Dietary Treatment Of Kwashiorkor Disease: Causes And Symptoms

Kwashiorkor is a term used for clinical syndrome which results from severe deficiency of protein in the body due to insufficient dietary intake of protein. It is a severe form of protein energy malnutrition. Cicely Williams, a Jamaican physician while working in Ghana during 1930 described the condition in detail and named it as ‘Kwashiorkar’ which in local language of Ghana means ‘disease of deposed child’ (disease in a child who no longer suckles mothers breast).

The condition is widely prevalent in developing countries of Asia and Africa where drought and famine leads to restricted food supply.

In United States kwashiorkor is rare. Kwashiorkor is most florid form of protein energy malnutrition occurring usually in children between the age of 1 and 3 years when they are completely dependent on weaning.

Frequent diarrhea and respiratory illnesses aggravate the condition. The three essential symptoms of Kwashiorkor are swelling in legs and abdomen, stunted growth, and intellectual disability. In addition there may be changes in skin and hair.

The condition can be prevented by including protein rich food in diet. Treatment consists of gradual increase of calories and protein rich foods. The disease is life threatening when left untreated.

What Causes Kwashiorkor Disease?

Kwashiorkor is caused due to lack of food and protein deficiency in diet. It can also occur as a result of impaired absorption of protein in the intestine due to intestinal parasites, chronic diarrhea etc. Protein is extremely essential nutrient needed for maintenance and repair of body cells. It is also equally important for growing child and pregnant women.

Most of the protein (amino Acids) you get is from the food that you eat. Lack of protein will affect the normal functioning of body leading to conditions such as Kwashiorkor.

It is common in children between the age 1 and 3 years, however the condition can also develop in elderly people. It mainly occurs in countries with shortage of food supply.

Kwashiorkor is widespread among children in areas hit with drought and famine due to lack of food. Delayed introduction of complementary food to infants is also responsible for protein energy malnutrition. Depending on food that are regionally grown such as diet mainly consisting maze can lead to Kwashiorkor.

Lack of nutritional knowledge, lack of time for mother, is also one of the determinants of conditions such as Kwashiorkor. Elderly persons who are hospitalized for long duration are also at risk of suffering from nutritional deficiency, including protein deficiency.

Signs And Symptoms Of Kwashiorkor Disease

Children and toddlers are mainly affected with Kwashiorkor syndrome. The three characteristic feature of Kwashiorkor are swelling, poor growth and mental disability.

  • Edema (swelling): It occurs due to fluid accumulation in tissues. At first slight swelling begins to develop in ankles which spread up in the legs. Later on abdomen, hands and face are also swollen.
  • Poor growth: Retarded growth is the earliest symptom of Kwashiorkor. The height and weight of infant and children after weaning will be below those of his peers having good nutrition. Hands and legs will appear thin due to muscle wasting.
  • Mental symptoms: Child suffering from Kwashiorkor is apathetic. He does not have any interest in his surroundings. He is always irritable and prefers to be alone in one place.

There are several of other changes seen in Kwashiorkor. They are as follows:

  • Hair: The hair becomes thin and loses its shine and shin. The color of hair turns coppery red. Hairs can be easily plucked out from its roots as they are loose.
  • Skin: Dermatitis is common in areas of friction such as in armpits, in groin area. The skin becomes dark in the areas of irritation. The flaky skin from these areas peels off leaving behind patches that may appear similar to sunburn.
  • Infections: Child suffers from frequent respiratory tract infection and diarrhea.

Dietary Management And Treatment Of Kwashiorkor

Nutrition support is the mainstay treatment for kwashiorkor. The child receives adequate amount of food rich in protein and calories. In the beginning foods rich in carbohydrates, fats and sugars are given. Once these foods are found to be enough for energy requirement, protein diet is started.

Initially the child may be fussy and refuse to eat any diet due to anorexia. Hence food is introduced gradually. The child may need spoon feeding or gastric intubation in some cases. In older children special solid diet based on cereal, pulses, dried skim milk powder, sugar and jaggery can be given. Addition of vegetable oil in small amount improves the energy level of the child. Vitamin and minerals are essential during the recovery to correct anemia.

Infection is treated simultaneously with dietary therapy. It is treated with appropriate antibiotics. Treatment of parasitic worms if not severe is postponed till the child completely recovers. Diarrhea is common in Kwashiorkor. In fact correction of fluid and electrolyte balance is the first line treatment. Homemade salt and sugar solution given to the child is beneficial to correct dehydration.