What are the clinical manifestations of acute pancreatitis?

Written by Jiang Guo Ming
Gastroenterology
Updated on September 01, 2024
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Acute pancreatitis includes two main types: acute edematous pancreatitis and acute necrotizing pancreatitis. It is a common acute and critical condition of the digestive system, particularly acute necrotizing pancreatitis, which can often be life-threatening. The primary symptoms usually include severe upper left abdominal pain, fever, chills, shivering, vomiting, etc. There is a significant relationship between abdominal pain and eating; generally, the pain worsens after eating and can sometimes radiate to the back. The main causes could be binge drinking, overeating, cholecystitis, gallstones, or hyperlipidemia, among others. Diagnosis is usually confirmed through examinations such as an upper abdominal CT and serum and urine amylase tests, followed by appropriate treatment measures.

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Dietary care for acute pancreatitis

Symptoms of acute pancreatitis include severe upper abdominal pain. During the treatment, it is essential to fast and decompress the stomach and intestines initially during the abdominal pain period. Once the pain subsides, the patient can begin a liquid diet, followed by a gradual transition to a semi-liquid diet under the guidance of a doctor. Since the causes of acute pancreatitis include binge eating or excessive alcohol consumption, patients with acute pancreatitis should abstain from alcohol and maintain a balanced diet to prevent binge eating. A light diet is preferable, avoiding fatty, greasy, fried, and barbecued foods. Additionally, it is important to maintain regular rest patterns and avoid excessive fatigue or staying up late.

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Can you drink milk with acute pancreatitis?

Acute pancreatitis, especially in the early stages of an attack, does not allow for the consumption of milk. During the onset of acute pancreatitis, especially at the beginning, it is crucial to completely refrain from eating and drinking anything, as consuming food can lead to excessive secretion of stomach acid. The stimulation from the food can cause the pancreas to secrete enzymes, potentially worsening symptoms like abdominal pain and bloating associated with acute pancreatitis. For patients with acute pancreatitis, if the condition is stable and intestinal function is restored or in the recovery phase, it is permissible to drink some milk. However, it is important to avoid consuming foods that are overly greasy, spicy or stimulating, especially alcoholic beverages, as these can exacerbate the symptoms of pancreatitis or even lead to a recurrence of the condition. The diet should primarily consist of light, low-salt, low-fat fresh vegetables and fruits.

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Is acute severe pancreatitis serious?

Acute severe pancreatitis is a very serious disease in clinical practice, with a high mortality rate, often requiring comprehensive treatment in the ICU. Acute severe pancreatitis is a disease caused by multiple etiologies that results in localized inflammation, necrosis, and infection of the pancreas, accompanied by a systemic inflammatory response and persistent organ failure. It is divided into three phases. The first phase is the acute response phase, occurring from onset to about two weeks, characterized by systemic inflammatory response; the second phase is the systemic infection phase, occurring from two weeks to about two months, characterized by necrosis and infection of the pancreas or peripancreatic tissues; the third phase is the residual infection phase, occurring two to three months later, with clinical manifestations primarily of systemic malnutrition and persistent fistulas, accompanied by gastrointestinal fistulas.

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Does acute pancreatitis cause abdominal muscle tension?

If a patient with acute pancreatitis shows symptoms of peritonitis, abdominal muscle rigidity may occur. Acute pancreatitis is divided into acute edematous pancreatitis and acute hemorrhagic necrotizing pancreatitis. The main symptoms of acute edematous pancreatitis include abdominal pain, nausea, vomiting, and fever. If it is hemorrhagic necrotizing pancreatitis, it can lead to shock, respiratory distress syndrome, high fever, jaundice, abdominal distension, and the abdominal compartment syndrome in the patient. Severe cases can cause intestinal paralysis and signs of peritoneal irritation, leading to abdominal muscle rigidity and also possibly presenting with shifting dullness, among other symptoms.

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What can be eaten during the recovery period of acute pancreatitis?

Patients with acute pancreatitis in the recovery phase should start to eat some sugary liquid diets, beginning with easily digestible sugary foods. Generally, it is recommended to transition from liquid to semi-liquid diets, and then to a normal regular diet. However, patients with acute pancreatitis in the recovery phase should still avoid overeating and consuming too greasy foods. They should also abstain from alcohol and avoid eating overly fatty foods such as meat fried noodles, fried rice with eggs, and braised pork. These foods should be largely avoided, while increasing the intake of protein-rich foods for the patient.