Symptoms of reactive pancreatitis
The first symptoms of reactive pancreatitis appear quite quickly. Sometimes after the action of the provoking factor, only a few hours can pass - and the disease will already make itself felt. The most characteristic signs of reactive pancreatitis include1:
- pain in the upper abdomen, radiating to the ribs and shoulder blades and intensifying after eating;
- increased gas formation;
- nausea, vomiting with traces of bile;
- slight increase in body temperature;
- decrease in blood pressure.
If signs of reactive pancreatitis appear, you should consult a specialist to conduct a professional diagnosis and begin treatment at an early stage of the disease.
How to recognize the chronic course of the disease by symptomatic signs
As a rule, before the onset of pain, the patient experiences steatorrhea, that is, the stool has a greasy and shiny color, a foul odor and is poorly washed off the walls of the toilet with water. Due to impaired bile outflow, some patients develop so-called obstructive jaundice, which turns the skin yellow. In the future, the pancreatic “drama” continues to cause discomfort to the person. The pain syndrome is of a girdling nature, which radiates to the left side of the back, affecting the area of the scapula, hypochondrium and epigastrium, that is, the projection area of the stomach. During a diagnostic examination, as a result of palpation, specialists note a fixed compaction in the peri-umbilical area, which may indicate the onset of a cancerous tumor on the pancreas. Other clinical symptoms of recurrent pancreatitis in a chronic course include:
- deterioration of the patient's well-being;
- flatulence, diarrhea, and constipation;
- nausea and constant vomiting;
- increased salivation.
Often the cause of such symptoms is a violation of dietary standards and/or abuse of alcoholic beverages. Also, emotional stress and/or stressful situations can cause another attack of chronic exacerbation of the digestive organ. The pain syndrome can cause discomfort to a person from several hours to 5-7 days.
Important! At the first symptomatic signs of recurrent chronic pancreatitis, you should immediately contact a gastroenterologist or local physician, who will provide qualified medical care and suggest further therapeutic actions.
Causes of reactive pancreatitis
The main cause of reactive pancreatitis is premature activation of enzymes produced by the pancreas. Normally, enzymes are activated only after they enter the intestines. But if the pancreatic duct is narrowed, for example, due to chronic diseases or alcohol abuse, stagnation of pancreatic juice occurs. As digestive enzymes accumulate, they begin to have a destructive effect on pancreatic tissue, which leads to severe inflammation and release of breakdown products into the blood.
The most common causes of reactive pancreatitis:1
- exacerbation of chronic pathologies: peptic ulcer, viral hepatitis, cholelithiasis;
- consumption of fatty, fried foods, alcohol;
- intestinal infections;
- food and industrial poisoning;
- endoscopic interventions on the biliary organs;
- abdominal injuries.
To determine the nature of damage to the pancreas and surrounding tissues, specialists may prescribe a comprehensive examination, which includes:1
- blood, urine and stool tests;
- ultrasound diagnostics of the digestive tract;
- X-ray examination;
- MRI, CT of the digestive system;
- endoscopic diagnosis.
In complex clinical cases, to clarify the diagnosis and choose the correct medical tactics, laparoscopy may be required - a microsurgery in which small (0.5-1.5 cm) incisions are made in the abdominal cavity to access the pancreas.
Causes and clinical manifestations of the disease
Chronic recurrent pancreatitis is observed most often with cholelithiasis, or cholelithiasis, which is characterized by the formation of calculi (stones) in the gallbladder or bile ducts. The cause-and-effect factor in the occurrence of a chronic form of pancreatic disease is considered to be alcohol abuse in combination with an abundant irrational diet. Other causes of chronic pancreatitis include:
- viral infection of the digestive organ;
- mechanical damage leading to shock of the pancreas;
- endoscopic or surgical intervention leading to a traumatic condition;
- psychogenic effects: nervous overstrain, stressful situation;
- spastic state of blood vessels;
- muscle atrophy at the exit of the pancreatic and/or bile ducts.
The attitude of the sick person towards smoking is of no small importance.
Important! According to statistics from the World Health Organization (WHO), the risk of the disease increases by 75% in people who smoke.
In chronic pancreatitis, the recurrent course of the disease is characterized by exocrine insufficiency, that is, inadequate production of exocrine glandular substances (digestive enzymes) by the pancreas. The recurrent condition of chronic pancreatitis is the result of an acute form of the disease, in which a pseudocyst forms in the pancreas. Accumulating fluid, it increases in size and, due to compression of neighboring anatomical organs, causes pain, disrupting the functional functioning of the duodenum, stomach and the entire digestive system. The progression of the disease leads to depletion of glandular tissue, proliferation (fibrosis), and replacement of connective tissue of the pancreatic parenchyma.
Important! Chronic parenchymal pancreatitis with recurrent pain syndrome can cause repeated manifestations of the acute form of pancreatitis.
Pancreatic pseudocyst
Treatment of reactive pancreatitis
Treatment of reactive pancreatitis includes eliminating inflammation of the pancreas, removing intoxication and restoring normal secretion of pancreatic juice. The treatment process must certainly take place under the supervision of a doctor.
Therapeutic fasting can help relieve inflammation, especially in the acute period. It relieves stress from the inflamed pancreas and the entire digestive tract. After the acute phase has passed, it is allowed to eat in small portions, eating crushed foods. But under no circumstances should you adjust your diet on your own. Only a doctor can prescribe a correct and healthy diet, based on the characteristics of your body.
As a rule, those foods that can provoke re-activation of pancreatic enzymes and intensify the inflammatory reaction in tissues are excluded from the patient’s diet for several months.
For reactive pancreatitis, the following are prohibited:
- alcohol;
- fatty and fried foods;
- legumes;
- sour juices;
- fresh baked goods;
- smoked meats, sausages;
- corn;
- mushrooms;
- sauces, seasonings, spices.
It is recommended to steam or boil the meat. It is advisable to prefer lean poultry, beef or rabbit. In the treatment of pancreatitis, it is very important to strictly follow the diet: regular eating disorders can provoke an exacerbation of the disease.
Drug therapy for pancreatitis includes taking enzyme preparations and antispasmodics that eliminate spasm of smooth muscles and relieve pain. The doctor may also prescribe medications that improve intestinal microflora and increase the content of live bacteria in the body.
To learn more
An important stage of treatment is taking enzyme agents based on pancreatin. An inflamed pancreas does not secrete enzymes in the required quantities to ensure high-quality digestion of food and the correct course of digestive processes. Medicines containing enzymes compensate for the lack of natural digestive elements and prevent the occurrence of fermentation and rotting of food in the intestines.
An example of an enzyme preparation used in the treatment of reactive pancreatitis is Creon®. A modern drug of the latest generation, produced in the form of capsules with active minimicrospheres of pancreatin, enclosed in a gelatin shell. Once in the stomach, the capsule quickly dissolves2, and the minimicrospheres are mixed with food and enter the intestines with it, helping the breakdown process and absorption of nutrients. More information about the drug Creon® can be found here.
Exacerbation of pancreatitis
Readers' questions are answered by Candidate of Medical Sciences, member of the Russian Gastroenterological Association, pancreatologist at the Clinic of Propaedeutics of Internal Medicine, Gastroenterology and Hepatology named after. V.Kh. Vasilenko at MMA named after. I. M. Sechenova Alexey Viktorovich Okhlobystin .
“Last year I underwent treatment for pancreatitis. But this spring I felt a familiar pain in the left hypochondrium, nausea appeared again and my appetite disappeared. Why did this happen?" — Vera Rozintseva, Moscow
- Obviously, your chronic pancreatitis - inflammation of the pancreas - has worsened. But spring is not to blame for this, because pancreatitis is not a seasonal disease. An exacerbation could occur for several reasons. The first of these is sensitivity to alcohol. A diseased pancreas cannot tolerate alcoholic drinks at all. So, if you took part in feasts with alcohol and fatty, fried foods, then this could very well provoke a new attack.
Another cause of exacerbation is the movement of gallstones. Of course, this assumption is only true if you suffer from gallstone disease. By moving, stones from the gallbladder can enter the pancreatic ducts, and an attack cannot be avoided.
To avoid guessing from the tea leaves, you should undergo a new examination. “Familiar” pain and nausea can be associated with irritable bowel syndrome, stomach ulcers, and other ailments. Most likely, a gastroenterologist will refer you for an ultrasound of the abdominal organs and ask you to take some blood, urine and stool tests.
“Is it possible to treat exacerbation of pancreatitis at home without going to the hospital?” — Svetlana Ezhova, Maloyaroslavets
— In most cases, pancreatitis is treated at home rather than in a hospital. But first you need to make sure that you have an “ordinary” exacerbation and there are no dangerous complications. After all, cysts, fistulas and even pancreatic stones can manifest themselves as “habitual” pain. In these situations, you will most likely need surgery. So it’s still not worth self-medicating.
“Is it true that during an exacerbation of pancreatitis, the best medicine is hunger?” — Tamara Kurgan, Volgograd
- In case of severe exacerbation, fasting for one to three days is really useful. This is a simple and yet effective event. Eating is not recommended, only drinking is allowed. Weak tea and rosehip decoction will do.
But with chronic pancreatitis, there is no need for complete fasting. You just need to switch to frequent, split meals. The energy value of a therapeutic diet is not so small - 2500-3000 kilocalories, but from dietary dishes.
From the menu you will have to exclude alcohol, everything spicy, fatty, fried and smoked. Canned food, spices, marinades, liver, brains and mushrooms are prohibited. Spinach, sorrel, onions and legumes are also not worth eating. The list of unhealthy foods also includes many treats: ice cream, cocoa, carbonated drinks, chocolate, cream, baked goods.
You need to boil or steam all dishes, and eat them in crushed, pureed form. Now animal protein is good for you - boiled meat, chicken, fish and eggs. There may be dairy products, cereals and stale bread on your table. For lunch, cook yourself vegetable, dairy and cereal soups. If you want something sweet, you can eat honey or jam. Reduce pure sugar to 70 grams per day, and salt to 10. You should not get too carried away with raw vegetables and fruits. They taste much better baked or boiled. And sour fruits and berries are generally contraindicated for you now.
“If your pancreas hurts, what medications can you take to relieve pain?” — Varvara Myasina, Klin
— If the pain occurs during an exacerbation and lasts for several days, antispasmodics are usually prescribed. They relieve spasms of the bile and pancreatic ducts well, and pain subsides. Simple remedies include no-shpu and papaverine, while stronger ones include buscopan.
When the pain is too severe, painkillers, or analgesics, are added to these medications - analgin and its derivatives - sedalgin, tempalgin, baralgin, pentalgin. You cannot do without them, especially when the pain is caused by damage to the nerves around the pancreas. There’s nothing you can do about it; you have to take analgin for months, or even years.
“I thought that during an exacerbation of pancreatitis it is necessary to take enzymes. And then I read somewhere that this cannot be done. Where is the truth? — Sofia Dorogomilova, St. Petersburg
“Indeed, there is an opinion that digestive enzymes inhibit the function of the pancreas. Allegedly, the organ becomes lazy, does not want to work, or even completely atrophies.
In fact, enzymes do not cause any atrophy. As soon as the patient stops taking them, the pancreas returns to its normal function. Therefore, taking them is not only possible, but also necessary. Enzyme preparations unload the pancreas. Let him work in a gentle mode, “gain strength.”
“Pharmacies sell enzymes in tablets and capsules, and they cost differently. What is better to choose in case of exacerbation of pancreatitis? — N.B. Tumanova, Donetsk
— For those whose exacerbation is not too severe and if it manifests itself in the form of pain, enzymes in tablets are suitable - pancreatin, mezim forte. You need to take one or two tablets each time you start eating. The medicine must be swallowed with water. In total, you can get from 3 to 10 or more tablets per day, depending on the severity of the disease.
When enzymes in tablets do not help, it makes sense to switch to capsules - Creon or pancitrate. There are microspheres inside the capsules. Dissolving in the stomach, they mix evenly with food. At the same time, they have a special coating that protects them from the harmful effects of gastric juice. Therefore, capsules are more effective than tablets, but they are, of course, more expensive. However, they do not drink them for long - until the exacerbation subsides.
Capsules are also taken when pancreatitis becomes truly chronic - lasting 10-20 years. During this time, part of the pancreatic tissue degenerates; it can no longer secrete the enzymes necessary for digestion. In this case, the patient suffers from constant bloating. The stool changes, becoming more abundant, unformed, and fatty. And the patient himself continues to inexorably lose weight. In this case, the pancreas needs serious support - Creon and pancitrate in high doses - 20,000-25,000 units. They drink one capsule 4 times a day. Such treatment often lasts for many years, or even a lifetime.
“The doctor said that I have inflammation of the pancreas and prescribed Almagel and Kvamatel. Why, since they take these medicines for an ulcer that I don’t have?” — Anastasia Losharova, Vologda
“There is nothing strange in the fact that the doctor prescribed such medications for exacerbation of pancreatitis. Enveloping drugs - Maalox, Almagel, Phosphalugel - do a very useful job - they “bind” bile. After all, an excess of bile salts and acids is dangerous for the diseased gland. In addition, these products, like enzymes, relieve the “tired” organ. The gland rests, and the pain noticeably decreases. These medications should be taken 15 minutes before meals.
And “ulcer medications” are sometimes necessary for severe exacerbation of pancreatitis. These include ranitidine, famotidine, Zantac, quamatel and omeprazole drugs - Losek, Omez. They reduce the secretion of gastric juice, which is also harmful to the pancreas.
“What means can I use to help myself if I have severe gas pain due to pancreatitis?” — Elena Muromova, Perm
— This often happens with inflammation of the pancreas. Living with constant bloating is very difficult. Try to completely eliminate foods that cause gas from your diet. And start drinking so-called adsorbents. The simplest remedy is, of course, activated carbon. But you can also buy a medicine such as pancreoflat. It consists of the digestive enzyme pancreatin and dimethicone, a flatulence reducer. Espumisan also helps with gas accumulation.
“Can inflammation of the pancreas be treated with homeopathy and herbs?” — Tatyana Kamenchuk, Naberezhnye Chelny
— Alas, with pancreatitis, herbs are most often contraindicated. After all, most herbal preparations have a choleretic and socogonal effect. Bile and gastric juice begin to attack the pancreas, thereby causing harm to it. Randomly chosen herbs are dangerous especially for those who have gallstones. They can move out of place and cause colic. So instead of recovery, it’s easy to get worse.
The benefits of using homeopathic remedies are also questionable.
In severe cases, it is better not to resort to this method of treatment. However, some believe in homeopathy so much that they actually begin to recover. But this is more like psychotherapy. Natalia DALNEVA
