Chronic pancreatitis due to impaired external secretory function. Ways of treatment of ovishnyosecretory insufficiency
For quote: Zakharova I.M., Zaidenvarg G.Y., Dmitrieva Yu.A., Kasatkina O.M. Severe secretory insufficiency of the submucosa: the possibility of diagnosis and methods of correction // RMZ. 2012. No. 33. S. 1604
Excessive secretory insufficiency of the submucosal cavity (PG) is worsened in various diseases and may be a chronic or isolated decrease in the production of enzymes, which is often associated with impaired activation in the small intestine. As a result of dysfunction of the PZ, which is accompanied by a deficiency of enzymes (maldigestia), a disorder in the soaking of the pharynx (malabsorption) often develops. Mechanisms for the development of ovishnyosecretory insufficiency of PZ are different. It is seen that absolute pancreatic insufficiency is associated with an ongoing decrease in the production of enzymes, and, apparently, is associated with impaired activation of enzymes in the intestine (Table 1).
Pancreatic insufficiency can occur as a result of a severe decrease in the production of all PZ enzymes, as well as an isolated decrease in the production of one of them. Klіnіchno zovnіshnosekretorna nedostatnіst PP Mauger viyavlyatisya dіareєyu, flatulence, sore zhivotі, nudotoyu, re blyuvannyami, znizhennyam appetite and takozh such nespetsifіchnimi symptoms yak zagalna slabkіst, znizhennya fіzichnoї aktivnostі, skhudnennya, vіdstavannya in zrostannі (if serious. Vazhlivoyu dіagnostichnoyu Find our ekzokrinnoї nedostatnostі PZ є change in the nature of the defect, because lipase deficiency develops earlier decrease in amylase and protease activity.
Diagnosis of the pathology of PZ is one of the most complicated problems of child gastroenterology and is based on the analysis of the results of both laboratory and instrumental methods of investigation.
The appointment of pancreatic enzymes in the blood (a-amilase, lipase, trypsin and iodine inhibitor) makes it possible to judge the organic damage to the organ, the presence of damage to the acinar cells, the proteo-secretory function of the pancreas in a smaller world. At the norm, 60% amylase of the sirowort should be amylase of the long vines, the grit 40% - PZ. An increase in the presence of the enzyme in the bloodstream is an early marker of acute pancreatitis: an increase in the activity of amylase is indicated for 2-12 years after the cob of illness. It should be noted that the sensitivity and specificity of this marker in pancreatitis in children is lower, lower in adults and become no more than 80-90%, with up to 40% of pancreatitis in a child, prolapse with normal amclase activity in syrovatism can occur. When evaluating the results of the laboratory follow-up, there was a memory that hyperamylasemia is a non-specific symptom and may be caused by another pathology: appendicitis, host cholecystitis, contagious sclerosis, nirk deficiency (included in the table).
For differential diagnosis of hyperamylasemia, it is possible to determine the level of amylase isoenzymes (Table 3).
Riven lipase in syrovattsi also sounds like it moves with acute pancreatitis and is overwhelmed by the advancement of more, lower amylase riven. The increase in the activity of this enzyme in the blood is more sensitive and specific marker of PZ damage, and with an one-hour assessment of both enzymes, the sensitivity of the method reaches 94%.
Important for the diagnosis of acute pancreatitis may be the activity of other enzymes in pancreatic cancer in blood serum, elastase-1, trypsin and iodine inhibitor with the indication of an inhibitor/trypsin, as it changes in pathology of the organ. Significant in the diagnosis of pancreatitis is the determination of the concentration in the blood and section of phospholipase A2, a marker of the destructive process in PZ.
For tribute N.B. Gubergrits (2001), the sensitivity of various pancreatic enzymes in the blood to lie in the presence of illness (Table 4).
For the diagnosis of acute and acute chronic pancreatitis, it is important to determine the level of pancreatic enzymes in the section. In acute pancreatitis, riven amylase section (diastasis) can be moved 5-10 times.
Slіd viznati scho koprologіchne doslіdzhennya doteper not vtratilo svoєї aktualnostі i Je naydostupnіshim method zdatnim pіdtverditi nayavnіst zovnіshnosekretornoї nedostatnostі PP against at vіdmіnu od viznachennya rіvnya fermentіv RV at krovі scho vkazuyut on bezposerednyu porazku body on pіdstavі rezultatіv koprologії hold diferentsіalnu dіagnostiku absolyutnoї that visual insufficiency of the PZ is authentically impossible. Follow-up feces were carried out until the recognition of pancreatic enzymes. The accuracy of this method is also added: the camp of intestinal motility, obsyag zhovchі, which is seen in the intestinal lumen, the acidic warehouse, the presence of ignition processes in the intestine and other.
Analysis of the results of coprological follow-up allows us to see the following symptoms:
. steatorrhea - movement together in feces neutral fat(steatorrhea type 1), fatty acids/mil (steatorrhea type 2) or both (steatorrhea type 3);
. Creatorrhoea - movement together in the feces instead of m'yazovyh fibers (++ or +++);
. amilorrhea - the presence of starch grains in kali.
Styika Zebelnyna Steaterya, the Creator Mozheznnya Mozdci's Velika Yamіrnіsti Svіdchiti pro showdown in the Pazіnta Zovnіshnostecretorino Naverochi PZ, Todі Yak Amilorerya to have a lack of ridko's shrimps, osskіlki gіlolіz Krochmalu often does not take advantage through the vocabulary.
Lipidogram of feces allows you to specify the nature of steatorrhea and may be of no significance in evaluating the effectiveness of enzyme therapy. Smіst zhiriv v stiltsі is estimated in a similar way (addition to the feces of a Sudan barvnik) in a kilkіsny way. The rest is the most informative, allowing you to sum up the total amount of fat in feces with the improvement of exogenous (grub) fat. Normally, the amount of fat seen in faeces is not responsible for overfeeding 10% of the fat administered to the hedgehog. When PSH is congested, the amount of fat seen in feces sometimes increases up to 60%.
The appointment of elastase-1 in kali allows to evaluate the stages of exocrine insufficiency of the prostate gland and to make a differential diagnosis between absolute ovine-secretory insufficiency and exocrine insufficiency. Elastase-1 is a proteolytic PZ enzyme with a molecular weight of about 28 mDa. Apparently, the enzyme does not change its structure in the world passing through intestinal tract which allows it to be recognized as a sensitive marker of exocrine insufficiency of PZ. The technique is given in order to overcome the methods of exocrine insufficiency of the pancreas (lipidogram feces, coprogram) in view of the greater specificity of the method and the impact of enzymatic therapy on the results of the elastase test. The amount of elastasi in kali may be higher than 200 mcg/g. A fecal elastase level of 200 to 100 µg/l is indicative of the death of exocrine pancreatic insufficiency, a decrease in the level of the enzyme in feces of less than 100 µg/l is an indication of severe pancreatic insufficiency. Danish test is known to be widespread in patients who suffer from cystic fibrosis, Shwachman's syndrome, shards of fecal elastase in them give the possibility, without compromising fermentotherapy, to control the stage of PS.
In Table 5 and small 1 representations, the algorithm for diagnosing exocrine insufficiency of PZ according to the results of the study of elastase-1 in kali.
The secretin-pancreozyme test (SPT), which should be widely used earlier, is a probing method for establishing the exocrine function of PZ bases on bicarbonates and enzymes assigned instead of bicarbonate in the duodenal region behind the help of the probe after direct stimulation of the proto-acinar cells. During the follow-up of the kidney, basal secretion is indicated with the introduction of secretin (1 U / kg), which stimulates an increase in the secretion of the PZ and the production of bicarbonates. Then administer cholecystokinin-pancreozymin (1 U/kg), which stimulates the production of enzymes and causes the rapid flow of mucilage (secretion is stimulated).
Normal indicators of the secretin-pancreozyme test: bicarbonate - not less than 70 mmol / l, amylase - not less than 12000 Od / 30 min., trypsin - not less than 3 Od / 30 min., lipase - not less than 65000 Od / 30 min. - Trochs more than 7 g/day.
On the basis of the content of the results, it is possible to assign types of pancreatic secretion to subdivisions:
. normosecretory activity - increased activity of enzymes, obsyagu secretion and equal bicarbonate;
. hypersecretory type of secretion - supra-mundane elevation of enzyme concentrations with normal or elevated obsession and bicarbonate secretion, typical for mild inflammatory-dystrophic changes in PS, caused by hyperfunction of acinar tissue;
. hyposecretory type of secretion - normal or decrease in the amount of juice and equal bicarbonate with a decrease in the activity of enzymes, which is indicative of a lack of pancreatic secretion, characteristic of the development of PC fibrosis;
. obstructive type of secretion - reduced volume of juice with a normal amount of enzymes and bicarbonates, characteristic of obstruction of the duct (papillitis, duodenitis, spasm of the sphincter of Oddi, choledocholithiasis).
It should be noted that in children the enzyme-synthesizing function of the pancreas is more often disrupted, the level of bicarbonates and secretion decreases less due to pronounced pancreatic insufficiency. Denmark test in this hour does not know a wide zastosuvannya through the presence of modern sensitive and minimally invasive methods for assessing the structural and functional state of PZ.
Instrumental methods of follow-up in the diagnosis of acute secretory insufficiency of the prostate gland may be of additional importance, allowing to assess the anatomical structure of the organ.
ULTRASOUND DOESLIVENNYY PZ є One of the providen methods of Promeryvo Diagnostiki, a kind of doser Schvidko, to reach it is an interformative, an unanimless VID Tyazhkostі I will become a bird of a pussy ЕЦінитольнов, ZMINSE EXPLODOSTY (Vychka, Zmіnnennya), extending Embedded, Mill Visungova Duch.
Acoustic characteristics of the permanent PP include the shape, contour, expansion, echogenicity of the internal structure and the head of the head pancreatic duct. Traditionally, in clinical practice, there are high standards for ultrasonic measurements of PZ (Table 6).
One of the main criteria for the improvement of the PZ is the change of the body. From the analysis of more than 3000 foster children M.I. Pikov (1997) showed that the expansion of the mucosa, especially the caudal part, and the visualization of the dilated duct in children with signs of increased pressure on the lumen of the 12-colon intestine. A number of authors consider the improvement of the expansion of PZ (or її parts) with the same echogenicity and homogeneous echostructure, as if showing functional changes to the organ of a compensated character. At the same time, for the organic lesion of the pancreas, there are characteristic changes in expansion, contours, shape, echostructure and expansion of the head pancreatic duct.
Before the sign of chronic pancreatitis on ultrasound, one can see: enlargement of the ducts of the pancreas, manifestation of stones in the protoci of the pancreas, uneven edges of the burrow/change of echostructure, presence of pseudocysts.
With the help of ultrasound scanners, which demonstrate the Doppler effect, it is possible to take data about the blood flow in arterial and venous vessels. Taking into account those that the most early changes in the PZ are on the level of the microvascular bed, the value of visualization of the parenchymal blood flow in the PZ for evaluation will be important to reevaluate. Damage to this organ is often accompanied by changes in hemodynamics and in great vessels, which bleed the upper blood vessels of the herbal system.
In the domestic literature, there are few reports about Dopplerographic indications in normal and pathological conditions. For tribute V.V. Mitkova (1998), the frequency of visualization of small vessels of the PZ for additional color Doppler scanning (CDC) and power Doppler (ED) becomes 60 to 90%, with the largest number of vessels being seen in the area of the PZ head. According to the pulse-wave Doppler data, the maximum systolic rate in the other arteries of the PS was 30±1 cm/s, in the veins - 15 cm/s, the index of resistance in the other arteries of the pancreas - 0.61±0.05. In case of acute pancreatitis, increased intraorganic blood flow is observed, in the world there is an increase in the parenchyma, followed by pulsed Doppler data (ID), there may be an increase in the index of peripheral support in other arteries. In the world of development of destructive processes in the parenchyma of PZ, the deformity of the vessel baby in the zone of destruction is fixed, and in case of VD - a decrease in indications of the peripheral support and a sign of arteriovenous shunting. In chronic pancreatitis, during CDI, there is a risk of weakened blood flow, and in case of VD, a decrease in blood flow indicators in other vessels of the pancreas.
Endoscopic retrograde cholangiopancreatography (ERPGG) is the "gold standard" for diagnosing PD pathology. For the help of this technique, it is possible to reveal expansion and deformation of the head pancreatic duct, to reveal strictures of the duct, to deposit calcium on the walls of the duct, to name the parenchyma of the pancreatic duct. In case of follow-up, there are also changes in the gastrointestinal system: stenotic papillitis, choledocholithiasis, anomalies in the development of the zhovchny ducts and zhovchny mіkhur thinly.
Indications before carrying out ERPGG є:
. recurrent chronic pancreatitis;
. blunt abdominal trauma with pronounced pain syndrome;
. duodenostasis;
. zhovtyanitsa of unclear etiology;
. chronic calculous cholecystitis;
. preoperative obstezhennya ailments.
The main indications before performing computed tomography and magnetic resonance cholangiopancreatography in children:
. complications of acute and chronic pancreatitis;
. suspicion of a volumetric process in the pharyngeal gland and in the lower organs.
Correction of pancreatic insufficiency is directed to the elimination of damage to the breakdown of fats, proteins and carbohydrates and the transfer of the recognition of a special high-calorie diet and enzyme replacement therapy, which can reduce the manifestation of maldigestion and malabsorption. Enzyme preparations are traditionally used by pediatricians and may have significant technological and pharmacological shortcomings, as well as low activity in the 12-colon intestine. By prescribing that second drug, the first drug is responsible for everything to know the warehouse and mother of information about the activity of yoga components.
Preparations for replacement therapy of ovishnyosecretory insufficiency of the pancreas in children guilty of:
. revenge at your warehouse lipase and be resistant to hydrochloric acid;
. mothers maximum dії at pH 5-7;
. quickly and homogeneously mix with chyme and transport into the duodenum;
. mother microtablets (microspherical) form with a diameter of not more than 2 mm, which ensures the large surface of the zіtknennya with chymus. Tse priyaє one-hour suppository of the drug in the 12-pale intestine and fast vilification of the lipase in the intestine;
. mothers are well tolerated;
. Don't mother toxicity.
To ensure smooth and homogeneous mixing of enzymes with chymus, to prevent internal duct inactivation and adequate passage of the duct into the duodenum, the enzyme preparation and pancreatin of a new generation - Creon 10000, Creon 25000.0 mm.
Mini-microspheres Creon 40000 coated with an enteric coating and placed in a gelatin capsule. When it gets into the tube, the capsule separates slightly, mini-microspheres move along with it and step by step go to the 12-pale intestine. At a pH of the duodenal cavity of 5.5, the membranes are separated and enzymes begin to work on the great surface. The mechanism of action of Creon 40000 allows to create a physiological process of etching, in which pancreatic sic is seen in portions in case of periodic suppuration of the esophagus. The drug is characterized by optimal spontaneity of lipase and protease activity, as well as high zmіstom carboxylesterol-pase and phospholipase A2 for the most effective digestion of fats.
Successful therapy of ovishnyosecretory insufficiency of PZ has many reasons. The most convenient and physiological for the patient is the intake of enzyme preparations in the afternoon. In times of adequate dose and form of the enzyme preparation, there is a significant improvement in the patient's condition. Criteria for effectiveness of treatment are the occurrence of polyfecal matter, change or elimination of diarrhea, growth of body mass, occurrence of steatorrhea, amylorrhea and creator.
The dose of the enzyme preparation is selected individually on the 1st day. investigation of fallow due to the virulence of exocrine insufficiency of PZ. The dose of the enzyme preparation should be dosed with respect to lipase and start at a low level (1000 OD of lipase per kg of mass). In case of different effects, the dose of the drug is incrementally increased under the control of coprological doses. In case of severe exocrine insufficiency of PZ, 4000-5000 OD lipase per kg of mass is taken. Triviality of therapy is determined individually. The use of enzymes is prescribed for various clinical and coprological signs of maldigestion and malabsorption. 3. Frank B., Gottlieb K. Amylase normal, lipase elevated: is it pancreatitis? Yak vipadki series and review of literature // Am. J. Gastroenterol. 1999 Vol. 94. R. 463-469.
4 Russell M.K. Acute pancreatitis: Review of pathophysiology and nutrition management // Nutr. Clin. Pract. 2004 Vol. 19. R. 16-24.
5. Gubergrits N.B., Golubova O.A. Laboratory diagnostics of diseases of the slugs / Medical laboratory diagnostics (programming and algorithms) / Ed. A.I. Karpishchenko. SPb., 2001.
6. Henderson D.M. Pathophysiology of organs of etching. M.: Binom, 1997. Z. 288.
7. Korovina N.A., Levitska S.V., Budakova L.V., Kameneva O.P. Diagnosis of pancreatitis in children M., 1989. 24 p.
8. Belmer S.V., Gasilin T.V. Grass insufficiency of the subslut infestation in children. Differentiation pidhіd / / Russian medical journal. 2007. No. 1. S. 57-60.
9. Pikov M.I. Dopplerographic study of the vessels of the subscapular cavity in children // Ultrasonic and Functional. diagnostics. 2001. No. 2. C. 53-57.
10. Zagorenko Yu.O. Clinical and pathogenetic assessment of informativeness and current possibility of optimizing ultrasound diagnostics of chronic recurrent pancreatitis // Med. visual. 2002. No. 1. C. 48-58.
11. Zubarev A.V. Ultrasonic monitoring of treatment of acute pancreatitis // Med. visual. 2000. No. 4. C. 21-24.
12. Mitkov V.V., Bryukhovetsky Yu.A., Kondratova G.M. Color Dopplerography and Eneogenetic Doppler with Ultrasound Follow-up of the Sub-Slut Hole. Clinical physiology. Diagnostics - new methods. M., 1998. Z. 177-180.
13. Yakovenko E.P. Enzyme preparations in clinical practice // Clinical pharmacology and therapy. 1998. No. 7. S.17-20.
14 Graham D.Y. Treatment of exocrine pancreatic insufficiency // Pract. Gastroenterol. 1980 Vol. 4. R. 18-23.
In the world of the progression of the ignition process in the subscapular cavity in patients with chronic pancreatitis, progressive replacement of salivary (secretory) tissue to the organ is successful or cicatricial. As a result, the number of secretory (acinar) clots changes in the colon, and in physiological minds, it is seen in the intestinal lumen of the duodenum that there is a secret (pancreatic sik).
Vіn revenge the whole spectrum of enzymes, grafting proteins, fats, carbohydrates, aloe lipase, an enzyme that ensures the splitting of fat into fatty acids and mils in the herbal tract, there are no significant “doublers” in the herbal tract. And to that, in the minds of a decrease in the number of secretory cells, the situation is more likely, if the amount of juice that was seen in the lumen of the twelfth colon, appear insufficient for the process of overdigestion and further soaking, we are in front of fats and fats of boron, carbohydrates.
Tsey camp fakhіvtsі call zovnіshnyosekretorny insufficiency of subshlunkovoj zoloza. Further progression of hot-cicatricial changes in the submucosal ridge can lead to damage to the endocrine function of the organ with the development of circulatory diabetes.
Clinical manifestation
The most typical manifestation of ovishnyosecretory insufficiency of the subslut ridge is poor tolerance of fatty scallops, especially lubricated and smoked. As a result, after the appearance of a slight heaviness in the stomach of a raspberry-like "fatty" style, the so-called pancreatic steatorrhea (seen with feces fat). The frequency of the emptying sounds does not change 3-6 times on the doba. Let's forgive and easily define the criterion for increased fat content of feces and your building is left behind on the toilet bowl, as if it were filthy to be washed away by water.
It is possible for the appearance of an abdominal distension and a colicky pain in the night. Obmezhennija to priyom greasy їzhі, priyom herbal enzymes (div. below) will reduce the significance of signs and induce them.
We have been shirtless in the organismism of Buti Boli in Kіstki, piviced in Kіstki, piviced to the designer of Mo'ymbіv (Gіpovіtamnos d), tasked with the Systems of the Zlotanna Kronovo at the Visigandi Blood, Sutіnkova Zoru, Abo Kijacch, dryness of the skin (hypotaminosis A), susceptibility to infections, decreased libido, potency (hypotaminosis E).
Blіdіst shkіrnih pokrivіv, zadishka, priskorene sertsebittya, Shvidka stomlyuvanіst, znizhennya pratsezdatnostі that INSHI Find our B12-defіtsitnoї anemії mozhut sposterіgatisya vnaslіdok torn down zasvoєnnya vіdpovіdnogo vіtamіnu scho nadhodit of їzheyu through marriage pankreatichnih proteases (fermentіv scho rozscheplyuyut bіlki). Decreased weight of the body, as a result of insufficient suppleness of the living speeches, testifies to the manifestation of the obvious secretory insufficiency of the substantia follicle.
11. The concept of liver failure. Etiology, reveal it.
etiology : Mostly it develops during the first time
protection of this organ: viruses (Botkin's ailment), plump, echinococcus, circus
trojan. Often, liver failure develops in different lesions
zhovchi, after zdavlіdnja or obturation of zhovchny ways. maybe
poisoning with hepatotropic bran, especially with chotirichloride coal,
chloroform, ether, benzene, rotted mushrooms. Often damage to the liver
caused by changes in the position of the organ - shock of various etiology, sepsis,
heart failure, collagenosis.
PATHOGENESIS: The pathogenesis is based on the manifestations of hepatic cytolysis
clitin. As a result of all the reinsurance of the most factors in pershu
the penetration of the membranes of the clitin of the liver is increased. So call in
the cytoplasm of hepatic cells needs sodium and water ions. Klitini on-
thump. At once, the organelles of clitin are growing in obscurity, especially
mitochondria and lysosomes. As a result, mitochondrial swelling and change
ATP concentrations increase the breakdown of the permeability of cellular membranes
bran, and swell, and as a result, an increase in the penetration of membranes
a large number of lysosomes and their distant opening into the cytoplasm
The presence of enzymes, especially proteolytic, yak, lysing cells, form manifestations of necrosis of hepatic cells. In connection with impaired functions of hepatocytes in liver failure, the breakdown of metabolic processes comes to the fore (div. nutrition 12)
- Medicamentous treatment of ovnishnyosecretor insufficiency
- Diet for syndromes of ovine-secretory insufficiency
- People's celebration of pancreatitis
In case of severe insufficiency of the subcutaneous secretion, treatment can be complex: the sick person needs to take dietary supplements and take special medicines. The stench will lead to the marriage of enzymes. You can take drugs with folk methods, but you can still be happy with the doctor.
Medicamentous treatment of ovnishnyosecretor insufficiency
With this illness, the following symptoms appear:
- flatulence;
- disgusting appetite;
- boredom;
- cut to fat їzhi;
- windmill;
- a rare style with a pungent smell and small pieces of uncorroded hedgehog.
It is not worth talking about a decrease in the activity of enzymes in trypsin, lipase, amylase by 70-80%. To support the body, enzymatic therapy is prescribed, but it cannot side effects. In order to minimize the damage caused by the absorption of lipids, "Mezim Forte" is prescribed. Dodatkovo ailments are guilty of taking fat-reducing vitamins A, E, K, D. The beginning of such therapy in an hour will cause symptoms of illness.
Turn to hell
Diet for syndromes of ovine-secretory insufficiency
It is possible to get rid of pancreatitis only for additional diet. From the diet it is necessary to include spices, fats, oiled herbs, gassed and alcoholic drinks. Dairy products are acceptable, but in small quantities. Lіkuvalny eating can be eaten, take food in small portions according to age. It is recommended to fast for 1 to 3 days. At this hour, it is necessary to drink more water. The ideal options are:
- water;
- vіdvar shipshini;
- compote;
- mineral water without gas;
- nasty chamomile.
Under the hour of rejoicing, walks are shown, relaxing baths, light physical exercise. For a few months, you can see yourself richer better, but not varto to be carried out in a diet, її next trimaty with a pivroku. So that the illness does not turn around again, it is necessary to take care proper eating, forget about fast food and have a dry snack
Turn to hell
People's celebration of pancreatitis
In case of insufficiency of the ovishnyosecretory function of the subscapular ridge, they can help folk recipes. It's necessary to wait for a doctor and get on with drug therapy and a diet. Without which one cannot reach greater results.
In case of ailments, folk healers recommend vicoristing polynes. Z tsієї roslina tincture is prepared. For whom it is necessary to take a double jar and fill it with fresh syrovina on the plate. Let's sweat it out with a throat up to the neck and dig into the ground. After 10 days, the jar will need a brew, and the tincture should be filtered. It is recommended to take zasib at 5 ml per day. After 2 hvilini, it is necessary to obov'yazkovo z'isti 5 ml of honey. Let's drink more plumpness and take 5 g of butter. Therapy is continued for 10 days, then we will try to break for a month and you can repeat the course. The jubilation should be repeated until the tincture is over again.
The syndrome of ovine-secretory insufficiency can be overcome with herbs. Clean up bіl that spasm to help such growths:
- peppermint;
- swamp cudweed;
- Oman is high;
- zvіrobіy;
- creep;
- coriander.
Three of them are getting ready. For this 20 g of syrovin, 400 ml of okrop are poured. Potim єmnіst put on a full fire and boil for 10 minutes. After the first intake, infuse in a thermos 30 quills, filter and take 4 ten days a day 100 ml.
Alfalfa posіvna tezh dopomozhe vporatis z ієyu ailment. Z ієї roslini is preparing a wholesome nastіy. For this 10 g of syrovin, 200 ml of sprinkles are poured and 15 quills are infused. If it needs to be filtered, then three times a day, 60 ml. It is recommended to drink nastіy and prophylactic method. To fight for a month for a month once for a pivroku.
Golden wus does a good job of helping with pancreatic insufficiency. To prepare liqueurs, it is necessary to pour a sheet with a length of 25 cm into 700 ml of water. Then let's put ourselves on full fire and be forced after boiling 15 minutes. After this intake, infuse for 2 years, filter and take 25 ml of trichi a day before eating.
For acute secretory insufficiency, dopomomo greek groats. 150 g of syrovin should be poured over 500 ml of kefir. Sumish can stand for 12 years. Take 300 ml of food per day to replace the meal that evening. Another part can be taken 2:00 before bedtime. Therapy is continued for 10 days. Let's try to break for 10 days and the course is repeated again.
Therapy is given by taking 100 ml of trichi juice per day 2 years before the day. After 5 minutes, you can drink a bottle of kefir. It is important to remember that sik zberigaє crooks of authority only with a stretch of 10 quills, it’s not varto to prepare yogo in reserve.
Potato juice also helps with my ailments. Vіn znіmaє inflamed and spasms, ale cey zasіb contraindications in case of increased acidity of the drain.
Even though there is no allergy to propolis products, you can try to get sick for help with propolis. Vіn is positively signified on the robotic pіdshlunkovoї zalі, zmіtsnyuyuchi її її її її її її її її skoryuyuchi regenerative protsess. To carry out the jubilation, it is recommended to chew 3 g of propolis in intermediaries.
The human organism is composed of rich organ systems that are closely related to each other. Whether or not the disruption of the activity of one of the workers of our body is negatively signified on the work of others and often results in a number of unacceptable symptoms. One of the most important organs in the body of a human being is the chain worm. She takes an active part in poisoning and borrows an important place in the organ of the endocrine system. І її it is wrong that the lack of a robot becomes the cause of the development of serious ailments. One of the possible ruptures of this type is the deficiency of the submucosal lining, the symptoms of which are negotiable.
In general, there is a deficiency of the ovary secretion - a pathological state, in which the organ synthesizes an insufficient amount of enzymes, the need for complete splitting of all brown rhizomes, as in human organisms. A similar situation is most likely to occur in chronic pancreatitis (inflammation of the pimples), pathological processes for such ailments lead to a change in the number of cells that are involved in the production of enzymes.
Symptoms of ovine secretory insufficiency
As if it were another disease, ovnіshnyosekretornі insufficiency pіdshlunkovoї zoloza characterized by singing specific symptoms, yakі vrakhovuyut doctors when making a diagnosis. A classic manifestation of such a disorder is intolerance to oily, oily and sour. It is very important for patients with the diseased secretory insufficiency of the submucosal cavity to be similar, it will not be practically conquered, otherwise it will not be accepted by the body.
Pathological processes for such ailments call out a little heaviness in the stomach. Such a symptom is caused by nevdovzі after the reduction of fat (oily or gastric) zhі, which is not accepted by the body.
In addition, a small amount of enzymes in the slug bed is manifested by changes in the voids. Wine is fat and porridge-like.
In addition, ailments due to the sever secretory insufficiency of the submucosal lining of the turbulence increase in gasification in the intestines, sometimes inaccurately overexposure to the intestines in the evening with flatulence, cause painful rings until the vinification.
Part of the symptom of this pathological state of mind is more and more sickness in the cysts.
Until then, the lack of a secret secretary can give itself a nobility by the appearance of an accelerated heartbeat, a court, a backside. In patients, dryness of the skin of the body is often suspected, and laboratory studies show the presence of respiration in cases of blood pharynx. Similar symptoms are explained by the lack of fat in the body, which leads to the development of a deficiency of these speeches. The very marriage of such elements leads to more uncomfortable problems, and in itself the lack of activity of the underslung ridge is practically not given signs.
Zovnіshnyosekretorna insufficiency of subslunkovoj zaloz - likuvannya:
Patients with a similar problem need to remember their way of life and adjust their food intake. Doctors recommend to eat dribno: increase the frequency of intakes and shorten the servings. It is very important to change the spasm of fatty meat, including fatty varieties of meat. In order to feel normal, it is necessary to quickly sleep, so that you can relax at the evening hour, and it’s better not to have a bite to eat in the evening and at night. For successful treatment of ovnishnosecretory insufficiency, it is also necessary to turn on the alcohol intake of that chicken.
The diet of the sick person is to be folded according to the recommendations of the doctor, and in his turn it is necessary to control the patient's diet. So fast reduction of fatty and savory food may be on the verge of a parallel increase in growing products in the daily menu, so before the diet of varto obov'yazkovo, include fresh vegetables and fruits. How to change the problem of superworldly gasification, hangings can come to measles.
Likarskoe likuvannya
Medicamentous therapy of acute secretory insufficiency of the submucosal lining may be necessary for the removal of us before taking drugs, directing to ease the activity of this organ, or to completely replace it (in the plan for the production of enzymes). With this drug, enzymatic drugs are prescribed, such as the drug preparation Creon, Pancreatin, Mezim (instruction, zastosuvannya dermal treatment is on the site). Most often, it is necessary to use it for a systematic intake - with a skin meal and stench, it will effectively prevent damage to poisoning. The number of tablets and capsules may be varied depending on one or more of them, which can be stored in a limited portion and in a warehouse. The most common way to increase the number of enzymes is to reduce the amount of stress, rich in fat. Varto signify that the intake of carbohydrates allows you to change the patient's need for herbal enzymes.
Doctors can also prescribe ill proton pump blockers, for example, Omeprazole, Pantoprazole, Lansoprazole, Esomeprazole and others. Such faces are friendly to the activity of enzymes, creating a puddle of reaction in the upper veins of the SHKT.
Properly recognized likuvannya allows you to do it quickly to normalize the health of the sick. Conducting a laboratory follow-up in his show the normalization of indications in the patient's feces. It’s a pity, the lack of secretory secretion of the stool often doesn’t give pleasure, but the right way of life, proper eating and adequate preparation allow the ailment to feel normal.
Folk recipes
For the fullness of the activity of the pidshlunkovoy vine, a variety of grasses and handicrafts can be stagnant. Dotsіlnіst їх vikoristannya need to be discussed with the doctor.
Such a miraculous effect is given by the milk, the recipe for preparing something even simpler. To prepare such a zasib, prepare one hundred grams of unpeeled grains, wash them on a drashlyak, pour again with liters of water in an enamel container. Bring the sum to a boil and boil it for forty chills. After that, crush the oats right in the pan and add twenty more quills. Cool the prepared water and pass it through gauze.
Otriman bіlu rіdina take a hundred milliliters of trichi-chotiri once a day, not long before the meal. Keep these drinks in the refrigerator for no more than two days.
In the world of the progression of the ignition process in the subscapular cavity in patients with chronic pancreatitis, progressive replacement of salivary (secretory) tissue to the organ is successful or cicatricial. As a result, the number of secretory (acinar) clots changes in the submucosal fold, and in physiological minds, it is seen in the lumen of the twelve-fingered intestine that the intestines are rich herbal enzymes that meadow secret (pancreatic sіk).
Vіn revenge the whole spectrum of enzymes, grafting proteins, fats, carbohydrates, aloe lipase, an enzyme that ensures the splitting of fat into fatty acids and mils in the herbal tract, there are no significant “doublers” in the herbal tract. And to that, in the minds of a decrease in the number of secretory cells, the situation is more likely, if the amount of juice that was seen in the lumen of the twelfth colon, appear insufficient for the process of overdigestion and further soaking, we are in front of fats and fats of boron, carbohydrates.
Tsey camp fakhіvtsі call zovnіshnyosekretorny insufficiency of subshlunkovoj zoloza. Further progression of hot-cicatricial changes in the submucosal ridge can lead to damage to the endocrine function of the organ with the development of circulatory diabetes.
Clinical manifestation
The most typical manifestation of ovishnyosecretory insufficiency of the subslut ridge is poor tolerance of fatty scallops, especially lubricated and smoked. As a result, after the appearance of a slight heaviness in the stomach of a raspberry-like "fatty" style, the so-called pancreatic steatorrhea (seen with feces fat). The frequency of the emptying sounds does not change 3-6 times on the doba. Let's forgive and easily define the criterion for increased fat content of feces and your building is left behind on the toilet bowl, as if it were filthy to be washed away by water.
It is possible for the appearance of an abdominal distension and a colicky pain in the night. Obmezhennija to priyom greasy їzhі, priyom herbal enzymes (div. below) will reduce the significance of signs and induce them.
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Blіdіst shkіrnih pokrivіv, zadishka, priskorene sertsebittya, Shvidka stomlyuvanіst, znizhennya pratsezdatnostі that INSHI Find our B12-defіtsitnoї anemії mozhut sposterіgatisya vnaslіdok torn down zasvoєnnya vіdpovіdnogo vіtamіnu scho nadhodit of їzheyu through marriage pankreatichnih proteases (fermentіv scho rozscheplyuyut bіlki). Decreased weight of the body, as a result of insufficient suppleness of the living speeches, testifies to the manifestation of the obvious secretory insufficiency of the substantia follicle.
Diagnostics
Forgive me, let's do it with an informative method of diagnosing ovnishnyosecretory insufficiency of the scrotum - clinical analysis of feces or a coprogram. Before the characteristic for pancreatic steatorrhea, the sign can be seen in the analysis of feces great number drops of neutral (not over-etched) fat. With a more severe deficiency of submucosal secretion in the feces, it will also appear in the superficial amount of starch grains (damage to carbohydrates, or amylorrhea) and / or undigested m'ulcer fibers (damage to digestion, proteins).
Additional criteria, which confirm the significant deficiency of the submucosa, increase in the mass of feces, which are seen as doba (polyfaeces), that increase in the amount of fat in them (more than 7 g, and often more than 20 g). W modern methods Diagnosis of ovishnyosecretory insufficiency of subcutaneous tissue is due to the importance of the appointment of elastase in the feces (one of the enzymes that break down the fibers), as well as a test for triolein absorption. The first one is a specific method for assessing the secretory activity of the subdural follicle, and the other one is for steatorrhea.
Celebration
An invisible component of the treatment of manifestations of sever secretory insufficiency of the sub-slut ridge is the correction of the regimen and diet of eating. Among the main warehouse dietary and regime recommendations:
- often (intervals no more than 4 years) shot (small) portions of food
- uniqueness of the superfluous receptionist, especially at the evening and night hours
- fat burning, we are the creatures that knew the thermal processing (lubricated, smoked)
- povna vіdmova vіd alcohol
What are the specific food products, їх warehouse dosit іndivіdualny і pіdbіraєtsya at the same time by the patient and the doctor, often empіrіchno. Varying important role of eating in the correction of manifestations of acute secretory insufficiency, the patient is well-nourished, in order to expand the food diet and / or change the regimen, he is guilty of serving his doctor first.
In times of defecation of nutrition in the body, fat and, often, protein, in a safe patient, the energy of the first plan is to go into carbohydrates. Obviously, the blame is not on refined carbohydrates (licorice), but on vegetables, fruits and cereals, as the main natural sources are not only herb cells, but the most important vitamins, microelements. However, not all patients due to the ovnishnyosecretory insufficiency of the submucosal follicle endure the roslinna zhu well. In part of the patients on aphids, I will take such brown and necessary products, like kvass, peas, see different cabbage, eggplant, borobi and borosna of cereals coarse pomelo ta іn.
A possible alternative to it can be regular fermentation in zhu virobiv, which can be avenged by the high vitamin-mineral complex of fermentation of wheat whiskey "Rekitsen-RD". It is better to ensure the intake of a sufficient amount of energy in the body, and to allow the problem of treating the deficiency of vitamins of that micronutrient. In addition, such products of the building "rozvantazhit" pіdshlunkovu ridge, which positively influences the functional activity.
The key medicinal preparations for the treatment of acute secretory deficiency are herbal enzymes (pancreatin, mezim-forte, panzinorm-forte, creon and other). Mіzh themselves stinks to be distinguished only by a small amount of lipase, which is avenged in them, and by additive ingredients (enzymes of the shell).
Qi preparation and next take pіd hour їzhі. The number of tablets or capsules can be widely varied from 1 to 3-4, fallow in general and warehouse. The world's largest enzyme preparations are indicated for taking zhі, rich in fats, the world's smallest proteins.
The emphasis on lowering carbohydrate intake reduces the need for herbal enzymes, but the significance of the substantia follicle in the current overexposed is significantly less, lower protein and more fat. To promote the herbal enzymes, stinks are taken with proton pump blockers (omeprazole, pantoprazole, lansoprazole, rabeprazole, esomeprazole), thus creating a puddle reaction at the upper branches of the herbal tract, adhering to the enzymes themselves.
Forgive Criterіm Usongennya Manovіv Zovnіshnostecretorino Non-fermented by Pislunkovo, Znori's grassy enzymes є Zhibnenenna Pryla Tu Normalіzatsiya Masi Tіl, and Torozhennia Pancreativity, and Torozhennia Pancreatic Caliva Tu Zniphennia (Normalіzatsіїї Yeh 7 g) Virmist Zhiru in Cali for Deta.
