Diagnosis of pancreatitis: determining the form of the disease in adults

Causes of pancreatitis

Diagnosis of chronic pancreatitis using laboratory methods

Pathological processes in the pancreas are characterized by a long period of occurrence, during which the liquid parenchyma is replaced by dense connective tissue, and endocrine and exocrine hypofunction of the organ develops. The most common causes of pancreatitis:

blockage of the main duct,
stone formation,
hyperparathyroidism,
hereditary predisposition,
alcoholism

The source of gland disorders is the precipitation of enzymes in the ducts. Enzymes clog the ducts, and this causes their expansion against the background of cellular destruction of the acinar apparatus, which is responsible for protein synthesis. As a result, the affected tissues atrophy, and tumors develop in the ducts.

Pancreatitis: what tests need to be taken?

woman working on a microscope Eine Anwenderin sitzt an dem Mikroskop

The inflammatory process that progresses in the pancreas is in many cases accompanied by symptoms that can easily be attributed to workload, fatigue, or lack of sleep. Weakness, fatigue, weight loss, disruptions in the digestive system - all this accompanies the everyday life of metropolitan residents who snack on the fly, drink coffee on an empty stomach, get little rest and spend a lot of time on the road.

Diagnosis of pancreatitis includes blood tests,

feces, urine. The insidiousness lies in the fact that the gland can tolerate bad habits, neglect of meals, stress, but one day it “explodes” and reminds itself of itself with an acute attack. Having suppressed severe pain, you will never return to your previous lifestyle. From then on, diet and medications will become your eternal companions. Any departure from the diet will result in new attacks or, even worse, severe complications.

What tests should be taken first for pancreatitis? As a rule, when contacting a specialist, the patient receives a number of referrals to a research laboratory. Depending on the results obtained, the doctor already decides whether a more in-depth examination is necessary and is based on the individual aspects of each patient. The above tests are mandatory, and more complex studies (MRI, ultrasound, etc.) are prescribed later, if necessary.

Clinical manifestations of pancreatitis

This disease manifests itself differently:

in a painful form, and it can be considered as classic:
usually the pain appears above the stomach and radiates from behind to the back;
Shingles pain syndrome is less common;
painful sensations in the right or left hypochondrium. The localization of pain is determined by which part of the pancreas is affected by the inflammatory process.

Often, an attack of pain is provoked by drinking alcohol, eating a lot of fatty and spicy food. And in order to stop this attack, you have to resort to strong and even narcotic painkillers. Recurrent chronic pancreatitis resembles acute pancreatitis in its manifestations, but often without much pain.

The latent form is characterized by the absence of pain. This is where her cunning lies. After all, a feeling of pain is a signal of a problem in one or another organ. Because while there is no pain, people continue to lead their usual lifestyle, not paying attention to other symptoms, or filling them with pills. But the disease rarely manifests itself in its latent form.

Patients often complain of nausea and reluctance to eat, provoked by involuntary contractions of the muscle tissue of the duodenum, or inflammatory processes in its mucosa. Belching and vomiting are observed. Intestinal function is impaired.

Patient's complaints

The first and main symptom of pancreatitis is pain in the epigastric region, radiating to the back (girdles). It occurs acutely, several hours after drinking alcohol, energy drinks, fatty or overly spicy foods. In rare cases, there is no provoking factor. The sensations intensify when the patient lies on his back.

The main complaint with pancreatitis is abdominal pain

Other characteristic symptoms:

Slight tachycardia (95-110 beats/minute), decreased blood pressure.
With severe pain syndrome, as well as with hypertension, episodes of high blood pressure are possible.
Body temperature is subfebrile.
Erythematous nodules may appear on the skin of the abdomen.
In severe processes, a blue spot forms around the navel, and on the sides there are areas of green-brown or red-violet coloring, caused by the breakdown of hemoglobin and the release of its destruction products into the tissue.
Dyspeptic symptoms occur several hours after the onset of the disease.
There is flatulence, moderate bloating, pain and tension in the abdominal muscles during palpation.

Diagnosis of pancreatitis

Instrumental diagnostics

Examination of the patient: palpation

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X-ray examination shows calcification. soft tissue of the pancreas, known as disseminated calcification. It can occur with hyperfunction of the thyroid gland, islet cell tumors, and is also typical for chronic alcoholics.

Computed tomography (CT) is usually used when a slow-growing malignant tumor is suspected. Being an expensive diagnostic method, CT significantly expands the ability to determine gland diseases.

Ultrasound examination helps to determine pancreatitis in 90% of patients, detect calcification, stretching of the ducts, determine or exclude the presence of neoplasms. Endoscopic retrograde cholangiopancreatography (ERCP) detects narrowing of the ducts and makes it possible to determine the localization of their pathological conditions - calcifications and protein plugs.

Additionally, for ERCP, an endoscopic examination of the entire gastrointestinal tract is performed, which allows:

Examine the pancreatic duct;
Take a sample of pancreatic juice for study;
Detect concomitant pathologies that provoked pancreatitis.

Laboratory research

Determination of the state of biological catalysts of the pancreas - enzymes. Amylase is one of the enzymes that indicates the pathological state of the gland, and therefore the state of its activity in the blood and urine is first studied. It has been noticed that the amount of this enzyme in the blood increases 2-12 hours after the onset of the attack, reaches its apogee by the beginning of the new day, and if the disease progresses favorably, returns to normal after 48-96 hours.

An attack of pancreatitis provokes a disruption of the central part of the nephron canal, as a result of which the absorption of amylase decreases and at the same time, renal clearance increases (the ability of the kidneys to remove waste products from the body).

But in a number of patients, worsening inflammation of the gland does not affect amylase activity, and it remains stable throughout the course of the disease. In this category of patients, the level of amylase is low, due to pathological processes in parenchymal tissue, and therefore changes in the activity of the enzyme are little noticeable.

Here it is necessary to note that the state of amylase may indicate not only pancreatic diseases, but also indicate an ulcer, peritonitis, renal failure and a number of other diseases. Amylase activity can change even due to taking certain medications: sulfonamides, contraceptives, diuretics, etc.

Ultrasound - how to diagnose chronic pancreatitis

A more accurate picture diagnosing the condition of the pancreas is shown by measuring the activity of trypsin, and especially trypsinogen, whose activity is demonstrated by hyperenzymatic pancreatitis. Phospholipase activity in the blood is determined in the following ways:

immunofluorometric,
biochemical,
radioimmunological.

The concentration and activity of this enzyme also gives a clear idea of the pathogenesis of pancreatitis. Another enzyme method has been developed - elastase analysis. As a result of studying the influence of enzymes on the condition of the pancreas, it was found that the content of this enzyme increases earlier than others and is maintained for 10-12 days. The combination of all the component tests gives a very clear picture of the course of the disease.

State of exocrine gland function

Another method that allows you to determine the condition of the organ is the secretin test, which allows you to determine the effectiveness of the exocrine function. This method is quite effective, but, unfortunately, is not available everywhere due to its high cost. The essence of this method is as follows: First, the pancreas is stimulated intravenously with secretin-pacreosimine. After some time, the duodenum is probed with a special device that collects pancreatic juice.

The presence of pancreatitis is indicated by a low bicarbonate content of less than 90 mEq/L. with a normal volume of duodenal contents.

The amount of pancreatic juice secreted into this section of the intestine is determined by the amount of chymotrypsin in the excretory products. A method is also used to determine the amount of elastase 1 in the patient’s stool. Steatorrhea - an increased concentration of fat in the patient's excretory products accompanies pancreatitis and indicates insufficient production of enzymes that break down fat. To effectively carry out the analysis before the procedure, it is necessary to organize the patient’s nutrition according to the Schmidt diet, which includes:

105 g protein,
135 g fat and
180 g carbohydrates.

A high composition of fat and soap with a normal state of fatty acids indicates exocrine insufficiency of the organ under study.

Analysis of urine

The color of the urine should appear light yellow. A high concentration indicates digestive problems and kidney disease.
The liquid should remain clear. Cloudiness indicates the presence of pus.
Yellow pigments (bilirubin) may indicate tumors in the pancreas.
In a normal urine test, glucose should not be present. It is determined in diabetes mellitus, renal dysfunction and acute pancreatitis.
Hemoglobin should not appear in the urine of a healthy person. Its presence indicates poisoning, hypothermia and prolonged illness.

Tests should be taken in the morning before meals. To get objective results, you do not need to drink alcohol or take medications the day before the procedure. Heavy physical activity definitely affects the results. When assessing indicators, the doctor focuses on many factors - age, gender, physiological condition of the patient.

But there are factors that do not depend on the above characteristics. Let's look at the main ones.

It is not recommended to eat food for twelve hours before taking the test. This is an important condition that affects the assessment of indicators.

When donating blood after a meal, a lot of fats are concentrated in the liquid. In this case, the results will be very controversial. This will lead to an incorrect diagnosis.

Beverages

Drinking strong coffee or tea will affect the determination of glucose tolerance. Alcohol can lower the level.

Physical exercise

Before tests, doctors do not recommend overly straining the body with physical exercise. After heavy loads, an increase in the number of enzymes is observed.

Medicines

Some types of drugs greatly influence the results of medical research. Paracetamol and ascorbic acid increase glucose levels.

If possible, you should not take medications before tests; this will affect the doctor’s conclusion and the establishment of the correct diagnosis.

On the eve of the tests, it is better to go to bed early and get up at least an hour before donating blood.

It is better to donate blood before ultrasound, massage, x-rays, or physiotherapy.

Laboratory tests for pancreatitis should be taken in the laboratory at the same time to obtain objective results and correct diagnosis.

Analysis of urine

Urinalysis in chronic gland disease shows a decrease in the level of α-amylase, which is associated with a weakening of the secretory functions of the gland during long-term pathology.

Treatment

Medication

Every gastroenterologist can diagnose chronic pancreatitis

Relief of pain attack. Drug treatment in the acute stage is aimed at relieving pain using painkillers - analgesics, Baralgin and others. Less often, if conventional painkillers do not help, heavy artillery is used - narcotic drugs.

Decreased gland activity

Cholecystokin and secretin are synthesized in the stomach - stimulants of the pancreas, forcing it to work. At this moment, the diseased organ begins to work in a stressful mode, causing additional pain to the patient. And in order to force the pancreas to slow down its functioning, blockers (Lanzoprazole and Omeprazole) are included in the treatment complex. Also, in order to reduce secretion (both endocrine and exocrine), Somastatin is administered. If side effects are detected, the dose of the drug is reduced.

Enzyme support

The central place in the treatment regimen for pancreatitis is occupied by replacement therapy with the use of digestive enzymes, and above all, pancreatin. They also help prevent pain and compensate for the deficiency of this enzyme in the body; they are urgently needed due to exocrine hypofunction of the gland. There are several different groups of enzyme preparations, united by their constituent components:

Preparations produced from extracts of the gastric mucosa and including pepsin - Acidin-pepsin, Abomin, Pepsidil;
preparations containing pancreatic enzymes such as lipase amylase and trypsin. These are Creon, Pancreatin, Mezim-forte, Triferment, Pankurmen;
preparations that contain pancreatin in combination with the components of bile and hemicellulose - Festal, Digestal, Enzistal;
Combined enzymes;
Anti-inflammatory therapy. Any disorder of the normal functioning of any organ is accompanied by the initiation of infectious and inflammatory processes. Therefore, during exacerbation of chronic pancreatitis, penicillins, beta-lactams, and tetracyclines are prescribed. Moreover, the choice of drug, dose and duration of the course are determined individually.
Antispasmodics. Medicines that affect smooth muscles are prescribed for hyper- or hypomotility of the gallbladder. In the first case, antispasmodics are prescribed - Papaverine, Platyfillin, Halidor, No-shpa, etc.; secondly, prokinetics that promote the activation of the contractile function of muscle tissue - Domperidone, Cisapride Eglonil, etc.
Diet

A nutritionist will definitely prescribe a diet!

A serious illness makes adjustments to the patient’s lifestyle. A person is forced to completely give up alcohol, excessively fatty foods, and adhere to certain diets and prohibitions in nutrition. In a state of exacerbation of pancreatitis, accompanied by an increase in enzyme activity, the patient is prescribed fasting and drinking still mineral water, weakly brewed tea or rosehip infusion.

Only from the third day a low-calorie diet is introduced into the diet, limiting fats and carbohydrates. When it is possible to stop the exacerbation, the patient is prescribed a therapeutic diet - table No. 5a, which is usually prescribed to patients with diseases of the digestive system. This dietary table includes:

Proteins up to 150 gr. (boiled meat, lean poultry or fish, milk and dairy products. 1 egg per day is allowed). 20 percent of the proteins can be of plant origin.
Fats – animal fats are strictly contraindicated. Allowed 10 g. butter, cream or sour cream, and 20-30 gr. – vegetable.
Carbohydrates - (jam, honey, sugar) - allowed to be consumed within 70 grams. in a day.
Sodium chlorine (table salt) - 8 g. Water - 2-2.5 l.

The daily menu must contain vitamins A, C, B1, B2, B12, folic acid, PP and K, and therefore the patient must consume vegetables and fruits in boiled, steamed and raw form. For the patient, it is necessary to prepare vegetable soups, cereals, milk soups, pureed porridges. Flour dishes and products are allowed (with the exception of pastry products). Fried, stewed, canned food, marinades, and spicy foods are strictly contraindicated. Dietary nutrition is part of the overall treatment program.

Why acute pancreatitis is called a “holiday disease”, you will learn from the video:

Laboratory tests will help you find out about the health of your pancreas.

Poor nutrition, widespread addiction to alcohol and smoking, and uncontrolled use of medications do not lead to instant death. They cause acute or chronic inflammatory and sometimes tumor processes in the pancreas and cause diabetes mellitus. Only those who, without waiting for any dangerous symptoms to appear, know how to check the pancreas will take action in a timely manner and avoid severe complications of pancreatitis. Let's lift the veil of secrecy.

Blood test for pancreatitis

A general clinical blood test for pancreatitis is only of auxiliary value, helping the doctor confirm that there is an inflammatory process inside the body. In addition to inflammation, a blood test can detect anemia.

Blood test indicators for pancreatitis differ according to the following changes:

The content of hemoglobin and red blood cells decreases - for example, with long-term chronic pancreatitis, as well as with complications associated with bleeding of the inflammatory focus.
The leukocyte level increases, and significantly, as a result of severe inflammation.
Erythrocyte sedimentation accelerates, which is considered an additional sign of inflammation.
The hematocrit increases if there is an imbalance of water and electrolytes.

[11], [12], [13], [14], [15], [16], [17], [18], [19]

Principles of pancreatic examination

Diagnosis of the pancreas must be comprehensive: it is necessary to obtain information not only about the structure of the organ, but also about its function. Let's explain why.

The pancreas is a large gland with a unique structure and functions. It is she who plays a key role in digestion, producing enzymes necessary for the breakdown of proteins and fats into substances that, entering the blood, will nourish the cells. This gland produces insulin, which helps the main energy substrate - glucose - provide energy to cells and tissues. Other hormones are also synthesized in it.

The gland is located in the retroperitoneal space, in front of it are the stomach, transverse colon and duodenum, and on both sides are the kidneys. Inside the organ there are ducts that collect pancreatic juice rich in enzymes from the glandular cells. They flow into one large duct, which opens in the duodenum.

The pancreas is an organ with many ducts located behind the stomach and intestinal loops

If a certain amount of gland tissue is damaged, the remaining tissue replaces its function, and no symptoms of the disease may appear. At the same time, a situation may arise when a very small area dies or becomes inflamed; this is not noticeable in the structure of the entire gland, but is accompanied by a pronounced change in the function of the organ. That is why the examination of the pancreas must be comprehensive, covering both the structure of the organ and its function.

Symptoms inherent in this disease

Tests for pancreatitis are a vital necessity, because both acute and chronic forms of the pathology have vague symptoms similar to many diseases:

nausea and vomiting that does not bring relief;
severe pain in the upper abdomen, it can change in character and radiate to the chest or back;
muscle tension;
heat;
rapid pulse;
sudden weight loss;
loose stools with an unpleasant odor;
stomach problems;
increased flatulence.

If you have one or more of the described symptoms, you should immediately go to the hospital. The specialist will conduct an examination, prescribe the necessary types of research and then, based on the test results, treatment.

What other tests can be taken to diagnose the functioning of the pancreas, read the article.

It is important to know that even the initial form of pancreatitis can develop into pancreatic necrosis, from which about 70% of patients die.

Laboratory diagnostics

Tests examining the pancreas determine the state of organ function. In acute lesions of the pancreas, there is an increase in the activity of the enzymes it produces. Some of them are more informatively determined in the blood, others in the urine, and some in the feces. To determine the severity of the lesion, indicators of the functions of the organ associated with the pancreas - the liver - are also assessed.

Diagnosis of the pancreas includes the following tests:

General blood test: during acute or exacerbation of a chronic process, an increase in the level of leukocytes, band and segmented neutrophils, and ESR is noted.
Biochemical blood test: increased levels of total and direct bilirubin - in the icteric form of pancreatitis (while ALT is slightly increased), increased levels of gamma globulins, seromucoid, sialic acids.
Pancreas-specific blood tests:
- blood alpha-amylase (its norm is 16-30 g/l per hour);
blood lipase (will be increased more than 190 U/l);
blood glucose - will be increased (more than 6 mmol/l) if the endocrine (islet) part of the pancreas is involved in the inflammatory or destructive process.

Warning! Enzyme activity standards may vary slightly according to different laboratories.

Determination of trypsin, lipase, amylase in the contents of the duodenal cavity on an empty stomach, and then several times after introducing 30 ml of a diluted solution of hydrochloric acid into the intestine. Normally, the levels of these enzymes in the first two portions of intestinal contents decrease, then gradually increase to the original value; in chronic pancreatitis, there is a significant decrease in all portions.
Urine tests: amylase, amino acid content (Lasus test). When the pancreas is damaged, an increased content of these substances is observed.
Coprogram. If there is a deficiency of glandular enzymes, fats, starch, undigested fiber and muscle fibers will be detected in the feces.

Previously, the main test used to diagnose pancreatic diseases was pancreatic amylase, an enzyme produced by the organ. In acute and exacerbation of chronic inflammation of the gland, there is an increase in the activity of this enzyme in the blood - above 30 g/l per hour and in the urine (where it is defined as “urine diastasis”) - above 64 U/l per hour. With the death of areas of the pancreas - pancreatic necrosis, sclerosing pancreatitis - there is a decrease in amylase activity both in the blood (below 16 g/l per hour) and in the urine (below 10 U/l).

To date, the main laboratory diagnostic criterion for pancreatic damage is the enzyme elastase, determined in stool. In case of insufficiency of gland function, the activity of pancreatic elastase is less than 200 mcg/g, in case of severe damage to the organ - less than 100 mcg/g.

Warning! All blood tests are taken on an empty stomach, but some pancreatic tests require some preparation. This point must be clarified, if not with a doctor, then with the staff of the laboratory where you plan to undergo diagnostics.

Laboratory stress tests

In some cases, it may be necessary to perform certain tests not only on an empty stomach, but also after introducing certain substances into the body - a stress test.

There are the following load tests:

Glycoamylasemic test. The initial concentration of blood amylase is determined, after which the person must drink 50 g of glucose; After 3 hours, a repeat amylase test is performed. In pathology, after 3 hours there is an increase in this enzyme by more than 25% of the initial level.
Proserine test. The initial concentration of urine diastase is determined, after which the drug “Proserin” is administered. Then, every half hour for 2 hours, the level of diastase is measured: normally it increases no more than 2 times, but then returns to normal. For different types of pancreatic pathology, different indicators are determined.
Iodolipol test. Upon awakening, the patient urinates, then takes the drug “Iodolipol” orally. Then, after an hour, one and a half, two and 2.5 hours, the level of iodide in the urine is determined. This diagnosis of pancreatic diseases is based on the activity of the lipase enzyme produced by this organ. Normally, iodide begins to be detected in the urine within an hour, and the degree of its excretion increases and is maximum - in a portion of urine collected after 2.5 hours.
Secretin-pancreozymin test. It is based on a change in the chemical composition of the contents of the duodenum after the introduction of a hormone-like substance secretin into it (it causes an increased secretion of pancreatic juice rich in bicarbonates and enzymes into the intestine).
The glucose tolerance test is important for diagnosing damage to the endocrine apparatus of the pancreas. In this case, the blood glucose level is determined on an empty stomach, one hour and two hours after ingesting a glucose solution. This test is prescribed only by an endocrinologist, and he also interprets it, since there is a danger of complications associated with an increase in the blood level of this simple carbohydrate.

Set of events

Ultrasound and other imaging techniques are used to make the diagnosis.

The diagnosis is made after a thorough history taking, external examination of the patient, laboratory and instrumental examinations.

Careful differential diagnosis is necessary, since some diseases lead to a clinical picture similar to pancreatitis:

Anamnesis collection . It is necessary to find out from the patient how long ago and in what sequence the disturbing symptoms appeared, what preceded their onset. The patient's diet, irregular food intake, alcohol abuse, and love of spicy, salty, and smoked foods are of great importance. The nature of the patient’s work activity is also clarified. The development of pancreatitis can be triggered by contact with toxic industrial substances.
Visual inspection . The examination begins with the oral cavity. With pancreatitis, dry mucous membranes, a white coating, and a “varnished” tongue may be noted. When examining the abdomen, the above-described changes in skin color are revealed. When a large amount of fluid accumulates inside the abdominal cavity, the abdomen is bulging and there is a protrusion of the navel. When tapping, there is an alternation of areas of dull and tympanic sound.
Laboratory diagnostics . The main diagnostic sign of acute pancreatitis is an increase in the level of pancreatic enzymes: amylase, lipase, trypsinogen, phospholipase. In chronic processes, leukocytosis is present in the blood, and a large amount of undigested fat is detected in the feces. The increase in the number of enzymes is moderate, not as sharp as in the acute form of the disease.
Instrumental methods . Used to clarify the diagnosis. The patient may be prescribed such examination methods as: Ultrasound - atrophy of the organ parenchyma, the presence of stones, pseudocysts, calcium deposits. In the early stages of development of chronic pancreatitis, it is ineffective;
CT scan – pancreatic atrophy, thickening of the peripancreatic fascia, dilatation of the main duct;
MRI – decreased T1W1 signal intensity, fluid-filled structures, decreased contrast;
ERCP - irregular dilation of the ducts, their obstruction, increase in the size of the organ;
FGDS - for pancreatitis has no important diagnostic value. In some cases, it is used to diagnose associated disorders;
radiography - 40% of cases of chronic pancreatitis reveal calcifications in the pancreas;
laparoscopy – allows you to visually examine the pancreas. It is used when all other diagnostic methods are ineffective, as it is associated with operational risks. Allows you to identify macroscopic changes in the organ.

Differential diagnosis is carried out with diseases such as acute appendicitis at the initial stage of development, cholecystitis, gastroenteritis and other diseases of the abdominal organs. As a rule, the use of imaging techniques leaves no doubt about the correctness of the diagnosis.

Study of organ structure

The examination of the pancreas is based on the properties of the tissue: it is not visible during a normal x-ray examination, but the ducts of the pancreas can be examined x-ray by injecting contrast into them. The gland is easily accessible for ultrasound examination, and Doppler ultrasound determines the blood flow in its vessels. Computed tomography visualizes its structure layer by layer, but its magnetic resonance analogue is optimal for determining the smallest structures of an organ. Let's look at everything in order.

X-ray methods

Plain radiography allows one to visualize only calcification of the gland tissue and large stones in its ducts.
Endoscopic retrograde cholangiopancreatography is the introduction of an X-ray contrast agent into the ducts of the gland from the duodenum using an optical apparatus, which is used to perform fibrogastroscopy.
Selective angiography is an X-ray examination of the vessels of the gland after the injection of a contrast agent into them.
Computed tomography helps in diagnosing tumor and inflammatory processes in the gland.

Each of the examination methods requires the patient to carry out preparatory procedures.

Ultrasonography

Ultrasound diagnostics is the simplest and most accessible method of studying the structure of the pancreas

This method is not as accurate as a tomographic examination, but due to its simplicity and safety, it is basic for the primary diagnosis of gland pathologies. Ultrasound allows you to visualize acute and chronic inflammation, tumors, abscesses, cysts; Doppler ultrasound is invaluable for the initial assessment of organ blood flow. This method requires preliminary preparation. We talked about how to carry it out so that the result of the study is reliable in the article: Preparation for ultrasound for pancreatic pathology.

Magnetic resonance imaging

NMR imaging is the most informative method for studying the gland, which very accurately visualizes organ tissue layer by layer. When combining MRI with the introduction of contrast into the ducts (cholangipancreatography) or vessels (angiography), maximum reliability of the study of the pancreas is achieved.

Indications for MRI of the pancreas are as follows:

organ tumors of small diameter;
liver pathologies;
pancreatitis;
preparation for glandular surgery;
as a control for organ treatment.

Features depending on gender and age

In older people, pancreatitis may be asymptomatic or mild

In general, diagnostics in patients of different sexes and ages does not have any fundamental differences. It must be taken into account that in older people the disease can occur in a blurred, implicit form. Many children tend to exaggerate the intensity of pain, which forces the doctor to prescribe an excessive number of diagnostic measures. This happens because the specialist cannot understand why the clinical picture does not correspond to the data of instrumental examinations.

For children and weakened patients, invasive examination techniques should not be used. Preference is given to percutaneous methods of examining the pancreas (ultrasound, radiography, CT, MRI).

https://youtu.be/SFlCLqJGZMs

When and how to take it

Blood for pancreatitis is donated in the morning on an empty stomach. 8-16 hours before visiting the laboratory, refuse to eat. You should not drink drinks, including plain water.

Before conducting laboratory tests, undergo training that includes the following:

Following a special diet. Products that negatively affect digestion processes (smoked meats, coffee, strong tea, confectionery, spicy and fatty foods) are excluded from the diet.
Rejection of bad habits. Drinking alcohol lowers sugar levels and increases the concentration of uric acid, which distorts the results of the study. Nicotine has a similar effect.
Physiotherapeutic procedures are stopped 5-7 days before blood donation. It is not recommended to be screened for pancreatitis immediately after an ultrasound or x-ray.
Avoiding excessive physical activity. Bending, running, and squats disrupt the functions of the digestive system.
Elimination of conflict situations and stress. These reasons affect the hormonal levels of the body, which is why the blood test gives incorrect results.

Biochemical blood test for pancreatitis

The main tests for chronic or acute pancreatitis are blood biochemistry, which allows us to study the functioning of all body systems.

If a person suffers from pancreatitis, the results of the biomaterial study will be as follows:

high amylase, which is a gland enzyme and is responsible for the dissolution of starch;
high elastase, lipase and trypsin;
increased glucose levels due to lack of insulin production;
the amount of bilirubin that will be higher than normal;
low protein levels;
high transaminase levels.

The main thing you should pay attention to when studying test results for pancreatitis is an increase in pancreatic enzymes.

General and biochemical analysis is carried out after hospitalization; further research will need to be performed only occasionally to monitor the condition. For example, constant pain and high levels of enzymes indicate that the disease is progressing, developing into an acute form.

If the patient was admitted to the hospital only a few days after the first symptoms appeared, the level of lipase, which lingers in the blood for several days, will most accurately tell about the problems.

How to determine pancreatitis using tests as accurately as possible? To diagnose gland destruction, it is better to study the level of serum elastase.

The total volume in the blood can indicate the presence of acute pancreatitis. The higher the indicator, the more areas of inflammation in the organ, which worsens the patient’s situation.

The analysis of plasma neutrophil elastase is considered the most accurate, but not every clinic can offer such a study.

It is important that elastase, in the presence of pancreatitis and inflammation, remains elevated for about 10 days. Therefore, the study can be carried out on patients who immediately went to the hospital or waited several days and only then came to the doctor.

As for preparing for the analysis, nothing special is required from the patient.

Essence of the disease

The pancreas is a small but important organ of the digestive system. It lies behind the stomach and extends from the duodenum to the spleen. The pancreas has a lobular structure. Each lobule has a duct. In the organ, all the ducts connect and form the main pancreatic duct. There is also a second (accessory) duct. Each of them flows into the duodenum.

Iron in the human body performs two functions:

Exocrine (exocrine). The juice released from the gland into the duodenum contains enzymes. They are involved in the digestion of protein, carbohydrate and fatty foods.
Endocrine (intrasecretory). The pancreas secretes polypeptide hormones into the blood. They regulate metabolic processes occurring in the body.

During inflammation, the functions of the pancreas are disrupted. This is confirmed by the diagnosis of pancreatitis. The secretion is not released from the organ into the duodenum. In this regard, the process of self-digestion of gland areas begins. Some of the enzymes and toxins are released into the blood vessels, spread throughout the body and damage other organs (liver, kidneys, lungs, heart and even the brain).

The disease occurs in people for various reasons. Statistics show that 50% of people suffer from inflammation of the pancreas due to alcohol abuse. In 20% of cases, the diagnosis of pancreatitis in adults shows that the disease develops due to cholelithiasis. Other causes of inflammation of the pancreas include:

infectious, viral and parasitic diseases;
fungal infections;
injuries and poisoning;
endoscopic manipulations and operations.

Features of diagnosis in children

To diagnose pancreatitis in a child, ultrasound and laboratory research methods are most often used: urine, blood, and stool analysis. Much less frequently, computed tomography or plain radiography of the abdominal cavity is performed. Other instrumental methods for diagnosing inflammation of the pancreas when examining children are not used due to the complexity of the procedures.

Pancreatitis is inflammation of the pancreas. An untreated disease leads to severe changes in the organ, which is marked by serious metabolic disorders. The role of the pancreas in the body is to synthesize hormones and produce pancreatic juice. The causes of the disease are poor nutrition, poor environment, and chronic alcoholism.

When asking what tests are performed, you need to consult a doctor in order to make a correct diagnosis.

Additional tests for pancreatitis

To make the diagnosis as accurate as possible, the patient may be offered other diagnostic methods:

Study of immunoreactive trypsin . It is not used often, since it “works” only in 30% of cases. That is, a positive result of 70% indicates, rather, the presence of another pathology, and not pancreatitis.
Study of the concentration of trypsin inhibitors. In this case, low levels indicate severe destruction in the blood. This is a negative sign for the patient.
Studying the level of trypsinogen in the blood . It is considered a fairly informative way. Can help make a diagnosis that will be almost 100% accurate. But not everyone can afford it, since this study is quite expensive and is not carried out in all clinics.

In combination with clinical and instrumental diagnostic methods, such as ultrasound, MRI or computed tomography, blood and stool tests allow you to quickly make a diagnosis.

The patient has to go through a series of tests, their repetition, but the most effective at the moment is studying the level of pancreatic enzymes in the blood, that is, amylase and lipase. Much depends on the patient’s condition, the time when the first symptoms appeared and the visit to the hospital.

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Complete blood count for pancreatitis

Tests for acute pancreatitis or chronic types of pathology are not particularly different. So, you cannot do without taking blood, which allows you to determine the presence of inflammation in the body.

The blood characteristics of a person with this disease will be as follows:

decrease in hemoglobin and red blood cells, which occurs due to complications from pancreatitis;
high white blood cell counts, sometimes even tenfold, are a sign of inflammation in the body;
rapid erythrocyte sedimentation;
high hematocrit is a sign of disturbances in water and electrolyte balance.

How to identify

If pancreatitis is suspected, self-diagnosis at home is difficult, since the disease has symptoms similar to those of many other gastrointestinal pathologies. The following signs may indicate inflammation of the pancreas in an adult:

pain of varying intensity in the left hypochondrium, which can radiate to the sternum or back;
nausea, vomiting;
loose stools;
flatulence (accumulation of a large amount of gases in the intestines);
belching, heartburn.

In acute pancreatitis, the symptoms are pronounced and greatly worsen the patient’s well-being; the chronic form of inflammation is most often accompanied by blurred signs.

The occurrence of the above changes in the body does not mean that a person is developing pancreatitis, so you should not make a diagnosis on your own and start treatment with medications without undergoing an examination at a medical institution.