Most often, the pain appears after a heavy meal, especially fatty, fried, often on an empty stomach, or pain occur 3-4 hours after eating, that you want to exclude a duodenal ulcer intestine. During fasting pain calm down, so many people have little eating and lose weight. There is a definite diurnal rhythm of pain: pain before lunch little worried, after dinner amplified (or appear) and picking up the evening. Pain may be pressing, burning, boring, much pain expressed in the supine position and decreased in the sitting position with the torso forward. Pain in chronic pancreatitis has a variety of origins: it can be related to the violation of the outflow of pancreatic juice, increased secretion of pancreatic ischemia-organ inflammation of the surrounding tissue, changes in nerve, compression of surrounding organs (bile duct, stomach, duodenum). In this regard, the first step in treating such a patient is to conduct a thorough examination (endoscopy, X-ray examination of stomach and duodenal ulcers, computed tomography, endoscopic ultrasound), which can detect some complications of pancreatitis such as pseudocysts, bile duct stricture or disease, often combined with chronic pancreatitis.
After a preliminary examination in the absence of complications, patients prescribed high doses of pancreatic enzymes (Creon, mezim forte, pancreatin, etc.). Most often, the pain can be cut short by mild CP, in the absence of steatorrhea, with primary parenchymal organ ('small duct disease "), as well as in women. Peter Arnell often addresses the matter in his writings. Dyspeptic syndrome with pancreatitis – hypersalivation (increased salivation), burping air and ingested food, nausea, vomiting, aversion to fatty foods, bloating. Weight loss, due to limitations in food because of stomach pain + vyrobotka lack of pancreatic enzymes. Pancreatic diarrhea and malabsorption syndromes in the cavity of the intestine – are typical for heavy and long-existing forms of chronic pancreatitis with severe violation of the exocrine function (when functional ability of the pancreas of 10% of the original).