In order to prevent and regenerate pancreatic diseases, it is worth taking the Biofiton Healthy Pancreas diet supplement.

Biofiton Healthy Pancreas Phytotablets include medicinal plants, the effect of which is aimed at:

1. NORMAL LEVEL OF BLOOD SUGAR. Biologically active substances of Bean Pods and Burdock Roots normalize blood sugar level.

2. NORMAL LEVEL OF BLOOD CHOLESTEROL. Biologically active substances of Bean Pods, Dandelion and Burdock Roots normalize blood cholesterol level, thus promoting health body weight.

3. GOOD DIGESTION. Nettle and Bilberry Leaves, Dog Rose Fruit, Marshmallow, Dandelion, Elecampane and Burdock Roots effect favorably the functioning of gastrointestinal tract and pancreatic work, promoting better digestion.

4. REDUCTION OF DISCOMFORT. Combined action of substances from Marshmallow, Elecampane and Dandelion Roots, and Nettle Leaves promoting reduction of discomfort in digestive system.

 

Chronic pancreatitis (Latin pancreatitis chronica) – a chronic, inflammatory disease of the pancreas, characterized by progressive, irreversible changes in the parenchyma (with subsequent fibrosis) and pancreatic ducts, which leads to a gradual impairment of this organ’s endocrine and endocrine function. The disease has a long-term course, its basis is usually alcohol abuse, and the dominant symptom – usually abdominal pain. One of the consequences of chronic pancreatitis is secondary diabetes.

EPIDEMIOLOGY
Exact data on the incidence of chronic pancreatitis are not known. It is estimated to be 0.04-5%. In Poland, estimates indicate an annual incidence of 5-10 / 100,000. and prevalence of 30-57 / 100 thousand.
In the case of alcoholic Chronic pancreatitis men are more often ill and the peak incidence falls on the 4th and 5th decade of life.
Idiopathic Chronic pancreatitis occurs with similar frequency in women and men. The first symptoms occur around 10-20 years of age in the early form and around 50-60 years in the late form.
Autoimmune Chronic pancreatitis is more common in men with a peak incidence of 45-75 years.
Hereditary Chronic pancreatitis gives the first symptoms already in the first decade of life.

The aetiology
Causes and risk factors
A classification of risk factors for the development of chronic pancreatitis under the name TIGAR-O has been proposed. The division into 6 groups of etiological factors:
1. toxic metabolic (T)
2. idiopathic (I)
3. genetic (G)
4. autoimmune (A)
5. recurrent or severe acute pancreatitis (R from recurrent)
6. dam (obstructive)

Toxic-metabolic factors account for 70-90% of all  Chronic pancreatitis cases, and the rest combined 10-30%.
Most often alcohol causes damage to the pancreas. In patients with chronic pancreatitis, a history of alcohol abuse is 70-90% in developed countries. The development of the disease depends to some extent on the amount of alcohol consumed, but its type and method of consumption do not matter. In the etiopathogenesis of Chronic pancreatitis with alcohol, most likely other disease factors interact, including predisposition
genetic, dietary and environmental factors. This is indicated by the fact that only 10% of alcoholics develop the disease.

Other toxic agents besides alcohol are:
• smoking – an independent risk factor that accelerates the progression and manifestation of the disease in alcoholic and late onset idiopathic pancreatitis
• taking or abusing some medicines
• hypercalcaemia (e.g. in the course of hyperparathyroidism)
• hyperlipidemia (hypertriglyceridaemia)
• chronic renal failure

Idiopathic chronic pancreatitis is the second most common after the alcoholic form. There are two disease peaks:
• early emerging
• late appearing
• and tropical

Genetic Factors:
• mutations
cationic trypsinogen gene (PRSS1); type 1 mutation R122H and type2 mutation N29I
CFTR gene (cystic fibrosis)
the SPINK1 gene
• α1-antitrypsin deficiency

The term autoimmune chronic pancreatitis has been introduced since 1995. It is characterized by infiltration from plasma cells in the pancreas and a therapeutic response to corticotherapy.
Recurrent, past severe acute pancreatitis and after radiation therapy.

The obstructive Chronic pancreatitis consists in obstructing the outflow of pancreatic juice to the duodenum:
• bifid pancreas (pancreas divisum)
pancreas annulare (malformation)
• changes related to the obstruction of the outflow of pancreatic juice through the Vater wart

pancreas tumors

duodenal diverticulum

narrowing of the pancreatic duct, post-traumatic and

narrowing of the wart

Anatomopathological changes

The most common anatomopathological phenomenon is chronic inflammation and fibrosis, as well as the loss of active pancreatic parenchyma. The fibrotic process is focal, segmental or diffuse. The occurrence of calcifications indicates the late phase of Chronic pancreatitis. There are changes in the pancreatic duct and its branches (narrowing, enlargement, deposits and calcification). In the course of Chronic pancreatitis, cysts are often found, most often pseudocysts.

SYMPTOMS AND COURSE
The most common (occurring in approximately 85% of cases) and the most common symptom of chronic pancreatitis is abdominal pain.
It is stinging, stabbing, drilling or squeezing; it is recurrent, persistent and has varying, sometimes severe, levels. Occurs mainly after a meal (after about 15-30 minutes) and is located deep in the epigastrium, usually in the upper left quadrant of the abdominal cavity, often with radiation to the back to the area between Th12 and L2.
The pain can last for several days or even weeks, rarely disappears within 24 hours. In the initial period of the disease, pain occurs in the form of periodic seizures; later the pains are getting stronger and lasts longer.
In most patients, the pain decreases or disappears within 5-25 years of the disease.

Other symptoms of chronic pancreatitis:
• progressive weight loss
• increased blood glucose – impaired glucose tolerance and progressive diabetes
• persistent diarrhea, usually of a fat nature, resulting from incomplete digestion of food due to a shortage of pancreatic enzymes
• slight jaundice (with compression of the intra-pancreatic part of the bile duct)
• itching of the skin
Symptoms require thorough diagnosis to differentiate from pancreatic cancer.

RECOGNITION

Based on medical history and physical examination, chronic pancreatitis can only be suspected. This diagnosis is likely if frequent abdominal pain is combined with weight loss and diarrhea in a person abusing alcohol.

Due to the significant functional reserve of the pancreas, the correct diagnosis can be delayed by up to several years. Especially considering that tests assessing the function of the pancreas give positive results only with a very significant degree of damage to the pancreatic parenchyma (about 90%).
Impaired fat absorption occurs earlier than protein absorption. Although evidence of impaired fat absorption is a non-specific symptom, it may indicate pancreatic exocrine insufficiency.
The presence of calcifications and deposits visible in imaging tests is characteristic of chronic pancreatitis (especially the alcoholic form). Another characteristic change in imaging tests is the irregular widening of the main pancreatic duct and its branches.
In the course of the disease, the determination of the concentration of the digestive enzyme amylase (and produced by the pancreas) in blood serum and urine gives variable results. It may be slightly increased, but it is often correct too. Therefore, this study has neither diagnostic nor prognostic significance.
Ultrasound and computed tomography are of great importance in diagnostics, which allows direct visualization of the pancreas. Ultrasound also allows to determine the cause of inflammation of, e.g., cholecystolithiasis and bile ducts, as well as complications of this disease, which can be e.g. pancreatic cysts.
A specialized examination carried out in the hospital is retrograde endoscopic cholangiography (ECPW for short), during which a contrast agent is injected into the pancreatic duct with a special device, which makes it possible to accurately depict the course and shape of this duct. Due to the invasiveness of this diagnostic method and the possibility of complications, the following tests are usually performed, and ERCP is reserved primarily for cases with planned intervention.

Other tests:
• cholangio-NMR
• endoscopic ultrasound (EUS)
At the conference in Rosemont in 2009, a proposal for a diagnostic classification of chronic pancreatitis based on the results of endoscopic ultrasound was presented.
Due to diagnostic difficulties, the diagnosis of this disease is, especially at the beginning of the disease, abused and put incorrectly. Chronic pancreatitis is a relatively rare disease, it occurs, for example, several dozen times less frequently than myocardial infarction and several hundred times less often than bacterial pneumonia.

Complications
The most important complications occurring in the course of chronic pancreatitis:
• pancreatic pseudocysts (in 10-25% of patients)
• mechanical jaundice, by compressing (narrowing) the common bile duct (in 5-10% of patients)
• pancreatic ascites
• splenic vein thrombosis, possibly with portal hypertension, gastric varices and gastrointestinal bleeding (in 2-4% of patients)
• aneurysm or pseudo-aneurysm of the surrounding vessels (e.g. spleen artery)
• pancreatic cancer (increased risk of developing this cancer in Chronic pancreatitis , especially in hereditary)
• pleural effusion
• duodenal stenosis

TREATMENT

General rules
Causal treatment is only possible with autoimmune pancreatitis. The use of corticotherapy causes the disappearance of the disease symptoms, as well as changes found in imaging and laboratory tests. Prednisone is used at a daily dose of 0.5-1 mg / kg body weight / day for 4 weeks, then the dose is reduced by 5 mg every week. Maintenance therapy is recommended for several months.
In other cases, only symptomatic therapy is possible.
• combating pain
• treatment of diabetes and other metabolic disorders
• dietary treatment and prevention of malnutrition, including a ban on alcohol consumption and smoking (using drug treatment)
• treatment of complications

Dietary treatment
A high protein and high calorie diet (2500-3000 kcal / day) is recommended for patients with chronic pancreatitis. Meals should be smaller in volume, but more frequent (5-6 per day). The consumption of fatty foods should depend on the patient’s individual tolerance, however, when substituting digestive enzymes, it should not be less than 60-70 g fat / day.
Supplementation of fat-soluble vitamins A, D3, E and K, as well as vitamin C (400 mg / day) is important. In addition, it is advisable to supplement the diet with other vitamins: B12, folic acid, as well as trace elements and antioxidants such as selenium, β-carotene and methionine. It is worth using regenerative dietary supplements, e.g. Healthy Pancreas
With extreme fat intolerance, the use of medium chain fatty acids (MCT) is recommended. Excessive dietary fiber intake can lead to decreased exogenous pancreatic enzyme activity.

Fighting pain
Lifting pain, dietary treatment and treatment using enzymatic preparations are conducive to combating pain occurring in this disease. If such treatment is ineffective, analgesics are introduced for therapy:
• non-narcotic analgesics (paracetamol, NSAIDs)
• spasmolytic drugs
• opioid analgesics (in selected cases, due to the risk of addiction)
• antidepressants (as an aid in some clinical situations)
• visceral plexus block or cut sympathetic nerve fibers
• endoscopic procedures
– duodenal major and minor sphincterotomy
– widen the pancreatic duct with stents
– removing deposits
– the treatment of pseudocysts
• surgery (most often to treat Chronic pancreatitis complications or if other analgesic treatments are ineffective)
• differentiation towards other causes of pain (especially with ineffective therapy)

Pharmacological treatment
In the presence of exocrine pancreatic insufficiency, pharmacological substitution of pancreatic enzymes is used.

Surgical treatment
Surgical methods are used in cases of pain resistant to other methods of therapy, the inability to perform or failure of endoscopic therapy, and when cancer changes are suspected.
• drainage operations
–  pancreatojejunostomy by Partington and Rochelle
–  Operation Puestowa
• resection operations
– modification of Whipple operations
–  pancreatojejunostomy by Frey’s method
– resection of the pancreas head with saving of the duodenum (surgery Beger)
– distal resection
–  total pancreatectomy (can be combined with islet pancreas autograft)
• gastrointestinal stenosis surgery associated with chronic pancreatitis

In order to prevent and regenerate pancreatic diseases, it is worth taking the Biofiton Healthy Pancreas diet supplement.

Biofiton Healthy Pancreas Phytotablets include medicinal plants, the effect of which is aimed at:

1. NORMAL LEVEL OF BLOOD SUGAR. Biologically active substances of Bean Pods and Burdock Roots normalize blood sugar level.

2. NORMAL LEVEL OF BLOOD CHOLESTEROL. Biologically active substances of Bean Pods, Dandelion and Burdock Roots normalize blood cholesterol level, thus promoting health body weight.

3. GOOD DIGESTION. Nettle and Bilberry Leaves, Dog Rose Fruit, Marshmallow, Dandelion, Elecampane and Burdock Roots effect favorably the functioning of gastrointestinal tract and pancreatic work, promoting better digestion.

4. REDUCTION OF DISCOMFORT. Combined action of substances from Marshmallow, Elecampane and Dandelion Roots, and Nettle Leaves promoting reduction of discomfort in digestive system.