A sign of serious illness is chronic diarrhea. Chronic diarrhea and its treatment in adults

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 all. 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. organism healthy person allocates per day from 100 to 300 g of normally formed feces. 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. more time, 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 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.

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 a chronic diarrhea arises as a result 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 nutrients are not excreted from the body along with toxins, 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 progresses to chronic form, rehydration therapy is needed. 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 organize drinking regimen which will prevent 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 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 not easily treatable. 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 until the diarrhea becomes chronic, you can miss the start of many serious illnesses. 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, accept preventive measures, and when lasting more than three days loose stool go to the doctor for a complete examination.

Video - Frequent (chronic) diarrhea

Chronic diarrhea is a syndrome of prolonged (longer than 4 weeks) existence of diarrhea. Diarrhea is defined as an increase in the frequency of bowel movements more than 3 times per day, as well as the volume of feces - more than 200 ml per bowel movement. The daily volume of feces with diarrhea is more than 500 ml, they are watery in nature.

Why does this condition occur?

Stool disorders in the form of diarrhea, constipation are symptoms (or syndromes, when there are many symptoms) that appear when various diseases. Their severity determines the severity of the course of the disease. The causes of chronic diarrhea can be divided into 2 large groups:

• Functional, when there is no violation of the structure of the intestine. Chronic diarrhea develops due to increased intestinal motility. The causes of this phenomenon may be neurogenic in nature, for example, irritable bowel syndrome (IBS), " bear disease" how special case its manifestations.
• Organic causes - in the presence of violations of the structure of the intestine caused by various damaging factors (infectious, toxic, autoimmune, physical). An example of such a reason would be chronic poisoning lead, Crohn's disease, nonspecific ulcerative colitis(NJK).

Manifestations and their danger to life

The symptoms that accompany chronic diarrhea depend on its cause. With functional diarrhea (IBS, "bear's disease", treatment with laxatives), abdominal pain is present at the same time, stressful condition with IBS. Diarrhea preceded by eating, no nightly bowel movements, weight loss. There is no danger to life either.

In Crohn's disease different departments intestine has various manifestations of chronic diarrhea. During the formation of the process in the small intestine, diarrhea is abundant, occurs at night, leads to weight loss due to malabsorption of food ingredients small intestine. With NUC, chronic diarrhea resembles dysentery (without seeding the pathogen).

There are pains in the lower abdomen, imperative urge to defecate, impurities of pus in feces. In both cases, body weight gradually decreases, there is constant increase temperature, poor appetite, joint pain. It is not yet possible to cure such diseases. In order to cure them, you need to know the causes of their occurrence, they, unfortunately, are unknown. If there is no treatment for these diseases, they fast development leads to life-threatening complications. It can be:

1. Perforation of the intestinal wall with the development of peritonitis.
2. Bleeding leading to anemia.
3. Edema syndrome due to reduced protein absorption.
4. Rebirth in tumor processes.

How can I help you

Treatment for chronic diarrhea depends on its cause. Treatment begins with diet number 4. It provides:

• The content of proteins, vitamins, minerals in required quantity sufficient calories. Amount of protein daily ration increased to 120 g, fat - up to 90 g, carbohydrates - up to 350 g.
• Diet treatment involves mechanically, chemically sparing food, its steam processing, exclusion a large number animal fats, coarse fiber fresh vegetables, fruits. Vegetables are recommended boiled, mashed, fruits - baked.
• Exclusion of milk with lactase intolerance. All products containing alcohol, spices, salt, excess sugar are excluded from consumption.
• Correction pronounced violations metabolism in case of diarrhea is carried out using metabolic mixtures (Peptamen, Nutrizon, Unipit, etc.). They are introduced through a tube.

Large fluid loss in chronic diarrhea forces substitution treatment Regidron, Glucosalan. It is given by mouth. Solutions of amino acids are administered intravenously, at the same time retabolil is administered intramuscularly in order to better assimilation amino acids.

In the presence of pathogenic microflora bowel treatment is carried out using antibacterial agents(Nitraksolin, Cifran, Intetrix, Ercefuril). This treatment is combined with the use of prebiotics that restore normal microflora intestines (Normoflorin, Hilak forte, Lineks). Prebiotics are used for a long time, until the stool normalizes, changing drugs every 2-4 weeks.

In the first 5-7 days of treatment of chronic diarrhea, astringent, enveloping preparations are given. This is Almagel, Smecta containing white clay, tannin, bismuth. New drug Tannacomp also has an antibacterial effect.

Enterosorbents are used to remove cell decay products, microbes from the intestinal lumen. Most often used Polyphepan, Enterosgel, Smecta. They are given for chronic diarrhea up to 2 weeks between meals.

Enzymes are used to digest food. The best are those that are resistant to action. gastric juice. This is Pantsitrat, Creon.

With NUC, Crohn's disease, anti-inflammatory treatment is used using corticosteroid drugs, salicylates. Treatment with these drugs is long-term. Large doses at the beginning of treatment, gradually reduced to maintenance doses for an indefinitely long time.

With the development of complications of chronic diarrhea in the form of intestinal perforation, it is necessary urgent operation. This complication is rare. Its appearance is accompanied by signs of peritonitis.

Treatment of functional diarrhea is the most difficult task, despite the apparent simplicity. In addition to dietary measures, a complex of psychotherapeutic influences is used, which give a slow effect. To this end, one resorts to compiling individual plans treatment.

Treatment of chronic diarrhea is a complex process, depending on the cause of the disease. When similar condition need to see a doctor. This will prevent the development of complications, help speed up recovery or improve well-being.

Diarrhea from pills is a fairly common occurrence. For today there is great amount diseases for which they take at least a number of drugs. At the same time, it should be noted that such synthetic agents not only help to get rid of the cause of the ailment, but also often become the culprits of new pathologies in the body. As a rule, diarrhea from pills occurs only if the patient is taking medications that are aimed at eliminating bacterial infections. But first things first.

Severe irritable bowel

It is not so important for what reason you have developed this disease, because in any case such a deviation is accompanied by unpleasant sensations in abdominal cavity. According to patients, with this pathology, they feel quite intense pain, a sensation of fluid transfusion, as well as gas formation and bloating.

In most cases, diarrhea from pills goes away on its own after you stop taking the medication. But if this did not happen, and the patient feels the following symptoms, then you should definitely make an appointment with a therapist. So, what should be the reason for going to the clinic:

• The temperature is over 38°C.
• Diarrhea has been baby or an elderly person.
• The stool has acquired a tarry or black color with an admixture of blood.
• Diarrhea from pills is accompanied by unbearable pain in the abdomen.
• Diarrhea lasts intensely for more than 2 days.

Other reasons

In addition to taking antibiotics, diarrhea can occur for other reasons. Among them, one can especially single out any infections, incorrect and unbalanced diet, poisoning toxic substances, digestive disorders, diseases internal organs, stress, etc. Moreover, the regularity and type of stool can vary significantly depending on what problem caused the diarrhea.

How to treat?

If you have diarrhea, then it should be treated immediately. After all, with prolonged and intense diarrhea, your body can become dehydrated. Typically, such therapy consists of direct elimination true reason the aforementioned deviation, as well as compliance strict diet and taking special medications. With regard to the latter, the means to help get rid of diarrhea can be classified as follows.

Diarrhea can occur in anyone, regardless of gender or age. Each of us at least once in his life experienced the unpleasant symptoms of indigestion - diarrhea. Loose, watery stools, abdominal cramps, and a frequent need to empty the bowels are the main signs of diarrhea.

People of all ages can experience this condition, which is considered especially dangerous for children and the elderly, as it can lead to dehydration.

In the healthy adult population, the most common is short-term diarrhea that lasts for several days and disappears on its own, without any special treatment, but only if you follow a diet for diarrhea.

When diarrhea lasts more than a week and is accompanied by dehydration, excessive thirst, dry skin and mouth, strong weakness and dizziness, you should immediately consult a doctor.

Medical attention is also needed when abdominal pain or rectal problems are present. pain, stools with an admixture of blood, as well as when the body temperature is elevated (more than 38.5 ° C).

The following signs may indicate the presence of diarrhea:

• frequent stools of a liquid consistency;
• bloating;
• nausea;
• cramps and pain in the abdomen;
• vomit;
• fever;
• stool with mucus or blood.

Causes of diarrhea

Tourists visiting hot distant countries often suffer from diarrhea. The reason for its occurrence in this case may be exotic products or water from an unknown well or reservoir, as well as non-compliance with sanitary standards.

Diarrhea can also occur in malabsorption syndrome, ulcerative colitis, or irritable bowel syndrome.

With carbohydrate malabsorption digestive system unable to digest and absorb sugar. If this condition is accompanied by lactose intolerance, then in the case of the use of dairy products with a sugar content, diarrhea develops.

Fat malabsorption may occur due to a decrease in pancreatic secretions necessary for normal digestion or due to mucosal changes small intestine which interferes with the digestion and absorption of fats. Undigested fats enter the thin and colon where, with the help of bacteria, they are converted into chemical substances which stimulate the formation of water in the colon. In this case, the passage of stool is much faster.

Frequent use of laxatives (for example, to lose weight) is also a cause of chronic diarrhea.

Some other medications (antidepressants, non-steroidal anti-inflammatory drugs, antibiotics) can also cause loose stools.

chronic diarrhea

Chronic diarrhea is a condition where symptoms persist for a long time or reappear after a period of time. Its presence indicates a serious illness.

Chronic diarrhea can be caused by some infectious diseases (dysentery, cholera, typhoid fever and etc.). AIDS patients often suffer from chronic intestinal infection which causes diarrhea.

Crohn's disease and ulcerative colitis contribute to the development inflammatory process in the small or large intestine, manifested by chronic diarrhea.

Diet for diarrhea is important element in the fight against an unpleasant symptom. Dishes with high content fats increase intestinal motility, so it is recommended to exclude heavy, fatty and fried foods. It is also advisable to avoid eating foods that irritate the mucous membrane of the stomach and intestines.

It is recommended to eat small meals throughout the day so that the digestive system works at a slower pace. It promotes better digestion and assimilation nutrients as well as decreased appetite. The diet for diarrhea should be oatmeal, boiled or baked vegetables, rice, lean meat, crackers and bananas.

Until the condition of the intestines returns to normal, it is necessary to exclude milk, fruit juices, fresh fruits and vegetables themselves, coffee and alcoholic beverages.

With cramps in the stomach, loss of appetite and a feeling of indigestion, it is advisable to stop eating for a while.

Treatment of diarrhea

Treatment of diarrhea aims to address the underlying cause disease state to normalize the stool and avoid possible complications.

Diarrhea may resolve within 1-2 days without any treatment. If the problem cannot be corrected with a liquid diarrhea diet, the doctor may prescribe medications that slow down bowel movements. Treatment is given after some tests are done to determine the cause of the diarrhea. These funds are contraindicated in children.

If you have a fever, nausea or vomiting, persistent abdominal cramps or pain, or obvious symptoms dehydration, detection of mucus or bloody impurities in the stool, you should definitely see a specialist. Hospitalization required for prolonged diarrhea(more than 2-3 days) especially in young children or the elderly.

To alleviate the condition, you can use medicines for diarrhea, which are dispensed in a pharmacy without a doctor's prescription (hilak forte, rehydron, smecta, etc.). However, with prolonged diarrhea (more than 5 days) with weight loss, you should urgently seek specialized help.

Infection requires antibiotic therapy. In some cases, treatment may be as simple as eliminating one drug or food. For people with lactose, carbohydrate, or fat intolerance, treatment for acute or chronic diarrhea consists of avoiding lactose-containing foods or drinks, as well as sugar substitutes (sorbitol) or fat.

Chronic diarrhea can be caused by inflammatory or bacterial diseases colon, in which damage to the epithelium occurs, abscesses and ulcers form. Chronic diarrhea often occurs with infectious diseases caused by enterotoxins. Significantly less often - with intestinal damage malignant neoplasms, ischemia.

Osmotic chronic diarrhea is associated with the accumulation in the intestines of undissolved carbohydrates that have been fermented but not absorbed into the bloodstream.

At functional disorders the work of the liver, stomach, pancreas and biliary system, anatomical imperfection of the intestine, with a number immune diseases, against the background of long-term use of laxatives or a number of pharmaceuticals chronic diarrhea may occur.

Treatment of chronic diarrhea

Effective treatment of chronic is possible only after diagnosing the main causes that led to its appearance. Only in the presence of the results of the examination received, the doctor prescribes a full-fledged therapy.

For all forms of chronic diarrhea, the patient is prescribed diet No. 46. For chronic bacterial diarrhea, the recommended intake is Baktisubtil, Enterol, Hilak-Forte, Bifidumbacterin.

As symptomatic therapy drugs are used: "Smecta", "Tannacomp", decoctions of chamomile, eucalyptus, oak bark, barberry.

In addition, with all types of chronic diarrhea, it is required to normalize motor function gastrointestinal tract. For this, the following are used: "Loperamide", "Octreotide", "Dalargin", as well as blockers calcium channels: "Foridon", "Verapamil". With secretory diarrhea, secretion inhibitors are prescribed, for example, Octreotide, Cholestyramine.

Osmotic chronic diarrhea is treated with absorption stimulants: Foridon, anabolic hormones, digestive enzymes. Also recommended complex therapy metabolic disorders.

Exudative diarrhea is eliminated with the help of Mesalazine, Sulfasalazine, glucocorticoids. With motor diarrhea, psychotherapy is prescribed, Loperamide.

The patient should be informed that chronic diarrhea can be triggered by antacids, long-term use antibiotics, antiarrhythmic drugs, artificial sugar, anticoagulants, medicines with potassium salts. For successful treatment chronic diarrhea, all of these remedies should be canceled or the treatment tactics should be reconsidered.