Calculous pancreatitis, chronic and acute forms of the disease

The digestive system is the basis of the body. Failure of any organ will inevitably have a negative impact on the body and lead to serious consequences. People often seek help in the treatment of such diseases: gastritis, pancreatitis, appendicitis, cholecystitis. The article discusses the disease pancreatitis, or more precisely, its type - calculous pancreatitis.

The general definition of the disease is an inflammatory process to which the pancreas is susceptible. Calculous pancreatitis is a disease accompanied by the deposition of calcium salts in the form of pebbles or sand inside the organ. This is explained by an imbalance in the chemical content of pancreatic juice. Stones or sand close the duct, preventing the secretion from escaping. The disease is often observed in people of retirement age.

Calculous type pancreatitis

What is calculous pancreatitis

This disease is an inflammatory pathology affecting the cavity of the pancreas, characterized by the deposition of calcifications in the cavity of this organ. The formation of stones or calcifications in the area of the excretory ducts of the gland occurs due to the development of a disease leading to a change in the chemical structure of pancreatic juice.

In most cases, the concretions that appear are formed from carbonated lime or phosphoric acid, and are also small in size, resembling grains of white sand with a porous structure.

Chronic calculous pancreatitis often affects older women over 45 years of age and is called stones in the pancreas. The cause of the development of this disease is the presence of the following factors:

excessive consumption of alcoholic beverages;
progressive stage of cholecystitis;
hepatitis group B or C;
prolonged chaotic use of antibiotic drugs;
ulcerative lesion of the duodenum;
gallstone pathology affecting the cavity of the bile ducts, gallbladder or liver.

What kind of disease?

Calculous pancreatitis is an inflammatory disease of the pancreas that occurs with deposits of calcium salts in the tissues of the organ. This occurs due to pathologies and disturbances in the chemical composition of pancreatic juice. As a result, stones form in the area of the excretory duct of the organ.

Most often, these stones consist of phosphate and carbon dioxide of lime. They are usually small in size, they look like gray-white sand, have a relatively low density and porous structure.

Most often, chronic calculous pancreatitis occurs in the female half of humanity, over the age of 50 years, and is popularly called stones in the pancreas. It is extremely rare and chronic.

Diet

In the treatment of calculous pathology of the gland, an important role is played by the diet, from which it is necessary to completely remove all dishes prepared by frying, as well as with a high percentage of fat content, spiciness, saltiness and smokedness. You need to eat fractionally, using small portions.

The following types of food are allowed:

white poultry and rabbit meat;
lean fish;
low-fat cottage cheese and all types of fermented milk products;
casseroles and omelettes;
vegetable soups and purees;
porridge based on buckwheat, semolina or oatmeal;
herbal teas;
jelly and rosehip decoctions.

Alcoholic drinks are strictly prohibited.

Among fruit and berry crops, only sweet fruits are recommended for consumption.

Clinical picture of the disease

The clinic of the calculous form of pancreatic pathology consists in the formation of various painful sensations, depending on the location of the stones:

in the epigastric and middle parts of the abdomen, pain occurs when stones form in the area of the body and head of the gland;
pain in the right region of the abdomen manifests itself when calcifications form only in the body of the gland;
pain appears in the left part of the hypochondrium if the stones are located in the area of the tail of the affected organ;
when the entire organ is affected by calcifications, a shingling pain occurs.

The patient's stool has an unpleasant odor, remains of undigested food and a mushy state, despite constant constipation.

Medicines of natural origin are also excellent assistants in the treatment of uncomplicated forms of pancreatic pathology. To restore the functionality of a parenchymal organ, the following folk recipes can be used:

Methods and means of traditional medicine

With the permission of the attending physician, traditional methods can be used to treat calculous pancreatitis in the stage of stable remission.

So, the following alternative medicines are usually used:

walnut tincture";
juice from fresh potatoes and carrots;
tincture of chamomile flowers, St. John's wort, wormwood, mint leaves and yarrow;
decoction or powder of aspen bark;
a decoction of dandelion roots and leaves;
a decoction of bean pods and blueberry leaves;
decoction of oat grains;
tincture of bitter wormwood;
Powdered stems of bittersweet nightshade. Take 15 minutes before meals three times a day. If sweet sensations appear, we can conclude that there is severe inflammation of the pancreas. If such a feeling occurs after 15 minutes, then the disease is mild.
a mixture of calamus roots, dandelion, nettle, mint leaves, thyme and hop cones, honey or jam;
a decoction of anise fruit, corn silk, celandine herb, tricolor violet and dandelion root, and knotweed herb.

With calculous pancreatitis, proper nutrition and diet are very important. It is necessary to exclude everything fried and sweet from the diet. Meals should be divided, in small portions. Food should be at medium temperature (neither very hot nor very cold).

Let's take a look at the products allowed for this disease:

lean types of poultry, fish and meat.
low-fat cottage cheese. It can be eaten fresh or made into casseroles.

It is advisable to steam or boil the consumed dishes. During periods of exacerbation of the disease, it is recommended to bake vegetables or fruits.

Recommended drinks:

herbal teas;
rosehip decoction;
various jelly.

Here is an approximate diet menu for this disease:

cookies and dry bread;
pureed soups cooked in low-fat broth;
low-fat dairy products;
casseroles;
omelettes. For cooking, use only protein.

Buckwheat, semolina or oatmeal porridge can be an excellent breakfast. But porridge should be consumed only in grated form. Fruits are allowed for this pathology only non-acidic varieties.

Disease prognosis

With calculous pancreatitis, experts usually leave an unfavorable prognosis, since this disease can often degenerate into a malignant tumor. Also, with this disease, the patient’s working capacity usually decreases, for this reason, in some cases a disability group is assigned.

Timely diagnosis, proper nutrition, and giving up bad habits will help avoid the development of many dangerous pathologies and complications.

Causes

The specific cause of the disease has not yet been identified.

There are factors that can affect the formation of calcifications in the parenchyma of the gland:

systematic consumption of alcoholic beverages in large quantities;
uncontrolled use of antibiotics;
peptic ulcer, chronic inflammation of the duodenum;
gallbladder diseases;
hepatitis type B and C;

Note! The risk of stone formation in the gland is high among chronic alcoholics and people suffering from cholelithiasis.

Operation

Acute calculous pancreatitis cannot be cured with medication (only put into remission). Removal of stones is only surgical.

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Surgery is performed to restore the patency of the main pancreatic duct. This will normalize the release of pancreatic enzymes into the small intestine, improve the functioning of the organ, and the digestion of food.

During the operation, various methods are used:

partial excision of the organ and suturing into the colon;
dissection of the duct to remove the stone, and then stitching it to the intestinal mucosa.

If at the time of going to the hospital most of the pancreas has died, it is removed to prevent blood contamination by decay products.

Diet

fried, fatty;
spicy, salty
alcohol;
smoked, marinated.

The diet involves split meals up to 6 times a day. The menu consists of fresh, boiled and steamed dishes from vegetables, fruits and lean meats and fish. Fermented milk products have a beneficial effect on digestion.

Causes of the problem

Calculous cholecystitis (CLC) does not form immediately. Let's consider the factors that contribute to the formation of stones in the gallbladder:

cholestasis, or stagnation of bile, for example, can occur when the body of the gallbladder is kinked;
dyscholia, or altered composition of bile, its thickening due to increased cholesterol content or impaired secretion;
cholecystitis, or inflammation in the gallbladder.

In addition, diet, or more precisely, systematic disturbances in nutrition (too high-calorie, fatty and cholesterol-rich foods, lack of vitamins in the diet) can provoke calculous cholecystitis.

Regular consumption of alcoholic beverages. Ethanol and its breakdown products have a toxic effect on the parenchyma of the organ.

Bile reflux into the pancreatic ducts. Systematic fasting and low-calorie diets, and even long-term use of contraceptive hormonal drugs can also lead to cholelithiasis. Among the diseases that often become the impetus for the formation of gallstones are:

obesity and metabolic disorders;
endocrine diseases, such as diabetes;
liver diseases, such as hepatitis and cirrhosis;
biliary dyskinesia;
pancreatitis;
duodenitis;
Crohn's disease;
chronic gastritis;
helminthiases.

The predisposing factors are:

increased levels of triglycerides in the blood;
obstruction of the sphincter of Oddi;
scar tissue changes in the area of the duodenal papilla;
autoimmune disorders;
smoking;
cystic fibrosis (damage to the exocrine glands);
increased calcium levels in the blood;
taking medications that disrupt cholesterol metabolism (cephalosporins, somatostatin analogues, estrogens, fibrates);
obesity;
intestinal diseases;
surgical interventions;
excess of spicy and fatty foods on the menu;
binge eating;
eating 1-2 times a day at large intervals;
change in the chemical composition of bile.

Risk factors for the formation of stones in the organ duct during pancreatitis are infectious diseases (bacterial, viral, parasitic) and old age.

Diagnostics

Comprehensive diagnostics consists of an analysis of the patient’s complaints, an objective examination and research data.

To establish a diagnosis, the following is prescribed:

Blood and urine tests for amylase/diastase.
An X-ray examination of the abdominal cavity, which helps to see the presence of one or more stones (stones), provided they have a dense structure.
Ultrasonography. Makes it possible to study the size of the gland, changes in its parenchyma, the presence and amount of calcifications; condition of nearby organs.

There are factors that can affect the formation of calcifications in the parenchyma of the gland:

Physiotherapy and diet therapy

Thanks to special physiotherapeutic procedures, it is possible to improve the functioning of the pancreas organ, accelerate the regeneration of its tissues and eliminate the inflammatory process.

Visiting sanatorium-resort areas that include taking baths in mineral water with a certain composition has a beneficial effect. You need to stick to a diet and give up alcohol, so you can achieve a phase of stable remission of calculous pancreatitis.

In fact, diet is a very important factor leading a person to recovery. Most likely, many people know that pancreatitis cannot be cured, but it is quite possible to blunt the development of the pathology.

To prevent the disease from making itself felt with unpleasant symptoms in the future, you should follow the permitted diet according to the dietary treatment example “Table No. 5”. Even beginners should not have any problems with cooking.

It is recommended to steam, boil and bake in the oven. Gradually, a person will try new dishes so much that he will not even have thoughts about switching to his previous diet.

Medicines

Pharmacy products are aimed at eliminating the clinical manifestations of pathology. It is necessary to eliminate attacks of vomiting and nausea, pain, normalize stools and improve the functioning of the gastrointestinal tract.

Medicines can relieve inflammation and stimulate the breakdown of deposits. They are able to influence the cause of the pathology.

Diagnosis of pathology

In order to make a correct and accurate diagnosis, the attending physician prescribes the following additional diagnostic procedures:

Ultrasound, which allows visualization of dilatation of the Wirsung duct, which occurs against the background of the formation of stones in its cavity.
Submission of blood and urine tests for laboratory research methods, as a result of which an increase in amylase levels is detected.
X-ray, which is used to determine the presence of large stones in the affected gland.
In the absence of the required level of information from the above-described diagnostic procedures, endoscopic retrograde pancreatography is prescribed.

Pathogenesis of calculous pancreatitis

Chronic calculous pancreatitis or the acute phase of the disease is provoked by pathologies such as hepatitis C or B, duodenal diseases or gastric ulcers.

Damage to connective tissue or blood vessels, unhealthy diet, negative environmental conditions, taking strong medications, smoking or drinking alcohol - all this also negatively affects the condition of the pancreas.

The chronic form of calculous pancreatitis can worsen in cases where a person does not follow a diet, experiences a stressful situation, or takes antibiotics.

All these cases can lead to complete disruption of the functional characteristics of the gastrointestinal tract. The likelihood of inflammation in the pancreas may be associated with the presence of other ailments of the digestive or hepatobiliary system.

If the organ is damaged, damaged areas or dead parts of the gland are removed during surgery.

Symptoms

Signs of the disease are:

Pain. Localized on the left in the hypochondrium or upper abdomen. Less commonly it occurs in shingles. May occur as biliary colic. Radiates to the left chest and back. Accompanied by signs of disruption of the digestion process. It intensifies with errors in diet and after drinking alcohol. Most often dull and aching, but can be stabbing and cutting.
Nausea.
Vomit. It happens repeatedly. Bile may be released during vomiting.
Heartburn.
Bitter belching.
Bloating due to increased formation of gases due to impaired enzyme synthesis.
Alternation of loose stools with constipation. In chronic pancreatitis, stool often contains remnants of undigested food and a lot of fat, making it difficult to wash off and shiny. With the development of inflammation against the background of cholelithiasis and stagnation of bile with the development of jaundice, feces may become discolored.
Decreased appetite.
Yellowish skin tone.
Dry skin.
Red-bluish spots in the abdomen and chest.
Pain in the upper abdomen.

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Sometimes with pancreatitis there is an enlargement of the liver and spleen.

Treatment of the disease

Treatment for calculous pancreatitis must be prescribed by a doctor, since this is a very serious and dangerous disease. Treatment methods depend directly on the severity of the disease.

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During stable remission, sanatorium-resort treatment is recommended, which offers the following methods:

1) Sanatorium-resort mode.

2) A set of treatment procedures:

- internal intake of mineral waters (drinking treatment, gastric lavage, rectal procedures, bile duct drainage and others).
— external intake of mineral waters (mineral baths).
- mud therapy.
— physical therapy and climatotherapy.

— UHF therapy;
- diathermy;
- paraffin;
- Sollux and others.

Most often, this disease is treated using a surgical method. If symptoms of internal and exocrine insufficiency are present, the patient is prescribed insulin injections. As mentioned above, the most effective method used to treat calculous pancreatitis is the surgical method. The purpose of the surgical operation is to create good conditions for the outflow of juice in the gastrointestinal tract from the pancreas itself.

Depending on how affected the gland and ducts are, the following types of surgical interventions are performed:

Subtotal pancreatectomy (resection of the pancreas). This operation is prescribed when there is major damage to the pancreas and most of the cells of the organ die.
Transduodenal papillosphincterotomy, in which the pancreatic duct is drained.
Resection of the distal part of the pancreas and suturing it into the colon.
An anastomosis between the loop of the small intestine and the pancreatic duct.

Treatment

If an acute attack of the disease occurs, you must call an ambulance. Before the team arrives, no food or medications are recommended; bed rest and a cold compress on the pancreatic area are required.

If the cause of the disease is that the gallbladder is filled with stones, it will have to be removed. In the presence of small stones, it is possible to remove stones using ultrasound. And microscopic sludge can be resolved with urodisoxycholic acid preparations. Surgical interventions are also performed using an endoscope for various pathologies of the major duodenal papilla and sphincter of Oddi.

Conservative treatment of biliary pancreatitis includes drug therapy and dietary nutrition. Treatment must be prescribed by the attending physician; self-medication is dangerous to life and health.

In the first days of exacerbation and acute illness, the following principles are observed: “cold, hunger and peace.” Bed rest and avoidance of emotional and physical stress are required. Patients are advised to restore the amount of fluid using saline solutions intravenously and still mineral waters orally. Patients are prescribed antispasmodics (no-spa, drotaverine), which reduce pain and relieve spasms in the bile ducts and pancreatic ducts. They use drugs that reduce acidity in the stomach (omeprazole, almagel, talcid).

To replace the exocrine function of the pancreas, enzyme preparations (Creon, Festal, Mezim) are used. In addition to these drugs, heparin, diuretics, antibiotics, and vitamin complexes are used in difficult situations.

In order to prevent and treat the disease, a diet for biliary pancreatitis must be strictly followed. For the first three days, the patient must fast and can only drink liquids (still water).

Then a small amount of low-fat food is introduced, and the patient gradually switches to diet number 5. It allows the consumption of boiled, stewed or steamed vegetables (with the exception of spinach, radishes and turnips), low-fat meat products, cereals with low-fat milk or water, dried bread, baked apples and dried fruits, vegetable soups, steam omelettes, compotes.

For biliary-dependent pancreatitis, fatty, fried and spicy foods, smoked foods, foods high in caffeine, sweets, except dry biscuits, marmalade and marshmallows, sour vegetables and fruits, and fast food are prohibited.

Meals during illness should be frequent and divided, in small portions.

There are traditional methods of treating this disease - the use of various decoctions (rose hips, chamomile, calendula, oats), tinctures (barabaris, golden mustache), and other recipes. Remember, the use of such drugs is only permissible for long-term chronic illness after prior consultation with a doctor. Self-medication can be harmful.

Features of the treatment of calculous pancreatitis

Any independent treatment of calculous pancreatitis is strictly unacceptable. Due to the severity of this disease, its treatment is carried out only by surgery. The purpose of surgery is to ensure the flow of gastric juice from the gland into the gastrointestinal tract.

Rehabilitation can be carried out in specialized sanatoriums, whose qualified personnel can ensure that the patient follows a therapeutic diet and carries out appropriate procedures.

Peculiarities

Pancreatitis with stones of various etiologies has its own characteristics.

Most often, inflammation of the gland is diagnosed in combination with cholelithiasis.

Calculous pancreatitis and cholecystitis

Women are more likely to suffer from calculous cholecystitis and pancreatitis. Stones are cholesterol (detected in 80% of cases) and pigment.

Women are more likely to suffer from calculous cholecystitis and pancreatitis.

When pancreatitis is combined with cholecystitis, biliary colic often occurs. This is an acute pain syndrome. The attack most often occurs at night. The pain intensifies when inhaling and lying on the left side. Worried about repeated vomiting and general malaise. This condition requires emergency care.

Symptoms of calculous pancreatitis

The symptoms of the disease are correlated with the localization of stones in the pancreas. The formation of stones throughout the gland causes girdle pain. With stones located in the tail of the pancreas, pain is felt in the left hypochondrium, as well as in the pit of the stomach. Stones in the body and head of the gland cause pain in the middle part of the abdomen.

A characteristic symptom of calculous pancreatitis is constipation and changes in stool. Undigested food residues are observed in the stool, it has an unpleasant odor, porridge-like and foamy consistency.

Laboratory and instrumental diagnostics indicate increased amylase in urine and blood, as well as increased acidity of gastric juice. Secretory insufficiency is pronounced. If it is impossible to diagnose calculous pancreatitis by laboratory, x-ray and ultrasound examinations, endoscopic retrograde pancreatography can be used.

Traditional recipes for the treatment of calculous pancreatitis

These treatment methods are used only with the consent of the attending physician; some recipes may be recommended by the doctor. Aimed at strengthening the result after traditional medicine in order to minimize the risk of exacerbation of the disease or progression of the disease.

Let's consider well-known and proven recipes:

Potato and carrot juice. Take 2 carrots and potatoes, wash them thoroughly, do not remove the peel, remove imperfections. Grind in a blender or meat grinder, squeeze out the juice. Drink in the morning on an empty stomach for a week. Then take a break for the same period.
Oats. A glass of grains is washed and scrolled in a meat grinder. The mixture is poured with 1 liter of water and cooked over low heat for 10 minutes. Cool and filter. Drink half a glass of the resulting drink in the morning before meals. The course is 10 days.
Walnut. 1 glass of walnut shells and partitions is poured into 0.5 liters of vodka into an opaque bottle, then left for a month, shaking occasionally. Take 1 teaspoon before meals for about a month, then the same break.
Dandelion. Take the shoot along with the root without the flower and chop it. Add 0.5 liters of water to the resulting mass and let it brew for a day. Drink ¼ glass before meals 6 times a day. The course of treatment is 2 weeks.

Not all known methods of preparing medicinal potions are listed here. Remember that you can use traditional methods if there is no intolerance or allergic reactions to the components of the mixtures being prepared. Traditional recipes do not replace the main treatment, but will become additional.

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I would like to add that prevention and prevention of the disease are considered the best way to prevent it. Do not ignore the first symptoms that appear when you feel unwell, suppressing them with pills or self-medicating. This practice can relieve symptoms, but does not treat the cause. Giving up bad habits, reducing physical activity, and following healthy eating rules are helpful.

If stagnation occurs in the pancreas or inflammatory processes begin, they disrupt the chemical composition of its juice, which leads to the formation of calculi, small stones or sand consisting of lime carbonate in the excretory duct. They clog the duct and lead to inflammation in a short time. In medical practice, this pathology, which occurs practically without symptoms, is called chronic calculous pancreatitis. Vivid signs of the disease appear only during its exacerbation, which develops immediately after a person with this pathology has abused alcoholic beverages, poor-quality food, or uncontrollably taken certain groups of medications.

Subtotal pancreatectomy (resection of the pancreas). This operation is prescribed when there is major damage to the pancreas and most of the cells of the organ die.
Transduodenal papillosphincterotomy, in which the pancreatic duct is drained.
Resection of the distal part of the pancreas and suturing it into the colon.
An anastomosis between the loop of the small intestine and the pancreatic duct.

Symptoms of the disease

Symptoms of the disease directly depend on the form of the disease (acute or chronic) and on the location of the stones in the pancreas itself:

1) Pain of various types:

In the case where the stones have arisen and are located in the body or head of the pancreas, the pain is localized under the spoon or in the middle part of the abdomen.
In the case where the stones are located in the area of the body of the pancreas, pain is felt in the right side of the abdomen.
When the stones are located in the tail of the organ, pain is felt on the left in the hypochondrium.
In cases where the stones have affected the entire gland, the patient suffers from girdle pain.

2) Change in the nature of the stool. Usually the patient suffers from constipation. The stool may have a mushy consistency. Undigested food remains in the stool may also be observed.

3) Frequent nausea and in some cases vomiting.

4) Increased sweating.

6) Increased heart rate.

If the stones are located throughout the pancreas, diabetes mellitus begins to develop. In this case, the pain is mild or absent altogether.

Possible complications

Calculous cholecystitis must be treated, because it is dangerous due to its complications. We list the most common of them:

Acute pancreatitis.
Empyema of the gallbladder (inflammation followed by filling of the bladder with purulent contents).
Destructive cholecystitis.
Cholangitis (inflammatory process in the bile ducts).
Secondary biliary cirrhosis of the liver.
Formation of fistulas between the bile ducts and the bladder.
Intestinal obstruction.
Oncology of the gallbladder.
Choledocholithiasis (stones in the bile ducts).

Symptoms and treatment of pancreatitis in adults

Acute pancreatitis is characterized by the following symptoms:

Severe abdominal pain localized in both the right and left hypochondrium.
General malaise.
Increased body temperature.
Nausea and vomiting, but no relief after emptying the stomach.
Constipation or diarrhea.
Moderate shortness of breath.
Hiccups.
Bloating and other unpleasant sensations in the stomach.
Changes in skin color - the appearance of bluish spots, yellowing or redness of the face.

The patient is placed in a ward where intensive care is provided. In severe cases, surgery is required.

Prescribed drug therapy:

antibiotics;
anti-inflammatory drugs;
enzymes;
hormones;
calcium;
choleretic drugs;
enveloping herbal preparations.

Postoperative therapy

As such, the treatment algorithm after surgery against the background of pancreatitis is determined by certain factors. In order to prescribe therapy, the doctor carefully studies the patient’s medical history along with the final outcome of the intervention, the degree of gland restoration, the results of laboratory tests and instrumental diagnostics.

If there is insufficient insulin production by the pancreas, additional insulin treatment may be prescribed. The synthetic hormone helps restore and normalize glucose levels in the human body.

It is recommended to take medications that help produce the optimal amount of enzymes, or that already contain them. Such drugs improve the functionality of the digestive organs. If these medications are not included in the treatment regimen, the patient may develop symptoms such as increased gas formation along with bloating, diarrhea and heartburn.

What else does surgical treatment of the pancreas involve?

Doctors' forecasts

Chronic calculous pancreatitis is life-threatening. Tissue degeneration is quite common, and therefore the patient may face cancer.

This does not always happen, but the pathology sharply reduces the patient’s ability to work and quality of life, and therefore many people after chronic calculous pancreatitis become representatives of the 2nd group of disability.

Planned operations for pancreatitis are carried out during the complete elimination of inflammatory processes in the diseased organ. The goal in this case is to prevent the recurrent course of the disease. Any measures are taken only after a thorough diagnosis, and in addition, a comprehensive examination of the patient. We will find out in what situations surgical intervention is required, and also find out what complications and consequences may arise during the recovery period.

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Prognosis and prevention

The history of the disease of pancreatic pathology of the calculous form usually proceeds with an unfavorable prognosis, since there is a high risk of degeneration into an oncological neoplasm. Moreover, when this disease develops, the patient’s level of performance is much lower than that of a healthy person, so one of the disability groups may be assigned.

In order to prevent the development of such serious pathological diseases, it is necessary to lead a healthy lifestyle, monitor your health, eat right and completely give up bad habits. And timely diagnostic procedures will help to identify pathological disorders in the body at an early stage and prevent their further development.

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