The pancreas is one of the most important glands in our body. It belongs to the group of glands of mixed secretion. This means that it simultaneously produces hormones that are released into the blood (internal secretion) and synthesizes enzymes that are necessary for digestion in the intestines (external secretion). Therefore, it is very important to have an idea of what problems with the pancreas can occur in a person, how they manifest themselves, and how to deal with them.
The importance of the pancreas in the body
To understand why there are certain signs of problems with the pancreas, you need to figure out what is the significance of this organ in the body and what functions it performs.
As noted above, the pancreas is an organ of mixed secretion. Acting as an endocrine gland, it secretes three main hormones:
- insulin - reduces the concentration of glucose in the blood, facilitates its utilization by cells, increases protein synthesis and reducesfat breakdown;
- glucagon is the exact opposite of insulin, it increases glucose levels, increases the breakdown of proteins and fats, which is why glucagon is also called the contrainsular hormone;
- somatostatin - inhibits the synthesis of pituitary hormones (somatotropic and thyrotropic).
External secretion of the pancreas is characterized by the production of the following enzymes:
- amylase - necessary for the absorption of carbohydrates, breaks down polysaccharides to monosaccharides (glucose and fructose);
- trypsin - breaks down proteins into amino acids;
- lipase - essential for fat absorption.
From the above basic functions of the pancreas, it follows that problems with it will lead to indigestion in the first place. And with a longer course of the disease, there is also a violation of protein and carbohydrate metabolism.
Possible diseases
The most common causes of pancreatic problems are listed below:
- Pancreatitis - inflammation of the tissue of the gland, can be acute and chronic. Most common in adults, rare in children.
- Neoplasms - benign and malignant tumors.
- Diabetes mellitus is the destruction of pancreatic cells involved in the synthesis of insulin, or impaired tissue sensitivity to insulin.
- Functional disorders of the gland - dysfunction of the organ in the absence of anatomical changes.
- Structural anomalies - oftena common cause of pancreatic problems in a child.
Common signs of pancreatic disease
Despite the variety of origin of diseases of this organ, there are a number of main signs that are characteristic of any problem with the pancreas:
- Pain in the left hypochondrium, often girdle in nature and radiating to the back. The intensity of pain increases with a violation of the diet, palpation of the abdomen. Depending on the pathology, they can be of different intensity, constant or cramping. Pain is the main symptom of pancreatic problems in adults, which makes the patient seek medical help.
- Dyspeptic manifestations. This group of symptoms develops with insufficiency of the external secretion of the pancreas, manifested by constipation and diarrhea, nausea and vomiting.
- Decrease in appetite, and as a result of weight loss and exhaustion of the body.
The rest of the symptoms are more specific, so they will be considered in the context of individual diseases of this organ.
It is also worth noting that the signs of diseases may differ depending on the severity of the pathology, its causes, but they do not depend on gender. The symptoms of pancreatic problems are the same for women and men.
Pancreatitis: general concepts
Inflammation of the pancreas or pancreatitis is a common problem of digestive disorders in adults. This pathology can be acute or chronic. Acute pancreatitis inadults occurs due to alcohol abuse, dietary disorders. However, this problem can also occur in children. Most often in childhood, the pancreas becomes inflamed due to viral infections (mumps), congenital pathologies (cystic fibrosis), damage to the gland by certain medications.
Chronic pancreatitis is most often the result of undertreated acute. It occurs when the patient does not seek medical help in time, the patient does not follow the diet and takes medicines in bad faith.
Inflammatory processes in the gland occur due to blockage of the ducts, which leads to an increase in pressure in their channels. After a certain time, the ducts are damaged, and their contents, together with enzymes, enter the bloodstream, injuring the cells of the pancreas. There is a death of parts of the gland (pancreatic necrosis). In the blood, enzymes accumulate in excess (fermentemia), which has a toxic effect on internal organs.
Pancreatitis symptoms
What are the most common symptoms of pancreatic problems in adults? All of the above clinical manifestations are true: pain in the hypochondrium, dyspeptic manifestations, loss of appetite and weight loss.
It is worth noting that in acute pancreatitis, the pain is extremely pronounced. It occurs acutely with malnutrition (drinking alcohol, a large amount of fatty and fried foods). The pain covers the entire upper abdomen, radiating to the back. Facilitates sitting positionlowered legs. Painful sensations are accompanied by a severe general condition of the patient: a decrease in blood pressure, increased heart rate, sweating and weakness.
In chronic pancreatitis, the pain is not so intense, it acquires a pulling or pressing character. Here, the phenomena of dyspepsia come to the fore: diarrhea alternating with constipation, nausea and vomiting. Characterized by the appearance of fatty stools, which are difficult to wash off. These symptoms occur due to impaired digestion of proteins, fats and carbohydrates. Raw nutrients are excreted in the stool.
Also, in the chronic course of the disease, alternation of periods of exacerbation with remission is characteristic. During remission, the patient's condition is satisfactory, there are no pains and dyspeptic manifestations.
Pancreatitis: Diagnosis
The above symptoms should lead the patient to suspect a problem with the pancreas, which requires an indispensable seek medical help and possibly further hospitalization.
When diagnosing pancreatitis, the reference method is the laboratory determination of fecal elastase-1, an enzyme produced by the pancreas. A reduced concentration of this substance in the feces indicates external pancreatic insufficiency. In addition, methods are performed to visualize this organ. Ultrasound diagnostics, computed tomography, magnetic resonance imaging are used.
Pancreatitis treatment
Treatment and symptoms of pancreatic problems are ininextricable connection. After all, relieving pain and reducing dyspeptic manifestations is task number 1 in the treatment of pancreatitis.
To reduce pain, antispasmodics ("Drotaverine", "Papaverine"), analgesics ("Analgin", "Baralgin") are used. The use of narcotic analgesics for pancreatitis ("Morphine") is strictly prohibited, as they cause spasm of the pancreatic ducts, which further prevents the outflow of secretions from the gland into the intestines.
It is also necessary to replace those enzymes, the synthesis of which was disturbed in the pancreas. For this, enzyme replacement therapy is used. This is a separate group of drugs containing pancreatic enzymes (lipase, amylase, trypsin). These include Creon, Pancreatin.
Another link in the treatment of pancreatic problems is the inhibition of the activity of enzymes that enter the bloodstream. For this, the drug "Kontrykal" is used.
Particular attention should also be paid to nutrition in diseases of the pancreas, but it will be discussed in the appropriate section.
Diseases in children
Problems of the pancreas in children can be either congenital or acquired.
Among congenital diseases, the following pathologies are distinguished:
- ectopic gland;
- bifurcated pancreas;
- annular (annular) gland;
- congenital decreased lipase activity (Sheldon-Reye syndrome);
- congenital amylase deficiency;
- isolated decrease in trypsinogen activity;
- generalized pancreatic insufficiency.
Among the acquired problems with the pancreas are:
- viral acute pancreatitis;
- cystic fibrosis;
- drug pancreatitis;
- traumatic pancreatitis;
- pancreatitis in Henoch-Schonlein disease;
- pancreatitis due to overnutrition.
Clinical manifestations and treatment of childhood pancreatitis do not fundamentally differ from those in adulthood. The main thing in this case is to determine the cause of inflammation of the pancreas and its elimination.
Therefore, below we will analyze those problems of the pancreas that are specific to childhood.
Cystic fibrosis: general concepts
Cystic fibrosis is a hereditary disease that can manifest both immediately after the birth of a child and several years later, depending on the severity of the disease. With this pathology, almost all organs and systems of the body are affected.
It occurs due to a violation of the exchange of chlorine between the cells and the space around them, which leads to an increase in the viscosity of the secret secreted by the gland. This secret accumulates and clogs the ducts of the pancreas, causing inflammation. This leads to severe exocrine insufficiency.
Cystic fibrosis: diagnosis and treatment
Diagnosis of the diseaseconsists in the determination of sweat chlorides (their increase is characteristic), ultrasound examination of the pancreas. Genetic screening is now on the rise.
Symptoms of pancreatic problems and treatment are in direct relationship with this disease. Enzyme replacement therapy and dietary therapy, as in adult pancreatitis, play a big role.
Isolated enzyme deficiency
Problems of the pancreas in children can result from an isolated deficiency in one of three enzymes: lipase, trypsin, or amylase.
Lipase deficiency is characterized by diarrhea and fatty stools. When diagnosed using a coprogram, a large amount of undigested fat in the feces (steatorrhea) is determined. The amount of fecal elastase-1 also decreases.
Possibly isolated disorder of amylase production, characterized by diarrhea with undigested starch (amilorrhea). Trypsin deficiency is also possible, in which diarrhea with protein inclusions (creatorrhoea) occurs. Protein malabsorption leads to a decrease in its amount in the body (hypoproteinemia), which contributes to the development of massive edema.
This pathology, fortunately, is quite rare, but it is worth knowing and remembering about it when diagnosing problems with the pancreas in children.
Diet therapy
Special attention should be paid to the diet in the treatment of pancreatic diseases. In the treatment of diseases of this organpatients are recommended to eat the following dishes:
- white bread;
- light soups with vegetable broth;
- lean meats: rabbit, chicken, turkey, lean cuts of beef, steamed, boiled or baked;
- vegetables in any form, except fried;
- dairy products;
- vegetable fats - vegetable oil, a small amount of butter is allowed;
- no more than one egg a day;
- among sweets, only fruits, compote, honey are allowed;
- among drinks, preference should be given to tea, rosehip broth.
When correcting nutrition for problems with the pancreas, the use of such products is prohibited:
- fatty meat and fish;
- fried foods;
- smoked dishes;
- smoked meats and spices;
- pastry, sweets, chocolate;
- alcohol.
Compliance with this diet in combination with drug treatment will help get rid of problems with the pancreas!
