Diarrhea in acute and chronic pancreatitis: symptoms and treatment

Diarrhea is probably one of the most unpleasant events in our lives, it causes a certain discomfort and often ruins important plans, occurring at the most inopportune moment. The cause of this condition can be food poisoning and nutritional disorders, taking certain medications and eating poor-quality food. However, diarrhea quite often becomes a symptom of gastrointestinal diseases, because such a manifestation of a digestive disorder can be observed with pancreatitis, gastritis, duodenitis, stomach ulcers and duodenal ulcers, colitis, etc. In other words, stool disorders are characteristic of any gastrointestinal pathologies of an inflammatory nature.

Today we will talk about diarrhea, which occurs against the background of chronic inflammation of the pancreas, which produces important digestive enzymes.

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Causes pancreatitis diarrhea

Diarrhea during pancreatitis is a phenomenon that characterizes the functionality of the pancreas. The more often this phenomenon is observed, the worse the condition of the organ.

Gastroenterologists agree that the main cause of diarrhea in chronic pancreatitis is a protracted inflammatory process that negatively affects the production of pancreatic juice, which consists of aggressive enzymes (trypsin, phospholipase, amylase, lactase, etc.), thanks to which food entering the gastrointestinal tract is almost completely digested and absorbed in the intestines in the form of nutrients necessary for the body.

With a deficiency of digestive enzymes, the process of digestion of food in the duodenum is slowed down. The situation is aggravated by the development of biliary dyskinesia against the background of an inflammatory process in the gastrointestinal tract, which reflexively weakens the functionality of the gallbladder and its motility. By the way, the inflammatory process in one of the abdominal organs can spread to other organs, for example, to the gallbladder (cholecystitis - inflammation of the gallbladder), which again affects its contractile function, causing hypotonic dyskinesia (with decreased motility).

Bile, produced in the liver and stored in the gallbladder, acts as a catalyst for pancreatic enzymes and an antimicrobial component. In other words, it activates the digestive function of pancreatic enzymes and prevents putrefaction processes in the duodenum, where bile enters along with pancreatic juice when food enters the body.

Weak functioning of the gallbladder and its ducts causes a shortage of bile in the duodenum, due to which even the insufficient amount of pancreatic juice secreted into the duodenum has low activity. Food remains incompletely digested, and impaired intestinal motility (again due to inflammatory processes in the peritoneum organs) contributes to the appearance of rotting and fermentation processes in the gastrointestinal tract with disruption of the intestinal microflora, which results in characteristic pancreatogenic diarrhea.

Indigestion due to inflammation and lack of digestive enzymes in the gastric and pancreatic juices is the main cause of diarrhea in pancreatitis. However, there are other, less common (secondary) causes that affect the functioning of the pancreas.

Risk factors

Risk factors for the development of diarrhea in patients with pancreatitis may include:

• viral, bacterial and parasitic pathologies of the abdominal organs, causing an imbalance of intestinal microflora,
• vascular pathologies affecting the kinetic function of the digestive organs,
• traumatic injury to the pancreas due to a blow, penetrating wound and surgery,
• diseases of the liver, gallbladder and bile ducts, including the formation of stones,
• taking strong medications (for example, for the treatment of the same cholecystitis), as well as allergic reactions to medications.

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Pathogenesis

Pancreatitis is one of the most dangerous progressive inflammatory pathologies of the gastrointestinal tract, which, if neglected, risks causing irreversible disturbances in the digestive process, which have the most negative impact on the functioning of almost all organs and systems of the body.

In most cases, the inflammatory process in the pancreas with its dysfunction is caused by bad habits. The most common cause of pancreatitis is considered to be alcohol abuse over a long period of time, followed by smoking, known for the negative impact of nicotine on most organs and systems of the body.

The development of pancreatitis can be promoted by: constant overeating, passion for fatty foods, protein-free diets. Complications to the pancreas are caused by many medications, especially with long-term use (some antibiotics, hormonal drugs, strong diuretics used for edema syndrome resulting from cardiovascular pathologies, etc.).

The disease can occur in both acute and chronic forms. Acute pancreatitis can develop against the background of infectious viral diseases caused by cytomegalovirus, hepatitis B and C virus, etc., parasitic infections, pathologies such as intestinal infarction, perforated ulcer of the duodenum, bile duct dyskinesia, chronic and acute cholecystitis, and gallstones.

If therapy is insufficient and the diet is not followed, acute pancreatitis with acute pain in the epigastrium, vomiting, jaundice and constipation very quickly turns into a chronic form, which is characterized by moderate pain on an empty stomach and after a large meal, increasing in the evening, a feeling of heaviness in the stomach, severe dyspeptic symptoms, and pancreatic diarrhea.

Diarrhea in chronic pancreatitis is a common symptom, but the intensity of this manifestation of the disease strictly depends on the severity of the pathology. While the inflammatory process is detected only in the initial sections of the pancreas and is not accompanied by severe pain, limited to a feeling of heaviness and pressure in the left side, diarrhea is observed in the case of overeating or a heavy dinner. During the day, such a symptom is extremely rare.

If the diet is not followed and appropriate treatment is not provided, the inflammation covers ever larger areas of the organ, significantly reducing its performance. Cases of diarrhea with pancreatitis become more frequent, accompanied by a deterioration in the patient's condition (increased nausea, vomiting, severe painful spasms in the stomach and intestines, etc.) and the appearance of neurological symptoms (weakness, dizziness, hyperhidrosis).

The pathogenesis of diarrhea in chronic pancreatitis is based on a decrease in the enzymatic function of the pancreas. Insufficient production of digestive enzymes leads to a deficiency in the duodenum, where half-digested food from the stomach enters. It disrupts the entire digestion process, the absorption function of the intestine suffers with the development of a putrefactive process in it (food is not broken down, but rots in the intestine).

Pancreatitis rarely occurs as an independent disease. It can usually be observed in combination with other inflammatory diseases of the gastrointestinal tract or against the background of an infectious lesion of the abdominal organs.

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Symptoms pancreatitis diarrhea

The mention that with prolonged and severe forms of inflammation of the pancreas, characteristic pancreatogenic diarrhea appears is not accidental. After all, with pancreatitis, diarrhea has its own distinctive features and is not similar to diarrhea caused by food poisoning.

Characteristic features of diarrhea in pancreatitis:

• mushy nature of stool,
• the presence of pieces of undigested food in the feces,
• strong unpleasant odor,
• oily appearance,
• a large volume of feces released during one act of defecation (polyfecalia),
• grayish or greenish tint (diarrhea with pancreatitis and accompanying cholecystitis due to impaired bile flow often has a grayish-yellow color).

The mechanism of development of diarrhea with enzymatic insufficiency of the pancreas determines what kind of diarrhea we observe with pancreatitis.

The main characteristic of feces in pancreatitis is the presence of undigested food residues. This indicator indicates a disruption of the digestion process due to a lack of special enzymes designed to break down food into the smallest particles. The lack of pancreatic juice and the low activity of enzymes in it lead to the fact that semi-digested food is excreted in the same form, because the process of final grinding of the food bolus falls out of the digestive chain.

Impaired absorption of nutrients in the intestines as a result of insufficient processing of the food bolus leads to the fact that fats, as a necessary energy component, simply “fly out into the toilet,” settling on its walls in the form of an oily, difficult to wash off gruel, and the patient begins to experience weakness and loss of strength.

A large volume of excreted feces indicates a low percentage of digestibility of food in the intestine. That is, virtually everything a person ate came out without benefit to the body.

As for the color and smell, the processes that occur in the body as a result of stagnation already leave their mark. The disruption of the flow of bile and pancreatic enzymes into the duodenum changes the color of the feces to a gray or light yellowish shade. And the processes of putrefaction and fermentation, carried out with the participation of bacteria, lead to the fact that with congestive chronic pancreatitis we observe green diarrhea. It is the putrefactive processes in the intestine that cause the foul smell of mushy gray-green feces.

Diarrhea occurs with pancreatitis after eating, usually 1-2 hours after eating. At the same time, other symptoms of the disease appear. The frequency of manifestations of such a symptom as diarrhea is 1 or 2 times a day. In severe cases of the disease, multiple acts of defecation are observed, repeated day after day after each meal and even between them.

Diarrhea with pancreatitis is accompanied by such symptoms as nausea and vomiting, spasmodic pain in the stomach and intestines, weakness, dizziness. Against this background, the patient breaks out in cold sweat, the skin becomes light-colored, sometimes with pronounced yellowness, the eyes darken, and tremors appear in the body.

As for vomiting, most often there are weak urges that do not lead to the ejection of the contents of the stomach.

A diffuse inflammatory process in the pancreas can cause a rise in temperature with the appearance of chills. Diarrhea and temperature with pancreatitis indicate that the inflammation inside the body is progressing and the disease is acquiring a life-threatening severe form.

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Complications and consequences

Whatever the cause of diarrhea, its most dangerous consequence is considered to be dehydration. The appearance, smell, color of feces do not matter, it is enough that the feces become more liquid, which means the volume of H2O _in them increases.

During one act of defecation with diarrhea, the body loses 2-3 times more water than usual. And if you consider that diarrhea with prolonged pancreatitis can occur several times a day, the loss of fluid will eventually reach critical levels.

This is the cause of dry skin and thirst, which are often diagnosed in patients with chronic pancreatitis.

The longer such a symptom as diarrhea with pancreatitis is observed, the worse the patient's condition, because along with water, the minerals necessary for the body are also lost, which means that the water-electrolyte balance is disrupted. Disruption of the digestion process and intestinal absorption results in a deficiency of vitamins and the development of anemia, a lack of protein in the body (an important building material for body cells), and various metabolic disorders.

All this leads to deterioration of the skin, bones, teeth, nails, hair, muscle weakness, inflammatory lesions of the tongue (glossitis), cracks in the lips and "angular cheilitis". The patient begins to lose weight rapidly, reaching critical figures. Complications of pancreatitis in the form of diarrhea contribute to the development of asthenic syndrome, accompanied by emotional lability (mood swings, irascibility, sentimentality), anxiety, sleep disorders.

The lack of nutrients necessary for the body's vital functions significantly reduces its protective functions. Therefore, patients with pancreatitis are more likely than others to suffer from bacterial and viral infectious pathologies.

Diarrhea with pancreatitis often causes necrosis of internal organs with the development of their dystrophy. Decreasing in size, organs and glands are no longer able to fully perform their assigned duties, which causes new and new disorders in the body. For example, a decrease in the functionality of the pancreas is fraught with the development of diabetes.

A subjective assessment of what is happening also plays a major role in the well-being of patients with pancreatitis accompanied by diarrhea. Frequent painful urges to defecate can significantly worsen the quality of life of patients, limiting their opportunities for productive work and rest, ruining their plans, putting them in an awkward position in front of others. This moment leads to the fact that many patients with advanced pancreatitis develop nervous disorders, depression, which only worsen the patient's condition and the course of the disease (stress has never contributed to recovery).

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Diagnostics pancreatitis diarrhea

Very often we do not pay attention to the alarm signals that our body gives us when it is susceptible to a particular disease. We attribute epigastric pain to stale or poor-quality food, diarrhea to food poisoning, nausea to the same poisoning, pregnancy or high blood pressure, dyspeptic symptoms to stomach diseases and stale food. Any symptom can be explained in a familiar and quite logical way. But only the results of diagnostic tests can tell us how correct our assumption is.

If you ignore unwanted symptoms for a long time, you can miss the onset of the disease and its transition to a chronic form, thereby exposing your body to even greater danger, because any chronic diseases weaken the immune system and leave a person defenseless against various infections. But this is not what we are talking about now, but about the fact that the appearance of some symptoms indicates not the development of the process, but its chronicity.

Thus, diarrhea with pancreatitis is a signal that the disease has become chronic. However, a late visit to the doctor even with such symptoms requires a special examination of the gastrointestinal tract to establish a primary diagnosis, in which diarrhea will be only one of the manifestations of the disease.

The symptoms of pancreatitis are very similar to the clinical picture of many gastrointestinal pathologies. However, the characteristics of pain, which mainly occur after eating "forbidden" food, a feeling of heaviness in the abdomen, the quality and quantity of excreted feces give the doctor a reason to suspect pancreatitis. But the presence of such a symptom as diarrhea with pancreatitis will tell a lot about the course of the disease.

Diagnostic measures for suspected pancreatitis include examining the patient with palpation of the epigastric region, studying the symptoms from the patient’s words, and, if necessary, measuring body temperature.

The patient is prescribed the following tests:

• general blood test (will show the presence of an inflammatory process and changes in the blood composition indicating the development of anemia),
• blood glucose test (will clarify whether pancreatitis has caused the development of diabetes),
• general urine analysis (will also provide information about inflammation, but will also conduct a diagnosis of kidney function, which is necessary when prescribing medications),
• stool analysis (will show the presence of undigested components of the food bolus, fats, as well as rotting processes against the background of bacterial activity).

If pancreatitis is suspected, laboratory diagnostics of the pancreas are performed. For this purpose, a special blood or urine test for enzymes (blood amylase or fecal elastase-1) is prescribed.

Instrumental diagnostics allows you to assess the size of internal organs and the processes occurring in them. Fibrogastroscopy, popular in gastrointestinal pathologies, is unlikely to provide sufficiently useful information in the case of pancreatitis, so you should not rely on it.

The most informative and therefore popular method of instrumental diagnostics of pancreatitis remains ultrasound examination (US) of the pancreas. More modern methods of diagnosing pancreatitis are also considered to be computer and magnetic resonance imaging of the organ, allowing to examine the pancreas from all sides in a three-dimensional image.

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Differential diagnosis

Differential diagnostics are carried out with inflammatory pathologies of the gastrointestinal tract (gastritis, duodenitis, colitis), intestinal infections, and intoxications.

Treatment pancreatitis diarrhea

Another feature of diarrhea in pancreatitis is that it is not so easy to stop. Fixing drugs alone are not enough, because they cannot affect the functioning of the pancreas. And is it worth slowing down the removal of toxic products of food decay from the body without taking detoxification measures?

You can get rid of diarrhea during pancreatitis only by stabilizing the functioning of the pancreas, and this requires patience and self-discipline.

An inflamed pancreas reacts very badly to heavy loads and heat exposure. Heat is generally contraindicated in inflammatory processes, since it only aggravates the situation. But eating hard-to-digest fatty foods requires a lot of effort from the diseased organ, which it cannot do. As a result, pain in the epigastrium, nausea, and bowel disorders appear.

To stop attacks of pancreatitis in the first days of exacerbation, the patient is asked to fast a little, drinking a sufficient amount of water. To relieve swelling and inflammation, an ice compress should be applied to the pancreas area (for example, a heating pad filled with pieces of ice, placing a cloth folded in several layers between the body and the heating pad to avoid frostbite of the skin).

During an exacerbation of the disease, bed rest is recommended, because rest is one of the main factors in the successful treatment of pancreatitis.

In the future, to facilitate the work of the pancreas, it is recommended to follow a gentle diet. Fractional meals (6-8 times a day) are mandatory, and the portions should be minimal, to only slightly satisfy hunger. The food should be liquid or semi-liquid, well-mashed, without seasonings and sauces.

It is necessary to limit the consumption of hard-to-digest coarse fiber, pearl barley, milk (in case of diarrhea, it can be added to porridge and soups in small quantities). Fruits and vegetables must be heat-treated. Alcohol and soda, legumes and mushrooms are strictly prohibited.

The diet should be such that it does not cause emergency work of the pancreas. Products are boiled or steamed, food is consumed only when warm. Water is recommended in large quantities (at least 2 liters per day), which will help to replenish its reserves in case of diarrhea.

Rest and proper nutrition will help normalize the functioning of the pancreas, but not as quickly as we would like. Therefore, to facilitate the work of this important organ, patients are prescribed enzyme preparations (Pancreatin, Creon, Mezim, Festal, etc.). Thus, the load on the pancreas is reduced, and the duodenum receives a sufficient amount of digestive enzymes that facilitate rapid and effective digestion of food. And if food does not stagnate in the intestines, it leaves the body naturally in the form of normal stool.

Activated carbon and other enterosorbents (for example, "White coal", "Polysorb" and even "Almagel", popular in gastroenterology) help to cope with the manifestations of intoxication that arise as a result of stagnation in the gastrointestinal tract. And you can restore the water-electrolyte balance with the help of intravenous injections of electrolyte salts (in a hospital setting) and drinking plenty of fluids.

Antidiarrheal drugs based on loperamide (Immodium, Loperamide, Lopedium, etc.) will help reduce the frequency of bowel movements and increase the tone of the rectum and anus. However, you need to be careful when using such drugs, because they cause a delay in toxic substances in the body. They should be taken only in case of extreme necessity.

Analgesics (for example, "Baralgin") and antispasmodics ("No-shpa", "Papaverine") will help relieve pain and spasms outside and during diarrhea with pancreatitis. Alternatively, you can take drugs with a complex effect that both relieve spasms and relieve pain ("Spazmil", "Spazmalgon", "Renalgan").

Since prolonged diarrhea always contributes to the disruption of the intestinal microflora, it is necessary to take measures to restore the beneficial bacterial composition of the internal environment of the body. For this purpose, the doctor prescribes a sequential intake of probiotics containing coli-, bifido- and lactobacteria ("Colibacterin", "Bifidobacterin", "Lactobacterin"). Each of the drugs is taken for 21 days, so the course of intestinal microflora restoration sometimes lasts up to 2 months or more.

But before you begin to restore the beneficial flora in the intestines, you need to thoroughly cleanse it of harmful microorganisms involved in the processes of putrefaction and fermentation that occur in chronic pancreatitis. For this purpose, the colon is cleansed using an enema. And a drug such as "Polyphepan" will help cleanse the entire intestines completely, preparing the ground for the successful settlement of beneficial microflora.

Diarrhea during pancreatitis leads to the body beginning to experience a deficiency of vitamins and minerals necessary for its functioning. The mineral reserve can be replenished by injection, which is done in severe cases of diarrhea. But the necessary vitamins with food restrictions can be obtained from vitamin-containing drugs. The optimal option for replenishing the deficiency of vitamins and minerals are considered to be vitamin-mineral complexes in the form of tablets, but they must be taken after diarrhea has been eliminated, otherwise the effect of taking them will be zero.

Medicines for diarrhea in pancreatitis

Treatment of diarrhea in pancreatitis is impossible without restoring the normal digestive process. Since the normalization of the pancreas occurs gradually, and you need to eat 6 or more times a day, you can improve the digestion of food only by taking pancreatic juice substitutes.

Replacement therapy in case of chronic pancreatitis is the regular intake of enzyme preparations that help eliminate diarrhea and prevent the development of other complications.

"Creon" is one of the popular substitutes for pancreatic enzymes. The drug is based on pork pancreatin, which is identical in its properties to human pancreatin. Pancreatin, in turn, consists of 3 enzymes: lipase, amylase and protease, which help break down fats, carbohydrates and proteins, respectively, that enter the body as part of food.

For ease of use, the drug is available in the form of capsules of various dosages: 150 mg (10 thousand units of lipase, 8 thousand units of amylase, 0.6 thousand units of protease), 300 mg (25 thousand units of lipase, 18 thousand units of amylase, 1 thousand units of protease), 400 mg (40 thousand units of lipase, 25 thousand units of amylase, 1.6 thousand units of protease).

Since the need for pancreatin varies among patients depending on the degree of pancreatic insufficiency, the effective dosage of the drug is determined individually (from 2 capsules of 150 mg to 3 capsules of 300 mg per dose). Snacks should be additionally accompanied by taking capsules in a reduced dose (one capsule of 150 or 300 mg).

The drug should be taken either during meals or immediately before or after eating. The capsules do not need to be chewed, it is enough to wash them down with plenty of water. During therapy, the amount of water drunk per day should be at least 2 liters.

The drug has very few contraindications for use. It is not prescribed to patients with intolerance to the components of the drug, as well as with hyperfunction of the pancreas. Side effects are limited to the appearance of constipation (due to insufficient amount of liquid drunk), dyspepsia, pain syndrome localized in the epigastric region.

"Festal" is a combination drug that, in addition to pancreatin, also contains other enzymes that promote faster and more effective digestion of food. Ox bile in powder form stimulates lipase activity in fat metabolism, and hemicellulase participates in the breakdown of plant fiber. It will be especially useful in the treatment of diarrhea in cholecystitis and pancreatitis.

The drug is produced in the form of a dragee, the shell of which protects enzymes from the effects of hydrochloric acid. One dragee contains: 6 thousand U of lipase, 4.5 thousand U of amylase, 0.3 thousand U of protease, 50 mg of bile, 25 mg of hemicellulase.

The drug is prescribed to adult patients 1-2 pills with each meal. The pills are swallowed with water.

Contraindications to the use of the drug are: hypersensitivity to the components of the drug, acute stages of hepatitis and pancreatitis, mechanical jaundice, severe intestinal obstruction, pathologies associated with impaired glucose and sucrose metabolism.

Side effects from taking the drug may include the following: gastrointestinal disorders, accompanied by nausea, vomiting, decreased or hardened stool with changes in its characteristics, spasmodic pain in the intestines, irritation in the anus.

Allergic and anaphylactic reactions occur rarely. Taking large doses of enzymes can lead to changes in blood composition, irritation of the oral mucosa, and the development of hyperuricosuria.

Enzymatic preparations are used for chronic pancreatitis during the period of remission of the disease.

If diarrhea due to pancreatitis becomes regular and poses a threat to the patient’s health, the doctor may cautiously prescribe the use of constipating agents.

"Immodium" is an antidiarrheal drug based on loperamide, which reduces mucus production in the intestines and improves the absorption of fluids in the digestive tract. It is available in capsules and tablets.

For the treatment of chronic diarrhea, adults are usually prescribed 2 capsules or lozenges, children - 1 tablet per day. Then the dose is adjusted so that the number of bowel movements is no more than 2 per day.

The capsules are taken with water without chewing, and the tablets are kept in the mouth until they are completely dissolved.

The drug is not used in case of intolerance to its components, acute dysentery, pseudomembranous and acute ulcerative colitis, bacterial enterocolitis, impaired intestinal motor function, lactation. Caution is exercised in liver pathologies.

During the medication intake, unpleasant symptoms such as nausea, leading to vomiting, flatulence, dizziness, weakness, drowsiness, and constipation may be observed. Spasmodic abdominal pain may be a concern, and signs of indigestion may appear. In rare cases, patients complain of trembling in the body, loss of consciousness.

Against the background of hypersensitivity, allergic reactions may be observed, including severe ones.

Diarrhea with pancreatitis, like the disease itself, is often accompanied by painful sensations in the pancreas and intestines. In this case, the doctor prescribes painkillers and antispasmodics.

"Spazmil" is a drug with a complex effect, which contains 3 active substances, simultaneously being both an antispasmodic (pitofenone and fenpiverinium) and an analgesic (metamizole).

It is recommended to take the tablets after meals with plenty of liquid. Daily dose - 1-2 tablets, Course of treatment - no more than 5 days.

The drug has quite a few contraindications, which must be taken into account when prescribing it. It is prohibited to take the drug to patients with hypersensitivity to its components, bone marrow dysfunction and blood pathologies, anemia, kidney and liver failure, decreased tone of the gallbladder and bladder walls, arrhythmia with high heart rate. The drug is not prescribed for acute porphyria, glaucoma, prostate adenoma with impaired urine outflow, intestinal obstruction, collapse, bronchial asthma, suspected appendicitis or peritonitis.

In pediatrics, it is used from the age of 15. It is not used to treat pregnant and lactating women.

The occurrence of side effects is associated with the analgesic component of the drug. These may include allergic reactions, skin rashes, asthma attacks, tachycardia, decreased blood pressure, and the development of blood diseases.

Quite rarely, patients complain of problems with the gastrointestinal tract, accompanied by dry mouth, nausea and vomiting, and bowel movements.

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Folk remedies

It cannot be said that alternative methods of treating pancreatitis are more effective than classical ones. However, their effectiveness should not be denied either. After all, many plants have effects that are useful for inflammatory pathologies of the gastrointestinal tract, since they can relieve inflammation, relieve pain, and improve digestion.

Diarrhea with pancreatitis passes only after the normalization of the digestion process, in which the pancreas takes the most active part. Its work is disrupted due to the inflammatory process in the organ.

Freshly prepared potato and carrot juices have a calming and regenerating effect on the mucous membranes of various digestive organs. The juice should be squeezed from thoroughly washed vegetables with the peel. It is better to mix the juices in equal proportions and drink 1 glass 3 times a day half an hour before meals.

Decoctions of pomegranate peels, walnut leaves, and horse sorrel seeds and leaves help fight loose stools.

Herbal treatment also has a good effect on pancreatitis; it will stop diarrhea and improve the general condition.

Chamomile infusion (1 tbsp. raw material per 1 glass of boiling water) helps relieve inflammation in the pancreas. It should be taken 3 times a day, ½ glass at a time.

And if you add corn silk and calendula flowers to chamomile, you can prepare an effective antidiarrheal remedy. Now take a tablespoon of the mixture per glass of boiling water, leave it in a warm place for about an hour and take it 15 minutes before meals for a month.

Herbs such as immortelle and wormwood will also help fight diarrhea. Pour a glass of boiling water over 1 tbsp of any of the herbs. It is enough to infuse immortelle for half an hour, and boil wormwood and infuse for 45 minutes.

The immortelle infusion is taken ½ cup 3 times a day. But you need to be careful with wormwood, since the herb is quite poisonous. It is recommended to take its decoction in small portions (2 tablespoons) up to 5 times a day.

To improve digestion in pancreatitis, choleretic infusions are also recommended.

• Collection 1: celandine, knotweed, dandelion root, wild pansy. Take 20 g of each herb, pour 1 liter of water over the raw material mixture and boil for 3 minutes. Take 3 times a day before meals. The course is 2 weeks.

After completing the course of treatment with the first collection, we move on to the second.

• Collection 2: dill seeds and mint - 60 g each, hawthorn fruits and immortelle - 40 g each, chamomile - 20 g. The composition is poured with 1 liter of boiling water and infused until it cools. Take after main meals. Course - 4 weeks.

It is important to remember that herbal infusions will not replace medications prescribed by a doctor, but will only enhance the effect of the latter. In addition, taking any folk remedies requires prior consultation with a doctor.

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Homeopathy

Fans of homeopathic treatment can also be offered several effective drugs that help combat such an unpleasant and dangerous phenomenon as diarrhea during pancreatitis:

The arsenic-based drug Arsenicum is prescribed for frequent loose stools, which may be accompanied by vomiting and painful spasms.

Iodum (an iodine preparation) also helps to normalize stool during pancreatitis.

Colocynth and Momordica compositum (a drug for intravenous administration) help combat intestinal pain and diarrhea.

If pancreatitis occurs against the background of gallstone disease, the homeopathic preparation Chelidonium-Homaccord N will be useful.

With any type of diarrhea, such drugs as Aloe and Belladonna will have a positive effect. But Argenticum nitricum is prescribed only when the feces contain particles of undigested food, which is observed in pancreatitis.

Despite the apparent safety of homeopathic remedies, they should only be taken as prescribed by a doctor.

Prevention

Diarrhea with pancreatitis is a signal that the disease, having become chronic, continues to develop, and the state of the pancreas is such that it cannot normally perform its functions, which is why the entire digestive process suffers. It turns out that it is not the diarrhea itself that needs to be treated, but the pancreas damaged by inflammation.

The same can be said about prevention. In principle, it is possible to prevent the occurrence of such an unpleasant symptom as diarrhea with chronic inflammation of the pancreas if you constantly follow certain rules:

• Forget about bad habits such as smoking, alcohol abuse, overeating.
• Adhere to a strict diet prescribed by the doctor, excluding fried, sweet, salty, spicy, and hard-to-digest foods. All products must be chopped. Vegetables and fruits must be boiled or baked. Fractional and preferably separate meals are mandatory, facilitating the digestion of products.
• Monitor your physical activity and weight.
• Be regularly examined by a gastroenterologist and follow all his/her instructions.

The restrictions are quite strict, but this is not a whim, but a harsh necessity. After all, chronic pathologies in the vast majority of cases are not treatable. You can only correct your condition by extending the period of remission, and for this you will have to completely reconsider your attitude to your lifestyle, some of its joys and nutrition.

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Forecast

If you stick to the above rules for at least 3 weeks, they will turn into a habit. This is the mechanism of habit formation described in treatises on psychology. After 21 days, the rules for preventing exacerbation of pancreatitis will become the norm of life and will allow you to enjoy it without excesses, finding joy in other things. Otherwise, the prognosis for the disease will not be so favorable.

Diarrhea with pancreatitis is a kind of signal about the degree of disruption of the pancreas. While these are rare cases of stool disorders, you can still fight for the organ by changing your habits and helping it to work with enzymes and herbs. If diarrhea becomes chronic, more conservative methods of fighting the disease are needed, carried out mainly in a hospital setting. And here you have to fight not so much with the disease itself, but with its dangerous consequences in the form of dehydration, disruption of water-electrolyte balance, failures in the work of other organs caused by a deficiency of substances necessary for the body due to a violation of their digestibility in the intestine.

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