This is done to reduce or suppress pancreatic enzymes to decrease stimulation of the pancreas and allow for rest. NG set to suction helps reduce vomiting and gastric distention and prevents gastric acidic contents from entering the duodenum. A major complication of pancreatitis is paralytic ileus. Patients with severe pancreatitis who cannot resume oral intake may be supported with enteral nutrition, such as through a jejunostomy tube or a nasogastric tube. TPN is sometimes used for very severe cases.
IV morphine is often used. Pain medications can be given with an antispasmodic agent; however, atropine and other anticholinergic drugs should be avoided in the presence of a paralytic ileus due to its effects of decreasing GI mobility. Place the patient in a position of comfort, typically on side with legs drawn to chest.
Albumin is a plasma volume expander, which is often given in the presence of shock to help replace blood volume.
Lactated Ringer’s solution or other electrolyte solutions are given as part of an aggressive hydration treatment plan to help correct fluid and electrolyte imbalances. In patients with persistent hypotension, vasoactive drugs such as dopamine may also be used to increase systemic vascular resistance. The replacement of calcium and magnesium may also be needed.
Proton pump inhibitors work by decreasing hydrochloric (HCl) acid secretion, as HCl acid stimulates pancreatic activity. A common PPI prescribed is omeprazole (Prilosec).
In the presence of necrotizing pancreatitis, patients often develop infection as the inflamed and necrotic pancreatic tissue is a good medium for bacterial growth. Administer antibiotics as prescribed.
Acute pancreatitis related to gallstones requires an endoscopic retrograde cholangiopancreatography (ERCP) plus endoscopic sphincterotomy. This can be followed by laparoscopic cholecystectomy to prevent reoccurrence.
It is important to stay properly nourished to aid with recovery. When able to eat, small, frequent high carbohydrate, high protein, low fat meals should be consumed. To avoid irritation, consume bland foods with no spices and avoid GI stimulants, such as caffeine or alcohol.
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