Functional disorders of the pancreas: causes

The main predisposing factors for the onset of functional disorders of the pancreas in peptic ulcer disease are the pronounced dyskinesia of the duodenum, the development and progression of duodenitis, the considerable duration of peptic ulcer and its frequent recurrence. The nature of functional changes in the pancreas during peptic ulcer in different patients is ambiguous, but the activity of pancreatic enzymes (amylase, trypsin, lipase) in duodenal contents (this is determined by duodenal probing) and their moderate increase in blood are more often observed. Some researchers observed "dissociation of pancreatic fermentation": increased amylase activity in duodenal contents, decreased lipase activity and other changes. In some cases, the incremental function of the pancreas decreases somewhat. In chronic atrophic gastritis with secretory insufficiency, there is also often a decrease in the exocrine function of the pancreas: a decrease in the total amount of juice produced per unit of time, both before pancreatic stimulation and after it, in the pancreatic juice of bicarbonates and enzymes some authors also noted the presence of "dissociation of enzyme release"), an increase in the content of pancreatic enzymes in the blood. There is moderate hyperamylasuria; minor violations are often noted and the incremental function of the pancreas.

Functional disorders of the pancreas in peptic ulcer and chronic gastritis are more often detected at a considerable prescription of the disease and are usually not accompanied by symptoms of the lesion of the gland, are often reversible, disappearing with the improvement of the course of these diseases under the influence of treatment (for example, in the stage of peptic ulcer remission), are not accompanied morphological changes of the pancreas, determined by modern diagnostic instrumental methods (for example, echography or scanning). Functional disorders in these diseases are explained by close functional interrelation of the digestive system organs, a violation of the nervous and humoral (gastrointestinal hormones) regulation of the pancreas. In rare cases, with these diseases develops chronic pancreatitis. Regular development of pancreatitis with the penetration of peptic ulcers into the pancreas, as well as with concomitant diseases of the bile excretory system. With atrophic duodenitis, the development of pancreatic juice is disrupted due to a decrease in the production of the mucosal membrane of the duodenum of natural stimulants of pancreatic secretion - the secretions of secretin and pancreosimin.

Some authors have found functional changes in the pancreas for chronic hepatitis and cirrhosis of the liver. In a number of cases, morphological changes such as chronic pancreatitis and even pancreatic fibrosis are detected with cirrhosis of the liver. Functional disorders of the pancreas in chronic colitis are described, especially with ulcerative colitis: dissociation of enzymes in duodenal contents (increased amylase activity, decreased lipase and trypsin), increased activity of ataxil-resistant lipase in serum. Approximately one-third of the patients had minor violations of the function of the endocrine apparatus of the pancreas, also of a reversible nature.

With functional disorders of the pancreas, however, if there is a decrease in pancreatic sowing, it usually does not happen very significant. Only with organic lesions of this organ, the exocrine function of the pancreas can be severely disrupted. Pancreatic Achilles (or a sharp decrease in the secretion of pancreatic juice) can occur in severe infectious diseases, with cancer cachexia (with any tumor location, in this case we are not talking about pancreatic cancer) and any other severe intoxication.

[1], [2], [3], [4]