Intestinal influenza in children (gastroenteritis). Symptoms and treatment of gastroenteritis in children Viral gastroenteritis in children how long does it last

Gastroenteritis - inflammation that affects the mucous membrane of the stomach and small intestine, infectious or other nature. This is a fairly common disease among children of all ages, including infants. The causes of acute gastroenteritis in a child can be different.

Classification

Gastroenteritis in children is divided into infectious and non-infectious. Along the course, gastroenteritis is divided into acute and chronic.

Infectious gastroenteritis in children, depending on the type of pathogen, are divided into:

• bacterial;
• viral;
• protozoan.

Bacterial gastroenteritis is caused by pathogenic and opportunistic bacteria:

• salmonella;
• dysentery sticks or shigella Sonne, Newcastle, Flexner;
• coli (enteropathogenic strain);
• yersinia;
• Proteus;
• campylobacter;
• staphylococcus;
• clostridia, etc.

Gastroenteritis of viral etiology can cause:

• rotavirus;
• cytomegalovirus;
• adenovirus;
• coronavirus;
• astrovirus;
• reovirus, etc.

The causative agents of protozoal gastroenteritis can be the following protozoa:

• cryptosporidium;
• lamblia;
• dysenteric amoeba;
• balantidia coli, etc.

Causes of non-infectious (alimentary) gastroenteritis in children:

• the simultaneous use of incompatible products (for example, whole milk and fresh vegetables or herring);
• gastroenteritis in infants can occur with improper introduction of complementary foods (a large portion of a new product) or with improper nutrition of a breastfeeding mother;
• chemicals that entered the body of a child with a food product (toxins from mushrooms, seafood, plants) - toxic gastroenteritis;
• individual intolerance to any products (for example, milk lactose) - allergic gastroenteritis;
• a side effect of certain medications (for example, non-steroidal anti-inflammatory drugs).

Non-infectious gastroenteritis usually does not have a significant adverse effect on health, which is not the case with infectious gastroenteritis. The infection is spread by the fecal-oral route. The most common viral infection is rotavirus gastroenteritis in children.

Pathogens can enter the child's body:

• with low-quality water;
• with food (in case of violation of the rules of preparation, expiration dates, storage conditions, the use of unwashed fruits, etc.);
• in case of non-compliance with hygiene rules;
• in contact with the patient through objects of common use.

Insects (flies, cockroaches) and rodents contribute to the spread of infection. Pathogenic or conditionally pathogenic microflora in the body of a child actively multiplies, causes the death of beneficial bacteria (lacto- and bifidobacteria), a violation of the absorption of food and its movement through the intestines.

Predisposing factors for the onset of the disease can be:

• early age: immaturity of the digestive system, low level of local immunity of the mucosa of the digestive tract in newborns;
• non-compliance with hygiene rules by adults caring for a child (they do not wash their hands after changing a diaper to a baby, do not process toys, do not provide high-quality processing of nipples, etc.).

Symptoms

Depending on the cause, the incubation period for the disease can last from several hours to 7 days. The onset of the disease is sudden.

Acute (infectious) gastroenteritis in children has the following main symptoms:

1. Pain in the umbilical and epigastric region, may be intermittent, spastic.
2. Nausea and vomiting, repeated many times, at first with undigested food, then with gastric contents mixed with bile.
3. Stools speeded up to 5-15 times at first mushy consistency, and then watery, profuse, light yellow, frothy, fetid. Depending on the causative agent of the disease, the stool may be greenish or orange in color.
4. Bloating, rumbling (due to increased gas formation) in the abdomen.
5. An increase in temperature from subfebrile (up to 37.5 0 C) to high.
6. Intoxication syndrome, manifested by lethargy, tearfulness, headache, decreased or lack of appetite.
7. Signs of dehydration (as a result of repeated vomiting and frequent watery stools): pale and dry skin, dry tongue with a white, thick coating, thirst.

The disease has 3 degrees of severity - mild, moderate and severe. The severity of the course is assessed by the frequency of the prevailing symptom: if vomiting occurs more often than loose stools, then it is assessed by the frequency of vomiting, and if very frequent stools, then by its frequency.

Leading symptom frequency:

• with a mild degree - up to 3 rubles;
• with moderate - up to 10 rubles;
• with severe - over 10 rubles.

Assessment of the severity of the disease is very important, since children can easily develop dehydration with the loss of not only fluid, but also essential trace elements, which negatively affects the functioning of internal organs and the brain.

Dehydration is assessed by the percentage decrease in body weight relative to the original (before illness):

• 1st step. dehydration - loss of 3-5% of the mass;
• 2nd step. – the loss is 5-10%;
• 3rd step. – loss over 10%.

Chronic gastroenteritis develops with prolonged intoxication, malnutrition, etc. It is characterized by periodic exacerbations of the process, which proceed less rapidly.

Diagnostics

In addition to interviewing parents and a child (at an older age), examining a small patient and the nature of the bowel movements, the doctor can rely on laboratory tests in diagnosis.

These include:

• microscopic analysis of feces (coprogram);
• bakposev feces to isolate the pathogen (or virological examination of feces);
• a serological blood test to detect antibodies to various types of pathogens and increase their titer (but antibodies are formed from the 5th day of illness, so the results of the study are used to retrospectively confirm the diagnosis);
• PCR to determine the pathogen.

Treatment

When identifying the first symptoms of gastroenteritis in children, treatment should be started as directed by a doctor. In mild cases, the treatment course is carried out at home. Children cannot be treated on their own. In severe cases, children are hospitalized in the infectious diseases department.

Treatment of gastroenteritis in children should be comprehensive:

1. Diet: hunger is prescribed for 6 hours. Breastfeeding is left after it for babies, but it is recommended to make them shorter. For formula-fed children, the doctor will reduce the single serving size. In some cases, an adapted fermented milk mixture is prescribed instead of the usual one.
   Older children start eating after a hungry pause with a fermented milk product, then they introduce porridge boiled in water, slimy soup. The diet expands gradually, the volume of the portion and the addition of other products are agreed with the doctor.

1. Drinking regimen: from the very first hours, the child is soldered to prevent the development of dehydration and replenish fluid losses in the body. It is better to use pharmacy solutions Regidron, Glucosolan, Oralit, etc. The solution is prepared before use (1 package per 1 liter of water).
   With dehydration 1 step. for 6 hours. it is necessary to drink liquid in small portions at the rate of 50 ml / kg of body weight, with the 2nd step. - 80 ml / kg. Further correction is carried out under the guidance of a doctor. In addition to saline solutions, a decoction of raisins, chamomile, rice decoction is used. In severe cases, with continued vomiting, solutions are administered intravenously.

1. Antibacterial drugs: Enterofuril, Nifuroxazide, Furazolidone in age dosages. With bacterial gastroenteritis, antibiotics (Polymyxin, Amikacin, Ceftriaxone, etc.) can be prescribed.

1. For viral gastroenteritis, antiviral drugs Anaferon, Ergoferon, Kagocel are used.

1. Sorbents are used to remove toxins produced by microbes from the child's body: Smecta, Polysorb, Enterosgel, etc.

1. Probiotics Linex, Hilak-Forte, Lactobacterin, Bifidumbacterin, Bifiform, etc. are used to restore the normal composition of beneficial microflora in the intestine.

1. Enzymatic preparations Creon, Mezim help to cope with the digestion and assimilation of food in the acute period of the disease.

With a timely visit to the doctor and the implementation of all recommendations, the prognosis is favorable, gastroenteritis ends in recovery.

Gastroenteritis is an inflamed gastric mucosa and small intestine, infectious and non-infectious nature. Signs are pain, vomiting, diarrhea, symptoms of intoxication, temperature. Timely access to a doctor and complex treatment lead to recovery.

The most common manifestations are diarrhea and vomiting, which can also be associated with systemic features such as abdominal pain and. The term gastroenteritis covers most infectious cases.

Etiology and pathogenesis of gastroenteritis in children

Features of the structure of the gastrointestinal tract in children

In childhood, the digestive tract has the following features:

• the mucous membrane is dry, thin in structure, it can be easily injured;
• the submucosa consists of loose fibrous connective tissue and is well supplied with blood;
• elastic and muscle tissues are not fully developed;
• the gastric glands produce small amounts of digestive juice and enzymes.

In this regard, if a child eats food that is not appropriate for his age, the digestion process becomes difficult, the protective function decreases, and inflammation may develop as a result.

Therefore, the child's digestive tract requires careful and attentive care.

The main predisposing factors are environmental pollution and increased exposure to enteropathogens. Additional conditions include: young age, immunodeficiency, measles, indigestion, artificial feeding (absolute or predominant), poor hygiene.

Other internal factors may lead to infection.

• Change in the normal intestinal flora can create a biological void that will be filled with pathogens. This occurs most often after antibiotic administration, but infants are also at risk prior to colonization with normal gut flora.
• Usually acidic stomach pH and colon is an effective antimicrobial defense. With the use of antacids H2-blockers, proton pump inhibitors, a decrease in the anaerobic flora in the large intestine, this protection is weakened.
• Gut hypomobility can lead to colonization by pathogens, especially in the proximal small intestine, where motility is the main mechanism for removal of organisms. Hypomobility often accompanies diabetes mellitus.

The main causes of gastroenteritis in children of different ages

In about 70% of cases, HE is caused by viruses, of which rotavirus is the most common culprit. Rotavirus infection is associated with about half of the hospitalizations of children with acute EH. The peak incidence is observed in babies from six months to two years.

The essence of the pathological process

The small intestine is the main absorptive surface of the gastrointestinal tract. The colon then absorbs the extra fluid, converting the relatively thin fecal stream in the caecum into a well-formed, hard stool in the rectosigmoid (sigmoid-to-rectum transition).

Infectious agents are a common cause of acute EH. These agents cause diarrhea by activating several mechanisms, including mucosal adhesion, penetration, and toxin production.

Damage to the small intestine leads to an increase in the amount of luminal fluid that cannot be adequately reabsorbed. As a result, dehydration develops, there is a loss of electrolytes and nutrients.

Microorganisms can produce toxins that increase the infection. Enterotoxins produced by some bacteria (eg, enterotoxigenic Escherichia coli, Vibrio cholera) act directly on the secretory mechanisms and cause the typical profuse watery (like rice water) diarrhea. Penetration into the mucosa does not occur.

The production of toxins by other bacteria (eg, Shigella dysenteriae, Vibrio parahaemolyticus, Clostridium difficile, enterohemorrhagic Escherichia coli) leads to the destruction of mucosal cells, resulting in bloody stools, and a decrease in absorption capacity.

Entry into enterocytes (intestinal epithelial cells) is the mode of action of Shigella and Campylobacter bacteria and enteroinvasive Escherichia coli, leading to cell destruction and inflammatory diarrhea. Similarly, Salmonella and Yersinia species enter the cells but do not cause cell death. These bacteria enter the bloodstream through the intestinal mucosa, leading to systemic intoxication.

Diarrhea occurs when microbial virulence (the ability of a pathogen to infect) disrupts the body's normal defenses. A large inoculum (volume) can overwhelm the host's ability to provide effective protection. Typically, more than 100,000 Escherichia coli are needed to cause disease, while only 10 are needed for intestinal amoebas, giardia, or norovirus particles. Some organisms (eg, V cholera, enterotoxigenic Escherichia coli) produce proteins that help these bacteria adhere to the intestinal wall, thereby displacing the normal flora and colonizing the intestinal lumen.

Classification of gastroenteritis in children and adults

GE is classified based on the cause of the disease:

2) Non-infectious

• eosinophilic (allergic reaction);
• alimentary (due to the use of products that irritate the gastrointestinal mucosa).

Classic symptoms of gastroenteritis

Symptoms of gastroenteritis are quite acute and painful. Children with viral EH usually have watery diarrhea without blood with or without vomiting, low-grade fever, and weight loss. Bacterial gastroenteritis in a child is usually characterized by bloody diarrhea, mucus in the stool, and high fever.

Clinical manifestations of gastroenteritis of various etiologies

GE degrees and their characteristics

Complications

The main complication of gastroenteritis is dehydration and hypovolemic shock (a condition caused by a critical decrease in blood volume, its thickening). Attacks can occur at high temperatures, especially with shigellosis. Intestinal abscesses can form with shigellosis and salmonellosis, especially typhoid fever, leading to intestinal perforation, a life-threatening complication.

Severe vomiting associated with gastroenteritis can cause rupture of the esophagus or aspiration pneumonia (caused by vomit entering the lungs). Mortality due to diarrhea reflects the underlying problem of impaired fluid and electrolyte homeostasis, leading to dehydration, electrolyte imbalance, vascular instability, and shock.

Dehydration score

The most important complication of HE is dehydration. The risk of dehydration is higher in young children.

Dehydration most often develops in:

• children under the age of 6 months;
• children with anatomical disorders in the intestines (for example, short bowel syndrome).

The degree of weight loss provides the best estimate of the degree of dehydration.

Also pay attention to the following warning signs:

• dry, chapped lips;
• dark urine;
• little or no urine for eight hours;
• cold or dry skin;
• sunken eyes or sunken fontanel (in infants);
• excessive sleepiness;
• low energy level;
• crying without tears
• excessive fussiness;
• rapid breathing.

In the most serious cases, the child may become delirious or lose consciousness.

When dehydration develops, an ambulance should be called immediately.

It should be noted that GE is a diagnosis of exclusion because vomiting and diarrhea can be non-specific symptoms in young children, and it is important to exclude other causes of these manifestations, namely:

• acute appendicitis;
• inflammatory bowel disease;
• systemic infections (urinary tract infections, pneumonia, meningitis);
• metabolic conditions (eg, diabetes mellitus).

Based on the medical history, epidemiological criteria, and physical examination, the physician determines the need for further diagnostic evaluation followed by microscopic examination of the stool.

The main groups of drugs

The goals of pharmacotherapy are to reduce morbidity, prevent complications, and provide prophylaxis.

Antibacterial drugs

Because most cases of acute gastroenteritis are caused by viruses, antibiotics are usually not prescribed.

For patients with detected Clostridium difficile and giardiasis, Metronidazole is the drug of first choice. Vancomycin is prescribed for resistant infections.

Antidiarrheals

Antidiarrheal drugs are generally not recommended due to the risk of side effects. Loperamide causes drowsiness and nausea in children under 3 years of age. Bismuth subsalicylate has shown limited efficacy in the treatment of acute gastroenteritis in children. The use of racecadotril, which reduces the secretion of water and electrolytes in the intestine without affecting intestinal motility, has been studied under stationary conditions with promising effects.

Antiemetics

The child's vomiting must be stopped to prevent dehydration. Ondansetron has been shown to be effective as an antiemetic, but it has a number of side effects. Older antiemetics (such as promethazine) have been found to be less effective in reducing vomiting.

Promethazine is only approved for use in children over 2 years of age and is commonly associated with neurological side effects that may interfere with the rehydration process. None of these drugs affect the causes of the disease.

Application of zinc

Zinc is an essential trace mineral that protects cells from oxidative damage. It is hypothesized that zinc may improve the absorption of water and electrolytes, although the exact mechanism of action is not fully understood.

Diet

With GE, the child must adhere to the dietary table No. 4. The features of the diet are as follows:

• decrease in the daily volume of salt (up to 10 g);
• calorie reduction up to 2000 kcal;
• meals in small portions 5 - 6 times a day;
• foods must be boiled, steamed or served mashed.

The duration of the diet is 2-4 weeks.

Diet in the acute period

In the acute stage of the disease, food should be completely abandoned. During this time, the patient only needs fluid replacement. Consumed liquids should be warm. For this purpose, the child is offered: weakly brewed tea without sugar, diluted juice, pure water.

Diet during convalescence

A diet consisting of applesauce, bananas, rice, yesterday's bread is preferred in the early recovery period. If the patient is tolerant of solid foods, the diet can be expanded to ensure adequate protein and calorie intake. It is necessary to introduce lean meat (without layers of fat) as soon as possible.

Drinking regime

Replacement of lost fluid is the initial emergency step in the treatment of acute HE.

The use of commercial rehydration solutions is the preferred method of replenishing fluids and electrolytes. Fluid should be quickly replaced within 3-4 hours.

Relevance of traditional medicine

Some home remedies can relieve the symptoms of gastroenteritis and minimize the chance of complications, but they do not address the underlying cause.

1. Anti-spasmodic properties basilica eliminate stomach cramps and strengthen the stomach.
2. Chamomile tea can help relax your nerves. It also has antibacterial and anti-inflammatory properties that can help relieve diarrhea and nausea in a child.
3. Cinnamon mixed with honey, has been a cure for gastroenteritis for ages, but science has not proven its effectiveness. But honey and cinnamon together can minimize inflammation.
4. Mint also has antispasmodic properties and helps reduce gas, bloating and indigestion.

Prevention of gastroenteritis in children

Provision of clean, uncontaminated water and proper hygienic conditions are the most important means of preventing childhood EH. Good hygiene, especially good handwashing with soap and water, is the best way to control the spread of most of the organisms that cause gastroenteritis from person to person. Likewise, poultry meat should be considered potentially contaminated with Salmonella and should be prepared accordingly. It is possible to carry out immunization against rotavirus infection.

Tips for those planning a trip with young children

When a child visits a place where the climate or sanitary conditions are different from the usual, the likelihood of gastroenteritis increases.

To reduce the risk of developing pathology, parents should pay special attention to food and drinks while traveling.

Travelers should drink bottled drinks or boiled water. They should avoid vegetables and fruits that they themselves have not peeled. Food should be consumed hot, if possible. Raw or undercooked seafood poses a particular danger. Swimming pools and other water recreational areas can also be contaminated.

Pharmaceutical prophylaxis is generally not recommended for previously healthy children or adults. However, travelers should carry azithromycin with them (<до 16 лет) или ципрофлоксацин (>under 16 years of age) and start antimicrobial therapy if diarrhea develops.

Conclusion

Hygiene combined with healthy dietary habits will help prevent acute gastroenteritis in children. Also, the child's diet should include foods that strengthen the immune system. A strong immune system helps fight infection faster and minimizes risks.

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Gastroenteritis is a disease characterized by inflammation of the lining of the stomach and small intestine.

You can read in detail about gastroenteritis in adults.

Causes of gastroenteritis

The formation of gastroenteritis in a child can occur for the following reasons:

Disease classification

Gastroenteritis is divided into several classifications, depending on various factors.

According to the nature of the course of the disease, gastroenteritis is:

• Acute, formed by the consumption of low-quality food;
• Chronic gastroenteritis manifests itself constantly due to failures in the diet, an allergic reaction, when helminths enter the body.

Symptoms of the disease

With gastroenteritis in a child, the following symptoms of the disease are observed:

If symptoms appear, consult a doctor immediately!

In severe cases, the child develops dehydration of the body, while exhaustion is observed, the amount of urine excreted (diuresis) decreases, and the turgor of the skin (elasticity) is reduced.

The tongue and oral cavity become dry, there is practically no salivation, the eyes begin to sink. A high temperature may rise; the child begins to "burn", becomes hot to the touch.

Diagnosis of intestinal flu

The diagnosis of gastroenteritis is made on the basis of complaints of the child, parents, history taking (past diseases, hereditary factor, contact with an infected person), on examination (palpation of the abdomen, examination of the skin, tongue and mucous membranes), according to the results of laboratory tests.

Diagnostic examinations:

• Clinical blood test, there is leukocytosis, accelerated ESR (indicates the presence of inflammation);
• Bacteriological sowing of feces (placed on specialized nutrient media) reveals the type of pathogen;
• Clinical analysis of urine, discoloration - dark, cloudy, leukocytes are present;
• Examination of feces for worm eggs.

Treatment Methods

Treatment of gastroenteritis in a child should be comprehensive, drug therapy (drug treatment) and non-traditional methods of treatment (herbal decoctions, infusions) can be carried out.

Medical therapy:

• Detoxification therapy focused on eliminating signs of dehydration. It is necessary to give the child as much liquid as possible - fruit drinks, weakly brewed sweet tea, still water. Prescribe specialized drugs - rehydron, pedialitis

Regidron, one sachet is dissolved in a liter of water, consumed throughout the day;

• Enterosorbents remove toxic substances from the body(activated carbon, smecta, polyphepan)

Polyphepan, daily dose for children 9-10 tablets, in the form of a paste, powder for children up to a year, a teaspoon per reception, 1-7 years, 2 teaspoons, over 7 years, 1 tbsp. spoon 3-4 times a day;

• A day after the onset of the disease, the child is prescribed antidiarrheal, antiemetics(previously not advisable, since the body naturally must remove toxins). Linex, biobacton, hilak-forte, motilium, cerucal, no-spasm and others are used

Linex (against diarrhea), children under 2 years old, 1 capsule three times a day (the contents of the capsule can be poured into a spoon, diluted with water), 2–12 years old 1–2 capsules 3 times, children over 12, 2 capsules three times a day;

Pirantel, chewable tablets, children over 3 years 1 per day, ages 6-12 2 tablets, over 12 3 tablets;

• Vitamin therapy, to increase immune forces, multivitamin complexes - alphabet, vitrum baby, kids formula

Kids formula, children over 3 years old, 1 plate per day, over 7 years old, 1 plate twice a day;

• Oxyquinoline derivatives (antimicrobials), intestopan, nitroxoline.

Intestopan 30 mg, for infants ¼ tablet three times a day, for a child over 2 years old, 1-2 tablets 2-4 times a day.

Folk remedies

Before using folk remedies, it is advisable to consult a doctor!

Cranberry brew. 15 gr. brew cranberries with a mug of boiling water, boil over low heat for 10-15 minutes. Cool, squeeze the berries, consume 40–60 ml three times a day;

• Oatmeal. 2 tbsp. spoons of cereals brew ½ cup of boiling water, stand for 15 minutes. Cool, consume in one go;
• Mint infusion. 12–15 gr. brew dried peppermint leaves with a cup of boiling water, leave for 2-3 hours. Filter the infusion, consume 30–40 ml throughout the day.

Diet for gastroenteritis

On the first day from the onset of the disease, fasting and drinking plenty of free fluid are prescribed. Nutrition at the time of an exacerbation of the disease should be as sparing as possible, with minimal portions 5-6 times a day. Food should be warm, steamed, boiled or baked.

On the 2nd day from the onset of the disease, unsweetened fruit and vegetable purees can be added to the menu, on day 3 include vegetarian, low-fat soup, chicken. On day 4, the diet is expanded with dry cookies, bread, beef, lean fish, eggs. Starting from day 5, all restrictions are removed, with the exception of whole milk.

Complications

In the absence of treatment or its ineffectiveness, the child may develop the following complications:

• Violations in cardiac, brain activity;
• Stop breathing;
• Damage to the heart, kidneys, liver and other vital organs;
• stomach bleeding;
• Peritonitis (inflammation of the peritoneum);
• Epilepsy (sudden onset of convulsive syndrome);
• Reactive arthritis (inflammation of one or more joints);
• Fatal outcome.

Gastroenteritis is an inflammatory process of the mucous membrane of the stomach and small intestine. Gastroenteritis is common in children. This disease is often called stomach flu, but not always the cause of the inflammatory process is virus infection. The main danger of this disease is that from the first days the child's body loses a large amount of fluid, which can result in dehydration. That is why the treatment of the disease should begin from the moment the first symptoms appear.

In order to prevent complications of gastroenteritis in a child, it is important to notice the first symptoms in time.

Gastroenteritis in children, including infants, can occur for several reasons. Unlike adults, the main origin of inflammation of the membranes of the digestive tract in them is due to the penetration of pathogenic microflora into the body:

• viruses - astro-, adeno-, retro-, corona- and cytomegalovirus;
• bacteria - clostridia, salmonella, shigella, proteus, Escherichia coli, staphylococcus and others;
• protozoa - cryptosporidium, lamblia.

According to statistics, about 70% of cases of gastroenteritis in a child are due to the presence of viruses in their bodies. Especially often in the diagnosis, a rotavirus infection is detected.

Also, signs of inflammation may occur after eating certain vegetables and fruits, especially if the child eats them with milk. In this case, we are talking about alimentary gastroenteritis, which is relatively rarely diagnosed in childhood.

The cause of the development of gastroenteritis in a child can be various viruses and bacteria.

In addition to the direct causes of gastroenteritis in infants and older children, experts identify an extensive group of factors contributing to the spread of the disease:

• lack of proper hygiene (non-sterile bottles, nipples and toys, dirty hands after walking);
• insufficiently adjusted functionality of the gastrointestinal tract (typical for children under one year old);
• the wrong way of cooking for children (especially often - undercooked vegetables and fruits, fish or meat).

A significant role in infection is played by the contact of the child with a person who has symptoms of food poisoning, indigestion or colds. If this happened during the period of breastfeeding, the mother of the baby should pay special attention to the hygiene of the mammary glands.

Symptoms of gastroenteritis in children

When pathogenic microflora enters the body, the symptoms of inflammation of the membranes and walls of the gastrointestinal tract in a child do not appear immediately. In medicine, there is such a thing as the incubation period - this is the period of time during which the infection spreads through the intestines and begins to release toxins into its lumen (in fact, they cause intestinal disorders).

Gastroenteritis is manifested by pain localized in the abdomen

The main symptoms of the disease are a complex of digestive disorders. This happens because the number of lacto- and bifidobacteria is significantly reduced in the child's intestines, which leads to a violation of the absorption of nutrients and fluids, and a slowdown in intestinal motility. The symptoms inherent in such processes are as follows:

• Pain in the abdomen, which do not have a clear localization and intensity, occurring at different intervals.
• Change in the frequency and nature of the stool - diarrhea, which at first has a mushy texture, and then becomes watery. This also increases the frequency of stools. Symptoms are complemented by rumbling in the abdomen, cramping pains in the navel.

Violation of the stool is a characteristic sign of gastroenteritis

• Flatulence, expressed in a feeling of swelling of the intestines, as a result of which colic may occur.
• Nausea and vomiting that contains particles of undigested food.
• General malaise, weakness and pain in muscles and joints.
• An increase in body temperature to 38 degrees and above (such symptoms appear mainly in the viral etiology of gastroenteritis).

The child may also show signs of dehydration. At the same time, the symptoms described above are supplemented by dry mouth, a feeling of thirst. The surface of the tongue is covered with a thick white or grayish coating, and the skin becomes gray and dry.

Diagnosis of gastroenteritis in children

Diagnostic measures for suspected gastroenteritis in children are carried out immediately, as soon as the symptoms of the disease appear. In this case, the doctor focuses on finding out the sources of inflammation by external examination of the child. This method does not provide reliable data on the origin of the disease, however, a thorough analysis of the current state of the baby allows you to establish the degree and prevalence of the inflammatory process.

Gastroenteritis can be diagnosed through a coprogram

To establish a complete clinical picture, you will need:

• a blood test for the content of leukocytes and antibodies to various pathogens in it;
• analysis of feces for bacteria;
• analysis of feces (coprogram) for the content of pancreatic secretion, particles of undigested food, mucus and fiber;
• analysis of feces for the presence of occult blood (erythrocytes) in it;
• clinical blood test for ESR;
• biochemical blood test for C-reactive proteins.

All this allows you to establish with 100% accuracy the cause of inflammation, as well as determine what methods and drugs to treat gastroenteritis.

In addition, the doctor conducts a dehydration risk analysis. If the chair occurs up to 3 times a day, the child's condition is considered normal, the risk of dehydration is minimal. If the chair occurs up to 10 times a day, the patient's condition is moderate. For a severe course of the disease, uninterrupted stools are characteristic, or when defecation occurs more than 10 times a day.

A blood test is required to confirm the diagnosis.

Methods of treatment of gastroenteritis in children

Treatment of a child requires the implementation of measures to prevent dehydration. On the first day, when the symptoms have just begun, it is recommended to increase fluid intake at the rate of 50 ml of water per kilogram of the baby's weight. With an average and severe course of the disease, this rate increases to 80 ml of water per kilogram.

It is advisable to alternate ordinary drinking water with a weak saline solution, which will allow you to maintain a normal water-salt balance. With nausea, it is recommended to water children often, but in small portions - a teaspoon or a tablespoon, depending on their age.

Treatment on the first day implies a complete refusal of food. During this time, infiltrates and most of the toxins synthesized by bacteria or viruses will be removed from the intestines along with the feces.

On the second day, a strict diet is recommended. Children up to a year are gently applied to the chest, trying to feed it, preventing the stomach from filling. Older children are recommended liquid food in the form of broths. At this stage, treatment may include taking medications to prevent fluid loss. For this purpose, it is not recommended to use kissels and natural juices, as they can provoke a new indigestion.

In case of complications or infectious gastroenteritis, the child needs inpatient treatment

In addition, on the first day, treatment is carried out with sorbents in the form of activated carbon or other medications that can neutralize and remove toxins in the intestinal lumen.

Also, drug treatment includes taking drugs aimed at eliminating the main causes of gastroenteritis:

• antibiotics - with a bacterial intestinal infection;
• antiviral drugs - if detected in the analysis of viruses;
• probiotics and prebiotics - in the presence of signs of dysbacteriosis;
• enzymes - with persistent dysfunction of the digestive system, in particular, the pancreas.

Treatment with the listed drugs lasts from 5 days or longer, depending on the symptomatic picture and the degree of changes in the functioning of the digestive organs.

With infectious gastroenteritis, treatment is carried out in a hospital. Children with mild inflammation can stay at home. In this case, a prerequisite is observation by a doctor and strict adherence to the doctor's recommendations.

From this video you will learn about intestinal infections:

Infection of the digestive tract with vomiting and diarrhea caused by viruses, bacteria and protozoa. For a short time, life-threatening loss of electrolytes and fluids is possible. Fever is noted not in all cases.

There are enterotoxic infections (the leading symptom is watery diarrhea; a typical example is salmonella) and enteroinvasive infections (the leading symptom is bloody-mucous diarrhea; a typical example is shigella, enterohemorrhagic strains of E. coch).

Vomiting and diarrhea can also occur as concomitant symptoms of extraintestinal diseases, such as pyelonephritis.

Typhoid fever (Salmonella typhi) is also transmitted by the fecal-oral route through contaminated food (such as raw eggs). The incubation period is 1-3 weeks. The general condition of the patient is severe, without typical gastroenteritis.

In addition to bacterial gastroenteritis, which occurs in the form of infections or toxic infections, there are food poisonings caused by bacteria, most often Staphylococcus aureus. The pathogen present in contaminated food releases a toxin that causes the disease.

Acute gastroenteritis with helminthic invasions is atypical, but possible.

Causes of acute gastroenteritis in children

Symptoms and signs of acute gastroenteritis in children

Uncomplicated gastroenteritis: vomiting, diarrhea, possible fever.

Rash - mainly with rotavirus infection.

Symptoms from the respiratory system (otitis media, bronchitis, pneumonia) - with rotavirus infection.

Additional symptoms (septic fever, vascular shock, hepatomegaly, splenomegaly) indicate generalization of the disease (eg, sepsis, typhoid).

Symptoms of dehydration up to hypovolemic shock (toxicosis):

• decrease in skin turgor, delay in the expansion of the skin fold, decrease in the tone of the eyeballs;
• sunken fontanel, dry mucous membranes;
• clouding of consciousness, rare blinking.

Clinical assessment of the volume of fluid lost.

In hypertensive dehydration (hyperpyrexic, hypernatremic toxicosis), the amount of fluid lost is often clinically underestimated. Ask parents about last weigh-in data.

Complications:

Compensation for fluid and salt losses orally or parenterally (intravenously), depending on the degree of dehydration and the clinical condition.

Inside: solution for rehydration.

Intravenously: isotonic sodium chloride solution, then glucose and electrolyte solutions.

Antibacterial therapy for typhoid, cholera, diseases caused by pathogenic protozoa, and septic complications. Treatment with antibiotics for salmonellosis only in exceptional cases (danger of the formation of bacillus carriers).

Patient monitoring

• Monitoring of vital functions (heart rate, respiration, blood pressure).
• Assessment of the level of consciousness.
• Feces: quantity, consistency, impurities.
• Observation of urine output, water balance.
• Body weight control.

Care

Rapid restoration of nutrition with diluted milk mixtures (for example, rice water) or breast milk; young children and older children - low-fat diet with the exception of carbohydrates (polysaccharides); goal: normal nutrition after a few days to quickly restore the intestinal mucosa.

Loose stools (in the absence of other symptoms) should not be considered as the reason for the delay in natural nutrition.

Antipyretic measures - if necessary, do not use candles.

Careful care of the skin of the perineum, babies change diapers more often.

Oral care.

Prevention of bedsores - if necessary.

Hygiene measures:

• isolation for the period of isolation of the pathogen (separate toilet);
• careful disinfection of hands before and after contact with the patient;
• disposable gloves for swaddling and disposal of feces;
• the use of a bathrobe (overalls) when leaving;
• mechanical disinfection.

The most important hygiene measure is to interrupt the fecal-oral route of transmission of the disease through hand hygiene.