Pain in pancreatitis

The pancreas synthesizes enzymes that are needed to break down food, and hormones responsible for metabolism in the tissues of the body. The main symptom of inflammation of the pancreas is the pain syndrome.

If you do not start therapy on time, then the disease flows into the chronic form of pancreatitis and disrupts the organ. Knowing the signs, symptoms of pancreatitis and where exactly it hurts you can recognize the disease at the initial stage and prevent its development.

Why there is a pain syndrome

Pain in pancreatitis is felt as a result of worsening microcirculation, obstruction of the bile duct, inflammation and dystrophy of the tissues. The cause of impaired patency of the pancreatic ducts is a blockage of stones or squeezing the organ with a tumor, scars.

The secret does not enter the intestines, but stagnates in the ducts, because of which they increase blood pressure, blood circulation is disrupted. This leads to the fact that the synthesized enzymes begin to digest the gland itself, which provokes inflammation and swelling. Inflammation leads to an increase in nerve endings, which is perceived as pain.

In the absence of adequate treatment, the disease acquires a chronic form, at which the replacement of normal tissue with scar tissue takes place, and enzymes enter the bloodstream and disrupt the activity of other organs.

Iron does not synthesize the necessary amount of insulin, which leads to an increase in the level of sugar in the blood and worsening of the digestive and endocrine system. Then what changes are more pronounced and will determine the nature of the pain. With acute pancreatitis, the tissues of the gland are inflamed, which leads to swelling, hyperemia and, as a result, organ dysfunction.

Edema accompanying inflammation, has a mechanical effect on adjacent tissues (and intestines as well), which increases the intensity of the pain syndrome. Enzymes of the pancreas, namely, trypsin and steupsin, cause necrotic changes in the tissues of the organ.

Foci with necrosis or dystrophy of the tissue can be single or multiple, up to full pancreatic necrosis. Sites with affected tissue are susceptible to perforation of parenchyma lobules, which leads to the release of enzymes beyond the boundaries of the ducts. The more such foci, the stronger the pain with acute pancreatitis.

When the inflammatory process subsides, the main cause of the pain syndrome is ischemia, in which blood circulation slows down and leads to permanent damage to the tissue or organ, the glandular tissue replaces the connective tissue.

In the pancreas, true or false cysts are formed. While they are small pain is characterized as moderate, than large sized cysts, the more painful the sensation. Often pathological formations are not limited to the pancreas, but penetrate into the omentum bag, causing the stomach to shift left or right and anteriorly.

Because of the cyst, the position of the transverse or duodenum may change somewhat. As a result of the growth of the neoplasm, the healthy adjacent tissues are squeezed, the movement of the enzymes is disturbed, which causes painful sensations.

With the long development of the disease, pathological changes of susceptibility occur, when the intensity of pain does not correspond to the strength of the stimulus. There is severe pain even with a weak stimulus.

As the disease develops, pain increases

More often pancreatitis develops in young women than in men, because the body is more predisposed to cholelithiasis, which is the main factor in the development of the disease (except alcoholism). Often, stones form in the bile ducts during pregnancy due to hormonal changes and ion exchange disorders.

What is the pain?

The nature, strength of pain and its localization depends on the location of the inflammatory process and the changes it causes, so you can not pinpoint the place where it hurts in pancreatitis. By nature, the pain is likely dull, aching, cutting, cramping.

Pathology can affect the entire gland or only part of it, for example, the body, head, tail. If the head is touched, it hurts on the right under the rib, the body of the organ is approximately "under the spoon", the pathological process affecting the tail causes aching pain in the entire left side.

Often pain in acute pancreatitis is felt at the top of the abdomen (under the pit of the stomach), but pain in the hypochondrium (from either side), or shingles, is possible. In some cases, the discomfort associated with pancreatitis is perceived by patients as signs of impaired cardiac function.

In the acute course of the disease, pain occurs immediately after eating, as mechanical and chemical irritation of the stomach and duodenum provokes the release of pancreatic juice, which leads to an increase in inflammation.

Pain in acute pancreatitis is caused by a chemical stimulus, that is, they occur under the action of enzymes, so changing the posture does not bring relief to the patient. Symptom is worse if a person lies on his back.

With chronic pancreatitis, the pains do not have a distinct localization and there may be different strengths. Deterioration of the condition is not observed as often, as a rule, after consumption of heavy food or alcohol.

Feel pain in chronic pancreatitis:

• in the lower back (can have both a shingling character, and affect only the left side of the back and abdomen);
• in the region of the ribs on the left;
• in the middle or upper square of the abdomen;
• in the back (do not apply to the nearest zones).

Pain rarely occurs with pancreatitis on an empty stomach

If the pain suddenly abated, especially if it was very severe, then this is an alarming symptom, as there is a possibility that the gland tissue has become dead. The main symptoms of the disease:

• pain in pancreatitis are noted after overeating or eating heavy food, alcohol, "hungry pains" are rare;
• vomiting does not relieve the condition;
• dyspeptic disorders (diarrhea is replaced by constipation, increased gas formation);
• possibly an increase in body temperature.

What to do if you have pain

If, in the event of abdominal pain, the patient drinks painkillers before the doctor's examination, this can slow the diagnosis. The symptom of the "acute abdomen" is typical for many diseases, in order to properly differentiate them, the doctor must know exactly where the pain is palpating more intense, and where less.

Admission of pain medication dulls the sensation and smears the clinical picture. The palpation of pain points and zones allows the doctor to determine which part of the body is localized with inflammation.

If there is acute acute pain in the epigastric region (under the spinal cord) or on the right side under the ribs, it is possible that the cause is in the inflamed pancreas. Such pain can occur with liver pathologies or appendicitis, so the patient should not make a diagnosis on his own.

Pain relief is possible with non-steroidal analgesics. The best analgesics for pancreatitis:

• Ibuprofen,
• Paracetamol,
• Diclofenac.

In acute pancreatitis, one of the most effective means to eliminate pain is the application of a cold compress

As a rule, first prescribe to take Paracetamol. The dose of the drug is recommended individually, if it does not eliminate pain, then it can be increased. Over time, the body stops responding to this drug, in this situation, you can go to ibuprofen or diclofenac. Tablets for acute pancreatitis should be selected by a doctor, given the patient's age and concomitant diseases.

How to deal with the problem?

For the treatment of chronic pancreatitis, the following medicines are prescribed:

• Enzymes. It is necessary to improve the process of digesting food and reduce the burden on the pancreas. Since the body does not synthesize in a large amount of secretions, the pain sensations become less intense.
• Hormones. Assigns a hormone somatostatin, which reduces the sensitivity of pain receptors. It can be replaced by a synthetic analogue of the octreoid. The product lasts a long time, so even taking it for three days allows you to get a lasting effect. The medicine has a long list of contraindications and undesirable actions, therefore it is prescribed only with a pronounced pain syndrome.
• Blockers of H2-histamine receptors. They reduce the production of hydrochloric acid, blocking the histamine receptors of parietal cells of the gastric mucosa. In addition, the drug inhibits the synthesis of pepsin, increases the amount of gastric mucus, increases the secretion of prostaglandins, improves microcirculation. Among the blockers Famotidine is most famous.
• Proton Pump Inhibitors. Also belong to antisecretory drugs, because they reduce the production of hydrochloric acid. They are derivatives of benzimidazole. To this group belongs Rabeprazole, Esomeprazole, Lansoprazole. Medications are considered safe, as they have a small list of side effects and contraindications. With a properly selected dosage, it can be taken for a long time.

Than to remove or take off a pain at a pancreatitis the decision only the attending physician can solve

With the development of severe pancreatitis, they are treated in the hospital. In the pancreas hospital, functional rest is provided (the patient is fasting for several days, the nutrition is parenteral). How much to lie in the hospital depends on the duration of the restoration of the gland.

In the most severe situations, intravenous nutrition is required throughout the time that the pancreas will recover, and this is up to six weeks. For the removal of acute exhausting pain in an adult in the hospital can be given narcotic analgesics (Omnupon, Tramadol, Ketanov, Promedol). If necessary, additionally prescribed neuroleptics, tranquilizers, antidepressants.

How to avoid recurrence of pain syndrome

If a person has already experienced pain in acute pancreatic pancreatitis, then he must observe a number of rules that will help to avoid its reappearance. The basic principle is not to make iron synthesize a large amount of secret.

First of all, those who have already got the pain must comply with a diet that excludes the consumption of fried, fatty, salty or acidic foods. It is necessary to give up alcohol. It is recommended to consume more protein and to refrain from fats and carbohydrates. Portions should be small, meals every 3-4 hours.

Exacerbation occurs after excessive stress on the gland

Patients with chronic pancreatitis should regularly take medications to reduce the synthesis of their own enzymes. All medicines must be prescribed by a doctor. Upon agreement with the treating gastroenterologist, phytotherapy can be used.

Help in the treatment of pancreatitis herbs that have choleretic and anti-inflammatory properties (fennel seeds, St. John's wort, yarrow, hips, horsetail, chamomile). Withdrawal of acute pain in grass is beyond the power.

If the attack still recurred, it is better not to eat at least two days. Analgesics recommended by a doctor will help anesthetize the gland. It is possible to drink mineral water without gas, heated to 35-39 ⁰С, for example, Narzan or Yessentuki No4 or No17.

Thus, enzymes will not be produced, so inflamed pancreatic tissue will not be attacked by trypsin. After 48 hours you can eat mashed food, cooked for a couple. Observe a strict diet for about two months.

It is important to understand why there is an inflammatory process in the gland. Only by eliminating the root cause, it will be possible to restore the tissues and get rid of the disease. In some cases, surgery may be required to empty the ducts and remove dead tissue.

Only the doctor will be able to tell how to relieve pain in pancreatitis in each case. It is important not only the intensity of the symptom, but also the patient's age, concomitant diseases, drug tolerance, additional signs of the disease. Therefore, if pancreatitis hurts, you need to contact the gastroenterologist as soon as possible.