Prevention and treatment of chronic pancreatitis

Complications of chronic pancreatitis can cause gastrointestinal bleeding, jaundice, biliary obstruction, biliary cirrhosis, diabetes . The disease needs early detection and timely treatment.

Pancreatitis comes in two forms: acute pancreatitis and chronic pancreatitis.

In chronic pancreatitis it is divided into 3 types: chronic calcified pancreatitis, chronic pancreatitis and chronic inflammation of the pancreas.

Chronic pancreatitis calcification : The medicine The factor related to chronic calcified pancreatitis is nutrition, in which the cause of alcoholism plays a significant role, followed by a lack of prolonged protein. Alcohol increases the consistency and protein of pancreatic fluids, causing precipitation to occur. If prolonged protein deficiency will cause chronic damage to the pancreatic tissue. If alcohol poisoning is common in developed countries, chronic pancreatitis due to prolonged protein deficiency is common in slow-moving countries.

Chronic pancreatitis is obstructed : Because of pancreatic obstruction or in the shadow vater or at the waist of the pancreas due to narrow ball vater, sometimes due to injury or surgery or a type of tumor that suppresses the pancreatic duct. These causes increased pressure in the pancreas, from which the pancreas is dilated and gradually causes fibrosis around the pancreas.

Chronic pancreatitis due to inflammation: Many causes of pancreatitis cause infection of mononuclear leukocytes causing fibrosis and atrophy of exocrine tissues.

Clinical symptoms of chronic pancreatitis

Clinical manifestations:

- Abdominal pain: Abdominal pain is the most common symptom in most cases of chronic pancreatitis. The patient complained of pain in the navel area to the right, left and pierced back. The pain is not frequent for a few days, sometimes longer and the symptoms disappear for a long time, sometimes months. Symptoms usually appear after a hearty, fatty meal, drinking lots of alcohol. Sometimes the disease occurs after hard work or intense emotions.

Symptoms of pain at the beginning are only dull, abdominal pain, burning in the area above the navel, then pain, the pain increases gradually and there are many consecutive pain. The pain may last for hours. Patients often sit hunched down to relieve abdominal muscles to relieve pain. In addition to pain patients may experience nausea or vomiting.

- Due to a lot of pain and chronic walls, patients do not dare to eat more food, in addition to chronic pancreatitis, the digestive enzymes of the pancreas secrete a lack of absorption of nutrients, so the more makes patients more thin and lose weight.

- Jaundice: Jaundice due to chronic pancreatitis is only mild yellow and for a short time. Jaundice may appear after a few hours of pain, but there is usually no fever (different from jaundice in gallstones, with typical symptoms such as pain, fever, jaundice).

- Symptoms of advanced disorders such as nausea and vomiting occur when there is pain, in addition less obvious.

Clinical examinations in addition to pain rarely detect any specific signs.

Test

- During the pain, blood glucose and amilase enzyme are usually increased within 72 hours. Bile pigments (bilirubin) and yeast phosphatase may also increase.

- In addition, it is possible to quantify manure within 24 hours to see the color of feces and observe under microscope can see some undigested foods, and can quantify fat by chemical or quantitative methods chymotrypsin in the stool but rarely done because of complexity.

- It is also possible to quantify lactoferrin in pancreatic fluid, if the elevation is significant in the diagnosis of chronic pancreatitis.

Supersonic

Today, if a good ultrasound machine and an experienced sonographer, with basic training, will help in diagnosing pancreatitis.

If conditions can be taken, tomography, selective angiography or cholangiography - endoscopic retrograde pancreas will be of great help for early diagnosis and effective support for treatment.

Prognosis of chronic pancreatitis

If not detected early and treated seriously, the disease will get worse. During a chronic illness there may be acute episodes, especially during the first 10 years. After 10 years of progression of the disease can become diabetes. This is a dangerous complication that needs to be considered.

Complications of chronic pancreatitis

- Emerging acute pancreatitis.

- Gastrointestinal bleeding due to pancreatic stones causing damage to nearby blood vessels or by increasing venous pressure of each segment.

- Because the head of the pancreas inserts the main bile duct causing jaundice, biliary obstruction, causing cirrhosis due to bile .

- Diabetes.

- Insert pressing duodenum .

What should I do when I suspect pancreatitis?

Suspected cases of pancreatitis should go to medical facilities that are eligible to be examined and indicated for proper treatment. Under no circumstances should alcohol be addicted. Alcohol in addition to causing injury and causing chronic pancreatitis also causes other adverse consequences.

Associate Professor, Dr. Bui Khac Hau