Treatment of dyspepsia in children. Functional dyspepsia in children - causes, types and treatment of indigestion. Treatment of functional dyspepsia in children

Dyspepsia in children occurs quite often due to the immaturity of the digestive tract. Probably, there are no parents who would not have a similar situation: until recently, a cheerful baby cries, complains of pain in the tummy and spits up food. These are dyspeptic disorders that are caused by indigestion. They can occur for different reasons, but they have similar symptoms and are equally dangerous if they are not treated in a timely manner.

Why is digestion disturbed in childhood? There are several pathological provoking factors.

Depending on the cause of dyspepsia, a child may have:

• alimentary;
• fermentation;
• putrid;
• fatty;
• toxic;
• parenteral.

Alimentary

Infants are more likely to be affected by this disease, and dyspeptic syndrome can be caused by:

1. Violation of the meal schedule. Too frequent feeding of newborns leads to the fact that the stomach cannot cope with digestion and excess food is eliminated by regurgitation or vomiting. Less commonly, excess food is removed with loose stools.
2. Change of milk mixture. This happens in infants on artificial or mixed feeding. Changing formula for feeding can provoke indigestion and symptoms of dyspepsia.
3. Changes in the composition of milk. Violation of the diet of a nursing mother or taking certain medications can affect the composition of breast milk and provoke digestive problems in a child.
4. Feeding inappropriate for age. The use of milk formulas for older children, untimely or too plentiful introduction of complementary foods is also the reason that dyspepsia develops in young children.

In older children, alimentary dyspeptic syndrome can be caused by a sharp change in diet or the use of low-quality products.

fermentation

This species occurs in children with a sweet tooth. An excess of carbohydrate-containing foods in the menu leads to increased reproduction of fermentative bacteria in the large intestine. The main manifestation of the disease is diarrhea with a specific odor, which is difficult to treat with the help of basic fixing drugs.

putrid

The main reason is a violation of enzymatic activity in the intestines and stomach or an excess of protein foods in the diet. At the same time, the food masses are not fully digested and putrefactive bacteria begin to intensively develop in them. Feces are liquid, with a specific putrid odor.

toxic

May occur with intestinal infections or accompany other acute infectious diseases. Pediatricians note that if timely treatment of ARVI, influenza or other respiratory diseases has not been undertaken, the child develops an intestinal syndrome with the development of general intoxication of the body.

fatty

An excess of fatty foods also has a depressing effect on the work of the digestive organs and causes stagnation of food masses in the gastrointestinal tract. For this form of the disease, a tendency to constipation is more characteristic, but diarrhea is also possible.

Parenteral

The syndrome occurs as a complication after past infections, when the balance of food microflora is disturbed against the background of taking medications.

Whatever the cause of dyspepsia, such a condition can be dangerous for the child, so a visit to the doctor is mandatory.

The main manifestations of dyspeptic syndrome

The disease always manifests itself in an acute form.

It notes:

• lethargy;
• refusal to eat or severe loss of appetite;
• change in the nature of the stool (diarrhea or constipation);
• the appearance of intestinal colic;
• bloating;
• belching or spitting up;
• vomit.

These symptoms occur regardless of the form of the disease.

1. Constipation provokes stagnation of feces, and the main symptom will be an increase in intoxication. Children become lethargic, capricious, refuse to eat, the temperature may rise.
2. During diarrhea, fluid loss and dehydration occur. Gradually, the skin loses its elasticity and becomes dry. If dehydration therapy is not carried out in a timely manner, then against the background of fluid loss, babies experience convulsions, and a decrease in reflexes is noted.

These conditions are always dangerous and require the advice of a pediatrician or pediatric infectious disease specialist. It is categorically contraindicated to eliminate the symptoms of dyspepsia in children on their own with the help of fixatives purchased at the pharmacy. Self-medication can lead to the fact that dyspeptic symptoms do not disappear completely, and the disease becomes chronic.

Self-treatment of dyspeptic disorders in children is prohibited: having identified the first sign of a gastrointestinal disorder, you should immediately seek medical help.

But for the prescribed treatment to be as effective as possible, the baby needs careful care.

A speedy recovery, in addition to taking prescribed medications, will contribute to:

1. Dieting. Children's digestive tract develops gradually, and only age-appropriate foods should be included in the menu. Treatment of alimentary dyspepsia in mild cases is carried out only by correcting nutrition.
2. Replenishment of lost fluid during vomiting and diarrhea. To do this, it is better to take pharmacy saline solutions, but you can also use slightly salted water. You need to drink fractionally, a teaspoon or a tablespoon every 10 minutes. This will help replace lost fluid and prevent vomiting.
3. Frequent loose stools irritate the delicate skin on the buttocks and perineum. To avoid irritation, after each visit to the toilet or when changing clothes, the baby is recommended to wash with warm water without soap. With heavy pollution, the use of children's bathing gels is allowed, but soap is contraindicated, it will provoke drying of the skin and flaking.
4. Stool control during treatment. If possible, then for the duration of therapy, children are allowed to use only a pot - this will help in a timely manner to detect impurities in the feces of mucus, blood, or particles of undigested food. Timely detection of deviations that have arisen helps not only to detect the developed pathology, but also to carry out timely correction of the therapy.

In childhood, dyspeptic disorders appear both in violation of the diet and due to serious diseases. Timely detection and treatment of the disease contributes to the fact that there is a complete cure, and the work of the gastrointestinal tract is normalized.

Childhood dyspepsia is an upset stomach. Dyspepsia causes the baby severe discomfort in the digestive system. Children often suffer from recurrent abdominal pain. Dyspepsia is found in 20% of children aged 7 to 12 years. Girls are more susceptible to this disease. It is not always possible to find the cause of dyspepsia, it is found only in 40% of cases, it happens that the disease appears and disappears on its own. However, this does not exclude the fact that in some babies dyspepsia can recur for years.

Depending on the cause of occurrence, the disease is divided into the following types:

1. fermentative dyspepsia in children - the cause of the occurrence is the child's excessive consumption of carbohydrates and fermented drinks. There are especially a lot of carbohydrates in potatoes, which children love so much (fries), as well as in flour products, pasta, for example.
2. putrefactive dyspepsia in children. An excess of protein in the diet provokes a putrefactive type of disease. Eating large amounts of lamb and pork meat, which is processed by the digestive system for a very long time, may well provoke the appearance of putrefactive dyspepsia. That is, the products do not have time to be digested, and a putrefactive process occurs in the body. The same is observed when eating stale meat.
3. fatty dyspepsia. Refractory and slowly digested fats in every possible way contribute to the appearance of this ailment.

Two main types of disease

There is simple and toxic dyspepsia. The difference lies in the fact that simple dyspepsia in children is when the organs of the digestive system suffer, and in the second case, the metabolism is disturbed. The toxic type is a great danger to the child, as it quickly spreads throughout the body, affecting other organs.

Most often, the cause of such a disease is non-compliance with the water-tea diet, which is prescribed for young children, or simply insufficient fluid intake by the baby. Toxic dyspepsia often affects premature babies, children suffering from rickets, dystrophy.

Variants of functional dyspepsia in children

Like any other disease, functional dyspepsia in children carries a threat to overall health. Constant relapses adversely affect the functioning of the digestive system, concomitant diseases of the gastrointestinal tract may occur, doctors call dyspepsia chronic gastritis, and this can eventually develop into an ulcer. Also, due to constant dyspepsia, the immunity of the child as a whole is weakened, since the disease exhausts the body.

There are three types of functional dyspepsia, with each of which we will introduce you.

ulcerative

It is characterized by pain in the epigastric region. As a rule, they occur after eating, especially acute after overeating. Also, the symptoms of the disease are felt after taking medications intended for the treatment of acid-dependent diseases of the digestive system.

Dyskinetic

At the same time, the child eats up very quickly, the feeling of satiety appears literally after a couple of minutes from the start of the meal. After each meal in the epigastric region, supersaturation, a sour taste is felt. Nausea and mild vomiting may also occur.

non-specific

The child shows signs of both variants of dyspepsia.

Causes

The cause of functional dyspepsia is often malnutrition. This concept is very broad, so specific provoking factors This:

• a sharp change in diet or lifestyle, as a result of which nutrition also changes;
• irregular meals, lack of breakfast, lunch or dinner;
• constant overeating;
• fast food, quick snacks, dry food;
• excessive consumption of carbohydrates or proteins, for example.

The cause of absolutely any disease may well be nerves. Frequent stressful situations can also lead to chronic gastritis, namely this:

• death of a loved one;
• frequent quarrels in the family or even divorce of parents;
• lack of friends, bad relationships in the team;
• fears;
• poor academic performance or non-compliance with the requirements of parents.

The fact is that during increased nervousness, hormones are released, and this, in turn, provokes an excessive release of hydrochloric acid hormones.

What happens to a child with functional dyspepsia

The gastrointestinal tract is undergoing major changes, namely:

This disease is easily confused with another. We provide list of symptoms that are NOT typical for functional dyspepsia:

• non-standard and inadequate behavior of the child during the next attack;
• awakening at night due to severe pain or insomnia for this reason;
• diarrhea;
• anorexia;
• pain in the joints;
• fever;
• irradiation of pain.

If your baby has any of these signs, most likely this is not functional dyspepsia, or this disease has combined with another. In any case, you should immediately go to the hospital.

Acute dyspepsia

Dyspepsia in young children often becomes acute. It appears due to the discrepancy between the volume and composition of the food consumed by the baby and the physiological capabilities of his digestive system. Signs of acute dyspepsia:

1. regurgitation;
2. diarrhea;
3. heterogeneous stool, sometimes with mucus;
4. slow growth.

The main method of struggle in case your baby has acute dyspepsia is food unloading - you need to skip 1-2 feedings, replacing food with liquid.

Diagnostics

Dyspepsia can easily be confused with many other diseases of the digestive system. Therefore, it is imperative to make a differential diagnosis, in no case should you resort to self-treatment.

In order to ascertain the presence of dyspepsia, the patient is prescribed:

• FEGDS;
• research on NR.

To understand the nature of the disease, as well as the degree of damage to the abdominal cavity, the child may also be prescribed daily monitoring of intragastric pH.

With dyspepsia in children, hypersensitivity of the stomach is often detected, this is determined using a special barostat test. In medicine, there is still a whole list of ways that allow you to learn as much as possible about the condition of the baby's stomach, but most of them are very expensive.

One of the easiest and most affordable methods is to keep a child's food diary. It's simple: you write down when the child eats, goes to the toilet in a big way, indicate the nature and time of the onset of dyspepsia symptoms, as well as all sorts of factors due to which the baby may be stressed. Such a diary should be kept for at least 2 weeks. This is the minimum period for which you can learn a lot of information about the disease.

How to cure

The first thing to understand is that treatment should be started immediately, and before that, seek help from a doctor. Perhaps herbal decoctions will not harm the child, but if they do not bring benefits, then it will simply be wasted time, during which the disease will have time to develop.

diet

Since the problems relate to the digestive system, we start with the nutrition of the child. As a rule, malnutrition is the result of an unhealthy lifestyle. When a baby has low activity, he rarely wants to eat, the whole body suffers from this. The ideal option for a children's diet is to eat food in small portions throughout the day, that is, the famous separate meals. We completely exclude allergic foods from the diet, that is, those after the use of which in large quantities the child has an allergic reaction.

Just fine if the baby does not eat fatty and fried foods, smoked meats, soda, sweets. It is quite difficult to restrict a child in anything, so such products are allowed, but in a minimal amount. Often, these changes in diet help to get rid of the symptoms of functional dyspepsia.

Medicines

Few diseases go away without medical treatment. In this disease, drugs are prescribed in accordance with the option.

For ulcerative dyspepsia recommend H2 blockers or proton pump inhibitors. This treatment lasts one and a half to two weeks.

Dyskinetic variant requires prokinetics, namely, requires motilium. 1 mg of the substance is calculated per 1 kg of the child's weight. Sometimes the doctor prescribes metoclopromide, which must be taken half an hour before meals. But the latter often provokes side effects. Medicines of this type are given to be taken within 14-20 days, depending on the prescription.

Non-specific variant medications are not treated. Most often, such dyspepsia can be eliminated by a simple dietary adjustment. If this does not help, then the problem lies in the psychological state of the child. So you should contact a psychotherapist, in a few sessions a good specialist will save your baby from discomfort in the stomach.

ethnoscience

You can not discount the traditional methods of treatment. But if you are already an adherent of traditional ways of getting rid of diseases, first consult a doctor. Yes, you have met these words a million times, but we are talking about a baby whose health should be carefully protected from the rash actions of parents.

Prevention

Any disease is easier to prevent than to cure. In order for your child not to know all the "charms" of functional dyspepsia, you should follow simple rules:

• balanced and rational nutrition;
• if you are a nursing mother, you need to carefully monitor your diet plus feeding hygiene is required;
• the child should not overeat;
• it is necessary to treat various diseases of the digestive system in time;
• eliminate as much as possible the amount of stress in the child's life;
• Give your baby a normal amount of time to rest.

Dyspepsia is not so scary if detected and treated in time. The child must eat right, because in addition to this disease, there is a whole list of ailments that can appear in a baby whose diet is based on hamburgers.

Dyspepsia in children is a disorder in the digestive system that is not infectious in nature, which leads to impaired digestion and absorption of nutrients. This is a kind of discrepancy between the child's digestive capabilities and the nutritional loads that are placed on him. With irrational feeding, nutritional errors, the introduction of products not according to age, there are disorders in the work of digestion, disruption of enzymatic systems, changes in metabolism and disruption of growth processes, assimilation of nutrition, which will provoke the development of certain childhood diseases (rickets, anemia), mental retardation. -physical processes of development.

Usually, dyspepsia is detected in children under 2-3 years of age, when digestion is most vulnerable to external factors and the requirements for the quality and quantity of products introduced are especially high.

The main reasons for the formation of dyspepsia include food that is not suitable for children to eat - these are fatty, indigestible foods (lamb, mushrooms, fatty pork, lard, sausages), a sharp change in diet, taking allergenic foods, eating without a schedule, dry food, severe overeating . Exotic products, the intake of incompatible products can become causes of dyspepsia. Also, the reasons for children after a year can be psychological factors - conflicts in the family, showdown at the table, punishment for food, corporal punishment.

All this leads to disturbances in the production of enzymes, inhibition of the activity of secretion of juices by the stomach and intestines, food is inadequately processed by enzymes, cannot be completely broken down and enters the large intestine partially digested. There, with the help of microbes, it undergoes fermentation or decay processes, depending on the predominance of certain components. With an excess of sweets and carbohydrates in the diet, fermentation processes can occur with the formation of gases and acids that irritate the intestines. With an excess of proteins, they rot with the formation of intermediate toxic compounds.

Symptoms

Dyspepsia can be distinguished in two forms - simple, in which digestion is only affected, and toxic, with deeper metabolic disorders. Usually, toxic varieties occur as a background in various infectious or somatic diseases (colds, otitis media, pyelonephritis). A simple form with the wrong tactics can turn into a toxic one. This occurs as a result of the accumulation of undigested, intermediate products of metabolism and their absorption from the intestines into the blood.

According to the type of indigestion, fermentation processes, steatorrhea or putrefactive disorder can also be distinguished. In the first form, an excess of sweet food and carbohydrates leads to its breakdown by microbes with bloating and diarrhea, with steatorrhea, an excess of fat leads to the release of portions of bile into the intestines, giving diarrhea, with a putrefactive process, an excess of proteins causes them to rot inside the intestines and poisoning with metabolic products with diarrhea and toxic vomit. All this happens because enzymes are temporarily not enough for the full digestion of all food components.

The main symptoms of dyspepsia in children will be abdominal pain, usually localized in the navel or lower abdomen, they are often accompanied by audible transfusions, seething, bloating. The child can quickly become satiated with a small amount of food, there may be a decrease in appetite, nausea with vomiting, especially when overeating. Often there is yellow diarrhea with pieces of undigested food, mucus, lumps, stools become more frequent up to 5 or more times a day. Also characteristic are eructations, fetid gases, a change in taste sensations. Usually there is no temperature with diarrhea, intoxication and severe condition, although frequent diarrhea can lead to severe thirst and dehydration. Prolonged presence of dyspepsia can lead to weight loss and developmental delays.

Diagnosis of dyspepsia in a child

It is important to distinguish functional dyspepsia from acute intestinal infections, they do not have pathogens (microbes and viruses), they are not sown in the feces and are not detected in blood tests. first of all, a study of the coprogram is prescribed with the determination of the digestion of food, sowing on the flora and intestinal group, blood tests with the absence of inflammatory processes. They also conduct ultrasound of the abdominal cavity and liver, pancreas, FGDS to exclude gastritis and enteritis, study of gastric secretion. Other tests may be ordered as needed.

Complications

The main complications can be the formation of chronic problems in the stomach and intestines - gastritis, duodenitis. One of the dangerous complications in acute dyspepsia with diarrhea and vomiting can be dehydration. It can lead to serious metabolic disorders.

Treatment

What can you do

The basis of the treatment of dyspepsia is a strict diet with the introduction of products only by age. It is important to remove from the diet all irritating, fatty, spicy foods, foods with an abundance of food chemicals, limit the consumption of sweets, plan the child's menu based on age recommendations. It is also necessary to accustom the baby to a diet, without snacks and dry food, the transition to a healthy diet.

What does a doctor do

With exacerbation of dyspepsia, a water-tea pause is shown, unloading digestion with the introduction of liquid (glucose and saline liquids) to make up for its losses with diarrhea and vomiting. As the condition improves, enzyme preparations are used to improve the digestion of food, sorbents to bind intermediate toxic substances, and preparations to correct the microbial flora. Antibiotics and intestinal antiseptics are not indicated for such dyspepsia.

In severe cases, with toxic forms, hospitalization and therapeutic measures of a similar plan, with the addition of antibiotics, may be indicated. As the child improves, he stays on a diet for a long time with a gradual expansion of the diet to the usual one. Enzymes can be prescribed for a long time with their gradual and smooth cancellation.

Prevention

The basis for the prevention of dyspepsia is the correct rational nutrition of the child, a complete diet in accordance with age norms, proper cooking, compliance with its qualitative and quantitative composition, based on age. It is necessary to refuse fast foods, a fatty, poorly digestible set of foods in the nutrition of children.

Acute indigestion in infants is a fairly common pathology, which rightfully takes second place after acute respiratory diseases. The high prevalence of acute digestive disorders in children of the first year of life is due to the anatomical and physiological characteristics of the digestive canal.

At the VIII All-Union Congress of Pediatricians in 1962, the classification of gastrointestinal diseases proposed by G.N. Speransky. According to this classification, there are: 1) diseases of functional origin: a) dyspepsia (simple, toxic (intestinal toxicosis), parenteral); b) dyskinesia and dysfunction (pylorospasm, atony of various parts of the alimentary canal, spastic constipation); 2) diseases of infectious origin (bacterial dysentery, amoebic dysentery, salmonellosis, intestinal infection, intestinal form of staphylococcal, enterococcal, mycotic infections, viral diarrhea, intestinal infection of unknown etiology); 3) malformations of the digestive tract (pyloric stenosis, megaduodenum, megacolon, atresia (esophagus, intestines, anus), diverticulum, other malformations of the digestive canal).

SIMPLE DYSPEPSIA is an acute indigestion of a functional nature, characterized by vomiting, diarrhea without significant disturbance of the general condition.

ETIOLOGY. In etiology, the leading factors are the alimentary factor, care defects (overheating, violation of the feeding regimen), as well as the infectious factor (most often E. coli). Predisposing factors are: early artificial and mixed feeding, rickets, exudative catarrhal diathesis, malnutrition, prematurity.

PATHOGENESIS. When overfeeding or feeding food that is not appropriate for age due to insufficient enzymatic activity and low acidity of gastric juice in young children, the food is not processed enough in the stomach, which causes an overstrain of the stomach function. Insufficiently prepared food enters the small intestine. The normal course of digestion is disturbed. Since the intestines have an alkaline environment, bacteria begin to multiply intensively in the food bolus, and the pathogenic properties of the constant intestinal microflora increase.

Bacterial breakdown by putrefaction and fermentation in the intestine promotes the formation of toxic products (indole, skatole, acetic acid) and gases (Fig. 8).

Irritation of the receptors of the mucous membrane of the stomach and intestines with toxic products leads to the appearance of protective reactions in the form of regurgitation, vomiting, increased intestinal motility, increased secretion of mucus by the intestinal glands and diarrhea. Fatty acids, which were formed as a result of improper breakdown of fat in the intestines, are neutralized by the intake of calcium, magnesium, sodium, and potassium salts from the intercellular fluid and tissues of the body. These salts react with fatty acids to form fatty acid soaps.

CLINICAL MANIFESTATIONS. The disease begins acutely. Appetite decreases, lethargy appears, sleep is disturbed. The main symptoms are single or double vomiting and loose green stools with mucus and white lumps. Chair 5-8 times a day. The stools have a sour smell. Green stool is due to the accelerated transition of hydrobilirubin to biliverdin in an acidic environment, and white lumps are soaps formed as a result of the neutralization of fatty acids with calcium, magnesium, sodium, and potassium salts.

In addition, periodically the child has intestinal colic due to gases accumulated in the intestines, after which the child calms down. Body temperature is often normal, but sometimes subfebrile can be observed.

When viewed outside an attack of intestinal colic, the child's condition is relatively satisfactory. There is some pallor of the skin, coated tongue, sometimes thrush on the oral mucosa. The abdomen is swollen, rumbling on palpation, diaper rash in the anus (feces are acidic, which causes skin irritation).

The diagnosis is not difficult. Correctly collected anamnesis (violation of the diet, overfeeding, overheating, etc.), epidemiological history (lack of contact with patients with diarrhea), as well as the clinical picture, make it possible to correctly diagnose. But it is necessary to differentiate with such diseases as dysentery, intussusception, appendicitis. Therefore, first of all, it is necessary to exclude those diseases that require urgent surgical care.

TREATMENT. Includes bowel lavage, the appointment of a water-tea diet for 6-8 hours (using rehydron, oralit, saline sodium chloride solution, 2% glucose solution, boiled water, tea in the amount of 150 ml per 1 kg of body weight per day), diet therapy.

Usually on the 1st day, 70-80 ml of women's milk is prescribed while maintaining the feeding regimen or applied to the breast for 3-4 minutes (usually a child sucks out 20 ml in 1 minute). In the absence of women's milk, adapted sour-milk mixtures or kefir are used in a 2: 1 dilution with rice water. Every day the amount increases, and by the 5th day the volume of food should reach the volume that the child consumed before the illness. From the 6th day from the onset of the disease, complementary foods can be introduced if the child received it, but introduced gradually. Grated apple and juices are prescribed from the 6-7th day.

For oral rehydration in acute digestive disorders in infants, the Austrian company "HIPP" produces a medicinal product - carrot-rice broth "HIPP ORS 200". The main ingredients of this product are carrot, rice, glucose, salt, sodium citrate, potassium citrate, citric acid. Carrot-rice water "HIPP ORS 200" is a homogenized, sterile, ready-to-eat food. 100 ml of the product contains 0.3 g of protein; 0.1 g fat; 4.2 g carbohydrates; 120 mg sodium; 98 mg potassium; 145 mg chloride; 135 mg citrate; energy value - 19 kcal / 100 ml; osmolarity - 240 mOsm / l.

The pectin substances contained in HIPP ORS 200 have the ability to adsorb microbial toxins, gases, products of incomplete hydrolysis and fermentation of nutrients. Rice mucus and starch, due to the enveloping action, contribute to the regeneration of the intestinal mucosa and the restoration of digestion processes.

The recommended amount of "HIPP ORS 200" with a mild degree of dehydration is 35-50 ml per 1 kg of the child's body weight per day, with an average degree - 50-100 ml per 1 kg per day. Repeated vomiting in infants is not a contraindication for the use of HIPP ORS 200 therapeutic nutrition. A prerequisite for the use of "HIPP ORS 200" for vomiting is its use in small amounts at short intervals, for example, every 10 minutes, 1-2 teaspoons of "HIPP ORS 200".

Be sure to use enzyme therapy. Usually hydrochloric acid with pepsin is used. Creon (pancreatin with minimal activity of lipase, amylase and proteases) has a good therapeutic effect, which ensures the digestion of food ingredients, facilitates their absorption, stimulates the release of the digestive tract's own enzymes, improves its functional state and normalizes digestion processes. The drug is prescribed 1 capsule 3-4 times a day with meals with a small amount of water. You can mix the contents of the capsule with a small amount of applesauce, drink juice or warm tea. With insufficient effectiveness, you can increase the daily dose to 6-12 capsules.

It is recommended to prescribe likrease. Newborns are prescribed 1 - 2 capsules per day (maximum dose - 4 capsules per day). Capsules can be previously opened and diluted in milk. Children under 5 years old are prescribed 2-4 capsules per day, from 5 to 10 years old - 4-6 capsules, over 10 years old - 6-8 capsules per day.

You can also use festal, mezim forte, pancreatin, digestal and other enzyme preparations, but since their children's forms are absent, the dosage of drugs should be approached carefully.

Antibacterial drugs are prescribed only if an infectious etiology is suspected or confirmed: furazolidone (10 mg / kg per day 4 times a day after meals), polymyxin (100,000 IU / kg per day 4 times a day).

Symptomatic treatment includes, with severe flatulence, the removal of gases through a gas outlet tube, the appointment of white clay (0.25 g 3 times a day), carbolen (0.25 g 3 times a day), smecta (1 sachet per day in 50 ml of boiled water, give during the day). With intestinal colic, a compress is used on the stomach, therapeutic enemas with valerian (1 drop of valerian for a month of a child's life), a 1% solution of bromine with valerian is prescribed. Subsequently, eubiotics are indicated to restore normal intestinal microflora.

Intestinal dysbacteriosis

With intestinal dysbacteriosis, already from the first days of the child's arrival from the maternity hospital, under the supervision of a pediatrician, a number of symptoms are noted, which can subsequently lead to impaired health of the baby. This is an insufficient increase in body weight, growth retardation, the development of rickets and deficiency anemia. The presence of the disease may also be indicated by such symptoms as a change in the nature of the stool, alternating constipation with diarrhea, intestinal colic, flatulence, frequent regurgitation, which affects the change in behavior: the baby becomes restless. In severe cases, there is a delay in psychomotor development.

The root cause of the above symptoms is a violation of the ratio of the quantitative and qualitative composition of normal and conditionally pathogenic intestinal microflora, as well as the addition of pathogenic microflora, which determines the so-called intestinal dysbacteriosis.

The intestines of the child are populated by natural microflora immediately from the moment of birth, and its main source is the mother. In the first hours of life, during the first breastfeeding, the intestines of the child are colonized by lacto-, bifidobacteria. The so-called bacterial ecosystem of the department and attendants of the maternity hospital, in which the newborn is in the first hours of life, is also of direct importance in the formation of the normal microflora of the intestines of the child.

There are many causal factors affecting the incorrect formation of the ratios of normal, conditionally pathogenic and pathogenic microflora. The most relevant are maternal diseases of both infectious and non-infectious nature (chronic pyelonephritis, chronic tonsillitis, diseases of the gastrointestinal tract, genitourinary system, complicated childbirth (caesarean section, fetal hypoxia), the use of antibacterial agents by a woman in the ante- and postnatal period. the formation of the intestinal microflora of the child at a later date is affected by artificial feeding with unadapted mixtures, unfavorable living conditions, exposure of the child to radioactive contamination, toxic substances, salts of heavy metals.

Unfortunately, the diagnosis of intestinal dysbacteriosis in outpatient settings in most cases relies only on clinical data. The analysis of feces for dysbacteriosis due to the high cost of enrichment media for growing microflora often becomes an unaffordable luxury for many families, especially those with an unfavorable social status. Despite this, the task of identifying the disease in time, correcting the child's nutrition, and prescribing the right treatment is before every pediatrician and is his responsibility.

For the formation of a diagnosis in the treatment of a disease, the most convenient is the classification proposed by Professor K. Ladodo in 1991 and supplemented by P. Shcherbakov in 1998, which is still used today. According to this classification, there are four degrees of dysbacteriosis.

The first degree - the latent phase, the so-called compensated dysbacteriosis, is characterized by the predominance of anaerobes over aerobes, while the level of bifidus and lactobacilli remains within the normal range. It develops in a healthy child and manifests itself only after the influence of certain negative factors, in particular, a violation of the diet or quality of nutrition. There is no bowel dysfunction.

The second degree is the starting phase. When analyzing feces for intestinal dysbacteriosis, the condition of the intestine is determined, in which the number of anaerobes is equal to or exceeds the number of aerobes, while the level of bifidus and lactobacilli is very low. In some cases, hemolyzing cocci and rods are detected.

Clinically, this phase is characterized by a decrease in appetite, a slow increase in body weight, a change in the nature of the stool: frothy stools alternate with normal ones.

The third degree is the phase of disinhibition and aggression of microbial associations. When analyzing feces for intestinal dysbacteriosis, the number of anaerobes is lower than aerobes. The processes of digestion and absorption in the intestine are disturbed, gas formation and intestinal motility increase. The general condition of the child is slightly disturbed. But at the same time, frequent regurgitation appears, body weight increases slowly or does not change. The character of the stool is frothy with an admixture of greenery and mucus. Periodically there are rashes on the face and extremities. The second and third degree of dysbacteriosis can be represented as subcompensated.

The fourth degree is the phase of associated (decompensated) dysbacteriosis. At this stage of the disease in the analysis of feces for intestinal dysbacteriosis there are no bifidobacteria and lactobacilli, there is a significant increase in opportunistic microorganisms (staphylococci, proteus, clostridia and others). Clinically stubbornly growing dyspeptic disorders, in which the child has bloating, frequent regurgitation, loss of appetite, the stool has a sharp unpleasant odor, liquid, with a green tint. At this stage of the disease, hypovitaminosis, deficiency anemia, rickets, and allergic dermatitis develop, which can subsequently lead to the formation of childhood eczema.

Treatment of dysbacteriosis At the moment, the baby food market in our country has a large assortment of such products, a feature of the therapeutic effect of which is the content in infant formulas of bifidobacteria, lactobacilli, lactulose, which are necessary for the formation of normal microflora in the intestines of the child. In the third and fourth degree of the disease, the parents of the child are not recommended to use diet therapy as an independent type of treatment. In these cases, pre- and probiotics are prescribed by the pediatrician to correct the normal intestinal microflora. Well proven prebiotics containing lactulose, which stimulates and activates digestion, has a bifidogenic factor. On the market of medicines in our country, probiotics are represented by various forms of living microorganisms, in particular, lyophilisates of bifidus and lactobacilli, colibacilli, spore-forming strains of the natural intestinal microflora (a combination of live lactic acid bacteria, a concentrate of metabolic products of symbionts of the small and large intestines), as well as specific bacteriophages ( coliproteic, staphylococcal).

The most optimal method for the treatment of dysbacteriosis today is a complex treatment, which includes not only diet therapy, but also the appointment of specific drugs that improve the motor and secretory function of the gastrointestinal tract. As additional funds, you can use decoctions of chamomile, fennel, dill water. If the treatment prescribed by the doctor is followed, spastic pains, flatulence are eliminated, along with the use of enzyme preparations, the secretory function of the pancreas improves, and stool normalizes. If treatment with probiotics is not effective enough and opportunistic microflora is isolated during repeated crops, it is necessary to use intestinal antiseptics, the peculiarity of which is the targeted effect on opportunistic microflora, while not affecting the natural intestinal microflora.

Dyspeptic disorders in humans, and even more so in children whose digestive system is at the formation stage, are not uncommon. These are disorders that, from the point of view of pathological physiology, are characterized by a violation of the functioning of the organs of the digestive tract.

The most dangerous manifestations of dyspepsia in young children, when dehydration occurs quickly and entails irreversible processes.

Changes in the functioning of the digestive system can occur at any time. The reasons for the formation of dyspepsia are both a complete transition to artificial feeding, and complementary foods with new ingredients. Dyspeptic syndrome occurs against the background of the unavailability of the enzymatic system to digest the introduced products.

Another negative factor is intestinal infections (salmonellosis, E. coli). In this case, there are severe pains in the abdomen, and this is noticeable even in very young children.

At an older age, the problem may arise against the background of overeating one or another product that is not intended for baby food (smoked meats, sugary drinks, confectionery, fried gastronomic products).

Individual genetic features of the anatomy of the gastrointestinal tract, nervous and enzymatic systems can also be the causes of the frequent occurrence of problems with the digestive processes.

Classification of pathology

No matter how experts try to classify this problem, it should be understood that this is not yet a diagnosis, but only a set of symptoms indicating a pathology.

Dyspepsia is usually divided into several varieties:

1. Alimentary dyspepsia in children. Such a disorder is associated with the consumption of new products for which the enzymatic system has not yet prepared. This species is the most common during the period of rapid transition to complementary foods.
2. toxic. It is observed with the development of opportunistic (E. coli) and pathogenic (Salmonella, Shigella) microflora, with a decrease in the resistance of the whole organism (decreased immunity). Toxic dyspepsia in young children proceeds quickly and requires urgent specialist intervention.
3. fermentation. In the intestines, microflora develops, which releases gases (fermentation process). Fermentative dyspepsia in a child occurs due to the consumption of excessively carbohydrate foods. Newborns suffer from overfilling of the ventricle and untimely removal of its contents into the intestines.
4. putrid. Appears with excessive overflow and compaction of the contents of the intestine (the so-called "blockage"). In this case, the chyme (intestinal contents) cannot exit in a timely manner and creates a favorable environment for the development of putrefactive microflora. Signs may include severe abdominal pain and foul-smelling stools.
5. organic. This is the name of the pathology with established chronic diseases of the gastrointestinal tract (ulcer, pancreatitis, cholecystitis, etc.).

Symptoms of dyspeptic phenomena in children

Simple dyspepsia in children is manifested by more frequent bowel movements, up to 4 times a day. Complaints of abdominal pain or discomfort may be absent. This phenomenon is preceded by a decrease in appetite, belching, regurgitation, lethargy. After 1-2 days, the stool becomes mushy or liquid.

Disorders in representatives of the younger group manifest themselves faster. They are characterized by the following manifestations:

• liquid stools will be observed already at 3-4 acts of defecation;
• precede the discharge of colic, the baby shakes its legs and cries, it is possible to release gases with feces;
• the nature of the feces varies from homogeneous to lumpy with impurities of mucus, flakes, blood;
• feces acquire different shades: from milky white to dark brown;
• on examination, swelling can be detected in the area below the ribs;
• listening to the abdomen easily reveals the sounds of splashing, squelching, seething.

Nausea, vomiting, frequent, indomitable or intermittent - these are the symptoms that accompany the toxic form of the pathology. Sometimes it is clearly felt that the baby is hot. Antipyretic drugs should be prescribed by a doctor after a thorough examination.

Acute pain in the abdomen may alternate with aching. Appetite is completely absent.

Dyspepsia in a young child is accompanied by the phenomena of rapid saturation, overflow of the stomach, which entails refusal to eat.

Diagnosis and treatment of dyspepsia in children

Diagnosis requires an examination by a pediatrician with anamnesis, general laboratory tests. If necessary, additional tests are carried out: ultrasound, bacteriological culture of feces, examination of feces for helminth eggs, and others.

Treatment of a mild form of dyspeptic disorder in children is carried out at home, on an outpatient basis. If you suspect intestinal infections (salmonella, etc.), hospitalization is necessary.

Revision of the diet is the basis of therapy. Check everything for freshness and good quality. Do not feed your baby foods that are not intended for baby food.

Infants immediately reduce the dose when feeding. For this, 1-2 feedings are replaced with water or a glucose-salt mixture.

Mucous decoctions are introduced into the diet of children: oatmeal, jelly. The use of fermented milk products with living microflora (bifido- and lactobacilli) also has a positive effect.

Diagnosis and treatment of dyspepsia in children is carried out only under the supervision of a qualified specialist.

Therapy may include enzymatic preparations (pancreatin), sorbents (activated carbon), antispasmodics (to relieve pain), antibiotics (to destroy putrefactive microflora).

Diet

Treatment of pathology cannot be carried out without monitoring the quality and quantity of food consumed. The frequency of receptions, the composition of the diet is determined by the doctor after an examination and an accurate diagnosis.

Exclude fried, fatty, confectionery and factory-made semi-finished products from the menu. The diet should contain natural dairy products, cereals, vegetables and fruits. Choose lean meats and fish.

The diet, as a rule, lasts longer than the treatment, and it is necessary to transfer the patient to the general table only at the direction of the doctor.

Prevention

The basis of prevention is proper nutrition and adherence to the regimen. Follow your dietitian's instructions to avoid gastrointestinal disturbances.

Frequent digestive disorders in children, especially young children, are fraught with negative consequences that will leave a mark for life.

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