home Audience 3 The pancreas is in danger: reactive pancreatitis in children. Pancreatic diseases in children - symptoms, treatment and diet

The pancreas is in danger: reactive pancreatitis in children. Pancreatic diseases in children - symptoms, treatment and diet

Pancreatitis among children, especially early age, is not very common, but still occurs. At the same time, the symptoms of the disease in a child are somewhat different from the manifestations of pancreatitis in adults, which can make it difficult to diagnose correct diagnosis and lead to delays in treatment.

As in adults, pancreatitis in children can occur in acute and chronic forms. A special form of the disease in children is the so-called reactive pancreatitis, or dyspancreatism, is a reversible condition that develops as a response of the pancreas to infection, diseases of the digestive system, unhealthy diet, etc.

Acute pancreatitis

Signs of acute pancreatitis develop suddenly, in healthy child. In most cases, there is a clear connection between previous exposure causative factor(abdominal injury, poisoning, taking medication, etc.) and the subsequent development of the clinic of acute pancreatitis.

Main symptoms:

Abdominal pain. Older children complain of acute diffuse pain throughout the abdomen or girdle pain, pain in the right hypochondrium radiating to the lower back, chest, and left arm.
As a rule, a painful attack is accompanied by repeated vomiting that does not bring relief.
Signs of shock and organ damage from pancreatic enzymes entering the blood quickly develop: a fall blood pressure, pale skin, blue or purple spots on the skin of the abdomen, weakness, dizziness, loss of consciousness. Due to the toxic effect of enzymes on the central nervous system The child may experience agitation, confusion, or even hallucinations and delusions.
Stool disorders - constipation or diarrhea.
Bloating, tension abdominal wall.
Dry mucous membranes and tongue. A thick white or yellow coating appears on the tongue.
Moderate increase in body temperature.
Due to a violation of the outflow of bile due to compression by the swollen pancreas bile ducts jaundice develops: the child experiences yellowness of the skin and visible mucous membranes (eye sclera, oral mucosa).

It is much more difficult to identify signs of acute pancreatitis in infants and younger age(up to 1.5-2 years), since they cannot make complaints. Abdominal pain in babies manifests itself in the form of screaming, incessant crying, and squeezing into a ball. The tension of the abdominal wall is also determined; vomiting does not always occur. But these are nonspecific symptoms that can develop in other diseases ( acute pyelonephritis, appendicitis, etc.), therefore, an examination by a pediatric surgeon is mandatory.

Chronic pancreatitis

With chronic pancreatitis, children experience approximately the same symptoms as adults:

Abdominal pain that occurs after an error in diet (eating fatty, spicy food, fried, smoked, etc.). Children with chronic pancreatitis are extremely sensitive to nutrition, and an exacerbation of the process in them can be provoked not only gross violations diet, but also minor errors, long breaks between meals.
Nausea and vomiting, also associated with poor diet.
Disruption of digestion processes, signs of which are fatty shiny feces, diarrhea, flatulence.
Due to the fact that food is not digested, the growing child’s body does not receive many necessary substances. Children very quickly develop malnutrition (exhaustion), signs of anemia and hypovitaminosis (pallor and dry skin, brittle hair, nails, etc.). With a long course, a lag in growth and mental development is possible.

Symptoms of reactive pancreatitis

Symptoms of reactive pancreatitis in children are explained by a decrease in the production of enzymes by the pancreas and subsequent disturbances in the process of food digestion:

Stool of semi-liquid consistency, with inclusions undigested food, with a greasy sheen, difficult to wash off from the potty or toilet walls. Some children may experience chronic constipation.
Bloating, rumbling in the stomach, flatulence.
Children over 2 years of age periodically complain of cramping or dull pain around the navel. Usually pain is associated with errors in nutrition.

Symptoms similar to the manifestations of chronic and reactive pancreatitis can occur in children with other diseases of the digestive system - gastritis, biliary dyskinesia, dysbacteriosis, colitis, etc. But the presence of at least one symptom, and even more so several that are constantly present, requires mandatory examination of the child by a pediatrician or gastroenterologist. Only a doctor after examination, questioning and prescribing additional diagnostic procedures, will be able to refute or confirm pancreatitis in a child and prescribe the necessary treatment.

Inflammation of the pancreas in a child, or pancreatitis, is dangerous look a disease characterized by edema and pathological processes in this organ. The pancreas is responsible for producing the hormone insulin and digestive enzymes.

Why does pathology occur in a child?

Pancreatitis occurs in both adults and children. IN childhood the disease occurs more often, especially in a protracted form. Children are more energetic than adults, so allergic or inflammatory in nature are more acute. There are many causes of the disease in children, including the following:

Allergies to various foods, infants- lactose deficiency.
Lack of daily routine and poor quality nutrition.
Use junk food(soda, chips, hot sauces, smoked meats, etc.) promotes the production of a large number of enzymes, resulting in an acute form of the disease.
The use of medications can lead to reactive pancreatitis.
Congenital pathologies in the digestive system.
Food poisoning, abdominal injuries.
Great physical activity.
Diseases of the digestive system, as well as various infectious pathologies(flu, mumps).

Symptoms of pathology in a child

Inflammation in children manifests itself in several stages: acute, chronic and reactive. The first form is mild and occurs less frequently than in adults. It is rarely detected in infants, but more often in older children. The child exhibits the presence of the following signs:

heat;
nausea;
vomit;
frequent diarrhea;
pain in the epigastric region.

In children infancy acute pancreatitis occurs as a result of taking medications, since the digestive system is not yet mature enough. Parents should monitor their children's vitamin intake as overdosing may promote inflammation due to increased enzyme secretion.

Chronic pancreatitis in children is more common than acute pancreatitis. The reason for the manifestation is poor quality nutrition and lack of proper diet. During the period of exacerbation, the gland becomes inflamed and very painful, irreversible processes occur in it. In chronic cases, the following symptoms of pancreatic inflammation in children are observed:

Reactive pancreatitis is more common than other forms of the disease. The symptoms are the same as for acute form. The reasons may be as follows:

inflammatory colds;
intoxication of the body.

In babies under one year of age, pathology usually develops due to improper introduction of complementary foods. This disease can develop into a purulent-necrotic stage of pancreatitis with serious complications.
If you notice these symptoms in your child, you should immediately consult a doctor. After the examination, the specialist will determine what kind of diagnosis needs to be carried out.

The first thing required is to donate blood for general analysis and biochemistry. Increased content leukocytes in the blood and an increase in enzyme levels will indicate that inflammation has begun in the body. When performing a stool test for coprogram, you can see whether iron produces enough enzymes.

Urine is tested for amylase. An ultrasound examination may be required. During testing, you will be able to see changes in the size of the gland, a decrease in echogenicity, or the absence of a signal. X-ray examination will help identify organ displacement digestive system, detect the accumulation of stones in them, changes in the position of the stomach and duodenum. At acute course diseases this study are not carried out.

Treatment methods for childhood pancreatitis

Inflammation is treated medications, which contain enzymes that help digest food. It's worth following a diet. For the first 3 days you must refuse food. Next, the child needs to gradually eat food in small portions and more than 4 times a day. It is necessary to exclude too fatty foods from the baby’s diet. The recommended dose is 60-70 g per day. Limit your intake of sugar and high carbohydrate foods. Freshly prepared food should be eaten warm.

Eliminate hot spices and sauces from your child’s diet to avoid irritating the gastric mucosa. These products are especially contraindicated for children under 3 years of age. In addition, smoked meats, pickles, borscht, rich meat broths. You are allowed to eat lean meat and fish, boiled and steamed vegetables, grated and baked fruits, dried fruits, compotes, low-fat cottage cheese, cheese, dairy products.

Treatment of pancreatitis in children contains methods that are aimed at unloading the pancreas, relieving symptoms, and preventing negative factors.

In case of acute pancreatitis, children are hospitalized in medical institution in compliance with bed rest and carry out fasting days, at least two days. Subcutaneous administration of glucose solution is prescribed according to indications, and medicinal mineral water is prescribed for drinking.

After fasting, a strict diet is carried out.

Treatment with drugs includes analgesics and antispasmodics, antisecretory agents (Pirenzepine, Famotidine), medications that contain pancreatic enzymes. In combination, when treating children, corticosteroids, antibiotics, and antihistamines are prescribed.

Surgical intervention occurs when there is escalation of pancreatic dysfunction, pancreatic necrosis and low effectiveness of conservative treatment.

In the initial form of the disease, the prognosis is better than in other cases. In purulent and reactive forms it is possible death. At chronic stage the severity of attacks depends on the frequency of their occurrence.

Prevention of pancreatitis involves proper nutrition and compliance with the regime, prevention of diseases (digestive system, infectious, helminthic), taking medications only under the supervision of a doctor. Children with pathology chronic form need dispensary observation from a pediatric gastroenterologist, pediatrician and in sanatorium-resort treatment.

To eliminate this disease, in addition to medications, you can resort to folk remedies at home. Here are some of them:

Take 2 tbsp. l. wormwood herbs, pour 0.5 liters of boiling water, place in a thermos and wait about 1 hour.
Take 1 tbsp. l. plantain, pour 1 cup of boiling water and leave for several minutes.
In case of illness, it is useful to chew propolis; a decoction of the substance with chamomile helps.
Can be cooked oatmeal in water without salt and eat 2-3 tbsp. l. during the day.
You can buy ready-made ones at the pharmacy. herbal teas with different components. You should brew them and drink them strictly according to the instructions.
Taking flax seed helps reduce pain. You can make jelly from it.
During the exacerbation phase, it is useful to drink rosehip decoction.
A decoction of the following herbs helps to cope with the disease: mint, hawthorn, immortelle, chamomile, dill seeds.

These are not all the recipes that can cure inflammation of the pancreas. The main thing is to choose a product that is harmless to the child.

Pancreatic diseases in children in clinical gastroenterology have their own characteristics and require careful differential diagnosis. The pancreas occupies an important place among the digestive organs. It takes an active part in the digestion of food, produces a number of hormones, including insulin, without which the body is not able to fully function. Inflammation of the pancreas in children (pancreatitis) is not uncommon among the young population and accounts for about 15% of all diseases of the digestive system. Unlike adults, pancreatitis in children has its own characteristics and is often disguised as other diseases. What are the causes and symptoms of inflammation of the pancreas in children, how to recognize the disease and what treatment is prescribed for pancreatitis?

Causes of pancreatitis in children

With pancreatitis, destructive changes develop in the structure of the pancreas, which significantly affect the child’s well-being. The reason for such changes may be different reasons internal or external environment. The epidemiology of pancreatitis in children may be based on the following factors:

infectious or viral diseases;
nervous shocks;
heredity;
congenital anomalies of the gastrointestinal tract;
improper or unbalanced diet;
food poisoning;
long-term use of some medicines;
abdominal or back injuries;
excessive physical activity.

In almost 70% of cases, after examination, the child is diagnosed with “reactive pancreatitis”, which develops against the background poor nutrition, eating large amounts of fatty, spicy or fried foods, as well as those foods that contain dangerous preservatives. Reactive change pancreas leads to slow resolution of gland cells. With the development of reactive pancreatitis, spasms of the pancreatic ducts are observed, which blocks the production of enzymes, as a result, enzymes accumulate in the gland, which causes a pronounced clinical picture.

How does pancreatitis manifest in children?

Pancreatitis in children most often has mild course, but just like in adults, it can occur in acute or chronic form. In young children, the clinical picture is mild, which often makes diagnosis difficult. Main features acute inflammation glands the following symptoms are considered:

sharp pain in the epigastric region,
pain radiates to the right hypochondrium;
decreased appetite;
nausea;
flatulence;
diarrhea;
pale skin.

Inflammation of the pancreas in a child - symptoms, some may be absent. Chronic pancreatitis in children is quite rare and only in cases when acute period, the child did not receive proper treatment. The clinical picture of the chronic form of the disease is mild, but often causes considerable discomfort to the child, especially during the period of exacerbation.

Diagnostics

If pancreatitis is suspected in children, the doctor prescribes a number of laboratory and instrumental examinations which will allow us to identify possible reason diseases, make a diagnosis and prescribe treatment. The examination includes:

collecting anamnesis from the child’s mother;
inspection;
blood analysis;
Analysis of urine;
Ultrasound abdominal cavity– assesses the size of the gland, possible compactions and inflammations in the parenchyma of the organ.

Treatment of pancreatitis in children

Pancreatitis must be treated comprehensively, including taking medications and following a diet. Treatment is aimed at restoring the functioning of the pancreas and eliminating inflammation. If the symptoms of pancreatitis are not severe, then treatment can be carried out at home. In the acute period, hospitalization of the child is recommended. The most commonly prescribed medications are enzyme preparations - Mezim, Festal, Pancreatin and others. In a hospital setting, all medications are administered intravenously or intramuscularly.

A strict diet for pancreatitis is an indispensable component therapeutic therapy. Meals for pancreatitis are fractional, the number of meals is 5 – 6 times a day. You need to exclude all spicy, fatty and salty foods from your child’s diet, as well as those that can irritate the intestinal mucosa.

All products that the child eats must be fresh, natural, high-calorie and fortified. Only proper care Taking care of your child will help significantly reduce the risk of developing diseases of the digestive system.

Reactive pancreatitis is not an independent disease. It represents a response child's body to various adverse effects in the form of inflammation of the pancreas. This condition, secondary in origin, develops in children in last years often enough. Perhaps improved diagnostics, or changes in the nutritional pattern of many children, have led to more frequent detection of this pathology.

Causes of reactive pancreatitis

Poor nutrition of a child, knowingly consuming harmful products may lead to the development of reactive pancreatitis.

The following reasons can lead to the occurrence of reactive pancreatitis:

various, often infectious, diseases with the development of an inflammatory process (tonsillitis, acute respiratory infections, and others);
inflammatory process in the digestive organs (, food poisoning, );
poor nutrition of the child (consumption of foods with preservatives, flavor enhancers, carbonated drinks, fast food, chips, etc.);
violation of the child's diet ( large gaps between meals);
the use of certain medications (Metronidazole, Furosemide, antibiotics and other drugs);
congenital pathology of the digestive system (anomaly of the excretory ducts of the pancreas, cystic fibrosis, insufficient amount of lactose);
abdominal trauma;
stressful situations.

With the development of reactive pancreatitis, a spasm of the excretory ducts of the gland occurs. The enzymes produced in it do not enter the gland, and begin to “digest” the tissue of the gland itself. The same mechanism of process development is noted when congenital pathology ducts

Stagnation of digestive juice and enzymes also occurs with rare meals during the day by the child. The swelling of the tissue of the inflamed gland that occurs with pancreatitis causes compression of the excretory ducts and further complicates the outflow of enzymes.

The development of reactive pancreatitis is possible even in the first year of a baby’s life if the rules for introducing complementary foods are violated: the introduction of foods ( meat dishes, industrial juices) ahead of schedule. Such products cause disruption of the immature pancreas.

Symptoms

The onset of the disease is usually acute. Most characteristic manifestations pancreatitis are:

Sharp pain in the upper abdomen of a constant nature. Children may point their finger at the navel area: it is simply more difficult for them to determine the location of the pain. Older children may notice a girdling nature of the pain or radiating pain to the back. The pain decreases somewhat when the child sits and bends forward. Small child reacts to painful sensations crying and worrying. Children can take a forced position in bed (lying on their stomach or left side, sometimes they pull their legs up to their stomach).
Constantly expressed.
Repeated vomiting gastric juice, which does not bring relief. In small children it may be absent.
In the first hours of illness, the temperature can rise to 37°C, in rare cases it can rise to higher numbers.
Speedy. Subsequently, alternating diarrhea and...
The tongue is dry, covered with a thick white coating.
Constant severe dryness in the mouth.
Decreased or lack of appetite.
Belching of air and bloating.
Intoxication (weakness,).

In young children, symptoms may be smoothed out and less pronounced. Even a doctor can find it difficult to make a quick diagnosis. A combination of at least one of specified symptoms With constant pain in the stomach should be a reason to urgently consult a doctor or call an ambulance. Parents' attempts to cope with the situation on their own can have disastrous consequences.

Diagnostics

The following methods are used in the diagnosis of pancreatitis:

Interview of parents and child (helps to identify irregularities in the diet, illness suffered the day before, and clarify complaints).
Examination of the child allows you to clarify the location of abdominal pain, the presence or absence of symptoms of peritoneal irritation, and identify symptoms of intoxication and other manifestations.
A clinical blood test helps detect changes characteristic of the inflammatory process: an increase in the number of leukocytes, an acceleration of ESR, a decrease in the number of lymphocytes and hemoglobin.
Coprogram (stool analysis): undigested starch, protein fibers, and an increase in the amount of fat are noted.
A biochemical blood test reveals an increase in the level of enzymes (amylase, trypsin, lipase). In is noted.
Ultrasound reveals heterogeneous tissue echogenicity.

Treatment

To relieve pain, the child is prescribed antispasmodics.

Treatment of reactive pancreatitis in children should be carried out only in a hospital setting. Mandatory appointment bed rest. Treatment includes drug therapy and dietary nutrition.

Principles drug treatment pancreatitis:

Antispasmodics (No-shpa, Spazgon, Platyfillin, Spazmalgin, Duspatalin) are used to relieve pain. The drugs not only reduce pain, but also relieve spasm of the gland ducts and thereby facilitate the outflow of digestive juice and enzymes. Thanks to this action antispasmodics the inflammatory process and destruction of gland tissue are reduced.

For the purpose of detoxification it is prescribed intravenous administration solutions (Reosorbilact, glucose 5% or 10% solution, plasma).

Protease inhibitors (Trasilol, Contrical, Gordox, Ingitril, Ingiprol, Patripin) are widely used to suppress the action of pancreatic enzymes.

As antihistamines may prescribe Tavegil, Suprastin, Claritin, etc.

Enzymatic preparations containing pancreatic enzymes are included in treatment when expanding the child’s nutrition. Most often, Pancreatin, Mezim-Forte, and Festal are used for this.

From vitamin preparations used in treatment ascorbic acid, Ascorutin, B vitamins.

There is a unique device called “Almedis”, created by Russian scientists, which can be used to treat pancreatitis. The device in the form of darkened glasses has small size(places in a case for glasses), can also be used to treat other organs.

In this unique new technology The law of resonant interaction of color, coinciding with the frequency of the color of the affected organ, is used. Every organ human body has a certain frequency and its own color. The energy of light, hitting the retina of the eye, is transmitted to the organ in need of treatment. The iris of the eye has a projection of all organs. There are 2-3 four-minute sessions per day.

The technique has received recognition at international exhibition and was awarded a silver medal for its versatility and efficiency.

Diet is of no small importance in the treatment of a child with reactive pancreatitis. For 1-2 days (as determined by the doctor), food intake is completely excluded to ensure rest for the inflamed gland. On these days, the child should only be provided with drinking alkaline, non-carbonated warm mineral water (Borjomi, Luzhanskaya, Polyana Kvasova, Essentuki, Sairme, Polyana Kupel and others). The required volume of water is determined by the doctor.

Nutrition is expanded very gradually:

From the 3rd day, the child is given unsweetened tea with white crackers and pureed porridge (oatmeal or buckwheat), boiled in water and without oil.
Starting from day 4, stale food is added to the diet. White bread, fermented milk products, jelly, dried fruit compote (without sugar), jelly.
From the 5th day they introduce vegetable puree(excluding cabbage) vegetable soup(excluding rich vegetable broth).
By the end of the week, steam omelette, meat (chicken, rabbit, veal, turkey) and lean fish– boiled or in the form steam cutlets, meatballs. Meat and fish broths are excluded. You can give cottage cheese casserole (from low-fat cottage cheese) and hard cheese (low-fat varieties).
After 2 weeks it is recommended to introduce fresh vegetables and fruits.

The child's meals should be fractional (small portions every 3-4 hours). During the first two weeks, pureed food is given.

You should limit the amount of fat (use butter, refined sunflower or olive).

It is also necessary to limit carbohydrates (honey, sugar, sweets).

It is strictly forbidden to give your child fried, fatty foods, marinades and spices, smoked foods, canned food, sausages, chocolate, baked goods, ice cream!!! It is not recommended to eat cabbage and legumes.

The volume of portions and expansion of the diet should be agreed with your doctor.

Prevention

In the first days of illness, the child is forbidden to eat. You can drink warm, non-carbonated alkaline mineral water.

To prevent the development of reactive pancreatitis and its relapses, parents should:

exclude harmful foods from the child’s diet;
ensure compliance with the diet;
timely and correct treatment acute infections The child has;
do not self-medicate, that is, exclude the unreasonable use of medications;
After suffering from reactive pancreatitis, it is necessary to follow diet No. 5 ("pancreatic") for at least a year.

Childhood pancreatitis usually resolves quickly, without long-term damage to the pancreas. It is important to recognize symptoms early to reduce the risk of complications. Child on a short time may need treatment or dietary changes.

Pancreatitis is an inflammatory disease of the pancreas. The pancreas is an organ that is part of the digestive system and is anatomically located just behind the stomach.

This organ produces the hormones insulin and glucagon, which regulate the amount of sugar in the body.

But the pancreas also plays a decisive role in digestion. It produces essential enzymes that help break down the food we eat.

If the pancreas is healthy, the enzymes do not become active until they reach the duodenum. But when the gland becomes inflamed, enzymes are activated to early stage, are still in the organ itself, and aggressively affect the internal structures.

The pancreatic tissue that produces enzymes becomes damaged and stops producing new enzymes. Over time, this tissue damage can become chronic.

Causes of pancreatitis in children:

cholelithiasis. Between 10% and 30% of children with pancreatitis may suffer from gallstones. Treatment for this condition can help restore normal work pancreas;
polyorganic diseases. Twenty percent of cases of acute pancreatitis are caused by conditions affecting multiple organs or organ systems, such as sepsis, hemolytic uremic syndrome, or systemic lupus erythematosus;
metabolic diseases. Metabolic disorders may be the cause of 2 - 7% of cases of acute pancreatitis. This is a metabolic disorder in children with high level lipids or calcium in the blood:
infections. Acute pancreatitis is sometimes diagnosed when a child suffers from an infection. However, it is difficult to establish a direct connection between these two conditions. Some of the infectious diseases that have been associated with pancreatitis include parotitis, rubella, cytomegalovirus infection, human immunodeficiency virus, adenovirus and Coxsackievirus group B;
anatomical abnormalities. Disturbances in the structure of the pancreas or biliary tract can lead to pancreatitis;
Pancreatitis can be triggered by medications. It is believed that medicines cause one quarter of cases of pancreatitis. It is not entirely clear why some drugs can cause pancreatitis. One factor is that children treated with these drugs have additional disorders or conditions that predispose them to pancreatitis;
Pancreatitis is sometimes caused by injury. Trauma to the pancreas can cause acute pancreatitis. Mechanical damage may occur in a car accident, during sports, falls, or due to ill-treatment with kids;
Pancreatitis is hereditary, meaning it was passed down by one or both parents. It is associated with cystic fibrosis, genetic mutation, which is detected in the child, but not in the parents;
finally exists a large number of cases of pancreatitis where the cause is unknown. This is called idiopathic pancreatitis.

Forms of pancreatitis

Acute pancreatitis

The acute form of pancreatitis is a severe inflammation that lasts for a short period of time. The course of the disease ranges from mild discomfort to severe, life-threatening illness. Most children with an acute form of the disease recover completely after receiving proper therapy. IN severe cases the acute form leads to bleeding in the organ, serious tissue damage, infection and the formation of cysts. Severe pancreatitis causes damage to other vital organs (heart, lungs, kidneys).

IN in rare cases Repeated attacks of acute pancreatitis will lead to a chronic course of the disease, which over time will cause permanent damage to the pancreas.

Acute pancreatitis in children usually goes away quickly, within a week. But it is important to recognize the symptoms in advance and consult a specialist to reduce the risk of complications.

The most common symptom of acute pancreatitis is intense pain V upper section belly. This pain is usually much more severe than typical colic. It can be constant, spasmodic in nature, worsening after eating. At the same time, it is difficult for the child to remain in an upright position.

Other signs of pancreatitis in children:

Symptoms of pancreatitis are nonspecific and can easily be confused with signs of another pathology. They vary depending on the age and level of development of the child. For example, babies who cannot speak will cry a lot.

Diagnostics

Making a diagnosis is often a challenge. Sometimes pancreatitis is misdiagnosed as constipation or irritable bowel syndrome.

To make a diagnosis, the doctor will conduct a thorough clinical examination and study the child’s medical history.

a blood test to find out how the pancreas is working;
ultrasonography;
computed tomography to check for signs of damage to the pancreas;
MRI (magnetic resonance imaging) to check for abnormalities in the development of the pancreas;
endoscopic retrograde cholangiopancreatography to study small intestine, pancreatic duct and other parts of the gastrointestinal tract;
genetic tests to look for a possible hereditary cause.

Treatment of pancreatitis in children is supportive care. There is no single cure or treatment that will help the pancreas recover. Children suffering from abdominal pain may be given a pain reliever. Nausea and vomiting are treated with antiemetic drugs.

If a child cannot eat because he has pain, nausea or vomiting, he is not fed, but given fluid through a vein to prevent dehydration.

The baby can start eating when he feels hungry and is ready to eat. The nutrition plan offers a specific diet from initial diets, ranging from clear nutrient broths to regular products nutrition.

The choice depends on the severity of the child’s condition and the preference of the attending physician. The baby usually recovers wellness in the first day or two after an attack of acute pancreatitis.

Sometimes symptoms are more severe or persist for a longer period of time. In this case, the child will be given feeding through a tube to prevent digestive upset and improve the body's recovery.

Chronic pancreatitis

Chronic pancreatitis in children is also an inflammation of the pancreas. Only instead of the damage that goes away over time with acute pancreatitis, inflammation in some more susceptible children continues and causes permanent disturbances in the structure and function of the pancreas. Genetic and environmental factors may be responsible for susceptibility to pancreatitis.

The disease condition persists for a long time and slowly destroys the structures of the pancreas. For example, she may lose the ability to produce insulin. As a result, the child develops glucose intolerance. Chronic pancreatitis also leads to weight loss due to poor digestion.

Chronic pancreatitis in children is rare. The diagnosis can be made in a child of any age, but is more common after 10 years.

children usually experience signs and symptoms identical to those caused by acute pancreatitis. This is a piercing pain in the abdomen, worse after eating, the episodes of which will be repeated again and again;
Another common symptom is weight loss. Part of the reason is that the child is unable to eat. In some cases, children avoid food because it makes painful symptoms worse. Sometimes pancreatitis can cause a decrease in appetite, which leads to weight loss.

Other symptoms of chronic disease include:

nausea;
vomiting (vomit may be yellowish, greenish or brownish due to bile);
diarrhea and fatty stools;
food digestion disorders;
yellow skin color;
There is pain in the back or left shoulder.

Diagnostics

Laboratory diagnosis of chronic pancreatitis for a child is similar to acute pancreatitis. The diagnosis of chronic pancreatitis requires a search for irreparable damage to the pancreas, loss of digestive function, or diabetes. Damage is assessed using radiographic studies (CT or MRI scans of the pancreas) and special endoscopic procedures.

Treatment of chronic pancreatitis

Pediatric pancreatitis can be treated in three ways:

Drug therapy

Painkillers.
Preparations based on digestive enzymes (if enzyme levels are too low) for normal digestion of food.
Fat-soluble vitamins A, D, E and K, since difficulty absorbing fat also impedes the body's ability to absorb these vitamins, which play a critical role in maintaining health.
Insulin (if diabetes develops).
Steroids if the child has pancreatitis of autoimmune origin, which occurs when immune cells attack their own pancreas.

In some cases, an endoscope is used to reduce pain and get rid of mechanical obstructions. An endoscope is a long, flexible tube that your doctor inserts through your mouth.

This allows the doctor to remove stones in the pancreatic ducts, place small tubes (stents) to strengthen their walls, improve the flow of bile, or neutralize leaks of digestive juices.

Surgery. Most children do not need surgery. However, if a child has severe pain that is not responsive to medication, removing a portion of the pancreas sometimes helps. Surgery is also used to unblock the pancreatic canal or widen it if it is very narrow.

Not all children who experience acute attacks pancreatitis, its chronic form develops.

There is no clear evidence that special baby food at chronic pancreatitis. However, many doctors prescribe a low-fat diet and recommend that patients eat smaller meals more frequently, with less than 10 grams of fat.

Chronic pancreatitis cannot be cured; it is a lifelong condition, with symptoms periodically appearing and then disappearing. Children should be seen regularly by a doctor to assess their condition, ensure adequate nutrition, and discuss treatment options. He will regularly conduct endocrine studies to identify any problems related to glucose tolerance or the development of diabetes.

In children with chronic course illnesses increased risk occurrence of pancreatic cancer. The degree of danger depends on the underlying cause of pancreatitis, family history, and type of genetic involvement.

Reactive pancreatitis in children

Reactive pancreatitis in a child is slightly different from other forms of the disease.

Reactive pancreatitis in children is not an independent disease. This is the child’s body’s response to various adverse effects in the form of inflammation of the pancreas.

Causes of this form of the disease:

Ordinary children's infectious diseases(ARVI, sore throat, etc.).
Pathology of the digestive organs.
Abdominal injury.
The use of potent antibiotics.
Poisoning with chemical toxins.
Irregular meals.
Products Bad quality and various kinds of “snacks” that are unhealthy for children.
Introduction to complementary feeding infant products that are not suitable for age (sour juice, meat).

The difference between reactive pancreatitis and the acute form of the disease:

The cause of reactive pancreatitis is diseases of other organs, and acute pancreatitis occurs due to the direct toxic and damaging effects of various conditions.
Reactive pancreatitis, if left untreated, becomes acute, but acute pancreatitis will not turn into reactive pancreatitis.
If the underlying disease is excluded, reactive pancreatitis can be effectively treated.
When determining the symptoms of reactive pancreatitis, the symptoms of the underlying disease come to the fore, and then the signs of pancreatitis. In acute pancreatitis, the main symptoms are signs of pancreatic dysfunction.
When diagnosing reactive pancreatitis, along with establishing symptoms of pancreatitis, symptoms of disease in other organs are detected. But in the acute form – not necessarily.

Similarities:

Diagnosis occurs using the same research methods.
The treatment prescribed is the same as for the acute form of the disease.
Prevention methods are often the same.

Signs of a reactive form of inflammation of the gland can be divided into two groups: clinical manifestations the underlying cause of the disease and signs of pancreatic inflammation itself.

For example, if reactive pancreatitis is provoked intestinal infection, there is often a high temperature and loose stool several times a day.

The onset is usually acute.

Strong pain in a stomach. The baby will probably curl into the fetal position to relieve the pain. After the first 2 days, the pain usually gets worse.

Other signs include:

constant vomiting, worsening after the first 2 days;
lack of appetite;
jaundice (yellow discoloration of the skin);
high temperature;
pain in the back and left shoulder.

Long-term signs include dehydration and low blood pressure.

In young children, the symptoms are smoothed out and not very pronounced. The combination of one of these signs with persistent abdominal pain is the cause immediate appeal to a specialist. Parents' independent attempts to cope with the situation will lead to dire consequences.

Diagnostics:

When a doctor suspects reactive pancreatitis, the first step is to do blood tests (amylase and lipase tests) to find out if pancreatic enzymes are at normal levels.
If they are too high, the doctor will order an ultrasound of the abdominal cavity to identify possible signs inflammation, blockages or stones in the pancreatic duct.
Sometimes your doctor will recommend a CT scan of your abdomen to confirm the diagnosis of pancreatitis.

Treatment

Treatment of reactive pancreatitis in children should only be carried out in a hospital. Bed rest is required.

Treatment of the reactive form consists of three parts - diet therapy, treatment of the underlying disease, treatment of pancreatitis. Without them, complete recovery of the pancreas is impossible.

Diet for reactive pancreatitis in children has great importance for treatment. For 1 - 2 days (at the discretion of the doctor), food is completely excluded in order to provide relief for the inflamed organ. At this time, the child should only be provided with drink. The required amount of water is determined by the doctor.

The menu is expanding very slowly. The caloric content of food should be small (small portions every 3 - 4 hours). For the first two weeks, the food is pureed.

It is necessary to follow a diet low in fat. Use fats and oils sparingly;
exclude fried foods;
You can bake, boil, steam food;
include fruits and vegetables;
eat often, in small portions.

Products that must be excluded:

fried food;
semi-finished meat products;
egg yolk;
fatty red meat;
cow's milk;
butter;
sour cream;
margarine;
ice cream;
refried beans;
peanuts and peanut butter;
nuts and seeds;
corn or potato chips;
baked goods from biscuit and shortbread dough (muffins, cookies);
salad dressing (mayonnaise, vegetable oil);
salo.

What can you eat?

IN children's diet should be included following products and dishes:

The diet menu for children with pancreatitis should contain foods that have digestive enzymes. For example, pineapples, papaya.

Example menu

Breakfast:

two egg whites with spinach;
one slice of whole wheat toast;

Lunch:

apple;
herbal tea.

Dinner:

rice, red or black beans;
one flatbread;
100 g chicken breast meat;
water or juice.

Afternoon snack:

crackers made from low grade flour;
banana;
water.

Dinner:

shrimp pasta;
small portion green salad(without oil) with low-fat sauce or balsamic vinegar;
juice or water.

After dinner snack:

low-fat Greek yogurt with blueberries and honey;
water or herbal tea.

Talk to your child's doctor and nutritionist about your child's diet. If you have diabetes, celiac disease, lactose intolerance or other health problems, dietary changes are required.