Chronic diarrhea in adults: causes, treatment. Galavit for the treatment of intestinal infections. Analysis of information relevant to different types of diarrhea

Name: Diarrhea chronic

Diarrhea chronic

chronic diarrhea- systematically abundant stools, the mass of which exceeds 300 g / day, lasting more than 3 weeks.

Etiology and pathogenesis

  • Exudative diarrhea - bacterial and inflammatory diseases of the colon with damage to the epithelium, the formation of ulcers, crypt abscesses.
  • Inflammatory diseases of the colon - ulcerative colitis, Crohn's disease, ischemic colitis, radiation colitis, microscopic colitis, diverticulitis.
  • Infectious diseases - enterotoxins Shigella, Salmonella, Clostridium difficile, Ciyptosporidium, Campylobacter, Neisseria gonorrhoeae, Yersinia, Entamoeba histolytica, Lamblia intestinalis, Strongyloides stercoralis.
  • Malignant neoplasms of the intestine.
  • Ischemic bowel disease.
  • Osmotic diarrhea is the accumulation in the intestinal lumen of non-absorbable osmotically active soluble carbohydrates that undergo bacterial fermentation with the formation of volatile fatty and lactic acids.
  • Diseases associated with a lack of enzymes - primary, secondary fermentopathy: lactase deficiency, celiac disease.
  • Functional insufficiency of the stomach, pancreas, liver and biliary system.
  • Anatomical lesions of the intestine: post-resection and vascular diseases.
  • Immune diseases.
  • Drug malabsorption - mannitol, sorbitol, lactulose, pectins, anthraquinones, antimetabolites, cytostatics, bile acids.
  • Secretory diarrhea - abnormal secretion fluid into the intestine due to excessive secretion of C1 ~, malabsorption of Na +, K1.
  • Enterotoxins Vibrio cholerae, Escherichia co//, Bacillus cereus; all kinds of viruses (adenoviruses, crronaviruses, etc.).
  • Hormones (vipoma, Berner-Morrison water diarrhea, Zomshnger-Ellisos syndrome, serotonin, somatostatinoma, etc.).
  • Other causes: malabsorption bile acids, accumulation of excess fatty acids, idiopathic secretory diarrhea (hypersecretion of C1 ~), drug-induced diarrhea while taking a laxative
  • agents (bisacodyl, laxacodyl, lactulose, phenolphthalein, castor oil).
  • Motor diarrhea - diarrhea due to spastic contractions of the intestine; normalization of the stool during fasting, taking drugs that inhibit peristalsis, and the abolition of laxatives is characteristic.
  • Endocrine pathology - hyperthyroidism, medullary carcinoma thyroid gland, C-cell adenoma of the thyroid gland, carcinoid syndrome.
  • Visceral neuropathy - vagotomy, sympathectomy, diabetic neuropathy, amyloid neuropathy, scleroderma.
  • Diseases of the brain and spinal cord - tumor, syringomyelia, amyotrophic lateral sclerosis, tabes of the spinal cord.
  • Anatomical damage associated with diseases or operations on the gastrointestinal tract: dumping syndrome, short bowel syndrome, irritable bowel syndrome, systemic sclerosis.
  • Drug exposure - antacids containing MgSO4, P042 ~, cholinomimetic agents.
  • Clinical picture

  • Frequent loose stools, abdominal pain, tenesmus, sensation of rumbling, transfusion, bloating, flatulence, possible fever, weight loss.
  • Exudative diarrhea - loose stools, often with blood and pus.
  • Osmotic diarrhea - plentiful stools (polyfecalia), may contain a large number of remains of semi-digested food (steatorrhea, creatorrhea, etc.).
  • Secretory diarrhea - painless profuse watery diarrhea(more than 1 l).
  • Motor diarrhea - a moderate amount of feces (up to 500 ml / day), the presence of undigested residues in them.
  • See also Malabsorption Syndrome.
  • Laboratory research methods

  • Peripheral blood test - identifying signs of malabsorption syndrome: total protein, albumins, cholesterol, plasma electrolytes, vitamins B12> D, folic acid etc. See Malabsorption Syndrome.
  • Scatological study
  • Seeding for isolation pathogenic bacteria and antibiotic susceptibility testing. The results are positive in 40% of patients with fever and leukocytes in the feces
  • Microscopy of feces for the presence of helminths and their eggs (you will need a three-time study)
  • occult blood test
  • Sudan black staining for steatorrhea
  • Wright stain or methylene blue to detect leukocytes, indicating invasive infectious causes of diarrhea. Can be distinguished Staphylococcus aureus, Clostridium perfringens and Entamoeba histolytica without the presence of leukocytes in the feces. Irritable bowel syndromes, malabsorption, and laxative abuse also do not cause cellular elements inflammation
  • Latex agglutination test for Clostridium difficile.
  • Special research methods

  • Irrigography
  • Rectv limitoscopy (proctosigmoidoscopy)
  • Biopsy for detection pathological changes in the intestinal wall at the histological level. Differential Diagnosis
  • Differentiation of functional and organic disorders
  • Finding out the cause of diarrhea.
  • Treatment:

    Diet

  • Diet number 46. Helps inhibit peristalsis, reduce the secretion of water and electrolytes into the lumen
  • intestines; the principle of mechanical and chemical sparing. AT acute period it will be necessary to exclude products that enhance motor-evacuation and secretory function intestines
  • Elimination diets for enzyme deficiency– gluten-free, alactose, etc. Bacterial products
  • Baktisubtil nbsp; - 1 cape 2-3 r / day 1 hour before meals
  • Enterol - 1-2 caps 2-4 r / day, the course of treatment is 3-5 days. Particularly effective in diarrhea that developed later antibiotic therapy
  • Khilak for-te - 40-60 drops 3 r / day; after 2 weeks, the dose of the product is reduced to 20-30 drops 3 r / day and treatment is continued for another 2 weeks
  • Bifidumbacterin, bifikol, lactobacterin, linex, acilact, normaflor are traditionally prescribed after antibiotic therapy for 1-2 months.
  • Symptomatic remedies

  • Smecta nbsp; - 3 g (1 sachet) 3 r / day 15-20 minutes before meals in the form of a mash (the contents of the sachet are dissolved in 50 ml of water) should be taken separately from other drugs
  • Tannacomp 2 tablets 3 times a day for 5 days
  • Phytotherapy - fees medicinal herbs(eucalyptus, chamomile, alder seedlings, oak bark, cinquefoil, barberry).
  • Motor Regulators

  • Loperamide nbsp; - with acute diarrhea first 4 mg, then 2 mg after each case of loose stools (no more than 16 mg / day); when a normal stool appears and there is no act of defecation within 12 hours, the product should be stopped. precautionary measures. At severe forms infectious diarrhea, non-specific ulcerative colitis and Crohn's disease, treatment with loperamide is not indicated due to the risk of developing toxic dilatation of the intestine, intestinal obstruction, enhancing endotoxicosis
  • Octreotide 100 mcg i / c 3 r / day - with a severe form of secretory and osmotic diarrhea of ​​various origins
  • Dalargin (2 mg/day s.c., i.v.) reduces the frequency of defecation, tenesmus
  • Blockers calcium channels(verapamil, foridon) are used for months or years - after resection of the intestine or with hyperkinesia of the colon). Therapy various kinds diarrhea
  • Secretory diarrhea - cholestyramine, secretion inhibitors (octreotide)
  • Osmotic diarrhea - absorption stimulants (octreotide, foridon), anabolic hormones, digestive enzymes, complex metabolic therapy
  • Exudative diarrhea - sulfasalazine, mesalazine, glucocorticoids
  • Motor diarrhea - motility modulators: loperamide, debridat; psychotherapy, treatment of the underlying disease. Rehydration therapy is mainly indicated for acute diarrhea; in chronic it is prescribed when necessary.
  • Synonym. Chronic diarrhea See also Viral diarrhea, Malabsorption syndrome ICD-10
  • A09 Diarrhea and gastroenteritis of suspected infectious origin
  • K52.9 Noninfectious gastroenteritis and colitis, unspecified
  • Note. Drugs that cause diarrhea: laxatives; antacids containing magnesium salts; antibiotics (clindamycin, lincomycin, ampicillin, cephalosporins), antiarrhythmic drugs (quinidine, anaprilin), digitalis products, drugs containing potassium salts, artificial sugar (sorbitol, mannitol), chenodeoxycholic acid, cholestyramine. sulfasalazine, anticoagulants.

    Who doesn't know from TV commercials what to do when adult diarrhea occurs? Drink a "magic" pill that will instantly stop diarrhea! However, any doctor will tell you what "treatment" is in best case will not help, and in the worst case, it will hurt. Firstly, drugs for diarrhea do not act instantly, they only reduce, and secondly, the use of such drugs is contraindicated in a number of diseases. What to do when tormented by loose stools?

    Diarrhea is not a disease, but a symptom that indicates problems in the gastrointestinal tract or in the body as a whole. Therefore, it is impossible to cure diarrhea without knowing what causes it. Diarrhea is the discharge of liquid stools both once and with an increased frequency of bowel movements. If such a violation passes in 2-3 weeks, we are talking about acute diarrhea, more than 21 days - chronic.

    AT normal condition the body of a healthy adult excretes 100-300 g of formed feces daily or at other intervals that are comfortable for a particular gastrointestinal tract. Liquefaction and accelerated evacuation of the stool occur due to sharp increase water content: with diarrhea, feces are 90% liquid. The amount of feces suggests the etiology of diarrhea:

    • violations of intestinal motility usually do not increase the daily volume of feces, it is excreted often, but in small portions;
    • if the problem is in the absorption of substances by the intestinal wall, there is a significant increase in the volume of feces due to the mass of undigested food.

    The main causes of loose stools in adults:

    Such diarrhea usually resolves in 3-4 days, and the sick person is likely to be able to associate the onset of diarrhea with previous events.

    However, the causes of diarrhea in an adult can be more serious:

    • infection with bacteria, viruses, protozoa (dysentery, salmonellosis, intestinal flu);
    • inflammatory diseases of the digestive system (gastritis, hepatitis, ulcers);
    • functional insufficiency of organs (deficiency of certain enzymes);
    • gastrointestinal diseases unclear etiology(Crohn's disease);
    • toxic damage (poisoning with lead, mercury).

    In such cases, it is not enough to simply stop the diarrhea: a diagnosis must be established and qualified treatment should be carried out, often in stationary conditions. Concerning clinical manifestations diarrhea, they can be mild. This applies to ordinary indigestion, when, in addition to loose stools, spastic abdominal pain and dyspeptic symptoms (seething, bloating,) can be observed.

    When food poisoning pains are accompanied by weakness, fever, nausea and vomiting, refusal to eat, the temperature may rise. Similar signs are accompanied by intestinal infections and viral diseases.

    Warning signs that require an immediate response are symptoms of dehydration. Dry skin and mucous membranes, chapped lips, intense thirst, infrequent urination, darkening of urine occurs with debilitating diarrhea, and this condition is of great danger: the pulse increases, arterial pressure falls, muscle cramps may begin.

    What to do with diarrhea in an adult - first aid

    To prevent dehydration, water and salt lost by the body must be compensated. plentiful drink: it is best to take rehydrating solutions (Regidron and analogues), in their absence, you can drink saline, salted water, chamomile tea. Prevention of dehydration should be started as soon as it becomes clear that loose stools are not an isolated case.

    Especially if the diarrhea is profuse and persistent, has been going on for several days, accompanied by vomiting. It is necessary to pay attention to the presence of blood in the feces. It can appear with dysentery, ulcerative colitis,.

    Depending on the established diagnosis, the doctor will select specific treatment, but there are general rules that are prescribed to be observed in any case of diarrhea. it diet food, taking adsorbing drugs, enzymes.

    Diet for diarrhea in adults

    The nature of the diet obviously affects bowel movements. Many products provide irritant effect on peristalsis, and with diarrhea you need to forget about them until complete recovery. These are the spices raw vegetables, plums and other laxatives.

    Some foods have a fixing effect, so in the first few days of the diet, you need to limit yourself to the following set of dishes:

    • wheat bread croutons;
    • vegetable purees;
    • mucous porridges;
    • pureed meat and fish of lean varieties (steam, boiled);
    • tea, blueberry jelly, decoction of bird cherry fruits, rice broth.

    You can start the diet from a "hungry" day: drink only strong sweet tea (8-10 cups during the day).

    If diarrhea is caused by lactose, gluten intolerance, then diet is the main, and often the only, factor in treatment. For these diseases, medical nutrition, completely excluding products containing milk sugar and cereal protein gluten.

    The diet is important: you need to eat often (every 3 hours) and in small portions.

    The diet must be followed throughout the treatment and beyond, but after the first "hard" days, you can remove the restrictions and expand the diet, adhering to the following principles:

    Thus, we list the products under the ban:

    • any fried meat;
    • offal;
    • saturated broths;
    • fatty fish cooked in any way, and lean if it is fried, canned, smoked;
    • milk, high-fat cream;
    • scrambled eggs, hard-boiled eggs;
    • cabbage in any form, beets, spicy root vegetables, turnips, radishes, cucumbers;
    • canned vegetables;
    • mushrooms;
    • sour berries and fruits;
    • pastries and bread;
    • carbonated drinks, kvass, cold drinks.

    What then can you eat with diarrhea in adults? Here sample list dishes from which it is recommended to make a dietary menu:

    • steam cutlets from minced meat, meat puree (can be from "children's" jars), soufflé;
    • boiled fish (such as pollock, cod), fish meatballs, steamed cutlets;
    • cereals boiled in water, you can add a little milk, a piece of butter to the finished porridge;
    • rice pudding;
    • puree soups on vegetable or weak meat broth;
    • boiled pasta;
    • fermented milk drinks;
    • fresh cottage cheese;
    • omelet, soft-boiled eggs;
    • boiled, baked or mashed vegetables: potatoes, pumpkin, zucchini, green beans;
    • baked fruits, in compote, a little fresh berries strawberries;
    • jelly and mousses from berries and fruits;
    • croutons from white bread, drying, biscuits like "Maria";
    • water, tea, compote, cocoa without milk.

    In addition to diet, it is important to organize the right drinking regimen. The fluid entering the body should be several liters in volume in order to fully compensate for the loss of water with diarrhea.

    Since trace elements are washed out with loose stools, plain water is not very suitable for drinking. It is better to take glucose-salt drinks, which will replenish the loss of electrolytes, maintain normal level sugar in the blood, besides salt contributes to fluid retention in the body.

    There are special preparations for the preparation of rehydrating drinks, these are Regidron, Citroglucosolan, Gastrolit, but in their absence, you can prepare the liquid with your own hands by diluting it in a liter of water:

    Instead of potassium chloride, you can pour a decoction of dried apricots, freshly squeezed orange juice into the solution. You need to drink in small portions, but constantly throughout the day.

    Medications to treat diarrhea in an adult

    As important advice It should be noted that diarrhea in an adult that has not passed in 3 days is a reason to see a doctor. Chronic diarrhea may indicate the presence serious illnesses, it happens even in some forms of cancer.

    It is also worth seeing a doctor if the temperature during diarrhea rises above 38, signs uncharacteristic of indigestion or poisoning appear: rash, jaundice skin and eyes, discharge of dark urine, sleep disturbances. Constant excruciating pain in the abdomen should not be the norm (spastic pain before and during defecation is acceptable).

    Black or green diarrhea, vomiting mixed with fresh or clotted (dark) blood, fainting, signs of severe dehydration indicate the criticality of the situation: it is urgent to call an ambulance.

    Persistent diarrhea or diarrhea in an adult can be a symptom of a number of diseases. But even at healthy person periodically observed signs of indigestion. Causes of disorders in the body can be different kind infections and chronic diseases. Timely diagnosis will allow to identify the disease at an early stage and prescribe appropriate treatment.

      Show all

      Causes of Diarrhea

      In an adult, diarrhea is accompanied by an increase in the volume of stools and a change in their consistency. The feces become thinner as the intestines move them along with large quantity water. The reasons for this phenomenon can be quite varied.

      Intestinal infections are accompanied by other symptoms of intoxication, including fever, sometimes even fever or chills, body aches, and nausea. Such attacks can last quite a long time.

      chronic diarrhea

      Chronic diarrhea usually has non-infectious nature.In this case, the causes of diarrhea may be:

      1. 1. Some food due to its chemical composition. Frequent diarrhea provoked by too fatty or spicy foods in the diet, drinking a lot of coffee. Chronic diarrhea can be caused by chronic consumption of foods containing sorbitol or fructose.
      2. 2. Taking certain medications, including antibiotics. Antibacterial drugs kill not only pathogenic bacteria. They destroy and beneficial microflora intestines. a lack of beneficial bacteria leads to the fact that their place is taken by other microorganisms. Mainly pathogenic bacteria, less often conditionally pathogenic microflora like Candida. In any case, their vital activity causes loose stools. This is a rather difficult case of diarrhea as other antibiotics or antifungals sold by prescription. It should be remembered that the cause of diarrhea can be medicines that have a laxative effect. Therefore, before taking the medicine, you need to carefully study the instructions and find out the possibility of adverse reactions.
      3. 3. Various diseases. Diarrhea can be caused by irritable bowel syndrome (IBS), celiac disease, lactose intolerance, gastritis, colitis, peptic ulcer.
      4. 4. Postoperative condition (after operations on gallbladder, intestines, stomach, liposuction procedures).
      5. 5. Emotional stress and anxiety.

      Gastroenteritis

      Gastroenteritis is inflammatory disease associated with indigestion. It can be both infectious and non-infectious in nature. In children, it is more often associated with a bacterial infection, in adults it develops for other reasons. Long-term use of non-steroidal anti-inflammatory drugs can provoke gastroenteritis. This disease is accompanied by lactose intolerance or celiac disease. Gastroenteritis often accompanies diseases of the gastrointestinal tract (Crohn's disease).

      In addition to diarrhea, symptoms of gastroenteritis include lack of appetite, muscle pain, fatigue. At infectious form fever is possible, traces of blood are present in the feces. At noncommunicable disease there are pains in the abdomen. With constant non-observance of hygiene rules bacterial form easily goes into chronic diarrhea.

      Gastroenteritis is a disease that is dangerous for its complications, as it leads to the development of disorders such as reactive arthritis, kidney failure a decrease in the level of platelets in the blood.

      Gastroenteritis itself does not require special treatment. All efforts are aimed at eliminating its cause. But the presence of diarrhea requires additional measures, which are to restore the water balance.

      celiac disease

      An upset stomach can be caused by a disease such as celiac disease. It is genetically determined and consists in the formation of reversible atrophic enteropathy under the influence of gluten. This compound is a component of the protein found in wheat. In healthy people, gluten is digested normally, but in celiac disease it is toxic.

      Symptoms of celiac disease appear after eating foods containing gluten - bread, pastries, pasta. Gluten attacks the immune system, resulting in disruption of the intestines. This disease develops in childhood. Sometimes symptoms only appear in adulthood. It can be caused by intestinal or respiratory infection. It may be that in childhood these signs are mild, but with age they gradually appear.

      In addition to diarrhea, symptoms of celiac disease include flatulence and bloating, weight loss, feeling chronic fatigue, weakness. The stool during the disease is liquid, but there are no traces of blood in it, unlike many other intestinal diseases.

      Celiac disease masquerades as other diseases - pancreatitis, dyspepsia, irritable bowel syndrome. But in the case of celiac disease, the symptoms appear only after eating certain foods. In such a situation, it is better to consult a doctor who will prescribe additional examinations - x-rays, fecal analysis, bone density tests, since celiac disease is often accompanied by osteoporosis.

      Treatment of this disease begins with diet. Do not eat foods that contain gluten, such as bread, rolls, crackers, confectionery products based on wheat, barley or rye. For the same reason, you can not drink beer. In case of lactose intolerance, as in the period of exacerbation of the disease, the use of cow's milk is not recommended. After the restoration of bowel function, you can return to fermented milk products again.

      Irritable bowel syndrome (IBS) and its features

      IBS is one of the most common gastrointestinal diseases. Its main symptoms are diarrhea, bloating, pain and cramps. This disease is long-term. It is often provoked by severe stress. Causes of malfunctions in the body this moment not defined.

      With IBS physical activity digestive tract does not match physiological norms. It has not yet been established under the influence of what substances this occurs. There is a theory that the disease is influenced by hormones, taking antibacterial drugs and not proper nutrition.

      IBS is not always accompanied by diarrhea, sometimes the disease is associated with constipation. And it manifests itself in each person individually.

      Only a doctor can diagnose IBS based on a full examination. Under this syndrome, much more dangerous diseases can be hidden, up to oncology.

      If diarrhea continues for more than three days in a row, and traces of blood appear in the feces, you need to see a doctor as soon as possible.

      Treatment of diarrhea

      Treatment mainly depends on the disease causing the diarrhea. But in any case, with diarrhea, a person loses a significant amount of fluid, so you need to restore water balance. For this, apply special means- solutions for rehydration with the content of substances that contribute to the retention of fluid in the body and replace the electrolytes lost by the body.

      The solution for rehydration can be prepared independently. To do this, dissolve a pinch of sugar or salt in a glass of warm boiled water. Such a solution should be drunk every 15 minutes, no more than 100 ml at a time, slowly and in small sips. If you drink this amount in one gulp, you can induce vomiting.

      If diarrhea is caused by an infectious disease that has passed into chronic form, then they take special drugs, the action of which is aimed at removing toxins from the intestines. At bacterial infection take antibiotics as prescribed by the doctor. Pre-conducted full examination and bakposev to choose the right drug, taking into account the resistance of microorganisms.

      If diarrhea is of an infectious nature, then you need to take drugs that slow down intestinal motility with caution. They delay the stay of microbes and toxins in the body, because diarrhea is a reaction to an infection, it allows the body to cleanse the intestines faster.

      In the treatment of diarrhea important role plays proper nutrition. Complete fasting is not only impractical, but can also be harmful.

      For some diseases, the diet should be followed for a long time. There are so-called treatment tables - diets designed specifically for patients with impaired functions of the gastrointestinal tract or liver. The choice of the type of diet depends on the specific disease, the diet is prescribed by the attending physician.

      Most diets provide for a sparing diet with an exception to the diet fatty varieties meat and fish, smoked meats, spicy dishes, refractory fats. With diarrhea, you can not eat peaches, plums, grapes, apricots - they have a laxative effect.

    One of the most unpleasant, debilitating ailments is chronic diarrhea. This is a pathology in which a liquefied, unformed stool leaves the patient for several months. Acts of defecation occur more than three times a day. They are accompanied by a weakened state, rumbling in the abdomen and intestinal sections, pain in the stomach, bloating, false calls to defecation, dehydration of the body and the appearance of pathological impurities in the stool.

    Why is this condition possible, and how can chronic diarrhea be cured? There are several reasons for this disease. As for treatment, it should be medical, combined with dietary measures.

    Diarrhea, as a synonym for diarrhea, is a phenomenon known to everyone. But diarrhea in and of itself is not a disease. Therefore, when patients try to treat it, especially without the participation of a doctor, by their own means, it can turn into chronic diarrhea and become a symptom of one or more dangerous diseases.

    Important! It is impossible to cure diarrhea, and even more so chronic diarrhea, without diagnosing the disease or finding other pathologies that caused it.

    The generally accepted definition of diarrhea is the outcome of loose stools an increased number of times. The body of a healthy person excretes from 100 to 300 g of normally formed feces per day. The frequency can be any, it is different for each organism, but usually it is once, maximum twice a day. If the fecal masses are evacuated more rapidly, but their consistency is within the normal range, we can talk about increased peristalsis intestines, which may occur as a result of the use of certain products that contribute to this. This does not apply to manifestations of diarrhea.

    Loose stools can occur for the following non-pathological reasons:

    • indigestion, which usually occurs after overeating and an abundance of poorly digested foods;
    • food poisoning of the first and medium degree;
    • an allergic manifestation to the use of an allergen product;
    • taking laxatives;
    • the use of synthesized sweeteners;
    • stress;
    • travel and climate change.

    Everyone has experienced diarrhea at least once in their lives for one of these reasons. It rarely lasts more than three or four days, in the most serious cases- a week. According to the official medical definition, such diarrhea cannot be considered chronic.

    More serious sources of diarrhea include:

    • viral infection;
    • toxic poisoning;
    • intestinal inflammation;
    • enzyme deficiency;
    • diseases of the gastrointestinal tract.

    Here, the manifestations of diarrhea can last much longer, be accompanied by other symptoms, and we are often talking about chronic nature diseases.

    Origin mechanism

    Diarrhea is not one, but a complex of symptoms that is characteristic of the following pathological conditions of the body.

    1. Infectious bowel disease.
    2. Non-infectious lesion of the intestine.
    3. Diseases of the digestive tract with damage to its upper sections.
    4. chronic intoxication.
    5. Psycho-emotional pathologies.
    6. Diseases of other (non-digestive) organs.

    Causes

    Since the list of causes is quite extensive, there are four groups of mechanisms for the development of this disease:

    • hyperkinetic;
    • hypersecretory;
    • hyperexudative;
    • hyperosmotic.

    Table. Classification of diarrhea according to the mechanisms of development.

    Movement typeDescription

    It is formed in the process of increased stimulation of the intestinal walls, in which its motor activity increases. It can occur both at a neurogenic level (diabetes, irritable bowel), and under the influence of hormones (Addison's disease) or drug stimulation. The latter case is the most common, since many patients abuse laxatives, taking them without a doctor's prescription and in high dosages.

    AT this case increased secretion of electrolytes and fluids into the intestinal lumen. The process can take place passively (with lymphoma or Whipple's disease), or actively (the presence of coli or staphylococcal infection).

    Also, the disease is caused by some of the laxatives and hormonal drugs.

    Occurs after inflammation of the intestinal wall, which is characterized by an increased dose of exudate injection into the intestinal lumen.

    It is noted in a number of inflammatory processes of the intestine. May also accompany chronic infections(intestinal tuberculosis), ischemic lesion, polyps and oncological formations.

    The reason for the development is a digestive disorder and a violation of the absorption process in the gastrointestinal tract.

    Provocateurs: fistula, pancreatitis, anastomosis, pancreatic tumor, malabsorption syndrome.






    The initial sources of chronic diarrhea are the above factors, both individually and in combination.

    In addition, the disease can lead to diseases such as:

    • polyposis;
    • functional diarrhea;
    • intestinal amyloidosis;
    • colorectal cancer;
    • helminthiasis;
    • carcinoid syndrome;
    • intestinal lipodystrophy;
    • uremia;
    • syphilis.

    Symptomatic manifestations

    As already noted, the main signs are liquefied stools and an increase in defecation episodes. But how to differentiate ordinary diarrhea and chronic if the two main symptoms are the same? Medical experts do not have a unanimous opinion on this matter.

    By the way. Someone puts chronic diagnosis based symptomatic manifestations lasting from three weeks. Someone recognizes chronic stage disease only if the symptoms last six weeks or more.

    Be that as it may, the main signs of this pathology are as follows.

    1. More than three episodes of bowel movements per day.
    2. The stool is unformed or insufficiently formed.
    3. The consistency of the stool is viscous, mushy or liquid, watery.
    4. Continuation given state unchanged for at least three weeks.
    5. Associated pain.
    6. False urge to defecate.
    7. Increased flatulence.
    8. Rumbling in the abdomen and throughout the intestines.
    9. Foreign matter in the stool (pus, fat, mucus, blood, water).
    10. Reducing the amount of stool.

    For pathological conditions small intestine fatty impurities in a watery stool are characteristic, without a pronounced pain syndrome.

    Esl and pathology in the large intestine upper divisions) , in the feces there is mucus and pus, occasionally blood. In addition, this type of disease almost always has an accompanying pain syndrome.

    With pathology in lower sections colon stools are minimal in volume, bowel movements more than three times a day, the patient experiences false bowel movements.

    If diarrhea accompanies colorectal cancer, diarrhea is accompanied by a feeling of fatigue, loss of appetite, weight, intestinal blockage and perforation of the intestines.

    At intestinal inflammation diarrhea is accompanied by pyrexia and extraintestinal symptoms such as stomatitis.

    If chronic diarrhea occurs due to endocrine disorders disrupted hormonal regulation.

    Diagnostics

    Since this disease is not independent, the main diagnostic measures aimed at identifying the causes of its occurrence. What disease or pathology lies behind the diarrhea that lasts for weeks? To clarify this issue, medicine has the following tools.


    Irrigoscopy prescribed for suspected polyposis or cancer.

    Colonoscopy allows you to assess the integrity of the intestinal walls and determine, in the presence of ulcers, their number, size and localization.

    Sigmoidoscopy will show the presence of polyps and help identify tumors.

    During the endoscopy procedure, a biopsy may be taken in parallel.

    How is chronic diarrhea treated?

    After a thorough examination of the patient, the doctor draws up a treatment plan, which can be of two types.


    Sorbents

    One of important points in the treatment of chronic diarrhea, since throughout the entire period of therapy it is necessary to remove toxins and bacteria from the patient's body, as well as to remove gas formation.

    Advice. When prescribing these drugs, doctors warn that they should not be combined with other drugs. What does this mean? Take them separately, at least two hours before or two hours after taking other drugs, otherwise their absorption will be impaired.

    Enterosorbents are not prescribed for diarrhea in only one case, when the process of absorption in the intestine is impaired. So that they are not excreted from the body along with toxins nutrients, sorbents are not accepted.

    The choice of drugs in this group is great. The following drugs are most often prescribed:


    Antidiarrheals

    Their choice depends on the cause of the diarrhea and the underlying disease. Stop diarrhea by reducing peristalsis, the following drugs:


    Intestinal anti-inflammatory

    With intestinal infections, it is necessary to remove inflammation, so the patient is prescribed antiseptics that act in all parts of the intestine, but are not absorbed into the blood. These are drugs such as:


    Probiotics

    This group is mandatory and indispensable in the treatment of diarrhea of ​​any etiology. This disease is completely out of balance. intestinal microflora, and probiotic preparations are best suited for its restoration.

    The probiotic group includes:


    Phytopreparations

    Help to reduce intestinal secretion, normalize peristalsis. They include natural herbal ingredients with astringent properties.

    These plants include:

    • bird cherry (berries);
    • oak (bark);
    • cinquefoil (root);
    • alder (cones);
    • chamomile (flowers).


    It is best to purchase this herbal raw material in a pharmacy, or use ready-made multicomponent fees.

    Diet and drinking regimen

    If diarrhea occurs, without waiting until the disease becomes chronic, rehydration therapy is necessary. It should be started immediately, at the first sign of diarrhea. It is very easy to do this, any patient can make up for the loss of fluid by the body on their own. However, this simple action is often underestimated by patients, and they still become severely dehydrated until they decide to see a doctor for diarrhea.

    What to drink with diarrhea

    It is important to immediately organize a drinking regimen that will not allow dehydration. The fluid should be ingested in a volume of at least two liters per day, while drinking should be of such a nature that the fluids in the body are retained, and not excreted along with diarrhea. plain water in this case - not the most suitable option. You need to drink solutions that will maintain balance and normalize water-salt metabolism.

    You will have to drink a lot throughout the course of diarrhea treatment, until the symptoms disappear. You need to take a drink often, but in small portions and sips.

    What to eat for diarrhea

    With diarrhea, and especially its chronic forms, it is necessary to observe a special diet. The composition of food affects the quality and quantity of feces, and the rate of bowel movement. Therefore, supporting nutrition can correct and enhance the effect of medications taken.

    First of all, you need to remove the following from the menu.

    1. Seasonings and spices.
    2. Raw vegetables.
    3. Raw fruits.
    4. Spicy, sour and salty foods.
    5. Fatty foods.
    6. Products containing coarse fiber.

    Grocery list, prohibited for diarrhea until it is completely cured, looks like that:

    • prunes, dried apricots, figs and other dried fruits;

    • tomatoes, carrots, cabbage, beets, cucumbers;
    • milk and cream, fat sour cream;
    • grapes and grape juice;

    • turnip and radish;
    • black bread;
    • cranberries and apples;

    • fried meat and fatty meat cooked in any way;
    • concentrated meat broth;
    • offal;

    • fried fish and fatty fish cooked in any way;
    • canned food;
    • smoking;

    • mushrooms;
    • hard boiled eggs and fried eggs;
    • sour fruits and berries;

    • any pastries;
    • drinks carbonated, alcoholic and kvass.

    The list is quite impressive, and at first glance it may seem that a patient with chronic diarrhea will have to sit on breadcrumbs and water for several months. This is not so, since the list of allowed products is also not small.

    For chronic diarrhea are allowed:


    On the first day, it is recommended to drink only tea with sugar and a small amount of crackers. Then gradually introduce permitted food, but make sure that it is taken in minimal portions (up to 200 g) every three hours. Thus, a patient on an antidiarrheal diet should eat at least five times a day. Do not forget about maintaining a drinking regimen.

    After a week, the strict conditions of the diet can be softened and introduced:

    • pasta;
    • soups on meat, fish and vegetable broth;
    • milk and butter;
    • cottage cheese and low-fat cheeses;
    • fresh fruits and berries;
    • beans and cocoa.

    Chronic diarrhea is not easily treated. But the disease is a logical continuation of the usual diarrhea, which is easier to cure. If you self-medicate and do not see a doctor, waiting for diarrhea to become chronic, you can miss the onset of many serious diseases. Do not wait for the emergence of a critical situation and the transition of diarrhea into a chronic form. If you are prone to diarrhea and indigestion, follow food regimen, take preventive measures, and with loose stools lasting more than three days, go to the doctor for a full examination.

    Video - Frequent (chronic) diarrhea

    Many people are familiar with the condition of diarrhea, but if it lasts for about a month, and bowel movements occur more than 2 times a day, then this is chronic diarrhea. This is considered serious violation body work that requires treatment. This disease can be classified as infectious or non-infectious.

    If chronic diarrhea is not caused by an infection, then possible cause there may be a pathology or deficiency of pancreatic enzymes. Diarrhea may occur after long-term use of antibiotics or laxatives. Thyroid disease or inflammation of the colon lining can also cause chronic diarrhea.

    If a person eats daily soy protein or natural cow's milk, then this can also cause prolonged diarrhea. The reason may be an allergy to certain foods or medications. Diarrhea may be due to various diseases immune system a person or after an operation that was performed on the abdominal cavity.

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    Treatment of chronic diarrhea

    With prolonged diarrhea, you should urgently seek advice from a doctor, he will conduct a complete examination, identify the causes of the disease and prescribe the appropriate treatment. In order for the diagnosis to be made correctly, it is necessary to carefully examine the feces and blood of the patient. If necessary, an endoscopy is prescribed, which will allow analysis gastrointestinal tract from within.

    If the disease is caused by an infection, then for treatment, the doctor prescribes antibiotics and therapy to support the body. In other cases, treatment will be longer and aimed primarily at eliminating those diseases that could cause diarrhea.

    When diarrhea occurs, the patient can take 10 tablets to relieve the condition. activated carbon, calcium gluconate or carbonate. These medications will help make the stool thicker. If, you can take Smecta powder up to 4 times a day. A sachet of the drug is dissolved in 50 ml of water and the solution is drunk half an hour before a meal.

    In some cases, the doctor may prescribe sorbents to help retain fluid in the intestines, while the stool becomes steeper. In the pharmacy you can buy Diasorb, Donnagel or Reaban, they are attached detailed instructions by the reception, which must be strictly observed.

    You can take Imodium, this drug helps to relax the muscles and remove the contents of the gastrointestinal tract from the body. At the same time, there will be a decrease pain that occur in the patient due to spasms. These drugs are for adults only and should not be taken by children under 2 years of age.

    In any case, dehydration of the body should not be allowed, the patient should drink as much liquid as possible, preferably it should be clean or boiled water. Particular attention is paid to the diet, nutrition should be balanced. At the time of treatment, you will have to stop drinking coffee and sugary drinks. It is strictly forbidden to use during this period alcoholic drinks and smoke.

    Be sure to follow the rules of personal hygiene, hands should be thoroughly washed with soap and water after each visit to the toilet and before each preparation of food. Handle food well and keep all utensils clean.

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    Treatment with folk remedies

    There are several recipes that will help stop long-term diarrhea. For example, an adult can be cured with walnut tincture. To do this, you need to take partitions, which are extracted from 300 g of fruit. They are poured with 20 ml of alcohol and infused for 5 days in a dark place. You need to take 15 drops, adding them to the water, you need to drink 3 times a day before each meal. When the patient feels better, he should stop taking this tincture.

    Another recipe helps well, for its preparation you need to take 2 tbsp. l. oak bark and 1 tbsp. l. blackberry leaves and nettle. The mixture should be poured with 500 ml of boiling water and insisted for about 2 hours. Drink the infusion should be 100 g, before each meal.

    Reception helps rice water, which is prepared from 100 g of rice. Grains are poured into 1.5 liters of water and boiled for about 1.5 hours. Then the broth is cooled and filtered. Take it 100 g up to 4 times a day instead of meals. You can prepare a starch solution, for this you can take both potato and corn starch. To do this, dissolve 1 tsp in 100 ml of water. product and take up to 3 times a day between meals.

    You can take 1 tbsp. l. dry blueberries, pour them with 0.5 liters of water. The container is put on fire and boiled over low heat until the volume of liquid decreases by 2 times. Then the broth must be filtered, drink it warm, 50 ml about 4 times a day before meals.

    Well helps to cope with chronic diarrhea infusion of pomegranate peels. To prepare it, it is necessary to peel one fruit, the crusts are poured with 2 liters of boiling water, wrapped in a blanket and infused for about an hour. The entire infusion should be drunk during the day, taking it alternately with fresh juice pomegranate, diluted in water in a ratio of 1:2.

    Chronic diarrhea gives a person great discomfort, with this disease, the normal rhythm of life is disrupted.

    But you can not be ashamed of this ailment, at the first manifestations of it, you should seek help from a doctor.

    This will help you recover faster. normal stool and avoid possible serious complications.

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