Chronic pancreatitis belongs to the number of polytheological diseases and its development is influenced by various causes.
The etiology of the onset of chronic pancreatitis are:
- the consequences of an acute form of the disease;
- excessive drinking;
- disease of the gallbladder and duodenum;
- smoking;
- improper diet;
- heredity.
Acute pancreatitis is accompanied by attacks, as a result of which pathological changes occur in the pancreas. They are manifested in the form of narrowing of the pancreatic ducts, the formation of stones, cysts, half-cysts, cicatricial curvatures. The glandular tissue becomes cicatricial, and the gland itself is dense, functionally inferior. These changes contribute to the transformation of the acute form of the disease into a chronic one.
Severe toxic effects on the pancreas are exerted by alcohol. Particularly high risk of the disease with daily intake of alcohol in unbearable quantities for a long time. But even small doses of alcohol contribute to the development of chronic pancreatitis, if there are other risk factors.
Progression of the disease is promoted by cholelithiasis, which occurs in the form of choledocholithiasis( especially in women), Oddi's sphincter pathology, duct stenoses, diverticula, papillitis. The development of the disease is also influenced by metabolic and vascular disorders, prolonged intoxications coming from the intestine( intestinal diseases, chronic colitis) and intoxication in other diseases( for example, syphilis, tuberculosis).
The pancreas does a great deal of damage through the misuse of tobacco. It provokes the formation of endocrine, exocrine insufficiency, leads to the calcification of the ducts, which becomes the etiology of pancreatitis in a chronic form.
The reason for this disease can be abundant food with a high content of proteins and fats. Under its influence, the production of pancreatic juice increases. He does not have time to leave the pancreas at the time, which leads to damage to pancreatic ducts.
Another important cause of the emergence of a disease in a chronic form is heredity. The development of the disease is based on mutations in the genes of cationic( PRSS1) and anionic trypsinogen( PRSS2), trypsin inhibitor( SPINK1), chymotrypsin C, which cause uncontrolled activation of pancreatic enzymes and autodestruction of the pancreas.
Etiology and pathogenesis of chronic pancreatitis
The pathogenetic mechanism of pancreatitis development in chronic form is based on a significant increase in pancreatic secretion and activation of enzymes( chymotrypsinogen, trypsinogen, phospholipase A, proelastase), resulting in autolysis( "self-digestion") of the pancreas.
Several mechanisms are involved in the pathogenesis of alcoholic pancreatitis:
- ethanol reduces the activity of the enzyme oxidase, which leads to the formation of radicals that affect the development of necrosis and inflammatory processes. As a result, there is a formation of fibrosis and fatty degeneration of the gland tissue;
- alcohol leads to a change in the composition of pancreatic juice: the amount of protein increases and the level of bicarbonates decreases. As a result, preconditions are created for the precipitation of protein precipitates. Subsequently, they calcify and obturate the pancreatic ducts;
- under the influence of ethanol contained in alcohol, there is a spasm of the sphincter of Oddi, the consequence of which is intraprotective hypertension. Enzymes, penetrating through the weakened walls of the ducts, begin to activate and "trigger" the autolysis of the gland tissues.
The etiology and pathogenesis of biliary pancreatitis is due to changes occurring in the pancreas, accompanied by stone formation and blockage of the ducts. As a result of the movement of stones and microcrystals, traumatization of the mucous membrane occurs, which leads to the dysfunction of the sphincter of Oddi, and subsequently to the occurrence of stenosing papillitis. In this case, outflow of bile is broken, biliopancreatic reflux is formed, activation of enzyme secretion takes place. To a similar outcome lead the formation of stricture, fistula, anomalies in the development of choledochus and pancreas.