Reactive pancreatitis in adults: symptoms and treatment. What can be included in the menu? Traditional recipes for reactive pancreatitis

Spicy, cutting pain With right side, which does not allow you to make even the slightest movement. It is difficult for adults to bear, but the disease does not spare children either. These symptoms are reactive pancreatitis, or inflammation of the pancreas. This condition requires emergency medical care, since it is impossible to alleviate it on your own. The prognosis, if you ignore professional medical intervention, is the most unfavorable.

What is the danger of the disease

Reactive pancreatitis- this is a powerful “bomb” inside the body, destroying it with lightning speed. Any ignoring professional help threatens fatal. During an attack, the pancreas stops producing enzymes and pancreatic juice for the normal functioning of the gastrointestinal tract. There is a release of toxins into the human blood, which leads to acute intoxication. Blood contaminated with toxins quickly affects the brain, lungs, liver, kidneys, and heart.

Treatment of reactive pancreatitis should be carried out immediately. Otherwise, it threatens with new pathologies. It can be:

phlegmon of the pancreas;
abscess in the pancreas;
inflammation of the gallbladder;
abdominal bleeding;
peritonitis;
necrosis.

All these consequences, like the inflammatory process in the pancreas itself, develop rapidly. Within a few hours, irreversible processes can begin in the body, leading to disability or death.

Symptoms and causes of the disease

With reactive pancreatitis in children, the symptoms resemble poisoning and appendicitis. This:

nausea;
vomit;
diarrhea;
unpleasant belching;
bloating;
lack of appetite;
cutting severe pain.

In the acute course of the disease it is noted heat. There are quite a lot of reasons that provoked the attack. These may be infectious and chronic diseases gastrointestinal tract, pathology digestive system, eating disorders, food poisoning, alcohol intoxication. Treatment of reactive pancreatitis is aimed at eliminating the causes that provoked the attack. It is carried out only in a hospital setting. It is impossible to localize an attack at home, because the patient needs a thorough diagnostic examination.

Diagnostics

Taking an anamnesis is a rather lengthy process. To alleviate the patient’s suffering, upon arrival at a medical facility, he may be given antispasmodics that temporarily relieve pain syndrome. During the first conversation with the doctor, the patient’s lifestyle, food intake, presence of gastrointestinal diseases, and use of medications are clarified. Only after this the patient undergoes an examination, which includes:

general and biochemical blood test;
Analysis of urine;
Ultrasound of organs abdominal cavity;
X-ray;
tomography.

After receiving the data laboratory examination diagnosed by a doctor final diagnosis, and treatment is prescribed.

Treatment of reactive pancreatitis

If reactive pancreatitis is detected, symptoms and treatment are expected to be long-term, in a hospital setting. Treatment of reactive pancreatitis in children and adults begins with complete fasting. No products may be consumed except mineral water without gas. Against this background, the patient is regularly administered glucose.

Important! Reactive pancreatitis can only be treated in a hospital. The consequences can be very sad, including disability and death.

After taking a medical history and identifying the causes that provoked the disease, treatment is prescribed. First of all, this is fasting for at least five days and drug therapy, including:

antispasmodics (No-shpa, Analgin);
enzyme therapy;
antibiotics;
non-steroidal drugs;
carminative medications;
means that reduce flatulence;
glucose.

There are many drugs introduced into the body, so most often this is done intravenously by drip. The patient feels relief after the first dropper. This condition gives patients confidence in recovery, which can provoke a desire to leave the hospital. This cannot be done, as the treatment will be lengthy.

At least five days are necessary to relieve the signs of acute inflammatory process. If this process is stopped, the pathology will develop further and will appear in the very near future more severe symptoms. It is necessary to understand that reactive pancreatitis has acute symptoms and the treatment will be long.

IN in rare cases shown surgical intervention. This is necessary in situations where the degree of damage to the pancreas is high, the presence of cysts or neoplasms is determined, and parenteral venous administration of medications is necessary.

On the first day, only acute pain can be relieved; serious treatment, which sometimes needs to be stretched out for the rest of your life. Non-compliance with the diet, violation of the diet, consumption of fatty, fried foods, alcohol and stress can provoke an exacerbation, and the pathology will manifest itself with new strength. Reactive pancreatitis can be cured, but only with strict adherence to the recommendations of the attending physician.

Diets and foods for reactive pancreatitis

The danger of this pathology is that it is completely impossible to cure this disease. Minor stress or taking medications for a common cold can already provoke new sign diseases. The gland reacts very negatively to the above factors. Therefore, whether a new attack occurs or not depends on the patient himself or on his parents, if this is a child.

The principle of nutrition, regardless of whether it is an adult or a child, is no different. It is necessary to completely remove spicy, salty, fried, and fatty foods from the diet. Sweet drinks with carbonation are strictly prohibited. Only healthy food made from the following products:

The diet can be much more varied. But these should be foods low in carbohydrates. The emphasis is on protein nutrition. Food is consumed in small portions in 5-6 meals and only warm. Cold or hot dishes can irritate the organ, disrupt the digestive system, cause inflammation and another acute attack.

Time-tested means traditional medicine give a positive result in complex treatment reactive pancreatitis. However, the disease cannot be cured acute stage using only traditional methods. Therefore, doctors recommend using them in complex treatment and further using them as a prophylactic agent.

Some decoctions and infusions can stop an approaching attack. But if this happens, it is better to see a doctor and or at least change your diet. Otherwise, a new stage of the disease may begin to develop with renewed vigor. Any attack is provoked by poor diet, alcohol and stress. Only then can you sin on everything else.

What an adult body can accept is not always perceived by a child’s body. This is the only type of pancreatitis that affects the children's pancreas. Never give any decoctions to children without consulting your doctor. The child may experience vomiting and nausea, which will again cause another attack.

If children completely change their diet and stop drinking soda and fast foods, the disease will not return. But this must be practiced constantly. As preventive measures, young patients are allowed to:

drink pomegranate juice three times a day for one month;
eat blueberries and black currants twisted in a meat grinder with an equal amount of honey;
drink fruit drinks, lingonberry jelly;
fruit jellies with minimal sugar content, which is better replaced with honey.

Important! Honey and honey products may cause allergies in children; they should be used with caution.

Conclusion

If a child has an attack of reactive pancreatitis, then the parents have only themselves to blame. But after treatment, it is necessary to have a conversation and explain that it is now impossible to live and eat as before - otherwise the attack may recur. All kinds of muffins, sweet cakes, and carbonated drinks should be excluded. These are the main provocateurs for the child’s body.

It is important to control the amount of food you eat. You need to eat foods slowly, in small portions and not overeat. Competent therapy and preventive actions will help you quickly forget about the horrors that come with reactive pancreatitis. Take care of the health of your children and be healthy yourself!

Reactive pancreatitis is an inflammation of the pancreas caused by other diseases. Read more about what reactive pancreatitis is. What are the symptoms of reactive rancreatitis? Treatment, diet, herbal medicine of reactive pancreatitis.

Reactive pancreatitis - what is this disease?

Pancreatitis is inflammation of the pancreas ( pancreas -pancreas, itis- inflammation).

The word “reactive” is translated as “coming as a response to any impact.” (primary factor)

The primary process (factor) provokes the beginning of the secondary process. Primary factor may be alcohol, cholelithiasis, gastritis, etc.

Reactive pancreatitis is an inflammation of the pancreas provoked by another disease or factor (primary disease)

Thus,

REACTIVE pancreatitis is a response of the pancreas to other diseases, dietary errors, alcohol, medications, adverse factors and stress.

Causes of reactive pancreatitis

and not necessarily strong drinks
chronic diseases (alcoholism, cholelithiasis, gastritis, duodenal diseases, etc.)
binge eating;
eating disorders (fatty and spicy food, highly carbonated drinks, hot dogs and fast food);
uncontrolled use of medications (for example, paracytomol, metronidazole, furosemide, etc.);
smoking;
frequent and prolonged stress;
abdominal injuries resulting in tissue rupture.

Reactive pancreatitis Symptoms

Symptoms of reactive pancreatitis are similar to those of acute pancreatitis

sudden burning pain;
localization of pain - above the navel, in the left hypochondrium, in the pit of the stomach, often of a shingles nature.

The localization of pain depends on the location of the inflammatory process in the pancreas:

with inflammation of the body of the pancreas - epigastric pain,
with inflammation of the head of the pancreas - pain in the right hypochondrium,
with inflammation of the tail of the pancreas, pain in the left hypochondrium.

the pain decreases if you take a sitting position and bend your torso forward;
belching, nausea, vomiting of gastric contents are observed;
chills and increased body temperature in the first hours after the onset of the disease;
There is no appetite, there is an aversion to spicy and fatty foods.

It is difficult to overcome an attack of reactive pancreatitis at home. Requires treatment in a medical facility.

Diagnosis of reactive pancreatitis

Diagnosis of reactive pancreatitis is made through a patient interview, medical checkup, and several tests, including blood, stool, computed tomography (CT), endoscopic retrograde cholangiopancreatography (ERCP), and magnetic resonance imaging (MRI).

1. History taking is one of the main methods of medical examination. By questioning the patient or persons who know the patient a medical history is compiled. The anamnesis data includes information about the manifestation of the disease and current diseases, existing chronic and allergic diseases, about living conditions, about hereditary factors. Medical history, a set of information obtained during a medical examination by questioning the person being examined and/or people who know him. Anamnesis is carried out to determine methods of diagnosis and treatment of patients.

The medical worker finds out about the presence of cholelithiasis, inflammation of the gallbladder, and pancreas. Finds out what medications the patient has used previously. About addiction alcoholic drinks. Have or have not had previous abdominal surgery, heart surgery or abdominal trauma
2. Blood tests. Clinical and biochemical blood tests.

If the level of leukocytes is elevated, this indicates an inflammatory process in the body.
If the level of amylase and lipase (these are pancreatic enzymes involved in digestion) is increased, this indicates pathological processes in the pancreas.

3. CT scan(CT)- this is the most accurate and informative method pancreas studies. Computed tomography - it is x-ray method research. But a computed tomogram is 1000 times more informative than a regular x-ray. An X-ray produces a static image. Using a computed tomogram, layer-by-layer images are obtained with a step of 0.8 mm. Ultimately, black and white cross-sectional images are obtained on the computer monitor in any necessary projection.

There is a technique for “enhancing” the image of a CT scan. For this they use intravenous administration X-ray contrast agents.

4. Ultrasound.. Stones in gallbladder do not always appear on CT scans. In order to detect stones in the gall bladder, the doctor usually prescribes an ultrasound scan.

5. Endoscopic Retrograde Cholangiopancreatography (ERCP)
An ERCP, or specialized x-ray of the bile ducts, allows the doctor to diagnose problems in the liver, bile ducts, gallbladder and pancreas, including pancreatitis. ERCP is used to determine the cause of inflammation of the pancreas and prevent possible exacerbations pancreatitis.

The endoscope is equipped with a light source, camera and working channel. Through the working channel, small instruments can be inserted into the target organ for various necessary manipulations (take tissue samples for biopsy, remove fluid, etc.) When performing ERCP, a contrast agent, which is clearly visible on x-rays.

6. Fibroesophagogastroduodenoscopy. Using fibroesophagogastroduodenoscopy, it is possible to determine the degree of inflammation and the need for a biopsy. It is performed under local or general anesthesia.

7. X-ray of the abdominal cavity.

8. Urinalysis.

All of these procedures are important, and each of them helps determine the extent of damage to the abdominal cavity. Clinical analysis blood is necessary to detect the number of leukocytes; during illness, its level increases. A biochemical blood test shows how elevated the level of the amylase enzyme is and allows for a final diagnosis.

Using gastroscopy, the doctor can take material for a biopsy, as well as determine the degree of inflammation of the stomach and duodenum. Ultrasound of the abdominal cavity is used to determine what changes from the norm have occurred in duodenum and organs of the gastrointestinal tract. For overall assessment the state of the body, doctors conduct a computed tomography scan.

Treatment of reactive pancreatitis

REACTIVE pancreatitis requires immediate treatment.
Treatment should be carried out under the supervision of a physician.
Self-treatment disease often leads to the transition of this form of the disease to chronic

I. Treatment of reactive pancreatitis begins with establishing the causes of inflammation of the pancreas (history).

And it is clear that treatment of a diseased organ is impossible without eliminating the root cause that caused this disease - removing stones for cholelithiasis, removing intoxication or treating alcoholism for an alcoholic root cause, consulting a psychologist or psychiatrist for stressful conditions etc

II. Drug treatment: painkillers, antispasmodics, enzymes.

The main tactics for treating reactive pancreatitis:

elimination of pain syndrome;
giving rest to the inflamed pancreas;
the appointment of enzymes that replace pancreatic juice enzymes during the normal functioning of the pancreas;
diet No. 5p for pancreatitis

Diet for reactive pancreatitis

III. The diet should be strictly followed. Diet for reactive pancreatitis plays a therapeutic role.

The principles of dietary nutrition for reactive pancreatitis remain the same as for acute and chronic pancreatitis. This was written in detail in the article ""
It is necessary to monitor the quality of the diet, in terms of the content of fats, proteins, carbohydrates:

Food should be low-fat (up to 70-80 g), low-calorie, portions should be small, the temperature of the dish should be 40-60 degrees. Eat regularly, 5-6 times a day. Prohibited dishes and products: fatty, spicy, containing coarse fiber.
In dietary nutrition for reactive pancreatitis, follow

Is it possible to cure reactive pancreatitis with folk remedies?

Reactive pancreatitis can be cured completely folk remedies impossible. However, knowing healing power plants can maintain a state of remission and chronic and reactive pancreatitis.

In order to effectively use traditional medicine in the fight against reactive pancreatitis, it is necessary to select preparations in such a way that they have a healing effect on both the pancreas and the root cause of reactive pancreatitis.

You can see what plants heal the pancreas in the article “”

With the help of herbal medicine, long-term remission can be achieved. with reactive pancreatitis.

Reactive pancreatitis is an acute, aseptic inflammation of the pancreas tissue caused by pathology of other digestive organs (liver, gall bladder, stomach or intestines).

The peculiarity of the disease is rapid improvement conditions during therapy. Disease code by international classification 10th revision - K86. Women most often face this problem. This is due to the development cholelithiasis. Reactive hepatitis can be diagnosed in children and adolescents.

Types of reactive pancreatitis

Inflammation of the pancreas occurs in mild or severe form. In the first case, interstitial edema of the organ tissue develops. Gland dysfunction is minimal. This pathology It is easy to treat and proceeds favorably.

The severe form of pancreatitis is characterized by the development local complications. Such patients are subject to mandatory hospitalization.

Depending on the etiological factor The following types of pancreatitis are distinguished:

iatrogenic (occurring after surgery);
toxic;
traumatic;
systemic;
medicinal;
associated with pathology of the gastrointestinal tract.

Separately, nutritional inflammation is distinguished.

Exacerbation

There are phases of exacerbation and remission.

Exacerbations are the result of a gland reaction in response to exposure unfavorable factors. There may be several of them throughout the year.

Acute course of the disease

The acute form of pancreatitis develops almost immediately after exposure to the etiological factor. The attack can last several hours or even days.

Causes

Reactive inflammation of the pancreas is caused by:

cirrhosis of the liver;
stones in the gallbladder cavity;
cholecystitis;
viral hepatitis;
chronic gastritis in the acute phase;
acute and chronic intestinal infections;
biliary dyskinesia;
abuse of spicy and fatty foods;
binge eating;
poisoning by various poisons;
food intoxication;
endoscopic examination biliary tract;
systemic diseases;
blunt and penetrating abdominal injuries;
ethanol and decomposition products of this substance;
taking toxic medications;
chronic gastroduodenitis;
performing cholangiopancreatography.

Reactive pancreatitis is based on the early production and activation of pancreatic enzymes (amylase, lipase, trypsin, protease). This leads to their accumulation in the lumen of the organ and tissue damage. Common cause stagnation of pancreatic juice is cholelithiasis (cholelithiasis).

Stones lead to spasm and irritation of the bile duct and duodenal papilla.

This causes a narrowing (stricture) of the common bile duct, which leads to stagnation of enzymes in the pancreatic duct. The pressure in it increases and the acini (excretory ducts) are damaged.

Symptoms of reactive pancreatitis

The following symptoms are characteristic of reactive pancreatitis:

Pain. Feels in the left hypochondrium or epigastric region. With total inflammation of the gland, it becomes encircling. The pain radiates to the shoulder blade or back on the left side. It is constant and intensifies when the person lies on his back. Pain of mild or moderate intensity. It increases after drinking alcohol or fatty foods.
Flatulence (bloating). The reason is a disruption in the process of digesting food.
Nausea.
Transient vomiting. Vomit in reactive inflammation contains pieces of food, mucus and bile. After vomiting, pain may intensify.
Low-grade body temperature. Observed when severe course diseases. It is caused by enzymes entering the bloodstream.
Pallor skin with a yellowish tint.
Reduced blood pressure.
Frequent (above 80 beats/min) heartbeat.

Along with these symptoms, signs of a concomitant disease that has caused reactive inflammation (gastritis, cholelithiasis, hepatitis) may be disturbing.

Observed: cloudy urine, yellowing of the sclera, discoloration of stool, diarrhea, rash, enlarged liver and biliary colic.

Diagnostics

The diagnosis of reactive pancreatitis is made by a doctor based on the results of a survey, physical examination (percussion, palpation, auscultation), laboratory and instrumental studies. You will need:

cholangiopancreatography;
abdominal organs;
CT or MRI;
FEGDS;
angiography;
radiography;
laparoscopy;
general and blood tests;
analyzes and;
definition specific symptoms(Mayo-Robson, Pasternatsky, peritoneal irritation).

When making a diagnosis, the gastroenterologist must identify possible factors risk and exclude other pathologies.

Ultrasound

With reactive inflammation, ultrasound reveals swelling and enlargement of the gland. Stones may also be found in the gallbladder and ducts.

Tomography

Tomography allows you to thoroughly assess the condition of the tissues of the abdominal organs and accurately determine the size, quantity and location of stones.

Analyzes

A blood test for reactive pancreatitis reveals the following changes:

increasing the concentration of trypsin and amylase inhibitor;
increased elastase in the first days of the disease;
acceleration of ESR;
increased leukocyte levels;
decreased calcium;
increase in sugar.

If the cause is hepatitis or cholecystitis, then increased content total bilirubin and liver enzymes.

Urine with reactive inflammation often contains large amounts of amylase.

Treatment

The main aspects of patient therapy are:

elimination of pancreatic edema;
prevention of complications;
elimination of the etiological factor;
normalization of secretory activity;
detoxification of the body.

Patients are hospitalized in the gastroenterology department. Rest and temporary abstinence from food are required. In case of acute pain syndrome, blockades can be performed. Applying ice to the projection area of the pancreas helps.

Reactive pancreatitis: symptoms, treatment and diet

What can you eat if you have pancreatitis?

Surgical method

Indications for surgical treatment reactive inflammation are:

the presence of stones in the bile ducts or bladder;
stenosis of the duodenal papilla;
pancreatic duct stones.

For this pathology you may need:

removal of stones endoscopically;
dissection of the papilla of Vater of the duodenum;
drainage.

Surgery for reactive pancreatitis is rarely required.

Drug therapy

For this pathology, the following medications can be used:

Proteolysis inhibitors (Aprotex). These medications reduce the synthesis of pancreatic enzymes. Aprotex inhibits plasmin, chymotrypsin and trypsin. Proteolysis inhibitors are contraindicated in individual intolerance, with DIC syndrome, during pregnancy and lactation.
NSAIDs (non-steroidal anti-inflammatory drugs). Help eliminate pain and inflammation. Used in the form of tablets for oral administration or solution.
Antispasmodics. They eliminate spasms of the pancreas and other organs, which reduces pain. Representatives are: Spasmonet, Sparex and Duspatalin.
Narcotic analgesics (Promedol). Prescribed only if there is no effect from simple painkillers. They are addictive.
Enzymes (Festal, Pangrom, Micrasim,). They are used only outside the acute stage.
Carminatives (Espumizan). Helps with bloating.
Choleretic (Urdoxa). They are used for reactive inflammation of the pancreas against the background of cholelithiasis to facilitate the separation of bile. They have a hepatoprotective effect. These medications are contraindicated in cases of severe pancreatic dysfunction.
Antiemetics (Torekan).
Blockers proton pump(Rabiet,).
Antacids (Almagel, Gaviscon, Phosphalugel). Prescribed for heartburn when pancreatitis is caused by peptic ulcer or hyperacid gastritis.

In case of reactive inflammation of the pancreas, infusion therapy may be necessary.

Saline and protein solutions are prescribed. If the cause of the disease is hepatitis, then hepatoprotectors (Heptral, Gepabene, etc.) are included in the treatment regimen. For reactive inflammation against the background of a peptic ulcer, bismuth preparations are prescribed.

For pancreatitis caused by poisoning, antidiarrheal drugs, sorbents, eubiotics and antimicrobials are used. In case of reactive damage to the pancreas non-infectious nature systemic antibiotics are not assigned.

Diet

In the first 2-3 days from the onset of the attack, it is required. The patient is allowed herbal and non-carbonated drinks. In mild cases, it is immediately prescribed therapeutic diet. It involves restricting the diet of proteins and fats. Meals should be fractional (5-6 times a day).

Products need to be baked, boiled or steamed. Preference is given to pureed and semi-liquid food. It is recommended to eat vegetables, lean soups, boiled lean meat and fish, cereals and. You need to give up spicy, fried and fatty foods, as well as alcohol.

Folk remedies

For reactive pancreatitis, various are useful. Folk remedies include:

yarrow;
immortelle;
calendula;
chamomile flowers;
sage;
horsetail;
barberry bark;
wormwood;
mint;
series.

You can pour 50 g of golden mustache leaves with boiling water and cook them for about 20 minutes. After this, the broth should be allowed to brew for 12 hours. It is recommended to drink 50 ml of liquid 2-3 times a day before meals. Treatment of reactive pancreatitis with juice is widely practiced. raw potatoes and propolis.

Features of reactive pancreatitis in children

Reactive inflammation in childhood most often caused by errors in nutrition (consumption of chips and carbonated water, long intervals, improper introduction of complementary foods), the use of chewing gum, acute respiratory viral infections, injuries and poisoning.

Young children with pancreatitis become whiny. Their appetite may decrease and their body temperature may increase. Clinical picture in children it is practically no different from that in adults.

In young children, symptoms may be mild.

All about reactive pancreatitis in children.

Prevention

The main measures to prevent reactive pancreatitis are:

timely treatment and prevention of hepatitis, cholecystitis, gastritis and peptic ulcer;
periodic examination by a gastroenterologist;
eating only fresh foods;
poisoning prevention;
to give up smoking;
prevention of abdominal injuries;
rational use of systemic medications (antibiotics, cytostatics, corticosteroids);
increased physical activity;
compliance with technique when carrying out medical manipulations(cholecystopancreatography);
refusal of alcoholic drinks;
maintaining equal intervals between meals;
exclusion from the menu of fatty and spicy dishes, as well as sparkling water;
limiting the consumption of coffee, confectionery and bakery products, canned food, sausages and smoked meats.

There is no specific prevention of reactive inflammation.

Consequences

Complications of this pathology are:

abscess formation;
bleeding;
transition of the disease to chronic form;
tissue necrosis;
peritonitis;

Most often, reactive inflammation ends in recovery.

Acute aseptic inflammation of the pancreas, developing along with pathology of the entire gastrointestinal tract, is called reactive pancreatitis.

It is characterized by a sharp deterioration of symptoms, increased girdle pain in all abdomen, the appearance of fever and indicators general poisoning.

Pancreatitis is diagnosed reactive nature taking anamnesis, physical examination of the patient, x-ray examination, ultrasound and endoscopy.

Therapy is supposed to be conservative, based on diet No. 5-p, taking painkillers, analgesics, and enzyme preparations.

Reactive pancreatitis

Reactive pancreatitis is a characteristic response of the pancreas to any pathology of the digestive tract.

The pancreas reacts with acute, sharp pain to sudden changes in diet, to food poisoning, to overload the stomach.

Half of the recorded cases of high reactive state of the pancreas are caused by cholelithiasis.

Statistics indicate that representatives of the female half of humanity often get sick. Reactive pancreatitis is a secondary lesion of the pancreas, it is formed due to diseases of the gastrointestinal tract, their systemic diseases, general poisoning.

A distinctive feature of this disease is the abrupt onset of the disease after the entry of a provoking factor into the body, and a rapid decline in symptoms immediately with the start of therapy, with the transition to strict dietary food.

Causes of reactive pancreatitis

The causes of reactive pancreatitis are diseases of the organs and tracts of the gastrointestinal tract, cholecystitis of the calculous type, chronic gastritis, systemic dyskinesia, infections in the intestines, and helminthic infestations.

The basis of pathogenesis is the early activation of enzymatic synthesis of the pancreas, which damages parenchymal tissue.

A common cause of stagnation of pancreatic secretions in the pancreatic ducts is cholelithiasis. When stones less than 4 mm form, they irritate the tissues of the walls and cause spasms of the smooth muscles of the duct.

If spasms occur constantly, strictures develop on the tissues of the common bile duct, and stenosis of all tissues is formed. Often this process leads to complete obstruction of the ducts with large-sized stones, then complicated stagnation of secretion is formed.

The risk of developing reactive pancreatitis increases significantly if a person has previously been diagnosed with cholelithiasis, gastroduodenitis, or a stomach ulcer.

With a duodenal ulcer, a reflex reflux of intestinal juices into the ducts of the pancreas occurs, due to which fermentation of the pancreas is untimely activated, and it corrodes the parenchyma tissue with its own juices.

Against this background, biochemical processes that regulate resistance to inflammation are activated, but elements of the decomposition of enzymes and juices penetrate into the blood, which is why intoxication processes develop in the pancreas.

Specialists are interested in reactive pancreatitis, the symptoms and treatment of which will give positive dynamics and effective results.

Manifestation of reactive pancreatitis

The clinical picture of reactive pancreatitis is rapidly deteriorating.

Within a few hours from contact with the provoking etiological agent, the human body develops sharp deterioration condition.

Since pancreatitis is often only a secondary pathology, the signs of the main disease sharply worsen.

Main manifestation:

pain of the girdling type, starts from the top of the abdomen, moves to the hypochondrium, spreads to the back, under the shoulder blades;
flatulence increases;
painful heartburn and belching appear;
symptoms of dyspepsia appear.

Vomit usually contains mucus and bile. Vomiting causes high intra-abdominal and intraductal pressure, which causes painful symptoms after vomiting they do not weaken, but intensify.

Reactive pancreatitis, symptoms and treatment are already well known to gastroenterologists, and can be treated with medication. early stage if the patient comes to the doctor on time.

From attack to attack, the symptoms become more complicated, more severe, and then pancreatitis can be cured reactive etiology It will be much harder for both specialists and the patient himself.

A person’s well-being deteriorates due to the massive penetration of enzymatic elements into the bloodstream.

It is from this that symptoms of general intoxication appear; the temperature can rise to subfebrile levels, the skin turns pale, the pulse and blood pressure rise.

Diagnostic measures for reactive pancreatitis

When the first signs of pancreatitis of reactive etiology appear, a thorough examination is required.

Diagnostics include:

clinical and biochemical tests;
coagulogram;
checking the presence of enzyme particles in the blood and urine;
study of elastase levels in the blood.

Typically, in this condition, a person’s blood tests exceed the norms for amylase, trypsin, and elastase.

These indicators last the first few days of illness. At this stage, a physical examination of the patient is indicative, where the doctor sees tachycardia, increased blood pressure, and pasty skin.

On palpation, the abdomen responds with increased pain in its upper part, especially the corner under the left rib. A slight swelling is visible, but the abdomen is palpable and does not show irritation of the peritoneum.

A survey ultrasound of the abdominal cavity is performed, and the condition of the pancreas and biliary tract is specifically studied. Ultrasound today is the safest and most informative diagnostic method.

Ultrasound shows small stones, sand in the bile duct, swelling, and an increase in the anatomical parameters of the pancreas.

The endoscopic method of cholangiopancreatography is used when indicated when a previous examination confirms that the ducts are blocked by stones.

The design of the endoscope has a backlight, a recording camera, and a working channel.

Through the working channel, the doctor introduces necessary tools to take pieces of tissue for biopsy and remove stagnant fluid.

Fibroesophagogastroduodenoscopy is performed using local or general anesthesia, to determine the degree of tissue damage by inflammation. At the same time, the issue of the need for a biopsy is decided.

To clarify the diagnosis and visualize the focus of the pathology in detail, a survey of the abdominal cavity is performed using radiography and CT.

The intravenous administration of a contrast agent improves the CT image. MSCT of the abdominal organs is performed.

If these examination methods prove that there is obstruction of the common bile duct with stones, this is a strict indication for endoscopic RP and choledochoscopy.

When using the ERCP method, the patient is injected with a contrast agent, which gives a clearer picture on x-rays.

Today, these complex examinations are successfully replaced by MRI of the pancreas and bile ducts. She visualizes stones in several projections, determines their size and position in the duct.

Angiography of the celiac trunk is required to confirm increased vascularization of pancreatic tissue.

The acute period requires esophagogastroduodenoscopy for all patients; it shows the presence of concomitant pathologies.

When diagnostic measures are difficult, the doctor performs a laparoscopic examination.

After diagnosis, and sometimes simultaneously with it, doctors already prescribe treatment for reactive pancreatitis.

Treatment of reactive pancreatitis

Target medical prescriptions– primarily relieve pain, relieve swelling during inflammatory processes in the pancreas.

It is important to promptly relieve the symptoms of general poisoning and restore pancreatin secretion. Pass successfully therapeutic measures when the etiological factor of the underlying disease is first eliminated. Treatment of reactive pancreatitis in adults is determined by doctors according to the intensity of the pancreatic pathology.

The acute stage of reactive pancreatitis requires therapeutic fasting 1-2 days. These days you can drink water and infusions of medicinal herbs.

A mild course of the disease does not require fasting, but it is important to follow diet No. 5-p, rich in carbohydrates, with the exception of proteins and fat.

The goal of the diet is to create complete rest of the pancreas so that the synthesis of pancreatic secretions is significantly reduced.

Meals are required in fractional amounts, with crushed food, in small portions. To relieve body intoxication, it is important to drink a lot.

The duration of dietary adherence is assessed according to the individual course of the disease in each patient.

The doctor assesses the level of organ damage and the patient’s well-being. IN specific situations You will need to follow the diet for the rest of your life.

Drinking alcohol and smoking for patients after recovery from reactive pancreatitis is prohibited forever.

In accordance with the symptoms manifested in adults, the doctor will prescribe treatment for pancreatitis of reactive etiology.

These will be Pancreatin, Festal, Mezim, Creon - enzyme substitutes; if necessary, an anesthetic injection will be prescribed.

Severe disease requires the use of narcotic analgesics to eliminate severe cramping pain.

IN inpatient treatment Tramalgon, Baralgin, Ibuprofen are used. Intravenous drips carried out to relieve signs of intoxication.

In a specifically determined course of the disease, a course of antibiotic is prescribed, usually Gentamicin.

A mild course of the disease allows you to relieve spasms with non-steroidal anti-inflammatory antispasmodics, these are Drotaverine, Spazmalgin, Platifillin, No-Shpa, Nise.

According to indications, drugs that reduce flatulence, Espumisan, are prescribed. If the acute course of pancreatitis of a reactive nature is complicated by the presence of cholelithiasis, a specialist will conduct endoscopic removal stones.

How drug therapy, proton pump blockers are used. This is necessary if there is accompanying illnesses associated with hypersecretion. Here doctors use Emanera, Omez, Nolpaza.

These are medications that slow down the synthesis of hydrochloric acid, reducing the load on the pancreas.

When the main diagnosis is a stomach ulcer, medications must be prescribed antibacterial action, stimulating the restoration of internal mucous membranes, which have a rather complex structure.

Severe development of the pathology requires immediate surgical intervention.

Surgical treatment is also used in situations where additional pathology, a complication of the underlying disease, sharply worsening the patient’s condition.

If diagnosed calculous cholecystitis, provoked by pancreatitis of reactive etiology, surgeons remove the organ.

If it is proven by diagnostics that stones are blocking the ducts, specialists also choose surgical treatment.

Possible complications

The acute course of the disease is fraught with serious complications, often resulting in death.

Dangerous complications:

endotoxin type shock;
inflammation of the abdominal cavity;
abscesses, phlegmons;
fistulas in the pancreatic ducts and common bile duct;
necrosis on adjacent organs.

Therefore, when a diagnosis of “inflammation of the pancreas” is made, doctors strive to immediately begin therapeutic measures. Without treatment, inflammation causes irreversible changes in tissues.

Possibility of treatment with traditional medicine

There are many folk ways treatment of reactive inflammation of the pancreas. They, like general therapeutic practice, are aimed at relieving pain symptoms, getting rid of inflammatory processes, and restoring normal organ functions.

Each traditional medicine must receive a doctor’s approval for use.

Most used means:

Pharmacy collection No. 1. It contains the herbs of chamomile, mint, hawthorn berries, and dill seeds. Method of preparation: pour 10 g of collection into 1 cup. boiling water, keep boiling for a couple of ½ hour, cover the dishes, wrap warmly with towels, leave until it cools naturally. Then strain, drink 100 ml 2 times. per day, strictly before meals. Do not leave it for tomorrow, prepare a fresh decoction every day.
Pharmacy collection No. 2. It contains the herbs of St. John's wort, knotweed, birch leaves, corn silk in the ratio 1:1:2:2. Method of preparation: pour 20 g of the collection into 400 ml of boiling water, keep it boiling for a couple of minutes for another ½ hour, cover the dish tightly, wrap it warmly. Let cool naturally. Then strain, drink 100 ml 4 times. per day, always before meals.
A mixture of fresh juices. Method of preparation: mix freshly squeezed carrot and potato juice in equal volumes, add 5 ml of olive oil, drink 4 r. per day, prepare fresh juice each time.
Chamomile tea. Cooking method. For 500 ml of boiling water, take 1 tbsp. l. dry chamomile. Brew like tea, drink 3 r. a day like tea. It reduces inflammation and relieves pain.
Water infusion of propolis. Soothes the pancreas, should be taken on an empty stomach, ½ hour before breakfast. Drink only if there is no acute pain.
Oatmeal jelly. Relieves inflammation in the pancreas. Method of preparation: 50 g of oatmeal, pour 300 ml of cold filtered water. Leave to infuse overnight. In the morning, eat instead of first breakfast.

The duration of taking medicinal herbal remedies depends on the patient’s well-being. If folk remedies help the patient, it can be repeated in courses, as prescribed by a doctor, as a treatment, and as a preventive measure for the correct functioning of the pancreas.

Useful video

Reactive pancreatitis - pathology inflammatory in nature With acute course, affecting the pancreas. An important feature that distinguishes the disease from other pancreatitis is that reactive inflammation always occurs against the background of other diseases of the digestive system. Dysfunction of the liver, stomach, intestines, and gall bladder provoke the development of reactive pancreatitis. The onset of the disease is unexpected and sudden, but after starting treatment the symptoms quickly disappear. The disease does not become chronic.

Pathogenesis

The pancreas plays important role among other organs of the digestive system. Its purpose is to secrete pancreatic juice, necessary for complete digestion of food. Pancreatic juice with its constituent enzymes enters the intestines through the ducts, where it begins to break down food. If there are reasons that cause the reflux of intestinal contents into the pancreatic ducts, premature activation of enzymes occurs - the gland digests itself, leading to the development of reactive processes.

Reactive pancreatitis in the form of a response to disruptions in the gastrointestinal tract occurs against the background of dysfunction of the ducts responsible for the flow of enzymes into the duodenum and small intestine. Inflammation begins after a violation of the patency of the ducts (complete, partial), or as a result of reflux of intestinal masses. The factors that provoke reactive inflammation of the gland are diverse, but primary importance is given to gastrointestinal diseases:

chronic and infectious pathologies stomach, including gastritis, peptic ulcer stomach and duodenum, acute intestinal infections;
liver pathologies - cirrhosis, viral hepatitis;
dysfunction of the gallbladder and biliary tract - cholecystitis, GIB, the presence of stones.

Other risk factors:

obesity, overweight;
regular drinking;
self-medication, prolonged uncontrolled use of medications;
poor nutrition with an abundance of spicy, fatty, fried foods;
frequent stress and anxiety;
abdominal trauma.

Clinical manifestations

Symptoms of reactive pancreatitis make themselves felt a few hours after the influence of a negative factor. First stage The course of the disease includes a set of symptoms of the nature of dyspepsia: the patient suffers from bloating and flatulence, belching with an unpleasant aftertaste, attacks of nausea and heartburn. As the underlying pathology progresses, the course of reactive pancreatitis worsens and pain occurs.

The pain during reactive inflammation is severe and girdling in nature. Location - upper area abdomen with transition to left hypochondrium. The pain often radiates to the back and shoulder blades. The exact location depends on the size of the inflamed area of the pancreas. Reactive pancreatitis is characterized by increased pain after eating, which is associated with excessive release of enzymes.

In the absence of treatment, the patient's condition sharply worsens due to the entry of proteolytic enzymes into the blood - signs of poisoning of the body develop, the temperature rises (low-grade indicators 37°-37.3°), blood pressure drops, and the pulse quickens. Clinical manifestations reactive pancreatitis can be supplemented by a set of symptoms of the primary pathology - sharp pains in the right side with gallstones, fever and diarrhea with intestinal infection, enlarged liver with cirrhosis.

The course of pathology in children

Reactive pancreatitis in children can occur at any age, including infants up to one year old. The reasons are varied and banal - ordinary respiratory infections can become a starting point for reactive processes in the pancreas. U infants the disease often develops due to congenital pathologies structure of the organ and its ducts. Poor nutrition, previous connection to adult food, the lack of a regime provokes inflammation of the pancreas.

The clinical course of the disease in children resembles reactive pancreatitis in adults - severe pain, dyspepsia, signs of intoxication. Additionally, a sick child experiences:

stool disorder - constipation, diarrhea, stool becomes yellow, mucus appears, steatorrhea often develops;
urine becomes deeply dark in color;
the skin may turn yellow;
Newborns and infants experience periods of sudden crying and screaming.

If the child has the slightest complaint of pain in the upper abdomen and left side, or episodes of night restlessness (between 3 and 5 a.m.), parents should consult a doctor. The course of reactive pancreatitis in children is severe and requires emergency care.

Diagnostics

The examination for suspected reactive pancreatitis is complex. At the first stage, the gastroenterologist collects anamnesis by asking about complaints, the presence of other gastrointestinal diseases, lifestyle and diet. Visual inspection patient is based on the study characteristic features- pale skin and mucous membranes, rapid pulse. At digital examination- the stomach is swollen, but not hard; pain in the region of the costovertebral angle on the left (Mayo-Robson symptom).

The list of mandatory diagnostic measures includes:

a blood test for biochemistry and immunology allows you to determine the severity of inflammation; in patients with reactive pancreatitis, leukocytosis, ESR, and the concentration of pancreatic enzymes increase;
echography of the abdominal organs is a reliable method for identifying pathology, allowing to identify swelling and enlargement of the organ, the presence of stones in the bile ducts;
carrying out CT and plain radiograph abdominal cavity - the gold standard in confirming the diagnosis; Carrying out procedures allows you to reliably determine the size and exact localization of inflamed areas;
endoscopic cholangiopancreatography is performed according to strict indications(confirmed fact of blockage of the pancreatic ducts with stones);
Laparoscopy is performed in complicated cases, when other methods are difficult due to the patient’s condition.

After confirmation of the diagnosis, treatment of reactive pancreatitis begins immediately.

Treatment

Treatment tactics depend on the intensity of the inflammatory process in the pancreas. In case of minor manifestations, primary importance in the restoration of the organ is given to the organization of dietary nutrition. In moderate and severe cases, treatment is complex and aimed at relieving swelling, restoring adequate secretory function and eliminating signs of intoxication.

Complex therapy for reactive inflammation of the pancreas:

therapeutic fasting for 24–48 hours is indicated for all patients in the acute stage, only water and herbal teas are allowed;
replacement therapy includes taking enzymes (pancreatin) in the form of capsules and tablets (Mezim, Creon);
painkillers with antispasmodic and analgesic effects (Drotaverine, Nise);
antibiotics (Gentamicin) are indicated for secondary infection;
drugs with a carminative effect for bloating (Espumizan);
strict diet with minimum quantity fat

Nutrition for the sick

A diet for reactive pancreatitis is necessary from the first days of treatment. The main goal of dietary nutrition is to remove excess load from the organ and reduce the activity of secretory processes. To achieve the goal, they use the principle of fractional nutrition - eating small amounts of food at equal time intervals (3–3.5 hours). Admission required large quantity liquids.

The diet for reactive inflammation of the pancreas includes:

cereal soups;
boiled lean meat, white fish, poultry;
white bread in the form of crackers;
pureed milk porridge;
protein steam omelettes;
vegetables with low fiber content (potatoes, broccoli, zucchini) boiled or baked;
oils - butter (up to 15 g per day), sunflower (up to 30 g);
low-fat fermented milk products;
compote, tea, jelly without sugar.

The duration of the diet depends on the individual characteristics of the patient, the degree of organ damage, general health and the main diagnosis. IN certain situations Dietary nutrition is required for life. Alcohol and smoking are strictly prohibited for persons who have suffered reactive pancreatitis.

Traditional medicine against illness

There are many folk ways to combat reactive inflammation of the pancreas. Therapy with folk remedies is aimed at stopping negative symptoms and recovery normal functioning organ. But before treatment with traditional recipes, consultation with a gastroenterologist is necessary.

Popular recipes:

herbal collection No. 1 - mix chamomile raw materials, hawthorn berries, mint leaves and dill seeds in proportions 1: 2: 3: 3, 10 g of the collection are steamed with a glass of boiling water, heated for steam for 30 minutes, left to cool, filter and drink 100 ml twice a day, an hour before meals;
herbal collection No. 2 - mix St. John's wort, knotweed, birch leaf and corn silk in a ratio of 1:1:2:2, 20 g of herbal collection are poured into 400 ml of boiling water, steamed for 25 minutes, allowed to cool and poured in required quantity water to the original volume; drink 100 ml 4 times a day, before meals;
juice therapy - a mixture of freshly squeezed carrot and potato juices in equal volumes, mixed with 5 ml of olive oil, drunk immediately after preparation, frequency of intake - up to 4 times a day.

Duration of admission medicinal infusions and juices for reactive pancreatitis depends on the patient’s condition. If treatment with folk remedies brings relief, it can be repeated periodically in order to prevent and maintain adequate pancreatic function.

Reactive pancreatitis is a disease that always indicates a problem in the gastrointestinal tract. At the first warning signs(pain, loss of appetite, abnormal bowel movements) it is important to consult a doctor immediately. Early diagnosis and adequate treatment can quickly overcome inflammation and completely restore the functions of the pancreas.