Treatment of chronic pancreatitis in pregnant women

Every woman knows that carrying a child is a serious burden on the entire body. At this moment, all organs and systems work in an enhanced mode; it is for this reason that various diseases can arise during pregnancy.

Pancreatitis is often encountered during pregnancy, and such a disease requires rapid diagnosis.

Note that inflammation of the pancreas in this position is treated differently. Therefore, at the first symptoms you should consult a doctor.

To the question: is it possible to cure a stomach or duodenal ulcer at home, a gastroenterologist, head of the gastroenterology department, Mikhail Vasilievich Arkhipov, answers.

Causes

Pancreatitis during pregnancy can occur due to:

1. If a girl has a high uterine fundus, which compresses the bile ducts.
2. Frequent constipation in the early stages.
3. If you have gastrointestinal diseases.
4. In the presence of viral or bacterial lesions of the organ.
5. Taking vitamins without first consulting a doctor.

Additional causes of the disease include decreased activity of the digestive organs, duodenal or stomach ulcers.

Clinical picture

Pancreatitis during pregnancy is very dangerous, because it can be confused with simple toxicosis, especially if the disease occurs in the early stages.
To prevent all kinds of diseases and complications, you need to carefully monitor your health. If symptoms such as nausea and vomiting occur after 3 months, you should immediately consult a doctor. After all, these are clear signs that the pancreas is not coping with its function.

Let's consider additional symptoms of pancreatitis in pregnant women:

1. Dyspeptic symptoms . In medical practice, all discomfort in the digestive tract is usually called dyspeptic. The main symptoms of the disorder are: flatulence, vomiting, nausea, sudden weight loss. In addition, particles of undigested food can be found in the patient’s stool.
2. Painful signs. Pancreatitis in pregnant women is accompanied by concentrated attacks. The pain syndrome is localized in the upper abdomen, girdle pain in the back.
3. Symptomatic signs . Such symptoms are difficult to determine, because there is no clear clinical picture.

Recommendations from Elena Malysheva in the special issue “Live Healthy!” on how to overcome pacreatitis using the healing effects of natural remedies.

In this case, doctors pay attention to the patient’s additional complaints. Since such an inflammatory process of the pancreas causes a malfunction in the functioning of the enzymatic organ, the patient may experience various disorders.

Also read on our website: Reactive pancreatitis in children: symptoms and treatment

For example:

1. An allergic reaction appears, and sometimes dermatitis occurs.
2. Vitamin deficiency.
3. Dysbacteriosis.

In rare cases, fungal infection of the female genital organs, in particular the vagina, is observed.

Pancreatitis during pregnancy can also occur in the acute stage. In this case, the body temperature rises and blood pressure begins to drop sharply. The woman also experiences severe dizziness, and the illness often occurs with convulsions.

If you experience any of the listed signs, consult your doctor immediately. After all, the disease can lead to premature birth, and in some cases even to the death of the expectant mother.

Complications of pancreatitis

Long-term chronic pancreatitis can significantly affect the condition of a pregnant woman. With frequent attacks, many expectant mothers complain of a complete lack of appetite, aversion to certain types of food, and increased salivation. Flatulence, alternating constipation and diarrhea are very typical.

If inflammation affects the β cells that produce insulin, diabetes mellitus may develop against the background of pancreatitis. In this case, severe hunger and thirst arise, and urination becomes more frequent. If left untreated, diabetes mellitus leads to various complications from the cardiovascular and nervous systems.

Chronic pancreatitis is one of the causes of significant weight loss. During pregnancy, this phenomenon is often attributed to severe toxicosis. Subsequently, low weight gain is observed until childbirth. Weight loss occurs as a result of disruption of the digestive tract and is accompanied by a sharp decrease in appetite.

Other complications of chronic pancreatitis:

• hepatitis;
• abscesses and cysts of the pancreas;
• thrombosis of the splenic vein;
• severe diabetes mellitus;
• pancreas cancer.

Such conditions develop over a long period of time and mainly outside of pregnancy.

Diagnostics

The main goal of diagnostic measures is to distinguish the main diagnosis from toxicosis. The second stage of diagnosis is recovery; doctors select gentle methods.

Tactics of doctors:

1. Reveal the form.
2. Rule out complications.

In the early stages of pregnancy with pancreatitis, a woman is most often sent for an ultrasound examination.

In addition, a referral is issued for laboratory diagnostic methods:

• a routine urine test will help determine what enzyme levels a woman currently has;
• a blood test will show what kind of hemoglobin is, and you can also find out the state of protein metabolism;
• stool analysis helps to establish information on the digestion of fats.

Note that we wrote above that the patient is referred for an ultrasound. This diagnosis shows the change and structure of the affected organ.

Pay special attention! If the period is long, then EGDS (esophagogastroduodenoscopy) can be performed.

Everyone should understand that being in this position, it is necessary to protect themselves and the fetus from the penetration of rays. Therefore, even if you suspect this disease, under no circumstances undergo an X-ray or CT scan, as this will lead to complications.

Principles of treatment

It is difficult to treat any diagnosis in this situation, because most medications cannot be taken.
Treatment of pancreatitis during pregnancy occurs according to a certain scheme. Also read on our website: Types and classification of pancreatitis of the pancreas

First of all, the doctor makes a complete adjustment of the expectant mother’s diet. Depending on the degree of damage and the general condition of the patient, specialists select a special dietary program.

The second stage is to reduce the acidity of digestive juices. That's why doctors use buffered anacids.

The third stage is replacement therapy. One of the drugs is prescribed: Mezim or Festal. These medicines include digestive enzymes that help alleviate the general condition.

Important! Festal is prescribed only for the chronic course of the disease; it cannot be taken in the acute phase.

If none of the remedies help, then analogues are prescribed. It is prohibited to buy analogues of medicines on your own. After all, each remedy has its own spectrum of action and has certain contraindications.

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The fourth stage is to prescribe medications that contain bifidobacteria. Such medications can normalize digestion and completely correct dysbiosis. Linex is most often prescribed (it has contraindications, carefully read the instructions for use).

The final stage includes normalization of the biliary tract.

Many people ask, is it possible to be treated with traditional medicine ? No, a patient in this situation is prohibited from taking traditional methods of treatment. After all, even harmless medicinal tinctures and decoctions cause harm to the fetus. As a result, pathologies arise in the child and complications in the mother.

Planning pregnancy with previously diagnosed chronic pancreatitis

You need to understand that inflammation in the pancreas itself does not affect the process of conception. Therefore, it is not at all difficult for a woman with established chronic pancreatitis to become pregnant. However, you need to keep in mind that in case of inflammation you need to take medications regularly, many of which are contraindicated during pregnancy. All this leads to spontaneous abortion or termination for medical reasons.

If a woman with chronic pancreatitis plans to become pregnant in the near future, she needs to undergo a full examination by a gastroenterologist. The doctor will help you choose the right period of conception, when the disease is in stable remission. During this period, regular daily medication is not required, which means the fetus will develop normally.

Important! You should not plan a pregnancy during an exacerbation of chronic pancreatitis and in the next month after the acute process has subsided. Due to the increasing load on the pregnant woman’s body, the disease may reactivate, which will negatively affect the fetus.

Diet food

It is immediately necessary to note an important fact that diet is not only one of the treatment methods. Proper nutrition is also a good prevention during exacerbation of chronic disease.

If you adhere to a proper balanced diet, you can eliminate many of the symptoms of the disease and the birth will go smoothly.

What you should do:

1. It is best to steam or boil foods.
2. Expand your diet from the second trimester. But only on the condition that the symptoms described above do not have a pronounced pattern.
3. Avoid eating fatty and fried foods. Such a diet will worsen the functioning of an already inflamed pancreas.
4. Exclude smoked meats and sausages.

Also read on our website: Which doctor treats the pancreas

So, with such an illness you need to eat in small portions, you should not overeat. Vitamins (complexes or fruits) are allowed to be consumed after consultation with a doctor. Improper intake of vitamins can lead to severe pancreas impairment.

Diet for the treatment of pancreatitis in pregnant women

When treating pancreatitis, the main rule is dietary nutrition. The only difficulty is carrying the fetus. Therefore, only the correct calculation of the amount of necessary vitamins and nutrients for the unborn child can be made by a nutritionist. General diet for pancreatitis:

• secondary boiled chicken broth;
• low-fat varieties of meat products;
• low-fat cottage cheese;
• kefir;
• low fiber vegetables;
• porridge with water;
• mineral still water.

Meals should be taken in pureed form and in small portions, often. This will relieve the load on the diseased organ and speed up recovery. Why it is advisable to refuse food:

• fatty food;
• candies;
• canned food;
• fresh baked goods;
• apples and many other foods that can cause irritation of the pancreas and its walls.

Choosing the timing and method of delivery

When a disease is diagnosed, everyone has a question: what to do with childbirth?
Only a doctor can answer this question, because delivery is individual and depends on the timing and severity of the illness. If the disease occurs in the first trimester, it is most often interrupted. If the period exceeds 35 weeks, then doctors insist on early birth. In some cases, a caesarean section is performed.

As you can see, such a disease is very dangerous, so it is necessary to recognize the first signs in time and prevent the disease from becoming aggravated.

How to treat

Treatment of acute pancreatitis is performed in a hospital. In the first days of the disease, parenteral nutrition is possible. Then they prescribe a diet, use medications to relieve the attack and alleviate the general condition of the expectant mother. Treatment tactics will vary depending on the severity of the pathological process and its prevalence. During treatment, constant monitoring of the fetus is required.

Treatment of chronic pancreatitis is carried out only in the acute stage.

Drug therapy involves the use of the following medications:

• antispasmodic - “Drotaverine”, “Papaverine”;
• anti-enzyme - to suppress pancreatic function - “Pantripin”, “Gordox”;
• enzymes that are prescribed outside the period of exacerbation - “Pancreatin”, “Mezim”;
• proton pump inhibitors - “Rabimak”, “Omez”;
• antacids - Almagel, Gaviscon. They help reduce the acidity of pancreatic juice, and this helps relieve the inflammatory process;
• choleretic drugs – “Holosas”, “Allohol”, which normalize the flow of bile and help improve digestion.

The duration of use and dosage of the medications taken are determined by the doctor. During therapy, pancreatic functions must be monitored.

Independent childbirth is acceptable if the condition of the woman and fetus is satisfactory. For pancreatitis, cesarean section is performed quite rarely. When all the doctor’s recommendations are followed, there is a high chance of having a healthy child.

If there are cysts in the pancreas, they are surgically removed. During pregnancy, surgery is not performed; it is postponed until the postpartum period.

Planned surgery. This type of surgery is performed when there is no progress in therapy or the rapid development of pancreatitis. The prerequisite is the complete inability to get rid of the pain syndrome. Before the operation, the diagnosis is again performed to get rid of possible misdiagnosis.

Nutrition for pathology

The basis of non-drug therapy is a diet, the rules of which are as follows:

• you should eat often - 5-6 times a day;
• reduce the size of portions;
• refuse fried, fatty, spicy foods;
• limit salt intake;
• increase the proportion of protein in the diet;
• take multivitamins;
• stop smoking and drinking alcohol.

In the first few days of exacerbation of pancreatitis, it is recommended to fast. Next, everything consumed must be baked or steamed. The temperature of the food should be at room temperature. The diet is expanded gradually, light dishes with a high content of proteins and carbohydrates are carefully added. If you have pancreatitis, you should eat according to the “Table No. 5” diet.

The list of permitted products is as follows:

• soups: vegetarian, with buckwheat, oatmeal, pearl barley, rice, noodles, fruit, dairy. Vegetarian cabbage soup, beetroot soup, pea soup with a minimum of peas;
• porridge: pureed, cooked in water or half and half with milk from buckwheat, semolina, oatmeal, millet, rice. Pilaf with dried fruits;
• pasta with low-fat sauce;
• lean varieties of beef, veal, poultry (turkey, chicken). Everything is steamed or boiled. Dishes prepared in pureed form are consumed - soufflé, mashed potatoes, quenelles, etc., cabbage rolls;
• low-fat varieties of fish, boiled or baked;
• bread: bran, rye, crackers;
• sour cream, yogurt and milk, low-fat, mild, feta cheese;
• eggs - in the form of omelettes;
• vegetables: bell peppers, tomatoes (a little), seaweed, cucumbers, potatoes, zucchini, pumpkin, cauliflower;
• fruits: pureed apples of non-acidic varieties, bananas (no more than one per day), fresh fruit compotes, watermelon, papaya, melon, pineapples,
• marshmallow, honey, gingerbread, lollipops, marshmallows.

The following drinks are allowed: weak black tea with lemon, rosehip infusion, juices diluted with water, non-acidic fruit drinks and jelly, chamomile infusion.

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