Can the pancreas cause a cough? Pancreatic diseases. Drug treatment of pancreatitis

Treatment of pancreatitis differs depending on the form of the disease: or, the phase of the disease: remission of the chronic form or exacerbation, and the cause that caused pancreatitis. Symptoms of pancreatitis also vary depending on the form and phase of the disease.

Without treatment, pancreatitis can lead to various severe complications or death.

So, how to treat acute pancreatitis? Is it possible to cure chronic or acute pancreatitis without going to the hospital? ? No, going to the hospital for medical help is necessary! AND ?

It is impossible to cure pancreatitis on your own at home. In case of acute pancreatitis, hospitalization is required. In case of chronic pancreatitis, hospitalization is necessary if there are indications: increasing and unrelieved abdominal pain, complications, severe diabetes mellitus, weight loss.

Modern medicine has three treatment methods: changing the diet, drug and surgical treatment of pancreatitis. All these methods of therapy must be prescribed and monitored by the attending doctor.

Acute pancreatitis and its signs:

• girdling pain (pain affects both hypochondriums, back, epigastric region), intensifies after eating. Pain in acute pancreatitis when coughing, taking a deep breath, or sneezing does not tend to increase;

The pain is so severe that some patients lose consciousness.

• acute pancreatitis is characterized by persistent repeated vomiting, after which the patient’s condition does not improve. Vomiting recurs after every meal or water. Abdominal pain after vomiting does not decrease; on the contrary, it only intensifies. First, vomiting pieces of food, and then mucus and bile;
• irritability, tearfulness, mental changes up to the appearance of hallucinations: auditory and visual;
• in patients with concomitant diseases of the lungs, heart, kidneys, exacerbations of diseases and deterioration of condition (multiple organ failure) are possible;
• When a large amount of enzymes from the pancreas enters the blood, blood clots can occur in blood vessels: thrombosis of the portal vein, venous vessels of the head, heart, lungs, and intestines. The consequence of such massive thrombosis is consumption coagulopathy: bleeding from injection sites, catheterizations, punctures;
• acute pancreatitis can be manifested by marbling of the skin, yellowing of the sclera, and a common symptom is bloating and lack of intestinal motility;
• the first two days, as a rule, body temperature is within normal limits. On the third and subsequent days, the temperature may rise to 38 degrees.

Chronic pancreatitis is not always recognized in time and is often disguised as other diseases. There are three periods and variants of the development of chronic pancreatitis: initial, advanced and complicated.

In the initial period, the main clinical sign of the disease is pain. Pain of varying strength and duration. Vomiting, heaviness in the epigastrium and nausea may occur, but they are temporary and quickly resolve with treatment. The initial period lasts approximately 10 years.

The second period - expanded - occurs after 10 years of the disease. Abdominal pain becomes less intense, and vomiting, nausea, belching, heartburn, and bloating come to the fore. Nutrients and vitamins are not absorbed due to a lack of pancreatic enzymes to digest food. The stool becomes liquid and profuse. Patients lose weight.

The third variant of chronic pancreatitis is complicated. Complications can arise both in the initial and in the advanced period. These include infectious complications, diabetes mellitus, splenic vein thrombus, pancreatic cancer, left-sided pleurisy, pancreatic cysts and others.

A characteristic sign of complications in chronic pancreatitis is a change in the intensity and location of pain. Pain can be projected only on the back or only in the right hypochondrium; in some patients there is no pain. Pain usually occurs half an hour after eating. Symptoms of dyspepsia worsen: heartburn, vomiting, nausea, belching, diarrhea.

As mentioned above, pancreatitis is treated three methods:

• and lifestyle;
• drug treatment;
• surgery.

Acute pancreatitis is treated with fasting in the first 2-3 days.

In acute pancreatitis, an important condition in the first 2 days is to create rest for the pancreas so that it does not produce enzymes for digesting food. This is achieved by prescribing hunger and simultaneously supporting the body with nutrients (through a tube or through injections).

If there is no persistent vomiting or stagnation of contents in the stomach and intestines, then you are allowed to drink water. The water should be at room temperature, boiled, without gas. You can drink rosehip decoction, weak tea, but no more than 1 - 2 glasses a day. You need to drink at least 1000 - 1500 ml of water per day.

If long-term fasting is necessary, it is very important to support the patient's body with nutrients. This should be done using an enteral tube or through injections of special intravenous nutritional mixtures into a vein. An enteral tube is a tube that is inserted through the mouth into the intestines and feeds food into the small intestine.

This method of supporting the body is preferable and more physiological, since atrophy of the intestinal mucosa does not occur, rest is created in the pancreas, and conditions for normal functioning of the intestine appear.

It is advisable to use special nutritional mixtures that do not require additional enzyme preparations.

During prolonged fasting, parenteral nutrition is used as an alternative to an enteral tube. With this method of nutritional support of the body, intravenous injections of amino acid solutions are prescribed up to 1 liter per day, fat emulsions 0.5 - 1 liter per day, glucose with insulin 1 - 2 liters per day.

It is possible to use ready-made balanced parenteral mixtures containing all the necessary nutrients and vitamins (oleclinomel, for example). This method of supporting the body during fasting is expensive.

On the second or third day, the condition of patients with this treatment should improve noticeably. Now you can switch to oral nutrition, but this must be done very carefully.

You need to switch to nutritious oral nutrition gradually, after the symptoms of inflammation of the pancreas have completely eliminated, the patient’s condition has stabilized and appetite has improved.

First, slimy liquid soups, pureed porridges, fruit and vegetable purees are allowed. Dishes should not be hot or cold. It is recommended to eat in small portions, but approximately 5 – 7 times a day. The patient must adhere to such a diet for 3–4 days, then a mechanically and thermally gentle diet is prescribed for a month.

The next important point is the use of cold in the projection of the pancreas, which also contributes to the functional rest of the diseased organ.

Treatment of pancreatitis with medications has the main goal of creating rest for the pancreas so that it does not produce enzymes.

This is achieved by diet - starvation, and also prescribed the following drugs:

• a synthetic analogue of somatostatin, ocreotide, is the main drug in the treatment and prevention of complications of acute pancreatitis. The principle of action of this drug is to suppress the activity of pancreatic cells and suppress the secretion of gastric juice by the stomach, which creates rest for the pancreas. A side effect is the excessive “switching off” of the pancreas from the digestion process, which is manifested by bloating and copious loose stools. These signs are easily eliminated by reducing the dose or discontinuing this drug. The only contraindication for use is an allergy to this drug;
• treatment of pancreatitis is impossible without eliminating the increased amount of enzymes in the blood; for this, the drug aprotinin (Kontrikal,) is successfully used. This drug is administered intravenously or intra-arterially. Contraindications to the use of this medicine: allergic reactions to aprotinin, use of aprotinin in the previous 12 months, disseminated intravascular coagulation syndrome, allergy to cattle protein, pregnancy, childhood, lactation. Side effects: allergic and anaphylactic reactions, intravascular thrombosis, myocardial ischemia, hallucinations, confusion, renal dysfunction.

Aprotinin is produced from the pancreas, salivary glands and lungs of animals. Therefore, this medicine contains a foreign protein that can cause allergies in patients.

• H2 – histamine blockers and proton pump blockers. These drugs suppress gastric secretion, thereby inhibiting the synthesis of pancreatic enzymes. These include: ranitidine, famotidine, omeprazole, lansoprazole. Contraindications to the use of this group of drugs are: allergic reactions, pregnancy, malignant neoplasms of the gastrointestinal tract, lactation. Side effects: nausea, headache, allergic reactions in the form of skin rash, loose stools;
• To reduce pain, non-narcotic analgesics (tramadol, ketorolac, metamizole sodium, butorphanol) are used. Together with this group of drugs, H1 histamine receptor blockers (diphenhydramine, suprastin) are used, which enhance the analgesic effect of non-narcotic analgesics and have a sedative and antiemetic effect. It is possible to use antispasmodics (drotaverine, platyphylline);
• M1 - anticholinergic blocker - pirenzipine - affects only the gastrointestinal tract, has the property of inhibiting gastric and pancreatic secretion, regulates intestinal motility, improves blood supply to the pancreas, relaxes the sphincter of Oddi. Contraindication for use is congestion in the duodenum, allergy to this drug. Side effects: temporary blurred vision, dry mouth, loose stools, allergic reactions;
• procaine, glucose-novocaine mixture have analgesic properties, reduce pressure inside the pancreatic duct and reduce sphincter tone (Oddi);
• A very important point is infusion therapy, with the help of which the volume of circulating blood is normalized, the functioning of the kidneys, heart, and blood vessels is restored, and the body is cleansed of toxins. The volume, type of solution, and rate of administration are prescribed and determined by the attending physician, assesses the effectiveness and monitors the patient’s condition using pulse, blood pressure, central venous pressure, diuresis and blood pH;
• for concomitant diseases: HIV infection, viral hepatitis, oncopathology, diabetes mellitus, tuberculosis, pancreatitis due to cholangitis or use antibiotics for prophylactic purposes.

The specific antibiotic and dose are prescribed by the attending physician!

In people without the above-mentioned concomitant diseases, antibiotics are not prescribed for prophylactic purposes.

But if the slightest symptoms of inflammation appear (fever, deterioration of condition, signs of intoxication), it is necessary to decide on antibiotic therapy. They use powerful broad-spectrum antibiotics.

• Prokinetics (domperidone, metoclopramide) are used to eliminate congestion in the duodenum and stomach. These drugs also reduce spasm of the sphincter of Oddi and facilitate emptying of the gallbladder. Contraindications to the use of these drugs: allergic reactions, gastrointestinal bleeding, children under 5 years of age, mechanical intestinal obstruction, increased levels of prolactin in the blood, perforation of the stomach and intestines. Side effects: spasms of the intestinal muscles, constipation or diarrhea, changes in appetite, drowsiness, headache, increased prolactin levels, enlarged mammary glands, skin rash, changes in the menstrual cycle;
• acute pancreatitis is often accompanied by a violation of the intrasecretory function - insulin production. Lack of insulin and increased blood sugar. Patients with a mild form of this pathology are prescribed limited carbohydrate intake and medications that reduce blood sugar concentrations. For more severe pathology, insulin therapy must be used. When taking insulin, it is necessary to take into account that the blood sugar level should not be lower than 4.5 mmol/l, since a sharp drop in blood glucose is possible with the development of hypoglycemic coma.

Insulin therapy must be carried out under the control of sugar concentrations in the blood and urine.

1. used in 3 cases:

• with destructive pancreatitis;
• with peritonitis;
• early minimally invasive surgery is necessary in the presence of fluid formations to drain these formations.

A patient with acute pancreatitis first of all needs powerful drug therapy.

Surgical treatment of pancreatitis without special indications is relegated to the background, since unjustified intervention often leads to death. So, principles of surgical treatment:

1. For mild acute pancreatitis, good drug therapy is prescribed.
2. If there are indications for surgical treatment, the operation should be performed as minimally invasive as possible.
3. In case of pancreatitis of biliary origin (when the root cause of the disease is cholelithiasis), the gallbladder should be removed; the operation is recommended to be performed after the inflammatory process has resolved and clinical recovery has occurred.
4. For infectious pancreatic necrosis and sepsis, a surgical treatment method is used: purulent foci are drained.

1. Diet.

In order to reduce pancreatic secretion in the acute phase of chronic pancreatitis, fasting is prescribed for the first two to three days, cold is applied to the epigastric region, and drinking plenty of fluids. Then, on the third or fourth day, the diet is gradually expanded, meals are prescribed in fractional amounts, in small portions, but often. Limit fats, milk, organic acids.

In the phase of initial remission (fading exacerbation), the diet is gradually expanded, but the energy value of food is limited to 1200 kcal; if the condition improves, it can be increased to 2500 kcal (100 g of proteins, 400 g of carbohydrates, 50 g of fat).

Food must be mechanically, thermally and chemically gentle. Meals should be 5 - 7 times a day, before and after meals it is important to rest for 15 - 20 minutes. Food is prepared boiled.

Gradually, raw vegetables are being added to the list of allowed foods: cabbage, celery, carrots. Vegetables are excluded in case of severe deficiency of pancreatic enzymes, in the presence of loose stools.

It’s a good idea to include foods containing “proteolytic enzyme inhibitors” in your diet: potatoes, buckwheat, oatmeal, egg whites, soybeans, beans.

During the remission phase, it is very important to follow a diet, as this helps to stabilize the patient’s condition and prolong the remission phase.

The diet should contain an increased amount of protein with a reduced amount of fat (75 g fat, 130 g protein, 400 g carbohydrates).

The energy value of products should not be more than 2500 - 2800 kcal per day. It is good to eat cottage cheese, lean meats and fish, and various cereals in the form of porridges. If necessary, use enzyme preparations (Pancreatin, Creon, Micrasim).

Fried, smoked, spicy foods, alcohol, coffee, very fresh cookies and bread are excluded from foods.

1. Drug treatment:

• in order to reduce the secretion of hydrochloric acid in the stomach, thereby reducing pancreatic secretion, proton pump inhibitors are prescribed: omeprazole, lansoprazole, H2 - histamine receptor blockers: ranitidine, famotidine;
• antacid drugs (Almagel, Maalox, Phosphalugel) are also a necessary medicine. They are prescribed 4–7 times a day. Contraindications to the use of this group: allergies to these drugs, breastfeeding, severe kidney disease. Side effects: nausea, abdominal pain, constipation, drowsiness;
• Anti-enzyme drugs are used when the concentration of pancreatic enzymes (amylase, trypsin, lipase) in the blood increases and pain in the upper abdomen does not subside. These drugs include: aprotinin, contrical, gordox. The positive effect from the use of the above drugs appears on the 3rd – 4th day;
• to reduce pain, antispasmodics and non-narcotic analgesics are prescribed: baralgin, ketorol, platyphylline, drotaverine, papaverine;
• Recommended products for use include debridate and trimedate. This medicine restores the motor activity of the gastrointestinal tract: with weak peristalsis it increases, with strong peristalsis it has an antispasmodic effect. Contraindications: allergy to debris, pregnancy, lactation. Side effects: allergic reactions are possible;
• Enzyme preparations are used only those that do not contain bile acids. These include: pancitrate, creon, pancreatin, mezim. These drugs are used both during fasting and when food intake is resumed. It is very important to exclude drugs containing bile acids: festal, enzistal, panzinorm;
• to quickly restore the body, infusion and detoxification therapy are used;
• If it is impossible to relieve pain with non-narcotic analgesics and antispasmodics, then they resort to prescribing narcotic drugs. If the pain does not decrease within a week, provided that narcotic analgesics are added to the treatment, then one should think about the presence of a pathology that requires immediate surgical assistance.

Surgical treatment is provided in three cases with chronic pancreatitis:

1. Severe, intractable pain syndrome. In this case, before surgery, the pancreatic ducts are carefully examined to find the cause of the pain. The organ is examined using CT, MRI, and endoscopic retrograde cholangiopancreatography. If the cause of pain is cysts and pseudocysts in the tail of the pancreas, then distal resection of the pancreas is performed.
2. Pancreatic cancer is suspected if the diagnosis is not confirmed histologically.
3. Strictures, abscesses, cysts, pancreatic pseudocysts, pancreatic fistulas, duodenal stenosis - when these diseases cannot be eliminated by the endoscopic method, surgical treatment is resorted to. Pancreatogastrostomy is performed (drainage of cysts and pseudocysts of the pancreas into the stomach cavity): in 83% of patients the pain syndrome decreases or disappears, pancreatojejunostomy with distal resection of the pancreas is also effective (in 80 - 90% of cases) and a safe operation (mortality less than 2% and the complication rate is 5%).

Subtotal pancreatectomy and pancreaticoduodenectomy are traumatic operations, the principle of which is to remove the diseased part of the pancreas, as well as remove part of the stomach, duodenum, gallbladder, and sometimes the spleen.

The consequence of these operations is intra- and exocrine pancreatic insufficiency (poor digestion of food, diabetes mellitus, etc.).

Conclusion

Treatment of acute and chronic pancreatitis must be carried out by a doctor. Self-medication in this matter is unacceptable. If signs of acute pancreatitis and exacerbations of chronic pancreatitis are detected, it is necessary to promptly go to the hospital and receive good treatment under the supervision of specialists.

Symptoms of acute pancreatitis in typical cases are clearly manifested. The main symptom of acute inflammation of the pancreas is a rather pronounced sharp pain in the abdomen, localized primarily in the umbilical region or in the hypochondrium, most often in the left, but can also be in the right; the pain can also surround the patient. Pain in acute pancreatitis has its own distinctive features: it usually appears (up to 80% of all cases) suddenly, against the background of complete well-being, quickly becomes intense and does not subside even with the administration of strong painkillers, including narcotics. There is often a connection between the onset of an attack and the consumption of alcohol the day before or a meal with an abundance of fatty, spicy food. Most often, pain in acute pancreatitis radiates to the back.

In rare cases, there is no pain during acute inflammation of the pancreas (the so-called painless form of the disease); in this case, the patient is worried about nausea and vomiting, belching air, hiccups, bloating, upset stool and other dyspeptic symptoms.

The overwhelming majority of patients with acute pancreatitis experience nausea and vomiting, and movements or coughing (and even deep breathing) increase the pain, while complete immobility alleviates suffering to some extent. Nausea and vomiting do not bring relief to patients with pancreatitis. Often in acute pancreatitis there is flatulence (bloating), an increase in body temperature: usually moderate (37.2-37.4 ° C), less often significant, which happens with severe damage to the pancreas. A laboratory test in the urine reveals an increase in the level of enzymes produced by the pancreas; in the blood - an increase in the number of leukocytes (white blood cells), which indicates inflammation; The concentration of glucose (sugar) in your blood may also increase.

The main clinical manifestations of chronic inflammation of the pancreas:

• abdominal pain (usually after eating),
• bloating,
• nausea,
• feeling of discomfort
• weakness,
• stool disorder,
• weight loss.

In parallel, there is a disorder of the functions of the pancreas: the production of digestive enzymes and hormones is disrupted. In the presence of pancreatitis, persistent digestive disorders occur in the body due to the functional failure of the affected organ.

If exacerbation of chronic pancreatitis occurs no more than 1-2 times a year, this form of the disease is called rarely recurrent (relapse - repetition); with exacerbations that occur at least 3-4 times a year, the disease is considered often recurrent.

A distinction is made between primary pancreatitis, when the pancreas is primarily affected, and then neighboring organs are affected, and secondary pancreatitis, which develops against the background of diseases, for example against the background of chronic cholecystitis. The appearance or intensification of pain in patients with chronic pancreatitis is often associated with the consumption of alcohol, fatty, fried, smoked, baked, spicy, cold and fizzy drinks, fizzy and fortified wines. Most often, pain appears 30-60 minutes after eating and weakens or goes away after 2-3 hours.

However, with the so-called painful form of the disease, the pain can be almost constant, not as intense as during an attack, but aching. With chronic inflammation of the pancreas, pain is most often localized in the upper half of the abdomen, depending on whether the head of the gland, its body or its tail are more affected; pain is noted either in the right hypochondrium (head), or in the left (tail), or in the epigastric region (body of the gland).

Often the pain in chronic pancreatitis is girdling in nature, radiating (radiating) to the lower back, shoulder, lower abdomen, under the shoulder blade and even to the heart area, reminiscent of a heart attack. Vomiting, often observed in chronic pancreatitis, does not bring relief to the patient. Those suffering from chronic pancreatitis often experience a decrease in body weight, and after pain syndrome with chronic damage to the pancreas, this is the most common symptom.

Often, chronic damage to the pancreas is manifested by diarrhea, which can last several (3-5) days, not only during exacerbation of the disease, but also outside of exacerbation. Stool with pancreatitis is usually foamy, grayish, with particles of undigested food, and is poorly washed off the surface of the toilet (“greasy”). Quite often, dyspeptic symptoms are observed: loss of appetite, up to its complete absence, heartburn, nausea, vomiting, belching of air after eating or on an empty stomach, drooling, bloating.

After an intense attack of pancreatitis, especially with severe pain, jaundice may appear, which is relatively quickly eliminated with adequate treatment of the disease. If, during chronic inflammation of the gland, the islets of Langerhans, which produce insulin, are simultaneously affected, then symptoms of diabetes mellitus appear: increased appetite, unmotivated thirst and an increase in the volume of urine excreted.

For adeno and enterovirus infections, in addition to the classic signs of enterocolitis and dyspeptic symptoms (nausea, vomiting, diarrhea, abdominal pain), respiratory syndrome may develop. It is characterized by coughing and even breathing problems. This clinical picture is explained by damage to the trachea and bronchi.

Cough in diseases of the gastrointestinal tract, for example, in esophageal disease, is associated with a malfunction in the normal functioning of the esophagogastric sphincter (a muscle ring that regulates the passage of food from the esophagus to the stomach). As a result of disruptions in its functioning, acidic gastric juice irritates the esophageal mucosa. Clinically, this is manifested by heartburn, a sore throat, and wheezing. At night, breathing may stop - apnea.

Respiratory disorders (respiratory syndrome) due to infection with worms and dysbacteriosis, including cough, are formed against the background of sensitization, that is, based on malfunctions of the immune system.

Cough itself is a painful symptom, so symptomatic therapy is quite well developed. It is mainly aimed at thinning sputum (mucolytics) and expanding the lumen of the bronchi (bronchodilators). There are also combinations of drugs of these two directions.

Effective, pathogenetic treatment of respiratory syndrome is possible only by eliminating its cause. That is, the underlying disease needs to be treated.

Cough due to gastrointestinal diseases or other pathologies is not a harmless symptom. Prolonged breathing disorder accompanied by cough can not only worsen the quality of life, but also lead to serious complications.

The Stolitsa Medical Center and experienced specialists will help you get examined to identify the real causes of your cough and provide effective treatment.

In the event that breathing and cough disorders do not go away when taking conventional medications that thin the mucus and dilate the bronchi, it is worth conducting an examination to identify disorders of the gastrointestinal tract as the main (pathogenetic) cause of the disease.

The examination includes blood tests (clinical and biochemical), a general urine test, and stool tests to detect worms and to clarify the composition of the intestinal bacterial flora. To complete information about the patient’s condition, it is necessary to carry out a number of functional diagnostic techniques, for example, echoscopy of the digestive organs (liver, gall bladder, pancreas). An assessment of the condition of the intestinal tube, including, for example, fibrogastroduodenoscopy, is also relevant. If gastrointestinal pathology is detected, consultation with a gastroenterologist is necessary; if a viral infection is suspected, consultation with an infectious disease specialist.

Naturally, all these additional examinations in the field of gastroenterological pathology should be carried out when the usual causes of cough are excluded. The most reasonable way to diagnose common causes of respiratory pathology is fluoroscopy of the lungs and mediastinal organs.

Sudden inflammation of the pancreas, which is one of the most severe surgical diseases, leading to necrosis of pancreatic tissue.

In acute pancreatitis, the glandular tissue is damaged by the gland's own enzymes, which are activated under the influence of one or another factor, then penetrating the glandular tissue and destroying it. Active enzymes circulating in the blood lead to dysfunction of all organs and systems of the body.

The main symptoms of acute pancreatitis are: acute pain in the upper abdomen, nausea and vomiting. Diagnosis of acute pancreatitis is based on determining the level of pancreatic enzymes (amylase and lipase) in the blood.

Treatment of acute pancreatitis is conservative and consists of following a diet, clearing the blood of pancreatic enzymes, as well as symptomatic treatment. If the condition worsens, surgery may be performed to remove dead pancreatic tissue.

Causes of acute pancreatitis

The greatest significance in the occurrence and development of this disease belongs to alcohol abuse, abuse of juice and choleretic foods (for example, fatty fried meats).

Trauma to the pancreas, diseases of the digestive organs (liver, biliary tract, duodenum), and various vascular diseases are also important.

Besides:

Attack of acute pancreatitis

An attack of acute pancreatitis usually develops suddenly, after ingesting food or alcohol.

The main symptoms of an attack of acute pancreatitis include:

First aid for an attack of acute pancreatitis

Important: In case of an attack of pancreatitis, you should immediately call a doctor, because any delay can lead to serious complications and even death of the patient.

Before his arrival, you should not eat anything, and to reduce the secretion of the gland, you can put an ice pack on your stomach.

You should not take over-the-counter analgesics. They will not bring relief, but may complicate the clinical picture of pancreatitis. You can take the following medications:

• "No-shpa";
• "Baralgin";
• "Papaverine" in combination with "Platifillin".

It should be noted that the first strong dose should not exceed two tablets, and the next dose should be taken only after two hours.

Important: in case of unbearable pain, the patient is given potent drugs that will protect against necrosis of the pancreas.

Symptoms of acute pancreatitis

The disease begins with severe girdling pain in the upper abdomen. Sometimes a severe attack of pain is preceded by the initial symptoms of acute pancreatitis - a state of discomfort, short-term vague abdominal pain, loose stools.

Lying on your back increases pain. With the onset of necrosis of pancreatic tissue, pain may decrease due to the fact that necrosis has also affected the nerve endings. Obligatory symptoms of acute pancreatitis are also nausea, vomiting and bloating.

Vomiting can be painful, persistent, sometimes uncontrollable and never brings relief. Increasing bloating due to the accumulation of gases disrupts the motor activity of the intestines.

When enzymes enter the blood, its circulation in small blood vessels is disrupted, stagnation leads to the appearance of small pinpoint hemorrhages on the skin in the navel and buttocks.

The skin of such patients becomes pale, with a bluish tint. General intoxication of the body with enzymes and breakdown products of the pancreas affects the activity of all organs.

Acute pain

Acute pain, girdling in nature, is localized in the right and left hypochondrium, epigastric (epigastric) region. The pain radiates (radiates) to the left side of the body: to the shoulder, shoulder blade, lower ribs from the back. Intense pain, constant, even with drug treatment can continue for another day. The cause of pain is necrosis (death) of the tissue and nerve endings of the pancreas.

Lack of appetite

Lack of appetite, aversion to food develops, is the result of a lack of excretion of pancreatic enzymes into the intestines.

Nausea with vomiting

Nausea and vomiting caused by eating are the result of a lack of enzymes in the intestines necessary for normal digestion. Uncontrollable, profuse vomiting of stomach contents or bile, which does not bring relief.

Symptoms of intoxication

Symptoms of intoxication develop with the development of purulent foci in the pancreas:

• body temperature rises above 38C with chills;
• pulse increases above 90 beats/min;
• the skin becomes cold and damp;
• increased breathing.

Shock

Signs of shock appear as a result of severe pain and loss of fluid from the body, due to uncontrollable vomiting: a decrease in pressure below 90 mm/Hg.

Bloating

Bloating of the upper abdomen and a feeling of fullness, as a result of digestive disorders associated with a lack of enzymes and impaired transit through the intestines.

Diarrhea

Frequent loose stools due to indigestion resulting from a lack of pancreatic enzymes in the intestines.

Skin is pale with a dark tint

Acute pancreatitis is characterized by specific symptoms of cyanosis, developing as a result of a sharp disruption of microcirculation, due to a decrease in the volume of circulating blood, as a result of profuse vomiting. Bluish spots form on different parts of the body (in the face and neck, sides of the abdomen, navel area).

Abdominal tension

The abdominal wall of the abdomen is tense on the left below the costal arch.

Descriptions of symptoms of acute pancreatitis

Complications of acute pancreatitis

Acute pancreatitis can be complicated by the formation of abscesses (ulcers limited by a capsule), as well as the transition of inflammatory phenomena to other organs of the gastrointestinal tract, for example, the biliary tract and gallbladder.

If the wall of a blood vessel is damaged, acute gastrointestinal bleeding may occur.

In the process of destruction of pancreatic tissue, various substances enter the bloodstream, which can cause complications in the form of a sharp decrease in blood pressure (collapse), impaired renal function, as well as various complications from other internal organs.

In addition, blood poisoning (sepsis) may occur.

Diagnosis of acute pancreatitis

Acute pancreatitis has very characteristic symptoms. The diagnosis is confirmed using laboratory tests. Thus, in the very first hours after the onset of the disease, a high level of the pancreatic enzyme amylase appears in the urine.

When pancreatic tissue is destroyed, the amount of amylase, on the contrary, decreases and may be completely absent. The amount of amylase and another enzyme - lipase in the blood also increases.

Signs of an inflammatory process are found in the blood of a patient with acute pancreatitis: a large number of leukocytes and an accelerated ESR (erythrocyte sedimentation rate).

To clarify the diagnosis, the following studies are sometimes performed:

Treatment of acute pancreatitis

Patients with acute pancreatitis primarily require hospitalization, painkillers and intravenous infusions of solutions in order to restore water-salt balance.

In about one in five, acute pancreatitis is severe and requires close monitoring in the intensive care unit or intensive care unit (ICU), as pancreatitis can lead to damage to the heart, lungs or kidneys.

Some cases of pancreatitis can lead to necrosis of pancreatic tissue (pancreatic necrosis). In these cases, or if there is a secondary infection, surgery may be required to remove the damaged tissue.

Which doctors should I contact for acute pancreatitis?

Surgical treatment of acute pancreatitis

An acute attack of pancreatitis caused by blockage of the bile duct with a stone may require removal of the gallbladder or the much less traumatic restoration of the patency of the bile ducts using an endoscope.

After gallstones are removed and inflammation subsides, the pancreas usually returns to normal fairly quickly. Surgery on the pancreas and gall bladder can be performed either with a wide section or with a laparoscopic, or “minimally invasive” method.

During laparoscopic surgery, a small (usually 5-10 mm) incision is made on the abdominal wall, through which the laparoscope and the surgical instrument itself are inserted into the abdominal cavity. During the operation, the surgeon is guided by the image of the internal organs transmitted from the laparoscope camera to the monitor.

The benefits of laparoscopic surgery include a reduced risk of infection, faster recovery, minimal cosmetic defects, low risk of postoperative adhesions, and a much less painful postoperative period.

Diet for acute pancreatitis

An important therapeutic factor for all forms of acute pancreatitis is diet:

Questions and answers on the topic "Acute pancreatitis"

The ABCs of well-being according to ancient Chinese treatises

Cough has many forms. It can last for weeks and months, appear out of nowhere, suddenly attack in the morning or evening, as well as at night. Each form of cough indicates disorders of one or another system of the human body. Let's take a closer look at some systems of the human body.

Bronchopulmonary system

The time of maximum activity (TMA) of cough is from 4 to 6 am.

Prolonged attacks of loud and heavy cough with sputum production and wheezing. Most often, coughing attacks begin in the morning after waking up and before starting physical activity. This cough causes a strong flush of blood to the face, and after it yawning begins, often turning into hiccups. You should be careful - the same cough can be caused by lung cancer and it is possible that you should undergo diagnostics for possible treatment of tumors and metastases (cancer) of the lungs.

Pour 300 g of pine needles into 2 liters of water, boil until 1 liter of decoction remains. Strain, cool to 40 degrees. add 300 g of honey, 5 g of cinnamon and cloves, 1 tbsp. nutmeg. Leave for six days and store in the refrigerator. Take 1 tbsp. 15-20 minutes before meals until the cough disappears.

Colon system

(VMA cough - from 6 to 8 o'clock). There are attacks of “voluminous” coughing, during which the whole body shakes and tenses. Coughing leads to a false urge to defecate.

After sunset, make a cleansing enema from urine (boil 1.5 liters of urine with 1 tablespoon of celandine herb for 15 minutes. Cool, strain and use for an enema). Before the enema, heat the abdomen for 15 minutes (sand, heating pad, bath, sauna). Starting the next morning, take the medicine: 2 tbsp. a mixture of equal parts of the roots of the knotweed (crayfish), cinquefoil erect (galangal) and burnet, pour 400 ml of water, boil for 10 minutes. Infuse, strain. And throughout the day, drink in equal portions 15 minutes before meals. The course of treatment is six days.

Stomach system

(VMA cough - from 8 to 10 o'clock) A superficial cough bursting from the chest, which causes “burning” of the cheeks. Coughing attacks provoke the urge to vomit, and an unpleasant taste is felt in the mouth. The cough is accompanied by cracks in the mucous membranes of the lips and swelling of the mucous membrane of the throat. Similar to treatment of the colon system. Course - 12 days. Don't run it, otherwise it won't even help Cyberknife in a clinical oncology hospital.

Spleen and pancreas system

(VMA cough - from 10 to 12 o'clock) The cough is provoked by sudden movements and is accompanied by dull pain in the right side, and is also observed against the background of frequent “petrification” of the legs, general weakness and lethargy of the muscles.

Pour 200 ml of canons (larvae) of the six-legged forest ant into 1 liter of Cahors wine. Leave for 12 days in a warm, dark place, take 1 tbsp. 15 minutes before dinner. In the morning, immediately after waking up, you need to drink 200 ml of ordinary water at room temperature (or better yet, silicon water). 15 minutes before breakfast, drink another 200 ml of plain water with a spoonful of honey dissolved in it. 15 minutes before lunch, drink 200 ml of water with 1 tsp. propolis tinctures. The course of treatment is 30 days.

The cardiovascular system

(VMA cough - from 12 to 14 o'clock) Short attacks of dry cough, leading to “numbness” of the throat, dry mouth and swelling of the face. The human body is in constant tension; lips, teeth, and fists often involuntarily clench.

Ants contain adenosine triphosphoric acid (ATP), which is a source of human energy. Thanks to many amino acids, plant amylose, unsaturated fatty acids, and many microelements (zinc, magnesium, chromium, etc.), ant preparations are able to restore heart function.

Tincture. 3 tbsp. ants dried in the oven at a temperature of 80 degrees, pour 200 ml of 96% alcohol, leave for two hours. Daily dose - 0.5 tsp. alcohol tincture of ants, wash down with 1 tbsp. water between 11 and 12 noon.

Pour 0.5 liters of peas and beans into a basin and massage the feet for 1-2 minutes (point No. 16) every morning for 30 days.

Take bee products (honey, pollen, propolis, royal jelly and drone jelly), which are a high-energy supplement for treating the heart.

Small intestinal system

(VMA cough - from 14 to 16 hours) A loud resonant cough, giving off pain in the temples and in the navel area or tension. With a prolonged attack, the chin becomes numb. Over time, painless rashes appear on the mucous membranes of the mouth and lips.

Treatment is the same as for the large intestinal system. Course - 12 days.

Bladder system

(VMA cough - from 16 to 18 hours) Difficult uterine cough with predominant tension of the abdominal muscles. Prolonged attacks lead to involuntary urination.

1 tbsp. wax moths and dead bees and 1 tbsp. propolis pour 1 liter of Cahors wine. Leave for 12 days. Take 1 tbsp. three times a day 15 minutes before meals. Instead of tea, drink a decoction of lingonberry and bearberry leaves. Eat more vegetables, berries and fruits that have diuretic properties.

Kidney system

(VMA cough - from 18 to 20 hours) The cough “radiates” to the lumbar and back area. At the same time, tears come to your eyes, your nose fills with mucus, and the noise in your ears increases. The same symptoms may indicate that you need surgery to treat kidney cancer (tumor).

Treatment is the same as for the bladder system.