Chronic pancreatitis occurs with alternating stages of exacerbation and remission. During the exacerbation, the main treatment is to remove the pain syndrome and normalize the patient's condition. With an exacerbation, irreversible pathological changes occur in the pancreas. According to many doctors, the pathological processes in the gland do not stop even in the stage of remission, but only slow down.
Since the inflammatory processes in the gland during remission cease for a while, most of the symptoms of the disease do not manifest themselves. Remission in pancreatitis does not arise by itself, but is the result of dietary nutrition and drug treatment.
The main task in the remission phase of pancreatitis is to use modern methods of treatment to prevent the development of diseases that promote the development of chronic pancreatitis. Pathogenetic therapy during remission without exacerbation is aimed at normalization of gastric secretion, stimulation of regeneration processes in the pancreas
and elimination of biliary dyskinesia. For this purpose, a diet with an increased protein content and a reduced fat content is prescribed. The protein diet is often supplemented by anabolic steroids such as Nerobol and Retabolil. If the stage of improvement proceeds with insignificant intrasecretory insufficiency and is burdened with an easy form of diabetes mellitus, the carbohydrates are excluded from the daily diet as much as possible. If restriction of carbohydrates does not lead to normalization of blood sugar level during the period of remission of chronic pancreatitis, I prescribe insulin.
Along with the diet during remission, it is very important to use substitution enzyme therapy. It is prescribed if a patient has pancreatitis:
- anorexia, dyspepsia;
- weight loss;
- confirmation of exocrine pancreatic insufficiency by test results.
Assigned enzyme preparations should not contain bile acids, but daily doses of lipase must be fully met. It is most preferable to administer microencapsulated preparations in an enteric-soluble, acid-fast coating. If the prescribed drugs do not have an acid-fast coating, then additionally prescribe acid-lowering drugs. Take medication with each meal.
By whether the number of meteorisms decreased, whether the body weight began to increase and whether the stool became regular in the amount of three calories per day, one can judge the adequacy of the prescribed dose of enzymes in the remission stage in chronic pancreatitis.