Kwashiorkor – An Overview

Kwashiorkor is caused by a protein deficiency in an individual’s diet. It is a form of acute malnutrition and is seen in growing children subjected to starvation and malnutrition. It is also called edematous malnutrition due to the formation of edema (fluid) retained in the body, especially the neck, joints, and stomach.

Kwashiorkor symptoms are swelling of the neck, legs, and abdomen due to fluid retention, etc. Treatment includes a protein-rich diet and other nutrients. In this article, we will study Kwashiorkor, symptoms, and treatment of Kwashiorkor along with the diagnosis.

What is Kwashiorkor?

Kwashiorkor disease is caused by the deficiency of protein in the diet for a prolonged period. Children living in developing countries are more prone to suffer from this disorder. Usually, Kwashiorkor is frequent within those populations that do not have access to an adequate nutritional diet. Kwashiorkor is characterized by swelling of the neck, legs, and abdomen due to fluid retention. Retarred growth, pale skin, etc. are additional symptoms. It can also be characterized by ascites in the advanced stages.

Who Does Kwashiorkor Affect?

Kwashiorkor mainly affects children below the age of 5. It is seen in children who have recently been weaned from breastfeeding and have been shifted to a diet of other normal foods. It is also seen to been more frequent in developing countries, drought affected areas and Sub-Saharan countries were acquiring nutrition via a balanced diet due to lack of food resources is difficult.

Kwashiorkor Causes

Protein is an essential part of our diet as it is the building block of life. It is required for the normal functioning of humans and cell division, repair, and growth. A prolonged protein deficiency in the diet causes Kwashiokor. Some obvious causes of Kwashiorkar are as follows:

• Dietary Deficiency: Kwashiorkor is primarily caused by a severe deficiency of protein in the diet. This deficiency can occur when a person’s diet lacks sufficient protein-rich foods.
• Limited access to variety of food: The condition often occurs in regions or situations where there is limited access to a diverse range of foods, particularly those containing essential proteins.
• Poverty: Poor population may not be able to afford variety of nutritional diet and stick to consuming starchy diet like rice, potato, wheat, etc. In such cases severe protein deficiency can result.
• Weaning from Breastfeeding: In some cases, the transition from breastfeeding to a diet lacking sufficient protein can trigger kwashiorkor, especially if the replacement foods are inadequate in protein content.
• Infections and Diseases: Long prevalent infections and diseases, particularly those causing gastrointestinal issues such as diarrhea or parasites, can result in mal absorption of dietary nutrients and result in nutritional deficiency.

Complications in Kwashiorkor Disease

Nutritional deficiencies like Kwashiorkor can cause a number of complications if not treated. These include:

• Cardiovascular issues
• Joint issues
• Gastrointenstinal issues
• Liver issues
• Loss of immunity
• Loss of cellular redox balance
• Loss of electrolyte balance

Sign and Symptoms of Kwashiorkor

The characteristic symptom of Kwashiorkor is edema. The various symptoms of Kwashiorkor include:

• Edema: The characteristic symptom of kwashiorkor, edema, is seen as fluid retention and swelling, particularly in the abdomen, face, and extremities. This edema is caused due to fluid leakage from blood vessels into surrounding tissues.
• Skin Changes: Kwashiorkor may cause noticeable skin changes, including dermatitis, hyperpigmentation, and desquamation (skin peeling).
• Growth Failure: Children with kwashiorkor typically experience growth failure. It is seen as stunted height and weight relative to their age. Protein deficiency disrupts normal growth processes, impairing skeletal and muscular development and leading to overall growth retardation.
• Fatigue and Weakness: Due to lack of protein and calories fatigue and muscle wasting is seen in affected children. Protein deficiency compromises muscle function and repair, resulting in decreased physical strength and endurance.

Other symptoms of Kwashiorkor include:

• Loss of appetite
• Irritability and fatigue
• Loss of muscle in extremities
• Diarrhea
• Stunted growth and development
• Thinning hair and skin discoloration
• Enlarged liver and/or spleen

Diagnosis of Kwashiorkor

Multiple tests are conducted to diagnose a patient with Kwashiorkor. These include

• Test for hepatomegaly (enlarged liver) and edematous stomach swelling.
• Creatinine tests.
• Blood counts
• Blood serum level tests
• Total protein levels
• Serum sodium and potassium levels
• Urinalysis
• Blood sugar level test.

Usually, children with Kwashiorkor show enlarged livers with low blood sugar levels and irregular serum proteins. Doctors also look into the diets of individuals suspected of having Kwashiorkor.

Treatment of Kwashiorkor

In patients where Kwashiorkor is diagnosed early, it can be treated completely. Primary treatment of Kwashiorkor is nutritional rehabilitation and supportive care. Additional treatments can also be required based on the severity of the problem.

1. Nutritional Replenishment: Nutritional replenishment is done by improving the diet of children diagnosed with Kwashiorkor. Children with Kwashiorkor are often prescribed a protein-rich diet, such as milk, eggs, fish, poultry, and legumes. In severe cases, nutritional supplements containing protein, vitamins, and minerals may be recommended to support recovery.
2. Supportive Care: Sometimes, children with Kwashiorkor find it challenging to rebuild protein merely by eating the right food. They also develop additional problems like lactose intolerance and irregular blood sugar that must be addressed with supportive care like enzyme medications, blood sugar regulators, and prescribed fluid intake.
3. Medical Management: Medical Management of Kwashiorkor includes fluid and electrolyte Management in form of oral or intravenous methods. Intravenous fluids may be necessary to correct dehydration and restore electrolyte balance, followed by oral rehydration solutions as the patient’s condition improves. Usually nutritional supplements and additional medicines are also prescribed by doctors along with general nursing care to patients suffering from Kwashiorkor.
4. Long Term Management: After the acute phase of treatment, ongoing follow-up and long-term care are crucial to monitor growth and development, prevent relapse, and address any nutritional or developmental issues. Continued nutritional support, regular medical check-ups, and access to essential healthcare services are essential components of long-term management.

Prevention of Kwashiorkor

Since Kwashiorkor is mainly a nutritional disorder, it can be easily prevented by following simple steps:

• Having a balanced intake of all nutrients, including proteins.
• Breastfeeding must be encouraged for up to 6 months after birth as breastmilk contains a balanced protein diet for infants.
• Easy access to a nutritional diet should be maintained for the mother and children up to the age of five to prevent any dietary disorders like Kwashiorkor.
• Healthcare systems worldwide, mainly in rural and developing areas, must be strengthened to improve the early detection and treatment of malnutrition in children.
• Awareness programs must be held to prevent the occurrence of the disease due to neglect.

Management of Kwashiorkor

The management of Kwashiorkor involves treatment of the nutritional deficiencies and managing complications. The key components of Kwashiorkor management are:

1. Adequate Nutritional Intake: Adequate nutrition and correct nutrient imbalances is the first step to managing Kwashiorkor. This often involves a gradual increase in calorie and protein intake to avoid complications such as refeeding syndrome. Nutrient-rich foods like therapeutic milk, fortified formulas, and ready-to-use therapeutic foods (RUTFs) are commonly used.
2. Fluid and Electrolyte Management: Kwashiorkor is often accompanied by fluid retention and electrolyte imbalances, leading to edema and other complications. Proper hydration and electrolyte management are essential, especially during the acute phase of treatment.
3. Treatment of Associated Complications: Kwashiorkor can lead to various complications, including infections, hypoglycemia, anemia, and impaired immune function. Identification and management of these complications are essential to prevent further problems and recover faster.
4. Mental Support: Providing mental support, counseling, and mental health services can help address emotional distress, promote bonding between caregivers and children, and improve overall well-being during the recovery process.

Please Note: These measures and Symptoms may vary and are just to provide educational information of the disease and are not standard practices. We advise you to consult a HealthCare Professional, before trying anything at home.

Conclusion: Kwashiorkor

Kwashiorkor is caused by a protein deficiency in diet and is treated with an intake of protein-rich food. The Kwashiorkor symptoms are edema (swelling), skin lesions, hair discoloration, fatigue, and a distended abdomen. All individuals and health organizations must know the causes, symptoms, and treatment of Kwashiorkor to prevent the occurrence of the disease. Developing children should be given proper balanced diets to avoid nutritional disorders like Kwashiokor for healthy body functioning and growth.

FAQs on Kwashiorkor

What is the Prevention of Kwashiorkor?

To prevent Kwashiorkor, one should have a protein-rich diet, including milk, legumes, meat, and eggs, to prevent Kwashiorkor.

What are the Causes and Symptoms of Marasmus?

The cause of marasmus is a deficiency of calories and protein in the diet. The symptoms of marasmus are the drastic reduction in muscle mass in children called muscle wasting.

What is the Diet Prescribed for Kwashiorkor?

A protein-rich diet is prescribed to children/patients suffering from Kwashiorkor. This includes daily milk, eggs, pulses, legumes, and meat intake.

What is the Cause of Kwashiorkor?

Kwashiorkor is caused by the severe deficiency of protein in the diet of children who have been recently weaned from breastfeeding.

What are the Symptoms of Kwashiorkor?

The hallmark of Kwashiorkor is the formation of bilateral edema. This is the swelling of the stomach, legs, and neck of children having the disease due to fluid retention.

Is kwashiorkor Caused Due to Deficiency?

A severe kind of malnutrition called kwashiorkor is caused on by a lack of dietary proteins.

Why Does kwashiorkor Cause Anemia?

Kwashiorkor can cause anemia due to inadequate protein intake, hindering hemoglobin production, and impairing iron utilization, leading to decreased red blood cell formation.

What are the 5 Causes of Kwashiorkor?

The five causes of Kwashiorkor include protein deficiency, insufficient dietary intake, infections, and digestive disorders.

What is the Difference Between Maramus and Kwashiorkor?

Maramus is characterized by severe malnutrition due to a lack of overall nutrients, while Kwashiorkor is primarily caused by protein deficiency, leading to symptoms such as edema and skin lesions.