What anti-inflammatory drugs are used for pancreatitis

Pancreatitis can be divided into acute pancreatitis and chronic pancreatitis. The causative factors are varied. After the disease occurs, there will be symptoms such as nausea, vomiting, and fever, which seriously affect the patient's health. Many people do not know much about pancreatitis and think it is a common inflammation. They are concerned about what anti-inflammatory drugs can be used to treat pancreatitis. In fact, pancreatitis cannot be treated simply with drugs. It must be treated in the correct way according to the condition of the disease.

1. Acute pancreatitis

1. General treatment

In the early stages of acute pancreatitis, mild pancreatitis and those without infection should be treated with non-surgical treatment.

(1) Fasting and nasogastric tube decompression to maintain gastrointestinal decompression and prevent vomiting and aspiration. Giving whole-body motility drugs can reduce abdominal distension.

(2) Replenish body fluids and prevent and treat shock. All patients should be given intravenous fluids, electrolytes, and calories to maintain circulatory stability and water-electrolyte balance. Prevent hypotension and improve microcirculation.

(3) For patients with a clear diagnosis of antispasmodic and analgesic conditions, symptomatic analgesics can be given in the early stages of the disease. However, it is advisable to give antispasmodics at the same time. Morphine is contraindicated to avoid spasm of the sphincter of Oddis.

(4) Inhibition of pancreatic exocrine secretion and pancreatic enzyme gastric tube decompression, H2 receptor blockers, anticholinesterase drugs, somatostatin, etc. are generally used for patients with more serious conditions. Trypsin inhibitors such as aprotinin and gabexate have a certain inhibitory effect on trypsin.

(5) Nutritional support: Early fasting, mainly relying on total parenteral nutrition (TPN). When the abdominal pain, tenderness and intestinal obstruction symptoms are relieved, you can resume eating. Except for patients with hyperlipidemia, fat emulsion can be used as a heat source.

(6) Antibiotics should be given in the early stage of treatment. In severe pancreatitis complicated by pancreatic or peripancreatic necrosis, intravenous administration of broad-spectrum antibiotics or selective intestinal administration of antibiotics can prevent bacterial infection caused by intestinal flora translocation.

2. Surgery

Pancreatic abscess, pancreatic pseudocyst, and pancreatic necrosis with infection are serious life-threatening complications of acute pancreatitis. If the diagnosis is uncertain; there is secondary pancreatic infection; there is concurrent biliary disease; or the clinical symptoms continue to worsen despite reasonable supportive treatment, surgical treatment should be performed.

For severe cases, there are two main surgical methods: ① Laparotomy to remove necrotic tissue, place multiple multi-porous drainage tubes for continuous irrigation after surgery, and then suture the incision. ② Laparotomy to remove necrotic tissue and partially open the wound for drainage. During the operation, gastrostomy, jejunostomy (for enteral nutrition support) and biliary drainage can be performed simultaneously. Occasionally, single abscesses or infected pancreatic pseudocysts can be treated with percutaneous catheter drainage.

In severe biliary pancreatitis accompanied by impacted stones in the ampulla, combined with biliary obstruction or biliary infection, emergency surgery or early surgery (within 72 hours) is required to relieve biliary obstruction, remove stones, and unblock drainage. Cholecystectomy or lesser omental pancreatic drainage can be performed according to the condition. When conditions permit, stone removal can be performed through fiberoptic duodenoscope-assisted Oddis sphincter incision, which has significant therapeutic effects and few complications.

2. Chronic pancreatitis

Chronic pancreatitis should be treated causally, such as treating gallbladder diseases and quitting alcohol; dietary therapy, eating small meals frequently, a high-protein, high-vitamin, low-fat diet; pancreatic enzyme supplementation; controlling diabetes; and nutritional support therapy. Pancreatic duct drainage and pancreatic surgery were performed when necessary.