Pancreatitis

The pancreas is an organ behind the stomach. It makes hormones and enzymes to help the body digest food.

Usually these enzymes flow from the pancreas to the intestines. But if they leak into the pancreas, they can irritate it and cause pain and swelling. This is called pancreatitis.

Pancreatitis often happens suddenly (acute). It lasts a short time. Most children have one attack and get better.

Sometimes a child gets pancreatitis more than once (acute recurrent). Or it turns into a long-term (chronic) condition. These problems are rare in children.

The main symptom of sudden (acute) pancreatitis is sudden moderate to severe pain in the upper area of the belly (abdomen). Pain may also spread to your back.

Sometimes the pain is mild. But the pain may feel as though it bores through the belly to the back. Sitting up or leaning forward sometimes eases the pain. Other symptoms of an attack of pancreatitis are:

• Nausea and vomiting.
• Fever.
• Fast heart rate.
• Sweating.
• Yellowing of the skin or the whites of the eyes (jaundice).
• Shock.

Long-term (chronic) pancreatitis also causes pain in the upper belly.

Other conditions that have similar symptoms include bowel obstruction, appendicitis, cholecystitis, peptic ulcer disease, and diverticulitis.

Your doctor will do a physical exam. The doctor will ask questions about your symptoms and your past health. You may also have blood tests. These tests check to see if your levels of pancreatic enzymes are higher than normal. Very high levels can mean you have pancreatitis.

Your doctor may also do a complete blood count (CBC) blood test, a liver test, or a stool test.

Other tests include a CT scan or an ultrasound of your belly to look for problems like inflammation or gallstones. Sometimes a special MRI test called magnetic resonance cholangiopancreatography (MRCP) is used. It looks for signs of blocked ducts that can cause pancreatitis.

A test called ERCP may help your doctor find the cause of chronic pancreatitis. ERCP stands for endoscopic retrograde cholangiopancreatogram. During this test, the doctor can find and remove stones that are blocking the bile duct or the pancreatic duct, or both.

Treatment includes taking care of symptoms and supporting your child's body while the pancreas heals. This care may happen at a hospital.

Your child may get medicine to ease the pain and nausea. Fluids may be given through a vein (I.V.). Your child can start eating as soon as they feel ready. For severe cases, your child may be fed through a feeding tube or an I.V. until they can eat by mouth.

If gallstones are causing the problem, the doctor may do a procedure to remove the stones.

Children with chronic pancreatitis might need to eat a low-fat diet and take enzyme pills. They may use pain medicine. In rare cases, surgery is needed if medicine doesn't help ease the pain.

• Drink clear liquids and eat bland foods until you feel better. Bland foods include rice, dry toast, and crackers. They also include bananas and applesauce.
• Eat a low-fat diet until your doctor says your pancreas is healed.
• If you drink alcohol, quit or cut back as much as you can. It's safest not to use it at all. Tell your doctor if you need help to quit. Counseling, support groups, and sometimes medicines can help.
• Be safe with medicines. Read and follow all instructions on the label.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
• Get extra rest until you feel better.

To prevent future problems with your pancreas

• Avoid or limit alcohol.
• Tell your doctors and pharmacist that you've had pancreatitis. They can help you avoid medicines that may cause this problem again.