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discomfort during or after eating caused by some interference with the normal digestive process. Symptoms include nausea, heartburn, abdominal pain, gas distress, and a feeling of abdominal distention.
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disturbances in digestion, varied in origin.
As distinct nosological forms of gastrointestinal diseases have increasingly been distinguished, the term “dyspepsia” has been reserved predominantly for syndromes of functional disturbance of the intestinal tract—putrefactive and fermentative dyspepsia. The term “dyspeptic symptoms” continues to be used in relation to various symptoms of functional disturbance of the stomach—belching, heartburn, nausea, and heaviness in the region of the stomach.
The basis of fermentative dyspepsia is increased motility of the small intestine, so that some carbohydrates are not digested and absorbed. Overloading the digestive organs with carbohydrates and plant cellulose (alimentary dyspepsia) is important here; it is manifested by distention and bulging of the stomach, loud rumbling and gurgling, coliclike pains, excessive gas, and liquid or pulpy stools.
Putrefactive dyspepsia is the result of an intensification of putrefactive processes in the large, and partially in the small, intestine. When there is a disturbance of the secretions of gastrointestinal digestion and a decrease in the bactericidal action of gastric juice (deficiency or absence of acidity in the stomach contents), the abundant microflora of the lower part of the small intestine settle in its upper part. A decisive role is played by an increase in the secretion of intestinal juice, which is rich in proteins and is the basic substrate for the putrefactive processes. Intestinal hypersecretion is most often caused by inflammations of the intestine. This may occur as an acute illness or chronically. It is manifested by persistent diarrhea—the stools are liquid, dark in color, and, along with gas, have an unpleasant odor.
The condition is treated by an appropriate diet, the introduction of increased quantities of vitamins C, PP, B1, and B2, and adsorbent and anti-inflammatory agents.
I. S. SAVOSHCHENKO
Infantile dyspepsia is an acute disturbance of digestion in children occurring predominantly during infancy. The anatomic and physiological characteristics of the gastrointestinal tract peculiar to children during the first year of life (insufficient fermentative activity of the stomach, intestine, and pancreas) create the conditions that readily lead to digestive disturbances. Weakened infants are most often stricken. The disease occurs in simple or toxic forms.
Simple infantile dyspepsia is caused chiefly by an alimentary factor (overfeeding, rapid transition to artificial feeding, food of inappropriate content). As a result of careless feeding, the digestive process is distorted, food is incompletely broken down, fermentative processes are intensified, and the stomach and duodenum become populated with colon bacilli, so that bacterial digestion replaces fermentative digestion. The infant begins to regurgitate and to have diarrhea. Stools (up to ten times a day) are watery and greenish with white clumps. The infant’s general condition, however, is hardly disturbed. An increase of gas in the intestine causes abdominal distention and coliclike pains. Complications, such as otitis, pyelitis, and pneumonia, are possible if the condition persists. The basic treatment consists in decreasing the volume of food by replacing one or two feedings with an equal volume of liquid and limiting the volume intake by 40-50 percent. Enzymes and vitamins are also prescribed.
Toxic infant dyspepsia is a severe form of the disease characterized by profound disturbance of all types of metabolism and of the functions of many organs and systems. It arises through disruption of the feeding regime and bacterial invasion. It is manifested by persistent vomiting and watery stools (up to 15 times a day). As a result of the great loss of water from vomiting and diarrhea, body weight decreases sharply, exsiccosis (dehydration) develops, and the toxic products of metabolism accumulate, affecting the central nervous, autonomic, and cardiovascular systems and causing disturbances of blood circulation, respiration, and liver and kidney functions. Complications are common (stomatitides, otitides, mastoiditides, pneumonia). A water and tea diet for 10-15 hours is recommended in treatment, with subsequent measured feeding (for infants in the first months of life, breast milk). Intravenous and subcutaneous injection of saline solutions of glucose, blood plasma, and antibiotics are also used.
Strict observance of a proper feeding schedule, a balanced nutritional regime, and general care help to prevent the condition.
REFERENCEMaslov, M. S. Lektsii po fakul’tetskoi pediatrii, part 1. Leningrad, 1963. Pages 18-43.
R. N. RYLEEVA and M. IA. STUDENIKIN