Contents
Intestinal dysbacteriosis in children is a change in its normal microflora to conditionally pathogenic. Violations occur both in qualitative and quantitative composition. In children, the symptoms of dysbacteriosis are significantly different from the symptoms of similar disorders in adults. This is especially true for children of early and younger ages.
The problem of intestinal dysbiosis in pediatrics is quite acute. Modern studies indicate that in varying degrees of severity, violations of the normal intestinal biocenosis are present in 25-50% of healthy children who are breastfed. In the event that the child has any concomitant disease – somatic or infectious, then there is a 100% probability of intestinal dysbacteriosis. The severity of the pathology is determined in each case individually.
The child, leaving the birth canal from the sterile conditions in which he was 9 months old, enters the environment filled with a variety of bacteria. Colonization by microbes of the body of a newborn occurs almost instantly. He receives most of the bacteria from the woman in labor during passage through the birth canal and during breastfeeding. The milk that the mother gives to the child and her colostrum contain immune factors that stand in the way of the pathogenic flora that is trying to colonize the intestines of the newborn. That is why doctors give such importance to natural feeding of children. The sooner the baby is attached to the breast, the better will be his protection against dysbacteriosis in the future. The optimal time in this regard is the first half hour after birth.
The first five days of a baby’s life are the time when the intestines are populated not only by beneficial bacteria, but also by opportunistic ones. Therefore, in all newborns in the first 7 days of life, the so-called transient dysbacteriosis occurs. It is manifested by regurgitation, spastic pains and loose stools in which mucus impurities are found. Normally, this type of dysbacteriosis resolves on its own after another week. If there are any aggravating factors, then the formation of normal flora with a predominance of lacto and bifidobacteria does not occur. As a result, the child develops true dysbacteriosis.
Symptoms of dysbacteriosis in children
Symptoms of dysbacteriosis in children will vary depending on the age of the child.
So, for newborns and infants, the following signs of a violation of the intestinal microflora are more characteristic:
Frequent regurgitation;
Vomiting;
Flatulence;
Rumbling and overflowing in the abdomen;
Spasms in the intestines;
Underweight, slow weight gain;
restless behavior;
sleep disorders;
Violations of the stool with impurities of mucus, with the formation of lumps;
Violations of the color of the stool, its lightening, or the acquisition of a greenish tint by the stool;
Putrid, sour smell from stools;
Feces are not formed, liquid, most often plentiful with foam;
Malabsorption syndrome against which infants develop diarrhea, polyhypovitaminosis, steatorrhea, malnutrition. Particularly acute in childhood, there is a deficiency of B vitamins, calcium, protein-energy deficiency;
Intoxication in infancy leads to serious consequences: the child begins to lag behind in physical development, his appetite disappears, polydeficiency anemia develops;
Atopic dermatitis, urticaria, angioedema, bronchospasm – all these manifestations of allergies can be the result of pathological processes occurring in the intestines of the child.
As the child grows older, the symptoms of dysbacteriosis change.
So, the signs indicating violations in the intestinal microflora in children after a year are:
Alternating diarrhea and constipation, with a possible predominance of diarrhea or stool retention;
intestinal colic;
Bad breath from the child’s mouth;
Burping;
Skin rash;
Feeling of fullness in the abdomen after eating;
Against the background of hypovitaminosis, metabolism is disturbed;
Seizures and cracks in the corners of the mouth may indicate a decrease in immune forces;
Acne, recurrent stomatitis and furunculosis may appear;
Hair and nails become brittle, etc.
Separately, it is worth dwelling on the symptoms of dysbacteriosis in children, depending on the type of bacteria that caused such violations:
If the fungal microflora prevails in the intestines of the child, then the feces are predominantly foamy, with films on the surface. May take the form of lumps. Often, against the background of such a dysbacteriosis, a child develops cheilitis, glossitis, thrush, smooth skin lesions, balanoposthitis, visceral candidiasis, vulvitis. Often there are exacerbations of bronchial asthma, atopic dermatitis.
If staphylococcal flora prevails in the intestine, then dysbacteriosis proceeds severely, often in the form of generalized sepsis. It is Staphylococcus aureus that has recently been increasingly affecting the intestines of children under the age of one year. Even a mild course of the disease is characterized by a rise in body temperature, nausea and vomiting, and the presence of impurities in the feces.
If a child has Pseudomonas aeruginosa or Escherichiosis dysbacteriosis, then the pathology often proceeds blurred, without pronounced symptoms. Parents should be alerted to stools with mucus impurities, dyspeptic disorders, the child’s complaints of dull pain in the sigmoid colon.
When proteus predominates in the intestines, the child will experience dyspeptic disorders, subfebrile body temperature can be maintained for a long time.
Fecal analysis for dysbacteriosis in children
It is possible to establish the diagnosis of dysbacteriosis only after visiting a pediatrician and a pediatric gastroenterologist. Doctors prescribe laboratory tests and, if necessary, additional instrumental studies. The condition of the skin of the child, his mucous membranes is assessed, the abdomen is palpated.
A mandatory study is the analysis of feces for dysbacteriosis in children. The proposed diagnosis is confirmed by a decrease in the number of lacto (less than 10 to 7 degrees) and bifidobacteria (less than 10 to 9 degrees), while gram-negative rods are found in the feces, the number of cocci and fungi increases (more than 10 to 3 degrees), as well as clostridia (more than 10 to the 5th degree). Normally, hemolytic streptococci should be completely absent. Other conditionally pathogenic enterobacteria should not exceed 10 to the 4th degree.
To find out the cause of dysbacteriosis in children, ultrasound, gastroscopy, analysis for Giardia, helminth eggs and other studies may be required.
When is an analysis for dysbacteriosis needed?
Treatment of dysbacteriosis in children
Treatment of dysbacteriosis in children always begins with the selection of the optimal diet for a small patient. If the infant is on mixed and artificial feeding, then he is shown the introduction of fermented milk products into the diet.
At an older age, it is necessary to remove sugar, animal proteins, and simple carbohydrates from the menu. The child should receive lactic acid products that allow you to restore the disturbed balance of microflora. Dietary fiber must enter the intestines with food.
In childhood, probiotics are prescribed. These preparations contain in their composition either one or several varieties of bacteria that are useful for the work of the intestines. Modern probiotic preparations are: Bifidumbacterin, Lineks, Bifikol, Baktisubtil. There are also probiotic preparations that promote the natural growth of your own beneficial bacteria in the intestines, creating optimal conditions for them. Such means include Hilak-forte, Dufalac. Combined drugs are symbiotics – these are Maltidofilus, Bifidobak.
In order to selectively cleanse the intestines of a child from pathogenic flora, he is prescribed bacteriophages that lyse harmful bacteria. In this case, no harm is done to beneficial microorganisms. In the event that treatment with bacteriophages does not give an effect, a course of antibacterial drugs from the group of cephalosporins or macrolides may be recommended to the patient.
When a high concentration of fungal microorganisms is found in the results of the analysis of feces, then antimycotics are indicated. It can be Nystatin, Fluconazole.
Sorbent preparations (Enterosgel, Activated carbon, etc.) are prescribed if there are signs of intoxication of the body. If there are digestive disorders, then enzymatic agents are selected individually.
It is possible to take vitamins, adaptogenic therapy with immunomodulators for frequent infections.