home→Stomach→ Acute and chronic gastroenterocolitis: symptoms and treatment in children and adults. Symptoms and treatment of acute gastroenterocolitis.

Acute and chronic gastroenterocolitis: symptoms and treatment in children and adults. Symptoms and treatment of acute gastroenterocolitis.

Gastroenterocolitis is one of the forms of gastric diseases, characterized by the formation of an inflammatory process in the intestines and stomach. The disease is also called food poisoning.

Types of disease

Gastroenterocolitis, depending on the course, can have three different forms:

chronic;
subacute;
acute.

By the nature of the inflammatory process is divided into:

hemorrhagic, characterized by damage to the intestinal mucosa;
phlegmonous, in which the lining of the stomach is affected;
catarrhal, covering the mucous membranes and causing them to swell;
ulcerative, represented by the formation of ulcerative lesions on the mucous membranes;
fibrous, causing the formation of a fibrous film on the mucous membrane of the gastrointestinal tract. Occurs very rarely.

Acute gastroenterocolitis begins to develop as a result of allergies, food poisoning and various infectious diseases. The mechanism of infection is through the blood or mouth.

Symptoms of the development of the disease

Gastroenterocolitis develops suddenly. The main symptom of the disease is nausea, accompanied by profuse vomiting. After eating food inadequate quality or a large amount of alcohol after 5-8 hours a person begins to feel weak. Then comes nausea and vomiting, which brings relief for a while. In adults, vomit contains recently eaten foods, and repeated vomit contains bile and mucus. The urge is always painful and is accompanied by painful sensations in the epigastric region. Increased nausea causes the smell or mention of food. Most often, after vomiting, weakness occurs and cold sweat appears. The skin is pale, and a gray-white coating forms on the tongue.

With gastroenterocolitis, diarrhea appears. The stool is loose, repeated and painful. The presence of pain in the lower abdomen indicates that the focus of inflammation is located in the large intestine. The occurrence of diarrhea in the acute form of the disease is individual. In some cases, it can begin a few hours after the infection enters the body, and in others - after a couple of days.

Often the symptoms of intoxication become pronounced. The person feels weak, chills, headache and dizziness. In rare cases, fainting occurs.

Vomiting, if it is repeated and abundant enough, can provoke dehydration of the body, which leads to a deterioration in the human condition. The patient feels dry mouth and thirst. In addition, there is a decrease arterial pressure, there is a coldness of the extremities.

Symptoms of gastroenterocolitis in children

This disease is much more common in children than in adults. Signs of the development of the disease are:

the appearance of general signs of poisoning;
stool disorder;
vomit;
the presence of blood in the stool;
staining of feces in dark green;
increase in body temperature.

During the period of high incidence of influenza in children, the occurrence of the influenza form can be observed. All symptoms appear very quickly, starting with an increase in temperature, which reaches its peak on the third day after the disease. Acute gastroenterocolitis is dangerous for the development of complications such as otitis media, pneumonia or pyuria.

Reasons for the development of gastroenterocolitis

The main cause of the disease is the use of low-quality products. Toxins for humans are the waste products of microorganisms and bacteria that develop in such products.

Gastroenterocolitis is caused by:

salmonella;
coli;
staphylococci;
yersinia;
viruses, the most common of which is rotavirus.

The disease usually affects entire families in cases where foods of inadequate quality were eaten. When visiting public catering establishments, entire groups of people can become infected.

Important. The development of gastroenterocolitis can be provoked by the constant use of foods that are rich in coarse fiber fibers, as well as cold drinks, increased acidity in the body and severe hypothermia.

Factors provoking the development of an acute form of the disease.

Infection or bacteria. Most often it is rotavirus diseases.
Overeating and excessive intake of alcoholic beverages. Gastroenterocolitis can also occur when taking too spicy or fatty foods.
Chemicals such as arsenic.
Allergens. These include citrus fruits, various berries and more.
Medical preparations. The disease can develop due to intolerance to individual components of the drug or in cases of overdose.

Diagnosis of the disease

Identification of acute gastroenterocolitis is not difficult. However, we must not forget that many diseases can be accompanied by nausea and vomiting. In order to correctly diagnose the disease, the doctor prescribes necessary tests. The infectious disease specialist also carefully analyzes the products that the patient has consumed over the past two to three days.

Treatment of acute gastroenterocolitis

With a mild form of gastroenterocolitis, hospitalization is not required. In the case of establishing a severe course, treatment takes place only in a hospital of the infectious diseases department under the supervision of specialists. Therapy includes rehydration - saturation of the body with fluid, salts and other substances. This is followed by antimicrobial treatment and detoxification.

In cases of severe disease and damage to the organs of the gastrointestinal tract, enteral rehydration is prescribed using intravenous administration a solution of trisil, disil or chlosil. Glucosteroid drugs can be added to them to relieve toxic shock and cordiamine or caffeine to stimulate the activity of the heart muscle.

Most often, with gastroenterocolitis caused by poisoning, gastric lavage is performed using a two percent solution of sodium bicarbonate. This is necessary to remove food debris and microbes contained in it. The procedure is carried out until the washing water is clean. Analgesics are prescribed to relieve pain. In addition, doctors recommend taking vitamin complexes and enzyme preparations.

If constipation occurs, laxatives are prescribed, for example, Duphalac or Sorbex. In rare cases, a siphon enema is used.

Diet has a huge impact on the speed of recovery. At the beginning of treatment, the patient is allowed to drink abundant and frequent drinks in order to quickly remove toxins from the body. It is best to use cereal decoctions. After two or three days, foods that do not irritate the intestinal mucosa, which is damaged by infection, can be introduced into the diet. Suitable for treatment protein diet. Throughout the day, it is better to eat about six times, sharing food. It is necessary to completely exclude fatty and spicy dishes, fresh milk and black bread for the duration of the entire course of treatment.

Prevention

In order to prevent the occurrence of acute gastroenterocolitis, it is necessary to wash hands thoroughly before eating and after visiting the toilet room. Eaten fresh fruits and vegetables should also be washed under running water. Fresh meat and fish must be cooked. In addition, you must carefully monitor the expiration date. In the event that any product is suspicious, it should not be eaten. It is also worth limiting the consumption of food on the street and in places of public catering.

Acute gastroenterocolitis is a serious enough disease that requires immediate treatment. When the first signs of illness occur, you need to take first aid measures and go to the hospital for qualified help. We must not forget that the disease in children develops more often than in adults. Therefore, children's diet requires careful monitoring.

Symptoms of gastroenterocolitis, which appear due to the consumption of poor-quality foodstuffs contaminated with pathogens or their toxins, usually develop rapidly, and if the disease is not controlled enough, it can lead to dehydration. However, when providing the patient with adequate medical care 3-4 days the disease recedes.

What is gastroenterocolitis?

Gastroenterocolitis is an inflammatory process that affects the entire digestive tract, but most of all it affects the large and small intestines. The disease can occur in acute and chronic form and have an infectious and non-infectious origin. Gastroenterocolitis has another name that more accurately expresses the causes of its occurrence: food poisoning.

Etiology of the disease

The main causes of gastroenterocolitis include:

Infection with bacteria (Salmonella, Shigella, Ischerichia and other enteropathogenic strains, as well as conditionally pathogenic Proteus and E. coli);
Viral infections (human rotavirus, which causes intestinal flu, ECHO virus, Norvalk agent of viral gastroenteritis, etc.);
Drug and food allergies;
Toxins (intoxication with heavy metals, alcohols, acids and alkalis);
other infections.

Note: Predisposing factors provoking the development of the disease can be the abuse of foods with a large amount of coarse fiber, cold drinking and hypothermia, increased acidity and beriberi.

Pathogenesis

The inflammatory process, as a rule, spreads by the alimentary (oral) or hematogenous route. In the latter case, infectious pathogens, poisons and toxins enter the lumen of the gastrointestinal tract from the bloodstream due to the absorption function.

pathological anatomy

With a mild course of acute gastroenterocolitis, patients experience slight swelling, hyperemia, bleeding, and slight vulnerability of the mucous membrane of the stomach and intestines. There is also an increased separation of mucus, which contains a large number of leukocytes, erythrocytes and epithelial cells.
If the patient is prescribed the wrong one, the disease can acquire a protracted chronic course. At the same time, the deeper layers of the digestive tract, up to the serous membrane, are involved in the pathological process. In some cases, patients have perivisceral adhesions.
Pathological changes can be focal or diffuse. Damage to nerve endings also occurs, which subsequently leads to trophic, vascular and motor disorders of the gastrointestinal tract.

Symptoms

Pain in the upper abdomen around the navel

The disease begins suddenly, with the characteristic phenomena of gastrointestinal dyspepsia. Patients complain of belching, heartburn, heaviness "in the pit of the stomach", as well as pains of a diffuse nature or localized around the navel and in the upper abdomen. Very often there is vomiting of food, stool retention for 1-2 days, and then diarrhea develops.

However, with gastroenterocolitis, there are symptoms of general intoxication: fever, headaches, confusion, and cardiovascular disorders. In medical practice, there are cases when the disease occurs with not pronounced or completely absent dyspeptic symptoms. Then the signs of general intoxication come to the fore.

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As a rule, with timely treatment acute form the disease passes very quickly, leaving no consequences. In a more severe course, the disease can last about two weeks, turning into a recurrent chronic gastroenterocolitis.

Signs of gastroenterocolitis in children

There are many reasons for the occurrence this disease in childhood. Along with food poisoning, it can be provoked by an increase in the virulence of the intestinal microflora (especially Proteus and Escherichia coli), as well as a decrease in the child's body resistance under the influence of various factors.

Often, gastroenterocolitis in children develops against the background of catarrh. respiratory tract, as parenteral dyspepsia, but in this case, the pathological process is delayed for a longer time.

Due to the aggressive action of microorganisms in the intestine, its mucous membrane becomes inflamed, that is, the dyspeptic process is replaced by a catarrhal one.

Note: Sometimes under the guise of this pathology in young children, a typhoid process may develop, accompanied by leukopenia and positive reaction Vidal. However, most often the disease in children under 3 years of age is caused by a dysentery bacillus.

The main symptoms of acute gastroenterocolitis in children include stool disorders and signs of general intoxication. From the first day of the development of the disease, the patient's stool contains a large amount of mucus and even a few streaks of blood. In most children, the stool has a dark green color, comparable to the color of frog spawn or swamp mud. In especially severe cases, symptoms of distal colitis (tenesmus, anus compliance, spasms of the sigmoid colon) are observed.

Also, children develop infrequent but persistent vomiting, and from the very first day of illness, the temperature rises. It reaches its maximum values in the first three days, then it lasts for a week and then goes down.

Note: There are many different forms of enterocolitis that are characteristic of childhood, and therefore in clinical practice they are usually grouped according to common features:

Rapid or gradual transition to the chronic stage.
Malignant course of the disease and high mortality.
Severe contagiousness (contagiousness).
Negative culture results.

Note: The latter is usually associated with a viral etiology of the disease or treatment with antibiotics.

Sometimes during an influenza epidemic, children under three years of age (and older) may develop influenza gastroenterocolitis. This form of the disease is characterized by a very rapid course with initially high temperature and complications such as pyuria, otitis and pneumonia.

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The digestive system is made up of several organs, each with its own unique function. The stomach breaks down food, making it receptive to further digestion into small intestine, which absorbs all useful substances and trace elements, and pushes residual food into colon. Agreed allows you to saturate the body with various useful elements and substances and get rid of all unnecessary waste.

However, inflammatory processes that can be observed immediately in some departments lead to a violation of the digestive function.

What is it - gastroenterocolitis?

The inflammatory process, which can be traced in several parts of the digestive system at once, is called gastroenterocolitis. What it is? This is an inflammation of the mucous membranes of the stomach, small and large intestines. It most often results from the ingestion of spoiled or bacterially contaminated food by both adults and children. Another name is food poisoning.

Acute - manifested against the background of infectious diseases, allergic reaction, intoxication through food or blood;
Chronic - has a relapsing character with exacerbations.

Hemorrhagic - damage to the mucosa of the predominantly small intestine;
Phlegmonous - purulent inflammation of the stomach, which has a local (outlined) or widespread (massive) character;
Catarrhal - redness and swelling of the mucous membranes, the release of exudate in large quantities;
Ulcerative - the formation of ulcers throughout the digestive tract;
Fibrinous - coating of the mucous membranes of the stomach, small and large intestines with fibrin protein.

Symptoms and signs

Symptoms and signs of gastroenterocolitis of the mucous membranes of the stomach, small and large intestines appear within an hour after infection:

Gas formation occurs, which causes bloating, accompanied by a loud rumbling.
Diarrhea can appear both immediately and after a few days, which indicates intoxication. In the feces, blood streaks and mucus can be observed.
The patient loses his appetite, does not feel hunger.
There is weakness, dizziness, fever up to 39ºС, pain in the head, possible fainting and loss of consciousness.
There are cramping or pulling pains in the navel area.
The skin becomes pale.
Bitterness appears in the mouth, heartburn is felt, belching occurs.
There is nausea and repeated gag reflexes with belching of undigested food.
If diarrhea does not appear immediately, then constipation is possible, which turns into diarrhea after a couple of days.
Anorexia occurs.

The acute form quickly arises and develops. There is a strong diarrhea, constantly there is a feeling of nausea, repeated vomiting. Signs of intoxication quickly appear: fever, chills, drowsiness, weakness, sweating.

If you start the immediate treatment of the disease, then it is quickly treated and passes. However, a prolonged visit to the doctor develops all the symptoms of the chronic form, which is recurrent.

Causes of inflammation of the mucous membranes of the stomach, small and large intestines

The main cause of inflammation of the mucous membranes of the stomach, small and large intestines is contaminated food, which penetrates during its absorption. We are talking about the bacteria Salmonella, Escherichia, Proteus, Shigella, Escherichia coli.

Also factors can be:

Infection with viruses, for example, rotavirus;
Damage by chemical and toxic substances, toxins, acid, alkali;
Allergic reaction;
Infectious diseases located near the digestive tract;
Toxic effects of certain drugs.

Sometimes the following reasons can provoke gastroenterocolitis:

Eating large amounts of cold food;
hypothermia;
Excessive consumption of foods rich in coarse fiber;
Increasing acidity.

Group infections within a family or in a group of people who ate in the same room become frequent here.

Gastroenterocolitis in children

Diarrhea and vomiting are the most striking signs of the disease in children. Gastroenterocolitis develops against the background of consumption of contaminated food, contact with patients with this disease, eating unwashed vegetables and fruits, viral diseases, and oversaturation with fatty foods.

Gastroenterocolitis in adults

Gastroenterocolitis in adults is manifested quite often due to the neglect of sanitary and hygienic standards for the preparation and consumption of food. It often manifests itself in men due to alcohol consumption, as well as quick snacks in public places. In women, it occurs against the background of constant diets, the irregularity of proper nutrition.

Diagnostics

Diagnosis is carried out in order to find out the causes of the disease and make an unambiguous diagnosis. So, a general examination is carried out, an anamnesis is collected (even the food that the patient last ate is checked) and complaints (what worries when it started?). Additional tests are also carried out to identify the pathogen:

Ultrasound of the gastrointestinal tract;
Analysis of blood, urine, feces;
Analysis of vomit;
Virological research.

Treatment

How to treat gastroenterocolitis? If all symptoms pass quickly, then treatment can be carried out at home. If the treatment is delayed, then it is carried out in a hospital. What medicines and procedures are used to eliminate the disease?

Rehydration, which allows you to restore the water-salt balance of the body, which is rapidly losing fluid and nutrients. With a mild form, it is carried out with solutions of rehydron and oralit. In severe forms, solutions are administered intravenously with the addition of glucocorticosteroids, caffeine and cordiamine;
Antimicrobial therapy in the form of taking antibiotics is carried out in case of severe intoxication;
Detoxification - elimination of toxins;
The patient's stomach is washed until the outgoing fluid is clear. Antispasmodics, enzyme preparations, analgesics, vitamins, laxatives for bowel cleansing are used here.

As an additional treatment, a special diet is well suited:

For the first couple of days, do not eat anything at all, just drink plenty of various herbal decoctions;
On the third or fourth day, add protein foods, which are consumed in small quantities several times a day;
Fried, smoked and hot dishes, coarse, spicy, fatty, spicy, fibrous foods, black bread and milk are completely excluded from the diet;
Over time, cottage cheese, cheese, kefir, lean fish are included in the menu.

The transition of the disease to the gangrenous form requires surgical intervention.

At home, treatment of gastroenterocolitis is permissible only in cases of mild form. Here you should stick to a diet, as well as use various decoctions of herbs. If treatment fails, you should seek medical help.

life forecast

The prognosis of life depends entirely on the type and form of the disease. How long do people live with gastroenterocolitis? This disease is not considered fatal, but if left untreated, complications can develop. Intoxication of the body with a bacterium is easily treated, the disease disappears in a month. Chronic form develops against the background of an incurable disease, as well as with various malformations of the digestive system.

You should adhere to preventive advice that will contribute to the non-occurrence of gastroenterocolitis:

Observe hand hygiene during food preparation and eating;
Adhere to sanitary standards when preparing food and storing food;
Do not use expired products;
Do not eat in public places or keep hygiene;
At the first sign, contact a gastroenterologist immediately

The nature of the disease enterocolitis - infectious, accompanied by inflammation of the gastrointestinal tract, including the mucous membranes of the small and large intestine, stomach. Gastroenterocolitis can occur in acute and chronic forms.

Symptoms

Symptoms of gastroenterocolitis in children are always pronounced. This is a whole complex of symptoms characteristic of all components of this disease - gastritis, enteritis and colitis.

With the appearance of belching, an attack of acute gastritis begins. After that, the patient feels pain in the upper abdomen - in the stomach. There is also pain on palpation of the abdomen. In some cases, vomiting opens.

Acute enteritis manifests itself in the form of frequent and liquid stool, bloating, nausea, pain.

For acute colitis symptoms are characteristic: cramping pains in the abdomen, severe pain during the act of defecation.

All these symptoms of gastroenterocolitis occur both simultaneously and sequentially, with a gradual deterioration in the patient's condition.

Causes of gastroenterocolitis in children

We list the main causes of gastroenterocolitis in children.

For the occurrence of gastroenterocolitis due to the above reasons, the following provoking factors are sufficient:

taking antibacterial drugs;
overeating, eating fatty foods, poor-quality foods, as well as unwashed vegetables and fruits, berries and herbs;
contacting a child with a person with gastroenterocolitis;

The most dangerous source of gastroenterocolitis in children is rotavirus.

Treatment of gastroenterocolitis

The basis of the treatment of gastroenterocolitis should be diet. The diet must be well-chosen. The previously used starvation and water-tea diets are not welcomed by doctors in our time. This is argued by the fact that the digestive function remains the main one in any intestinal infection, while a starvation diet can provoke the appearance of ketoacidosis, another intestinal disease.

Small children should be given small meals, but up to eight times a day. You also need to follow one rule that is the same for children of all ages: food should be steamed or cooked, and then mashed to a puree state or served in liquid form.

The diet should create a minimum load on the stomach and intestines of the child. Therefore, food that contributes to putrefactive and fermentation processes, as well as indigestible foods and foods that stimulate the separation of bile, should be excluded from the diet.

Children should get plenty of fluids, especially in the first two days. Warm boiled water or weak tea with a slice of lemon, as well as berry broth, is best. Freshly squeezed juices can be given diluted. A child can be given a raw apple, but only in a pureed form.

In the following days, you can connect kissels, jelly, mashed vegetables and fruits. From flour products, wheat crackers, soups with semolina or crushed rice are allowed. Legumes, sweets, milk, spices are excluded.

Distinguish Gastroenterocolitis infectious and non-infectious; allergic is also referred to as non-infectious.

Infectious gastroenterocolitis can be of bacterial, viral, protozoal, fungal origin. The most common Gastroenterocolitis of bacterial etiology (pathogens from the group of Salmonella, as well as opportunistic pathogens - Escherichia coli, Proteus, and others.). A causal relationship of infectious gastroenterocolitis with some viruses from the Coxsackie and ECHO group has been established (O. V. Baroyan, I. N. Gailonskaya, 1962). The role of enteroviruses in the occurrence of infectious Gastroenterocolitis is not well understood.

Non-infectious, alimentary, gastroenterocolitis occurs mainly as a result of malnutrition. Less common is allergic gastroenterocolitis, which occurs when eating certain foods that are allergens. Chemical poisons or medications(derivatives of salicylic acid, diuretin and others.) along with chronic lesions of the stomach and intestines can cause acute (drug) gastroenterocolitis.

Pathogenesis

In infectious gastroenterocolitis, the pathogenesis is determined by the type of pathogen. The pathogenic agent always enters through the mouth. The reproduction and death of microbes with the formation of exo- and endotoxins occur mainly in the intestine. Toxins affect the mucous membrane of the stomach and intestines and, penetrating into the bloodstream, cause general intoxication of the body. A special position is occupied by neurogenic exotoxins (see Botulism, Dysentery), toxins that disrupt the function of the intestine, and primarily its epithelial cells (see Cholera), toxins that have a necrotizing histological effect (see Amoebiasis). Some pathogens penetrate the intestinal mucosa, and from there into the blood (see Salmonellosis).

In the pathogenesis of alimentary gastroenterocolitis, an acute digestive disorder is of paramount importance, caused by irrational (malnutrition, overeating, eating very cold foods, spicy foods, alcohol) or one-sided nutrition (excessive consumption of fatty foods, carbohydrates, especially rich in fiber). In most cases, alimentary gastroenterocolitis occurs in people with functional insufficiency of various parts of the digestive system (defects in the chewing apparatus, insufficient secretory function of the stomach, pancreas and intestines, intestinal dyskinesia, biliary disorder).

An allergic reaction to certain foodstuffs, caused both by the food factor itself and by its cleavage products, occurs respectively soon after its use or at a later date.

Pathological anatomy of non-infectious gastroenterocolitis is characterized by an inflammatory reaction of the tissues of the stomach and intestines (hyperemia, edema, increased exudation, cell infiltration, degenerative changes in the surface epithelium). The defeat of the gastrointestinal tract can be generalized or localized. The predominant localization is due to the etiological factor. Usually the changes do not spread beyond the mucosa. Deeper layers are affected in a protracted and complicated course of the disease.

With infectious Gastroenterocolitis, the development of dystrophic processes of parenchymal organs and the occurrence of focal changes in them (in the case of bacteremia) are observed.

The clinical picture for all Gastroenterocolitis is characterized by an acute onset and sudden development of dyspeptic phenomena. There are pains in the abdomen, spilled or in a certain area, rumbling, flatulence, belching, nausea and vomiting, lack of appetite. Stool quickened liquid. The nature of the stool depends on the localization of the pathological process. With a predominant lesion of the small intestine, there is copious excretion fecal masses of yellow-green color with an admixture of mucus, but without blood. At microscopic examination feces revealed a syndrome of impaired digestion and absorption - creatorrhea, steatorrhea, and the like. With a predominant lesion of the large intestine, the feces are more scarce, with a large amount of mucus and often with an admixture of blood, defecation is more frequent, false urges become more frequent, scatological examination does not reveal impaired digestion and absorption. Characterized by a violation of the basic functions of the intestine: digesting, absorption and motor. Excessive excretion of water and salts with vomit and feces can lead to a violation of the water and electrolyte balance, dehydration and demineralization of the body (see Water-salt metabolism, Dehydration of the body). The quantitative ratios of intestinal microorganisms change, that is, dysbacteriosis develops (see). On palpation of the abdomen, areas of the spasmodic colon are determined, alternating with loops of the intestines, stretched with feces and gases.

With infectious Gastroenterocolitis, in addition to these symptoms, there are signs of toxicosis. In severe cases, accompanied by severe toxicosis, the liver enlarges, there is a slight yellowness of the sclera. In generalized forms of the disease with bacteremia, the liver and spleen are enlarged. Acute vascular insufficiency may develop.

Non-infectious gastroenterocolitis is milder than infectious. There are no distinct symptoms of toxicosis. Mucus in the feces is contained in small quantities, blood, as a rule, is not detected.

Allergic gastroenterocolitis occurs suddenly, proceeds rapidly, with a temperature reaction, often in combination with other allergic manifestations. Characteristic are positive skin tests with an allergen and the Prausnitz-Küstner reaction (see Prausnitz-Küstner reaction). The number of eosinophils in the blood increases.

The diagnosis is made on the basis of an epidemiological history, clinical symptoms, results of an instrumental examination, serological blood tests, bacteriological research feces and vomit. If a viral nature of the disease is suspected, appropriate virological studies are carried out. If necessary, conduct an allergological examination.

The changes in the mucous membrane of the sigmoid and rectum found during sigmoidoscopy (see) are very diverse, which is associated with the localization of the pathological process. With the predominance of enteritis, diffuse catarrhal changes are detected, more pronounced in the proximal section, occasionally with pinpoint hemorrhages. With the predominance of colitis, a picture can be observed from moderately pronounced catarrhal to fibrinous inflammation in combination with focal changes in the mucous membrane in the form of hemorrhages, erosions and ulcers.

At differential diagnosis It should be borne in mind that gastroenterocolitis is a frequent manifestation of acute intestinal infectious diseases. However, with some infections, for example, with tuberculosis, a secondary specific lesion of the digestive tract is also possible. Symptoms Gastroenterocolitis can also accompany a number of acute conditions of the abdominal cavity (appendicitis, cholecystitis, pancreatitis, and so on), which can lead to diagnostic errors.

Treatment

Both in the acute period of gastroenterocolitis and in the period of convalescence, a decrease in functional loads on the organs of the digestive system, in particular on the intestines, is shown; This is achieved by a diet and a sparing diet. Food should be taken 4-5 times a day in a warm form in small portions. On the 1st-2nd day of illness, the patient's diet is usually sharply limited: mucous rice or oatmeal soups, weak meat broth, liquid cereals on water with butter, fruit and berry jelly or jelly, white crackers. Drinking (unsweetened tea with lemon, alkaline mineral water without gas, decoction of blueberries, rose hips) is not limited. With severe intoxication, only drinking (up to 2 liters) is recommended for 1 to 2 days. From the 3-4th day, when the patient's condition improves, they are transferred to diet No. 4 (see Health food), and after 7-10 days - gradually to a normal diet.

Showing gastric juice, enzyme preparations that contribute to the normalization of digestion and absorption. To restore homeostasis, the violation of which is mainly associated with the loss of significant amounts of water and salts, requires the introduction of salt solutions in large volumes corresponding to the losses. Usually, dehydration in gastroenterocolitis has an isotonic extracellular character. For the purpose of rehydration, the use of Trisol, Quartasol and Ringer solutions is more justified.

For detoxification, a drip intravenous infusion of isotonic solutions of salts and glucose (up to 2-3 liters), hemodez (100-250 milliliters), blood plasma or its substitutes (100-200 milliliters), hydrocortisone (125 milligrams) or prednisolone (30 milligrams) is performed. . If bacterial toxins are suspected, gastric lavage is done. Tetracycline preparations, ampicillin and levomycetin, as well as nitrofuran derivatives (furazolidone) and 8-hydroxyquinoline (enteroseptol, 5-NOC) are used. The use of binders, enveloping and adsorbing agents is shown.

Important, especially in allergic gastroenterocolitis, is the use of antihistamines and antiallergic drugs (suprastin, pipolfen, diphenhydramine, stugeron). At a dysbacteriosis appoint biol. drugs that help restore normal intestinal flora (colibacterin, bifidumbacterin, bifikol).

Forecast

The acute period of infectious gastroenterocolitis is short, the disease usually ends in recovery. Full recovery of bowel function occurs 3-6 weeks after the subsidence of acute events and depends on the severity of the disease. Acute gastroenterocolitis of alimentary etiology ends with recovery after 5-7 days with proper diet therapy. In some cases (if the disease Gastroenterocolitis was preceded by functional insufficiency of the stomach or intestines, diseases of the digestive system, including helminthiasis), after acute infectious Gastroenterocolitis may develop chronic gastritis, chronic enterocolitis.

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