Pain with pancreatitis

Pancreatitis is a very common disease today. According to statistics for last five years every 4th woman and every 8th man in the world suffer with pancreatitis! These are depressing facts. Thus, pancreatitis is inflammation of pancreas, which main objective is to produce insulin and enzymes necessary for proper and smooth digestion of food.

Any pain in peritoneum or iliac area, accompanied by inability to walk straight, sit comfortably, as well as loss of appetite, liquid or oily stools, dry mouth, thirst and vomiting, severe weight loss and prolonged constipation must certainly alert you, as above ailments may be signs of progressing pancreatitis.

[1], [2], [3], [4], [5], [6], [7], [8], [9], [10]

Causes of pain in pancreatitis

Causes of pain in pancreatitis are diverse: from systematically wrong food (delayed, with large share of fried, spicy and greasy), ending with abnormalities of gallbladder and duodenum, injuries, wounds and effects of abdominal surgery, taking certain medications (furosemide, estrogens, frequent reception of antibiotics), tumors of abdominal organs, metabolic disorders, diabetes of 1 and type 2, hormonal changes and genetic predisposition to disease. Approximately in half of cases it is not possible to establish true cause of disease. Pancreatic disease affects more often women than men.

[11], [12], [13], [14], [15], [16], [17]

Localization of pain in pancreatitis

What pain does usually disturb patients in pancreatitis? There is no specific answer to this issue, because pain in inflammation of pancreas may be different: stinging, sharp, aching, localized in particular area (for example, under right rib), or across abdomen, and sometimes even extending to groin or back. Type of pain depends on which part of pancreas is inflamed: head, body and tail. If head of pancreas is inflamed - pain is in the right side directly under rib; if body - pain is palpable in so-called area of "stomach"; if tail - entire left side of the peritoneum aches, but most vivid pain is pointed under the left rib. Localization of pain with pancreatitis is very blurred, often patients cannot pinpoint where it hurts, they say "everything hurts» - in this case, we talk about complete inflammation of pancreas: body, head and tail. In this case pain can irradiate in coccyx, back (as if girding patient), leg, hip and groin. Women often complain of strange pain in perineum, it is literally painful to walk. Back pain is frequent with pancreatitis as sick pancreas radiates to all organs of peritoneum. That is why it seems that back hurts. By same principle back aches with inflammation of kidneys. Headache with pancreatitis is a frequent phenomenon that occurs on background of general weakness and exhaustion. Thus, inflammation of pancreas typically is not accompanied by fever, but almost always appears in form of some yellowness of face and skin. It should be noted that quite often (especially if disease is already in chronic stage) acute pain in pancreatitis is absent and disease is in latent form (no sharp pain or attack of pancreatitis). With this pancreatitis, referred to as "stone" (due to stone formation in structure of pancreas), head is inflamed prohibitively, level of amylase increases in blood and urine. In this case, against background of acute pancreatic insufficiency, patients complain about long-term diarrhea and constant bloating. This type of pancreatitis is harmful because besides above-described symptoms, which often cannot be determined without medical intervention (e.g. level of amylase in blood and urine sugar level in blood), there is favorable environment for development of diabetes as 1st and 2th type (latent diabetes, not insulin dependent).

How to recognize acute pancreatitis?

Acute pancreatitis, popularly referred to as "storm of pancreas" is a quite dangerous disease, and one of most frequent among diseases of peritoneum. With such pancreatitis pancreas begins to "digest itself", and if not to intervene timely and not to have a correct medication and not to start appropriate low sugar diet - swelling, inflammation of tissue around pancreas up to necrosis of this vital organ may develop.

Thus, acute pancreatitis can be recognized by presence of these complaints:

• Acute pain in the upper abdomen (below the right rib).
• Encircling sharp pain, subsiding in sitting or lying down position, with tucked knees.
• Nausea.
• Vomiting (with impurities of bile).
• Aversion to all food, including plain drinking water.
• Feeling of tearing of intestinal, bloating.
• Pale wet skin with earthy or yellowish tinge.
• Noticeable (patient feels himself) decrease in blood pressure and heart palpitations.

Diagnosis of pain in pancreatitis

Diagnosis in acute pancreatitis requires following tests and manipulations:

• General blood analysis.
• Biochemistry of blood (makes it possible to track level of amylase in blood and urine).
• X-ray of abdomen.
• Abdominal ultrasound.
• Fibrogastroduodenoscopy ("probe" in common) - helps to establish presence of ulcers and tumors, as well as gives opportunity to take gastric juices for analysis.
• Laparoscopy.
• Computed tomography (if you suspect presence of cancer).

[18], [19]

Treatment of pain in pancreatitis

Pain in acute pancreatitis is quite pronounced, and it makes person somehow respond to it. Treatment is carried out strictly under supervision of physician. With chronic pancreatitis patient already knows how to fight disease or relieve pain (judging by previous bouts), in case of attack of acute pancreatitis (especially primary one) you should immediately call an ambulance. It should be noted that age-old question "what to do to remove pain of pancreatitis?", there is simple answer – use cold. Cold as if freezes pain, subsiding it.

Encircling pain with pancreatitis often leads to panic and distracting, but if for some reason you cannot visit doctor, you must do the following:

• Limit intake of food (up to starvation) for 18-24 hours in acute phase (drinking - only alkaline mineral water or weak tea without sugar).
• Apply cold (heating pad can be iced) in area of pain (from right hypochondria and navel). In no case, do not warm abdominal area! This can lead to edema and septicemia, which often require immediate surgery.
• During exacerbation, and few days after attack, dropper with solution of glucose or reosorbilact (200-400 ml) is recommended.

At the end of initial fasting patient will want to eat, since inflamed pancreas for lack of food for digestion, begins to digest itself. In this case, you can begin to gradually eat. Attention! Sugar should be limited to record low doses, because consumption of sugar can now bring on attack again. But glucose is still needed for body, so if you have not made dropper with glucose - weak black tea can be sweetened slightly.

Eliminate all flour, fried, fat foods – i.e. everything, for with already sick pancreas will have to spend a lot of energy, which a weakened body just doesn’t have. You can eat one boiled egg, piece of yesterday's (dried or toasted) bread, couple of plates of wafer cookies and couple of crackers. Also, a decoction of dried apples, raisins, steamed juice or tea from hips are recommended (better to take fresh rose hips and infuse them in thermos, rather than to drink tea bags). Above-mentioned broths contain vitamin C and glucose (fructose), which is harmless, but very useful for body.

After 3-4 days, with overall diet patient's condition should stabilize. However, he should continue to stick to diet with low content of pure sugar, plentiful drink and avoidance of difficultly digested food. During or after each meal it is recommended to take enzyme preparation (Mezim 10000, Pancreatin 8000, Festal, and Festal Forte) 1-2 tablets, depending on dosage (it is important that daily dosage of enzyme does not exceed 25000).

Be sure to consult a doctor-gastroenterologist for further full gastrointestinal examination with subsequent identification of causes of acute pancreatitis. Do not neglect the disease, even if you feel better, because problem with pancreas may be a first step to development of diabetes.

Pain in chronic pancreatitis is less pronounced than in acute. Such pain patients of gastroenterologists described as dull, undulating (grab and release), worse after eating. It can irradiate to different points of peritoneum, but more often it is "whining" under the left rib. Pain in chronic pancreatitis is not primary and only secondary problem, as it occurs against background of gallstones, bowel disease and duodenal ulcer, hepatitis B and C, mumps, intestinal lesions worms, as well as on background of long and continuous reception of alcohol (more than 50 grams of spirits and 80 grams of dry wine per day). Constant use of carbonated water and fizzy drinks has negative impact on pancreas, causing constant inflammation of pancreas, complicated by constant bloating, and gradually cirrhosis of tissue of pancreas. With chronic pancreatitis pain does not always occur, but only when there are flaws in diet. That is why, if you have chronic pancreatitis, you should stick to right diet. Namely:

• Moderate consumption of foods with high content of "complex" sugars: chocolate, pastries and sweets, flour products.
• Carbonated drinks and concentrated juices, chilled fizzy drinks.
• Fried, fatty and spicy foods.
• You should not abuse seasonings.

All above-mentioned absolutely does not say that you should limit yourself in food, just do not abuse and overeat. You should not refuse meat, fish or mushrooms, proteins are very necessary, only with pancreatic diet it is better to bake or boil such products. It is important to know that nourishing soups on fat broth are strictly contraindicated. It is better to cook soup on natural vegetable broth, and then they will be easy to digest and bring benefit.

Prevention of pain with pancreatitis

Preventing with pancreatitis both in acute and chronic forms is simple enough, and it does not end with just right nutrition. It is necessary to observe regime of day, do not eat at night (since at night pancreas goes into slow motion, or so-called "sleep mode" as well as entire body). With consumption of food during night we "wake up" it and are force it to work. Do not often use fast- food and alcohol, as well as a lot of fatty and fried food. It is better to eat boiled and baked meat, and to minimize consumption of starchy food. You should not eat a lot of sweet (in cakes and chocolate simple sugar is usually added, which is hard to be split by pancreatic enzymes). If you know that feast is coming - better take enzyme preparation. Do not get involved in soda and juice drinks with colorants. Take care of your pancreas and stay healthy!