Dysbacteriosis is not a disease. This is a clinical and laboratory syndrome associated primarily with metabolic and immune disorders, with the possibility of further development of intestinal problems.

This is a state of reduced bacteria counts. Each person lives from 2 to 5 kg of beneficial bacteria. For the first time, a person receives them at the moment of birth, during the passage of the mother’s birth canal, he is seeded with a certain amount of maternal microflora and subsequently lives with this. If a child does not receive these bacteria for various reasons, a deficiency of beneficial microorganisms develops - dysbacteriosis.

Children who were favorable in the neonatal period: were immediately placed on the mother's chest, were breastfed, arrived together with their mother, and were discharged home after the maternity hospital. In such newborns, the colonization of the intestines and the most acute period, which is called catarrh, passed perfectly and the intestines are populated with normal parental bacteria, which are safe for the child. But if this process is disrupted, then various changes occur in the intestines.

It happens that the child was not immediately released to his mother, he was given resuscitation measures, and he was in the incubator for a long time separately from the mother. The baby is born with a sterile intestine, and it was not the mother’s native microflora that populated it, but the hospital flora and, naturally, not so favorable. And such a newborn begins to have problems: watery stools, mucus, greens in the stool, fermentation processes, abdominal pain, frequent regurgitation.

In some children, as they mature, this process is stopped, but in others it is not. Intestinal dysbiosis is also associated with factors such as:

• diseases of the gastrointestinal tract;
• use of antibiotics;
• immune depressants, steroids;
• X-ray therapy;
• surgical operations.

Antibiotics reduce not only pathogenic microflora, but also the growth of normal microflora in the colon, this gives rise to the proliferation of microbes from the environment and endogenous species that are resistant to drug therapy, such as staphylococcus, Proteus, yeast-like fungi, enterococci, Pseudomonas aeruginosa.

An unbalanced diet and a deficiency in the diet of necessary components, the presence of various chemicals entering the baby’s body from the outside also help suppress the growth of normal microflora. A failure in the diet or a sudden change in its character can lead to dysbiosis. There are also such external factors that weaken the body:

• infectious diseases;
• ionizing radiation.

Under the guise of dysbacteriosis, infectious diseases such as salmonellosis and shigellosis can be hidden.

Functions of microflora

First function What bacteria do is create immunity and maintain it. The normal microflora that determines the human microbiocenosis is most concentrated in the following locations:

• gastrointestinal tract;
• external genitalia;
• leather;
• upper respiratory tract.

Second function- this is participation in metabolic processes: the breakdown of food using the juices of the stomach and pancreas. If these conditions are disturbed: immunity is reduced, metabolic processes are weakened, then this is followed by the colonization of pathogenic bacteria and the disease develops.

So, for example, if staphylococcus is colonized, diseases associated with staphylococcal flora develop, these are, first of all:

• diseases of the ENT organs: sinusitis, otitis;
• skin lesions: from pustular rashes to furunculosis;
• pyelonephritis;
• colpitis.

Fungi of the genus Candida cause allergic reactions, skin damage: from dry peeling to atopic, psoriasis, damage to the genital organs: candidiasis (thrush), urethritis, prostatitis.

Symptoms of dysbiosis

It is worth remembering that dysbiosis does not have strictly specific symptoms.

In infants, regurgitation (or vomiting), bloating, anxiety, pulling the legs towards the stomach 1.5 - 2 hours after eating appear and become more frequent; sleep disturbances and poor weight gain are also noted.

Older children notice an unpleasant metallic taste in the mouth. Loose stools and alternate. The feces smell unpleasant, and an admixture of mucus and undigested food appears in the feces.

There is an increase in the urge to defecate - a symptom of “food slipping”: after a short period, after the child has eaten, he sits on the potty or runs to the toilet. The stool becomes watery, mucous with undigested food debris.

Allergic reactions may appear in the form of various rashes, dermatitis, and peeling. Vitamin deficiency also develops, which manifests itself in the form of bleeding gums, brittle nails and hair.

Dysbacteriosis reduces the child's body's defenses, which results in frequent colds, viral and other infectious diseases. This further aggravates the manifestations of dysbiosis.

The child’s behavior changes: tearfulness, poor sleep, and irritability appear. In severe cases, the temperature may rise to 37.5 degrees.

Methods of research for dysbacteriosis

A common research method is stool culture for dysbacteriosis. But it does not give a general picture of the state of the intestinal microbiota, since this analysis shows only those microbes that are located in the final section of the large intestine. In addition, this examination is performed within 5 - 7 days, and during this time the composition of the intestinal flora may change.

There are about 10 thousand species of bacteria, this is comparable to the flora of the ocean, while the bacteriological conclusion consists of 15 - 20 species of bacteria; Modern molecular genetic methods make it possible to identify only up to 40 species of bacteria. Accordingly, evaluating an analysis is the same as looking through a keyhole at the flora of the world's oceans. It is even more strange to treat a child based on the results of this analysis alone.

Analysis results may vary during the day for the same person, since the flora is changeable. And you should not rely only on this analysis.

Diagnosis of dysbiosis at the moment is a difficult task, the reason for this is the conventionality of laboratory data, the lack of real knowledge about the normal intestinal microflora, and, as a consequence, the detection of pathology by laboratories even with a temporary deviation.

To make a final clinical and laboratory conclusion about the condition of the intestines, tests alone are not enough; it is necessary to carefully examine the child to identify the causes of dysbiosis.

The second test you will be asked to take is a coprocytogram. It is advisable to carry out this study if there are any gastrointestinal diseases. It reflects the overall functioning of the gastrointestinal tract, its enzymes, the degree of decomposition of fats, carbohydrates, proteins and is reliable. It also shows the presence of flora, bacteria, mucus, but does not show the imbalance of microorganisms itself.

Treatment of dysbiosis

The term probiotics is the opposite of antibiotics. Antibiotics are the enemies of life, probiotics are the allies of life. Today there is a clear definition of what a probiotic is - it is a live bacterium, an inhabitant of the normal intestinal microflora. These are bacteria with proven positive effects on human health when consumed in sufficient quantities.

To put it in simpler terms, these are bifidobacteria, lactobacilli, and thermophilic streptococci. In addition to the fact that they must have a proven positive effect, probiotics, especially those used in children's practice, are subject to serious safety monitoring.

Do these bacteria remain in our gastrointestinal tract, acquired either through drugs or through food? Today it is believed that no. This is due to the existence in our intestines of parietal microflora, permanent inhabitants who do not want to let foreign bacteria in there.

But, nevertheless, the positive effect of probiotics is associated with their passage through the gastrointestinal tract and participation in the processes of digestion, metabolism, acidification of the internal environment of the intestine and thereby preventing the growth of pathogenic bacteria. In general, they act as antagonists to pathogenic bacteria and affect the immune system, which implies the obvious benefits of probiotics.

What are prebiotics? This is food for probiotics, for our protective microflora. Prebiotics mainly consist of medium-chain carbohydrates, oligosaccharides, dietary fiber, and plant fiber. People do not digest them, but our microflora digests them. Prebiotics make up part of breast milk, so babies who receive breast milk have more bifid flora in their intestines. This is why you will find prebiotics in medicinal mixtures, foods, etc.

There are also medications containing prebiotics - Hilak forte, Duphalac, Lactulose.

Adults and older children receive prebiotics from vegetables and fruits. In addition to the natural content of pre- and probiotics in food or their special addition there, there are probiotic preparations (for example, Bifidumbacterin, Lactobacterin, Linex, Bifiform, Acipol, Maxilak and others), which can be taken in cases where you cannot take advantage of any -reasons: fermented milk products containing probiotics. For example, after a course of antibiotics, during illnesses, when moving, when a child goes to the seaside, when there is a change in climate, water, or food.

Prevention of dysbacteriosis

1. Examination of the mother before and during pregnancy to study the microflora of the genital tract.
2. Putting the baby to the breast immediately after birth.
3. Compliance with the diet of nursing women.
4. Maintenance up to 1 year.
5. Introduction of complementary foods according to age.

Conclusion

It is worth remembering that dysbiosis is our price for an industrial lifestyle. Errors in diet and uncontrolled use of antibiotics lead to dysbiosis. Prevention of this disease consists of proper treatment of concomitant diseases, a healthy diet and nutritional regimen.

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.

Reasons for the development of dysbiosis in a child

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

Pathogenic viruses and bacteria are a common cause of dysbiosis in children

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

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

It is important to remember that the severity of this disease is often directly related to the cause of its development. This is how dysbacteriosis occurs most severely when it occurs due to exposure to radiation, taking antibiotics, 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.

Diagnosis of childhood intestinal dysbiosis

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 mild 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.

Symptoms of intestinal dysbiosis in children

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 are common symptoms of 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.

Otherwise, a situation is possible where 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. So, three days before the procedure, children under one year old can be given only the usual formula or breast 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).

Normal test results for dysbiosis in children

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 can 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 the children’s drug “Primadofilus”. 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” for dysbiosis, which not only restores normal intestinal microflora, but also helps digest food in 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.

Drugs for the treatment of childhood dysbiosis

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

1. 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).
2. Local treatment of individual symptoms of dysbiosis (rash, discomfort, fever, bad breath).
3. For grade 3 dysbiosis, intestinal motility stimulants are prescribed.
4. For grade 4 dysbiosis, antibiotics are prescribed (only a doctor can prescribe them!).
5. Further, if after therapy and relief of dysbiosis there are consequences, they are eliminated.
6. At the very end, prevention of relapse of the disease is carried out (only a pediatrician should do this!).

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.

A diet includes strict restrictions on the consumption of certain foods. 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 the appearance of intestinal dysbiosis or its relapse after successful treatment consists of proper nutrition of the baby and timely treatment of 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 yogurts are ineffective in this regard).

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

Symptoms of dysbiosis in children by age

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

Manifestations of dysbacteriosis in them are:

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

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

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

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

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

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

Diet for dysbiosis

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

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

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

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

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

Risk factors

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

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

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

Reasons

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

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

Clinical manifestations of the disease in different age groups

Children under one year old

Symptoms of dysbiosis in 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 intestines, which can lead to insufficient supply of vitamins and important microelements.

After a year

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

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

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

• 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

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

Types of dysbacteriosis

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

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

By degree of compensation:

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

Stages of the disease

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

Stage 1

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

Stage 2

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

Stage 3

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

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

Stage 4

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

Severity of dysbacteriosis

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

I degree

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

II degree

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

III degree

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

IV degree

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

Primary form of dysbiosis in children

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

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

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

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

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

Diagnostics

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

Which doctor deals with gastrointestinal pathologies?

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

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

What tests need to be taken for dysbacteriosis?

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

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

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

Treatment of dysbiosis in children

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

Antibiotics

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

Probiotics

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

There are mono- and polycomponent forms:

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

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

Prebiotics

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

To get results you must follow the rules:

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

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

Possible complications

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

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

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

Diet

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

If diarrhea occurs, you must include:

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

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

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

Preventive measures

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

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

Intestinal dysbiosis is a clinical and laboratory syndrome in which the quantitative or qualitative composition of the intestinal microflora changes with the further formation of immunological and metabolic changes and the development of gastrointestinal disorders.

A child, when born, enters from the completely sterile environment of the mother’s body into a world in which there are many different microorganisms. It cannot remain sterile for a long time and almost immediately from the moment of birth it is populated by various microbes.

Representatives of the microbial world begin to populate the baby’s intestines during the birth process, when the fetus passes through the birth canal. After the first portion of food enters the stomach, many microorganisms begin to inhabit the intestines. Their number is constantly increasing and has become so significant that 1 gram of microbes is present for every 3 grams of baby’s feces. The presence of so many microbes in the intestines is beneficial for both microbes and the human body. This mutually beneficial coexistence is called symbiosis.

All microorganisms that live in the intestines can be divided into two groups. The first is called obligate flora. These microbes must be in the intestines. Without them there can be no good health, no strong immunity, no normal digestion. These are lactobacilli, bifidobacteria and E. coli. This group also includes saprophytic bacteria, which have absolutely no effect on human health - neither negative nor positive. These are enterococci and bacteroides. The group of obligate microflora is the most extensive; it accounts for approximately 97% of the total number of all intestinal microorganisms.

The second group is called facultative flora. Its presence in the intestines is not mandatory. Under unfavorable conditions (dietary errors, decreased immunity, stressful situations, infections), facultative microorganisms can become pathogenic and, multiplying in significant numbers, cause symptoms of intestinal infection. This group also includes microorganisms that are called conditionally pathogenic (klebsiella, clostridia), as well as those that should not normally be in the baby’s intestines (fungi of the genus Candida, Proteus, staphylococci). For an adult, they can be conditionally pathogenic and can provoke illness only in some cases, but for an infant they will certainly become pathogenic and in all cases cause illness.

The protective filter in the intestines are beneficial microorganisms - bifidobacteria and lactobacilli. They create conditions that are absolutely unsuitable for the life of pathogenic microorganisms. It is through their vital activity that they protect the intestines from excessive growth of conditionally pathogenic and pathogenic flora in it. In addition, such microorganisms stimulate the baby’s immune system to produce its own immunoglobulins.

Beneficial microorganisms have the positive influence of natural vitamins in the intestines (folic acid, B12 and B6). Lactobacilli and bifidobacteria take part in the absorption of many important food components (for example, vitamin D, calcium, iron) and stimulate intestinal motility.

In the intestines, the correct ratio of the number of bacteria is very important, and if it is disturbed, it decreases, hypovitaminosis develops and the risk of intestinal infection increases, due to insufficient iron intake, rickets may develop as a result of a deficiency of vitamin D and calcium.

Reasons

The death of beneficial intestinal bacteria begins in the following cases:

The reasons that lead to dysbiosis in children are very diverse; they begin to act in the prenatal period or immediately after the birth of the baby. Bacterial hemostasis of the intestine can be disrupted by complicated pregnancy or childbirth, prematurity of the child, late breastfeeding, or bacterial vaginosis in the mother.

In infants, dysbacteriosis can cause poor nutrition of the nursing mother, the development of mastitis in her, and early transfer of the baby to artificial feeding.

Classification of dysbacteriosis

Depending on which opportunistic flora predominates in the intestine, staphylococcal, Proteus, candidiasis and associated forms of the disease are distinguished.

According to the clinical course, local, latent and generalized variants of dysbacteriosis.

According to clinical and bacteriological criteria, dysbiosis occurs in the stages of compensation, subcompensation and decompensation.

Compensated dysbacteriosis does not manifest itself clinically. The child’s health is satisfactory; by chance, when stool is tested for another reason, it is possible to detect a violation of the microbial flora.

The subcompensated form of the disease is manifested by moderately severe symptoms: dyspeptic disorders, poor appetite, lethargy, and weight loss.

With decompensated dysbacteriosis, the child’s general condition worsens significantly. This happens due to intoxication, vomiting and loose, frequent stools. Against this background, bacteremia and sepsis can easily occur.

The clinical picture of the disease is dominated by one or more syndromes: diarrhea, malabsorption (malabsorption and maldigestion) and digestion, asthenoneurotic, intoxication and dermointestinal.

Symptoms

A baby whose intestines have disrupted the qualitative and quantitative composition of the microflora often has disturbed sleep and is restless as a result of painful paroxysmal intestinal spasms that occur 1.5-2 hours after feeding. This is almost always accompanied by bloating, which develops due to increased gas formation, and rumbling occurs along the intestines. The movement of food through the intestines is disrupted, resulting in vomiting and regurgitation.

In severe cases, intestinal dysbiosis is accompanied by malabsorption syndrome (absorption of nutrients in the small intestine is impaired). This is manifested by diarrhea (stool has a putrid or sour odor and is green in color), as well as insufficient weight gain. Since intestinal dysbiosis is always a secondary pathology that develops against the background of some underlying problems in the child’s body (improper feeding, prematurity, taking antibiotics, intestinal infections), as a result of the addition of malabsorption syndrome, the severity of the disease is aggravated even more.

Against the background of intestinal dysbiosis, many babies can develop stubborn ones, since there is no normal amount of bifidobacteria, which is why the substance that stimulates the contractile activity of the intestine is not produced in the required quantity.

With dysbacteriosis, endogenous intoxication is accompanied by delayed physical development of the child, polydeficiency anemia and decreased appetite. Due to rotting and fermentation in the intestines, autoallergization occurs and dermointestinal syndrome develops (,). Asthenoneurotic syndrome is manifested by weakness, irritability, and sleep disturbance.

Dysbacteriosis in older children can occur not only with diarrhea, but also constipation, as well as their alternation, bad breath, belching, intestinal colic, and after eating - a feeling of fullness in the stomach. Secondary extraintestinal manifestations of the disease, which are associated with metabolic disorders, hypovitaminosis and decreased immunity, are stomatitis, seizures in the corners of the mouth, acne, furunculosis, brittle nails and hair, and others.

Often, children with immunodeficiencies develop generalized dysbiosis. It can occur as cheilitis, glossitis, or vulvitis, candidomycosis with signs of thrush.

Diagnosis of intestinal dysbiosis

A diagnosis of dysbacteriosis can be made after examining the baby by a pediatrician, pediatric gastroenterologist, laboratory test data, and instrumental studies. The condition of the skin and mucous membranes is assessed; palpation of the abdomen along the intestines can reveal pain.

Laboratory diagnostics consists of biochemical and bacteriological examination of stool for dysbacteriosis. Microbiological examination reveals a decrease in the number of lacto- and bifidobacteria, the number of normal E. coli decreases or increases, their modified strains appear, and the number of fungi, cocci and clostridia increases. Biochemical analysis consists of determining the metabolites of volatile fatty acids (butyric, acetic, propionic) that are secreted by microorganisms living in the gastrointestinal tract.

To find out the cause of dysbacteriosis, stool analysis for helminth eggs and Giardia cysts, biochemical liver tests, examination of the abdominal organs using ultrasound, and gastroscopy will help. Using a coprogram, you can determine how much the breakdown and absorption of food is impaired.

If you suspect dysbiosis in a child, rule out malabsorption syndrome, acute intestinal infection and nonspecific ulcerative colitis.

Prevention

Is it possible to prevent dysbiosis in a child? When planning a pregnancy, the expectant mother must be examined by a gynecologist in order to promptly detect and treat possible disorders of the flora of the genital organs. If pregnancy has already occurred, it is not too late to take care of this either. It is necessary to avoid the use of antibiotics, watch your diet, and lead a healthy lifestyle in all respects. In the maternity hospital, it would not be superfluous to inquire in advance whether the child and mother stay together there, and how quickly after birth the newborn baby is put to the breast.

Antibiotic therapy in children must be carried out under the guise of probiotics.

Treatment of dysbiosis in children

One of the most important points in the treatment of intestinal dysbiosis is breastfeeding. Every child needs breast milk for as long as possible during the first year of life. And especially for children with manifestations of dysbacteriosis. Maternal colostrum contains many substances that promote the formation of normal microflora and protect against opportunistic microorganisms.

From the point of view of preventing dysbiosis, mature mother's milk is no less valuable. It provides ideal conditions for the growth of beneficial microflora, and also maintains a balance between lactobacilli, bifidobacteria and E. coli, ensuring complete digestion and preventing the occurrence of allergic reactions.

If breastfeeding is impossible for some reason, give preference to adapted formulas that are enriched with protective factors. These include fermented milk mixtures, which contain live bacteria, as well as mixtures with probiotics in their composition, which help the reproduction and absorption of healthy microflora.

In the diet of older children, it is necessary to limit animal proteins, sugars, and carbohydrates. In order to restore normal microflora, it is recommended to consume dietary fiber, as well as fermented milk products enriched with biocultures.

After conducting a bacteriological examination of stool and confirming the diagnosis, correction of the microflora must be carried out in two stages.

At the first stage, it is necessary to suppress the growth of opportunistic microflora. This can be achieved by using special immunopreparations (bacteriophages), which are able to absorb microbial cells and dissolve them within themselves, or by using intestinal antiseptics (nifuroxazide) or antibiotics (cephalosporins, macrolides). Almost always, during a bacteriological examination of feces, it is necessary to conduct and determine the sensitivity of opportunistic flora to a particular antibiotic or bacteriophage.

Of course, it is preferable to use bacteriophages. If they cannot be used for any reason, then the choice of antibacterial drugs must be those that act exclusively in the intestinal lumen, do not enter the bloodstream and do not have a general effect on the child’s body.

The goal of the second stage of correction of intestinal microflora is to populate it with healthy microorganisms and create conditions that are suitable for its growth. In parallel with prebiotics (hilak-forte, duphalac), probiotics (linex, bificol, lactovit, yogurt, etc.) are used - products that contain live microorganisms (bifidobacteria and lactobacilli, E. coli) and their metabolic products, which help them settle in the intestines. Prebiotics contain indigestible substances that have a beneficial effect on the growth of healthy microflora and activate it (fiber, lactulose, oligosaccharides). These components stimulate intestinal motility and help relieve constipation. To treat candidiasis dysbiosis, antifungal agents (fluconazole, nystatin) are used.

In case of severe digestive disorders, the use of enzymes is indicated; in case of intoxication, sorbents are used. Children from the group of frequently ill patients are recommended to take immunomodulating agents, vitamins and adaptogens.

If a child has abnormal stools, colic, flatulence and other signs of digestive system disorders, parents often hear from a doctor a diagnosis of “dysbacteriosis.” In this case, it is important to know the cause of its occurrence; this is the basis for prescribing treatment.

The health of the digestive system depends on the balance of pathogenic and beneficial bacteria. Microorganisms live throughout the digestive system, from the mouth to the intestines. In a healthy child, beneficial bacteria help process food, synthesize vitamins, and help absorb nutrients. These bacteria include lactobacilli, bifidobacteria and E. coli. When negative factors arise, the number of beneficial bacteria decreases due to the increased growth of pathogenic ones: fungi, staphylococcus and others, which can provoke a number of diseases.

First of all, it is necessary to suspect the disease in time. Dysbacteriosis is characterized by an imbalance of intestinal microflora, namely a decrease in the number of microbes, and in some cases, complete disappearance with a predominance of those whose numbers should be negligible or completely absent. Symptoms of dysbiosis can develop gradually, making diagnosis difficult at the beginning of development.

Disorders of the intestinal microflora in children under 2 years of age may manifest themselves in the following symptoms:

• constipation is replaced by diarrhea and vice versa;
• colic;
• bloating;
• nausea;
• the presence of fragments of undigested food in the feces;
• change in stool color;
• vomit;
• decreased appetite;
• the presence of mucus or streaks of blood in the stool.

Very often, dysbiosis is accompanied by rashes of an allergic nature; food allergies to foods that were already present in the diet may occur. In severe cases of the disease, the child may lag behind in development. Therefore, it is necessary to diagnose the disease in time and identify the causes for timely treatment.

Identifying the causes of dysbiosis

The development of dysbiosis can be provoked by various unfavorable factors that contribute to the weakening of immune defense. Such reasons include:

• environmental pollution;
• antibacterial therapy;
• malnutrition;
• artificial feeding immediately after birth;
• presence of infectious diseases;
• acute viral infections.

Dysbacteriosis can be caused by teething, as well as food or drug poisoning. These negative reasons can cause significant harm to the health of an adult, not to mention the child’s body.

The microflora of a child is formed in the womb and any pathological disorders of pregnancy can cause the development of dysbacteriosis after birth. Also, this disease often affects children who are constantly bottle-fed, as well as with poor nutrition and early complementary feeding.

Prescribing various drugs, including antibiotics, during pregnancy and breastfeeding can subsequently lead to an imbalance of the microflora. Undiagnosed dysbacteriosis is more difficult to treat and can lead to the development of certain complications in the future.

Diagnostics

Treatment is not prescribed for symptoms alone, especially since you cannot give your child medications on your own, since dysbiosis is sometimes caused by serious illnesses. Therefore, examination must be carried out if the following manifestations occur:

• upset stool, pain in the abdomen, nausea, vomiting, decreased appetite;
• in the presence or previous infectious diseases;
• allergic reactions, rash;
• change in diet;
• food poisoning;
• taking antibacterial drugs.

A microbiological examination can help identify the cause of the development of dysbiosis, as well as find out the condition and severity of the disease, the balance of beneficial and harmful microorganisms, fungi and bacteria. If a violation of the intestinal microflora is detected, corrective actions must be taken to restore it. This process can be lengthy and may include dietary changes and medications.

Is it necessary to treat dysbacteriosis?

The condition of the intestines in 2-year-old children is not constant, so some microflora disorders do not require drug treatment, since the symptoms can be temporary and do not cause complications or worsen the child’s condition.

False allergy

Increasingly, up to 2 years of age it is accompanied by pseudo-allergic food reactions. Externally, the symptoms are similar to ordinary allergies: rashes appear on the skin and bowel movements are disrupted. But if the diagnosis revealed that the child has no sensitivity of the gastrointestinal tract, i.e. all the symptoms of dysbacteriosis are absent, in this case doctors recommend waiting for some time without using medications. You just need to take into account that during this period it is important to get tested, observing the dynamics of the alignment of pathogenic and beneficial bacteria.

Compensated dysbacteriosis

Also, a wait-and-see approach should be chosen for compensated types of dysbiosis, when the body’s defenses are sufficient to cope with the development of dysbiosis. In such children, when diagnosed, a decrease in one of the types of bacteria was detected: lactobacteria, bifidobacteria or Escherichia coli. are in the minority. In the absence of acute symptoms, drug correction is not required.

Opportunistic microorganisms

It also happens that the intestines are populated by opportunistic microorganisms that are resistant to treatment, but the child is in good condition, without symptoms. This indicates a weak influence of pathogenic bacteria, as well as good resistance of the baby’s body. Such cases also do not require treatment.

Secondary dysbacteriosis

Restoring the balance of intestinal microflora

If in the absence of symptoms and any discomfort treatment is not required, then in acute cases, treatment is absolutely necessary. To restore intestinal microflora, the pharmaceutical market is full of drugs that must be taken for about 2 weeks to be effective.

Primadophilus

It is a hypoallergenic drug that contains lactobacilli, which help stop the proliferation of harmful bacteria. Primadophilus breaks down carbohydrates, fats and proteins, activates the production of vitamins and amino acids. The drug can be used from birth, since it practically does not cause side effects.

Hilak Forte

Helps restore the balance of beneficial and pathogenic bacteria, which normalizes the intestinal microflora. The active component of the drug is lactic acid, which restores the functioning of the stomach and the mucous membrane of the small and large intestines, thanks to the waste products of lactobacilli. The drug does not have a negative effect on the body, since it acts only in the intestines, without entering the blood. Hilak Forte is recommended for children under 2 years of age to take 20 drops up to 3 times a day. There are no side effects, only if the components are intolerant, an allergic reaction may develop.

Enterol

Has an antidiarrheal effect, restores intestinal microflora. Enterol can be used in children from 2 months to 3 years; when passing through the gastrointestinal tract, it has a positive effect on the intestinal microflora. The drug is available in capsules and in the form of powder for suspension; for children under 2 years of age, it is better to mix the powder with milk. During treatment, it may cause mild discomfort in the abdominal area, which disappears after cessation of treatment.

Bifi-Form

Immediately after taking the drug, it has a protective effect on the preservation of lactobacilli, which, thanks to the creation of a nutrient medium by Bifi-Form, begin to multiply. The drug contains 2 types of lactic acid bacteria, which block the proliferation of pathogenic bacteria and restores the intestinal microflora. The drug is allowed to be given to children from 2 months to 3 years old; it does not have a negative effect on the body. Contraindications include individual intolerance to the components.

Lactovit-Forte

The drug contains lactobacilli, which stop the development of harmful bacteria. Vitamins, amino acids, including folic acid normalize hematopoiesis. The metabolism of fats, proteins and carbohydrates improves. Treatment with Laktovit-Forte is indicated for children under 2 years of age, 1 capsule per day. The drug does not have negative effects because it is not absorbed into the blood, and its effect occurs directly in the intestines.