What is Alimentary Dyspepsia?
Alimentary dyspepsia – an acute digestive disorder that is diagnosed for children up to 12 months of age; develops due to nutritional defects: the rapid transition to artificial feeding, overfeeding, indiscriminate feeding, the rapid introduction of complementary foods.
Types of dyspepsia in children:
- fermentation
- putrid
- steatorrhea
- mixed
Fermentative alimentary dyspepsia in children develops from a lack of pancreatic amylase and, as a result, transient enzymopathy. Putrid alimentary dyspepsia is the result of bacterial digestion of nutrients, mainly protein. Steatorrhea is a reaction to metals such as magnesium, calcium, sodium and potassium.
Causes of Alimentary Dyspepsia
Alimentary dyspepsia in infants develops as a result of a violation of the nature, mode and quality of nutrition. Among the reasons are called long-term unbalanced nutrition, which leads to a deficiency (shortage) of ingredients necessary for the body of the baby: vitamins, proteins, fats, trace elements, etc. The considered children’s disease can be caused by an excessive nutritional load of proteins or carbohydrates, especially if there are factors that inhibit the secretory function of the digestive glands: hypothermia, overheating, etc.
Pathogenesis During Alimentary Dyspepsia
The mucous membrane of the small intestine is quickly updated, losing beneficial substances along with dying cells. The epithelium of the small intestine is updated in 2-3 days. Therefore, the intestine reacts sharply to the lack of certain substances. For the normal structure of the mucous membrane, you need a large range of nutritious foods – it increases with the age of the child.
In the pathogenesis of the important role of the exocrine function of the pancreas and bile secretion. Underdeveloped food enters the small intestine, which negatively affects the secretion of enzymes. These conditions lead to impaired motor function of the small intestine. Bacteria migrate through the intestines. The processes of fermentation and rotting begin.
Toxic products of the breakdown of food substances in large quantities are formed: skatole, indole, ammonia, hydrogen sulfide, etc. They irritate the receptors of the intestinal mucosa, affect its motility, cause diarrhea. Accelerated passage of food masses prevents normal digestion. With this disease, lime salts are formed, which “kill” bifidobacteria normally living in the microflora of a healthy intestine.
Digestive processes are disturbed even more. As a consequence, diarrhea appears, which in turn leads to impaired absorption. The mucous membrane of the small intestine becomes thinner, digestion and absorption of proteins and fats decreases. Bacteria colonize the small intestine even more. A structural reorganization of the small intestine arises – flattening of the epithelium of its mucous membrane and changes in the brush border, which are considered the most characteristic, atrophy of the villi.
Symptoms of Alimentary Dyspepsia
When a child has alimentary dyspepsia, a 1-2-time vomiting occurs, anxiety, the baby spits, meteorism occurs. Chair 6 to 8 times per day, which is not the norm.
Some researchers identify, in addition to the above types of nutritional dyspepsia, also fatty dyspepsia. Symptoms such as profuse diarrhea, polyfecalia, and the appearance of a light, “fat” fecal neutral or alkaline reaction.
The feces study (coprogram) shows many drops of neutral fat, especially fatty acid crystals and their insoluble salts – soaps. In clinical practice, there is often a mixed type of alimentary dyspepsia due to involvement in the pathological process along with the intestines of other parts of the digestive tract.
Diagnosis of Alimentary Dyspepsia
For the diagnosis of nutritional dyspepsia, anamnesis should be collected. The physician should have an idea about the nature and diet of the little patient. The doctor assesses the symptoms, conducts macro-and microscopic examination of feces. Radiography and endoscopic method are not used to diagnose the disease under consideration.
Differentiating alimentary dyspepsia from diseases that manifest the clinical symptoms of digestive disorders: chronic enteritis, atrophic gastritis, chronic pancreatitis.
Treatment of Alimentary Dyspepsia
The main treatment for alimentary dyspepsia is diet. Its goal is to eliminate the abnormal colonization of the upper intestine by bacteria and to eliminate the increased fermentation, which negatively affects the intestines of the infant. The easiest way is to deprive the baby for 6-12 hours of food, and then appoint easily digestible food.
Treatment regimen
First day
To deprive the baby of breast milk for 6-12 hours, to give him during this period only slightly candied tea with a volume of 200-300 ml. After that, give the breast 2-3 times so that the baby takes 75-100 ml of mother’s milk at a time.
Second day
Assign breast milk 4-5 times a day, at one time – the volume of 100 ml. Additionally, give sweetened tea.
From the third to the fifth day
Gradually apply the baby to the breast for more and more time until the intake of milk at a time reaches 150-175 ml. Be sure to carry out control weighing.
If there is no improvement in the stool, you can temporarily replace part of the breast milk with buttermilk or protein milk (75-100 ml per reception). Effective additive to breast milk drug plasmon – a dose of 5 to 10 grams per 24 hours.
The same principles apply to the treatment of babies who are fed artificially. 6-12 hours a child is given only tea. From the diet exclude mixtures in which a lot of fat and carbohydrates. They feed the kid with concentrated (10%) rice water in the amount of 100-150 ml per reception.
Starting from the second day, part of the rice broth is gradually replaced by half milk with broth. If the effect does not occur, they prescribe pudding: first, 3 times a day, then 5-6 times, the amount per day from 600 to 800 ml. It is unprofitable to keep a child on one buttermother for a long time, and it is necessary to gradually transfer him to mixtures that are more complete in terms of fat content.
The same effect as churning, give acidified mixture. Alimentary dyspepsia is also treated with protein milk. It is taken at the beginning 2-3 times a day, and then brought to a total volume of 800 ml per day with the addition of sugar from 2 to 8-10%. Protein milk give your baby a maximum of 3-4 weeks.
Doctors may also prescribe kefir or acidophilus milk.
Treatment regimen:
First day
Tea diet for 6-12 hours, the volume of tea with 200-300 ml. Then give concentrated rice water, 3-4 times 100-150 ml.
Second day
Give the kid a concentrated rice water of 125-150 ml 3-4 times a day and 2 times buttermilk or kefir.
Third day
The child is fed with concentrated broth 2 times a day and 3 times with buttermilk, kefir or protein milk with 2% sugar, 125 ml per reception
Fourth day
Babies are fed with buttermilk, kefir or protein milk 4-5 times a day, 125-150 ml and concentrated rice water 1-2 times in 24 hours.
Fifth day
Give the baby kefir, buttermilk or protein milk with 3% sugar 5 times a day, 150 ml. As the stool returns to normal, fat is added to the diet. It is best to add it to the buttermilk. Similarly, buttermilk No. 2 and 3, acidified with hydrochloric or lactic acid, as well as kefir and acidophilic milk act similarly to buttermilk, because they also lead to the same goal – to stop bacterial fermentation and improve the enzymatic work of the infant’s stomach. As a therapeutic agent, a mixture of milk with broth and lime water is sometimes used – all parts are mixed in equal proportions. Excellently binds water and regulates intestinal peristalsis agar-agar. Therefore, it is advised to enrich dairy mixes with agar-agar in the amount of 1%.
Diet therapy in the presence of dystrophy is carried out more carefully, especially with artificial feeding. If a child has severe dystrophy, it is first kept for some time on breast milk, and then mixtures are added. It is better in such cases not to dilute the milk with broth and water. Treatment is carried out with churn or protein milk. Ensure that the child does not have malnutrition. Gradually increase the amount of fat and carbohydrates in the diet. The weight curve improves gradually, do not wait for an instant effect. In parenteral dyspepsia, it is necessary to temporarily reduce the amount of food, eliminate fatty mixtures, prescribe acidic mixtures and continue to carry out the treatment as indicated above. Diarrhea will stop when the infectious process is suppressed.
When dyspepsia on the basis of malnutrition, the child increases the number of calories. Protein milk, lazan is added to the main diet, which affects the weight gain.
In acute dyspepsia, which is caused by overfeeding of the infant, first give 1 tsp of castor oil to remove pathological products from the intestines. If there is severe vomiting, do a gastric lavage. To soothe the pain in the abdomen, apply warming compresses on the stomach. For the discharge of gases, a special gas vent tube is sometimes used or the baby is given caring water, chamomile or mint tea, 1 teaspoon each.
To calm the child (after all, anxiety is one of the symptoms of alimentary dyspepsia), warm baths, warm wraps, valerian intake are advised. If the stool remains liquid for a long time due to irritation of the large intestine, the appointment of carbolene, aluminum oxide hydrate, tannalbin is useful.
Prevention of Alimentary Dyspepsia
Prevention of alimentary dyspepsia in children who are breastfed is achieved by simply settling the feeding, eliminating irregularities, gradual and timely training for complementary feeding, prohibiting weaning during the hot summer months.
If the baby is fed artificially, you need to monitor the correctness of sterilization of milk formulas, pay attention to the correctness of their storage in a cool place, to avoid overfeeding and one-sided feeding. During the summer heat avoid overfeeding and mixtures with a large amount of fat. In the summer, the baby is easily digestible mixture.
For the purpose of prevention, it is necessary to improve hygienic conditions, take measures against overheating of the child, air the room more often, take cold douches, and walk more often. It is necessary to strengthen the sanitary and educational work with mothers.