To prevent pancreatitis, we must keep the five “hurdles”

  What is pancreatitis? There are acute and chronic pancreatitis. Acute pancreatitis presents with acute, persistent left upper abdominal pain (occasionally without abdominal pain), blood amylase ≥ 3 times the upper limit of normal, and imaging suggesting morphological changes in the pancreas. In a few cases, serum amylase activity is normal or mildly elevated. The clinical condition can be divided into various clinical types such as mild acute pancreatitis, severe acute pancreatitis, early onset severe acute pancreatitis, fulminant acute pancreatitis, and pancreatic abscess according to the severity and sequence of onset. The most common causes of chronic pancreatitis are alcoholism and idiopathic, and similar to acute pancreatitis, certain patients with chronic pancreatitis are accompanied by microscopic stones. Less common causes are hereditary pancreatitis, hyperparathyroidism, stenosis, obstruction of the common pancreatic duct due to stones or cancer. The clinical presentation is severe upper left abdominal pain. The abdominal pain may subside if there is further destruction of the alveolar cells that secrete pancreatic digestive enzymes. When the secretion of lipase and protease is reduced to less than 10% of the normal value, the patient develops steatorrhea, which is the excretion of feces containing fat. Destruction of islet cells decreases insulin secretion and causes intolerance to glucose. Laboratory tests for blood and urine amylase and lipase are often normal. Blood white blood cell count is often mildly elevated. Abdominal radiographs show pancreatic calcification, suggesting stones in the pancreatic duct. Ultrasound or CT of the abdomen shows abnormal size and texture of the pancreas, pancreatic pseudocysts or dilated pancreatic ducts. Retrograde cholangiopancreatography by duodenoscopy shows abnormalities of the common pancreatic duct and secondary branches.  So, what should be done to prevent pancreatitis?  1, to keep the antecedent disease prevention and control. Those who have gallbladder stones should be removed surgically as soon as possible. When there is inflammation of the gallbladder and bile ducts, anti-inflammatory and biliary drugs such as ampicillin and anti-inflammatory and biliary tablets should be used in a timely manner. When there are roundworms in the biliary tract or intestines, we should use drugs such as intestinal worms and umeboshi pills to de-worm as soon as possible to avoid inducing biliary pancreatitis. In addition, early and thorough treatment of typhoid, hepatitis, sepsis and other infectious diseases that may complicate acute pancreatitis.  2, to keep not alcohol abuse off. Each of us should do not drink alcohol or less alcohol, especially do not drink high-purity liquor, so as not to induce alcoholic pancreatitis.  3, to hold not overeat off. The binge eating, especially a large amount of high-fat, high-protein food, it may lead to acute pancreatitis. You should eat regularly and quantitatively, eat before you are hungry and stop before you are full.  4, to keep a careful medication off. Commonly used drugs such as hormones, dihydrocotrimoxazole, azathioprine, remifentine, anti-inflammatory pain, estrogen, etc., can induce pancreatitis. If the condition is not particularly necessary, it should be listed as a contraindication.  5, to keep the technical barrier of retrograde cholangiopancreatography. When injecting drugs for retrograde cholangiopancreatography (ERCP), the dose of contrast agent and the pressure at the time of injection should be strictly controlled so as not to cause bile, pancreatic juice and bacteria to flow back into the pancreas and induce or aggravate pancreatitis.