Pancreatic insufficiency in children

The pancreas is an organ that produces enzymes in response to the flow of food into the duodenum. Pancreatic enzymes enter the duodenum in an inactive form and are activated by intestinal enzymes.

  • Children, especially young children quite often a so-called relative pancreatic insufficiency, when the iron itself is not damaged and disrupted its function. In this case, the enzymes can not adequately provide the physiological demand the function. this condition is often interpreted as “reactive pancreatitis”.

Causes of disorders of the pancreas in childhood may be different states, including functionality. Thus, functional disorders of the gastrointestinal tract, such as irritable bowel syndrome, functional constipation, diarrhea, and often accompanied by other relative pancreatic insufficiency.

  • The cause in these cases is a disturbance of intestinal motility, in which case the mixing is accelerated or slowed down food and enzymes, which reduces the action of enzymes during their normal secretion.

The reasons are often viral and bacterial infections. In addition dysmotility in infections is essential and getting infection beginning in the pancreas or in the case of a general infection, or a contact.

  • Accompanied by a relative iron deficiency are inflammatory diseases of the stomach and duodenal ulcers, especially accompanied by increased secretion. There is a sharp acidification in the intestine, which causes violation of the activation of pancreatic enzymes in the intestine and enzymes do not have the desired effect.

A role in a variety of children play dysfunction dyskinesia and biliary tract, resulting in impaired bile flow into the duodenum, which is accompanied by deficiency of bile acids in the intestine that activate normally pancreatic enzymes. It is worth noting that the dysfunction of the biliary tract pathology is very common in children, especially pre-school and early childhood.

  • The relative failure of the pancreas accompanied by allergic conditions, it is based on swelling and violation mikroobmena in iron, which causes decreased production of pancreatic enzymes. In this regard, in most cases, children’s allergists and pediatricians prescribe long courses at current rates of allergic conditions of the pancreas enzymes.
  • Bowel disease is often accompanied by dysbiotic disorders, sometimes with severe degree of such violations can be observed bacterial overgrowth in the small intestine. The microflora affects the deconjugation of bile acids in the upper part of the small intestine, the enterohepatic circulation of bile acids and activation of pancreatic enzymes.
  • Clinical manifestations of relative exocrine pancreatic insufficiency are diarrhea, flatulence, nausea, greasy stools, loss of appetite, general weakness, growth retardation, weight loss. diagnostic method is available scatological study of feces, which hitherto has not lost its relevance and is a method that can confirm the presence of a relative pancreatic insufficiency.

Scatological study should be conducted prior to the appointment of pancreatic enzymes. At the same time identify the following pathological signs:

  • · Steatorrhea – detection in the stool of neutral fat, fatty acids, soaps
  • · Creator – a large number of muscle fibers, which are normally very small stool
  • · Amiloreyu – the appearance of the stool plurality of starch grains, indicating a violation of carbohydrate digestion

Current relative pancreatic insufficiency may be completely asymptomatic, the symptoms of the underlying disease may come to the fore. Therapy includes, first of all, the treatment of the underlying disease: correction of motor disorders, gastric hypersecretion, correction of biliary tract dysfunction, anti-inflammatory therapy for intestinal diseases.

Itself relative pancreatic insufficiency requires the addition to the enzyme treatment. The question of the duration and dosage is determined by the state fermentoterapii severity, comorbidities in consultation with a pediatric gastroenterologist and a pediatrician.

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