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July 05, 2010

B.A.C.K !!!!!

Wow,it's been a while since i  last posted here..
A lotta stuff happened and I did stop writing  cuz i was suffering from acute pancreatitis & had to be hospitalized. But, now I'm back, despite having to undergo a very strict diet abt my food and abt my sleeping hours.
Now I wanna share a little abt acute pancreatitis. Hopefully when you read this blog and if you have symptoms like that which I wrote, immediately correct your diet & stop alcohol consumption (if you're alcoholic) before you hit pancreatitis. Seriously, this disease can be fatal and it can change ur life forever!!

Pancreatitis occurs when there is activation of pancreatic enzymes within the pancreas, with the result autodigesti. A spark causes the release of granule zimogen from acinar cells into interstisium and activate tripsinogen into trypsin. This activation resulted in a variety of pathophysiological changes ranging from mild inflammation to necrosis (often bleeding) and spread to tissues around the pancreas. Pathological findings correlated with clinical degrees, ranging from edema to necrosis. Hipoperfusi splansnik secondary infection and can lead to complications of sepsis and multiple organ failure.
The two largest causes of acute pancreatitis is excessive alcohol consumption and gallstones, although the aetiology may include other factors (hypertriglyceridemia, iatrogenic, drugs, trauma, idiopathic, etc.). Both became the cause of 80% of cases

SYMPTOMS
Almost every patient experiencing severe pain in the abdomen above the middle, below the breastbone (sternum). Pain often extends to the back. Sometimes pain can be felt first in the lower abdomen. This pain usually occurs suddenly and reaches its maximum intensity within minutes. The pain is usually severe and persist for several days. Even large doses of injections narkotikpun often can not reduce this pain. Cough, rough movement and breathing that in, could make the pain worse. Sitting upright and leaning forward may help relieve pain.
Most sufferers feel nauseous and want to vomit.
Patients with acute pancreatitis due to alcoholism, may have no symptoms other than pain that is not too great. While other patients will look very sick, sweating, rapid pulse (100-140 beats per minute) and fast and shallow breathing.
Initially, the body temperature can be normal, but increased in a few hours until 37.8 to 38.8 Celsius. Blood pressure can be high or low, but tends to fall if that person is standing and can cause fainting.
Sometimes the whites of the eyes (sclera) looks yellowish.
20% of patients with acute pancreatitis experiencing some upper abdominal swellings. This swelling can occur because of interruption of the movement of the contents of the stomach and intestines (gastrointestinal condition called ileus) or due to an inflamed pancreas was enlarged and pushed to the front of hull. Fluid collection can also occur in the abdominal cavity (ascites).
In severe acute pancreatitis (pancreatitis nekrotisasi), blood pressure may drop, possibly causing shock. Severe acute pancreatitis can be fatal.

When a healthcare provider identifies symptoms suggestive of pancreatitis, specific questions are asked about the person's symptoms, lifestyle and habits, and medical and surgical history. The answers to these questions and the results of the physical examination allow the healthcare provider to rule out some conditions and to zero-in on the correct diagnosis.In most cases, laboratory tests are needed. The tests check for several possibilities, including the following:


  • Pancreas, liver, and kidney functions (including levels of pancreatic enzymes amylase and lipase)
  • Signs of infections
  • Blood cell counts indicating signs of anemia
  • Pregnancy test
  • Blood sugar, electrolyte levels (an imbalance suggests dehydration) and calcium level
Results of the blood tests may be inconclusive if the pancreas is still making digestive enzymes and insulin.


Diagnostic imaging tests are usually needed to look for complications of pancreatitis, including gallstones.

Diagnostic imaging tests may include the following:

X-ray films may be ordered to look for complications of pancreatitis as well as for other causes of discomfort.

A CT scan is like an x-ray film, only much more detailed. A CT scan shows the pancreas and possible complications of pancreatitis in better detail than an x-ray film. A CT scan highlights inflammation or destruction of the pancreas.

Ultrasound is a very good imaging test to examine the gallbladder and the ducts connecting the gallbladder, liver, and pancreas with the small intestine.

Ultrasound is very good at depicting abnormalities in the biliary system, including gallstones and signs of inflammation or infection.

Ultrasound uses painless sound waves to create images of organs. Ultrasound is performed by gliding a small handheld device over the abdomen. The ultrasound emits sound waves that "bounce" off the organs and are processed by a computer to create an image. This technique is the same one that is used to look at a fetus in a pregnant woman.

Endoscopic retrograde cholangiopancreatography (ERCP) is an imaging test that uses an endoscope (a thin, flexible tube with a tiny camera on the end) to view the pancreas and surrounding structures.

ERCP is usually used only in cases of chronic pancreatitis or in the presence of gallstones.
To perform an ERCP, a person is first sedated. After sedation, an endoscope is passed through the mouth, to the stomach, and into the small intestine. The device then injects a temporary dye into the ducts connecting the liver, gallbladder, and pancreas with the small intestine (biliary ducts). The dye makes is easier for the healthcare provider to see any stones or signs of organ damage. In some cases, a stone can be removed during this test.



Pancreatitis Treatment


Self-Care at Home

For most people, self-care alone is not enough to treat pancreatitis. People may be able to make themselves more comfortable during an attack, but they will most likely continue to have attacks until treatment is received for the underlying cause of the symptoms. If symptoms are mild, people might try the following preventive measures:

Stop all alcohol consumption.

Adopt a liquid diet consisting of foods such as broth, gelatin, and soups. These simple foods may allow the inflammation process to get better.

Over-the-counter pain medications may also help.


Medical Treatment

Medical treatment is usually focused on relieving symptoms and preventing further aggravation to the pancreas. Certain complications of either acute pancreatitis or chronic pancreatitis may require surgery or a blood transfusion.




Acute Pancreatitis Treatment

In acute pancreatitis, the choice of treatment is based on the severity of the attack. If no complications are present, care usually focuses on relieving symptoms and supporting body functions so that the pancreas can recover.

Most people who are having an attack of acute pancreatitis are admitted to the hospital.

Those people who are having trouble breathing are given oxygen.

An IV line is started, usually in the arm. The IV line is used to give medications and fluids. The fluids replace water lost from vomiting or from inability to take in fluids, helping the person to feel better.

If needed, medications for pain and nausea are prescribed.

Antibiotics are given if the health care provider suspects an infection may be present.

No food or liquid should be taken by mouth for a few days. This is called bowel rest. By refraining from food or liquid intake, the intestinal tract and pancreas are given a chance to start healing.

Some people may need a nasogastric tube (NGT). The thin, flexible plastic tube is inserted through the nose and down into the stomach to suck out the stomach juices. This suction of the stomach juices rests the intestine further, helping the pancreas to recover.

If the attack lasts longer than a few days, nutritional supplements are administered through an IV line.



Chronic Pancreatitis Treatment

In chronic pancreatitis, treatment focuses on relieving pain and avoiding further aggravation to the pancreas. Another focus is to maximize a person's ability to eat and digest food.

Unless people have severe complications or a very severe episode, they probably do not have to stay in the hospital.

Medication is prescribed for severe pain.

A high carbohydrate low fat diet; and eating smaller more frequent meals help prevent aggravating the pancreas. If a person has trouble with this diet, pancreatic enzymes in pill form may be given to help digest the food.

People diagnosed with chronic pancreatitis are strongly advised to stop drinking alcohol.

If the pancreas does not produce sufficient insulin, the body needs to regulate its blood sugar, and insulin shots may be necessary.




Surgery

If the pancreatitis is caused by gallstones, an operation to have the gallbladder and gallstones removed (cholecystectomy) is likely.


If certain complications (for example, enlargement or severe injury of the pancreas, bleeding, pseudocysts, or abscess) develop, surgery may be needed to drain, repair, or remove the affected tissues.




Follow-up

The following recommendations may help to prevent further attacks or to keep them mild:

Stop all alcohol consumption.

Eat small frequent meals. If in the process of having an attack, avoid solid foods for several days to give the pancreas a chance to recover.

Eat a diet high in carbohydrates and low in fats.
Prevention


Completely eliminating alcohol is the only way to reduce the chance of further attacks, to prevent the pancreatitis from worsening, and to prevent the development of complications that can be very serious or even fatal


Owkayy..i hope you guys find it usefull.. :)
Stay Happy, Stay Healthy!!

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