Acute gastroenteritis
The content of the article:
- Causes and risk factors
- Disease stages
- Symptoms of acute gastroenteritis
- Diagnostics
- Treatment of acute gastroenteritis
- Potential consequences and complications
- Forecast
- Prevention
Acute gastroenteritis is an inflammation of the mucous membrane of the stomach and small intestine, caused by the influence of infectious (bacterial, viral), allergic or alimentary factors.
The disease is widespread and affects both adults and children with equal frequency - in terms of prevalence it is only slightly inferior to respiratory viral infections. In developing countries, acute gastroenteritis is one of the leading causes of infant mortality.
Acute gastroenteritis is inflammation of the lining of the stomach and small intestine
In recent years, in the practice of gastroenterologists, patients with acute gastroenteritis of an allergic nature are increasingly observed. Experts explain this phenomenon by the formation of wrong food habits in the population, passion for fast food, snacks, sugary carbonated drinks and other products containing a large amount of industrial food additives. Allergic acute gastroenteritis is most often noted in children in the first years of life. According to medical statistics, about 8% of young children suffer from food allergies, manifested by signs of damage to the stomach and intestines.
Causes and risk factors
Infections, food allergies and gross errors in nutrition lead to the development of acute gastroenteritis.
Acute gastroenteritis of infectious origin is caused by infection with different types of pathogenic microflora (noravirus, rotavirus, campylobacter, shigella, salmonella, E. coli). As statistics show, most often the disease is caused by rotavirus. It is this infection that is responsible for 90% of cases of acute gastroenteritis in winter and 50% in spring and summer.
Acute gastroenteritis can be caused by infectious agents
Infection occurs through one of the following mechanisms:
- contact and household;
- water;
- food.
The contributing factors to the development of infectious acute gastroenteritis are malnutrition and antibiotic therapy (long-term and / or carried out with the use of broad-spectrum antibiotics), which suppresses the normal intestinal microflora.
Microorganisms that enter the stomach, and from there into the small intestine, begin to actively reproduce. At the same time, they release toxins that cause inflammation of the mucous membrane and an increase in the secretion of electrolytes and fluid by cells into the lumen of the digestive tract. As a result, nausea develops, then vomiting, and a little later, diarrhea. Toxins from the digestive tract enter the bloodstream and are carried throughout the body, causing the development of general intoxication (headache, weakness, lack of appetite, fever).
Another reason for the development of acute gastroenteritis can be the consumption of low-quality foods, as well as the use of exotic dishes, heavy, fatty or spicy foods, that is, an alimentary factor. If the rules for cooking or storing food are violated, conditionally pathogenic flora actively multiplies in it, while releasing a huge amount of cytotoxins and enterotoxins. These substances cause the development of toxicoinfection, i.e. acute gastroenteritis of alimentary genesis.
Acute gastroenteritis can develop when eating poor quality food
The correct immune response of the digestive tract to food antigens is formed in a child during the first year of life. If during this period the rules of feeding, the introduction of complementary foods are violated, then there is a high probability that in the future the child will form an abnormal reaction to some food products. This reaction will manifest as symptoms of acute gastroenteritis. The most common food allergens are cereals and legumes, fish, chicken eggs, and cow's milk.
Factors that increase the risk of developing acute gastroenteritis of an allergic nature in children are:
- frequent antibiotic treatment (more than three courses in 5 years);
- the presence of allergic diseases;
- hereditary predisposition;
- living in ecologically unfavorable areas.
Disease stages
Depending on the severity of clinical symptoms, acute gastroenteritis is divided into three degrees of severity:
- Mild - the general condition suffers slightly, the body temperature is normal, there is no vomiting, diarrhea no more than three times a day, there are no signs of dehydration.
- Average - the general condition is significantly reduced, repeated vomiting is observed, the frequency of bowel movements reaches 10-12 times per day, the body temperature rises to febrile values (38-39 ° C), symptoms of moderate dehydration are noted.
- Severe - vomiting and diarrhea take on an indomitable character, which leads to severe violations of the water-electrolyte balance, the body temperature rises to 40-41 ° C, signs of damage to the central nervous system appear (stunnedness, lethargy, sometimes loss of consciousness).
Symptoms of acute gastroenteritis
Acute infectious gastroenteritis occurs suddenly. Its first sign is usually nausea and one-time vomiting (vomiting can be frequent and even indomitable). Then there are pains in the epigastric region, bloating. Intestinal peristalsis increases significantly and becomes audible at a distance as a characteristic rumbling. Appetite is significantly reduced, up to complete absence. The body temperature may rise.
The first symptoms of acute gastroenteritis are nausea and vomiting.
After a few hours, diarrhea joins the symptoms described above. The stool is profuse, liquid, frothy, pathologically colored (dark green, orange, green, bright yellow), contains lumps of undigested food.
Allergic acute gastroenteritis begins with severe nausea and abdominal pain shortly after eating sensitized foods. Then vomiting and diarrhea appear, after which the patient's condition improves.
Diagnostics
Diagnosis of acute gastroenteritis is usually straightforward and is based on the characteristic clinical picture of the disease. To identify the pathogen and determine its sensitivity to antibacterial agents, a bacteriological examination of feces is performed.
To assess the degree of violations of the water-electrolyte balance, carry out:
- general blood test (against the background of dehydration, the level of erythrocytes, hemoglobin rises and the hematocrit increases);
- determination of blood electrolytes (frequent vomiting and diarrhea lead to a significant loss of chlorine and potassium ions);
- biochemical blood test (severe dehydration can lead to the development of prerenal acute renal failure, which is manifested by an increase in the concentration of creatinine and urea in the blood).
To diagnose acute gastroenteritis, general and biochemical blood tests are performed
In acute gastroenteritis of allergic genesis, it may be necessary to conduct an endoscopic examination, which allows it to be differentiated from ulcerative colitis and Crohn's disease.
Treatment of acute gastroenteritis
Acute gastroenteritis in children in the first three years of life, as well as a severe form of the disease in older children and adults, are indications for hospitalization. In other cases, acute gastroenteritis is treated on an outpatient basis.
Patients are prescribed a semi-bed rest, drinking plenty of fluids, enterosorbents and enzyme preparations. Until the complete cessation of nausea and vomiting, a water-tea break is indicated. Then the diet is gradually expanded by introducing a weak broth, white bread croutons, boiled rice, jelly, mashed potatoes in water without oil. With good food tolerance, the menu includes steamed meatballs from lean meat, well-boiled cereals.
With a mild degree of acute gastroenteritis, it is enough to drink plenty of fluids and take enterosorbents
In acute gastroenteritis of moderate and severe severity, it becomes necessary to carry out infusion therapy aimed at correcting violations of water and electrolyte balance.
Antibiotics are prescribed only for severe disease. Initially, broad-spectrum antibiotics are used, and after receiving the results of bacteriological examination of feces, the drug is changed taking into account the sensitivity of the pathogen to it.
Treatment of acute gastroenteritis caused by allergies consists in the exclusion from the diet of foods to which individual sensitivity is increased. In most cases, this is enough to prevent the development of exacerbations. Antihistamines may be prescribed as needed.
In cases where the phenomena of acute gastroenteritis are caused by proteins in cow's milk, any dairy products are completely excluded from the diet. Formulas based on soy milk are recommended for breastfed infants instead, which they usually tolerate well.
Potential consequences and complications
In the absence of treatment, acute gastroenteritis can lead to significant dehydration, the development of hypovolemic or toxic-infectious shock, acute renal failure. Dehydration is especially dangerous for children in the first years of life, as it can quickly cause disorders that lead to death.
Forecast
Overall forecast. It worsens with severe dehydration and complications. Early interruption of antibiotic therapy for an infectious form of acute gastroenteritis leads to the transition of the disease to a chronic form or the formation of an asymptomatic carrier of bacteria.
Prevention
Prevention of acute gastroenteritis includes:
- careful adherence to the rules of personal hygiene;
- refusal to drink water from questionable sources;
- thorough washing of vegetables and fruits before eating, with blanching with boiling water;
- compliance with the technology of cooking products and the rules for their storage.
Elena Minkina Doctor anesthesiologist-resuscitator About the author
Education: graduated from the Tashkent State Medical Institute, specializing in general medicine in 1991. Repeatedly passed refresher courses.
Work experience: anesthesiologist-resuscitator of the city maternity complex, resuscitator of the hemodialysis department.
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!
