DISAPPEARANCE IN CHILDREN

DISPERSE IN CHILDREN is a digestive disorder that occurs as a result of a mismatch in the volume or composition of food in the physiological possibilities of the child's gastrointestinal tract. It is usually observed in children of the first year of life. Isolate a simple dyspepsia, in which only the function of the gastrointestinal tract suffers, and toxic, characterized by both dyspeptic disorders and pronounced changes in metabolism. It is also possible to develop so-called parenteral dyspepsia, which occurs against the background of a disease.

Simple dyspepsia develops as a result of infant feeding errors (overfeeding, irregular feeding, incautious introduction of new products into the diet). It is caused by the overheating of the child's organism , which can, for example, occur when the child's clothing does not correspond to the high temperature of the room. Entering the gastrointestinal tract of the child, the products are not completely digested, which leads to an intensification of fermentation processes. As a result, there is regurgitation, vomiting , and the chair becomes more frequent 6-8 times a day. Exercises have a sour smell, an admixture of greens, they show white lumps (calcareous or magnesian soaps). The child's body weight decreases, appetite worsens, bloating is noted.

Differential diagnosis of simple dyspepsia should be carried out with the so-called physiological dyspepsia, in which newborns with proper feeding, absence of regurgitation, vomiting, and a satisfactory condition are noted for frequent stools, an admixture of greens in their bowel movements, due to the transient immaturity of the gastrointestinal tract. Simple dyspepsia should be distinguished from regurgitation and vomiting, which are observed as a result of a breach of the feeding technique, however, the stool is normal, the child's condition is satisfactory, and it normally increases weight. With an increase in body temperature, a decrease in body weight, no effect of treatment, the presence of intoxication requires the sowing of stool to exclude intestinal infection.

Treatment of simple dyspepsia is usually done at home; It is primarily aimed at eliminating the cause that caused digestive disorders, and on the normalization of nutrition. Assign a water-tea diet for 6-12 hours, including weakly boiled tea, isotonic sodium chloride solution, 5% glucose solution in an amount of 150-180 ml per 1 kg of body weight per day. In the future, the age-appropriate diet is prescribed, somewhat limiting the amount of food in the first days. In the first two days after a water-tea break, the child is given half of the required amount of food, then 2/3 and so gradually increase the amount of food to the age norm. On the 5th - 6th day, they switch to the age-appropriate diet. Simultaneously with the diet appoint enzyme and vitamin preparations. With the artificial feeding of children (especially in the age of up to 6 months) it is advisable to give the child expressed breast milk during the treatment period. The prognosis with the timely begun treatment is favorable.

Toxic dyspepsia ( intestinal toxicosis ) is caused by the same reasons as simple, or it may be a consequence of simple dyspepsia when it is treated incorrectly. Toxic dyspepsia often develops in weakened children (premature, suffering from dystrophy, anemia, rickets, etc.). Absorption of toxic products formed as a result of the vital activity of microorganisms, as well as digestive disorders lead to liver damage and intoxication. Toxic dyspepsia can also develop against the background of colienteritis, dysentery, salmonellosis, etc. Vomiting and diarrhea that occur in this case lead to disruption of water-salt metabolism, acid-base state with the development of a toxic syndrome, accompanied by a violation of the functional state of various organs and systems. Symptoms of the disease develop acute, violently. The child has frequent vomiting , stool up to 10 - 15 times a day or more, body temperature rises to 38 - 39 ° C. Stools lose their stool character, become watery, splashing. There is a sharp drop in the child's body weight, dryness of the mucous membranes and skin, a decrease in the tissue turgor. Within a few hours, there are signs of impaired peripheral circulation - a weak frequent pulse , acrocyanosis, cold extremities. The heart sounds are muffled, breathing is rare, noisy and deep (like Kussmaul). With the progression of the disease, the child's anxiety is replaced by adynamics, vomiting and diarrhea increase, dehydration increases, and a "suffering" facial expression appears. With the progression of toxicosis, collapse and coma may develop.

Treatment of toxic dyspepsia is carried out only in a hospital. Feeding the baby is stopped, a water-tea diet is prescribed or rehydration therapy is performed within 24 hours (with dystrophy 6-18 hours). The liquid is administered orally, intravenously. Initially, plasma and plasma-substituting solutions are introduced, then saline solutions - sodium chloride, Ringer, 5% glucose solution. Correction of acidosis with 4% sodium hydrogen carbonate solution at the rate of 3 - 5 ml per 1 kg of body weight. After hydration therapy for one week, it is necessary to feed breast milk or acidic milk formulas. The amount of milk or mixtures in the first day should be 100-200 ml, ie 10-20 ml per feeding 10 times a day, and the missing volume is replaced with a liquid. In the following, the volume of food is increased by 100-200 ml daily. From the 3rd day of the child, you can start applying to the breast 1-2 times (taking into account his condition), and from the 4th to the 5th day you can enter other types of nutrition that the child received earlier. Assign enzymatic and vitamin preparations, antibacterial drugs (broad-spectrum antibiotics, sulfonamides, drugs of the nitrofuran series) inside and parenterally; In severe cases - glucocorticoids, gamma globulin, cardiovascular drugs. The prognosis with the timely begun treatment is favorable.

Parenteral indigestion may occur in children on a background of various diseases and. Refers to functional disorders of the gastrointestinal tract. Clinical manifestations are the same as with simple dyspepsia. Treatment of parenteral dyspepsia is aimed at the underlying disease; Recommended digestible food in accordance with age.

Prophylaxis of dyspepsia is strict adherence to the regime of feeding of children, compliance of the food volume with the age of the child, the gradual introduction of complementary foods, the observance of hygiene rules for feeding children, timely and adequate treatment of infectious diseases of the intestine and general diseases.