Features of treatment of pancreatitis in a hospital setting


Causes

  • Gallbladder diseases.
  • Drinking alcoholic beverages.
  • Diseases of the stomach and intestines.
  • Abdominal injuries.
  • The presence of worms and the toxins they secrete.
  • Incorrect treatment with medications.
  • Overweight.

There are several types of pancreas problems.

  • Reactive pancreatitis. The cause of this disease is considered to be a disorder of the gastrointestinal tract. During an exacerbation, intense pain appears under the left rib.
  • Acute pancreatitis. Severe pain appears after certain factors: drinking alcoholic beverages the day before, spicy, fried or salty foods. And also after poisoning with preservatives or spoiled products. The patient's condition deteriorates very quickly. It is in this form that the symptoms of pancreatitis in a woman after 30 years of age are diagnosed. The pancreas must be treated for problems that are just beginning.
  • Chronic pancreatitis. If a person repeatedly avoids treatment for pancreatitis, then gradually he leads his body to chronic manifestations of pancreatitis.

Prevention

You should stop drinking alcohol, as they are the main factor in the development of pancreatitis. Ethyl alcohol molecules, regardless of quantity, affect gland cells.

Don't smoke: nicotine and tar affect the organ. In people who have such a bad habit, exacerbation of the chronic form develops more often. Another element of prevention is proper nutrition. It is not necessary to immediately use a strict diet; it is enough to exclude harmful foods.

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Treatment of pancreatitis in a hospital: indications for hospitalization, length of stay, types of therapy

Hospitalization is necessary for a severe attack of acute pancreatitis, which cannot be controlled with painkillers at home. After the patient is delivered, he is transferred from the clinic’s emergency department to the intensive care ward. Treatment is carried out with the mandatory participation of an anesthesiologist and resuscitator.

Acute pancreatitis is treated as follows:

  1. First, doctors relieve the patient’s pain and various nervous and reflex disorders with the help of analgesics. For this, the drugs Baralgin, Promedol, Analgin, etc. are used. Novocaine blockade can be used.
  2. To combat hypertension in the bile ducts, doctors use No-shpu, Nitroglycerin and other drugs.
  3. The pancreas needs to be unloaded, so the patient is prescribed fasting. He should take alkaline drinks, such as Borjomi.
  4. In combination with the above measures, the prevention and treatment of blood clots in the vessels of various organs (pancreas, liver, etc.) is carried out.

To prevent the condition of a patient with pancreatitis from worsening due to intoxication, the performance of the heart and lungs is checked, and then drainage and gastric lavage are performed. This procedure is carried out with a solution of soda, Pyrroxan or Obzidan are used.

It is not always possible to cope with attacks of acute pancreatitis on your own at home.

They may be accompanied by a significant deterioration in health, acute pain, nausea, vomiting and even loss of consciousness. In such cases, hospitalization and treatment under medical supervision are necessary.

Failure to provide medical care in a timely manner at such a clinic can result in the development of complications, as well as death.

Pancreatitis is an inflammation of the pancreas, in which the digestive enzymes produced by the gland cannot enter the intestine to digest food and, as a result, begin to digest the tissue of the parenchymal organ. It turns out that the gland “eats” itself.

This is a very serious and dangerous disease that requires qualified medical care. The disease can occur in two forms: chronic and acute.

Usually, treatment of the disease takes place at home, according to the regimen prescribed by the doctor. However, the development of acute pancreatitis or exacerbation of a chronic disease may be accompanied by attacks with severe painful symptoms.

Untimely medical intervention during acute attacks of the disease can lead to the development of complications, disability and even death of the victim.

Thus, the indication for hospitalization of a patient with pancreatic inflammation is the development of an acute attack, which is accompanied by severe pain and a significant deterioration in well-being.

Nausea and profuse vomiting (especially with bile) can also be alarming symptoms. If they occur, it is recommended to consult a doctor as soon as possible.

Symptoms of an acute attack of pancreatic inflammation include:

  • Severe pain in the right hypochondrium, as well as slightly above the navel;
  • Vomit;
  • Diarrhea;
  • Temperature rise to 38 degrees or higher;
  • Tachycardia.

If an acute attack of pancreatitis occurs, before the ambulance arrives, under no circumstances should you:

  1. Take painkillers and antiemetics.
  2. Bandage the subcostal area.
  3. Apply hot, warm or any warming compresses to the painful area.
  4. Drink any drinks except a small amount of water.

The patient should be placed on a sofa or bed in a reclining state, a cool cloth or heating pad should be applied to the sore spot, and fresh air should be allowed into the room.

Upon arrival, the ambulance team, after analyzing the symptoms and general condition of the patient, will provide first aid to the victim.

In order to relieve pain, the patient is usually given an injection with Papaverine diluted with saline solution.

In order for treatment to be effective, it is very important to give the patient a correct diagnosis and find out the sensitivity of his body to certain medications. For this purpose, the patient may be prescribed the following types of diagnostics:

  • blood and urine tests;
  • hemogram (to determine the development of the inflammatory process based on leukocyte indicators);
  • CT or MRI;
  • ECG;
  • blood biochemistry (to determine whether there are pancreatic enzymes in the blood);
  • Ultrasound (to identify the source of inflammation);
  • emergency laparoscopy (for purulent pancreatitis, development of serious complications).

Based on the results of the examination, the doctor confirms or denies the presence of pancreatic disease, establishes its form, the extent of damage to the organ, whether other digestive organs are affected, whether there is a risk of complications, and also decides on the appropriate treatment methods in this case.

Treatment of pancreatitis in the hospital depends on the stage of the disease at which the patient was admitted to the hospital and the presence of complications. From the emergency department the patient is sent to the intensive care unit. Ambulance specialists can also deliver the patient to the gastroenterology department.

At the same time, doctors at the stage of a person’s admission to the department have two main tasks:

  • stabilize the patient’s condition, stop the attack;
  • prevent the development of complications.

And only after completing these tasks, doctors begin to treat the disease.

If a person collapses with an attack of severe purulent, necrotizing pancreatitis, he is immediately sent to the intensive care unit for urgent surgical intervention under the supervision of a resuscitator or surgeon.

After providing emergency care and complete stabilization of health, the patient is immediately transferred to the gastroenterology or surgery department, where he will be under the supervision of a gastroenterologist or surgeon, respectively.

At the time of discharge, the person receives recommendations for continuing the prescribed therapy at home, and is also informed about the need for regular monitoring with a local physician. Maintenance therapy lasts another six months.

How long people stay in the hospital with pancreatitis depends on the form, stage of the disease, the nature of its course and the presence of complications.

In acute form

The acute course of the disease generally lasts from two to seven days. In this case, the first two or three days are considered the most difficult and responsible, since the patient’s condition needs to be stabilized. During this period, there remains a high risk of complications with a fatal outcome, so it is characterized by the most intensive therapy. The patient may be on a drip for the first few days.

If an acute form of pancreatic inflammation develops or an exacerbation of a chronic disease occurs, the patient may remain in the hospital for 7(10) to 14 days. The duration of treatment is also influenced by the effectiveness of the selected therapy.

If surgical intervention is necessary, after the operation the patient usually spends another week in the day ward, and after discharge he must periodically visit the doctor for one and a half to two months.

Treatment of pancreatitis in a hospital in its chronic form is carried out mainly in case of exacerbation of the disease. The duration of hospitalization may take from one to two weeks.

https://www.youtube.com/watch?v=0ysXodb2OGw

In general, treatment for chronic pancreatic inflammation can take years. Therapy takes place at home, and during periods of acute attacks, a hospital stay under the supervision of doctors is definitely required.

The standard of treatment for pancreatitis in a hospital involves the following actions:

  1. Relieving pain syndrome.
  2. Relieving spasms of the smooth muscles of the pancreas.
  3. Elimination of puffiness.
  4. Stopping the activity of digestive enzymes of the gland.
  5. Therapy of the disease.
  6. Normalization of digestion.
  7. Elimination of side effects of drugs.

How is pancreatitis treated in the hospital? This question interests many patients with long-standing inflammation of the pancreas. Doctors prescribe medication therapy (including IVs, injections), diet and surgery. The use of traditional methods in hospitals is not practiced.

In most cases, pancreatitis is treated with medications. However, the first step in treating the disease will be to ensure pancreatic rest. For this, the patient is prescribed water fasting. For 3-4 days he is prohibited from eating anything except mineral still water (it is advisable to drink it slightly chilled).

In addition, a catheter can be installed in the patient’s stomach for several days, through which its contents will be released.

Treatment of the disease involves the use of the following drugs:

  • Diuretics, to remove fluid and eliminate swelling.
  • Painkillers (Novocaine, Promedol, Lexir, etc.).
  • Antispasmodics to relieve spasms of the smooth muscles of the gland (No-shpa).
  • Antienzymes that suppress the production of gland secretions to renew its tissues
  • Drugs may be prescribed to prevent thrombosis in blood vessels.
  • For purulent processes, antibiotics are prescribed.
  • Drugs aimed at restoring normal gastrointestinal acidity.
  • Vitamin therapy for general strengthening of the body, raising tone and immunity.

Medicines must be taken strictly according to the dosage prescribed by the doctor so as not to harm the body. At the same time, it is necessary to take medications that will support the functioning of the liver and kidneys, since during the treatment period they are subject to enormous stress.

To detoxify the body from medications, gastric lavage is performed with a soda solution.

Throughout the entire period of treatment, protein, electrolyte, and carbohydrate metabolism are monitored.

If necrotic processes have already begun in the gland, surgical intervention is performed. There are three ways to operate the pancreas:

  • Removal of the tail and body of the gland.
  • Removal of the tail, body and part of the head of the gland.
  • Removing fluid formations from the pancreas and washing it.

The operation is performed under general anesthesia in the surgery department. Subject to stable health, after 1-2 weeks the patient is transferred to home treatment, lasting on average 1.5-2 months.

Emergency

Chronic form

In the chronic form, an inflammatory-degenerative process develops in the body. One can distinguish recurrent, painful, latent or indurative types of chronic pancreatitis.

Often chronic pancreatitis is accompanied by other diseases of the gastrointestinal tract, which include:

  • gastritis;
  • ulcer;
  • cholecystitis;
  • hepatitis.

If a person is diagnosed with a chronic type of disease, then to suppress the main symptoms he needs to take medications and follow a strict diet, which will save the patient from relapse. The timing of chronic pancreatitis and its exacerbation directly depends on correctly selected therapy. People often live with this disease for many years.

This form of pancreatitis is characterized by the appearance of girdling pain, which radiates to the right or left hypochondrium. In some cases, the pain syndrome becomes permanent.

The patient suffers from belching, nausea, decreased appetite, vomiting, and unstable bowel movements. Pain intensifies when eating fatty foods and heavy physical activity.

In terms of treatment time, pathology occupies a leading place among other gastrointestinal diseases. This is due to the increased sensitivity of the pancreas, which reacts to junk food and alcohol. The duration of chronic pancreatitis is increased by concomitant diseases of the digestive system, which are also chronic.

Depending on the frequency of exacerbations, the following types of chronic pancreatitis are distinguished:

  • rarely recurrent, when exacerbations occur no more than 2 times a year;
  • often recurrent, when exacerbations occur in a person 2 to 4 times in 12 months;
  • persistent - means the constant presence of complaints, characteristic changes in tests and ultrasound.

On average, an exacerbation of chronic pancreatitis lasts 2-3 weeks, which depends on the severity of the process, the prevalence of inflammation and the condition of the human body. Without treatment, the disease will progress and the risk of complications will increase.

Treatment is usually prescribed for 4 weeks, the effectiveness of which is monitored by the patient’s complaints, the results of laboratory and instrumental studies (ultrasound, biochemical blood test).

This type of disease is characterized by immediate development and the appearance of symptoms. The main cause of an attack is food that has an irritating effect. As a result, the pancreatic ducts are blocked, leading to the digestion of the organ itself by enzymes. Since the development of symptoms is acute, the patient will require assistance from medical personnel.

After contacting an ambulance, treatment will be prescribed, during which the attack of pain will be relieved. Analgesics and antispasmodics are prescribed. The attack does not last long: with complete rest, the disease subsides after three to four days.

Treatment of pancreatitis is selected exclusively by the doctor, based on concomitant diseases, general condition and characteristics of the patient’s body. The use of traditional medicine methods is also permitted with the permission of a specialist. It is important to remember that the pancreas is a sensitive organ that responds with the development of discomfort to the slightest irritant.

https://www.youtube.com/watch?v=yhZmBH39VDE

Therapy for this disease is aimed at reducing the amount of bile. Pancreatitis of the pancreas, the treatment of which is limited to the use of special tablets, will give a temporary result. And if, in addition to this, the patient eats properly and follows a diet, then this will be an almost 100% guarantee of successful recovery.

But let us now dwell on the drugs that help fight this disease.

So, medications that help relieve muscle spasm:

  1. These are pancreatic pills. Pancreatitis is treated with the following antispasmodics: “No-shpa”, “Spazmoverin”, “Spazmol”.
  2. Substance for the preparation of dosage forms "Papaverine".

The following drugs reduce the secretion of gastric juice:

  1. Omeprazole capsules.
  2. Tablets "Ranitidine", "Famotidine".

The following drugs normalize the digestion process and regulate the functions of the pancreas. “Allohol”, “Pancreatin”, “Phenipentol” are tablets for the pancreas. Pancreatitis is not a death sentence.

Also, for the treatment of pancreatitis, drugs are prescribed that inhibit the production of pancreatic enzymes. Among such drugs, Aprotinin solution is often used.

If there is severe pain or a person loses weight, then hospitalization and further therapy are possible strictly under the supervision of specialists. Surgical intervention is prescribed if the pancreas is no longer subject to treatment. Treatment and diet will not help with severe damage. Only removing one part of it will save it from further destruction.

It cannot be said that after drug treatment there is a complete recovery. It’s sad to say, but pancreatitis cannot be completely cured. But in order to prevent the pancreas from further destruction, it is important to undergo treatment, as well as follow a strict diet, which was described above.

Typically, this type of disease can be successfully treated on an outpatient basis or at home. Only conservative treatment is used, to which a special diet is added. But there is an exception - the phases of exacerbation of the disease, when the remedies prescribed by the doctor are powerless. Treatment of chronic pancreatitis in the hospital is usually carried out with medication: it is treated in the same way as pancreatitis in the acute stage is treated.

Planned therapy is also carried out: all patients must go to the hospital twice a year. The entire course takes no more than 3.5 weeks. First of all, the body is cleansed of toxins and wastes; for this, the stomach is washed and enemas are given. The next stage is a three-day fast, during which the patient is under constant supervision. After examination, depending on the condition, sorbents, diuretics and anti-inflammatory drugs are prescribed.

Symptoms

Symptoms of pancreatitis

The pancreas is a relatively small organ, but it performs a number of vital functions for the body. For example, the production of enzymes for the breakdown of products. When the gland malfunctions, enzymes remain in its ducts, thereby disrupting its functioning. What symptoms can occur with inflammation of the pancreas?

  • Fever. It indicates the presence of an inflammatory process. Indicators can be very high. It is necessary to treat not only the symptoms, but also the organ itself.
  • The pressure can become either very high or very low. With the intensive development of the disease, the patient notices a sharp change in pressure figures.
  • Nausea, belching, dry mouth, hiccups are all symptoms that indicate problems with the pancreas. If you only eliminate the symptoms, the treatment may be delayed.
  • Painful sensations. This is the very first symptom that occurs. The pain can be acute, constant, and sometimes changes to dull. They can be so intense that they even cause painful shock. Pain with pancreatitis is considered stronger than even with a heart attack. With partial inflammation of the pancreas, pain appears under the right or left rib, and with complete inflammation - around the waist. In case of severe pain, it is recommended to consult a doctor, and he will choose how to treat chronic pancreatitis.
  • Vomiting with bile. A person cannot eat anything at this time. Fasting during an exacerbation period leads to faster recovery of the body.
  • Change in complexion. The skin becomes pale at first, and then a gray, earthy hue. Facial features become more and more pointed.
  • Sticky sweat.
  • Shortness of breath associated with vomiting.
  • You may first notice the presence of a yellow coating on the tongue.
  • Constipation or diarrhea treatment at home. A sudden change in stool with an unpleasant odor and particles of food that has not been digested. Acute pancreatitis and loose stools are characterized by foamy discharge. But another situation is also possible. This is constipation, which is accompanied by bloating. The stomach becomes hard.
  • Change in skin color. For example, the lower back and area around the navel may take on a bluish, sometimes marbled tint. The lower abdomen and groin area become greenish-blue.
  • Manifestations of obstructive jaundice. Due to the increase in the size of the pancreas, compression of the gallbladder occurs and yellowing of the skin and sclera occurs.

If symptoms are detected, it is necessary to urgently call an ambulance, since pancreatitis causes very severe pain, and this can be fatal. Treatment for acute pancreatitis on your own is also not recommended.

First aid for an attack

The first step when pain in the right hypochondrium, nausea, vomiting and other symptoms of pancreatitis appears is to call an ambulance at home. While waiting for the doctor, you will need to complete the following steps:

  1. Place the patient on a bed or sofa in a comfortable position.
  2. Apply a heating pad or a bottle filled with cold water and ice to the painful area.
  3. Ventilate the room.
  4. Have an empty basin or other container ready in case of excessive vomiting.

It is not recommended to take painkillers, soda solution or any medications on your own during an attack. You should also not drink any liquid, not even water.

Treatment of pancreatitis in a hospital: indications for hospitalization, length of stay, types of therapy

The operation is prescribed if the patient has developed complications, signs of jaundice, pain that cannot be relieved with medications, despite long-term treatment.

Indirect types of surgery on the bile ducts or stomach and intestines can be used. If necessary, surgery is performed to drain the cysts, remove stones, and sometimes pancreatic resection may be necessary.

Many patients want to know how many days it takes to treat acute pancreatitis. Typically, hospital treatment lasts from 7 to 10 days, and then he is discharged, but the person undergoes maintenance therapy for another 6 months.

If the disease has taken severe forms, then after 2-3 days of intensive treatment the patient should remain under the supervision of doctors for about 1.5-2 months.

For chronic types of pancreatitis, the patient (if he does not need surgery or is in remission) stays in a medical institution for 1 day for examination.

How many days patients remain in bed after surgery depends on the type of surgical intervention and the recovery ability of the patient’s body. Usually this period does not exceed 7 days. After this, the person is transferred to home treatment, which lasts 1.5-2 months. He takes medications, follows a diet, and exercises.

Hospitalization of a patient with an acute form

If emergency doctors suggest hospitalization during an attack of illness, it is highly not recommended to refuse, since pancreatitis cannot be cured at home, and a trip to the doctor may be delayed. As soon as the patient enters the medical facility, he undergoes a medical examination consisting of the following procedures:

  • measuring body pressure and temperature;
  • initial examination and palpation of painful areas;
  • examination of blood tests (for the level of leukocytes and enzymes);
  • Ultrasound examination;
  • laparoscopy (in some cases).

Other procedures and consultations with doctors in other fields may also be necessary to identify the causes and intensity of inflammatory processes. Only after a comprehensive diagnosis is therapy prescribed, and the patient is placed in a ward for long-term observation.

The hospital prescribes this treatment

  • To reduce swelling, diuretics are prescribed. They help reduce enzymes in the blood, as well as the spread of toxins throughout the body. These may be medications added to an IV or taken separately in tablets.
  • Drugs that are used intravenously: contrical reopolyglucin, saline solution.
  • Omeprazole - tablets or quamatel - droppers.
  • Tablets to reduce spasms.
  • If the disease is advanced and has entered the purulent stage, then antibiotics are prescribed.
  • In acute conditions - enzyme inhibitors.
  • Treatment in hospital
    Medicines to relieve pain or stop vomiting.
  • To maintain the body during dehydration caused by vomiting or diarrhea, it is necessary to take vitamins.
  • The first days the patient does not eat and drinks only warm still water. In case of prolonged pancreatitis, when the patient has been fasting for several weeks, the doctor prescribes parenteral nutrition.
  • Only when the functioning of the pancreas has significantly improved is one allowed to eat something. First it is yogurt, then cottage cheese, and after a few days he may be on a special diet.
  • A state of complete rest. This will help reduce blood circulation to all organs, including the pancreas.
  • It is necessary to treat pancreatitis not until the symptoms are eliminated, but until this problem is solved once and for all.

In acute pancreatitis, the pain is so severe that it must be relieved with the help of narcotic analgesics.

There are cases in which it is necessary to remove the affected area of ​​the pancreas through surgery. Additionally, the abdominal cavity is washed.

When the acute period has passed, the patient is recommended diet No. 5. It consists of fractional meals - up to 8 times a day. Everything should be pureed, boiled or steamed. Food should be warm, but not hot or cold. You should not eat fried, smoked or salted foods; products, in copious quantities. But you should not take diet as the main treatment. You should also avoid drinking alcohol while you are undergoing treatment.

Acceptable products include: rye crackers soaked in water; porridge cooked in water, pureed zucchini, pumpkin, carrots, potatoes; puddings, jelly. Nothing else is allowed to be eaten. It is unacceptable to drink alcoholic beverages even in small doses.

What is done in the treatment of acute pancreatic damage?

  • Rest of the pancreas. If vomiting and pain are present, the doctor prescribes fasting, which must be followed for 3-4 days. A catheter is also installed through which the contents of the stomach are released for 1-4 days. The patient should take antacids and drink mineral water, preferably cold. In severe cases, blockers are administered to the patient.
  • Elimination of puffiness. To stimulate diuresis, the patient is given diuretics, this is done intravenously. A cold pack is also included.
  • Anesthesia. To relieve pain, novocaine blockades and analgesics are prescribed. It is worth noting that narcotic drugs can also be used. To eliminate hypertension in the bile ducts, antispasmodics are used, which dilate blood vessels.
  • Enzyme activity. To suppress their movement, substances are used that prevent the chemical reaction. Antienzymes in large dosages normalize processes in the pancreas and renew organ tissue.


In some cases, treatment involves fasting

If a serious situation with intoxication occurs, treatment is prescribed taking into account the characteristics of the person.

  • Therapy. Antibiotics are used only for purulent complications. Basically, bicomponent preparations are used, which have the ability to accumulate active substances in their natural form.
  • Metabolism. To normalize metabolic processes, it is necessary to ensure acid and water balance. To do this, soda, saline and plasma solutions are administered.
  • Detoxification of the body. If necessary and the patient's condition requires it, thoracic duct drainage or dialysis is performed.


Various solutions can be administered to maintain water balance.

Diet for chronic pancreatitis

The diet for this disease is very unpleasant - it excludes all tasty foods. For example, chocolate, coffee, mushrooms, shish kebab, fried foods, smoked meats. Vegetables and fruits are boiled or baked, and then turned into pulp using a blender or meat grinder.

You need to eat several times a day. One meal should fit in a glass. But you should not allow yourself to feel hungry, so meals should be repeated at least once every three hours.

If the patient does not violate the diet, then painful sensations may not bother him. You need to know how to relieve pain if you don’t eat properly.

  • Doctors prescribe drugs to relieve pain - Drotaverine, No-shpa. But if the pain does not stop within 24 hours, it is necessary to urgently call an ambulance.
  • Drugs to eliminate spasms in the gastrointestinal tract.
  • Medicines with a diuretic effect to reduce swelling.

Buckwheat diet for pancreatitis
There is also an effective method for treating the pancreas.

Day one, two and three. Boil buckwheat powder in whey for 3 minutes. You need to take a tablespoon every hour. You don't need to eat anything else on this day.

Days four and five. Replace whey with low-calorie milk. You can eat this porridge as much as you like. Time is also not important. The main rule is that a person cannot starve.

Day six. Porridge with whey is consumed in the morning and evening, and during the day you can eat your favorite food.

Using these recipes you can treat the pancreas. But it is easier to do prevention than to treat.

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