Mit lehet és mit nem lehet tenni a hasnyálmirigy-gyulladással?

In addition to prescribing a diet, all patients with a chronic form of inflammation of the pancreas are given appropriate recommendations regarding lifestyle in general, that is: what you can and what you can not do with pancreatitis. Some of them are worth recalling again.

Pancreatitis and bad habits

This includes smoking and alcohol. Can I smoke if I have pancreatitis?

The answer of medical experts is unambiguous: absolutely not! Nitrosamines and polycyclic hydrocarbons formed as a result of pyrosynthesis of nicotine, occurring in the process of its combustion, provoke oxidative stress, aggravate intralobular fibrosis of the pancreatic parenchyma and reduce the already insufficient production of pancreatic enzymes acinar cells.

In addition, smoking increases the activity of stellate cells of the inflamed pancreas, which in its healthy state regulate the synthesis and catabolism of extracellular matrix proteins, maintaining the normal morphological structure of the tissue, but in pancreatitis begin to secrete an excessive amount of fibrillar proteins, which is a predisposing factor in the development of pancreatic cancer.

Since in 72% of cases chronic alcohol abuse leads to inflammation of the pancreas, we should not forget that alcohol in this diagnosis is also absolutely contraindicated. For details, see Alcohol in pancreatitis: to drink or to live?

Pancreatitis and exercise

Moderate exercise is essential for normal body function, but for patients with chronic pancreatitis, i.e., the chronic relapsing form (which accounts for about 60% of clinical cases), a plan to increase physical activity - to help restore muscle strength - should be individualized and only in remission. Although even during periods of "quiescence" of the disease, many people experience rapid fatigue and general weakness. [1], [2]

Is it possible to do sports with pancreatitis? Usually doctors recommend physical therapy (with stretching of various muscle groups), yoga and walking. So the answer to the question - whether you can walk with pancreatitis - positive. And after the initial acute symptoms have decreased, you can start walking at a relaxed pace of 5-10 minutes twice a day, gradually increasing the duration of daily walks to 30-40 minutes. But you should always follow the recommendations of your doctor, because the level of physical activity can vary depending on the severity of the disease and general condition. And it can worsen at any time, including due to exercise.

Is it possible to run with pancreatitis? For each patient, the answer to this question is individual, and if the condition is satisfactory, you can try jogging - no longer than a quarter of an hour a day. However, no one is immune from the aggravation of the disease provoked by running, so at the slightest signs of malaise and discomfort jogging should be stopped.

Is it possible to pump abs in pancreatitis? Given the anatomical position of the pancreas and the state of its parenchyma in the presence of inflammation, doctors have a negative attitude to this type of exercise - with the tension of the abdominal wall muscles.

Is it possible to lift weights in pancreatitis? No, this can not be done, as such physical exertion can cause intra-abdominal hypertension - an increase in intra-abdominal pressure, as a result of which hemodynamics is disturbed and the supply of blood to the pancreas is impaired. Even short-term hypoxia of its tissues against the background of inflammation leads to increased dysfunction.

In addition, there is an increase in pancreatobiliary pressure - with compression of the pancreatic and bile ducts, decreased tone of the sphincter of Oddi and reflux of duodenal contents.

Pancreatitis, nutrition and body weight

Patients are prescribed diet #5 for pancreatitis or diet for exacerbation of pancreatitis, providing at least 1800 kcal per day.

Is it possible to fast in pancreatitis? Anyone who has faced acute pancreatitis in adults, knows that for the first three to five days the patient should not take food. During this period - to avoid violations of the water-electrolyte balance in the body - rehydrating solutions are dripped in/v, it is allowed to drink water (in limited quantities). Also, food intake is stopped during attacks of chronic pancreatitis, and patients drink only water.

But the question - can you lose weight with pancreatitis - seems strange. After all, in this disease, digestive functions are disturbed: appetite worsens, food is not sufficiently digested due to a deficiency of pancreatic enzymes, and nutrients are poorly absorbed in the intestine (from what develops pancreatogenic diarrhea). And in seven patients out of ten as one of the symptoms of chronic pancreatitis, weight loss is noted, which, according to some data, ranges from 5-35% of the original body weight. And in the severe form of the disease, aggravated by debilitating diarrhea, it is not excluded progressive emaciation of the body.

Is it possible to get well with pancreatitis? To restore body weight, i.e. To get well with pancreatitis, firstly, enzyme preparations are taken to compensate for the deficiency of endogenous pancreatic enzymes; more information in the material - Effective drugs for pancreatitis.

Secondly, to correct secondary protein and energy deficiency associated with impaired absorption of nutrients in the intestine, one resorts to enriching the diet with protein products (in the form of shakes), taking vitamin and mineral preparations, and in extreme cases - anabolic steroids.

Pancreatitis and procedures

Can ice be applied in chronic pancreatitis? Both in acute pancreatitis and in recurrences of chronic pancreatic inflammation, it is mandatory to apply an ice pack to the abdomen - on the subcostal area on the left side. This helps to reduce pain and inflammatory swelling. For more information see.- How to relieve an attack of pancreatitis?

Is it possible to do an enema in pancreatitis? Enemas increase intestinal peristalsis, while patients with chronic pancreatitis have diarrhea and flatulence. Therefore, in hospital conditions, lavage (lavage) of the large intestine is performed only in acute pancreatitis and pancreatic necrosis with the development of acute paralytic intestinal obstruction.

If the pancreatic inflammation is chronic, then in the periods between exacerbations - to activate the outflow of bile from the gallbladder - can be carried out tubage (with a probe or blind method).

Can massage for pancreatitis? In this disease of chronic course, therapeutic massage can be used for relaxation - reducing stress and relieving muscle discomfort. As studies have shown, massage for pancreatitis can improve the overall well-being of patients.

Is it possible to give blood in pancreatitis? Periodically, patients with chronic pancreatitis, who are on dispensary registration, take blood tests: biochemical; for the activity of amylase, lipase, trypsin, hepatic aminotransferases; for the level of glucose, insulin, creatinine and others.

But an attempt to donate blood with this diagnosis will be unsuccessful at the stage of medical examination of potential donors.

Is it possible to remove the gallbladder in pancreatitis? Yes, and such an operation in the form of laparoscopic cholecystectomy is practiced when conservative therapy is ineffective in cases of so-called cholecystopancreatitis - when there is simultaneous inflammation of the gallbladder and pancreas.

Pancreatitis: from the bathhouse to the beach

The main question, of course, is whether you can go to the bathhouse when you have pancreatitis, and whether you can steam?

Swelling of pancreatic tissue, observed in pancreatitis, as well as the negative effect on it of heat stress received by the body in the bath and steam room, should convince avid fans of bathing procedures that have this diagnosis, replace them by taking a shower.

Is it possible to take a bath in pancreatitis? Not very hot, and not longer than 10 minutes - you can, provided that the level of general exhaustion of the body does not cause dizziness.

Is it possible to sunbathe in pancreatitis? If the skin is very dry and flaky, ultraviolet light should be avoided. But at the same time, patients with chronic pancreatitis often develop fat malabsorption, and there is a deficiency of cholecalciferol (vitamin D). Therefore, sun exposure is beneficial, but it is not necessary to overheat.

Until very recently, it was thought that UV exposure was strongly contraindicated for the malignancy that pancreatitis can lead to. Recent studies (conducted by Japanese and Turkish physicians) have shown that living in areas with higher levels of UV radiation in the environment can reduce the risk of pancreatic cancer by almost a third.

Pancreatitis: sex and pregnancy

Is it possible to have sex with pancreatitis? During remission - you can, provided that pancreatitis does not have such a complicating circumstance as diabetes mellitus, which is detected, on average, in 60% of patients.

Patients with inflammation of the pancreas are interested in whether it is possible to get pregnant and give birth with pancreatitis. The average degree of severity of chronic inflammation of the pancreas in women is often accompanied by menstrual disorders - secondary amenorrhea, which affects fertility. And in such cases, pregnancy is hardly possible.

But with a mild degree of pancreatitis you can get pregnant and it is not contraindicated, but carrying a baby is associated with problems. First of all, the bottom of the gradually enlarging uterus will inevitably press on the subcostal area and the pancreas located there - further complicating its functioning.

Secondly, the lack of pancreatic enzymes reduces the absorption of not only such nutrients as fats, proteins, carbohydrates: vitamins and micronutrients the mother's body also lacks. And, therefore, not enough of them and the fetus. From this point of view, it is safer not to expose the fetus to the negative effects of maternal pancreatitis.

In addition, in the I trimester there is a risk of spontaneous abortion, and during the III trimester, hemodynamic disorders - disseminated intravascular coagulation syndrome - are possible.

By the way, it is possible to develop gestational pancreatitis: in the presence of a history of cholelithiasis (gallstone disease), as well as elevated triglyceride levels in the blood (hypertriglyceridemia), often developing in women who take oral contraceptives for a long time. More information in the article - Pancreas in pregnancy

Pancreatitis and work life

Is it possible to work with pancreatitis? In a mild form of the disease, you can perform work without much negative consequences (if you take the prescribed medications and follow the diet).

With 2-3 degrees of chronic pancreatitis and the presence of accompanying severe symptoms, patients are referred to the medical and social expert commission - to determine the disability group.

Labor activity in the disability of the third group on chronic pancreatitis should not be associated with physical exertion.