A Down syndrome patient refuses to eat or drink anything if not on IV fluids. Why?

Hi,

Welcome to icliniq.com.

According to your statement, your daughter has stopped drinking and occasionally eating too. She is a known case of Down syndrome. When she was on IV fluids, then she started drinking and eating. But, after stopping IV infusion, she also stopped drinking and eating.

Down syndrome is a condition in which a child is born with an extra copy of their twenty-first chromosome and which causes physical and mental developmental delays and disabilities. Many patients with down syndrome experience eating, drinking, and swallowing difficulties that can lead to life-threatening conditions like malnutrition, dehydration, and aspiration pneumonia.

Research shows that more than 50% of children with down syndrome may experience swallowing difficulties or dysphagia. This disease often affects the muscles in the mouth, causing the tongue to stick out, and that may interfere with feeding, including bottle feeding and eating solid foods. Again, a smaller oral cavity and low muscle tone in the facial muscles can be responsible for dysphagia. In addition, the tongue may appear larger due to a high arched palate, a smaller oral cavity, and reduced muscle tone in the tongue. Again, many patients with down syndrome are mouth breathers due to smaller nasal passages and may have difficulties coordinating sucking, swallowing, and breathing while feeling. All of these factors can impact how a patient with down syndrome develops efficient oral and feeding skills.

There is a relationship between low zinc status and a reduced sense of taste and smell. This is because zinc is needed to produce salivary enzymes and is also needed to maintain healthy taste buds. Unhealthy taste buds, low salivary enzymes, and a poor taste and smell may cause picky eating behavior or abnormal eating behavior.

This may explain the behavior of refusing water and oral intake. Zinc is also needed for the proper secretion of stomach acid and improvement of appetite. Long-term zinc deficiency can also affect the central nervous system so that perception is completely altered.

Again, according to your daughter's case histories (attachments removed to protect the patient's identity), your daughter had burning mouth syndrome, teeth problems, gums Infection, fungal Infections or oral candidiasis, dehydration, etc. All these factors are responsible for dysphagia. Burning mouth syndrome is a condition characterized by a continuous burning sensation in the mouth. Dehydration may aggravate or initiate burning mouth syndrome, and burning mouth syndrome is responsible for dysphagia.

Dehydration can cause electrolytes imbalance, and when potassium level is low, muscles and nerves may not function normally, and swallowing difficulties or dysphagia may arise or occur.

So, when your daughter was on IV infusion along with multivitamins and minerals, then triggering factors for dysphagia were subsided and started to eat and drink, after stopping IV infusion and multivitamins with minerals, those triggering factors like burning mouth syndrome, dryness of mouth, lack of saliva production, dehydration, electrolytes imbalance, etc., come back again and cause swallowing difficulties. Improvement of dehydration status, nutritional deficiencies, vitamin and mineral deficiencies, psychotherapy, etc., may help to subside your daughter's swallowing difficulties gradually.

I hope this was helpful. Please get back if you have further doubts.