Chronic pancreatitis - treatment for exacerbation and remission

Chronic pancreatitis is a disease of the pancreas of an inflammatory nature with a change in the patency of its ducts. With prolonged course of pancreatitis, sclerosis of the parenchyma of the organ develops and the loss of its exocrine and endocrine function. In the development of the disease, great importance is played by diseases of the digestive system. Therefore, if chronic pancreatitis is detected, treatment of the disease should be carried out in conjunction with the treatment of other concomitant pathologies. Therapy of pancreatitis is continuous, systematic, continuous during exacerbation and remission.

Chronic pancreatitis: treatment in the acute stage

The exacerbation of the disease manifests itself in a pronounced clinical picture, an intense pain syndrome. In a period of severe exacerbation, chronic pancreatitis should be treated in a hospital. It is necessary to eliminate all causes and pathogenetic mechanisms of the development of the disease. Elimination of the causes leading to the appearance of symptoms of the disease includes sanation of the gallbladder and bile ducts, treatment of acute and chronic diseases of the stomach, complete refusal of alcohol.

In the first days of treatment, in order to suppress the secretion of the pancreas, complete fasting and an alkaline drink are prescribed, for which warm, still mineral water is used. In addition to diet, cold on the epigastric region, emotional and physical rest, constant aspiration of gastric juice aspiration is mandatory. To improve the outflow of juice produced by the pancreas, antispasmodics and anticholinergics are prescribed (preparations of No-shpa, Platifillin, Baralgin, Atropin, Papaverin). In order to reduce the stimulating effect of gastric juice, antacids (Almagel, Fosfalugel), H2 receptor blockers (drugs Ranitidine, Kvamatel) and proton pump inhibitors (Omeprazol drug) are also prescribed. To reduce the activity of proteolytic enzymes, they are administered a suppressive administration of their inhibitors (preparations "Kontrikal", "Trasilol", "Gordoks").

Diuretics in chronic pancreatitis are prescribed not only as diuretics for reducing intoxication by removing degradation products, but also for the purpose of inhibiting the activity of pancreatic enzymes. A similar effect is provided by epsilon-aminocaproic acid and protein hydrolysates.

With an intense pain syndrome, the appointment of various analgesics is indicated. The use of narcotic analgesics is contraindicated. To correct the disorders of microcirculation and water-salt metabolism use rheopolyglucin, other saline solutions.

With exocrine insufficiency for the purpose of substitution therapy, enzyme preparations are used (Pancreatin, Festal, Mezim).

With destructive forms of pancreatitis intravenously injected cytostatics (drugs "Cyclophosphamide", "fluorouracil").

If the hormonal function of the gland is insufficient, insulin or tableted hypoglycemic drugs are used.

To prevent purulent inflammation, antibiotics are prescribed.

Now we know what to treat pancreatitis in the period of exacerbation. But this disease has a chronic course and no less important is the treatment in the stage of remission, since this will prevent the appearance of acute symptoms and the further development of the disease.

Chronic pancreatitis: treatment in remission

Treatment of chronic pancreatitis in the phase of remission consists in the prevention of diseases that promote its development, and their timely treatment. Pathogenetic therapy in the phase of remission consists in the normalization of gastric secretion, the exclusion of dyskinesia biliary tract, as well as stimulation of regenerative processes in the pancreas. For this purpose, dietary nutrition with restriction of fats and an increase in the protein content is prescribed. To improve protein metabolism against the background of a protein diet, anabolic steroids are prescribed (preparations "Retabolil," Nerobol ") .In the presence of moderate intrasecretory insufficiency and mild diabetes mellitus, the use of carbohydrates is limited.If glycemia is not normalized, insulin preparations are prescribed.The patient should completely stop using Alcohol, throughout life adhere to a rational diet.

Chronic pancreatitis, the treatment of which is carried out in accordance with the foregoing, often turns into a prolonged remission, is not accompanied by the development of complications.