Reactive pancreatitis in children

Date of publication: 04/01/2016

Pancreatitis

- a disease that affects not only adults, but also children.

Pancreatitis is inflammation of the pancreas. The pancreas produces digestive enzymes. If for some reason these enzymes do not enter the esophagus, but remain in the gland, digestion of the mucous and glandular tissue begins, which causes pain and leads to destruction of the gland.

More information about pancreatitis

The child’s body responds more sensitively to any changes, and the processes in it proceed more actively. Therefore, almost any allergic or infectious disease in childhood affects the pancreas.

At the same time, acute pancreatitis is rare in children, since many factors contributing to its development are absent. In children, reactive and chronic forms of the disease are more common.

Causes of inflammation

The pancreas or pancreas has an oblong structure and includes a head, body and tail. The parenchyma consists of glandular tissue and ducts.

An enlarged gland can be caused by a number of reasons:

Congestion accompanied by impaired blood flow.
Plasma enters the intercellular substance of tissues, which causes edema.
Violation of the outflow of pancreatic juice into the lumen of the duodenum.
Growth of pathological neoplasms.

The causes of inflammation of the pancreas must be taken into account when selecting therapy.

Pancreatitis is a pathology whose development can be influenced by many factors. Usually the occurrence is due to systemic diseases, unhealthy diet - the predominance of fatty foods in the diet.

As already mentioned, with pancreatitis the pancreas suffers. It is located next to the stomach, its functions include the production of various groups of enzymes to facilitate the digestion process and absorb the maximum amount of substances necessary for the body.

Pancreatitis provokes inflammation of the pancreas tissue, which causes a failure in the production of enzymes. This negatively affects the digestion process, causing serious harm to the child’s health.

Important!

Lack of treatment can lead to irreversible consequences - inflammation of the gland tissue can completely destroy its structure.

Causes of pancreatitis

The pathogenetic basis of pancreatitis of any origin is local inflammation of the gland tissue.
The key mechanism of this pathological process is the release of excessive amounts of active enzymes, which begin to damage the organ's own structures. Hyperactivation of the secretory function of the gland can be either primary or secondary (develops as a result of pathology of other organs and systems). In newborns and infants, pancreatitis most often occurs as a result of congenital anomalies in the development of the organ and its ducts. Due to the lack of adequate outflow, enzymes accumulate inside the gland and trigger the process of lysis (chemical destruction) of its own tissues.

In school-age children and teenagers, activation of the secretion of bioactive enzymes can be triggered by the following factors:

eating large amounts of fried and fatty foods - the child’s digestive tract is not suitable for digesting “heavy” foods;
viral or bacterial lesions of the gastrointestinal tract with penetration of the pathogen into the pancreas;
narrowing of pancreatic ductuses against the background of neoplastic processes in the abdominal cavity.

The risk of developing pancreatitis also increases with irregular nutrition, consumption of large amounts of fast food, and carbonated drinks. Damage to the pancreas sometimes occurs due to the use of aggressive medications or the entry of toxins into the baby’s gastrointestinal tract.

Classification of pancreatitis

In children, the disease is classified into forms - acute and chronic. Pancreatitis is considered chronic if it lasts for more than six months. The acute form provokes swelling and catarrhal inflammation of the gland tissue. In especially severe cases, hemorrhages occur, which provoke necrosis of gland tissue.

The nature of the changes occurring in the tissues of the gland divides pancreatitis into:

acute edematous;
hemorrhagic (with hemorrhages);
purulent;
fatty pancreatic necrosis.

Typically, the causes of pancreatitis in children are nutritional disorders. Being under constant load, the gland tissues lose their properties and begin to degenerate, reducing their activity.

In children over 7 years of age, chronic pancreatitis of a latent or recurrent nature is usually diagnosed. The acute form is less common in children.

Depending on the origin, pancreatitis can be:

primary;
reactive, occurring against the background of inflammation of other organs;
hereditary.

Proper diet for reactive pancreatitis in childhood

The main goal of dietary nutrition is to eliminate inflammatory changes, as well as quickly restore pancreatic function.

Stages of diets

For the first 3 days, fasting is prescribed. Why? Due to fasting, the child stops secretory activity, thereby ensuring peace of the inflamed organ.

But this does not mean that the child should completely refuse to eat, because otherwise dehydration will occur. Therefore, for the first time, you are allowed to drink water without gas, for example, Borjomi, for 3 days.

Chief gastroenterologist of the Russian Federation: “PANCREATITIS does not go away?! A simple treatment method has already healed hundreds of patients at home! To cure the pancreas forever you need...” Read more »

The second stage is a gentle diet, which lasts for 14 days. At this point, adhere to diet No. 5.

The third stage is beyond the exacerbation stage. The duration of the third stage is from 2-3 months, it all depends on the general condition of the child.

Also read on our website: Modern classification of chronic pancreatitis

What kind of dishes can you eat?

Puree soups;
Rusks;
Porridge;
Mashed potatoes.

You can prepare a dish from carrots, beets, cauliflower or pumpkin.

The dangers of poor nutrition

Dr. Komarovsky talks about many diseases in his programs, including pancreatitis. He says : “If we feed a child crap in a beautiful cover, then he wonders where we got diseases from!” .
Therefore, it is important to always adhere to proper nutrition, and not just during illness. According to Dr. Komarovsky, if parents stop adhering to the diet for any type of pancreatitis, then all the symptoms of the disease will worsen. After all, drug therapy must be comprehensive; this is the only way to get rid of the disease.

Now you understand what symptoms children have and what treatment should be given. Remember that treatment is strictly under the supervision of a doctor.

In the case of reactive pancreatitis, the process is reversible; it is only necessary to identify and begin to treat the underlying disease in time. If left untreated, the disease progresses to true pancreatitis. Such problems are more common in children aged 10–14 years.

The etiology of reactive pancreatitis lies in existing foci of infection in other organs, which complicate the functioning of the pancreas. In addition to infectious diseases, the reactive form can be caused by taking antibiotics and other potent medications.

The latent form is not characterized by obvious clinical manifestations, but the relapsing type of the disease occurs in waves - exacerbations alternate with remissions. Exacerbation of inflammation of a chronic process, like acute pancreatitis, can be mild, moderate or severe.

Etiology

In the vast majority of cases, the etiological factor remains unclear. Then we are talking about idiopathic pancreatitis. In total, there are three groups of factors that predispose to the development of inflammation in the pancreas.

Toxic-allergic. Unlike adult pathology, this group of factors comes first in the pathogenesis of childhood pancreatitis. This includes excessive consumption of imported or domestic sweets, drinks, chewing gums, which contain dyes and other chemicals. These compounds accumulate in the body and, after reaching a toxic concentration, have a toxic effect on the child’s body, including the pancreas. Often, such children have concomitant general somatic pathology (chronic gastritis, digestive disorders, etc.). This group also includes food poisoning, drug poisoning, and the effects of toxins from various infectious agents.
Stressful. Prolonged psychological overstrain and stress contribute to disorders of the nervous regulation of pancreas activity. All this ultimately leads to disruption of microcirculation in the organ and disruption of its enzymatic function. Due to local circulatory disorders, multiple small foci of necrosis first form in the tissue, which then become inflamed. Gradually, the process covers the entire gland, which is called acute pancreatitis.
Mechanical. Pancreatitis occurs due to a violation of the outflow of secretions through the ducts due to an obstacle in its path. Most often, the lumen is blocked by stones (calculi), which are formed as a result of poor nutrition and frequent consumption of fatty, high-carbohydrate foods. Under such conditions, the load on the pancreas increases, the secretion thickens, and over time, stones form, preventing the normal circulation of pancreatic juice. The active compounds and enzymes that the secretion contains are thrown back. The pancreas undergoes a process of autolysis, which gives pronounced clinical symptoms.

Reasons for organ enlargement in children

Inflammation of the pancreas in a child can be caused by a number of pathological conditions:

Closed abdominal injuries associated with a fall or other mechanical damage; against this background, an enlarged spleen can often be observed.
Autoimmune disorders are malfunctions of the immune system, in which the body begins to produce antibodies to its own tissues, including the pancreas.
Poisoning with chemicals , causing disruption of the digestive system. Against this background, an enlarged liver is often observed.
Infectious processes in other organs.
Chronic pancreatitis can be caused by improper treatment of the acute form of the disease.
Growth of neoplasms in organ tissues , abscess, cyst, benign or cancerous tumor. Inflammation of the organ can be localized - for example, only the tail of the gland enlarges.
Stomach ulcer , in which the integrity of the structure of the mucous membrane of the stomach or duodenum is disrupted. Over time, this leads to dysfunction of the pancreas and an increase in its size.
Duodenitis is an inflammation of the duodenum that obstructs the outflow of pancreatic juice.
Cystic fibrosis is a systemic congenital pathology that provokes damage to various glands, including the pancreas.

Important!

Identifying the main cause of pancreatic inflammation in children is a mandatory diagnostic measure. Further treatment will be based on these data.

Which doctor should I contact if pancreatitis is detected in a child?

If your child experiences abdominal pain, nausea, vomiting or other symptoms of pancreatitis, you should consult a pediatrician.

If pancreatitis is suspected, the child is admitted to the hospital for a comprehensive examination. Once the diagnosis is confirmed, depending on the stage of the disease and the presence of complications, doctors may be involved in treatment:

gastroenterologist, specialist in the fight against gastrointestinal disorders;
nutritionist, to develop the correct diet for therapeutic nutrition;
endocrinologist, with the development of hormonal disorders;
surgeon (in extreme cases).

Once the diagnosis is confirmed, depending on the stage of the disease and the presence of complications, surgeons may be involved in treatment.

Inflammation of the pancreas is considered a serious disease and requires the participation of several specialists in the treatment.

Symptoms, signs of inflammation

Inflammation of the pancreas in children is usually mild. The younger the child, the less pronounced his symptoms of the disease.

The acute form of the disease is expressed by sharp paroxysmal pain (it can be relieved), often of a girdling nature, which radiates to the hypochondrium and spine. In addition, pancreatitis is characterized by lack of appetite, nausea, increased gas formation, diarrhea and vomiting.

Subfertile temperature, pale skin, dry mouth, and coating on the tongue are observed. With tissue necrosis, the temperature rises sharply, obvious signs of intoxication and intestinal paresis appear. The development of a collaptoid state is possible.

Why does the disease occur in children?

The development of pancreatitis in an infant is based on an inflammatory process, and less commonly, on the destruction of pancreatic tissue.

Modern classification identifies 4 forms of gland damage in childhood:

acute inflammation of the pancreas (rare);
chronic pancreatitis;
chronic latent form (characterized by an asymptomatic course);
reactive pancreatitis.

Dysfunction of the organ (pancreatic insufficiency) in infants is recorded extremely rarely, which implies a relatively favorable course of the disease.

The acute form of gland damage occurs with pronounced destructive processes, a massive release of proteolytic enzymes into the systemic circulation and a vivid clinical picture. Chronic pancreatitis is characterized by the presence of episodes of exacerbation; the latent form occurs with virtually no symptoms or complaints from parents and is detected during a routine ultrasound.

Reactive inflammation of the pancreas causes a lot of controversy among scientists and clinicians, since it can imply two conditions: moderate transient inflammation of the organ against the background of existing gastrointestinal pathology, an infectious process, or initial swelling of the gland tissue - the first stage of acute destructive pancreatitis.

Pancreatitis in a newborn child is often the result of a congenital anomaly of the digestive tract. This may be lactase deficiency, abnormalities of the intestines, gallbladder or pancreas.

The most common causes of organ damage in infants:

disruption of the normal outflow of pancreatic enzymes as a result of the abnormal structure of the ducts of the gland, gall bladder and duodenum; presence of calcifications;
improper nutrition; hereditary factor in which the secretory function of the pancreas is actively stimulated;
infections (congenital, acquired hepatitis, herpes virus infection, mumps, salmonellosis);
congenital endocrine pathology (hypothyroidism);
helminthic infestation, septic condition.

Useful video

Video about symptoms (where it hurts, what can cause a breakdown):

Symptoms of the chronic form depend on the duration of development of the pathological process, the stage and form of the disease, the degree of damage to the pancreas and other digestive organs. The child is bothered by periodically occurring aching pain in the right hypochondrium, which is aggravated by eating disorders, after physical exertion or stress.

The attack can last from several hours to several days. Children suffering from this form of the disease have no appetite and periodically suffer from heartburn, nausea, and vomiting. Constipation replaces diarrhea. There is weight loss.

Important!

Complications of pancreatitis in children are quite dangerous - false cyst, pancreolithiasis, peritonitis, pleurisy, diabetes mellitus.

How does pancreatitis manifest in a newborn?

Symptoms of pancreatitis in children depend on the age of the child and the severity of the disease.
Pancreatitis in newborns is characterized by a poor clinical picture and the absence of specific symptoms. Parents of a newborn or infant may complain of periodic anxiety in the baby, loud crying for no reason, pulling the legs towards the stomach, decreased appetite and changes in the nature of the stool (liquid, greasy and undigested food). It can only be determined through a comprehensive examination of the child.

Symptoms in young children (up to 3 years of age) are more pronounced, since the functions and load on the pancreas are greater than in a newborn.

Symptoms of organ inflammation are:

refusal to eat, regurgitation;
abdominal pain, nausea;
diarrhea, vomiting;
sometimes increased body temperature.

In severe cases of the disease, general weakness, coating on the tongue, weight loss, and marbling of the skin appear.

The growing up of a child affects the consistent expansion of his diet. The risk of developing chronic or reactive inflammation of the pancreas increases. Semi-finished products, concentrates, and sweets can act as catalysts; eating disorder. If a baby is fed by the hour, observing all the norms, then in children older than one year the rules are rarely followed, which affects the functioning of the pancreas.

Diagnosis of the disease

The prognosis of treatment directly depends on the timeliness and correctness of diagnosis. After a visual examination and medical history, the doctor prescribes a series of examinations to confirm the diagnosis.

The child must have blood, urine and feces tested. The study will show whether there is inflammation in the body and indirectly confirm the development of pancreatitis in the child. An ultrasound examination of the abdominal organs and fibrogastroscopy will show a clearer picture. The conducted studies will help the specialist to reliably assess the patient’s condition and prescribe the necessary therapeutic measures. If treatment is necessary, the child may be hospitalized.

Diagnosis and treatment

Diagnosis and treatment of reactive pancreatitis in children is carried out by a gastroenterologist. After interviewing the patient and parents in order to collect the necessary information (nutrition, previous diseases, taking medications, severity of symptoms, time and order of appearance), the young patient is examined. Pale skin and mucous membranes, white coating on the tongue, tachycardia, low blood pressure, pain on palpation of the upper abdomen confirm the diagnosis of “reactive pancreatitis”.

After the examination, laboratory tests are prescribed:

general blood and urine analysis;
blood chemistry;
stool analysis;
Ultrasound of the abdominal organs.

Do not forget that reactive pancreatitis in children is a secondary disease; the first priority is to find the cause and eliminate the provoking factors. Children with a diagnosis are hospitalized for comprehensive monitoring of the course of the disease and tracking changes in the patient’s well-being.

The main tool for treating pancreatitis remains the diet prescribed by the attending physician depending on the stage and severity of the disease. For the first two to three days, it is recommended to avoid eating altogether. Then the damaged organ is provided with rest and stress relief. For this, enzymatic preparations are prescribed to facilitate the absorption of proteins and carbohydrates. It is important to know that prolonged use of this type of medication leads to a decrease in the production of pancreatic juice, and the pancreas ceases to function!

Antispasmodics and analgesics are used to relieve pain. The main sign of recovery is a weakening or complete absence of pain.

Principles of proper nutrition

The main risk factor is poor nutrition – an abundance of fatty, salty and spicy foods (fast food) in the diet.
The use of carbonated drinks has a negative impact on the functioning of the digestive system, which, in addition to increasing the acidity of the stomach, has a mechanical effect on the walls of the duodenum and provokes the reflux of contents into the pancreatic ducts. As a result of such actions, the activation of enzymes will occur before reaching their destination and will start the process of digesting the tissues of a healthy organ.
It's also worth paying attention to portion sizes. Overeating is unacceptable. To avoid digestive problems, you should not force your child to eat if he refuses.
Frequent snacking is a malicious enemy of the normal functioning of the digestive system.
Food dyes, preservatives and flavor enhancers should be excluded from the child’s diet if possible.

Methods and rules for treating illness, illness

Any therapy begins with finding out the causes of the disease. Sometimes it is enough to eliminate the provoking factor and pancreatitis will subside. Separately, congenital anomalies should be touched upon - this requires medical supervision of the child for many years.

One of the main reasons for the progression of inflammatory processes in the pancreas in adolescents is malnutrition - schoolchildren's pancreatitis. The main thing in the treatment of such a pathology will be a strict diet.

Nutrition for pancreatitis in children

Diet is an essential component of therapy. You need to know what to feed and what products to buy. It will help eliminate problems in all organs of the abdominal cavity and the pancreas as well.

Basic nutrition rules:

fractional meals - 5-7 times a day in small portions;
refusal of unhealthy foods: fast food, fizzy drinks, fatty, fried, salty, spicy, preservatives;
a balanced diet, which includes various cereals, pasta, dairy products, lean meat and fish, vegetables and fruits;
predominance of boiled and steamed food;
eating not hot, but only warm food;
fresh food for cooking.

Drug treatment

The diet will help reduce the load on the digestive organs. In addition, the doctor prescribes enzyme preparations that improve the digestion process:

"Creon."
"Festal".
"Mezim forte."

These medications are taken with meals. Children may also be prescribed medications containing bifidobacteria, for example, Bifacil.

To alleviate the patient's condition, the following is prescribed:

Pirenzepine, Famotidine.
Pancreatin.
No-spa, Mebeverine, children's Paracetamol.

In more severe cases, antibiotics are prescribed; antihistamines; drugs that help improve blood microcirculation; protease inhibitors.

Important!

Treatment comes down to following simple measures, the main thing is that the child understands the importance of these actions - this will benefit him not only now, but will also allow him to live fully in the future.

What to do with very young children

If the disease is diagnosed in a very young patient, the nutritional rules will be as follows:

predominance of protein foods;
cooking any porridge with water;
vegetables and fruits should be heat treated.

Sometimes surgical intervention is necessary, for example, in cases where there are congenital anomalies in the pancreas. The decision to undergo surgery is made after a comprehensive examination and only if there are no results from conservative therapy.

Treatment of pancreatitis in children is often performed in a hospital setting. Only here doctors will be able not only to treat the baby, but also to monitor his nutrition, observing the dynamics of therapy.

Traditional methods of treatment

From time immemorial, potato juice has been considered one of the effective methods of treating pancreatitis. You need to grate 2-3 potatoes along with the peel and squeeze out the juice. Directions for use: 50 ml 2 times a day. The course of treatment is 2 weeks. Then a week break and repeat the course. An excellent addition to kefir is low-fat kefir, which is consumed 5-10 minutes after taking the main product.

Important!

Regular honey can protect you from many diseases. If the child does not have an individual intolerance to this product or diabetes, a good habit would be to eat 1 tsp. honey in the morning, diluted in milk or water.

It is necessary to take St. John's wort, motherwort, and immortelle inflorescences in equal proportions. 2 tbsp. Boil the collection for 10–15 minutes in 1 liter of water, let the broth brew for 2 hours, strain. The course of administration is 50 days, half a glass before meals.

A complex but very effective collection. You should take equal proportions of dry burdock root, buckthorn bark, plantain, blueberry leaves, dill and flaxseeds. Add dandelion root, knotweed and sage. The preparation method is identical to the previous remedy - for 1 liter of water, 2 tbsp. collection, boil for 10–15 minutes. The course of administration is 14–20 days, half a glass after meals.

Important!

Any treatment methods for very young patients must be agreed with a doctor, otherwise self-medication can lead to irreversible consequences.

If a child has an enlarged pancreas, it is necessary to first find out the causes of this condition, and only then begin therapy. Timely detected pathology will allow you to avoid surgery and cure the disease using conservative methods. Read also about bending of the pancreas in children.

Treatment

The therapeutic course includes taking medications. Together with drug therapy, doctors prescribe a diet for the child. If the disease occurs in a breastfed child, then the diet is prescribed to the mother.

Important! The drug is prescribed not only based on the patient’s age, but also on the severity of the disease. Therefore, you should not self-medicate.

The first stage of treatment is taking medications that will help reduce the volume of gastric juice produced; Pirenzepine is most often prescribed in childhood.
Also read on our website: Acute pancreatitis: symptoms and treatment at home

Festal or Panretin may be prescribed as a pain reliever, as well as to improve digestion. If a child has an allergic reaction, then No-shpa is prescribed. To improve the outflow of pancreatic juice, it is necessary to take antispasmodic drugs, for example Platiphylline. Note that this drug also helps eliminate pain symptoms.

As you understand, with this disease the digestive tract is disrupted, so it is necessary to replenish the body with easily digestible nutritional material. Therefore, doctors at older ages prescribe Glucose drips to the child.

Important! Reactive pancreatitis can also be treated with other drugs prescribed by the treating doctor.

Many people ask, is it possible to cure pancreatitis with traditional medicine ? No, herbal recipes alone will not bring a positive result for such a disease, because it is imperative to take medications and adhere to a diet. If necessary, traditional methods can be prescribed, but only in combination with the main therapy.

Prevention

As preventive measures against inflammation of the pancreas, it is recommended:

a balanced diet, including all necessary micro- and macroelements;
refusal of junk food;
timely detection and treatment of pathologies of the digestive system;
promptly identify and eliminate helminthic infestations in the body;
when prescribing potent drugs, monitor the general condition of the child;
use only high-quality and fresh products for cooking;
do not overeat, so as not to overload the pancreas.

If you experience any symptoms of pancreatitis, you should immediately consult a doctor. This will help avoid many problems and prevent relapses of the disease in children. Self-medication can cause complications that will subsequently require additional treatment.

Diagnosis of pancreatitis

If reactive pancreatitis is suspected, a blood test (lipase and amylase test) is performed to determine the level of pancreatic enzymes. If their level is elevated, an abdominal ultrasound is performed to identify possible signs of inflammation and stones in the pancreatic duct. Your doctor may recommend an abdominal CT scan to confirm the diagnosis.

Children with this diagnosis must be hospitalized to monitor the course of the disease and monitor changes in their general condition.