What is gastroenteritis?

Gastroenteritis is an inflammatory disease of the digestive tract that begins with the stomach and spreads to the small intestine. The source of the disease may be infection or non-infectious disease. Both adults and children are ill.

As a result of changes in secretion, the process of digestion of food, absorption from the intestine is disrupted. Together with water, patients lose proteins, electrolytes, glucose. There is involvement of all internal organs, the metabolism suffers, the immunity decreases.

Causes and types of the disease

In acute and chronic form of the disease, the causes of gastroenteritis differ. Acute inflammation is divided into infectious and non-infectious. Infection involves the infection of humans with microorganisms with a predominantly damaging effect on the stomach, intestines, and their mucous membranes.

Pathogens can be caused by different classes of pathogenic microbes, so gastroenteritis is called:

• bacterial if they are caused by bacteria( salmonella, dysentery rod, pathogenic strain of Escherichia coli, Staphylococcus, proteus, Klebsiella);
• viral - when affected by rotaviruses, adenoviruses, coronaviruses, influenza;
• protozoal, when the causative agents are lamblia, cryptosporidia, dysentery amoeba.

Acute gastroenteritis among infectious diseases ranks second in prevalence after influenza and ARVI.Children are most susceptible to illness in organized collectives. The source can be a sick child, an infected pet( with coronavirus gastroenteritis), a carrier bacterium from among the attendants.

Food toxicoinfection is the result of poisoning with poisonous substances, poor-quality products, violation of the rules of storage and cooking. In this case, rapid infection can be achieved. Gastroenteritis in adults is less likely to be caused by pathological microorganisms.

The reasons are:

• disregard for healthy eating( passion for sharp and fatty foods, fast food, fizzy drinks, starvation diets, snacks for dryness) - alimentary gastroenteritis;
• excessive drinking;
• toxic effect of nicotine on smoking;
• allergic reactions or intolerance to any product;
• negative side effects of medications;
• is a consequence of ionizing radiation and radiation therapy of tumors.

To damage the stomach and intestines, both overeating and famine

are equally dangerous. The mechanism of such gastroenteritis is a disruption in the regulation of the formation of hormone-like substances in the stomach and intestines, a decrease in the acidity of the gastric juice, dysbiosis, a disruption in production and intake of digestive enzymes from the gallbladder and pancreas.

Diseases in the lower parts of the intestine proceed as gastroenterocolitis, accompanied by a syndrome of impaired water absorption.

Chronic form - is formed with incorrect or absent treatment of acute gastroenteritis. The most common cause is infection with Helicobacter pylori.

Indigestion begins with the pyloric part of the stomach. The increased acidity disrupts the process of alkalization in the bulb of the duodenum and the throughput function of the pyloric pylorus. The defeat of the upper parts of the small intestine extends to other departments. The local immunity is greatly depressed.

In alcoholics, disruption of food digestion and inflammation are associated with gradual atrophy of the mucous membrane, metabolic changes with cirrhosis of the liver, decreased blood flow in the mesentery vessels that feed the intestine. Chronic eosinophilic gastroenteritis - remains an unclear disease.

Common signs of the disease

Symptoms of gastroenteritis in adults indicate a lesion of the functions of the stomach and intestines. The disease begins with vomiting eaten food, which turns into a repeated acidic stomach contents with an admixture of bile. Patients are concerned:

• persistent nausea;
• abdominal cramping pain in the epigastrium and around the navel;
• diarrhea, the stool is liquid, foamy, copious, fetid( frequency depends on the severity of the condition);
• with hemorrhagic form there are impurities of blood in the feces;
• temperature rises from low figures to 39 degrees;
• increased intoxication( weakness, dizziness and headache, loss of appetite).

Loss of fluid with diarrhea and vomiting leads to dehydration syndrome. It is especially dangerous for infants and elderly people. Lack of medical care can lead to fatal complications.

Therefore, the clinic necessarily takes into account the signs of dehydration:

• blanching of the skin;
• increased dryness in the mouth, skin;
• thirst;
• apathy of adults, a propensity for immobility in a child;
• marked weakness;
• dizziness and headache;
• cramps in the muscles of the limbs;
• rare urination, decreased urine output;
• heart palpitations;
• hypotension( low blood pressure);
• possible decrease in body temperature to 35 degrees.

Increased fatigue accompanies gastroenteritis

In chronic gastroenteritis symptoms worsen after a violation of diet, agitation, respiratory disease, physical work. Often observed in the autumn-spring period.

Patients are concerned about persistent weakness, lack of appetite, weight loss, lack of sleep, increased irritability, early signs of aging( dry skin, loss of elasticity, wrinkles, brittle nails, hair loss), sometimes convulsive contractions in the muscles of the legs and hands.

The manifestations of dyspepsia syndrome include: frequent nausea, sometimes vomiting, diarrhea, abdominal pain along the bowel and epigastrium in an hour and a half after eating, belching, rumbling and bloating.

Infectious gastroenteritis has its differences depending on the pathogen. Children are more often affected, but it is possible to infect adults. Details about the course of gastroenteritis in childhood can be found in this article.

Features of infectious gastroenteritis

We will consider several of the most common types of infection that lead to gastroenteritis. All infectious lesions are considered from the point of view of the danger of the pathogen for the surrounding people.

For the diagnosis and prevention measures, it is important to know:

• the incubation period when the pathogenic microorganism is already in the human body, multiplies intensely, but so far does not cause clinical manifestations, it helps to establish the time and place of infection, the number of contact persons;
• is infectious or not a sick person;
• how long lasts the acute phase of gastroenteritis and the recovery period;
• is it possible for an asymptomatic bacteriocarrier.

If infectious gastroenteritis is detected in a children's institution, quarantine is imposed for a time equal to the incubation period

. Children who are not ill are at home, receive preventive treatment if necessary, and are examined daily by a doctor for the purpose of early detection of the disease.

Viral gastroenteritis

Almost all viral gastroenteritis begins with respiratory symptoms( a cold, redness of the throat, low temperature).In adults, the most frequent manifestation is a loose stool, in children - repeated vomiting. Duration of the disease is within 7-10 days.

Rotavirus gastroenteritis - characterized by incubation up to five days. The onset of the disease is rapid: frequent vomiting, a loose stool with mucus, the color of stools is yellow-green. The multiplicity of diarrhea is three to 20 times a day. Pain in epigastrium and in the perepump zone is more often aching, with colic occurring less often.

The temperature rises in 20% of patients. Patients complain of severe weakness. The virus is considered to be "school", the children from one class most often fall ill, as the spread is by air.

With parvovirus gastroenteritis, the incubation period lasts up to three days. Then begins vomiting, growing weakness, dizziness, patients note muscle pain. Diarrhea is rare. The abdomen is moderately swollen, the pain syndrome is weakly expressed.

Adenoviral gastroenteritis - common among children under two years of age, high risk is for infants in inpatient treatment. The incubation period lasts 8-10 days, and the duration exceeds the average indicators( 2 weeks or more).

Much less pronounced diarrhea and general intoxication. Unlike other viruses, mesenteric lymph nodes are affected, so abdominal pain and temperature persist. Dyspeptic symptoms are mild, stopping after 3 days.

Picornavirus gastroenteritis - accompanied by severe fever with a fever of 39 degrees, chills. On the second day, fetid diarrhea appears, the feces have a greenish tinge.

Coronavirus is transmitted from pets. The disease lasts up to two days,( incubation - up to 24 hours).Start with nausea and vomiting, the temperature rises sharply, then diarrhea begins. Lesions of the stomach and intestines are not necessary, more often the infection is manifested by a runny nose, complicated by pneumonia.

Bacterial gastroenteritis

Bacterial gastroenteritis affects children and adults, they are more difficult to carry than viral. Often accompanied by the spread of inflammation to the large intestine( colitis).Salmonella gastroenteritis - the spread of salmonella infection - a scourge of children's institutions, where the kids are.

Infection occurs through dairy products, chicken eggs, meat dishes, contact with sick service personnel. Symptoms appear after 24 hours. Immediately increasing signs of intoxication( weakness, headaches).Then begins vomiting with bitterness, pain in the stomach, frequent diarrhea without pronounced pain in the intestines. Characteristic signs of dehydration.

Dysenteric gastroenterocolitis - caused by shigella. The latent period lasts for up to a week. The temperature rises sharply. Vomiting is rare. Pain in the abdomen is localized in the epigastrium, in the left ileal region( spasm of the sigmoid colon).

With dysentery palpable spasmodic sigmoid colon

Infection with cholera vibrio - with cholera diarrhea is non-stop. At the same time, vomiting is possible. The chair is massive in the form of a "rice broth".Pain in the abdomen is not typical, the temperature can be normal. At the forefront is significant dehydration, loss of electrolytes.

Staphylococcal gastroenteritis is a causative agent transmitted to newborn children from infected personnel or mothers in maternity wards. This is one of the reasons for the closure of maternity hospitals to quarantine and extraordinary disinfection. Pregnant women are transferred for delivery to other institutions.

How many days will be closed by the hospital determine the bodies of Rospotrebnadzor after a thorough check. Adults also get sick. Usually severe pains occur in the epigastrium, repeated vomiting, and diarrhea is poorly expressed. With timely treatment, the improvement of the condition comes in a day.

Diagnosis

Obligation of the doctor to show signs of gastroenteritis to remove the suspicion of the infectious nature of the pathology. Therefore, it is important to clarify the sequence of symptoms, the estimated time of infection, the presence of similar manifestations in others. When suspected of infectious gastroenteritis, it is necessary to identify the causative agent. To clarify the degree of defeat help:

Blood test - acceleration of ESR, leukocytosis indicate a bacterial infection, leukopenia is characteristic for the action of the virus. An indication of dehydration is a thickening of the blood( growth of hemoglobin and erythrocytes), a change in the hematocrit.

Under a microscope in a smear of a feces show an increase in the amount of mucus, pus, leukocytes, erythrocytes. Observe a significant amount of undigested fiber, fatty inclusions, muscle fibers, starch. These indicators assess the degree of digestive disorders.

Bacteriological examination of stool and vomiting is carried out to identify pathological microorganisms that are the causative agents of the disease. The analysis scheme includes microscopy with a special staining of the smear, planting on nutrient media, determining sensitivity to antibacterial drugs.

A full bacteriological study will take up to 5 days, but the laboratory can provide intermediate data after 2 days

Immunoenzyme method allows you to establish an increase in 4 times the titer of antibodies for infection. For the diagnosis, the dynamics of the indicator is important. Unspecified gastroenteritis is reflected in the diagnosis.

Virological studies are not carried out in ordinary polyclinics.

Equipment is usually available in regional institutions or private clinics. A specific pathogen is established by an enzyme immunoassay or by polymerase chain reaction( PCR), which allows to fix the genetic material. The result of the analysis helps to diagnose the gastroenteric form of lesion by enteroviruses.

For the purpose of differential diagnosis from other diseases of the digestive system, accompanied by a disorder of the stool, the following are prescribed:

• fibrogastroduodenoscopy - provides visual inspection of the gastric mucosa, duodenum, biopsy sampling( confirms the degree of atrophy, eosinophilic gastroenterocolitis);
• method of anthroduodenal manometry - is necessary in the study of the disturbed motility of the digestive tract;
• pH-metry - reveals the acidity of gastric contents;
• ureazny respiratory test - helps to establish infection with Helicobacter pylori;
• Ultrasound of the abdominal cavity organs - used for suspected secondary gastroenteritis caused by diseases of the pancreas or liver.

Treatment of

Prescribing medicines and choosing a method for treating gastroenteritis is a matter for a specialist doctor. A scheme of complex therapy is made taking into account the choice of a rational menu, antiviral or antibacterial drugs, drugs that normalize the intestinal microflora and the secretory function of the stomach.

Treatment of gastroenteritis in adults is performed on an outpatient basis, since severe course is observed in rare cases. Patients are recommended to strengthen the drinking regime( 2 liters per day).The liquid not only compensates for the loss of water with vomiting and diarrhea, but also removes intoxication, removes pathological microorganisms.

Therefore, it is not advised to take drugs that stop diarrhea by affecting intestinal motility. Patients are advised to eat often, but in small portions. Products should not load digestion. Choose what you can eat follows from easily digestible dishes.

Excluded:

• fatty foods;
• spicy seasonings;
• all fried, canned;
• sparkling water;
• coffee, milk, kefir;
• chocolate and sweets;
• raw vegetables and fruits.

Recommended:

• low-fat chicken broth;
• porridges cooked on the water( oatmeal, rice, buckwheat);
• boiled meat and fish;
• vegetables stewed;
• wheat bread;
• baked apples.

When eosinophilic gastroenteritis requires a hypoallergenic diet without berries, protein products. For drinking advise to prepare compote of dried fruits, broth of dogrose, raisins, you can drink mineral water after releasing the gas.

Ready-made pharmacy products are bred in boiled water( Oralit, Regidron, Glucosolan)

In severe cases, a drip injection of electrolyte solutions into a vein( Trisol, Quartazol) is carried out in a hospital. At bacterial gastroenteritis antibiotics of a wide spectrum of action, Furazolidonum are applied. Viral infection can not be treated with antibiotics, they are not effective. Appointed drugs based on Interferon, immunomodulators.

With the help of sorbents( Smecta, Enterosgel, Polysorb) toxins and slag substances are removed from the intestine. Patients need to restore the balance of microflora, therefore, probiotics are prescribed( Bifiform, Linex, Bifidumbacterin).

For the removal of pain, antispasmodics are effective. Patients with chronic gastroenteritis apply courses of physiotherapy( magnetotherapy, electrophoresis).It is necessary to adhere to a diet constantly.

Prevention of

To prevent infectious gastroenteritis, it is necessary to monitor hygiene, hand washing, food processing. In children's groups, food blocks are controlled by epidemiological surveillance.

The consequences of non-infectious lesions can be avoided if you contact the doctor in a timely manner and treat gastritis, pancreatitis, and normalize acidity. For the treatment of gastroenteritis there is a large selection of means. When symptoms appear, you must begin treatment as early as possible. Do not try to endure or follow the advice of friends.