Rickets

Overview of Rickets

Rickets Meaning in Urdu

اس بیماری کی وجہ سے بچوں کی ہڈیاں بھربھری یا کمزور ہو جاتی ہیں۔ عام طور پر وٹامن ڈی کی کمی کی وجہ سے ہڈیاں کمزور ہو جاتی ہیں۔ وٹامن ڈی بچوں کے لیے نہایت اہم ہوتا ہے کیوں کہ یہ انہیں مختلف غذاؤں سے کیلشیم اور فاسفورس جذب کرنے میں مدد فراہم کرتا ہے۔ اگر بچوں کو متوازن مقدار میں وٹامن ڈی نہ ملے تو ان کے لیے کیلشیم اور فاسفورس جذب کرنا مشکل ہو جاتا ہے۔ اس بیماری کی وجہ سے بچوں کی افزائش نہیں ہو پاتی اور ان کے پٹھے بھی کمزور ہوتے ہیں، جب کہ کچھ بچوں کو کمر یا ٹانگوں میں درد کا بھی سامنا کرنا پڑتا ہے۔

Rickets is a health condition in children that affects the development of bone in children. It occurs due to prolonged and extreme deficiency of vitamin D. Rare inherited health issues can also cause rickets. 

People suffering from rickets have soft and weak bones, stunted growth, and even skeletal deformities. Rickets is not same as osteomalacia. It is similar to rickets and it is a health condition that is shown in adults. 

The major difference between these two diseases is that rickets only affect children when their bones are still developing while osteomalacia affects adults when their bones have already stopped growing. 

Vitamin D is necessary for calcium absorption in the body. Therefore, low levels of vitamin D can lead to low levels of calcium in the body. Due to this, the developing bones become weak and irregularly formed. This can also lead to pain in the bone. The resulting symptoms are even present in adulthood. The deficiency of vitamin D in adulthood can lead to osteomalacia which is similar to rickets.

Rickets can also result from genetic and metabolic conditions. Taking vitamin D supplements in this case can help reduce the risk.

Prevalence of Rickets 

Rickets is more common in Asian, Middle Eastern, and African-Caribbean children who are more prone to rickets. More melanin in their skin prevents UVB absorption, which is why they need more sunlight to get enough vitamin D. Premature babies are also at risk of suffering from rickets. 

 

As per studies, the prevalence of rickets is around 70% in males and 30% in females. 

 

Doctors Treating Rickets

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Signs and Symptoms of Rickets

Some of the major rickets symptoms and signs are as follows:

  • Tenderness and pain in bones 
  • The slow growth of bones 
  • Curved or bowed legs 
  • Weakness of muscles 
  • Bones that are soft and can easily break 
  • Large abdomen or forehead
  • Wide joints in the wrists and elbows 
  • The unusual shape of the breastbone and ribs

Some of the other signs and symptoms of rickets can include:

 

  • Delayed motor skill
  • Delayed growth 
  • Pain in the spine, legs, and pelvis
  • Teeth deformities such as delayed tooth formation, abscesses, holes in the enamels, increased number of cavities, defects in tooth structure, etc
  • Skeletal deformities

Types of Rickets

Rickets is based on the following three types:

  1. Nutritional Rickets

Nutritional rickets is caused due to intake of food that does not have sufficient calcium, phosphorus, and vitamin D. 

  1. Hypophosphatemic Rickets

It is an X-linked genetic disorder. It is caused due to low levels of phosphate. In this, the kidneys are unable to control the amount of phosphate that is excreted from the urine. 

  1. Renal Rickets

 

People who suffer from kidney disorders also have renal rickets. Such patients are unable to regulate the amount of phosphate and calcium excreted in their bodies.

Causes of Rickets

Genetic and nutritional problems are the major causes of rickets. 

  1. Genetic Causes 

There is various genetic disease that can affect the ability of the body of your child to absorb vitamin D. Other genetic issues can even affect the handling of phosphorus and can lead to rickets. However, these types of disorders are rare. 

  1. Nutritional Rickets 

If you are not taking enough vitamin D, your body will be unable to absorb calcium. Some of the major causes of these deficiencies are:

  • Insufficient exposure to sunlight. Sunlight is the natural producer of vitamin D in your body.
  • Lack of Vitamin D in Diet. This normally happens in the case of vegan/vegetarian diets, or lactose intolerance. Or, it can be also due to any health condition such as Celiac disease, Crohn’s disease, ulcerative colitis, or cystic fibrosis where the body of a child is unable to absorb enough Vitamin D. 
  • A diet that does not have enough calcium in it.
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Risk Factors of Rickets

The rickets risk factors are increased in a child if a child has:

  • Dark Skin - Dark skin means that skin is more pigmented and it has a low ability to produce vitamin D from the sunlight.
  • Deficiency of Vitamin D in Mother - If during pregnancy, a female has severe vitamin D deficiency, it can affect the baby as well. A baby born will show the signs of rickets and may even develop it after a few months. 
  • Premature Birth - Babies who are born before their due dates tend to suffer from low levels of Vitamin D. The reason is that they have less time for receiving vitamin D from their mothers while in the womb. 
  • Northern Latitudes - Geographical location does matter. For example, children who live in such geographical locations where there is less sunlight, are at high risk of suffering from rickets. 
  • Exclusive Breast Feeding - There isn’t enough vitamin D in breast milk to prevent rickets. Babies who only rely on their mother’s milk should also be given vitamin D drops to prevent rickets. 
  • Medications - There are certain medicines that can affect your body’s ability to absorb vitamin D. Such medicines are normally given to treat infections due to HIV, antiviral medications, and certain types of anti-seizure medicine. 

Health Complications due to Rickets 

If rickets is left untreated, it can cause other health issues such as:

 

  • Seizure
  • Cramps
  • Breathing issue
  • Dental health issues
  • Bone deformities
  • Abnormally curved spine
  • Growth problems
  • Pneumonia 
  • Lifelong disability 
  • Heart health issues 
  • Obstructed labor

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Prevention

Rickets can be prevented easily by a healthy diet. Your diet should include a sufficient amount of vitamin D, calcium, and phosphorus. People who suffer from kidney health issues should get themselves regularly checked by the doctor for their phosphate and calcium levels. 

In the case of infants or people who are pregnant, rickets can be prevented in the following ways:

  1. Infants 

Vitamin D drops should be given to infants. They are easily available in most pharmacies. All infants who are breastfed should get about 400 IUS of vitamin daily.

  1. Pregnant People

Pregnant females should take vitamin D supplements as recommended by their physicians. The suggested standard recommendation is to take at least 600 IUs of vitamin D daily. However, it can vary from person to person. Doctors recommend taking vitamin D supplements during pregnancy to avoid loss of bone in later life. 

For Older Children

  1. Vitamin D Rich Foods

Children should have a balanced diet that is rich in vitamin D such as fish, milk, cereals, and orange juice. There are foods that are fortified with Vitamin. It means that vitamin D is added to them. 

  1. Sunlight

Your body can naturally produce vitamin D after exposure to sunlight. If people with dark skin stay indoors a lot and don’t get sunlight exposure then it’s very hard for them to produce vitamin D. 

In case rickets is due to any inherited disease than early detection of this disease is necessary to prevent it.

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Diagnosis

There are several tests for rickets diagnosis. If a child specialist suspects that your child is at risk of suffering from rickets then the doctor would do a physical examination, ask for medical history and check symptoms. The doctor might also recommend the following test as well:

Treatment of Rickets | When to Consult a Doctor

In most cases, rickets is curable, especially in nutritional rickets. Mostly, adding vitamin supplements to your diet and changes in diet and exposure to the sun can cure this disease. 

Depending on the severity of the case, a pediatrician can recommend any of the following rickets treatments.

  1. Diet Changes 

You need to have a healthy diet that has the necessary amount of Vitamin D that your body needs. You can also add it in the form of supplements. The doses of supplements and duration can vary from case to case. Once a person has completed the course of vitamin D, the doctor may also recommend a necessary standard dose of vitamin D supplement. 

  1. Sunlight

Our body is capable of producing vitamin D naturally. So, it is recommended to take enough sunlight for a healthy body. 

  1. Surgery

Normally the bones of a child straighten out on their own. However, in severe cases, a child might require braces to help in correcting the bending of the bones. In some cases, surgery is also opted to correct bone deformity in children. 

Apart from this, if a child is suffering from genetic rickets, then there are several treatment options based on the condition. Therefore, always consult a certified child specialist and nutritionist for customized treatment for your child.