Symptoms, causes and pathogens of infectious diarrhea (bacterial origin) in adults. Features of infectious diarrhea and tactics of treating the disease

Diarrhea(diarrhea) - rapid, repeated loose stools. Diarrhea is usually accompanied by pain, rumbling in the abdomen, flatulence, tenesmus. Diarrhea is a symptom of many infectious diseases and inflammatory processes of the intestine, dysbacteriosis, neurogenic disorders. That's why importance in the prevention of complications plays the diagnosis and treatment of the underlying disease. The loss of a large amount of fluid during profuse diarrhea leads to a violation water-salt balance and can cause heart and kidney failure.

Diarrhea (diarrhea)

Diarrhea is called a single or frequent bowel movement with liquid stools. Diarrhea is a symptom that signals a malabsorption of water and electrolytes in the intestine. Normally, the amount of feces excreted per day by an adult varies between 100-300 grams, depending on the characteristics of the diet (the amount of vegetable fiber consumed, poorly digestible substances, liquids). In the case of increased intestinal motility, the stool may become more frequent and thin, but its amount remains within the normal range. When the amount of fluid in the feces increases to 60-90%, then they talk about diarrhea.

There are acute diarrhea (lasting no more than 2-3 weeks) and chronic. In addition, the concept of chronic diarrhea includes a tendency to periodically plentiful stools (more than 300 grams per day). Patients suffering from malabsorption of various nutrients, tend to polyfaeces: the release of a large amount of feces containing undigested food residues.

Causes of diarrhea

With severe intoxication in the intestine occurs excess secretion in its lumen of water with sodium ions, which helps to thin the stool. Secretory diarrhea develops with intestinal infections (cholera, enteroviruses), taking some medicines and biologically active additives. Osmolar diarrhea occurs with malabsorption syndrome, insufficiency in the digestion of sugars, overconsumption osmotically active substances(laxative salts, sorbitol, antacids, etc.). The mechanism of development of diarrhea in such cases is associated with an increase in osmotic pressure in the intestinal lumen and diffusion of fluid along the osmotic gradient.

A significant factor contributing to the development of diarrhea is a violation of intestinal motility (hypokinetic and hyperkinetic diarrhea) and, as a result, a change in the rate of transit of intestinal contents. Strengthening of motility is facilitated by laxatives, magnesium salts. Violations motor function(weakening and strengthening of peristalsis) occur with the development of irritable bowel syndrome. In this case, they talk about functional diarrhea.

Inflammation of the intestinal wall is the cause of the exudation of protein, electrolytes and water into the intestinal lumen through the damaged mucosa. Exudative diarrhea accompanies enteritis, enterocolitis of various etiologies, intestinal tuberculosis, acute intestinal infections (salmonellosis, dysentery). Often with this type of diarrhea in the stool there is blood, pus.

Diarrhea may develop as a result of taking medications: laxatives, antacids containing magnesium salts, certain groups of antibiotics (ampicillin, lincomycin, cephalosporins, clindamycin), antiarrhythmic drugs (quindiline, propranol), digitalis preparations, potassium salts, artificial sugars (sorbitol, mannitol) , cholestyramine, chenodeoxycholic acid, sulfonamides, anticoagulants.

Classification

There are the following types of diarrhea: infectious (with dysentery, salmonellosis, amoebiasis, food poisoning and entroviruses), alimentary (associated with violations in the diet or allergic reaction on the food products), dyspeptic (accompanies digestive disorders associated with insufficiency of the secretory functions of organs digestive system: liver, pancreas, stomach; as well as with insufficient secretion of enzymes in the small intestine), toxic (with arsenic or mercury poisoning, uremia), drug (caused by drugs, drug dysbacteriosis), neurogenic (with changes in motility due to impaired nervous regulation associated with psycho-emotional experiences).

Clinical Features of Diarrhea

AT clinical practice distinguish between acute and chronic diarrhea.

Acute diarrhea

chronic diarrhea

Diarrhea that lasts more than 3 weeks is considered chronic. It may be a consequence various pathologies, the identification of which is the main task for determining the tactics of treatment. Information about the causes of chronic diarrhea can be provided by the history data associated with clinical symptoms and syndromes, physical examination.

Particular attention is paid to the nature of the stool: the frequency of defecation, daily dynamics, volume, consistency, color, the presence of impurities in the feces (blood, mucus, fat). The survey reveals the presence or absence of accompanying symptoms: tenesmus (false urge to defecate), abdominal pain, flatulence, nausea, vomiting.

Pathologies small intestine present with copious, watery or greasy stools. For diseases of the large intestine, less abundant stools are characteristic, streaks of pus or blood, mucus may be noted in the feces. Most often, diarrhea with lesions of the large intestine is accompanied by pain in the abdomen. Diseases of the rectum are common scanty chair as a result hypersensitivity to stretching of the walls of the intestine, tenesmus.

Diagnosis of diarrhea

Acute diarrhea, as a rule, is characterized by a very pronounced loss of fluid and electrolytes in the feces. On examination and physical examination of the patient, signs of dehydration are noted: dryness and decreased turgor skin, increased heart rate and decreased blood pressure. With severe calcium deficiency, positive symptom"muscle roller", there may be convulsions.

With diarrhea, the patient's stool is always carefully examined, in addition, it is desirable to carry out a proctological examination. Identification of an anal fissure, fistula, paraproctitis may suggest the presence of Crohn's disease. With any diarrhea, a comprehensive study of the digestive tract is performed. Instrumental endoscopic techniques (gastroscopy, colonoscopy, irrigoscopy, sigmoidoscopy) allow you to examine inner walls upper divisions gastrointestinal tract and large intestine, detect mucosal damage, inflammation, neoplasms, bleeding ulcers, etc.

Microscopy of feces reveals a high content of leukocytes and epithelial cells in it, which indicates the presence of inflammation of the mucous membrane of the digestive tract. Detected excess fatty acids is the result of malabsorption of fats. Together with the remains of muscle fibers and high content starch in the feces steatorrhea is a sign of malabsorption syndrome. Fermentation processes due to the development of dysbacteriosis contribute to a change in the normal acid-base balance in the intestine. To identify such disorders, intestinal pH is measured (normally 6.0).

Persistent diarrhea in combination with excessive gastric secretion is characterized by Zollinger-Ellison syndrome (ulcerogenic adenoma of the pancreas). In addition, prolonged secretory diarrhea may be the result of the development of hormone-producing tumors (for example, vipoma). Laboratory research blood is directed to detect signs inflammatory process, biochemical markers of liver and pancreas dysfunction, hormonal disorders that can be causes of chronic diarrhea.

Treatment of diarrhea

Diarrhea is a symptom of many diseases, so choosing medical tactics the main role is played by the identification and treatment of the underlying pathology. Depending on the type of diarrhea, the patient is referred for treatment to a gastroenterologist, an infectious disease specialist, or a proctologist. It is imperative to seek medical attention if you have diarrhea that lasts more than 4 days, or if you notice streaks of blood or mucus in the stool. In addition, symptoms that should not be ignored are: tarry stools, abdominal pain, fever. If there are signs of diarrhea and there is a possibility of food poisoning, it is also necessary to consult a doctor as soon as possible.

Treatment for diarrhea depends on the type of diarrhea. And includes the following components: dietary nutrition, antibiotic therapy, pathogenetic treatment(correction of malabsorption in case of enzyme deficiencies, decreased gastric secretion, drugs that normalize intestinal motility, etc.), treatment of the effects of prolonged diarrhea (rehydration, restoration of electrolyte balance).

With diarrhea in diet introduce products that help reduce peristalsis, reduce the secretion of water into the intestinal lumen. In addition, the underlying pathology that caused diarrhea is taken into account. Diet components must be functional state digestion. Products that promote secretion of hydrochloric acid and increasing the rate of evacuation of food from the intestines, are excluded from the diet for the period of acute diarrhea.

Antibiotic therapy for diarrhea is prescribed to suppress the pathological flora and restore normal eubiosis in the intestine. With infectious diarrhea, broad-spectrum antibiotics, quinolones, sulfonamides, nitrofurans are prescribed. The drugs of choice for intestinal infections are drugs that do not adversely affect the intestinal microbiocenosis ( combined preparations, nifuroxazide). Sometimes, with diarrhea of ​​various origins, eubiotics may be prescribed. However, more often such treatment is prescribed after the signs of diarrhea have subsided to normalize. intestinal flora(elimination of dysbacteriosis).

As symptomatic remedies adsorbents are used, enveloping and astringents, neutralizing organic acids. To regulate intestinal motility, loperamide is used, in addition, acting directly on the opiate receptors of the small intestine, reducing the secretory function of enterocytes and improving absorption. A pronounced antidiarrheal effect is exerted by somatostatin, which affects the secretory function.

In infectious diarrhea, drugs that reduce intestinal motility are not used. Loss of fluid and electrolytes with prolonged and profuse diarrhea requires rehydration measures. Most patients are prescribed oral rehydration, but in 5-15% of cases there is a need for intravenous administration electrolyte solutions.

Prevention of diarrhea

Diarrhea prevention includes body hygiene and nutrition. Washing hands before eating, washing thoroughly raw vegetables and fruits and proper culinary processing of products help to avoid food poisoning and intestinal infections. In addition, it is worth remembering the need to avoid drinking raw water, unfamiliar and suspicious food, food products that can cause an allergic reaction.

Today, infectious diarrhea is one of the most common pathologies around the world. It is only preceded by infections of the upper and lower respiratory tract. Most often, the disease progresses in underdeveloped countries, where millions of people die from it every year, among which the bulk are children. In Russia, this figure is much lower, but in case of untimely provision medical care the chance of death is also high.

• through unwashed hands;
• when swallowing water from reservoirs;
• due to the use of low-quality products;
• from an infected person
• through objects that may contain contaminated particles.

After entering the body, microbes begin to attack the intestinal mucosa, causing inflammatory foci. In this case, the absorption of fluid and the work of the intestine as a whole are disturbed. Trying to cleanse itself of threats, the body increases perilstatics, so the feces move faster to the exit, and the accumulated in the lumen excess fluid liquefies them.

• its color tends to turn yellow, green and even white;
• the smell can be fetid, sour, sweetish;
• may contain inclusions of blood, mucus, remnants of undigested food;
• foam is often present on the surface.

They turn to bloody stools Special attention, as this is often an alarming sign that causes infectious diarrhea or acute pathologies abdominal organs. Even a single bloody bowel movement should be a reason to visit a doctor.

Often diarrhea infectious genesis accompanied by the following symptoms:

• nausea, severe vomiting that does not bring relief;
• intense pain in the abdomen, most often spastic in nature;
• an increase in body temperature, sometimes to very high levels;
• general deterioration of the patient's well-being;
• lethargy, drowsiness;
• increased heart rate;
• lowering blood pressure;
• delirium, fever.

In case of expressed complaints, you should not try to cope with the situation on your own. This patient needs to be called urgently. ambulance Such conditions are very dangerous, especially for babies under 1 year old.

Despite careful selection of products and personal hygiene, some expectant mothers still face intestinal infections.

If loose stools do not cause discomfort and are observed infrequently, this does not pose any threat. But a stormy start with all the consequences is caused by infectious diarrhea, the symptoms of which are hard to miss. This condition is very dangerous for both the fetus and the mother.

• deviations in the formation of the fetus;
• death of the future baby;
• premature birth;
• intrauterine infection;
• hypoxia.

• dry skin, mucous membranes;
• strong thirst;
• appearance dark circles under the eyes;
• pointed facial features;
• urine becomes dark, its rare allocation in small portions is observed.

A pregnant woman with signs of infection must be hospitalized and undergo the necessary examination.

Treatment is tailored to the severity of the infection. If you cannot do without the use of antibiotics, the doctor selects the safest drug.

The disease is no less dangerous for babies under 1 year old. Frequent bowel movements, combined with profuse vomiting for 1-3 days, leads to severe dehydration, which, without emergency medical care, leads to the death of the child.

Noticing warning signs, do not hesitate, but immediately call a doctor.

Self-treatment of stool disorders in pregnant women and children under 1 year of age is unacceptable and can lead to serious consequences.

The contagiousness of such diseases is obvious, therefore:

1. Almost all patients with suspicion of this group of pathologies are hospitalized in a specialized institution.
2. In case of detection dangerous infections, for example, salmonella, the room in which the patient was located is disinfected (kindergartens, schools), and all contacts are closely monitored.

the same therapeutic regimen not provided for everyone. the main task doctor - to identify the cause as quickly as possible and begin to treat the disease.

• general or detailed blood test;
• Analysis of urine;
• coprogram;
• bacteriological culture of feces.

These methods are sufficient in most cases to eliminate physiological pathologies and detection of the bacterial pathogen. In the case when the disease was provoked by a virus, they can be carried out additional types tests (at the discretion of the doctor).

As mentioned earlier, the treatment of infectious patients should be carried out in a hospital. With a slight disorder of the stool, not representing real threat for health, home therapy is possible, but doctors usually insist on hospitalization, especially if we are talking about small children.

In case of dehydration, the patient is placed under a drip and drugs are administered intravenously.

A special place in the treatment is given to nutrition. In the early days, it is not recommended to take any food, although most patients have no appetite anyway.

If you still want to eat, then you need to give preference to crackers and rice porridge, boiled on water. From drinks only water or black tea.

As the condition improves, other foods are gradually introduced into the diet.

• bananas;
• boiled potatoes (without butter and milk);
• light vegetable soups;
• biscuit cookies;
• therapeutic mineral water (previously releasing gas).

Before recovery normal consistency stool any dairy products are prohibited. When it becomes formalized, you can gradually introduce kefir, and then everything else.

As a rule, the acute phase of the disease passes within 7-10 days. Full recovery bowel function is observed after approximately 2-4 weeks. In the presence of complications, this period may be slightly delayed.

it unpleasant disease It is easier to prevent than to cure, for this it is necessary:

• always wash hands before eating after visiting the street and contact with animals;
• avoid contact with an infected person;
• timely conduct antihelminthic therapy for your pet;
• do not eat food that has expired and in violation of the conditions of its storage;
• do not visit suspicious places of public catering;
• keep an eye on your young children, who constantly strive to shove picked up garbage or dirty hands into the mouth.

According to statistics, it is children who most often suffer from this disease.

Thanks to the diversity pharmaceuticals in the pharmacy, many carry out treatment on their own. However, it should be remembered that the rapid deterioration of well-being, which provokes infectious diarrhea, can lead to death.

Diarrhea is loose, watery stools frequent urges, accompanied by painful sensations in the abdomen, sometimes vomiting, elevated temperature. Infectious diarrhea in adults (ICD code: A09) is caused either by viruses or bacterial (microbial) pathogens.

fall bacterial pathogens(salmonella, staphylococci, E. coli, etc.) most often through poorly cleaned drinking water, poor quality food, dirty hands. But viral ones can be infected by airborne droplets, like SARS. The risk of contracting viral diarrhea often depends on the person's age and immune status.

The course, nature and treatment of infectious viral diarrhea in adults directly depends on the definition of the etiology (origin) of a microbial or viral pathogen. It is possible to detect a specific pathogen only in laboratory conditions.

Viral

Diarrhea of ​​viral origin manifests itself in different variations, but medicine classifies three main groups.

Accurate diagnosis in modern medicine carried out clinically by fecal analysis or by immunological examination. Viral diarrhea mostly do not require treatment, except for the prevention of dehydration, replenishment of the water and electrolyte balance of the body with frequent diarrhea and vomiting.

Bacterial origin

Many bacteria, germs can cause diarrhea bacterial nature. Some types of bacterial diarrhea are longer, more difficult, more acute than viral. Bacterial has a longer incubation period, it lasts from 8-10 hours (staphylococci, salmonella) to 10 days.

Infectionists identify the most common pathogenic bacteria in the following classification:

1. Food poisoning (enterotoxicogens) causing "traveler's diarrhea". Sources - food, milk, water.
2. Staphylococcus is a dangerous bacterium that multiplies quickly and is infectious. Source - stale foods, thermally insufficiently processed food.
3. Bacillus is a bacterium living in rice, often found in China, Southeast Asia.
4. Clostridia. The source of infection is meat products.
5. Cholera - enters the intestines from water, food, most often in Asia and Africa.
6. Shigella - can cause severe disorders, up to dysentery.
7. Campylobacter. The source is raw milk. The disease is accompanied by vomiting, diarrhea, fever, in some cases up to 4 weeks.
8. Salmonella. Source - food of animal origin, insufficiently thermally processed.
9. Chlamydia, mycobacteria, gonococci, Yersinia and others.

Non-infectious is caused by a violation of eating habits, taking medications, a large amount of fluid drunk (5-6 liters), eating foods high in fiber, allergic manifestation diarrhea.

Disease symptoms

General symptoms of infectious diarrhea of ​​bacterial and viral origin the same:

• increase in body temperature;
• intoxication of the body, deterioration general condition, weakness;
• loose stools with frequent, sometimes false urges;
• dehydration, with the appearance of cyanosis, pallor of the skin;
• pain, cramps in the abdomen;
• headache, pain in muscles, joints;
• vomiting, nausea;
• with acute bacterial infections there may be impurities of blood, pus in the feces.

May be asymptomatic rotavirus infection in 30-40% of cases among adults and children. The chair with rotavirus has a light color. There may not be diarrhea (about 40% of cases), but only vomiting, nausea can be observed in case of an illness caused by the Norfolk virus.

Abundantly vilify with watery stools, you can experience vomiting with bacterial diarrhea caused by shigella, salmonella (with salmonellosis green stools), cholera, rotavirus. Nausea, vomiting, severe fever can be with staphylococcus aureus, gonococcus, caliciviruses. Cytomegalovirus usually infects people with AIDS, except for diarrhea, it is manifested by an increase lymph nodes(not to be confused with mononucleosis).

Treatment for infectious diarrhea

If symptoms appear, a doctor should be consulted. The selection of drugs and therapy is carried out after determining the pathogen that caused infectious diarrhea. If the pathogen is not identified, doctors can make a diagnosis: an intestinal infection of unknown etiology with a predominant syndrome of colitis, enteritis (diarrhea), gastritis (vomiting).

Infectious diarrhea of ​​a viral nature will not require long treatment in addition to replenishing the fluid lost by the body and taking antiviral, antipyretic drugs. But getting rid of bacterial diarrhea has to take prescribed antibiotics. Medicines, complex medical measures appointed after the research, taking into account individual characteristics patient and are reduced to the following measures:

• the appointment of a diet;
• rehydration therapy;
• adsorbent preparations;
• antiviral drugs;
• antidiarrheals;
• antibacterial drugs;
• probiotics - to restore microflora;
• in some cases, gastric lavage is prescribed with special probes and solutions.

Without waiting for the arrival of an ambulance, you can begin to be treated for dehydration with the loss of vital electrolytes with special preparations (Regidron) or ordinary non-carbonated mineral water. Liquid should be given in small portions every 10-15 minutes. In order to avoid fluid loss through sweat, the patient should be laid in a cool place, provide him with peace.

Do not eat milk, fruits, vegetables, spicy dishes until the cure.

How long does diarrhea last with an intestinal infection

Diarrhea of ​​infectious origin is one of the most common diseases after colds and respiratory diseases of the upper respiratory tract. Diarrhea caused by a viral infection accounts for about 10%.

Mild indigestion, usually resolving after 3-4 episodes of diarrhea, is easily distinguished from an acute infection, which is accompanied by a deterioration in well-being and can last from 48 hours to 10-12 days. At the same time, diarrhea lasts for everyone in different ways, but on average, its duration should not exceed 14 days. With a viral infection, diarrhea can occur from 2 to 4-5 days. At bacterial infection diarrhea lasts longer, depending on the type of bacteria that caused it.

Symptoms associated with infection intestinal disorder, at proper treatment pass on their own, do not cause complications, health threatening or chronic relapses.

It must be remembered that diarrhea is a manifestation protective function organism, with its help it is excreted pathogenic microflora, toxins, bacteria. With diarrhea that lasts 1-2 days with a gradual decrease in intensity, it is better to do nothing.

It is important to follow a diet, exclude fatty, fried, spicy food. You can take enterosorbents (activated carbon), rehydron. If the symptoms do not go away within a few days, the state of health does not improve, you will need to consult a doctor.

With relapses intestinal infection that do not go away within a few weeks, be sure to contact medical professionals. After all, we can talk about chronic diarrhea because of ulcerative colitis, malabsorption, oncological disease intestines.

Possible Complications

Doctors talk about a favorable outcome of an intestinal infection in almost 100% of cases, subject to proper treatment.

The main complication of long-term diarrhea is dehydration, especially in newborns, the elderly, and unconscious patients. Dehydration and a large loss of minerals (electrolytes) can cause following states patient:

• hypotension, orthostatic collapse weakness, dizziness when changing body position);
• renal failure;
• acidosis - an increase in the level of toxins in the blood due to a decrease in urination;
• hypokalemia, causing heart failure;
• possible irritation in the area anus, hemorrhoidal inflammation.

So, diarrhea of ​​​​infectious genesis develops according to two algorithms:

• getting into the gastrointestinal tract infection from the outside;
• an increase in the concentration of pathogens due to a violation of the normal balance of microflora.

Most often, doctors have to deal with the second case. In a healthy person, there is always a certain amount of various bacteria in the digestive tract. Conventionally, they are usually divided into useful (which contribute to the normal digestion of food) and harmful. The concentration of the latter is always at a low level due to the fact that beneficial bacteria substantially more. They simply suppress reproduction harmful microorganisms. Naturally, the balance is disturbed under certain factors. This can be as taking certain medications (for example, narrow-spectrum antibiotics), as well as a weakened immune system, or eating low-quality foods (for example, those that increase acidity). gastric juice to a critical level).

But infectious diarrhea can also develop due to the entry into the cavity of the gastrointestinal tract of those bacteria that are completely absent in a healthy person in the digestive tract. Their presence there is already a pathology. These microorganisms include E. coli, staphylococci, mold, and so on. However, the gastrointestinal tract for them is a positive environment for reproduction. How do they enter the human body? Mostly through the use of spoiled products. A similar situation will be, for example, if someone ignores the rules of hygiene and simply does not wash their hands before eating. This type diarrhea is more dangerous, as it can provoke not only diarrhea, but also other dangerous diseases. For example, a diphtheria bacillus can even be fatal if it is not detected in a timely manner. The same applies to botulism, one of the most dangerous bacteria, which can enter the body with food.

Doctors also distinguish infectious diarrhea into a separate category, in which the bacteria themselves do not enter the cavity of the digestive tract. But in the intestines, their toxins are eventually absorbed. The simplest example is an infection with the flu or a sore throat. The infection does not affect digestive tract, but the poisons that they secrete in the process of life can indeed be found in the intestines. And then the body reflexively causes diarrhea in order to get rid of toxins as soon as possible. But diarrhea, in fact, in this case is caused by an infection.

Symptoms of infectious diarrhea

In almost all cases, infectious diarrhea is accompanied by an excessively high temperature, reaching up to 40 degrees. Along with this, the patient may experience severe bouts of vomiting, including blood (this is rare). This is often supplemented muscle cramps, pallor of the skin, a sharp loss of appetite and weight. In fact, these are signs of severe poisoning, since such a reaction will also be on high concentration toxins in the gastrointestinal tract. The only difference is that very high temperature.

The patient may also have intense thirst. And even a large number of drinking water does not satisfy her. This indicates dehydration, that is, salt imbalance in the body. That is why thirst in this state can only be quenched with special solutions, like Regidron and its derivatives. In this case, it is impossible to refuse to drink in any case, so as not to provoke dehydration. In critical cases, this can be fatal. Salt solutions should be given even if the patient often has the urge to vomit.

With severe infectious diarrhea, the patient may also fall into a coma or lose consciousness. Accordingly, without medical assistance there is no way around here. It is better immediately, when the first symptoms of infectious diarrhea occur, to call an ambulance. Such diarrhea is especially dangerous for young children who have natural resistance. immune system to pathogenic bacteria is still quite weak.

First aid for infectious diarrhea

With infectious diarrhea, the main thing is to reduce the concentration of the very toxins synthesized pathogenic bacteria. Accordingly, the first thing to do is to give the patient Enterosgel or Activated charcoal (at the rate of 1 tablet per 10 kilograms of human body weight). Naturally, all this is done after calling the doctor.

At very high temperature the patient should also be given an antipyretic. It is recommended to do this only if the temperature has exceeded the threshold of 39 degrees. Up to this point, it is not worth "interfering" with the body to fight the infection. From the same coli, for example, a strong immune system can cope on its own. If you give an antipyretic at a temperature just above 37 degrees, then this will only slow down the release of immune cells.

Up to the moment when the doctors arrive, the patient should be given as much as possible to drink. Better yet, make saline solution. How to use Regidron? The contents of 1 sachet are dissolved in 1 liter of boiled chilled water. It should be taken at the rate of 10 milliliters per kilogram of human body weight per hour. That is, for a patient weighing 70 kilograms, 700 milliliters of the solution should be drunk within an hour. It should be drunk until the signs of dehydration disappear. After - the dosage is reduced to 5 milliliters per kilogram of live weight per hour. All this time, the patient's body temperature should be monitored. It is better to take measurements every 60 minutes and write down the data in a notebook - this information will then be required by doctors for a more accurate diagnosis.

In the event that the patient has vomiting, then after it the reception of Regidron is repeated. If vomiting does not stop, then without qualified assistance not enough. You just need to make sure that the patient does not choke on his own vomit, that is, put his head on his side (if he is unconscious).

Treatment in a clinic

Infectious diarrhea already in a hospital is treated initially symptomatically. The patient, as a rule, is given droppers of Rheosorbilact, Sodium Chloride, Glucose (all intravenously). This will reduce the concentration of toxins, and at the same time provide the body with energy (if the victim cannot eat on his own or he immediately has an attack of vomiting). In the future, the patient takes blood, urine and feces tests to determine the exact type of infection that provoked diarrhea. If necessary, he will also be prescribed antibiotics (intravenously, intramuscularly or orally), immunomodulators (if diarrhea develops against the background of chemotherapy, for example), vitamin complexes. All this time he also gives him as much to drink or saline solutions as possible.

How long does the treatment last? For each patient - purely individually. But the cessation liquid stool and improvement in well-being do not always indicate a complete recovery. Therapy is usually observed for at least 5-7 days from the onset of the first symptoms of infectious diarrhea. Control of his condition is carried out only by passing tests.

In the future, after discharge from the hospital, the patient is prescribed a strict diet aimed at normalizing the balance of microflora and strengthening the natural protection of the digestive tract from infection.

Diet for infectious diarrhea

Doctors recommend following a diet after treatment for at least 7 days. Its main purpose is to reduce the load on the digestive tract and restore the balance of beneficial bacteria and lactobacilli. For this purpose, probiotics may also be prescribed (for example, Bifidumbacterin in the form of a solution for oral use).

From the diet should be temporarily excluded:

• fried;
• fat meat;
• salted, peppered;
• sweet muffin;
• fatty dairy products;
• fresh vegetables and fruits;
• raisins, nuts;
• fruit or vegetable juices;
• chocolate and other sweets;
• alcohol;
• legumes.

But it will be useful different kind homemade starter cultures and yogurts, but made necessarily from low-fat pasteurized milk. Their intake is allowed only with normal fermentation of gastric juice and the absence of diseases associated with the work of the pancreas.

As for the children infancy, then for the period of treatment they are allowed to eat only mother's milk and special dairy-free formulas(hypoallergenic). Unfortunately, most of the nutrients will have to be introduced into the body through a drip. Otherwise, there is a high probability of dehydration, which is extremely dangerous for babies under one year old.

You should also include in your diet boiled vegetables and fruits, rice and buckwheat porridge, soft boiled quail eggs(to exclude the possibility of infection with salmonellosis). In order to prevent the patient can prescribe a single dose per day activated carbon at the rate of 1 tablet per 15 kilograms of live weight. This will eliminate residual intoxication, especially if broad-spectrum antibiotics have been used in the course of treatment.

In total, infectious diarrhea is the same diarrhea, but caused due to the activity of pathogens that release toxins into the cavity of the gastrointestinal tract. This is considered the most dangerous subspecies of poisoning. The main thing is to identify the infection that provoked the appearance of signs of diarrhea as soon as possible and prevent dehydration. It is imperative to seek help from a doctor. With an increase in body temperature, you should immediately call an ambulance.

Do not take loperamide for invasive diarrhea (i.e. diarrhea with blood or pus).

Despite various prohibitions and restrictions, loperamide is useful in the treatment of a number of diarrheas:

• hyperkinetic diarrhea: irritable bowel syndrome, " bear disease"(Nervous diarrhea due to stress - for example, at a wedding, etc.), but doses should be minimal,
• secretory diarrhea,
• Crohn's disease,
• in complex treatment diarrhea during chemotherapy malignant tumors etc.

In other cases, it is better to avoid loperamide or at least consult a specialist.

Loperamide is available in capsules 2 mg. The instructions recommend taking 2 capsules first, and then 1 capsule after each liquid stool. However, practice shows that in mild cases, more than 1 capsule is not required, otherwise constipation will occur for 1-3 days. The maximum permitted dose is 8 capsules per day.

Galavit for the treatment of intestinal infections

In the late 1990s, a safe and effective universal anti-inflammatory immunomodulator was created in Russia. Galavit. Among the many indications for use - treatment of any infectious diarrhea accompanied by fever and symptoms of intoxication ( weakness, headache, dizziness, nausea, vomiting, palpitations). Galavit normalizes the activity of hyperactive macrophages, reduces excess inflammatory response and speeds up recovery.

Galavit well compatible with others medicines(including with the traditional treatment of intestinal infections), is well tolerated and has a minimum side effects(rarely allergic). It is safe and allowed healthy people except for pregnancy and breastfeeding. Galavit is not recommended for children under 6 years of age, because. they did not check.

Clinical studies of Galavita with diarrhea were carried out in adults and children over 12 years of age with intramuscular injection according to the scheme: 200 mg once, then 100 mg twice a day until the relief (disappearance) of the symptoms of intoxication. However, taking pills is a more convenient and safer method of treatment.

Galavit

Dosage forms for treatment with Galavit:

• adults and children over 12 years old: 25 mg tablets, 100 mg ampoules, rectal suppositories 100 mg;
• children 6-12 years old: ampoules of 50 mg, rectal suppositories of 50 mg, there are no tablets with a "child" dose;
• children under 6 years of age: not indicated.

In acute intestinal infections, the initial dose of Galavit for adults and children over 12 years of age is 2 tab. 25 mg once, then 1 tab. 3-4 times a day until symptoms disappear intoxication within 3-5 days (but usually one day of admission is enough). Please note that Galavit tablets should be placed under the tongue (!) and kept there until completely dissolved (10-15 minutes). In children 6-12 years old, intramuscular injections or rectal suppositories are used at a dose of 50 mg.

So, with acute diarrhea no temperature and symptoms of intoxication (weakness, nausea, vomiting, headache, palpitations, etc.) RECOMMENDED (adult dosages):

1. 1 sachet per 0.5 glass of water 3 times a day in breaks (!) between meals and other medicines for 2-4 days,
2. enterol 1-2 capsules morning and evening 1 hour before meals with a small amount of liquid for 7-10 days.

For diarrhea with elevated temperature and symptoms of intoxication to the above treatment need add:

• necessarily - galavit under the tongue, 2 tablets. once, then 1 tab. 3-4 times a day until the symptoms of intoxication disappear for 3-5 days,
• optional - inside 200 mg every 6 hours for 3 days.

With large losses of fluid, it is necessary rehydration:

• or dissolve in clean water according to the instructions and drink often, but little by little. However, if the patient has repeated vomiting that does not allow him to take liquid inside, you should call an ambulance and go to the hospital.

If you are clearly something got poisoned, you feel sick, before taking medication it is desirable gastric lavage(drink 1 liter warm water, then bend over and press your fingers on the root of the tongue; then the whole procedure can be repeated). If the cause of nausea is food poisoning, after gastric lavage, you will immediately feel relief. After that, you can take the enterosorbent inside ( smecta, polyphepan, enterosgel, atoxil, polysorb).

If a after 3 days your diarrhea persists, you should consult your doctor to determine its cause. Remember that diarrhea can be a sign of quite serious and even fatal diseases(even in some forms of cancer). If a chronic diarrhea(lasts more than 3 weeks), you should immediately go to the doctor, be examined and find out the cause. It is highly desirable to remember after which it arose, this will help to choose the right treatment. For example, if after taking antibiotics, then it should be treated as dysbacteriosis.

AVOID the following drugs unnecessarily:

• Activated carbon- it is ineffective and outdated drug;
• - relieves symptoms of diarrhea, but does not cure. In the case of an intestinal infection, loperamide enhances self-poisoning of the body. It is forbidden to small children and is dangerous for infectious diarrhea. Reception of loperamide is possible only with chronic diarrhea after consulting a doctor (for example, after removal of the gallbladder, irritable bowel syndrome, etc.). At acute diarrhea accept it only in emergency situations or if you are well aware of what you are doing;
• antibiotics and antibacterial drugs- they should be taken as prescribed by a doctor, since they themselves can cause diarrhea due to dysbacteriosis. Allowed Exception - .

Diarrhea is usually treated at home. Need to see a doctor in the following cases:

• no effect of treatment for more than 3 days,
• diarrhea developed in a child under one year old or in an old (debilitated) person,
• diarrhea is accompanied by a temperature above 38 ° C (the aforementioned Galavit is highly effective in these cases),
• occurrence unclear adverse reactions for treatment ( allergic rash on the skin, irritability, sleep disturbances, yellowness of the skin and sclera, darkening of urine, etc.),
• worried about constant stomach ache,
• (!) black stool (tar type) may indicate bleeding from the upper gastrointestinal tract,
• (!) vomiting dark brown masses or with impurities of fresh blood is possible with bleeding from the stomach or esophagus,
• (!) observed impaired consciousness or severe dehydration(dry mouth, weakness, dizziness, cold skin, urine is small and dark with strong smell, wrinkled skin and sunken eyes).

In the last three cases (!) you need not just to see a doctor, but immediately call an ambulance and be prepared to send the patient to the hospital.

Prevention of acute intestinal infections

Wash everything in a row: vegetables and fruits, hands after using the toilet and before eating. Use clean water and fresh produce.

Use the refrigerator and freezer - bacteria multiply more slowly in the cold. True, there is one exception - salmonella feel great on chicken eggs in a refrigerator.

AT home first aid kit , in the country and on long trips, have (per 1 person):

• smecta (5 sachets),
• enterol (bottle of 30 capsules or more),
• galavit (plate for 10 tablets),
• rehydron or gastrolith,
• loperamide (2 capsules for emergency cases).

To prevent diarrhea when traveling or during antibiotic therapy, it is recommended to take Enterol 1-2 capsules daily in the morning during the entire trip or taking antibiotics.