Pancreatitis: Practical Disease Management Councils

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Pancreatitis: Practical Disease Management Councils

Section 1: understanding of pancreatitis and its varieties

Pancreatitis is inflammation of the pancreas, an organ located behind the stomach in the upper part of the abdominal cavity. The pancreas plays a critical role in digestion and regulation of blood sugar. It produces enzymes necessary for the splitting of proteins, fats and carbohydrates, as well as hormones, such as insulin and glucagon, which control the level of glucose in the blood.

When the pancreas is inflamed, these enzymes can be activated inside the organ, causing its self -digestion. This leads to pain, inflammation and damage to tissues. Pancreatitis can be acute or chronic.

1.1 acute pancreatitis:

Acute pancreatitis is a sudden inflammation of the pancreas. Its symptoms usually develop rapidly and can be very intense. In most cases, acute pancreatitis is caused by bile stones or alcohol abuse. Other, less common causes include abdominal injuries, some drugs, infections and genetic factors.

  • Symptoms of acute pancreatitis:

    • Severe pain in the upper abdomen, which can radiate to the back. The pain often intensifies after eating.
    • Nausea and vomiting.
    • Fever.
    • Charp heartbeat.
    • Bloating.
    • The sensitivity of the abdomen on palpation.

  • Diagnosis of acute pancreatitis:

    Diagnosis of acute pancreatitis usually includes:

    • Physical examination: The doctor evaluates the symptoms and conducts a physical examination.
    • Blood tests: Blood tests can show an increased level of amylase and lipase, enzymes secreted by the pancreas.
    • Visualization studies: Computed tomography (CT) or magnetic resonance imaging (MRI) can help visualize the pancreas and identify signs of inflammation, edema or the presence of bile stones.
    • Ultrasound study: Ultrasound examination can be used to detect bile stones.

  • Treatment of acute pancreatitis:

    Treatment of acute pancreatitis usually includes:

    • Hospitalization: Most patients with acute pancreatitis need hospitalization.
    • Intravenous fluid administration: Intravenous fluid administration helps to prevent dehydration and maintains blood pressure.
    • Painkillers: Anesthetic drugs are used to relieve pain.
    • Abstinence from food and drinking: During the first few days of treatment, the patient, as a rule, is not allowed to eat or drink to give a pancreas to rest. Power can be administered through an intravenous dropper or through a nasogastric probe (a tube inserted through the nose into the stomach).
    • Treatment of the main reason: If acute pancreatitis is caused by bile stones, surgical removal of the gallbladder (cholecystectomy) may be required. If the cause is alcohol abuse, it is important to stop drinking alcohol.
    • Supporting therapy: In severe cases, supportive therapy may be required, such as oxygen therapy or artificial ventilation of the lungs.

1.2 Chronic pancreatitis:

Chronic pancreatitis is a prolonged inflammation of the pancreas, which leads to irreversible organ damage. Over time, this damage can lead to a decrease in the function of the pancreas, which can cause problems with digestion and regulation of blood sugar. The most common cause of chronic pancreatitis is the prolonged abuse of alcohol. Other causes include genetic factors, autoimmune diseases and obstruction of pancreatic ducts.

  • Symptoms of chronic pancreatitis:

    • Constant pain in the upper abdomen, which can radiate to the back. The pain can be constant or paroxysmal.
    • Weight loss.
    • Diarrhea.
    • Steator (fat chair).
    • Diabetes.
    • Lack of vitamins.

  • Diagnosis of chronic pancreatitis:

    Diagnosis of chronic pancreatitis usually includes:

    • Physical examination: The doctor evaluates the symptoms and conducts a physical examination.
    • Blood tests: Blood tests can show an increased or normal level of amylase and lipase. In the late stages of the disease, the level of enzymes can be normal.
    • Visualization studies: CT or MRI can help visualize the pancreas and identify signs of damage, such as calcification, cysts or atrophy.
    • Endoscopic ultrasonography (EUS): Eus is a procedure in which the ultrasonic probe is introduced into the esophagus and stomach for obtaining images of the pancreas. EUS can be more sensitive than CT or MRI in identifying the early signs of chronic pancreatitis.
    • Pancreatic function tests: These tests measure the ability of the pancreas to produce enzymes and hormones.

  • Treatment of chronic pancreatitis:

    Treatment of chronic pancreatitis is aimed at relieving pain, improving digestion and treatment of complications. Treatment may include:

    • Painkillers: Anesthetic drugs are used to relieve pain. Strong painkillers can be required, such as opioids.
    • Enzyme drugs: Enzymes help improve digestion and absorption of nutrients. They are taken with each meal.
    • Insulin: If diabetes develops, insulin may be required.
    • Changes in the diet: It is important to observe a low fat diet and a high protein content. Alcohol should be avoided.
    • Surgical intervention: In some cases, surgical intervention may be required to relieve pain or treatment of complications, such as the obstruction of the pancreas or pseudo -wingers.
    • Endoscopic treatment: Endoscopic treatment can be used to drain the pseudocyst or expand the narrowed pancreatic ducts.
    • Refusal of alcohol: The cessation of alcohol consumption is critical for slowing the progression of the disease.
    • Vitamin additives: Since chronic pancreatitis can lead to violation of vitamins absorption, vitamin additives may be required, especially fat -soluble vitamins (A, D, E, K).

Section 2: Dietary recommendations for pancreatitis

The diet plays a key role in pancreatitis management, both acute and chronic. Proper nutrition can help reduce inflammation, relieve pain and improve digestion.

2.1 General principles of diet for pancreatitis:

  • Low fat content: Limit fat intake up to 20-30 grams per day. Fat is difficult to digest with pancreatitis and can aggravate the symptoms.
  • High protein content: Use a sufficient amount of protein to help restore damaged tissues and support the immune system.
  • Easy carbohydrates: Choose easily digestible carbohydrates, such as white rice, pasta and potatoes. Limit the consumption of simple sugars, such as sweets and carbonated drinks.
  • Frequent small meals: Instead of three large meals, eat 5-6 small meals during the day. This will help reduce the load on the pancreas.
  • Adequate fluid use: Drink enough fluid to prevent dehydration.
  • Refusal of alcohol: Exclude alcohol completely. Alcohol is one of the main causes of pancreatitis.
  • Caffeine restriction: Limit the consumption of caffeine, as it can stimulate the pancreas.
  • Avoid fried and fatty foods: Fried and fatty foods are difficult to digest and can aggravate the symptoms of pancreatitis.
  • Steam food, cook or bake: These methods of cooking can avoid adding excess fat.

2.2 products recommended for pancreatitis:

  • Low -fat meat and poultry: Chicken without skin, turkey, fish.
  • Low -fat dairy products: Skim milk, yogurt, cottage cheese.
  • Fruits and vegetables: Low fat fruits and vegetables such as apples, bananas, berries, broccoli, carrots, spinach. Prepare vegetables for steam or cook.
  • Grain products: White rice, pasta, whole grain bread, oatmeal.
  • Legumes: Lentils, beans, peas (in moderate quantities).
  • Vegetable oils: Olive oil, sunflower oil (in small quantities).

2.3 products that should be avoided with pancreatitis:

  • Fatty meat: Fat beef, pork, lamb.
  • Fat dairy products: Whole milk, cheese, cream, ice cream.
  • Fried and fatty foods: Free potatoes, chips, fried chicken.
  • Processed products: Sausage, bacon, hot dogs.
  • Sweet products: Sweets, cakes, cookies, soda drinks.
  • Alcohol: Beer, wine, strong drinks.
  • Caffeine: Coffee, tea, energy drinks.
  • Avocado: Contains a lot of fat.
  • Nuts and seeds: Contain a lot of fat.

2.4 diet for acute pancreatitis:

In the acute phase of pancreatitis, it is important to give the pancreas to rest. It is usually recommended:

  • Complete abstinence from food and drinking: During the first few days.
  • Intravenous nutrition: To provide the body with the necessary nutrients.
  • Gradual return to food: After pain and inflammation are reduced, you can gradually begin to eat liquid and easily digestible food.
  • Start with transparent liquids: Broth, tea, water.
  • Then go to soft food: Porridge, puree, yogurt.
  • Gradually add low fat products: Low -fat meat, vegetables, fruits.

2.5 diet for chronic pancreatitis:

In chronic pancreatitis, it is important to observe a low fat diet and a high protein content on an ongoing basis. It is also important to take enzyme preparations to improve digestion and absorption of nutrients.

  • Individual approach: It is important to work with a doctor or nutritionist in order to develop an individual nutrition plan that takes into account your needs and preferences.
  • Food diary: Keeping a food diary can help determine the products that cause symptoms and avoid them.
  • Gradual changes: Make changes to your diet gradually to give the body time to adapt.
  • Enzyme drugs: Take enzyme preparations with each meal to improve digestion and absorption of nutrients.
  • Vitamin additives: Vitamin additives may be required, especially fat -soluble vitamins (A, D, E, K).

Section 3: Medical treatment of pancreatitis

Medication treatment of pancreatitis is aimed at relieving pain, reducing inflammation and treatment of complications.

3.1 analgesic drugs:

  • Nonsteroidal anti -inflammatory drugs (NSAIDs): NSAIDs, such as Ibuprofen and Netroksen, can be effective with mild and moderate pain.
  • Opioids: Opioids, such as morphine and oxycodon, may be required to relieve severe pain. Opioids should be used with caution due to the risk of dependence.
  • Other painkillers: Other painkillers, such as amitriptylin and size, can be used to treat chronic pain for pancreatitis.

3.2 enzymes:

Enzyme drugs contain pancreatic enzymes, such as lipase, amylase and protease. They help improve digestion and absorption of nutrients, especially fats. Enzymes are taken with each meal. The dose of enzymes depends on the severity of the disease and the amount of fat in food.

  • Types of enzyme preparations:
    • Panocreatine
    • Creon
    • Mezim Forte

3.3 Proton pump inhibitors (IPP):

IPP, such as Omeprazole and Lanceprazole, reduce the production of acid in the stomach. This can help reduce pancreatic irritation and relieve pain.

3.4 Antacids:

Antacides neutralize acid in the stomach. They can help reduce heartburn and other symptoms of stomach disorders.

3.5 Insulin:

If diabetes develops, insulin may be required to control blood sugar.

3.6 antibiotics:

Antibiotics can be prescribed in the development of pancreatic infection.

3.7 corticosteroids:

Corticosteroids, such as prednisone, can be used to treat autoimmune pancreatitis.

Section 4: surgical and endoscopic treatment of pancreatitis

In some cases, surgical or endoscopic treatment of pancreatitis may be required.

4.1 Surgical treatment:

  • Cholecystectomy: If acute pancreatitis is caused by bile stones, surgical removal of the gallbladder (cholecystectomy) may be required.
  • Drainage pseudo -Kistyst: Pseudocysts are clusters of fluid that can form in the pancreas with pancreatitis. If the pseudocyst is large or causes symptoms, its drainage may be required. Draining can be performed surgically or endoscopically.
  • Pancreatic resection: In rare cases, part of the pancreas may be removed (pancreatic resection). Review can be performed for the treatment of chronic pancreatitis, complications or pancreatic cancer.
  • Operation Wippla (pancreatoduodenal resection): This complex operation includes the removal of the pancreatic head, part of the small intestine, gall bladder and part of the stomach. It is used to treat pancreatic cancer and other pancreatic diseases.

4.2 Endoscopic treatment:

  • Endoscopic retrograde cholangiopancreatography (ERCP): ERCHPG is a procedure in which an endoscope (a thin flexible tube with a camera) is introduced through the mouth into the esophagus, stomach and duodenum. Then, a contrast agent is introduced into the ducts of the pancreas and bile ducts, which allows them to visualize them in an x ​​-ray. ERCP can be used to remove bile stones, expand the narrowed pancreatic ducts or drain pseudocysts.
  • Endoscopic ultrasonography (EUS): Eus is a procedure in which the ultrasonic probe is introduced into the esophagus and stomach for obtaining images of the pancreas. EUS can be used to diagnose chronic pancreatitis, assessment of pseudocyst and pancreatic biopsy.
  • Transpapillary drainage of pseudocyst: This is an endoscopic procedure in which the pseudocyst is drained through the main duct of the pancreas.
  • Transmural drainage of pseudocyst: This is an endoscopic procedure in which the pseudocyst is drained through the wall of the stomach or duodenum.

Section 5: Life and home remedies for pancreatitis

In addition to diet and medical treatment, changes in lifestyle and some home remedies can help control pancreatitis.

5.1 Refusal of alcohol:

The cessation of alcohol consumption is critical to prevent further damage to the pancreas.

5.2 Termination of smoking:

Smoking can also aggravate pancreatitis.

5.3 Stress decrease:

Stress can aggravate the symptoms of pancreatitis. Find ways to reduce stress, such as yoga, meditation or walking in nature.

5.4 Exercises:

Regular exercises can help improve the general health and reduce inflammation.

5.5 Warm:

Applying a warm compress to the stomach can help relieve pain.

5.6 ginger:

Ginger has anti -inflammatory properties and can help alleviate nausea and vomiting.

5.7 turmeric:

Turmeric also has anti -inflammatory properties and can help reduce pancreatic inflammation.

5.8 MCT oil:

MCT oil (medium -chain triglycerides) is easier to digest than other types of fats, and can be useful for people with pancreatitis.

5.9 Herbal teas:

Some herbal teas, such as chamomile tea and mint tea, can help relieve stomach disorder.

5.10 Acupuncture:

Acupuncture can help relieve pain in pancreatitis.

Section 6: complications of pancreatitis

Pancreatitis can lead to a number of complications that can be serious and even life -threatening.

6.1 pseudo -worshipers:

Pseudocysts are clusters of fluid that can form in the pancreas with pancreatitis. They can cause pain, nausea, vomiting and other symptoms. In some cases, pseudocysts can be infected or bleeding.

6.2 infection:

Pancreatic infection can occur in acute pancreatitis. This can lead to sepsis, a serious blood infection.

6.3 Pancreatic failure:

Chronic pancreatitis can lead to pancreatic insufficiency, which means that the pancreas cannot produce enough enzymes and hormones. This can lead to digestive problems, weight loss, diarrhea and diabetes.

6.4 diabetes:

Pancreatitis can damage pancreatic cells that produce insulin, which can lead to diabetes.

6.5 pancreatic cancer:

Chronic pancreatitis increases the risk of pancreatic cancer.

6.6 jaundice:

If pancreatitis blocks the bile duct, this can lead to jaundice, yellowing of the skin and eyes.

6.7 renal failure:

Severe pancreatitis can lead to renal failure.

6.8 Respiratory failure:

Severe pancreatitis can lead to respiratory failure.

6.9 Death:

In rare cases, pancreatitis can be fatal.

Section 7: Pancreatitis Prevention

It is not always possible to prevent pancreatitis, but there are several things that can be done to reduce the risk of the development of the disease.

7.1 restriction of alcohol use:

Alcohol abuse is one of the main causes of pancreatitis.

7.2 Maintaining a healthy weight:

Obesity increases the risk of pancreatitis.

7.3 Compliance with low fat diets:

A high fat diet can aggravate pancreatitis.

7.4 Refusal of smoking:

Smoking can also aggravate pancreatitis.

7.5 Treatment of bile stones:

If you have bile stones, consult a doctor for treatment.

7.6 Avoid some drugs:

Some drugs can increase the risk of pancreatitis. Talk to your doctor if you take any drugs that can cause pancreatitis.

7.7 Genetic counseling:

If your family has cases of pancreatitis, it may be useful to undergo genetic counseling.

Section 8: Life with pancreatitis: tips and support

Life with pancreatitis can be complex, but there are ways to manage the disease and improve the quality of life.

8.1 Understanding your disease:

Find out as much as possible about pancreatitis so that you can make reasonable decisions about your treatment.

8.2 Working with a doctor:

It is important to work with a doctor who has experience in treating pancreatitis.

8.3 Connection to the support group:

Connecting to the support group can give you the opportunity to communicate with other people who live with pancreatitis.

8.4 Pain Management:

Pain is a common symptom of pancreatitis. It is important to find ways to manage pain, such as medicines, physiotherapy or alternative treatment methods.

8.5 Diet Management:

Diet plays an important role in pancreatitis management. It is important to observe a low fat diet and a high protein content.

8.6 Stress management:

Stress can aggravate the symptoms of pancreatitis. Find ways to reduce stress, such as yoga, meditation or walking in nature.

8.7 Regular inspections:

It is important to regularly visit a doctor for examinations and tests.

8.8 Be patient:

Life with pancreatitis can be complicated. It is important to be patient with yourself and not give up.

8.9 Remember that you are not alone:

Many people live with pancreatitis. There are resources and support that can help you manage your disease and improve the quality of life.

Section 9: Alternative methods of treating pancreatitis

Some people with pancreatitis use alternative treatment methods to relieve symptoms. It is important to talk with your doctor before starting any alternative treatment.

9.1 Acupuncture:

Acupuncture is a treatment method in which thin needles are introduced into certain points on the body. Acupuncture can help relieve pain in pancreatitis.

9.2 Herbal remedies:

Some herbal products can help alleviate the symptoms of pancreatitis. It is important to talk with your doctor before taking any herbal remedies, as they can interact with other drugs.

9.3 Meditation:

Meditation can help reduce stress and improve the overall health.

9.4 Yoga:

Yoga can help reduce stress, improve flexibility and strength.

9.5 hypnosis:

Hypnosis can help relieve pain and reduce stress.

9.6 Massage:

Massage can help relieve pain and reduce stress.

9.7 Dietary additives:

Some dietary supplements, such as probiotics and enzymes, can help improve digestion and absorption of nutrients. It is important to talk with your doctor before taking any dietary supplements.

Section 10: Questions that the doctor should be asked about pancreatitis

When visiting a doctor about pancreatitis, it is important to ask questions in order to get complete information about your disease and treatment options.

10.1 questions about diagnostics:

  • What type of pancreatitis do I have?
  • What are the causes of my pancreatitis?
  • What tests do I need to go through?
  • How damaged is my pancreas?

10.2 questions about treatment:

  • What treatment options are available to me?
  • What are the side effects of treatment?
  • How long will I need to be treated?
  • How much will the treatment cost?
  • Do I need to change my lifestyle?
  • What changes in the diet do I need to make?
  • Do I need to take any medicine?
  • Do I need to undergo any surgical intervention?

10.3 Questions about complications:

  • What complications can I have?
  • How can I prevent complications?

10.4 questions about the forecast:

  • What is my forecast?
  • How much will I live?
  • Will I be able to lead a normal life?

10.5 General questions:

  • Where can I find more information about pancreatitis?
  • Are there any support groups for people with pancreatitis?
  • What should I do if I have any questions or problems?

By asking these questions to your doctor, you can get complete information about your pancreatitis and make reasonable decisions about your treatment. Remember that active participation in your treatment will help you better manage your disease and improve the quality of life.

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