Acute pancreatitis - description, causes, diagnosis, treatment.

Nosological classification (ICD-10)

• E84.1 Cystic fibrosis with intestinal manifestations
• E90 Eating and metabolic disorders in diseases classified elsewhere
• K29 Gastritis and duodenitis
• K29.4 Chronic atrophic gastritis
• K30 Dyspepsia
• K52 Other non-infectious gastroenteritis and colitis
• K59.1 Functional diarrhea
• K74 Fibrosis and cirrhosis of the liver
• K75 Other inflammatory liver diseases
• K76 Other liver diseases
• K86.0 Chronic pancreatitis of alcoholic etiology
• K86.1 Other chronic pancreatitis
• K87 Lesions of the gallbladder, biliary tract and pancreas in diseases classified elsewhere
• R14 Flatulence and related conditions

Nutrition for the sick

There will be no big secret and the phrase will not shock you if you read that a diet for pancreatitis is not only nutrition, but also a continuation of treatment, which must be treated extremely responsibly.

However, approaches to organizing dietary nutrition for acute pancreatitis have a number of features.

These include the following:

1. Don't take breaks from eating. Regularity is a principle that must be strictly observed. During the day you need 5-6 meals (3 main + 2-3 additional).
2. Portions should be low in calories and small.
3. The fundamental condition is the temperature regime. The food should be warm. Neither cold nor high temperature should be felt - it should be 40-50 degrees.
4. The structure of food - it should not contain coarse fiber and fiber, which require additional efforts from the gastrointestinal tract for digestion. It is advisable that the food be steamed and pureed.
5. The chemical composition must be gentle. To do this, you need to monitor your intake of proteins, fats and carbohydrates.
6. Exclude easily digestible carbohydrates: sugar, honey, jam, jams.

Recommended foods and dishes:

1. Lean fish and meat (domestic chicken, young beef, veal).
2. Vegetable decoctions and soups with the addition of cereals and pasta.
3. Biscuits, crackers, dried white bread.
4. Low-fat fermented milk products.
5. Porridges from cereals: buckwheat, semolina, rice, oatmeal - have a liquid consistency or, as people say, “chatter”.
6. Daily norm of oil: vegetable - up to 15 grams, butter - up to 30 grams. You need to understand this norm correctly, that is, taking into account the preparation of other dishes using them.
7. Drink – weak tea, rosehip decoctions, compotes, natural juices (with a low glycemic index in fruits).
8. Recommended vegetables: carrots, cauliflower, pumpkin, beets, green peas, but only boiled or baked.

Important! In the spring-summer period, refrain from eating early vegetables, berries and fruits, such as cucumbers, tomatoes, strawberries, melons, watermelons - this can introduce toxins into the body in the form of nitrates.

The patient is strictly prohibited from eating:

• butter dough and fresh bread;
• fried, smoked and dried sausage and meat;
• sharp and fatty cheeses;
• borscht, cabbage soup cooked in broths of meat, fish, and mushrooms;
• fat sour cream;
• lamb and pork fat;
• sour fruits;
• pickles and marinades;
• various legumes;
• sorrel, spinach, radish, radish, white cabbage;
• sweets, spices, cakes, ice cream;
• alcohol in any form.

Important! It is necessary to remember the axiom: it is impossible to cure pancreatitis by taking pills but not following a diet. Strict nutrition can protect you from relapses and medications.

Video from Dr. Malysheva:

Composition and release form

10 pcs in blister; There are 5 blisters in a box.

Traditional medicine

The use of folk remedies, the usefulness and effectiveness of which has been tested for centuries, is not disputed even by eminent heads of medicine. Their skillful and competent use significantly speeds up the healing process, because they have an antispasmodic effect, as well as biliary, sedative, analgesic, and antibacterial properties.

Decoctions of medicinal herbs

How to prepare a decoction: 10 grams of herbal tea (2 tablespoons), placed in a glass container, pour 200 grams of hot water. Then close the lid and place in a water bath for 30 minutes. After this, cool for 20 minutes, filter and pour into a container.

The herbal mixture is purchased at a pharmacy or prepared from separately purchased herbs.

Collection No. 1:

1. Peppermint – 3 parts.
2. Dill (seeds) – 3 parts.
3. Hawthorn (fruit) – 2 parts.
4. Chamomile (color) – 1 part.

Take half a glass 3 times a day an hour after meals.

Collection No. 2:

1. Knotweed (grass) – 1 part.
2. St. John's wort – 1 part.
3. Corn silks – 2 parts.
4. Birch leaves – 2 parts.

Take half a glass after meals 4 times a day.

Collection No. 3:

1. Rose hips – 2 parts.
2. Horsetail (herb) – 1 part.
3. St. John's wort – 1 part.
4. Nettle – 1 part.

Take half a glass before meals, 4 times a day.

Collection No. 4 - all in one part:

1. Celandine.
2. Anise fruit.
3. Corn silk.
4. Dandelion root.
5. Tricolor violet herb.
6. Knotweed herb.

Take a glass of decoction 20 minutes before meals, 3 times a day.

Collection No. 5:

• Trifoli leaves - 3 parts.
• Buckthorn bark – 4 parts.
• Celandine grass – 3 parts.
• Dandelion root – 4 parts.
• Peppermint leaves - 3 parts.

Take half a glass 3 times a day 30 minutes before meals.

Indications for the drug Pancreatin

Insufficiency of exocrine pancreatic function (chronic pancreatitis, cystic fibrosis, etc.); chronic inflammatory-dystrophic diseases of the stomach, intestines, liver, gall bladder; conditions after resection or irradiation of these organs, accompanied by disturbances in the digestion of food, flatulence, diarrhea (as part of combination therapy); improvement of food digestion in patients with normal gastrointestinal function in case of errors in nutrition, as well as in cases of chewing dysfunction, and a sedentary lifestyle; in preparation for x-ray examination and ultrasound of the abdominal organs.

Causes

Pathogenesis • Enzymatic autolysis of gland tissue with the development of a demarcation inflammatory reaction and the formation of microthrombi • The progressive course of the disease is characterized by pancreatogenic toxemia, hemodynamic disturbances, inhibition of the activity of parenchymal organs and post-necrotic complications. Pathomorphology. Autolysis, interstitial edema, hemorrhages, cellular and fat necrosis are noted in the pancreas.

Clinical and morphological classification • Edematous form of pancreatitis • Fatty pancreatic necrosis • Hemorrhagic pancreatic necrosis. Clinical picture • Constant severe girdling pain and pain in the epigastric region, accompanied by nausea and vomiting • The abdomen on palpation is painful, tense and moderately swollen • Positive symptoms of Shchetkin-Blumberg, Voskresensky, Mayo-Robson, Razdolsky. The severity of symptoms depends on the form of the disease, the degree of intoxication and complications • The skin and mucous membranes are often pale, sometimes cyanotic or icteric. Mondor's syndrome, Gray Turner's symptom, and Cullen's symptom appear. The body temperature with edematous pancreatitis is normal. • With pancreatic necrosis, pain is most pronounced in the epigastric region. With the progressive course of pancreatic necrosis, on the 7th–10th day of the disease, abdominal pain decreases due to the death of sensory nerve endings in the pancreas. Also characteristic is a serious condition, vomiting, increased body temperature (37.7–38.3 °C), cyanosis of the skin, tachycardia, arterial hypotension, oliguria, and symptoms of peritonitis. Symptoms of Grunwald and Davis are characteristic. Often, symptoms of intoxication prevail over local manifestations of the disease • With parapancreatic phlegmon and abscess of the pancreas, deterioration of the condition is noted: increased body temperature, chills, inflammatory infiltrate in the upper floor of the abdominal cavity, leukocytosis with a shift in the leukocyte formula to the left • Severe inflammation and necrosis of the pancreas can cause bleeding into the retroperitoneal space, which can lead to hypovolemia (arterial hypotension, tachycardia) and accumulation of blood in soft tissues. Laboratory tests • CBC - leukocytosis (10–20109/l) with a shift of the leukocyte formula to the left • Biochemical blood test •• Increased content of  - amylase - 95% of cases (with pancreatic necrosis it decreases) •• Increased ratio of amylase to creatinine clearance (higher 5%), which is normally 1–4% •• Increase in Ht to 50–55% •• Moderate increase in ALT and/or AST with concomitant alcoholic hepatitis or choledocholithiasis •• Moderate increase in ALP concentration with concomitant alcoholic hepatitis or choledocholithiasis •• Hyperbilirubinemia - in 15–25% of patients •• Increased levels of serum lipase •• Hyperglycemia in severe cases •• Hypocalcemia on the first day of the disease.

Synonyms of nosological groups

Treatment of chronic pancreatitis

If pancreatitis is not treated promptly, it will lead to dysfunction of other organs. If you are diagnosed with chronic pancreatitis and its symptoms worsen, then therapy must be carried out immediately.

The patient is treated in a hospital, where he is prescribed a set of measures:

1. Following a strict diet. For the first time, fasting is practiced. When the patient is allowed to eat, the food should be taken in small portions.
2. Elimination of pain and spasms.
3. Normalization of the digestive process.
4. Replenishment of enzyme deficiency.
5. Stop the inflammatory process.
6. Restore damaged organ tissue.
7. Carry out preventive measures.

When treating the chronic form, antibiotics are used if infection is present. This course lasts approximately 7 days. In case of inflammation of the ducts, Amoxicillin is prescribed to facilitate the outflow of bile; this allows the inflammatory focus to be stopped and prevent it from developing further.

Anti-inflammatory drugs can relieve pain. Only a doctor can competently select the dose of the drug.

“No-shpa” and “Drotaverine” will help to cope with spasms.

Chronic pancreatitis ICD code 10 is accompanied by digestive pathology, for this reason the patient must adhere to a strict diet and take enzymes.

In complex treatment, medications are prescribed to reduce the level of acidity (Almagel, Maalox).

Injections of Ringer, the drug “Hemodez” and saline have proven themselves to be effective in reducing intoxication in the body.

If therapeutic measures do not have the desired effect, then the patient is prepared for surgery.