How does intestinal gas volume relate to acute pancreatitis severity. What are the clinical implications of elevated gas volume scores in acute pancreatitis patients. Can intestinal gas analysis serve as a potential diagnostic tool for acute pancreatitis complications.

Understanding Acute Pancreatitis and Gastrointestinal Complications

Acute pancreatitis (AP) is a serious inflammatory condition of the pancreas that can lead to various complications, including significant disturbances in gastrointestinal function. One of the key aspects of these disturbances is the alteration in intestinal gas volume, which may serve as an indicator of the severity and progression of AP.

Researchers have long recognized the importance of monitoring gastrointestinal function in AP patients, but quantitative methods for assessing intestinal gas have been limited. This study aims to bridge that gap by analyzing intestinal gas volume in AP patients using plain abdominal radiographs.

The Role of Intestinal Gas in Acute Pancreatitis

Intestinal gas plays a crucial role in gut function and can be affected by various pathological conditions. In the context of AP, changes in intestinal gas volume may reflect:

• Alterations in gut motility
• Disruptions in the gut microbiome
• Inflammatory processes affecting the gastrointestinal tract
• Potential bacterial overgrowth

Understanding these changes can provide valuable insights into the patient’s condition and potential complications.

Methodology: Quantifying Intestinal Gas Volume

The study employed an innovative approach to quantify intestinal gas volume using plain abdominal radiographs. Here’s a breakdown of the methodology:

1. Patient Selection: 68 AP patients and 21 normal controls were included in the study.
2. Timing: Abdominal radiographs were taken within 24 hours of admission for AP patients.
3. Digitization: The radiographs were digitized and transmitted to a computer for analysis.
4. Image Analysis: Specialized image manipulation software was used to identify regions of intestinal gas.
5. Gas Volume Score (GVS) Calculation: A quantitative measure called the Gas Volume Score was calculated based on the identified gas regions.

This methodology allowed for a standardized and objective assessment of intestinal gas volume across all study participants.

Advantages of Using Plain Abdominal Radiographs

The use of plain abdominal radiographs for this analysis offers several advantages:

• Non-invasive: Patients are not subjected to additional procedures
• Readily available: Most hospitals have X-ray facilities
• Cost-effective: Compared to more advanced imaging techniques
• Quick results: Allows for timely decision-making in patient care

These factors make this method potentially valuable for routine clinical use in AP management.

Key Findings: Intestinal Gas Volume in Acute Pancreatitis

The study revealed several significant findings regarding intestinal gas volume in AP patients:

Elevated Gas Volume Scores in AP Patients

AP patients showed significantly higher Gas Volume Scores (GVS) compared to the control group:

• AP Group: 0.084 ± 0.016
• Mild AP (MAP) Group: 0.070 ± 0.005
• Severe AP (SAP) Group: 0.094 ± 0.013
• Control Group: Lower than all AP groups (P<0.01)

These results indicate a clear association between AP and increased intestinal gas volume.

Correlation with Disease Severity

The study found a strong correlation between GVS and established severity scoring systems:

• Ranson’s scores: r = 0.762, P<0.01
• APACHE II scores: r = 0.801, P<0.01

This suggests that intestinal gas volume may be a useful indicator of AP severity.

Clinical Implications of Elevated Gas Volume Scores

The findings of this study have several important clinical implications for the management of acute pancreatitis:

Potential Diagnostic Tool

Given the significant differences in GVS between AP patients and controls, this method could potentially serve as an additional diagnostic tool for AP. It may be particularly useful in cases where the diagnosis is not immediately clear based on other clinical parameters.

Severity Assessment

The strong correlation between GVS and established severity scoring systems (Ranson’s and APACHE II) suggests that intestinal gas volume analysis could complement existing methods for assessing AP severity. This could aid in early identification of patients at risk for severe disease, allowing for more timely and appropriate interventions.

Monitoring Disease Progression

By tracking changes in GVS over time, clinicians may be able to monitor the progression of AP more effectively. This could provide valuable insights into the effectiveness of treatment and help guide clinical decision-making.

Intestinal Gas Volume and Secondary Infections

One of the most intriguing findings of the study was the relationship between intestinal gas volume and secondary infections in AP patients:

Higher GVS in Patients with Secondary Infections

Patients who developed secondary pancreatic and/or peripancreatic infections showed significantly higher GVS values:

• With secondary infection: 0.107 ± 0.014
• Without secondary infection: Lower (P<0.01)

This observation suggests that intestinal gas volume may be a potential predictor or indicator of secondary infections in AP patients.

Implications for Infection Prevention and Management

The association between elevated GVS and secondary infections has important implications for patient care:

• Early warning: Elevated GVS could alert clinicians to an increased risk of secondary infections
• Targeted interventions: Patients with high GVS may benefit from more aggressive infection prevention measures
• Monitoring: Serial GVS measurements could help track the effectiveness of infection control strategies

These findings open up new avenues for research into the relationship between intestinal gas, gut barrier function, and infection risk in AP patients.

Limitations and Future Directions

While the study provides valuable insights into the relationship between intestinal gas volume and acute pancreatitis, there are some limitations to consider:

Sample Size and Diversity

The study included 68 AP patients and 21 controls. A larger and more diverse sample size would help to:

• Validate the findings across different patient populations
• Explore potential variations based on factors such as age, ethnicity, and comorbidities
• Establish more precise GVS thresholds for clinical decision-making

Future studies with larger cohorts could address these limitations and provide more robust evidence.

Temporal Dynamics of Intestinal Gas

The current study analyzed radiographs taken within 24 hours of admission. However, intestinal gas volume may change dynamically over the course of AP. Future research could focus on:

• Serial measurements of GVS throughout the course of AP
• Correlation of GVS changes with clinical outcomes and treatment responses
• Development of predictive models based on GVS trajectories

This longitudinal approach could provide deeper insights into the role of intestinal gas in AP progression and recovery.

Mechanistic Studies

While the study demonstrates a clear association between intestinal gas volume and AP, the underlying mechanisms remain to be elucidated. Future research directions could include:

• Investigation of the gut microbiome in relation to GVS in AP patients
• Exploration of the impact of AP on gut motility and gas production
• Analysis of the relationship between intestinal gas composition and AP severity

These mechanistic studies could provide a more comprehensive understanding of the gut-pancreas axis in AP and potentially lead to new therapeutic approaches.

Potential Applications in Clinical Practice

The findings of this study open up several possibilities for integrating intestinal gas volume analysis into clinical practice for acute pancreatitis management:

Risk Stratification

GVS could be incorporated into existing risk stratification models for AP patients. This may help to:

• Identify high-risk patients more accurately
• Guide decisions on admission to intensive care units
• Tailor monitoring and treatment plans based on individual patient risk

By adding GVS to the clinician’s toolbox, more nuanced and personalized care strategies could be developed.

Treatment Response Monitoring

Regular monitoring of GVS during AP treatment could provide valuable information about treatment efficacy. Potential applications include:

• Assessing the impact of nutritional interventions on gut function
• Monitoring the effects of antibiotics on intestinal gas volume
• Evaluating the success of strategies aimed at restoring normal gut motility

This approach could help clinicians make more informed decisions about continuing or modifying treatment plans.

Development of Novel Therapeutic Approaches

Understanding the relationship between intestinal gas volume and AP severity could lead to new therapeutic strategies. Potential areas of exploration include:

• Targeted interventions to modulate intestinal gas production
• Development of probiotics or other gut-focused therapies for AP
• Exploration of treatments that aim to restore normal gut function in AP patients

These novel approaches could complement existing AP treatments and potentially improve patient outcomes.

Conclusion and Future Perspectives

The quantitative analysis of intestinal gas volume in acute pancreatitis patients represents a significant step forward in our understanding of the gastrointestinal complications associated with this condition. The study’s findings highlight the potential of Gas Volume Score (GVS) as a valuable tool for diagnosis, severity assessment, and monitoring of acute pancreatitis.

Key takeaways from this research include:

• Significantly elevated intestinal gas volume in AP patients compared to controls
• Strong correlation between GVS and established severity scoring systems
• Association between high GVS and secondary pancreatic/peripancreatic infections
• Potential for GVS to serve as a new marker for AP severity and complications

These insights open up exciting possibilities for improving patient care and outcomes in acute pancreatitis.

Looking ahead, further research is needed to:

• Validate these findings in larger and more diverse patient populations
• Explore the temporal dynamics of intestinal gas volume in AP
• Investigate the underlying mechanisms linking intestinal gas to AP severity
• Develop standardized protocols for GVS measurement and interpretation
• Integrate GVS analysis into clinical decision-making algorithms for AP management

As our understanding of the gut-pancreas axis in acute pancreatitis continues to evolve, the quantitative analysis of intestinal gas volume may become an increasingly important tool in the clinician’s arsenal. This approach not only offers new insights into the pathophysiology of AP but also holds promise for improving patient care through more personalized and targeted interventions.

Quantitative analysis of intestinal gas in patients with acute pancreatitis

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. 2012 Jun;11(3):314-8.

doi: 10.1016/s1499-3872(12)60166-0.

Ying Liu 
¹
, He-Sheng Luo

Affiliations

Affiliation

• ¹ Department of Gastroenterology, Renmin Hospital, Wuhan University, Wuhan, China.

• PMID:

  22672827

• DOI:

  10.1016/s1499-3872(12)60166-0

Ying Liu et al.

Hepatobiliary Pancreat Dis Int.

2012 Jun.

. 2012 Jun;11(3):314-8.

doi: 10.1016/s1499-3872(12)60166-0.

Authors

Ying Liu 
¹
, He-Sheng Luo

Affiliation

• ¹ Department of Gastroenterology, Renmin Hospital, Wuhan University, Wuhan, China.

• PMID:

  22672827

• DOI:

  10.1016/s1499-3872(12)60166-0

Abstract

Background:

Disturbance of gastrointestinal function is a common complication in the early phase of acute pancreatitis (AP). Intestinal gas may reflect the function of the gut. Using plain abdominal radiographs, we investigated whether intestinal gas volume is related to AP.

Methods:

Plain abdominal radiographs of 68 patients with AP within 24 hours after admission and 21 normal controls were digitized and transmitted to a computer. The region of intestinal gas was identified by an image manipulation software and the gas volume score (GVS) was calculated. The relationships between the GVS values and various clinical factors of AP were analyzed.

Results:

The GVS in the AP group was 0.084+/-0.016, in the mild AP (MAP) group 0.070+/-0.005, and in the severe AP (SAP) group 0.094+/-0.013; all values were higher than that in the control group (P<0.01). The GVS in the SAP group was higher than that in the MAP group. The GVSs were correlated to the Ranson’s scores (r=0.762, P<0.01) and the acute physiology and chronic health evaluation II (APACHE II) scores (r=0.801, P<0.01). In addition, the GVS in patients with secondary pancreatic and/or peripancreatic infection was 0.107+/-0.014, higher than that in patients without secondary infection (P<0.01). GVS was not related to gender, age, etiology or clinical outcome of AP.

Conclusions:

Intestinal gas volume is significantly elevated in patients with AP. It is closely related to Ranson’s and APACHE II score and secondary pancreatic and/or peripancreatic infection. GVS may be a new prognostic tool for assessing the severity of AP in the early course of the disease.

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Chronic pancreatitis: Treatments, symptoms, and causes

Chronic pancreatitis is a long-term progressive inflammatory disease of the pancreas. Alcohol use, chemotherapy, and some autoimmune conditions can cause it.

The pancreas is a gland in the upper abdomen, behind the stomach and below the ribcage. It produces important enzymes and hormones that help break down and digest food. It also makes insulin to moderate the levels of sugar in the blood.

The most common cause of chronic pancreatitis is long-term alcohol use disorder, which causes 40–70% of all cases. Autoimmune conditions, blockages of the ducts, vitamin deficiencies, chemotherapy, and some other factors may also cause chronic pancreatitis.

Chronic pancreatitis sometimes begins with acute pancreatitis, which is a sudden and severe type of the condition. It can persist after the acute phase passes, causing progressive and permanent damage to the pancreas.

Keep reading to learn more about chronic pancreatitis, including treatment, symptoms, and causes.

Common signs and symptoms of chronic pancreatitis include severe upper abdominal pain that can sometimes travel along the back and is more intense following a meal, as well as nausea and vomiting, more commonly occurring during episodes of pain.

As the condition progresses, the episodes of pain become more frequent and severe. Some individuals will experience constant abdominal pain.

As chronic pancreatitis progresses, and the ability of the pancreas to produce digestive juices deteriorates, the following symptoms may appear:

• smelly, greasy stools
• bloating
• abdominal cramps
• flatulence

Eventually, the pancreas may not be able to produce insulin at all, leading to type 1 diabetes, which can produce the following symptoms:

• thirst
• frequent urination
• intense hunger
• unintentional weight loss
• tiredness
• blurred vision

Treatment focuses on alleviating symptoms, slowing or stopping damage to the pancreas, and managing health problems stemming from chronic pancreatitis.

Lifestyle changes

People with chronic pancreatitis may need to make some lifestyle changes, including:

• Avoiding alcohol consumption, if applicable: Stopping consuming alcohol will help prevent further damage to the pancreas. It will also help relieve the pain. Some people may need professional help to give up alcohol. Continuing to drink increases the risk of death.
• Stopping tobacco use, if applicable: Smoking is not a cause of pancreatitis, but it can accelerate the progression of the disease.
• Making dietary changes: Eating small low fat meals more frequently may help ease symptoms.
• Taking vitamins and enzymes: A person may need to replace pancreatic enzymes in their diet or take fat-soluble vitamins to ensure proper nourishment.

Pain management

Doctors may recommend pain relievers, starting with over-the-counter options. If these do not work, a doctor may recommend stronger pain-relieving medication, including:

• nonsteroidal anti-inflammatory drugs, such as ibuprofen or naproxen
• pregabalin
• opioids, if other pain treatments prove ineffective

Living in pain can lead to depression, which may increase the perception of pain. A doctor may prescribe antidepressants to ease both emotional and physical pain.

Insulin

The pancreas may stop producing insulin if the damage is extensive. This can cause diabetes. In one study involving people with genetic pancreatitis, 48% of the participants eventually developed diabetes.

A person may need regular insulin therapy if the pancreas no longer produces this hormone.

Surgery

Sometimes, severe chronic pain does not respond to pain relievers. The ducts in the pancreas may have a blockage. This can cause an accumulation of digestive juices, causing intense pain.

Another cause of chronic intense pain could be inflammation of the head of the pancreas.

Several forms of surgery may treat more severe cases.

Endoscopic surgery

A surgeon inserts a narrow, hollow, flexible tube called an endoscope into the digestive system, guided by ultrasound. This allows them to thread a tiny deflated balloon through the endoscope and into the duct. Inflating the balloon widens the duct so that the surgeon can place a stent to keep it open.

Surgery relieves symptoms in approximately 60% of people who choose this option.

Pancreas resection

Pancreas resection is the removal of part of the pancreas. This relieves the pain caused by inflammation irritating the nerve endings, and it also reduces pressure on the ducts.

Three main techniques are used for pancreas resection:

• The Beger procedure: This involves resection of the inflamed pancreatic head with careful sparing of the duodenum. Then, a surgeon attaches the rest of the pancreas to the intestines.
• The Frey procedure: A doctor may recommend this when inflammation at the head of the pancreas and blocked ducts together cause pain. The Frey procedure adds a longitudinal duct decompression to the pancreatic head resection. The surgeon removes the head of the pancreas and compresses the ducts by connecting them to the intestines.
• Pylorus-sparing pancreaticoduodenectomy: A surgeon removes the gallbladder, the ducts, and the head of the pancreas. Doctors typically only recommend this in very severe cases of intense chronic pain when the head of the pancreas is inflamed and the ducts are also blocked. This is the most effective procedure for reducing pain and conserving pancreas function. However, it has the highest risk of infection and internal bleeding.

While treatment can work well, it is also very risky, with a death rate as high as 10%.

Total pancreatectomy

This involves the surgical removal of the whole pancreas. It is very effective in dealing with the pain.

However, a person who has had a total pancreatectomy will be dependent on treatment for some of the vital functions of the pancreas, such as the release of insulin.

Autologous pancreatic islet cell transplantation

During the total pancreatectomy procedure, a suspension of isolated islet cells is created from the surgically removed pancreas and injected into the portal vein of the liver. The islet cells will function as a free graft in the liver and produce insulin.

Alternative and complementary remedies will not cure chronic pancreatitis, but they may help ease symptoms.

Combining alternative remedies with standard treatments may help get better results. Replacing standard treatments with alternative ones may allow the disease to progress more rapidly, causing more symptoms.

Some options include:

• Yoga: Yoga may help a person relax, easing pain, anxiety, and depression.
• Massage: Massage can improve circulation and may help with relaxation and pain.
• Acupuncture: Acupuncture is a traditional Chinese medicine technique for realigning the body’s energy. Some people anecdotally report that it helps them.
• Meditation: Meditation can help ease the stress of living with a chronic condition and may help some individuals better manage their pain.
• Exercise: Exercise can help a person reach or maintain a moderate body weight and may reduce the side effects of other conditions, potentially also reducing inflammation. Moreover, regular exercise may improve mood and alleviate pain.

Taking dietary measures is vital to reduce the effects of pancreatitis.

The pancreas is involved in digestion, and pancreatitis can impair this function. This means that people with the condition will have difficulty digesting many foods.

Rather than three large meals per day, people with pancreatitis will be advised instead to consume six small meals. It is also better to follow a low fat diet.

Managing the diet during pancreatitis aims to achieve four outcomes:

• reducing the risk of malnutrition and shortages of certain nutrients
• avoiding high or low blood sugar
• managing or preventing diabetes, kidney disease, and other complications
• decreasing the likelihood of an acute flare-up of pancreatitis

A diet plan will be drawn up by a doctor, or the person may be referred to a qualified dietitian. The plan is based on the person’s current levels of nutrients in the blood shown in diagnostic testing.

Meal plans will generally involve food sources that are high in protein and have dense nutritional content. These are likely to include whole grains, vegetables, fruits, low fat dairy products, and lean protein sources, such as boneless chicken and fish.

Fatty, oily, or greasy foods should be avoided, as these can trigger the pancreas to release more enzymes than usual. As a primary cause of chronic pancreatitis, alcohol is also best avoided while on a pancreatitis-friendly diet.

Depending on the extent of the damage, individuals may also have to take artificial versions of some enzymes to aid digestion. These will ease bloating, make their feces less greasy and foul-smelling, and help any abdominal cramps.

Chronic pancreatitis is usually a complication of recurrent episodes of acute pancreatitis. These can lead to permanent damage in the pancreas.

Acute pancreatitis occurs when trypsin becomes activated within the pancreas. Trypsin is an enzyme that is produced in the pancreas and released into the intestines, where it breaks down proteins as part of digestion.

Trypsin is inactive until it has reached the intestines. If trypsin becomes activated inside the pancreas, it will start to digest the pancreas itself, leading to irritation and inflammation of the pancreas. This becomes acute pancreatitis.

Alcohol misuse

Consuming alcohol can cause a process that triggers the activation of trypsin inside the pancreas, as can gallstones.

People who misuse alcohol and develop acute pancreatitis tend to have repeated episodes and eventually develop chronic pancreatitis.

Repeated bouts of acute pancreatitis eventually cause permanent damage to the pancreas, leading to chronic pancreatitis.

This is also known as alcohol-related chronic pancreatitis.

Idiopathic chronic pancreatitis

When a condition is idiopathic, it has no known cause. Idiopathic chronic pancreatitis accounts for most of the remaining cases.

Most cases of idiopathic chronic pancreatitis develop in people aged 10–20 years and those aged over 50 years.

Experts do not exactly know why other age groups are rarely affected. The SPINK-1 and the CFTR genes, types of mutated genes, exist in about 50% of people with idiopathic chronic pancreatitis. These genetic mutations may undermine the functions of the pancreas.

Other, much rarer causes include:

• autoimmune chronic pancreatitis, wherein the person’s immune system attacks the pancreas
• hereditary pancreatitis, wherein a person has a genetic condition and is born with a pancreas that is not working effectively
• cystic fibrosis, another genetic condition that damages various organs, including the pancreas

While chronic pancreatitis can develop in anyone, certain factors increase the risk, including:

• chronic alcohol misuse
• autoimmune conditions
• chronic inflammation, often due to an autoimmune condition
• chemotherapy
• genetic mutations that may run in families
• nutritional deficiencies

There are no reliable tests to diagnose chronic pancreatitis. A doctor may suspect the condition because of the person’s symptoms, history of repeated acute pancreatitis flare-ups, or alcohol misuse.

Blood tests may be useful in checking the blood glucose levels, which may be elevated.

Blood tests for elevated levels of amylase and lipase are not reliable at this stage. Amylase and lipase blood levels rise during the first couple of days of pancreatitis and then settle back to normal after 5–7 days. An individual with chronic pancreatitis would have had the condition for much longer.

Doctors need to have a good look at the pancreas in order to diagnose the condition properly. This will most likely involve:

• An ultrasound scan: High frequency sound waves create an image of the pancreas and its surroundings on a monitor.
• A CT scan: X-rays are used to take many pictures of the same area from several angles, which are then placed together to produce a 3D image. The scan will reveal changes of chronic pancreatitis.
• Magnetic resonance cholangiopancreatography scan: This scan shows the bile and pancreatic ducts more clearly than a CT scan.
• An endoscopic ultrasound: An endoscope is inserted into the digestive system. The doctor uses ultrasound to guide the endoscope through.

People with chronic pancreatitis have a greater risk of developing pancreatic cancer. If symptoms worsen, especially the narrowing of the pancreatic duct, doctors may suspect cancer. If so, they will order a CT scan, an MRI scan, or an endoscopic study.

There are several ways in which chronic pancreatitis can develop and become more harmful to a person’s well-being.

Stress, anxiety, and depression

The condition may have an effect on a person’s psychological and emotional well-being. Constant or recurring pain that is often severe may cause distress, anxiety, irritability, stress, and depression.

It is important for a person to tell a doctor if they feel depressed, anxious, or very unhappy. A support group can help them learn coping skills and feel less isolated.

Pseudocyst

This is a collection of tissue, fluid, debris, pancreatic enzymes, and blood in the abdomen, caused by leakage of digestive fluids escaping from a pancreatic duct that is not working effectively.

Pseudocysts do not usually cause any health problems. However, sometimes they can become infected, cause blockage to part of the intestine, or rupture and cause internal bleeding. If this happens, the cyst will have to be surgically drained.

Pancreatic cancer

Pancreatic cancer is more common in people with chronic pancreatitis. Although the relative risk increases, the absolute risk remains low.

Avoiding alcohol consumption significantly reduces the risk of developing chronic pancreatitis in people with acute pancreatitis. This is especially the case for individuals who drink large amounts of alcohol regularly.

Refraining from drinking excessive amounts of alcohol may prevent pancreatitis. It is also important to manage chronic medical conditions to reduce the risk of inflammation, which damages the pancreas.

Chronic pancreatitis is a serious condition that can undermine a person’s overall health and shorten their life span. It can lead to pancreatic cancer, diabetes, and other chronic conditions.

Several medical conditions increase the risk of pancreatitis. This means many people with this diagnosis also have other serious health issues.

Early diagnosis and treatment are critical for prolonging a person’s life and easing their pain. The right treatment can slow or stop damage to the pancreas.

Individuals with abdominal pain or other pancreatitis symptoms should contact a doctor to discuss treatment options.

causes, symptoms and treatments for pancreatic inflammation

Contents

• 1 Everything you need to know about pancreatic inflammation – pancreatitis
  • 1.1 Inflammation of the pancreas pancreatitis
    • 1. 1.1 By definition and causes
  • 1.2 Classification of pancreatitis
    • 1.2.1 Acute pancreatitis
    • 1.2.2 Chronic pancreatitis
    • 1.2.3 Reactive pancreatitis
  • 1.3 Pancreatic inflammation symptoms of pancreatitis
    • 1.3.1 Main features of the disease
    • 1.3.2 Specifying symptoms
  • 1.4 Diagnosis of pancreatitis
    • 1.4.1 History and physical examination
    • 1.4.2 Laboratory diagnostics
    • 1.4.3 Instrumental diagnostics
    • 1.4. 4 Additional studies
  • 1.5 Treatment of acute pancreatitis
    • 1.5.1 Conservative treatment
    • 1.5.2 Surgical treatment
    • 1.5.3 Prevention of recurrence
  • 1.6 Treatment of chronic pancreatitis
    • 1.6.1 Diet
    • 1.6.2 Drug therapy
    • 1.6.3 Surgery

  90 005 1.7 Prevention of pancreatitis – the importance of a healthy lifestyle

  • 1.7. 1 Consequences of eating disorders
  • 1.7.2 Active lifestyle
  • 1.7.3 Regular medical check-ups
  • 1.7.4 Maintaining a healthy diet
  • 1.8 Nutrition for pancreatitis
    • 1.8.1 General principles of nutrition in pancreatitis:
    • 1.8.2 Recommended products in pancreatitis:
    • 1.8.3 Dietary features in exacerbation of pancreatitis:
  • 1.9 Complications of pancreatitis 9000 4
  • 1.9.1 Infectious complications
  • 1.9 .2 Dysfunction of other organs
  • 1.9.3 Pancreatic necrosis
• 0010
• 1.10.2 Take medication
• 1.10.3 Moderate physical activity
• 1.10.4 Regular doctor visits
• 1.10.5 Stop smoking
• 1.10.6 Psychological support

Pancreatitis is an inflammation of the pancreas that can lead to serious complications. Learn about the causes, symptoms and treatments for pancreatitis from the doctors on our website.

The pancreas is an important organ responsible for the production of hormones and enzymes necessary for the proper functioning of the body. However, if an inflammatory process occurs in the gland, then this can lead to negative consequences: from a mild form associated with discomfort to a severe one, when immediate hospitalization is necessary.

Pancreatitis is an inflammation of the pancreas, which can be caused by many factors, from poor environmental conditions and malnutrition, to injury and hereditary predisposition. Despite the rather wide range of causes of the disease, it is not easy to recognize pancreatitis. The symptoms of the disease are quite different, in addition, pancreatitis can appear in acute or chronic form, affecting the corresponding period of the disease.

Treatment for pancreatitis depends on the type, cause, and severity. You should immediately consult a doctor if any symptoms occur, such as: acute or paroxysmal pain in the abdomen, nausea, vomiting, diarrhea, fever, and others. Chronic pancreatitis can lead to various complications, so it is important to have regular medical checkups and maintain a healthy lifestyle to avoid the onset of the disease.

Inflammation of the pancreas pancreatitis

Concept and causes

Pancreatitis is a disease in which the pancreas is inflamed and can cause complications. Pain in the upper abdomen, vomiting, nausea, fever are the main symptoms of the disease. Pancreatitis can be acute or chronic.

Acute pancreatitis most often occurs due to dietary excess fat, alcohol consumption, gallstone disease, or trauma.

Chronic pancreatitis is usually associated with alcohol abuse, chronic biliary tract disease, and may also be genetic.

• Dietary excess fat – Eating a large amount of fatty foods leads to an increased level of fat in the blood, which increases the likelihood of developing acute pancreatitis.
• Alcohol – Regular alcohol consumption can cause chronic pancreatitis.
• Gallstone disease – When a stone blocks the bile duct, bile can flow into the pancreas, causing inflammation.
• Injury – Injury to the pancreas can cause it to become inflamed.

Acute pancreatitis can occur suddenly and lead to dangerous complications, so it is important to know about the causes of the disease and seek medical attention in a timely manner.

Classification of pancreatitis

Acute pancreatitis

Acute pancreatitis is an inflammatory process in the pancreas that develops rapidly and strongly.

1. Mild – characterized by moderate abdominal pain and mild fever.
2. Moderate course – severe abdominal pain, vomiting, fever.
3. Severe – possible complications such as gangrene and pancreatic necrosis.

Chronic pancreatitis

Chronic pancreatitis is a slowly progressive inflammatory process in the pancreas that lasts for several years.

• Calcific pancreatitis – characterized by the formation of calcifications in the tissues of the pancreas.
• Alcoholic pancreatitis – caused by drinking large amounts of alcohol.
• Pancreatitis after surgery – develops after surgery on the abdominal organs.

Reactive pancreatitis

Reactive pancreatitis is an inflammatory process that develops as a result of diseases of other abdominal organs.

• Gastritis – inflammation of the gastric mucosa.
• Cholecystitis – inflammation of the gallbladder.
• Gastric and duodenal ulcer – lesion of the mucous membranes of the corresponding organs.

Symptoms of inflammation of the pancreas pancreatitis

Main signs of the disease

The main symptom of pancreatitis is a sharp pain in the abdomen, which can spread to the back, left shoulder and shoulder blade. Also, the pain may be aggravated by eating and being in the supine position.

Other symptoms of pancreatitis include nausea, vomiting, diarrhea, decreased appetite, yellowish skin and eyes, increased body temperature and heart rate. In the case of acute pancreatitis, there may be a feeling of malaise and weakness, as well as a decrease in blood pressure.

Clarifying features of symptoms

The duration of pain in pancreatitis may vary depending on the degree and form of the disease. So, acute pain can be observed within a few days, and with chronic pancreatitis – months or even years.

The extent of the pain syndrome is one of the criteria for determining the degree of inflammation. The more the pancreas is affected, the more extensive the pain syndrome.

Influence of food on pain syndrome inflammation of the pancreas can be increased by fatty, spicy, salty, sweet foods, as well as alcohol. In this case, patients with pancreatitis may experience discomfort and pain even with small meals or drinks.

Combination of symptoms pancreatitis may depend on the stage of the disease, the cause of development and the individual characteristics of the organism. A combination of symptoms of pancreatitis and other diseases of the gastrointestinal tract is also possible, so the disease should be diagnosed by a doctor.

Diagnosis of pancreatitis

History and physical examination

Diagnosis of pancreatitis begins with the history and physical examination of the patient. The attending physician asks questions about the presence of pain in the epigastric region, nausea, vomiting, weight loss and other symptoms. Physical examination includes palpation of the abdomen, testing of sensation in the epigastric region, and other manipulations.

Laboratory diagnosis

Laboratory testing of blood and urine is required to confirm the diagnosis of pancreatitis. Elevated levels of amylase and lipase are usually detected. A complete blood count is also performed to assess the level of leukocytes and C-reactive protein.

Instrumental diagnostics

To clarify the diagnosis of pancreatitis, the following tests may be prescribed:

• abdominal ultrasound
• computed tomography
• magnetic resonance imaging
• endoscopic ultrasound diagnostics

These studies allow you to see changes in the conditions of the pancreas and tissues of the liver, spleen and other organs in the abdominal cavity.

Additional tests

Additional tests may be required after initial diagnosis. For example, duodenal intubation to obtain control of the contents of the stomach and duodenum. A biopsy of the pancreas may also be performed to clarify the diagnosis and assess the extent of tissue damage.

Treatment of acute pancreatitis

Conservative treatment

The main objective of the conservative treatment of acute pancreatitis is to reduce pain and prevent complications. For this, antispasmodics, anti-inflammatory drugs and analgesics are prescribed. It is necessary to follow a strict diet that excludes fatty, spicy and sweet foods, as well as alcohol.

Surgical treatment

Surgical treatment is used in cases where conservative therapy is ineffective or doctors are forced to prevent the development of complications. There are several methods of surgical treatment of acute pancreatitis: drainage, resection and pancreatectomy. The choice of method depends on the patient’s condition, the degree of damage and the functional activity of the pancreas.

Prevention of recurrence

Prevention of recurrence of acute pancreatitis is based on the exclusion of the causes of the disease. It is important to monitor your health, monitor nutrition, give up bad habits and drinking alcohol. It is recommended to undergo regular examinations by a gastroenterologist in order to correctly assess the condition of the pancreas and prevent the development of acute pancreatitis in a timely manner.

Treatment of chronic pancreatitis

Diet

An equally important stage of treatment is proper nutrition. In chronic pancreatitis, a diet is indicated that excludes foods that increase the secretion of the stomach and pancreas. Spicy, smoked and fatty foods, as well as alcohol, are prohibited. It is recommended to eat a small amount of food in small portions (5-6 meals per day).

Drug therapy

Chronic pancreatitis is treated with drugs that reduce gastric acid excretion and pancreatic enzyme production. Drugs such as proton pump inhibitors and antacids help to reduce the acidity of the gastric juice and reduce its irritating effect on the pancreas.

To relieve pain symptoms, analgesics and antispasmodics are prescribed, which help reduce spasms in the pancreas and reduce pain. Also shown are drugs that improve digestion and enhance the functions of the pancreas.

Surgery

In cases where chronic pancreatitis is accompanied by the formation of cysts, tumors or stones in the pancreas, surgery may be necessary. Most often, minimally invasive methods are used, such as laparoscopy, laser treatment or endoscopic drainage surgery.

Thus, the complex treatment of chronic pancreatitis includes not only drug therapy, but also proper nutrition, and in some cases, surgical intervention. All these measures help to reduce pain symptoms, prevent complications and improve the patient’s quality of life.

Prevention of pancreatitis – the importance of a healthy lifestyle

Consequences of eating disorders

The habit of overeating, excessive consumption of fatty and spicy foods, smoking and drinking alcohol are among the main causes of inflammation of the pancreas. Therefore, it is important to monitor your diet and give up bad habits.

Active lifestyle

Physical exercise and sports increase the overall endurance of the body and reduce the risk of developing many diseases, including pancreatitis. It is recommended to exercise regularly and at least 30 minutes a day.

Regular medical check-ups

Timely detection of disorders in the pancreas using ultrasound and tests is an important step in the prevention of pancreatitis. A doctor may recommend a special diet and treatment at an early stage of the disease.

Maintaining a proper diet

Moderate consumption of fatty and spicy foods, active consumption of water and vegetables containing a lot of fiber, starch and vitamins, as well as the rejection of quick snacks in favor of full meals are important measures to prevent pancreatitis.

Nutrition in pancreatitis

General principles of nutrition in pancreatitis:

• Exclusion from the diet of fatty, fried, spicy, smoked, salty, canned and pickled foods, as well as sweets, coffee, alcohol and carbonated drinks;
• Gradual introduction of easily digestible foods into the diet, such as cereals, vegetable soups, fermented milk products;
• The diet should be rich in proteins, complex carbohydrates and minerals, but low in calories.

Recommended foods for pancreatitis:

• Lean meats: chicken, veal, rabbit, turkey;
• Fish, zander, pike, cod, crucian carp;
• Water-based cereals: buckwheat, oatmeal, rice, corn;
• Vegetables: potatoes, carrots, beets, broccoli, zucchini, pumpkin;
• Dairy products: yogurt, kefir, cottage cheese;
• Fruits and berries: kiwi, apples, pears, bananas, prunes, cranberries;
• Wholemeal breads and crackers;
• Mineral water without gas.

Features of the diet during exacerbation of pancreatitis:

During an exacerbation of pancreatitis for 1-2 days, you must refuse to eat and drink, fast under the supervision of a doctor. After that, they switch to a low-carbohydrate diet, consisting of small portions and easily digestible foods. The ration expands as the condition improves.

Diet pattern Meal routine

9 0383 3-4 meals a day day without breaks during the day

It is important to develop the habit of proper nutrition and monitor the diet in the future to prevent the recurrence of exacerbations of pancreatitis.

Complications of pancreatitis

Infectious complications

Pancreatitis increases the risk of infectious complications. The most dangerous are pneumonia and sepsis. In addition, patients may develop localized peritonitis or abdominal abscess. In the presence of such complications, immediate intervention of the surgeon is necessary.

Dysfunction of other organs

Dysfunction of the pancreas can lead to disruption of other important organs and systems of the body. So, with pancreatitis, a multiple organ syndrome can develop, which leads to dysfunction of the cardiovascular, respiratory, renal and other systems.

Pancreatic necrosis

Pancreatic necrosis is a severe complication of pancreatitis characterized by necrosis of pancreatic tissue. It can occur as a result of an acute form of pancreatitis or as a result of its chronic course. This complication can pose a serious threat to the life of the patient and often requires surgical intervention.

• Conclusion: Complications of pancreatitis can be varied and serious, ranging from infectious complications to severe pancreatic necrosis. Timely diagnosis and treatment can help prevent or reduce the risk of these complications.

Key moments of rehabilitation in inflammation of the pancreas pancreatitis

Strict diet

One of the most important points in the rehabilitation of a patient after pancreatitis is the observance of a strict diet. It is necessary to exclude fatty, spicy, smoked, salty, sweet and alcoholic foods from the diet. It is important to eat small portions and avoid overeating so as not to overload the gland and cause relapses.

Take your medications

From time to time, take medications prescribed by your doctor to reduce pain and improve your general health. In addition, patients may be prescribed enzymes to improve digestion.

Moderate physical activity

After pancreatitis, it is important to slowly return to physical activity, avoiding too intense exercise. Patients are encouraged to engage in moderate jogging, walking, swimming and yoga. Exercises should be chosen taking into account the individual health characteristics of each patient.

Regular visits to doctors

To monitor the condition of the body and timely detection of relapses, patients need to visit a doctor regularly. Doctors conduct the necessary studies aimed at determining the nature of the disease and adjusting the treatment, if necessary.

Stop smoking

Smoking negatively affects the state of the body, especially if there are diseases of the pancreas. Smoking cessation is an important step towards successful rehabilitation and transition to a healthy lifestyle.

Psychological support

Many patients after pancreatitis experience psychological pressure due to pain, dietary and lifestyle restrictions. In such cases, it is important to receive professional psychological support in order to effectively cope with emotional difficulties and prevent the development of depression.

National and international guidelines for the treatment of pancreatitis

Treatment of inflammation of the pancreas, or pancreatitis, depends largely on the form and severity of the disease. National and international guidelines offer different approaches to the treatment of this disease.

Acute pancreatitis often requires hospitalization and medication, which may include certain antibiotics and drugs to control pain.

• International guidelines also suggest the following treatment approaches:
• Surgery to remove diseased pancreatic tissue. Surgery may be needed in case of complications such as abscesses and cysts.
• Initial fluid therapy and reliable monitoring of electrolyte balance. This reduces inflammation and prevents complications.
• Priority is given to pain control, which may be due to the prescription of analgesics and other drugs to relieve pain.

The end result of successful treatment of pancreatitis is the reduction of inflammation, the prevention of complications and the achievement of a stable condition of the patient. Treatment recommendations are designed to reduce the risks and improve the effectiveness of the treatment of patients with this pathology.

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Q&A:

What is pancreatitis?

Pancreatitis is an inflammation of the pancreas that can be acute or chronic. Acute pancreatitis develops suddenly and can cause severe pain, nausea, and vomiting, while chronic pancreatitis develops slowly and can lead to poor pancreatic function.

What are the causes of pancreatitis?

Almost half of the cases of acute pancreatitis are associated with alcohol, and the other half with gallstone disease, i.e. the presence of stones in the gallbladder or in the bile ducts. Chronic pancreatitis can be caused by alcohol, smoking, genetic factors, or other pancreatic disorders.

What are the symptoms associated with pancreatitis?

Acute pancreatitis can cause severe pain in the upper abdomen, nausea, vomiting, fever, and increased heart rate. Chronic pancreatitis may be accompanied by persistent abdominal pain, weight loss, diarrhea, nausea, and vomiting.

How is pancreatitis diagnosed?

Diagnosis of pancreatitis may include blood and urine tests, ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), endoscopic ultrasound (EUS), and celiacography. To confirm the diagnosis, a pancreatic puncture or duodenal infusion cholangiography can also be performed.

How is pancreatitis treated?

Treatment of pancreatitis may include observation without hospitalization, anti-inflammatory drugs, antibiotics, insulin, or other drugs. In some cases, surgery may be required.

How can pancreatitis be prevented?

To prevent pancreatitis, avoid heavy alcohol consumption, eat a healthy diet and stay active. In the case of gallstone disease, it is necessary to carry out timely treatment and regularly undergo monitoring by a doctor.

Pancreatitis: so that the holiday does not end in the hospital…

As part of a decade of prevention of alcohol abuse on New Year’s holidays (from December 26 to January 8)

Interview with Marina Vladimirovna Perekalina, head of the gastroenterology department of the Stavropol Regional Clinical Hospital, Candidate of Medical Sciences, chief freelance gastroenterologist of the Ministry of Health of the UK.

Pancreatitis: so that the holiday doesn’t end in the hospital…

Everyone has heard about seasonal illnesses. We usually get influenza in the winter, and dysentery in the summer. In spring and autumn, chronic ailments, such as rheumatism or gastritis, are statistically more likely to worsen. But there are diseases, the exacerbation of which often occurs not due to seasonality, but to certain holidays. They are sometimes even called “holiday” or “after-holiday”. But despite the beautiful name, there is nothing pleasant and good in them.

Exacerbation of pancreatitis (inflammation of the pancreas) during the New Year holidays, alas, has become a traditional problem. An abundance of fatty foods and alcohol is not at all conducive to the health of this important organ. How to avoid pancreatitis, tells the candidate of medical sciences, head of the gastroenterology department of the Stavropol Regional Hospital, a gastroenterologist of the highest qualification category Marina Perekalina.

— Marina Vladimirovna, what role does the pancreas play in our body?

— Each gland of the human body is unique and irreplaceable in its own way, each performs many functions. However, the pancreas is a special case. This unpaired organ, located behind the stomach in the upper abdomen, is both an exocrine and endocrine gland, that is, a gland of mixed secretion. The pancreas produces a number of important enzymes – substances necessary for digestion. They contain components that break down fats – lipase, proteins – trypsin and carbohydrates – amylase. In addition, it is the only organ that produces insulin, a hormone that regulates carbohydrate and fat metabolism.

It is worth noting that no other body is able to take on these functions. And therefore, when the pancreas fails, in a matter of days or even hours, all other organs can die. Which leads to very sad consequences, even death.

— Everyone knows that one of the most common pathologies of the pancreas is pancreatitis. Tell us more about this disease?

– Pancreatitis is an inflammation of the pancreas. During the day, the pancreas produces up to 1 liter of pancreatic juice, which has a huge digestive capacity. These substances, necessary for food processing, simply must be chemically active, if not aggressive. In cases where these enzymes cannot fully enter the duodenum, they are activated right inside the gland, causing inflammation and damage to the organ, because in fact it begins to digest itself. This leads to an inflammatory process, swelling, and then, if adequate treatment is not carried out, to the mass death of functional cells, that is, pancreatic necrosis.

There are two types of pancreatitis – acute and chronic. Acute pancreatitis develops just in the case when activated pancreatic enzymes penetrate into the tissue of the gland itself. Chronic pancreatitis most often develops after suffering acute pancreatitis, or this ailment has become a concomitant disease of ulcers, cholecystitis, gastritis or other diseases. Both acute and chronic pancreatitis require immediate treatment.

– At what age and who usually encounters these problems?

– Pancreatitis is a fairly common disease. Moreover, recently there has been an increase in patients suffering from this disease: in adults, the incidence has increased by 3 times, and in adolescents – by 4 times. And yet, such a diagnosis is more often put on people of middle and old age, more often women than men.

— And what causes the pancreas to become inflamed?

– The main cause of pancreatitis – 68-70 percent – alcohol abuse. The greatest harm to the pancreas is caused by daily or very frequent use of alcoholic beverages, even weak ones – beer, wine. In second place – 25 percent – cholelithiasis and surgical interventions on the gastrointestinal tract. In third place is an unbalanced diet, especially the abuse of fatty foods. In isolated cases, the disease can manifest itself after trauma, viral infections, allergies, stress, peptic ulcer, various poisonings, as well as congenital anomalies of the structure.

— What are the main symptoms of this disease?

— In acute cases, it is difficult not to notice pancreatitis. Severe pain in the upper abdomen, radiating to the back – such pains are called girdle pains, vomiting that does not bring relief, heart palpitations – all these are symptoms of inflammation that has begun in the pancreas.

Signs of chronic pancreatitis are less obvious. 30-40 minutes after eating, abdominal pain and mild nausea may occur. People often lose weight, although they eat enough and with appetite. They suffer from flatulence and diarrhea. However, chronic pancreatitis sometimes occurs without symptoms, so that a person learns about its presence only when an exacerbation occurs. And it is not much different from the manifestations of an acute variety of the disease.

If you or someone close to you has such an attack, call an ambulance immediately.

In mild cases, the main principle of the treatment of pancreatitis can be summarized in three words – cold, hunger and rest. For several days, you will have to refrain from food, only mineral water without gas, rosehip broth and weak tea are allowed. Mandatory bed rest and cold compresses on the upper abdomen.

However, this does not mean that you can cope with acute pancreatitis on your own. Treatment should be carried out in a hospital: it is necessary that the doctor monitor your condition. Most often, the patient is in the surgical department of a medical facility. And only after stabilization of the patient’s condition, they are transferred to the gastroenterological department or discharged home, having prescribed treatment, but always under the supervision of a doctor.

— And what would be recommended to the patient?

– In chronic pancreatitis, and even after a single acute attack, doctors usually prescribe enzyme preparations and antispasmodics. But in the treatment and prevention of exacerbation of pancreatitis, diet is much more important. Eat little and often. In chronic pancreatitis, doctors advise five to six meals a day, at about the same time. Warm vegetarian soups, lean beef steam cutlets, rabbit and chicken meat, lean fish and cottage cheese are allowed. Plus boiled vegetables, baked fruits. After a while, the diet is supplemented with other useful products. But in any case, they exclude fatty meats, fried meats and sausages, pies and puff pastry rolls, meat, fish and mushroom soups, borscht, okroshka, eggs. Banned chocolate, ice cream, sodas, mayonnaise and ketchup, Korean snacks and spices. It is desirable that the food be thermally processed, it should not be very cold or very hot. Naturally, alcohol is excluded. Follow the diet, depending on the severity of the disease, will have from three weeks to a year. Otherwise, complications cannot be avoided.

— What complications does pancreatitis cause?

– As mentioned above, none of the organs can take over the functions of the pancreas, so the sooner the patient begins treatment, the less damage will be done to the body.

Possible complications of pancreatitis are diabetes mellitus, inflammation of the abdominal cavity or peritonitis, pseudocysts and cysts of the pancreas, renal failure, hypoxia, respiratory failure, exhaustion, chronic pain syndrome, impaired flow of bile and pancreatic juice, vitamin and mineral deficiencies, congestion fluid in the abdominal cavity, pancreatic cancer.

— Unfortunately, healthy people who do not have digestive problems rarely think about the prevention of pancreatic diseases. But pancreatitis, like other diseases, is much easier to prevent than to cure…

— Of course. Moreover, the measures for the prevention of pancreatitis are quite simple, they correspond to the basic principles of a healthy lifestyle. Infrequent and moderate alcohol consumption, a healthy diet, physical activity – this is enough to keep the pancreas healthy. And one more thing: if you don’t want to get sick, stop smoking. Pancreatitis in heavy smokers occurs about 5 years earlier than in non-smokers. And the risk of developing neoplasms in the pancreas in smokers is 2-3 times higher. You also need to be regularly examined for the presence of stones in the gallbladder.

– New Year’s Eve is just around the corner, a feast, alcohol … How can you avoid being in a hospital bed after the holidays?

— Enemy number one is not the New Year’s menu as such, but the amount of food that we are accustomed to consume at the festive table. Therefore, rule number – follow the measure! Eat small meals without mixing a large number of different foods in one meal.