The human body, and especially the child, is a complex mechanism in which all organs and systems interact with each other, ensuring coordinated work. Violations of the functionality of any of them can provoke pathological processes in other organs with which it interacts. An example of such a condition is reflux. It can be both a physiological phenomenon and cause serious harm to the body. In this article, we will analyze the symptoms and treatment of reflux in a child.
What is reflux?
Reflux is a condition in which the movement of the contents of the hollow organs in the opposite direction is observed. In some physiological processes, such conditions can manifest themselves within the normal range without harming a person. But in other cases, these pathologies can develop serious diseases.
Refluxes are conditionally divided into several groups, depending on the organs in which they appear. These include:
- refluxes of the upper gastric tract;
- urinary system;
- gall bladder, liver, pancreas;
- female reproductive system;
- gastric.
Gastroesophageal Reflux
Gastroesophageal reflux (esophagitis) is one of the most common digestive system pathologies. In this case, the stomach contents are refluxed together with stomach acid into the esophagus. With constant contact with it, irritations and inflammation appear in the body, which can lead to the formation of ulcers. This condition, especially in children up to a year when the digestive system is imperfect, can be physiological in nature. At an older age, reflux can lead to serious consequences and be a sign of dangerous diseases.
In young children, the esophagus is short, and the valve, which does not allow food to pass back from the stomach, is still poorly developed. For this reason, regurgitation occurs. Reflux esophagitis helps to remove air that gets to the baby during feeding. Regurgitation also protects the child from overeating. These processes can be observed until the digestive system is fully formed. As a rule, this happens in the first year of life. If the child’s condition is within normal limits, the presence of reflux should not bother the parents, but it is recommended that you consult a pediatrician if you have warning signs. If reflux esophagitis is diagnosed, the symptoms and causes in children should be indicated by a specialist.
Forms and degrees of pathology
Specialists distinguish four stages of the development of the disease.
- At the first stage, the symptoms are mild. In this case, the esophagus comes in contact with stomach acid, which provokes swelling of the organ, redness and irritation. Small, single sores may appear.
- At the second stage, the symptoms of reflux in the child begin to appear - heartburn, burning in the chest, pain after eating. This stage is caused by the appearance of ulcers up to 6 mm, which can merge with each other, affecting the mucous membrane of the esophagus. The child feels severe discomfort and becomes moody.
- The third stage is manifested by severe symptoms. Ulcers occupy about 70% of the mucous membrane of the esophagus. Discomfort when swallowing, burning and pain in the stomach.
- The fourth stage is very dangerous, as it can provoke a cancerous tumor. The child feels constant pain, burning, and swallowing is difficult. Ulcers affect more than 75% of the esophagus.
There are two main forms of reflux:
- Sharp. In this case, esophagitis is more a symptom than a separate disease. It occurs against the background of existing diseases of the digestive system. At the same time, there is pain in the child, problems when swallowing due to pain and discomfort, fever, increased salivation.
- Chronic This form is a complication of other diseases of the digestive system. It is manifested by hiccups, pain and burning, shortness of breath. This form can develop independently from malnutrition.
Types of pathology
The following types of reflux are distinguished:
- Catarrhal. There is irritation of the mucous membrane of the esophagus due to exposure to gastric juice. Ulcerative manifestations are not observed.
- Edematous. The mucous layer swells, narrowing of the walls of the esophagus.
- Esfoliative. Fibrin is separated from the mucosa, which provokes a strong cough, pain and bleeding.
- Pseudomembranous. A pathological condition in which fibrin films form in the esophagus. Nausea and vomiting with particles of a gray-yellow film are observed.
- Ulcerative. The most dangerous species requiring surgical treatment. It is characterized by ulcerative organ damage.
Causes
The causes of physiological reflux in young children are associated with an underdeveloped digestive system. There are also certain congenital anomalies that can increase the likelihood of pathological conditions. These include:
- early birth;
- transferred fetal hypoxia;
- congenital malformations in the digestive system;
- birth injuries of the spine in the cervical spine;
- inflammatory processes of the gastrointestinal tract;
- the wrong lifestyle of mom during pregnancy;
- diaphragm paralysis;
- disorders of the nervous system.
The following reasons can also contribute to the development of reflux:
- lactose intolerance;
- an allergic reaction that occurs in most cases on cow's milk protein;
- reduced immunity;
- Maternal malnutrition during breastfeeding;
- diseases of the gastrointestinal tract, such as gastritis, ulcers, stool disorders;
- improper diet of the child;
- artificial feeding;
- taking certain medications, such as "Theophylline", "Suprastin."
- stress and emotional stress;
A very common cause of manifestation of esophagitis reflux is overeating of the baby, when the contents of the stomach begin to interfere with the normal functioning of the digestive system, pressing the esophagus sphincter.
Symptoms
With reflux esophigitis, symptoms and causes are interconnected. But often in diagnosing pathology in children there are difficulties, since some manifestations are similar to the symptoms of other diseases.
Possible signs of developing reflux will be the following:
- frequent spitting up, and sometimes vomiting;
- poor weight gain;
- hiccups;
- burping;
- stool disorders;
- stomach pains;
- heartburn;
- gas formation;
- anxiety and moodiness of the child, frequent crying;
- it happens that the discharge of the contents of the stomach into the respiratory tract, which provokes a cough, especially at night. Hoarse crying and otitis media can also be a consequence of reflux.
- when gastric acid enters the bronchi, bronchitis and pneumonia can occur;
- with advanced stages, developmental delay and neurological problems are observed.
Diagnostics
Diagnostic measures are carried out comprehensively and include:
- analysis of urine and blood;
- endoscopic examination;
- X-ray examination;
- study of daily pH;
- manometric research.
Treatment
If symptoms of reflux esophagitis in children are detected, the doctor prescribes treatment based on the results of the tests and the stage of development of the disease. Often, drugs are used (Omeprazole, Motilium, Rennie and others, according to age). Also, with symptoms of reflux in children, a huge role in the treatment is played by diet and diet. Infants are prescribed special adapted mixtures.
The baby needs to be fed often, but in small portions, after which it should be held upright for some time. You can not overfeed the child. Food should be at a comfortable temperature. After eating, it is not recommended to go to bed.
If the above treatment methods do not give a result, and the situation is aggravated, the doctor may decide on a surgical procedure.
It is important to remember that you can not self-medicate. Medicines should be prescribed only by a doctor, according to the age of the child and the severity of the disease.
Kidney reflux and its classification
This pathology is manifested by the return of urine into the kidneys and ureters. Kidney reflux is rare and occurs mainly in children. This is a rather dangerous disease, since in advanced stages it can lead to serious complications. These include urolithiasis and kidney failure.
Kidney reflux is usually divided into two types, depending on localization.
- Renal pelvis reflux. In this case, the contents of the pelvis enters the kidney.
- Bladder-ureter (or bladder reflux). Urine is thrown from the bladder into the ureters.
Also, pathology is classified depending on the course of the disease:
- Active form. The discharge of urine back into the ureters occurs during urination.
- Passive. Urine enters the kidney regardless of the process of emptying the bladder.
- Mixed form. It includes manifestations of both passive and active forms.
Reflux can be bilateral and one-sided and cause impaired renal function. The following degrees of violations are distinguished:
- At the first, the kidney loses functionality by about 30%;
- The second degree is characterized by suppression of functions by 60%;
- In the third stage, functionality decreases by more than 65%, which is a dangerous condition.
Causes
To date, all the causes of this pathology have not been studied. It is assumed that the main factor in this case are congenital malformations in primary reflux and complications after diseases - in secondary.
Consider the main reasons:
- pathology of the urethral sphincters;
- duplication of the ureter;
- violations of the structure of the kidneys and ureters;
- protrusion of the bladder;
- abnormal shape of the mouth;
- incorrect location of the mouth.
Also provoke the development of pathology:
- overactive bladder;
- phimosis;
- cystitis;
- bladder stenosis;
- urethritis;
- operations on the organs of the genitourinary system;
- prostate adenoma;
- SARS, the flu.
Symptoms
Very often it is not possible to timely recognize the disease, especially if it touched a small child. With kidney reflux in children, the symptoms are quite blurred, because the child can not always indicate the discomfort and malaise that has arisen. Parents need to carefully monitor any changes in the baby.
With reflux in children, the following symptoms can be observed:
- increase in body temperature;
- dark urine;
- an admixture of blood or foam in the urine;
- intense thirst;
- general malaise, weakness, moodiness;
- swelling
- vomiting
- loss of appetite;
- colic
- pain during urination and some time after it;
- pain in the abdomen;
- pressure in the lumbar region;
- feeling of fullness and pain in the kidneys;
- the smell of acetone in the urine may also be heard.
In older children, an increase in blood pressure can be observed.
To the symptoms of urinary reflux in an older child, refusal to go to the toilet may be added, as this causes a strong burning sensation.
Diagnostics
If symptoms of bladder or kidney reflux are observed in children, you should consult your doctor as soon as possible, who will prescribe the necessary study. This may include:
- history taking and palpation;
- urine and blood tests;
- ultrasonography;
- uroflowmetry;
- nephroscintigraphy.
Treatment
If there are symptoms of kidney reflux in children, treatment should begin as soon as possible, because the disease can lead to dangerous consequences.
Treatment should primarily be aimed at eliminating the symptoms and causes of the disease. For this, a special diet is prescribed, antibacterial drugs, physiotherapy. A catheter is used to completely empty the bladder.
When there are symptoms of reflux in children associated with the genitourinary system, the diet should include limiting salt intake, refusing fatty, smoked, acidic foods. Alcohol and other irritating drinks are prohibited.
If pathologies of the development of organs are found or for a long time there is no effect of conservative treatment, surgical intervention is advisable.
Conclusion
If a child is diagnosed with reflux, timely treatment gives positive results. Parents at the first suspicious manifestations need to see a doctor who will prescribe the optimal therapy. The doctor's prescriptions should not be neglected, since the consequences of reflux can be very dangerous. Identification of symptoms and treatment of reflux in a child should be carried out by a specialist.