Treatment of infectious gastroenteritis. Gastroenteritis in adults: symptoms and treatment. How the disease manifests itself

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Gastroenteritis a disease characterized by inflammation of the gastric mucosa and small intestine. The disease is manifested by pain in the abdomen, nausea, vomiting, frequent loose stools. These phenomena may be accompanied by fever, weakness and muscle pain.

Causes of gastroenteritis. The development of gastroenteritis is associated with various factors: bacteria, viruses (intestinal or stomach flu), protozoa, aggressive chemicals or allergens in food. However, in most cases, gastroenteritis is infectious disease. The patient is a danger to others and must be isolated.

The prevalence of gastroenteritis. Gastroenteritis is one of the most common diseases. In terms of incidence, it is second only to SARS and influenza. It is believed that 20% of people annually suffer gastroenteritis of varying severity. This is especially true for susceptible categories - children of early and preschool age, pregnant women and the elderly. The disease is particularly prevalent in countries with low levels of development, where good hygiene is practiced and people do not have access to quality products and drinking water.

Outbreaks of gastroenteritis occur at any time of the year. In the summer, bacterial forms predominate, and in the cold season, viral ones (adenoviral gastroenteritis).

Why is gastroenteritis dangerous? Acute infectious gastroenteritis is life-threatening due to the risk of dehydration. Chronic gastroenteritis in severe cases is the reason for the transfer to disability. It happens that gastroenteritis is not an independent disease, but a syndrome that occurs with dangerous intestinal infections - cholera, dysentery, salmonellosis.

Anatomy of the stomach and small intestine

The stomach is a sac-like expansion in which food accumulates. In the stomach, it is processed by acidic gastric juice and acquires a liquid consistency. This is where it happens initial stage digestion.

The wall of the stomach consists of three layers:

• mucous membrane has three layers:
  • columnar glandular epithelium lines the inner surface of the stomach;
  • own plate is represented by a loose fibrous tissue located between the glands;
  • The glands of the stomach produce components of gastric juice. Types of glands: cardiac, fundic, pyloric, as well as mucous and endocrine cells.
• Muscular membrane , which ensures the mixing of food masses with gastric juice and the promotion of its contents into the intestines.
• Serous membrane performing a protective function.

The small intestine consists of three sections:

• duodenum;
• jejunum;
• ileum.

• mucous membrane , lining the inner surface, is covered with villi and has a folded surface. Its components:
  • circular folds - transverse folds on the surface of the mucosa;
  • intestinal villi - finger-shaped outgrowths of the mucous membrane;
  • intestinal glands that produce components important for digestion (Brunner's, Lieberkün's).
• Muscular membrane has 2 layers: longitudinal and circular. This structure ensures the promotion of the contents towards the large intestine;
• Serous membrane is an outer cover and provides a protective function.

Causes of gastroenteritis

• Viruses:
  • rotaviruses;
  • caliciviruses;
  • intestinal adenoviruses;
  • astroviruses;
  • coronaviruses.
• Bacteria:
  • campylobacter;
  • shigella;
  • salmonella;
• Protozoa:
  • intestinal Giardia;
  • dysenteric amoeba;
  • cryptosporidium.
• Helminths:
  • crankheads.
• Toxic Substances:
  • mushrooms - fly agaric, false mushrooms;
  • arsenic, sublimate;
  • fish products - burbot liver, mackerel caviar.
• Food allergens:
  • eggs;
  • strawberry;
  • crabs.
• Medicines:
  • non-steroidal anti-inflammatory drugs;
  • antibiotics;
  • sulfa drugs;
  • bromine and iodine preparations.

• cold drinks;
• plentiful rough food rich in fiber;
• spicy seasonings;
• alcoholic drinks;
• vitamin deficiency;
• general hypothermia.

• Nausea and vomiting on early stage occur when sensitive nerve endings on damaged areas of the mucosa. Further vomiting is caused by toxins circulating in the blood.
• Damage to the intestinal villi disrupts the digestion and absorption of food - undigested particles appear in the feces.
• The osmotic pressure rises and water is released into the intestinal lumen. These processes lead to the development of diarrhea (diarrhea).
• Toxins formed in the intestines enter the bloodstream and cause a deterioration in the general condition and an increase in temperature.

Symptoms of gastroenteritis

Classification. Forms and stages of gastroenteritis

• Acute gastroenteritis(acute intestinal infection) is subdivided according to severity:
  • First degree- diarrhea 3-5 times a day, single or repeated vomiting, normal temperature, no signs of dehydration.
  • Second degree- diarrhea and vomiting 5-10 times a day, abdominal pain, fever up to 38.5 o C, mild symptoms dehydration - thirst, dry mouth, rare urination, palpitations, loss of up to 3% of body weight.
  • Third degree- diarrhea and vomiting up to 15 times a day, fever up to 40 o C, pronounced signs of dehydration: pallor of the skin, bluish tint on the fingertips, nose, earlobes, cramps of the calf muscles, dizziness, fainting, rare slight urination, impaired consciousness, loss of 4-6% of body weight.
• Chronic gastroenteritis: diarrhea, nausea, signs of dyspepsia. Local mucosal lesions lead to chronic malabsorption, which is accompanied by weight loss, weakness, fatigue, irritability, and sleep disturbance.

According to the factor that caused the disease:

• Viral gastroenteritis- inflammation of the mucous membrane of the stomach and intestines caused by viruses.
  Seasonality - the incidence increases in winter.
  The source of the disease is a sick person.
  The incubation period is 1-3 days.
  Most often occurs in children from 3 months to 3 years.
  The transmission mechanism is airborne with droplets of mucus from the respiratory tract when talking, coughing. Fecal-oral - through dirty hands, contaminated food, water, objects on which the patient's discharge has fallen. The patient continues to excrete the virus in the feces for 30 days after recovery.
  Symptoms of viral gastroenteritis are described above. Runny nose, sore throat, dry cough are also characteristic. With adequate treatment, the symptoms disappear after 1-3 days.
  Immunity - after the disease, specific antiviral immunity is formed. With re-infection, the disease proceeds in a milder form.


• Bacterial gastroenteritis- inflammation of the mucous membrane of the digestive system associated with the entry of bacteria and / or their toxins into the gastrointestinal tract. They include such heavy infectious diseases like cholera and salmonellosis.
  Seasonality - the incidence increases in the summer-autumn period, when high temperatures promote the growth of bacteria in food and water.
  The source of the disease is a sick person, a bacteriocarrier, animals, contaminated food and water.
  The way and mechanism of transmission - food, water, contact. In terms of epidemics, the most dangerous are meat and dairy products, which are a good breeding ground for bacteria, greens and vegetables, which can be contaminated with soil particles.
  The incubation period is from 2 to 24 hours.
  It affects all categories of the population. Children and the elderly are especially sensitive - they have reduced enzymatic activity.
  Symptoms. The disease is more severe than with viral gastroenteritis. Acute onset, severe chills and fever, nausea and repeated vomiting, cramping pain in the abdomen, in the navel. Diarrhea - frequent watery stools with mucus and greens. Symptoms last 5-10 days.
  Immunity. After infection with certain bacteria (Shigella, Salmonella), post-infection immunity develops, which, however, does not protect against re-infection.


• Toxic gastroenteritis occurs when consuming toxic substances, of which there are more than 50. Among them are alcohol, non-steroidal anti-inflammatory drugs, herbal infusions, household chemicals and salts heavy metals, preparations used for fluoroscopy.
  It develops when ingesting substances containing aggressive toxic components.
  Seasonality - any time of the year.
  It develops in the first 48 hours from the moment the substance enters the body.
  Symptoms. Pain in the stomach and left side of the abdomen, nausea, vomiting, frequent stools mixed with blood or melena (black stools resembling tar). Symptoms persist for 2-5 days.
  The immune system does not develop.


• Helminthic gastroenteritis. Worms cause chronic gastroenteritis. They damage the mucous membrane of the small intestine, causing infiltrates and dysfunction of the digestive tract.
  Seasonality. The number of infections increases in the summer-autumn period. Manifestations of the disease throughout the year.
  The source of the disease is sick people and animals.
  The route of infection through the consumption of products containing eggs or helminth larvae.
  The disease develops several weeks or months after infection.
  Symptoms. The disease proceeds in a mild form, characterized by nausea, frequent mushy or loose stools, bloating, accompanied by rumbling, an increase or lack of appetite.
  The immune system does not develop.


• Eosinophilic gastroenteritis. Inflammation of the digestive organs caused by the consumption of an allergic food. Islet lesion is characteristic - the formation of infiltrates containing a large number of eosinophils. With allergization, eosinophils (a type of leukocyte) migrate into the mucous membrane of the digestive organs, disrupting their structure and function.
  The reason may be citrus fruits, exotic fruits, strawberries, crabs, peanuts. Allergies can be caused by dairy products and cereals in the absence of the enzymes necessary for their absorption (lactose intolerance).
  Seasonality is not expressed.
  Gastroenteritis develops during the first 24 hours after consumption of the product.
  Symptoms - nausea, possibly vomiting, pain in the left side of the abdomen, rumbling, frequent copious stools, normal temperature. May be accompanied by a rash. The duration of the disease is 1-3 days, subject to the exclusion of the allergen.
  The immune system does not develop.
  Treatment is the exclusion of the products that caused the disease. Short courses of corticosteroid hormones (prednisolone 20-40 mg).


• Alimentary gastroenteritis. Indigestion caused by excessive consumption of fatty or spicy foods that irritate the mucous membrane digestive organs. It is caused by unusual food seasoned with hot spices, alcohol.
  Symptoms - pain in the stomach, upper abdomen and around the navel, aggravated before bowel movements, nausea, refusal to eat. Symptoms last 1-3 days if the diet is followed.
  The immune system does not develop.

Diagnosis of gastroenteritis

1. Examination by a doctor

The disease is treated by a gastroenterologist or infectious disease specialist. He feels the patient's stomach, which helps to identify inflamed areas of the intestine and promptly identify an enlarged liver or inflammation of the appendix.
At the appointment, the doctor specifies:

• When did the first symptoms appear?
• What are the signs of the disease - temperature, frequency and nature of the stool, the presence of vomiting?
• Has there been a deviation from the usual diet?
• What kind of food does the patient associate the disease with?
• Are there similar cases of the disease in his environment?

• Clinical a blood test reveals signs of general inflammation:
  • acceleration of ESR;
  • increased eosinophils in allergic (eosinophilic) gastroenteritis;
  • leukocytosis (an increase in the level of leukocytes) - indicates inflammation;
  • signs of hemoconcentration - thickening of the blood during dehydration - a decrease in the amount of water and an increase in the amount of hemoglobin and blood cells.
• Serological blood test - detects antibodies to the causative agent of the disease:
  • An increase in antibody titer by 4 or more times indicates the pathogen.
• Coprogram- Examination of feces. Reveals signs indicating damage to the mucous membrane of the upper intestine, as well as a violation of the digestion and assimilation of food. Traces are found in the stool:
  • hidden blood;
  • mucus;
  • muscle fibers;
  • undigested fiber, fats and starches.
• General Urinalysis may indicate dehydration:
  • increased specific gravity of urine;
  • the presence of ketones, protein, single erythrocytes.
• Microscopic and bacteriological examination to identify the pathogen. Material under study:
  • vomit;
  • washing water of the stomach;
  • contents of the duodenum.

Treatment of gastroenteritis

Indications for hospitalization for gastroenteritis:

• ineffectiveness of the treatment - within 24 hours the degree of dehydration increases, fever persists, repeated vomiting;
• prolonged diarrhea with dehydration of any degree;
• signs of dehydration - urine output less than 50 ml per day;
• signs of shock development - a decrease in blood pressure below 80 mm. rt. Art., fever over 38.9 degrees, a rash resembling a sunburn, confusion, thready pulse;
• the development of any complications;
• heavy comorbidities in a patient;
• the inability to isolate the patient at the place of residence - dysfunctional families, communal apartments, boarding schools, barracks.

Medication treatment

Medical treatment of viral gastroenteritis

To restore the mineral balance, you can use oral rehydration solutions sold in pharmacies. You can prepare its analogue at home: dissolve 1 teaspoon in 1 liter of water baking soda and salt, and 1 tablespoon of granulated sugar.

Alternative methods of treatment of gastroenteritis

• Infusion of mint leaves. It has a bactericidal effect, reduces nausea and bloating, improves digestion. To prepare the infusion, 1 tbsp of mint leaves is poured with a glass of boiling water. Let it brew for 30 minutes and strain. Take in small portions throughout the day.
• A decoction of cranberries. Due to the large amount of tannins, it has anti-inflammatory and antimicrobial properties. Tones the body and improves digestion. Enhances the action of antibiotics and antimicrobials. Cranberries are contraindicated in people with hyperacidity gastric juice and peptic ulcer. To prepare a decoction, cranberry leaves and berries are mixed in equal proportions. 3 tablespoons of vegetable raw materials are poured into 0.5 liters of hot water. Boil for 10 minutes on low heat, cool and filter. Take 1/2 cup 4 times a day.
• St. John's wort decoction. Flavonoids, essential oil and resinous substances have a strong bactericidal effect. Tannins provide astringent and anti-inflammatory effect. St. John's wort relieves spasm and improves the production of digestive enzymes. The decoction is prepared in an enamel bowl at the rate of 1.5 tbsp. (10 g) St. John's wort per 100 mg of water. Heated in a water bath for 30 min., 10 min. cool, strain and squeeze. The volume is brought to a full glass of boiled water. Take 50-100 ml 3 times a day for half an hour before meals.

Diet for gastroenteritis

Cooking method: Products are boiled in water or steamed, rubbed or crushed with a blender.

Diet: 5-6 times a day in small portions.
List of recommended products:

• White bread crackers, stale wheat bread;
• Pureed soups with the addition of cereals (rice, semolina). Quenelles, meatballs, egg flakes are added to soups;
• Vegetables only in the form of decoctions in soups;
• Not fatty varieties meat and poultry - veal, beef, chicken breast. Cutlets on the water, steam meatballs;
• Fish lean varieties, boiled in water or steamed. Products from minced fish or a piece;
• Eggs 1-2 per day in the form of a steam omelet or soft-boiled;
• Freshly prepared calcined cottage cheese, mashed unleavened cottage cheese;
• Cereals from cereals on the water - oatmeal, semolina, buckwheat;
• Butter in the first and second courses;
• Fruits - pureed fresh apples;
• Drinks - black or green tea, diluted fruit juices (except grape, plum and apricot). Compotes, jelly, decoctions from dried berries rosehip, blackcurrant, blueberry.

• Any bakery products other than those listed above;
• Vegetables and fruits in natural or boiled form;
• Snacks;
• Spicy, fatty, fried and baked foods;
• Cold dishes and drinks;
• Milk, kefir and fatty dairy products;
• barley and pearl barley, millet, legumes;
• Cocoa with milk, sweet and carbonated drinks.

Table number 2 is prescribed during the recovery period after acute gastroenteritis and in the chronic form of the disease. The purpose of the diet is to normalize the work of the digestive organs and provide the patient with good nutrition.

Cooking method: boiled, steamed, baked and fried (without crust) dishes.

In the diet, gradually increase the amount of carbohydrates up to 400 g, and fats up to 100 g (25% vegetable). Squirrel 90-100 g.

Allowed meals:

• Yesterday's or dried bread, inedible bakery products. 2 times a week cooled lean pies with cottage cheese, meat, jam;
• Soups on a weak broth (meat, fish, mushroom) with finely chopped or pureed vegetables;
• Meat - low-fat varieties without fascia, tendons and skin: beef, veal, rabbit meat, chicken, turkey meat, boiled tongue, milk sausages. Pork and lamb in limited quantities;
• Fish are lean varieties. Chopped products or a whole piece;
• Milk - sour-milk drinks, cottage cheese and products made from it, cheese, sour cream for dressing dishes;
• Eggs - soft-boiled, in the form of an omelette, fried without a crust. Avoid hard boiled eggs;
• Vegetables - boiled, stewed and baked, in the form of casseroles, fried without a crust;
• Cereals - in the form of semi-liquid and crumbly cereals, casseroles, cutlets without a crust;
• Snacks - salads of boiled vegetables and fresh tomatoes with the addition of eggs, low-fat ham, meat and fish, low-fat aspic, liver pate.

• Spicy and fatty foods;
• Salted and pickled dishes;
• Soups - with millet, beans, peas, okroshka;
• Vegetables - onion, garlic, radish, Bell pepper, cucumbers , mushrooms;
• Cereals - barley, pearl barley, millet, corn, legumes.

Consequences of gastroenteritis

Prevention

• Drink only bottled water. You can also use it to wash fruits.
• Wash your hands as often as possible.
• Use liquid soap, the usual contains a large number of germs.
• After visiting public places wipe your hands with wet wipes and treat with an antiseptic.
• Avoid swimming in stagnant water where sewage may have entered.
• Don't buy food on the streets. Choose dishes that have been heat-treated and cooked in front of you.
• Avoid steaks with blood and other undercooked meats, fish, and shellfish.

Vaccination against gastroenteritis

Scheme. The vaccine is administered twice:

• The first stage is at the age of 6-14 weeks;
• The second stage - 4-10 weeks after the first at the age of 14-24 weeks.

Side effects. Based on a survey of 63,000 vaccinated children, it was found that the vaccine does not cause serious consequences and safe to use.

What are the symptoms and treatment of gastroenteritis in children?

Infectious gastroenteritis in children

In the summer months, gastroenteritis is more often associated with food poisoning associated with the consumption of a large number of opportunistic microorganisms in food. Minced products, pies, cakes and pastries with cream, dairy products are especially dangerous.

The child may become infected:

• From a sick person. The patient becomes contagious from the moment the first signs of the disease appear. With viral gastroenteritis, it remains contagious for 5-7 days, with bacterial - for several weeks or months. Therefore, if rotavirus gastroenteritis occurs in the garden, a large number of children in the group may become infected.
• From the carrier. A carrier is a person who is apparently healthy but is shedding viruses or bacteria. greatest danger represent carriers that are involved in food preparation.
• From animals. Bacteria can enter the body with the meat and milk of sick animals. Gastroenteritis caused by salmonella develops after the consumption of eggs, especially waterfowl.
• When consuming contaminated food and water:
  • Insufficient heat treatment - the dishes are poorly cooked, fried.
  • Bacteria from the patient or the carrier got on the products after preparation. Such dishes become dangerous after standing without a refrigerator for 2 or more hours - enough time for bacteria to multiply.
  • Products that have expired. In this case, the number of bacteria increases dramatically, even if the storage conditions are correctly observed.

Non-infectious gastroenteritis in children

• Drug gastroenteritis. It can develop against the background of a common ARVI or influenza. In this case, the first symptoms will be fever, runny nose, sore throat and cough. Diarrhea and nausea appear 12-24 hours after taking antipyretics (Nurofen, Panadol) or antibiotics. These drugs irritate the mucous membranes, and plentiful drink makes the stool even more liquid. In this case, it is desirable to use antipyretics in the form of suppositories, and add sorbents to the SARS treatment regimen.
• Alimentary gastroenteritis associated with overeating, the consumption of too fatty, spicy and coarse foods, a large number of berries and fruits. The child does not produce enough digestive enzymes to digest such food. The intestines are trying to clear it with the help of increased motility.
• Allergic gastroenteritis develops when consuming foods to which the body has hypersensitivity. 0.6% of infants under 4 months develop an allergy to cow's milk, which is part of mixtures or used in its pure form. In children of preschool and school age, allergens are:;
• infrequent scanty urination;
• increased heart rate and respiration;
• sunken fontanel.

When does a child need urgent medical attention?

• there are signs of dehydration;
• diarrhea and vomiting continue for more than a day, despite treatment;
• the temperature rose above 39 degrees;
• for 4-5 hours the child's condition worsens;
• mucus or blood is found in the stool;
• appeared great weakness, disturbance of consciousness.

Treatment

• Human electrolyte. The contents of 1 sachet are dissolved in 1 glass of boiled water. Scheme of administration: about 500 ml for the first 4 hours - every 5 minutes, a teaspoon. In the future, 100-150 ml after each liquid stool.
• Regidron. 1 sachet is dissolved in 1 liter of boiled water. The amount of solution depends on the degree of dehydration. For the first 6-10 hours, the child should receive a portion of Regidron, twice the weight loss caused by diarrhea and vomiting.

• Smecta contents of the sachet are dissolved in 50 ml of water. Daily dose: children under one year old 1 sachet, 1-2 years old - 2 sachets, children over 2 years old - 3 sachets per day. The dose is divided into several doses. It is allowed to mix in semi-liquid food - cereals, mashed potatoes.
• Polysorb. The powder is diluted with water (50-100 ml) until a suspension is formed. Powder dosage - for every 10 kg of body weight 1 scoop without top. Apply one hour before meals. The suspension is prepared each time before use.

• Enterol 250. For children 1-3 years old, 1 capsule 2 times a day. Over 3 years old - 1 capsule 3 times a day. If necessary, the capsule can be opened and its contents diluted in water (50 ml). Take 1 hour before meals.

• breast milk without restriction. Cow, goat milk and dairy products are completely excluded from them;
• rice water and viscous rice porridge;
• crackers;
• protein steam omelet.

Prevention

• For cooking, only high-quality and fresh products should be used.
• Products should be stored in the refrigerator in hermetically sealed containers.
• Vegetables, fruits and greens must be scalded with boiling water before eating.
• A child up to a year needs to cook before each meal. If this is not possible, then the portion must be brought to a boil.
• The child's dishes should be thoroughly washed. Bacteria multiply rapidly on leftover food.
• Teach your child to wash their hands before eating.

What is chronic gastroenteritis?

The reasons

• malnutrition;
• abuse spicy food and alcoholic beverages;
• food allergy;
• harmful working conditions;
• radiation exposure;
• worm infestations.

Symptoms

• nausea;
• loose stools 4 or more times a day, particles of undigested products are visible in the feces;
• pain in the upper abdomen and around the navel;
• bloating;
• weight loss.

Treatment of chronic gastroenteritis

During treatment, it is necessary to follow a diet 4 (4-a, b) and completely eliminate alcohol.

Used as an astringent and anti-inflammatory decoctions of medicinal plants:

• Decoction of oak bark. 2 tbsp the bark is poured with a glass of boiling water and heated for half an hour in a water bath. Cool, wring out, bring boiled water to 200 ml. Take 1/4 cup 4 times a day on an empty stomach.
• Infusion of bird cherry fruits. 2 tbsp dried berries pour a glass of boiling water. Let it brew for 20 min. They are accepted in the same way.
• Infusion of blueberries. 2 tsp dry or 4 tsp. fresh berries are poured into a glass cold water and leave overnight. Take during the day, 2 tbsp.

• Yekateringofskaya;
• Zheleznovodskaya;
• Izhevsk;
• Essentuki No. 4;
• Narzan.

Physiotherapy gastroenteritis improves blood circulation and trophism in the tissues of the stomach and small intestine. In the course of treatment, the innervation and functioning of the digestive organs are normalized:

• inductometry is indicated for reduced acidity of gastric juice;
• decimeter therapy for gastritis with increased secretion;
• galvanization and electrophoresis with antispasmodics;
• exposure to diadynamic currents;
• ultrasound therapy;
• paraffin and ozocerite applications;
• heating pads on the stomach and small intestine.

Prevention of chronic gastroenteritis

• Compliance with a healthy diet;
• compliance with the daily routine;
• treatment of diseases of the digestive system.

• alcohol consumption;
• overeating;
• excessively spicy and fatty foods;
• professional hazards.

Does immunity develop after gastroenteritis?

After rotavirus gastroenteritis, antibodies remain in the blood of people, which provide a milder course of the disease in adults.

Gastroenteritis is an infectious-inflammatory disease that mainly affects the walls of the stomach and small intestine. Among the brightest severe symptoms of this disease, nausea and frequent loose stools can be distinguished.

The main reasons why gastroenteritis occurs in adults may be somewhat different from those that provoke the development of this disease in children.

The statistics of the incidence of gastroenteritis shows that it is faced with similar pathology every fifth inhabitant of our planet.

This disease can develop in an adult for two groups of reasons:

AT special group people whose work or hobbies are associated with frequent trips to exotic countries are at risk of developing infectious gastroenteritis. The main causative agents of the so-called "diarrhea of ​​tourists" among viruses are norovirus and rotavirus, bacteria - shigella, protists (a type of protozoan microorganisms) - intestinal and cryptosporidium.

Viral gastroenteritis is the most common. This is commonly referred to as the stomach flu. Bacterial is less common, but has a severe course. Gastroenteritis in adults, caused by protists of the genus Cryptosporidium (Cryptosporidium), is relatively mild, but in immunocompromised people it can lead to extremely serious consequences.

Regardless of the cause of the disease, its outcome can be severe dehydration. Infectious gastroenteritis is a fairly contagious disease that is transmitted exclusively by the fecal-oral route. An infection can enter the human body through unwashed hands, insufficiently processed vegetables and fruits, meat and fish products. In most cases, gastroenteritis occurs with a moderate degree of intensity, and can be treated outside the hospital. In more severe cases, the person may need to be hospitalized.

Main symptoms

Medical therapy

Application medicines with gastroenteritis, as a rule, it is recommended in case of severe course diseases. Below are the main groups of drugs through which treatment and normalization are carried out. functional state organism.

Antibacterial drugs

In most cases, gastroenteritis is treated with broad-spectrum antibiotics. More detailed selection antibacterial drug carried out by the attending physician, after determining the type of pathogen.

Antiemetics

The cause of dehydration of the body can be a significant loss of fluid with vomit. For correction this process antiemetic medications are recommended.

Intestinal enterosorbents

In order to remove toxic substances from the body, with gastroenteritis, the use of enterosorbents is recommended.

Preparations for restoring water and electrolyte balance

The most popular is the drug Regidron in the form of a powder for preparing a solution. The composition of the drug includes components such as potassium chloride, sodium chloride, sodium citrate and glucose.

Treatment of gastroenteritis in pregnant women

Comprehensive treatment of gastroenteritis in pregnant women practically does not differ from standard scheme However, there are a number of some restrictions in taking medicines. Treatment of pregnant women includes the following items:

• adherence to a diet that excludes vegetable fiber and animal fats;
• replenishment of lost fluid through increased water intake;
• taking drugs that have a mild effect and do not have a toxic effect on the fetus. Dosage in this case selected by the doctor individually. (No ratings yet)
  

Gastroenteritis is a lesion of the epithelial membrane (catarrh) of the stomach and duodenum of a predominantly acute nature. Catarrh of the stomach and proximal small intestine can be caused by infectious pathogens (viruses and bacteria), as well as external and internal factors, for example, malnutrition or uncontrolled medication. Symptoms and treatment of gastroenteritis in adults differ from children and adolescents: in patients over 18 years of age, the disease usually proceeds in a milder form, which significantly reduces the risk of complications and severe consequences for the body.

Sources of infection for an adult can be:

• polluted water (especially when swimming in open water);
• contaminated soil (contact with helminths and bacteria may occur during work in the garden);
• poorly fried meat or fish without sufficient heat treatment (sushi, rolls);
• unwashed vegetables, herbs and fruits;
• stale dairy products and eggs.

Table. Causative agents of infectious gastroenteritis.

Non-infectious catarrh of the stomach and small intestine

Inflammation of the mucous membranes of the duodenum and stomach is not always associated with infection in the gastrointestinal tract. Sometimes gastroenteritis develops against the background of a weakened immune system when exposed to adverse factors or with a long-term violation of healthy eating habits (regular use of smoked, pickled, fatty foods and spices).

Malnutrition is one of possible causes diseases

The most common causes of non-infectious inflammation in adults are:

• long-term (more than 7-10 days) treatment with non-steroidal anti-inflammatory drugs and antibiotics;
• congenital lactose intolerance;
• frequent use raw fish and fish caviar;
• some types of fermentopathy (for example, celiac disease - intolerance to some "cereal" proteins, in particular gluten).

In celiac disease, proteins contained in the gluten of almost all cereals damage the villi of the small intestine, which are responsible for the absorption of nutrients and digestion of food. As a result, the patient develops profuse diarrhea, vomiting and other symptoms. inflammatory process Therefore, celiac disease has received a second name - gluten enteropathy.

Important! Long-term use of any medication can adversely affect the condition of the mucous membranes of the stomach and intestines, especially if the patient suffers chronic diseases digestive organs, unbalanced or irregular meals. An increased risk is present when taking antibacterial drugs, since long-term treatment can lead to the development of resistance of individual strains of pathogenic bacteria to a particular antibiotic and the development of superinfection.

How the disease manifests itself: signs and symptoms

The main signs of catarrh of the small intestine and stomach are vomiting and loose stools. feces may have a watery or foamy texture, the smell is fetid. With some bacterial infections, a large amount of mucous and bloody streaks can be found in the stool. Vomiting is profuse, repeated, occurs after each meal or fluid intake, therefore, during the first day, the patient is recommended to completely abandon any products (against the background of rehydration therapy). The number of bowel movements in viral gastroenteritis can reach up to 15-20 times a day. With other types of inflammation, this figure varies from 4 to 8 times a day.

Vomiting is one of the main symptoms of the disease.

Simultaneously with vomiting and diarrhea, the patient may experience the following symptoms:

• temperature increase within subfebrile indicators (up to 38 ° C);
• painful cramps in the central part of the abdomen;
• nausea and complete absence appetite
• muscle weakness and joint pain (characteristic of a viral infection);
• manifestations of febrile syndrome (chills, followed by fever, excessive sweating, trembling in the body).

In severe cases, the clinical picture may be supplemented by a decrease in intracellular filling, impaired respiratory function (the patient develops shortness of breath) and symptoms of dehydration.

Note! In the elderly, signs of gastroenteritis are often only mild abdominal cramps, nausea, diarrhea, and lack of appetite. Diarrhea in patients older than 50 years is more pronounced, may be accompanied by bloating, flatulence and painful distension. Body temperature in elderly patients usually remains within the normal range.

Diagnostics

The diagnosis of "gastroenteritis" in most cases is made on the basis of a physical examination of the patient and the collection of a medical history. On examination, the doctor pays attention to appearance skin and mucous membranes, the condition of the tongue (with gastroenteritis, it is usually lined with a grayish coating), abdominal pain on palpation. Laboratory diagnostics includes biochemical research feces (coprogram) and blood test. Clinical signs of gastroenteritis when deciphering the results will be an increase in the number of leukocytes and an acceleration of the ESR, as well as a decrease in the liquid components of the blood in case of acute dehydration.

Secondary diagnostic methods in adults include:

• serological blood test;
• gastroscopy with biopsy of altered areas of the epithelial membrane and further histological examination;
• antroduodenal manometry;
• breath tests (to detect the possible presence of pathogens of gastritis and enteritis - Helicobacter bacteria pylori);
• PCR diagnostics (polymerase chain reaction);
• measurement of gastric acidity.

To obtain a general clinical picture and exclude others possible pathologies the patient may also be assigned an ultrasound of the abdominal cavity.

Treatment

Treatment of gastroenteritis can take up to 7-10 days (in severe cases - up to several weeks). Therapy of the disease is always complex and includes not only medical methods but also dietary and lifestyle modifications.

Mode

Within 2-3 days after the onset of acute symptoms, bed rest is indicated. If for some reason this is not possible, physical, mental and emotional stress. In acute gastroenteritis, a person can sleep up to 16 hours a day: if there are no signs of respiratory depression and consciousness disorder, it is not necessary to wake the patient (the exception is the time intervals in which prescribed medications must be taken).

The room must be ventilated several times a day - this will help to cope with viruses faster in case of a viral nature of inflammation. Wet cleaning - 1-2 times a day using gentle disinfectants (without chlorine).

Rehydration Measures

Restoring the balance of fluid and electrolytes is the main task in the treatment of gastroenteritis in adults. Severe dehydration is always accompanied by an active leaching of sodium and potassium ions, which can lead to loss of consciousness, respiratory depression, or the development of acute heart failure. To avoid this, it is recommended to drink plenty of water (boiled water, sweet compotes, strong tea with sugar). With severe vomiting, the use of ready-made saline solutions (Gidrovit, Regidron) is recommended. They must be diluted in boiled water according to the instructions and taken 1-2 teaspoons every 5 minutes.

Important! In severe forms of gastroenteritis, intravenous infusion of detoxifying solutions, such as glucose solution, is indicated.

Food

Diet is an important element in the complex treatment of gastroenteritis in adults, as it allows you to accelerate the healing of mucous membranes, reduce inflammation and reduce the load on the gastrointestinal tract during the acute course of the disease. Within 24-48 hours after the onset of diarrhea and vomiting, you should refrain from eating. Starting from the third day, vegetable soups and broths, liquid cereals, meat soufflés, vegetable and fruit purees, wheat croutons can be introduced into the diet. It is desirable to grind food as much as possible for better assimilation: puree or mushy consistency is considered optimal.

Soups with a strong broth, dairy products, meat and fish cuts, confectionery, foods rich in simple carbohydrates- all these products are allowed to enter the menu not earlier than the tenth day from the onset of the inflammatory process.

Preparations

Table. Symptomatic treatment of gastroenteritis.

Important! Despite the fact that gastroenteritis in most cases has a favorable prognosis, self-medication is not worth it. In rare cases, against the background of acute catarrh of the stomach and duodenum, severe complications such as reactive arthritis, kidney failure, acute autoimmune polyradiculoneuropathy. In some patients, active destruction of erythrocytes in the blood was noted against the background of severe thrombocytopenia, so treatment should be carried out under the supervision of a specialist.

Briefly about prevention

To reduce the risk of gastroenteritis and other inflammatory diseases digestive tract, it is enough to follow the advice of doctors.

Gastroenteritis is a fairly common disease of the gastrointestinal tract in adults. In most cases, the disease completely disappears in 7-10 days, but with improper treatment or in case of a strong weakening of the immune system, there may be serious complications Therefore, patients with this diagnosis are always offered hospitalization in an infectious diseases hospital.

Video - Gastroenteritis. Symptoms, signs and treatments

Gastroenteritis rarely develops as an independent disease, very often it is a syndrome of any disease.

Viral gastroenteritis usually develops suddenly, patients develop spastic abdominal pain, nausea, and vomiting. Perhaps an increase in body temperature, weakness, muscle pain. Patients complain of bloating, strong rumbling, while gas discharge is minimal. In some cases, abdominal pain may not be accompanied by diarrhea. There is usually no blood or mucus in the stool.

Gastroenteritis often develops as a syndrome of bacterial diseases (dysentery, salmonellosis). In such cases, the stool in patients is watery, may be mixed with blood and mucus, its frequency is up to 30 times a day.

Diagnosis of gastroenteritis

A doctor can diagnose gastroenteritis based on the patient's complaints and anamnesis of the disease. But to identify the nature of the disease, additional laboratory research feces, vomit, blood. If symptoms of gastroenteritis appear, you should consult a doctor, as this may signal a serious illness.

Treatment of gastroenteritis

At the first symptoms of gastroenteritis, food intake should be limited. Due to the loss of fluid with vomit and frequent loose stools, dehydration of the body may develop, so you should drink more fluids. Can be cooked at home saline solution. To do this, in 1 liter of boiled water you need to dissolve 1 tbsp. l. table salt and 2 tbsp. spoons of sugar. Also, to replenish the loss of fluid and electrolytes, you can use pharmaceutical powders for the preparation of solutions for rehydration, such as rehydron or oralit. It is also useful to drink sweet tea, rosehip broth and jelly. You need to take the liquid often, but in small portions (no more than 50 ml at a time), so as not to provoke an attack of vomiting.

If the symptoms of gastroenteritis persist for more than a day or the patient's condition worsens, you should consult a doctor, as hospital treatment may be necessary.

In severe dehydration, when oral rehydration is not enough, intravenous administration of solutions (physiological saline, 5% glucose solution, reopoliglyukin) is possible. Infusion therapy also shown with pronounced intoxication syndrome, which can be observed in gastroenteritis.

Quite often, patients with gastroenteritis show signs of beriberi, so treatment includes vitamin therapy. Patients are prescribed vitamins of group B, which in stationary conditions may be administered intramuscularly. On an outpatient basis, patients are advised to take multivitamin complexes(biomax, complivit, alphabet, etc.)

To restore the affected mucous membrane of the stomach and intestines, patients are prescribed astringents and enveloping agents (de-nol, tanalbin). For these purposes, it is also possible to prescribe drugs based on plant materials (St. John's wort, tansy, serpentine grass).

Physiotherapy is very effective in the treatment of gastroenteritis. Patients are given warm compresses paraffin applications, ozocerite, inductothermy.

With gastroenteritis, the composition of the normal intestinal microflora is often disrupted, so it is advisable to take eubiotics (bifidumbacterin, linex, acipol).

It should be noted that the appointment of antibiotic therapy is possible only by a doctor. Do not try to self-treat gastroenteritis with antibiotics. If the disease was caused by a virus, this group of drugs will be completely ineffective. Wherein Negative influence antibiotics on the intestinal microflora can only aggravate the condition.

diet therapy

Special attention should be given to the nutrition of patients with symptoms of gastroenteritis. For patients with diseases of the gastrointestinal tract, a special therapeutic diet- table number 4.

AT acute stage illness, food intake should be limited. If the patient can eat, then it is possible to eat crackers from white bread, rice porridge and bananas. Food should be fractional, in small portions, food must be warm.

After the exacerbation symptoms subside, the diet can be expanded. It is allowed to eat porridge cooked in water, dairy products, boiled vegetables, not containing coarse fiber (potatoes, carrots, cauliflower etc.), fruits, lean meats and fish, dried White bread. You should drink kissels, fruit juices, compotes, tea.

Excluded from the diet are fatty meats, poultry and fish, legumes, fatty dairy products, confectionery with fatty creams, muffins, coffee, carbonated drinks. You should also remove smoked meats, marinades, fried, fatty, spicy and salty dishes, convenience foods, canned food and fast food from the table.

After the symptoms of gastroenteritis subside, such a regimen and diet should be followed for at least a month, and people suffering from chronic form diseases, such a diet must be followed constantly.

Which doctor to contact

If the symptoms are moderate, you can call a therapist / pediatrician at home or contact a gastroenterologist and continue treatment on an outpatient basis. When the condition worsens, you need to call " ambulance”, which will take the patient to the infectious diseases hospital.

Gastroenteritis is infectious pathology Gastrointestinal tract, which is accompanied by diarrhea, vomiting. This ailment considered to be very common. Developed countries are successfully fighting outbreaks of the infection, as it is easily treatable. With regard to countries with shortages of net and drinking water Thousands of children die every year from this pathology. Main symptoms: fever, profuse loose stools and vomiting, abdominal pain, nausea, weakness, pallor skin. If signs of illness are found, emergency treatment because it leads to severe dehydration.

Gastroenteritis is an inflammation of the small intestine and the gastric mucosa, causing a malfunction in the digestive and transport and secretory function, immune and metabolic changes. The main forms of pathology: chronic gastroenteritis, acute. These forms have distinctive features associated with signs, methods of treatment and etiology.

The disease gastroenteritis is very common. She is in second place after respiratory infection. Chronic gastroenteritis is observed in schoolchildren and adults. The most common causes of gastroenteritis are viruses and bacteria. These include amoeba, salmonella, coli, shigella, enterotropic virus. Also, chronic gastroenteritis can occur against the background of malnutrition, exposure to chemicals, ionizing radiation and drugs.

In rare cases, viral gastroenteritis appears against the background of malnutrition, individual intolerance and allergies. Basically, an acute form of infectious gastroenteritis is fixed. With this form of the disease, the pathogenic flora penetrates the gastrointestinal tract, invasion and adhesion of microorganisms are observed. The diagnosis of gastroenteritis is established when the listed phenomena are accompanied by a high osmotic pressure the contents of the intestines of the patient, as well as its secretion into the lumen. Bacterial gastroenteritis is much more common. With this disease, intestinal microbiocenosis is disturbed, acidity decreases.

Chronic gastroenteritis manifests itself as a complication of an acute process. The main cause of this disease is Helicobacter pylori. This bacterium recognized as an acid-resistant microorganism that has tropism and defense mechanisms, as well as the ability to exist in an aggressive environment. Chronic gastroenteritis causes insufficient production of digestive juice and suppression of local immunity.

The chronic form often occurs due to excessive alcohol consumption. In this situation, there may be atrophic change in the shell of the gastrointestinal tract, as well as malabsorption of important elements.

Classification of the pathological process

There are chronic and acute gastroenteritis. The disease is also classified according to clinical signs, etiological factor. For acute form have 3 degrees of severity. The first form is accompanied by vomiting, not too much frequent diarrhea, normal temperature. For an average degree, vomiting, diarrhea up to 10 times a day, slight dehydration, and an increase in body temperature up to 38.5 degrees are inherent. As for the severe degree, it is characterized by confusion, fever and severe dehydration.

The main types of the disease:

Coronavirus gastroenteritis

This pathology is associated with symptoms intestinal lesion and respiratory symptoms. An isolated course of the disease without damage can also occur. respiratory system. Coronavirus gastroenteritis causes acute respiratory syndrome. Clinical picture: malaise, weakness, pain in the abdomen and throat, vomiting, diarrhea and nausea, migraine and shortness of breath. There are no serious complications.

Alimentary gastroenteritis

This kind of disorder of the gastrointestinal tract is a consequence of the consumption of alcohol and coarse food, an excessive amount of spicy food.

Hemorrhagic gastroenteritis

There is vomiting and diarrhea with blood, weakness, decreased appetite, weight loss, dehydration.

Adenovirus gastroenteritis

It appears much more difficult. The duration of the incubation period is eight to ten days. Viral gastroenteritis has the following clinical picture: vomiting, loose stools and loss of appetite observed for several days. In some cases, a relapse is recorded after a few months. In severe hypertensive dehydration, viral gastroenteritis can be fatal. shown next treatment: diet therapy, water-salt resuscitation.

Eosinophilic gastroenteritis

This pathology is rare, since it is difficult to get infected with such an infection. It is characterized by infiltration of the digestive organs. Autoimmune pathologies, food allergies can cause the disease. Eosinophils are white blood cells that form in the lymphatic tissues located in the intestines. Their goal is to fight pathogenic microorganisms penetrating into the gastrointestinal tract with food. The diagnosis can be established with the help of a complete examination and appropriate tests. Symptoms of pathology: vomiting, nausea, diarrhea, discomfort in the abdomen, weight loss and appetite, weakness, malaise, swelling and anemia. In some cases, obstruction of the pylorus and the upper part of the gastrointestinal tract is manifested.

Clinical picture

The incubation period of the disease is 2 days. For bacterial form inherent period - from 1 to 5 days, depending on the pathogen.

The main symptom of pathology is diarrhea. Feces may contain mucus, blood. Associated symptoms:

• nausea;
• vomit;
• increased body temperature (38-39 degrees);

Due to profuse diarrhea and vomiting, dehydration occurs. Such a complication is considered very serious and life-threatening, so it is necessary to replenish the water-salt balance. In the elderly and newborns, dehydration syndrome can be fatal if not started. timely treatment. Dehydration in gastroenteritis can be detected by the following signs:

• apathy and dizziness;
• fatigue, dry mouth;
• muscle cramps;
• fatigue;
• nausea and vomiting;
• sunken eyes;
• frequent heartbeat;
• little urine when going to the toilet;
• the face becomes haggard.

In many cases, medication is not required, as the symptoms go away on their own. However, in severe forms of the course of the disease, appropriate treatment is indispensable. You need to see a doctor immediately if you are concerned about the following symptoms:

• vomiting does not stop for 2 days;
• more than 3 days diarrhea lasts;
• there are convulsions, speech is slurred, it may double in the eyes;
• blood is present in feces, vomit;
• obvious symptoms of dehydration;
• disorientation.

Treatment and prevention of pathology

With this diagnosis, replenishment of the lost fluid is shown. It is recommended to drink at least two liters of water a day and a glass of water after each bowel movement. You can use a special oral rehydration solution, which is sold in pharmacies. Such a tool perfectly replenishes the lost glucose, salt, important mineral components. If you have kidney disease, you should consult a specialist before taking this solution.

During the treatment period, it is necessary to observe special diet. Eliminate fatty, spicy and salty foods from the diet, as they can exacerbate symptoms. It is recommended to use dairy and sour-milk products, cereals, whole grain bread.

Prevention of gastroenteritis suggests washing hands thoroughly before eating, after visiting the street and the toilet, as well as using individual towels, linen, cutlery and cutlery. After treatment, it is recommended to stay at home for two days to allow the body to recover.

Gastroenteritis is a dangerous disease of the gastrointestinal tract that can cause dehydration. If you have any suspicious symptoms, contact your doctor immediately.