Chronic Pancreatitis Treatment
In chronic pancreatitis treatment consists of hygienic-dietary measures, medical treatment, endoscopic treatment and in some cases surgical treatment
1. Dietary regime: An imperative measure is complete cessation of alcohol. In addition, do not eat a lot of food at one meal, avoid products high in fat and protein. These foods can exacerbate pancreas pain by stimulating the production of pancreatic juice in order to digest them. If on a background of a chronic pancreatitis occurs an acute pancreatitis the treatment will be done in hospital.
2. Medical treatment
- analgesic medication (pain-killer) is used during painful periods. Ex: Algocalmin, Piafen.
- enzyme substitutes: can relieve the symptoms of pancreatitis. These drugs have the effect of decreasing the secretion of the pancreas juice (by replacing the secretion of the pancreas it will no longer be forced to produce the enzymes needed for digestion). Even in the absence of a malabsorption the substituents dose must be increased. Examples: Kreon, Panzytrat, Festal, Cotazym. The dose is approximately 20,000 lipase units per meal. If one of these preparations is not protected against gastric acid then half an hour before meals take a drug with antisecretory action (decreases production of stomach acid, ex. Ranitidine, cimetidine). If however there are still signs of incomplete digestion you will receive medium chain triglycerides (coconut oil).
3. Endoscopic Treatment: selection for endoscopic surgery is done with great attention. Currently endoscopic treatment is used increasingly more. Techniques:
- papillotomy (it will be made an incision of duodenal papilla – the place where pancreatic juice flows into the duodenum);
- making a prosthesis for Wirsung duct or bile ducts (in case of any stenosis – obstruction). Following these therapies were observed favorable results in more than 85% of cases;
- extraction of calculi from the pancreatic duct. Extraction is done using balloons or baskets which catch the stones. If the calculi is increased in size it will be tred a lithotripsy for breaking and removal of small fragments that result;
- pseudocyst drainage using EUS.
4. Surgery is done in cases with hyperalgesia forms of chronic pancreatitis (severe pain). Interventions: celiac plexus blockage, removal of a part of the pancreas or pancreas completely (pancreatectomy), various methods of derivation between the pancreas and jejunum.