Why does a child have acetone in his urine, what symptoms does this manifest?

Acetonymic syndrome - many parents face this threatening condition. It is this disease that is manifested by the appearance of a persistent odor of acetone from the baby’s mouth and severe vomiting, which is always sudden. A similar disorder develops in children with acetonemia, when the concentration of ketone bodies in the blood greatly increases. These components from the bloodstream enter various organs, causing severe intoxication in the child’s body, and are then excreted from his body with urine.

Why does acetone appear in the urine of children? What should parents do if an acetonymic crisis occurs? We invite you to find out the answers to these questions right now.

Acetone, what is it?

You may have wondered what acetone means in children? When there is a lack of glucose in the body, an accelerated breakdown of fats and proteins occurs with the formation of ketone bodies. Normally, a small amount of these substances should be contained; they act as an additional source of energy. Ketone bodies initially break down and are eliminated from the body through respiration and excretion. However, with the accelerated process, their concentration increases, they begin to irritate the digestive tract, resulting in vomiting. The baby loses a lot of fluid, which causes an accelerated metabolic process and can result in acidosis.

Signs and causes of ACETONE in a child

Acetone syndrome or Acetone in a child is a condition caused by an increase in ketone bodies in the blood. Often detected by the smell of acetone from the child’s mouth, an unusual smell of urine, nausea and vomiting. All these signs mean that the level of acetone in the child’s body is exceeded, so it is released in the urine and poisons the body, causing a bad breath. Acetonemia is a serious problem; if you cannot eliminate the symptoms on your own, you need to go to the hospital. With proper treatment, acetone returns to normal in children with age. (Komarovsky).

SYMPTOMS:

• Vomiting, often immediately after trying to eat.
• Pale skin color, blue under the eyes.
• Lethargy, drowsiness, muscle weakness.
• Attacks of intestinal pain.
• Temperature 37-38 degrees.
• Urine, vomit and breath have a specific odor from the mouth, similar to acetone. May resemble “fumes”, the smell of sour apples.
• There are ketone bodies in the urine (tested with special strips).

CAUSES

A common cause is an unbalanced diet. Children simply need more carbohydrates than adults. If there are not enough of them, then an excess amount of ketone bodies and acetone enters the blood (it causes bad breath and other secretions). This condition can also be caused by sudden fasting, for example, on “fasting days.” (Komarovsky).

If the body system is functioning normally, the liver partially takes over the processing of fats and proteins into carbohydrates. The liver stores these carbohydrates as a reserve in the form of glycogen. With some liver function disorders in children (obesity, etc.), symptoms may appear: a smell of acetone in the mouth, fever, etc. (Komarovsky).

GUT DYSBACTERIOSIS

Fermentation processes occur during childhood dysbiosis. Because of this, some of the carbohydrates obtained from food are broken down in the intestines, bringing no benefit. If this condition develops, then children will have a lack of carbohydrates, which cannot be corrected by nutrition - symptoms of AS and the smell of acetone from the mouth will appear. (Komarovsky).

PANCREAS

This gland facilitates the digestion of carbohydrates and is responsible for the level of sugar in the system. If its work is disrupted, children may develop acetone syndrome and diabetes, ulcers of the mouth and mucous membranes. (Komarovsky).

Table of foods for children with acetonic syndrome

ADRENAL TENSION

The adrenal glands are responsible for the stress hormone. A large amount of this hormone blocks carbohydrate metabolism. Instead, fats are used for the body's needs, and at the same time the amount of acetone in the blood always increases. (Komarovsky).

TREATMENT

BETWEEN SETTINGS

It would be very good to prevent relapses of the syndrome in children, which means prevention needs to be carried out at home.

Dr. Komarovsky recommends changing the child’s routine, focusing on a healthy lifestyle. Introduce reasonable physical activity and avoid overwork. If possible, eliminate stress, since tension in the nervous system can cause an increase in acetone in the child’s blood. The patient should not stay at home all the time; activity in the fresh air is necessary.

Children with acetone syndrome are at risk of diabetes, so prevention or treatment prescribed by a doctor should be carried out at home. Monitor your breath for signs of bad breath and test for glucose absorption.

Be sure to pay close attention to your child’s nutrition; there is no need to overfeed him or expose him to prolonged hunger. It is better to divide meals into 4-6 times throughout the day, in small portions. Children's diets should be low in animal fats and acidic foods. It is necessary to limit the intake of foods that stimulate gas formation (legumes, cabbage) and irritate the mucous membranes in the mouth (onions, garlic, hot spices).

TREATMENT OF VOMITING AND ABDOMINAL PAIN

A sick child should stay at home. It is very important to relieve symptoms and prevent the condition from getting worse. As soon as the first signs appear, such as lethargy, nausea, the smell of acetone from the mouth, headache, the child should not be allowed to starve. If a child feels nauseous and refuses to eat, you can give him tea with sugar or any other carbohydrate drink.

When vomiting, a child loses a lot of fluid, which means it is necessary to restore the water level in the body. If attempts to give water to a child cause vomiting, it is necessary for him to drink often and little by little; some of the water will be absorbed through the pores in the mouth.

As soon as the child has an appetite, you need to feed him immediately. Eating small portions, often. Choose products according to the principle: more easily digestible carbohydrates (potatoes, semolina, rolled oats, bananas), minimum fat. When the vomiting goes away, you can add meat, light soups, and dairy products.

As for medications, you can give antispasmodics (for example, No-Shpa) and sorbents (activated carbon, etc.) in pediatric doses. You can rinse your stomach with cool water - this will lower the temperature and remove bad breath. (Komarovsky).

MEDICAL CARE

Consistently carry out the treatment prescribed by your doctor, since acetonemia in children usually occurs against the background of some illness.

You should consult a doctor immediately if:

• Uncontrollable attacks of nausea.
• Increasing weakness.
• Unusual breath smells like acetone.
• Impaired consciousness.
• High temperature.

Don't self-medicate! Although this can stop the crisis, without clarifying the causes of the attacks, treatment will be incomplete.

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Acetonemic syndrome

This diagnosis is mainly given to children. Why are children more susceptible to this condition?

1. The child grows quickly, moves actively, and spends more energy than the average adult.
2. Glucose reserves in children are significantly lower than in adults. In addition, as you grow older, glucose will accumulate in the form of glycogen, which is not the case in children.
3. In childhood, the enzymatic system necessary for the utilization of ketone bodies is not sufficiently developed.

The syndrome is a whole complex of characteristic symptoms that accompany an increased concentration of acetone in the urine of a child:

• repeated vomiting, often profuse;
• the presence of bile in the vomit;
• rapid dehydration of the body;
• tachycardia;
• noisy deep breathing;
• photophobia;
• restless sleep;
• convulsive state;
• intense smell of acetone from the child’s mouth, from vomit;
• stomach ache;
• pale skin;
• the temperature may be low-grade, or may rise.

There are two types of syndrome:

1. Primary. It occurs for unknown reasons; this condition is not preceded by pathological processes in systems and organs. As a rule, this type of acetone syndrome develops as a result of nervous overstrain, sensitivity to irritants, and is also typical for highly emotional and excitable children. The primary type is characterized by the presence of symptoms such as loss of appetite, digestive problems, lack of body weight, abnormalities in speech development, lack of adequate sleep, and enuresis is possible.
2. Secondary. It is a consequence of problems in the functioning of organs and entire systems. For example, it can develop against the background of a viral infection or with pathology of the thyroid gland. In addition to an increase in the level of acetone and the presence of a characteristic odor from the mouth, there will be symptoms characteristic of a particular disease.

Home treatment for acetonemia

Acetone treatment can be outpatient, that is, at home, or inpatient, in a hospital.

What to do with acetone in a child’s home? There are several points on which therapy should be carried out. Each of them must be performed exactly and completely. Then recovery will come much faster.

1. Desoldering. With severe intoxication, the child’s body actively loses water, so its supply must be constantly replenished. This should be done every 5-10 minutes, but it is necessary to drink in small portions, 1-2 teaspoons, so as not to cause a new attack of vomiting. The best things to drink are water, saline solutions, dried fruit compote, weak tea, but all these drinks should be sweet (in moderation, naturally) to replenish glucose in the blood. From medications, you can add a 5% glucose solution. Sometimes you can give rice water. It is important that the aqueous solutions are at a temperature of about 36˚C, then they are quickly absorbed by the body. Give your baby water not only during the day, but also at night; babies are given water from a syringe.
2. Nutrition. It is better not to feed the baby for the first five hours from the onset of the disease. Firstly, this will alleviate his condition, and secondly, it will allow us to determine the extent of his illness. Don't force him to eat; glucose solutions will prevent him from starving. As soon as he asks for food, give him a few crackers (exclusively homemade), after a while a couple of biscuits, then you can give him a few spoons of semolina porridge or vegetable soup. The baby should be fed every 2-3 hours, but in very small portions. If he doesn't want it, it's better to give him water. Do not forget that desoldering is stopped 20 minutes before a meal and resumed 20 minutes after the end.
3. Taking medications. The patient can be given sorbents to reduce intoxication and inject glucose intravenously. You can do an enema with slightly warm water (a teaspoon of soda per liter of water, always boiled) to reduce the temperature. But in this case, before taking medications, you should consult your pediatrician.

In severe cases of acetonemia, children are hospitalized. The main indicators for this are disturbance of consciousness, frequent vomiting, fainting, convulsions and, most importantly, coma. In this case, the main therapy will remain the same, only it will initially be carried out exclusively with medications to normalize and maintain the baby’s condition.

Why does acetone rise?

If acetone is diagnosed in the urine of a child, the reasons that cause it play an important role. In addition, if parents know what conditions can provoke an increase in ketone bodies in the urine, then they can either prevent such a situation or be prepared for such a development.

The reasons that provoke this condition may be of a physiological nature, depending on nutrition, daily routine or the type of temperament of the child. In most cases, the appearance of acetone in the urine occurs due to the immaturity of the enzyme system, lack of glucose and large energy losses.

So, the following reasons can be identified:

1. Lack of fluid in the body. Especially if you are dehydrated.
2. Severe hypothermia or overheating.
3. Prolonged stress.
4. Physical or emotional fatigue.
5. Unbalanced diet, high in protein and fat.
6. Fasting, lack of glucose.
7. Constant overeating.
8. Disturbance of metabolic processes in the body. For example, in diabetes mellitus carbohydrate metabolism is disrupted.
9. High temperature and infectious diseases.
10. Postoperative period.
11. Poisoning, food or industrial.
12. Enzyme deficiency. Carbohydrates cannot be digested properly.
13. Pathology of the digestive system.
14. Dysentery.
15. Anemia.
16. Parasitic infestation.
17. Mental disorders.
18. Oncology.

Prevention

A diet is indicated for a child prone to acetone crises. Fatty meat foods (especially stewed meat), legumes, chocolate, cocoa, nuts and chips should be excluded. Limit fried foods, animal fats, citrus fruits, tomatoes, pasta, biscuits. The diet should be dominated by fermented milk products, vegetables, fruits, lean meat, and seafood.

It is necessary to protect the child from strong experiences - both negative and positive; long exposure to the sun and hypothermia are undesirable. Such a baby, more than other children, needs strict adherence to the regime, which helps restore the nervous system.

Time spent near the TV or computer should be minimal. The child needs to spend more time in the fresh air; water treatments and moderate physical activity are recommended. The most stressful age for children suffering from acetone syndrome is 6-7 years of age - by the age of 13, the disease is usually forgotten. A balanced diet and adherence to a daily routine are the key to success in the fight against acetone syndrome.

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Symptoms

There are signs by which a mother can easily determine that the child has an increased concentration of ketone bodies in the urine:

1. The baby loses his appetite.
2. Painful sensations appear in the navel area.
3. The child literally falls asleep on the go.
4. A feeling of nausea appears.
5. General weakness is characteristic.
6. An increase in temperature is possible both against the background of a viral infection and without it.
7. Vomiting that is repeated many times.
8. Dry skin.
9. Urine is excreted in much smaller quantities.
10. The appearance of plaque on the tongue.
11. Smell of acetone from the mouth.

Reasons for appearance

The occurrence of acetone syndrome is caused by a lack of carbohydrates. When the amount of glucose decreases, the body compensates for the deficiency by using internal reserves. By breaking down fats with the enzyme lipase, it forms an excess of fatty acids, which are transformed into the metabolite coenzyme A. Energy is released, cholesterol and ketone bodies are synthesized.

A high concentration of acidic compounds and acetone disrupts the electrolyte and acid balance, has a toxic effect on the central nervous system and gastrointestinal tract, which is expressed by clinical symptoms.

More often, the pathology manifests itself in children from 1 to 13 years of age, in adults it occurs due to fasting, diabetes mellitus due to the inability to digest carbohydrates, and is observed in pregnant women during the period of toxicosis. The acetonemic state in children is divided into two forms:

• Primary. Classified as non-diabetic ketoacidosis, diagnosed in 6% of cases. The picture is characterized by a crisis course, accompanied by periodic manifestations of cyclic vomiting. It occurs due to age-related characteristics of metabolism in a child’s body. It is explained by a reduced ability to utilize ketones and a deficiency of liver enzymes involved in oxidative processes.
• Secondary. Develops in a child against the background of diseases: diabetes, thyrotoxicosis, neuroendocrine disorders, disorders of the liver, formations in the brain or its infectious lesions. The formation of the condition is facilitated by head injuries and epilepsy, leukemia and hemolytic anemia. Here, symptoms and prognosis are determined by the underlying pathology. Acetonemic syndrome in infants manifests itself in frequent regurgitation, which is associated with the presence of nephropathy or toxicosis in late pregnancy in the mother.

In a child, the development of cyclic vomiting syndrome can be triggered by the following factors:

• low carbohydrate diet;
• starvation;
• excessive consumption of fatty foods in the absence of carbohydrates;
• stress and pain;
• infections;
• overwork and overheating, prolonged insolation;
• excessive physical activity.

Ketotic hypoglycemia is often diagnosed in children with neuro-arthritic diathesis, a constitutional abnormality with impaired metabolism of purines and uric acid. In adulthood, these features of metabolic processes increase the risk of kidney stone formation, arthritis, gout, diabetes, and obesity. Such children are distinguished by mental lability, neuroses, fearfulness, and a thin physique, but they have excellent memory and are distinguished by cognitive interests.

Diagnostics

1. Examination of the child, collection of complaints. The doctor will probe the organs, problems with which can be caused by an increase in acetone.
2. Clinical blood test. An increased content of leukocytes and ESR is detected.
3. Blood chemistry.
4. Urine test for acetone. Special test strips are used that can give the following results:

• + - mild degree;
• ++ - average;
• +++ - heavy;
• ++++ - very heavy. The child needs urgent hospitalization.

Negative result when testing urine for acetone

When my son had increased acetone in his urine, as luck would have it, there were four pluses. The child had to lie under a drip. Saline and glucose were administered. After this procedure, the level of ketone bodies decreased, but very slowly. One day, after a drip, the analysis showed two pluses, and in the morning - four again.

I would like to note that after the first case of detection of acetone in the urine, I always had a jar of test strips on hand. At the first suspicion, I did an analysis. The only disadvantage of these strips is their short shelf life after opening the package, only 25 days. This is inconvenient, since no more than 10 strips are used, and most of the contents of the bottle have to be thrown away.

1. If necessary, an ultrasound is performed.

What to do after symptoms disappear

There is still a long road of rehabilitation ahead. And the most important thing in this is nutrition. Food should be given in small portions, 5-6 times a day. At night, try to avoid feeding, and it is better to give compotes and sweet tea or just water. Food is introduced gradually, increasing portions little by little every day.

The patient can be given the following products:

• semolina, oatmeal, buckwheat porridge;
• chicken or quail eggs (one per day);
• vegetable soups;
• rice water or porridge;
• dried fruit compote, very healthy raisins;
• fruit drinks and juices with pulp;
• dairy products kefir, yogurt, cottage cheese (non-fat);
• chicken, turkey meat;
• biscuits, crackers;
• non-acidic fruits (pears, apples, grapes, peaches);
• a small amount of honey, caramel, marmalade (it is better to limit other sweet foods);
• potato and carrot puree;
• some walnuts or hazelnuts.

It is very important that all foods are steamed or baked.

The list of foods that a patient should not eat is also very large.

These products include:

• meat, mushroom and fish broths;
• chicken, pork;
• fatty fish species;
• full-fat yogurt, cottage cheese;
• smoked meats (including sausage and cheese);
• seasonings, sauces and spices;
• chocolate and cream products;
• citrus fruits (oranges and lemons), as well as bananas (although these are fast carbohydrates, they are heavy);
• offal (liver, heart, etc.);
• coffee, black tea;
• carbonated drinks and drinks containing dyes and preservatives;
• sweet and puff pastry;
• chips, crackers, crackers and other unhealthy foods;
• tomatoes, eggplant, parsley, sorrel;
• all kinds of fast foods;
• pickled products;
• legumes (peas, beans, lentils);
• chewing gum.

An increase in acetone in children indicates that the required diet may not have been observed previously. Therefore, the main control of parents must be directed precisely to this area.

In children who have been diagnosed with “acetonemic syndrome,” monitoring of the production of ketone bodies should be carried out regularly. To do this, you must always have test strips at home.

It is better to carry out monitoring in the morning urine for the first three days after the crisis and periodically at the slightest suspicion of acetonuria. Parents should be more attentive to changes in the baby’s behavior; sudden drowsiness or fatigue can be the first signs of illness.

Treatment

If the disease is mild, treatment at home is allowed. If the acetone level is three or four plus, then hospitalization is impossible. This issue is especially acute for infants, because they can quickly develop dehydration, and this will lead to serious intoxication.

Acetone in the urine of a child, treatment:

1. Infusion therapy. In case of large fluid losses, when the first symptoms of dehydration are observed, the child will be prescribed glucose and saline solution intravenously.
2. If the baby experiences spasmodic pain in the stomach area, antispasmodics will be prescribed.
3. If vomiting does not stop, appropriate medications are prescribed.
4. If a lack of potassium in the body is detected, then potassium chloride will be prescribed.
5. If a deviation in the functioning of the pancreas is diagnosed, enzymes will be prescribed.
6. If necessary, heart medications are prescribed.
7. In order to quickly remove ketone bodies, a cleansing enema may be prescribed, as well as the use of enterosorbents.
8. An important condition for a speedy recovery will be taking a sufficient amount of daily fluid. However, it must be taken into account that a single dose should not exceed two teaspoons. But you need to give your child water every 10-15 minutes.
9. You need to stay in bed and follow a diet.

Diet

Proper nutrition is very important, especially if the child’s condition is accompanied by nausea and vomiting. Naturally, in such a state it is unacceptable to consume fried, fatty, bitter, spicy, salty, smoked foods.

Parents should know what the diet for acetone in children should be:

1. It is advisable not to eat anything on the first day. The emphasis is on drinking small amounts frequently. If there is no vomiting, you are allowed to eat a few homemade crackers.
2. On the second day, you can start giving biscuits, baked apples and rice broth.
3. On the third day, grated porridge and puree are added to the permitted products. However, it should be borne in mind that the preparation of dishes should be without salt and without adding oil.
4. On the fourth day, it is allowed to introduce vegetable soup and even add a small portion of sunflower oil.
5. Starting from the fifth day, you can gradually introduce kefir and products made from low-fat minced meat. Everything must be steamed.
6. Gradually, the child’s menu expands, and new products are slowly added to his diet.

Treatment of elevated acetone

The disease should be treated with enterosorbents, the action of which is aimed at accelerating the elimination of ketone bodies and normalizing glucose levels. In addition, cleansing enemas help reduce the symptoms of poisoning.

Medicines should be prescribed exclusively by a doctor. Along with drug treatment, the child must be given plenty of fluids.

Drug treatment

Prescription of medications is carried out taking into account the age and health characteristics of children. It is strictly forbidden to change the dosage of medications - this can lead to the development of serious complications. At the end of treatment, you must take your baby to the doctor for a follow-up examination. Information on medications used to eliminate the symptoms of acetonuria in children is presented in the table.

Drink plenty of fluids

To reduce the content of ketone bodies, increased drinking regimen is indicated. It is not recommended to give your baby a large amount of water at once - this can cause vomiting. The child is fed in small doses every 15 minutes. The total daily volume of fluid should be at least 1.6 liters. Mineral water without alkaline gas, tea with lemon, and the drug Regidron will help reduce high levels of acetone in a child. If the baby categorically refuses water, you need to give him a nutritious enema with a soda solution.

Preventive measures

If you know that your child is predisposed to this condition, you need to do everything to prevent a new increase in the concentration of acetone in the urine:

1. The child must have a proper daily routine. It is very important to follow a routine, set aside time for walks, active and mental rest.
2. It is important to follow preventive measures to prevent the development of infectious diseases.
3. You need to feed your baby at regular intervals. Nutrition should be balanced, including all the necessary vitamins, elements, carbohydrates, fats and proteins.
4. If the cause of the development of acetonemic syndrome has been identified in your baby, then in order to prevent a new surge in this condition, it is necessary to treat the root cause in a timely manner, for example, taking hepatoprotectors for a diseased liver or hormones for their deficiency in the thyroid gland.

Now you know what can cause an increase in the concentration of acetone in the baby’s urine. Make sure you follow all the recommendations, because they will help reduce the risk of increasing ketone bodies in the child’s body. Remember the need for proper nutrition and good sleep, and the absence of stressful situations. This is an important component of a healthy baby. Take care of your children and be healthy!

Diet with acetone in children

When the baby's health improves, he will ask to eat. What food can you give your child? What diet should you follow if you have acetone in children?

• rice porridge with water
• semolina porridge on water
• potato and rice soup with water
• mashed potatoes
• crackers
• drying
• baked apples
• dried fruit compote with virtually no sugar

Follow this diet for another two weeks after discharge from the hospital, gradually diluting the child’s diet with lean boiled meat, dried fruit jelly, and vegetable soups with pieces of lean meat. Fried and fatty foods will remain prohibited for a long time!

How to prepare soup for a child who is on a diet? For 750g of water, take 1 potato, 1 tbsp. washed rice, throw it into boiling salted water (you can’t add too much salt!) and cook until tender. Do not add onions, carrots, butter or any other fat under any circumstances!

When my son and I were in the hospital, our grandmother brought us freshly cooked rice soup. After lunch, the child began to have diarrhea and lasted for several more days. As it turned out later, my grandmother found the soup without meat and fat tasteless and she added a little butter to it. The result was that the child’s condition did not improve for several days; diarrhea was treated. Warn compassionate grandmothers about this!

The same goes for semolina and rice porridge - there should be no butter there!

Also, do not add any butter or sour cream to mashed potatoes - nothing! After cooking, the salted yushka was poured into a cup, the potatoes were mashed and slightly diluted with the drained yushka so that the child would not choke on dry potatoes. All!