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Acute pancreatitis
How many days of fasting for acute pancreatitis?
The duration for which patients with acute pancreatitis must fast is determined by the severity of their condition. Some may only need to fast for a day or two, while others may require around three to four days, or even a week. In severe cases of acute pancreatitis, it might be difficult to say how long the fasting could last, potentially around two weeks. Once patients with pancreatitis start eating after a series of active treatments such as anti-infection measures, inhibiting pancreatic secretion, replenishing electrolytes, and balancing acid-base levels, and following treatments like using rhubarb to facilitate bowel movements, if their bowel movements and gas expulsion have mostly returned to normal and amylase levels have largely normalized, they can cautiously start consuming low-fat, high-vitamin, and high-calorie liquid foods.
What IV fluids should be administered for acute pancreatitis?
If the diagnosis confirms acute pancreatitis, venous medication generally involves the use of proton pump inhibitors to suppress gastric acid, which also helps reduce the secretion of pancreatic enzymes. Meanwhile, to prevent infection, antibiotics can be used appropriately. Medications that reduce pancreatic secretion, such as octreotide or somatostatin, can be considered, as well as drugs that inhibit pancreatic enzyme activity. Since patients with pancreatitis must abstain from food and water intake, it is important to pay attention to energy intake and maintain electrolyte balance. Once acute pancreatitis is confirmed, it is essential to seek hospital treatment as this condition can be quite dangerous. All mentioned medications should be used under the guidance of a doctor.
Does acute pancreatitis cause abdominal muscle tension?
If a patient with acute pancreatitis shows symptoms of peritonitis, abdominal muscle rigidity may occur. Acute pancreatitis is divided into acute edematous pancreatitis and acute hemorrhagic necrotizing pancreatitis. The main symptoms of acute edematous pancreatitis include abdominal pain, nausea, vomiting, and fever. If it is hemorrhagic necrotizing pancreatitis, it can lead to shock, respiratory distress syndrome, high fever, jaundice, abdominal distension, and the abdominal compartment syndrome in the patient. Severe cases can cause intestinal paralysis and signs of peritoneal irritation, leading to abdominal muscle rigidity and also possibly presenting with shifting dullness, among other symptoms.
What are the clinical manifestations of acute pancreatitis?
Acute pancreatitis includes two main types: acute edematous pancreatitis and acute necrotizing pancreatitis. It is a common acute and critical condition of the digestive system, particularly acute necrotizing pancreatitis, which can often be life-threatening. The primary symptoms usually include severe upper left abdominal pain, fever, chills, shivering, vomiting, etc. There is a significant relationship between abdominal pain and eating; generally, the pain worsens after eating and can sometimes radiate to the back. The main causes could be binge drinking, overeating, cholecystitis, gallstones, or hyperlipidemia, among others. Diagnosis is usually confirmed through examinations such as an upper abdominal CT and serum and urine amylase tests, followed by appropriate treatment measures.
How to take care of acute pancreatitis
Patients with pancreatitis should pay attention to their diet during the recovery period. The basic dietary principle for pancreatitis patients is to consume small amounts of easily digestible foods, with low protein and fat content, primarily carbohydrates. During acute episodes, it's crucial to strictly control the intake of fatty foods. Once the condition has improved, patients may gradually consume protein-rich, high-vitamin, high-carbohydrate foods, along with non-irritating, easily digestible foods. Patients should avoid consuming large amounts of meat and alcohol, and can eat rice soup, lotus root starch, noodles, etc.
Acute pancreatitis clinical manifestations and signs
The clinical manifestations of acute pancreatitis generally present as upper abdominal pain, with some patients also experiencing fever, nausea, vomiting, and pain in the lumbar and back areas. In terms of physical signs, the main ones are abdominal distension and tenderness in the upper abdomen, with abdominal pain being the most commonly seen symptom in clinical settings. This pain is typically in the upper abdomen, persistent, and difficult to alleviate, although bending forward may provide some relief for the patient; some patients may also experience symptoms of vomiting. Diagnosis of the condition primarily relies on blood and urine amylase levels and imaging studies. Typically, an ultrasound and CT scan of the abdomen are completed, which can reveal typical changes associated with acute pancreatitis, such as effusion, etc. Treatment, for now, involves enzyme inhibition, fasting, acid suppression, fluid replacement, and other symptomatic treatments. Generally, the acute phase of pancreatitis can be controlled within five to seven days, but if severe pancreatitis is considered, the treatment period may be longer. (The use of medication should be under the guidance of a physician.)