Pancreatitis is a disease that develops against the background of pancreatic dysfunction. The reason for this is the penetration into the organ of bacteria from the duodenum, blood, biliary tract, and also as a result of the negative influence of provoking factors from the outside. One of the most common types of pathology is parenchymal pancreatitis. This is a chronic form of the disease, the development of which is caused by damage to the parenchyma of the organ with progressive factors, which, if left untreated, leads to its atrophy.
Parenchymal form of pancreatitis - what is it?
This form of the disease is characterized by a sluggish inflammatory process, the cause of which is a violation of the synthesis of enzymes produced by the pancreas. Excessive enzyme concentration provokes self-digestion of parenchymal tissues, followed by their scarring and wrinkling.
Bas a result of this, diffuse changes in the organ occur. This is expressed in the gradual replacement of the affected tissue areas with connecting segments, followed by loss of pancreatic functionality. As a result, the synthesis of digestive enzymes in the body is reduced.
In medicine, there are two types of inflammation of the parenchyma:
- diffuse (extensive) - affects most;
- limited - the head or tail is partially affected.
The danger of parenchymal pancreatitis is that it is difficult to diagnose at the initial stage of development. This is due to the fact that the disease does not have pronounced symptoms and only manifests itself sometimes with minor periods of exacerbation. As a result, the disease gradually progresses and, in the absence of adequate therapy, can lead to pancreatic atrophy.
Basic shapes
Parenchymal pancreatitis is divided into three main forms. Each of them is characterized by certain clinical signs and the course of the pathological process:
- Edematous. This form develops due to excessive accumulation of fluid in the tissues of the organ. The provoking factor is nutritional errors, which is aggravated by alcohol. In rare cases, the edematous form develops as a complication of pathologies of the digestive tract. Clinical signs are expressed due to severe intoxication. Treatment is non-surgical and has a favorable prognosis.
- Sclerosing. It develops against the background of blockage of the glandular ducts, less oftencause of concomitant diseases of the digestive system. This form is characterized by the formation of sclerotic changes in the organ, which leads to a significant expansion of its ducts. Common symptoms of the lesion: pain in the left hypochondrium, the presence of glucose in the urine, frequent urge to urinate, thirst. 5% of diagnosed cases develop completely asymptomatically. For treatment, traditional methods of treatment are used.
- Calculous. It is characterized by the deposition of insoluble calcium s alts in the glandular ducts, which can provoke a complete blockage of the lumen. This form progresses significantly and can provoke the formation of a malignant tumor.
Subspecies with exocrine insufficiency
In addition to the morphological forms of the disease, experts distinguish two subspecies. Each of them is characterized by certain pathological changes that lead to partial or complete loss of pancreatic functionality.
The diagnosis of "parenchymal pancreatitis with exocrine insufficiency" is established with a decrease in the synthesis of digestive enzymes. As a result of damage, the body is not able to produce the necessary enzymes in sufficient quantities. This provokes their deficiency in the body, which negatively affects the functioning of the digestive organs.
Laboratory and hardware studies, which are confirmed by the patient's complaints, help to identify the subspecies of the pathology.
Chronic parenchymal biliary pancreatitis - what is it?
Another common subspecies -biliary-dependent, which needs close attention. It accounts for 50% of the detected cases of pancreatitis. The development of parenchymal biliary-dependent pancreatitis is a consequence of hepatobiliary disorders of a different nature.
The disease is closely associated with sluggish inflammation of the pancreas, which develops against the background of congenital and acquired pathologies of the organ.
Chronic parenchymal biliary-dependent pancreatitis - what is it? This disease is characterized by a partial or complete decrease in the efficiency of the gland for the production of digestive enzymes and hormones.
With pancreatitis of the biliary-dependent type, the outflow of bile from the duodenum occurs back into the pancreatic ducts. This ultimately leads to a change in the structure of tissues. This subspecies is characterized by constant relapses, which threaten serious he alth complications. A characteristic sign of pathology is a constant or frequent feeling of bitterness in the mouth.
Possible complications due to the development of parenchymal biliary-dependent pancreatitis:
- blockage of the bile duct;
- diabetes mellitus;
- further spread of the inflammatory process to adjacent organs and tissues;
- enzyme deficiency, which leads to the failure of all digestive organs.
With biliary-dependent pancreatitis, a critical decrease in the functionality of the pancreas up to 70% is possible.
Worrying symptoms
Pathological signsdiseases are often quite difficult to recognize, as they are similar to many diseases of the digestive tract. At the same time, the symptoms are not bright, which many people simply do not pay attention to.
Symptoms of parenchymal pancreatitis:
- Dull pain in the left hypochondrium radiating to the back, most often felt after eating spicy and fatty foods, alcohol and as a result of overeating.
- Nausea with frequent bouts of vomiting.
- Disturbance of the stool, with constipation alternating with diarrhea, feces characterized by a fetid odor, have a mushy texture and undigested food residues.
- Excessive flatulence.
- Constant drowsiness, absent-mindedness, which makes it impossible to concentrate on work.
- Significant weight loss that occurs as a result of a lack of digestive enzymes, so many nutrients are not able to be absorbed by the body and are transited to the exit.
- Increased dryness of the skin, red spots in the abdomen, due to hypertrophic changes in the subcutaneous fat layer.
The appearance of two or more pathological signs is a reason to see a doctor and undergo an examination. You should not immediately think of a diagnosis for yourself, since these symptoms are characteristic of many pathologies. And only an experienced specialist is able to identify the causes of their appearance.
Reason for development
Chronic parenchymal pancreatitis develops under the influence of certain provoking factors.
The most common ones are:
- cholecystitis, as a result of excessive deposition of cholesterol on the walls, the gallbladder becomes inflamed and swells, which leads to a decrease in the outflow of acid and throwing it back into the bile ducts;
- Urolithiasis, resulting in partial or complete blockage of the outflow of acid;
- formation of benign and malignant tumors;
- decreased biliary motility;
- excessive consumption of alcohol, as well as fatty and s alty foods;
- deficiency in the diet of proteins and vitamins;
- regular stress;
- failure of thyroid function;
- uncontrolled medication;
- regular frostbite or heatstroke;
- organ injury;
- chronic diseases of the digestive system.
In some cases, parenchymal pancreatitis develops as a complication after suffering the flu, scarlet fever, tonsillitis.
Diagnosis
To identify pathology, the doctor first interviews the patient for the presence of characteristic signs. In addition, examination with palpation and percussion is used, which allows you to identify a painful area in the left hypochondrium.
To confirm the diagnosis, the following types of tests and studies are prescribed:
- blood test to determine the level of red blood cells, white blood cells, enzyme concentrations, as well as to determine the level of calcium, sodium and potassium;
- examination of feces for maintenancecertain enzymes and fragments of undigested food;
- urinalysis to detect microhematuria, proteinuria, cylindruria;
- Ultrasound is the most informative method to detect diffuse changes in the pancreas;
- CT with contrast pigment, allows you to accurately determine the presence of stones in the bile ducts.
How to treat?
Treatment of chronic parenchymal pancreatitis is carried out in accordance with the identified stage of pathology. At the initial stage, it is enough to carry out the prescribed course of drug therapy and subsequently adhere to a certain diet in order to fully restore he alth.
If the pathology is advanced, which has led to irreversible consequences for the pancreas, a surgical operation is prescribed to cut off the affected area in order to prevent further deterioration of the situation.
Medicated treatment
The selection of the necessary drugs is carried out by the attending physician based on the severity of the identified pathology. Their dosage and course of administration are prescribed taking into account the individual characteristics of the patient.
The main types of medicines that are used to treat parenchymal pancreatitis:
- drugs that reduce the production of gastric juice ("Omeprazole", "Ezameprazole");
- antispasmodics for pain relief ("No-Shpa", "Papaverine");
- prokinetics that improve intestinal motility and promote the rapid passage of foodlump ("Domperidone", "Metoclopravid");
- replacement drugs that compensate for the resulting deficiency of enzymes.
Special Diet
How to treat chronic parenchymal pancreatitis with diet? It will not be possible to get rid of the pathology without an appropriate adjustment of the diet. Therefore, it is recommended to adhere to the following rules in nutrition:
- Refuse alcohol, smoking, and fatty, s alty, smoked, fried and spicy foods.
- Minimize your intake of sugar and s alt.
- All food should be boiled and steamed and ground to a puree consistency.
- In case of exacerbation, it is recommended to drink more kissels and compotes.
- Porridge should be cooked with water.
- Food should not be cold or hot.
- Fruits can be used almost anything, but they should not be sour.
- It is forbidden to eat fresh bread. It is better to replace it with crackers, bread, crackers.
- Meat and fish should be lean. They should be boiled.
- Dairy products must have a fat content of less than 2%, the use of curd mass with a high content of sugar and palm oil is not allowed.
- It is recommended to stick to a fractional diet, eating small meals 5-6 times a day.
- Meals should be prepared from a small number of ingredients.
Follow a strict diet for parenchymal pancreatitis should be within 1-2 months after the coursedrug therapy.
Healing herbal therapy
Phytotherapy is also an effective treatment for this disease. Medicinal herbs are used during remission to prevent recurrence of pathology. It is impossible to cure the pathology with purely medicinal fees, since they are not able to replace the main treatment.
You can buy ready-made mixtures of medicinal herbs at the pharmacy. But also, if necessary, they can be prepared independently. To do this, you need to mix the components in equal proportions.
Valid drug fee options:
- wormwood, motherwort, St. John's wort, mint;
- sudnitsa, wormwood, St. John's wort, chamomile, yarrow;
- dill, mint, immortelle, hawthorn, chamomile;
- St. John's wort, wormwood, sage, elecampane, burdock root, calendula, horsetail.
To prepare a decoction, pour 30 g of herbal mixture into 250 ml of boiling water. Leave for 40 minutes, peel. Drink the drink throughout the day in equal portions. Full course - 3 weeks.
Physical exercise as prevention of exacerbations
Therapeutic exercise also helps a person to forget about the pathology and return to their usual way of life. The most effective exercises are prescribed by the attending physician in accordance with the individual characteristics of the patient.
But there are a few guidelines to follow:
- More physical activity, so it is better to give preference to walking, exercise bike, simple physicalexercise.
- Do not use breath-holding exercises: squats, leg presses.
- It is forbidden to use drag belts during training.
- Eat 60-90 minutes before exercise.
Conclusion
Parenchymal pancreatitis is a serious disease that requires timely and adequate treatment. Ignoring doctor's prescriptions or self-medication threatens with serious he alth complications. It should also be understood that pills will not be able to solve the problem without adjusting the diet and giving up bad habits. Only complex therapy can prevent relapses.
