Diarrhea(common name diarrhea) - a painful condition of the human body, accompanied by rapid liquid (watery) stools and in most cases pain in the abdomen, high fever and vomiting.
Diarrhea (diarrhea)- a symptom that causes, therefore, quite dangerous for children and the elderly, which, if not given proper attention, can lead to serious consequences, even death.
According to statistics for 2009, more than 1.5 million children (under the age of 5 years) died from diarrhea in third world countries.
Types of diarrhea
Medicine distinguishes between two types of diarrhea (diarrhea) - acute and chronic, the symptoms of which are generally similar. The difference is mainly the duration of other accompanying symptoms.
Acute diarrhea
The duration is usually short, 1-14 days. The causes of loose stools in acute diarrhea can be: allergic reactions to drugs, food poisoning, as well as various infections (viruses, bacteria).
chronic diarrhea
Chronic diarrhea (diarrhea) is persistent, prolonged diarrhea (diarrhea) with possible periods of remission. Chronic diarrhea (diarrhea) can lead to weakening and dehydration of the body, and also be a symptom of an underlying disease, so you should definitely see a doctor so that he can prescribe treatment for an intestinal disorder.
Possible causes of chronic diarrhea (diarrhea) as a bowel disease: ulcerative colitis, Crohn's disease, IBS (irritable bowel syndrome), drug therapy, endocrine diseases, etc.
Symptoms accompanying diarrhea (diarrhea) are as follows:
- feces with blood;
Urgently see a doctor if:
- diarrhea lasts more than 2 days in a child, more than 5 days in an adult;
- high body temperature;
- feces dark, bloody or with mucus;
- there is severe and prolonged pain in the abdomen (more than 2 hours);
- nausea and vomiting appeared;
- diarrhea began after a trip to Africa, Asia and other exotic corners of the planet;
- showed signs of dehydration.
A doctor should be contacted immediately if any of the above symptoms occur in infants or the elderly.
Causes of acute diarrhea:
Causes of chronic diarrhea:
In most cases, diarrhea resolves on its own within 2 days. The main thing these days is to stick to a diet, and also to prevent dehydration. That is why experts prescribe patients to drink plenty of fluids and other means to prevent the body from losing the necessary amount of fluid for its normal functioning.
If diarrhea does not go away within 2 days in a child, 5 days in an adult, consult a doctor who, based on the examination, can prescribe medications, and, if necessary, refer you to the hospital for tests and treatment.
Basically, the treatment of diarrhea includes the following set of measures:
- diet;
- support for the body's water balance;
- medical treatment at home;
- treatment in a hospital (if the doctor has concerns or diarrhea does not go away for a long time).
Diet for diarrhea
What to eat with diarrhea? We've put together some helpful tips:
- In case of diarrhea, it is necessary to consume an abundant amount of liquid (water, non-carbonated mineral water, broth), preferably warm or at room temperature.
- If you have no appetite, abdominal cramps are felt, then it is better to refrain from eating;
- Eat food in small doses;
- If the baby has diarrhea, continue to breastfeed him, if the feeding is artificial. Replace cow's milk with clean water when formula-fed.
If you have diarrhea, avoid the following foods:
- fatty and fried foods;
- coffee;
- alcohol;
- milk and dairy products (yogurt, ryazhenka);
- fruit juices (except apple);
- grapes, plums and most other fresh fruits;
- legumes, beets, radishes, radishes, cucumbers and other green vegetables;
- sweets;
- sauces, ketchups, mayonnaises and spices;
- black bread
What to eat with diarrhea:
- boiled rice, oatmeal and other cereals;
- white bread crackers;
- potatoes and other boiled or baked vegetables;
- lean meat, can be in the form of cutlets or meatballs, but always steamed or boiled;
- applesauce;
- bananas.
Medications for diarrhea
Medicines are best taken after a doctor's appointment. If, nevertheless, there is such a need, then they can be taken, but strictly follow the instructions for use and remember that if over-the-counter antidiarrheal drugs are taken for a long time, diarrhea can become chronic and provoke more serious disturbances in the body.
Antidiarrheal group: Enterol, Eubicor, Mezim Forte, Smecta, Enterosgel, Imodium, Hilak Forte, Loperamide Akri, Panzinorm Forte, Lopedium, "", "Polysorb MP ”, “Linex”, “Polifepan”, “Diosmectite”, “Coapectate”, “Enterosorb”.
To prevent dehydration:"Regidron", "Gidrovit".
Intestinal antiseptics: Nifuroxazide ("Enterofuril", "Ersefuril", "Stopdiar"), Rifaximin ("Alpha Normix"), "Intetrix".
For infectious diarrhea:"Galavit".
Diarrhea with colitis is treated with drugs that relieve inflammation.
Attention! Products containing salicylate may temporarily darken the tongue or stool.
antibiotics for diarrhea
Antibiotics for diarrhea are prescribed only by a doctor, and only after diagnosing the body and identifying the “infectious” cause of diarrhea.
Prevention of diarrhea
To prevent diarrhea, the following rules must be observed:
- always wash your hands, especially after the street, the toilet, contact with money, before eating, before contact with food for cooking. Hands should be washed with warm water and soap.
- before use, fruits and vegetables should be washed thoroughly;
- diarrhea and other problems with the gastrointestinal tract can cause: unpasteurized dairy products, meat, eggs;
- do not eat food that has expired;
- meat, before eating, must necessarily undergo a complete heat treatment;
- in the kitchen, including places and items for cooking, must be clean (tables, knives, boards, plates, etc.);
- do not leave cooked food for a long time in the heat, because. This is an excellent breeding ground for bacteria harmful to the body.
- try not to drink raw water or any unpurified water, especially of unknown origin. To purify water, boil it for 15 minutes and then drink it. You can also purify water using special filters, as well as adding tablets or drops of iodine and chlorine to it.
- do not eat fruits or vegetables that have not yet come into ripening season, for example: strawberries, melons, watermelons. Often, unscrupulous producers inject such berries and fruits with “chemistry”, which provokes their rapid ripening and, of course, frequent poisoning of their buyers.
- This is a polyetiological syndrome that accompanies the course of a number of infectious and non-infectious diseases, characterized by frequent loose stools. In acute diarrhea, the stool becomes copious, watery or mushy, it may contain impurities of undigested food, mucus; its frequency is more than three times a day. To determine the causes of the disorder, complaints and anamnesis are collected, a general blood and feces analysis, stool culture, as well as instrumental studies: colonoscopy and irrigoscopy are carried out. Treatment includes diet therapy, the appointment of antibacterial drugs, antidiarrheals, eubiotics, as well as rehydration therapy.
ICD-10
A09 Diarrhea and gastroenteritis of suspected infectious origin
General information
Causes
Acute diarrhea can develop under the influence of many etiological factors against the background of various pathological processes. The main causes of this condition are infectious agents, exposure to toxins, medications, ischemic or inflammatory bowel disease, and acute diseases of the pelvic organs. In developed countries, acute diarrhea most often occurs against the background of a viral infection, the causative agents of which are rotaviruses and adenoviruses. In addition to viruses, strains of various bacteria that produce enterotoxins, such as salmonella, E. coli, Shigella, Campylobacter, and so on, can provoke the development of the syndrome. In some cases, diarrhea is caused by protozoa (giardia, blastocysts, and others) and intestinal helminths (causative agents of strongyloidiasis, schistosomiasis, and angiostrongylosis).
Acute diarrhea sometimes occurs while taking various medications, being a side effect of their action on the body. The appearance of diarrhea may be associated with treatment with antibiotics, magnesium-containing agents, antiserotonin drugs, digitalis, anticoagulants, and chenodeoxycholic acid. In addition, acute diarrhea occurs with overdose and misuse of laxatives, while stool disorder can develop both immediately after taking a certain drug, and with an increase in its dosage.
The hypokinetic form of diarrhea is observed in caecum syndrome or scleroderma, when the transit of intestinal contents is disturbed. As a result, there is an excess of bacterial growth, against which the malabsorption of fats and increased mucus formation in the intestine progresses. A symptom of hypokinetic acute diarrhea is loose, fetid stools with the presence of undigested fats.
Acute diarrhea is often accompanied by general non-specific intestinal symptoms such as abdominal pain, fever, nausea and vomiting. Also, with frequent heavy stools, symptoms of dehydration can be observed in the form of dry skin, lowering blood pressure and tachycardia. In addition, there may be impurities in the feces that are characteristic of the defeat of a certain section of the intestine. For example, acute diarrhea caused by damage to the small intestine is accompanied by the presence of undigested food debris in the stool. At the same time, the stool often has a greenish tint and emits an unpleasant odor. With the development of a pathological process in the large intestine, spotting and an increased amount of mucus may be noted.
Diagnostics
An important factor that allows you to determine the nature of acute diarrhea is a complete collection of complaints and anamnesis. In this case, it is important for the patient to find out the frequency and consistency of the stool, the presence of various impurities or blood in the feces. The severity of the pathological process is indicated by symptoms such as abdominal pain, vomiting, dry skin and high fever. These clinical manifestations require either an infectious disease specialist or a proctologist to promptly prescribe appropriate therapy. When talking with the patient, the specialist clarifies which drugs he has taken recently, since this factor can also lead to the development of acute diarrhea. The diagnostic criterion for acute diarrhea is the appearance of loose stools more than 3 times a day with a duration of intestinal disorders of no more than three weeks.
Laboratory tests, such as complete blood and fecal counts, are used to diagnose acute diarrhea. These studies allow us to confirm the inflammatory genesis of the process. In particular, the coprogram determines the concentration of leukocytes and erythrocytes, which makes it possible to differentiate between inflammatory and non-inflammatory diarrhea. In the absence of signs of inflammation, stool culture is not carried out. If a large number of leukocytes and erythrocytes are found in the stool, a microbiological examination of the feces is mandatory. This method allows you to identify pathogenic bacteria that caused the development of acute diarrhea. However, in some cases, microbiological examination of feces does not give a result, since other factors cause diarrhea.
Of the instrumental methods, colonoscopy is used to determine the cause of acute diarrhea. This study makes it possible to identify inflammatory changes in the intestinal mucosa, as well as the presence of ulcers and erosions of the intestinal wall. Bowel endoscopy can diagnose colitis, Crohn's disease, diverticulitis, and other diseases that could cause acute diarrhea. An informative instrumental method of research is a contrast radiography of the intestine (irrigoscopy). This technique makes it possible to determine the rate of passage through the intestine and to suspect inflammatory changes in the mucosa.
Treatment of acute diarrhea
Regardless of the reason that caused the disorder of the stool, all patients are prescribed a special diet, eubiotics, as well as astringents and adsorbents. The diarrhea diet is used to reduce intestinal motility and reduce the secretion of fluid into the intestinal lumen. It is very important to exclude foods that can lead to irritation and damage to the mucous membrane.
With a pronounced loss of fluid and electrolytes with feces, rehydration therapy is performed. With a mild degree of dehydration, oral therapy is prescribed - special salt-containing solutions. In severe forms of diarrhea, there is a significant loss of fluid and electrolytes. In such cases, parenteral rehydration is used, which involves intravenous administration of balanced salt solutions. Antibacterial drugs are prescribed only in cases where the diarrhea syndrome is caused by pathogenic bacteria. In this case, the duration of the course of antibiotic therapy can vary from several days to a month.
In the treatment of acute diarrhea, drugs that inhibit intestinal motility play an important role. They reduce the secretion of fluid into the intestinal lumen, thereby slowing down the contraction of smooth muscles. Loperamide is an effective antidiarrheal drug, but it is not recommended to prescribe it for inflammatory diarrhea. It is also mandatory to use eubiotics to restore normal intestinal flora.
Forecast and prevention
To prevent acute diarrhea, it is necessary to observe the rules of personal hygiene and properly store food. In addition, meat, fish and eggs must be thoroughly cooked. With timely complex treatment, the prognosis for this pathological condition is favorable.
Acute diarrhea is considered a dangerous disease that leads not only to complications, but also to death. Children, adults and are at risk for the disorder. In most cases, when a minor cause becomes a contributing factor, no special treatment is required. However, with serious additional signs, urgent medical attention is needed.
Varieties of damage and indigestion
Diarrhea is divided by impurities of blood, mucus or inclusions of foreign bodies. Depending on this factor, further manifestations of intestinal disorders vary. Allocate pathogens that affect the small intestine. This manifestation includes:
- bacteria;
- viruses;
- worm infestations.
With such factors of infection of the intestine, an upset stomach occurs. The process of defecation is characterized by watery stools. Admixtures of blood in the feces with infectious lesions are rarely found.
However, there are factors that affect the colon. In most cases, pathogens are classified as such. Microorganisms penetrate into the mucous epithelium of the intestine. In this case, the feces have impurities of mucus and blood. In this case, the diagnosis finds a large number of leukocytes.
In addition to lesions of certain parts of the intestine, some pathogens disrupt the function of all departments. At the same time, the stools are watery, and the patient feels the manifestations of colitis.
Why does acute diarrhea occur?
In addition to lesions of the upper or lower intestines, the main causes of acute diarrhea are distinguished. In this case, the digestive organ is often exposed to substances, microorganisms, viruses and inflammation. This leads to indigestion, which causes loose stools.
Viral and bacterial infections
When pathogens enter the intestines, toxins are released. This enhances the contractility of the organ. These infections affect the small or large intestine. With cholera, the disease proceeds in an acute form. The infection only affects the small intestine.
Salmonellosis is isolated, which occurs in an acute form. The infection affects the digestive tract. Microorganisms cause a state of severe intoxication. Because of this, the whole body suffers.
The cause of acute diarrhea in adults is dysentery. At the same time, general intoxication of the body is noted. The distal colon is affected. The infection destroys the intestinal mucosa.
Enterovirus infection is similar in its damaging effect to dysentery. However, the disease destroys not only the intestinal epithelium, but other internal organs are also at risk.
If intestinal flu is detected, then loose stools in adults rarely occur. Diarrhea is manifested with an additional course of dysbacteriosis. Sometimes patients come with acute diarrhea, which has arisen due to food poisoning. This happens due to the use of products containing substances and elements unacceptable for the body. In products, this occurs due to the activity of pathogenic bacteria.
Violation of microflora
Dysbacteriosis is characterized as a change in the balance of positive and negative pathogens. The process develops due to the long use of antibacterial agents. Otherwise, the patient has a reduced immunity. Especially when combining the treatment of chemotherapy or radiotherapy.
If the baby has an intestinal upset, acute pain in the stomach and diarrhea, then parents should immediately call an ambulance. In most cases, the child develops diarrhea due to dysbacteriosis. However, there is a high risk of intestinal infections. Before the doctor arrives, you can provide first aid for and maintain water balance.
fermentopathy
With this disease, a violation of the production of certain enzymes occurs. In most cases, only those involved in the digestion of food. This becomes a factor in the development of acute diarrhea in adults. However, diseases of the digestive tract and adjacent organs are isolated.
The process of fermentopathy leads to:
- pancreatitis;
- gallbladder stone;
- lactose deficiency.
Diseases due to impaired immunity
Such a manifestation of acute diarrhea includes pathologies in which lesions of the colon epithelium occur, depending on a malfunction in the immune system. At the same time, Crohn's disease is isolated, when a disorder of absorption of substances occurs. Pathology is accompanied by increased release of water. This leads to the rapid passage of feces through the intestines.
In an adult, the appearance of acute diarrhea with reduced immunity is referred to as ulcerative colitis. This pathology proceeds in a chronic form, and changes occur in the mucous epithelium of the digestive organ. Also referred to as factors for the occurrence of acute diarrhea in violation of immunity - enteritis and enterocolitis.
Nervous and mental disorders
When there is a violation in the nervous system, such failures lead to digestive problems. In this case, irritable bowel syndrome is distinguished. Such a diagnosis of acute diarrhea is the absence of other signs and factors for the appearance of loose stools. The disorder continues for several months.
Other reasons
In some cases, acute diarrhea occurs due to poisoning with toxic substances. These elements include:
- nitrates;
- heavy metals;
- pesticide;
- antibiotics.
Toxic substances have a negative effect on the intestinal microflora. Antibacterial agents do not belong to pesticides. However, due to frequent use, cell growth is disrupted. This reduces the number of positive microorganisms in the intestine. This leads to dysbiosis.
Sometimes cancerous tumors are found in the digestive organ. In this case, diarrhea appears along with interspersed with blood and mucus in the stool. This disorder occurs due to intolerance to fatty foods. In addition, pathological changes in the epithelium of the digestive organ have a great influence. In other cases, the appearance of loose stools is associated with the manifestation of chronic diseases of the internal organs.
Symptoms of acute diarrhea
Additional signs of diarrhea depend on the factor of occurrence or the individual characteristics of the organism. In most cases, when acute diarrhea occurs in adults, the following symptoms occur:
- diarrhea at the most inopportune moment;
- frequent bowel movements;
- general malaise;
- state of lethargy and drowsiness;
- burning and itching in the anus;
- pallor;
- decrease in the volume of urine;
- bad smell;
- no appetite.
For any reason for the appearance of indigestion, such signs can intensify. It depends on the degree and severity of the pathology. When weakness and general malaise begin to appear, the patient needs to replenish the water balance. If there are primary symptoms of dehydration, then immediately seek medical help.
However, with the main signs, attention should be paid to dizziness or fever. The pain syndrome can be located in the navel or hypochondrium. Treatment of additional symptoms separately is prohibited. Especially it is impossible to make independent decisions on the treatment of the disease. This will lead to complications. Otherwise, death will occur.
Liquid stool treatment methods
Diagnosis of acute diarrhea takes place in the form of a survey, examination and laboratory tests. By dry skin, vomiting, fever and pain, the disease is determined by a proctologist or infectious disease specialist. Diagnosis is carried out by patients who have an upset stomach more than 4 times a day.
As laboratory tests, general blood and stool tests are used. When a large number of leukocytes and erythrocytes are found in the feces, a microbiological examination of the masses is prescribed. Otherwise, continue the diagnosis with a colonoscopy. This helps to identify inflammatory processes in the intestinal mucosa epithelium. A detailed picture of the disease of the digestive organ is carried out using radiography. After that, an accurate diagnosis is established. The doctor, based on the results of the research, prescribes a comprehensive treatment of acute diarrhea from medicines and dietary nutrition.
Medical therapy
If it is diagnosed that acute diarrhea is due to an infection, then antibiotics are prescribed. The following medications are prescribed:
- Furazolidone;
- Enterofuril.
If poisoning occurs, then in case of acute diarrhea, sorbents are taken. Such drugs reduce the manifestation of intoxication and help remove harmful substances. Means are used after meals.
Probiotic preparations are aimed at restoring the intestinal microflora. In most cases, such therapy is prescribed for dysbacteriosis, and the drugs are aimed at maintaining immunity in tone. At the same time, enzyme preparations are prescribed. Medicines are used for pancreatitis and exacerbation of pathology. Sometimes opioid drugs are used, which act on the contractility of the digestive organ.
To eliminate discomfort, antispasmodic drugs are prescribed. In this case, the patient can combine some drugs that eliminate not only acute pain in the abdomen, but also relieve spasms. Otherwise, anti-inflammatory drugs are prescribed. Such medicines are used for chronic diarrhea.
Diet Therapy
If you take any dishes with acute diarrhea, then this will lead to a deterioration in the condition. During the diet, fermented milk products should be excluded from the diet. Lactose for the patient becomes an intolerable component. Do not consume foods with caffeine or alcohol.
When using drugs that slow down intestinal motility, do not take during an exacerbation of colitis. Medicines cause the development of intoxication.
With acute diarrhea, you can eat cottage cheese, cereals on the water, boiled dietary meat and bread crumbs.
From drinks it is allowed to drink unsweetened black tea, juice from green apples and jelly.
The occurrence of loose stools is associated with many factors. Therefore, the causes of acute diarrhea affect the methods of treatment and methods of diagnosis. In most cases, developmental factors are associated with diseases of the stomach. If the pain in the abdomen increases, then you need to seek help from a doctor. The prescribed treatment will help stop the development of the disease or infection.
The information on our website is provided by qualified doctors and is for informational purposes only. Do not self-medicate! Be sure to contact a specialist!
Gastroenterologist, professor, doctor of medical sciences. Prescribes diagnostics and conducts treatment. Expert of the group on the study of inflammatory diseases. Author of more than 300 scientific papers.
Diarrhea- this is a syndrome that manifests itself as watery loose stools (diarrhea) 3 or more times a day or loose stools with an admixture of blood more than 1 time per day.
Diarrhea symptoms:
Frequent bowel movements, loose stools, loose stools, diarrhea, watery stools
Diseases that can cause diarrhea
Diarrhea can be caused by:
Causes of diarrhea
Acute diarrhea is transmitted by the fecal-oral route by ingestion of food and water contaminated with microorganisms. The causative agents of diarrhea are: bacteria (E. coli, salmonella, dysentery bacteria, cholera vibrio), viruses (rotaviruses, adenoviruses, enteroviruses) and protozoa (giardia, dysentery amoeba). The severity of the manifestation of the disease depends on the pathogen, the number of microbes that have entered the gastrointestinal tract, the state of the human immune system.
Acute intestinal infection caused by Escherichia coli occurs with moderate symptoms of general intoxication: chills, weakness, loss of appetite, fever up to 38 C, paroxysmal pain in the lower abdomen, false urge to defecate, loose stools up to 10 times a day. Symptoms last no more than a week.
Diarrhea caused by salmonella, dysentery bacteria is severe. Frequent watery stools up to 10-30 times a day, mixed with blood and pus. Abdominal pain, false urge to defecate. During and after defecation, tenesmus occurs - a pulling nature of pain in the rectal area, the temperature rises to 40 C. Due to dehydration of the body, tachycardia occurs, a decrease in blood pressure, dry skin, and weakness.
The most severe infectious disease prone to pandemic spread - cholera, begins suddenly, acutely with frequent, profuse, watery diarrhea, repeated vomiting, quickly leading to dehydration. Muscle weakness, dry skin increases, pulse quickens, blood pressure drops, convulsions appear. Body temperature remains normal or decreased, there are no abdominal pains, nausea.
Allocate traveler's diarrhea. It occurs in the first two weeks in people traveling outside their region, and lasts no more than one week. The causes of this form of diarrhea are changes in diet, water quality, changing climatic conditions, stress. All cases of the disease are associated with infection of water and food by microorganisms. The disease begins acutely, body temperature is normal, nausea, vomiting, cramping abdominal pain, frequent, up to 10 times a day, watery stools appear. The disease disappears when taking enveloping agents and observing the diet, sanitary and hygienic rules (avoid eating food that is not thermally processed enough, unpasteurized dairy products, tap water, vegetables and fruits washed with such water; wash hands before eating and after visiting public places, toilet).
Acute respiratory diseases, often caused by adenovirus and rotavirus infection, along with catarrhal symptoms (nasal congestion, rhinorrhea, dry cough, sore throat) can cause acute viral gastroenteritis, manifested by frequent loose stools, nausea, vomiting, fever, muscle weakness. In severe flu, more often "swine", along with fever up to 40C, headache, pain in muscles and joints, dry cough, shortness of breath, there is also frequent, loose stools.
Chronic diarrhea manifests itself in many diseases of the gastrointestinal tract. Chronic pancreatitis is characterized by pain in the upper abdomen, girdle, radiating to the left side of the chest. The pain is accompanied by nausea, vomiting that does not bring relief, bloating and frequent, copious, fetid stools, steatorrhea. Exacerbation of the disease provokes the use of spicy, fatty, smoked foods, alcohol.
Bloody diarrhea, especially at night, abdominal pain, anemia, fever up to 38 degrees, joint pain - occur with ulcerative colitis, Crohn's disease, pseudomembranous colitis, intestinal tumors.
Celiac disease is a congenital disease caused by a deficiency of enzymes that break down cereals, manifested by diarrhea (abundant, frothy stools), bloating, weight loss, anemia. Exacerbations of the disease are associated with the use of products from wheat, rye, oats, barley.
Diarrhea is accompanied by non-infectious colitis. They can be caused by the toxic effect of drugs (cytostatics, antibiotics, digoxin, salicylates, diclofenac, uncontrolled use of laxatives), allergies, helminthic invasion, alcohol abuse, after radiation therapy.
Antibiotic-associated diarrhea occurs during administration or 1-10 days after discontinuation of drugs. It is manifested by cramping pains in the abdomen, subsiding after a plentiful watery stool. After discontinuation of the drug, the symptoms quickly disappear.
Functional diarrhea in irritable bowel syndrome is associated with impaired intestinal motility and is determined when all diseases are excluded. This condition develops at a young age, the manifestations are associated with the transferred stress, against the background of depressive conditions. Disturbed by pain, rumbling, bloating, impaired stool in the form of pseudodiarrhea (increased stool with a formed stool consistency).
Examination for diarrhea
To make a diagnosis, a bacteriological examination of feces is necessary, while identifying the causative agent of the disease, fecal analysis for worm eggs - to determine helminthic invasion, fecal occult blood analysis - to exclude bloody diarrhea, fecal examination for dysbacteriosis - to assess the state of intestinal microflora.
Coprocytogram - will help to identify the inflammatory process in the intestine, and the degree of digestion of food, the determination of elastase-1 in the feces, its presence confirms the diagnosis of chronic pancreatitis.
Complete blood count - it determines the signs of acute or chronic inflammation, the presence of anemia. With frequent, profuse diarrhea, it is necessary to assess the degree of dehydration of the body, for this, electrolytes, total protein and protein fractions are determined in a biochemical blood test.
In chronic diarrhea, a colonoscopy is performed, sigmoidoscopy is performed to exclude the pathology of the colon.
To assess the motor function of the intestine, to identify organic changes in the intestine, an x-ray examination is performed - irrigoscopy.
Ultrasound of the abdominal cavity and small pelvis - to exclude diseases of the pancreas, liver, tumors in the abdominal cavity and retroperitoneal space.
Treatment of diarrhea (diarrhea)
In the treatment of diarrheal syndrome, diet is necessary. The food is fractional, all dishes are steamed or boiled, spicy, salty, fried, smoked foods, alcoholic drinks, canned food, carbonated drinks, coffee, chocolate are excluded. It is recommended to take mucous soups, rice porridge, crackers, baked potatoes, boiled eggs.
With a mild form of diarrhea, rehydron, gastrolith are used to prevent dehydration. The contents of the package are dissolved in 1 liter of boiled water, cooled to room temperature and taken in small sips after each loose stool, 200 ml. You can prepare solutions yourself. Take 1 teaspoon of table salt, 1 teaspoon of soda, 8 teaspoons of sugar, 1 glass of orange juice, dissolve in a liter of boiled water, take a glass after each case of loose stools. The volume of liquid drunk should be at least 2-3 liters.
With diarrhea, they take enveloping agents, adsorbents that adsorb and remove viruses, pathogenic bacteria, toxins, and intestinal gases from the body. These are drugs: activated charcoal (1-2 grams 4 times a day, dissolving the tablets in 0.5 cups of boiled water), smecta (1 sachet 3 times a day, dissolving the contents in ½ boiled water), polyphepam (1 tablespoon 3 times a day, diluted in 100 ml of water). They are used 1 hour before meals and medication, for 3-7 days.
Attention! The use of antidiarrheal agents (imodium, loperamide) is contraindicated in acute intestinal infections, as they prevent the removal of part of the toxins from the liquid contents of the intestine, with bloody diarrhea, since these drugs contribute to the aggravation of damage to the intestinal mucosa, thereby aggravating the course of the disease.
In the treatment of diarrhea, medicinal plants are used that have a bactericidal, astringent, anti-inflammatory effect. Blueberries (1-2 teaspoons of dried berries are poured into a glass of boiling water, cooled and taken 4 times a day), decoctions of oak bark, alder fruit, burnet root (2 tablespoons of plants are poured into 0.5 liters of boiling water, boiled for 20 minutes, cooled, and take 2 tablespoons 4 times a day). Accepted within 7-10 days.
Complications of diarrhea
Diarrhea is a sign of many diseases, but above all, it causes dehydration of the body, which leads to the development of convulsions, coma. Possible complications of diarrhea include: infectious-toxic shock, sepsis, peritonitis.
The outcome of the disease may be unfavorable in patients with immunodeficiency conditions (taking hormones, cytostatics, HIV-infected, undergoing chemotherapy and radiation therapy). Delayed treatment can lead to poor outcome.
Which doctor should I contact for diarrhea
If diarrhea occurs, you should contact a general practitioner (general practitioner, pediatrician, family doctor). He will assess the severity of the patient's condition, prescribe the necessary examinations and treatment. You may need to consult a gastroenterologist.
Patients with diarrhea should urgently seek medical help if: loose stools more than 10 times a day, high fever, bloody diarrhea, mucus in the stool, copious light-colored stools, a decrease in body temperature below normal, diarrhea in children under 5 years of age, and adults older 60 years old, with a sharp decrease in blood pressure and deterioration of the general condition.
Therapist of the highest category Vostrenkova I.N.
Normally, the frequency of bowel movements ranges from two times a day to three times a week. An increase in the frequency of bowel movements, accompanied by a decrease in the density of the stool, is interpreted as a satisfactory, but still inaccurate, definition of diarrhea. Acute diarrhea is defined as three or more bowel movements per day for at least 2 weeks. If the disease manifests itself for more than 14 days, then such diarrhea is called persistent. If the duration of symptoms exceeds 1 month, then it is called chronic.
Symptoms
Due to its low density, it is common for diarrheal stools to take on the shape of the container in which it is placed. Visually, it is characterized as loose or watery. Some people mistakenly believe that diarrhea is a condition caused by an increase in the amount of stool, but its consistency is key. Associated symptoms may include:
- abdominal cramps;
- Nausea;
- Vomit;
- General fatigue.
Features of the stool can sometimes lead to the cause of the disease. For example, in small bowel disease, stools are copious, watery, and often associated with malabsorption. Often accompanied by dehydration. Diarrhea caused by colon pathology is more often associated with rare, small stools streaked with blood.
Causes of acute diarrhea
With intoxication, as a rule, the leading symptoms are nausea, vomiting and watery diarrhea, fever is less common. Vomiting that begins 6 hours after ingestion should suggest food poisoning caused by preformed S. aureus or B. cereus toxins. When the incubation period lasts more than 14 hours, and vomiting prevails among the key symptoms, then the influence of viral agents should be assumed.
Diagnostics
When diagnosing acute diarrhea, the most important thing is to identify the cause that caused the violation of the stool. To do this, it is necessary to collect an anamnesis of the disease from the patient, to clarify what he ate until recently, and it is also necessary to conduct a physical examination to assess the general condition of the patient.
History taking and physical examination
Careful questioning of the patient provides valuable clues that can help diagnose and select the most appropriate and cost-effective treatment. Acute diarrhea, as a rule, is of an infectious origin, so the diagnosis should be guided by this feature.
It is necessary to find out from the patient what medications he is taking or has taken before. Of greatest diagnostic interest are antibiotics and antacids, as well as the presence of the fact of alcohol abuse.
You should also ask the patient about his diet, find out the amount of consumed foods containing non-absorbable carbohydrates and fat substitutes. Also under suspicion are dairy products, shellfish, copious amounts of fruit, juice and caffeinated drinks.
In addition, when taking an anamnesis, it is necessary to take into account the place of residence, the patient, the source of drinking water (purified city or well), the consumption of raw milk, meat, fish, contact with farm animals that can spread diseases such as salmonellosis and brucellosis.
Physical examination for diarrhea can assess disease severity and hydration status. It includes determining vital signs (temperature, pulse, blood pressure) and signs of dehydration (dry mucous membranes, decreased skin turgor and confusion).
Of great importance is the study of the abdominal wall, its tension, swelling, as well as an assessment of the nature and consistency of stools. Even if the stool does not have bloody impurities, it must be tested to determine occult blood.
Often a good history and physical examination is enough to make a diagnosis, but for some diseases, a more in-depth diagnosis is needed to allow more specific treatment and prevent unnecessary interventions. A stool test should be ordered for patients who have had diarrhea for one day and have the following symptoms:
- Fever;
- bloody stool;
- The presence of a systemic disease in history;
- recent antibiotic treatment;
- Hospitalization or severe dehydration.
Studies in Selected Patients with Acute Diarrhea
Patients suffering from acute diarrhea should undergo the following series of tests:
A stool test for white blood cells is an excellent initial test because it can confirm the presence of inflammatory processes in the intestine.
The mechanism of violation of the consistency of the stool
If the test is negative, then the determination of the bacterial culture may not be necessary, but if the test is positive, then a bacteriological examination is mandatory. In addition, practitioners need to be aware that non-infectious inflammatory diarrhea may be accompanied by an increase in the number of leukocytes in the stool.
Treatment
The basis of the treatment of acute diarrhea is the normalization of water and electrolyte balance, diet correction and drug treatment. All recommendations are consistent with the guidelines for the management of acute infectious diarrhea in adults published by the American College of Gastroenterology.Rehydration
In most cases, with acute diarrhea, the normalization of fluid and electrolyte balance is the most important part of the treatment. If the patient does not show obvious signs of dehydration, oral rehydration with soft drinks, fruit juice, broth, or soup is recommended.
IV infusion
Patients who have lost a large amount of fluid are prescribed more aggressive therapeutic measures, consisting of intravenous infusion or oral rehydration using isotonic electrolyte solutions containing glucose or starch.
Diet
Complete abstinence from food is neither required nor recommended. Calories obtained from the digestion and assimilation of products are necessary for the renewal of intestinal cells. Patients are advised to eat frequent small meals, including fruit juices, tea, and soft, easily digestible foods such as:
- Bananas;
- Applesauce;
- Boiled potatoes;
- Noodles;
- crackers;
- Bread toast.
Dairy products should be avoided as the lactase they contain can be a breeding ground for bacteria. You should also avoid alcohol and foods and drinks that can increase intestinal motility.
Medicines
Antidiarrheals will help relieve the symptom, but will not cure the underlying condition. The most effective representatives of this group are opium derivatives (Loperamide). They reduce intestinal motility, but do not affect the nervous system.
When confirming the infectious nature of the disease, antibacterial drugs are prescribed. To prevent dysbacteriosis, it is better to combine them with probiotics.
