What is dyspepsia in adults and children? In simple words about the complex

Definition of dyspepsia

Fermentative dyspepsia is a functional disorder of the digestive system, in which fermentation predominates in the intestines as a result of consuming excessive amounts of carbohydrate foods.

Dyspepsia is a term that combines any digestive disorders of a functional (non-organic) nature. Pathological fermentation of gases in the intestines is only a form of dyspepsia, since pathology exists in various forms:

• gastric;
• hepatic;
• fat;
• putrid;
• intestinal.

The pathological process in the lower part of the digestive system may not necessarily be localized in one place. For example, fermentation in the stomach may be present along with increased gas formation in the intestines. Therefore, diagnosis and treatment must be comprehensive.

Treatment of dyspepsia

Treatment of dyspepsia of nutritional origin consists of prescribing a fasting pause, lasting from a day to a day and a half, then gradually introducing food. Particular attention is paid to a balanced diet and adherence to food intake. It is necessary to limit the consumption of foods that cause dyspepsia. You also need to monitor your drinking regime; the recommended amount of water should be at least 1.5 liters per day.

Treatment of dyspepsia caused by enzyme deficiency consists of correcting enzyme deficiency, for which replacement therapy with drugs containing the necessary enzymes is used, as well as following a diet that relieves the affected area of ​​the gastrointestinal tract. With this type of dyspepsia, it is necessary to treat the underlying disease.

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Reasons for development

The main cause of dyspepsia is poor nutrition. However, not every person knows what this definition includes.

First of all, we are talking about the consumption of low-quality products and an unbalanced diet. The term also includes:

• quick snacks on the run;
• eating during times of stress and emotional irritation;
• monotonous diet (mono-diet);
• binge eating.

All these factors increase the load on the digestive system, resulting in even healthy organs being unable to digest food properly.

Such disorders are called functional: that is, human organs are absolutely healthy, but their function is impaired under the influence of external factors.

The main cause of fermentative dyspepsia is an excess of carbohydrates in the diet: when a person eats a lot of foods rich in carbohydrates, especially fiber, the amount of fermentative microflora in his intestines increases. It is at this moment that a person experiences all the unpleasant symptoms of dyspepsia.

In some cases, disruption of the digestive process can occur under the influence of not only external, but also internal factors.

• For example, if a person has reduced secretion of gastric juice: in this case, even a moderate amount of fiber consumed cannot be digested correctly, which is why fermentation actively develops in the intestines.
• Similar reasons include a decrease in the volume of pancreatic amylase, a special enzyme that is produced by the pancreas and salivary glands to break down carbohydrates, and a decrease in the motor activity of the small intestine.
• Another reason why pathology may develop is insufficiently thorough chewing of food. Firstly, this increases the load on the digestive system, and secondly, the food bolus is not sufficiently treated with amylase from saliva.

Statistically, dyspepsia is more common in the hot season, when a person drinks large amounts of liquid. In this way, it dilutes the digestive secretions so that food cannot be digested completely and correctly. This is especially relevant if a person suppresses thirst not with water, but with cold carbonated drinks.

Causes

Fermentative dyspepsia is caused by two groups of reasons: enzyme deficiency and malnutrition.

Enzyme deficiency

Pancreatic amylase in the duodenum breaks down complex carbohydrates - polysaccharides into oligo- and disaccharides. Under the action of enzymes in the small intestine, monosaccharides are formed from them, which are then absorbed into the blood.

Intestinal enzymes have substrate specificity, each of them converts only a certain disaccharide: lactase breaks down lactose (milk sugar), maltase - maltose, invertase - sucrose, etc. Disruption of one enzyme leads to intolerance to a particular product. In Russia, lactase deficiency (milk intolerance) occurs in 15% of the adult population and 18% of children under one year of age. Against the background of intestinal diseases, intolerance to several carbohydrates develops.

Be sure to read: Diarrhea: possible causes and treatment (diet, rehydration, medications)

Causes of enzyme deficiency:

• heredity;
• pancreas pathology;
• bacterial and viral intestinal infections;
• helminthiases;
• chronic enteritis;
• Crohn's disease;
• food allergies;
• long-term parenteral nutrition.

Eating disorder

When the intake of carbohydrates from food exceeds the capabilities of the body's enzyme systems, some of the undigested components undergo fermentation. Dyspepsia occurs when eating large amounts of high-carbohydrate foods:

• whole milk;
• infant formula;
• dairy products;
• fresh vegetables and fruits;
• baking;
• sweets;
• mushrooms;
• potato;
• kvass, beer;

In older people, enzyme activity decreases, and even a small error in nutrition can lead to fermentative dyspepsia.

Symptoms

Symptoms of fermentative dyspepsia are not specific. That is, it is difficult to understand from them that we are talking specifically about this disease, because most pathologies of the gastrointestinal tract have almost the same clinical picture.

The main symptoms of the disease are:

• bloating and flatulence;
• nausea and feeling of fullness in the stomach;
• belching and rumbling in the stomach;
• frequent loose stools, which have a strong unpleasant odor (usually sour), foam, particles of undigested food.

Even if a person empties his bowels in a timely manner at the first urge, some of the gases from the intestines are still absorbed into the blood. This leads to symptoms of intoxication:

• weaknesses;
• headache;
• nausea;
• general malaise.

Digestive problems - symptoms

The content of the article

Proper digestion is not felt by a person. Abdominal pain, for example after eating, occurs due to stretching of the wall of the digestive tract by overeating. In some cases, so-called dyspeptic symptoms appear, which include:

• early satiety, which patients describe as fullness immediately after starting a meal, which prevents them from continuing to eat;
• postprandial feeling of stomach fullness - the feeling of food in the stomach;
• pain in the epigastric region;
• epigastric burning.

Feeling of fullness in the stomach

Epigastric burning

These symptoms are commonly referred to as digestive problems. They are often very unpleasant and can cause reluctance to eat and weight loss. Very often, dyspeptic symptoms coexist with:

• heartburn, which is a symptom of gastroesophageal reflux disease;
• nausea, vomiting;
• diarrhea, constipation, which is often a symptom of irritable bowel syndrome or other functional disorder.

Fermentative dyspepsia in children

Dyspepsia can also occur in children, who will experience and present the same complaints as adult patients. The exception is infants who cannot report their illness, so parents have to guess about the pathology that has arisen based on external signs.

• The main symptom of indigestion in an infant is green stool with white spots, as well as bloating.
• Discomfort makes the child restless and capricious.
• Like an adult, vomiting and diarrhea cause dehydration in an infant. This is easy to recognize by dry skin. But for a child’s body, dehydration is a much more dangerous phenomenon, which can lead to seizures.

When the first signs of dyspepsia appear in a child, you should immediately consult a doctor.

Children: features of dyspepsia

Functional digestive disorders in children can occur in several forms:

• Simple. Manifests itself in disruption of the functioning of the gastrointestinal tract.
• Toxic. It is characterized not only by the presence of indigestion, but also by pronounced toxicosis, which can cause disruption of the heart muscle, liver and central nervous system. Toxic pathology can be caused by diseases such as dysentery or salmonellosis.
• Parenteral. Occurs as a consequence of pneumonia, otitis or influenza.

Depending on the course of the pathology, it is divided into:

• Reflux-like. Symptoms: a nauseating state, sometimes turning into vomiting; belching, heartburn and bloating.
• Dyskinetic. Flatulence, intolerance to certain foods (for example, dairy or fatty foods) and discomfort in the hypochondrium area are observed, which intensify immediately after eating.
• Ulcer-like. Causes severe pain in the abdominal area.
• Non-specific. The symptoms do not correspond to any of the above.

The causes of acute digestive upset in older children can be:

• Complete non-compliance with food intake.
• Increased physical activity.
• Passion for soda and fast food (i.e. fast food).
• Presence of stressful situations.

Chronic digestive disorders in children occur in the first two years of their life. They are characterized by either being overweight (i.e. paratrophy) or underweight (i.e. malnutrition). Most often, children experience a second pathology, the causes of which may be:

• Irregular eating.
• Unbalanced diet. As a result, there is a shortage of such an important plastic material for tissue formation as protein. It is its presence that contributes to the normal functioning of the entire organism as a whole, that is, the full physical, mental and mental development of the child.

On a note! Protein deficiency can also occur against the background of acute respiratory viral infections, as well as gastrointestinal pathologies.

• Certain features of fetal development inside the womb.
• Failure to comply with baby care rules.

Depending on the symptoms, malnutrition is divided into three types:

• 1st degree. This type does not radically affect the baby’s stool, appetite or sleep. All indicators are within normal limits. Children can attend preschool institutions.
• 2nd degree. In this case, there is a sharp decrease in appetite, sleep disturbances, loose stools and vomiting. Sometimes excitement gives way to lethargy and weakness. There may be some delay in the development of speech or motor skills (and sometimes even already acquired ones, that is, the baby stops sitting or standing). The level of immunity decreases (due to metabolic disorders) and, as a result, frequent illnesses.
• 3rd degree. This type of malnutrition is extremely rare. Mainly in children whose parents were “discovered” using drugs and “strong” drinks. It is possible that such a pathology may arise against the background of hereditary diseases associated with metabolism. If a child has third degree malnutrition, he cannot attend preschool institutions.

Important! To eliminate the causes of stage I malnutrition, it is enough to follow a food intake regimen and balance the diet. Therapy for pathologies of the 2nd and 3rd degrees can only be prescribed by a specialist, and it is carried out, as a rule, in a hospital setting under the “sensitive” guidance of doctors.

Diagnostics

On the one hand, the symptoms of dyspepsia are nonspecific, that is, characteristic of many diseases. On the other hand, the clinical picture almost unmistakably makes it clear where the pathological process is localized and how the patient can be helped using symptomatic therapy methods.

But for etiological treatment, that is, to eliminate the direct cause of dyspepsia, it is necessary to conduct a full examination of the body.

Taking an anamnesis is of great importance in the diagnostic process. The doctor needs to find out:

• regimen and nutrition of the patient;
• what exactly preceded the appearance of the first symptoms of dyspepsia;
• what foods and dishes he consumed the day before.

Then the doctor prescribes studies, the purpose of which is to exclude the presence of internal pathologies, the clinical picture of which may include digestive disorders.

You can learn about the condition and functioning of the stomach, pancreas, liver and other organs of the digestive system using the following studies:

• general blood analysis;
• blood chemistry;
• coprogram - stool analysis;
• breath test for the presence of Helicobacter pylori in the stomach;
• endoscopic examination of the gastric cavity.

As a rule, this list of studies is exhaustive, and each analysis makes it possible to determine whether fermentative dyspepsia is caused by internal pathology, or whether the cause of the disease is a nutritional disorder.

Predictions and prevention

Preventive measures to prevent diseases of the digestive tract among preschoolers and schoolchildren concern the exclusion of crackers, chips, and soda from the diet. In childhood, functional disorders require special attention, since in the future they can lead to the formation of organic pathology. To do this, you need to regularly conduct laboratory diagnostics, visit a family doctor or pediatrician, adhere to a diet, and monitor the child’s emotional state. Complete prevention of dyspepsia will allow you to forget about this problem for a long time.

Prevention in adults means changing the nutritional culture and treating the underlying pathology.

Possible complications

One of the common complications of long-term dyspepsia is colon syndrome. Gases, bursting the intestines from the inside, stretch its walls, injuring and irritating the mucous membrane. In addition, the stool disorder itself, which occurs during the acute stage of the disease, negatively affects the condition of the large intestine. Symptoms of its defeat are:

• constipation;
• intense pain, usually associated with the process of defecation;
• small portions of stool coupled with a frequent urge to bowel movement.

An equally dangerous complication of functional intestinal disorder is malabsorption syndrome. With this pathology, the process of absorption of substances necessary for the body in the small intestine is disrupted.

• In this regard, the body does not receive enough of the nutrients and vitamins it needs, serious changes occur in metabolic processes, as well as chronic diarrhea.
• If malabsorption in the small intestine is impaired, a person experiences chronic inflammation in the oral cavity, anemia, atrophy of the colon mucosa, and bone pain.

This is why it is so important to pay close attention to functional disorders of the intestines, even if fermentative dyspepsia is a consequence not of pathology, but of poor nutrition.

Classification of dyspepsia

Based on the pathogenetic principle, functional and organic dyspepsia are distinguished. Organic dyspepsia usually accompanies various diseases of the digestive tract, while functional dyspepsia occurs in the absence of organic damage to the gastrointestinal tract.

Based on the causative factor, the following variants of dyspepsia are distinguished:

• Nutritional
  – usually associated with a violation of the ratio of essential nutrients in the diet. Fermentative dyspepsia develops when carbohydrates predominate in the menu, putrefactive dyspepsia develops when proteins and stale meat predominate, soap dyspepsia develops when there is an excess of refractory fats;

• Enzymatic
  – associated with insufficient production of digestive enzymes. Depending on the organ in which enzyme deficiency has developed, gastrogenic, pancreatogenic, hepatogenic and enterogenic dyspepsia are distinguished;

• Dyspepsia with malabsorption syndrome
  - associated with impaired absorption of nutrients in the intestine;

• Infectious
  - develops with various intestinal infections, most often with dysentery and salmonellosis;

• Intoxication
  – occurs in acute poisoning, severe general infections, extensive injuries.

There are also four clinical forms of functional dyspepsia: ulcer-like, dyskinetic, reflux-like and indeterminate.

Treatment

Treatment is carried out conservatively. The doctor selects medications for the patient that improve and simplify the digestion process.

1. Prokinetics are stimulants of gastric and intestinal motility that improve and facilitate the digestion process:

• Cerucal;
• Motilium;
• Itomed.

1. Enzymes are preparations that contain digestive enzymes that improve the process of digesting food:

• Pancreatin;
• Creon;
• Festal.

1. Adsorbents are drugs that reduce fermentation processes in the intestines and remove toxins, bacteria and other substances from the body:

• Activated carbon;
• Polysorb;
• Neosmectin;
• Enterosgel.

1. Calcium carbonate is an antacid that reduces the severity of dyspeptic symptoms, mainly vomiting.
2. Antibacterial drugs are necessary when identifying the infectious genesis of the disease.