Chronic Pancreatitis in Children

What symptoms would my child have?

Frequent or chronic abdominal pain is the most common symptom of pancreatitis. The pain can be constant or can come and go unpredictably. Other symptoms include nausea, vomiting, weight loss, diarrhea and oily bowel movements. Some patients have trouble digesting food and may experience poor growth, especially if they are quite young when their first episode of pancreatitis occurs. Diabetes generally takes many years to appear, but this, too, is highly variable; some patients with chronic pancreatitis will develop diabetes in adolescence.

Who gets chronic pancreatitis?

Those at risk for chronic pancreatitis are children who have genetic, metabolic or anatomic abnormalities that predispose them to having multiple episodes of acute pancreatitis. Not all patients with a genetic predisposition or anatomic abnormalities will develop chronic pancreatitis. The reason for the variability is that modifying factors act in concert with the primary predisposition to increase an individual’s risk of developing chronic pancreatitis. Examples of modifying factors include other genes or environmental variables, which is a term that scientists use to describe things that your child is exposed to in his or her daily life, or certain behaviors. Researchers are still working on achieving a better understanding of the way in which these factors interact to cause the disease.

How long does chronic pancreatitis last?

Unfortunately, chronic pancreatitis is a life-long condition, although the severity of symptoms tends to wax and wane over time.

How do you diagnose chronic pancreatitis?

The diagnosis of chronic pancreatitis requires the demonstration of irreversible damage to the pancreas, loss of digestive function or of diabetes. Currently, damage is assessed by radiographic studies such as CT or MRI scans of the pancreas, by special endoscopic procedures known as ERCP, or by endoscopic ultrasound.

Is chronic pancreatitis treatable?

If there is an anatomic abnormality, then surgery, often performed through an endoscope, can be curative. Metabolic abnormalities such as high serum calcium or serum fat (triglycerides) can also be treated.

Currently, there are no effective medical treatments for patients with a genetic predisposition. Some patients are candidates for surgery. In this procedure, the surgeon removes the pancreas and the hormone-producing cells known as ‘islets’ are isolated and returned to the patient, usually by injecting them into the liver. This surgical procedure is called ‘pancreatectomy with islet cell autotransplant.’

Many physicians will prescribe pills containing pancreatic digestive enzymes to patients who experience chronic pain.

Is there a specific diet my child should be following?

There is no clear evidence that a special diet is required for chronic pancreatitis. Still many physicians will prescribe a low-fat diet, and advise their patients to eat more frequent, smaller meals, typically with fewer than 10 grams of fat. About 20 potato chips contain 10 grams of fat, so it takes discipline to make sure to stay within this range. Patients who have lost the ability to digest food will be prescribed pills containing pancreatic enzymes to help with digestion. They may also be prescribed fat-soluble vitamins A, D, E, and K, since the difficulty absorbing fat also interferes with patients’ ability to absorb these vitamins, which are crucial for maintaining good health.

Can chronic pancreatitis give my child cancer?

If your child has chronic pancreatitis, he or she will be at an increased risk of developing pancreatic cancer compared to the general population. The degree of risk depends on the underlying cause of pancreatitis and should be discussed with your doctor.

The National Pancreas Foundation thanks the following physicians for providing this information:

Mark E. Lowe, MD, PhD
Professor of Pediatrics
Director, Pediatric Gastroenterology, Hepatology and Nutrition,
Children’s Hospital of Pittsburgh
Julia B. Greer MD MPH
Research Assistant Professor
University of Pittsburgh School of Medicine
Department of Medicine, Division of Gastroenterology, Hepatology and Nutrition
Arvind Srinath, M.D.
Pediatric Gastroenterology Fellow
Children’s Hospital of Pittsburgh