Diarrhea (diarrhea)- a very common phenomenon in children, in which there is frequent and loose stool. Diarrhea can be caused for various reasons and lead to dehydration and digestive disorders. Term "diarrhea" translated from Greek means “to flow through.”
Normally healthy child In the first year of life, the stool is light and mushy; the frequency can range from once every few days to several times a day and even correspond to the number of feedings. In children receiving artificial nutrition or those on mixed feeding, the stool is thicker, from once every one or two days to three to four times a day. Signs of diarrhea may include increased frequency of bowel movements, as well as changes in the consistency of stool; they become watery, often turn greenish, and may contain streaks of blood. The child's general condition is deteriorating.
After three years, diarrhea is considered to be a volume of stool exceeding 200 g per day, its character also changes, it becomes liquid or pasty with a frequency of more than 2 times a day, diarrhea may be accompanied by increased gas formation. A very dangerous stool can be very loose, abundant, with greens, and which occurs more often than 6-10 times a day.
If diarrhea does not stop within 2-3 weeks, then this is considered chronic diarrhea.
Causes leading to diarrhea in children
Eating disorder- a very common cause of diarrhea in children. For example, eating too much fiber can cause acute diarrhea. In children of the first year of life, bowel dysfunction occurs when the rules for introducing complementary foods are violated, and in children who are breastfed, a violation of the mother’s diet occurs.
Sometimes diarrhea is allergic reaction for use food products if they are intolerant. Excluding these products from the diet will normalize digestion and normalize stool.
The process of teething in young children may be accompanied by diarrhea.
Taking some medicines , such as laxatives, antibiotics, drugs containing bile acids, non-steroidal anti-inflammatory drugs, antacids, etc., can also cause diarrhea.
The most common intestinal infections causing diarrhea- this is a rotavirus infection (caused by Rotavirus), salmonellosis (caused by Salmonella), campylobacteriosis (caused by Campylobacter), escherichiosis (caused by Escherichia coli), bacterial dysentery (caused by bacteria of the genus Shigella), amoebic dysentery (caused by dysenteric amoeba).
Very often, diarrhea occurs in a child while traveling. There is even a term "travelers' diarrhea". Most cases are caused by bacteria found on the handles of train and airplane toilets. Changes in diet, climatic conditions, and stress can also have an adverse effect. Typically, travelers' diarrhea develops 2-3 days after the start of the trip.
There is diarrhea that is not associated with any organic damage to the digestive organs. This - functional diarrhea. It is associated with impaired intestinal motility and is not accompanied by pain.
What to do if a child has diarrhea?
The most important thing to know is that diarrhea in children very quickly leads to dehydration of the body, which in turn leads to disruption of vital organs. Therefore, there is no need to self-medicate, but you should urgently consult a doctor.
If it is not possible to call a doctor, then you should immediately begin to replenish the lost fluid. To do this, you can use ready-made solutions, such as Regidron or Hydrovit, or prepare the solution yourself (per 1 liter boiled water 1 teaspoon salt, 1 tablespoon sugar, 0.5 teaspoon soda).
For children infancy The number of feedings should be increased, and water should be given in between. The amount of hydration solution you should give your baby depends on his weight, as well as the severity of the dehydration. The solution should be continued until the child's normal bowel movements are completely restored. If the child is on artificial feeding, the nutritional mixture should be diluted more.
Along with the liquid, it is necessary to give the child drugs that have protective properties in relation to the intestinal mucosa, absorb and remove pathogenic microflora, toxins and gases from the body, for example, Smecta, Enterosgel, etc.
During the period of illness, you should follow a diet. It is necessary to exclude difficult to digest foods, raw vegetables and fruits, and fruit juices from the diet. IN acute period It is better not to give your child whole milk. You can feed your child slimy soups, rice water, dried bread, crackers, and baked potatoes.
Treatment of diarrheadepends on the cause of its occurrence. At bacterial infection appoint antibacterial drugs, for diarrhea caused by inflammation in the colon, anti-inflammatory drugs are prescribed. For dysbacteriosis diarrhea, drugs that restore intestinal microflora are needed.
The main thing in diagnosis of diarrhea in children identify its causes. To do this, the doctor must examine the child and also find out what preceded this condition. A stool test is required.
Functional diarrhea description
Functional diarrhea – frequent urge to bowel movements and/or frequent, loose, watery stools twice a day or more.
Functional (corticovisceral or nervous) diarrhea usually occurs in difficult periods life and/or emotional stress (before defending a dissertation, passing exams, making important decisions, prolonged stress, fear). Prolonged diarrhea can lead to dehydration and threaten the patient's life, especially in frail patients, young children or the elderly.
Functional diarrhea symptoms
Functional diarrhea is a disease that does not have general or local organic pathology and is characterized by:
A slight increase in stool frequency (from 2 to 4-6 times a day) without pathological impurities in the stool (blood, mucus, foam, bile and pus);
Severe pain, which in most cases decreases after defecation;
An imperative urge to defecate in the first half of the day and a feeling of incomplete bowel movement;
Absence of “alarm” symptoms indicating severe organic pathology - fever, anemia, unmotivated weight loss, increased ESR;
Pain in the joints, spine and sacrum;
Frequent paroxysmal migraine headaches;
Other subjective complaints are a feeling of lack of air, a lump in the throat, and the inability to sleep on the left side.
Highlight different variants course of irritable bowel syndrome, characterized by different symptoms violations of stool frequency: frequent stools, constipation or alternating diarrhea and constipation.
The long course of the disease, which can last for years, without an established cause of the disease, and in most cases without dynamics towards deterioration or improvement, significantly affects the neuropsychic status of patients (the majority are women from 30 to 40 years old). Therefore, there may be depressive states, phobias, which significantly increases irritable bowel symptoms, forming a so-called “vicious circle”. At the same time, stress has a specific effect on patients - the regulation of proper intestinal function is turned off and a stress attack causes hyperkinetic activation of the activity of the colon and small intestine, leading to functional diarrhea. Experts believe that patients suffering from functional (“nervous diarrhea” or “bear disease”) have a hereditary predisposition to its development.
Functional diarrhea treatment
In most cases functional type diarrhea goes away on its own within a few days, after eliminating the causative factor in the development of irritable bowel syndrome or nervous dyspepsia.
If you have diarrhea that lasts more than 3 days, you should consult a doctor. The local therapist prescribes an examination plan to establish a diagnosis, and, if necessary, refers to specialists - a gastroenterologist or infectious disease specialist, who prescribe additional laboratory tests (blood test, coprogram, bacterial culture feces and others) and diagnostic procedures (contrast radiography intestines, colonoscopy and sigmoidoscopy).
For true functional diarrhea, sedatives, tranquilizers, a special diet and
Functional diarrhea is a polysymptomatic intestinal disease, which is accompanied by frequent bowel movements (3-5 times a day), while the stool does not have a clear shape.
The main feature of the disease is that There are no characteristic painful and spastic sensations in the intestines. There are many reasons for the development of this pathology: from poor nutrition to heredity.
What is functional diarrhea, how does it manifest itself, and what ways can it be cured? We will discuss further.
This pathology associated with disruption of not only the intestines, but also the entire gastrointestinal tract . Clinical picture accompanied by symptoms such as:
- Stool disorder – there is diarrhea, in which there is a liquefaction of the stool, as well as the presence of water and mucus in it. The number of trips to the toilet per day exceeds 4-5 times.
- Flatulence - the patient is tormented by gases. There is a feeling of fullness in the intestines, and the stomach also increases in volume.
- No urge to defecate at night - the patient usually sleeps well and is not bothered by diarrhea. The desire to go to the toilet occurs every time a person has eaten.
- Absence of acute abdominal pain - the patient feels discomfort in the area sigmoid colon, and upon palpation there may be a slight and vague manifestation of mild pain.
- Severe headaches and other symptomatic manifestations.
- Weight loss, which is explained by poor absorption of nutrients in the intestine as a result of the accelerated movement of food to the rectum.
Prolonged diarrhea, treatment for which long time ignored, provokes in a person inferiority complexes and attachment to the toilet.
Sick forced to deny myself simple joys life, constantly being in close proximity to the oval office. This situation provokes mental disorders, which in turn intensifies the course of the disease. Such a vicious circle can only be broken complex treatment, which is based on diagnosis.
Causes and risk groups
The disease does not develop out of the blue. There are always prerequisites and pathogenic factors, causing the development of functional diarrhea:
- Frequent stress and anxiety - increased intestinal motility during nervous tension is a natural defensive reaction. The body tries to reject everything unnecessary. What can get in the way of overcoming fear? These include unhappy love, exams, a new job, an unhealthy atmosphere in the family.
- Hyperexcitability of the nerve endings in the intestines, which provokes the urge to defecate when even a small portion of digested food or plain water enters it.
- Heredity - it has been proven that if parents suffer from of this disease, there is a high probability that children are able to inherit a certain genotype.
Stress remains the key factor.
With constant fear and nervous tension, the body synthesizes chemical substances, which can influence the rate of reaction. At the same time, the work of the digestive tract also accelerates, and the intestines themselves try to reject everything that is in it as quickly as possible.
First aid
Many people encountering this problem for the first time believe that the problem is related to nutrition. In fact distinctive feature functional diarrhea is the absence of deterioration in general condition, as well as manifestations of dehydration. For first aid, available antidiarrheal drugs, such as Loperamide and other drugs based on it, can be used.
It is important to consume enough fluid, as it is not fully absorbed in the intestines and is excreted along with the feces.
When should I see a doctor?
Functional diarrhea may masquerade as initial stages more serious illnesses gastrointestinal tract. Therefore, when manifesting the following symptoms, consultation with a specialist is simply necessary:
- Appearance high temperature accompanied by chills – indicates the presence inflammatory process in the gastrointestinal tract.
- Blood in the stool frequent diarrhea(5-8 times a day) – may indicate the presence of acute intestinal infection.
- Weakness, the appearance of convulsions, drowsiness indicate the presence of dehydration and severe intoxication.
- Nausea and vomiting - occur when the infection spreads from the intestines to the stomach.
- Coloring of stool green color– indicates enteritis.
Functional diarrhea itself is not capable of provoking such symptoms, however, it significantly weakens the immune system, which causes a bacterial infection.
You should not joke with these symptoms, since frequent diarrhea entails the leaching of lytic components, without which metabolic processes impossible in the body.
Drug treatment
In the case when it is reliably established that stool disorder has nothing to do with enteritis, they resort to help various groups medications that can suppress frequent bowel movements.
Antidepressants– reduce excitability and increase stress resistance of a person, which allows you to avoid increased stress on the psyche. These medications are selected on an individual basis, and they should be prescribed exclusively by a psychotherapist after tests and conversations. The most popular of them are:
- Mirtazapine - the drug affects the central nervous system, reducing excitability and normalizing the conductivity of nerve fibers. The cost of the drug is 300-400 rubles, it is available with a doctor’s prescription. It has a hypnotic effect, so therapeutic dosages are selected individually.
- Amitriptyline has a pronounced sedative effect, causing increased drowsiness. An individual dose is selected at which performance is maintained. The cost of one package is 75-120 rubles.
- Doxepin is a tricyclic antidepressant. wide range impact. Blocks the urge to defecate, reducing the sensitivity of intestinal fibers to irritants.
- Paroxetine is a selective serotonin reuptake inhibitor. Cost – 4500 rubles.
- Citalopram is a broad-spectrum antidepressant. Cost – 600-700 rubles.
Antidiarrheal drugs– affect the intestinal mucosa, inhibiting its peristalsis.
IN in this case use only those medications that do not inhibit the saprophytic flora(natural intestinal bacteria). The most effective of them are:
- Ersefuril - affects oxidative processes in the intestines, having a slowing effect on peristalsis. In high concentrations it can exhibit antibacterial effects. Price – 350 rubles.
- Uzara is a phytotherapeutic drug that affects the sympathetic nervous system, reducing the sensitivity of intestinal fibers to irritation. Price – 680 rubles.
- Imodium, a constituent of loperamide, binds to receptors in the intestinal walls, reducing their conductivity and slowing down the passage of food through the intestine. Cost – 450 rubles.
Adsorbents– microelements that can act on waste, toxins and pathogenic microflora, neutralizing them.
Also, drugs in this group are able to bind water molecules, which will thicken the stool and reduce the occurrence of diarrhea.
For functional diarrhea, the following adsorbents are used:
- Smecta - contains astringent components of white clay, which envelop irritated intestinal walls and also reduce the manifestation of diarrhea. The cost of one package is 35 rubles.
- Activated carbon is the most popular sorbent with high efficiency. It “collects” harmful components on its surface, reducing their aggressiveness and number. The cost of one package is 10-12 rubles.
- Polyphepan is the most effective sorbent, the effectiveness of which is 10 times higher than that of activated carbon.
Eubiotics– these medicines contain bacterial cultures that enhance digestion processes and also help normalize the intestinal microflora.
They can reduce the manifestation of diarrhea if one of its causes is dysbacteriosis.
Some of the most effective ones today include:
- Linex – normalizes the intestinal microflora, populating it beneficial bacteria. Cost 200-250 rubles.
- Lactiale - has an approximate composition and a similar effect. Price – 30-40 rubles per bag of powder for preparing the solution.
- Bifiform - produced in the form of capsules, allowing bacteria to activate directly in the intestines, bypassing the aggressive environment of the stomach. The cost of the medicine is 400-450 rubles per tube.
In addition to reception medicines, a key aspect in the treatment of functional diarrhea is following a strict diet. The patient is offered roughage food with a high fiber content, grain bread, cereals, premium pasta. Prohibited use fermented milk products, as well as vegetables and fruits that can provoke fermentation processes in the intestines, which leads to increased gas formation.
You should avoid eating too hot and cold foods, which have a detrimental effect on the digestive system.
Sample menu
Let's consider two diet options that will reduce intestinal irritation, but at the same time make up for the deficiency of all necessary substances in the body.
First day
Breakfast: buckwheat on water with salt, omelette, baked apple with honey.
Second breakfast: croutons with raisins, black tea with sugar.
Lunch: rice soup with chicken meatballs, toasted white bread, pasta with steamed meatballs and stewed vegetables.
Afternoon snack: dried fruit compote with crackers.
Dinner: fish baked with rice and vegetables.
Second day
Breakfast: rice porrige with banana and honey, green tea.
Second breakfast: dried fruit jelly.
Lunch: buckwheat soup with rabbit, rice with vegetables.
Afternoon snack: banana.
Dinner: steamed fish cutlets without spices with boiled potatoes.
These dishes can be varied.
The main thing is not to use those products that are strictly prohibited:
- milk and fermented milk products;
- fresh fruits and vegetables, as well as juices from them;
- mushrooms;
- canned food;
- smoked meats;
- spices;
- fatty food;
- legumes;
- confectionery.
Complications
Since intestinal motility is accelerated, Not everyone useful material have time to be absorbed from food. Therefore, functional diarrhea is not something to joke about. This condition needs to be treated as quickly as possible, even if it does not cause pain or discomfort. Otherwise, complications may develop, which manifest themselves in the form of an intestinal infection, as well as the development chronic syndrome irritable bowel.
If the root cause of this disease has not been established, complex treatment is carried out, where antidepressants come first. In addition to taking medications and following a diet, it is important to minimize stress and increased psycho-emotional stress.
You should rest more, listen to positive music, meet kind and positive people.
Features of the development of the condition in children
If this disease bothers children, it is important to start treatment as quickly as possible. Children's body more vulnerable to pathogenic microflora, which can be activated with constant irritation of the intestinal mucosa. In children, dehydration develops much faster, which in especially severe cases can lead to death.
If you detect frequent shapeless stools (even in the absence of complaints), you must urgently seek help from a specialist. It is important to establish what exactly caused what was happening.
Early diagnosis can reduce the likelihood of developing unpleasant consequences, and also reduces the chances of chronic irritable bowel syndrome.
Prevention
As a preventive measure, doctors advise following three rules:
- Reduce the level of stress in life by surrounding yourself only with positive people, thoughts and actions. To relax, it is recommended to choose any kind of needlework, sports or a walk with animals. Cat is the most accessible antidepressant.
- Normalize your diet by eliminating harmful products, contributing to irritation of the intestinal mucosa.
- Lead an active lifestyle and diversify your leisure time.
Note! Treatment of this disease requires an integrated approach, as well as eliminating the root cause.
Therefore, you should not self-medicate, which may be ineffective and life-threatening.
Thus, diarrhea caused by the disorder nervous system, quite difficult to liquidate. An important condition for treatment is complete rest and absence of stress. Only when integrated approach there is a chance to get rid of unpleasant symptoms.
In the absence of proper treatment or delay this state may become chronic making a person a prisoner own needs.
Be sure to watch the following video on the topic
Information: DIARRHEA (diarrhea) - frequent (more than 2 times a day) discharge of liquid feces associated with the accelerated passage of intestinal contents due to increased peristalsis, impaired absorption of water in the large intestine and the release of a significant amount of inflammatory secretion or transudate by the intestinal wall. In most cases, diarrhea is a symptom of acute or chronic colitis or enteritis. Infectious diarrhea is observed with dysentery, salmonellosis, food toxic infections, viral diseases(viral diarrhea), amoebiasis, etc. Alimentary diarrhea can occur due to poor nutrition or allergies to certain foods. Dyspeptic diarrhea is observed when the digestion of food masses is impaired due to secretory insufficiency of the stomach, pancreas of the liver or insufficient secretion of certain enzymes by the small intestine. Toxic diarrhea accompanies uremia, mercury and arsenic poisoning. Drug-induced diarrhea can be a consequence of suppression of the physiological intestinal flora and the development of dysbiosis. Neurogenic diarrhea is observed when there is a violation nervous regulation motor activity intestines (for example, diarrhea that occurs under the influence of excitement, fear). The frequency of stool varies, and stools are watery or mushy. The nature of bowel movements depends on the disease. So, with dysentery, the feces first have a dense consistency, then become liquid, scanty, mucus and blood appear in it; with amebiasis - contains glassy mucus and blood, sometimes the blood permeates the mucus and the stool takes on the appearance of raspberry jelly. With diarrhea, there may be abdominal pain, a feeling of rumbling, transfusion, bloating, and tenesmus. Light and short-lived diarrhea has little effect on general condition patients, severe and chronic lead to exhaustion, hypovitaminosis, and pronounced changes in organs. To establish the cause of diarrhea, coprological and bacteriological examination. The severity of diarrhea can be judged by the speed of passage (promotion) of carbolene through the intestines (the appearance of black color in stool after a patient takes carbolene after 2-5 hours instead of the normal 20-26 hours) or barium sulfate during x-ray examination. If cholera, salmonellosis, or foodborne toxic co-infection are suspected, patients are subject to immediate hospitalization in the infectious diseases department. Treatment is aimed at eliminating the cause of the diarrhea. For example, for hypovitaminosis, appropriate vitamins are administered parenterally; for gastric achylia, gastric juice or its substitutes, in case of pancreatic insufficiency - pancreatin or panzinorm, festal, etc. For diarrhea not associated with infection, a gentle diet is indicated (limitation of carbohydrates, refractory fats of animal origin), frequent fractional meals, chewing food thoroughly. Calcium carbonate, bismuth preparations, tanalbin are used as symptomatic remedies; decoctions of oak bark, St. John's wort, serpentine rhizomes, cinquefoil or burnet, bird cherry fruits, blueberry infusion, alder fruits, chamomile flowers, belladonna tincture, etc. For diarrhea caused by dysbacteriosis, colibacterin, lactobacterin, bificol, bifidumbacterin are prescribed. Viral diarrhea is becoming more common in modern times medical practice special relevance. Children's presenter etiological factor, causing acute infectious diarrhea, becomes rotavirus. Most often the company viral diarrhea observed in children under 2 years of age in the form of sporadic cases; epidemics are possible rotavirus infection, more often in winter. In adults, rotavirus is rarely the causative agent of gastroenteritis and the process caused by it is erased. Acute diarrhea in adults is most often caused by the Norwolk virus. The latent period for rotavirus infection is from one to several days. The onset of viral gastroenteritis is acute - with vomiting, severe in children; then diarrhea occurs, as well as general symptoms infections: headaches, myalgia, fever, but these phenomena are usually moderate. Abdominal pain is not typical for viral gastroenteritis. Swelling and inflammation in the wall small intestine caused by a virus, lead to impaired secretion and absorption of fluid rich in sodium and potassium. Diarrhea is watery in nature; the fluid lost with diarrhea contains little protein, but a lot of salts. This pattern is reminiscent of secretory diarrhea caused by Vibrio cholerae or enterotoxins coli; it can lead to massive fluid loss, exceeding 1 liter per hour in an adult. With viral diarrhea, the large intestine is not affected and there are no leukocytes in the stool; viral diarrhea in adults lasts 1-3 days, in children - twice as long. Severe dehydration can threaten the patient's life. Therapy comes down mainly to replacing lost fluid. This replacement can be carried out by infusion, using a drink containing glucose and salts (glucose stimulates sodium absorption). Liquid is administered at the rate of 1.5 liters per 1 liter of stool, but the main control is the visible filling of the vessels of the skin and mucous membranes. Antibiotic therapy for watery diarrhea does not change the duration of the disease.
– this is a continuous or periodic disorder of intestinal functions, manifested by an increase in bowel movements up to 3 or more times a day with the passage of liquid or pasty stools. There are no abdominal pains. Possible urgency, rumbling, flatulence and a feeling of incomplete bowel movement. Mucus impurities are often found in stool. Functional diarrhea is diagnosed based on complaints, medical history, endoscopic and radiological examination methods, ultrasound, balloonography, laboratory tests and other techniques. Treatment – elimination of provoking factors, diet, drug therapy, psychotherapy.
ICD-10
K59.1
General information
Functional diarrhea is a constant or episodic increase in bowel movements with the passage of insufficiently formed stools. Along with irritable bowel syndrome (IBS), functional constipation, functional bloating and nonspecific bowel disorder, functional diarrhea is included in the group of functional diarrhea intestinal disorders. It differs from IBS in the absence of pain and discomfort in the abdomen associated with the act of defecation. Like other functional disorders, functional diarrhea is characterized by the severity of the psychosomatic component and a tendency to persistent recurrent course. Despite the absence of organic pathology, it is difficult for patients to tolerate due to the variety of clinical symptoms and unfavorable psycho-emotional background.
It is a widespread pathology. Diagnosed in 1.5-2% of residents of developed countries. Can affect people of any age and gender. Functional diarrhea most often affects people over 40 years of age. Among young and middle-aged people, there is a predominance of male patients. In old age, the gender distribution changes; after 70 years, women suffer from functional diarrhea more often than men. There are no data on incidence in children. Treatment is carried out by specialists in the field of clinical proctology and psychotherapy.
Causes
The reasons for the development of functional diarrhea are not precisely understood. Experts believe that increased intestinal motility and increased frequency of bowel movements arise due to two main circumstances: the first is a disorder of the nervous regulation of intestinal activity, caused by psychological and emotional stress (acute and chronic stress); second – increased sensitivity nerve endings located in the intestinal wall to the pressure of feces.
In patients with functional diarrhea, even slight stretching of the intestinal wall causes the urge to defecate. If unfavorable psycho-emotional state patient physical activity intestinal pain intensifies even more, and the intestinal wall becomes even more sensitive to irritants. As a result, functional diarrhea occurs or becomes more severe before exams, moving to a new job, during periods of difficulties in relationships with relatives and in other situations associated with high level uncertainty and accompanied by severe anxiety. The impetus for the development or exacerbation of functional diarrhea can be both negative and positive experiences, for example, a wedding, an appointment for more high position etc.
Pathogenesis
It has been established that with functional diarrhea there is an increase in intestinal motility, as a result of which intestinal contents move faster through the digestive tract. The consequence of the accelerated passage of contents is an increase in bowel movements and a deterioration in the absorption of fluid in the lower parts of the colon. Normally, stool contains 60-70% water. In patients with functional diarrhea, the water content in the stool increases to 75-90%, depending on the amount of liquid, the stool becomes pasty, thin or watery.
Symptoms of diarrhea
The main signs of functional diarrhea are an increase in the frequency of bowel movements and a change in stool consistency. To make a diagnosis, it is necessary that these symptoms appear at least six months before the start of diagnosis, persist for at least 3 months, are observed in ¾ of bowel movements and are not accompanied by discomfort or pain in the abdomen. Along with the above clinical manifestations With functional diarrhea, rumbling and flatulence are often observed.
The stool is liquid or pasty, the urge usually occurs quite consistently in the morning and repeats several times during the day, immediately after eating. Less often, the desire to defecate appears before eating. At night there is no urge. In most cases, bowel movements with functional diarrhea become more frequent up to 3-5 times a day, less often - up to 6-8 times a day. The more often the act of defecation occurs, the smaller the volume and lower the density of feces. False and imperative urges are usually observed with a significant increase in bowel movements; as a rule, these symptoms are mild or moderate.
In the stool of patients with functional diarrhea, mucus impurities are often detected. Mucus can be mixed with fecal matter or located in the form of smears on the surface. In some cases, mucus may be discharged almost without fecal impurities. There is no blood or pus in the stool with functional diarrhea. No steatorrhea was observed. Abdominal bloating and moderate pain on palpation without clear localization of pain are detected. Sometimes the area of maximum pain is in the projection of the sigmoid colon.
Diagnostics
When conducting a detailed interview with the patient, preliminary diagnosis of functional diarrhea, as a rule, does not cause difficulties. During the interview, the proctologist reveals the existence of a connection between the exacerbation of the disease and stressful situations, determines the time of the urge to appear (after eating), notes the absence of pain before and during defecation. The coprogram of a patient with functional diarrhea indicates the absence of inflammation of the large intestine. Fat is not detected in stool. To make a final diagnosis of “functional diarrhea,” it is necessary to exclude other diseases accompanied or complicated by diarrhea.
Due to the need to exclude a large number of different pathological conditions the examination plan for functional diarrhea includes many instrumental studies, including colonoscopy, gastroscopy, plain radiography abdominal cavity, irrigoscopy, Dopplerography of abdominal vessels, ultrasound of the abdominal organs and balloonography. Add to list laboratory tests included general tests blood and urine biochemical analysis blood, coprogram, stool tests for dysbacteriosis and bacterial culture, etc.
The plan of necessary diagnostic measures is drawn up individually. To identify somatic pathology and clarify the list of studies, a patient with suspected functional diarrhea is referred for consultation to an endocrinologist, urologist and gynecologist. To determine the significance of the psycho-emotional component and evaluate mental state The patient is prescribed a consultation with a psychotherapist.
Differential diagnosis of functional diarrhea is carried out with irritable bowel syndrome, intolerance to various foods, infectious colitis, inflammatory diseases colon (nonspecific ulcerative colitis, Crohn's disease), side effects when taking medications, diarrhea due to AIDS and diarrhea due to endocrine diseases and neuroendocrine tumors.
Treatment of functional diarrhea
Treatment is carried out in outpatient setting. The doctor, together with the patient, identifies factors that contribute to the appearance and persistence of symptoms of functional diarrhea, and then draws up a plan to eliminate or reduce the significance of these factors. It may be necessary to adjust the diet (food composition, frequency and regularity of consumption, etc.) and take probiotics to eliminate dysbiosis. Important role plays a role in reducing anxiety and stress levels, so a patient suffering from functional diarrhea is advised to eliminate stress-producing influences if possible and seek help from a psychotherapist.
When selecting a diet, the doctor recommends that the patient completely eliminate foods that cause food allergies, causing increased intestinal motility and bloating. With functional diarrhea, aggravated side effects taking medications, the gastroenterologist replaces the drug that causes increased bowel movements, or refers the patient to a doctor of the appropriate profile for correction drug therapy one disease or another. If diarrhea persists, a patient with functional diarrhea is prescribed antidiarrheal drugs (loperamide and its analogues), adsorbents, antacids, etc. If the above are ineffective therapeutic measures in some cases antidepressants are used.
