Dr. Durga Prasad

What Is the Pancreas?

The pancreas is a gland located in the abdomen behind the stomach. It has two major functions:

Digestive Function (Exocrine): Produces enzymes that help digest food (especially fats and proteins).
Hormonal Function (Endocrine): Produces hormones like insulin and glucagon to control blood sugar levels.

What Are Pancreatic Disorders?

Pancreatic disorders in children can affect either the digestive or hormonal functions — sometimes both. These conditions may be acute (sudden) or chronic (long-term), and may result from genetic, inflammatory, infectious, or structural causes.

Pediatric Gastroenterology

Common Pancreatic Disorders in Children

1. Acute Pancreatitis

Definition: Sudden inflammation of the pancreas.
Causes: Infections, trauma, medications, gallstones, high triglycerides.
Symptoms:
- Severe abdominal pain (often in the upper abdomen, radiating to the back)
- Nausea and vomiting
- Fever
- Swollen abdomen
Diagnosis:
- Blood tests: Elevated amylase and lipase
- Abdominal ultrasound or CT scan
Treatment:
- Hospital care with IV fluids, pain relief, and bowel rest
- Most children recover within a week

2. Chronic Pancreatitis

Definition: Ongoing inflammation that leads to permanent damage.
Causes: Genetic mutations (e.g., PRSS1, CFTR), recurrent acute pancreatitis.
Symptoms:
- Recurrent abdominal pain
- Poor weight gain
- Fatty stools (steatorrhea)
Treatment:
- Pancreatic enzyme supplements
- Pain management
- Nutritional support
- Sometimes surgery

3. Cystic Fibrosis (CF)

Definition: A genetic disorder that affects the lungs and digestive system, including the pancreas.
Symptoms related to pancreas:
- Fatty, bulky stools
- Failure to gain weight
- Vitamin deficiencies
Treatment:
- Pancreatic enzyme replacement therapy
- High-calorie, high-protein diet
- Fat-soluble vitamin supplements (A, D, E, K)

4. Congenital Pancreatic Disorders

Pancreatic agenesis: Very rare absence of pancreas
Annular pancreas: A ring of pancreatic tissue encircles the duodenum, causing blockage
Treatment: Depends on symptoms; may require surgery or enzyme therapy

5. Pancreatic Insufficiency

Definition: The pancreas does not produce enough digestive enzymes.
Causes: Cystic fibrosis, Shwachman-Diamond syndrome, chronic pancreatitis
Symptoms:
- Malnutrition
- Steatorrhea (greasy, foul-smelling stools)
- Growth failure
Treatment:
- Enzyme replacement therapy
- Nutritional and vitamin support

When to See a Doctor

Seek medical attention if your child has:

Recurrent or severe abdominal pain
Poor weight gain or growth delay
Persistent vomiting
Greasy, foul-smelling stools
Jaundice (yellowing of the skin or eyes)