Pediatric pancreatitis: What is it and how is it treated? | Health - Hindustan Times
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Pediatric pancreatitis: What is it and how is it treated?

ByZarafshan Shiraz, New Delhi
Jun 02, 2024 01:14 PM IST

Pediatric pancreatitis: Know all about its causes, signs and symptoms, diagnosis, treatment, prevention and diet tips, as revealed by the health experts

Paediatric Pancreatitis is an inflammation of the pancreas in children, a large gland behind the stomach. The pancreas secretes digestive enzymes into the small intestine to help digest fats, proteins and carbohydrates in food.

Pediatric pancreatitis: What is it and how is it treated? (Photo by Phonemantra)
Pediatric pancreatitis: What is it and how is it treated? (Photo by Phonemantra)

In an interview with HT Lifestyle, Dr Sanket Goyal, Head of Department - Pediatrician and Neonatologist at Marengo Asia Hospital in Gurugram, shared, “There are two types of pancreatitis: Acute pancreatitis, which arises suddenly and typically lasts for a short duration, and chronic pancreatitis, which doesn't resolve on its own and leads to gradual damage to the pancreas. Chronic pancreatitis is uncommon in children.”

Bringing his expertise to the same, Dr Saurabh Khanna, Lead Consultant - Paediatrics and Neonatology at CK Birla Hospital in Gurgaon, briefed, “Children with pancreatitis are defined as those who have inflammation of the pancreas and are younger than 18. It is usually brought on by conditions like gallstones, cystic fibrosis, medications, infections, or trauma and can be either acute or chronic.”

Causes:

According to Dr Sanket Goyal, causes of pediatric pancreatitis include trauma to the pancreas and hereditary factors. Additionally, rare causes encompass drug reactions, infections, or anatomical abnormalities.

As per Dr Saurabh Khanna, pancreatitis in children can be caused by a variety of factors, including -

1. Gallstones: Since gallstones can obstruct the pancreatic duct and induce inflammation, they are one of the most frequent causes of pancreatitis in children.

2. Cystic Fibrosis: Due to abnormal mucus production in the pancreas, children with cystic fibrosis, a hereditary disease affecting the lungs and digestive system, are more likely to develop pancreatitis.

3. Medication: Children who take certain medications, like valproic acid, corticosteroids, and some chemotherapy therapies, may experience pancreatitis as a side effect.

4. Illnesses: Children can develop pancreatitis as a result of viral illnesses such as the mumps, coxsackie virus, and Epstein-Barr virus.

5. Trauma: Children who suffer abdominal trauma, such as from a vehicle accident or sports injury, may develop pancreatitis.

6. Genetic Factors: In certain instances, particularly in hereditary pancreatitis cases, genetic factors predispose children to developing pancreatitis.

7. Metabolic Disorders: Hyperlipidemia, hypercalcemia, and hypertriglyceridemia are examples of metabolic disorders that might aggravate pancreatitis in children.

8. Nutritional Factors: Children who suffer from severe malnutrition, especially in cases such as protein-energy deficiency, are more likely to develop pancreatitis.

Symptoms:

Dr Sanket Goyal revealed, “Severe abdominal pain, nausea, vomiting, fever, and, in certain situations, jaundice, weight loss, or changes in bowel habits are some of the symptoms that are commonly associated with pediatric pancreatitis. While nausea and vomiting can result in dehydration and electrolyte imbalances, abdominal pain is typically acute and centered in the upper abdomen, with occasional spreading to the back or chest. Children may also feel tired, lose their appetite, and have abdominal pain or swelling. Breathing problems may arise in extreme cases as a result of complications like pleural effusion.”

Dr Saurabh Khanna echoed, “Abdominal pain, nausea, vomiting, fever, and jaundice are possible symptoms. Pancreatitis in children can be diagnosed by physical examinations, blood tests, imaging scans, and sometimes a biopsy. Hospitalisation, intravenous fluids, pain control and treating the underlying cause are common forms of treatment. Monitoring and follow-up care are crucial for controlling the illness and avoiding complications.”

Diagnosis:

Dr Sanket Goyal highlighted that diagnosis typically involves blood tests, along with abdominal ultrasound (USG) and CT scans.

Management and treatment:

Dr Sanket Goyal informed, “The severity of the attack determines how the patient is treated. Acute pancreatitis usually goes away on its own if there are no pre existing lung or kidney issues. Supporting vital body functioning and preventing problems are the main priorities. Intravenous fluid replacement usually necessitates hospitalisation and in certain cases, surgery can be required.”

Dr Saurabh Khanna opined, “A comprehensive strategy is needed for the management and treatment of pediatric pancreatitis in order to address the underlying causes, minimise complications, and relieve symptoms. At first, supportive treatment is the major priority, which includes managing discomfort and replacing lost fluids to stay hydrated. In order to reduce pancreatic stimulation and promote recovery, dietary modifications are essential. Targeted therapies can be required if an underlying cause—such as gallstones or hereditary factors—is found. Prescription medications are frequently given, including analgesics, pancreatic enzyme supplements, and antibiotics in the event of an infection.”

He added, “Surgical interventions, such as endoscopic procedures to clear blockages or surgical excision of the pancreas, may be considered in severe or recurring cases. In order to limit the risk of problems and prevent recurrence, long-term therapy entails routine monitoring, dietary adjustments, and lifestyle modifications. To offer complete care appropriate to each child's unique needs, a multidisciplinary approach comprising pediatric gastroenterologists, dietitians, surgeons, and other specialists is necessary. Pediatric patients with pancreatitis require optimal therapy and improved results, which necessitate regular follow-up sessions and continuous support.”

Diet to follow:

Dr Sanket Goyal advised, “Increase the amount of fruits and vegetables you eat. Choose healthy grains instead of simple carbs, and set aside around 25% of your dish for proteins. Limit your consumption of sugar and simple carbs, such as those found in chips, juice and cookies. Upon reaching fullness, stop eating. Stop eating when you feel full.”

It is imperative that doctors look into the underlying cause of pediatric pancreatitis in order to treat patients appropriately and avoid recurrence. A personalised strategy can be required in each situation, depending on the precise reason found by diagnostic assessments.

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