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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Is the recurrence rate of acute pancreatitis high?

After recovering from acute pancreatitis, if patients do not pay careful attention to their diet, there is a significant risk of relapse. For example, they should not drink alcohol excessively, overeat, or consume greasy foods. Also, if the acute pancreatitis is caused by conditions such as gallstones, it is important to have the gallbladder removed promptly. Without gallbladder removal, the recurrence rate of the disease noticeably increases. Patients with acute pancreatitis should initially eat foods that are easy to digest and low in protein and fat, such as carbohydrates that are also easy to swallow. Once the patient's condition significantly improves, they can gradually transition to a diet higher in protein and vitamins, among other nutrients.

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What IV fluids should be administered for acute pancreatitis?

If the diagnosis confirms acute pancreatitis, venous medication generally involves the use of proton pump inhibitors to suppress gastric acid, which also helps reduce the secretion of pancreatic enzymes. Meanwhile, to prevent infection, antibiotics can be used appropriately. Medications that reduce pancreatic secretion, such as octreotide or somatostatin, can be considered, as well as drugs that inhibit pancreatic enzyme activity. Since patients with pancreatitis must abstain from food and water intake, it is important to pay attention to energy intake and maintain electrolyte balance. Once acute pancreatitis is confirmed, it is essential to seek hospital treatment as this condition can be quite dangerous. All mentioned medications should be used under the guidance of a doctor.

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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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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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What to do if acute pancreatitis recurs for the second time?

If acute pancreatitis recurs for the second time, it should still be treated as acute pancreatitis. This means conservative treatment is possible, including gastrointestinal decompression, fasting, rehydration, anti-shock measures, administering pain relievers and antispasmodics, along with certain drugs that inhibit pancreatic secretion. Additionally, provide some nutritional support and symptomatic antibiotic treatment. Some traditional Chinese medicine can also be consumed. If non-surgical conservative treatment is ineffective, surgical treatment options may be considered. Fundamentally, the treatment methods are the same as those used for the first episode of pancreatitis, and specific decisions should be made based on the condition of the disease.