How long does it take to treat dysbiosis in a child? Treatment of intestinal dysbiosis in children: causes, symptoms, diet and medications

Dysbacteriosis in children is a violation of the normal ratio of obligate and facultative microorganisms in the intestines in favor of the latter.

According to various studies, a violation of the intestinal biocenosis is detected in 25–50% of healthy children in the first year of life. In children with somatic diseases, certain forms of intestinal dysbiosis are diagnosed in almost 100% of cases.

The composition of the microflora populating the intestines of a newborn depends on the method of delivery, the environment in the neonatal period, and feeding. During passage through the birth canal, as well as during breastfeeding, the child receives the main part of the obligate microflora from the mother. Colostrum and breast milk contain immune factors that prevent colonization of the intestine by opportunistic microflora. Therefore, it is important to put your newborn to the breast in the first two hours after birth.

With long-term intestinal dysbiosis, immunodeficiency develops, as a result of which the child becomes susceptible to infectious diseases.

During the first week of life, a large number of opportunistic microorganisms settle in the child’s intestines, which leads to the development of transient intestinal dysbiosis, which usually ends in the second week of the child’s life (as lacto- and bifidobacteria replace other representatives of the intestinal microbiocenosis). Normal microflora prevents the colonization of the intestines by pathogenic microorganisms, participates in the production of certain vitamins, metabolism, the development of immunity, stimulates intestinal motility and performs some other functions necessary for the normal functioning of the body. Under the influence of unfavorable factors, normal intestinal flora in a child may not be formed, and transient dysbiosis becomes true.

Causes and risk factors

Dysbacteriosis refers to polyetiological disorders, the development of which can be facilitated by both exogenous and endogenous causes.

Risk factors for dysbiosis in newborns and infants include:

• the presence of infectious and inflammatory diseases of the urogenital tract in a pregnant woman;
• complicated course of pregnancy and/or childbirth;
• prematurity of the child;
• late latching of the baby to the breast;
• poor nutrition of the mother during breastfeeding;
• mastitis in a nursing mother;
• early transfer of the child to artificial feeding;
• improper child care.

Dysbacteriosis in children of the first year of life, as a rule, does not require treatment. The best way to normalize the balance of intestinal microflora in this case is natural feeding.

In older children, the following factors contribute to the development of dysbiosis:

• frequent acute respiratory viral infections;
• diseases of the gastrointestinal tract;
• unbalanced diet (with a predominance of carbohydrates and animal proteins in the diet);
• long-term treatment with antibacterial drugs;
• changes in hormonal levels;
• exposure to adverse environmental factors on the body;
• surgical interventions;

Forms of dysbiosis in children

Depending on the predominance of one or another opportunistic microflora, dysbiosis in children can be of the following types:

• candida;
• staphylococcal;
• Proteaceae;
• associated.

According to the clinical course, the pathological process can be latent, i.e. hidden, local, i.e. local or generalized, i.e. widespread.

Depending on the species and quantitative composition of the microflora, four degrees of dysbiosis in children are determined.

1. The predominance of anaerobic microorganisms, the number of bifidobacteria more than 107-108 CFU (colony-forming units) in 1 g of feces, no more than two types of opportunistic microorganisms in the amount of 102-104 CFU in 1 g of feces.
2. An equal amount of aerobic and anaerobic microflora, an increase in the concentration of lactose-negative and hemolytic Escherichia coli, the number of opportunistic microorganisms is 106-107 CFU per 1 g of feces.
3. The predominance of aerobic microflora up to the complete absence of lacto- and bifidobacteria, a significant increase in the number of opportunistic microorganisms.
4. Associated dysbacteriosis; absolute predominance of opportunistic microflora, which becomes resistant to most antibacterial drugs.

Equally important, or rather, primary importance in the treatment of dysbiosis is given to diet.

According to clinical and bacteriological indicators, dysbiosis in children can be compensated (corresponding to degrees I-II), subcompensated (corresponding to degrees II-III) and decompensated (corresponding to degrees III-IV).

Compensated dysbiosis in children, as a rule, occurs without any obvious clinical signs and is detected during an examination for another reason.

At the subcompensation stage, infants experience frequent regurgitation, vomiting, decreased appetite, rumbling in the stomach, flatulence, and spasms along the intestines. The child is not gaining weight well, is restless, irritable, and has trouble sleeping. The stools are usually copious, liquid or mushy in consistency, foamy, and contain an admixture of mucus. The feces are white or greenish in color, with a putrid or sour odor. Children with dysbiosis may experience an increase in the amount of fatty components in feces (steatorrhea), protein-energy deficiency, polyhypovitaminosis, anemia, and delayed physical development. The processes of fermentation and putrefaction occurring in the intestines lead to autoallergization with symptoms of urticaria and atopic dermatitis.

Among the signs of dysbiosis in an older child are increased salivation, bad breath, frequent belching, heartburn, intestinal colic, excessive gas formation, pain in the upper abdomen, a feeling of fullness in the stomach after eating, as well as diarrhea, constipation or their alternation, with In this case, the patient's stool has uneven coloration. Children experience seizures in the corners of the mouth, bleeding gums, acne, furunculosis, brittle hair and nails, dry skin, headaches, irritability, weakness and fatigue. The generalized form of dysbacteriosis in children (especially against the background of immunodeficiency) can manifest as glossitis, cheilitis, balanoposthitis or vulvitis, smooth skin candidiasis, visceral candidiasis.

According to various studies, a violation of the intestinal biocenosis is detected in 25–50% of healthy children in the first year of life.

In severe cases, a child with dysbacteriosis has increased body temperature, chills, cramping abdominal pain (mainly in the afternoon), nausea, and diarrhea.

Diagnostics

A pediatrician and pediatric gastroenterologist are involved in the diagnosis, and a laboratory test for dysbacteriosis in children is required.

During physical diagnosis, the condition of the skin and mucous membranes is assessed, pain along the intestines during palpation, and abdominal bloating are determined.

Laboratory diagnosis of dysbiosis consists of conducting a biochemical and/or bacteriological analysis for dysbiosis in children (examination of stool, bile). Microbiological criteria are a decrease in the number of lacto- and bifidobacteria, a decrease or increase in the concentration of typical Escherichia coli, an increase in the number of microscopic fungi, cocci, and clostridia.

To determine the etiological factor, you may need an ultrasound examination of the abdominal organs, gastroscopy, colonoscopy, laboratory testing of feces for Giardia, worm eggs, coprogram, biochemical blood test.

Differential diagnosis is carried out with malabsorption syndrome, nonspecific ulcerative colitis, acute intestinal infections.

Dysbacteriosis in children of the first year of life, as a rule, does not require treatment. The best way to normalize the balance of intestinal microflora in this case is natural feeding.

Effective treatment of dysbiosis in children, first of all, requires eliminating the cause of the development of the pathological process.

Colostrum and breast milk contain immune factors that prevent colonization of the intestine by opportunistic microflora. Therefore, it is important to put your newborn to the breast in the first two hours after birth.

In order to normalize the intestinal biocenosis, probiotics (contain monocultures of beneficial microorganisms or combinations thereof), prebiotics (promote the growth and reproduction of representatives of normal intestinal microflora), symbiotics (combined preparations combining pro- and prebiotics), bacteriophages (lyse pathogenic microorganisms) are usually prescribed. In some cases, antibiotic therapy may be necessary.

Dysbacteriosis (dysbiosis) is a disruption of the normal intestinal microflora. Pathological changes in it can be qualitative (when nonspecific microorganisms appear among the usual intestinal bacteria) and quantitative (for example, a decrease in the number of bifidobacteria with an increased number of clostridia).

Formation of intestinal microflora in a child

During intrauterine development, the child “does not use” his digestive system. It receives all nutrients through the blood vessels of the placenta. Therefore, the child’s intestines are sterile; there are no beneficial or harmful bacteria in it.

The gastrointestinal tract (GIT) begins to become colonized after birth. The nature of the first feeding is of great importance: the baby will receive breast milk or formula. In addition to essential nutrients, human milk contains the amount of bifidobacteria and lactobacilli necessary for normal intestinal function. Therefore, in most maternity hospitals, great attention is now paid to ensuring that the newborn is attached to the mother’s breast immediately after birth, while still in the delivery room.

According to some experts, the colonization of the gastrointestinal tract by microorganisms begins even before the birth of the child, namely during its passage through the mother’s birth canal. Followers of this theory believe that the bacteria that live on a woman’s genitals can enter the baby’s intestines.

The first two days of life, the gastrointestinal tract is just beginning to be populated by bacteria; over the next few days, slight shifts in the ratio of individual types of bacteria to each other may be observed. Next, the phase of stabilization of the intestinal biocenosis begins. Its picture is specific for each person, but special patterns still exist.

In the body of a newborn, a large proportion of the microflora should be bifidobacteria and anaerobic flora. All other microorganisms (non-pathogenic Escherichia coli, clostridia, Proteus, etc.) are contained in extremely small quantities (less than 5%).

Normal intestinal microbial landscape (CFU/ml) in a child of the first year of life

Normal intestinal microbial landscape (CFU/ml) in a child over 1 year old

• Bifidobacteria - 10 9 -10 10;
• lactobacilli - 10 8;
• E. coli with normal enzymatic activity - 10 8 -10 10;
• E. coli with weakly expressed enzymatic properties - 10 6 -10 7;
• lactose-negative E. coli
• hemolytic E. coli - absent;
• enterococci - 10 6 -10 7;
• Proteus ≤ 10 4 ;
• Klebsiella ≤ 10 4;
• clostridia ≤ 10 3 ;
• other enterobacteria (Hafnia, Serratia, Cytrobacter, etc.) ≤ 10 4;
• Staphylococcus aureus - absent;
• Staphylococcus epidermidis
• fungi Candida and others - absent;
• non-fermentative gram-negative bacteria
• Pseudomonas (Pseudomonas aeruginosa) - absent.

Causes of dysbiosis

There are two groups of causative factors contributing to the development of dysbiosis.

1. Causes associated with taking antibiotics:
a) with irrational antibiotic therapy:

• long-term use of antimicrobial agents,
• increasing age-related dosages of antibacterial drugs,
• uncontrolled treatment (when the patient starts therapy and, without completing the course, quits it, then continues the treatment started, etc.),

b) with rational antibiotic therapy:

• if the child has diseases of the gastrointestinal tract,
• in case of individual intolerance to a particular drug or pharmacological group to which it belongs,
• with initial immune disorders.

2. Causes not related to antibiotics:

• early transfer to artificial feeding,
• feeding with partially adapted or non-adapted milk formula,
• long-term stay of a newborn child in a hospital with characteristic hospital microflora,
• acute intestinal diseases,
• malabsorption syndrome (malabsorption in the intestines),
• dysbacteriosis of the mother's birth canal,
• failure to maintain proper hygiene of nipples and mammary glands before feeding,
• insufficient treatment of nipples and bottles during artificial feeding.

Clinical manifestations

Initial degrees of dysbiosis may not manifest themselves clinically. Often such an imbalance in the intestinal microflora goes unnoticed, because It does not bring any discomfort to the child.

The most common symptoms of dysbiosis include:

• change in stool consistency (there may be a tendency to loose stools or constipation),
• change in the color of feces (often the stool has a greenish tint or becomes completely green),
• foamy stool,
• the presence of mucus in the stool,
• frequent regurgitation,
• nagging pain in the abdomen,
• intestinal colic,
• skin rashes (often similar to an allergic rash, manifestations of atopic dermatitis).

Diagnostics

Suspicion of intestinal dysbiosis arises from symptoms characteristic of this condition. Most often it is diagnosed after examination for complaints related to intestinal disorders (intestinal colic, frequent loose stools, regurgitation). The diagnosis can be confirmed after examining stool for dysbacteriosis.

There are 4 degrees of dysbiosis:

• 1 tbsp. - reduction in the number of beneficial bacteria by 1-2 orders of magnitude (for example, a decrease in the number of bifidobacteria to 10 7, lactobacilli to 10 6).
• 2 tbsp. - a decrease in the number of beneficial microorganisms by more than 2 orders of magnitude (for example, a sharp decrease in bifidobacteria to 10 4, and lactobacilli to 10 3).
• 3 tbsp. - an increase in the number of opportunistic bacteria with a reduced number of lactobacilli and bifidobacteria (for example, an increase in the number of Klebsiella to 10 5 with a decrease in lactobacilli to 10 5).
• 4 tbsp. - a pronounced disturbance of the intestinal biocenosis with the appearance of pathogenic microorganisms in it (for example, the appearance of Salmonella or yeast fungi of the genus Candida). This degree of dysbiosis is often accompanied by an increase in the number of opportunistic microbes with a strong suppression of beneficial microflora.

Differential diagnosis

It is important to carry out differential diagnosis taking into account the fact that dysbiosis is always secondary. It can occur as a response of the body to taking antibiotics or be a manifestation of malabsorption (syndrome of impaired intestinal absorption).

It's important to understand. What green chair is not always a sign of dysbiosis. This color change can be observed when foods of the appropriate color (zucchini, cauliflower, broccoli) predominate in the child’s diet. A greenish color of stool can be observed if there are irregularities in the diet of a nursing woman, when her diet contains fresh cucumbers, green peas, broccoli, etc.

Regurgitation may even have a more serious cause than dysbiosis. For example, such as pylorospasm or even pyloric stenosis of the gastric outlet. It is necessary to examine the child, because he may require emergency surgery. In addition, regurgitation occurs as a result of overfeeding with an excessive amount of breast milk in a nursing woman or with a rapid flow through the nipple during artificial feeding.

Skin rashes of a child may have a completely different nature of occurrence. These can be harmless manifestations of prickly heat when wearing inadequately warm clothes, tight swaddling or high ambient temperatures. The rash may be allergic in nature (atopic dermatitis, food allergy). If the rash is localized in the area of ​​the inguinal folds and on the skin of the perineum, then most likely there is contact (diaper) dermatitis, which occurs from the child’s prolonged stay in the diaper, from prolonged contact of the baby’s skin with urine and feces.

In case of allergic rashes, specific cells - eosinophils - will appear in a clinical blood test. Normally, their content in a clinical blood test is less than 5%. An increase in this indicator by at least 1% indicates an allergy. If necessary, skin tests with different types of allergens will help clarify the situation.

Miliaria rashes are distinguished by typical localization (in places of natural folds: in the armpits, on the neck, in the groin folds, etc.) and rapid cleansing of the skin, subject to adequate temperature conditions and regular adherence to personal hygiene measures. While rashes due to dysbacteriosis do not have a clear localization, and the skin takes a very long time to clear the rash (only after the intestinal microbial landscape has stabilized).

Constipation in a child are also provoked not only by intestinal dysbiosis. The cause may be enlarged intestinal loops (megacolon, dolichosigma), the presence of polyps in the intestinal tube, and congenital or acquired intestinal obstruction. Ultrasound of the abdominal cavity, clinical blood test, and radiography of the abdominal organs using contrast agents will help to establish an accurate diagnosis. All examinations are carried out if there are appropriate indications and characteristic complaints or symptoms of the patient.

Treatment

Treatment of dysbiosis should be long-term and complex. You need to start first of all from the severity of this condition, i.e. from his degree. A great help here is the result of a stool test for dysbacteriosis.

Important components of complex treatment are:

• Child nutrition. The ideal food product for a child under one year of age is breast milk. Children who are breastfed for a long time are less susceptible to dysbacteriosis, inflammatory diseases of the gastrointestinal tract, and acute intestinal infections. In addition to the required amount of beneficial microflora (lacto- and bifidobacteria), breast milk contains immune defense factors that have a beneficial effect on the regeneration (renewal) of enterocytes, improving digestion processes.

  If breastfeeding becomes impossible for a number of reasons, the child should receive an adapted formula that is as close in composition to human milk as possible (for example, NAN, Nutrilon, Similak Premium, etc.). Feeding your baby with whole animal milk is unacceptable. The protein in such milk has a very large molecule size and is poorly digestible. The ratio of proteins: fats: carbohydrates is not adequate and only aggravates the problem of dysbiosis.

  For those children whose dysbiosis manifests itself as constipation, the use of fermented milk drinks or specialized fermented milk mixtures is indicated. They are recommended for drinking in the evening once a day.

• Probiotics. These are drugs obtained by drying out beneficial intestinal bacteria. To maintain their activity and vital functions, such medicines are stored in the refrigerator. The bacteria contained in probiotics are able to multiply in the intestines. They stimulate the growth of normal microflora and prevent the proliferation of pathogenic microorganisms. Such drugs improve parietal and intracavitary intestinal digestion. They eliminate the inflammatory process and normalize the motility of the departments.

  In children, medications are used that contain the main inhabitants of the gastrointestinal tract: bifidobacteria (Bifidumbacterin), lactobacilli (Lactobacterin), E. coli (Colibacterin dry).

  Drugs that contain a mixture of beneficial bacteria are often prescribed. For example, lyophilisate of live bifidobacteria and E. coli - Bificol dry.

  Modern probiotics include Bifiform. It contains 2 types of bifidobacteria, enterococci, as well as substances necessary to feed these bacteria (lactulose, glucose, yeast extract, gum).

  Probiotics are prescribed in a course of 10-21 days, but if necessary, the duration of their use increases.

• Prebiotics. These are substances that support the existence of beneficial bacteria in the intestines. Prebiotics are food for anaerobic (normal) microflora. They promote proper renewal of mucosal cells and have a healing, anti-inflammatory effect on the endothelium. An important characteristic of prebiotics is that they increase the volume of feces due to the water component. This feature is successfully used in the treatment of dysbacteriosis, manifested by constipation.

  Prebiotics, unlike probiotics, do not require special storage conditions. These two groups of drugs are prescribed together, but the course of taking the first of them is not limited in time.

  Examples of prebiotics recommended in childhood are Eubicor (a plant-yeast microflora regulator based on the yeast Sachoromices cerevisiae, dietary fiber, vitamins, amino acids, micro and macroelements), Hilak Forte (contains metabolic products of microorganisms, lactic acid, fatty and amino acids, lactulose ), Lactulose (synthetic fiber derived from lactose).

• Bacteriophages. These are substances that have a highly specific ability to absorb pathogenic microorganisms. Bacteriophages are used for severe degrees of dysbacteriosis. In children, staphylococcal, Klebsield bacteriophages, and polyvalent pyobacteriophage are more often used.
• Antibiotics. Antimicrobial agents are prescribed for the 4th degree of dysbiosis (intestinal infection), when a pathogenic microorganism enters the child’s body, leading to characteristic clinical symptoms and disrupting the normal functioning of the gastrointestinal tract. Nitrofurans (Furamag, Enterofuril), cephalosporins (Ceftriaxone), less frequently fluoroquinolones (Ofloxacin, Ciprofloxacin), etc. are used more often.
• Pancreatic enzymes. Severe forms of dysbiosis are often accompanied by dysfunction of the pancreas. During the period of treatment of dysbiosis, the child is prescribed enzymatic drugs such as Mezim, Creon. They improve the processes of breakdown of food in the intestines and promote more complete absorption of nutrients into the bloodstream.

Intestinal dysbiosis is a common pathological condition in childhood. However, thanks to accessible research methods and a wide selection of effective medications, it is successfully treated. It is important not to start dysbiosis and seek qualified medical help in the early stages of its manifestation.

Modern pediatricians are increasingly saying that dysbiosis is not a disease, but a condition of any mucous membrane in which the balance of microflora is disturbed. The most common intestinal dysbiosis in children is a decrease in beneficial microflora and the proliferation of pathogenic organisms.

Dysbacteriosis in children under one year of age is a very common phenomenon. Normally, bifidobacteria and lactobacilli are present in the human intestine; they protect the intestines from pathological flora and toxins, participate in digestion, and allow the complete absorption of proteins, fats, carbohydrates, vitamins, and various acids.

In addition to beneficial bacteria, opportunistic organisms (staphylococcus, enterococcus and others) also live in the child’s intestines, which in small quantities are not dangerous, but when multiplying, they can cause signs of dysbacteriosis in children: nausea, bloating and abdominal pain, and so on.

Dysbacteriosis in children: causes

Immaturity of the gastrointestinal tract

Dysbacteriosis in a one-month-old baby is most often caused by the immaturity of the microflora of the mucous membranes of the stomach and intestines. The functioning of the newborn’s gastrointestinal tract is still just getting better, and there may not be enough beneficial bacteria for stable intestinal function.

Poor nutrition

Age-inappropriate nutrition (frequently changing formula or introducing complementary foods too early), as well as eating allergens (for example, dairy products for lactose intolerance) can contribute to the development of dysbiosis.

Dysbacteriosis after antibiotics in a child

If a child has taken antibiotics, the natural microflora of his intestines is disrupted, since antibiotics kill any bacteria, without distinguishing whether they are pathogenic or beneficial.

Intestinal infections

If a functional digestive disorder in an infant is most often caused by the immaturity of the gastrointestinal tract or errors in nutrition, then dysbiosis in a 2-year-old child may be the result of a viral infection (rotavirus, dysentery, salmonellosis), as a result of which pathogenic microbes enter the intestines.

Unfavorable environment

The environment also affects the condition of the stomach and intestines: air polluted by industrial exhausts, chemical poisoning, and insufficiently clean drinking water can provoke the development of dysbiosis.

Even before going to the doctor, parents usually understand that the child has intestinal dysbiosis. Symptoms in children are quite pronounced and cause discomfort, especially for newborns and infants.

Dysbacteriosis in a child: symptoms

• Pain, feeling of heaviness and bloating in the abdomen, flatulence;
• bowel disorder: constipation or diarrhea;
• remnants of undigested food, mucus or grains in the stool;
• excessive regurgitation, belching, and sometimes vomiting;
• peeling and redness of the skin, rashes and diaper rash, atopic dermatitis;
• hair loss, brittle nails, bleeding gums;
• bad breath;
• white or gray coating on the tongue;
• dark plaque on teeth;
• poor appetite.

Many gastrointestinal diseases have the same symptoms as the symptoms of dysbiosis in children. Treatment must be different, which is why it is so important to make a correct diagnosis.

Treatment of dysbiosis in children

To determine the qualitative and quantitative composition of the intestinal microflora, it is necessary to undergo a scatological, biochemical and bacteriological analysis of feces. Depending on what opportunistic flora is detected and in what quantities, the gastroenterologist will select treatment.

To combat dysbacteriosis the following are used:

• bacteriophages – drugs that destroy bacteria that cause dysbacteriosis;
• probiotics – preparations based on living microorganisms that allow you to artificially populate the intestines with beneficial flora;

• prebiotics – indigestible substances (lactulose, fiber) that stimulate intestinal motility;
• Digestive enzymes are substances that help break down and digest food.

When choosing drugs, the cause of dysbacteriosis is also taken into account. If the cause of an intestinal disorder is antibiotics, the treatment will be one, if the body is allergic - another.

Do not choose drugs to treat intestinal microflora on your own. There are a lot of them in pharmacies now (“Acipol”, “Linex”, “Bifidumbacterin”, “Bifiform Malysh”, etc.) and the pharmacist will definitely advise you on something, but the wrong drug and the wrong dosage can further disrupt the intestinal microflora.

Non-drug treatment of dysbiosis

When populating your child’s intestines with beneficial flora, do not forget about the basic principles of nutrition:

Keep breastfeeding

Dysbacteriosis in infants is less common than in formula-fed children, since breast milk is a source of beneficial lactobacilli. If maintaining or restoring breastfeeding is not possible, use medicinal formulas.

Stick to your diet

If your baby is no longer breastfed, take care of his diet: exclude raw vegetables, fruits, white bread, legumes, dairy and other products that increase gas formation. The basis of the diet should be cereals, lean meat, fermented milk products; bananas and baked apples are allowed as fruits.

Keep a daily routine

When treating dysbiosis, it is very important to create a calm and comfortable environment for the child, eliminate stress and pay attention to healthy sleep, walks, and physical activity in the fresh air.

Dysbacteriosis is a very common phenomenon in childhood; it is not a disease, but rather a condition of the body that reflects recent events - taking antibiotics, intestinal infection, prolonged poor nutrition, stress, as a result of which the number of beneficial lacto- and bifidobacteria in the intestines has decreased and reproduction has increased harmful, pathogenic. All this leads to an unpleasant clinic, a lack of vitamins, especially deterioration of the condition of the skin, hair and nails. The smaller the child, the more often dysbiosis occurs.

Newborn period. More often, infants born by cesarean section encounter bacteriosis (since they receive formula and antibiotics in the first days of life), and children who are on.

Manifestations of dysbacteriosis in them are:

• Anxiety and screaming.
• Bloating, which is accompanied by.
• Heterogeneous stools, often liquid, with mucus and greens. The consistency of the stool may be inconsistent - there are alternations of normal and liquid, there may be.

In children of preschool and primary school age The clinic of dysbiosis usually occurs in the second half of the day and is manifested by the following symptoms:

• A rumbling sound that can easily be heard by a prying ear from a distance.
• Spasmodic pain over the entire surface of the abdomen; the child cannot point to a specific area of ​​pain.
• Dyspeptic symptoms: loss of appetite, belching.
• Among the general symptoms: the temperature may intermittently rise to low numbers (37.0–37.2), irritability, drowsiness and insomnia, children, there may be a tendency to anemia.
• Changes in stool to liquid, the appearance of mucus, alternation of normal and liquid stool are manifestations of more severe forms of dysbacteriosis.

In adolescent children all the same symptoms are observed, but less pronounced; they usually seek help due to stool instability and general fatigue.

If untreated dysbiosis is prolonged, then symptoms of vitamin deficiency appear: red tongue, increased amount of saliva, dry skin and visible mucous membranes. Children become apathetic and tired. It may appear.

Note! A stool analysis may not confirm the condition of the intestines - dysbiosis, since the stool must be examined in a warm, fresh state. But even with the correct test collection technique, a false negative result can occur, since more often stool reflects the state of the intestinal flora in the lumen, but is not able to fully reflect the state in the intestinal wall.

Diet for dysbiosis

The most suitable food for a baby suffering from dysbiosis is mother's milk.

Infants should be strictly breastfed; if the mother has already completely interrupted breastfeeding, then an adapted formula should be chosen. The most favorable for intestinal microflora are “Nutrilon Omneo”, “Frisovoy”, “Lactofidus”, “NAN with bifidobacteria”, “Humana”, “Malyutka acidophilus” and other mixtures with the addition of probiotics; Nucleotides added to the mixture have a positive effect on the intestinal flora.

For children older than six months, it is necessary to use subsequent mixtures with pre- and probiotics; from 8 months, fermented milk products based on adapted milk formulas. Prepare, introduce into complementary foods, juices.

Children who eat from a common table do not need any restrictive or strict diet; they are recommended to:

• Reduce consumption of spicy and.
• Prepare vegetable salads every day with the addition of, be sure to eat fruits, except grapes and pears.
• It is recommended to eat dietary bread and cookies with the addition of wheat. You can give crackers for tea. bran is a nutritional substrate for healthy intestinal flora.
• It becomes a mandatory attribute - at least 0.5 liters per day, or it is worth doubling the amount usual for the child. From 10 months, children can be given “live” yoghurts. For children from 1 to 1.5 years old, fermented milk products made from whole milk should be used - bicillin, children's kefir, whey-based drinks. Children over 1.5 years old can additionally be offered fermented milk products with prebiotics (lactulose) and probiotics - kefir, curdled milk, yogurt.
• Breakfast should consist of easily digestible food. You can add fiber to porridge and muesli. You should use whole grain cereals and cook them in water. Oatmeal has a good enveloping effect.
• You should not force the child to eat during this period - it intensifies putrefactive processes, and this should not be allowed during treatment.
• Preferred cooking methods are steaming, boiling, baking, you can cook healthy food in a slow cooker.

Note! Plants that reduce the manifestations of dysbiosis and promote the growth of normal intestinal flora:

• , lingonberries, strawberries, raspberries, currants, barberries - can be eaten fresh, cooked in compotes, or eaten dried.
• Apricot, apple,
• Horseradish, onion, radish, dill, caraway seeds, pepper, cinnamon.

Interesting to know! In Omsk, in 15 kindergartens, children are given ice cream with the addition of lacto- and bifidobacteria, which was created by doctors from Tomsk Medical University. Ice cream is included in the diet in courses of 30 days, the main goal of the experiment is the prevention of dysbiosis. The study showed positive results. This bio-ice cream won first place in an international innovation competition.

Supplements for dysbiosis

Regardless of the degree of dysbiosis, all children, especially newborns, are prescribed probiotics (preparations containing live bacteria): Bifidumbacterin, Lactobacterin, Acylact, Linex, Bifiform, Bifiliz, Acipol. Acipol is allowed for children over three months old, all others are allowed from birth, the course of taking any of these probiotics is 2 weeks. Also, in severe forms of dysbiosis, you can consult with a pediatrician about the need to use bacterial preparations Hilak forte, lactulose, which restore intestinal cells. After taking a course of one of the drugs, it is advisable to take a stool test and check with a pediatrician to determine further actions.

The use of Smecta is completely justified.

The intestinal flora is especially well seeded when the child is given infusions of medicinal plants with an effect on the gastrointestinal tract and gastroenterological herbal teas. They can be used no earlier than six years of age. Basically, the course lasts from 2 weeks to two months, longer use with breaks is possible.

And finally: in order for the treatment of dysbiosis to give quick and high-quality results, it is necessary to eliminate the cause of its occurrence.

The program “Doctor Komarovsky’s School” talks about the treatment of dysbiosis in children:

Dysbacteriosis (dysbiosis) is a fairly common disease. This is a change in the normal intestinal microflora. The condition in children is not an independent disease. Dysbacteriosis is a secondary symptom of already existing disorders in the body.

The disease is diagnosed by examining stool. An imbalance of intestinal microflora in a child requires careful diagnosis and comprehensive treatment.

Reasons for the development of dysbiosis

Depending on the age of the child, various factors can cause dysbiosis. This problem can arise after the use of antibiotics, poor nutrition, or poor environment.

Causes of microflora disorders in children under 1 year of age:

• improper nutrition of the mother while breastfeeding;
• artificial feeding with formulas;
• abrupt weaning;
• taking antibiotics;
• allergy;
• weakened immune system;
• poor environmental situation.

In children over 1 year of age, other causes of intestinal dysbiosis appear:

• helminthic infestations;
• improper and unbalanced diet;
• frequent colds;
• acquired diseases of the gastrointestinal tract (intestinal atony, gastritis);
• chronic infections;
• taking medications that reduce intestinal motility and inhibit enzyme synthesis (antispasmodics, sedatives);
• stress, hormonal changes.

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Symptoms and stages of the disease

Dysbiosis is accompanied by quantitative and qualitative changes in microflora. Beneficial bacteria take the place of harmful ones, which have a destructive effect on the child’s health.

Typical symptoms are:

• bowel dysfunction;
• stomach ache;
• gas formation and colic;
• metallic taste in the mouth;
• dry skin, dermatitis;
• weakening of the immune system, which is expressed in frequent colds and exacerbations of chronic diseases.

In infants, signs of dysbacteriosis appear after 1-1.5 months. Observed:

• loss of appetite;
• poor weight gain;
• loose and greenish stools.

Older children experience a significant number of bowel movements. The feces are liquid and contain remains of undigested food.

Manifestations of dysbiosis largely depend on the stage of the disease:

• With initial dysbiosis, there is still no significant decrease in the level of beneficial bacteria; the pathogenic flora has not grown. During this period, the child’s appetite worsens and he is bothered by frequent constipation, which alternates with diarrhea. There is restlessness and excitability.
• The second stage is characterized by the growth of pathogenic microflora. The child develops flatulence, diarrhea with a strong odor, or constipation. Symptoms of dysbiosis are similar to those of other diseases. Infants vomit and regurgitate. 2 hours after feeding, he begins to feel restless, pulls his legs towards his stomach, and sleeps poorly. Older children have symptoms of gastritis: bloating and pain in the abdomen, decreased or loss of appetite, heartburn and belching, severe gas formation.
• In phase 3 of dysbiosis, diarrhea becomes chronic, gas formation and colic continue. The child is irritable and often suffers from colds and ARVI. In children under 1 year of age, signs of rickets are observed. Interest in food disappears, the child is lethargic due to lack of vitamins and nutrients. The stool may have a sour odor with mucus and greens. Symptoms may resemble colitis: diarrhea followed by constipation, incomplete bowel movement syndrome, coating on the tongue, accumulation of gases.
• Severe dysbacteriosis is a fundamental violation of the microflora. The intestines contain a large concentration of several types of pathogenic bacteria that can cause an intestinal infection. The child may periodically have a fever, chills, fever, and headaches. Undigested food releases toxins that cause symptoms of chronic poisoning.

Pay attention! The baby's skin can also react to dysbacteriosis, on the surface of which allergic rashes appear.

Tests and diagnostics

To diagnose the disorder, it is necessary to take a test for dysbacteriosis and microbiological examination of stool. It will determine the ratio of different types of bacteria in the intestines. Thanks to this analysis, it is possible to assess the sensitivity of organisms to various drugs, which subsequently helps to determine a treatment regimen. For analysis, stool collected in the morning (5-10 g) is required. It cannot be stored for a long time at room temperature, otherwise the test result will be incorrect.

Intestinal function and the likelihood of dysbiosis can be determined by passing feces for a coprogram. It can be used to assess the ability of the intestines to digest food and identify violations of its absorption. If the coprogram is bad, a stool test for carbohydrates is prescribed. When their level increases, we can talk about lactose deficiency.

Additionally, an analysis is performed for worm eggs and enterobiasis.

Treatment methods

How and with what to treat dysbiosis in children? Traditional therapy at any stage should be carried out in several directions:

• taking medications;
• diet;
• symptomatic therapy;
• unconventional therapy.

Drug therapy

For treatment to be effective, first of all you need to remove all the factors that provoked the disease (adjust nutrition, stop using antibiotics).

The goal of the first stage of therapy is to stop the growth of pathogenic bacteria, normalize intestinal microflora. The child needs to eliminate the symptoms of intestinal disorders (vomiting, diarrhea, abdominal pain).

If the baby has a poor appetite, the lack of food should be compensated for with glucose-salt solutions (Bio Gaia, Regidron) or sweet tea.

To destroy “bad” microflora, several groups of drugs for dysbiosis are prescribed.

Bacteriophages– these are special bacteria that will “eat” pathogenic organisms. This can be Salmonella, Coliproteus, Pseudomonas bacteriophage, etc. The drug should be given simultaneously orally and in the form of small enemas. The first reaction to the drug in a child may be severe abdominal pain.

Probiotics– preparations containing live “beneficial” bacteria. They help regulate the balance of intestinal microflora. They can be monocomponent, polycomponent, combined, recombinant.

• Baktisubtil;
• Bifiform;
• Primadophilus;
• Enterol.

At stage 2 of treatment, a 7-10-day course is prescribed prebiotics. These are non-microbial products that help maintain normal levels of “good” bacteria.

• Hilak forte;
• Duphalac;
• Lactusan;
• Primadophilus.

In parallel with pro- and prebiotics, the child is given sorbents:

• Smecta;
• Polyphepam;
• Polysorb.

If dysbiosis is severe, it affects the functioning of the pancreas. Therefore, the child is prescribed enzyme preparations (Pancreatin, Creon, Mezim). Thanks to them, the process of breaking down food and absorbing nutrients is better.

If you have dysbacteriosis, you need to take antibiotics very carefully. Most of them do not affect the intestinal microflora and can harm the child. Broad-spectrum intestinal antiseptics are mainly prescribed:

• Nifuratel;
• Encefuril;
• Nifuroxazide.

Diet and nutrition rules

One of the main components of disease therapy is proper nutrition and adherence to a diet for dysbacteriosis. In the initial stages of the disease, natural probiotics, fiber, pectins, and dietary fiber should be included in the diet. In the first days, it is better to focus on drinking plenty of water and limiting your diet. If the baby has severe diarrhea, the diet should be more strict. It needs to be agreed with a doctor, but you yourself need to exclude your child from eating raw vegetables and fruits (except for bananas and baked apples).

If the child is breastfed, then the mother must adhere to a diet. Microflora can be normalized with the help of probiotics from fermented milk mixtures and kefir.

From the age of 2 years, the child’s menu should include dishes with dietary fiber. It is useful to give:

• boiled or steamed vegetables;
• baked apples;
• porridge;
• vegetable puree;
• vegetable soups;
• lean boiled meat (chicken, rabbit);
• jelly;
• compote of rowan or rosehip.

If a child has diarrhea with yellowish stools, his diet should include protein foods (fish, eggs, cottage cheese). If the stool is dark, you need to include fermented milk products, fruit compotes, and boiled vegetables. Juices and soda should be excluded. You should not give children whole milk, pasta, animal fats, canned food, or sweets.

Traditional medicine

In small quantities for dysbacteriosis, you can give herbal decoctions that have an antiseptic effect:

• chamomile;
• St. John's wort;
• sage.

Decoctions help to strengthen the stool:

• blueberries;
• cinquefoil root.

In parallel with traditional treatment, the child can be given microenemas from 100 ml of vegetable oil (olive, sesame, peach) with 5 drops of tea tree and fennel ether. You need to administer an enema of 5 ml daily into the rectum for 10 days.

What to do if your baby has loose stools? Read the tips for parents.

How to teach a child to use a pacifier is written on this page.

Find out about the symptoms and treatment of chronic pharyngitis in children at this address.

Prevention of dysbiosis in a child should be addressed at the planning stage. A woman must undergo examination for the microflora of the genital organs. If necessary, it must be adjusted before the baby is born. A pregnant woman needs to monitor her diet and stable bowel function.

When the baby is already born, you must:

• apply it to the chest in a timely manner;
• breastfeed him as long as possible;
• introduce complementary foods correctly;
• be sure to give your child fermented milk products with bifidobacteria;
• if the baby often suffers from colds, he should additionally be given probiotics;
• monitor the condition of the child’s stool and the dynamics of his weight.

Intestinal dysbiosis in children is a common disorder that requires careful examination and timely elimination of the problem. Today there are many research methods and medical means that make it possible to successfully treat dysbiosis. The main thing is to detect the problem in time and seek qualified help.

More interesting details about childhood dysbiosis in the following video:

The clarity and coherence of the digestive tract is determined by the presence of beneficial microflora. Against the background of external changes and pathologies of the gastrointestinal tract, changes occur that lead to the predominance of pathogenic microorganisms, and dysbiosis develops in children. Symptoms and treatment will directly depend on the type of pathogenic flora. A child's body is an extremely fragile system, and it is important not to miss the early signs of the disease.

What is intestinal microflora?

Normally, beneficial and pathogenic forms of microorganisms peacefully coexist in the intestines. Each of them performs its own specific functions:

• Lactobacilli and bifidobacteria are necessary for normal intestinal function;
• pathogenic forms (cocci, fungi, yeasts, clostridia, protozoa) are normally present, but not more than 1% of the total. If their content increases, then gastrointestinal symptoms occur.

Functions of intestinal microorganisms:

Digestion

Bacteria cover the intestinal walls and produce enzymes and active substances. Designed for final digestion of food, ensuring the absorption of nutrients and water.

Immunity

The intestines contain a large number of cells that are responsible for protective mechanisms through the production of immunoglobulins. In addition, bacteria have the ability to synthesize internal antibiotics, which are important in activating the body’s local defenses.

Detoxification of the body

Neutralization and removal of toxins occurs with the participation of representatives of healthy microflora. Microorganisms have a direct effect on intestinal motility, and indirectly on the structure of the skin, hair, blood vessels, bones, and joints.

Risk factors

If the composition is disturbed, an imbalance occurs, which leads to the development of the disease. Provoking factors may be:

• frequently recurring acute respiratory viral infections;
• food with insufficient supply of vitamin complexes;
• infectious, endocrine diseases;
• depletion of the body’s protective functions against the background of tumor processes;
• systemic connective tissue diseases;
• use of antibiotics, non-steroidal anti-inflammatory drugs;
• diseases of the gastrointestinal tract and biliary system.

Against the background of external and internal causes, conditions are created for the development and reproduction of opportunistic microorganisms. As a result, dysbiosis develops.

Reasons

The likelihood of the primary development of dysbacteriosis is very small (with the exception of infants), most often the factors are pathological changes caused by taking medications. Such drugs are antibiotics, cytostatic substances that are designed to suppress the activity of pathogenic microorganisms. In addition to the direct therapeutic effect, medications affect beneficial representatives of the intestinal microflora.

Another reason for the development of dysbacteriosis is malnutrition with insufficiency of microelements, the predominance of additives in the diet (flavor enhancers, stabilizers). An important aspect of the proper functioning of the intestines is uniform nutrition throughout the day, which, if disturbed, can lead to the development of the disease.

Clinical manifestations of the disease in different age groups

Children under one year old

Symptoms of dysbiosis in children 1 year of age and dyspeptic changes against the background of gastrointestinal pathology have quite similar clinical manifestations:

• the mother will notice that the one-year-old child has a very poor appetite;
• there may be diarrhea, or, as the opposite, difficult bowel movements;
• Dysbacteriosis in children under one year of age is accompanied by symptoms of increased gas formation. In a baby, it manifests itself as bloating and periodic pain. Of course, a child of this age is unlikely to be able to tell what is bothering him, but the mother will pay attention to the excited state, worsening sleep, increased tearfulness;

• One of the manifestations of the disease is the symptom of “slipping food”. In this case, the time between eating and the process of defecation is significantly reduced. Due to insufficient digestion, food fragments are detected in the feces;
• often intestinal diseases are accompanied by allergic skin reactions, such as urticaria. The rash (pictured) with dysbiosis is variable in color intensity and prevalence.

If you notice such manifestations in your baby, you should contact your pediatrician.

Important! Dysbacteriosis in childhood with a long course has a number of consequences, manifested by impaired absorption in the intestines, which can lead to insufficient supply of vitamins and important microelements.

After a year

As people get older, most of the clinical manifestations remain the same, but new symptoms may be added. A child over 12 months can already indicate what is bothering him, where it hurts, which certainly facilitates diagnostic issues:

• problems with defecation persist (increased or delayed), accompanied by an unpleasant odor;
• increased intestinal motility (rumbling);
• increased gas formation;
• soreness in the stomach or intestinal loops that occurs after eating.

Groups of consequences arise due to long-term disruption of the digestive tract:

• a child very often suffers from acute respiratory viral infections, acute respiratory infections, and rotavirus infections. After one year, mothers begin to send their children to kindergarten. Of course, all children who find themselves in a new society begin to get sick. But in the presence of dysbacteriosis, the frequency of viral infections increases;
• Parents note that the baby does not tolerate dairy products well. The disease may affect the function of lactose digestion;
• skin allergic reactions.

Since most products, and therefore vitamins and microelements, are not absorbed when passing through the gastrointestinal tract, the child may lose weight or not gain enough weight.

Important! The psycho-emotional background of a baby with gastrointestinal pathologies becomes unstable. An adult will be nervous if the stomach constantly hurts, suffers from increased gas formation, or too loud peristalsis. Against the background of the disease, the baby becomes nervous and tearful.

2 years and older

Dysbacteriosis in a child over 2 years of age, if left untreated, retains all the symptoms of digestive disorders. With a long course of the disease, manifestations of intoxication occur (low-grade fever, weakness, loss of appetite), and general protective mechanisms decrease.

Types of dysbacteriosis

The disease is classified according to several criteria.
- By type of pathogenic microflora:

• candida;
• staphylococcal;
• Proteaceae;
• mixed form (a combination of two or more pathogens).
• By type of clinical course:
• latent – ​​hidden development;
• local – local changes predominate;
• generalized – changes affect all systems.

By degree of compensation:

• compensated - no obvious clinical manifestations are detected, changes are reflected only in laboratory tests;
• subcompensated – symptoms are moderate, reflect local inflammatory changes;
• decompensated – a complex of clinical manifestations in the form of intoxication, diarrhea, and constant abdominal pain.

Stages of the disease

Clinically, dysbiosis goes through 4 successive stages, with each subsequent stage showing an increase in symptoms.

Stage 1

The first stage is diagnosed based on stool analysis. In this case, obvious manifestations may not be observed.

Stage 2

The second stage begins with a violation of bowel movements, diarrhea or constipation appears. Parents may notice a change in the color (greenish tints predominate) and odor of the stool.

Stage 3

At the third stage, more pronounced symptoms are observed - pallor of the skin, the child becomes lethargic, appetite worsens, and weight decreases.

Infants at the third stage may develop skin reactions - atopic dermatitis (diathesis).

Stage 4

The fourth stage is life-threatening for the baby, which requires hospitalization with emergency treatment.

Severity of dysbacteriosis

Depending on the predominance of beneficial or pathogenic microflora, doctors distinguish 4 degrees of severity of dysbiosis.

I degree

Occurs when the amount of beneficial microflora decreases relative to the norm by 1-2 orders of magnitude.

II degree

A combined process in the form of a continued reduction in the number of bifido- and lactic acid bacteria with the gradual colonization of the intestines by pathogenic microorganisms.

III degree

Pronounced aggressiveness of pathogens due to an increase in their ratio in the intestine.

IV degree

Beneficial microflora almost completely disappears and is replaced by pathogenic ones. Accompanied by the accumulation of toxic substances from bacterial activity with damage to the mucous membranes. Clinically, the digestive process is severely disrupted in combination with decreased immunity.

Primary form of dysbiosis in children

According to Dr. Komarovsky E.O. - This is a physiological process in a newborn. Since after birth there is practically no microflora present in the baby’s intestines. As it interacts with the outside world, settlement occurs. Only the mother can help the baby’s intestines through skin contact and breastfeeding.

But situations arise when pathogenic microorganisms begin to predominate. Occurs in the following situations (based on reviews from pediatricians):

• absence or insufficient duration of breastfeeding (BF);
• incorrect maternal diet;
• mother taking antibiotics. It is advisable to limit breastfeeding for the period of therapy;
• psychological problems in the family, accompanied by prolonged stress of the mother.

Important! It is during breastfeeding that pediatricians recommend that a woman exclude any foods that can lead to the development of allergies in a child - sweets, colored fruits, carbonated drinks, spicy, fatty foods, citrus fruits. The diet should be as hypoallergenic as possible.

To exclude the development of the disease, a woman should pay attention to herself; any errors in the diet or nervousness can lead to undesirable consequences.

Diagnostics

As has already become clear, dysbiosis is secondary changes in the gastrointestinal tract against the background of external or internal processes. Therefore, the main task of the doctor is to find out the initial cause of intestinal dysbiosis in children based on the identified symptoms and then prescribe treatment. To do this, it is necessary to undergo a number of laboratory tests (general and biochemical analysis of blood, urine, microbiological analysis of stool, examination of stool for dysbacteriosis), and instrumental research methods (ultrasound of the abdominal organs).

Which doctor deals with gastrointestinal pathologies?

If dyspepsia occurs, it is recommended to first consult a pediatrician. Based on clinical and laboratory tests, the doctor will make recommendations. If necessary, he will refer you to a gastroenterologist for consultation. It is the doctor of this specialty who deals with pathologies of the stomach and intestines.

It is not advisable to give your child any medications before visiting the clinician. Since the clinical picture becomes smoother against the background of medications. The quality of diagnosis may decrease.

What tests need to be taken for dysbacteriosis?

Indirect studies (general blood count, stool, biochemical analysis of stool) provide information regarding the general condition of the gastrointestinal tract and the presence of inflammation.

The “gold standard” is bacteriological culture of stool, which allows one to evaluate the content of beneficial and pathogenic microorganisms in quantitative and qualitative composition. This method has both advantages and disadvantages. Positive aspects - high sensitivity, easy implementation. Negative aspects arise from the duration of the study (up to 7 days), different results during control manipulations.

It is important to understand that test results may be within normal limits. For this purpose, pediatricians and gastroenterologists prescribe repeat tests.

Treatment of dysbiosis in children

Based on the results of laboratory research methods, complex therapy is prescribed, aimed at eliminating the main process that led to the development of dysbiosis.

Antibiotics

If dysbiosis occurs against the background of an intestinal infection, then broad-spectrum antibiotics are prescribed.

Probiotics

To restore normal microflora, medications consisting of microbial elements, living bacteria, are prescribed. Probiotics are harmless and can be taken from 3 months of age, but only a doctor should choose the type.

There are mono- and polycomponent forms:

If it is necessary to restore a certain type of microorganisms (mild form of the disease), choose a monocomponent drug - Bifidumbacterin, Colibacterin, Lactobacterin;

Multicomponent ones include microorganisms of several types - Atsipol, Atsilakt, Linex, Bifolong, Bifiliz.

Prebiotics

It is important not only to populate the intestines with beneficial microflora, but also to provide the environment. For this purpose, prebiotics consisting of oligosugars are prescribed - Duphalac, Lactusan, Goodluck, Normaze, Prelax, Portalac.

To get results you must follow the rules:

• integrated approach – drug therapy, diet;
• the doctor should prescribe therapy;
• strict adherence to all pediatrician’s recommendations;
• proper maternal nutrition;
• adding the first complementary foods within the time frame established by pediatricians.

Compliance with all points will allow you to cure and reduce the risk of consequences. In consultation with your doctor, you can add recipes from traditional medicine to the complex.

Possible complications

Long-term dysbiosis in older children may be the cause of decreased protective functions of the body. Manifested by frequent respiratory diseases and allergies.

The lack of beneficial bacteria leads to the fact that all food that enters the intestines is not digested, but is rejected. Accordingly, the growing body does not receive the required amount of nutrients and microelements.

Pathogenic microflora has the ability to spread beyond the gastrointestinal tract and affect the biliary and urinary systems.

Diet

The basis of the diet of children from 1.5 years old should be various cereals, soups, vegetable dishes, fresh fruits, lean meats, and dairy products.

If diarrhea occurs, you must include:

• rice or oatmeal decoctions, jelly (have an enveloping property);
• thermally processed vegetables, fruits;
• fish or chicken, steamed or boiled.

If the main symptom is constipation, then the basis of nutrition should be fermented milk products, as they normalize the composition of the microflora due to lactobacilli.

Bacterial imbalance in children is quite difficult to correct, so it is much easier to follow nutritional rules.

Preventive measures

Prevention of dysbiosis in a child is in the hands of an adult. It is he who can create harmonious living conditions - provide age-appropriate nutrition, ensure physical activity, emotional stability, and treat infectious diseases in a timely manner.

As a result, the baby will be healthy and will not know about the existence of intestinal problems.

For many parents, the words “germs” and “bacteria” mean hordes of “monsters” that can cause an infectious disease and harm the health of their beloved child. But it turns out that microbes can be not only pathogenic, but also beneficial for the child’s body.

These microbes are not enemies, but rather friends and helpers of the human body. They populate the intestines. In this case, their quantity and ratio are very important.

A condition that develops when the qualitative composition of these beneficial microorganisms or their quantitative ratio (balance) is disturbed is called dysbacteriosis, or dysbiosis.

The role of microflora in the intestines

The role of beneficial microflora in the intestines is huge and multifaceted:

• microbes are involved in the process of digesting food;
• bacteria synthesize not only enzymes to improve digestion, but also hormone-like active substances;
• they promote the absorption of vitamin D and many microelements: iron, copper, calcium, phosphorus, potassium, sodium, magnesium;
• synthesize vitamins (group B, ascorbic acid, folic acid, vitamin K, biotin);
• participate in regulatory mechanisms of metabolism;
• protect the child’s body from pathogenic microbes (salmonella, dysentery bacillus, fungi, etc.) that can cause intestinal infection: they produce substances that block the proliferation of pathogenic flora;
• promote the movement of digested food and bowel movements;
• participate in the formation of immunity;
• protect the body from the effects of adverse factors: neutralize the effects of nitrates, chemicals (pesticides), drugs (antibiotics).

What microorganisms are human “friends”?

The composition of normal flora in the intestines is provided by:

• bifidobacteria – the main (90%) and most important flora;
• accompanying flora (from 8 to 10%): lactobacilli, enterococcus, non-pathogenic Escherichia coli;
• conditionally pathogenic microorganisms (less than 1%): Proteus, Citrobacter, Enterobacter, Klebsiella, yeast-like fungi, non-pathogenic Staphylococcus, etc.; in such small quantities they are not dangerous, but under unfavorable conditions and an increase in their numbers they can become pathogenic.

If the nature and quantity of beneficial microflora changes in the intestines, putrefactive fungi and other harmful microorganisms begin to multiply. They increasingly displace beneficial microflora from the intestines and cause digestive, metabolic and immune disorders in the child.

Dysbacteriosis is not an independent disease, but a secondary condition of the body. A number of reasons and factors contribute to its occurrence.

Reasons

The intestines are sterile during fetal development. The first portions of microbes come to the baby from the mother during childbirth. After birth, the baby should be immediately put to the breast so that the mother's flora enters the baby's digestive system. This contributes to the formation of a normal balance of bacteria in the newborn with a predominance of bifidobacteria and lactobacilli.

The causes of disturbances in the normal microflora in the intestines of an infant can be very different:

• maternal malnutrition;
• mother or child taking antibiotics;
• later the baby's first breastfeeding;
• sudden cessation of breastfeeding;
• improper introduction of complementary foods;
• artificial feeding and frequent changes of milk formula;
• milk protein intolerance;
• atopic (exudative) diathesis and other allergic diseases.

In preschool children and schoolchildren, the causes of dysbiosis can be:

• unhealthy diet (excessive consumption of meat products and sweets);
• previous intestinal infections;
• chronic diseases of the digestive system;
• frequent or long-term use of antibiotics (orally or by injection); Antibiotics destroy not only pathogenic, harmful microbes, but also beneficial ones;
• long-term treatment with hormonal drugs;
• allergic diseases;
• frequent colds and viral infections;
• helminthic infestations;
• immunodeficiency states;
• stress;
• surgical interventions on the digestive organs;
• hormonal changes during puberty;
• vegetative-vascular dystonia;
• unfavorable environmental conditions.

Symptoms

A child suffering from intestinal dysbiosis may alternate between diarrhea and constipation.

Dysbacteriosis does not have any particularly specific manifestations.

Symptoms of dysbiosis can be very diverse. Most often, disorders of the digestive tract appear. The child's appetite decreases and a feeling of bloating occurs. Aching, nagging pain in the abdomen may occur, more pronounced in the afternoon. They may be cramping in nature. In infants, regurgitation (or vomiting) and loss of body weight are observed.

Older children may notice an unpleasant metallic taste in their mouth. Characteristic is alternation of diarrhea and constipation. The stool has an unpleasant odor, and an admixture of mucus and undigested food may appear in the stool.

There is a frequent urge to defecate - the so-called “duck symptom” or “slipping of food”: only after eating, the child sits on the potty or runs to the toilet. The stool may be watery, mucous, with undigested food debris.

Allergic reactions often develop in the form of various types of rashes, dermatitis, and peeling of the skin. Vitamin deficiency that develops with dysbacteriosis is manifested by bleeding gums, brittle nails and hair.

Dysbacteriosis reduces the defenses of the child’s body, so frequent colds, viral and infectious diseases constantly “cling” to the child. And they, in turn, contribute to an even greater aggravation of dysbiosis.

The child’s behavior also changes: he becomes capricious, restless, whiny, and sleeps poorly. With advanced dysbacteriosis, the temperature may rise within 37.5 C.

Diagnostics

Laboratory methods are used to confirm the diagnosis:

• bacteriological examination of feces: makes it possible to determine the types of microorganisms, their quantity and sensitivity to antibiotics and bacteriophages; For analysis, you need approximately 10 g of the morning portion of feces, collected in a sterile container and delivered immediately to the laboratory;
• clinical stool analysis (coprogram): study of food digestibility in the intestines.

To clarify the condition of other organs of the digestive system, ultrasound, fibrogastroduodenoscopy, and duodenal intubation may be prescribed.

Treatment

Only comprehensive treatment of dysbiosis can be effective. The important point is to find out the root cause of this condition and eliminate it in the future.

Treatment may include the following components:

• diet therapy;
• drug treatment;
• symptomatic treatment.

At any age of a child, dietary nutrition is of great importance for the treatment of dysbiosis. Diet is an even more important remedy than medications with live lacto- and bifidobacteria.

It is good if the baby is breastfed. If the child is bottle-fed, then you need to decide with the pediatrician whether to keep the same milk formula or switch to medicinal formula (such as Bifidolact, Humana, etc.).

In some mild cases, dysbiosis can be completely eliminated in a small child only by correcting the diet, without drug treatment.

It is advisable for children of any age to include fermented milk products (or fermented milk formulas for infants) containing bifidobacteria and lactobacilli in their diet. These are the so-called natural probiotics, most often used for dysbiosis and are a good alternative to medications:

• Bifidok: is kefir with the addition of Bifidumbacterin: restores normal flora in the intestines, helps suppress putrefactive and conditionally pathogenic bacteria, slows down the growth of staphylococcus;
• Bifilin: can be used from the very birth of the baby, contains bifidobacteria, can also be used during antibiotic treatment; restores intestinal microflora;
• Immunele: contains a large amount of lactobacilli and vitamins; normalizes microflora, improves immunity;
• Activia: contains bifidobacteria, but can only be used from a child over 3 years of age;
• Actimel: contains lactobacilli, also helps restore intestinal microflora.

Milk is completely excluded from the child’s diet. It must be replaced with fermented milk products.

Your pediatrician will help you choose the right fermented milk product for your child. Yogurts, kefir, Narine can be prepared at home, because purchasing a yogurt maker and special starter cultures at the pharmacy is currently not a problem.

Fermented milk products prepared independently will bring more benefits to the child, since, contrary to advertising, the amount of beneficial bacteria in industrially produced products is not enough. Moreover, the longer the shelf life of the product, the less probiotics it contains, since living beneficial bacteria die within the first few days.

Fresh, tasty and healthy fermented milk products can and should be prepared at home!

For older children, the diet should include porridge (barley, oatmeal, buckwheat, rice, millet), fruits and vegetables. For small children, porridge should be given pureed. Pasta and white bread should be excluded completely.

Vegetables, thanks to the fiber in them, improve digestion and movement of food through the intestines. At the age of 2, the baby should prepare vegetable purees (excluding vegetables containing starch).

Vegetables such as zucchini, carrots, pumpkin, cauliflower, and beets will be useful for children. Moreover, until the age of 3, the child should be given boiled, stewed or steamed vegetables.

A decoction of these vegetables is also useful. Raw vegetables can be given after 3 years in small quantities to prevent their irritating effect on the mucous membrane of the digestive tract.

Some fruits (lingonberries, black currants, apricots, pomegranates, rowan berries) have a detrimental effect on “harmful” microorganisms. Baked apples and rosehip decoctions are also useful for children. You can give your baby bananas raw.

Fresh juices are excluded. The child should be given non-carbonated water.

It is recommended to cook fruit and berry compotes and jelly, compotes from dried fruits for children. It is advisable not to sweeten them, as sugar creates an unfavorable environment for beneficial intestinal bacteria. As a last resort, you can add a little honey to the decoction or compote, provided that the child does not have allergies.

To provide the body with proteins, your child should prepare steamed omelettes, low-fat fish, boiled or steamed rabbit or chicken.

From the diet of older children, it is necessary to completely exclude fried foods, smoked foods, pickles, pickled and spicy foods, fast food, sweets, and carbonated drinks. It is advisable to follow a diet and avoid snacking.

Popular drug

Drug treatment of dysbiosis includes two important stages:

1. Elimination of pathogenic flora from the intestines:

• use of antibacterial drugs, or antibiotics;
• appointment of bacteriophages;
• use of probiotics.

1. Replacement therapy, or “populating” beneficial microflora into the intestines with the help of probiotics.

An individual treatment regimen for each child is drawn up by a doctor (pediatrician, infectious disease specialist or gastroenterologist).

The appropriateness of using antibiotics is determined by the doctor after receiving a stool test for dysbiosis. Typically, antibacterial drugs are prescribed for massive contamination with pathogenic flora. Nifuroxazide, Furazolidone, Metronidazole, and macrolide antibiotics can be used.

Some pathogenic microorganisms can also be eliminated using bacteriophages. A bacteriophage is a virus for a strictly defined type of bacteria (salmonella, dysentery bacillus) that can destroy them. It is clear that it can only be used when the causative agent of the disease is precisely identified.

Linex - the most popular probiotic

A more gentle method of destroying pathogenic flora is the use of probiotics. Beneficial bacteria multiply in the intestines and create unfavorable conditions there for “harmful microbes”, that is, they gradually displace them. Such drugs include Enterol, Baktisubtil, Bifiform. They are used after one year of age.

Probiotics and prebiotics are used for replacement therapy. Probiotics (containing lactobacilli or bifidobacteria) are selected based on the result of an analysis for dysbacteriosis. And prebiotics create favorable conditions for beneficial bacteria, “feed” them, stimulate growth and reproduction.

There are symbiotic drugs that contain both probiotics and prebiotics. These include the drugs Bifiform, Bakteriobalans, Bifidin, Bonolact, Polibacterin, etc.

The following drugs are most often used to restore intestinal microflora:

As symptomatic therapy, enzymatic preparations can be prescribed to improve food digestion, sorbents (prescribed in severe cases, remove toxins from pathogenic flora), and vitamin complexes.

Maintaining a daily routine, avoiding stressful situations and overwork, daily walks in the fresh air - all this will help cope with the disease.

Some parents are supporters of traditional medicine. Tips for the treatment of dysbiosis are based on the use of decoctions and infusions of herbs. The use of herbal decoctions with an antiseptic effect (chamomile, St. John's wort, sage) will be useful, but their use must also be agreed with a doctor, because there is always a risk of developing an allergic reaction to herbs.

Some traditional medicine tips:

• for diarrhea, you can use a decoction of oak bark, which has, in addition to a fixative, an anti-inflammatory effect;
• onion infusion, prepared from 2 onions, chopped and poured with 3 glasses of chilled boiled water, infused overnight, drunk during the day for a week; Probably, this infusion can (??) only be taken by an older child;
• a decoction of shrubby cinquefoil herb or “Kuril tea”, purchased at a pharmacy: take 1 g of herb and 10 ml of boiling water per 1 kg of baby’s weight, boil for 3 minutes, strain, cool, give the child something to drink;
• for the treatment of dysbacteriosis in infancy: take kefir (10 ml/kg body weight), rub through a strainer, heat it up and after the child has stool, give him an enema with kefir; You need to repeat the procedure 2-3 times.

Prevention

Prevention of dysbiosis should begin at the planning stage of pregnancy and during it. The expectant mother should undergo an examination to determine the state of the microflora in the vagina and treatment if any pathology is detected. In some cases, doctors recommend a preventive course of treatment with bifido- and lactose-containing drugs.

Of great importance is the early attachment of the baby to the breast, the longest period of breastfeeding, and the nursing mother's adherence to a proper diet. Complementary foods should be introduced on time, including fermented milk mixtures with bifidobacteria as complementary foods.

Often and long-term ill children should be given probiotics for preventive purposes. If any manifestations of impaired digestion of food appear, you need to consult a doctor and promptly receive treatment if dysbiosis is detected.

It is important to find out the reason for its appearance in order to prevent it from occurring again.

Summary for parents

Dysbacteriosis is quite common in children of all ages. Changes in stool character in children and complaints from the digestive tract in older children should not be ignored. Diagnosing dysbiosis is not difficult. And the available arsenal of special drugs allows us to cope with this pathology.

What dysbiosis actually is in children

It can be much more difficult to establish and eliminate the cause of the pathology in order to rid the child of it forever. Knowing the measures to prevent dysbiosis, we must strive to prevent its development. After all, the most reliable method of treatment is prevention.

Which doctor should I contact?

If you have problems with your intestines, you should contact your pediatrician. After the initial examination, he will refer the child to a gastroenterologist. Additionally, a consultation with an infectious disease specialist (if infectious diseases are detected) and an immunologist is prescribed, because dysbiosis is directly related to the disruption of immune processes in the body. Often the child is examined by an allergist, and in case of skin manifestations of the disease, by a dermatologist. Consulting a nutritionist will be helpful.

Pediatrician E. O. Komarovsky speaks about dysbiosis:

Dysbacteriosis - School of Dr. Komarovsky

Dysbacteriosis in children - main symptoms:

• Abdominal pain
• Mucus in stool
• Loss of appetite
• Diarrhea
• Abdominal cramps
• Bad breath
• Constipation
• Flatulence
• Unstable chair
• Uncharacteristic color of stool

Intestinal dysbiosis in children is a pathological process in which there is a disturbance in the composition of the intestinal microflora. The total number of opportunistic microorganisms increases, while beneficial bacteria gradually die. Imbalance provokes the appearance of various gastrointestinal disorders, decreased body reactivity, progression of anemia, as well as other serious pathological conditions. In the medical literature, this disease is also called intestinal dysbiosis.

Quite often, signs of dysbiosis can be found in a child of early childhood, often even in an infant. Prevention of illness in a child affects not only the impact on his health, but also on the health of the mother.

Reasons

Disorder of the intestinal microflora can occur for the following reasons:

• Late latching of the baby to the breast. The fact is that colostrum contains protective elements necessary for the baby’s intestines, including immunoglobulin, which causes an increase in the number of beneficial bacteria;
• a sharp or too early transition of an infant to artificial feeding. This causes beneficial intestinal bacteria to appear “late”;
• unbalanced and undiversified diet. Intestinal problems can be caused by both currently fashionable diets and the consumption of refined foods with minimal fiber content, which “feeds” beneficial intestinal bacteria;
• diarrhea, constipation and other gastrointestinal problems;
• diseases associated with impaired absorption of substances in the intestinal environment;
• chronic gastrointestinal diseases (ulcers, colitis, gastroduodenitis);
• food allergies;
• acute diseases caused by infections;
• radiation exposure;
• previous operations;
• uncontrolled use of antibiotics.

Symptoms

The main symptoms of dysbiosis are:

• stool instability - diarrhea alternating with constipation. In this case, there may be mucus in the child’s stool, and the stool itself may be colored in an uncharacteristic color;
• flatulence;
• periodic cramps and pain in the abdominal area;
• loss of appetite;
• bad breath.

It is worth knowing that the above signs of dysbiosis in children may also indicate other, more serious diseases associated with poor functioning of the gastrointestinal tract, so before starting treatment, you must make an appointment with a doctor.

Symptoms of intestinal dysbiosis in children

Degrees

Intestinal dysbiosis is conventionally divided into 4 degrees:

• first degree characterized by a slight predominance of anaerobic flora over aerobic flora. The baby feels well, there are no signs of illness, and no treatment is carried out;
• second degree The disease is characterized by inhibition of anaerobic bacteria in the intestine to approximately the same amount as aerobic bacteria. At this degree, opportunistic microorganisms begin to multiply and an atypical form of E. coli begins to appear. Symptoms of this degree of disease are diarrhea and abdominal pain. In infants, this stage of the disease can even cause growth retardation;
• third degree characterized by an increase in the amount of aerobic flora with an increase in the amount of fungus of the genus Candida, staphylococcus and other bacteria. The process of intestinal inflammation begins, which interferes with normal digestion of food. As a result, undigested food can be found in the stool. At this degree of the disease, treatment is prescribed, which lasts up to several months;
• fourth degree is characterized by a clear predominance of pathogenic flora, which causes deterioration in children's condition, weight loss, lack of vitamins and even intoxication. It is the last stage of dysbacteriosis, requiring long-term restoration of the microflora.

Diagnostics

Often, symptoms of dysbiosis in children indicate that dysbiosis is just a secondary disease, and the primary one is another gastrointestinal disease. Correct diagnosis of symptoms by a doctor is possible only on the basis of data obtained as a result of research in the laboratory. Today the following are used for these purposes:

• scatological analyses;
• biochemical research;
• bile tests;
• determination of the composition of bacteria in the intestines using specific tests;
• scraping, which is taken from the mucous membrane of the small or duodenal intestine;
• a scraping taken from the colon as well as the rectum.

It is the last two studies that allow us to obtain the most objective data, since they examine the parietal microflora, which is not contained in the stool analysis. Complex intestinal examinations, however, are performed only with the preliminary indication of a doctor.

Treatment

Regular feces taken from a child can only indirectly suggest what kind of microflora he has in his intestines. So if an infant or older child has tests with slight deviations from the norm, and they do not have problems with stool, are not bothered by abdominal pain and do not experience other symptoms of dysbiosis, you should not give him medicine with bacteria. If dysbiosis appears in children under one year of age or more, then it is necessary to find out its true causes. When the root cause is found, correction of the composition of the intestinal microflora begins. Treatment of the disease is carried out by a gastroenterologist, pediatrician, infectious disease specialist or allergist, depending on the root cause of the disease.

In addition, when the doctor begins to treat the primary disease, the secondary disease - dysbiosis - can also be eliminated automatically. For example, if you treat enzymatic disorders in the intestines of an infant, then his microflora will be restored.

To successfully treat dysbiosis in infants and adolescents, it is necessary, first of all, to follow a diet. It differs for different age categories of patients; for example, it will be enough for an infant to return to feeding with mother’s milk or introduce complementary foods gradually. Older children should review their diet by adding dairy products to their diet. You can treat and restore intestinal microflora with the following medications:

• “Bifidumbacterin” – available in liquid and dry form;
• "Lactobacterin";
• "Linex".

To stimulate the proliferation of beneficial microorganisms in the intestinal flora, it is recommended to drink “Hilak-Forte” or “Lysozyme”. Also, to treat dysbiosis, the doctor will most likely prescribe you bacteriophages, as well as antibiotics that will destroy harmful bacteria. After correction, probiotics will be used to restore microflora.

As for diet formulas for infants, they will benefit from taking the following medications:

• "Lactofidus";
• mixture of “NAN with bifidobacteria”;
• "Narine."

Many believe that the treatment of dysbiosis in children in all cases is accompanied by taking medications. In fact, medications to treat dysbiosis will be prescribed by a doctor if:

• long-term treatment with antibiotics was used, which destroy both harmful and beneficial bacteria;
• suffered from intestinal diseases;
• The baby was given an unadapted formula too early.

In other cases, if the child did not have the above situations, the microflora will be corrected using the best prevention - diet. It is worth knowing that changing the diet of children under one year of age must be agreed upon with the attending physician, and for schoolchildren and preschoolers the following advice on diet will be relevant:

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