Is it possible for pancreatitis to worsen? Treatment of chronic pancreatitis, diet for exacerbations, medications. Other dangerous complications

The pancreas is an organ that simultaneously belongs to two different systems of the body. Firstly, it is in this gland that specific enzymes are produced that are actively involved in the digestion process. Secondly, the pancreas produces insulin - this organ belongs to both the digestive and endocrine systems of the body.

Possible pathologies

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Pancreatic diseases have many varieties - from classic inflammation to diabetes mellitus. It is hardly worth considering home treatment for diabetes mellitus - such a direction simply does not exist, the patient must be under constant supervision medical workers and take special medications. And benign neoplasms in the pancreas should be under the supervision of doctors - as a rule, specialists either prescribe surgical intervention or simply monitor the tumor.

The most common disease of the pancreas is pancreatitis, which can occur in acute or chronic form. In the first case, the patient is unlikely to be able to do anything at home to alleviate the condition - intense pain and repeated vomiting mean going to a medical facility. But the chronic form of pancreatitis (inflammation of the pancreas) may well be discussed in this material.

Causes of chronic pancreatitis

Most often, the cause of chronic pancreatitis is alcohol, but the simultaneous consumption of alcoholic beverages and fried, fatty, protein-rich foods (our favorite “kebab with cognac”) is especially dangerous. It is noteworthy that it is not at all necessary for the development of chronic pancreatitis to drink alcohol with fried meat for many years - in some cases, one such abuse is enough to inflammatory process developed in the pancreas.

In second place in terms of frequency of diagnosis are secondary pancreatitis - they develop against the background of other diseases of the digestive system. For example, an inflammatory process in the pancreas can develop against the background of the stomach.

In addition, the development of chronic pancreatitis can lead to:

, viral hepatitis, mumps and any infectious diseases;
periarteritis nodosa, aortic atherosclerosis and other circulatory disorders;
burdened heredity;

Separately, it is worth mentioning the so-called idiopathic pancreatitis - an inflammatory process, the etiology of which cannot be clarified even after a full examination.

Symptoms of chronic pancreatitis

The disease in question occurs in 4 stages - each of them has certain symptoms that can become a reason for differentiating chronic pancreatitis.

Stage 1

The patient complains of abdominal pain, which is localized in a crescent: left hypochondrium, epigastric region, right hypochondrium. In some cases, girdle pain may be present when the lower back joins the indicated areas of pain.

There are no functional impairments; the patient does not notice anything other than pain. It is noteworthy that the characteristic pain syndrome appears approximately 30 minutes after eating food.

Stage 2

Against the background of regularly occurring pain, two types of failure develop:

esocrine - increased gas formation, bloating, stool abnormalities (diarrhea), laboratory examination of stool reveals a decrease in elastase, “fatty” stool;
endocrine - glucose tolerance decreases, diabetes mellitus may develop.

Stage 3

Both esocrine and endocrine insufficiency develop simultaneously. The peculiarity of this stage of the course of chronic pancreatitis is a decrease in the intensity of the pain syndrome, the appearance of pain not 30 minutes after eating, but at least 2 hours later. The pain does not have any specific localization.

Stage 4

Functional disorders of the pancreas are pronounced, pain is practically absent.

Chronic pancreatitis occurs with alternating stages of remission and exacerbation. If an exacerbation of the disease in question begins, the pain will be quite severe, nausea and vomiting may be present, after which the patient does not experience relief. Diarrhea and increased blood glucose levels appear exclusively during exacerbations if chronic pancreatitis occurs in the initial stages.

Exacerbation period - how to help yourself at home

In some cases, during an exacerbation of chronic pancreatitis, it is advisable to seek professional medical help - doctors will be able to quickly relieve pain using a wide range of medications and prevent the development of dehydration due to repeated vomiting and diarrhea. But many patients who have previously been diagnosed with chronic pancreatitis prefer to help themselves at home - for example, if the pain intensity is not great, and vomiting and diarrhea happened once.

What can be done at home during exacerbation of chronic pancreatitis:

On the first day of an attack, you should stop eating any food. You are allowed to drink still mineral water and a few sips of rosehip decoction every 15-20 minutes.
On the second day, if you feel relief, you can introduce steamed cutlets or meat soufflé, mashed potatoes/vegetables without butter, and pureed soups with a second chicken broth into your diet.
Subsequent days - cottage cheese is added to the menu, baked apples or pears, dairy products, fruit and berry compotes or jelly.

Note:Fried, smoked, fatty, spicy foods should be excluded from the menu. Moreover, such a diet should be followed for at least 30 days, or even better – 60 days.

If nausea and vomiting are present during an exacerbation, then it is advisable to take Cerucal or Motilium 1 tablet 3 times a day.
To reduce pain it is recommended:

Omeprazole or Famotidine - these medications help reduce the concentration of hydrochloric acid in gastric juice;
Pancreatin or Creol - the level of secretion of enzymes by the pancreas decreases, providing functional rest to the organ;
antispasmodics - No-shpa or Duspatalin, if chronic pancreatitis develops against the background of cholelithiasis.

Note:all recommendations for the use of these medicines general, for each individual case the doctor must select the drug itself, its dosage, and the duration of therapy. If an exacerbation of chronic pancreatitis occurs for the first time, then it is advisable to seek medical help.

Remission period - what can be done at home

After the period of exacerbation has ended, the patient should not “relax” - he will need to adhere to certain rules to prevent the development of a new attack.

Alcoholic drinks should be completely excluded from the diet. But even if circumstances force you to drink, then let it be alcohol in small quantities and without heavy snacks - lard and sausage with a glass or two of vodka will certainly lead to an exacerbation of the disease in question.
Make up a rational correct menu– there is no need to eat exclusively steamed cutlets and pureed soups for the rest of your life; it is enough to just eat food in small quantities, but often.
Get rid of the habit of taking medications at the first appearance of a cold or acute respiratory viral infection - uncontrolled use of Tetracycline, Biseptol and some other medications can lead to exacerbation of chronic pancreatitis.
Undergo treatment for those diseases that may be a provocateur for the development of pancreatitis - for example, cure a gastric ulcer under the supervision of doctors, remove stones from the gall bladder, and so on.

Note:in some cases, patients may experience signs of exogenous deficiency even during a period of remission - the person loses weight, constantly has diarrhea, and has “fatty” feces. Doctors will probably prescribe lifelong use of specific enzyme preparations - for example, Creon.

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During the period of remission, it will not hurt to use recipes from the category “ ethnoscience». For example, the most common and effective medicine would be a herbal decoction:

3 parts each of dill seeds and peppermint leaves;
2 parts each of immortelle flowers and hawthorn fruits;
1 part chamomile flowers.

Mix all the raw materials, add water so that it completely covers the herbs and heat in a water bath for 7-10 minutes. Next, the broth should brew for 2 hours in a sealed container. You need to take this remedy ½ glass three times a day 20-30 minutes before meals.

During the period of remission, doctors may recommend visiting a sanatorium-resort complex - balneological procedures are of great help, and drinking mineral waters on a special schedule has a good effect on the health of a patient diagnosed with chronic pancreatitis.

Chronic pancreatitis is a disease that requires long-term treatment and long-term adherence to certain nutritional rules. If you ignore the above recommendations from specialists, the disease in question can lead to the development of severe complications, including pancreatic necrosis. But on the other hand, if you follow all the doctor’s prescriptions, you can achieve stable remission - the normal rhythm of life practically does not change.

Tsygankova Yana Aleksandrovna, medical observer, therapist of the highest qualification category

Those who have suffered acute pancreatitis remember what a terrible disease it is. And it is scary not so much because of its danger to life, but because of its severe pain. There is a concept of “pancreatogenic shock”, and treatment of acute pancreatitis begins with eliminating the symptoms of pain. Fortunately, in most cases, acute pancreatitis ends favorably for life. But, when a significant part of the gland tissue is damaged, chronic pancreatitis occurs, the exacerbation of which forces a person to take various medications in the hope that the nightmare will not recur.

Why does this process occur? How does it manifest itself, and what to do if pancreatitis worsens? How to transfer this “smoldering” state back into the inactive phase?

Causes of exacerbation of chronic pancreatitis

We have already written that pancreatic enzymes are locked in it and are dangerous for surrounding tissues. At one time, enzymatic aggression was the cause of acute inflammation. Then necrosis occurred, and after recovery, the “legacy” was a chronic pancreatic disease.

Typically, its signs are intolerance to certain types of food, and the development of malabsorption, or malabsorption syndrome. It is on such clinical signs that the diagnosis of exacerbation of pancreatitis is most often based.

But sometimes a process occurs in which these symptoms intensify, and epigastric pain reappears. They are similar to a repeat of the attack, although much weaker than the first time.

Why doesn’t acute pancreatitis arise again, but most often only a weakened version appears?

There are two circumstances involved in this:

the enzymatic “power” of the gland is no longer the same, since a certain part of it is destroyed. And with exacerbation of chronic pancreatitis, autolysis (self-digestion) is much less pronounced;
The patient, nevertheless, remembering his torment in the surgery department, somehow follows a diet, and no longer drinks a liter of vodka with a spicy and hot snack in one evening. The era of heroism, alas, is left behind. There is nothing to do, the gland has become more sensitive, and now eating a piece of smoked lard or canned fish in tomato leads to an aggravation.

These two factors lead to the fact that treatment of exacerbation of chronic pancreatitis is not as difficult a task as treatment of acute pancreatitis. The mortality rate is much less, as is the suffering. To know what to do during an exacerbation of pancreatitis, you need to remember how it manifests itself.

Symptoms of exacerbation of chronic pancreatitis

Exacerbation of chronic pancreatitis usually occurs after an error in diet. The main symptoms of such an exacerbation are:

attacks of pain that are localized in the left epigastrium, or in the hypochondrium;
they are almost always associated with food intake, or occur after eating;
intense flatulence, bloating, and gases appear;
unstable stool occurs, which becomes greasy and therefore cannot be washed away with water - you have to use a brush;
as long as the exacerbation of chronic pancreatitis lasts, the person will lose weight and lose weight, so this condition depletes the person;
the patient is also frightened. He expects pain, so he eats very small portions, and often monotonously, choosing the type of food that has never caused pain, for example, thin mashed potatoes.

All this leads to the fact that during the period of exacerbation the sick person does not look well. He has dull hair, dry and flabby skin that flakes. There are “jams” in the corners of the mouth, or angular stomatitis, which indicates vitamin deficiency. Spider veins, or telangiectasias, appear on the skin of the body. As a result, sleep deteriorates, performance decreases, and an anxiety-depressive state develops.

How can you avoid all these unpleasant manifestations? How to treat chronic pancreatitis in the acute stage?

What to do in case of exacerbation of chronic pancreatitis

The necessary therapy for this disease involves a number of goals that must be achieved. Only in this case can we consider that a period of remission has been achieved. These goals include:

elimination of pain syndrome;
normalization of external secretion, elimination of malabsorption, improvement of absorption;
prescription of replacement therapy for insulin deficiency;
reduction of inflammation symptoms.

These are the principles of treatment of chronic pancreatitis in the acute phase. Let's look at the means by which this is done.

Cold, hunger and rest: we begin treatment

Treatment of exacerbation of chronic pancreatitis begins with a 2-3 day diet No. “0”, or with complete fasting, which is very useful. As a result, the pancreas “falls asleep” and its enzymes stop producing. During this period, in order to reduce the secretion of hydrochloric acid in the stomach, you can take good quality hydrocarbonate-chloride mineral waters, after releasing the gas.

An ice pack placed on the epigastric area, as well as semi-bed rest, will not be amiss. After 2-3 days have passed, we return to the patient’s proper nutrition.

Diet for pancreatitis during exacerbation

There is nothing special about the diet. But it is precisely this that is the cornerstone of therapy, and is no less important for exacerbation of pancreatitis than the best medications. Prohibited:

refractory, animal fats, as well as poultry fats - goose and duck, and dishes made from duck, lamb and pork;
smoked, fried, pickled, fatty and spicy;
Seasonings, sauces (except for sweet milk dressings), spices, homemade pickles and marinades are prohibited;
alcohol, carbonated drinks, sweet lemonades, strong tea and coffee, sour berry juices and fruit drinks.

Eggs, which release hydrogen sulfide in the intestines, are not recommended; excess sweets, which cause fermentation or fermentation dyspepsia, are harmful, as well as consuming large amounts of ballast fiber, which absorbs enzymes, reducing the already low activity of digestion.

Fractional meals, boiled vegetables, soups with vegetable broth, lean chicken and beef, well-heat-treated, and steamed dishes are allowed. Those who follow a very strict diet can cope with exacerbation of chronic pancreatitis in some cases, and without drug treatment.

Medicines

Drugs for exacerbation of pancreatitis can be symptomatic (for example, eliminating pain and nausea) and pathogenetic (helping with digestion). The most effective include:

antinausea and antiemetic drugs (“metaclopramide”, “cerucal”);
myotropic antispasmodics (“No-Shpa”, “Galidor”);
enzyme inhibitors - proteases, for example, Gordox, Kontrikal, Trasylol.

All these means are used during the hungry period to prevent the continuation of the enzymatic “war”;

In severe cases, anticholinergics, for example, platyphylline, are administered subcutaneously. This can be done, for example, by an emergency doctor;
drugs that reduce gastric secretion (since it “stimulates” the pancreas) - H2 receptor blockers (Zantac, Kvamatel, Gastrosidin);
antacid and coating agents (“Maalox”, “Phosphalugel”);
proton pump inhibitors (“omeprazole, lansoprazole”);
enzyme preparations, for example, “Creon”, “Festal”, “Panzinorm”, “Enzistal”. Their task is to help the gland cope with digestion.

Drug treatment of exacerbation of chronic pancreatitis also necessarily includes taking multivitamins and prescribing eubiotics that normalize the intestinal microflora.

There are many subtleties that need to be taken into account when dealing with enzymatic deficiency, but this is the task of the doctor - gastroenterologist, nutritionist, and, of course, the active participation and commitment to the treatment of the patient himself. All this can make the course of an exacerbation, so to speak, more comfortable for the patient.

Prevention of exacerbations of chronic pancreatitis

Of course, the best treatment is prevention. Chronic pancreatitis can worsen and throw out “surprises” that the patient is not even aware of. This may be hyperglycemia and hypoglycemia, severe vitamin deficiency, processes leading to atrophic gastritis, liver dysfunction and nervous and physical exhaustion.

The basic rule of prevention is very simple. If you want to be healthy, “pass through your head” what gets into your mouth. Before you swallow anything, you need to think about whether it will harm your digestion.

Alcohol should be strictly avoided. In conditions of insulin deficiency, it can lead to hypoglycemia and the development of a serious condition, and if you are “lucky” and a pleasant intoxication develops, then the person “without brakes” gorges on junk food. Therefore, complete abstinence from drinking, smoking (swallowing tobacco saliva irritates the digestive tract) and food temptations will allow you to avoid this disease.

Chronic pancreatitis is a disease with a wave-like course. It has periods of remission, when the patient’s condition improves, as well as periods of exacerbation, which a person usually spends in an inpatient surgical or gastroenterological department. With a mild course of chronic pancreatitis, the patient can wait out the exacerbation of the disease at home, taking sick leave and reducing the symptoms with the help of medications. In severe cases, an exacerbation can result in surgery or even the death of the patient.

Causes of exacerbation of chronic pancreatitis

Chronic pancreatitis can worsen for two most common reasons:

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

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

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

As a rule, symptoms of exacerbation of chronic pancreatitis develop quite quickly. Already on the first day, a person’s condition deteriorates sharply, as a result of which he has to take medications or seek help from a doctor.

Symptoms of exacerbation of chronic pancreatitis

A patient may suspect exacerbations of chronic pancreatitis based on the following clinical signs:

abdominal pain with vague localization, radiating to the back, worsening after eating;
frequent and loose stools, fat in the stool;
bitterness in the mouth, vomiting of bile, which does not bring relief and is difficult to control with medications.

All these clinical signs are not characteristic only of chronic pancreatitis. But if a person has had an exacerbation of this disease not for the first time, he already knows that it was the inflammation of the pancreas that caused the appearance of all the symptoms.

What should be done if abdominal pain and dyspeptic symptoms occur? It is advisable to consult a doctor. If the pain is severe and vomiting cannot be eliminated, you should call an ambulance and immediately take the patient to the intensive care unit for correction of water and electrolyte metabolism. Such conditions are life-threatening, so you should not delay seeing a doctor. Exacerbation of pancreatitis may well lead to partial destruction of the pancreas, which may require surgical treatment.

If the symptoms are mild and an exacerbation of pancreatitis appears with a dull aching pain, nausea, and increased frequency of bowel movements, you can wait until the morning and then go to the clinic at your place of residence. Many patients are afraid of doctors, and therefore do not want to seek their help. This is a big mistake. The more often a person treats an exacerbation of chronic pancreatitis at home, the faster he will experience destruction of the functional tissue of the pancreas and its replacement with adipose or connective tissue. This leads to severe disruption of digestive processes, and in the future can cause diabetes.

Treatment of exacerbation of chronic pancreatitis

In most cases, exacerbation of chronic pancreatitis lasts no more than one week and does not pose a significant threat to the life and health of the patient. Primary goals of treatment during exacerbation of the disease:

relieve pain;
restore the amount of fluid in the body;
unload the pancreas, thereby stopping the further development of the pathological process.

When a patient first consults a doctor, he is usually prescribed non-steroidal anti-inflammatory drugs. In most cases, they can significantly reduce the severity of the inflammatory syndrome. Preference is given to paracetamol because it has minimal negative effects on the gastric mucosa. But taking this drug is undesirable if the cause of inflammation of the pancreas is liver pathology. Do not forget that paracetamol has a hepatotoxic effect. If the pain cannot be relieved with NSAIDs, the person may be prescribed narcotic analgesics. Most often, the drug of choice in such cases is Tramadol.

Auxiliary drugs for pain relief:

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

In order to restore the water-electrolyte balance in the body, a person is infused intravenously with physiological solutions - 0.9% sodium chloride or 5% glucose. In case of severe hypovolemia, it is possible to prescribe colloidal solutions (reopolyglucin, gelatinol). In case of bleeding, whole blood is transfused or red blood cells are administered.

To unload the pancreas, use:

a diet with severe fat restriction or complete fasting for several days;
complete exclusion of alcohol and smoking;
Octreotide is a drug that is an analogue of the pancreatic hormone somatostatin.

Prevention of exacerbations of chronic pancreatitis

With chronic pancreatitis, exacerbations always occur. The patient’s task is to ensure that they occur as rarely as possible. Ideally, no more than once every few years. This requires careful control of your diet, complete cessation of smoking and alcohol, introduction of a fractional diet. If the cause of inflammation of the pancreas is a pathology of other organs and systems, it is worth taking measures to treat them as quickly as possible.

To avoid exacerbation of pancreatitis, you must:

limit the amount of fat in the diet;
limit calorie intake and prevent weight gain;
accustom yourself to frequent and small meals;
avoid feasts that are accompanied by the consumption of alcoholic beverages and overeating;
Before taking any medications, consult your doctor.

Even in the absence of exacerbation of chronic pancreatitis, it is worth regularly seeing your doctor and having an ultrasound of your organs. abdominal cavity and take the necessary tests. This will allow us to identify functional disorders in the pancreas at an early stage, as well as identify possible complications pancreatitis. If the patient follows all of the above recommendations, the prognosis of the disease is conditionally favorable. It should be remembered that the most common cause of frequent and severe exacerbations of pancreatitis is the patient's intake of alcohol.

Attention! Articles on our website are for informational purposes only. Do not resort to self-medication, it is dangerous, especially for pancreatic diseases. Be sure to consult your doctor! You can make an online appointment with a doctor through our website or select a doctor in the catalog.

Chronic pancreatitis is a disease that has a wave-like course. This type of pancreatitis is characterized by remission periods: a person’s condition either improves or worsens.

In case of exacerbation of pancreatitis, a person is treated in a gastroenterological or surgical department.

If there is a mild course of chronic pancreatitis, then a person can wait out the exacerbation of the disease at home; treatment here is symptomatic, and eliminates the signs and symptoms of the disease, and also improves the patient’s well-being.

In this case, he takes sick leave and undergoes treatment with medications. It is still better not to ignore exacerbation of chronic pancreatitis and seek medical help.

Severe forms of the disease may require surgery. Improper treatment can be fatal.

Main reasons

The disease can enter the acute phase for the following reasons:

Drinking large amounts of alcoholic beverages;
Disruption of the biliary tract.

In addition, there are other reasons that have different important. However, these reasons seriously increase the frequency of exacerbations of the disease. The main ones:

Constant overeating
Systematic intake of small amounts of alcohol;
Smoking;
Excess weight;
Eating large amounts of fatty foods;
Taking medications;
Frequent stressful situations;
Infectious diseases.

In most cases, symptoms of exacerbation of pancreatic disease occur fairly quickly. During the first day, a person feels a significant deterioration in health, so he takes medications or consults a doctor; treatment can be continued in a hospital.

Key symptoms of exacerbation of chronic pancreatitis

Exacerbation during chronic pancreatitis of the pancreas can be suspected by the following clinical manifestations:

abdominal pain with blurred location. They radiate to the back and intensify after eating;
loose and frequent stools with fat in the stool;
a feeling of bitterness in the mouth, vomiting with bile, which does not provide relief and is difficult to remove with medications.

If this is not the first time a person feels an exacerbation of the disease, then he is already informed that the cause of all symptoms is inflammation of the pancreas, which has its own symptoms.

If you experience pain in the abdomen or dyspepsia, it is advisable to undergo an initial examination by a doctor, who will then prescribe treatment and tell you what to do.

If there is severe pain and it is impossible to eliminate vomiting, you need to call an ambulance immediately.

The ambulance team will take the person to the intensive care unit, since correction of water and electrolyte metabolism is necessary, and this can be done normally in a hospital setting. These conditions are dangerous to human life, so it is strictly forbidden to postpone a visit to the doctor if they occur.

There is a high probability that an exacerbation of pancreatitis will lead to partial dysfunction of the pancreas, which will subsequently require surgical intervention.

If the symptoms are mild, for example, if an exacerbation of pancreatitis manifests itself as a dull aching pain, increased frequency of stools, nausea, you can wait until the morning to contact your local clinic.

Many people are afraid of doctors and possible discomfort, so they are in no hurry to start treatment, which is a big mistake. Over time, the destruction of the pancreas and the replacement of fatty or connective tissue occurs more and more quickly.

This will disrupt the digestion process and can lead to diabetes.

Treatment

As a rule, exacerbation of chronic pancreatitis does not last more than one week. This phase does not pose a serious threat to the patient’s life and does not lead to total disruption of the body’s functioning, but its symptoms and signs prevent a person from leading a full life.

First of all, you need to determine the goal of treatment in the acute phase of chronic pancreatitis:

Relieve pain;
Restore fluid volume in the body;
Reduce the load on the pancreas, this will stop the situation from getting worse.

When first visiting a doctor, the patient is prescribed non-steroidal anti-inflammatory drugs. As a rule, drugs reduce severe inflammatory syndrome.

Paracetamol is very common and has a slight negative effect on the gastric mucosa. Paracetamol should not be taken if there is liver disease. We must not forget that the medicine has a hepatotoxic effect.

If the pain does not go away with the help of these remedies, then the patient needs to be prescribed narcotic analgesics. Usually this is tramadol.

Additional drugs to stop pain are:

: creon and pangrol;
antispasmodics: papaverine and drotaverine;
proton pump inhibitors: rabeprazole, lansoprazole.

To restore the water-electrolyte balance, the patient is given an intravenous injection of physiological solution: 5% glucose or 0.9% sodium chloride.

Severe hypovolemia requires the administration of colloidal solutions, namely gelatinol or rheopolyglucin. In case of bleeding, whole blood transfusion or administration of red blood cells is indicated.

To relieve the pancreas, you must take the following measures:

a diet with limited fat or fasting for several days;
complete cessation of smoking and alcohol;
taking octreotide, a drug that is an analogue of somatostatin, a pancreatic hormone.

Preventive measures

Exacerbations are one of the characteristic features of chronic pancreatitis. The patient must ensure that exacerbations occur as rarely as possible. Ideal result: no more than once over several years.

What do you need to do for this? It is important to carefully control your daily diet and completely give up alcoholic beverages and smoking.

In addition, the fractional feeding mode is effective. In this case, the symptoms and signs of the problem long time will not appear. The ideal choice would be .

If the cause of inflammation of the pancreas is a pathology of organs or systems, then treatment measures should be taken as soon as possible.

To prevent exacerbation of chronic pancreatitis, you need to:

limit caloric intake and prevent weight gain;
strictly limit fats in the diet;
eat often and in small portions;
do not attend feasts accompanied by an abundance of alcohol and food;
Before using any medications, consult your doctor.

Every chronic inflammatory disease, including pancreatitis, lasts a long time; periods of remission alternate with periods of exacerbation. Remission may be long-term or may not be stable. Exacerbations - seasonal (spring-autumn), rare or frequent. The course of the disease can generally be continuously relapsing - when a fading exacerbation flares up again with a vengeance. What does this depend on and how to behave during exacerbations of chronic pancreatitis?

Causes of exacerbations of chronic pancreatitis

The main reason is gross violation of diet and alcohol consumption. Perhaps alcohol even comes first. Even in minimal doses. Next, in order of importance:

Insufficient protein intake from food.
Strong feelings, stress.
Taking certain medications (hormones, aspirin, some antibiotics, chemotherapy drugs for the treatment of cancer).
Exacerbation of cholecystitis and cholelithiasis, cholangitis
Poisoning and acute infectious diseases.

During an exacerbation, the activity of pancreatic enzymes sharply increases, the pancreatic tissue is irritated under their influence, swelling occurs, compression of the large pancreatic duct occurs, the blood supply to the gland worsens - the clinical picture resembles acute pancreatitis and, in fact, is not much different from it.

Symptoms of exacerbation of chronic pancreatitis

Intense or dull pain in the left hypochondrium, radiating to the back and under the shoulder blade.
Impaired digestion of food - during exacerbation, frequent loose stools occur.
Analysis of stool shows that it contains fragments of muscle fibers, fiber, and fat drops. The color of the stool is grayish, the consistency is greasy, the feces are poorly washed off the walls of the toilet and have a greasy sheen and an unpleasant odor.
Symptoms of dyspepsia are almost always present - bitterness in the mouth, nausea, vomiting, rumbling in the stomach, loss of appetite.

An exacerbation with pronounced symptoms lasts about a week. The less intense the pain and signs of indigestion, the longer this condition lasts, sometimes up to several weeks. Patients experience weight loss due to poor appetite, nausea, vomiting, impaired digestion and absorption of essential nutrients.

Diagnostics

Usually it does not present any difficulties; it is simply necessary to carry out the necessary tests in a timely manner and apply special examination methods to prevent the development of complications:

A biochemical blood test shows high levels of trypsin, amylase, antitrypsin, and lipase.
Hyperglycemia and glycosuria indicate damage to the insulin-producing apparatus of the gland and the development of diabetes.
A clinical blood test shows leukocytosis and an increased ESR.
Ultrasound scanning revealed that the pancreas was enlarged and swollen.
A computed tomogram can determine the degree of fibrosis (sclerosis) of the gland
X-ray examination can detect areas of calcification (calcification) in organ tissue, which is an indirect sign of a complication such as diabetes.

Hardware methods make it possible to differentiate exacerbation of pancreatitis with cholelithiasis, stomach ulcers, tumor diseases, gastroduodenitis, and enteritis. You should also not discount the possibility of pancreatitis co-occurring with one or more pathologies of the digestive system. Therefore, it is better to carry out a full diagnosis in a specialized hospital.

How to treat an exacerbation?

Treatment of exacerbation consists of regimen, diet and drug therapy.

In cases of severe pain, bed rest is prescribed and patients are unable to work.

In the first few days, fasting is necessary; you can only drink water - purified without gas, or boiled. In the future, the diet is gradually expanded, table No. 1a is prescribed, as during an exacerbation peptic ulcer stomach. Protein-rich foods are allowed - lean meat - beef, rabbit, turkey, in the form of steamed meatballs or soufflé, boiled lean fish, steamed protein omelet, low-fat cottage cheese, pureed viscous porridge. Drinks you can drink include tea, rosehip infusion, and blackcurrant compote.

All dishes are prepared either steamed or boiled, carefully chopped or pureed. Portions are small, not exceeding the amount that fits in one handful. The number of meals is from 6 to 8 times a day.

Extractive substances that enhance secretion are excluded from the menu - strong broths, mushrooms, coffee, cocoa, chocolate, marinades, smoked meats. All foods that require effort from the pancreas - fatty, fried, salty, spicy, seasonings and spices, canned food, cream, sour cream, fatty cottage cheese, lard - will have to be put aside. You can't eat fast food, soda, colorful candies and chocolate bars, chips, crackers, nuts - everything we're used to snacking on on the go. An unconditional, categorical, non-discussable taboo on alcohol. And for beer. And for non-alcoholic drinks, too.

Typically, diet solves about 70% of the problems that arise during exacerbation of chronic pancreatitis. Once you give the gland rest, the inflammation will begin to subside. The main thing is to withstand the necessary time, and not “break down” when everything starts to get better and stops hurting.

Antispasmodics are prescribed - platifillin, no-shpu. At the same time, they try to suppress gastric secretion - for this the patient needs to take omez or other inhibitors proton pump- rabeprazole, lanzap, nolpaza, etc. With pronounced activity of pancreatic enzymes, intravenous drip administration of gordox (contrical) is required. If the patient becomes dehydrated due to vomiting and diarrhea, a drip of fluid is prescribed - Ringer's solution, isotonic solution etc.

For some reason, the issue of taking enzymes during an exacerbation is always actively discussed. At the peak of exacerbation and pain, enzymes are contraindicated! Only after some time, when the inflammation begins to subside, and laboratory indicators confirm this, they begin to help digestion by taking pancreatin in doses prescribed by the attending physician.

An important issue is the prevention of exacerbations

To prevent exacerbations of chronic pancreatitis, it is necessary to avoid situations that lead to it:

Do not drink alcohol or smoke;
Do not overeat or break your diet;
Follow a diet (often and in small portions and, preferably, at the same time);
Avoid stress;
Timely treat concomitant pathology - cholelithiasis,