Medical Management of Chronic Pancreatitis in Children
Patient Guideline Summary
- Pancreatitis is inflammation of the pancreas, a digestive organ beneath the stomach. Pancreatitis can be acute, chronic, or recurrent and mild, moderate, or severe in intensity. It is uncommon in children.
- Some of the most common causes of pancreatitis in children are genetic. Other causes include obstruction of the outflow tract, injury, infections, smoking, and alcohol consumption.
- Common symptoms of chronic disease are pain in the upper abdomen, stomach upset, and weight loss.
- Because the pancreas secretes digestive chemicals, your child may suffer several specific nutritional deficiencies as well as overall insufficient nutrition.
- This patient summary focuses on treating chronic childhood pancreatitis.
- Your child should be evaluated and followed for general as well as specific nutritional needs by a team of healthcare specialists that includes a dietitian.
- Weight, height, vitamin intake, and laboratory studies should be monitored at regular intervals of 6-18 months.
- Since the pancreas also controls blood sugar, periodic diabetes screening is also necessary.
- If diabetes is diagnosed, referral to an endocrinologist/diabetologist is recommended.
- Your child’s treatment team will monitor all elements of a complete nutritional program and make changes based on laboratory tests as well as overall growth and health.
- Deficiencies in fat-soluble vitamins (A, D, E, and K) are particularly likely.
- Pancreatic enzyme replacement therapy may be recommended.
- Your child’s pain treatment team ideally will consist of a pediatric pain physician, pediatric gastroenterologist, psychologist, nurse, and physical therapist.
- Treatment can involve:
- Cognitive Behavioral Therapy (CBT)
- Physical therapy
- A pain medication “ladder” that begins with the safest medications and adds opioids cautiously as needed.
- Throughout your experience with your child’s medical team, you will learn about living with chronic pancreatitis — things to do and not to do to enhance the quality of your child’s life.
- You and your child will be advised of certain behaviors that can worsen chronic pancreatitis, such as alcohol and tobacco use.
- Nutrition education will be a centerpiece of your education.
- CBT: Cognitive Behavioral Therapy