What is lamblia in children

Parasitic infections are a group of infectious diseases, the causative agents of which are the simplest microorganisms or worms that can exist at the expense of the human body. Most often, they are exposed to children from 1 to 4 years old, since the main cause of infection with parasites is poor hygiene. The study of the surrounding world "to taste" is an important stage in the intellectual development of an infant, therefore young children pull in their mouths anything that piques their interest (including earth, sand). The final formation of basic hygiene skills appears in children by about the age of four, therefore, the prevalence of helminthiasis after 4 years of age slightly decreases.

One of the varieties of parasitic diseases is giardiasis - an infection of the small intestine caused by protozoa with four flagella and a suction cup (lamblia). Giardiasis in children can occur without any symptoms and lead to serious consequences, for example, developmental delay, anorexia, blockage of the bile ducts and intestinal lumen. In order to provide the child with the necessary assistance on time, it is important to know the signs of infection, its main manifestations, possible indirect symptoms, and if they occur, consult a doctor. An infectious disease parasitologist is engaged in the treatment of giardiasis. If there is no such specialist in the medical institution, the local pediatrician will draw up the therapy regimen.

How does giardiasis develop?

Giardiasis in children develops after the pathogen (lamblia) enters the gastrointestinal tract. This type of microorganism can exist in two forms: "dormant" (motionless) and active (mobile). Giardia enters the child's body in a motionless form (such microorganisms are called cysts), after which, with the help of a special disc and flagella, is attached to the walls of the large intestine and causes it irritation. Giardia feeds on elements of epithelial cells, blood, and can damage intestinal blood vessels.

If the protozoa travel from the small intestine to the large intestine, they will again turn into cysts and come out. together with feces, since this pathogen cannot maintain its activity and mobility outside the thin intestines.

Important! Giardia have good environmental resistance and can maintain their viability in within 3-5 weeks, therefore, if giardiasis is detected in a child, increased hygiene should be observed mode. If there are other children in the family, they should have a separate pot, and the sick child's pot must be disinfected after each bowel movement. Bed linen and underwear should be changed daily, washed at high temperatures separately from the rest of the family, and ironed on both sides using steam.

Infection routes

In most cases, the infection enters the child's body through dirty hands. Children between the ages of 1 and 3 need to be constantly reminded of the need for hygiene. Hands should be thoroughly washed with antibacterial or baby soap before eating, after going outside, going to the toilet, coming into contact with pets, or playing on the floor. The child should have a separate soap and towel, which should be hung in such a way that the child was able to reach him on his own: this will help to quickly accustom him to hygiene and frequent hand washing.

If the child is not yet a year old, parents should wash their hands with him. For the prevention of giardiasis, it is also important to sanitize toys, floors, furniture and other surfaces with which the baby comes into contact. Baby dishes and bottles must be sterilized or rinsed with boiling water after washing.

Other sources of infection can be:

• products that are not subject to prolonged heat treatment (greens, berries, fruits, dairy products);
• sand in the sandbox;
• outdoor and domestic animals;
• water in puddles and reservoirs.

Important! Giardiasis is especially widespread in kindergartens, as in almost all groups (with the exception of nursery groups), children use the same pot or toilet. Giardia is excreted along with feces, so the risk of infection if there is a sick child in the team is very high.

Signs and symptoms

In most children, infection with lamblia proceeds without pronounced symptoms, so the infection is usually detected in the later stages. The first symptoms of the disease may be manifestations of general intoxication of the body: headache, weakness, drowsiness. In older children, academic performance may decrease, sleep disorders appear. In almost all cases of giardiasis, there is a marked decrease in appetite. An important diagnostic sign (as well as a consequence of the disease) is weight loss. If the child's diet did not change, physical activity did not increase, but at the same time body weight decreased by 8-10% or more, you need to go to the hospital, as this is uncommon for healthy children.

More specific signs that appear after the amount of lamblia in the small intestine increases to dangerous levels are:

• bloating and heaviness in the intestines, not associated with food intake;
• pain in the area of ​​\ u200b \ u200bthe location of the small intestine (upper abdomen in the center and the umbilical zone);
• severe flatus syndrome (profuse discharge of odorous gases);
• pallor of the skin of the face (the appearance of dark circles under the eyes is possible);
• nausea (vomiting is rare);
• rumbling and gurgling in the stomach between meals or immediately after a meal;
• pain while moving food through the small intestine;
• frequent constipation, which can suddenly be replaced by diarrhea.

Stools with giardiasis are usually yellow in color, and may contain a small amount of thick mucus. About half of children with chronic giardiasis develop diffuse neurodermatitis - recurrent skin disease of an allergic nature and characterized by the appearance of skin blemishes and itching.

Important! One of the complications of advanced giardiasis can be biliary dyskinesia - a violation of the motility of the bile ducts. Pathology can cause their blockage and the need for surgical intervention. A sign of damage to the hepatobiliary system is yellowing of the skin, which is usually mild in children.

What tests do I need to pass?

The most common method for diagnosing parasitic infections in children of any age is scatological examination of feces (coprogram). It allows you to assess the functioning of the large and small intestines, to identify signs of an inflammatory process, and also to determine the composition of the bacterial flora. For analysis, it is necessary to collect the child's morning feces in a sterile container and submit to the laboratory no later than 2-3 hours from the moment of bowel movement.

If more than 14 days have passed since the moment of infection, serological blood test - immunobiological analysis, which helps to determine the presence of antibodies and antigens in serum.

Important! Stool analysis helps to identify the causative agent of giardiasis only if it is in a mobile state. Giardia cysts with the help of a coprogram can not always be detected, therefore, in some cases, the child may a duodenal endoscopic examination with the collection of biological material for laboratory analysis.

Treatment of lamblia in children

Giardiasis is a fairly severe parasitic infection, the treatment of which is carried out in several stages. Therapy is aimed at creating conditions unfavorable for the reproduction of lamblia, increasing the immunological status, elimination of the inflammatory process, restoration of mucous membranes and enzymatic activity of the intestine and stomach. The basis of therapy is antiparasitic drugs, which are prescribed in accordance with the age and weight of the child.

Table. Antimicrobial agents for the treatment of giardiasis in children.

Name of the medicine	How to apply
"Furazolidone"	30-50 mg 4 times a day for 5-10 days. For adolescents over 14 years of age, the drug is prescribed in a dosage of 100-150 mg 4 times a day.
"Nemozol"	15 mg / kg daily (divided into divided doses). The duration of treatment is 5-7 days.
"Sanoksal"	15 mg / kg per day (divided into 2-3 doses). The maximum duration of therapy is 1 week.
"Tinidazole"	50-75 mg per kilogram of body weight once with or after meals. If necessary, you can repeat the appointment after 10 days.

One of the main manifestations of giardiasis is intoxication, which causes a general deterioration in well-being and increased weakness, therefore, an important task in the complex treatment of infection is to carry out detoxification treatment. For this, drugs from the group of enterosorbents are used: Enterosgel, Filtrum, Smecta, Activated Carbon. In most cases, children are prescribed funds based on smectite ("Neosmectin", "Smecta"). If the child refuses to drink the prepared solution because of the suspension floating in it, you can use "Smecta" in the form of a ready-made suspension with caramel flavor (1 sachet - 1 dose).

To eliminate skin reactions and reduce the possible consequences of antimicrobial therapy, histamine blockers (Claritin, Erius, Zodak) can be prescribed to the child. In severe cases, infusion therapy with Suprastin can be performed, but this treatment regimen is usually used only in adolescents over 12 years of age.

The complex therapy, depending on the available indications, may also include:

• prebiotics and probiotic fibers ("Normobact", "Bifidum liquid concentrate", "Bifiform");
• digestive enzymes to restore the enzymatic activity of the gastrointestinal tract ("Mezim", "Creon", "Festal");
• multivitamin complexes to increase the body's resistance and strengthen the protective functions ("Pikovit", "Revit", "Alphabet").

Good results in the fight against giardia are given by treatment with mineral waters, but it should be carried out only under the supervision of a doctor after the relief of acute inflammation.

Diet upon infection

Special food for the child is prescribed from the first day of treatment. It is necessary to reduce the load on the inflamed intestines, accelerate the healing and restoration of mucous membranes, and increase immunity. The main principle in drawing up the menu during the treatment of giardiasis is to increase the amount of plant fiber in the daily diet.. Coarse vegetable fibers are found in sufficient quantities in cereals, fruits, herbs, vegetables. To enrich the body with vitamins, it is useful to drink from dried fruits (dried apricots, raisins, figs). Vegetable oil envelops the walls of the small intestine and facilitates the evacuation of lamblia and their cysts to the end sections of the digestive tract.

The basis of the diet of children with giardiasis should be vegetable and fruit purees, broths, boiled meat, fish and poultry. To improve the peristalsis of the intestinal walls, baked fruits, dairy products, vegetable stews and casseroles should be present in the menu. It is possible to neutralize the toxins released by lamblia in the course of their vital activity by adding drinks from sour berries to the daily diet: lingonberries, cranberries. The drinking regimen should be plentiful: the amount of liquid drunk per day should not be less than 1.5 liters.

Video - Giardia in children and adults. Symptoms and treatment of giardiasis