Difference between Kwashiorkor and Marasmus

For our body to function normally, it requires some basic nutrients, calories and proteins without which the body fails to function as it has to. Due to the lack of nutrients in the body, the muscles and bones start to weaken. This lack of proper nutrients in the body leads to malnutrition. Generally, malnutrition does not occur due to short-term illnesses like fever, cough, and cold occurring at some point in time. The body tends to become malnourished if it has refrained from necessary nutrition for a long duration of time.

Even if the person is taking enough quantity of food, sometimes the food lacks quality or the food lacks proper nutrient value. Some underlying conditions are also responsible for the improper absorption of nutrients in the body.

Kwashiorkor

This is a type of malnutrition due to the deficiency of protein. Generally, it is characterized by enlargement of the liver and edema. There is a difference between proper calorie intake and protein consumption. The patient, in this case, has proper calorie intake but lacks proper protein consumption. Kwashiorkor cases are usually food in places where there is scarcity in food supply like underdeveloped or developing countries. The Kwashiorkor term was first introduced by a Jamaican pediatrician named Cicely Williams in 1935. This condition was first noticed in children who were weaned from breast milk quite early due to the birth of the younger siblings. Breast milk is the powerhouse of amino acids which is crucial for the proper nourishment and growth of infants. The risk of developing Kwashiorkor increases when the infant lacks the intake of these amino acids and is subjected to a diet that is high in carbohydrates like maize quite early in their life.

Kwashiorkor occurs when there is a severe protein deficiency. Children often affected by kwashiorkor are older than children who get marasmus. Having a carbohydrate diet can lead to this condition.

The following are some of the symptoms of kwashiorkor,

• edema, or puffy or swollen appearance by fluid retention

• bulging of the abdomen

• inability to grow or gain weight

There is a high risk for kwashiorkor in people who live in a rural area with a shortage of protein-rich foods. Children who lack breastfed have a high risk if they don’t have adequate protein-rich foods.

Pathology

When there is a severe lack of protein in the body, there is an osmotic imbalance in the gastro-intestinal system leading to swelling in the gut which is later characterized as retention of water or edema. Extreme fluid retention is noticed in patients in whom the lymphatic system has irregularities. Proper functioning of the lymphatic system is necessary for proper lipid absorption and immunity. The lymphatic system in patients suffering from Kwashiorkor fails to recover fluids leading to the failure of the immune system and ultimately there will be low lipid absorption. This leads to malnourishment.

Diagnosis and Treatment

Kwashiorkor is characterized by bilateral peripheral pitting edema due to fluid retention, abdominal distention, and low weight as per the height.

The treatment protocol includes rectifying the electrolyte imbalance, preventing infection, treating hypoglycemia. A diet rich in carbohydrates and sugar that is enriched in proteins as well as essential micronutrients is provided. Diet rich in lactases is introduced in children who have become lactose intolerant. Further milk is replaced with cereals rich in vitamins and minerals for the achievement of proper weight. Once the child reaches a normal weight, traditional food can be introduced in their meals.

Marasmus

Unlike Kwashiorkor, Marasmus is malnutrition that is characterized by a deficiency of energy. The child is malnourished due to insufficient energy intake in all forms which includes even proteins. This leads to 62% low body weight with respect to height and age. The chances of death increases in children who are not subjected to treatment early.

Marasmus mostly occurs in young children and babies. It causes dehydration and severe weight loss. One of these forms of disorder is starvation. The following are some of the symptoms of marasmus,

• weight loss

• dehydration

• chronic diarrhea

• stomach shrinkage

There is a high risk for marasmus if people live in a rural area where there is a scarcity of food. Babies, young children, or older adults too have a high risk for marasmus.

Diagnosis and Treatment

The main clinical signs and symptoms include overall muscle wasting and loss of subcutaneous fat.

The first line of treatment includes prevention of dehydration, treatment of the infection, and circular disorders if any. Skim milk mixed with boiled water is introduced until the child becomes lactose tolerant. Later, a mix of vegetables is added to the diet and children should be subjected to a more balanced diet once they start to recover and gain back proper weight.

Difference Between Kwashiorkor and Marasmus

The human body requires protein, calories, and nutrients to function. Without enough nutrition, muscles waste away, bones get brittle, and thinking becomes foggy.

Calories and protein are energy units that are necessary to function. Without enough protein, healing injuries or wounds will not be easy.

When there is a shortage of nutrients, the body gets malnourished. Protein-energy undernutrition is a type of malnourishment.

Protein-energy undernutrition is also referred to as protein-energy malnutrition. This is caused due to a severe calorie or protein deficiency. This occurs if the number of calories and protein consumption is not enough to function.

This does not occur because of short-term illness but is likely due to long-term malnutrition. There are two main types of undernutrition. They are marasmus and kwashiorkor. 

Symptoms

Undernutrition occurs due to various reasons. Unavailability of food resources, difficulty in eating, absorbing nutrition, or preparing food. Too much alcohol consumption also leads to undernutrition.

The following are symptoms of undernutrition,

• fatigue

• difficulty staying warm

• a lower body temperature

• diarrhea

• reduced appetite

• a lack of emotion

• irritability

• weakness

• slower breathing

• numbness of hands and feet

• dry skin

• hair loss

• bruises

Causes of marasmus and kwashiorkor

The shortage of food is the main cause of both these diseases. The following are some of the common effects of both diseases

• famine

• insufficient food access

• living in poverty

• Some of the other things include:

• having an eating disorder

• lacking education about dietary needs

• taking medication that affects the absorption of nutrients

• having a health issue that increases the body’s calorie needs

First of all, consult a doctor on your physical health.  Access to food, history of eating disorders, and medications undergoing are analyzed and even about the current mental state or mood.

A skin test will be taken to determine the function of the immune system. Collection of urine or blood is taken to identify nutrition deficiency.

Both can be treated by increasing the calorie intake through multiple small meals. If there are digestion-related problems, liquid protein supplements can be added to the diet.

Multivitamin supplements and medications can be recommended based on doctor consultancy to improve appetite. If the symptoms cross the limit, hospitalization is necessary.