There are many diseases which affect the human being because of deficiency of nutrients required for our body. Among those different diseases Rickets is one which affects an individual due to deficiency of vitamin D, calcium, or phosphate. All these nutrients are necessary to make our bones strong and healthy. Lack of vitamin D is identified to be the main cause behind Rickets but Lack of calcium or phosphate are also necessary to our body without which the person can be a patient of Rickets. The term Rickets is derived from the Old English word “wrickken”, meaning to twist or bend. In the 19th century, Rickets was very common in the UK and the US. Rickets has its impact more on the developing countries especially on the children so it is called most common childhood disease in many developing countries. This disease is very rare in developed industrialized nations. It mostly affects the children but sometimes the adults can also suffer from Rickets. When somebody suffers from Rickets, the bones soften and become prone to fractures and deformity. It also causes skeletal deformities and stunted growth.
Symptoms of rickets
There are several signs and symptoms which are related with Rickets. As it makes the bones weaker and obstructs in its normal development, the major symptoms are related with bones too. Some of the major symptoms of Rickets are listed below.
- The bones become soft and tender which causes increased tendency for fractures.
- The muscles also may become weak.
- It causes disturbance in normal growth process of the children.
- There will be low level of calcium in blood called as Hypocalcemia.
- The skull may become softer.
- There may be uncontrolled muscle spasms all over the body which is called Tetany.
- Due to metaphyseal cartilage hyperplasia, the wrists may widen.
- Toddlers may have bowed legs known as genu varum.
- Older children may have knock knees which is called genu valgum.
- A horizontal line can be noticed at the lower margin of the thorax, where the diaphragm is attached to the ribs.
- It can cause deformity in the Spine, Pelvis, Ribcage or the Chest.
- Rickets can also cause dental problems.
The main cause of Rickets is the deficiency of Vitamin D which absorbs calcium from the intestines. If our body doesn’t get enough vitamin D then our body cannot absorb the calcium and phosphorus from the food that we eat. As a result the person suffers from Hypocalcemia which makes the bones, muscles and teeth weaker. Lack of ultraviolet rays we get from the sunlight prevents our skin cells from converting vitamin D from an inactive into an active state which can be one cause of Rickets. In some conditions Rickets is also caused due to Genetic problems in which the kidneys cannot process phosphate properly because of which Phosphate blood levels become too low, leading to weak and soft bones. In case of some diseases like kidney, liver and intestinal problems there might be problems in the way the body absorbs and metabolizes minerals and vitamins, resulting in rickets. There are also cases in which severe diarrhea and vomiting have caused Rickets.
Who is at risk?
There is high likelihood of getting Rickets especially among children from poor family background. Most children who don’t get enough sunlight, balanced diet and are living in drought hit countries are at high risk of Rickets. It is most common in children aged 6 to 36 months old. It is also noted that mostly people who eat a vegetarian diet or have a problem in digesting milk are at high risk of Rickets. In the countries which fall in geographical region without enough sunlight the children and people are at more risk of rickets. The people who mostly work indoors may also have high chances of getting Rickets than other people. According to studies, children from African descent who have dark skin are prone to Rickets because dark skin cannot react strongly to sunlight as light skin does. In case of hereditary rickets disorder can be passed through the genes because of which the kidneys cannot absorb phosphate which can result in Rickets. In recent times studies have also proven that in developed countries, the maximum use of sun block creams has resisted the body to absorb necessary amount of sunlight which causes deficiency of vitamin D and puts the children at risk of Rickets.
As it is said ‘Prevention is better than cure’ so it is better to adopt a healthy lifestyle and eat healthy food containing enough nutrients such as butter, margarine, fish, liver, juice, milk, and eggs which will help to prevent Rickets. It is important to eat a diet that includes adequate amounts of calcium, phosphorous, and vitamin D. We should get exposed to enough sunlight so that the body absorbs necessary ultraviolet rays. The children should not be stopped from playing out in the sun few times in a week. But we should also be careful of over exposure in the sun which can cause damage too. Those who have kidney problem should check their calcium and phosphate levels regularly and seek consultation from doctors.
Diagnosis at the right time is very important in case of any medical problems because if the disease is diagnosed at the correct time then proper treatment can be done which will decrease the severe effects which it may bring. In case of Rickets too, it can be easily treated if the disease is properly diagnosed on time. Rickets can be diagnosed by the physician doctor after a normal examination of the tenderness or pain in the bones by lightly pressing on the bones. The doctor may recommend certain tests including blood tests to measure the levels of calcium and phosphate in the blood or bone X-rays to check for bone deformities. Arterial blood gases may also be checked to find out the quantity of calcium and phosphate in the blood. In some rare cases, the doctor may suggest for bone biopsy in which a very small section of bone is removed and sent to laboratory for analysis.
Rickets can be treated by replacing the missing vitamin or mineral in the body. If a child is suffering from Vitamin D deficiency then the doctor will suggest the parents to expose the child to more sunlight. It is necessary to increase the intake of food which is high in nutrients containing vitamin D, such as fish, liver, milk, and eggs. Vitamin D or calcium capsules are also available in the market which can replace the deficiency of those nutrients in the body but they should only be taken under expert doctors’ advice. Over consumption of Vitamin D and Calcium capsules without doctor’s advice can be dangerous. Braces can be used to correct the skeletal deformities if any. A combination of phosphate supplements and high levels of a special form of vitamin D are required for treatment of Rickets if it is of hereditary type. If the treatment is done in time then the symptoms will begin to disappear within a week of taking the nutrient rich food or medicines. There can be permanent skeletal deformities if the child is not treated in time.