Chronic enteritis prognosis. Viral infectious enteritis. Treatment of enteritis in adults

Under the name enteritis, doctors mean problems in the digestive system when absorption processes are disturbed. The disease is quite specific - its appearance can be provoked different factors and there is no cure as such.

Causes of enteritis

Most often, the symptoms of the disease in question appear against the background of pathologies of the organs of the gastrointestinal tract - for example, when diagnosed (inflammation of the pancreas), (inflammation of the gastric mucosa), (inflammation of the gallbladder) and others.

But the factors provoking the appearance of enteritis, doctors also recognize various infectious diseases, which are accompanied by a pathological lesion of the intestinal mucosa. These include salmonellosis, dysentery and/or viral infections.

The disease may occur when helminthic infestations, when affecting the work of the digestive system external factors(physical / chemical), against the background of an improper diet.

In each individual case, the physician must determine true reason development of enteritis. To be able to prescribe adequate treatment.

Enteritis symptoms

The symptomatology of the disease in question is considered variable and may depend on the severity of the course of enteritis, the form of pathology. Despite the fact that in medicine there is a distinction between acute and chronic enteritis s, the chronic form of the disease is most often diagnosed. This is because the symptoms acute enteritis are pronounced, the patient tries to help himself and this most often "works". Naturally, there is no talk of any appeal for medical help - it is precisely at these moments that the nature of the disease changes from an acute form to a chronic one.

All the symptoms of enteritis are divided into two groups.

Extraintestinal symptoms

Just this group of symptoms includes a violation of the absorption process, so the patient almost immediately understands that not everything is in order with his health. Judge for yourself what doctors refer to the group of extraintestinal symptoms of enteritis:

Sudden weight loss. Moreover, people do not make any efforts to this, sometimes even the appetite does not decrease, and the weight drops rapidly - in some cases, patients lose up to 20 kg in 4-6 weeks.
General weakness. This symptom is inherent in many diseases, but enteritis is characterized by a combination of lethargy and weight loss.
Violations of the psycho-emotional background. It's about about problems with sleep - at night the patient suffers from insomnia, but in the daytime he is overcome by drowsiness. Do not forget about increased irritability without obvious reasons for such a state.
Appearance changes. Patients with enteritis, when the absorption process is disturbed, note brittleness and dryness of the hair, thinning and delamination of the nail plates, tarnishing and a grayish tint of the skin.

Note:if enteritis progresses, but no medical measures the patient does not conduct, then palpitations, decreased tendon reflexes, and muscle cramps are added to the extraintestinal symptoms.

Everything is simple here - enteritis is an inflammatory disease that is localized in the intestine, so the symptoms will be appropriate:

recurrent pain in the lower abdomen or in the right iliac region;
diarrhea that occurs regardless of what foods were eaten;
bloating, rumbling;
increased gas production.

Note:if the disease in question occurs against the background of cholecystitis, then the patient will complain of dry mouth and a bitter aftertaste when eating food, but if the main disease is gastritis, heartburn, belching with an unpleasant odor will be noted.

If we talk about how to treat enteritis that has arisen against the background of any pathology of the organs of the gastrointestinal tract, then doctors say that you first need to eliminate the cause of enteritis, then it will be possible to normalize bowel function.

It is strictly forbidden to take medications that slow down intestinal motility when symptoms of enteritis appear. In this case, all harmful / toxic substances will not be excreted from the body, which leads to a deterioration in the patient's well-being, the development of intestinal dysbacteriosis.

Note:if a person has acute attack enteritis, and there were no indicated drugs nearby, then green or black tea will help to alleviate his condition - you just need to chew and swallow a teaspoon of these leaves. Don't forget to drink warm water.

The main rule of successful treatment of enteritis is strict observance diets. Firstly, the disease in question most often develops against the background of a violation of the diet. Secondly, the diet will help normalize the work of intestinal motility, relieve diarrhea. Thirdly, the facilitated mode of functioning of the organs of the gastrointestinal tract will help to quickly restore the work of the intestines.

Diet for enteritis

In general, patients with enteritis need to carefully consider their own menu - there are some restrictions, there are also categorical contraindications for use certain products nutrition. The following dietitian recommendations should be followed:

In the daily menu when diagnosing enteritis, you can include dishes from low-fat varieties meat. They must be either baked, or boiled, or steamed. Lubrication of meat with an egg is allowed, but breading of the dish is strictly prohibited.
With enteritis, it is allowed to use chicken, turkey, rabbit and veal cutlets. But a whole piece is better to boil or bake chicken and veal. It is not forbidden to introduce sausages, boiled beef tongue, pancakes with meat filling into the diet.
You can eat fish of lean varieties - it is cooked either in a whole piece or in chopped form. Fish can be baked and boiled, but not fried.
Soups for patients diagnosed with enteritis are prepared on vegetable or mushroom broths, but if meat broth is being prepared, then it should be the second. All ingredients (vegetables, cereals) should be finely chopped, and if enteritis is in the acute stage, then the patient should eat pureed soups.

Note:borsch is allowed to enter the menu only in the stage of remission of enteritis. At the same time, the vegetables for it must be carefully chopped, and the amount of tomato paste must be significantly reduced.

It is allowed to introduce milk, fat-free cottage cheese, kefir, yogurt into the diet. hard cheese can only be eaten grated or cut into thin slices. Sour cream is allowed to be added to ready-made dishes, but not more than 15 grams per plate. Cream is added to pastries, meat casseroles or hot drinks.
Porridge should be boiled in water or vegetable / meat broths. During periods of remission of enteritis, it is allowed to add a little milk to the porridge. Millet and pearl barley are excluded from the diet.
Vegetables can be consumed with enteritis, but not all. Nutritionists recommend including potatoes, pumpkin, zucchini, carrots, beets, cauliflower / white cabbage in the menu, green pea. These vegetables can be boiled, baked and stewed, but adding vegetable or animal fats to meals should be kept to a minimum. You can also enter greens in the menu (dill, parsley, basil and others), but it needs to be finely chopped.
It is quite possible to afford fruits and berries, but it is better to cook compote from them, make jelly or mousse, apples can be baked, but lemons / oranges can only be added to tea. If the patient prefers watermelons, grapes and tangerines, then they can be consumed only with prolonged remission of enteritis, no more than 200 g per day and without skin.

Many patients of gastroenterologists worry about the fact that it will be necessary to exclude sweets and pastries from the diet - what can we hide, most people are downright addicted to these culinary joys. Do not be upset - with the disease in question, it is quite allowed to use toffee, not chocolate caramels, marmalade, marshmallows, sugar, nuts, honey, marshmallow. From baking, you can safely enter dried muffins, dry cookies into the menu.

Note:if enteritis is in remission, then no more than once a week you can eat curd cheesecakes, pies with fish and green onion, pies with jam, eggs and liver.

Traditional medicine has enough large quantity recipes to help you deal with unpleasant symptoms enteritis. It will not be superfluous to recall that before applying such folk remedies the patient must be examined and receive confirmation of the diagnosis. And still it is necessary to consult with the attending physician concerning expediency of alternative treatment.

If permission has been obtained, or you have been diagnosed with chronic enteritis and all tests / studies have been completed for a long time, then you can help yourself with the following means:

Prepare a decoction of chamomile, calendula flowers and yarrow. These components are taken in equal amounts (1 tablespoon each) and pour 500 ml of boiling water. Then the mixture is put on a low fire and boiled for 7 minutes. The broth must be cooled, strained and stored in a cool place.

How to use: 2 tablespoons 4-5 times a day before meals.

If a chronic form of enterocolitis is diagnosed, it is accompanied by diarrhea, then you can restore / normalize bowel function by eating 200-300 grams of green apples per day. Nothing else can be eaten on this day!
Prepare juice from plantain leaves, mix it with water in the proportion of 1 teaspoon of juice and 2 tablespoons of warm water.

How to use: a teaspoon three times a day 20 minutes before meals.

Tansy flowers should be brewed with boiling water according to the principle of making ordinary tea. To do this, take a teaspoon of tansy and 250 ml of boiling water, leave for 20-30 minutes.

How to take: 1 tablespoon 6-10 times a day.

If you take a pomegranate, then you can also cook excellent tool to relieve the symptoms of enteritis. It will take 20 g of pomegranate peel (dry) and 50 g of fresh grains - they are poured with 300 ml of boiling water and left to simmer for 10-20 minutes. Then the medicine is filtered and cooled.

How to use: 2 tablespoons 2 times a day.

rhizome of the herb burnet;
alder cones;
bird cherry berries;
cumin fruits;
fennel fruit;
peppermint leaves;
fruits of the highlander snake;
chamomile flowers;
St. John's wort grass.

Everything is taken in equal amounts and thoroughly mixed. Then you need to take 2 tablespoons of medicinal herbal collection and pour them with 200 ml of boiling water, leave in a water bath for 10-15 minutes. It remains only to cool the finished product for 45 minutes and strain, and only after that the broth is brought to the amount of 200 ml by adding ordinary boiled water to the broth.

How to take a decoction from the collection medicinal herbs : 3 tablespoons before meals.

Enteritis enough strange disease- it is, even doctors differentiate it, but only the simplest medicines and diets can offer treatment. And. Experts assure that it is possible to restore the efficiency of the intestine quickly, but for a long-term remission, you need to try - adhere to a strict diet, carry out alternative treatment if possible. But the prognosis is favorable - patients live safely all their lives with chronic enteritis.

Tsygankova Yana Alexandrovna, medical observer, therapist of the highest qualification category

Enteritis is an inflammatory or inflammatory-dystrophic lesion of the small intestine, leading to atrophy of its mucous membrane in a chronic course. Violated the synthesis of intestinal juice and its barrier function. Therefore, patients should, whenever possible, refuse products for which mechanical and chemical methods processing.

Enteritis can appear in patients of any age, and in children appears acute stage, and in the older generation - chronic, which is associated with other diseases. The chronic stage develops when there was no treatment for the acute form.

Studies have shown that in countries with a hot climate, enteritis is diagnosed more often than in countries with a temperate climate. Very often, the occurrence of enteritis is associated with prolonged use of antibiotics and other antibacterial drugs, alcohol abuse. Enteritis in children is especially dangerous, since it is often quite difficult to identify the cause of the disease and start the correct treatment.

According to statistics, every person in his life suffered from an acute form of enteritis, and a quarter of the world's population has a chronic form of the disease.

Causes of enteritis

Enteritis is caused by the following reasons:

malnutrition;
food poisoning;
food allergens;
alcohol;
smoking;
fatty food;
side effects of drugs;
infectious agents;
autoimmune diseases;
heredity;
chemical poisoning with lead salts, mercury;
surgery and intestinal trauma.

Enteritis symptoms

Enteritis most often begins suddenly.

On the background general malaise, loss of appetite occur quite intense pain in the abdomen. Appears rumbling in the abdomen and diarrhea characteristic of enteritis. The chair happens from 3 to 10 times a day. The stools are usually profuse, at first sometimes with a putrid odor and a lot of flatus, later foamy, with a sour smell.

The temperature often immediately rises to high numbers; in other cases, it is subfebrile, rarely normal. Nausea, vomiting and belching are observed mainly in the presence of a lesion of the stomach. In the vomit, in addition to food debris, contains mucus, bile impurities.

Appetite is usually absent. Patients are thirsty. The face is usually pale, the tongue is dry and furred. The abdomen is more often swollen, less often retracted. During an attack of cramping abdominal pain, peristalsis can be visible to the eye.

During palpation, abdominal pain and rumbling are noted. Protein, hyaline casts, urobilin and indican are found in the urine. In severe forms of enteritis, collapse phenomena can be observed - a thready pulse, a decrease in temperature, convulsions, etc.

Food intoxications are the most violent and are accompanied by fever and a drop in cardiovascular activity. Often they are accompanied by an enlargement of the spleen and in their manifestations are similar to typhoid fever, paratyphoid or cholera. Frequent diarrhea and vomiting lead to severe dehydration, anuria and seizures. The stools look like rice water.

With salmonella toxic infection, in some cases, death can occur.

Treatment of enteritis

Patients with severe enteritis, as well as enteritis of toxic origin (the further course of which is difficult to determine in the first hours of the disease) must be hospitalized. Patients with infectious enteritis are hospitalized in infectious diseases hospitals.

In all cases of acute enteritis, in order to remove toxins from the gastrointestinal tract, the stomach is washed (by an eond or tubeless method) with a weak solution of sodium bicarbonate, a laxative is given orally (30 ml of castor oil or 25 g of magnesium sulfate in 100 ml of water).

Viral enteritis

An acute inflammatory process in the mucous membrane of the small intestine caused by a virus pathogen is called viral enteritis. Often, along with the small intestine, the large intestine and stomach are affected, enterocolitis or gastroenteritis develops.

MKb-10 code

All viral infections causing violation bowel work according to the International Classification of Diseases (ICD) 10th revision belongs to the group of intestinal infections, which, in addition to viruses, also cause bacteria and protozoa. The ICD-10 code for viral enteritis is A08.

Separate subgroups include rotavirus enteritis (A08.0), acute gastroenteropathy caused by Norwalk (norovirus) (A08.1), adenovirus enteritis (A08.2), other viral enteritis (A08.3), and unspecified intestinal infection of viral origin ( A08.4).

causative agents of viral enteritis

With enteritis of the viral type, infection with enterotropic viruses occurs, in which the slime layer small intestine. Sometimes nearby and distant organs and systems are involved in the pathological process. The causative agents are precisely viral infections such as enteroviruses, rotaviruses, ECHO or Coxsackie virus.

How does infection occur with viral enteritis

The viral agent is transmitted from a sick person or carrier to a healthy person with reduced immune status mainly with "dirty hands", when shaking hands, when coughing and sneezing, when eating contaminated food and water, when kissing and hugging, and other contacts.

Possible transmission to the fetus from the mother during pregnancy. Children of toddler and preschool age are most susceptible to viral enteritis. They, as a rule, endure the disease much easier than adult patients.

Symptoms and treatment of viral enteritis

Viral enteritis is confirmed by specific symptoms of intoxication, vomiting, diarrhea. Therapeutic activities consist of symptomatic, detoxifying actions. But, unfortunately, there are no preventive and narrowly targeted antiviral measures for people.

Consequences of viral enteritis

The consequences of viral enteritis can be serious for vulnerable groups of patients, as they plentiful drink may not be enough to correct dehydration. Small children sometimes refuse to drink.

Therefore, in severe cases, hospitalization is indicated for such patients. Intravenous fluids perfectly correct dehydration and make it possible to quickly restore normal water and electrolyte balance in the body.

Chronic enteritis

The reasons

The causes of chronic enteritis are most often the consequences of poor nutrition, helminthiasis, giardiasis, geotrichosis, poisoning with some heavy metals.

Also, chronic enteritis can be a consequence of long-term use of antibiotics, various drugs (usually saline laxatives).

Some congenital diseases, accompanied by a violation of the synthesis of certain enzymes in the intestine, can also be causes of chronic enteritis.

Symptoms

In chronic enteritis, symptoms such as rumbling in the abdomen, dull pain in the umbilical region, weakness and nausea are also present, in some cases there are diarrhea (more often with enterocolitis). On palpation of the caecum, rumbling and splashing are observed.

During bowel movements, there is an increase in the amount of feces, which becomes more watery or mushy, and its color is yellow-green with inclusions of undigested food.

The general condition of a person worsens, weakness and fatigue are observed, appetite decreases, sleep is disturbed, a person becomes irritable.

Degrees

Three degrees of severity of the course of chronic enteritis are noted.

Treatment

Treatment of chronic enteritis should be comprehensive, including agents that affect etiological and pathogenetic factors, as well as local and general manifestations of the disease.

According to research, positive result from complex treatment, including diet, enzyme and weak choleretic drugs, antibacterial, enveloping, astringent, adsorbing, neutralizing organic acids means, along with drugs that normalize the passage of contents through the intestines and reduce inflammation in it when applied topically, were received by 84% of patients with chronic enteritis.

In patients, diarrhea, abdominal pain, bloating, rumbling stopped, which in 52% of cases was combined with a decrease in the degree of colonization of the upper parts of the small intestine by microorganisms.

Diet

An indispensable component of complex therapy is a mechanically, chemically and thermally sparing diet. Therapeutic nutrition has a positive effect on the main links in the pathogenesis of diarrhea: it reduces not only increased osmotic pressure in the intestinal cavity, but also intestinal secretion, leading to the normalization of the passage of contents through the intestines.

First, during an exacerbation, diets No. 4 and 4a are prescribed, which help to eliminate inflammation, fermentation processes in the intestines, and normalize intestinal peristalsis. After 3-5 days, the patient is transferred to a complete diet No. 4b, rich in protein, containing normal amounts of fats and carbohydrates (100-115 and 400-500 g, respectively).

Diagnosis of enteritis

The diagnosis is made on the basis of the clinical picture, epidemiological history, laboratory results.

On palpation, pain and rumbling in the small intestine are noted. Oliguria, proteinuria, microhematuria, often leukopenia, erythrocytosis are observed. In feces are determined a large number of mucus, undigested fiber, starch grains, muscle fibers.

Of great importance are the results of bacteriological and virological studies of feces, the detection of antigens of pathogens in urine, saliva, blood, or an increase in the titer of antibodies to them.

Differential Diagnosis

Differential diagnosis is made with acute appendicitis, less often with acute intestinal obstruction, perforated stomach or duodenal ulcer, acute pancreatitis. When excluding appendicitis, it is taken into account that in adults it usually proceeds without diarrhea.

Pain in appendicitis is usually localized in the right iliac region, in contrast to acute enteritis, signs of peritoneal irritation are revealed. In acute intestinal obstruction, there is no stool, the stomach is not swollen, the gases do not go away, they disappear bowel sounds, there are symptoms of irritation of the peritoneum, with x-ray examination intestinal fluid levels are determined.

A perforated ulcer is characterized by “dagger” pain in the abdomen, pronounced tension of the anterior abdominal wall (board-like abdomen), absence of stool, leukocytosis, the presence of free gas in abdominal cavity during x-ray examination.

At acute pancreatitis pain is usually of a surrounding nature, often due to intestinal paresis, stool retention is observed, the level of a-amylase in the urine and blood increases.

Enteritis in children

The disease can occur in a child at any age.

Enteritis in children is dangerous due to the complexity of its course, which is especially true in the case of young children who mainly eat dairy products and cannot, for obvious reasons, talk about discomfort.

The reasons

The causes of the appearance and development of the disease are extremely diverse. All kinds of violations digestion, decreased efficiency of the small intestine, rapid passage of food through the intestines, malnutrition - these are the factors due to which the child may experience enteritis.

Symptoms

Symptoms of the disease depend on the severity and form of the disease. As a rule, enteritis in children is accompanied by diarrhea, discoloration of feces (from light yellow to gray), diarrhea, gas formation, rumbling in the abdomen and painful sensations in the region of the stomach. Accurate Diagnosis doctors put after a preliminary examination of the child and the necessary tests.

Treatment

Assign a complete diet with a 10-15% higher protein content, a physiological amount of fat and a restriction of carbohydrates. Exclude foods containing a large amount of fiber, as well as whole milk (diet number 4).

The use of protein enpit and sour-milk lactobacterin enriched with lysozyme is effective. In severe cases, parenteral nutrition is used. Enter vitamins C, group B, folic acid.

Reception shown enzyme preparations(pancreatin, panzinorm, polyzyme, festal). In the severe course of the process, antibacterial drugs are prescribed: derivatives of 8-hydroxyquinoline (enteroseptol), nitrofuran series (furadonin, furazolidone), nalidixic acid (nevigramon), as well as sulfasalazine and biseptol.

After the course antibacterial treatment biological preparations normalizing intestinal microflora(colibacterin, bifikol, lactobacterin, bifidumbacterin). Bacteriophages are also used (staphylococcal, Pseudomonas aeruginosa, coli-Proteus, etc.).

Enveloping and adsorbing agents (tanalbin, white clay, bismuth preparations), medicinal plants (chamomile, peppermint, St. John's wort, nettle, blueberries, etc.) are effective. Forecast at long-term treatment favorable.

Forecast for enteritis

The prognosis for enteritis is favorable.

If a patient with an acute form is treated strictly according to the doctor's recommendations, then recovery begins in the near future. As for the chronic stage, things are somewhat different here. The chronic form is constantly progressing, due to the depleted body in adults, a fatal outcome occurs.

Questions and answers on the topic "Enteritis"

Question:What is enterostasis?

Answer: Hello. Enterostasis - intestinal obstruction.

Question:Hello! My baby is 8 months old. The doctor diagnosed us with enteritis. We receive treatment: stopdiar, enterosgel and creon. Presumably we are deficient in enzymes. Symptoms of lactase deficiency. We can’t start complementary foods - the doctor sends for a consultation with a geneticist. Can you please tell me what information we can get from a geneticist? How much is this consultation needed? What tests will need to be done before this consultation?

Answer: Hello. A geneticist will help you understand how likely cystic fibrosis is, another digestive disorder, but already due to a genetic predisposition. You don’t need to take any tests before a geneticist, he himself will send you where he sees fit.

Question:Hello! My child was diagnosed with enteritis from the age of 11 months (before that, she had been treated unsuccessfully for dysbacteriosis since a month, the food was very poorly digested). The diagnosis was made by an experienced gastroenterologist, who, unfortunately, is not from our city. The treatment was prescribed: enterol + bifiform + diet, we coped with this problem, but for a while, because with the slightest violations in nutrition or hygiene ( dirty hands) she has diarrhea and tummy ache. Now she is 5 years old, we drank another course in January after an exacerbation. The daughter of the last 3-4 weeks began to often complain of abdominal pain in the navel area, pulling. The gastroenterologist in our clinic is so "experienced" (I would not like to discuss the doctor, but she was not able to give us a correct diagnosis, she did not know about such a disease) that it remains either to go to a consultation in another city, or here is a virtual consultation. I understand that treatment is not prescribed in absentia, at least a consultation! And another question is - can the body get used to the drugs? In particular, to the bifiform biological product? Does it make sense to drink, for example, Linex?

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What it is? Enteritis is a collective term for various pathological processes that cause inflammatory reactions in the intestinal walls. The mucous membrane, muscular and serum membranes can be affected, but the mucous membrane of the small intestine suffers more often than others.

Inflammatory reactions provoke catarrhal or diphtheric changes in the intestinal lining, can manifest themselves different character lesions - hyperemia and swelling of the mucous membrane, hemorrhagic, purulent and ulcerative processes.

The provoking factor of enteritis can be long-term use drugs, autoimmune and allergic processes, diseases and disorders in the enzymatic and gastrointestinal systems, genetically determined pathologies and much more.

Types of enteritis are classified:

Enteritis can manifest itself as an independent form (primary, idiopathic), or as a secondary, symptomatic form, concomitant background pathologies(mainly diseases of the kidneys and liver).

Chronic enteritis in adults

In the development of chronic enteritis in humans, the main role is assigned to several factors - inflammatory reactions in the intestine develop as a response to permanent damaging factors affecting the intestinal walls (irritation, toxins). Such violations become a prerequisite for the development of dysbacteriosis.

Usually the small intestine is sterile, or contains a meager bacterial flora in its cavity. Its population is noted mainly in the area of the distal segment of the intestine.

Dysbacteriosis, in turn, provokes an increased colonization of the intestinal cavity with microorganisms atypical for the intestine (flora and opportunistic organisms), their transformation occurs (their features and functions change), and aggression towards the intestinal mucosa increases. The already disturbed processes of digestion are aggravated. In the process toxic effect end products of microbial metabolism, permanent damage to the intestinal walls occurs.

The formation of chronic enteritis is facilitated by immunological disorders due to the development of a food hypersensitivity reaction and autoallergization of the body to tissue decay products. With a protracted illness, under the influence of toxins, the protein structure of the intestinal lining changes, which subsequently plays an antigenic role in the development of autoallergic manifestations.

An important component in the formation of enteritis in adults are weakened processes of protective factors and deficiency of lgA immunoglobulin (secretory).

Under the inflammatory influence, the processes of enzymatic secretion are disrupted, which leads to dysfunction in the cavity and parietal digestion, and the development of malabsorption syndrome in small intestine.

Not the least important in the causes of enteritis is the motor and tonic functions of the intestine, which are responsible for mixing products with food secretion and moving intestinal contents through the gastrointestinal tract. In chronic enteritis in adults, secondary disorders are often detected in the internal environment of the body - immune, endocrine and endocrine, nervous, etc.

Symptoms and signs of the disease are variable, and the manifestations depend on the form and severity of the pathology. Despite the fact that enteritis is manifested by acute and chronic process, more often the initial diagnosis states a chronic course.

This is due to the fact that adults often try to stop the pronounced symptoms of acute enteritis on their own. And it is during this period of "successful" self-treatment of the symptoms of enteritis by adults that the disease, as a rule, enters its chronic phase.

However, patients may present with extraintestinal and intestinal signs diseases.

Extraintestinal signs due to malabsorption syndrome (impaired absorption in the intestine). According to their manifestation, it is not difficult to suspect problems in the body that manifest themselves:

Rapid weight loss. In a couple of months, a person with a normal appetite can lose over 15 kg. body weight;
chronic fatigue, characteristic features fast weight loss;
Psychosomatic disorders - nocturnal insomnia and drowsiness during the day, imbalance and incontinence;
Changes in appearance- dryness and brittleness of hair, thinning and stratification of nails, a gray tint of the skin;
If left untreated, tachycardia, hyporeflexia and muscle cramps may develop.

individually are rare, so inflammatory reactions most often develop in all parts of the gastrointestinal tract, manifesting themselves:

Violation of bowel movements (constipation or diarrhea);
Meteorism, flatulence (passage of foul-smelling gases) and tenesmus;
Periodic pain that occurs in the iliac and lower abdomen.

If the disease is accompanied by cholecystitis, patients experience xerostomia (), an unpleasant bitterness after eating. If the genesis of the disease is due to gastritis, signs of enteritis in a person will be manifested by heartburn, accompanied by bad smell belching.

The development of enteritis in children, signs and symptoms

The genesis of the development of enteritis in children is primarily due to a decrease immune protection child on the background infectious diseases, beriberi and intestinal dysbacteriosis, provocative effects of cold drinks and foods rich in fiber. Often, the first symptoms of enteritis in children are preceded by gastritis and recent infections.

The main symptom of enteritis in a child is diarrhea.

The stools may be yellow color with the inclusion of many particles of undigested food and mucus. Sometimes the stool has a gray color with a characteristic clay sheen and a fetid odor, which indicates a violation of the absorption of fats. If there is a fermentation process in the intestines, the stools may be foamy.

As additional features are:

Pain during bowel movements;
Increased frequency of emptying (more than 15 times / day);
Flatulence and intestinal rumblings;
Cramping, dull, or arching soreness in the navel area;
Intoxication symptoms in the form of vomiting and nausea;
High temperatures.

Otherwise, the course of the disease in children is not much different from the manifestation in adults. Appointments of correct and adequate therapeutic procedures in the treatment of enteritis in children are carried out only by a doctor, after establishing the provocative factor and the severity of intestinal damage by inflammatory reactions.

Therapeutic therapy for enteritis is based on complex treatment medications along with the diet. Wherein, healing process not aimed at eliminating causative factor, but has a symptomatic orientation - the elimination of symptoms.

Treatments for chronic enteritis include:

Antisecretory agents that help relieve diarrhea are Imodium and its analogues, for example, Lopreamide.
Antibacterial therapy with drugs "Monomycin", "Erythromycin", "Levomethycin", "Rifampicin" and "Oleandomycin". After that, drugs are prescribed that restore the intestinal microflora - Bifidumbacterin, Lactobacterin.
Vitamin complexes that restore iron deficiency - "Maltofer", "Ferokal", "Ferum-lek", "Aktiferin".
With disorders of absorption and digestion, food is the drug "Panangin", vitamin complexes, "Calcium gluconate", "Protein hydrolysates" and multivitamins.
Signs of flatulence are eliminated by the appointment carminatives, for example "Espumizana".
In the form of replacement therapy, enzyme preparations are used - "Festala", "Mezima", "Creon", etc.
AT complex therapy steroid hormone preparations may be included to help reduce intestinal inflammation and improve absorption.
To restore body weight, drugs that promote protein absorption are prescribed - this is intravenous administration"Intralipid" or "Lipofundina", which contributes to the rapid regeneration of the mucous membrane of the intestinal walls.

positive effect from drug therapy can be achieved only if certain nutritional rules are observed. Diet for enteritis is the main focus of therapy.

The time to follow the diet determines the severity of clinical symptoms and the individual characteristics of the patient's body. diet diet food should be complete, balanced and high-calorie. It is unacceptable to exaggerate the diet and "torture" the patient with hunger.

In addition to observing the rules providing for a sparing regimen for the intestines (mechanical and chemical effects), the diet should be dominated by protein food, primarily meat, which helps to counter fermentation processes in the intestines. The main direction in therapeutic diet- this is to restore as much as possible the disturbed functions of the intestines and other organs covered by the pathological process.

According to their effect on intestinal functions, nutrients are divided into groups:

1) Influencing the functions of intestinal emptying, these are kefir, fruit juices, black bread, mineral water, fats, foods rich in fiber, salt and foods consumed cold.

2) Delaying emptying is food containing tannins (tannins) - tinctures, juices or jelly from blueberries, cocoa, strong, tart tea, red wine, pureed food and warm drinks, slimy soups.

3) Having indifferent properties - fish and meat products prepared in a chopped way, or in the form of pastes, well-baked bread, unleavened, fresh cottage cheese.

Guided by these indicators, you can create an excellent menu for the patient. Usually, in a diet for enteritis, dietary (a, b and c) is recommended, for many, this does not mean anything. Simply put, this means that in case of an acute course with signs of profuse diarrhea, a sparing diet is prescribed containing a normal amount of protein food with carbohydrate restriction and not more than 10 g. salt per day.

Dishes must be pureed or steam cooked. The total calorie content of the daily diet should not exceed 2100 kcal. Such food should be within the first five days. Then you can go to (b) option, for a period of one to two months.

This nutritional option is a complete diet with energy calories up to 3500 kcal. Products that stimulate the secretion of the stomach and contain vegetable fiber are excluded. Cooking - boiled and steamed.

In the remission phase - (c) the option is used for pain relief and the absence of dyspeptic symptoms.

The gradual expansion of the diet begins. Products do not rub off. Perhaps the inclusion in the diet of soaked herring, low-fat ham, boiled vegetables in the form of a salad, up to 200 gr. / day, raw fruits and vegetables, juices, herbs (parsley dill), jellied tongue and fish.

Forecast

In the acute form of the disease, the mild and moderate clinic of the disease is quickly stopped, with the right therapy. Severe processes that are difficult to treat with medication can provoke the development various complications in the form of intestinal hemorrhages, perforation of the small intestine, necrotic areas or severe dehydration, which requires emergency medical interventions.

The chronic picture is due to periods of remission and exacerbations. Gradual progression exacerbates inflammatory processes, spreading the inflammatory response throughout the gastrointestinal tract and increasing intestinal malabsorption.

The lack of adequate treatment with a long course of the disease, dangerously severe complications and the addition of an infection. As a rule, the untreated chronic course of the disease ends in lethality from exhaustion and severe internal disorders.

Enteritis- inflammation occurring in different forms with many various symptoms, which is why it may require urgent hospitalization and urgent medical treatment in adults. The occurrence of enteritis is characteristic of the small intestine, in which, due to inflammation, the normal functioning. The mucous membrane is strongly changed.

Therapist: Azaliya Solntseva ✓ Article checked by Dr.

Enteritis - symptoms and treatment in adults

It is a common inflammatory disease of the small intestine. In some cases, the disease process may also involve the stomach (gastroenteritis) and colon (enterocolitis).

Exist various reasons enteritis, the most common are:

alcohol or drugs;
an autoimmune process (due to a defective immune response that causes inflammation without any apparent effect);
viral or bacterial infection;
inflammatory disorders such as Crohn's disease or ulcerative colitis;
violation of local blood circulation;
taking certain medications;
radiation (almost all cases are caused by radiation therapy in the treatment of cancer);
trauma and surgery.

Usually, the process does not develop in isolation, but affects several parts of the small intestine at once: the duodenum (duodenitis), the jejunum (eunit), or the ileum (ileitis). It can affect the "upper floor" of the digestive tract all over at once.

Swelling of the wall of the small intestine as a result of inflammation reduces the surface area of the mucosa and impairs passive and active absorption. nutrients from the intestinal lumen into the blood. The exchange of water and electrolytes between tissue spaces (intestine and blood) is disturbed, and a large amount of fluid remains in the gastrointestinal tract.

The destruction of the epithelial layer contributes to the formation of mucosal ulcers, the natural intestinal microflora is disturbed and pathogenic microorganisms begin to develop.

Symptoms of enteritis in adults may include fever, nausea, vomiting, diarrhea, and abdominal pain. The viral process usually stops without treatment after a few days. However, if symptoms persist for three to four days or more, a bacterial disease process may be suspected and requires hospital treatment.

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The main manifestations of pathology

The manifestations of pathology vary from mild to severe. They may be present for several hours after bacterial or viral infection, penetrating into the small intestine, or not appear for many days.

Signs of inflammation of the small intestine include:

discomfort and pain in the abdomen that worsens shortly after eating;
fever;
loss of appetite;
signs of nutritional deficiency (malabsorption syndrome);
vomiting is infrequent, but may be present if duodenitis and concomitant gastritis develop;
severe diarrhea (the stool can sometimes contain traces of blood from streaks to red staining).

Generally clinical symptoms will depend on the degree of involvement of the small intestine. Given its length, if only a small extent is affected, then malabsorption (loss of one or many nutrients entering the digestive tract due to insufficient absorption in the small intestine.) may be absent or hardly noticeable.

excessive belching, sharp pain(similar to sensations in gastritis), and a change in the severity of manifestations immediately after eating may indicate that inflammation is more pronounced in duodenum. Conversely, symptoms that tend to change with bowel movements, especially those associated with straining during bowel movements, may indicate a more active disorder in the ileum of the digestive tract.

For an adequate assessment of damaged areas, it is required diagnostic study. Severe symptoms can be a sign of chronic enteritis and put you at risk of dehydration. Lack of treatment can lead to further complications.

Signs of dehydration include: weakness, excessive thirst, fatigue and dizziness. Changes in urine color, odor, and stool volume may also indicate dehydration.

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Effective treatment of the disease

Treatment of enteritis in adults can be carried out in stationary or outpatient settings, and in the case mild degree the severity of the condition specialized care may not be required. Our body has an excellent ability to heal itself under certain circumstances, and inflammation can be stopped without external intervention.

You may need to replace lost fluids with intravenous or oral (by mouth) fluids to manage symptoms of diarrhea and vomiting. Drinking adequate amounts of boiled water is often enough to prevent dehydration at home.

Sometimes antidiarrheal therapy is used. However, in some cases it is not recommended, as it can slow down the evacuation of bacteria from the digestive tract.

If you are taking diuretics and diarrhea develops, you may need to stop taking the diuretics to avoid dangerous dehydration. However, do not suspend any medication regimens unless additional consultation with a doctor.

Depending on the cause and severity of symptoms, anti-inflammatory or antibiotic therapy may be required, especially in patients with concomitant Crohn's disease.

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Chronic enteritis and its symptoms

The disease is characterized by undulating courses: remissions followed by periods of exacerbation caused by dietary errors, mental fatigue, hypothermia (hypothermia), overheating of the body, inflammatory diseases of the upper respiratory tract and other reasons.

Symptoms of exacerbation of chronic enteritis are the same as acute. With frequent and severe activations and progression of a long-term inflammatory process, due to malabsorption (loss of one or many nutrients entering the digestive tract) of nutrients in the small intestine, protein and vitamin metabolism disorders are more and more clearly detected.

This leads to a change in the functions of the digestive, nervous, hematopoietic and endocrine systems. Prognosis in mild cases and with proper treatment favorable.

Patients complain of discomfort and paroxysmal pain around the navel, rumbling and transfusion in the abdomen, a feeling of heaviness after eating, nausea, diarrhea after eating or early in the morning, sometimes dizziness and general weakness.

Stools are watery, yellow, mixed with undigested muscle and dietary fiber. The pain is due to flatulence and intestinal spasms, which often spread through the abdomen around the navel.

Sometimes hypotension (decrease in pressure), bradycardia and vascular insufficiency develop.

Violation of the intake of proteins, fats and carbohydrates leads to hypoproteinemia and increased inflammatory exudation. The latter entails a violation of the processes of absorption of other nutrients, the exchange of trace elements and the synthesis of vitamins.

Vitamin deficiency and microflora changes develop. The lack of vitamin B1 causes the accumulation of pyruvic acid in the blood and tissues, which has a toxic effect on the body: weakness, irritability, peripheral and central neuropathy, crawling sensation and burning feet, skin tingling and itching.

Deficiency signs appear nicotinic acid: crimson tongue and atrophy of its papillae, cracks and erosion of the surface.

A lack of vitamin C causes an increase in capillary permeability and bleeding, especially in the gum area. Deficiency of calcium salts leads to bone fragility and osteoporosis.

In patients who are concerned about chronic enteritis, there is a decrease in the pituitary-adrenal connection. This leads to hypotension, increased skin pigmentation, weakness of sexual function in men and amenorrhea in women. In severe forms, a chronic disease provokes hypochromic anemia.

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Proper nutrition and diet

Rational nutrition is aimed at:

Abundant replenishment of body fluids until vomiting and diarrhea disappear.
Rehydration with electrolyte drinks if fluid intake is low.
Gradual transition to easily digestible soft foods such as bananas, congee or applesauce, and then gradually adding boiled vegetables.
Exclusion of products with high content fiber and those that are difficult to digest.
Avoidance of fresh fruits and vegetables.
Exclusion of dairy and fatty foods, alcohol, seeds, nuts and tobacco.
Focus on drinking water and fluids to prevent dehydration. The goal is to take 3 liters (or twelve glasses) throughout the day. Intravenous fluids are prescribed in severe cases: if there is indomitable vomiting or diarrhea, severe exhaustion.
Food consumption room temperature, exclusion of too hot or cold drinks and food.
Taking lactose-free supplements, which can help you maintain your calorie levels without making your symptoms worse.
Inclusion in a further diet of baked chicken and fish, eggs, cooked vegetables, pasta and white bread.

Diet for enteritis is considered one of the necessary methods for successful treatment of inflammation.

Medicines to cure

For suppression bacterial inflammation bowel use various groups antimicrobials.

The purpose of a particular agent depends on the type of pathogen:

Aeromonas - cefixime and most third and fourth generation cephalosporins.
Bacillus sp. Vancomycin and clindamycin are used for severe pathology.
Campylobacter - erythromycin may shorten the duration of illness, delaying therapy 4 days after symptom onset has no effect.
Plesiomonas species - trimethoprim-sulfamethoxazole or any cephalosporin.
V.cholerae -tetracycline, co-trimoxazole, erythromycin, doxycycline, chloramphenicol and furazolidone.
Yersinia-trimethoprim-sulfamethoxazole, fluoroquinolones. Aminoglycosides are used for difficult cases.

Antidiarrheal drugs. Loperamide is usually the first drug recommended. If diarrhea does not stop with the use of this agent, then octreotide is prescribed at a dose of 100 mcg subcutaneously twice a day.

Cholestyramine also reduces the frequency of stool disorders. Sulfasalazine, by mouth and as an enema, reduces the symptoms of tenesmus (painful urge to defecate), abdominal cramps, and diarrhea.

In chronic enteritis, multivitamin preparations are prescribed, which allow compensating for the lack of trace elements due to the presence of malabsorption.

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What feces are observed in chronic enteritis

The color of the stool is yellow because it contains unreduced bilirubin. Dark feces become because, passing through the inflamed intestine, stercobilinogen is not metabolized into stercobilin.

In severe and moderate forms of pathology, a fetid greenish-brown, light yellow or clay-colored stool appears. Its viscosity is due to a significant admixture of mucus, which is mixed with feces. Sometimes it may not be if the mucus is broken down by enzymes and bacteria in the large intestine.

The stool contains an abundant content of neutral fats and acids. Because of this, the surface of the feces is covered with a shiny oily film (steatorrhea, Porge's soapy dyspepsia).

Microscopic examination of feces reveals a significant amount of undigested muscle fibers with preserved transverse striation (under a microscope), and sometimes pieces of meat (creatorrhoea). This is very characteristic of chronic enteritis in the absence of damage to the pancreas.

The acute form of inflammation differs in symptoms and the course of the disease. Creatorrhoea and steatorrhea may be absent if muscle fibers and fat are additionally digested in the distal intestine during the slow passage of feces.

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bowel disease in adults

It is an inflammatory disease of the middle part of the digestive tract, which is caused by irritants (stress, drugs), poisons, viral or bacterial infections or unknown factors. The symptoms are extremely varied, but usually include persistent or intermittent diarrhea, sometimes with blood, accompanied by painful abdominal cramps.

Fever is common and sometimes masks the signs of digestive disorders under a cold. Serious complications can occur, especially in children and the elderly.

Enterocolitis occurs when inflammation spreads to the large intestine, and gastroenteritis to the stomach. Regional enteritis (ileitis, or Crohn's disease) is chronic inflammation, which in its classical form is limited to the terminal part ileum(farthest from the stomach).

For all forms of inflammation, treatment is usually aimed at relieving symptoms, important role play anti-inflammatory and antibacterial agents.

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Allergic type of enteritis

Usually develops in response to individual intolerance to certain food products and accompanied inflammatory processes. Initially, there are practically no symptoms, except for a small amount blood in the stool.

Signs may also include abdominal pain, flatulence, intestinal cramps, postprandial vomiting, and chronic diarrhea.

The diagnosis of allergic enteritis is based on clinical examination and the results of additional tests, including endoscopy of the digestive tract with histopathological evaluation. The main treatment for this pathology is an elimination diet - the exclusion of products that provoke inflammation. Symptoms should disappear within 1-2 weeks after starting diet therapy.

This pathology consists in violations of the activity of the intestine (failures in digestion, absorption). The cause of bowel dysfunction is degenerative changes in the mucosa of the small intestine. She thins out and inflames. This article highlights the signs of the above disease.

Enteritis is a disease of the gastrointestinal tract.

There are several classifications of chronic enteritis. It is possible to distinguish its types based on the clinical and functional picture, on the morphological changes that this disease entails. But the most important classification is based on the reasons that provoked the development of this pathology. So, according to the etiology, the following types of enteritis can be distinguished:

infectious (bacterial and viral infections);
helminthic;
lamblia;
as a result of diseases of the digestive tract;
Consequently
provoked nutritional reasons(malnutrition);
manifested as a result of chemical or mechanical action

In accordance with the characteristics of the distribution, a superficial variety is distinguished, accompanied by degeneration of enterocytes, and chronic enteritis, which did not lead to atrophy. According to functional features, one can distinguish a variety with disaccharidase deficiency (when there are failures in membrane digestion), with malabsorption (when water, electrolytes, proteins, iron, carbohydrates, vitamins, fats are not absorbed); problems with motor skills (both hyperkinetic type and hypokinetic).

The clinical picture of the disease can also proceed differently depending on the severity of the manifestation of the disease. The course sometimes has relapses. The disease has several stages, according to which the manifestation of clinical signs can be characterized. This is an exacerbation and remission. The disease sometimes has complications (nonspecific mesadenitis, solaritis).

Reasons for the development of the disease

The disease develops, progresses, if there is a pathology in the state of the walls of the small intestine. This condition provokes a decrease in the necessary activity of cell membranes, the transport channels cease to perform their functions, preventing the normal absorption of water and ions. This state is always accompanied by the detrimental effect of the pathology of other organs of the gastrointestinal tract: the digestive glands lose their activity, metabolism develops in the intestine, and immunity is weakened due to these negative changes in the intestine. Due to a weakened immune system, the condition of the intestines can worsen even more. All this turns into a vicious circle.

Enteritis symptoms

Diarrhea and abdominal pain are the main symptoms of enteritis

The main manifestations of enteritis are malabsorption, diarrhea that does not stop completely. Diarrhea appears as a result of increased intestinal secretion, increased osmolality of the contents of the intestine, the development of dysbacteriosis, increased speed movement of intestinal contents. All symptoms of the disease are divided into intestinal, as well as extraintestinal.

Intestinal symptoms

Intestinal symptoms appear depending on the degree of development of the disease. In the case of damage exclusively to the upper sections, intestinal symptoms are smoothed out. If the process has spread to the ileum, then absorption is impaired in the distal intestine. bile acids. They, entering the large intestine, provoke diarrhea, because under their influence the secretion of sodium, chlorine, and water ions into the intestinal lumen increases.

In addition, there is an acceleration of motor skills. In this case, patients talk about pain in the iliac region on the right side. Then there are malfunctions of the ileocecal valve, this leads to the reflux into the ileum of everything that is in the colon, from here microbial infection begins in the ileum. If refluxitis lasts a long time, then the body faces problems with the absorption of vitamins, in particular B 12, this ends with a corresponding anemia.

Patients complain of pain in the middle part of the abdomen, in the navel area. Cramping pains or dull bursting sensations make themselves felt after eating, after 3 to 4 hours. If you palpate, then the area in the area of the projection of the small intestine (to the left and above the navel) will be painful, you can also feel a splash in the intestine (in the caecum). This symptom is called Obraztsov's symptom.

Another symptom is (yellow). Defecation happens 5 - 6 times a day. There is steatorrhea. It manifests itself in shiny stools that have increased stickiness, this is noticeable by how hard they are flushed down the toilet. Another manifestation is flatulence, rumbling, bloating. The jejunal diarrhea is very hard to bear.

Extraintestinal symptoms

These symptoms appear due to malabsorption in the intestine. This leads to weight loss, nervousness, irritability, fatigue. The condition of the skin, hair, nails worsens. Edema may develop, pastosity of the skin may appear. Patients suffer from pain in the muscles, weakness, changes EKG picture. Most of patients loses a lot of calcium, resulting in small cramps. A sharp lack of vitamins also provokes corresponding serious conditions.

Diagnosis of enteritis

The results of a laboratory blood test

In the study of blood in most cases, anemia is observed: iron deficiency, folic acid deficiency, B12 deficiency. Also, a lack of vitamin K, calcium is detected, the content of serum iron, potassium ions, chlorine is reduced in the blood serum, the concentration of vitamins is greatly reduced.

Coprological studies

Steatorrhea, amylorrhea, creatorrhea are revealed. With a deeper diagnosis, the amount of fat in the feces is studied for three days. If more than 5 g per day of fat is detected during a normal diet, then this can be regarded as a pathology.

Special Research Methods

Necessary and bacteriological examination feces. After all, the development of microbial flora. Aspiration of the contents filling the small intestine is carried out in order to study the microbes and their number (normally, the number of microbial bodies in the intestinal juice should not exceed 104 in 1 ml, with enteritis the number can increase to 109). Sowing is also carried out to identify the pathogenic environment, analysis for.

To check the ability to absorb substances entering the body, it analyzes the composition of saliva, urine, feces, and blood after the introduction of special marker substances through a probe. Most often, D-xylose is taken for the sample, which is administered in an amount of 5 g. Normally, 30% of the taken substance should be excreted in the urine, D-xylose may show a decrease in the amount of excreted substance.

A lactose digestion test may be done. Insufficiency of lactose is indirectly indicated by an increase in glucose in the blood serum.

X-ray examination, probing

To analyze the changes that have captured the terminal ileum, x-ray examination small intestine. This examination reveals tumors, Crohn's disease, diverticulosis. In order for the data on the mucosa to be the most accurate, probe enterography is performed with artificial hypotension with double contrast. This method gives complete picture about the filling of intestinal loops, about the speed of advance of the contrast agent, about the amount of liquid, mucus, about the condition of the folds and the uniformity of the retention of the substance in them.

Endoscopy

This type of examination, accompanied by a biopsy, allows you to exclude similar symptoms serious illnesses(tuberculous ileotiflitis, celiac disease, Crohn's disease). During histological examination can detect changes in enterocytes dystrophic character, moderate villous atrophy, cellular infiltration of the stroma.

Differential diagnosis of enteritis

To rule out other similar symptoms of the disease is carried out differential diagnosis. Enteritis can be confused with gastritis, accompanied by reduced secretory activity of the stomach, with pathologies of the pancreas, as well as with other diseases of the small intestine. In particular, with Crohn's disease, with Whipple's disease, celiac disease, tumors, diverticulosis.

With tuberculous lesions of the intestine, there is fever, pain in the iliac region on the right, partial obstruction intestines. Morphological changes are manifested in necrosis of the mucous membrane of the ileum, leukocytosis is present, ESR increases, the Mantoux reaction gives a positive result, post-tuberculous changes are observed in the lungs.

If it is necessary to distinguish between enteritis and amyloidosis, then the walls of arterioles and stroma should be examined. There, amyloid itself is detected. It is very difficult to distinguish between inflammation in the small intestine and in the large intestine. In this case, you should pay attention to the suction function. With damage to the colon, this function is practically not disturbed.

Basic principles of treatment

Treatment should be carried out in a hospital setting. Patients are kept on diet No. 4 (a, b, c). The diet must contain protein (150 g) in the form lean meat, fish, cottage cheese and eggs and fats (100 g), only easily digestible. Refractory animal fats are strictly prohibited (lamb, pork). If there is a period of exacerbation, then the amount of fat should not exceed 70 g. Carbohydrates should be 450 g per day, as with a normal load.