Burning diarrhea causes. Acute diarrhea: causes, symptoms, diagnostic methods and treatment. Hidden blood in stool

In itself, diarrhea in an adult is not a separate disease, but a symptom that occurs in a wide variety of ailments. Therefore, in order to successfully normalize stool, it is necessary to understand the causes of diarrhea in each specific case and, if possible, eliminate them.

What is diarrhea in adults?

Diarrhea (diarrhea) is a pathological condition when there is an increase in stool in adults more than 3 times a day, as well as a change in its consistency: it becomes watery, maybe with mucus and bloody discharge. Acute diarrhea lasts up to 2 – 3 weeks. Chronic diarrhea lasts more than 21 days.

Classification of diarrhea by mechanism of occurrence

Sodium and chloride ions accumulate in the intestinal lumen, which leads to an increase in osmotic pressure. High osmotic pressure causes additional water intake and a sharp increase in the volume of intestinal contents. Typically, this type of diarrhea is characterized by very large and loose stools, as well as loss of water and electrolytes.

In severe cases, without timely treatment, secretory diarrhea can lead to death due to acute fluid deficiency and the development of hypovolemic coma.

This type of diarrhea is observed with cholera, salmonellosis, viral intestinal infections, and hormonally active tumors. In addition, some laxatives and prostaglandins cause increased stool frequency in this way.

To some extent it is similar to the secretory one, since in this case the increased osmotic pressure also leads to excessive accumulation of water in the intestinal lumen and an increase in the volume of feces. However, here hyperosmolarity does not arise due to increased secretion of sodium and potassium ions, but due to the fact that the intestinal contents initially have high osmotic pressure. This type of diarrhea usually occurs in the case of rotavirus infection, as well as with an overdose of saline laxatives.

Inflammation develops in the lower intestines, which impairs the reabsorption of water. Observed in dysentery and amoebiasis.

Dilution of feces occurs due to additional release of blood, protein exudate, mucus or pus into the intestinal lumen. This type of diarrhea is typical for diseases accompanied by inflammation of the intestinal mucosa - Crohn's disease, intestinal tuberculosis, ulcerative colitis, etc.

Characterized by acceleration of intestinal motility. Typically observed in cases of stress, functional digestive disorders, diabetic enteropathy, amyloidosis, scleroderma.

Main causes of diarrhea in adults

The leading causes of diarrhea in adults are:

• food poisoning;
• excessive consumption of “heavy” foods;
• diseases of the digestive system, accompanied by inflammation of the intestinal walls (enteritis, enterocolitis);
• food allergies;
• enzyme deficiency;
• taking certain medications (for example, synthetic sweeteners, laxatives);
• sudden change in food style and conditions (travelers' diarrhea);
• intestinal flu and other infections;
• lead and mercury poisoning;
• stress.

When diarrhea is accompanied by a fever up to 380C, vomiting, or diarrhea with blood or water diarrhea, it is important to immediately consult a doctor in order to receive adequate treatment and avoid the development of serious complications.

Why is frequent diarrhea dangerous?

If stools are watery and frequent, you are more likely to develop dehydration and electrolyte loss, which can be fatal. For this reason, you should immediately see a doctor and immediately provide assistance to the sick person if the following symptoms are observed:

• dry mucous membranes;
• increased heart rate;
• chapped lips;
• rare or complete absence of urination;
• decreased blood pressure;
• the appearance of muscle cramps;
• disturbance of consciousness.

Be sure to consult a doctor in the following situations:

• diarrhea does not stop for 3 or more days;
• bowel dysfunction occurs and develops without reason;
• in addition to diarrhea, yellowness of the sclera and skin, intense abdominal pain, sleep disturbance and high fever are observed;
• stools are dark black or green in color, mixed with blood.

First aid for diarrhea

If you experience diarrhea and vomiting or diarrhea and fever, it is better to consult a doctor as soon as possible, since these symptoms may indicate the development of a serious illness, for example, acute intestinal poisoning. First aid until the patient is examined by a doctor is to prevent dehydration and significant loss of minerals. In this regard, experts, in case of diarrhea, recommend the following:

1. Drink plenty of minerals. For this purpose, Regidron (and its analogues) is best suited. If it is absent, then you can take lightly salted water or saline solution.
2. Stick to a strict diet. When diarrhea begins, it is better to generally abstain from 1 – 2 or more meals, unless the doctor recommends otherwise. To relieve intestinal inflammation, you can drink tea or decoctions of anti-inflammatory herbs.

Treatment of diarrhea: diet

Complete treatment for diarrhea includes the following dietary recommendations.

1. It is allowed to eat such foods as white crackers, slimy porridges, vegetable purees, steamed and boiled fish, lean meats, rice water, and tea.
2. It is prohibited to eat spicy, salty, sour foods, or foods containing large amounts of coarse fiber. In addition, milk, brown bread and anything that can cause increased gas formation and “fermentation” are not recommended.
3. In the first days, foods that stimulate the release of bile are excluded from the diet: eggs, fatty meat, butter, etc.

Gradually, the list of permitted products is expanding, and the patient, as stool normalizes, can switch to a normal diet. In situations where diarrhea is caused by enzyme deficiency or any chronic intestinal diseases, systematic diet is one of the most effective means of therapy.

How to treat dehydration with acute or chronic diarrhea

As a rule, glucose-saline solutions are prescribed until stool normalization. They replenish the loss of mineral salts and fluids in the body. The most well-known drugs in this group are Regidron, Gastrolit, Citroglucosan. In the absence of them on hand, you can independently prepare and use the following solution: for 1 liter of water, take ½ teaspoon of baking soda, 1 teaspoon of salt, ¼ teaspoon of potassium chloride, and also add 4 tbsp. l. Sahara. Instead of potassium chloride, you can take a decoction of dried apricots (dried apricots).

How to treat diarrhea with medications

The most common drugs used to treat diarrhea are:

The best prevention of diarrhea is maintaining personal hygiene, eating only high-quality foods and timely treatment of various chronic intestinal diseases.

Acute diarrhea is increased frequency of bowel movements for less than 3 weeks

Acute diarrhea Abnormally increased frequency or decreased consistency of stools for less than 3 weeks.
Osmotic diarrhea. Caused by the use of a solution that is poorly absorbed (malabsorption of carbohydrates; absorption of mannitol, sorbitol, lactulose, deficiency of disaccharidases: lactose intolerance, pancreatic insufficiency, diseases of the small intestinal mucosa: tropical sprue [gluten-sensitive enteropathy]; excessive consumption of antacids containing magnesium ).
Secretory diarrhea. Increased secretion or decreased absorption in the small intestine. This may be a consequence of bacterial enterotoxins, infections in patients with AIDS (Cryptosporidium spp. and M. avium complex); hormonal secretagogues, such as vasoactive intestinal peptide (VEP), which is secreted by pancreatic tumors and causes “pancreatic cholera”; carcinoid; hypersecretion of gastrin (for example, Zollinger-Ellison syndrome); or laxatives. Characterized by large volume, watery stools without blood or white blood cells.
Exudative diarrhea. Inflammatory conditions such as inflammatory bowel disease and eosinophilic gastroenteritis; radiation enterocolitis; infection by invasive organisms, cytotoxins, ischemia or vasculitis. The intestinal lining becomes inflamed, causing mucus, blood and pus to leak into the intestinal lumen.
Impaired mobility. Normal discharge diarrhea (< 250 г/день) характеризуется маленькими по объему, частыми и сформированными испражнениями, ассоциированными со срочной необходимостью. Причины включают гипертиреоидизм, аноректальные заболевания, проктит или копростаз, синдром раздраженного кишечника.

Causes of acute diarrhea

Diagnosis of acute diarrhea

Treatment of acute diarrhea

Fluid recovery

Orally (clear liquids, oral rehydration solutions containing sodium and glucose).
Intravenously (normal saline or lactated Ringer's solution, especially if severe dehydration or persistent vomiting is present).

Absorbents

Absorbents (aluminum hydroxide). They do not change the course of the disease or reduce fluid loss, but they allow the patient to have greater control over the time of bowel movements. Medicines should be taken at least 1/2 hour before or 2 hours after consuming absorbents.

Antisecretory substances

Antisecretory substances such as bismuth subsalicylate. The usual dose is 30 ml every 30 minutes for up to 8 doses.

Antiperistaltic agents

Antiperistaltic agents, in particular anticholinergic agents and opiate derivatives. Do not use in patients with fever, systemic toxicity, or bloody diarrhea. Stop if no improvement; or if the patient deteriorates. However, antiperistaltic agents are otherwise safe in adult patients with diarrhea. Antiperistalsis agents have been used safely in children, but are not standard of care and should be used only after careful consideration.
Diphenoxylate with atropine. Exists in the form of tablets (2.5 mg diphenoxylate) and liquid (2.5 mg diphenoxylate/5 ml). The starting dose is two tablets 4/day (20 mg/day). For children, the dose is 0.1 mg/kg/dose 4/day. The dose is reduced to zero with the cessation of diarrhea. It is not indicated for diarrhea caused by pseudomembranous colitis or enterotoxin-producing or invasive microorganisms. Lomotil should not be used if you have ulcerative colitis or if you are under 2 years of age. Lomotil is quite toxic with a narrow therapeutic interval in children.
Loperamide (Imodium). Available over the counter as 2 mg capsules and liquid (1 mg/5 ml). Increases intestinal absorption of electrolytes and water and reduces intestinal motility and secretion. The adult dose is 4 mg initially followed by 2 mg after each diarrheal stool, to a maximum of 16 mg in a single 24-hour period. In children, the dose is based on age, children 2-5 years old receive 1 mg 3 times a day, 6-8 years old 2 mg 2 times a day and 9-12 years old receive 2 mg 3 times a day on the first day of treatment. Next, 0.1 mg/kg is administered after each diarrheal stool, but not more than the total daily dose recommended for the first day of treatment. Loperamide is safe and reduces the number of failed stools and the duration of diarrhea in patients with Shigella dysentery treated with ciprofloxacin.

Antibiotics

Not necessary for most episodes of diarrhea. Once a specimen is obtained for culture, empiric treatment is reasonable to cover Shigella and Campylobacter in patients with severe diarrhea, systemic signs, or heme-positive diarrhea. A 3-day course of fluoroquinolones (ciprofloxacin 500 mg po bid or norfloxacin 400 mg po bid) is first-line therapy. Trimethoprim-sulfamethoxazole (Bactrim O/S 1 tablet po/day) is an alternative treatment, but resistant microorganisms are common. If diarrhea is caused by consumption of seafood, infection with Vibrio Cholerae or Vibrio parahaemolyticus is possible and can be treated with a fluoroquinolone or doxycycline 100 mg po 2/day. Antibiotics may increase the risk of hemolytic uremic syndrome in patients infected with E. coli.

Acute diarrhea in adults is a common complaint in family practice. The most common cause of acute diarrhea is viral gastroenteritis, a disease that does not require special treatment and goes away on its own. With the increase in the number of foreign trips, concomitant diseases and food poisoning, the role of bacterial causes of acute diarrhea is increasing. History and examination should be aimed at identifying risk factors and signs of inflammatory diarrhea and severe dehydration. Most patients do not require laboratory testing, and stool culture is usually not necessary. Treatment is aimed at preventing and treating dehydration. Additional diagnostics are required for severe dehydration, persistent fever, the presence of blood in the stool, patients with immunosuppression, or suspected epidemic or hospital infection. Oral rehydration and early nutrition are the preferred treatment for dehydration. If there is blood in the stool, drugs that inhibit peristalsis are contraindicated. For patients with watery diarrhea, loperamide/simethicone can be prescribed as symptomatic treatment. Probiotics may speed up recovery. When prescribed correctly, antibiotics are effective in treating shigellosis, campylobacteriosis, infection Clostridium difficile, diarrhea travelers and protozoal infections. Prevention of acute diarrhea includes hand hygiene, safe food preparation, vaccinations and access to clean water.

Acute diarrhea is the passage of stools with increased water content, increased volume and frequency of stools for less than 14 days. 1 Every year, 2.5 million people worldwide die from diarrhea. 2 In developed countries, infectious causes of acute diarrhea are usually associated with contaminated food and water. 5 In developed countries, technological progress and increased mass production of food have paradoxically led to the persistence of food-borne infections despite high standards of food production. 6

Differential diagnosis of acute diarrhea

Clinically, acute diarrhea is divided into two pathophysiological syndromes: the so-called. “noninflammatory” (usually viral, less severe diarrhea) and “inflammatory” (severe diarrhea, usually caused by invasive or toxin-producing bacteria). 7, 8 Table 1 compares noninflammatory and inflammatory acute diarrhea. 7, 8

Table 1. Non-inflammatory and inflammatory diarrheal syndromes

Viral infection is the most common cause of acute diarrhea. 9 Bacterial infections are more commonly associated with travel, comorbidities, and foodborne illnesses. If the pathogen can be identified, in the United States it most often turns out to be Salmonella, Campylobacter, Shigella and Shiga toxin producing Escherichia coli(enterohemorrhagic E. coli). 10

History and examination for acute diarrhea

History of acute diarrhea

You should find out from the patient the time of onset, duration, severity and frequency of diarrhea; it is especially important to know the nature of the stool (watery, mixed with blood, mucus, pus, bile). The doctor also needs to be aware of the presence of signs of dehydration - decreased urine volume, thirst, dizziness, changes in mental status. Vomiting is more typical for a viral disease or when a preformed bacterial toxin enters the gastrointestinal tract (toxicoinfection). Symptoms indicating invasive bacterial (inflammatory) diarrhea are fever, tenesmus, severe blood in the stool. eleven

Children attending day care, nursing home patients, food handlers, and recently hospitalized patients are at risk for developing infectious diarrhea. Pregnant women have a 12-fold increased risk of developing listeriosis 12; listeriosis is contracted by eating cold meat, soft cheeses, and raw milk. 13 From a patient with acute diarrhea, information should be collected on infectious contacts, use of antibiotics and other drugs. Anal and oral-anal intercourse predisposes to direct rectal inoculation of the pathogen and fecal-oral transmission.

Also important is a history of gastrointestinal diseases and surgical interventions, endocrine diseases, pelvic irradiation and factors causing immunosuppression, including HIV infection, long-term use of corticosteroids, chemotherapy and immunoglobulin A deficiency. Anamnestic data on diarrhea are shown in table 2 1, 7, 8, 14 , 15 , and clinical symptoms depending on the pathogen are shown in Table 3. 1, 14

Table 2. Important medical history for acute diarrhea

Table 3. Clinical symptoms for various pathogens

References in the list of references 1 and 14

Physical examination for acute diarrhea

The main purpose of examination for acute diarrhea is to determine the degree of dehydration of the patient. Signs of dehydration are a general unhealthy appearance, dry mucous membranes, slow capillary refill, tachycardia, orthostatic changes in blood pressure and heart rate. An increase in temperature is usually characteristic of inflammatory diarrhea. Abdominal examination is necessary to assess the degree of pain and exclude an acute abdomen. A rectal examination may be useful in assessing stool consistency, the presence of blood in the stool, and the severity of rectal pain.

Laboratory tests for acute diarrhea

Watery diarrhea usually resolves quickly on its own, so further testing is not required. 1, 16 In general, laboratory diagnosis is needed in patients with severe dehydration, severe disease, blood in the stool, immunosuppression, or suspected nosocomial infection.

Hidden blood in stool

The extent to which the presence of occult blood in the stool affects pretest probability is currently unclear. However, the stool occult blood test is a quick and inexpensive test; if it is positive and leukocytes or lactoferrin are detected in the stool, a diagnosis of inflammatory diarrhea is more likely. 17 The stool occult blood test in developed countries has 71% sensitivity and 79% specificity for the presence of inflammatory diarrhea; in developing countries, sensitivity decreases to 44% and specificity to 72%. 18

Leukocytes and lactoferrin in stool

Analysis of stool for leukocytes presents some difficulties, the main of which are the storage and processing of biomaterial, standardization and interpretation of laboratory data. Sensitivity and specificity can vary greatly between laboratories. All these factors have led to the increasingly rare use of this test today. 18

Lactoferrin is a white blood cell marker that is released from damaged or dying cells; lactoferrin increases during bacterial infection. 19 Commercial immunoassays for lactoferrin are more accurate and less susceptible to variability compared to the analysis for leukocytes in stool, their sensitivity exceeds 90%, and specificity exceeds 70%. 20 Therefore, the fecal lactoferrin test is the test of choice when screening stool for the presence of leukocytes. 21

Stool culture for acute diarrhea

Uncontrolled administration of stool culture for acute diarrhea is ineffective (the results are positive only in 1.6-5.6% of cases) 1 and leads to additional costs - $900-1200 for each positive culture. 22 If cultures are taken only in cases of positive stool tests for leukocytes, the price drops to $150. 23 If stool cultures are taken only in cases of obvious blood in the stool, the percentage of positive cultures increases to 30%. 24

Currently, there is no clear opinion on which patients with acute diarrhea should undergo stool culture. It would be reasonable to take stool cultures if there is obvious bloody diarrhea, severe dehydration, signs of inflammatory diarrhea, symptoms lasting more than 3-7 days, or immunosuppression. 25, 26 Stool culture is often prescribed for travelers' diarrhea, although empirical treatment is also possible for this pathology. 1, 11 In hospitalized patients, stool cultures are obtained in all of the above cases, plus if symptoms occur more than three days after hospitalization, or if there is an outbreak of infectious diarrhea in the hospital, in patients with HIV, with neutropenia, in patients over 65 years of age with concomitant diseases (terminal disease of the liver, kidneys, lungs, with leukemia, with hemiparesis caused by cardiovascular catastrophe, with inflammatory bowel diseases). 25

Diagnosis of infection Clostridium difficile

If diarrhea develops in patients hospitalized for more than three days, a stool test for the presence of toxins A and B is recommended. Clostridium difficile, the test turns out to be positive in 15-20% of cases. 25, 27 Moreover, the risk of exposure to Clostridium difficile increases by 7-10 times after antibiotic therapy of any duration, and the risk remains for one month after the end of antibiotic therapy, 2-3 months after the end of antibiotic therapy it remains increased by 3 times, 28 therefore testing for C. difficile toxins is recommended for those patients in whom diarrhea develops during the use of antibiotics or within three months after the end of antibiotic therapy, in addition, analysis for toxins is indicated for the development of diarrhea in patients with significant concomitant diseases, elderly and immunocompromised patients.

Worm eggs and enterobiasis in acute diarrhea

Routine testing for helminth eggs and enterobiasis in patients with acute diarrhea is not economically feasible, especially in developed countries. 29 Indications for this analysis may include a duration of diarrhea of ​​more than 7 days, especially if the patient has had contact with kindergarten children, travel to a mountainous area, if the patient has AIDS, or the patient is homosexual, if there are epidemics in the population associated with water contamination, if the patient has blood in the stool and there are white blood cells in the stool. 11 It is currently unclear whether it makes sense to send multiple stool samples for this test.

Endoscopy for acute diarrhea

The role of endoscopy in the diagnosis of acute diarrhea is small. Endoscopy may be indicated if the diagnosis cannot be made after obtaining the results of standard blood and stool tests, if empirical therapy is ineffective, and symptoms persist. 30 Colonoscopy with colon biopsy and culture may be useful in patients with diarrhea and suspected tuberculosis or diffuse colitis (as in clostridial colitis) and in the diagnosis of non-infectious causes of acute diarrhea - inflammatory bowel disease, ischemic colitis, NSAID-induced enteropathy, etc. cancer 31

Treatment of acute diarrhea

Rice. 1. Algorithm for the treatment of acute diarrhea. 1, 14, 20

Rehydration therapy for acute diarrhea

The first step in treating acute diarrhea is to treat dehydration, preferably by mouth. 1 First, you need to compensate for the lost fluid (the difference between the patient’s current weight and his weight before the illness). Next, you need to keep the patient in neutral water balance. Oral solutions for rehydration should contain a sufficient amount of salts and, necessarily, glucose, in order to better use the intestinal glucose-sodium transport mechanism.

In 2002, WHO approved oral rehydration solutions with reduced osmolarity (250 mOsm/L instead of 311 mOsm/L). Compared with standard solutions, reduced osmolarity solutions reduce stool volume, the number of episodes of vomiting, and the need for intravenous rehydration, 32 without causing hyponatremia. 33 At home, an oral rehydration solution can be prepared by dissolving half a teaspoon of salt, 6 teaspoons of sugar in 1 liter of water. If oral rehydration is ineffective, intravenous rehydration is used.

Feeding for acute diarrhea

Early initiation of feeding reduces bowel permeability caused by infection, shortens disease duration, and improves nutritional outcomes. 34,35 The latter is particularly important in developing countries where pre-existing malnutrition plays an important role. The BR diet (bananas, rice, orange juice and toast) and avoiding dairy products are often recommended, but there is currently little evidence for the effectiveness of these measures. The recommendation to abstain from solid food for 24 hours is also not supported by evidence. 36

Antidiarrheal drugs

For traveler's diarrhea, the anti-motility drug loperamide (Imodium) can reduce the duration of diarrhea by one day and increase the likelihood of clinical recovery at 24 and 48 hours when given concomitantly with antibiotics. 37, 38 The combination of loperamide plus simethicone relieves acute nonspecific diarrhea and discomfort caused by flatulence faster and more effectively than both drugs alone. 39

Loperamide can cause a dangerous prolongation of illness in some patients with blood in the stool and inflammatory diarrhea, so it should only be used when there is no blood in the stool. 40 In patients with fever and inflammatory diarrhea, bismuth subsalicylate (Pepto-Bismol) may be a safe alternative. There is no evidence of the effectiveness of kaolin/pectin, activated carbon, or attapulgin absorbents. The antisecretory drug racecadotril, widely used in Europe, is easier to tolerate and is as effective as loperamide, but is not available in the United States. 41

Antibiotic therapy for acute diarrhea

Acute diarrhea usually resolves spontaneously and is often viral in nature, so antibiotics are not prescribed in adults with mild diarrhea with watery stools. The widespread use of antibiotics leads to the emergence of resistant bacteria (e.g. campylobacter), destruction of normal flora and prolongation of the course of the disease (eg, superinfection with C. difficile), prolonged carriage (eg, prolonged shedding of Salmonella), induction of Shiga toxin secretion by E. coli and increased cost of treatment. Properly used antibiotics are effective in treating shigellosis, campylobacteriosis, C. difficile infection, traveler's diarrhea, and protozoal infections. Antibiotic therapy for traveler's diarrhea (usually a fluoroquinolone) reduces the severity and shortens the duration of the disease by 2-3 days. 1, 42 If the clinical presentation is suspicious for Shiga toxin-producing E. coli (blood in the stool, consumption of raw ground meat, local epidemic), antibiotics are contraindicated because they may increase the likelihood of hemolytic uremic syndrome. 43 Conservative treatment without antibiotics is less effective if diarrhea lasts more than 10-14 days; in this case, it is recommended to exclude protozoal infection. 1 Antibiotics are indicated for patients over 65 years of age, immunocompromised, with severe disease, and with sepsis. In table Table 4 shows antibiotic treatment regimens for acute diarrhea. 1, 14, 16, 44, 45

Table 4. Antibiotic therapy for acute diarrhea

Probiotics for acute diarrhea

The mechanism of action of probiotics is stimulation of the immune system and competition for binding sites on intestinal epithelial cells. Their use in children leads to a decrease in the severity and duration of the disease (on average by less than 1 day of illness). 46 Many types of bacteria are called “probiotics,” but in fact even related strains may have different clinical effects. Currently, evidence-based recommendations for the use of probiotics in adults have not yet been received. 16

Zinc preparations for acute diarrhea

Studies in children have shown that zinc supplements 20 mg for 10 days in children over two months of age play an important role in the treatment and prevention of acute diarrhea, especially in developing countries. A reduction in the risk of dehydration, severity and duration of a diarrheal episode has been shown to be approximately 20-40%. 47 In adults, further research is required to demonstrate the beneficial effects of zinc.

Preventing Acute Diarrhea

Hygiene, hand washing, proper food preparation, and clean water are key factors in preventing acute diarrhea. 48 Public efforts to promote proper handwashing reduce the incidence of acute diarrhea by a third. 49 In developing countries, the development and use of new vaccines plays an important role. Currently, effective and safe vaccines against rotavirus, typhoid fever and cholera already exist, and vaccines against Campylobacter, enterotoxigenic E. coli and Shigella are being developed. To prevent epidemics, information about the occurrence of cases of certain dangerous infections must be brought to the attention of sanitary authorities. In the USA, such infections include cases of detection of V ibrio cholerae, Cryptosporidium, Giardia, Salmonella, Shigella and Shiga toxin-producing E. coli.

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There are a number of diseases that many people who suffer from them do not like to talk about and are even ashamed of. And diarrhea (in common parlance - diarrhea) is one of them. Meanwhile, this condition is often a sign of very serious disorders in the body. Not to mention, diarrhea itself is dangerous and can even be fatal. However, practice shows that not all people know how to treat diarrhea properly.

What is diarrhea?

First of all, let's define this concept. Diarrhea in medicine is usually called a condition when a person performs an act of defecation, or bowel movements too often. Of course, frequent bowel movements is an imprecise criterion, so it should be clarified. A person who eats normally and consumes a normal amount of water should have bowel movements from 1 time in 2 days to 2 times per day. If defecation occurs more often than twice a day, then this condition can be considered one of the characteristic signs of diarrhea.
The second determining factor is the consistency of the stool. Normally, human excrement is cylindrical in shape and quite hard. With diarrhea, the type of stool is always different from usual - it is a semi-liquid, liquid or mushy mass, or even just water. If these symptoms of diarrhea - frequent urge to defecate and loose stools - continue for more than two weeks without a break, then the diarrhea is considered acute. Otherwise, it should be classified as chronic.

Generally speaking, diarrhea can be a symptom of many diseases. However, this disease cannot be determined by the mere fact of diarrhea. Other symptoms also play a huge role. It is extremely rare to find a case where diarrhea occurs against the background of complete health and is not accompanied by other characteristic signs.

The main symptoms that often accompany diarrhea:

• elevated temperature;
• weakness;
• nausea;
• gas formation in the intestines;
• pain in the lower or upper abdomen.

You should also pay attention to such characteristics of diarrhea as stool consistency. Pasty, liquid, watery diarrhea may indicate various gastrointestinal diseases. Also, with diarrhea, some additional discharge may be observed - blood, mucus, pieces of undigested food. What matters is the color of the discharge, its volume - abundant or scanty, the smell - foul or not.

Causes of diarrhea

What causes diarrhea? The causes of this condition can be varied. It is important to know well the cause of diarrhea, as otherwise treatment may not be effective.

Additional factors contributing to the occurrence of diarrhea are:

• insufficient personal hygiene;
• insufficient chewing of food, incorrect eating habits;
• stress and neuroses;
• sedentary lifestyle;
• use of certain types of medications;
• reduced immunity;
• pregnancy;
• childhood.

However, whatever the causes, diarrhea requires serious treatment and adequate treatment.

The main viral and bacterial infections that can cause diarrhea are:

• salmonellosis,
• dysentery,
• rotavirus infection,
• enterovirus infection.

As a rule, the main symptom indicating that diarrhea is caused by an infection is fever. Also, infections of the gastrointestinal tract are often accompanied by nausea, vomiting, and general weakness. Patients often complain that they have a stomach ache or pain in the lower abdomen. Stools with infectious diarrhea are frequent. Diseases such as dysentery are characterized by very liquid stool, which usually has a foul odor and contains mucus or blood.

Lack of digestive enzymes

Digestion is a complex chemical process. It involves many substances, whose task is to break down the organic substance entering the digestive tract into those simple compounds that can be absorbed by the body’s tissues. Many of the substances necessary for digestion are produced by various organs - the liver, stomach, pancreas. Such compounds include pepsins, bile, pancreatic enzymes - protease, lipase, amylase. If any of the enzymes is missing, this means that undigested food remains will accumulate in the intestines. This causes irritation and upset of the intestines, which causes diarrhea.

Poisoning

Often, loose stools are the body’s reaction to toxic substances. There may well be some toxins in the food we eat. This may mainly apply to stale or expired products, products treated with some chemicals or containing poisons (mushrooms, fruits and vegetables). It is also possible that drugs and chemicals may be ingested in large doses. This circumstance may well cause poisoning of the body, accompanied by diarrhea. As a rule, in case of poisoning, not only loose stools are observed, but also other symptoms. Typically, poisoning is initially accompanied by pain and stomach cramps. As the pathological process develops, poisoning begins to manifest itself with cramping pain, vomiting, nausea, sometimes headaches, neurological symptoms, or symptoms of cardiovascular failure.

One of the varieties of this type of diarrhea is the so-called “travelers’ diarrhea”. Although in fact this disease has a whole range of causes. It occurs in people who try a large amount of unusual and unfamiliar food. Most often, this behavior is typical for people who travel to distant and exotic countries and want to get new sensations. However, the problem is that our gastrointestinal tract and the body as a whole are conservative in nature and, to a certain extent, are tuned to the diet to which they have been accustomed since childhood. And when faced with something new, their work becomes disorganized, resulting in loose stools and an upset stomach.

Inflammatory processes of the digestive organs

Diarrhea often accompanies inflammatory diseases of the digestive system that are not directly caused by infectious agents. With these diseases, inflammation or ulcers of the surface of the mucous membrane of the stomach and intestines are observed, which, in turn, leads to gastrointestinal disorders. In addition to stool disorders, inflammatory diseases of the stomach and duodenum are often accompanied by heartburn, characteristic belching, and an unpleasant taste in the mouth (bitter or metallic). Such diseases include:

• enteritis,
• cholecystitis,
• autoimmune diseases (for example,).

Intestinal motility disorder

In diseases of this type, undigested food remains due to malfunctions of the autonomic nervous system of the intestine move too quickly through it and do not have time to form solid feces. Most often, this type of diarrhea is characteristic of a disease called “irritable bowel syndrome.” The urge to defecate with this syndrome may appear more often than usual and be associated with moments of nervous tension. However, the total amount of feces usually does not exceed the norm, and dehydration of the body, characteristic of other types of diarrhea, is usually not observed.

Dysbacteriosis

Many of the bacteria that live in our intestines are not pathogenic, but take part in the digestive process. If the number of intestinal bacteria drops catastrophically, for example, in the case of taking antibiotics, then a proliferation of other microorganisms may be observed, as well as disruptions in the digestion process, which often leads to diarrhea. After restoring the balance of the microflora, the stool, as a rule, returns to normal.

Diagnostics

What to do if diarrhea is chronic? To identify the causes of the pathology, you must consult a doctor. Although not all patients do this. But this is not always prudent, because it is completely unknown what pathology manifests itself due to diarrhea. This could be an accidental mild food poisoning, a relatively harmless irritable bowel syndrome, which, in principle, you can not pay much attention to, ulcerative colitis requiring long-term treatment, salmonellosis, in which the patient is subject to immediate hospitalization, and extremely dangerous tumors.

As for acute diarrhea, especially in severe form, then, of course, any doubts about the advisability of seeing a doctor should be discarded. If diarrhea occurs in an acute form, then the acute dehydration accompanying the disease can often lead to death. Statistics show that diarrhea kills more than a million children every year around the world. It must be remembered that most infectious diseases of the gastrointestinal tract are dangerous not in themselves, but in the complications associated with diarrhea.

In some cases, if we are talking about relatively mild diarrhea, the patient himself can determine the causes of diarrhea - for example, overeating or food poisoning, and draw appropriate conclusions about how treatment should be carried out.

Treatment

How to treat diarrhea? It must be remembered that this is not an independent disease, but only a symptom, although quite dangerous in itself. Therefore, in order to eliminate diarrhea, it is necessary, first of all, to eliminate the pathology that caused it. However, symptomatic treatment of diarrhea is also very important in many cases.

Let's look at the main methods that can successfully treat diarrhea. They can be both medicinal and non-medicinal. Non-drug ways to combat diarrhea include diet, methods for cleansing the stomach, etc.

Drug treatment

First of all, medications will help get rid of diarrhea. They can be divided into several main groups:

• sorbents,
• antibiotics and antiseptics for intraintestinal action,
• probiotics,
• antidiarrheals,
• means for restoring fluid in the body (rehydration).

Enterosorbents are products that absorb the contents of the stomach and intestines, bind and neutralize them, and then excrete them with feces. Thus, if loose stools are caused by some foreign agents (microorganisms or toxins), then with the help of enterosorbents they can be removed from the body.

Diarrhea is most often treated with antidiarrheals such as loperamide, which affect intestinal motility and slow down the movement of feces through it. This type of medication, however, may not be effective for all diarrhea, and sometimes they can even be harmful. Therefore, before using this type of medication, it is necessary to clarify the cause of diarrhea.

To relieve severe pain, you can use antispasmodics, painkillers or anti-inflammatory drugs. However, it should be firmly understood that they can only be used if the source of pain is accurately identified, the disease is diagnosed and does not threaten the patient’s life. Therefore, you should consult your doctor before taking these medications. In some cases, painkillers can mask the development of life-threatening infectious and inflammatory processes in the gastrointestinal tract.

Fluid replenishers are a type of medication that is often not taken seriously. And it’s completely in vain, because they help the body fight dehydration. Most often, saline solutions, such as Regidron, are used for this purpose.

Probiotic drugs are usually used if diarrhea is caused by dysbiosis. If the amount of normal intestinal microflora decreases, probiotics will help restore balance in the gastrointestinal tract and normalize digestion. However, in most cases, the use of these drugs alone will not correct the situation.

The choice of drugs from any group depends on the etiology of the disease. Therefore, in order to know how to treat diarrhea, you must first identify the source of the problem.

If frequent loose stools are caused by food or household poisoning, then the most effective method of treatment is gastric lavage and/or taking enterosorbents. It is also necessary to take means to restore fluid in the body.

If diarrhea is caused by an infection, then it is necessary to use antibiotics prescribed by a doctor, anti-inflammatory drugs as an auxiliary element of therapy, and rehydration agents.

For irritable bowel syndrome, non-infectious colitis, enteritis and gastritis, antidiarrheal and anti-inflammatory drugs will be most effective. The method of treating inflammatory processes of the gastrointestinal tract is quite complex and the treatment strategy should be determined by a doctor.

How to treat diarrhea caused by a lack of digestive enzymes? This is quite simple - first of all, you should take enzyme preparations containing pancreatic enzymes and bile. Antidiarrheal medications will also be helpful.

Diet

Diet is an important part of therapy. First of all, it is necessary for those who do not know how to get rid of diarrhea. Taking any medications in most cases will be useless if the patient simultaneously eats foods that irritate the digestive organs and help prolong the disease.

The diet largely depends on the type of disease. However, there are a number of principles that must be followed when eating.

You should exclude from your diet too fatty and sweet foods, foods that provoke active fermentation and gas formation in the stomach, carbonated drinks, spicy foods, and alcohol. Preference should be given to boiled food rather than raw food, and especially not fried or smoked. Food should be easily digestible, that is, hard-to-digest foods such as mushrooms should be excluded from the diet. Drinking is also important. In case of severe dehydration, it is useful to drink saline solutions; for intestinal infections - decoctions of chamomile, rose hips, and strong tea.

Prevention

Prevention includes, first of all, personal hygiene, washing and proper heat treatment of food. It is also important to follow a proper diet, not to eat expired or spoiled foods, products of dubious origin, and to ensure that hazardous chemicals do not get into your food. It is also important to monitor your eating habits, do not eat on the go or dry food, avoid stress and overwork, monitor your health and treat chronic diseases in a timely manner.

Few people in their life have not suffered from such a disease as indigestion. However, in the absence of proper treatment, a common ailment can turn into.

Intestinal infections most often take the form of acute diarrhea and, if not properly treated, can become chronic. There are two types of this disease in acute intestinal infections:

• With watery stool. Most often caused by bacteria or toxins. It is dangerous due to the loss of large volumes of water, salts and microelements necessary for the body. It should be remembered that watery diarrhea is not recommended or any other antimicrobial drugs. The appearance of watery stools indicates that beneficial microorganisms are being washed out of the body, therefore, their number in the intestines is sharply reduced. The only exceptions are cases of salmonellosis.
• . This type of diarrhea occurs due to the penetration of microorganisms into the intestinal mucosa, destroying it. Often occurs with diseases such as dysentery or salmonellosis.

However, in addition to acute intestinal infections, there are a number of other causes that cause indigestion (diarrhea): and chronic diseases of the organs involved in the process of digesting food.

The occurrence of diarrhea due to intestinal dysbiosis means a sharp reduction in the number of beneficial microorganisms that help the normal functioning of the digestive system.

Disruption of the normal intestinal microflora allows harmful bacteria to take the place of beneficial ones, which, in turn, causes various disorders and diarrhea, which is protracted and unstable. Diarrhea, in turn, can be a symptom of pathologies such as:

• Chronic enteritis (inflammation of the small intestine)
• Chronic colitis (inflammation of the large intestine)
• Ulcerative type colitis

In addition, acute diarrhea occurs with other organ pathologies not related to the digestive process. For example, with inflammation of the appendix, emotional stress and solar overheating. However, regardless of the cause or severity, diarrhea must be treated and treated correctly. Indeed, in some cases it poses a real threat to human life.

Symptoms of acute diarrhea and its types

Almost every person has experienced acute diarrhea at least once in their life.

Symptoms may vary depending on the cause of diarrhea. Most often, they depend on the individual predisposition of the patient and the influence of other diseases on the course of his intestinal disorder. Conventionally, the symptoms of acute diarrhea are divided into two groups - absolute and optional (conditional). The category of absolute symptoms includes the following:

• Sudden onset of diarrhea
• Increasing the frequency of bowel movements from usual to several times per hour
• The occurrence of weakness and lethargy, drowsiness
• Irritation and
• Development of symptoms of dehydration with prolonged indigestion (pallor, general weakness and drowsiness, decreased volume of urine and its strange color and smell, etc.)
• A sharp decrease (or complete absence) of appetite.

These symptoms are observed in all cases, regardless of the cause and severity of the disease. It should be noted that if the slightest signs of dehydration appear, medical attention is necessary. Conditional symptoms include those that may be present, may appear partially or not appear at all:

• Dizziness
• Vomiting (or)
• Temperature increase
• Pain localized in the navel area, in the upper abdomen.

But regardless of whether the symptoms appear or do not appear, they cannot be treated separately in any case, nor can the disease be triggered. What kind of treatment is needed will be discussed below.

Acute diarrhea: treatment

Acute diarrhea is dangerous due to dehydration

Diarrhea is not the main cause of the disease, it is a symptom. And in order not to aggravate the situation, it is necessary not only to choose the right medication, but also to follow a certain list of recommendations that will allow you not only to get rid of the unpleasant problem, but also to restore the substances and microelements necessary for the body that are lost along with the feces. You should not hesitate to call a doctor or ambulance if:

1. Elevated body temperature does not drop below 38 during the day
2. Manifestation of the first signs of dehydration - general weakness, thirst, increased vomiting and dizziness
3. Bloody or
4. Incessant abdominal pain.

The doctor will not only help relieve discomfort and avert the threat of complications, but will also recommend the necessary continuation of treatment, depending on the results of tests for the presence of harmful bacteria in the stool.

If it is not possible to call a doctor or you do not think that your condition requires it, the first thing you need to do is take an astringent medicine. Among those products that should always be on hand just in case is activated carbon, which has an almost instant effect. It is recommended to take these medications at the first sign of diarrhea. The microelements included in their composition quickly restore intestinal function.

Smecta is also good as a restorative. Its solution must be taken on an empty stomach, one glass three times a day. It not only strengthens the stomach in three days of use, but also restores and replenishes the supply of vitamins and essential microelements.

If you are not a supporter of medications and give your full preference, then a powder made from the dried inner films of chicken stomachs is a suitable remedy for combating almost all types of diarrhea.

By taking a teaspoon of this remedy 2-3 times a day, you can not only prevent the further development of the disorder, but also prevent serious consequences caused by a lack of vitamins and nutrients. You need to drink it with plain water. As a rule, with unsevere forms of diarrhea, the measures described are sufficient to improve the condition.

The topic of the video is probiotics in the treatment of diarrhea:

Recovery after illness

For acute diarrhea, diet is mandatory

The most important thing after first aid is to restore lost fluid and microelements. In order to quickly and without consequences return to normal life after an attack of diarrhea, you must follow a certain list of rules:

1. The main problem is the loss of large amounts of fluid, replenishing which is a priority. To do this, you need to consume at least 3.5-4 liters of liquid per day - boiled or mineral water. It is recommended to refrain from eating vegetables and fruits.
2. Fermented milk and dairy products require complete exclusion.
3. The powder will serve well as a remedy that restores the salt balance in the body.
4. If you don’t have one in your medicine cabinet, you can prepare Regidron yourself by mixing 1 teaspoon of baking soda with half a spoon of salt and 5 tablespoons of sugar. All this must be diluted with boiled water and taken throughout the day.
5. Even if the feeling of thirst has subsided, you must continue to drink plenty of fluids.
6. After a day or two, you can start consuming compote.

During the recovery period, it is recommended to follow a special diet that excludes everything hot, fatty and untrustworthy. You need to consume broths and cream soups, exclude fruits and vegetables, as well as semi-finished products from your diet. But under no circumstances should you go hungry. The body needs to recover, so you should eat food every three hours, but in small portions.

If pain in the intestinal area does not stop, you can refrain from eating solid food for a couple of days.

In order to fully recover from an attack of acute diarrhea, you must follow the rules, consume plenty of fluids, follow basic hygiene rules and avoid various stressful situations. It should also be remembered that acute diarrhea is a rather dangerous disease that requires attention and medical care.