Take it
The content of the article:
- Causes and risk factors
- Forms of the disease
- Disease stages
- Symptoms
- Features of the flow of take-take in children
- Diagnostics
- Treatment
- Possible complications and consequences
- Forecast
- Prevention
Beriberi is a disease caused by a lack of intake of thiamine (vitamin B1) (vitamin B1).
The disease was widespread in the late 19th - early 20th centuries in the Far East. The epidemic claimed the lives of people, and the causative agent of the disease could not be found. Christian Eikman, a Dutch physician who worked on the island of Java, succeeded in discovering the reason for beriberi. He drew attention to the fact that the disease affected people who ate white rice instead of traditionally used by the local population of black brown rice. Eikman suggested that the shell of rice contains a substance necessary for metabolism. This substance turned out to be thiamine, or vitamin B1.
Beriberi disease develops due to vitamin B1 deficiency
The diet of most modern people contains a sufficient amount of vitamins, therefore, beriberi is rare today. As a rule, the disease is diagnosed in people suffering from alcohol dependence.
Causes and risk factors
Thiamine is actively involved in the regulation of biochemical processes of carbohydrate and protein metabolism. A lack of vitamin causes an increased content of pyruvic acid in the blood, which has a toxic effect on the tissues of many organs and systems (nervous, cardiovascular, digestive). Such biochemical disorders lead to the development of polyneuritis, Korsakov's syndrome, Wernicke's encephalopathy, dry beriberi (damage to the nervous system), wet beriberi (damage to the cardiovascular system).
The reasons for the development of beriberi:
- Insufficient intake of thiamine from food.
- Violation of the mechanism of absorption of thiamine from the small intestine.
- Increased need for thiamine.
With the constant use of large doses of alcohol, the consumption of thiamine increases and its absorption from the small intestine is impaired, therefore, in people suffering from alcoholism, hypovitaminosis B1 is formed even with a sufficient intake of thiamine into the body. Other predisposing factors include:
- long-term nutrition with refined foods;
- peptic ulcer of the stomach and duodenum;
- thyrotoxicosis;
- acute and chronic diseases of the small intestine;
- high ambient temperature;
- pregnancy or lactation;
- poisoning;
- diabetes.
Stomach and duodenal ulcers - predisposing factors in the development of beriberi disease
Forms of the disease
There are two clinical forms of beriberi:
- Wet. Primarily the cardiovascular system is affected, characterized by severe weakness, heart palpitations, edema and shortness of breath.
- Dry. In the peripheral nerves, degenerative processes of the type of parenchymal neuritis occur, manifested by impaired skin sensitivity in the extremities, difficulty walking, deterioration of logical thinking and memory. If untreated, paralysis develops.
Children's beriberi is considered a special form of the disease.
Disease stages
Depending on the duration of the flow, two stages of beriberi are distinguished:
- Sharp. The clinical picture develops rapidly over several days.
- Chronic. It is observed with long-term thiamine deficiency. It is often accompanied by the development of complications.
Symptoms
The most typical signs of beriberi:
- vomiting;
- dyspnea;
- tachycardia;
- nystagmus;
- swelling of the lower extremities;
- pain in the lower extremities;
- paresthesia;
- violation of coordination of movements;
- slurred speech;
- severe weakness;
- memory impairment;
- paralysis.
Beriberi disease is characterized by paresthesias and paralysis.
Features of the flow of take-take in children
The childhood form of beriberi is found mainly in Asian countries among the poor, whose diet is dominated by white polished rice. Such nutrition causes a low content of thiamine in breast milk and the development of vitamin B1 deficiency in children aged 2-4 months.
As in adults, the disease can be acute or chronic.
The acute form of infant beriberi develops rapidly and often leads to a rapid death. The death of a child occurs suddenly, against the background of an outwardly satisfactory state of health.
The characteristic features of the acute form of beriberi are:
- rejection of the breast;
- dyspnea;
- aphonia;
- intestinal colic;
- constipation or diarrhea;
- decrease in the amount of urine separated;
- anxiety;
- swelling of the limbs;
- laryngeal edema.
In children, beriberi disease can develop if the basis of the diet is polished rice.
In the absence of specific treatment, heart failure develops, accompanied by tachycardia, cyanosis, enlarged liver, fluid accumulation in the pericardium, pleural and abdominal cavity. Then meningeal symptoms and seizures appear. Consciousness is lost and the child falls into a coma. Against the background of an increase in respiratory and cardiovascular insufficiency, a lethal outcome occurs.
The first signs of chronic infant take-take:
- increased fatigue;
- excessive agitation;
- lack of appetite;
- pallor of the skin.
In the future, paresthesias, polyneuritis phenomena are added to the named symptoms. Tendon reflexes are reduced. Swelling and the intensity of symptoms of heart failure increase. The main distinguishing feature of beriberi in children is paralysis of the cranial nerves. Clinically, this is manifested by hyporeflexia, aphonia, and ptosis of the eyelids.
Diagnostics
Diagnosis of beriberi is carried out on the basis of a characteristic clinical picture of the disease and anamnesis data concerning the nature of the diet, metabolic pathologies, and alcohol abuse.
To confirm the diagnosis, the content of thiamine in daily urine is determined. If it is not possible to perform this laboratory study, the patient is prescribed trial therapy with thiamine. If, against its background, the condition improves, the diagnosis of beriberi is considered confirmed.
A urine test for thiamine levels helps confirm beriberi
Treatment
Beriberi therapy begins with the intramuscular injection of vitamin B1. After improving the patient's condition, the patient is transferred to oral vitamin intake. If the cause of beriberi is chronic alcoholism, maintenance courses of thiamine injections are prescribed for life.
Symptomatic treatment of neurological and cardiovascular disorders is also carried out.
For the treatment of beriberi disease, intramuscular administration of vitamin B1 is indicated
Physiotherapy (physiotherapy exercises, massage, pine baths, ultraviolet light, Bernard currents) plays a significant role in eliminating the neurological symptoms of beriberi.
Possible complications and consequences
The most common complications of beriberi:
- heart failure;
- memory disorders;
- difficulty walking, unsteadiness of gait;
- paralysis.
Forecast
With timely treatment, the prognosis is favorable. Severe damage to peripheral nerves and heart muscle significantly worsens it.
Prevention
For the prevention of take-take, good nutrition is required. The diet should be balanced in terms of protein, fat, carbohydrates, vitamins and microelements. It must include foods rich in thiamine: wholemeal or rye bread, eggs (yolks), meat and fish, beans, carrots, tomatoes, etc.
People prone to alcoholism need to stop drinking alcohol.
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Elena Minkina Doctor anesthesiologist-resuscitator About the author
Education: graduated from the Tashkent State Medical Institute, specializing in general medicine in 1991. Repeatedly passed refresher courses.
Work experience: anesthesiologist-resuscitator of the city maternity complex, resuscitator of the hemodialysis department.
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
