How a bad lifestyle can lead to pancreatitis

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Pancreatitis – non-infectious inflammatory disease of the pancreas. The pancreas (pancreas) is one of the organs of the digestive system, which has an alveolar-tubular structure. Through the pancreatic ducts, the body secretes pancreatic juice, containing digestive enzymes, into the duodenum, and thus participates in the digestion process. However, under the influence of known factors, inflammation of the pancreatic tissue can rarely develop. In the event that the inflammation becomes long-lasting, irreversible morphological changes develop in the organ (chronic pancreatitis – CP), replacement of normally functioning parenchyma cells with connective tissue, which leads to a violation of the digestive function of the pancreas, as well as hormonal changes (pancreatogenic diabetes mellitus) .

Risk factors for developing pancreatitis are smoking, poor nutrition, and alcohol abuse. Important factors are hereditary, in which case pancreatitis forms at a young age (up to 20 years). Autoimmune pancreatitis, which can develop in isolation or in combination with other autoimmune diseases, is separately identified. Often, pancreatitis develops against the background of gallstone disease. The anatomical feature of the pancreas is the connection of its ducts in their final section with the biliary tract. Therefore, an increase in pressure in the bile ducts leads to a delay in pancreatic juice, which leads to edema and inflammation of the organ tissue. Against this background, the so-called biliary-dependent pancreatitis develops. 

Pancreatitis, like many inflammatory diseases, is manifested mainly by pain. However, often there are only signs of exocrine insufficiency – steatorrhea, due to impaired absorption of fats, which can lead to a deficiency of fat-soluble vitamins. In addition, the clinical manifestations of pancreatitis can be loosening of the stool, flatulence, weight loss. In the later stages of the disease, when a large number of hormone-active pancreatic cells are damaged, diabetes mellitus can form, requiring the observation of an endocrinologist and the appointment of hypoglycemic agents.

Diagnosis of pancreatitis is based on an analysis of complaints, anamnesis, a patient examination, laboratory tests (blood amylase level, feces analysis) and instrumental radiation methods (ultrasound, CT, MRI, MRPHG, ERCP). Which diagnostic method in a particular clinical case is most informative is decided by a specialist doctor (therapist, gastroenterologist). To diagnose steatorrhea, stool elastase-1 is determined using an enzyme-linked immunosorbent assay. An increase in size or wrinkling of the pancreas according to radiation methods for examining the pancreas, increasing the density of the pancreatic tissue, determining calcifications, cysts or pseudocysts of the pancreas indicates chronic pancreatitis. Determination of fasting glucose in blood serum and glycosylated hemoglobin, and in some cases, the use of glucose tolerate test allows you to evaluate the endocrine function of the pancreas.

Complications of pancreatitis can be caused by compression of adjacent organs (the duodenum), blood vessels and ducts of the enlarged pancreas. Also important complications of CP are gastroduodenal ulcers, erosive esophagitis, pancreatic adenocarcinoma, etc. 

When diagnosing chronic pancreatitis, enzymes are prescribed. In the case of persistent complaints, proton pump inhibitors (PPIs) are included in the course of therapy in order to suppress gastric secretion and improve fat absorption. When such a complication of CP is formed, as erosive esophagitis, it is advisable in combination with enzyme therapy to prescribe IPPs and prokinetics (Itomed) to patients to improve motor-evacuation function of the upper gastrointestinal tract. If CP has developed due to the presence of a pathology of the gallbladder (biliary-dependent pancreatitis), then treatment with ursodeoxycholic acid (Ursosan) can be used under the supervision of a specialist. It should be noted that the treatment of chronic pancreatitis is usually carried out on an outpatient basis, however, with a severe course of chronic pancreatitis or the presence of acute pancreatitis, as well as in the case of suspected development of such a formidable complication as pancreatic necrosis, there is a need for hospitalization of the patient and treatment in a hospital. Self-medication can be dangerous, so clearly follow the doctor’s instructions. Replacing even one drug prescribed by a doctor can lead to disastrous consequences. Be healthy! 

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