The text is presented for informational purposes only. We strongly urge you not to self-medicate. When the first symptoms appear, consult a doctor. We recommend reading: “Why you can’t self-medicate?”
Pieces of undigested food in the feces ( lientorrhea ) can occur in both a healthy child and a child with pathology. The difference lies in the quantity, frequency and the presence of a connection with the foods consumed. Depending on the nature of the changes in stool, the pathological condition may be called amilorrhea, steatorrhea or creatorrhoea - the appearance of undigested starch, fats or muscle fibers in the stool, respectively.
Causes
Non-pathological causes
The gastrointestinal tract of a newborn and infant is gradually populated by microorganisms, and the enzyme systems are in a stage of functional immaturity for some time.
This explains the appearance in the stool of a healthy child of a small amount of undigested food, both on natural and artificial feeding. Medical products (drugs, medicines, vitamins, dietary supplements) are mentioned for informational purposes only. We strongly do not recommend using them without a doctor's prescription. We recommend reading: “Why can’t you take medications without a doctor’s prescription?”
A similar condition occurs when indigestible fiber is consumed. Thus, sesame seeds, flax seeds, fruit peels, some vegetables and root vegetables (tomatoes, celery, etc.) normally pass through “transit”. Their appearance in stool is not considered a pathology.
Pathological causes
- Congenital exocrine pancreatic insufficiency. It occurs against the background of organ development anomalies, Sheldon-Reay syndrome, cystic fibrosis, Pearson and Diamond-Shwachman syndrome.
- Acquired insufficiency of exocrine pancreatic function. In childhood, acute pancreatitis occurs against the background of an infectious process and abnormal development of the bile ducts. A similar complication is typical for kwashiorkor - protein-energy deficiency due to fasting.
- Acute intestinal infections (AI). This is a group of diseases that often occurs in children and also occurs with transient disruption of the stomach, pancreas, and intestines.
- Antibiotic-associated diarrhea (“intestinal dysbiosis”). Excessive proliferation of opportunistic microorganisms in the lumen of the colon also disrupts the digestion processes.
- Lactase deficiency. This is a congenital or acquired pathology in which the child’s body is not able to break down milk sugar normally due to a deficiency of a special enzyme - lactase. The leading syndrome of the disease is malabsorption syndrome (impaired absorption and digestion of food).
Thus, the constant or frequent appearance of undigested food in the feces may indicate a congenital or acquired pathology of the pancreas, small or large intestine.
Prescribing a coprogram and correct collection of tests
Muscle fibers are not normally detected in stool
In order to prescribe a coprogram, the doctor must have certain grounds. It may be indicated in the following situations:
- in the diagnosis of gastrointestinal pathologies
- for suspected helminthiasis
- in order to assess the effectiveness of the therapy
Comprehensive preventive examinations also involve stool analysis. Using a coprogram, you can identify various disorders in the child’s digestive system:
- infectious and inflammatory processes in the intestines
- cystic fibrosis
- presence of parasites
- lactose intolerance
In order for the coprogram to bring reliable results, when collecting feces it is necessary to adhere to certain rules. A couple of days before the analysis, you should stop eating foods that contain meat and that affect the color of stool.
These include various green vegetables, tomatoes, beets, and red fish. They are able to distort the result of a coprogram when searching for hidden blood in the patient’s stool. Sometimes, the doctor independently prescribes a special diet for the patient. The products prescribed by her contain proteins, carbohydrates and fats in a certain amount.
This creates a maximum load on the digestive system, as a result of which stool analysis helps to detect any, even the slightest, deviation in the digestive processes. Before the analysis, you should avoid taking various enzymes and medications that affect intestinal motility. Taking antibiotics, drugs containing iron and bismuth, as well as anti-inflammatory drugs should also be postponed.
People who have had a barium x-ray or colonoscopy need to wait a few days for the test. It is not advisable for women to donate feces for coprogram during menstruation. People suffering from hemorrhoids should delay testing until the problem is resolved if the hemorrhoids bleed.
Stools for analysis must be obtained naturally. It is recommended to donate stool obtained as a result of morning bowel movements. Evening samples can be stored in the refrigerator for ten hours. The material for analysis is collected in a special sterile container. It will be enough to collect 15g of material for analysis.
Associated symptoms
Undigested lumps of food in a child’s stool are one of the symptoms of the disease. Consequently, the pediatrician does a complete examination of the child and conducts a thorough interview. As a rule, signs of congenital pathology appear in the first days or months of a baby’s life.
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Congenital diseases such as cystic fibrosis and Diamond-Shwachman syndrome occur with exocrine pancreatic insufficiency. Characteristic signs of cystic fibrosis (in addition to impaired digestion of fats and fiber):
- frequent inflammatory diseases of the bronchial tree and lungs, accompanied by the discharge of purulent sputum, wet cough and shortness of breath;
- weight loss, weakness, vitamin deficiency;
- “salty” sweat;
- multiple stools;
The following symptoms occur with Diamond-Shwachman syndrome:
- growth retardation, skeletal abnormalities (clinodactyly, narrow chest, hypoplasia of the phalangeal bones);
- a decrease in the level of platelets and neutrophils in the peripheral blood, which contributes to increased bleeding and a tendency to frequent infections;
- anemia (weakness, pallor of the mucous membranes and skin, dizziness).
With acute intestinal infection in children, the following appears:
- severe nausea, vomiting;
- paroxysmal abdominal pain, rumbling;
- frequent loose stools mixed with undigested pieces, greens or mucus;
- increased body temperature, weakness, lethargy.
Antibiotic-associated diarrhea usually occurs with multiple loose stools and painful sensations in the umbilical area. The feces contain many streaks of mucus, greenery, and have a foul odor. The body temperature remains normal, and the medical history must include recent use of systemic antibiotics.
In case of lactase deficiency, the child will be bothered by intestinal colic, frequent bowel movements up to 10 times a day, constant bloating, regurgitation, and abdominal pain. As the disease progresses, dysbiosis develops and body weight deficiency appears due to impaired absorption of nutrients and microelements. To relieve symptoms, you should avoid all foods containing lactose.
Digestive system
The digestive system develops along with the body. On the one hand, it grows, matures, learns to digest new types of food. On the other hand, it must not only grow, but also through its work provide nutrition to cells and tissues with building materials and energy, as well as remove waste products. There are many more functions that the digestive system influences indirectly.
There can be many reasons for “indigestion” in a child. But it is important to remember that the main processes of food digestion occur in the small intestine with the participation of the pancreas. It is she who secretes the necessary enzymes that break down food into its component parts2. When, for various reasons, there are not enough digestive enzymes, food may not be completely digested, which often leads to symptoms of “indigestion.”
What can lead to “indigestion” in a child?2
- overeating, a sharp increase in load against the background of a favorable general condition;
- violation of the diet with obvious restrictions on any products;
- new products that the child tried for the first time;
- intestinal infections, poisoning, their consequences;
- use of antibiotics and other drugs;
- congenital characteristics, allergies, intolerance to certain foods;
- stress and emotional overload.
As many reasons as there are, there are just as many manifestations of digestive disorders.
The main symptoms of “indigestion” in a child:2
- heaviness in the stomach;
- discomfort after eating;
- bloating;
- flatulence.
If the digestive processes are disrupted for a long time, this can also manifest itself as diarrhea and even weight loss due to lack of nutrients.
Diagnostics
To establish an accurate diagnosis, a pediatrician or gastroenterologist may require additional studies:
- clinical or biochemical blood test;
- coprocytogram is an analysis that shows qualitative and quantitative changes in feces (neutral fats, digestible fiber, muscle fibers, iodophilic flora, etc.);
- bacteriological examination of feces for pathogenic microorganisms and their sensitivity to antibacterial drugs;
- ultrasound examination of internal organs, including the pancreas;
- genetic tests for congenital pathologies;
- radiography.
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The range of examinations is determined by the expected diagnosis and the age of the child.
Treatment
The approach to treatment depends on the nature of the pathology, against which undigested food particles are found in the stool. Sometimes strict adherence to a diet is sufficient; in some cases, long-term drug treatment may be required.
Drugs
Since the appearance of undigested products in a child’s stool is most often a sign of exocrine pancreatic insufficiency, synthetic enzymes are the drugs of choice. In childhood, preference is given to Creon (contains amylase, protease, lipase), which consists of microgranules enclosed in a special protective shell.
This drug can be prescribed for exacerbation of pancreatitis, cystic fibrosis, lactase deficiency and acute intestinal infection. Enzymes such as Panzinorm, Micrasim, Pancreatin are also used.
For acute intestinal infections of a bacterial nature, systemic antibacterial drugs (penicillin, cephalosporin series), intestinal antiseptics, and silicon sorbents are prescribed. They are taken in a course until the pathogen is completely eliminated.
Probiotics or synbiotics can help improve digestion. In pediatrics, preference is given to Linex, Bak-Set-Baby, Bifiform and Acipol. Their pharmacological action is aimed at restoring normal intestinal microflora and improving digestion processes.
In case of lactase deficiency, in addition to a strict diet, doctors prescribe special low- or lactose-free formulas for infants. Replacement drugs containing the enzyme the child lacks, lactase (Mamalak, Lactazar), have a good effect.
What can a microscopic examination of stool tell you?
Coprogram: decryption
The absorption of food is a complex mechanism of interaction between various organs of the human digestive system. It begins in the oral cavity and proceeds throughout the digestive tract, right up to the anus. Food processing occurs not only at the mechanical level, but also at the chemical level - as a result of the action of gastric juice and various enzymes on nutrients.
Using a microscopic examination of stool, it is possible to determine which foods eaten by the patient were poorly digested. Based on the information received, the specialist can determine what kind of digestive problems a person has.
Feces in normal form are a homogeneous mixture of various substances, which consists of products obtained as a result of secretion and excretion of the gastrointestinal tract, remnants of undigested or poorly digested food, particles of the upper intestinal tissues and its microflora. When carrying out a coprogram, the homogeneity of feces is determined as detritus. With normal functioning of the gastrointestinal tract, food is processed well and detritus has a more uniform appearance.
If any disorders develop in the patient’s digestive system, food is not fully digested, so undigested remains of consumed foods begin to appear in the stool. Thus, among the remains of animal products, fats and muscle fibers can be found in feces.
Plant foods are represented in the analysis in the form of fiber and starch. All these components, present to varying degrees in the analysis material, can tell about specific diseases of the patient’s digestive system. The quality of a person’s life depends on the efficiency of the body’s digestive system. Food is the main source of various nutrients that the body needs to meet all its needs.
Microscopic examination of stool can tell you how efficiently your digestive system is doing its job. Depending on the presence of various components in the stool, the doctor diagnoses this or that deviation from the norm and determines its cause.
