spices, but also non-acidic, you can taste a little. Carbonated drinks are not for you - they provoke heartburn and belching. Coffee and chocolate, as well as non-hot foods, can cause or exacerbate heartburn. It is advisable not to consume anything chilled below room temperature at all. As for alcohol, you can sip a glass, but the alcoholic drink must be of high quality and non-acidic. But smoking is strictly not recommended.

In addition, you need to periodically get up from the table and move. For example, when changing dishes. And after the end of the feast, try not to go to bed for at least two hours. And do not even take a horizontal position.

If overeating still could not be avoided, which happens often, you need to help your body - take enzymes with bile components. The usual dose is one to two tablets. Do the same with cholecystitis, when the wall of the bladder becomes rigid and prevents the emptying of bile in response to food stimuli. Enzymes are also taken to rest the pancreas in chronic pancreatitis. In short, if you accept these rules and consider the feast, in sports terminology, not as gambling - gambling, but as wrestling - a pre-rehearsed fight, then everything will be in order.

Is it possible to relieve inflammation of the pancreas on its own?

Most likely, you will not be able to relieve inflammation in the pancreas on your own without medical help. You can only alleviate your condition until the ambulance arrives. For this we can recommend:
take a pill of duspatalin or drotaverine or noshpa;
apply cold from the back and in the stomach area;
take a comfortable posture;
drink several sips of clean drinking water or warm infusion of chamomile.

Pay special attention to nutrition in case of inflammation of the pancreas. In the first three days after the attack, complete food rest is recommended. You can drink only a small amount of clean water. In the future, you should give up coffee, cocoa, tea and chocolate. All these products cause increased production of enzymes in the gland.

Fatty meats, offal, smoked meats and salted canned food are completely excluded. It is recommended to give preference to light vegetable salads without the addition of mayonnaise, chicken broth and slimy porridges. You must follow this diet for at least 3 months after an attack of pancreatitis.

About the benefits of physical activity

Many chronic diseases of the pancreas, even during remission, are accompanied by a breakdown, asthenia, depression - in short, the whole world becomes not nice. A person begins to look for where to draw energy. So, not only a cup of coffee can cheer up. There is a stronger remedy - physical activity. In almost every recommendation of a doctor observing patients with pancreatic diseases, there is a reminder of the need to move more. “Where more, I’m already spinning like a squirrel in a wheel, and my time is scheduled literally by the minute,” many of you will object.

The attending physician means in this case not everyday fuss, but purposeful physical activity to maintain the tone of your pancreas. To achieve a good result, it is not necessary to train like athletes. Even moderate physical activity gives a positive effect - 1 walks and jogs in the fresh air, housework and gardening, dancing, swimming and, of course, exercising and exercising at home. Of course, all these activities will be beneficial only in a calm period, when all exacerbations subside.

"Charging" for the pancreas

With specific movements of the abdominal and diaphragm muscles, you can learn how to gently massage your pancreas. Due to these exercises, blood circulation in the pancreas and the outflow of digestive juices improves. Such a "charging" for the pancreas is an excellent prevention of pancreatitis and its exacerbations. First you need to practice: inhale, exhale and hold your breath. Slowly, but strongly enough, pulling in the stomach, count to three, and then relax the abdominal muscles. Let's move on to the exercises.

1. Inhale, exhale and hold your breath. During the breathing pause, inflate your stomach as much as possible, count to three and relax. 2. In the middle of inhalation, hold your breath for 1-2 seconds (at the same time, the diaphragm tenses and flattens) and continue to inhale further, as if directing air into the stomach and slightly protruding the abdominal wall. At the end of the inhalation, stop, count to three while expanding the abdomen, then quickly relax the muscles and continue counting to six while slowly drawing in the abdominal wall. Exhale and relax your abdominal muscles. 3. Strongly draw in the stomach as you exhale. Holding your breath for a few seconds, relax your abdominal muscles. Actively inflate the abdomen on the inhale and retract it on the exhale.

Gymnastics should be performed lying down, sitting or standing 2-3 times a day. Start with 3-4 repetitions of each exercise and gradually work your way up to 9 repetitions. But do not exercise through force - postpone classes if you are tired or uncomfortable.

Here is another simple exercise that improves blood circulation in the abdominal cavity, and will also serve to strengthen the muscles and bones of the legs. Place your palms on your lower back, over your kidneys, and walk around the room on your toes, heels, and on the inside and outside of your feet. Exercise is recommended for diseases of the kidneys, liver and pancreas.

A set of exercises after surgery

Physical activity in cholelithiasis and pancreatitis is indicated only during remission. If the patient underwent surgery on the pancreas or his gallbladder was removed, then there can be no talk of any gymnastics in the first month after abdominal surgery - any tension in the abdominal muscles causes pain. Only after the recovery period and under the guidance of an instructor in physical therapy begin to do special exercises to form a good mobile postoperative scar and strengthen the abdominal muscles. And obese patients with a sagging belly also need to wear a bandage. Where to buy it, the doctor will tell you. Those who underwent surgery with the help of endoscopy also need to do exercises - they help the outflow of bile.

1. Starting position (ip) - lying on your back, legs bent at the knees, feet spaced slightly wider than shoulders. After a deep breath, tilt your knees to one side or the other. 2. I. p. - lying on your back, legs bent at the knees. Place a sandbag (weighing 250-300 g) on ​​your upper abdomen. As you exhale, try to raise it as high as possible, while inhaling, lower it. Do the same with the bag placed on the lower abdomen. 3. I. p. - lying on the left side, legs bent at the knee and hip joints. As you exhale, take your right leg back, gradually increasing the amplitude and decreasing the angle of flexion. The same is on the right side. 4. I. p. - lying on your back, legs extended and maximally spread apart, arms along the body. Cross movement of straight legs - right over left, left over right. Breathing is arbitrary. 5. I. p. - sitting on a chair, leaning back, grab the seat with your hands. Take a deep breath. As you exhale, leaning on your arms and legs, raise your pelvis, return to the starting position. 6. I. p. - sitting on the mat, arms along the body, legs together. After a deep breath, alternate torso to the right and left. Then tilt the torso to the left with the right hand raised up and to the right with the left hand raised. 7. I. p. - standing behind a chair, holding on to the back. After a deep breath on the exhale, take your right leg to the side and back. The same with the left foot. 8. I. p. - standing, feet shoulder-width apart, hands on the belt. Torso turns to the right and left alternately. Breathing is arbitrary.

Perform each exercise 10-15 times, but if you feel tired, reduce the load, reduce their repetition. Some believe that therapeutic exercises are replaced by work in the garden, in the country or at home. This is a completely different load, not related to physical fitness and health. In the first half-year-year after the operation, you generally need to take care of yourself: avoid work associated with significant tension in the abdominal muscles (washing floors, lifting weights, digging up beds).

Yoga breathing exercises

Certain benefits in pancreatitis can be brought by breathing exercises according to the yoga system - by accumulating the body of vital energy received from the air, and a kind of massage of the internal organs. To learn how to consciously control breathing and master abdominal (lower) breathing, you will have to practice - on your own or under the guidance of an instructor.

You need to sit up straight on the floor, cross-legged (head, neck and back should be located on the same line), lie on the floor or stand on your feet. Before you take a breath, you should exhale the air from the lungs, while the stomach is drawn in (the diaphragm rises up). Then you need to slowly inhale air through the nose, sticking out the stomach (the diaphragm goes down), without moving the chest and arms. The lower part of the lungs fills with air.

When we exhale again, the belly goes deep in and the diaphragm rises, exhaling air from the lower lobes of the lungs. This breathing is characterized by the fact that only the diaphragm participates in it, while the ribs and intercostal muscles remain motionless. To quickly master this exercise, place your palms on your stomach. Then, with the help of touch, it will be easier for you to follow the rise and fall of the abdominal wall. After you learn how to breathe with your stomach, you can move on to regular exercises.

Bhujangasana (cobra pose). Lie on the floor and place your palms on the floor at chest level. Leaning on your hands, lift your upper body, arch your waist and throw your head back. Return to starting position. Repeat the exercise 4-5 times.

Exercise eliminates diseases of the organs located in the abdominal cavity, and also strengthens the muscles of the abdomen, chest, neck and arms.

Dhanurasana (bow pose). Lie on your stomach, bend your knees, grab your ankles and pull them up so that your arms straighten, your back arches, and your stomach tightens. First, let the knees be apart. After a short practice, do the exercise with joined knees. During the exercise, perform 4-6 swings. Over time, the stomach will tighten.

Exercise helps to eliminate diseases of the digestive system, and is also good for the spine.

Prushta valitz hanumasana (monkey king pose). Stand straight with your feet together. Leave your left leg as far forward as possible, bending it at the knee. The right leg remains straight. Raise your folded hands above your head, pulling them back. Then lower your arms down, touching the floor and turning your body to the left. Repeat the exercise on the opposite side. Do this exercise on both sides.

Exercise causes a strong tension in all the muscles of the body, strengthens the waist well and treats diseases of the organs located in the abdominal cavity and in the chest.

Jogging

And now let's remember a sport that was insanely popular not so long ago and which does not require you to spend a lot of money and special equipment. All you need for jogging is comfortable shoes and warm socks. Runners believe that in this way they prolong their lives by 5-7 years. Indeed, jogging improves metabolism, lowers cholesterol levels, and even prevents diabetes to some extent. In the absence of contraindications, this sport is also suitable for the prevention of indurations and pancreatic fibromas.

To understand the enthusiasm of the fans, you must at least once force yourself to get up from the couch and run in the fresh air. At a minimum, you will enjoy the movement itself, as a maximum, improve your health - and not only physical. One of the benefits of running is that it can relieve stress. Run through the park, listening to the birds singing, or along the road, watching the cars passing by - the choice is yours. In any case, a good run literally “winds your head”, and for those who live in a metropolis, this is simply necessary.

If you have never played sports, then even 4-5 minutes of jogging will tire you out. As soon as you feel tired, stop and take your pulse. It should be on average 100-110 beats per minute; if more than 120 - reduce the load. A half-hour run usually covers 4.5-5 km, so you can explore the surroundings at the same time. Use different paths, try not to run on the same one too often. In heavy rain, skip classes and never run without spikes on icy paths. If the weather is warm enough, you can run in a light drizzle.

The first sign of pancreatitis, which should immediately seek emergency medical attention, is intense, sudden pain in the upper abdomen under the ribs. Self-medication with such a serious disease will only lead to a deterioration in the condition and the development of severe complications.

Role of the pancreas

The organ, located in the abdominal cavity behind the stomach at the level of the upper lumbar vertebrae, performs two purposes in the body:

• It secretes pancreatic juice with digestive enzymes into the small intestine, where the process of assimilation and absorption of nutrients into the blood takes place.
• It produces the hormones glucagon and insulin, which play a role in the regulation of metabolic processes.

Women's bad habit of overeating, eating fatty foods, or going on protein-deficient diets leads to inflammation of the pancreas, when digestive enzymes are stimulated before they enter the small intestine. The photo below shows a healthy and diseased organ.

Symptoms of inflammation of the pancreas

Manifestations of pancreatitis are similar to signs of gastrointestinal diseases or poisoning: the stomach also worries, nausea and vomiting opens due to intoxication of the body. But at the same time, there are other symptoms of inflammation of the pancreas, which are determined after a study of blood, stool, skin and depend on the form of the course of the disease.

Acute pancreatitis

Video: Acute pancreatitis

The first signs of inflammation are the occurrence of colic and repeated vomiting. Then there is girdle pain in the upper abdomen, which radiates to the shoulder blades for three days, and then acquires a aching character with a gradual decrease in intensity over the course of a week. At the same time, the following symptoms are noted:

• Paleness of the skin of the face, sharpness in features.
• Enlarged belly.
• Constipation and bloating.
• Fetid stools with foam and undigested pieces of food.
• Rapid heart rate.
• Fever - increased body temperature and muscle trembling, feeling cold.

With these signs, you need to urgently seek medical help. An acute attack of pancreatitis in severe cases leads to bleeding in the gland, infection and cyst formation. Because of these violations, other vital organs are damaged - the kidneys, heart and lungs.

Chronic pancreatitis

A prolonged inflammatory process develops for two reasons:

• After drunkenness, when men become addicted to alcohol.
• At the end of an episode of an acute form of the disease, if the correct treatment has not been carried out, since qualified assistance with such a course of pancreatitis helps sick people to fully recover.

Chronic inflammation spans two periods. The first is characterized by a recurring change of deterioration with no painful symptoms, and the second is a constant discomfort, similar to an acute course, also with nausea, vomiting and constipation, but with the appearance of new signs:

• Yellowish skin tone.
• Diarrhea and weight loss.
• Prolonged pain in the upper abdomen after overeating or taking fatty foods. At the same time, it becomes easier in a sitting position or only after several hours or even days from the moment heavy food enters the stomach.

Video: Effective treatment of the pancreas without drugs or drugs

Chronic pancreatitis, which lasts for years, leads to the destruction of the pancreas, a change in the structure of the tissues of the organ. As a result, they develop:

• secretory insufficiency.
• Diabetes.
• Malabsorption syndrome, which serves as a source of serious complications: anemia, reproductive disorders, nutritional deficiencies in the body.

Causes of inflammation of the pancreas

Pancreatitis develops due to two hundred causes, but is more common in women and men with certain risk factors, which include:

• Drunkenness.
• Cholelithiasis is the formation of stones in the gallbladder.

Inflammation in the pancreas always begins against the background of other diseases of the gastrointestinal tract - ulcers, gastritis, pathologies in the duodenum. The process is difficult to diagnose or treatable due to the complexity of the structure and the small size of the organ, which consists of a head - 32 mm, a body - 21 mm and a tail - 35 mm.

These figures refer to indicators corresponding to the norm, deviations from which indicate pathology. In addition to gallstones, or drunkenness, the causes of the acute form of the disease are:

• Uncontrolled intake of drugs - steroids, antibiotics, statins, proton pump inhibitors, due to which drug-induced pancreatitis develops. This rare form of inflammation of the pancreas can affect both an adult and a child, but more often this pathology occurs in childhood and in HIV-infected people.
• Infections - hepatitis, parotitis, tonsillitis, smallpox, sepsis in the intestine.
• Abdominal injury.
• Metabolic disorders.
• Surgical intervention.
• Autoimmune diseases.

Causes of chronic pancreatitis:

• Alcoholism.
• Stones in the gallbladder.
• Hereditary pathologies of the pancreas.
• cystic fibrosis.
• High levels of triglycerides in the blood.
• Smoking.
• Overeating and fatty foods.

Exacerbation of the chronic form of pancreatitis can also occur under the influence of prolonged use of drugs, which include: glucocorticoid hormones, estrogens, narcotic drugs, Furosemide, Indomethacin. In this case, the pancreas becomes aggravated against the background of a diseased liver or gallbladder.

Diagnostics

The conclusion about why the pancreas hurts in women is made after tests and instrumental methods:

• General and biochemical analysis of blood. Inflammation in the organ is evidenced by high levels of amylase and lipase, an increase in the number of leukocytes, and an increase in ESR.
• Glucose tolerance test.
• Radiography, ultrasound examination of the abdominal cavity.
• EGDS - gastroscopy. Evaluation of involvement in the inflammatory process of the stomach and duodenum.
• Computed tomography - to look for stones in the gallbladder and determine the degree of damage to the pancreas.
• Coprogram and urinalysis, in which amylase is present in pancreatitis.
• Biopsy and functional tests.
• ERCP and magnetic resonance imaging.

Treatment of inflammation of the pancreas

Acute pancreatitis poses a danger to health and life, therefore, with bouts of pain, they are not treated with folk remedies at home, and the person is immediately sent to the hospital. At the same time, patients with severe pathology are transferred to the intensive care unit, where they are under the close attention of doctors.

Treatment of inflammation in women with an acute course of the disease or chronic during a relapse begins with the following non-drug measures:

• Bed rest.
• Therapeutic hunger.
• Ice on the belly.
• Push-ups of the gland (fingertips are placed on the hypochondrium area and gently pressed until a feeling of tension in the abdominal wall for three minutes).
• Exercises to improve circulation and pancreatic function.

Drug therapy includes the appointment of:

• Intravenous infusions that replenish body fluids and normalize blood pressure.
• Painkillers, diuretics.
• Procedures for cleansing the blood.
• Somatostatin or synthetic analogues, to inhibit pancreatic function.
• Broad spectrum antibiotics.

With the complication of diabetes mellitus, therapy for patients is prescribed by an endocrinologist.

With destructive pancreatitis, operations are performed to remove dead or damaged tissue. The surgical method also has to treat patients who:

• Exacerbated intoxication syndrome.
• No improvement after two days of conservative therapy.
• A diagnosis of focal infected pancreatic necrosis was made.

Medicines for treatment

In the chronic course of inflammation in the pancreas, when a relapse occurs, therapy is carried out:

• Enzyme preparations are Wobenzym with a course of up to two months, Pancreatin, Mezim, Cholenzym.
• Allohol tablets, but they can be drunk only in the absence of symptoms of severe exacerbation.
• Painkillers are Baralgin, No-shpa, Duspatalin.
• Mineral water (Smirnovskaya, Slavyanskaya, Essentuki No. 4 and No. 17).
• Medicinal herbs - dandelion, corn stigmas, milk thistle, burdock root.

In the acute course of inflammation in the pancreas, the following drugs are prescribed for treatment:

• Antispasmodics - Papaverine, Drotaverine, No-shpa. With their help, the pain syndrome is stopped, the smooth muscles of the sphincter of Oddi and the biliary tract relax, the pressure in the duodenum and stomach decreases.
• Anti-inflammatory drugs - Diclofenac, Dexketoprofen, which stop pain and reduce swelling.
• Narcotic analgesics - Morphine is prescribed for destructive pancreatitis.

Therapeutic diet

Video: Pancreatitis - causes and getting rid of the disease

Nutrition in inflammatory processes in the pancreas plays an important role. The diet is chosen so that it does not provoke the resumption of symptoms of the disease after recovery. In this case, certain rules for eating should always be followed:

• Don't overeat.
• Eat often and in small portions.
• Do not eat cold or hot dishes, but only in the form of heat.

At the moment of crisis, when painful symptoms appear, nothing is eaten for the first 24 hours. Every 15–20 minutes, they drink several sips of boiled or mineral water Borjomi and Essentuki, rosehip broth, weak green tea, prepared from 1 tablespoon of raw materials per glass of liquid.

The diet for inflammation of the pancreas, starting from the second day after the relapse, consists of the following approximate list:

• For breakfast, you can boil liquid cereals in water.
• It is allowed to drink berry compotes, currant and cranberry fruit drinks, eat crackers.
• From day 3, the diet is diversified with decoctions of rice or oatmeal. Vegetables are made into liquid purees without oil. Cereals from semolina, ground buckwheat or rice are prepared both in water and in milk.

Starting from the second week, the menu includes:

• Fish and meat souffles or steam cutlets.
• Omelets without yolks.
• Oven baked apples and pears.
• Cottage cheese and lactic acid products.
• Slimy cereal soups.
• Puddings and mashed vegetables - potatoes, zucchini, pumpkin with carrots.

Treatment at home with a diet implies an exception:

• Alcoholic drinks and beer.
• Condiments and spices.
• Fatty, smoked and fried foods.
• Sausages and canned food.
• Sweets, cakes, pastries and other similar products, chocolate.
• Sour juices.
• Salted fish.
• Coffee and bananas.

Dietary nutrition for inflammation of the pancreas continues for a year. In the future, including forbidden foods in the diet, there is a possibility of repeated relapses.

Sample menu for a week with pancreatitis: