Chronic pancreatitis is especially dangerous. Chronic pancreatitis (certificate for doctors) Alcoholic pancreatitis code according to ICD 10

Pancreatitis– a disease meaning inflammation in the tissues of the pancreas. Reactive pancreatitis is not a dangerous disease if the patient consults a doctor in a timely manner. Otherwise, the disease may develop into complex forms.

According to the generally accepted international classification of diseases ICD 10, pancreatitis can be (K85) and (K86). And there is no ICD 10 code for reactive pancreatitis.

Let's answer the question: reactive pancreatitis - what is it? This is only the first reaction of the human body to poor nutrition. Adult men are more often affected by the disease.

The main causes of the disease can be identified:

• poor nutrition;
• occasional alcohol consumption;
• strong blow, with tissue rupture;
• after taking certain medications without consulting a doctor;
• after certain diseases (and viral hepatitis).

Symptoms

Reactive pancreatitis is manifested by characteristic symptoms:

• belching;
• intolerance and aversion to fatty foods;
• cutting pain under the ribs.

Over time, the patient's condition worsens. There is an increase in temperature, breathing worsens, and chills appear. The abdomen begins to swell, causing pain. If any of the listed signs appear, you should consult a doctor.

Diagnostics

Reactive pancreatitis is very difficult to diagnose. The following methods are used to diagnose the disease:

• general urine analysis;
• (will show all pathological processes occurring in the peritoneum);
• abdominal x-ray;
• (clinical analysis for the disease will show an increased level of leukocytes, and a biological analysis will show an increase in the level of the amylase enzyme);
• computed tomography (will show the general condition of the body);
• (will show the degree of inflammation).

All of the tests listed will definitely help you understand the problems of the pancreas.

More on the topic: Pancreatic enzyme disease. Manifestations and causes.

Features of the disease in childhood

For reactive pancreatitis in children, timely treatment is important. Many parents simply ignore the first signs of the disease, attributing them to childhood whims. You should pay very close attention to the child’s complaints, because a slowdown in desire threatens destructive changes in the pancreas, which can lead to diabetes. Or to necrosis of the pancreas, which will entail surgical intervention. A child with signs of reactive pancreatitis should be admitted to a hospital, where he will be monitored by a doctor.

While you are waiting for medical help, you must do the following:

• sit the child down with the body slightly tilted forward;
• do not feed the child;
• apply a cold heating pad to the pancreas area;
• It is not recommended to treat pain with analgin or No-shpa.

If a child is gagging, support the child's head and allow the stomach to empty. When the doctor arrives, you must tell about all the medications that the child took, as well as his menu for the last 5 days.

Treatment

Reactive pancreatitis requires treatment and control, as well as diet. Self-treatment can provoke complications of the disease. Treatment of reactive pancreatitis involves restoring the functioning of the gastrointestinal system. Patients are initially prescribed IVs, pain-relieving injections, and diuretics. The latter will relieve swelling. They are also prescribed to suppress the secretion of pancreatic juice. Prescribed by a doctor. The essence of the diet: exclusion of fried, fatty, salty, smoked, sweet foods, as well as alcohol.

For children, the doctor prescribes more gentle methods: tablets are prescribed, a diet is prescribed that excludes fatty and spicy foods, sausages, chips, sausages, and soda.

The doctor may prescribe medications that improve the functioning of the duodenum and biliary tract. Also, in some cases, medications are prescribed. To improve intestinal microflora, doctors recommend taking live bacteria.

Inflammation of the pancreas is called pancreatitis. Most often, this disease is chronic.

This pathology can occur without any symptoms or develop against the background of other diseases of the abdominal cavity, so the diagnosis is not always made in a timely and correct manner. That is why you need to have an idea about this disease and, if you suspect pancreatitis, consult a doctor.

International classification of diseases

Modern medicine knows over forty classifiers of pancreatitis, this makes it difficult for doctors to communicate internationally on the topic of diagnosis and treatment. In order for specialists from different countries to freely exchange experience and understand each other well, the International Classification of Diseases (ICD) was adopted.

This classification is regularly reviewed under the guidance of the World Health Organization. Now the ICD-10 is in force, the number “10” means the tenth revision.

According to this classification of ICD - 10, pancreatitis occurs:

• spicy (code K85);
• chronic (code K86).

Mechanism of development of pancreatitis

The pancreas produces digestive enzymes and the hormonal substance insulin. These enzymes in the gland are in an inactive state, and begin to work only when they enter the duodenum.

But it happens that the outflow of enzymes from the pancreas is disrupted or the enzymes for some reason begin to activate before reaching the duodenum. That’s when enzyme substances begin to destroy the pancreas itself and digest its tissue. This releases toxins that can enter the circulatory system, spread throughout the body and harm internal organs.

Damaged gland tissue is replaced by other types of tissue, such as fat or scar tissue. Necrosis of a large area of ​​this organ is also possible. As a result of such changes, the normal functioning of the pancreas is disrupted, the production of enzymes in the required quantity stops, and inflammatory processes begin. Complications of this pathology are diabetes mellitus and pancreatic cancer.

Causes of the disease

Pancreatitis begins for various reasons. In ICD-10 there is a different gradation of this pathology depending on the suspected causes. For example, drug-induced, alcoholic, purulent, hemorrhagic pancreatitis.

To successfully treat the pathology, it is necessary to find out the cause of the problem.

The causes of pancreatitis can be:

It is no coincidence that ICD-10 distinguishes between chronic and acute pancreatitis. These two types of the same pathology have their own characteristics, consequences and differ in treatment tactics.

In the acute form, digestive enzymes begin digestion already in the pancreas, the disease develops in a short time. Treatment is aimed at normalizing the functioning of the digestive organs.

The chronic form is characterized by changes in the structure of the gland that have already begun. The tissues of this organ lose their integrity and are replaced by another type of tissue. As a result of these pathological changes, the damaged organ cannot fully perform its basic functions.

This leads to irreversible consequences and affects all internal organs and systems of the human body. In the future, there is a lack of enzymes produced, the pancreas will atrophy and diabetes will begin.

The chronic form is often caused by advanced acute pancreatitis. Also, prerequisites may include malnutrition, consumption of fatty foods, alcohol, chronic diseases of other internal organs and the harmful effects of medications.

Treatment of the chronic stage of pathology comes down to maintaining the normal functioning of the body. They also strive to reduce the impact of harmful effects on the body to prevent attacks of the disease and deterioration of well-being.

It is impossible to cure the chronic form, you can only reduce the number of attacks of exacerbation of the disease. But even this brings relief to the life of a sick person.

Symptoms of the disease

The clinical picture of the manifestation of pathology is different for all stages. The main symptom is a fairly strong, unexpected girdling pain. It often begins on the left side and can become stronger if the patient lies on his back. This pain is sometimes mistaken for pain in the heart or kidney, since it is felt more in the upper abdomen.

Digestive disorders are always observed. This, as a rule, is vomiting mixed with bile, diarrhea with particles of undigested food, hiccups, and flatulence. The temperature rises, and the pressure can be both low and high. The patient's condition sharply worsens, shortness of breath and increased sweating appear.

These symptoms are pronounced and are often signs of the acute stage. You need to know them, because even during the chronic form, acute attacks can occur. But the manifestations of the chronic phase are more diffuse and extended over time.

For several years, a person may feel discomfort in the upper abdomen, more often after eating, especially when eating fatty, fried and spicy foods. It is difficult for a damaged pancreas to digest everything at once, which is why such pain occurs.

If a person adheres to proper nutrition, and even more so a separate diet, then the manifestations of pancreatitis will occur much later. Poor digestion over a long period of time should serve as a signal. A person tends not to notice obvious symptoms, but any disease must be treated in a timely manner.

With a chronic disease, acute attacks may sometimes occur, but the person will associate this with overeating or drinking alcohol. The chronic stage is dangerous because the process of destruction of the pancreas is already underway, but the person does not know about it and does not take any measures. But it is very important to identify the disease on time; diagnosis helps with this.

Diagnostic examination and tests required

If you suspect chronic pancreatitis, you should consult a doctor. A gastroenterologist deals with such pathologies.

Urine, feces and blood tests are required, including a biochemical blood test. The abdominal organs are examined using ultrasound and radiography. The pancreas is checked using computed tomography, gastroscopy and functional tests are performed.

Main directions in the treatment of the disease

In case of exacerbation of a chronic disease, treatment will be similar to that prescribed for the acute stage; hospitalization is almost always recommended. Treatment must be carried out under medical supervision, as there is a danger to life.

For mild chronic symptoms, treatment will be aimed at lifestyle adjustments.

For life you will need to follow a certain diet and take medications that will compensate for the lack of enzymes in the body. It is useful to visit sanatoriums that offer comprehensive treatment with the use of medicinal mineral waters.

Treatment must be outlined and planned by a doctor. Even when choosing mineral water, it is necessary to consult a specialist, since it is a medicinal product and has contraindications.

The chronic stage of the disease is dangerous because even with proper treatment, insulin levels still decrease over time, and this will lead to diabetes mellitus. That is why patients with chronic inflammation of the pancreas should periodically seek advice from an endocrinologist. This will help keep your sugar levels under control and identify the disease at an early stage, which will help with successful treatment.

Possible ways of prevention

Chronic pancreatitis (ICD - 10) is a complex disease with difficult treatment. Code 10 means that this pathology has an alcoholic or infectious etiology.

Prevention in these cases will include stopping the consumption of alcoholic beverages and timely treatment of infections in the body. Such measures for chronic pancreatitis will help reduce exacerbations.

ICD-10 was introduced into healthcare practice throughout the Russian Federation in 1999 by order of the Russian Ministry of Health dated May 27, 1997. No. 170

The release of a new revision (ICD-11) is planned by WHO in 2017-2018.

With changes and additions from WHO.

Processing and translation of changes © mkb-10.com

Cholecystopancreatitis

Cholecystopancreatitis is a pathological condition that is characterized by simultaneous inflammation of the gallbladder and pancreas. This disease is classified as one of the most common diseases of the digestive system. In the International Classification of Diseases (ICD-10) it has its own code - K87.0. It is important to know the symptoms and treatment of cholecystopancreatitis, since the pathology can affect any person. It has no restrictions regarding gender or age category.

The main reason why the symptoms of cholecystopancreatitis appear is the close location of the gallbladder and pancreas, as well as their close relationship with each other. Therefore, if inflammation manifests itself in one organ, then the chances are high that it will soon spread to another. It is also worth noting that if a person has acute cholecystopancreatitis, then the liver is also involved in the pathological process. It is important to immediately begin to treat this condition, since without drug treatment and normalization of nutrition (diet is indicated), the patient’s condition will worsen, and dystrophic and necrotic changes will begin to occur in the affected liver.

Causes

Many etiological factors can provoke the progression of the inflammatory process. The most common are the following:

• the formation of stones in the gallbladder, which is observed with the progression of cholelithiasis in humans;
• diabetes;
• the course of diseases of an infectious nature;
• the formation of benign or malignant neoplasms in the human body;
• ulcerative lesions of the stomach;
• helminthic infestations.

It is also worth noting that errors in nutrition and addiction to junk food also become the reason due to which signs of inflammation of the pancreas and gallbladder appear (which is why the attending physician must include diet in the treatment plan). Often, symptoms of the disease also appear in people who have bad habits - they are addicted to alcoholic beverages or smoking tobacco.

Symptoms can also be triggered by treatment of other pathologies with medications not prescribed by the doctor. Very often, people do not go to the doctor if any signs of pathology appear, but self-prescribe medications and take them in the wrong dosages. All this has a detrimental effect not only on the gallbladder and pancreas, but also on the liver.

In addition to the factors already mentioned, constant stressful situations, psychological overload, etc. can provoke the development of cholecystopancreatitis. Also, the presence of foci with a bacterial infection in the human body can cause an acute type of illness or an exacerbation of chronic cholecystopancreatitis. These include sinusitis, dental caries, etc.

Symptoms

Cholecystopancreatitis is expressed by the same symptoms as many gastrointestinal pathologies. Therefore, it will be difficult to immediately suspect him. Only a qualified gastroenterologist can make an accurate diagnosis and tell you how to treat the pathology and how to properly organize your diet.

The severity of symptoms depends on what particular form of the disease began to develop in a person. In total, there are two types of cholecystopancreatitis - acute and chronic. Signs of the acute form appear in a person immediately after eating fatty or fried foods. He experiences epigastric pain of a shingles nature, belching, bitter taste in the mouth, nausea and vomiting. Sleep may be disturbed and intestinal dysfunction may occur (constipation or diarrhea).

The chronic type of pathology is characterized by alternating periods of remission and intense expression of symptoms. At the time of the exacerbation phase, the signs indicated above appear. During remission, hepatomegaly can be detected. When trying to palpate the liver, the patient feels discomfort and pain. Treatment of cholecystopancreatitis of this form is very complex and lengthy. It is very important that complex therapy is used, which will include medication, diet, physiotherapy, and the use of folk remedies.

Separately, it is worth highlighting another type of cholecystopancreatitis - obstructive. Characterized by blockage of the bile ducts and disruption of digestive processes. May be accompanied by the development of ascites, jaundice, and the formation of false cysts.

Diagnostics and treatment measures

If the clinical picture of this disease appears, it is important not to hesitate, but to immediately seek help from a qualified doctor for diagnosis and treatment. If you do not carry out therapy at all or take dubious folk remedies, then there is a high probability of developing complications - thrombosis of venous vessels, blockage of the bile duct, peritonitis and damage to peripheral nerve fibers.

At the initial appointment, the doctor examines the patient and also interviews him, which will help him make a preliminary diagnosis and further outline a plan of diagnostic measures. Laboratory tests and instrumental examinations will help confirm the presence of cholecystopancreatitis:

• general clinical blood test;
• General clinical urine analysis;
• stool analysis;
• blood biochemistry;
• Ultrasound of the gallbladder and pancreas;
• CT and MRI.

Treatment of pathology is based on the prescription of medications, physiotherapeutic procedures, and diet. For cholecystopancreatitis, the patient is prescribed the following medications:

• painkillers;
• antibacterial agents;
• drugs to normalize metabolism;
• products with enzymes;
• medications to suppress juice secretion.

The diet should be balanced, but some categories of foods are excluded. The diet is prescribed by the attending physician. You should completely exclude canned foods, marinades, salty, spicy and fried foods, alcoholic and carbonated drinks from your diet. Such nutrition is necessary not only in the acute stage, but also in the remission stage.

• fresh dairy products;
• boiled lean meat and fish;
• semi-liquid cereals;
• vegetarian soups;
• compotes;
• teas and more.

Cholecystopancreatitis: international classification of diseases

The ICD characterizes the disease cholecystopancreatitis as complex, affecting simultaneously the pancreas and gall bladder. Therefore, the issue of consistent treatment of several organs at once is especially relevant. The abbreviation ICD stands for International Classification of Diseases. In some sources, you can also see the number 10 next to it. This means that the reader is looking at a document that has international force for the medical community, and it has been revised, changed and supplemented for the tenth time.

What is cholecystopancreatitis

Inflammation of the gallbladder and pancreas does not differ by gender, social status, or age. All people are susceptible to pathology, since these organs are located the same anatomically in everyone. And if the pancreas fails, then the gallbladder is often involved in the process.

ICD-10 classifies cholecystopancreatitis in the eleventh class along with other diseases of the digestive system. In total, the document identifies 22 classes. The latter, codes for special purposes, begins with the letter U. The approach is very similar to a library catalog, in which each book has its own letter and number so that the librarian can easily find it on the shelf.

Among many diseases, chronic and acute cholecystopancreatitis also have their own ICD-10 code. In the classification, diseases of the gallbladder and biliary tract are listed under codes K80 to K87; other pancreatic diseases are recorded under K86. But for chronic cholecystopancreatitis, the ICD-10 code is marked K86.8.2*.

If acute or chronic cholecystopancreatitis develops, the features of its course are such that they can lead to irreversible damage to the pancreas. Cholecystitis according to ICD-10 and pancreatitis are assigned different codes, but if the disease has spread to the pancreas and gallbladder, they are treated comprehensively.

Causes of the disease

Exacerbation of chronic cholecystitis and pancreatitis is due, first of all, to the specific location of these organs.

Practice shows: there is a high probability that if there are simultaneous problems in the gallbladder and pancreas, the liver will also be at risk.

Most often, inflammation occurs due to:

• formation of stones in the bile ducts;
• infectious diseases;
• neoplasms of various nature;
• an open source of infection (caries, sinusitis);
• problems with the liver and gallbladder;
• increased pressure on the duodenum from accumulated air;
• diseases of the circulatory system;
• diabetes mellitus;
• activity of opportunistic flora in the body (pseudomonas aeruginosa, staphylococci, streptococci);
• the presence of helminths;
• stomach ulcer;
• blockage of the pancreatic ducts.

Based on how the disease progresses, it is customary to consider the following types of cholecystopancreatitis:

Factors that provoke malfunctions of the pancreas and biliary tract can also be overeating, irregular meals, excessive consumption of alcoholic beverages, and smoking.

Symptoms of acute and chronic cholecystopancreatitis

The first symptom of the disease will be severe pain on the right side of the abdomen, under the ribs. As the inflammatory process spreads, the pain will spread to the back and become girdling, which is characteristic of pancreatitis. The man feels unwell and vomits. If urgent measures are not taken, the most undesirable consequences are possible. Cholecytopancreatitis, unfortunately, has a fairly high mortality rate.

Lack of medical care can lead to damage to nerve fibers, blockage of the bile ducts, and vein thrombosis. All these complications are fraught with an extremely serious condition – peritonitis.

The gastroenterologist reveals the following clinical picture:

• bloated stomach;
• constipation and loose stools alternately;
• belching;
• dryness and bitterness in the mouth;
• skin itching;
• dehydration.

Tests show signs of diabetes.

Diagnostic methods

The diagnosis of cholecystopancreatitis is made after the doctor examines the patient and sends him for laboratory tests and hardware diagnostics. Since many diseases of the digestive system have similar symptoms, it is necessary to conduct research as thoroughly as possible. For example, ultrasound and MRI give excellent results.

The doctor will definitely order blood, stool and urine tests, a biochemical blood test, and you may need duodenal intubation and fluoroscopy. These measures will help determine how much inflammation has affected the organs, what their size is, and how they perform their functions.

How to treat pathology

Treatment of chronic cholecystitis consists of taking medications and a strict diet.

The complex of medicines includes the following drugs:

• Painkillers that relieve pain.
• Enzyme products help with digestion.
• Drugs are needed to inhibit the formation of pancreatic secretions.
• Antibiotics will most likely be required.
• Mineral water will remove toxins from the body.
• Probiotics should introduce beneficial microorganisms into the intestines that will reduce fermentation and gas formation.
• Prokinetics will improve stomach function.

For any form of illness - acute or chronic - you must adhere to diet No. 5. A diet for pancreatitis is a whole nutritional system aimed at restoring the functions of the pancreas and gall bladder. The patient is prescribed stewed, boiled, baked dishes. Sweet, baked, spicy, salty foods will have to be excluded. Food should not be allowed to provoke an increased secretion of enzymes and juices.

Many familiar products are banned. This forced measure is designed to prolong a person’s life. Among the main recommendations are the following:

• Only yesterday's bread is allowed;
• vegetables – after heat treatment;
• soups – pureed vegetable soups without frying;
• eggs in any form other than hard-boiled are prohibited;
• You can’t drink sweet soda at all, it’s better to minimize strong teas and coffee;
• It is better to consume carbohydrates in the form of liquid porridges - buckwheat, oatmeal, rice;
• meat and fish dishes should be prepared from low-fat varieties, without a fried crust;
• fermented milk products – only low-fat ones;
• You will have to master jelly, compotes, and decoctions of healthy herbs.

Various marinades, dishes with spices, and fibrous vegetables without heat treatment are harmful to a diseased pancreas, and therefore should be completely excluded from the diet.

The diet is regulated by the attending physician, and it must be strictly followed even during remission. You need to eat small portions 5-6 times a day. This way, there will be no unnecessary stress on the pancreas and gallbladder.

There are a lot of prescriptions, you need to get used to the diet. But this is the only way to stay healthy.

Treatment prognosis

Inflammation of the gallbladder and pancreas, if the patient has been given the correct treatment and prescribed a diet that he strictly follows, enters the relapse stage. How long the disease will remain in a chronic state without inflammation depends on how accurately the person follows the instructions of his new lifestyle:

1. To avoid repeated inflammation of the organ, you should give up bad habits that provoke malfunctions - drinking alcohol, smoking.
2. A measured lifestyle, lack of stress, alternating work and rest will help restore strength.
3. A dietary diet will help the pancreas and gall bladder to better perform their natural functions.
4. It won’t hurt to reduce body weight and, accordingly, the load on all organs.

You will also have to regularly visit a gastroenterologist and undergo examinations. The doctor will issue a referral for sanatorium treatment.

Cholecystopancreatitis: symptoms and treatment

Cholecystopancreatitis - main symptoms:

• Nausea
• Vomit
• Bloating
• Liver enlargement
• Diarrhea
• Belching
• Bitterness in the mouth
• Pain in the right hypochondrium
• Insomnia
• Heaviness in the right hypochondrium
• Constipation
• Accumulation of fluid in the abdominal cavity
• Yellowing of the skin
• Liver pain on palpation
• The occurrence of false cysts
• Damage to small joints

One of the most common diseases of the gastrointestinal tract is cholecystopancreatitis, a disease in which there is simultaneous inflammation of the pancreas and gall bladder. According to ICD 10, the code for this disease is K87.0.

The main reason for the progression of this pathology is the close anatomical and physiological connection between two organs - the pancreatic duct and the bile duct. Therefore, if one organ is affected, the pathological process can spread to the second. In a disease such as acute cholecystopancreatitis, the liver is often involved in the process - it becomes inflamed, and dystrophic and necrotic changes occur in it.

Causes

This disease occurs for various reasons. The most common are:

Of course, poor diet and bad habits can also often trigger the occurrence of this disease. In addition, people who abuse alcoholic beverages and smoke a lot often suffer from pathology such as cholecystopancreatitis. Inflammatory changes in the gallbladder and pancreas can also be caused by various medications that people take uncontrollably, without taking into account side effects.

Stress and excessive emotional stress are also a provoking factor for this disease, and since today all segments of society are exposed to stress, the disease is quite common, and the number of cases is growing every year. If a person has pockets of bacterial infection in the body, for example, untreated caries, or sinusitis, etc., then these pockets can also trigger the development of acute cholecystopancreatitis.

Symptoms

Cholecystopancreatitis has symptoms similar to those of other gastrointestinal diseases. In particular, these are dyspeptic disorders, nausea (and sometimes vomiting) after eating, a feeling of heaviness or even pain in the right hypochondrium.

There are acute and chronic cholecystopancreatitis. The acute form occurs immediately after eating, when a person eats fried or fatty foods. Patients complain of girdling pain, painful vomiting, bloating, belching and bitterness in the mouth. Insomnia may occur due to constant pain, and diarrhea or constipation may develop.

In a person diagnosed with chronic cholecystopancreatitis, the disease occurs with periods of exacerbations and remissions. During the period of exacerbation, the symptoms of the disease are similar to those described above, and during the period of remission, the doctor determines an enlargement of the liver, which is painful on palpation, and pain in the area of ​​the gallbladder. The course of a disease such as chronic cholecystopancreatitis is long-term and treatment requires an integrated approach, which includes drug therapy, physiotherapy, traditional methods and diet.

Sometimes cholecystopancreatitis takes a severe form - obstructive. With this form of the disease, the pancreatic ducts are clogged, which leads to disruption of digestive processes and the development of inflammatory phenomena in other organs of the gastrointestinal tract.

There are also rare symptoms of this disease that appear in some people:

• development of ascites;
• yellowing of the skin;
• damage to small joints;
• the occurrence of false cysts.

In cases where the disease is not treated in a timely manner, the likelihood of complications increases. Among the most common complications of this pathology are bile duct obstruction, vein thrombosis, diseases of the endocrine system, as well as damage to peripheral nerves and peritonitis.

Diagnosis and treatment

The diagnosis of cholecystopancreatitis is made based on patient complaints and visual examination. Laboratory diagnostic data (blood and urine tests) are also taken into account.

When it is not possible to accurately diagnose the disease, ultrasound of the gallbladder and pancreas, as well as MRI, are indicated.

Treatment of this disease must be comprehensive. This means that drug treatment is complemented by diet and physical therapy. The drugs that are prescribed to the patient for this disease are:

• antibiotics;
• painkillers (baralgin, analgin);
• metabolic drugs (methyluracil);
• enzymatic agents (pancreatin, festal);
• means of suppressing juice secretion (cimetidine, omeprazole).

Nutrition for illness should be normalized, and certain categories of foods should be excluded. In particular, the diet provides for a complete abstinence from pickles, marinades, smoked meats, preserves and alcoholic beverages. Meals should be small and frequent, and the diet should be followed for a long time, and not only during the period of exacerbation of the disease.

There are many other foods that the diet for cholecystopancreatitis does not allow for consumption. In particular, these are baked goods, ice cream and chocolate, green onions, strong tea, radishes, sorrel, sour juices, lean meat and fish broths, as well as some other products. Therefore, nutrition for this disease requires a careful approach - a person needs to completely rebuild his diet in order to avoid repeated exacerbations of the disease.

Patients are allowed diet No. 5, and all the products that it includes, for example, boiled meat, fish, vegetable soups, semi-liquid cereals, fresh dairy products and much more. A full description of what diet No. 5 consists of will be written by the attending physician after confirmation of the diagnosis.

Folk remedies have a good effect on the digestive organs, so treatment with them is quite justified, but only in combination with diet and drug therapy.

As for physiotherapy, it is prescribed purely individually, depending on the severity of the process and the form of the disease. Moreover, in the acute stage it is contraindicated, and in chronic cholecystopancreatitis it is carried out only in the remission stage. Sometimes the only possible method of eliminating pathology is surgical treatment.

If you think that you have cholecystopancreatitis and the symptoms characteristic of this disease, then doctors can help you: a gastroenterologist, a therapist.

We also suggest using our online disease diagnostic service, which selects probable diseases based on the entered symptoms.

What is calculous cholecystitis: ICD 10 code, classification

Bile takes an active part in the process of fat breakdown and if its outflow is disrupted, then the gallbladder becomes inflamed and the normal functioning of the body is disrupted and cholecystitis develops. Sometimes the process of inflammation of an organ is associated with the formation of stones, and then the gastroenterologist diagnoses chronic calculous cholecystitis.

If the system of normal release of bile is disrupted, then the body not only disrupts the absorption of fats, but also the vitamins necessary for the body to function properly. In the article we will take a closer look at what the disease is, what are the reasons for its development and prognosis.

Calculous cholecystitis - what is it?

The calculous form of cholecystitis is diagnosed if, along with inflammation, gallstones are found in the patient’s gall bladder during diagnosis. These crystalline lumps can also block the bile ducts, preventing the release of bile, leading to intense pain. Stones are formed of different sizes and types.

Acute deposits, scratching the mucous membrane of the organ and ducts, help inflammation develop even more actively. Almost 70% of all cases of the disease develop against the background of cholelithiasis; studies also confirm the presence of bacteria in the gallbladder, but gastroenterologists believe that the addition of a bacterial infection is a secondary condition.

Clinical picture of the disease: pain under the right rib; when the pain worsens, it can be very strong, cramping, muscle tension in the anterior wall of the abdomen and on the right side.

ICD-10 codes

K80.0 - Gallstones with acute cholecystitis.

K80.1 - Gallstones with other cholecystitis.

K80.4 - Bile duct stones with cholecystitis.

Etiology and pathogenesis

The root cause of the development of the disease is the formation of stones, which block the possibility of free release of bile.

Risk factors for developing such diseases include:

• pregnancy;
• sudden weight gain or loss;
• age factor (with age, the risk of disease increases);
• gender (in women, the diagnosis of calculous cholecystitis is much more common);
• regular use of hormonal medications;

The formation of stones leads to the fact that they block the ability of bile to outflow, and stagnation of bile leads to its thickening and the release of enzymes that cause the development of the inflammatory process. The inflamed mucous membrane of the bladder can stratify and produce additional fluid, in which stones form. When they move, they damage the mucous membrane, activating inflammation.

As the volume of an organ increases, the pressure in it increases, which leads to disruption of blood supply to the tissues and can lead to their death, necrosis and perforation of the walls.

Causes of calculous cholecystitis

The main reason is the formation and growth of stones. But the following factors lead to sediment and crystallization of deposits: changes in the composition of bile, its thickening and stagnation, bacteria causing inflammation.

In a normal state, bile should be liquid and homogeneous; if there is a violation of the ratio of bile acids to the amount of cholesterol, then the latter settles into sediment. Over time, the sediment crystallizes and clumps into stones of different shapes and sizes.

This process awaits people who do not watch their diet. If you eat a lot of fatty foods and do not monitor the amount of cholesterol, then most likely risk stones will form in the gallstones very quickly. People with diabetes, hepatitis, obesity and chronic infectious diseases are also at risk. During the process of stagnation, bile thickens and creates favorable conditions for the penetration of infection from the blood, lymph or intestines.

Very often, calculous cholecystitis develops against the background of acalculous cholecystitis, which in turn appears when the dynamics of the gallbladder are disrupted, which leads to failures in its emptying. The following diseases can also be considered as causes:

• narrowing or deformation of the biliary tract,
• gastritis in chronic form,
• liver diseases,
• helminth damage,
• pancreatitis.

Classification

According to the clinical form of the disease, it is divided into two types: acute and chronic. Each of them may exhibit complications or the absence of additional diseases. We'll talk about them in more detail below.

Acute form

In this case, inflammation of the gallbladder occurs quickly with pronounced pain. Most often, this form of the disease can be complicated by concomitant diseases and infection. Exacerbation of calculous cholecystitis occurs precisely after the penetration of pathogenic microorganisms from the intestines, lymph or liver into the gallbladder.

Acute obstructive calculous cholecystitis develops as a result of stones blocking the neck of the bladder or duct. In addition to the pain, which has a cramping nature, intensifying with physical activity, and sometimes simply when the patient’s position changes.

Chronic form

The medical history of this form of calculous cholecystitis is distinguished by the practically asymptomatic course of the disease at the initial stage of development, and the sluggish development of the inflammatory process. The diagnosis is made after several stopped exacerbations.

A person simply constantly experiences a feeling of heaviness, suffers from bloating and diarrhea. Belching is often noticed, after which a metallic aftertaste or bitterness is felt in the mouth. After overeating and breaking the diet, symptoms may intensify.

Catarrhal, purulent, phlegmonous, gangrenous forms and other complications

If gallbladder problems are left to chance and not treated, the organ increases in size, begins to swell, and its walls turn red, which leads to thickening and swelling of the tissue. At this stage, the catarrhal form is diagnosed.

Further, without the necessary medical care, pus begins to collect in the inflamed gall bladder, which leads to the development of a purulent form of the disease. When the walls thicken, stratify, and the purulent contents do not find a way out, then we can say that phlegmonous calculous cholecystitis develops. In this case, the process of suppuration leads to the occurrence of irreversible changes in the gallbladder that can no longer be treated.

The next stage, gangrenous, is the most severe and fatal for the patient’s life. At the moment of its onset, necrosis of the organ tissue occurs, the appearance of ulcers on the surface, which can provoke rupture of the gallbladder. Inflamed bile with pus, entering the abdominal cavity through ulcers, spreads the inflammatory process and leads to the occurrence of peritonitis and abscess.

Forecast

If the course of cholecystitis with the presence of stones is not accompanied by complications and additional diseases, then we can say that the patient is lucky. In this case, death was recorded in a very small number of patients who did not even intend to take care of their health.

If complications have already appeared, then the process of recovery and death is at a 50% difference. Here, even with proper treatment, the development of a gangrenous form of the disease is possible, which leads to epiema of the gallbladder, the formation of fistulas, ulcers, atrophy of wall tissue, peritonitis, abscess and, as a result, death.

The most common questions from readers

Do they take you into the army with calculous cholecystitis?

If cholecystitis occurs in a chronic form and exacerbations do not appear or occur less than once a year, then most likely he will have to repay his debt to his homeland. If a conscript has frequent exacerbations of the disease recorded in his medical record, for which hospitalization was carried out, then he is not fit for military service. It is necessary to confirm the diagnosis with a gastroenterologist and undergo the necessary studies.

How does calculous cholecystitis occur?

In the chronic form, the disease can develop over many years, slightly worsening, and then subside again. But you need to understand that cholecystitis progresses. Most often, the disease manifests itself in people who are older, but sometimes this diagnosis also occurs in children.

The main danger occurs to the patient when the stones begin to move. If they block the bile duct, this leads to severe pain, yellowing of the skin and general intoxication of the whole body.

What diet should you follow for calculous cholecystitis?

Your daily diet should be rich in protein and fiber. It is recommended to eat at least 5-6 times a day and make sure that portions do not exceed. Completely eliminate junk food. Dishes must be warm, no boiling water or frozen ingredients.

Give preference to lean meat, fish, vegetables, fruits, and low-fat dairy products. Porridge, soups and boiled dishes are welcome. Compote tea, jelly, still mineral water. The liquid can be drunk in unlimited quantities. When the condition has stabilized a little, you can diversify the menu with melons and dried fruits. Find out more about the diet for cholecystitis.

How to behave if you notice symptoms of calculous cholecystitis?

In the end, I would like to say that if you can apply even some of the symptoms of calculous cholecystitis to yourself, then it makes sense to consult a doctor for diagnostic measures. Only after consultation and personal examination with a gastroenterologist can you get answers to all your questions.

To understand whether your assumptions are true, you need to take general and biochemical blood tests and do an ultrasound. Such a minimum set of tests will allow the doctor to accurately diagnose or refute the alleged diagnosis. Even if the diagnosis is confirmed, you should not give up. As long as the disease proceeds without complications, you can fight it, the main thing is to follow the doctor’s recommendations and understand that the quality of your life in this case is strained.

Acute and chronic cholecystitis: ICD code 10

Causes of chronic cholecystitis

Chronicity of the process is caused by an insufficiently treated acute form of inflammation of the gallbladder.

Representatives of opportunistic flora most often provoke exacerbation of chronic cholecystitis:

What is ICD-10?

ICD-10 is an international classification of diseases, which has been revised for the 10th time. This is a generally accepted disease coding approved by the World Health Organization.

Digestive diseases are encrypted in the 11th grade, divided into sections from K00 to K93. Liver diseases are found in sections K70 to K77. Diseases of the gallbladder and biliary tract - coded from K80 to K87.

Coding of cholecystitis according to ICD-10

Cholecystitis can be found under the code K81.

Because inflammation of the walls of the gallbladder is divided into acute and chronic forms, respectively, the coding of diseases according to ICD-10 is under different sections.

Acute cholecystitis

Acute cholecystitis is coded K81.0.

• angiocholecystitis;
• emphysematous cholecystitis;
• gangrenous;
• purulent;
• and inflammation of the gallbladder without the formation of stones in it.

By K80.0 it is necessary to understand acute cholecystitis with stones, and under the heading K 80.2 the independent existence of stones without inflammation of the walls of the gallbladder is encrypted. This code also characterizes the conditions of gall bladder colic, cholelithiasis, the formation of stones of an unrefined nature and blockage of the bile ducts with a stone without inflammation of the gallbladder.

Chronic cholecystitis

Chronic cholecystitis is coded K81.1, and K80.1 is coded for a chronic inflammatory process with stones.

Chronic cholecystitis of an unspecified nature is usually classified as group K81.9, and other forms of inflammation are subject to group K81.8.

Symptoms of acute and chronic cholecystitis

Acute cholecystitis can be recognized by the following symptoms:

• severe pain in the right hypochondrium, which is felt with echoes in the right shoulder and shoulder blade on the right side;
• elevated body temperature;
• nausea with possible vomiting, after which the condition improves slightly.

Moreover, pain, as a rule, manifests itself mainly in the evening or at night.

Chronic cholecystitis may not be noticeable for a long time, but under certain factors it may worsen, which is expressed in:

• dull or aching pain in the area where the liver is located;
• nausea, bitter belching;
• insomnia;
• increased irritability.

In some cases, symptoms of exacerbation may be accompanied by vomiting.

It is worth noting that pain in chronic cholecystitis is constant; it appears for the first time after an error in diet, especially after drinking alcohol. The sensation is localized exclusively in the right hypochondrium, but can radiate to the shoulder or scapula on the right or be similar to an attack of gall bladder colic. Pain is always accompanied by nausea.

In some cases, the signs of chronic cholecystitis are perceived as manifestations of gastritis, but the hallmark of the disease can be jaundice, which occurs when bile stagnates.

Chronic calculous cholecystitis manifests itself with particular intensity of painful sensations, when a stone that has moved from its place clogs the neck of the gallbladder or duct. Colic is an acute, unbearable pain. If it appears, urgent hospitalization and the help of a doctor, sometimes a surgeon, are necessary.

Treatment of acute and chronic cholecystitis

Treatment for cholecystitis can only be determined by a doctor, because the nature of therapy depends on the form of the disease, its complexity and individual features, which are determined using special studies.

If stagnation of bile is detected, its outflow can be facilitated by the administration of a choleretic drug, and digestive disorders can be resolved by treatment with special enzymes.

Physiotherapeutic approaches to treating the disease also give good results.

If the composition of stones in calculous cholecystitis allows them to be dissolved, then drugs with bile acids (ursodeoxycholic or chenodeoxycholic) can be prescribed for treatment.

How can chronic cholecystitis be cured once and for all?

No matter how much modern pharmacology boasts about its achievements, medications are not able to eliminate relapses of chronic cholecystitis. However, this is completely subject to surgery; removal of the disturbing gallbladder will make serious adjustments to the patient’s future lifestyle, but will free him from the disease forever.

Removal of the gallbladder can be performed using the traditional open method, percutaneous cholecystostomy, or laparoscopic method.

Calculous cholecystitis can be treated with shock wave lithotripsy, but crushed stones do not guarantee the impossibility of their re-formation. Therefore, a radical, but rightfully effective method of treating chronic inflammation is precisely the removal of the inflamed gallbladder.

Prevention of chronic cholecystitis

To prevent inflammation of the gallbladder from becoming chronic, it must be properly treated in an acute form. Traditional methods and methods of alternative medicine, in this case, are not relevant; they can not only fail to work, but also aggravate the patient’s situation.

It should also be remembered that the prevention of chronic cholecystitis includes:

• proper dietary nutrition that does not contribute to the formation of stones and stagnation of bile;
• normalization of body weight;
• regular examinations of the liver, pancreas and gallbladder, especially if the development of the disease is suspected.

Who said that curing the liver is difficult?

• You are tormented by a feeling of heaviness and dull pain in your right side.
• And bad breath will not add confidence.
• And it’s somehow a shame if your liver still causes digestive problems.
• In addition, the medications recommended by doctors are for some reason ineffective in your case.

There is an effective cure for liver disease. Follow the link and find out what Elena Malysheva has to say about liver care!

Bad habits do not lead a person to anything good. Alcohol abuse and constant and frequent intake of fatty foods can lead to the development of a serious illness. This disease requires urgent medical attention. It is almost impossible to cope with this situation on your own. Here we need good quality diagnostics, timely assistance, and possible surgical intervention by doctors. Often the harbinger of this disease is not only alcohol... All this and not only pancreatitis.

Pancreatitis: types of pancreatitis

It is difficult for specialist doctors to qualify pancreatitis. Currently, this disease has up to forty species. Therefore, pancreatitis is divided according to the generally accepted international classification of diseases - ICD. This is a code by which this disease can be divided into acute and chronic pancreatitis. Acute pancreatitis is accompanied by an inflammatory process that occurs in the pancreas as a result of activation of digestive enzymes. It is worth talking about chronic pancreatitis in more detail. This is the most serious and most dangerous pancreatitis, which is not immediately noticeable. It can persist in the human body for a long time, poisoning it and aggravating its entire life. That’s actually why it’s called chronic. And the following code corresponds to it, in accordance with ICD - 10.

Chronic pancreatitis

Chronic pancreatitis is a chronic process that occurs in the pancreas, as a result of which the internal and external tissues of the organ are replaced, as a result of which it loses all its basic functions. The scary number 10 confirms this. This is the most serious and most dangerous disease, unlike another disease - acute pancreatitis. Acute pancreatitis can be quickly detected and also quickly cured, of course, if assistance is provided in a timely manner. Therefore, acute pancreatitis is easier to cure. Unnoticed, this pancreatitis worsens a person’s life and health, leading to quite serious and dangerous problems. In this situation, if you detect even a slight suspicion of a chronic form of this disease, you must urgently consult a doctor. Self-medication in this situation is useless. This will only make the situation worse.

Causes of chronic pancreatitis

The reasons for the development of this disease, number 10, can be anything. But first of all, this disease is provoked by the person himself. According to the ICD classification, the cause of the development of a disease such as pancreatitis can be alcoholism. Alcohol abuse can lead to the formation of this disease. This also includes drug abuse and even malnutrition. Certain types of diets can lead to the development of this disease. But, among other things, the number 10 can also indicate other forms of development of this disease. These are various chronic diseases that can provoke pancreatitis, both acute and chronic, and this disease can also provoke gallbladder diseases. As you can see, there are a huge number of reasons. And most of them show pancreatitis with the number 10 in the person himself. It is important to take care of your health, take care of yourself and not abuse bad habits.

Symptoms

The symptoms of this disease are very dangerous. According to the ICD, they can progress every day. And it is very similar to another disease, pancreatitis, which is called acute. This pancreatitis, number 10, provokes nausea, vomiting, pain in the upper abdomen. Moreover, the disease can progress incredibly quickly, and the patient’s condition worsens. Every day a person will begin to lose weight, weaken, until dehydration begins in the body. The patient may experience heaviness in the stomach after eating, shortness of breath, and it becomes difficult for him to breathe. In addition, constant nausea can occur even without eating. Of course, this can be explained by ordinary hunger, but sometimes a frequent form of nausea can cause the development of this disease. And after this, death occurs. This is why the number 10 is so scary. If the slightest signs of this disease appear, you should urgently consult a doctor. Otherwise, the consequences could be even more dire.

Diagnostics

Diagnosis of a disease such as chronic pancreatitis is carried out using various procedures. This includes ultrasound of the abdominal organs and computed tomography. A stool test is also performed. But the most interesting analysis is the C-respiratory tract analysis, by which doctors can more reliably determine whether a person is sick or not. It is very difficult for doctors to put a number 10 and give an accurate description of the disease. This is already being done using special methods.

Treatment

Treatment of this disease, chronic pancreatitis, can be carried out both surgically and with the help of special therapy. So the very first cure is diet and stopping drinking alcohol. This is essentially something that a patient can do on his own. The patient is also given special enzyme preparations, tablets to take before meals and other medications. Then the patient regularly undergoes tests and is checked for the presence of this disease. In very severe cases, the surgical method is used, when the chances of self-treatment are minimal. It is not uncommon for a patient suffering from this disease, chronic pancreatitis, to be admitted to the hospital. Because it is almost impossible to treat a person on your own.

Conclusion

Chronic pancreatitis is a very dangerous disease. Of course, this is not acute, which is accompanied by serious pain, which can be accurately determined and the person immediately provided with medical assistance. And yet the number 10 says something. This is a very frightening figure and you should not bring your body to such a terrible state. It can worsen a person’s health and lead to death. It is necessary to monitor your health, take care of it and take care of the condition of your body.

Under the chronic form of pancreatitis, a constant inflammatory process of the pancreas is observed. During the acute course of the disease, replacement of the cellular elements of the organ with connective tissue and the formation of exo- and endocrine insufficiency of the organ functions is observed.

Classification of pancreatitis according to ICD 10

Healthcare, for the purpose of systematization and management, has developed a classification of diseases (ICD), which is revised once every 10 years. This is a normative document that provides a unified approach to the classification of diseases and serves as a mandatory classifier when making a diagnosis.

There are more than 40 classifiers of pancreatitis, which significantly complicates the communication between doctors when voicing a patient’s diagnosis. So that experts from different countries could easily share skills and understand each other, the International Systematization of Diseases (ICD) was established. Currently, the 10th revision system (ICD-10) is in effect, which is used to diagnose the disease.

According to the international classification, pancreatitis according to ICD 10 is divided into:

1. K85 Acute pancreatitis.
2. K86.0 Chronic pancreatitis of alcoholic etiology.
3. K86.1 Other chronic pancreatitis.

There are 3 key types of chronic pancreatitis ICD code 10:

• Chronic calcific inflammation, often caused by alcoholism. With this inflammatory process, changes in the structure of the ducts of the organ and thickening of secretion are observed, which leads to blockage of the ducts.
• Chronic obstructive inflammation. It is characterized by a narrowing of the main ducts of the gland or its large branches.
• Acute inflammation of pancreatitis is not common and is an exacerbation of chronic pancreatitis.

In some cases, biliary or biliary-dependent pancreatitis is observed, which develops against the background of existing diseases - pathologies of the liver, gallbladder or biliary tract.

Etiology

The prerequisites for the occurrence of chronic pancreatitis according to ICD 10 are quite diverse. The formation of pain syndrome is caused by a number of factors:

• pathologies of the digestive system (ulcerative and cholelithiasis, cholecystitis, duodenitis, gastritis);
• excessive intake of alcoholic beverages, lack of protein in food;
• viral lesions, allergic reactions and toxic poisoning;
• surgical interventions;
• pathology of metabolic and hormonal processes;
• heredity.

Chronic pancreatitis ICD 10 (K86.0) often occurs with chronic alcoholism. In second place in terms of the purity of detection of this disease are dysfunctions of the biliary tract, duodenum and stomach diseases.

Diagnosis of pancreatitis code according to ICD 10

Patients often consult a doctor if they have the following symptoms and signs:

• presence of pain;
• for nausea;
• vomiting;
• with rapid loss of body weight;
• with unstable stools;
• manifestation of bad breath.

The doctor conducts and prescribes a number of tests if he suspects a person has pancreatic disease:

1. Initial examination of the patient. The course of the disease in this type of disease, as a rule, is not pronounced. Moderate bloating is observed. Small protruding red formations are visible on the skin of the abdomen. By palpation, the organ can be felt in severely malnourished patients. With cystic disease of the pancreas, the organ is easily palpable due to pathological changes that lead to its enlargement. In severe forms of this disease, slight abdominal tension is often observed.
2. In the acute course of the disease, an increase in phospholipase A 2 is observed.
3. The doctor prescribes laboratory tests to make a diagnosis, one of which is a general analysis of blood, stool and urine. In severe cases of the disease, an increase in the number of leukocytes and ESR is observed. In other forms of the disease, blood counts remain normal.
4. A person is given glucose to drink, and if after a couple of hours its level exceeds 8 mmol/l, then this indicates the presence of diabetes mellitus, which is often a concomitant pathology of this disease.
5. Study of enzymes. In acute exacerbation of chronic pancreatitis according to ICD 10, an increase in amylase is observed. The study of this enzyme is rather non-specific. That is why another enzyme test, elastase, is being studied at the same time.
6. Conduct a study of lipase activity.
7. Study of blood elastase. This indicator increases with acute exacerbation.
8. Study of blood trypsin. A reduced rate indicates insufficiency of the exocrine function of the gland, which manifests itself in the chronic form of the disease.
9. Study of the mass of feces produced per day. Externally, secretory organ failure (polyfecal matter) leads to an increase in fecal mass. This indicator is observed in the later stages of the disease.-00
10. Carrying out tests to study exocrine function using special probes. With their help, secretin and pancreozymin are administered, as a result of which the gland secretes pancreatic secretions of a different nature. The combination of both stimuli allows us to judge the external secretory insufficiency of the organ.
11. X-ray of the pancreas.
12. CT scan of the pancreas.
13. MRI of the organ.

Treatment of chronic pancreatitis

If pancreatitis is not treated promptly, it will lead to dysfunction of other organs. If you are diagnosed with chronic pancreatitis and its symptoms worsen, then therapy must be carried out immediately.

The patient is treated in a hospital, where he is prescribed a set of measures:

1. Following a strict diet. For the first time, fasting is practiced. When the patient is allowed to eat, the food should be taken in small portions.
2. Elimination of pain and spasms.
3. Normalization of the digestive process.
4. Replenishment of enzyme deficiency.
5. Stop the inflammatory process.
6. Restore damaged organ tissue.
7. Carry out preventive measures.

When treating the chronic form, antibiotics are used if infection is present. This course lasts approximately 7 days. In case of inflammation of the ducts, Amoxicillin is prescribed to facilitate the outflow of bile; this allows the inflammatory focus to be stopped and prevent it from developing further.

Anti-inflammatory drugs can relieve pain. Only a doctor can competently select the dose of the drug.

“No-shpa” and “Drotaverine” will help to cope with spasms.

Chronic pancreatitis ICD code 10 is accompanied by digestive pathology, for this reason the patient must adhere to a strict diet and take enzymes.

In complex treatment, medications are prescribed to reduce the level of acidity (Almagel, Maalox).

If therapeutic measures do not have the desired effect, then the patient is prepared for surgery.

Disease Prevention

If you do not want to develop pancreatitis in the future, then it is recommended to take preventive measures for those people who have a predisposition to this disease and like to treat themselves to smoked, spicy, fried and fatty foods. Prevention of pancreatitis includes:

• preventing organ inflammation;
• prolongation of the remission period;
• improving quality of life;
• reduction of risk factors;
• normalization of nutrition.

Preventive measures also include:

• prevention of stressful situations;
• periodic walks in the fresh air;
• proper rest and sleep;
• active lifestyle.

If you follow these recommendations, you can improve your immunity, improve your health, and increase your body’s stamina. All this will help you significantly reduce the threat of developing this disease, which kills millions of people every year.