Symptoms and treatment of enterocolitis in adults and methods of prevention. Acute enterocolitis

Enterocolitis is a nonspecific inflammatory disease of the colon and small intestine of various origins, accompanied by painful sensations in the abdomen and dyspeptic symptoms.

As a result, inflammation forms in the wall of the small intestine (enteritis), large intestine (colitis), or both parts (enterocolitis). The stomach and other organs may be involved in the process, resulting in various symptoms.

It is important to know that during the disease the intestines cannot fully perform their function, so the patient may experience other signs of pathology.

Enterocolitis can occur in two main forms

1. Spicy. Characterized by inflammation of the superficial layers of the intestine. Most often provoked by aggressive irritants (burn, injury, etc.).
2. Chronic. This form is justified if more than 6 months have passed since the onset of the disease. In this case, the structure of the mucous membrane completely changes and the inflammatory process moves to the deeper layers. The villi are less pronounced, the activity of enzyme complexes is disrupted, as a result of which parietal digestion and absorption are reduced.

Five reasons that provoke enterocolitis

It should be noted that not everyone develops enterocolitis, since certain conditions must be created:

• decrease in general immunity (IgA concentration, number of macrophages and other protective factors);
• genetic predisposition(more often in women);
• concomitant gastrointestinal diseases (for example, atrophic gastritis).

Depending on the type of damage, various forms of enterocolitis may occur: catarrhal, ulcerative, ulcerative-necrotic and others.

Symptoms

It is difficult to identify signs that would accurately indicate that the patient has enterocolitis. All symptoms are not specific and reflect only the severity of this pathology.

Main symptoms

• Abdominal pain is a key symptom of gastrointestinal pathology. The pain intensifies upon palpation, is paroxysmal in nature and is localized in the navel area and along the flanks.
• Diarrhea or constipation. In the chronic form, these conditions can replace each other.
• General manifestations. We are talking about fever, weakness, muscle pain.
• Flatulence. Patients complain of bloating and gases. This is due to disruption of digestive processes.
• Scatological changes. Feces may change in color and consistency, and fatty patches, streaks of blood, and mucus may appear. All this may confuse the patient, and he will consult a doctor.

Diagnostics

To make a diagnosis of enterocolitis, signs of the disease and epidemiological data (with whom and when the patient had contact, what food he took, etc.) play an important role. Additional analyzes and instrumental methods are also shown:

• complete blood count and liver tests;
• bacteriological and scatological examinations of feces;
• barium radiography;
• if necessary, CT;
• sigmoidoscopy.

Effectively treating enterocolitis: eight key steps

A comprehensive approach to the treatment of enterocolitis should include influence on all parts of the pathological process and symptoms. Therapy of acute forms of this disease carried out strictly under the supervision of a doctor in an infectious diseases hospital. Chronic enterocolitis in adults can be treated at home. And pediatricians and pediatric surgeons are fighting the necrotic variant (which is more typical for newborns).

Treatment includes the following:

1. Diet. With the exception of foods that irritate the intestines, fatty foods, and dairy products. The diet lasts about 1.5 months.
2. Taking antibiotics or antifungals. This is etiotropic (directed at the very cause of the disease) treatment.
3. Enzymes – eliminate the symptoms of the disease.
4. Multivitamins. It happens anyway nutrients and vitamins.
5. Probiotics. Improves intestinal motility. And lactobacilli (normalize microflora).
6. Sorbents. To improve the removal of toxins from the gastrointestinal tract resulting from indigestion.
7. Herbal preparations.
8. Steroid treatment (15-30 mg per day Prednisolone).

Diet for enterocolitis

In the hospital, patients with enterocolitis are always prescribed diet No. 4. In addition to this, such a diet should be followed for at least 1.5 months before it occurs. full recovery intestines.

Nutritional features of adult patients with enterocolitis

• the basis of the diet is soups made from finely chopped seasonal vegetables, porridge with water (except pearl barley and semolina);
• the diet provides for fractional meals, in small portions, 4-5 times a day, overeating is prohibited;
• dishes should be steamed (in a double boiler, multicooker) with limited addition of fat;
• do not consume foods that increase putrefaction (indole formation) in the intestines;
• for diarrhea - frequent and fractional drinks in the form of strong tea, decoctions of dried fruits;
• Despite the presence of exception products, patients' diet should consist of foods rich in vitamins.

It is also important to remember about foods that should be excluded from the diet during treatment for both acute and chronic enterocolitis:

• the diet excludes dairy products (milk, butter, cheese);
• fatty meat and fatty fish (including soups with fatty meat);
• any hard-to-digest carbohydrates;
• sweets (except honey, you can have it 2 weeks after disappearance clinical manifestations diseases);
• alcohol and other substances containing alcohol;
• hot spices and seasonings.

It is advisable to introduce fruits into the diet of patients who have suffered acute enterocolitis two weeks after stopping antibiotics, gradually, starting with apples and bananas.

Drug treatment

Treatment of acute enterocolitis in adults, as a rule, begins with gastric lavage, laxatives or cleansing enemas. For the first couple of days, such patients are prescribed bed rest, detoxification therapy (infusions of solutions and oral hydration), sorbents.

Treatment for chronic enterocolitis

• antibacterial drugs wide range actions (for example, Fthalazol 1-2 g every four to six hours in the first 1-3 days, then half the dose, Furazolidone 0.1-0.15 g four times a day);
• lactobacilli and probiotics to eliminate the symptoms of dysbiosis (Linex two capsules three times a day, Bifikol);
• sorbents (Enterosgel, Polysorb 1.2 g dissolved in water, taken 3-4 times a day before meals);
• water-electrolyte imbalances are corrected intravenous administration saline solution sodium chloride, calcium gluconate, panangin (20 ml three times a day);
• herbal preparations(Australian Ectis from plant extracts).

Depending on what symptoms are observed in the patient, more points may be added to this treatment. Any correction of therapy is made by the attending physician.

Traditional methods of treating enterocolitis

Enterocolitis is a disease that people have encountered for a long time before the advent of pharmacology as such. Then it was necessary to be treated with herbal remedies, and the most effective methods passed down from generation to generation right up to the present day.

Popular means

• for constipation in adults, it is recommended to use laxative tea made from cilantro, licorice root and buckthorn bark before bedtime (10 g each of cilantro seeds and licorice root, plus 80 g of buckthorn bark, pour into a glass hot water and boil for 10 minutes, strain before use);
• in case of diarrhea, freshly squeezed carrot juice on an empty stomach, 1/3 cup three times a day, will help (it will not only stop diarrhea, but also help replenish vitamin A deficiency);
• an infusion of nutmeg 50 ml three times a day before meals (1 g of nut is crushed into powder, poured with a glass of boiling water, left for 60 minutes;
• To normalize intestinal function, use a couple of drops of myrtle essential oil 4-6 times a day.

Enterocolitis is a disease that requires long-term and complex therapy. To recover, patients must modify their diet, take medications, and take multivitamins regularly. Some patients with enterocolitis (for example, necrotizing) even require surgical treatment.

Enterocolitis - inflammation of the mucous membrane of the small and large intestines - one of the most common diseases of this department digestive tract. Their long-term inflammatory-dystrophic disease - chronic enterocolitis - leads to atrophy of the mucous membrane and impaired intestinal function.

Causes of enterocolitis

Enterocolitis can be caused by pathogenic microorganisms(dysenteric bacteria, amoebas, balantidia, salmonella, staphylococci, streptococci, etc.), intestinal helminths. The cause of the development of enterocolitis may be the presence of chronic foci of infection in the body, especially in organs anatomically associated with the intestines (pancreas, gallbladder), as well as inflammation of the pelvic organs in women.

Alimentary enterocolitis develop as a result of a violation of the diet (irregular food intake, consumption mainly of foods poor in vitamins and proteins, difficult to digest, spicy food, alcohol, long breaks between meals).

Toxic enterocolitis occur due to exogenous poisoning with colotropic substances (salts heavy metals, alkalis) and with endogenous intoxication - renal and liver failure, Addison's disease, hyperthyroidism. Often the cause of enterocolitis is an allergy (food, drug, microbial).

Drug-induced enterocolitis arise as a result of the damaging effect on the intestinal mucosa of a number of medications (digitalis, salicylates, etc.), as well as during irrational therapy with broad-spectrum antibiotics, when the normal intestinal microflora is suppressed, with long-term use herbal laxatives.

Secondary enterocolitis develop when the function of the stomach, liver, gall bladder is impaired, in cases of habitual constipation with colonospasm, dolichosigma, as well as in diseases of the cardiovascular system. In the development of the disease, as a rule, more than one plays a role etiological factor, but their complex.

Symptoms of enterocolitis

Predominantly affecting the colon

In cases of damage to the colon, the clinic is dominated by local symptoms: abdominal pain and stool disorders. The pain is dull, aching character. Paroxysmal pain is characteristic of spastic colitis. The diffuse nature of the pain (over the entire abdomen) is evidence of pancolitis, and the localization of pain in certain parts of the colon indicates its segmental damage. Characteristic relief of pain after the passage of gas and feces. As a result of digestive disorders, gas formation increases, which causes bloating - flatulence. Patients feel heaviness, distension in the abdomen; palpitations, shortness of breath, and discomfort in the heart area often occur due to the diaphragm being pushed upward by swollen loops of intestines. Abnormal stool manifests itself in alternating diarrhea and constipation, a symptom of insufficient bowel emptying, when a small amount of pasty or liquid feces with mucus is released and the patient experiences a sensation incomplete emptying intestines after defecation. False urge to lower (tenesmus), when only gas and mucus are released, are characteristic of proctosigmoiditis.

Persistent constipation is caused by slow motility of the colon with symptoms of spasm (spastic constipation) or intestinal atony. Spastic constipation is characteristic of inflammation of the distal intestine. It manifests itself as pain along the bowel during bowel movements. Feces are excreted in several stages throughout the day and have a fragmented appearance (“sheep feces”).

Predominantly affecting the small intestine

Patients with enterocolitis with a predominance of damage to the small intestine are characterized by complaints of pain around the navel, which appears 3-4 hours after eating and is accompanied by flatulence and rumbling in the abdomen. Stool disorders often manifest themselves in the form of diarrhea, characterized by an increase in the amount of feces (polyfecal matter), which contains remnants of undigested food. IN severe stages diseases, the general symptoms caused by disturbances in the digestive and absorption functions of the small intestine and the development of malabsorption syndrome - insufficient absorption - come to the fore. The latter is manifested by a violation of the metabolism of proteins, fats, carbohydrates, vitamins, as well as water and mineral metabolism.

Clinically, this is expressed in a sharp decrease in weight, various trophic disorders of the skin and mucous membranes. Dry skin, brittle nails, glossitis, stomatitis, bleeding gums, esophagitis, paresthesia in the extremities and other manifestations of hypovitaminosis are noted. Typical tachycardia arterial hypotension, decreased performance, symptoms of hypochondria (“going into illness”).

Dyspeptic syndrome in its manifestations resembles dumping syndrome: after eating, severe weakness, a feeling of heat, and palpitations suddenly occur, which are replaced by trembling in the body, sweating, and dizziness. Such conditions are caused by sharp fluctuations in blood sugar levels - a short-term rise and a steep decline. Characterized by milk intolerance. Prolonged course of the disease leads to dysfunction of the pancreas and liver.

In elderly and old age enterocolitis occurs with mild pain syndrome. Atonic constipation, which sometimes alternates with diarrhea, and flatulence are characteristic. Often a combination of enterocolitis with other diseases of the digestive system: chronic gastritis, pancreatitis, cholecystitis, which aggravates the course of the pathological process. Atonic and spastic constipation cause the development of hemorrhoids and anal fissures, which in turn makes constipation more persistent.

Diagnosis of enterocolitis

In the diagnosis of enterocolitis, a scatological study is important, with the help of which elements of the inflammatory process (mucus, leukocytes, red blood cells) are detected in enterocolitis with predominant defeat colon or remnants of undigested food - with enterocolitis with a predominant lesion of the small intestine. A stool examination is carried out for protozoa and worm eggs, stool is inoculated for bacteria of the dysentery group, and for dysbacteriosis. In blood tests severe course Enterocolitis reveals anemia, hypoproteinemia, dysproteinemia, a decrease in the level of lipids in the blood serum, as well as sodium, potassium, and calcium.

Endoscopic research methods (colonoscopy, sigmoidoscopy) give a picture of catarrhal inflammation of the mucous membrane of the colon (hyperemia, swelling of the mucous membrane, pinpoint hemorrhages, the presence of mucus). X-ray examination of the colon using a contrast enema (irrigoscopy) gives a picture of the altered relief of the mucosa and characterizes the motor activity of the intestine (atony, spasm). The small intestine is examined x-ray and special study to determine the absorption function of the small intestine, aspiration biopsy.

Differential diagnosis

Differential diagnosis of enterocolitis involves many diseases. Colon dyskinesia is clinically very similar to enterocolitis. At the same time, with dyskinesia there is no distinct pain on palpation of the abdomen, bowel disorders are more often manifested by constipation, which only sometimes alternates with diarrhea. Feces - without pathological impurities and undigested food residues. The final diagnosis is made by endoscopy with colon biopsy. There are no signs of inflammation.

Nonspecific ulcerative colitis - disease unknown etiology, is characterized by the development of ulcers, erosions, and hemorrhages in the intestinal wall. Manifested by abdominal pain, diarrhea with tenesmus, intestinal bleeding. Often the only symptom at the onset of the disease may be the discharge of blood with mucus and pus during bowel movements (“hemorrhoid-like” onset). Rectal bleeding may occur unrelated to bowel movements. This pathology is observed in people aged 20 to 40 years. Abdominal pain is localized mainly in the left groin area, palpation reveals spasmodic sigmoid colon. At the onset of the disease pathological process covers only the rectum. Nonspecific ulcerative colitis is characterized by a greater severity of general symptoms of the disease: sudden loss weight, weakness, anemia, leukocytosis, often with a shift to the left, in severe cases - toxic granularity of leukocytes. During irrigoscopy and endoscopy, multiple ulcers and cicatricial narrowing of the intestinal lumen are noted.

It is necessary to differentiate enterocolitis from Crohn's disease. This disease, the etiology of which is unclear, is characterized by limited inflammation of predominantly the terminal part of the ileum with granulomatous changes in the entire intestinal wall, ulceration of the mucous membrane and narrowing of the intestinal lumen up to complete obstruction. The pathological process in Crohn's disease can affect any part of the digestive tract - from the esophagus to the rectum. Most persistent symptoms hers is diarrhea and prolonged, low-intensity abdominal pain. In case of defeat duodenum they are localized in the right upper quadrant of the abdomen, if the jejunum is affected - in the peri-umbilical region, ileum - in the right lower quadrant of the abdomen, stimulating chronic appendicitis. The stool is usually free of pus and mucus and has a gray-clay color. Common symptoms of the disease include weight loss, weakness, persistent low-grade fever, and signs of polyhypovitaminosis. It is often possible to palpate a painful infiltrate in the right iliac region, which is not found in enterocolitis. Big diagnostic value has an examination of the anal area: with Crohn's disease, swelling of the mucous and perianal tissues is noted, as a result of which the skin of the perineum acquires a purple-bluish tint. The formation of mildly painful wide cracks and ulcers in the anal area is characteristic. These changes may be the first manifestations of the disease. Important for diagnosis endoscopic examination with a biopsy of a mucosal area.

Tumors of the colon can occur as enterocolitis. Distinctive features are the persistence of constipation, the absence of a pattern in the replacement of constipation with diarrhea, the appearance after prolonged constipation copious foul-smelling loose stools. Often symptoms of relative intestinal obstruction. You should think about cancer if a middle-aged or elderly patient experiences unmotivated weakness, weight loss, decreased appetite, and symptoms of “intestinal discomfort.” Patients undergo irrigoscopy, sigmoidoscopy and colonofibroscopy with targeted biopsy of a section of the colon.

Treatment of enterocolitis

Treatment of enterocolitis should be comprehensive. The main method of pathogenetic therapy is nutritional therapy. A properly selected diet helps normalize the motor-evacuation and digestive functions of the intestines. Frequently shown fractional meals(4-6 times a day) mechanically gentle food with a sufficient amount of protein, vitamins, easily digestible fats and carbohydrates. During the period of exacerbation, diet No. 4 according to Pevzner is prescribed, during the period of remission - diet No. 4 and No. 2. Landmark in therapeutic nutrition should serve the character of the stool at the moment.

Antibacterial therapy is indicated for persistent intestinal inflammation, stool disorders that cannot be normalized by diet, and dysbacteriosis.

For colitis caused by opportunistic flora, antibiotics (chloramphenicol, polymyxin, etc.) are recommended. The course should last no more than 10 days due to a possible increase in dysbiosis and the development of side effects. From sulfa drugs Long-acting drugs are used (sulfadimethoxine, phthazine, etc.). For enterocolitis of dysenteric and salmonella etiology, nitrofuran derivatives (furazolidone, furadonin) are used.

For symptoms of dysbacteriosis after a course of antibiotic therapy, give biological drugs, containing the main microorganisms of the intestinal microflora (colibacterin, bifidumbacterin and bificol). These drugs, normalizing the microbial flora, eliminate flatulence, stool disorders, and reduce painful sensations. In case of violation secretory function stomach and pancreas, enzyme preparations (festal, mezim-forte) are prescribed.

To normalize stool during diarrhea, medications are prescribed that have astringent, enveloping and adsorbing properties ( White clay, bismuth preparations, tanalbin, etc.). For the same purpose they are used medicinal herbs- decoctions of flax seeds, plantain, oak bark, pomegranate peels, bird cherry or blueberry fruits, cinquefoil rhizomes. For flatulence, give chamomile, peppermint, dill, fennel fruit. Calendula flowers, eucalyptus leaf, St. John's wort herb, sage leaf, and yarrow have an anti-inflammatory effect.

Constipation is an indication for the prescription of a variety of laxatives: senna leaf, buckthorn bark, rhubarb root, isaphenine, castor oil, seaweed, magnesium sulfate, petroleum jelly, vegetable oils. Long-term, uncontrolled use of laxatives increases inflammation in the intestines.

Therapeutic enemas are effective in cases of damage to the distal parts of the colon (proctosigmoiditis, proctitis). They are administered with fish oil, sunflower oil, olive oil, rosehip oil, etc., for pain and tenesmus, add 10% propolis tincture, for spastic phenomena - atropine sulfate.

Physiotherapeutic treatment plays an important role in the treatment of enterocolitis. The intake of mineral waters should be strictly individualized depending on functional state intestines. In the remission phase, spa treatment is recommended.

Enterocolitis is an inflammatory process of the small and large intestines. It usually begins acutely, but incorrect treatment contributes to the transition to a chronic form. In an acute course, only the intestinal mucosa becomes inflamed, and in a long-term chronic process, deeper layers can be damaged, and irreversible changes mucous membrane, which leads to indigestion. In this article we will look at the symptoms and treatment of enterocolitis.

With an exacerbation of chronic enterocolitis, the pain is localized in the navel area, but can spread throughout the abdomen. Increased pain is felt in the afternoon, when physical activity, 1.5-2 hours after eating, before bowel movements. The patient has no appetite. Fermentation or putrefactive digestion disorders often occur, which leads to bloating due to excess gas formation, as well as constipation alternating with diarrhea. If relapses are frequent, body weight decreases, lethargy, general weakness appear, fast fatiguability, attention disturbance, apathy.

If signs of enterocolitis appear, you should contact a gastroenterologist.

Diagnostics

Acute intestinal inflammation is usually determined simply by characteristic symptoms. It is also important to clarify the patient’s diet in last days. To confirm the disease, a bacteriological analysis of stool and a coprogram are done. If necessary, rectoscopy is performed.

To recognize chronic enterocolitis, colonoscopy is also prescribed, which makes it possible to determine the extent of the affected areas, the presence of ulcerations, erosions, destruction of the mucosa, and also to perform a tissue biopsy. An X-ray examination reveals changes in the intestinal lumen, the nature of the structure of the folds, and defects in the intestinal walls. A blood test may reveal anemia, dyslipidemia, and ion imbalance (a consequence of impaired nutrient absorption).

Chronic enterocolitis requires a diet that excludes salty, spicy, sour fried foods. If putrefactive dyspepsia is pronounced, limit the consumption of coarse fiber, fermented milk products, and complex proteins. With the fermentation option, reduce the consumption of cabbage, rye bread, milk, and sugar. They use enzyme preparations that improve food digestion, pre- and probiotics that restore microflora, agents for normalizing intestinal motility, vitamin complexes. Local treatment is carried out in the form of microenemas. For diarrhea, infusions of plants (St. John's wort, oak bark, bird cherry) are administered, for flatulence - chamomile decoction, and for constipation - sea buckthorn oil.

Adequate and on time Taken measures provide complete cure of acute enterocolitis within 3-6 weeks. Long-term remission of a chronic process can be achieved by maintaining a correct lifestyle, following a diet, and appropriate treatment for the first signs of inflammation.

Which doctor should I contact?

If you have inflammation of the intestines that is not accompanied by severe fever and vomiting, you can contact a gastroenterologist, and if there are significant signs of intoxication, it is better to immediately call an ambulance, which will take the victim to infectious diseases hospital. Additional useful information can be obtained by consulting a nutritionist.

Inflammation of the mucous membrane of the small intestine is called enteritis, and the same process occurring in the large intestine is called colitis. If the entire intestine is affected, we are talking about enterocolitis - a disease that leads to disruption of the digestive processes with all the ensuing consequences (vomiting, diarrhea, dehydration, etc.). The syndrome complex develops against the background of a bacterial infection, toxic damage, due to poor nutrition, concomitant diseases Gastrointestinal tract. The disease requires complex treatment. Neglecting therapy leads to dire consequences.

What is enterocolitis

The syndrome complex occurs due to the negative impact of aggressive factors on the intestinal mucosa. First, inflammation occurs, then the cells begin to destroy, and the deeper layers of the intestinal walls are affected (in the chronic form). Food is less digestible, which causes unpleasant and painful symptoms. There is no separate ICD-10 code for enterocolitis. Non-infectious enteritis and colitis are classified into groups K50-K52. Here are the designations of some of them:

Factors that provoke intestinal inflammation are very different. The main causes of enterocolitis:

• Wrong reception medicines. Uncontrolled intake of antibiotics or laxatives leads to disruption of the intestinal microflora. Dysbiosis occurs, which in a complex form develops into enterocolitis.
• Bacterial and viral lesions. Streptococci, staphylococci, salmonella, pathogenic E. coli and a number of viruses that negatively affect the mucous membrane can develop in the gastrointestinal tract.
• Infection with helminths and protozoa, such as amoebas.
• Wrong mode food consumption. Irregular meals, fasting, too large gaps between meals, unbalanced nutrition, consumption of alcoholic beverages lead to disruption of the stomach and intestinal tract. Enterocolitis develops against the background of gastrointestinal diseases.
• Other causes: allergic reactions to food, damage by toxic substances, nervous strain, autoimmune disorders.

Kinds

The classification of enterocolitis depends on the causative agent of the disease. They can be divided into two large groups: acute and chronic, infectious and non-infectious. In the acute form, only the intestinal mucosa is affected, deep tissues are not affected. The chronic form is a prolonged enterocolitis, in which the deep layers of the intestinal wall become inflamed and destroyed. Other types of syndrome complex:

If mainly affected small intestine, patients complain of upset stool, nausea, flatulence, lack of appetite, abdominal distension after eating. With predominant inflammation of the colon mucosa, the patient experiences aching pain in the lateral sections of the intestine, diarrhea and constipation occur with equal frequency. Signs of enteritis and colitis differ depending on the form of the disease.

Acute enterocolitis

The syndrome complex manifests itself suddenly. In adults, the following symptoms are observed:

• abdominal pain - with damage to the small intestine, discomfort is localized around the navel, with pathology of the large intestine - in the lateral and lower parts belly;
• rumbling;
• bloating;
• frequent urge to defecation;
• nausea, repeated vomiting;
• diarrhea, pieces of food, blood and mucus in the stool;
• coating on the tongue.

If the cause of acute enterocolitis is bacterial or viral infection, a person’s temperature rises sharply, headaches and muscle pain, weakness, symptoms of general intoxication are observed. At severe diarrhea the body becomes dehydrated, which leads to dry skin and mucous membranes, severe thirst, and a decrease in the number of urinations.

Chronic

The symptoms of this form of the syndrome complex are less pronounced during the period of subsidence of the disease and become more pronounced during exacerbation. Signs of enterocolitis:

• Abdominal pain – peri-umbilical or of unclear localization. The severity depends on the severity of the process. In most cases, discomfort occurs in the afternoon. If the small intestine is more affected, the pain is dull and moderate. With inflammation of the colon, the pain is intense. Its intensification occurs a couple of hours after eating, before defecation, and during physical activity.
• Symptoms of intestinal enterocolitis in women are pain radiating to the lumbar region or lower abdomen. The same manifestations occur in pelvic inflammatory processes, which makes diagnosis difficult.
• Dyspepsia is a disorder of the digestive process in the intestines of putrefactive, fermentative or mixed types.
• Flatulence – increased gas formation, occurs due to intestinal dysbiosis and impaired digestion of food.
• Defecation disorder – constipation, diarrhea, occurring with equal frequency.
• Astheno-vegetative syndrome is a tissue metabolism disorder caused by prolonged inflammation of the intestinal mucosa. Shows weakness increased fatigue, apathy and impaired attention.
• Loss of body weight. Occurs due to a person’s fear of eating (with enteritis); due to a failure in the process of digestion and absorption of nutrients (colitis).

Symptoms in children

In infants, boys and girls, the disease is expressed slightly differently than in adults. The first sign of enterocolitis is Blunt pain lower abdomen. The child feels discomfort, becomes irritable and whiny. Added to this symptom are dizziness and headaches. 2-3 hours after eating, a boy or girl has a desire to go to the toilet; as the disease progresses, bowel movements become more frequent (diarrhea more than 6 times a day). Undigested food is found in the stool.

In severe cases of enterocolitis, repeated vomiting occurs. Food comes out first, followed by saliva and bile. There is bloating and colic. The most dangerous thing in this condition is dehydration. A growing body quickly loses water. Symptoms of dehydration: weakness, moodiness, dry mouth, infrequent and scanty urination. A very severe loss of fluid, requiring emergency medical attention, in a child manifests itself in the following signs:

• drowsiness;
• cold hands and feet;
• dry or barely wet diaper during the day;
• fast shallow breathing;
• sunken fontanel.

Symptoms of necrotizing enterocolitis in infants: painful, enlarged, red tummy, poor appetite, low or unstable body temperature. Defecation is impaired, constipation or diarrhea with bloody/black stool occurs. Green vomit is rarely observed. The child has a short sleep and wakes up crying and screaming. During the day the baby is very restless and constantly screams.

Diagnostics

Infectious enterocolitis is quickly identified. The doctor asks what food, drinks and medications the person consumed the day before, assesses the epidemiological situation in locality(for example, takes into account outbreaks of dysentery, salmonellosis, stomach flu). In case of unclear etiology, a number of biochemical and instrumental studies. It is very important to determine the cause of chronic enterocolitis and eliminate it, rather than engage in symptomatic treatment. The most informative research:

Treatment of enterocolitis

Treatment regimens are selected depending on the cause of the disease. Syndrome complex caused by viral diseases, requires symptomatic treatment. You need to drink a lot of liquid in small portions, and in 1-3 days the patient will recover. If a person is poisoned, his stomach is washed out, enterosorbents, antispasmodics are prescribed, severe vomiting or diarrhea, control the volume of incoming fluid. The patient should drink a lot of water, tea or rehydration solution, consume rice water, porridge with water. If the patient has a fever, he takes an antipyretic.

Necrotizing enterocolitis requires conservative therapy. The patient is given intravenous antibiotics, rehydrating solutions, and nutrients. Gas that has accumulated in the intestines or stomach is removed using a special tube. If drug treatment does not help, the patient has peritonitis or perforation and requires surgical intervention. The surgeon removes the affected part of the intestine.

In case of a depressed mental state, consultations with a psychotherapist will not be superfluous. The patient is also recommended to visit a physiotherapist, who will draw up a comprehensive treatment regimen, consisting of bowel cleansing procedures, reflexology, magnetic therapy, etc. Good dynamics of recovery are observed in patients who have undergone sanatorium treatment on balneological resorts. During the period of quiescence of enterocolitis, it is necessary to conduct active image life and do exercises from physical therapy.

Treatment with drugs

For this intestinal disease, experts prescribe a complex of medications. Main groups of drugs:

• Antibacterial – suppress pathogenic microflora. Representatives of the group: Nifuroxazide, Furazolidone, Enteroseptol.
• Enzyme-containing. Necessary for restoring normal digestion of food. Representatives of the group: Pancreatin, Festal, Plestal.
• Probiotics, prebiotics. Colonize the intestines after antibiotic therapy. These include preparations with bifidobacteria, lactobacilli, nutrient media for the development beneficial microflora– Bifidumbacterin, Linex.
• Means for normalizing intestinal motility. Relieves cramps, eliminates constipation or diarrhea. Representatives of the group: Trimebutin, Loperamide, Mebeverine.
• Oral rehydration products: Regidron, Gidrovit, Humana Electrolyte.
• Antipyretics: drugs based on paracetamol, ibuprofen.

For bactericidal colitis, inexpensive and effective remedy– Furazolidone (0.05 g of furazolidone in 1 tablet). The drug exhibits an antimicrobial effect, destroying the structure of the cell membrane and blocking a number of biochemical processes in the bacterial cell. Has a weak immunostimulating effect. Used when infectious diseases Gastrointestinal tract, genitourinary system, skin. Directions for use: 2-3 tablets (0.1-0.15g) 4 times a day, swallow them whole without chewing. The course of treatment is 5-10 days. Separately, it is necessary to highlight the following points of the instruction:

• Side effects: vomiting, nausea, abdominal pain, skin rash, itching, Quincke's edema, urticaria.
• Contraindications: individual sensitivity to the components of the drug, terminal stage of chronic renal failure, pregnancy, lactation, renal dysfunction, liver disease, nervous system, work related to driving cars and potentially dangerous mechanisms, age up to 1 month.

Enzymatic preparations are no less important. Pancreatin is popular. 1 tablet contains pancreatin powder 192 mg. The product replenishes the deficiency of pancreatic enzymes (alpha-amylase, protease, lipase), enhances the breakdown of proteins, fats and carbohydrates in the duodenum, and normalizes digestive processes. Pancreatin is prescribed for non-infectious diarrhea, flatulence, and eating disorders. Dosage regimen, contraindications, side effects:

• Directions for use: 1-4 tablets with each meal. Maximum daily dosage– 21 tablets. The duration of the course is from several days to several months.
• Pancreatin should not be taken if there is intestinal obstruction, age under 2 years, pancreatitis, or sensitivity to the components of the drug.
• Side effects: constipation, diarrhea, nausea, abdominal discomfort, allergic reactions.

Diet

With enterocolitis, the process of absorption of nutrients in the intestine is disrupted, which is why an insufficient amount of vitamins and minerals reaches the organs. The patient is exhausted. During the acute form of the disease, the intestines must be spared as much as possible. On the first day you need to drink sweet tea, rice water, blueberry jelly. When the condition stabilizes, liquid dishes are introduced into the menu: ground vegetable soups, lean meat, light porridge. Gradually, the degree of grinding of food is reduced, returning to the previous form of food.

If the patient suffers from constipation, he should not consume products made from premium flour, rice and semolina porridge, fatty meats, hard-boiled and fried eggs, animal fats. Vegetables should be limited to radishes, garlic, onions, and turnips. It is highly undesirable to consume sauces, black coffee, jelly, chocolate, and buttercream. With severe putrefactive dyspepsia, you should not eat fermented milk products, coarse fiber, or complex proteins. At fermentation processes limit intake of sugar, rye bread, milk, cabbage.

All patients are prescribed a diet. For enterocolitis with diarrhea, table No. 4 is prescribed, with constipation - table No. 3. Outside of an exacerbation, they adhere to diet table No. 2. For patients with predominant damage to the small intestine, a diet rich in protein, foods with high content calcium, vitamins, polyunsaturated fatty acids. Products that irritate the mucous membrane are excluded from the menu.

Prevention and prognosis

Early diagnosis diseases and complex treatment ensure complete recovery. To avoid complications, it is important to follow all doctor’s recommendations. Timely treated acute enterocolitis leaves no consequences for the body. After 3-6 weeks, the intestines completely restore their function. Prevention of the syndrome complex is as follows: