Treatment of pancreatitis

Apr 14, 2012 , Jiří Dyntr

lecba-zanetu-slinivky-brisni.jpg - kopie
lecba-zanetu-slinivky-brisni.jpg - kopie
Treatment of pancreatitis results in relieving pain, ensuring adequate intake of fluids and food, often intravenously. All measures should lead to avoiding shock, which threatens the patient's life. In the next phase of the treatment of pancreatitis patient's eating habits have to be changed; consumption of certain foods must be limited. Despite all the efforts of excellence for the treatment of pancreatitis, more than half of the patients die due to the disease.

Treatment of pancreatitis

Pancreatitis is a very serious disease with many unpleasant symptoms. It belongs among the acute abdomen conditions and may even threaten the patient's life. Therefore early diagnosis is extremely important in order to start treatment. It is the only way to significantly improve the patient's health and often save his life. Whether it is acute or chronic pancreatitis, hospitalization is always necessary and continuous monitoring of the blood circulation, breathing and kidney function. The major task for the medical team is to evaluate the severity of the disease, its causes and risk factors to which the patient was exposed. Only then can the treatment be properly directed.

Causes of pancreatitis

Pancreatitis or inflammation of the pancreas is caused due to the retention of digestive enzymes in the pancreas. They are formed in the exocrine part of the pancreas, while the endocrine part produces hormones insulin and glucagon involved in carbohydrate metabolism. Activated enzymes in the pancreas cause swelling and lead to self-digestion of the pancreas. This condition occurs most frequently due to gallstones that are stuck in the common duct of the pancreas and gallbladder. The second most common cause of pancreatitis is chronic consumption of alcohol, which stimulates the secretion of digestive enzymes.

Symptoms of pancreatitis

Pancreatitis can be acute or chronic. The acute form is manifested by severe pain in the upper abdomen that radiates into the back and under the scapula. Furthermore are present nausea, vomiting, often high temperature, increased heart rate, rapid breathing and also disorientation. The chronic form is also manifested by pain in the lower abdomen, usually after meals, and patients also lose weight.

Treatment of pancreatitis

For milder forms of pancreatitis, which accounts for about 80% of all cases, it is sufficient to administer painkillers and maintain an adequate fluid volume in the body. However, if the patient's life is endangered by various complications, a number of other methods are used since the provided care must be comprehensive and very intense. It is essential to support the heart and the circulatory system by drugs, to ensure adequate tissue congestion and prevent shock. Also monitored are fluid intake and output and the kidneys that prevent complications from reduced volume of fluids in the body. Usually fluid supply is necessary, but not to overload the heart.

Fluid intake

Fluid intake is essential and the first step in the treatment of pancreatitis. This is necessary primarily because of the disorder of microcirculation and vascular permeability during pancreatitis. The fluid then gets out of them and lowers the volume circulating in the blood vessels. This condition is called hypovolemia and hypoperfusion. Tissues have low blood supply.

Diet

Proper diet has a significant role in the therapy of especially acute pancreatitis. The food can be given to the patient orally virtually anytime if he tolerates food. It is served as soon as possible in the aftermath of pain and disorders of passage. If food can not be served through the mouth, it is possible to introduce a nasogastric probe and serve food this way.

Antibiotic prophylaxis

Since pancreatitis in 3-4 weeks can result in necrosis of the tissue, its death, this region has an increased risk of infection. Therefore, prophylactic antibiotics are administered, but generally only in cases where there is a significant circulatory failure, sepsis, or after a traumatic inflammation of the pancreas. Opinions on the use of antibiotic prophylaxis in pancreatitis are various.

Adjusting diet

In addition to the above mentioned treatment methods adjusting diet is also emphasized. Patients should avoid alcohol and fatty foods, especially in single high doses. At the same time it is recommended to follow a healthy diet, especially rich and balanced, but to remember some restrictions that come with the disease. Despite intensive therapy and good cooperation of the patient is pancreatitis a very serious condition that even with hospitalization in high-end hospitals ends in 60% of cases with death.

Pharmacological treatment

Pharmacological treatment consists of painkiller administration, so-called analgesics. Mostly are served opiates like buprenorphine, pentazocine or fentanyl. If the inflammation is long, often there is an insufficient production of digestive enzymes, which are necessary to be replaced by medication. Since compromised may be also the area of the pancreas, which produces insulin, it is necessary to administer this hormone by injections or tablets.

Surgical treatment

Surgical treatment of pancreatitis consists of the removal of necrotic tissue of the organ i.e. that is already dead. If the cause of pancreatitis is a gallstone stuck in the bile ducts, or in the pancreatic duct, it is necessary to remove this obstacle.

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