Pancreas

Pancreatic fibrosis

Inflammation of the pancreas often takes a chronic course. At the same time healthy cells can die and be replaced by connective tissue. This process is called fibrotic changes in the pancreas. Moreover, it is not an independent disease, but a state of the tissues of the gland, which usually appears during a long course of chronic pancreatitis. Usually, the patient finds these words in the results of an ultrasound examination. Moreover, such a diagnosis occurs quite often. The difficulty is that fibrosis is usually asymptomatic, therefore it is rarely found at the initial stage. But the gradual replacement of healthy cells with connective tissue leads to a loss of their functions.

general characteristics

Pancreatic fibrosis is a condition of the tissues of an organ that develops against the background of chronic pancreatitis. It is a pathological change of cells, replacing them with connective tissue cells. Usually, this process develops only with exacerbation of the inflammatory process. It can provoke the use of alcoholic beverages, a violation of the diet, injury and other pathologies.

This pathology has several varieties. They differ in the location of the modified cells, their number and type. Most often in place of healthy tissue connective grows. If this occurs evenly over the entire surface of the gland, it is said that diffuse fibrous changes of the organ are present. But sometimes the modified cells are located in separate small islands. This is focal fibrosis. The progression of such a condition can lead to the development of a benign tumor - fibroma.

In addition to connective tissue, healthy cells can be replaced by fat. Such fibrous fatty tissue can also be located either over the entire surface of the gland or in separate places. Depending on which cells are larger - fibrous or fat, a diagnosis of lipofibrosis or pancreatic fibrolipomatosis is made. With the predominance of adipose tissue often speak of obesity glands. This process is accompanied by its dystrophy. And the prevalence of fibrous cells leads to an increase in the density of tissues.

If their concentration increases, seals, knots, multiple fibroids appear. At the same time, fibromatosis is diagnosed - a serious disease that can only be treated surgically. After all, an increase in the density of the tissues of the gland greatly violates its function.

Another type of such cell changes of this organ is cystic fibrosis. Unlike normal fibrosis, which develops in response to inflammation, this is a hereditary disease. It is more commonly known as cystic fibrosis. Many organs affect the pathology, but the pancreas suffers especially. Cystic fibrosis in this place leads to cell degeneration as a result of the fact that the pancreatic juice becomes very thick and clogs the ducts of the gland.


Fibrous changes are diffuse or localized in one place.

The reasons

What is fibrosis is usually recognized by patients with chronic pancreatitis, in which frequent exacerbations of the disease occur. They provoke cell death and growth in their place of connective tissue. The causes of the development of both fibrosis and pancreatic lipofibrosis are inflammatory diseases of this and neighboring organs. This condition is diagnosed in patients with pancreatitis, cholecystitis, cholelithiasis, fatty hepatosis.

In addition, there are factors that accelerate the replacement of healthy cells with connective tissue. This most often happens in those who smoke, abuse alcoholic beverages, are overweight, eat improperly. Infectious diseases, stress, abdominal trauma, severe intoxication of the body, or long-term use of certain drugs can stimulate this process. It has been observed that this often happens due to age-related changes in metabolic processes, so people’s fibrosis after 60 years can develop for no apparent reason.

Symptoms

Similar changes in pancreatic cells are quite common among the older population. But the problem is that it is not always immediately able to detect pathology. Such changes usually do not cause any discomfort. Especially often asymptomatic diffuse fibrosis occurs, in which cell replacement occurs evenly throughout the parenchyma of the gland, so its functions are partially preserved. And with the damage of the islets of Langerhans, the patient develops diabetes, as the secretion of both insulin and glucagon decreases.


Usually, fibrosis is asymptomatic, but as it progresses, pain, nausea, bloating can occur.

This pathology develops mainly as a complication of pancreatitis or other diseases. Therefore, the discomfort is still present. But it occurs when exacerbation of the inflammatory process or after a violation of the diet.

At the same time, the following symptoms of fibrosis can be noted:

Diet for pancreatic diseases
  • decreased appetite, heaviness in the abdomen, slowing down the digestion of food;
  • nausea, vomiting, especially after eating fatty foods;
  • upset stools, the presence of undigested food particles in the feces;
  • belching, hiccups, increased flatulence;
  • pain in the left hypochondrium.

Strengthening of such signs can occur if the altered cells are localized in one place and this formation squeezes adjacent tissues, blood vessels or ducts of the gland. At the same time, the temperature may rise, severe vomiting, girdling pain in the upper abdomen, and obstructive jaundice may appear. This condition requires immediate medical attention.

Diagnostics

Since this pathology does not have specific symptoms, and its manifestations are the same as in many pathologies of the gastrointestinal tract organs, it is recommended to undergo regular medical examination to stop the changes and prevent complications. Detect the presence of pancreatic fibrosis is possible only during ultrasound. Tissue compaction is manifested on the sonogram with increased echogenicity.


Most often found fibrous changes in the pancreas during ultrasound

Blood tests are also prescribed that detect the presence of enzymes. For example, low amylase activity is indicative of damage to a significant part of the gland cells Enzyme deficiency can also be detected with coprogram. If there are undigested fibers, fats or proteins in feces analyzes, this indicates a low level of enzymes produced by the gland. To confirm the diagnosis, a CT scan or a biopsy can be assigned, which can more accurately determine the location and type of altered tissue.

Treatment

Even with timely diagnosis, the prognosis of pancreatic fibrosis is unfavorable. Modern possibilities of medicine cannot restore pathologically altered cells. Therefore, there are no specific treatments. The main task of therapy is to relieve symptoms and prevent the progression of fibrotic changes. For this purpose, medications and a special diet are used.

Combined therapy is used to relieve symptoms of pancreatic fibrosis. Usually used different drugs, the choice of which depends on the manifestations of the pathology:

  • antispasmodics help relieve pain - Drotaverinum, No-Spa;
  • NSAIDs reduce inflammation - Ibuprofen, Nimesulide, Diclofenac;
  • if the patient suffers from nausea and frequent emetic urges, Reglan, Domperidone, Metoclopramide are prescribed;
  • with diarrhea, you can drink Lopedium or Smecta;
  • increased gas formation is removed by Espumizan;
  • heartburn and pain in the stomach require the use of omeprazole or almagel.

Treatment of fibrosis should be aimed at eliminating the causes of pathological changes in tissues, as well as the elimination of enzyme deficiency. Therefore, the main drugs for fibrosis of the pancreas are enzyme preparations. Such remedies are often recommended to drink for a long time at each meal. After all, the death of healthy gland cells leads to a decrease in the secretion of pancreatic juice, so digestion slows down. To unload the gland and improve the absorption of nutrients, take Pancreatin, Panzinorm, Festal, Enzistal, Mezim and other enzyme preparations.


Treatment necessarily includes a special diet and taking enzyme preparations.

If pancreatic fibrosis caused damage to the endocrine cells, the use of glucose-lowering drugs is required. They help eliminate violations of carbohydrate metabolism. Other drugs are also used, the action of which is aimed at correcting disorders in other organs that could lead to fibrotic changes. It may be antacids for the treatment of gastritis, choleretic drugs, antibiotics.

In addition, complex therapy necessarily includes a special diet, which is appointed individually. Food should be gentle. It is necessary to exclude those products that create stress on the pancreas and can cause aggravation. These are smoked, spicy foods, pickles, canned goods, all fried and fatty dishes, spices, meat broths, carbonated drinks, fresh pastries. Alcohol is necessarily excluded.

Meals should be fractional, you need to eat often, but in small portions. It is recommended to grind or wipe all food. Useful semi-liquid porridge, soup-puree, steam meatballs, souffles, jelly.

It is not recommended to fry and bake products with butter, it is better to boil, stew or steam. It is undesirable to eat fresh vegetables and fruits, pastries, black bread. It is also recommended to drink at least 2 liters of water daily.

Fibrous changes in the pancreas can be stopped. Although this function of the tissues will not be restored, but you can get rid of discomfort and avoid serious complications. True, for this you need to constantly control yourself: follow a diet, give up bad habits, take medications prescribed by a doctor.

Watch the video: What is Pancreatitis? Q&A (October 2019).