Depending on whether it is acute or chronic pancreatitis, there are different therapeutic options, pharmacological and not.
The inflammatory state is a condition common to most diseases, some more well-known and widespread than others. Among these, pancreatitis is certainly among the least known.
It is a pathology of the pancreas that is distinguished, depending on the symptoms and its duration, in acute and chronic.
Acute pancreatitis
Pancreatitis, in its acute form, is due to a sudden onset inflammation that generally manifests itself with intense abdominal pain associated very often with nausea, vomiting and fever.
In milder forms the symptomatology resolves in about 7-15 days without significant consequences. On the contrary, in severe cases, it can lead to a chronicization of the disease, as well as septicemia, renal and / or respiratory failure and shock.
The causes are many: the most relevant risk factors are to be found in the presence of gallstones as well as alcohol abuse, smoking, anatomical or genetic abnormalities, the presence of tumors, the intake of certain drugs, the increase in triglycerides in the blood or complications of surgical maneuvers. The male sex would also seem on average more subject.
Chronic pancreatitis
Unlike the acute form, the chronic one is an irreversible pathology characterized by a progressive worsening of the inflammatory and painful state with loss of physiological functions of the pancreas.
Alcohol abuse is responsible in 40-60% of cases, while smoking would seem to triple the risk compared to non-smokers.
In recent years it has also been observed that the increase in cases of acute pancreatitis is also reflected in an increase in chronic ones. The progression of the disease is in fact more frequent than expected, especially in patients who smoke and take alcohol.
Genetic mutations play a secondary role, as do autoimmune pancreatitis.
Treatments
If it is an episode of acute pancreatitis, surgery in the operating room is generally not required. In most cases, treatment involves fasting and intravenous fluid and electrolyte administration.
If necessary, we intervene with anti-protease drugs, which reduce the activity of digestive enzymes in the pancreas, and antibiotics. In the most serious cases, however, we proceed with the drainage of abscesses, ie accumulations of infected fluid resulting from the rupture of the organ itself.
Even in the case of a form of chronic pancreatitis, the intervention procedures are many and depend on the severity. In the initial phase usually the pain, a recurrent and persistent symptom, is treated with classic painkillers (paracetamol) and then move on to narcotics of increasing intensity up to antidepressants and neuromodulating drugs (pregabalin).
In the most advanced stages, i.e. when the organ has undergone morphological and functional alterations, pancreatic enzyme therapy is often necessary to reduce the effects of reduced pancreatic function, which would be reflected in impaired digestion and therefore in reduced absorption of nutrients.
Thanks to this supplement, patients report an improvement in quality of life and a lower risk of developing co-pathologies related to malnutrition, such as osteoporosis or muscle weakness.
However, surgical therapy remains the main route of intervention and the options available are different. “Derivative surgery” aims to remove pancreatic duct obstruction through drainage, “endoscopic” surgery is used for stone removal or stent placement, while “demolition” surgery involves removing part of the organ.
Recently, although still being perfected, the possibility of autotransplantation of pancreatic islets to restore insulin production, thus avoiding the onset of diabetes, has also taken hold.
In cases where this experimental technique is not applied, insulin therapy is administered at variable doses.
Joycelyn Elders is the author and creator of EmpowerEssence, a health and wellness blog. Elders is a respected public health advocate and pediatrician dedicated to promoting general health and well-being.
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