Parotitis

The text is presented for informational purposes only. We urge you not to self-medicate. When the first symptoms appear, consult a doctor. Recommended reading: “Why not self-medicate?”. Parotitis, mumps, or mumps is a viral disease of a systemic nature with specific external manifestations. The main sign of the formation of the disease is an increase in the salivary glands, accompanied by painful sensations caused by inflammation.

For the first time, such a pathology was mentioned as early as the 5th century BC. Mumps is classified as a “children’s” infection, since the causative agent of the disease, which has a fairly high contagiousness index, is capable of rapidly spreading mainly among the children’s contingent. Mumps infection refers to “managed” infections, the incidence of which depends on vaccination. To date, only in 58% of the countries of the world, vaccination against mumps is included in the national vaccination schedules, so measures to reduce the incidence of this infection and its prevention remain very important.

The viral nature of the disease was determined by specialists in the field of microbiology only in the 20th century. Until the 18th century, it was believed that the disease was local in nature and affected only the salivary glands. Only at the end of the 18th century were the main forms of parotitis affecting the glandular and nervous tissues identified, including some patients with parotitis diagnosed with meningitis – a viral lesion of the meninges of the brain, orchitis or oophoritis – damage to the reproductive organs, as well as pancreatitis.

The etiology of the disease was determined only in the 30s of the 20th century, after researchers Johnson and Goodpasture first isolated the causative agent of mumps from the patient’s biological material in 1934. In 1947, scientists McDougal and Henley isolated the virus from the cerebrospinal fluid of a patient.

Morphology and pathogenesis of the disease. With the development of mumps, the salivary glands are edematous with petechial hemorrhages. Examination of the glands under a microscope shows lymphoid mononuclear infiltrates in the region of the ducts and glandular cells. At the same time, the glandular epithelium undergoes dystrophic changes, a thickened secret containing leukocytes is visualized in the lumen of the ducts.

Risk factors. The only source of infection with mumps is the entry of the pathogen into the body, in which it causes a pathological condition due to the inflammatory process. However, some risk factors may contribute to increased morbidity and susceptibility to the development of the lesion.

The risk factor affecting the incidence, in the first place, is seasonality. In the northern hemispheres, the seasonality of the most extensive spread of the disease covers the period from March to May, in the southern hemispheres, the disease more often affects the population from October to December.

Refusal to vaccinate is a determining factor that increases the risk of morbidity. Recently, the refusal to vaccinate is a problem that provokes outbreaks of poliomyelitis, measles, mumps, that is, typically childhood diseases that can be completely avoided by timely vaccination in a child and repeated in an adult. People without immunity developed by vaccination fall ill with mumps after initial contact with the pathogen in 95-97% of cases.

Other risk factors include:

• childhood;
• general decrease in immunity and weakening of the body;
• non-compliance with the rules of hygiene, sanitary regime;
• high population density.

Epidemiology of the disease. Who belongs to risk groups? The main group is school-age children. With age, the likelihood of getting sick decreases due to increased immunity. It should be noted that adults with a weakened immune system are also at risk, but newborns, people over the age of 40, including the elderly, rarely get mumps. Boys and men get sick more often than the female half of humanity.

Forms of the course of the disease and types of parotitis

Infectious parotitis according to ICD 10 (International Classification of Diseases 2010) is classified by code B 26. Depending on the severity of the disease, the following forms of parotitis are distinguished:

• easy;
• medium;
• heavy.

With a mild form, the patient has subfebrile temperature, as well as mild manifestations of intoxication of the body. The disease usually proceeds without complications. The average or moderate form is accompanied by a temperature of up to 38-39 degrees, as well as a prolonged severe fever with symptoms of intoxication. Development of a bilateral mumps with complications is possible. The severe form is characterized by high body temperature (above 40 degrees), for a week or more, accompanied by pronounced symptoms of intoxication (asthenia, severe weakness, tachycardia, lowering blood pressure, sleep disturbance, anorexia). Mumps in severe form, as a rule, is bilateral, and complications are multiple.

There is also an asymptomatic (inapparent) clinical type of mumps, when the presence of the virus in the body does not manifest itself.

Depending on the presence or absence of complications of the disease, the following types of parotitis are distinguished:

• complicated;
• uncomplicated.

Depending on the etiology of parotitis, the following varieties are determined:

• non-infectious, or non-epidemic parotitis: it can form against the background of an injury, certain diseases or prolonged hypothermia, followed by inflammation of the salivary glands, as well as after a specific surgical intervention (postoperative parotitis);
• infectious (epidemic): formed after the penetration of the pathogen into the body;
• allergic parotitis: develops as a result of the body’s reaction to allergens.

Depending on the clinical picture of the course of the pathology, there are:

• specific parotitis: epidemic, tuberculous, actinomycotic;
• nonspecific: non-epidemic and purulent mumps.

All known types of mumps can acquire:

• sharp;
• chronic form (these include interstitial parotitis).

The chronic form can be recurrent, that is, periodically make itself felt by the appearance of minor inflammation and pain. This type of disease is not infectious.

Causes of the development of the disease: mumps virus and other factors

The causative agent that causes the development of mumps is an RNA-containing virus from the Paramyxoviridae family, Paramyxovirus genus, characterized by neuraminidase, hemolytic and hemagglutinating activity. Viruses are very polymorphic, they are mostly round in shape, and reach 120-300 nm in diameter.

The virus belongs to unstable microorganisms, it is destroyed by heating, under the influence of ultraviolet rays, as well as a solution of formalin, ethanol, lysol, and other disinfectants.

In the human body, the pathogen is excreted in urine and saliva, while the virus is found in blood, breast milk, and liquor.

In addition to viral etiology, the following factors can provoke the disease:

• hypothermia;
• salivary gland injury;
• blockage of the gland duct by a foreign body;
• infection of the gland with bacteria that have fallen from the mucous membrane of the oral cavity;
• salivary stone disease;
• allergic reaction.

Blockage of the duct of the salivary gland, as well as salivary stone disease – diseases associated with functional disorders of the normal outflow of saliva, due to which there is a violation of the secretion of saliva and an increase in the gland due to the emerging inflammation. Most often, large glands are affected, less often – parotid and submandibular.

The process of formation of stones in the ducts occurs against the background of a decrease in the production of saliva or its thickening, as well as due to malnutrition, dehydration, excessive intake of minerals into the body, against the background of long-term use of antihistamines and psychotropic drugs, as well as means to normalize blood pressure.

Allergic parotitis is formed as a result of sensitization of the body to medicinal, bacterial, food allergens. This type of disease does not belong to the otolaryngological group.

How does mumps infection occur?

The source of the disease is a sick person who sheds the virus into the environment in the last 1-2 days of the incubation period and within 9 days from the onset of the disease. The patient is especially contagious in the first 3-5 days of the disease. After the symptoms disappear, the patient is no longer contagious. The source of the disease can also be patients with an erased and asymptomatic form. The virus is transmitted by airborne droplets, but in some cases it is possible to become infected through household items, such as dishes or toys.

The virus is highly contagious in the air.

Approximately 25% of all cases of the disease are asymptomatic, but the patient releases the virus into the environment.

In addition to the airborne and domestic route of infection, there is also a vertical way, when the virus is transmitted from mother to child during pregnancy or lactation.

The normal resistance of the body to the virus is usually high, and after the disease, a long and lasting immunity is developed.

The gate of infection is the mucous membrane of the upper respiratory tract. Penetration into the salivary glands occurs through the blood.

Once in the circulatory system, the pathogen spreads throughout the body, finding favorable conditions for further growth and reproduction in the glandular organs and the nervous system. The favorite place of the virus is the salivary glands, where it accumulates and reproduces. The virus is re-expelled from the salivary glands and viremia is maintained for 5 days. During this time, the virus has time to involve other organs and systems in the process.

Damage to the nervous system can occur in parallel with inflammation of the salivary glands, before or after it. It should be noted that the pathogen isolated from the blood, parenchymal tissue of the pancreas, breast milk.

In the body of a patient with parotitis, specific antibodies are produced that perform neutralizing, binding and other functions aimed at removing the pathogen from the body. These antibodies can be found in the blood for several years after the illness, and even throughout life.

Damage to the central nervous system, pancreas and peripheral nervous system occurs with the involvement of immune mechanisms, namely, a decrease in the number of T cells, a weakening of the primary immune response, the presence of a low titer of immunoglobulin M, and a decrease in the level of production of class A and G immunoglobulins.

Neutralization of the viral pathogen occurs due to the production of specific antibodies that inhibit the activity of the virus and its ability to spread intracellularly.

Clinical picture: diseases

The main manifestations of parotitis

The incubation period lasts from 11 to 21 days, that is, from the moment the virus enters the human body until the first clinical symptoms of the disease appear.

The initial period of the development of the disease is characterized by obvious febrile manifestations: fever, loss of appetite, chills. Headache, myalgia, dry mouth, insomnia, and general weakness may be present. A specific manifestation of mumps is inflammation of the parotid salivary glands. In addition, the sublingual with submandibular glands can be captured. The patient feels pain, the glands noticeably increase in size due to inflammatory infiltration. This can be seen not only on palpation, but also visually. To the touch, the glands acquire a plastic structure. The oval of the face can be deformed, up to a pronounced pear-shaped shape, which can be observed visually. The earlobe rises above the inflamed gland, and the cheek on one side (or both cheeks) increases in size. The skin over the glands does not change color, but becomes stretched and shiny. Most often, the disease affects both parotid glands with an interval of 1-2 days, that is, it is bilateral, but mumps can also be unilateral.

Mostly at night, the patient feels bursting pain in the inflamed tissues. In some cases, the disease affects the Eustachian tube, as inflamed tissues compress it, which is accompanied by noise and pain in the ears, and hearing acuity may decrease.

Another specific sign that allows you to diagnose parotitis is Filatov’s symptom, which is expressed in pain during pressure behind the earlobe. Because of pain and inflammation, it is difficult for the patient to chew food; against their background, trismus of masticatory muscles may develop. Normal processes of salivation are disturbed, the patient’s production of saliva decreases.

The course and stages of the disease in adults and children

In children, prodromal events are extremely rare and appear within 1-2 days before the onset of typical clinical symptoms – it is accompanied by chills, headache and pain in muscle tissue, joints, dry mouth and unpleasant sensations in the glands.

The prodromal period in adults is noted more often, and is accompanied by the presence of more pronounced manifestations. In addition to the above general toxic syndromes, the patient may develop dyspeptic and catarrhal phenomena.

After the completion of the incubation stage, an acute period of the disease develops – its name fully reflects the clinical condition. In most cases, the patient feels a sharp deterioration in well-being. In adults, more often than in children, there is inflammation of the sublingual and submandibular salivary glands, which are painful and plastic on palpation, acquire an elongated shape along the length of the lower jaw. Around the affected tissue, subcutaneous tissue becomes inflamed, swelling can spread to the neck area. Inflammation of the sublingual glands can be identified by swelling in the chin area, pain under the tongue, swelling and redness of the mucosa. In adults, such symptoms persist for more than 2 weeks.

The onset of the acute period is also characterized by the appearance of chills and an increase in body temperature, while the temperature may be subfebrile or stably high. However, cases of the development of the disease without an increase in temperature are quite common. The feverish state is accompanied by general weakness and malaise, headache, insomnia. It is during this period that the patient begins to be disturbed by pain and enlargement of the salivary glands, a change in the shape of the face, noise and pain in the ears, redness and inflammation of the oral mucosa, dry mouth, and a decrease in salivation.

In general, adults suffer parotitis more severely than children: they often develop prodromal and catarrhal symptoms, and intoxication is more pronounced. In children, the maximum body temperature (up to about 40 degrees) is usually observed on the second day of the onset of symptoms of the disease. Over the next week, it gradually decreases. By the middle of the second week, the soreness of the glands gradually disappears, they decrease in size. If the disease proceeds without the development of complications, by the end of the second week the child feels better, and the manifestations of the disease disappear almost completely. Adult patients lose their ability to work for 2-3 weeks. Women and girls tolerate the disease more easily, they are less likely to experience complications.

In other cases, we can talk about the formation of a particularly dangerous stage of the disease – complicated mumps, which in children is accompanied by loss of appetite, dehydration and exhaustion, severe weakness, and a decrease in blood pressure. On the fifth day, the baby may develop serous meningitis and acute pancreatitis, on the 6-8th day, symptoms of damage to the genital organs appear.

Serous meningitis is the most common complication in pediatric patients. In addition to high fever, headaches, nausea and vomiting, parents should be alerted by the increased tone of the occipital muscles when the child cannot touch the chest with his chin, that is, he cannot tilt his head forward. Meningoencephalitis is a disease in which the process affects the brain tissue and the membranes of the brain at the same time. In young male patients, often, as a complication of mumps, there is a lesion of the gonads. Inflammation of the testicles and their appendages can begin 6-8 days after the onset of the first symptoms of the disease. Pain appears in the scrotum, inguinal lymph nodes increase, the skin of the testicles becomes red. Oophoritis is a complication that threatens girls and women. Inflammation of the ovaries proceeds in them easier and faster than orchitis in boys, it can be one- or two-sided. Pancreatitis appears as a result of the penetration of the virus into the pancreas, and develops in an acute form, especially if the patient does not adhere to dietary restrictions. There are sharp pains in the abdomen, nausea, vomiting, loss of appetite, constipation, which alternates with loosening of the stool.

Diagnosis of mumps

During the incubation period, it is almost impossible to detect the disease. In general blood and urine tests during this period, changes characteristic of the inflammatory process can be observed.

As for the acute and complicated period, at first glance, the diagnosis does not present problems, since parotitis is most often accompanied by a characteristic inflammation of the salivary glands, which can be seen and felt during the initial examination. However, there are several nuances: firstly, an increase in the salivary glands can be triggered by some other diseases, and secondly, with a latent, latent course, external manifestations of the pathology are completely absent. During the examination of the patient, information about the disease and an epidemic history is collected – information about all the contacts of the patient in recent days. During the time when the incubation period passes into the acute stage of the disease, the pathogen can be detected in saliva, urine, cerebrospinal fluid. Serodiagnostics involves determining the number of antibodies of different classes, their increase confirms the diagnosis. Laboratory immunofluorescent analysis (determination of specific antigens in the blood) is considered the most informative for diagnosing the disease.

One of the tasks of the doctor during the differential diagnosis is to distinguish classic mumps (epidemic or non-epidemic) from Herzenberg’s false mumps, which is formed as acute serous lymphadenitis. Most often, the process is one-sided, characterized by the accumulation of a dense infiltrate in the parotid region, with effusion in the deep group lymph nodes located inside the parotid gland, while the gland ducts are not affected. Inflammation is formed against the background of the development of an infectious lesion on the root of the tongue, in the nasopharynx and tonsils, with difficult eruption of wisdom teeth.

Treatment of parotitis in children and adults

The general orientation of treatment is characterized by the appointment of symptomatic treatment, since there is no therapy aimed directly at eliminating the pathogen.

First of all, the patient must be isolated from others, as well as provide him with bed rest in order to prevent additional infection and the development of complications. Usually children and adults are treated at home, hospitalization is required only if the disease occurs in a severe complicated form.

Mild forms in adults and children are treated with the appointment of non-steroidal anti-inflammatory drugs, if necessary, steroid therapy is performed.

To reduce pain symptoms and signs of fever, the patient is given painkillers and antipyretics.

It is very important to follow a diet for the period of treatment so as not to create an additional load on the internal organs with indigestible food. For patients with an attack of acute pancreatitis, it is important to follow the rule “cold, hunger and rest” until the attack stops.

Antibiotics for the treatment of viral parotitis are ineffective.

In severe cases of the course of the disease, the attending physician in the hospital determines the treatment regimen, and can prescribe hormonal, anti-inflammatory and antipyretic drugs in the form of droppers and injections.

If the patient strictly observes all the rules of treatment and the requirements of the doctor, the chances of a successful and quick cure without complications are almost 100%.

Water procedures during parotitis, as in other acute infectious diseases, are not recommended until the acute symptoms have passed, or better, until the attending physician permits. Conventional bathing procedures, swimming in open water and pools do not exclude the possibility of hypothermia, which for the patient can cause an aggravation of the condition and the formation of complications.

Prevention of parotitis: how to protect yourself from the disease

Anti-epidemic measures to prevent mumps infection are necessarily applied to the sick person – for this, he is placed in quarantine for 9-10 days, completely limiting contact with others. Children cannot attend kindergarten or school, adults cannot go to work. If children who have not had a history of vaccination against the virus have been in contact with the patient, they must be placed in quarantine for a period of 11 to 21 days.

An important active measure for the prevention of mumps is routine and emergency vaccination. The patient is injected subcutaneously, into the shoulder area or under the shoulder blade, with 0,5 ml of a live attenuated vaccine. The first vaccination is recommended for children at 12 months of age. Re-vaccination is carried out at the age of 6 years. In this case, a single vaccine is used (only against mumps), or a combined vaccine against mumps, measles and rubella (the so-called MMR). Revaccination with a monovaccine is carried out after 4 years.

Non-specific measures during an increased epidemiological danger to the population and to persons in contact with the patient include:

• ventilation of the premises where the patient is located;
• disinfection of objects in the focus of the epidemic, including those with which the patient comes into contact (dishes, linen, toys, clothes);
• wearing gauze bandages;
• immunoprophylaxis.

Increasing nonspecific immunity includes quitting smoking and drinking alcohol, constant walking and sufficient exposure to fresh air, proper balanced nutrition. As a prophylaxis for children in the foci of mumps, pediatrics allows the appointment of immunomodulators of the interferon class.

Prevention of the development of postoperative parotitis includes careful oral hygiene (constant rinsing, brushing your teeth and massaging your gums), and preventing dehydration. The patient is also advised to periodically suck on a slice of lemon to stimulate salivation, a technique used to prevent stagnation of saliva.

In epidemic foci, anti-epidemic measures consist of emergency vaccination of all unvaccinated adults. Wearing masks and gauze bandages, as well as constantly disinfecting objects that people come into contact with, are important measures to prevent the spread of the virus. Also, as a prophylaxis for mumps, quarantine in child care facilities can be declared, usually for up to 21 days.

Complications and consequences of mumps

Mumps in an infectious form is a rather dangerous disease. One should not think that its mild course will certainly pass without a trace, even if it is not fully treated and the doctor’s recommendations are neglected.

Orchitis

One of the possible complications of a viral lesion for a male is orchitis – inflammation of the testicles. It should be noted that this complication is less common in children and adolescents than in unvaccinated adults. Orchitis usually develops 5-8 days after the defeat of the salivary glands. The condition lasts 7-9 days, after which the symptoms gradually fade away.

The development of orchitis is accompanied by a new wave of fever symptoms. A large amount of toxic substances circulate in the blood, due to which thermoregulation fails. In the first few days, the temperature rises to 39-40 degrees, after which it gradually decreases. Due to inflammation, edema develops and the testicle increases in size by one and a half to two times. The rush of blood to the inflamed tissue of the scrotum causes it to redden. Orchitis is also accompanied by dysfunction of urination, pain in the groin, prolonged erection with pain. Orchitis is a complication that must be treated in a hospital setting. The outcome of orchitis can be testicular atrophy, infertility, chronic orchitis, impotence.

pancreatitis

In 20-30% of cases, acute pancreatitis may develop in an infected person on days 4-6. Such a complication requires treatment in a hospital, as it can cause irreversible changes in the tissues of the pancreas. The patient develops abdominal pain of a girdle character, extending to the back with concomitant nausea and vomiting, fever, diarrhea, and increased tone of the abdominal muscles. Assimilation of food is disturbed due to functional changes in the pancreas.

Patients may experience other complications of parotitis. Oophoritis is an inflammation of the ovaries in women, which is characterized by the appearance of pain in the lower abdomen, menstrual irregularities, bleeding not associated with menstrual flow, pain during intercourse. Usually, subfebrile temperature is observed. This complication is extremely rare, and, unlike orchitis, does not lead to infertility.

Inflammation of the thyroid gland is called thyroiditis. It is accompanied by pain in the throat, swelling in this area, enlargement of the cervical lymph nodes, as well as febrile manifestations (chills, fever, loss of appetite, headache, sweating). Functional cells are destroyed, hormones enter the bloodstream and cause an abnormal immune response. This complication is extremely rare.

Meningitis and meningoencephalitis is an inflammatory process of the brain (in isolation or with damage to the meninges). It is characterized by an acute onset with a sharp jump in temperature, severe headaches, vomiting without nausea. The rigidity of the muscles of the back of the head does not allow the patient to freely tilt his head so as to touch his chest with his chin. The condition is accompanied by lethargy, drowsiness, confusion. Pathology can develop 4-7 days after the defeat of the salivary glands. Treatment is carried out only with the condition of hospitalization. Men can develop prostatitis, an inflammation of the prostate gland. Its characteristic symptoms are chills, fever, pain when urinating, headache, feeling overwhelmed and tired. The patient’s health deteriorates sharply, adequate treatment in a hospital in 1-2 weeks gives a positive result for the patient. Labyrinthitis is an inflammation of the membranous formations and nervous structures of the inner ear, which is accompanied by hearing loss, tinnitus, with concomitant nausea, vomiting, and impaired coordination. This rare complication of mumps occurs as a result of a constant increase in pressure in the auricle caused by inflammatory edema. Be sure to consult an otolaryngologist.

Arthritis is accompanied by swelling of the joints, stiffness and pain when moving. It usually begins 1-2 weeks after the onset of the disease. It is extremely rare that there is a parallel lesion of several large joints, for example, the elbow, shoulder, knee.

With mastitis in women, the mammary glands become inflamed, the temperature rises, and a feverish state appears. In rare cases, mastitis develops in men. Complications are not the only danger of mumps. It is also classified as a dangerous disease due to the fact that after an infection, a person may experience a number of dangerous consequences and residual effects that entail irreversible consequences, and sometimes cause disability.

Due to untimely or improper treatment of orchitis in men, infertility may develop. First of all, unvaccinated adult males who have been ill can suffer. Irreversible damage to the gonads by the virus has a direct impact on reproductive function and causes male infertility.

Deafness is formed due to a neglected lesion of the inner ear or auditory nerve as a result of a transferred labyrinthitis. In advanced cases, hearing loss is irreversible.

Diabetes mellitus is a dangerous disease caused by inflammation in the tissues of the pancreas. If the damage captures the islets of Langerhans, which are responsible for the production of insulin and lowering blood glucose levels, the patient may develop impaired glucose tolerance. The death of cells that produce the hormone insulin leads to a decrease in its level in the blood, which is characteristic of type XNUMX diabetes.

A residual phenomenon in the form of diabetes mellitus appears in patients extremely rarely, but the likelihood of its development cannot be underestimated, since missed time in diagnosis or errors in treatment can cause the formation of a most dangerous pathology with which the patient will have to live all his life.

Dry eye syndrome is a consequence of the transferred inflammation of the lacrimal glands. Due to a malfunction of the gland, secretion and the level of normal nutrition of the eye are reduced. The mucous membrane dries out too quickly, pains begin in the eyes and discomfort appears. Violations may persist for 3-6 weeks after illness. For treatment, you should consult an ophthalmologist.

After cured meningitis or meningoencephalitis, the patient may experience impaired sensitivity of the skin, muscles, limbs. Sensitivity is restored years after the illness. Such a consequence is the result of incorrect or untimely treatment of inflammation of the brain, and appears quite rarely, but can have a significant impact on the quality of life.

Can you get parotitis again? Usually, people who were sick in childhood do not get sick again due to a stable immune response. However, the probability of re-infection exists, and is approximately 2%. After a disease, specific antibodies are produced in the body against a specific type of pathogen. Specific immunity appears as a result of contact of the virus with macrophages in the body of a sick person. Macrophages absorb viral particles, neutralize them, and form an immune response, namely antibodies in the blood. These antibodies are produced already several weeks or months after the initial infection.

Antibodies to mumps remain in human blood throughout life. It is due to this that the re-development of a viral lesion is extremely unlikely.

With regard to non-epidemic parotitis, one of the complications of its improper treatment, or in the absence of therapeutic therapy, is a relapse of the disease, as a result of which the patient may develop a chronic form of parotitis.

Vaccinated people can become ill with mumps if a low-quality vaccine was used for vaccination, or if the vaccine was given with contraindications.

Diet as an integral part of the treatment of parotitis

The main task of the prescribed diet for mumps is to unload the pancreas in order to avoid an attack of acute pancreatitis. For this, the patient is prescribed a standard diet No. 5.

The patient’s diet per day should not exceed calorie content of 2600 kcal. It is necessary to take food fractionally, 4-5 times a day, in small portions. In addition, you need to drink about 1,5-2 liters of liquid per day – weak black tea, non-acid compote or plain water.

The menu may contain low-fat meats, poultry, fish, almost all fresh vegetables and fruits (except cabbage, radishes, sorrel, onions, garlic), low-fat soups, some sweets (marshmallows, honey, marshmallows), pasta and cereals, as well as low-fat dairy products in small quantities.

Cheeses, eggs, boiled sausage, butter, tomatoes and tomato paste – the patient should be limited in taking these foods.

It is strictly forbidden to use foods that provoke appetite and increased digestion – these are fatty meats, fatty fish, smoked meats, alcohol, chocolate, coffee, strong tea, fresh bread, legumes, pickled snacks, fried, spicy, salty dishes. The pancreas, like the digestive tract as a whole, has a hard time digesting milk, so it should be completely abandoned until the final recovery.

The main principle of the diet is that the easier and faster the food is digested, the less enzymes the gland needs to produce for digestion, which means that the risk of its damage will be reduced.

In the case of acute pancreatitis, even fasting is allowed in the first one or two days of an attack, in which only water is allowed. Such a measure is prescribed only by the attending physician.

It is allowed to cook steamed dishes, as well as cooking, stewing and baking without crusting (especially true for vegetables, meat, fish).

Epidemic viral parotitis is considered a typical childhood disease, but recently it has somewhat “grown up”. This is due to the fact that the immunity of an adult is not always able to cope with the pathogen that has entered the body, for example, if the body is weakened by an improper lifestyle, or if a person was not vaccinated against mumps in childhood.

The disease most often has a positive prognosis for the patient, if it is detected on time, if the correct treatment is prescribed and all the doctor’s recommendations are carried out in full. This is especially important in order to prevent the development of complications and dangerous consequences in the patient.

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