Familiar to almost every disease of the gastrointestinal tract can be a separate disease, as well as a symptom of another, more serious pathology.
What is gastroenteritis, its causes
Gastroenteritis is a very common inflammatory disease of the stomach and intestines. Vomiting, diarrhea, colic, weakness, and sometimes fever are his main and familiar symptoms.
Causes of gastroenteritis, there are a huge number:
- causative agents of infectious (viruses, bacteria) and parasitic diseases;
- food toxicoinfection - poisoning by toxins of bacteria, which are formed as a result of their vital activity;
- side effects of taking certain medications (for example, nonsteroidal anti-inflammatory drugs), radio and chemotherapy;
- unhealthy diet;
- food allergies or intolerance to certain products;
Gastroenteritis can also be one of the symptoms of certain diseases.
The causative agents of infectious and parasitic diseases are excreted into the external environment along with feces, often in large quantities. That is why before the epidemic of intestinal infections (cholera, diphtheria, typhoid) spread so quickly and claimed a huge number of lives. They enter the human body with contaminated food and water. Therefore, failure to observe the basic rules of personal hygiene (thorough washing of hands after the toilet, before eating) and visiting public catering establishments that violate sanitary norms significantly increase the chances of encountering gastroenteritis.
Gastroenteritis is divided into two large groups: infectious and non-infectious. Infectious (infectious) gastroenteritis is caused by pathogens - viruses (50-70%), bacteria (15-20%), parasites (10-15%). You can pick up this disease: not washing your hands, using utensils and food items shared with a sick person, eating unwashed vegetables and fruits. Viral gastroenteritis develops when infected with many types of viruses. Among them, the most common are rota-, noro-, adeno-, coronavirus infections. All of them are treated equally, so the doctor does not need to distinguish between them. Among the many pathogens of bacterial gastroenteritis, the most common are salmonella, campylobacter, shigella, E. coli, clostridia. Giardia and cryptosporidia are unicellular parasites, causing, as it is easy to guess, parasitic gastroenteritis.
Non-infectious gastroenteritis is less common than infectious. Inflammation of the stomach and intestines can be provoked by an abnormal diet, certain medications, chemotherapy and radiotherapy, microbiological toxins, and allergies to food components. Some diseases (AIDS, certain types of cancer, peptic ulcer, Crohn's disease) are also accompanied by gastroenteritis as a symptom, sometimes major.
Gastroenteritis can be acute or chronic. Infectious processes are acute diseases, they begin abruptly; symptoms are pronounced; the duration of the disease is relatively short. Non-infectious gastroenteritis can be acute and chronic. Chronic lasts a long time, periods of exacerbation alternate with asymptomatic.
The ICD-10 code for gastroenteritis of infectious origin is from A00 to A09, depending on the causative agent, non-infectious K50 - K52, depending on the cause.
Gastroenteritis in children
Infectious gastroenteritis is one of the most common diseases in children. The most massively sick children under 5 years old, hard - up to a year, and very seriously - less than 6 months. Emerging immunity, frequent stay in large groups of peers (kindergartens, schools) and still imperfect hygienic habits (pulling everyone in the mouth, not always washing their hands) greatly contribute to the rapid spread of intestinal infections among children.
If for an ordinary adult infectious gastroenteritis, as a rule, is an unpleasant thing, but not dangerous, then they are a real threat to the health of the child. In children, diarrhea and vomiting very quickly violate the water and electrolyte balance, which can lead to shock, coma and even death. Today, it is these diseases that take the greatest number of children's lives. Therefore, parents need to be very attentive. If a child has drowsiness on the background of an infection, urination is very insignificant, hands or feet are cold, a spring is hollow, breathing is frequent - it is necessary to seek help as soon as possible. These are all symptoms of dehydration life-threatening degree. The milder signs of dehydration (dry mouth, irritability, sunken eyes, tearless crying) should also alert the parents.
Symptoms and signs of gastroenteritis
Symptoms of gastroenteritis vary depending on the cause of the disease. Infectious gastroenteritis usually begins suddenly. Vomiting, diarrhea (diarrhea) with or without blood and mucus, intestinal colic, weakness, fever (moderate or high) are classic signs of an intestinal infection. The disease may also be accompanied by muscle pain and prostration.
Parasitic gastroenteritis is usually manifested by chronic diarrhea, in most cases without blood, with the exception of amoebic dysentery. Weakness and weight loss occurs when diarrhea is severe.
Non-infectious gastroenteritis is mainly accompanied by digestive disorders. Their manifestations may be very slight (soft feces, flatulence) or severe (severe diarrhea, colic, weakness, weight loss, deterioration of the general condition).
Children, the elderly and patients with impaired immunity can be especially painful. As a result of severe vomiting, they may develop severe dehydration, which can lead to serious complications and even death. With moderate dehydration, symptoms such as dry mouth, poor urination, and weakness are observed. This degree can be adjusted without hospitalization, using a sufficient amount of fluid. The warning signs of severe dehydration (cold extremities, drowsiness, urination, very little or no, frequent shallow breathing) require urgent medical attention.
Diagnosis of gastroenteritis
The clinical picture of many types of gastroenteritis is very clear. And to make a diagnosis, it is enough for the doctor to ask the patient about complaints and conduct a general examination. When abdominal palpation, swollen bowel loops are detected. Also, the doctor can listen to the bowels. She is usually very active, accompanied by many sounds.
The most important thing is to establish the cause of the disease, as this determines the treatment plan. Therefore, in some cases, the doctor prescribes additional research. For many infectious diseases, tests have been developed that can identify the causative agent; parasites and bacteria are detected by microscopy or feces.
General and biochemical blood tests are prescribed to patients with a severe form of the disease, since in these cases the functioning of the internal organs is disturbed (for example, the kidneys suffer from gastroenteritis caused by E. coli).
Gastroenteritis therapy works in two directions:1.Eliminates the root cause, if possible; 2.Corrects symptoms and effects.
There is no specific treatment for viral gastroenteritis. With mild symptoms, rest and heavy drinking are all that is needed for a successful recovery. Severe dehydration, lack of fluid and individual electrolytes are adjusted by the introduction of intravenous solutions.
Bacterial gastroenteritis requires treatment with antibiotics, parasitic - antihelminthic drugs, the best of them are Cytotec. If you suspect food intolerance, the most important thing to exclude from the diet foods that can cause a painful condition. If gastroenteritis develops as a side effect of drugs, the doctor may try to replace drugs from the current scheme with analogues. In cases where inflammation is only a symptom, the way to get rid of it is in the treatment of the underlying disease.
It is always necessary to drink plenty of liquids, and antipyretic drugs are prescribed at a temperature. Anti-diarrheal drugs are not always welcome.
They are prescribed only to children older than two years with watery diarrhea, and only after checking for fecal occult blood.
For children and other people at risk, with diarrhea and vomiting, rehydration drinks are recommended.
Diet with gastroenteritis
The most important thing with gastroenteritis is to drink. This should be done correctly: often, but little by little, in small sips. Older children and adults during the acute course of the disease can try to dissolve the ice. With vomiting and diarrhea, many minerals are released, especially calcium, sodium, potassium, magnesium. To compensate for the loss is shown to drink mineral water alkaline composition.
Eating should be resumed carefully. To start, try to eat something light: vegetable or chicken broth, oatmeal, banana, rice - all salted and spiced. If vomiting comes back - again to take a break without food (at least a few hours), then you can eat again. For a while it is necessary to refuse alcohol, fatty and spicy dishes, dairy products, coffee, carbonated drinks. New foods are added to the diet little by little, making you feel good.
For gastroenteritis, triggered by intolerance to food components, the main treatment is diet. It can be very strict, exclude even trace amounts of a certain component in food or recommend reducing the consumption of certain foods. It all depends on the diagnosis and the individual course of the disease.
Prevention of gastroenteritis
The best prevention of infectious gastroenteritis is to follow the basic rules of personal hygiene, familiar to everyone:
- wash hands thoroughly after using the toilet and before eating;
- do not drink raw water, especially from unfamiliar sources and standing bodies of water;
- avoid suspicious catering establishments;
- in the presence of the patient's home, provide him with individual dishes, do not use towels shared with him;
- disinfect the places of swaddling and changing diapers, if the child is sick;
- travel lovers are advised to find out in advance the specialties of local cuisine and to avoid potentially dangerous dishes. First of all, it concerns visiting countries in which the native kitchen is very different from the usual one, or ingredients that are not thermally processed are used. Water is better to buy bottled.
Proper nutrition and a healthy lifestyle will help prevent chronic gastroenteritis.
Children can be vaccinated from the most common intestinal virus - the causative agent of rotavirus infection. The need for vaccination and details can be obtained from your pediatrician.
What is enterocolitis? The common name for inflammatory diseases of the small and large intestine. We can say that this is not a diagnosis, but a group of diseases.
Causes of enterocolitis
There are many reasons:
- viral infections;
- the simplest;
- food components;
- side effects of drugs, chemotherapy and radiotherapy.
In some cases, for example, in Crohn's disease and necrotizing enterocolitis in newborns, the causes are completely unknown.
Classification of enterocolitis. ICD-10 codes
All enterocolitis can be divided into two huge groups:on the course of the disease: acute and chronic; depending on the cause: infectious and non-infectious.
Infectious enterocolitis is divided in turn into bacterial, viral, parasitic, and caused by protozoa.
Non-infectious enterocolitis is a separate disease or one of the side effects of some drugs. The most common:
- inflammatory bowel disease - Crohn's disease and ulcerative colitis; in case of ulceration on the surface of not only the colon, but also the small intestine, the pathology is treated as ulcerative enterocolitis;
- pseudomembranous colitis (antibiotic-associated) - inflammation that develops as a result of the reproduction of a specific bacterium - Clostridium difficile. Practically, such activity of microorganisms is always associated with antibiotics, as they disrupt the normal balance of intestinal microflora;
- necrotizing enterocolitis is a very serious disease of newborns with high mortality, in which intestinal tissues die. Its causes are unknown. Almost always, the pathology occurs in premature and weak children. Extremely rare inflammation with tissue death occurs in adults;
- allergic and alimentary enterocolitis - associated with allergies or intolerance to individual components of food. For example, gluten intolerance (cereal protein) provokes the dying off of the villi and inflammation of the small intestine;
- toxic enterocolitis - triggered by toxic substances and certain medications.
There is no separate code for ICD-10 (the international classification of diseases of the 10th revision) for enterocolitis. Necrotizing enterocolitis of the fetus and newborn is isolated (P77). Non-infectious colitis and enteritis are assigned to the groups with K50-K52 indices, intestinal infections - to the groups with A00-A09 indices.
Symptoms and signs of enterocolitis in adults
Intestinal infections are most often abdominal pain, diarrhea, with mucus, with or without blood, watery or just mild. It all depends on the specific pathogen. Vomiting may occur if the small intestine is affected. Bacterial and viral enterocolitis almost all are acute, parasitic are more often chronic. The temperature can remain normal, and rise both slightly and strongly. Joint pain, muscle aches, and weakness are characteristic of certain intestinal infectious disorders.
Diarrhea of a different nature - the main symptom of non-infectious gastritis. Abdominal distention, intestinal cramps, general weakness, vomiting and nausea are equally common symptoms of this disease. Other health problems depend on the nature of the disease and its causes.
Symptoms and signs of enterocolitis in children
The main difference in the course of enterocolitis in adults and children is the severity of the disease. Kids younger than a year very quickly become dehydrated due to serious loss of fluid and electrolytes with vomiting and diarrhea. Strong dehydration can very quickly lead to shock, coma or death. Associated with diarrhea and vomiting diseases are one of the first places in mortality among young children.
How to understand that the baby is severely dehydrated?
- he is irritable, capricious, but weak;
- dry mouth;
- urination is not abundant.
Symptoms that indicate a very strong, life-threatening dehydration, which requires emergency medical care:
- dry or slightly wet diaper throughout the day;
- cold hands and feet;
- sunken spring;
- fast shallow breathing.
Necrotizing enteritis is most typical:
- swollen, reddened, painful tummy;
- poor appetite;
- constipation or diarrhea with black / bloody feces;
- low or unstable temperature;
- rarely - vomiting green contents.
Diagnosis of enterocolitis
Features of diagnosis depend on the nature of the disease. Some types of enterocolitis, for example, infectious variants, have a rather characteristic picture, are treated according to similar schemes.
In other cases, the clinical picture is not so obvious and additional tests may be needed:
- determination of the causative agent of the disease;
- general analysis of feces, which helps to determine the presence of not only clear, but also hidden blood, the degree of digestibility of food, signs of inflammation;
- feces specific substance markers of the disease;
- various types of visual examination of the intestinal mucosa (colonoscopy, sigmoidoscopy, retrograde endoscopy);
- MRI, CT, X-ray with and without contrast;
- intestinal biopsy - a small tissue sample is taken to study the microscopic structure.
For the nutritional (nutritional) enterocolitis, the diet is often the only and indispensable component of treatment, for others it is important to follow the diet during exacerbations. Infectious diseases, especially those that occur with vomiting, require fasting for a period of several hours to a day.
There are general nutritional guidelines that exclude foods that can irritate the mucous membranes, or overload the intestines.
Reduce or eliminate:
- milk products;
- alcohol, strong tea, coffee;
- high fat foods;
- in some cases - fresh vegetables, fruits, whole grain cereals (due to the high fiber content);
- fried foods.
It is important to eat often (5-6 times a day), regularly, in small portions. And do not forget to drink enough water.
Prognosis of enterocolitis
Infectious diseases have a good prognosis if the assistance is rendered correctly and on time. Otherwise, for children, people with weak immunity and the elderly, the situation is threatening. Every year in the world up to one and a half million children die from dehydration.
Inflammatory bowel disease requires systemic lifelong treatment. A good result of treatment is rare and mild periods of exacerbations, which are replaced by long asymptomatic periods.
The prognosis for inflammatory processes associated with medication is good. Withdrawal of drugs and adequate therapy in most cases ensures complete recovery if the inflammatory process is still at an early stage.
Necrotizing enterocolitis of newborns has a different prognosis depending on the timeliness and adequacy of treatment, weight and degree of prematurity. The worst prognosis for children weighing less than 1 kg and gestation period of less than 28 weeks. Mortality among babies weighing up to 1000 g is 40-100%, in the range from 1000 to 1500 g - 10-50%, and among those who weigh more than 2500 g - up to 20%. Every second recovered child has complications. The two most common ones are short bowel syndrome and bowel stenosis.