Gastroenterocolitis
The content of the article:
- Causes
- Forms
- Symptoms of gastroenterocolitis
- Features of the course of gastroenterocolitis in children
- Diagnostics
- Treatment of gastroenterocolitis
- Prevention
- Consequences and complications
Gastroenterocolitis is a simultaneous inflammation of the mucous membranes of the gastrointestinal tract (stomach, small and large intestines). The acute form is more common in children; chronic gastroenterocolitis is usually a manifestation of the underlying systemic disease.
Gastroenterocolitis - inflammation of the mucous membranes of the gastrointestinal tract
Causes
Dyspeptic disorders and diarrhea in gastroenterocolitis are caused by damage to the mucous membranes of the gastrointestinal tract and, in particular, the villi of the intestinal ciliated epithelium, which are responsible for the absorption of nutrients and water into the bloodstream. Infectious gastroenterocolitis is accompanied by intoxication of the body with products of microbial vital activity.
The acute form of gastroenterocolitis is closely associated with foodborne diseases. Among the pathogens, enteropathogenic and opportunistic bacteria predominate - Salmonella, Shigella, Listeria, Escherichia coli and Proteus vulgaris. Several viruses are also known that cause acute gastroenterocolitis: echovirus, rotavirus (the causative agent of the so-called intestinal flu), Norwalk virus, etc.
Infection occurs in an alimentary way - when using unboiled water and poor-quality products contaminated with bacteria, non-compliance with the rules of personal hygiene and sanitary and hygienic standards adopted in cooking. With sepsis and the presence of chronic infectious foci, hematogenous drift of infection can be observed - pathogenic agents migrate into the gastrointestinal tract through the circulatory system from other organs and systems.
Gastroenterocolitis of non-infectious etiology is associated with food and drug allergies, poisoning with salts of heavy metals, alcohols, alkalis and acids, or radiation injury.
Gastroenterocolitis may be associated with food allergies
Chronic gastroenterocolitis develops as a result of a protracted course of an acute inflammatory process or against the background of primary gastrointestinal diseases. Inflammation spreads to the submucosa, blood vessels, nerve endings and serous membranes, which leads to disturbances in blood supply, trophism and motility of the digestive tract.
The likelihood of developing gastroenterocolitis is slightly increased in conditions that lead to increased permeability of the mucous membranes and suppression of local immunity:
- deficiency of B vitamins;
- anemia;
- hypothermia, frequent cold drinks;
- prolonged stress;
- achilia - lack of hydrochloric acid and pepsin in gastric juice;
- irritation of the intestines due to an excess of coarse fiber foods in the diet.
Forms
By the nature of changes in the tissues of the stomach and intestines, several forms of gastroenterocolitis are distinguished:
- catarrhal - the manifestations of the inflammatory process are limited by hyperemia and edema of the mucous membranes, along with intensive production of exudate;
- fibrous - a plaque of fibrin appears on the inner surface of the stomach and intestines, which is formed during the interaction of tissue thromboplastin with fibrinogen, secreted together with exudate;
- phlegmonous - inflammation of the mucous membranes of the gastrointestinal tract is accompanied by suppuration;
- ulcerative - characterized by the presence of manifestations on the surface of the mucous membranes;
- hemorrhagic - the inflammatory process is accompanied by impaired capillary blood circulation in the submucosal layer, which leads to hemorrhages and the formation of extensive foci of erosion.
Symptoms of gastroenterocolitis
As a rule, gastroenterocolitis begins with a sudden deterioration in health - nausea and vomiting, pulling or cramping pains in the navel or upper abdomen, flatulence, belching and heartburn appear. Diarrhea can be observed both from the first day of the disease and on the third or fourth day after short-term constipation. The stool often contains mucus and blood streaks. At the same time, signs of intoxication are observed: a feeling of weakness and malaise, an increase in body temperature, headaches and attacks of dizziness. In the most severe cases, the symptoms described are accompanied by fainting, confusion and delirium. In the chronic course of the inflammatory process, dyspeptic disorders are moderately expressed or completely absent, and the symptoms of gastroenterocolitis are limited to manifestations of intoxication. Chronic gastroenterocolitis can also occur in the form of recurrent dyspeptic disorders.
Gastroenterocolitis begins with nausea and vomiting
Features of the course of gastroenterocolitis in children
Due to insufficient development of the immune system, young children are especially susceptible to gastroenterocolitis. The clinical picture of inflammation of the mucous membranes of the gastrointestinal tract in a preschooler may appear as a result of a spontaneous increase in the virulence of opportunistic intestinal microflora and a decrease in the body's resistance in case of respiratory infections, allergic and atopic conditions, prolonged stress, unbalanced nutrition or a sharp change in diet.
Infectious gastroenterocolitis in children under three years of age in most cases is caused by dysentery bacillus, as a result of which a characteristic clinical picture of profuse diarrhea, fever and severe intoxication develops. A large amount of mucus mixed with blood is found in the stool. Due to the oxidation of iron in the composition of hemoglobin, feces acquire a characteristic dark green color. The child's body temperature reaches its peak values in the first three days of the disease, after which it lasts for a week, and then goes down. In the most severe cases, children develop tenesmus and spasms of the sigmoid colon, characteristic of dysentery colitis. In the absence of adequate treatment, acute dysentery gastroenterocolitis in children often becomes chronic.
Children with gastroenterocolitis have profuse diarrhea
Also, children often have viral gastroenterocolitis - an intestinal form of influenza, accompanied by severe gastroenterocolitis and persistent fever. The disease can be complicated by otitis media, pyuria, or pneumonia. Gastroenterocolitis is especially dangerous for infants and young children of preschool age due to the rapid onset of dehydration and severe intoxication of the body.
Diagnostics
Gastroenterocolitis in adults and older children is diagnosed by a physician or gastroenterologist based on the clinical picture and anamnestic data. Particular attention is paid to the products that the patient consumed shortly before the onset of symptoms of gastrointestinal inflammation. To clarify the diagnosis, it will be necessary to consult an infectious disease specialist and laboratory tests of feces - coprogram and bacterial culture with the isolation of the pathogen and determination of sensitivity to antibiotics. To assess the general condition of the patient and identify the degree of dehydration, a general and biochemical blood test is prescribed. In children under three years of age, acute gastroenterocolitis is differentiated from typhoid fever by staging the Vidal reaction.
Ultrasound of the abdominal organs allows you to assess the degree of damage in gastroenterocolitis
To assess the degree of gastrointestinal tract damage and identify concomitant pathologies in chronic gastroenterocolitis, instrumental examinations of the stomach and intestines are shown: ultrasound of the abdominal cavity and small pelvis, gastroduodenoscopy, sigmoidoscopy, colonoscopy, irrigoscopy. If necessary, a histological examination of a biopsy of the affected tissues is performed.
Treatment of gastroenterocolitis
Alimentary gastroenterocolitis triggered by toxicoinfection in adults and older children is usually mild. There is no need for hospitalization - it is enough to abstain from food on the first day and consume as much liquid as possible. In the next two to three days, follow a sparing diet, adhering to a fractional diet - eat 5-6 times a day in small portions.
The restoration of the damaged epithelium of the mucous membranes of the gastrointestinal tract is facilitated by the use of broths of cereals, oatmeal in water and boiled rice, low-fat cottage cheese and chicken broth. At the end of the acute period, you can gradually introduce into the diet low-fat meat and fish products, steamed, vegetable purees, soft-boiled eggs and casseroles. For two to three weeks after suffering gastroenterocolitis, it is worth refraining from fatty, spicy and fried foods and smoked meats, as well as fresh bread, pastries, milk, legumes and foods containing a large amount of fiber.
With a mild form of gastroenterocolitis, it is enough to abstain from food for the first day and drink plenty of water
When signs of severe intoxication and dehydration appear, gastroenterocolitis is treated in a hospital. First of all, detoxification therapy is carried out - washing the stomach with a solution of bicarbonate and potassium permanganate and a course of enterosorbents, for constipation, deep enemas and saline laxatives are prescribed. To replenish fluid loss, they resort to infusion therapy. In milder forms, oral water and electrolytes may be dispensed with. With some toxicoinfections, etiotropic therapy with antibiotics is possible. Stomach and intestinal pains are eliminated with antispasmodics. To normalize digestion during the recovery period, enzyme preparations, multivitamins, prebiotics and probiotics are used.
Prevention
For the prevention of alimentary gastroenterocolitis, it is enough to follow the basic rules of hygiene and sanitization of food: wash your hands before eating and preparing food, as well as after visiting the toilet, use clean dishes, towels and kitchen utensils. Vegetables and fruits must be washed under running water, and milk and drinking water must be boiled. You should not visit street cafes and canteens with poor sanitary conditions. During the summer, it is important to refrain from consuming perishable foods of unknown origin, and when bathing, to avoid getting water in your mouth.
To prevent reactive gastroenterocolitis, you should not take strong medications without consulting your doctor. With a tendency to allergic reactions, new and unusual products are introduced into the menu gradually, starting with small portions. Prevention of chronic gastroenterocolitis is reduced to preventing diseases of the digestive system and metabolic disorders - controlling the diet and adhering to an optimal diet.
Consequences and complications
The most dangerous complication of gastroenterocolitis is dehydration, resulting from constant vomiting and profuse diarrhea, which can cause death in young children and debilitated patients. With a long chronic course of gastroenterocolitis, periventricular adhesions and intestinal polyps, prone to malignant degeneration, may appear.
Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
