During periods of exacerbation of chronic pancreatitis patients require inpatient treatment, where during the first week of hospitalization the patient is monitored by water balance, blood parameters, number of leukocytes, acid-base balance, enzyme index in blood serum.
One of the most important tasks in treating exacerbation of chronic pancreatitis is the desire to suppress the secretion of the pancreas, which corrodes the tissues of the organ, causing painful sensations. For this, in an inpatient environment, activities such as:
- cooling of the epigastric region;
- curative fasting for three days after the onset of exacerbation of chronic pancreatitis and frequent administration of alkaline solutions every few hours;
- appoint peripheral M-cholinolytics;
- prescribes somatostatin-type drugs that help reduce gland secretion, thereby eliminating pancreatic pain;
- is prescribed omeprazole for the blockade of the "pump" of the lining cells, cimetidine for blocking the H2-histamine receptor and antacid preparations. All this is necessary in order to reduce the acidity of the contents of the stomach, thereby providing a functional pancreas rest;
- may prescribe dalargin or peritol to inhibit the functioning of the gland;
- before the appointment of treatment with enzyme inhibitors, such as gordoks, contrikal and trasilol, the patient determines their individual tolerability. Allergic reactions occur in 10-12% of cases. These drugs are administered simultaneously in a dropwise solution of sodium chloride or in a 5% solution of glucose;
- if during an exacerbation of a chronic pancreatitis the raised temperature and an intoxication is observed, apply antimicrobial therapy, appointing antibiotics of a wide spectrum, such as clatoran, kefzol, ampiox, oxacillin, ampicillin and other cephalosporins and penicillins.
According to the study, about 20% of patients entering the hospital with a diagnosis of exacerbation of chronic pancreatitis are immune to the methods of conservative treatment. In such cases, it is customary to prescribe surgical therapy. About 10% of them refuse to follow the prescribed diet not only in everyday life, but also during treatment in the hospital. It is not practical to use surgical treatment for this category of patients. Other 10% perform all the prescribed doctor's recommendations, but the improvement of the patient's condition is not achieved. It is in this case that surgical treatment should be prescribed.
Treatment for symptoms of exacerbation of chronic pancreatitis
Patient suffering from hr.pancreatitis, with the appearance of symptoms of exacerbation, in need of hospitalization. Treatment should be appointed by the therapist or gastroenterologist and under constant monitoring. To monitor the dynamics of healing, daily blood fetuses are made.
In the first 3 days it is necessary to completely stop eating and drink as much alkaline mineral still water as possible. In the case of exacerbations occurring in severe form, drinking is prohibited. The juice formed in the stomach is sucked off with a probe. In some cases, it is advisable to transfuse blood, plasma or their substitutes.
For the removal of pain during exacerbation of chronic pancreatitis, analgesics and antispasmodics are used. To prevent the penetration of pancreatic enzymes into the blood, drugs that depress its function are used. Antibiotic therapy is carried out with the help of broad-spectrum antibiotics. Vitamins A, B, and C are necessarily prescribed. If external pancreatic insufficiency is revealed, a substitution therapy is prescribed in the form of taking medications containing its enzyme.
An important part of complex treatment of symptoms is nutrition. Meals should be divided and regular. Food should contain an increased protein content( diet number 5).
For the period of therapy, the physical activity of the patient should be reduced to a minimum. During the remission, profile sanatorium-and-spa treatment is shown.
Than to treat and how to remove an exacerbation of a chronic pancreatitis?
Hunger, cold and tranquility. These 3 rules are fundamental in the treatment of exacerbation of chronic inflammation of the pancreas. The primary task is to remove the pain syndrome. Seeking a doctor is mandatory. Before his arrival, to ease the symptoms, put on the stomach with a hot-water bottle with ice( in the absence of a hot-water bottle you can use products from the freezer).Alkaline mineral water( Borjom type water) without gas reduces the secretion of the pancreas, which also leads to suppression of exacerbation. Until the symptoms of exacerbation of chronic pancreatitis are removed, the patient is shown complete peace and bed rest.
Drug treatment is reduced to taking painkillers and antispasmodics. To eliminate the pain of a doctor, Novocaine blockades are carried out. A prerequisite is the observance of a diet, the type of which the doctor appoints depending on the form of exacerbation of xp pancreatitis( from reducing fat intake to fasting).