Severe dysbacteriosis in a child. Tests and rules for collecting them if intestinal dysbiosis is suspected in a child. The role of microflora in the intestine

When the baby is in the womb, he lives in sterile conditions, but during labor, colonization occurs gastrointestinal tract, mucous membranes with numerous bacteria that create microflora. Healthy intestinal microflora is directly involved in the formation of a strong and stable immune system, breaks down fats, carbohydrates and proteins, helps normalize digestion, and also protects the child’s body from pathogenic microbes. When there is an imbalance in the ratio of harmful and beneficial bacteria, dysbiosis develops. Every parent should know what to do in this situation.

There are 4 main forms of microflora:

obligate;
pathogenic;
optional;
transient.

The obligate variety includes bifidobacteria, lactobacilli, Escherichia (bacillus), enterococci, bacteroides, and peptostreptococci. Bacteria in this group occupy about 95% of the entire intestinal microflora of a healthy baby. They normalize healthy digestion and motility, protect the mucous membrane, and prevent the proliferation of harmful microorganisms. This form participates in the production of folic acid, enzymes, amino acids, and B vitamins. These microorganisms also destroy cancer cells, undigested food products that enter the intestines are broken down.

The facultative type consists of clostridia, enterobacteria, staphylococci, yeast-like fungi, and Klebsiella. These microorganisms must exist in the body in small quantities. With a stronger immune system, the presence of these bacteria does not provoke the development of diseases. They take part in intestinal motility and the breakdown of animal proteins. If their numbers increase rapidly, dysbacteriosis develops. This disease is accompanied by the following symptoms in children: rumbling, distension and pressure in the abdomen, belching and increased gas formation, violation of healthy stool.

Transitory and pathogenic types of flora consist of dangerous bacteria, which should not colonize the intestines. They provoke the appearance of various infectious diseases. The presence of these microbes can be detected by performing a stool test.

Features of the disease in children

Dysbacteriosis is an imbalance of intestinal microflora, manifested by a large number of pathogenic microorganisms and a decrease in beneficial bacteria. It is possible to understand that a child has dysbiosis based on a coprogram - a stool analysis. With the help of microbiological research, it is possible to identify all inhabitants of the microflora. The coprogram determines what pathologies of the gastrointestinal tract occur in the child’s body.

Since the initial stage of the disease is easier to treat, you need to be attentive to your child’s condition. In the presence of the slightest sign It is recommended to consult a doctor and undergo an examination.

You should not choose medications and start treatment on your own, since many gastrointestinal ailments have similar symptoms. A qualified doctor must determine the diagnosis and prescribe a course of therapy. Self-medication can lead to complications.

Intestinal dysbiosis in children has certain clinical manifestations. As for babies under one year old, they are behind in weight, spit up and sleep poorly, are capricious, and loose stools predominate. Characteristics of feces: there is a sour and putrid smell, foam. IN one year old the symptoms are similar. There may also be cramping abdominal pain observed after feeding. The painful attack ends with diarrhea, rumbling and increased gas production. Children under three years of age experience belching, colic, flatulence, unstable stools, decreased appetite and bloating in the abdomen.

It is important to start treatment of dysbiosis in children on time, since the incubation period is accompanied by intoxication, infectious toxicosis and reduced body resistance. Symptoms: weakness, lack of appetite, sweating and low-grade fever. Lack of treatment can lead to the following complications: hypovitaminosis, lack of bile acids and enzymes, anemia (anemia), decreased immunity, vitamin D and calcium deficiency, gastrointestinal bleeding.

There are 4 degrees of dysbacteriosis. During the first stage, there are the following symptoms: constipation, lack of appetite and weight loss, bloating. The bowel movements have an uneven color.

Dysbacteriosis of the 2nd degree is manifested by nausea, vomiting, belching, heartburn, epigastric pain, impaired motor skills, lack of appetite, constipation. Dysbacteriosis of the 2nd degree can occur against the background of gastroenteritis. In addition, the disease can accompany enteritis, when signs such as coating on the tongue, diarrhea, bloating, cramps, hypovitaminosis and anemia are noted. Allergies in children may occur in this form.

Grade 3 is characterized by transient bacteremia, as well as headaches, chills, high body temperature, and intoxication. Pathogenic bacteria are present in bile and urine. The color of the stool is green. form.

As for degree 4, it has the following symptoms: poor appetite, nausea, headaches, high fever and loose stools that have a putrid odor. There is a central nervous system disorder.

At mild form It is enough to adhere to a strict diet to eliminate symptoms. In more severe cases, drug therapy will be needed. Antibiotics may be prescribed to restore the microflora.

Etiology of pathology of the digestive system

In order for the treatment and prevention of dysbiosis to give good results, it is important to find out the causes of this syndrome. The causes of pathology under the age of one year may be the following:

improper nutrition of a nursing mother;
taking antibiotics;
food allergies;
stress;
weakened immune system;
artificial feeding, sudden weaning;
the presence of infectious diseases - dysentery, Staphylococcus aureus, salmonellosis.

As for the disease that occurs after a year, most often the causative agents are worms, poor nutrition, colds, etc. Malicious influence provide hormonal drugs. Preschoolers and schoolchildren may experience similar symptoms due to frequent stressful situations and puberty, operations on the gastrointestinal tract, vegetative-vascular dystonia.

Medical therapy

The treatment regimen for dysbiosis in children is determined by the attending physician. In addition to medications, nutrition plays a decisive role. It is important that the treatment is comprehensive.

Anti-dysbacteriosis medications for children:

Linex - helps restore the epithelial layer of the intestine, improves the natural absorption of electrolytes. The course of treatment is at least five days. Dosage: children under two years of age – 1 capsule, from two years of age – 2 capsules;
Acipol - can be given even to infants, has wide range effects, helps restore intestinal immunity. The dosage for newborns is five doses per day, for children from six months of age - about 15 doses, which must be divided into 3 doses before meals;
Bifiform Baby - contains lactobacilli, bifidobacteria, B vitamins.

To replenish the intestinal flora, you will need medications. Live bacteria are found in the following food products: Actimel, Bifidok, Activia, Biolact. To prepare the drink, it is better to buy a starter at the pharmacy in order to make healthy, tasty yoghurts for your child yourself.

It is necessary to adjust the diet, enrich the baby’s diet with plant fibers and lactic acid bacteria, which are found in cottage cheese, kefir and milk. You can increase your consumption of yogurt, vegetables and fruits, millet, oatmeal and buckwheat. Children under one year of age are advised to breastfeed, so the mother is obliged to preserve lactation. This is due to the fact that breast milk contains a lot of beneficial microorganisms and bacteria. Milk contains lactose, which promotes the growth of healthy bacteria.

Microflora imbalance in children is a common phenomenon that requires timely treatment. Therapy should be comprehensive, including taking certain medications, diet and regimen adjustments.

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 may occur after the use of antibiotics, if not proper nutrition, bad ecology.

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

mother's malnutrition breastfeeding;
artificial feeding with formulas;
abrupt weaning;
taking antibiotics;
allergy;
weakened immune system;
poor environmental situation.

In children older than 1 year, 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.

What can you give your child if he has a stomach ache? Read useful information.

About what and how to treat allergic dermatitis in children, find out from this article.

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;
weakened immunity, 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 stool is liquid and contains remnants 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 chair may have sour smell with admixtures of mucus and greens. Symptoms may resemble colitis: diarrhea gives way to constipation, syndrome incomplete emptying intestines, 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.

Note! 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 determine the 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 submitting stool to 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 relieve symptoms 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 strong pain in a stomach.

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 level"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 initial disease You need to include natural probiotics, fiber, pectins, and dietary fiber in your 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 2 years of age, 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.

Facilities 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 You can give your child microenemas from 100 ml of vegetable oil (olive, sesame, peach) with 5 drops of ether tea tree and fennel. 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 symptoms and treatment at chronic pharyngitis in children.

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 supplies, which make it possible to successfully treat dysbiosis. The main thing is to detect the problem in time and seek qualified help.

More interesting details O childhood dysbacteriosis in the following video:

Clarity and coherence of work digestive tract 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. Children'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 coat the intestinal wall, produce enzymes, active substances. Designed for final digestion of food, ensuring the absorption of nutrients and water.

Immunity

Concentrated in the intestines 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.

Causes

The likelihood of the primary development of dysbiosis is very small (with the exception of infants), most often the factors are: pathological changes while 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 1-year-old children and dyspeptic changes against the background of gastrointestinal pathology have quite similar clinical manifestations:

mom will notice that one year old child 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 skin diseases allergic reactions, like 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, it has a number of consequences, manifested by impaired absorption in the intestine, 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 violations functioning 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 noted - pallor 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 digestion process is severely disrupted in combination with decreased immunity.

Primary form of dysbiosis in children

According to Dr. Komarovsky E.O. - This 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 the child - sweets, colored fruits, carbonated drinks, spicy, fatty dishes, 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, you need to pass a series of laboratory tests (general and biochemical analysis blood, urine, microbiological analysis of stool, stool examination for dysbacteriosis), instrumental methods research (ultrasound of the abdominal organs).

Which doctor deals with gastrointestinal pathologies?

Whenever dyspeptic phenomena It is recommended that you consult your pediatrician first. 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.

Before visiting the clinician, it is not advisable to give your child any medicines. 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 sides - high sensitivity, easy to perform. Negative aspects add up to 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

According to the results laboratory methods studies prescribe complex therapy aimed at eliminating the underlying 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, dairy products.

If diarrhea occurs, you must include:

rice or oat infusions, 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 actions

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 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 intestine

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 children's bodies from pathogenic microbes(salmonella, dysentery bacillus, mushrooms, etc.) that can cause intestinal infection: they produce substances that block reproduction pathogenic flora;
promote the movement of digested food and bowel movements;
participate in the formation of immunity;
protect the body from exposure unfavorable factors: neutralize the effect of nitrates, chemical substances(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 disorders, metabolic processes and immunity 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.

Causes

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 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. There may be aching, nagging pain in the abdomen, 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 unpleasant metallic taste in the mouth. Characteristic is alternation of diarrhea and constipation. The stool has an unpleasant odor, stool an admixture of mucus and undigested food may appear.

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 digestive system Ultrasound, fibrogastroduodenoscopy, and duodenal intubation may be prescribed.

Treatment

It can only be effective complex treatment dysbacteriosis. 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 the child, dietary nutrition has great value for the treatment of dysbiosis. Diet is even more important means than medications containing live lacto- and bifidobacteria.

It is good if the baby is breastfed. If the child is on artificial feeding, then you need to decide with your pediatrician whether to keep the same milk formula or switch to a 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 opportunistic bacteria, slow 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.

Pick up necessary for the child The pediatrician will help with a fermented milk product. 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, and cauliflower, beet. 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 of age. small quantity 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. IN 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:

Elimination of pathogenic flora from the intestines:

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

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. Usually antibacterial drugs 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 favorable conditions for “harmful microbes”, that is, they gradually displace them. Such drugs include Enterol, Baktisubtil, Bifiform. They are used after one year of age.

For replacement therapy probiotics and prebiotics are used. 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 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, in addition to having a fixative effect, has an anti-inflammatory effect;
infusion onions, prepared from 2 onions, chopped and poured with 3 cups 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 a 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 early attachment of the baby to the breast, the longest period of breastfeeding, and compliance by the nursing mother with proper diet nutrition. 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 special drugs allows you 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 is prescribed (if infectious diseases), as well as an immunologist, because dysbiosis is directly related to the disruption of immune processes in the body. Often the child is also examined by an allergist, and if skin manifestations diseases - 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 reactivity of the body, progression of anemia, as well as other serious pathological conditions. IN 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.

Causes

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;
abrupt or too early transition infant for 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 indicate other, more serious diseases associated with poor functioning gastrointestinal tract, so before starting treatment, you must make an appointment with a doctor for examination.

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, the proliferation of opportunistic microorganisms begins and the appearance of an atypical form coli. 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, you can find in stool undigested food. 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. Is last stage dysbacteriosis, requiring long-term restoration of microflora.

Diagnostics

Often, symptoms of dysbiosis in children indicate that dysbiosis is just secondary disease, and the primary disease 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.

Exactly two latest research and allow us to obtain the most objective data, since they study 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 clarify it. true reasons. 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:

Ringworm on the head of a child, treatment, traditional methods of treatment, Vegetative vascular dystonia in an 8-year-old child, symptoms and treatment
I began to notice that the child was blinking with one eye: causes and treatment

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.

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

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.

Causes

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.

Clinical manifestations of the disease in different age groups

Children under one year old

Symptoms of dysbiosis in 1-year-old children 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
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 intestine, which can lead to insufficient supply of vitamins and important microelements.

After a year

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:

the child very often suffers from acute respiratory viral infections, acute respiratory 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

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 noted - 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

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

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

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.

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 actions

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

Dysbacteriosis in children is a fairly serious and common problem. Diagnosis of dysbiosis in children is especially difficult, since its symptoms are similar to a huge number of other gastrointestinal diseases.

And in this article we would like to talk about how to treat intestinal dysbiosis in children, what tests to take to diagnose it, and how this disease generally manifests itself. In addition, the article will contain reviews of medications for dysbiosis in children and recommendations on what to eat for children with dysbiosis.

The most common causes of dysbiosis in children are associated with poor nutrition and long-term use antibiotics. At the same time, dysbiosis after antibiotics in a child is a rather serious condition, in rare situations ending in the development serious illnesses(pseudomembranous enterocolitis, for example).

But not in all cases it is possible to understand the exact pathogenesis (causes) of the developed dysbacteriosis. Sometimes dysbiosis develops in a child without any visible predisposing causes.

If we talk about all the possible causes of intestinal dysbiosis in children, then they are:

Late latching of the baby to the breast.
Situations when a mother has to feed her child artificially.
Malnutrition of the child.
Frequent constipation or, on the contrary, diarrhea.
Disruption of the mechanism of absorption of microelements in the intestine.
Gastroduodenitis, peptic ulcers, colitis.
Food allergies and atopic dermatitis.
Intestinal infections, flu.
Exposure to high doses of radiation.
Gastrointestinal injuries.
Surgical interventions.
Taking antibiotics.

It is important to remember that the severity of the disease of this disease often directly related to the cause of its development. This is how dysbacteriosis occurs most severely due to exposure to radiation, taking antibiotics, infectious infection and after injuries to the gastrointestinal tract.

Risk groups: at what age do children most often suffer from dysbiosis?

The peak incidence of dysbacteriosis in children occurs at a very early age (in an infant) and at the age of 5-10 years. And this is not surprising; in such young children, the gastrointestinal tract does not work effectively enough, as does the immune system.

As a result, it turns out that it is at this age that you should especially closely monitor your baby and promptly treat any gastrointestinal diseases. Moreover, if your baby often gets the flu, then it makes sense to give him courses (once every six months) of drugs to improve intestinal microflora.

How dangerous is dysbiosis in a child?

In 70% of cases, dysbiosis in children does not pose any particular danger and is easily treatable (in 50% of cases it completely goes away on its own, without therapy). However, there are also situations when the disease progresses, which is already a very dangerous condition.

So, against the background of grade 3-4 dysbiosis, a baby may develop such serious complications as pseudomembranous enterocolitis or perforation of the intestinal wall. Such diseases can not only worsen the baby’s health, but in rare cases lead to his death.

That is why you should never ignore such diseases in children and expect them to resolve on their own. In all cases, even with weak severe symptoms, you should consult a pediatrician with your baby!

Symptoms of dysbiosis in a child

Childhood dysbiosis has a huge number of clinical manifestations (symptoms). Generally symptoms of this disease in a baby the following:

regurgitation in infants;
bad breath (sometimes even foul);
temperature (often fever);
reduction in the child’s weight gain;
rash on hands and face;
nausea and vomiting;
rashes in the mouth (stomatitis);
constipation or diarrhea;
false urge to defecate;
foamy or mushy stools;
blood in stool;
melena (black stool);
steatorrhea and flatulence;
intestinal colic;
intestinal dyskinesia;
belching;
decreased appetite.

What is obvious is that the signs of this disease are nonspecific and are found in a huge number of other gastrointestinal pathologies. For example, vomiting, rashes, constipation or diarrhea - frequent symptoms food intolerance.

However, due to a lack of diagnosis, doctors often mistake these symptoms for manifestations of dysbiosis and treat the child for the wrong reason. Therefore, it is very important that the doctor confirms his subjective opinion with the results of an analysis for dysbacteriosis in children.

IN otherwise A situation is possible when inadequate treatment is carried out (due to an error in diagnosis), and in the meantime the disease rapidly progresses. As a result, the child begins to be treated only when the disease has become serious and aggressive treatment is required.

Analysis for dysbiosis in a child

Tests for dysbiosis in children should be done if the symptoms described above persist for three or more days. The analysis itself is carried out in order to determine the concentration and ratio of symbiotic (beneficial) bacteria in the child’s body relative to conditionally pathogenic ones.

And it is better not to delay diagnosis, since intestinal dysbiosis in children develops very quickly and reaches grade 3-4, the consequences of which often require hospitalization. Delay is especially dangerous in the case of children under one year of age.

Before carrying out the analysis, it is imperative to carry out proper preparation. Thus, children under one year old can be given only the usual formula or breast milk three days before the procedure. mother's milk. Children aged 1-16 years will not be given fatty, fried, smoked, spicy and starchy foods (so as not to cause constipation or diarrhea).

The test material itself (feces) can be donated in any suitable container. However, it is important to note that it is best and generally correct to donate feces in a special pharmacy container, if you have the opportunity to purchase it. This needs to be done because the pharmacy container is sterile, unlike its household counterparts.

Drugs for the treatment of dysbiosis in children

In most cases, in order to cure a baby of intestinal dysbiosis, it is enough to give him analogues of those medications that are used to treat adult patients. Similar analogues are available in every pharmacy.

For example, the drug "Linex" for the treatment of adult patients can easily be replaced with baby remedy"Primadophilus". In general, “Primadofilus” is not much different from “Linex”, which, by the way, is confirmed by numerous reviews of mothers on the Internet.

Both the “Linex” product and the “Primadofilus” product restore such a fragile intestinal microflora, balancing it and significantly reducing (up to complete destruction) pathogenic microorganisms. Using Primadofilus can be used to cure not only dysbiosis, but also other childhood gastrointestinal diseases (diarrhea, constipation, IBS, colitis, and so on).

It also makes sense to give children the drug “Lactusan” against dysbiosis, which not only restores normal microflora intestines, but also helps to absorb food from the gastrointestinal tract. But remember, despite the fact that you can give this drug for dysbiosis to children yourself, it is better for a pediatrician to do it.

Also treatment regimen includes the following tactics for managing children with dysbacteriosis:

Correction of nutrition and correction of eating habits (ban on baby’s night meals, ban on baby’s frequent consumption of fast food, and so on).
Local treatment of individual symptoms of dysbiosis (rash, discomfort, fever, bad breath).
For grade 3 dysbiosis, intestinal motility stimulants are prescribed.
At 4 degrees of dysbiosis, antibiotics are prescribed (only a doctor can prescribe them!).
Further, if after therapy and relief of dysbiosis there are consequences, they are eliminated.
At the very end, prevention of relapse of the disease is carried out (this should only be done by a pediatrician!).

Diet for a baby with dysbiosis

Very often, children are prescribed nutritional correction for dysbiosis. In the vast majority of cases, if it is grade 1-2 dysbiosis, it can be treated exclusively with diet.

And the diet includes a strict restriction on the consumption certain food. Moreover, the baby will have to adhere to it for about 2-3 months (in case of severe dysbiosis, 2-5 years), in order to avoid a possible relapse of the disease in case of cure.

The nutrition system itself is simple. Parents need to start by introducing a fractional feeding system for the baby. So he needs to be given food 5-8 times a day in small portions. In terms of restrictions: You should not give your baby the following foods:

fatty meats, and for children under 5 years old and meat products;
chocolate and cocoa;
sausages and sausages;
any fast food;
fatty and fried foods;
spices;
fat milk.

Review of the drug "Primadofilus" for the treatment of dysbiosis in children

Let us repeat that only 1-2 degrees of dysbiosis can be treated with diet (only analysis can determine the specific degree); in other cases, diet is one of the components of the treatment regimen, but not an independent treatment.

Intestinal dysbiosis in children (video)

Prevention: how to avoid dysbiosis in a baby?

Prevention of intestinal dysbiosis or its relapse after successful treatment, consists in proper nutrition of the baby and timely treatment all diseases of the baby's gastrointestinal tract. Even the most “banal” diseases, such as gastritis and colic, need to be treated.

Prevention also involves feeding the baby natural foods rich in grains and vitamins. That is, simply put, children should be given more vegetables and fruits, cereals and dairy products ( store-bought yoghurts are ineffective in this regard).

The health of the child is the main concern of parents, and the detection of any illness in the baby is a serious test for the parental psyche. Unfortunately, doctors often not only fail to call parents to calm down, explain the situation and offer a clear and accessible plan of action with detailed instructions, but they also intimidate moms and dads until they lose their pulse with incomprehensible terms and diagnoses that are eerie to hear. Even if behind them there is something completely treatable and does not pose a direct threat to the baby’s health. Due to the reluctance of doctors to explain anything, it also happens that diseases and methods of their treatment are surrounded by a variety of rumors and speculations that have little to do with reality.

One of these “legendary” ailments has long been dysbiosis in children, the nature, causes and methods of treatment of which cause a real stir among parents.

A particularly emotional attitude to the problem is typical of mothers and fathers of infants who, listening to not entirely competent medical workers and more experienced parents, attribute any feeling of discomfort in the child to dysbiosis, and begin to eliminate it with everyone accessible ways. However, this approach is unlikely to bring any benefit, but can cause significant harm. Therefore, in order to preserve the baby’s health, it is necessary to have an idea of such a state of the body as dysbiosis.

What is it and why does it happen?

To understand what intestinal dysbiosis (or dysbiosis) is in children, you need to have an idea of the microflora of the gastrointestinal tract. Microflora of the gastrointestinal tract (also called eubiosis) is the quantitative and qualitative ratio of microorganisms of certain species that support correct exchange substances and human immunity at the level necessary for normal life.

Simply put, a healthy gastrointestinal tract is constantly populated with beneficial bacteria. They are responsible for the breakdown of food entering the stomach and intestines, absorption, exchange and assimilation useful substances as well as normal digestion. As a result of the correct regulation of digestive processes, cells of the immune system are formed, and therefore the body’s defenses are strengthened.

Intestinal microflora healthy person There are about 500 species of different bacteria. All of them are divided into obligate and opportunistic groups. Obligate bacteria make up 90% of the total intestinal flora and perform the most important functions for human immunity and digestion. These include:

Bifidobacteria are the most important microorganisms responsible for the synthesis of vitamins and strengthening the body's defenses. In newborn babies, colonization of the intestines by bifidobacteria begins on the 5th day of life, and by about a month they form persistent active colonies.
Lactobacilli – suppress foreign bacteria, fight pathogens gastrointestinal infections. They colonize the intestines of a newborn during the first month of life.
Propionic acid bacteria support metabolic processes and activate the immune system.
Peptostreptococci - maintain the acid-base balance in the intestines and are responsible for the breakdown of proteins.
Enterococci are responsible for normal fermentation with the breakdown of essential nutrients.

Opportunistic microflora are colonies of microorganisms that perform protective and digestive functions. They differ from obligate microbes in that they are harmless when their number does not exceed a certain value. Enhanced growth opportunistic flora leads to suppression of the activity of obligate bacteria and causes disruption of metabolic processes. These include:

Escherichia coli (Escherichia) - responsible for the synthesis of vitamins P, A and K, normally should not exceed 108 CFU/g.
Staphylococcus (saprophytic and epidermal) - support water-salt metabolism. Harmless to the body in quantities not exceeding 104 CFU.
Yeast-like fungi are responsible for the synthesis of lactic acid and the breakdown of food debris. Normally, their number should not exceed 104 CFU.

In addition to these bacteria, opportunistic bacteria include Proteus, Klebsiella, lactic acid streptococcus and Fusobacterium. All of them are beneficial to the body only in small quantities.

Pathogenic microorganisms V healthy intestines there should not be: they are the ones who provoke the development of infections, diseases of the gastrointestinal tract, and also weaken the immune system. Such bacteria include Salmonella of various types, as well as Yersinia, Shigella, Pseudomonas aeruginosa, Staphylococcus aureus and other pathogenic microbes.

How does dysbacteriosis occur in infants? The thing is that the intestines of a newborn are practically sterile - there are no microorganisms in it. Immediately after birth, the baby receives nutrition - breast milk or a mixture - which the intestines need not only to process, but also to extract the maximum benefit from it, therefore obligate microflora begins to actively develop. However, if pathogenic bacteria enter the body before beneficial ones, digestive and immune processes will immediately be disrupted, and the percentage of obligate microbes will be lower than necessary.

In older children, this condition may occur after taking medications, having had infectious diseases, or poor nutrition. In both infants and children under one year of age, dysbiosis is precisely this phenomenon. International classification diseases does not classify dysbiosis as an independent disease: it is considered only a consequence of previous infections and a weakened immune system. However severe violations intestinal microflora is quite dangerous and even requires hospitalization, which, however, does not happen so often.

Symptoms and diagnosis of dysbiosis

Since the disorder is directly related to digestive processes, signs of dysbiosis in children are quite obvious: it can be nausea, vomiting, bloating, frequent skin rashes, food allergies, weakness and even headaches.

While it is not so easy to suspect a violation of the intestinal microflora in a child over one year old, signs of dysbiosis in infants are usually obvious. The baby regularly experiences prolonged constipation or, conversely, diarrhea, and the feces become unpleasant color and smell. Baby often burps, sleeps poorly, becomes nervous and tearful, pimples, irritations and rashes may appear on the skin. All these phenomena are the first sign that something is wrong with the baby’s intestines, and it’s time to take tests to study the microflora.

Most informative analysis for dysbiosis in a child today - examination of stool for the presence of various types of microorganisms. The rules for its collection are quite simple: feces must be collected in a sterilized container and submitted to the laboratory in within three hours. Taking any medications and using rectal suppositories must be stopped at least three days before the test.

The test result form indicates the type and quantity of all identified microorganisms. If the study was carried out in a private laboratory, in the conclusion, next to the number of bacteria found, the rate of their presence in the intestines is indicated. Thus, one can see deviations in the ratio of obligate and pathogenic microorganisms, but put final diagnosis and only a specialist can prescribe treatment for dysbiosis in children.

Normalization of microflora

If the test for the presence of intestinal microflora disorders is positive, parents are faced with the question: how to treat dysbiosis in a child and how should the baby eat now? Many moms and dads run to the pharmacy in panic and buy everything known remedies to try to improve the functioning of your baby’s intestines using radical methods.

However, this behavior is unacceptable: drugs for the treatment of dysbiosis in children should be selected only by a gastroenterologist, since microflora disorders can be caused by different pathogens, each of which requires its own drug.

To eliminate pathogenic microorganisms, a specialist may prescribe bacteriophages – means in the form of special viruses that kill bacteria a certain type. They are considered safer than antibiotics, since each bacteriophage is destructive only for certain microorganisms, while the rest of the microflora remains intact. Depending on the direction, Klebsiella, Staphylococcus, Coliproteus and other bacteriophages are isolated. These drugs are considered the most effective and harmless medicines for dysbiosis in children.

After eliminating pathogenic bacteria, it is necessary to restore and strengthen the beneficial intestinal microflora. For these purposes it is prescribed preparations based on bifidobacteria and lactobacilli . The microorganisms obtained with the product take root in the intestines, create new colonies and stabilize eubiosis. The most effective and popular drugs for the treatment of dysbiosis in infants are considered to be “Hilak Forte” and “Linex”. For children over 1 year of age, the use of such drugs as Acipol, Bifiform, Bifidumbacterin is allowed.

If the child is breastfed, the mother is also recommended to have her breast milk tested: pathogenic microorganisms may also be present there. If pathogenic bacteria not found, recommended for baby natural feeding and restrictions in complementary feeding until disappearance unpleasant symptoms. For older children, a special diet is recommended. Diet for dysbiosis in children is to consume rice, millet, semolina and buckwheat cereals, potatoes, low-fat dietary meat and not too sweet drinks. Dairy products, fruits, and vegetables are excluded from the diet during treatment.

Causes and prevention of dysbiosis

The child’s intestines are a rather vulnerable organ, so microflora disturbances can be caused by a variety of reasons:

infectious and colds that weaken the immune system;
unfavorable environmental conditions;
violations of hygiene rules;
errors in nutrition;
taking antibiotics, because antibacterial drugs kill all microflora, including beneficial microorganisms.

To protect your child from stomach and intestinal disorders, it is first necessary take care of hygiene : treat breasts before feeding, ensure the sterility of toys, pacifiers, and baby dishes. Complementary feeding should be introduced carefully and strictly according to the rules: an excess of foods unfamiliar to the baby causes increased fermentation and fast growth conditionally pathogenic microorganisms. When a child begins to crawl and walk, it is necessary to ensure that the floors and furniture are clean and ensure that the baby does not put things in his mouth dirty hands. To prevent dysbiosis after taking antibiotics, it is recommended to give the child medications containing bifidobacteria and lactobacilli - this will help preserve the beneficial intestinal microflora. The most effective drug for children is considered to be Linex, which is also recommended to be given to children from birth to accelerate the formation of colonies of obligate bacteria. However, the advisability of taking a probiotic in this case can only be assessed by a doctor.

In any case, dysbiosis is not a reason to panic, but it still should not be ignored. It is very important to carefully monitor the baby’s health and nutrition, and if symptoms of dysbacteriosis occur in a child, immediately contact a specialist. Attentive attitude and careful adherence to all medical recommendations will help to establish normal digestion in the child and maintain his good health.