Pancreatitis is a serious inflammatory disease of the pancreas. Nowadays, the number of people suffering from this disease is steadily increasing. Why? What are the causes of pancreatitis? What symptoms indicate its development? And how to treat this disease? This and many other things will be discussed now.
Pathogenesis
Most often the cause of pancreatitis lies in a person's diet and lifestyle. In order for proteins, fats and carbohydrates to be absorbed by the body, the presence of enzymes such as trypsin, lipase, etc. is necessary. But if a person is addicted to junk food, abuses alcohol, or actively takes certain medications, his pancreas is disrupted.
As a result, the juice stagnates. This leads to disruption of the digestion process. After another overeating, injury or poisoning, the gland becomes inflamed.
Now pancreatitis is becoming more common. If 5-10 years ago this pathologyaffected people over the age of 30, now it is diagnosed even in teenagers.
At risk are people who are prone to the abuse of fatty foods, overeating and alcohol. These are the provoking factors that activate the production of specific enzymes in the pancreas. And this process causes the development of inflammation.
Predisposing factors
They should also be listed. Since it is they who determine the cause of pancreatitis. All common predisposing factors can be identified in the following list:
- Mechanical damage to the peritoneal organs. Usually caused by injury.
- Alcohol abuse, especially poor quality. Intoxication is the leading cause of pancreatitis.
- Diseases of the biliary tract and liver.
- Use of estrogens, diuretics and antibiotics.
- Surgical interventions.
- Exposure to industrial, food and household toxins.
- Overweight.
- Infectious or viral diseases.
- Problems of the cardiovascular system.
- Worms.
- Poisoning.
- Malignant neoplasms, narrowing of the channels and other developmental anomalies.
- Eating disorders (overeating, starvation, abnormal mode).
- Changes in the hormonal background.
- Hyperparathyroidism and other endocrine pathologies.
- Genetic predisposition.
It is important to note that in25-35% of cases fail to determine the cause of the disease pancreatitis in patients.
Some statistics
All known factors that provoke the onset of the disease were listed above. And here is what the statistics look like, taking into account the causes of pancreatitis:
- 40% of patients suffer from alcoholism. In addition to the disease, they often have destructive disorders of the pancreas or its necrosis.
- 30% of patients had a history of gallstone disease.
- 20% of people are obese.
- 5% of patients had a history of intoxication, pancreatic injury or long-term use of any drugs.
- Slightly less than 5% of people have a hereditary predisposition or some kind of congenital defect in the development of an organ.
Stages of development
They should also be considered, since we are talking about the causes of pancreatitis in women and men. It is customary to distinguish four stages:
- Swelling of the pancreas.
- Hemorrhagic phase.
- Pakreonecrosis.
- Cholecystitis-pancreatitis.
But this is not the only classification. There is also the Filin principle. According to him, there are four phases, each of which lasts a certain time. These include:
- Enzymatic stage (3-5 days).
- Reactive (6-14 days).
- Sequestration stage (from 15 days).
- Outcome of the disease (over six months).
There is also a classification of A. D. Tolstoy. In its basisput pancreatic necrosis and its volume. There are also four stages:
- Interstitial or edematous pancreatitis. It is characterized by a slight flow.
- Small focal fat necrosis. Runs moderately.
- Common necrosis with large foci and hemorrhagic syndrome. Leaking heavily.
- Subtotal and total pancreatic necrosis. A large number of deaths are recorded at this stage.
Course of disease
It is important to pay a little attention to this topic, since we are talking about the causes of pancreatitis in adults. The basis of the disease, as it was already possible to understand, is the digestion of the pancreas itself, which is associated with excessive activity of the enzymes phospholipase and lipase.
The development of the disease begins with edema. The pancreas increases in size. There is no pancreatic necrosis in the tissues, but cellular already appears. As a rule, there is girdle pain in the right and left hypochondrium, as well as in the epigastric region.
When a person suffers from acute pancreatitis, the causes of which have been described above, the discomfort becomes so unbearable that even loss of consciousness is possible. To reduce pain, some patients involuntarily draw their legs up to their stomach.
There is also uncontrollable vomiting, which does not bring relief. And the emptying field from the remnants of the food consumed leaves mucus, periodic with an admixture of bile and blood. Mucous membranes, skin integuments also turn pale. Sometimes there is blueness. Gradually developstachycardia.
Often, patients are diagnosed with leukocytosis. The blood becomes thicker, there is an increased amount of amylase.
Specific symptoms
In the early stages of chronic pancreatitis, caused by one of the previously mentioned factors, there is severe bloating. If you feel it, then the patient will experience pain in the stomach area. And the abdominal muscles will be tense at that moment.
I also notice a decrease in peristalsis. Approximately 50% of patients develop Mayo-Robson's symptom, characterized by pain that is localized in the region of the left costophrenic angle.
At the 4th stage, the inflammatory process spreads to other tissues and organs. There are such complications:
- Diseases of the cardiovascular system.
- Lung atelectasis, respiratory failure, pleurisy.
- Toxic hepatitis.
- Liver and kidney failure.
- Abscesses in the retroperitoneal region, peritonitis.
- Intestinal fistulas, bleeding.
Enzyme release accompanies omental necrosis. Due to the ingress of pancreatic juice into the bloodstream, blood pressure drops sharply. Even collapse is possible.
Chronic form
Something has already been said about the causes of the disease "pancreatitis", as well as the symptoms of the disease. It must be noted that its chronic form has features. And theydeserve special attention. Here are the three main signs characteristic of chronic pancreatitis:
- Change of stages of remission and exacerbation.
- Thyroid disorders.
- Progressive course.
As a rule, the chronic form develops due to previously transferred pancreatic necrosis. The disease can be of the following forms:
- Cystic. Accompanied by the formation of pseudocysts.
- Fibrosclerotic or indurated. It is characterized by a gradual decrease in the function of the gland.
- Fistula. With this form, fistulas form in the tail, body or head of the gland.
- Calculous. It is characterized by the deposition of calcium s alts in the tissue.
The chronic form of the disease is indicated by constantly increasing pain in the epigastric region, jaundice, high fever, bloating, and diarrhea, which are replaced by constipation.
When a person's condition improves, remission occurs. But this is a very unstable stage. An exacerbation occurs as a result of any, even a minor malnutrition. However, if you follow the diet and follow the doctor's recommendations, the remission will last for months, even years.
Diagnosis
Talking about the symptoms and causes of pancreatitis in adults, you must also talk about how the diagnosis is carried out.
First of all, the gastroenterologist collects an anamnesis and takes into account the patient's complaints. On examination, the doctor pays attention to the skin, the appearance of the mucous membranes, and also necessarily palpates the abdomen. Usually observedthe following deviations:
- No pulsation of the abdominal aorta.
- Phenicus symptom positive.
- Subcutaneous fat is thinned.
An analysis is also carried out to determine the presence of enzymes in the pancreas, functional tests, biochemical analysis of urine and blood. Of the instrumental methods, ultrasound of the abdominal cavity is prescribed. CT may be ordered if complications occur.
Therapy
Having studied the symptoms and causes of pancreatitis, you can pay attention to the topic of treatment. Taking medication is prescribed by a doctor on an individual basis, this must be remembered. To relieve pain, for example, one of the following may be prescribed:
- H2 blockers. Help with persistent pain syndrome. It could be Famotidine or Ranitidine.
- M-cholinolytics. The best drugs are Chlorosil, Atropine, Metapin and Gastocepin.
- Anspasmodics. Medicines in this category include Sparex, Drotaverin, Spazmalgon, Maksigan, Fenikaberan, No-Shpa and Duspatalin.
In addition, anti-enzymatic therapy is prescribed, the purpose of which is to stop the processes that destroy the pancreas. The drugs of this group include "Kontrykal", "Gordoks", "Trazilol", "Pantripin", "Amidopyrin", "Omez", "Rabelok", "Nexium", "Omeprazole".
To reduce the load on the pancreas, pancreatic enzymes are prescribed. Usually it is "Festal", "Ermital", "Biozim", "Penzital", "Vigeratin", "Pancreatin",Gastenorm, Mezim, Creon. Taking these drugs also helps to eliminate bloating, nausea and stool disorders.
Surgical treatment
It is indicated if a person has pancreatitis in an advanced or severe stage. The operation is usually performed by laparoscopy.
After the intervention, the person will have to undergo antibiotic therapy. He is also prescribed other drugs, the purpose of which is to stop inflammatory processes.
If the doctor sees fit, enzymatic medications and dehydration therapy are prescribed.
Sanatorium treatment
It is highly recommended. At least 1-2 times a year, a person should visit sanatoriums and resorts where they treat the gastrointestinal tract.
The most popular type of therapy is the use of non-carbonated mineral waters. As a rule, people suffering from pancreatitis visit the Truskavets, Morshin, Zheleznovodsk, Pyatigorsk and Kislovodsk sanatoriums.
Diet
It is also necessary to talk about proper nutrition, since we are talking about the symptoms, causes and methods of treating pancreatitis.
Diet is the most important, basic component of therapy. It is aimed at stopping the production of pancreatic juice. Here are the basics of good nutrition:
- Dishes should be boiled, wiped and chopped.
- You need to increase your protein and carbohydrate intake. Fats are introduced gradually, and no more than 70 g / day.
- Fiber and extractives must be removed from the diet. Therefore, the meat is boiled in pieces of 100 grams, be sure to drain the first water.
- S alt should be at least (up to 6 g/day).
- You need to eat 5-6 times a day, fractionally, in small portions.
- Dishes with a juice effect (mushroom, fish, bone, meat broths) should be excluded. Fried, spicy, s alty, too greasy - too.
- It is necessary to give up alcohol, soda, coffee, cocoa. During remission, moderately mineralized water is allowed.
What can you eat? Mucous soups, boiled cereals (oatmeal, rice, semolina), pureed cereals, white crackers, compotes, vegetable juices, lean boiled meat and fish, some dairy products, boiled vegetables. The diet is strict, but the body will receive all the substances and vitamins it needs. A nutritionist will definitely give detailed recommendations and suggest an approximate diet.
