Clinic of chronic pancreatitis does not have clear symptoms of the inflammatory process of the pancreas. Most often the disease develops on the background of sensations that are familiar to the patient, which can be caused by other long-standing diseases, such as peptic ulcer or cholecystitis. Therefore, patients go to the clinic only when new symptoms begin to appear, such as severe pain attacks, sudden weight loss, jaundice. The main symptom with which patients are treated are pains in the right hypochondrium, which, together with the development of the disease, pass to the left hypochondrium, back and left scapula. Often, painful attacks are caused by nervous and physical stress, gross violation of diet or relapse of the underlying disease.
The frequency of seizures per year for the initial stages of the disease is 1-2 relapses, and then can happen up to 4 times a month. Clinical features of chronic pancreatitis are diarrheal disorders, severe flatulence, nausea, salivation, belching, weakness, malaise and much more.40% of patients are hospitalized with severe exhaustion or signs of jaundice. Jaundice is caused by stones in the ampulla of the pharyngeal papilla and bile ducts, as well as due to cicatrical narrowing of the sphincter of Oddi, compression of the common bile duct and the gland of the gland.
In medicine, there are cases when it was possible to palpate in the epigastric region a dense, painful formation, in which the pulsation of the abdominal aorta is distinctly felt. The clinic of this phenomenon is caused by thinning of the abdominal wall with chronic pancreatitis. For pancreatic palpation, Grotta poses or the Mayo-Robson method are used in medicine, allowing the doctor to feel a painful tight shaft in the left hypochondrium with fingertip tips.
An important aspect in the clinic of pancreatitis is the conduct of a medical study of the presence of proteolytic enzymes in duodenal juice, blood and urine. If the disease occurs within the framework of moderate severity, the results of the tests will show increased activity of trypsin, lipase and diastase. Of great importance in the clinic of chronic pancreatitis is the constant medical control of the activity of diastase in the urine, the dynamics of this enzyme can understand the extent, nature and dynamics of the passage of inflammatory processes in the gland.
In the clinic of the disease there are changes in the composition of feces, the motility of the duodenum, the composition of blood and the digestive system as a whole.
Etiology, diagnosis and treatment of chronic pancreatitis
In medicine, in most cases, it is noted that the beginning of chronic pancreatitis leads to organ damage, the structure and functions associated with the pancreas. These are gastrointestinal diseases( duodenitis, peptic ulcer disease) and pathologies of the bile duct and liver( cholangitis, cholecystitis, hepatitis and cirrhosis).After the operation to remove the gallbladder, this form of the disease develops in 30% of patients. Even in 20-30% of patients the disease begins to progress after an earlier acute attack.
In addition, the disease can be triggered by systematic errors in nutrition( excessive intake of acute, salty, fried and fatty foods, a lack of protein in the nutritious diet).As a result of alcohol abuse, alcohol pancreatitis develops( in this case, the type of the drink has no decisive significance for the development of the disease).
The etiology of chronic pancreatitis also contains hereditary factors, the systematic administration of certain medications, certain viral diseases( hepatitis B and C viruses, mumps virus, Koskaki virus, as well as pathogens of tuberculosis, syphilis, malaria, etc., play a role in the development of this disease.).
The clinic for chronic pancreatitis contains four main syndromes:
- Pain syndrome( pronounced with exacerbation, usually disappears during the remission period).
- Dyspeptic syndrome( complaints of heartburn, eructation, nausea, vomiting, flatulence).Most of the symptoms are associated with concomitant disorders of the digestive system.
- Syndrome of exocrine insufficiency( often its manifestations - weakness, weight loss, diarrhea, anorexia).
- Syndrome of intrasecretory insufficiency( otherwise pancreatogenic diabetes mellitus).
In addition to physical examination and palpation, the diagnosis of chronic pancreatitis determines the degree of inflammation in the pancreas, exocrine and intrasecretory insufficiency, and visualization studies are carried out.
Chronic pancreatitis: medicine
In the initial stages of the disease( in the absence of complications) conservative treatment is used. At exacerbations it is recommended to be in a hospital under the supervision of a doctor.
Main tasks:
- elimination of clinical symptoms of the disease( symptomatic treatment, elimination of pain syndrome, detoxification, removal of the inflammatory process, restoration of the digestive function);
- prevention of complications;
- prevention of relapse( exacerbations).
Diet therapy is an integral part of the treatment of chronic pancreatitis. During the exacerbation it is recommended to refrain from sour and salty, fatty, spicy, fried, completely eliminate alcoholic beverages. In the case of an alcoholic type of illness, refusal of alcohol is a key factor and leads to a marked improvement in the patient's condition.
Severe course of the disease, not amenable to conservative treatment, as well as the occurrence of complications may become indications for surgery.