What health complications are associated with Down’s syndrome?

Every individual is different and while some may be seriously affected by Down’s syndrome, others may have very few health concerns. Down’s syndrome does increase the risk of developing medical conditions, some of which can be very serious but not all people with Down’s syndrome will be affected. This section deals with the common health complications associated with Down’s syndrome, but more information concerning each condition is available in the relative sections on Medic8.

Heart problems

Around 50 percent of children with Down’s syndrome are born with heart defects; around 60 percent of these children will require surgical treatment.

Approximately 9 out of every 10 heart defects involve septal defects; septal defects occur when a hole forms in the walls which separate the chambers of the heart. A septal defect can cause the blood to collect in one of the chambers, which places greater strain on the heart muscle as it has to work harder to pump blood around the body.

Other heart problems include tetralogy of Fallot and patent ductus ateriosus; tetralogy of Fallot causes the levels of oxygen in the blood to be lower than usual, which can cause breathing difficulties. Patent ductus ateriosus (PDA) occurs when the PDA fails to close after birth; this can mean that oxygenated and deoxygenated blood mix together.

In the majority of cases, surgery will be performed to correct the defect; this is particularly common for septal defects. If the heart condition is severe, surgery may be performed very quickly after the baby is born; with less severe cases, the condition will usually be monitored closely while the consultant decides when it is best to operate.

Problems with eyesight

Around 50 percent of people with Down’s syndrome suffer from problems with their eyesight. Common problems include:

• Squinting: this is the most common visual problem amongst people with Down’s syndrome. A squint can usually be treated with glasses, but in some cases, an operation may be required.
• Cataracts: this occurs when the lens becomes clouded
• Long-sightedness: this is usually corrected by wearing glasses
• Short-sightedness: this is usually corrected by wearing glasses
• Eye infections
• Nystagmus: this occurs when the eyes move very quickly from side to side
• Keratoconus: this occurs when the cornea thins and begins to bulge

Most visual problems can be treated easily and effectively with glasses but occasionally surgery may be required.

Hearing problems

Hearing problems are very common amongst people with Down’s syndrome; around 50 percent of people suffer from hearing problems. The most common condition is glue ear, which is an infection which causes fluid to build in the middle ear; this can cause difficulties with hearing. Hearing problems often contribute to problems with speech and communication, as children learn to speak by hearing and repeating sounds. Speech and language therapy can help to improve speech and communication skills.

Thyroid problems

Thyroid problems are common amongst people with Down’s syndrome; approximately 1 in 10 people suffer from thyroid problems. The most common problem is hypothyroidism, which means the thyroid gland is underactive; this can cause weight gain, tiredness, a lack of energy, slow reactions and muscle weakness.

Sometimes, although this is much rarer, people can develop hyperthyroidism, which means the thyroid gland is overactive. Hyperthyroidism can cause breathing difficulties, changes in mood, sleep disturbances, weakness in the muscles and a lack of energy.

Oral health problems

People with Down’s syndrome are more prone to developing oral health conditions, including tooth decay and gum disease. It is important for people with Down’s syndrome to visit their dentist on a regular basis to prevent existing conditions from getting worse.

Leukaemia

Children with Down’s syndrome are more likely to develop acute leukaemia; it is estimated that around 1 in 100 children with Down’s syndrome will be affected by the disease.

Digestive disorders

Digestive disorders are very common amongst people with Down’s syndrome; some people suffer mild conditions, while others can be affected much more severely. Common conditions include indigestion, diarrhoea, constipation, obstruction of the small bowel and coeliac disease.

Dementia

People with Down’s syndrome are more likely to develop dementia; Alzheimer’s disease is particularly common amongst older people with Down’s syndrome. Alzheimer’s disease can cause the following side-effects:

• Confusion
• Memory loss and forgetfulness
• Problems with speech
• Changes in mood

Psychological problems

It is estimated that one fifth of people with Down’s syndrome suffer from psychological problems; many children develop conditions including ADHD (attention deficit hyperactivity disorder) and autistic spectrum disorder.

Adults are more likely to suffer from conditions such as depression and OCD (obsessive compulsive disorder).

Dysphagia

Dysphagia is a condition, which affects the ability to swallow and makes drinking and eating very difficult. People with Down’s syndrome are susceptible to dysphagia due to the lack of muscle strength and tone. Most cases of dysphagia can be controlled by changing the diet to incorporate soft foods and liquids; more severe cases may require the patient to be fed using a feeding tube.

General health

People with Down’s syndrome are more susceptible to infections and illnesses because their immune systems are not fully developed. It is estimated that people with Down’s syndrome are around 12 times more likely to get an infection than people without the condition.