Acute gastroenterocolitis symptoms and treatment. Modern diagnostic methods. Infectious variety of acute and chronic gastroenterocolitis

Gastroenterocolitis is a disease infectious nature with inflammation of the gastrointestinal tract, namely, the mucous membranes of the stomach, small, large intestine. The disease can be both acute and chronic.

Signs of gastroenterocolitis are always very bright. They include the symptoms of the three components of this disease: gastritis, enteritis, colitis.

Acute gastritis usually begins with belching and nausea. Then there are pains in the upper abdomen. Pain is also felt on palpation of the abdomen. Vomiting may occur. And the symptoms acute enteritis- frequent and liquid stool, bloating, pain, nausea. Acute colitis characterized by very frequent stools, which may contain impurities of mucus, blood. Abdominal pains are cramping in nature, very painful urge during bowel movements. These symptoms can appear either simultaneously or sequentially, gradually worsening the patient's condition.

The culprits of the disease

There are quite a few causes of gastroenterocolitis. Among them:

For these unfavorable factors to appear as causes of gastroenterocolitis, it is enough only:

• eating poor-quality products, unwashed fruits, vegetables, berries;
• eating a large amount, especially fatty, food;
• contact of children with a person suffering from gastroenterocolitis;

Rotavirus is the most dangerous source for children, due to which gastroenterocolitis develops.

Diet is one of the main treatments

In the treatment of gastroenterocolitis, a properly selected diet is important. Nowadays, doctors do not recommend the previously used water-tea and starvation diets. Indeed, with any intestinal infection, the digestive function remains the main function of the intestine, and a starvation diet can cause another disease - ketoacidosis (acetone). For children younger age it is recommended to reduce the amount of food in initial stage diseases only by 50%, but increase the frequency of food intake (6-8 times a day).

For patients of all ages, there is an unambiguous requirement: products must be boiled or steamed, and food must be taken in pureed, pureed or liquid form. With gastroenterocolitis, a diet is prescribed that creates a minimal burden on the child's gastrointestinal tract. Indigestible food is excluded from the diet, and food that contributes to the formation of putrefactive, fermentation processes. One of the important conditions: to exclude all products that stimulate bile secretion, as well as products that enhance secretory functions stomach and pancreas.

Eat for health!

The diet provides for the consumption of the following products: crackers, lean varieties meat and fish . Both meat and fish should be minced or pureed. From dairy products, pureed cottage cheese (calcined) and acidophilic milk are best suited. Soups for children with such a diet should be prepared only on low-fat, weak broths, it is possible with butter. It is permissible to add decoctions of vegetables to soups. Eggs are allowed to be consumed soft-boiled, as well as added to various dishes.

With gastroenterocolitis, the diet does not allow eating fatty fish and meat, any fats (except butter), vegetables, fruits, any smoked meats, spices, pickled, canned foods. In cereals and soups, you should not use barley and millet groats. It is not recommended to give children fresh bread, muffins, pancakes and pancakes, sweets, carbonated drinks, grape juice. It is better to cook jelly and jelly from the juices of berries and fruits (non-acidic), and decoctions from dried blueberries, black currants, quince.

These are the requirements for food diet number 4. Due to fats and carbohydrates, it reduces the energy content of the diet, and the amount of protein remains in physiological norm. The diet of infants with gastroenterocolitis does not exclude breast milk, and for supplementary feeding it is better to use fermented milk mixtures. For complementary foods, nutritionists recommend 5-10% porridge (rice or buckwheat), low-lactose mixtures.

...and medicines to help

Treatment of this disease always involves hydration therapy. Severe forms of gastroenterocolitis are dangerous due to dehydration in children. But even if there is no such threat, the child should drink a lot - 5-6 glasses of fluid per day. Treatment of severe gastrointestinal infections involves the use of appropriate antibacterial agents.

Gastroenterocolitis is traditionally treated with sulfonamide drugs - disulfan, sulfidine, fthalazol, sulgin; adsorbing agents - calcium carbonate or phosphate, coal, anti-inflammatory and analgesic agents - papaverine, kaolin, belladonna. Although modern medicine considers some of these drugs as ineffective.

Gastroenterocolitis is usually treated in medical hospitals, so the attending physician, based on the symptoms, will prescribe necessary drugs individually.

Symptoms of gastroenterocolitis develop quickly and, if left untreated, lead to dehydration. But with timely medical care, the condition stabilizes after 3 days.

Forms of the disease

According to the form of the course, the disease is divided into:

• Acute gastroenterocolitis, which is characterized by a sharp and sudden onset, a progressive deterioration in well-being.
• Chronic gastroenterocolitis, which occurs with alternating periods of remissions and exacerbations and develops against the background of other diseases that lead to damage to the gastrointestinal intestinal tract.

Depending on the nature inflammatory process, distinguish the following types of gastroenterocolitis:

• Hemorrhagic. In the submucosal layer, vascular microcirculatory disorders are formed, as a result of which hemorrhages, inflammation and erosion develop.
• catarrhal. The mucous membrane becomes hyperemic, edematous. Increased exudate secretion.
• Phlegmonous. mucous membrane digestive tract not only becomes inflamed, but also begins to accumulate pus.
• Ulcerative. Defects (ulcers) form on the mucous membrane.
• Fibrous. When exudate is released, fibirinogen accumulates on the surface of the mucous membrane, under the action of thromboplastin it turns into fibrin, and a thin film is formed.

Reasons for the development of gastroenterocolitis

Gastroenterocolitis can develop in the following cases:

• at bacterial infection- reproduction of salmonella, shigella, escherichia, proteus, Escherichia coli leads to inflammation of the mucous membrane;
• when infected with viruses -, ECHO-virus;
• with the development of an allergic reaction to food, drugs or waste products of microorganisms and viruses;
• when toxins enter the gastrointestinal tract - heavy metals, alcohol, acids and alkalis, intoxication develops.

Symptoms

Gastroenterocolitis often has a short incubation period, the first symptoms appear a few hours after exposure to the infection or allergen.

The disease makes itself felt by the following signs:

• gas formation increases, flatulence and bloating develop;
• diarrhea appears at the onset of the illness or on days 3-4 as a sign of intoxication, blood and mucus may be present in the feces;
• appetite is disturbed, interest in food disappears;
• body temperature rises, general malaise develops, headache, dizziness, severe cases- fainting;
• the stomach begins to hurt, most often in the navel, sensations can be cramping or pulling;
• appears, bitterness in the mouth, belching;
• nausea increases, vomiting becomes more frequent;
• sometimes there is constipation for 1-2 days.

Symptoms of acute gastroenterocolitis most often develop quickly, 2 to 3 hours after infection, exposure to toxins, or allergens. But sometimes the full clinical picture is observed only for 2-3 days.

The earlier the diagnosis is made and treatment is started, the lower the risk of the disease progressing to chronic form with relapses, which is much more difficult to eliminate.

Diagnostics

Diagnosis of gastroenterocolitis begins with the collection of anamnesis and clarification of symptoms. The doctor specifies when the first signs of the disease appeared, in what order they increased, what foods were consumed shortly before the deterioration of health, etc. The main examination is carried out by a gastroenterologist, an infectious disease specialist may additionally be required.

To establish an accurate diagnosis, a number of laboratory examinations are carried out:

• general and biochemical analysis blood;
• bacteriological analysis of feces;
• coprogram.

For more detailed examination and differentiation of gastroenterocolitis with other diseases can be carried out, sigmoidoscopy, irrigoscopy, ultrasound of organs abdominal cavity and small pelvis. Imaging techniques help the doctor to identify lesions in the intestine, changes in its width. If necessary, tissue particles are taken for biopsy.

Treatment of the disease

Gastroenterocolitis in adults can be treated without hospitalization if the symptoms are mild or moderate. At severe forms it is necessary to place the patient in a hospital in the infectious diseases department.

Therapy includes the following:

• Rehydration - procedures to eliminate dehydration. The body is saturated with water, salts and other important compounds that were excreted with vomiting and diarrhea. If the disease occurs in mild form then oral administration will suffice. saline solutions(Rehydron, Oralita). When fluid loss is more pronounced, drugs are administered intravenously (Disol, Trisol, Chlosol).
• Antibacterial therapy - Antibiotics are required for certain types of infectious gastroenterocolitis (Levomycetin, Ampicillin, etc.).
• Detoxification - elimination of toxins. For this, gastric lavage is usually performed, during which food residues, pathogenic microorganisms, and toxins are removed. Sodium bicarbonate (2% solution) or potassium permanganate (0.1% solution) is used. If there is constipation, then enemas and laxatives are used (Duphalac, Sorbex, glycerin).
• Symptomatic therapy . To eliminate pain, antispasmodic drugs (No-shpa, Riabal) are prescribed, to normalize digestion - enzymes (,) and probiotics (Laktofiltrum, Lineks), for general recovery of the body - multivitamins.

Diet

Diet for gastroenterocolitis important condition convalescence. On the first day after the onset of the disease, only drinking is allowed. You can use compotes, tea, water, decoctions of cereals.

For the next 2 days, foods are introduced into the diet that will not irritate the mucous membrane: curd mass, viscous boiled rice porridge, oatmeal, jelly. When the acute period of the disease is over, you can eat cutlets, schnitzels, meatballs, steamed fish, as well as casseroles, soft-boiled eggs (limited), broths and grated cooked vegetables. You need to eat little and often.

Smoked, fatty, spicy and fried foods, vegetables, fruits and meat with coarse fibers are prohibited. You will also have to refuse products, causing fermentation: legumes, fresh pastries, bread, milk.

The same principles of nutrition should be followed in the chronic form of gastroenterocolitis.

Complications

One of the most common and dangerous complications of gastroenterocolitis is dehydration. Loss of fluid and salts occurs due to frequent profuse vomiting and diarrhea. Dehydration of the body leads to a decrease blood pressure, dizziness, shortness of breath, and in severe cases - to fainting and coma.

For this reason, the first aid to the patient should be to provide him with fluid. It is best to drink water, in small portions every 10-15 minutes, so as not to provoke an attack of vomiting. At the same time, it is necessary to call a doctor who will send the sick person to the hospital.

Consequences

Gastroenterocolitis is accompanied by pathological changes in the digestive tract. When the disease proceeds in a mild form, the mucous membrane becomes inflamed, swells, becomes hyperemic. Sometimes bleeding develops in the stomach and intestines.

If the treatment of gastroenterocolitis is not started on time or is not carried out completely, then its course is delayed. This leads to deep damage to the walls of the digestive tract, perivisceral adhesions. The mucous membrane thickens and muscle fibers and glandular ducts atrophy. Polyps appear, which over time can degenerate into cancerous tumors.

Prevention

Treatment of acute gastroenterocolitis lasts about a week, the chronic form is more difficult to cure, sometimes therapy is carried out several times a year, but relapses still develop.

• Follow the rules of personal hygiene - wash your hands before eating, after visiting the toilet or the street, do not use someone else's towel and other accessories.
• Observe sanitary and hygienic standards when preparing food - thoroughly wash fruits and vegetables, heat meat and fish to the end, keep cutting boards, knives and other tools clean.
• Purchase products only in verified places: large stores, food markets that undergo sanitary and epidemiological control.
• Eliminate infectious diseases in a timely manner and under the supervision of a doctor.
• Keep active immune system– take courses of multivitamins, eat right, play sports or other physical activity(hiking, dancing), avoid emotional turmoil and stress.

Gastroenterocolitis is inflammatory disease gastrointestinal tract. It appears as a result of the development of infection, allergies, exposure to toxic substances. With the right and timely treatment gastroenterocolitis symptoms recede after 3 days.

Useful video about the treatment of intestinal infections

Pain in the abdomen, accompanied by vomiting, nausea, diarrhea or constipation, indicates that an inflammatory process has begun in the stomach, intestines - acute gastroenterocolitis. If you just take pills that usually help get rid of the ailment, then the pain will subside, the stool will return to normal, but the cause will not be eliminated. And this means that the inflammatory process will go on, the structure of the mucous membrane will be disturbed, ulcers may form that will bleed. The stomach and intestines will no longer cope with their direct duties (digestion, absorption of food), this will lead to exhaustion and disruption of the work of all body systems. Therefore, it is imperative to establish the cause of gastroenterocolitis in order to begin adequate treatment.

Dependence of the treatment of gastroenterocolitis on the cause

A variety of factors can cause an inflammatory process on the mucous membrane. But initially, the disease affects some part of the gastrointestinal tract (GIT), and only because of improper treatment does it develop into gastroenterocolitis. Provoke the occurrence:

• intestinal infections;
• malnutrition;
• exposure to allergens;
• diseases of the pancreas and liver;
• nervous tension.

And accordingly, the cause needs to be treated, and gastroenterocolitis is a consequence. So, for example, the disease can be caused by various microorganisms:

Accordingly, it is necessary to treat the disease in different ways. Even antibiotics can only work on one type of bacteria and not cause the slightest harm to another. Select the appropriate course of treatment for this case must be an infectious disease specialist.

With psycho-emotional overstrain, it is excited nervus vagus, which innervates the entire gastrointestinal tract, a spasm of smooth muscles occurs, which in turn causes sharp pain and stool disorder. In this case, help:

• sedatives (corvalol, validol);
• antispasmodics (spasmolgon, no-shpa).

Which of them will be more effective, the doctor will advise.

Naturally, if you do not eliminate the cause, do not cure concomitant diseases, especially the liver and pancreas, restore normal work GI tract will be impossible.

And over time, this will lead to a violation of the metabolism of all substances. Not to mention that vomiting and diarrhea cause severe dehydration, and in this case acute gastroenterocolitis in children can be fatal.

But the most dangerous and most common cause of gastroenterocolitis is malnutrition. In a child, the disease may occur due to early refusal breastfeeding. In some cases, inflammation occurs due to intolerance to certain food products and even milk. Most harmful to normal functioning GIT:

• fast food when food is badly chewed;
• food, anywhere and anytime;
• medicines not prescribed by a doctor (especially aspirin and some antibiotics);
• dry food;
• binge eating.

For prevention infectious inflammation you must follow the basic rules of personal hygiene.

Eating a large amount of vegetables and fruits containing coarse fiber can also contribute to inflammation of the mucosa. This does not mean that they should not be eaten at all. You can eat everything, but the main thing is to know when to stop and remember that some foods can only be consumed once in a lifetime (pale toadstool, expired foods, swollen canned food and other foods that cause severe poisoning up to lethal outcome).

Whatever factor caused the disease, treatment of acute gastroenterocolitis must begin immediately. If you wait for serious complications, when pathological changes all organs are affected, then it will take much longer to be treated, and it is likely that it will not work.

Consequences of the disease

If you do not pay attention to the symptoms of gastroenterocolitis in time, or if you feel pain in the abdomen, nausea, take pills without consulting a doctor, then over time acute inflammation develop into chronic. And this means:

1. There will be irreversible pathological changes in the mucosa. Up to necrosis, the appearance of ulcers on it. And over time, the intestines and stomach atrophy, the food will not be digested, instead, the processes of decay will begin.
2. Due to the lack of micro and macro elements, metabolic disorders will occur. In turn, this will lead to dystrophy, osteoporosis. Due to the lack of glucose and vitamins, especially group B, there will be malfunctions in the central nervous system.
3. Frequent diarrhea and vomiting cause severe dehydration. The skin will become dry, the hair will become brittle, and these are not the most dire consequences. Lack of fluid in the body leads to a decrease in the volume of circulating blood. Due to broken water-salt balance convulsions will occur, and in severe cases - coma.

Prevent occurrence severe consequences only one is possible in an efficient way– Proper treatment of gastroenterocolitis. And only a doctor will prescribe it.

How is gastroenterocolitis treated?

The therapeutic course largely depends on the cause of the disease. But there are drugs that are prescribed in any case. This:

1. Painkillers. But they are recommended only for the relief of severe pain.
2. Pro- and prebiotics. Inflammatory process in the intestines, taking antibiotics negatively affects normal microflora. The growth of the necessary lacto- and bifidobacteria is inhibited. And this leads to a deterioration in digestion, contributes to the development of pathogens.
3. Sorbents and drugs for detoxification. Especially when intestinal infections when microorganisms synthesize toxins, persistent poisoning occurs.
4. Carry out the correction of metabolism, prevention of anemia and hypovitaminosis.

But the mainstay of treatment for gastroenterocolitis is diet. Recommend table number 4.

What to eat and what not to eat with gastroenterocolitis

• spicy, salty;
• cold or hot;
• rough, tough;
• promote the formation of gases in the intestines;
• containing alcohol.

But this does not mean that only slimy and unappetizing cereals are possible. Allowed a large number of delicious foods, and if they are also decorated (methods to make attractive appearance there are many dishes), then food will contribute not only to the intake of necessary substances into the body, but also to aesthetic pleasure.

With gastroenteritis it is allowed:

• soups with low-fat broth;
• cereals;
• butter;
• grated cottage cheese ( fresh milk Absolutely forbidden);
• vegetables and fruits, but peeled, without rough skin;
• low-fat meat and fish dishes, it is better if they are steamed;
• soft-boiled egg, steam omelette (no more than 1 per day);
• kissels, jelly;
• compote, weak tea.

• rosehip decoction;
• weak, unsweetened blackcurrant compote.

You can starve for no more than 2 days, and then with very strong diarrhea.

A generalized concept of an inflammatory process that affects the entire gastrointestinal tract and is manifested by a disorder of its activity soon after exposure to a variety of factors.

1 Causes of gastroenterocolitis

Depending on the cause of the occurrence, gastroenterocolitis is divided into:

1. Infectious (bacterial and viral), due to toxic effects pathogenic and conditionally pathogenic microorganisms - most often these are salmonella, less often staphylococci, streptococci, coli, shigella, etc. Pathogens such as rotavirus, ENSO-virus and protozoa (giardia, amoeba, Trichomonas) can become a factor in the development of the disease. Infection occurs mainly through the mouth. Further, toxins and some pathogens from the intestinal tract enter the bloodstream, causing a deterioration in overall well-being.
2. Non-infectious (alimentary) type of gastroenterocolitis develops mainly due to malnutrition: irrational (monotonous or excessive) and includes acute or fatty foods and excessive consumption of foods containing coarse fiber. Most often, the development of pathology is given an impetus: hypothermia, cold drinking, hyperacidity, alcohol intoxication and avitaminosis. Dysfunctions of the digestive tract (stomach, pancreas, liver, intestines) often provoke the occurrence of gastroenterocolitis. Allergic to certain foods and medications, in case of poisoning chemicals or heavy metals, damage to the digestive tract is also observed.

2 Clinical picture of the disease

With gastroenterocolitis, the symptoms are the same for all types of pathology, and the inflammatory process in the digestive tract makes itself felt within a few hours or days. Initially, pain in the abdomen, flatulence, heartburn and / or belching are disturbing. Appetite disappears, nausea appears, turning into vomiting, an abundant grayish coating is noted on the tongue. Frequent stools are accompanied by cramping abdominal pain and muscle weakness. With a severe form of gastroenterocolitis, the following are possible:

• streaks of blood and mucus in the stool;
• confusion and blanching of the skin;
• repeated and indomitable vomiting;
• fever up to 39 ºC and headache;
• violation of metabolic processes and dehydration;
• significant weight loss;
• short-term loss of consciousness.

Non-infectious food-borne gastroenterocolitis is milder than infectious gastroenterocolitis - after about 3-5 days with proper treatment and following the diet, he passes.

3 Disease in children

Due to the immaturity of the digestive tract and due to weakened immunity, gastroenterocolitis in children is quite common. Dysentery bacillus, influenza, and the multiplication of own opportunistic microorganisms in the intestine cause childhood gastroenterocolitis, which is more severe than in adults. Diarrhea is accompanied by inclusions of mucus or blood, vomiting can last up to a week along with fever. Influenza, rotavirus and other types of viral gastroenterocolitis appear suddenly and acutely and can cause complications. Dehydration child's body due to vomiting, diarrhea and elevated temperature leads to serious violations metabolism.

Eating contaminated foods (cottage cheese, milk, etc.), poorly washed fruits, berries and vegetables, low-quality canned food, as well as contact with sick animals or people are the most common causes diseases in both children and adults.

4 Diagnosis and treatment

With gastroenterocolitis, treatment at home is permissible only with a mild form of pathology and according to the instructions of the doctor. After applying for medical care in case of deterioration general condition the patient is examined: palpation in the abdomen, history taking, clarification of the details of nutrition and possible causes intoxication. When making a preliminary diagnosis emergency help consists in washing the stomach with a probe, or the patient is given a plentiful drink, followed by provocation of vomiting. Further appointed bed rest and intravenous administration of isotonic fluids.

Laboratory tests (coprogram, blood and urine tests, examination of the stomach and ultrasound of the abdominal organs) are important for making an objective nosological diagnosis, that is, for determining true reason. At the same time, the epidemiological situation, the identification and analysis of a product that has pathogens play an important role.

Because clinical manifestations gastroenterocolitis are similar to diseases of the abdominal organs, such as acute appendicitis, cholecystitis, etc., it is necessary to differentiate and exclude them in time. For example, botulism, which is fraught with a fatal outcome, manifests symptoms similar to gastroenterocolitis, which in this case develop very quickly and vividly.

With prolonged course of gastroenterocolitis and improper treatment damage to the deeper layers of the walls of the intestine and stomach is possible, which leads to hypertrophy of the mucosa, the appearance of polyps and atrophy of the muscles and glands of the walls digestive organs. Damage to nerve endings provokes cardiovascular and movement disorders. Therefore, with signs of severe and acute gastroenterocolitis, one should not be limited to taking symptomatic drugs that provide only temporary relief. Finding out the causes of intoxication of the body and adequate antibacterial, detoxification and rehydration therapy are carried out in a hospital.

Diet therapy is the main method of improving the state of the body during and after medical measures. It is necessary to drink more liquid - an infusion of rose hips, chamomile, liquid jelly, non-acidic fruit compote, or just warm water. Meals should be fractional and frequent - up to 6-8 times a day; food is taken in a puree or liquid state. Excluded from the diet:

• fried, spicy, salty, fatty and smoked foods;
• raw vegetables and fruits;
• milk;
• fresh and black bread.

Pastries, sweets, carbonated drinks and other foods that complicate the process of digestion are also included in the list of prohibited foods for diseases of the gastrointestinal tract.

The menu for the first time is made up of fat-free fermented milk products(grated cottage cheese, kefir), meat broths And vegetable soups, chicken and boiled fish. Rice and oat decoction can replace food intake in the first two days after the elimination of acute manifestations of gastroenterocolitis.

5 Prevention measures

avoid many pathological processes in digestion, observing sanitary and hygienic standards and adhering to a balanced and rational nutrition. It is necessary to carefully approach the purchase of eggs, meat, dairy and other food products, heat treatment and storage of which at home must be careful. Limit or avoid fast food snacks in public places nutrition and direct contact with a person infected with an infectious form of gastroenterocolitis.

Gastroenterocolitis is a simultaneous inflammation of the mucous membranes of the gastrointestinal tract (stomach, small and large intestines). acute form more common in children; chronic gastroenterocolitis is usually a manifestation of an underlying systemic disease.

Gastroenterocolitis - inflammation of the mucous membranes of the gastrointestinal tract

Causes

Dyspeptic disorders and diarrhea in gastroenterocolitis are caused by damage to the mucous membranes of the gastrointestinal tract and, in particular, the villi of the ciliated intestinal epithelium, which are responsible for absorption nutrients and water into the bloodstream. Infectious gastroenterocolitis is accompanied by intoxication of the body with products of microbial activity.

The acute form of gastroenterocolitis is closely associated with food poisoning. Enteropathogenic and opportunistic bacteria- Salmonella, Shigella, Listeria, Escherichia coli and Proteus vulgaris. Several viruses are also known to cause acute gastroenterocolitis: echovirus, rotavirus (the causative agent of the so-called intestinal flu), Norwalk virus, etc.

Infection occurs in the alimentary way - with the use of unboiled water and poor-quality products contaminated with bacteria, non-compliance with the rules of personal hygiene and sanitary and hygienic standards adopted in cooking. With sepsis and the presence of chronic infectious foci, hematogenous infection can be observed - pathogenic agents migrate into the gastrointestinal tract through circulatory system from other organs and systems.

Gastroenterocolitis of non-infectious etiology is associated with food and drug allergies, poisoning with heavy metal salts, alcohols, alkalis and acids, or radiation injury.

Chronic gastroenterocolitis develops as a result of a protracted course of an acute inflammatory process or against the background of primary diseases GIT. Inflammation extends to the submucosal layer, blood vessels, nerve endings And serous membranes, which leads to impaired blood supply, trophism and motility of the digestive tract.

The likelihood of developing gastroenterocolitis is slightly increased in conditions that lead to an increase in the permeability of the mucous membranes and suppression of local immunity:

• vitamin B deficiency;
• hypothermia, frequent cold drinking;
• prolonged stress;
• ahiliya - absence of hydrochloric acid and pepsin in gastric juice;
• irritation of the intestines due to an excess of coarse fiber in the diet.

Forms

According to the nature of changes in the tissues of the stomach and intestines, several forms of gastroenterocolitis are distinguished:

• catarrhal- manifestations of the inflammatory process are limited by hyperemia and swelling of the mucous membranes along with intensive production of exudate;
• fibrous- on inner surface a plaque of fibrin appears in the stomach and intestines, which is formed during the interaction of tissue thromboplastin with fibrinogen secreted along with exudate;
• phlegmonous- inflammation of the mucous membranes of the gastrointestinal tract is accompanied by suppuration;
• ulcerative- characterized by the presence of manifestations on the surface of the mucous membranes;
• hemorrhagic- the inflammatory process is accompanied by impaired capillary circulation in the submucosal layer, which leads to hemorrhages and the formation of extensive foci of erosion.

by the most dangerous complication gastroenterocolitis is considered dehydration due to persistent vomiting and profuse diarrhea, which can be fatal in young children and debilitated patients.

Symptoms of gastroenterocolitis

As a rule, gastroenterocolitis begins with a sudden deterioration in well-being - nausea and vomiting appear, pulling or cramping pains in the navel or upper abdomen, flatulence, belching and heartburn. Diarrhea can be observed both from the first day of the disease, and on the third or fourth day after short-term constipation. The stools often contain mucus and streaks of blood. At the same time, signs of intoxication are observed: a feeling of weakness and malaise, fever, headaches and bouts of dizziness. In the most severe cases, syncope, confusion and delirium join the described symptoms. At chronic course inflammatory process, dyspeptic disorders are moderately expressed or absent at all, and the symptoms of gastroenterocolitis are limited to manifestations of intoxication. Chronic gastroenterocolitis can also occur in the form of recurrent dyspeptic disorders.

Features of the course of gastroenterocolitis in children

Due to the underdevelopment of the immune system, young children are especially susceptible to gastroenterocolitis. The clinical picture of inflammation of the mucous membranes of the gastrointestinal tract in a preschooler may appear due to a spontaneous increase in the virulence of opportunistic intestinal microflora and a decrease in the body's resistance when respiratory infections, allergic and atopic conditions, prolonged stress, unbalanced nutrition or a sudden change in diet.

Dyspeptic disorders and diarrhea in gastroenterocolitis are caused by damage to the mucous membranes of the gastrointestinal tract and, in particular, to the villi of the ciliated intestinal epithelium, which are responsible for the absorption of nutrients and water into the bloodstream.

Infectious gastroenterocolitis in children under three years of age in most cases is caused by a dysentery bacillus, as a result of which a characteristic clinical picture of profuse diarrhea, fever and severe intoxication develops. A large amount of mucus mixed with blood is found in the stools. Due to the oxidation of iron in the composition of hemoglobin, feces acquire a characteristic dark green color. The child's body temperature reaches peak values ​​in the first three days of illness, after which it lasts for a week, and then declines. In the most severe cases, children develop tenesmus and spasms of the sigmoid colon, characteristic of dysentery colitis. In the absence of adequate treatment, acute dysentery gastroenterocolitis in children often becomes chronic.

Also in children, viral gastroenterocolitis is often observed - intestinal form influenza, accompanied by severe gastroenterocolitis and persistent fever. The disease can be complicated by otitis, pyuria or pneumonia. Gastroenterocolitis is especially dangerous for infants and young children. preschool age due to rapidly onset dehydration and severe intoxication of the body.

Diagnostics

Gastroenterocolitis in adults and older children is diagnosed by a general practitioner or gastroenterologist based on clinical picture and anamnestic data. Special attention is given to products that the patient consumed shortly before the onset of symptoms of inflammation of the gastrointestinal tract. To clarify the diagnosis, consultation with an infectious disease specialist and laboratory research feces - coprogram and bakposev with the isolation of the pathogen and the determination of sensitivity to antibiotics. To assess the general condition of the patient and identify the degree of dehydration, a general and biochemical blood test is prescribed. In children under three years of age, acute gastroenterocolitis is differentiated from typhoid fever by staging the Vidal reaction.

To assess the degree of damage to the gastrointestinal tract and identify comorbidities in chronic gastroenterocolitis, instrumental research stomach and intestines: ultrasound of the abdominal cavity and small pelvis, gastroduodenoscopy, sigmoidoscopy, colonoscopy, irrigoscopy. If necessary, a histological examination of the biopsy of the affected tissues is performed.

Gastroenterocolitis of non-infectious etiology is associated with food and drug allergy, poisoning with salts of heavy metals, alcohols, alkalis and acids or radiation injury.

Treatment of gastroenterocolitis

Alimentary gastroenterocolitis, provoked by toxic infection, in adults and older children usually proceeds easily. There is no need for hospitalization - it is enough to abstain from food and drink as much liquid as possible on the first day. In the next two to three days, follow a sparing diet, adhering to a fractional diet - eat 5-6 times a day in small portions.

The restoration of the damaged epithelium of the mucous membranes of the gastrointestinal tract is facilitated by the use of decoctions of cereals, oatmeal on water and boiled rice, low-fat cottage cheese and chicken broth. At the end acute period you can gradually introduce into the diet low-fat meat and fish products steamed, vegetable puree, soft-boiled eggs and casseroles. For two to three weeks after suffering from gastroenterocolitis, it is worth abstaining from fatty, spicy and fried foods and smoked meats, as well as fresh bread, pastries, milk, legumes and foods containing a large amount of fiber.

When signs of severe intoxication and dehydration appear, treatment of gastroenterocolitis is carried out in a hospital. First of all, detoxification therapy is carried out - gastric lavage with a solution of bicarbonate and potassium permanganate and a course of enterosorbents, with constipation, deep enemas and saline laxatives are prescribed. To replenish the loss of fluid resort to infusion therapy. In milder forms, oral water and electrolytes can be dispensed with. With some toxic infections, etiotropic therapy with the use of antibiotics is possible. Stomach and intestinal pains are eliminated with antispasmodics. To normalize digestion recovery period apply enzyme preparations, multivitamins, prebiotics and probiotics.

Prevention

For the prevention of alimentary gastroenterocolitis, it is enough to follow the basic rules of hygiene and sanitization products: wash hands before eating and preparing food, as well as after using the toilet, use clean dishes, towels and kitchen utensils. Vegetables and fruits must be washed under running water, and milk and drinking water- boil. You should not visit street cafes and canteens with unfavorable sanitary conditions. In the summer, it is important to refrain from eating perishable foods of unknown origin, and while bathing, avoid getting water in your mouth.

To prevent reactive gastroenterocolitis, do not take strong medications without consulting a doctor. With a tendency to allergic reactions new and unusual products are introduced into the menu gradually, starting with small portions. Prevention of chronic gastroenterocolitis is reduced to the prevention of diseases of the digestive system and metabolic disorders - diet control and compliance optimal mode nutrition.

Consequences and complications

The most dangerous complication of gastroenterocolitis is dehydration due to constant vomiting and profuse diarrhea, which can be fatal in young children and debilitated patients. With a long chronic course of gastroenterocolitis, the appearance of periventricular adhesions and intestinal polyps, prone to malignant degeneration, is possible.