1, main symptoms
Abdominal pain Acute pancreatitis can be caused by many factors, but its main symptom is abdominal pain. 95% patients have different degrees of abdominal pain, which often occurs after a full meal or drinking. The pain site varies according to the condition, usually in the middle and upper abdomen, and can be transferred to the left lower abdomen.
Abdominal distension does not occur in all patients with acute pancreatitis, which is related to the clear degree of inflammation. Inflammatory infiltration in retroperitoneal space, localized or diffuse peritonitis in upper abdomen, etc. It can paralyze your intestines and cause abdominal distension, while mild acute pancreatitis without infiltration will not cause abdominal distension.
(1) Nausea and vomiting
About 90% patients with acute pancreatitis will have symptoms of nausea and vomiting, which are called the three major symptoms of acute pancreatitis together with abdominal pain. Nausea and vomiting are more frequent at the beginning of the disease, which can be gradually relieved with the illness, and abdominal pain will not be alleviated after vomiting.
Diarrhea Acute pancreatitis can also cause diarrhea, mainly pancreatic lesions. The excretion function of pancreatic juice is impaired, the food entering the duodenum is not fully digested, or the autonomic nerve function is disordered, and the secretion and absorption function of the intestine are impaired, resulting in diarrhea.
(2) Fever
Most patients with acute pancreatitis will have moderate or above fever, and a few severe patients will have high fever, which usually lasts for 3~5 days. The main reason is that pancreatic necrosis products or pancreatic inflammation products enter the blood and act on the thermoregulatory center. Generally, the body temperature will slowly recover in 7~ 10 days. Of course, there will be secondary infection and fever again in the course of the disease.
Jaundice I believe many people regard jaundice as an inevitable symptom of pancreatitis. Actually, it's not. Only 20~25% of acute pancreatitis will have jaundice symptoms, which usually appear within 1~2 days after onset. Pancreatitis with obstruction of pancreatic duct and biliary tract is the most prone to jaundice, but it will gradually subside after a few days. The main reason is that the pancreatic head edema compresses the common bile duct, which may also be caused by infection.
(3) Hypocalcemia
There are still 30~60% patients with acute pancreatitis with hypocalcemia, such as convulsion, muscle spasm, abdominal cramps, tendon hyperreflexia and so on. The main reason is that trypsin decomposes neutral fat into glycerol and fatty acids in pancreatic parenchyma and extrapancreatic adipose tissue. The combination of fatty acids and calcium will promote the excretion of calcium and easily lead to hypocalcemia.
2, the principle of treatment
1, etiology and treatment
There are many reasons for acute pancreatitis. If we know the cause, we can treat it in time, such as biliary diseases, excessive drinking, infection, drugs and other factors, which can eliminate symptoms as soon as possible and reduce the harm to the body.
2. Enzyme inhibition therapy in acute phase
Acute pancreatitis is inflammation of pancreatic enzyme self-solubility. This disease needs to seek medical attention in time during the severe period of symptoms, and be treated in the hospital to inhibit pancreatic enzyme activity, so as to eliminate symptoms as soon as possible and reduce the harm to the body.
3. Surgical therapy
Surgical treatment of acute pancreatitis is the last choice, but the earlier the operation, the better. Therefore, it is very demanding for doctors to grasp the timing of surgery. At present, it is agreed that the earlier the operation is performed, the more secretory function of the pancreas will be preserved, which will have the least impact on the life and diet of the cured patients.
4. Dietotherapy principles of pancreatitis
Fasting in acute phase: In acute phase of pancreatitis, we need to fast, not only can't eat, but also take out the gastric juice in the stomach to reduce the stimulation to the pancreas.
Fluid supplement during intermission: After acute fasting, you need some liquid diet, mainly foods with high calorie, high protein, high sugar and low fat, and some fat-soluble vitamins to promote the rapid recovery of the body.
Food choice after recovery: After acute pancreatitis is cured, there are still many places to pay attention to in diet. Remember to stay away from alcohol, tobacco and spicy food to avoid recurrence.