What is pancreatitis?

Ancient Greek doctors called the pancreas "pancreas" - "all of meat." Its role in the body is unusually great: it provides digestion, participates in the regulation of energy metabolism and other important processes.

For example, pancreatic enzymes help digest proteins, fats and carbohydrates in the intestine. And hormones of the pancreas (insulin, glucagon and others) - regulate the level of glucose in the blood.

Pancreatitis is an inflammation of the pancreas. The disease can occur in acute (rapidly and rapidly) or chronic (long and sluggish) form, with periods of exacerbation of chronic pancreatitis.

Causes of pancreatitis

The use of alcohol and gallbladder disease (primarily cholelithiasis) in 95-98% of cases are the causes of pancreatitis. Other risk factors that can cause inflammation of the pancreas:

  • Diseases of the duodenum (duodenitis, peptic ulcer disease);
  • Operations on the stomach and biliary tract;
  • Trauma, injured stomach;
  • Endoscopic retrograde cholangiopancreatography (ERCP);
  • Taking certain medications (furosemide, estrogens, antibiotics, sulfonamides, etc.);
  • Infection (epidemic parotitis (mumps), viral hepatitis B, C, etc.);
  • Parasitic infestations (ascaridosis);
  • Anatomical abnormalities of the pancreatic duct (constriction, tumors, etc.);
  • metabolic disease;
  • A change in the hormonal background;
  • Cardiovascular diseases;
  • Hereditary predisposition (so-called hereditary pancreatitis).

Approximately 30% of patients can not establish the cause of acute pancreatitis.

What's happening?

Inactive in the pancreas, inactive precursors of enzymes are produced - their transition into the active form occurs directly in the duodenum, where they enter the duct of the pancreas and the common bile duct.

Under the influence of various factors (for example, the stone clogging the bile duct) the pressure in the duct of the pancreas rises, the outflow of its secretion is broken, and premature activation of the enzymes occurs. As a result, instead of digesting food, enzymes begin to digest the pancreas itself. An acute inflammation develops.

With chronic pancreatitis, the normal pancreatic tissue is gradually replaced by cicatricial, the exocrine deficiency (the development of enzymes) and the endocrine (development of hormones, including insulin) of the gland functions develop.

How is it manifested?

The main symptom of acute pancreatitis is severe pain in the upper abdomen (epigastric region, right or left hypochondrium), as a rule, shingles. The pain is not eliminated by spasmolytics (no-shpa) and analgesics. Often noted vomiting, stool, weakness, dizziness. In the biochemical analysis of blood in pancreatitis, the level of alpha-amylase is increased 10-fold. The main signs of pancreatitis on ultrasound (ultrasound) of the pancreas - a change in shape and uneven edges, may be the presence of cysts.

Illness is severe. A lethal outcome is possible.

In chronic pancreatitis, the patient, in the first place, is concerned with pain. They are localized in the "epigastric" region, often extending into the left and right hypochondrium and giving in the back. Often the pain is shrouded, it increases, if you lie on your back, and weaken, if you sit down and lean forward slightly. The pain occurs or worsens 40-60 minutes after eating (especially after abundant, fatty, fried, spicy food). "Echoes" of pain can reach the heart area, imitating angina.

Other unpleasant signs of pancreatitis are diarrhea. The stool becomes mushy, and can contain particles of undigested food. The amount of feces is greatly increased. It has an unpleasant smell, a gray tint, a greasy look, is heavily washed off the walls of the toilet bowl. There may be an eructation, nausea, episodic vomiting, flatulence. A man loses his appetite and quickly grows thin.

Complications

Quite often pancreatitis is associated with cholecystitis (inflammation of the gallbladder), and, on the contrary, cholecystitis can provoke the development of pancreatitis. Often with acute pancreatitis, an infection (purulent complications) is attached. Develops phlegmon or abscess of the pancreas. In some cases, intra-abdominal bleeding develops. Another formidable complication of pancreatitis is the destruction of the pancreas and the development of deadly peritonitis.

After acute pancreatitis, the disease becomes chronic. Exacerbation of chronic pancreatitis, as a rule, provokes irritating food, alcohol. Chronic pancreatitis can cause diabetes.