It’s a familiar scene: Your child wakes up in the middle of the night feeling feverish, nauseated, and experiencing a stomach pains. Then come the tears, the vomiting, and the inability to keep fluids down. Normally, these symptoms amount to absolutely nothing more than a 24-hour stomach bug.
But sometimes there’s a different cause. The symptoms of pancreatitis (a swelling of the pancreas) can often look like a stomach virus.
Pancreatitis generally goes away rapidly, with no irreversible damage to the pancreas. But it is very important to acknowledge the symptoms early to decrease the risk of complications. A child may need treatment or dietary changes for a short while.
Pancreatitis can be regional or scattered and is classified as severe, chronic, acquired, necrotic, or hemorrhagic. Periodically, pancreatitis is complicated by the formation of a fibrous-walled cavity filled with pancreatic enzymes, described a pseudocyst.
Pancreatitis is a swelling of the pancreas, a big gland behind the stomach that produces digestion juices, or enzymes, that help break down food in the upper part of the duodenum (small intestine). The pancreas also is accountable for producing insulin and glucagon, two hormonal agents that help control levels of blood glucose, the body’s primary energy source.
When the pancreas is working typically, the enzymes it produces do not become active until they reach the duodenum. However when the pancreas is irritated, the enzymes become activated early on (while still in the pancreas) and start attacking internal structures. Tissues within the pancreas that produce enzymes are harmed, cannot produce brand-new enzymes. Over time, this tissue damage can become long-term.
Types of Pancreatitis
Pancreatitis can be intense (long lasting for a couple of days) or chronic (repeating). Severe pancreatitis establishes all of a sudden, while chronic pancreatitis establishes gradually and keeps coming back. Though uncommon in children, chronic pancreatitis is usually inherited.
Kids typically get the intense type of the condition, which can develop idiopathically (without any known cause) or in action to a viral infection or medication. Severe pancreatitis can arise from traumatic injury to the abdomen, cystic fibrosis, or from excess fat in the blood (hyperlipidemia).
Pancreatitis or a Stomach Bug?
The main difference in between pancreatitis and a stomach infection or other digestive system illness is the severity of abdominal pain. Kids with intense pancreatitis will have severe pain in the upper abdominal area that makes it difficult for them to stand or sit upright, and they’ll most likely sit or lie in the fetal position to obtain more comfortable. After the first 2 days, the pain typically intensifies.
Other signs include:
- persistent vomiting, which increases after the first 2 days of illness
- loss of appetite
- when able to eat, failure to keep food down
- vomit that is yellowish, greenish, or brownish
- jaundice (yellow staining of the skin)
- in many cases, back pain or left shoulder pain
Short-term symptoms can consist of dehydration and low blood pressure.
If a doctor thinks pancreatitis, the first step is to carry out blood tests, like an amylase test or lipase test, to see whether the enzymes made by the pancreas are at typical working levels. If they are elevated, the doctor may order an abdominal ultrasound to look for inflammation, blockages, or stones in the pancreatic duct that leads to the first part of the duodenum, and other abnormalities.
In some cases, the doctor may buy an abdominal computed tomography scan (CT) scan, which uses X-rays and computer system technology to produce detailed pictures of the body’s internal organs, to help verify a diagnosis of pancreatitis.
During the initial see, the doctor may ask you to describe the color and kind of your child’s vomit. If it includes a great deal of bile (greenish digestion juices from the liver), the doctor may wish to more examine your child for pancreas or liver issues.
In most cases, pancreatitis improves on its own. Sometimes, the doctor will suggest putting your child on a low-fat diet with lots of fluids. This is less likely to aggravate the pancreas and assists it to recover quicker.
Kids with a more severe case of pancreatitis who become dehydrated might require a short remain in the hospital. Treatment involves resting the pancreas by not eating or drinking, and receiving intravenous (IV) fluids and pain medication. Other medications might assist to minimize the quantity of acid in the body. For some kids, this suffices and they can go home after a couple of days of treatment.
Other kids might need additional treatment with special IV fluids called overall parenteral nutrition (TPN). TPN treatment bypasses the regular gastrointestinal procedure to offer the essential nutrients of salt, glucose, amino acids, lipids, and vitamins.
Another technique is the placement of a soft plastic feeding tube called a naso-jejunal (NJ) tube. This tube is directed through the nose and ends up in the small intestine, where it provides nutrition without promoting the pancreas. Local anesthesia is used for this procedure, so a child will experience only minor discomfort.
Once home, most kids are placed on a low-fat diet to help heal the pancreas, which they should follow until their enzyme levels are back to normal. A follow-up blood test will probably be done to validate typical enzyme levels.
Thankfully, most kids who establish pancreatitis overcome it rapidly– in just 4 or 5 days– with few or no complications.
In the unlikely case that a child develops a recurrence or complications such as cysts, bleeding, infection, or persistent pain, additional tests or surgery may be had to dismiss other conditions.
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