Prevention and treatment of chronic pancreatitis

Prevention of chronic pancreatitis is reduced to the timely treatment of diseases, which play an etiologic role in causing diseases (diseases of liver and biliary tracts) and elimination of factors such as chronic intoxications (alcoholism, saturnism etc), and also to the prevention and treatment of diseases of the gastrointestinal tract and ensure the rational nutrition.
Therapy of chronic pancreatitis involves the elimination of the reasons causing the disease, the suppression of the inflammatory process and the possible restoration of the functional activity of pancreas, symptomatic and restorative treatment. More often it is done conservative treatment, it is sometimes necessary and surgical intervention.
In order to suppress the inflammatory process used antibiotics and sulfa drugs. In the period of exacerbation shows the use of trasilol. On the positive effect of trasilol in a joint application with oxytetracycline when exacerbate latent pancreatitis reported Grott and others (1967). About the same is reported by L. Ya. the Gubergrits, E. N. Nechaev, O. K. Holubchenko (1971), received the effect from antifermentny therapy without combination with antibiotics.
The great value has a healing power. The construction concept is determined by the nature of the violation of digestion and metabolism, as well as the phase of the disease. In the period of exacerbation to reduce the exocrine gland activity for several days, it is advisable to exclude oral intake of food and replace it with parenteral introduction 5% glucose solution, izotoniceski solution of sodium chloride, protein hydrolysates, plasma given daily needs of the organism in fluids, salts and vitamins. Such a regime is not complete and should be replaced by oral administration of nutrients. The patient receives the most easily absorbed dishes, there is little incentive pancreatic secretion and rich in vitamins. Fats and proteins are limited. As the remission of acute diet is expanding at the expense of inclusion of carbohydrates, sufficient quantities of proteins, while maintaining restrictions fats. Carbohydrates are introduced in the form of sugar, potatoes and flour dishes, proteins in the form of cheese and tender meats or fish, fats - in the form of milk, cream, eggs, small amount of butter.
Regular intake of large doses of Pancreatin (from 4.0-5.0-25,0 g per day), gastric juice or hydrochloric acid and pepsin and active cholagogue and improves digestion. Prolonged use of inadequate food regime associated with insufficient introduction of nutrients during violated their assimilation, is invalid because it leads to the depletion of the sick and development. they nutritional deficiency. Especially essential to ensure optimal introduction of proteins and vitamins. Currently, there are observations (C. A. Tuzhilin, 1965) about the positive effect on patients with chronic pancreatitis food regimes with an increased content of proteins (up to 140 - 150 g). The appointment of a high-protein diet was accompanied by positive clinical effect and corresponding changes in enzyme systems of blood and duodenal contents.
When carbohydrate metabolism may be necessary in the use of insulin, but it should be borne in mind that, unlike conventional diabetes insulin needs of patients with chronic pancreatitis changes during a short period of time, which may be the cause of unexpected hypoglycemic reactions.
In order to reduce exocrine activity of the pancreas in the period of exacerbation also used drugs. These include atropine, ephedrine, barbiturates, holinolitiki and other Symptomatic treatment is diverse and is mainly aimed at eliminating pain. The use of morphine and other drugs of the opium is inappropriate, because they cause spasm of the sphincter of Oddi and strengthen nausea and vomiting.
For the treatment of pain are injected in, intravenous administration of novocaine procaine blockade, apply papaverine, no-Spa, atropine, procaine, barbiturates, nitroglycerin, and other medications. Patients with chronic pancreatitis in the absence of exacerbation recommended treatment in Essentuki, Zheleznovodsk, Truskavets and on other resorts of a similar profile.
Surgical intervention in chronic pancreatitis is applied in case of failure of conservative treatment, especially when patients suffer severe pain or appear complications: a pseudocyst, sequestration, abstsedirovanie, extensive calcification, stone formation in ducts. Operations are reduced to a partial resection of the pancreas, removal of stones, cut the sphincter, cholecystectomy (if pancreatitis is causally associated with cholecystitis) and others also Proposed operations on the sympathetic and parasympathetic nerves, designed to reduce the increased afferent pathological activity pancreas.