Pancreatitis Chronic

Chronic Pancreatitis: Causes, Symptoms, and Treatment

Chronic pancreatitis is a disease characterized by long-term inflammation of the pancreas. It usually develops in people in middle and old age and is more common in women. Chronic pancreatitis can cause serious health problems such as exocrine and endocrine insufficiency.

Etiology

The main causes of chronic pancreatitis are chronic alcoholism (especially in men) and cholelithiasis (more often in women). Less commonly, the etiological factor is the use of certain medications, cystic fibrosis, hyperparathyroidism, familial hypercholesterolemia, hemochromatosis, insufficient protein and fat content in food.

Acute pancreatitis with stenosis of the main pancreatic duct can develop into chronic pancreatitis. Predispose to the occurrence of chronic pancreatitis are spasms, inflammatory stenosis or tumor of the major duodenal papilla, which prevent the release of pancreatic juice into the duodenum, as well as insufficiency of the sphincter of Oddi, which facilitates the free entry of duodenal contents into the pancreatic duct, especially enterokinase contained in the intestinal juice, which activates trypsin.

Pathogenesis

An important role is played by the delay in release and intraorgan activation of pancreatic enzymes - trypsin and lipase, which carry out autolysis of the gland parenchyma. Destruction of gland tissue and a progressive inflammatory process lead to atrophy and hardening of the organ. Chronic calculous pancreatitis is based on damage to the ducts and tubules due to the formation of stones and protein plugs in them, which can subsequently become calcified.

There are several forms of chronic pancreatitis: calcific, obstructive and parenchymal.

Symptoms and course

The main symptom of chronic pancreatitis is pain in the epigastric region and left hypochondrium. The pain can be constant or paroxysmal and appear some time after eating fatty or spicy foods. The pain is localized in the epigastric region on the right with the process predominantly localized in the head of the pancreas and in the left hypochondrium when the body and tail of the gland are affected.

In addition, nausea, vomiting, diarrhea, fatigue, weight loss, and increased body temperature may occur. As the disease progresses, complications may arise, such as pancreatic abscess, pancreatic pseudocyst, jaundice, and diabetes.

Diagnosis

The diagnosis of chronic pancreatitis is established on the basis of clinical manifestations, data from instrumental methods and laboratory tests. Instrumental methods include ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI), endoscopic retrograde cholangiopancreatography (ERCP), percutaneous transhepatic cholangiography (PTCH).

Laboratory tests include blood tests for the level of pancreatic enzymes (amylase, lipase), total protein, glucose, and the level of bile pigments. Feces may also be tested for fatty acids and pancreatic enzymes.

Treatment

Treatment of chronic pancreatitis is aimed at eliminating symptoms, preventing complications and improving the patient's quality of life. The basis of treatment is a diet that excludes fatty and spicy foods, alcohol, and smoking. Drugs that reduce the secretion of pancreatic enzymes (pancreatin, somatostatin) and antibiotics for complications can also be used.

In some cases, surgery may be necessary, such as pancreatic duct stones or bile duct obstruction. In such cases, endoscopic or laparoscopic cholecystectomy, pancreatectomy, or drainage of pseudocysts may be performed.

In general, treatment of chronic pancreatitis requires an individual approach and can be a long and complex process. At the first signs of the disease, it is necessary to seek medical help and begin treatment as early as possible to prevent possible complications.

Pancreatitis is an inflammation of the pancreas, which can have both acute and chronic forms. Chronic pancreatitis is one of the most common pathologies of the pancreas, accompanied by its gradual destruction. For a long time, constant pathological processes occur in the gland, leading to excessive synthesis of trypsin.

The main symptom of chronic pancreatitis is loss of appetite. Gradually, the body begins to ignore such a signal, the process ceases to be controlled. But usually they are minor and do not interfere with food intake. Other symptoms of chronic pancreatitis may include the following: - constant aching pain of a girdle nature; - weight loss, even if a person consumes enough food and continues to work actively; - a feeling of pressure and discomfort when palpating the upper abdomen on the right; - nausea, vomiting; - flatulence, diarrhea or constipation; - jaundice.

Acute pancreatitis is a serious condition and requires immediate medical attention. Symptoms of acute pancreatitis include severe abdominal pain, vomiting and diarrhea. In severe cases, hospitalization and surgery may be required.

Various methods are used to diagnose chronic pancreatitis, including ultrasound, computed tomography, magnetic resonance imaging and others. Treatment for chronic pancreatitis may include lifestyle changes, drug therapy, and surgery. It is important to see your doctor for treatment recommendations.