Acute diarrhea. Diarrhea or diarrhea - what it is, prevention, causes burning diarrhea cause

Normally, the inclusion frequency of the intestine ranges from two times a day, up to three times a week. Increasing the frequency of defecation, accompanied by a decrease in the density of the chair, is interpreted as satisfactory, but still inaccurate, determining diarrhea. Acute diarrhea is defined as three or more defecation act per day for at least 2 weeks. If the disease manifests itself more than 14 days, then such a diarrhea is called persistent. If the duration of symptoms exceeds 1 month, then it is called chronic.

Symptoms

Due to low density, the diarrhea chaul is characterized by the form of the container in which it is placed. Visually, it is characterized as loose or watery. Some people mistakenly believe that the diarrhea is a state due to an increase in the number of stool, but its consistency has a key value. Related symptoms may include:

• Abdominal spasms;
• Nausea;
• Vomiting;
• Total fatigue.

Features of the chair can sometimes push the cause of the disease. For example, with the pathology of the small intestine, the chair is abundant, watery and is often associated with Malabsorption. Often accompanied by dehydration. The diarrhea caused by the pathology of the colon is more often associated with a rare, small stool with strengths of blood.

Causes causing acute diarrhea

When intoxication, as a rule, leading symptoms are nausea, vomiting and water-bright diarrhea, less often an increase in temperature is observed. Vomiting, which begins 6 hours after meals, should assume food poisoning caused by pre-formed toxins S. aureus or B. cereus. When the incubation period lasts more than 14 hours, and vomiting prevails among key symptoms, then it is necessary to assume the effect of viral agents.

Diagnostics

When diagnosing acute diarrhea, the most important thing is to identify the reason that caused the stool violation. To do this, it is necessary to collect anamnesis of the disease in the patient, clarify that it used to eat until recently, and it is also necessary to hold a physical examination for evaluation general status patient.

Collecting Anamnese and Physical Inspection

Careful patient survey gives valuable tips that can help diagnose and choose the most suitable and cost-effective treatment. Acute diarrhea, as a rule, have infectious origin, so when diagnosing you need to focus on this feature.

It is necessary to find out the patient, which drugs he accepts or took earlier. Antibiotics and antacids are the greatest diagnostic interest, as well as the presence of alcohol abuse.

It should also be found in a patient about his diet, find out the number of products consumed containing non-abstract carbohydrates and substitutes of fat. Also under suspicion, dairy products, mollusks, abundant amount of fruit, juice and caffery beverages fall.

In addition, when collecting anamnesis, it is necessary to take into account the place of residence, the patient, the source drinking water (Purified urban or well), consumption of raw milk, meat, fish, presence of contact with agricultural animals, which can spread diseases such as salmonellosis and brucellosis.

Physical examination in diarrhea allows you to evaluate the gravity of the disease and the state of hydration. It includes the definition of vital functions (temperature, pulse, blood pressure) and signs of dehydration (dryness of mucous membranes, reducing the leather turgora and confusion).

Of great importance is the study abdominal wall, its tension, breach, as well as assessment and consistency of feces. Even if the chair does not have bleeding impurities, it must be handed over to the analysis to determine the hidden blood.

Often correctly collected anamnesis and physical inspection is enough to form a diagnosis, but for the treatment of some diseases, more in-depth diagnosis is necessary, which will allow to prescribe a more specific treatment and prevent unnecessary interventions. Kala Analysis should be assigned to patients suffering from diarrhea within one day and having the following symptoms:

• Fever;
• Bloody chair;
• The presence of a systemic disease in history;
• Recent antibiotic treatment;
• With hospitalization or pronounced dehydration.

Research from individual patients with acute diarrhea

Patients suffering from acute diarrhea, it is necessary to carry out the following series of research:

The assessment of the chair for leukocytes is an excellent initial test, since it allows you to confirm the availability inflammatory processes In the intestines.

Stool consistency mechanism

If the test is negative, then the definition of bacterial culture may not be needed, but if the test is positive, then bacteriological research is necessarily carried out. In addition, practicing doctors need to know that inflammatory diarrhea of \u200b\u200bnon-infectious origin may be accompanied by an increase in the number of leukocytes in the chair.

Treatment

The basis for the treatment of acute diarrhea is the normalization of the water and electrolyte balance, the correction of the diet and medicia treatment. All recommendations are consistent with the basic principles for the treatment of acute infectious diarrhea in adults published by the American College of Gastroenterology.

Rehydatutation

In most cases, with acute diarrhea, the normalization of the water and electrolyte balance is the most important part of the treatment. If the patient has no explicit signs of dehydration, then he is recommended to orally rehydrate with non-alcoholic beverages, fruit juice, broth or soup.

Intravenous infusion

Patients who lost a large amount of fluid are prescribed more aggressive medical measures, which consist in conducting intravenous infusion or oral rehydration using isotonic electrolyte solutions containing glucose or starch.

Diet

Full abstinence from food is not required and is not recommended. Calories obtained when digesting and learning products are necessary for the resumption of intestinal cells. Patients are recommended frequent fractional foodcomprising fruit juices, tea, soft easily products such as:

• Bananas;
• Applesauce;
• Boiled potatoes;
• Noodles;
• Crackers;
• Bread toasts.

Dairy products should be avoided, since the lactase contained in them may be a nutrient medium for bacteria. Alcohol should also be avoided, as well as products and beverages that can enhance the intestinal motorcycle.

Medications

Antiodeary agents will help eliminate the symptom, but will not cure the main disease. The most effective representatives of this group are opium derivatives (Loperamide). They reduce intestinal motorcy, but do not affect the nervous system.

In confirming the infectious nature of the disease are prescribed antibacterial drugs. To prevent dysbacteriosis, it is best to combine together with probiotics.

In people with normal immunity, the disease most often passes independently, or only oral rehydration is necessary if there is no significant loss of fluid. If diarrhea continues more than 14 days, they usually speak of a protracted or chronic flow, and in such situations the reason may be hidden in something else. An exception to this rule is cases of infection of patients with Giardia immunodeficiency (giardiasis) and Yersinia (Iraciniosis).

Diagnostic approaches and treatment depend on many factors, including responds to the following questions:

• How long does the disease continue?
• Whether there is a general symptoms (Fever, tachycardia) and vomiting?
• Is there no blood visible to the eye in a chair?
• What is the frequency of the chair?
• Are disturbed by pain, what are their localization?
• Could not get into the human body infected water; Did it consume a stupid, suspicious food?
• Whether the patient has returned from detail travel? Where traveled in the recent past?
• Have contacts with people suffering from similar pathology? Does anyone from family members notic?
• Did the symptoms indicating dehydration and dysfunction of nutrition detected in the survey process?

It is also necessary to take into account the following factors.

• Age. Correction from the chest is associated with the disappearance of the protective role breast milk. Elderly people are significantly weakened immune defenseBut, along with this, gastric secretion is reduced: for example, as a result of pernicious anemia (atrophic gastritis), infections caused by Helicobacter Pylori (HP), the effects of proton pump inhibitors and other drugs.
• Immunodeficiency states. The question is relevant in relation to persons infected with virus Human immunodeficiency.
• Medications used, including antibiotics.
• Trips and travels.
• Infected food and water. True infections as a consequence of oral entry into the organism of enteropathogenic pathogens breeding in the intestines, as well as pathology as a result of the effects of toxins appearing in food, if it is intergenected by microorganisms capable of synthesize enterotoxins.
• Revealed hypersensitivity with respect to certain types of food.

Classification of acute diarrhea

First of all, the diseases accompanied by diarrhea must be divided by the presence of blood in the chair, as the causes depending on this can differ very much (it should be remembered that there is sometimes watered stools during shgelles and Campylobacteriosis).

The question is to be resolved: Is the defeat of the small intestine?

The pathogens affecting the colon. As a rule, this is penetrating the intestine of microorganisms: shigella, campylobacter, enteroinvasive and entero-hemorrhagic E. Son (EISE and EGES). The disease is manifested by pains at the bottom of the abdomen and the rectum (tenesmas), a chair with mucus and blood, a large number of leukocytes in feces, inflammation of the mucous membrane of the rectum.

A number of pathogens (for example, Salmonella and Yersinia) are able to affect both the lower departments of the small intestine and the colon. Respectively clinical picture In these cases, it changes in the set of symptoms and a water chair and all manifestations of colitis are included.

Causes of acute diarrhea

Causes of acute diarrhea with blood intake in feces

• Bacterial dysentery (Shigellosis)
• Enterohemorgic diarrhea (E. coli)
• Camlobacter (Campylobacter)
• Salmoneella (Salmonella)
• Iraciniosis (Yersinia)
• Ameboy Dieseneria
• Colitis associated with taking antibiotics
• Rare causes - Schistosoma (Schistosoma Mansoni or S.Japonikum) and infection with the power of the Vlaminov (Tricuris)

Causes of acute diarrhea without blood impurities in feces

• Viruses (Rotavirus, Norwalk Virus, Astrovirus, Adenovirus).
• Bacteria: Heavy infections caused by Shigella, Salmonella, Campylobacter; E. coli (TNTROTOVYXIGEN, Enteropathogenic, Enteroaggigagative); Cholera, Clostridia SPP.
• Simplest: Giardia, cryptosporidiosis, Cyclospora.
• Strondhyloidosis.
• Food toxicoinfection.
• Malaria.

Survey at acute diarrhea

In many cases, the acute diarrhea passes independently.

The need for an additional examination occurs in the following situations:

• Duration of the disease more than 2 weeks;
• Serious general symptoms, including fever;
• Tenses and bloody diarrhea.
• Special cases: outbreaks, presumably due to food poisoning; male homosexuality; imminency impairment in the patient; eating raw seafood; Background - antibiotic therapy.

Leukocytes in general feces analysis with intestinal infections

To identify the diarrhea of \u200b\u200binflammatory genes, the detection of leukocytes in the overall fee analysis is very significant.

Present - Shigella, Campylobacter, Ees, Ees. There may be either there are no - Salmonell, Yersinia, C. Difficile.

Absent - Cholera, ZES / ZPES, Viral diarrhea, Giardia, amoebic dysentery.

Note.

Ees - Enteroinvasive Coli. EPES - Enteropathogenic E. coli. Ethest - enterotoxygenic £ coli.

Definition of microbial antigens

Compared to Cala microscopy, Giardia is better to identify the ELISA method (solid-phase immunoassay analysis), and amoebic dysentery - according to serological markers of Ambas Invasia. If there are appropriate anamnestic data, even without increasing the number of leukocytes in the drug, it is recommended to carry out these studies. It helps a lot in the detection of an infection due to Yersinia Enterocolitica., serological analysis for antibodies to the causative agent. The ELISA test sets for the diagnosis of strondeidosis and schistosomosis are also developed.

Patient with sharply pronounced intoxication in order to detect signs of diffuse colitis, intestinal obstruction or toxic megacolon needs to be examined x-ray (make a survey picture of the abdominal cavity).

Treatment

Filling fluid loss

• Preference almost always gives oral rehydration, but if the patient continues vomiting or there is data confirming the decrease in the volume of circulating blood (tachycardia alone with postural fall arterial pressure - hell), shown intravenous administration solutions.
• In contrast to the situation with the resection of a small intestine or the eunostomy, when the maximum absorption of salt and water provides a solution with a sodium concentration of 90-120 mm, the optimal concentration of this element for rehydrating during a sharp diarrhea of \u200b\u200blight or moderate intensity is about 50 mm. The diarrhea becomes less, and recovery is accelerated if instead of starch from rice or other cereals inwards give dextrose (glucose).

Diet

Meal to the resolution of acute diarrhea can provoke pronounced discomfort, as the flow of food into the intestine always becomes an additional stimulus for defecation. Nevertheless, fasting does not give a big advantage. Due to the danger that lactose intolerance will be manifested, dairy products should be avoided. Alcoholic, caffeine-containing and carbonated drinks are also eliminated.

Preparations that slow down intestinal motor can be shown, but they cannot be used in severe acute colitis due to the high risk of toxic megalon. The drug is recognized by Loperamide.

Indications for the appointment of antibiotics

• Pathways: Shigella, Vibrio Cholerae, Salmonella Typhi, Clostridium Difficile.
• Complete diarrhea with frequent liquid stools, pain, fever, vomiting, Malgia, headache.

Showing quinolone.

The optimal duration of treatment is not installed. Even one-time reception can be very effective if the drug is appointed at the earliest stage of the disease.

• Laboratory confirmed cases of Invasia Giardia Intestinaiis.
• In relation to the feasibility of using antibiotics in infection caused by EGES, opinions differ, therefore it is desirable to know the opinion of the expert (see "Hemolytic-Uremic syndrome"),
• Laboratory confirmed infection of enteropathogenic E. coli (EPES) especially in small children or in older people.
• Traveler diarrhea in adults. The duration of diarrhea is reduced if quinolones are prescribed, for example, ciprofloxacin.

Diarrhea travelers

The episodes of diarrhea of \u200b\u200binfectious nature when traveling to developing countries are found in 30-50% of travelers.

Such diarrhea usually proceeds as light or middle severity The disease passes independently.

In an additional examination and treatment, only persons who have a blood adherence in the feces appear (which indicates the penetration of the pathogen into the wall of the intestine), or if the disease does not go home.

Pathogens

Everywhere in the world, the most frequent pathogen in the traveler diarrheus is an efforts of E. Coli, E. Coli's leading bacterial factor (it is also a leading bacterial factor of gastroenteritis on cruise liners), but more and more often the representatives of the genus Shigella are published on the fore.

Other representatives of the group under consideration include Aeromonas, Plesiomonas and Vibrio.

Frequently often (up to 30% of cases) the disease is caused by viruses (Rota virus, Norwalk virus).

When blood appears in the chair, it is necessary to think about Amebiase, i.e. Invasia Entamoeba Histolytica.

The most likely pathoge can be judged depending on geography. While Shigella is most often sourced in Africa and the Middle East, in Asia, more than 50% of people infect Campylobacter.

Anamnesis and the course of infection

As a rule, the disease begins 5-15 days after arrival in the country. A set of typical symptoms includes overall malaise, anorexia, gravity abdominal pain, a watery chair, sometimes with nausea and vomiting. Approximately a third of the patients marked fever. In most cases, the disease ends independently after 6-10 days.

Risk increases if a person has reduced the acidity of gastric juice or immune protection. Also, the risk category includes persons suffering from non-specific ulcerative colitis (niac), crown disease and celiac disease.

It is possible to minimize the danger of infection by cautiously choosing the food and beverages, but it is impossible to completely eliminate the risk.

There are two other approaches:

• hemoprophylaxis;
• the supply of travelers with medicines that should be taken in the event of the appearance of diarrhea.

Medical prophylaxis

If we follow the recommendations of the incidence control center, not all implies antibiotics with a prophylactic goal due to side Effects drugs and the appearance of resistant bacteria strains. The appointment of antibiotics is recognized as justified in two situations.

• A short stay in the endemic zone (2 weeks or less) persons whose business or vacation will be torn if diarrhea arises.
• Ride faces with existing pathology or immunodeficiency.

In places where Ethest, Shigella and Salmonella are prevalent, chinolone derivatives are becoming selection (cyprofloxacin 500 mg 1 time per day). Travelers in Asia, where the Campylobacter is distributed, resistant to quinolo-us, prescribe azithromycin 500 mg 1 time per day.

Independent use of antibacterial drugs. With the appearance of the first harbingers of the disease, its durability and severity can reduce the one-time taking of ciprofloxacin at a dose of 500 mg.

Other aspects related to self-medication. The question of the feasibility of adding drug antibiotics, the action of which is aimed at suppressing diarrhea, such as Loperamide (see "Preparations used in diarrhea"), not allowed to end. It is very important to ensure adequate entry into the body of fluid and electrolytes. For this, a solution for rehydration is used, for example, a solution for rehydration proposed by the World Health Organization (WHO).

Clinical approach to the patient with diarrhea that returned from another country

• The initial approach is the same as the tactics of self-admission of drugs with traveler diarrhea (3 days quinolone derivative or azithromycin plus loperamide on sufficient reimbursement of losses of fluid and electrolytes).
• Diarrhea can be one of the symptoms of malaria, so persons with diarrhea and fever who returned from endemic areas must necessarily analyze the malaria to the microscopy of the blood smear in order to detect the malaria plasma.
• Watery chair for more than 10 days, as a rule, is due to hyardiasis (giardiasis). Chair is sent to the analysis to identify Giardia, Cryptosporidium, Cyciospora and Isospora.
• In such cases, the empirical purpose of metronidazole or Tinidazole - drugs acting on the giardias is often justified. If the treatment does not have a proper effect, the further examination of the gastrointestinal tract is shown (gastrointestinal tract). Perform endoscopy upper departments With the biopsy of the mucous membrane of the small intestine, sigmoidoscopy, biopsy of the mucous membrane of the rectum. If symptoms and results histological research Indicate the tropical SPRU, tetracycline and folic acid are used.

Diarrhea or diarrhea is a bowel disorder, in which frequent acts of defecation are observed.

Chair during diarrhea is characterized by watery mass of feces with liquid or semi-liquid consistency. In adults, diarrhea is considered not independent pathology, but a sign that a failure and stomach occurred in the gastrointestinal tract. The stomach disorder is a dangerous threat to people, which leads to serious consequences.

Consider how to treat diarrhea at home, as well as what drugs are used for diarrhea in adults.

Causes of diarrhea

The main reasons for the liquid chair in adults:

• intolerance of certain products (allergic reactions, hypologist);
• silventary after abundant meal with "heavy" dishes;
• easy food poisoning;
• stressful state (excitement, fear, fright, in which diarrhea - the result of the emission of hormones);
• reception of some drugs (laxatives, antacids, anticultimifications, anticoagulants, synthetic sugar substitutes);
• traveler diarrhea (associated with changing climatic conditions and diet).

Such diarrhea, as a rule, takes place for 3-4 days, and the sick, most likely, will be able to associate the onset of diarrhea with previous events. However, the reasons for diarrhea in an adult can be more serious:

• inflammatory diseases of the digestive organs (gastritis, hepatitis, niac (nonspecific ulcerative colitis), ulcers);
• infection with bacteria, viruses, simplest (dysentery, salmonellosis, intestinal influenza);
• diseases of the gastrointestinal tract of unclear etiology (Crohn's disease);
• functional failure of the organs (deficiency of certain enzymes);
• toxic damage (lead poisoning, mercury).

In such cases, it is not enough to stop the diarrhea: the diagnosis should be diagnosed qualified treatment, often in stationary conditions. Concerning clinical manifestations diarrhea, they can be lowraged. This applies to ordinary nonsense when, in addition to the liquid chair, spastic abdominal pains and dyspeptic symptoms (drilling, bloating, strong accumulation of gases in the intestine can be observed.

Clinical features of diarrhea in the presence of OCI (acute intestinal infections)

As a result of the impact of various pathogens of microorganisms, there is a violation of the digestive organs. In winter, the Oka becomes a consequence of the impact on the organism of the viruses, and in the summer - bacteria. Disorders of the digestion occur both due to penetration of microbes in the intestinal mucosa, and due to the development of toxic agents.

Diarrhea caused by Oci, for example, salmonellosis or enteroinvasive chopsticks, can last a rather long period of time. In some cases, such a state may even threaten the life of the patient.

There are two main types of diarrhea with Oci:

1. With blood admixture. Such a type of diarrhea arises due to the intestinal mucosa of bacteria, which affect it. Often it is found in the development of diseases such as salmonellosis and dysentery;
2. Watery. This type of diarrhea is characteristic of the Oka, which are caused by the bacteria and viruses in the body, capable of separating toxic substances, such as cholera vibrium. As a result, the intestinal mucosa, which was destroyed by pathogenic microorganisms, begins to highlight water and salts, which then fall into the composition of the feces.

In the presence of OCI, as a rule, a diarrhea is observed in acute stage. In the development of certain diseases, for example, dysentery, diarrhea can go into a chronic form.

In what cases should urgently go to the doctor:

• if a strong diarrhea does not stop more than 4 days;
• when watery diarrhea accompanied by high temperatures;
• if the powerful masses of the dark color and the tar-shaped consistency;
• when permanent diarrhea contains mucus or blood;
• if the watery strong diarrhea is observed more than 15 times a day;
• when the body temperature is below 36.6;
• if a stomach hurts strongly;
• heat;
• if there is a strong diarrhea, which is accompanied by sharp pain in the stomach;
• if there is a probability of poisoning toxic substances, and poisons.

Even one of the symptoms is considered a serious reason for urgent appeal to the doctor both women and men.

How to treat diarrhea?

If the diarrhea is manifested regularly, accompanied by pain, bloating, unpleasant sensations, if there is mucus and blood in the cartoons, and the frequency of the chair exceeds 15-20 times a day - it is necessary to consult a doctor and find out the causes of the state. Only an understanding of the cause allows you to assign the right effective treatment diarrhea.

At home, treatment with the help of drugs should be carried out only after consulting with a specialist! Incorrectly selected drugs, as well as non-compliance with the dosage can lead to very serious consequences!

The greatest danger to a person diarrhea is due to the high risk of dehydration, the prevention of which can be carried out using special drugs, such as recider.

• Regidron. Glucose-electrolyte mixture with rehydrating effects. It is used in diarrhea to restore lost electrolytes. Contraindicated patients who are unconscious, as well as people with intestinal obstruction, increased sensitivity To components drug and the functional disorders of the kidneys. Not applied with diarrhea caused by cholera. Sick diabetes Should take a regiment only with permission and under the supervision of a doctor!

To combat diarrheses also use the following drugs:

• Acipol. Probiotic, which helps to restore the intestinal microflora and takes part in the normalization of the synthesis of vitamins K, B1-B12. It is used to treat diarrhea caused by intestinal dysbiosis, violation of motor skills and intestinal peristalsis. Contraindicated patients sensitive to any of the components of the drug. The average price is 250 rubles.
• Activated carbon. Water insoluble drug based on animal or vegetable coal, which has a disinfectant, adsorbing, antidiarsey effect. Contraindicated to adult patients with ulcerative lesions of the gastrointestinal gastric bleeding. With simultaneous reception with other drugs, their action neutralizes and becomes useless for the treatment of diarrhea. The average price for 10 tablets of the drug is 15-20 rubles.
• Hilak Forte. Means from diarrhea providing a beneficial effect on the growth of the useful intestinal microflora. Facely affects the pathogenic and conditionally pathogenic flora. Contraindicated in the intolerance of the main and / or auxiliary substances that are part of the drug. With acute bacterial conditions for the treatment of diarrhea, antibacterial drugs are used, which destroy the pathogens of intestinal pathologies. All antibacterial drugs have a negative impact not only on pathogenic microorganisms, but also to the normal intestinal microflora.
• Smacks. The sorption drug that has a positive effect on the body in chronic diarrhea caused by allergic reactions or influence infections. Not recommended for the use of patients with increased sensitivity and in intestinal obstruction. The average price is 125 rubles.
• Enterol. Antibiotic with antimicrobial and anti-anti-influence. It has antitoxic and immunostimulating effects. Contraindicated women who carry a child and in the period breastfeeding. It is also not used to treat patients with increased sensitivity to the drug. The average price is 250 rubles.

As an important Council, it should be noted that diarrhea in an adult who has not passed for the 3rd day - a reason to appeal to the doctor. Chronic diarrhea may indicate availability serious diseasesIt happens even with some forms of cancer.

It is also worth seeing a doctor if the temperature at diarrhea rises over 38, appear uncharacteristic for indigestion or poisoning signs: rash, jaundice skin Pokrov and eye, allocation of dark urine, sleep disorders. Permanent agony painful pains should not be the norm (spastic pains before and during defecation).

Black or green diarrhea, vomiting with an admixture of fresh or curved (dark) blood, a seven-resistant state, signs of strong dehydration talk about the criticality of the situation: it is necessary to urgently cause ambulance.

How to treat diarrhea after antibiotics?

The treatment of diarrhea after antibiotics is carried out comprehensively and is directed to the restoration of intestinal functions. Also purpose medical events is the elimination of symptoms and the consequences of this disorder.

The methods of treating diarrhea after antibiotics include:

• compliance with diet food;
• approx of medicines corrective in the composition of the intestine microflora;
• prevention of dehydration and intoxication of the body.

Receive medicines for intestinal microflora correction

To normalize the composition and properties of intestinal microflora patients, special drugs are prescribed. Depending on the composition and the rendeked effect, such drugs are divided into several categories.

Preparations are:

• probiotics - include cultures of living microorganisms;
• prebiotics - contain substances that stimulate the activities of the useful microflora;
• synbiotics - combined drugsconsisting of probiotics and prebiotics.

Therapeutic effect of these drugs is to form favorable conditions for the growth of the useful intestinal microflora and oppression of the vital activity of pathogenic microorganisms. The active components of these drugs take part in the development of vitamins and create a medium for their effective absorption. Also, the reception of such drugs contributes to the best cleavage of food and the derivation of toxic substances.

What to eat with diarrhea?

It is recommended to use bananas, boiled rice, apple puree, crackers. Food should be boiled, rubbed or cooked for a pair, without spices, fat and coarse plant fiber. You need to eat often and small portions (preferably every 3 hours with a break for the night). Daily salt consumption - 8-10 g

Prohibited:

• strong broths from meat, fish, vegetables or mushrooms,
• canned, smoked, sharp foods,
• any flour products (except permitted above)
• all sweet (intestinal infection disrupts the functions of the mucous membrane, so undigested sugars roam and cause osmotic diarrhea),
• any fat dishes (welded soups, fatty meat and fish),
• mushrooms (hard even digested healthy peoplebecause containing polysaccharide chitin, which is also available in the outer cover of crayfish, insects, etc.),
• vegetables, fruits and berries in cheese and not a wipe,
• other (fresh) milk (there are many lactose, see below),
• bean (beans, lentils, beans),
• carbonated drinks (carbon dioxide irritates mucous membrane),
• cold dishes.

• white bread (worn or in the form of crackers),
• fresh wipe cottage cheese low fatness,
• mucous rubber cashels on the water (rice porridge is especially recommended),
• boiled eggs or omelet for a couple,
• soups on a weak meat, fish or vegetable broth with ruled croups,
• low-fat varieties of meat and fish in the form of steam meatballs,
• acidic apples in the baked, boiled, grated form (apple pectin displays toxins, and organic acids suppress the growth of bacteria),
• bananas.

In the presence of signs of rotting (rotten smell of feces, flickering rotten, increased gas formation In the intestine) it is necessary to reduce the amount of protein in food and more often give cereal, mucous soups, kisins. If there are signs of fermentation (frothy steam with sour smell), it is necessary to reduce the amount of carbohydrates in food to 150 g / day. And at the same time increase the amount of protein (cottage cheese, eggs, minced meat).

As the food is recovered, it is expanding, including dry cookies, bakery products made of fresh non-dough, fermented milk products, fresh fruits (with normal tolerability).

In diarrhea, the hospitals are prescribed therapeutic table No. 4 (according to Pevznera), during the period of recovery - No. 2, subsequently - No. 15 (shared table). On the Internet, a lot of information on this topic, including the description, calorieness and even examples of dishes.

Prevention

To minimize the risk of penetration into the body intestinal infections And not allow food poisoningThe following measures should be followed:

• careful hand washing with soap in front of the meal;
• high-quality washing fresh fruits and berries, especially purchased in the markets and in supermarkets, in running water;
• competent culinary processing of products;
• refusal of overdue, low-quality or suspicious food.

Acute diarrhea is an increased chair frequency for less than 3 weeks

Acute diarrhea - It is an abnormal increasing frequency or reduced stool consistency for less than 3 weeks.
Osmotic diarrhea. It is caused by the use of a solution, which is poorly absorbed (maleabsorption of carbohydrates; absorption of mannitol, sorbitol, lactulose, deficiency of disaccharidases: lactose intolerance, lactium deficiency, diseases of the small intestine: Tropical Spring [gluten-sensitive enteropathy]; excessive antacid consumption with magnesium content ).
Secretory diarrhea. Increased secretion or reduced absorption in thin intestines. This may be a consequence of bacterial enterotoxins, infections in AIDS patients (Cryptosporidium SPP. And M. Avium complex); hormonal agents that stimulate secretion, for example, a vasoactive intestinal peptide (WCP), which is secreted by the pancreatic tumor and causes a "pancreatic cholera"; carcinoid; Hypersection of gastrin (for example, Zolinger-Ellison syndrome); or laxatives. It is characterized by a watery stool of a large volume without blood or leukocytes.
Exudative diarrhea. Inflammatory states such as inflammatory disease intestines and eosinophilic gastroenteritis; radiation enterocolitis; Infection of invasive organisms, cytotoxins, ischemia or vasculitis. The intestinal mucosa is inflamed, which causes the expansion of mucus, blood and pus in the intestinal lumen.
Violation of mobility. Normal emission diarrhea (< 250 г/день) характеризуется маленькими по объему, частыми и сформированными испражнениями, ассоциированными со срочной необходимостью. Причины включают гипертиреоидизм, аноректальные заболевания, проктит или копростаз, синдром раздраженного кишечника.

Causes of acute diarrhea

Diagnosis of acute diarrhea

Treatment of acute diarrhea

Liquid restoration

Oral (pure liquids, solutions for oral rehydration with sodium and glucose content).
Intravenously (normal saline or Ringer's solution with lactate, especially with a strong dehydration, or if the patient has stable vomiting).

Absorbents

Absorbents (aluminum hydroxide). They do not change the flow of the disease and do not reduce the loss of fluid, but allow the patient to a greater degree to control the defecation time. Medicines should be taken at least 1/2 hours before or 2 hours after the use of absorbents.

Antisecretory substances

Antisecretory substances such as bismuth subsalicylate. The usual dose is 30 ml every 30 minutes to 8 doses.

Antiperistaltic

Antiperistal agents, in particular anticholinergic agents and derivatives of opiates. Do not use in patients with fever, systemic toxicity or blood diarrhea. Stop in the absence of improvement; Or if the patient degrades. However, otherwise, antiperistalists are safe in adult patients with diarrhea. Antiperistalistic tools were safely used in children, but this is not a standard of treatment, and they should be used only after careful thinking.
Diphenoxylate with atropine. There is in the form of a tablet (2.5 mg of diphenoxylate) and liquid (2.5 mg of diphenoxylate / 5 ml). The initial dose is two tablets 4 / day (20 mg / day). For children, the dose is 0.1 mg / kg / dose 4 / day. The dose is reduced to zero with the termination of diarrhea. This is not shown for diarrhea caused by pseudommbranous colitis, or enterotoxin-producing or invasive microorganisms. Lomotil should not be used for ulcerative colitis or under 2 years old. Lomotil is quite toxic with a narrow therapeutic interval in children.
Loperamide (Imodium). Available without a recipe in the form of capsules 2 mg and liquid (1 mg / 5 ml). Increases intestinal absorption of electrolytes and water and reduces intestinal mobility and secretion. The dose for adults is 4 mg first with the following 2 mg after each diarrhea stool, but not more than 16 mg in one 24-hour period. In children, the dose is based on age, children 2-5 years old receive 1 mg 3 / day, 6-8 years-2 mg 2 / day and 9-12 years old - 2 mg 3 / day on the first day of treatment. Next is introduced 0.1 mg / kg after each diarrheal chair, but no more than a common day dose recommended for the first day of treatment. Loperamide is safe and reduces the number of failed stools and the duration of diarrhea in patients with shigella dysentery, which is treated with ciprofloxacin.

Antibiotics

Are not necessary with most episodes of diarrhea. As soon as the sample is taken for culture, the empirical treatment is reasonable, covers Shigella and Campylobacter in patients with strong diarrhea, systemic signs or gem-positive diarrhea. 3-day fluoroquinolone (Ciprofloxacin 500 mg P / B 2 / day or Norfloxacin 400 mg P / O 2 / day) is the therapy of the first line. Timetoprix-sulfamethoxazole (Bactrim P / C 1 Table. P / O to / day) is an alternative treatment, but resistant microorganisms are common. If the diarrhea is caused by the consumption of marine products, the VIBRIO cholerae or Vibrio Parahaemolyticus infection is possible, and can be treated with fluoroquinolone or doxycycline 100 mg p / o 2 / day. Antibiotics can increase the risk of hemolytic-uremic syndrome in patients infected with E. coli.

Few in their life did not tolerate such a disease as a stomach disorder. However, in the absence of proper treatment, ordinary malaise can turn into.

In intestinal infections, most often takes the form of acute diarrhea and, in the absence of proper treatment, it may become chronic. There are two types of this disease with acute intestinal infections:

• With a watery chair. Most often caused by bacteria or toxins. It is dangerous loss of large volumes of water, salts and the necessary organism of trace elements. It should be remembered that water diarrhea is not recommended or by any other antimicrobial preparations. The appearance of a watery chair indicates a flushing from the body of beneficial microorganisms, therefore, their number in the intestine is sharply reduced. Exception is perhaps the cases of salmonellosis.
• . This type of diarrhea arises due to penetration into the intestinal mucosa microorganisms that destroy it. It often occurs with diseases such as dysentery or salmonellosis.

However, in addition to acute intestinal infections, there are still a number of reasons causing a stomach disorder (diarrhea): and chronic diseases of the organs involved in the process of digestion of food.

The emergence of diarrhea in the intestinal dysbiosis means a sharp reduction in the number of useful microorganisms that help the normal functioning of the digestive system.

Violation of the normal intestinal microflora makes it possible for malicious bacteria to take a place useful, which, in turn, causes various disorders and diarrhea wearing a protracted, non-permanent character. Diarrhea, in turn, can be a symptom of such pathologies as:

• Chronic enteritis (inflammation of the small intestine)
• Chronic colitis (fat intestine inflammation)
• Colitis of ulcerative type

In addition, the acute diarrhea occurs with other not related to the digestive process, organic pathologies. For example, with inflammation of appendix, emotional overvoltage and solar overheating. However, regardless of the causes and severity, diarrhea must be treated and treated correctly. After all, in some cases it is a real threat to human life.

Symptoms of acute diarrhea and its types

Acute diarrhea was at least once in life almost every person

Depending on the causes of the diarrhea, its symptoms may vary. Most often, they depend on the individual predisposition of the patient and the influence of other diseases on the flow of intestinal disorder. Conditionally symptoms of acute diarrhea are divided into two groups - absolute and optional (conditional). The category of absolute symptoms includes such as:

• Unexpected appearance of diarch
• Increasing the frequency of emptying from the usual up to several times during an hour
• The emergence of weakness and lethargyness, drowsiness
• Irritation I.
• Development of dehydration symptoms with long-term stomach disorder (pallor, total weakness and drowsiness, reduction of urine volumes and its strange color and smell, etc.)
• A sharp decline (or complete absence) appetite.

These symptoms are observed in all cases, regardless of the cause and acuteness of the disease. It should be noted that in the manifestation of the slightest signs of dehydration of the body, it is necessary medical Help. The conditional symptoms include those that may be present, can manifest themselves partially or not to appear at all:

• Dizziness
• Vomiting (either)
• Temperature increase
• Pains localized in the navel area, in the top of the abdomen.

But regardless of the symptoms manifested or not manifested, they cannot be treated in any way, as well as to launch the disease. What kind of treatment is needed, it will go below.

Acute diarrhea: treatment

Acute diarrhea is dangerous dehydration

Diarrhea is not the main cause of the disease, it is its symptom. And in order not to aggravate the position, it is necessary not only to choose drug TreatmentBut also to comply with a certain list of recommendations, allowing not only to get rid of an unpleasant problem, but also to restore the necessary organisms of the substance and trace elements that have gone along with the feces. It is worth not hesching with a call to a doctor or ambulance if:

1. Increased body temperature does not fall below 38 within a day
2. Manifestation of the first signs of dehydration of the body - general weakness, thirst, reinforced vomiting and dizziness
3. Blood or
4. Invertible abdominal pain.

The doctor will not only help relieve unpleasant feelings and takes a threat to complications, but also recommends the necessary continuation of treatment, depending on the results of analyzes for the presence of malicious bacteria in feces.

If you call a doctor, it is not possible or you do not consider that your state requires that the binding drug must be taken firstly. To the number of funds that should always be at hand to every case - providing a practically instant effect, and activated carbon. Take these medicines is recommended at the very first signs of diarrhea. The trace elements included in their composition quickly restore the intestinal operation.

Smekt is also good as a reducing agent. Its solution must be taken on an empty stack of a glass three times a day. It not only fixes the stomach for three days of use, but also restores, and also replenishes the stock of vitamins and the necessary trace elements.

If you are not a supporter medical preparations And give our complete preference, then a suitable means of struggle with almost all types of diarch will be a powder of dried internal films of chicken stomachs.

Taking this means 2-3 times a day on a teaspoon, you can not only prevent further development Disorders, but also prevent severe consequences caused by lack of vitamins and nutrients. Haw on it is simple water. As a rule, with non-contractual forms of diarrhea, the measures described is sufficient to improve the state.

The topic of video shirts - probiotics in the treatment of diarrhea:

Restoration after illness

With acute diarrhea, diet - mandatory

The most important thing after the first medical care - Restoration of lost liquid and trace elements. In order to quickly and without consequences to return to normal life after the diarrhea attack, it is necessary to comply with a certain list of rules:

1. The main problem lies in the loss of large amounts of liquid, to fill the primary task. To do this, you need to consume a day at least 3.5-4 liters of liquid - boiled or mineral water. From the use of vegetables and fruits it is recommended to refrain.
2. Complete exception requires fermented dairy and dairy products.
3. The powder will serve as a restoring salt balance in the body of the means.
4. If it did not turn out in your first aid kit, then the regiders can be prepared independently, mixing 1 teaspoon of food soda and a half spoons of salt and 5 tablespoons of sugar. All this must be divorced with boiled water and take throughout the day.
5. Even if the feeling thirst retreated, it is necessary to continue to consume a large amount of fluid.
6. In a day or two, you can start using and compote.

During the recovery period, it is recommended to comply with a special diet that excludes everything hotter, greasy and not inspired by trust. It is necessary to use broths and cream soups, eliminate fruits and vegetables from their dietary, as well as semi-finished products. But in no case can not be starved. The body needs to be recovered, so you should take food every three hours, but in small portions.

If the intestinal pain does not stop, you can refrain from taking hard food throughout the couple of days.

In order to fully recover after the attack of acute diarrhea, it is necessary to observe, consume a lot of fluids, comply with the elementary hygiene rules and avoid different stressful situations. And it should also be remembered that the acute diarrhea is enough dangerous diseaserequiring attention and medical care.

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