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What is dysentery?
Dysentery- This is an acute infectious disease characterized by a predominant lesion of the intestine and pronounced manifestations of general intoxication of the body. The first mention of this disease dates back to the first century BC. Until the 18th century, the cause of this pathology was unknown, and developing epidemics claimed the lives of millions of people ( most patients with dysentery died as a result of developing complications). After the discovery of the causative agent of the disease and the development of effective methods of treatment, the number of deaths has decreased significantly, but this pathology is still dangerous, since outbreaks of dysentery can occur when personal hygiene is not observed and when living in unsanitary conditions. The incidence of dysentery ( epidemiology)
According to the World Health Organization (WHO) WHO) annually, more than 80 million people fall ill with dysentery, of which about 9% die. It should be noted that the incidence of dysentery varies depending on many factors.The incidence of dysentery is due to:
- Sanitary and hygienic conditions. Most often, outbreaks of dysentery occur when sanitary and hygienic standards and personal hygiene rules are not observed ( during wars, disasters, as well as in underdeveloped countries).
- The age of the patients. More than 35% of all cases of dysentery are registered in preschool children ( from 1 to 6 years). This is due to the fact that at this age children begin to actively explore the world around them, and most of the unfamiliar objects they “taste” ( i.e. put in the mouth). And since they still do not know how to observe the necessary rules of personal hygiene, the risk of contracting various infectious diseases ( including dysentery.) rises.
- The time of the year. Dysentery is characterized by a distinct summer-autumn seasonality. As a result of the research, it was found that from July to September, more than half of all cases of dysentery are recorded per year. This is most likely due to the fact that at this time there is a ripening of many fruits and vegetables, the use of which without appropriate processing can cause infection with dysentery.
The causative agent of dysentery
Dysentery is caused by bacteria from the genus Shigella ( Shigella), belonging to the family Enterobacteriaceae ( Enterobacteriaceae). To date, there are several types of Shigella, each of which can cause different forms of dysentery.Among the causative agents of dysentery are:
- Shigella dysentery ( Shigella dysenteriae). This species includes several subspecies ( Grigoriev-Shiga, Stutzer-Schmidt and Large-Sachs bacteria). The Grigoriev-Shigi bacterium is the most toxic of all known Shigella and was responsible for the majority of dysentery deaths until the early 20th century.
- Shigella Flexner ( Shigella flexneri). In the middle of the last century, it was the cause of more than 75% of all outbreaks of dysentery.
- Shigella Sonne ( Shigella sonnei). From the middle of the last century to the present, it is the cause of most outbreaks of dysentery on Earth.
- Shigella Boydie ( Shigella boydii).
Shigella die:
- In water and food– within a few weeks.
- At a temperature of 60 degrees- within 25 - 30 minutes.
- When exposed to direct sunlight- within 15 - 20 minutes.
- When boiling- instantly.
- in human gastric juice- within a few minutes depending on the initial dose of the pathogen, that is, on the number of Shigella that entered the stomach).
- When exposed to chlorine and other disinfectants) – within a few minutes.
Shigella have:
- Endotoxin. This substance is contained in the cell wall of bacteria and is released into the environment when they are destroyed. Upon entering the systemic circulation, endotoxin is distributed throughout the body, causing the development of symptoms of general intoxication.
- Enterotoxins. Produced by live Shigella. They act on the intestinal mucosa, increasing the release of fluid and salts into the lumen of the affected intestine.
- Cytotoxin. It is secreted by live shigella and damages the membranes of the cells of the intestinal mucosa.
- Neurotoxin. Can affect the human central nervous system. It is distinguished only by Shigella Grigoriev-Shiga.
Ways of transmission of dysentery
Dysentery is characterized by a fecal-oral transmission mechanism. This means that Shigella released from the intestines of an infected person enters the gastrointestinal tract of a healthy person, thereby infecting him.The source of infection can be:
- A sick man- a patient with a pronounced clinical picture of dysentery or with a chronic form of the disease.
- convalescent- a convalescent patient who has experienced an acute form of the disease, but can still shed shigella.
- carrier- a person in whose gastrointestinal tract shigella multiplies without causing the development of clinical signs of dysentery.
- food way- with fresh, poorly processed ( thermally or mechanically) food ( is the main route of spread of Shigella Sonne).
- By water– when drinking untreated water from polluted reservoirs ( is the main route of spread for Shigella Flexner).
- By contact-household way- in contact with contaminated surfaces or objects ( that is, if a person touches contaminated objects, and then takes food with unwashed hands or simply puts his fingers in his mouth, which is typical for children).
Incubation period and pathogenesis ( development mechanism) dysentery
incubation period ( that is, the time from the moment of infection to the development of symptoms of the disease) with dysentery lasts from 1 to 7 days, averaging 2 to 3 days. After entering the body, most Shigella dies in the human stomach as a result of exposure to acidic gastric juice. Part of the bacteria passes into the intestine, where it is also exposed to the harmful effects of intestinal microflora ( Normally, there is always a certain amount of bacteria in the intestines that are safe for the person himself, but are able to fight foreign infectious agents.).A certain proportion of bacteria overcomes all the described barriers and reaches the intestinal wall, where it is introduced into the cells of its mucous membrane. After that, Shigella begin to actively multiply, producing exotoxins and cytotoxin. At the same time, the immune forces of the body are activated, causing the cells of the immune system ( neutrophils and macrophages) begin to engulf and destroy shigella. As a result, endotoxin is released into the surrounding tissues, which in total determines the development of the clinical picture of acute dysentery. In parallel with the development of the first symptoms of the disease, part of the Shigella penetrates the large intestine and affects its mucous membrane, which aggravates the course of dysentery.
The development of an infectious-inflammatory process in the intestine disrupts all its functions ( including motility, nutrient absorption and so on), causing the development of the corresponding clinical manifestations.
Types and forms of dysentery
In medical practice, several forms of dysentery are distinguished, which is due to the type of pathogen, the severity of the course of the disease and the characteristics of the clinical picture. Depending on the clinical manifestations, dysentery can be:
- Acute. It is characterized by the rapid development of symptoms, pronounced local and general manifestations of the disease, as well as a rather rapid improvement in the patient's condition after the start of adequate treatment.
- Chronic. It is characterized by a sluggish, slowly progressive course. It can occur both in continuous and in recurrent ( escalating from time to time) form. In the latter case, there is an alternation of exacerbations of the disease with periods of remission, during which there are no symptoms of dysentery.
Depending on the affected part of the gastrointestinal tract, there are:
- Colitis variant of acute dysentery. It occurs most often and is characterized by a predominant lesion of the large intestine, while the stomach and small intestine are practically not involved in the pathological process.
- Gastroenteric variant of acute dysentery. It is characterized by signs of damage to the stomach and small intestine, while the symptoms of damage to the large intestine are mild or may be completely absent.
- Gastroenterocolitic variant of acute dysentery. A severe form of the disease, in which the mucous membrane of the stomach, as well as the small and large intestines, is simultaneously affected.
- A mild form of dysentery. It is characterized by mild manifestations of general intoxication, a favorable course and a quick recovery ( which usually occurs within 4 to 6 days).
- Dysentery of moderate severity. It is characterized by severe intoxication of the body and signs of damage to the central nervous system. With timely treatment, recovery occurs within 2 weeks.
- Severe form of dysentery. It is characterized by an extremely pronounced intoxication of the body, which, without timely medical care, can lead to the death of a person. Treatment is long, and full recovery occurs no earlier than after 3 to 6 weeks.
Symptoms and signs of dysentery
Clinical manifestations of dysentery are due to the type of pathogen ( i.e. its toxicity), the initial infectious dose, as well as the general condition of the body of an infected person. Stages of dysentery
In the development of dysentery, several successive stages are distinguished, each of which is characterized by certain symptoms.In the development of dysentery, there are:
- Initial stage. It is characterized by the appearance of the first symptoms of the disease, which progress over time and become more pronounced.
- stage of the disease. It is characterized by the maximum severity of clinical manifestations of dysentery. It is at this stage that the likelihood of developing various complications is high ( especially in severe forms of the disease).
- The stage of extinction of symptoms. At this stage of development, the body's immune system defeats the causative agent of the infection, as a result of which the symptoms of the disease begin to gradually subside. It should be noted that if treatment is interrupted at this stage, the symptoms of the disease may recur.
- Recovery stage. There are no clinical manifestations of acute dysentery, however, there may be signs of developing complications from other organs and systems. Also at this stage, the transition of the disease to a chronic form is possible.
- increase in body temperature;
- signs of intoxication of the body;
- violation of the chair;
- body dehydration.
temperature for dysentery
An increase in body temperature is one of the first clinical manifestations of the disease. The temperature rises sharply during few hours), often accompanied by other signs of intoxication of the body. In mild forms of the disease, it can rise to 37 - 38 degrees, while in severe dysentery it can reach 40 degrees. The elevated temperature persists for several hours or even days, after which it also drops sharply ( which indicates the beginning of the recovery period). It is also worth noting that with erased forms of dysentery, body temperature may be normal or slightly elevated ( up to 37 - 37.5 degrees).An increase in temperature is a natural protective reaction of the human body, which is activated when infected with foreign microorganisms, including shigella. The mechanism for the development of this symptom is associated with the entry into the systemic circulation of special substances called pyrogens. Pyrogens are present in Shigella themselves ( the most powerful pyrogenic is endotoxin, which is released during the destruction of a bacterial cell), as well as in the cells of the body's immune system ( in macrophages).
With the penetration of the infectious agent into the wall of the gastrointestinal tract, immunity is activated, as a result of which a large number of leukocytes migrate to the place of introduction of bacteria ( immune system cells). cell data ( predominantly neutrophils and macrophages) destroy and absorb particles of the infectious agent, trying to digest them. Some of the macrophages die at the same time, as a result of which bacterial endotoxins are released into the surrounding tissues, as well as pyrogens contained in macrophages ( interleukins, tumor necrosis factor, interferon). All these substances enter the systemic circulation and reach the brain, where they act on the thermoregulatory center, which leads to an increase in body temperature.
Intoxication with dysentery
The development of symptoms of general intoxication is associated with the entry into the bloodstream of bacterial toxins ( endotoxin, neurotoxin), as well as with the activation of the immune system in the process of fighting infection. A characteristic feature of dysentery caused by Grigoriev-Shiga bacteria is the rapid involvement of the nervous system in the pathological process, which is due to the action of a neurotoxin. In this case, the so-called vegetative ( autonomous) the nervous system responsible for the normal functioning of internal organs ( including the cardiovascular system) and the whole body.Intoxication of the body with dysentery can manifest itself:
- general weakness;
- brokenness;
- increased fatigue;
- depressed mood;
- tachycardia ( an increase in heart rate over 90 beats per minute);
- delirium ( in severe forms of the disease).
Pain in the abdomen with dysentery
Abdominal pains appear during the first day after the onset of clinical manifestations of dysentery. Patients complain of cutting, pulling, cramping pains, the localization of which depends on the affected area of the gastrointestinal tract.Pain in dysentery is localized:
- With colitis- in the lower lateral parts of the abdomen ( predominantly on the left).
- With gastroenterocolitic form- in all parts of the abdomen.
- With gastroenteritis- only in the upper abdomen, since the large intestine is not affected.
The nature of the stool in dysentery
Stool disturbance is one of the main clinical manifestations of the colitis and gastroenterocolitic forms of the disease, while in the gastroenteric form the stool may be normal. The development of this symptom is due to the action of cytotoxin and enterotoxins on the cells of the mucous membrane of the gastrointestinal tract, as well as impaired intestinal motility.At the beginning of the development of dysentery, the stool is usually plentiful, contains a lot of feces. As the disease progresses, the amount of feces in the intestine decreases while the amount of fluid increases ( due to the action of enterotoxin).
Approximately a day after the onset of the disease, the patient's stools consist of thick transparent mucus, to which streaks of blood can join ( bleeding develops as a result of ulceration of the mucous membrane of the large intestine) or pus. The frequency of stool fluctuates depending on the severity of dysentery.
The frequency of stool in patients with dysentery is:
- With a mild form of the disease- 3 - 10 times a day.
- With moderate dysentery- 10 - 20 times a day.
- With a severe form of the disease- 20 - 50 times a day.
Vomiting with dysentery
Vomiting is not a characteristic manifestation of dysentery and is usually observed in the severe course of the disease, as well as in the development of the gastroenterocolitic form. Vomiting is usually single, less often it can be repeated 2-3 times ( no more). The vomit may contain recently eaten food or be bilious in nature. The mechanism of development of vomiting is associated with impaired motility of the gastrointestinal tract ( gastrointestinal tract), as well as with stagnation of the contents in the lumen of the intestine and stomach. As a result of this, the formation of so-called anti-peristaltic waves occurs, which push the contents of the gastrointestinal tract in the opposite direction ( i.e. into the stomach and then into the esophagus).Dehydration in dysentery
dehydration ( fluid loss) with dysentery develops due to profuse diarrhea and vomiting. It is also worth noting that as a result of exposure to enterotoxin, not only a large amount of water is released into the intestinal lumen, but electrolytes, which are also removed from the body along with vomit and feces. That is why, by the end of the first day after the first symptoms of dysentery appear, a person may develop signs of dehydration.Amoeba can survive:
- in wet faeces- up to 1 month.
- In water ( at a temperature of 17 - 20 degrees) – within 3 – 4 weeks.
- In moist soil not illuminated by direct sunlight) - up to 8 days.
- In chilled foods- within a few days.
- On furniture surfaces- 12 o'Clock in the noon ( at optimal humidity and air temperature).
- When frozen ( down to minus 20 degrees) - within a few months.
- When drying- few seconds.
- When exposed to disinfectants– within 5 minutes – 4 hours ( depending on the substance used).
After penetration into the intestines of a healthy person, amoeba ( their cystic forms) can exist there for a long time without causing the development of the disease. With a decrease in the body's defenses, they can turn into active ( tissue and vegetative) forms that penetrate the intestinal mucosa and destroy it, leading to the formation of ulcers. Also, amoebas can penetrate into the systemic circulation and be transported with blood flow to various organs, lingering in them and leading to the formation of abscesses ( accumulations of the pathogen surrounded by a dense capsule) in the liver, lungs, brain, and so on.
Clinically, amoebic dysentery is manifested by a moderately pronounced intoxication syndrome ( body temperature may be normal or slightly elevated). The main symptom of this disease is a violation of the stool, the frequency of which ranges from 4-6 times a day at the onset of the disease to 10-20 times a day during the height of clinical manifestations. Initially, the stool is profuse and contains a large amount of stool with an unpleasant odor. After a few days, the amount of discharge is significantly reduced, and they acquire a mucous character. With ulceration of the intestinal wall, bleeding may develop. The blood mixes with the secreted mucus, causing the bowel movements to take on the appearance of "raspberry jelly". Also, patients may complain of sharp pains in the lower abdomen, aggravated during bowel movements.
The diagnosis is considered confirmed when active ( vegetative) forms of amoebas from the patient's fresh feces. Treatment consists in the use of drugs that have a detrimental effect on various forms of amoebae ( quiniophone, dehydroemetine, metronidazole).
Before use, you should consult with a specialist.An infectious disease with a fecal-oral mechanism of transmission, caused by bacteria of the genus Shigella and proceeding with a primary lesion of the mucous membrane of the large intestine.
Dysentery is manifested by such symptoms as general malaise, cramping pains in the abdomen, frequent liquid diarrhea, which in typical cases contains an admixture of mucus and blood and is accompanied by false urges.
The clinical concept of "dysentery" has existed since ancient times. This term meant any disease accompanied by "bloody or straining diarrhea." Only much later did this term begin to be used to refer to infectious diseases of the intestine.
causative agents of dysentery
The causative agents of dysentery belong to the genus Shigella. Their length is 2-3 microns. width 0.5-0.7 microns. Capsules and spores do not form, immobile, gram-negative. Shigella contain a thermostable O-antigen. When destroyed, endotoxin is released, and they are also capable of producing exotoxin. Shigella Grigoriev-Shiga produce a neurotoxin.
According to the international classification, shigella are divided into 4 subgroups: A (Grigorieva-Shiga, Fitting-Schmitz, Large-Sachs), B (Flexner, Newcastle), C (Boidi), D (Zonne). At a temperature of 100°C they die instantly, at 60°C and from direct sunlight after 30 minutes. Viable in the shade - 79 days, in milk - 2-17 days, butter - 8-62 days, in sour cream from 10 hours to 4 days, in cottage cheese - 6-15 days, in bread crumb - 7-12 days, in minced meat can multiply, in sewage - 25-30 days and in the soil up to several months.
How is dysentery transmitted?
Of particular danger to the development of dysentery are workers with dysentery in food and water supply systems. From them, germs can enter food or water and cause massive outbreaks of the disease. The incubation period for dysentery averages 3-4 days. Dysentery is transmitted primarily through water and food. Household infection with dysentery infection occurs through household items (dishes, switches, door handles). Dirty hands play a huge role in the spread of dysentery infection. Therefore, for the prevention of dysentery (disease of dirty hands), it is very important to observe the rules of personal hygiene.
Symptoms of dysentery
According to the nature of the symptoms, dysentery is usually divided into acute and chronic. Acute dysentery lasts from a few days to three months, a disease with a longer course is considered chronic. Most often, the disease proceeds in an acute form and is currently characterized by a relatively mild course and very low mortality. The mild form of acute dysentery is characterized by a typical, albeit pronounced, clinical picture.
The incubation (hidden) period, as in other forms of dysentery, traditionally lasts 2-5 days, but can be shortened to 18-24 hours. The disease most often begins suddenly. Patients have moderate pain in the lower abdomen, mainly on the left, there may be nagging pain in the rectum. The stool is frequent, from 3-5 to 10 times a day, with an admixture of mucus, sometimes blood. Body temperature is normal or slightly high.
More clearly the symptoms of dysentery are expressed in the moderate course of the disease. Usually, acutely or after a short period of malaise, weakness, chilling, unpleasant feeling in the abdomen, characteristic signs of the disease are detected. In the bulk of cases, cramping pains appear first in the lower abdomen, mainly on the left. The frequency of stools (painful, liquid, mixed with mucus and blood) ranges from 10-15 to 25 times a day and can increase during the first 2 days.
At the same time, a headache appears, the temperature rises, which lasts 2-5 days, reaching 38-39C. The duration of the increase in body temperature is not more than 2-3 days. Approximately 80% of patients have cramping abdominal pain for a long time. In some patients, they may be permanent. Usually pains are in the lower half of a stomach, sometimes - mainly at the left. In 30% of patients, the pain is diffuse, in 5-7% - in the epigastric or within the umbilical region. Sometimes there is bloating with gases.
The severe form of acute dysentery is characterized by the presence of an acute clinical picture. The disease begins violently, patients mainly complain of severe cramping abdominal pain, frequent loose stools, weakness, high body temperature, not often nausea and vomiting. The chair is very frequent, with an admixture of mucus, blood, sometimes pus. The pulse is sharply accelerated, shortness of breath is observed, blood pressure is reduced. The disease can last up to 6 weeks and, with an unfavorable course, becomes chronic.
Dysentery in children
Dysentery is much more common in children than in adults. The risk of contracting a child with dysentery is especially great in large groups of children in preschool institutions. In children's groups, dysentery is easily transmitted from child to child through dirty toys. Symptoms of dysentery in children coincide with those in adults: the child complains of abdominal pain, feeling unwell, lack of appetite. Parents of a child infected with dysentery may notice a fever and the appearance of persistent diarrhea. In all cases of diarrhea that occurs against a background of fever (especially if the diarrhea contains an admixture of blood and lasts for several days), the child should be shown to the doctor as soon as possible!
Children with dysentery should be isolated from healthy children until complete recovery. Children who have been in contact with a child with dysentery are usually kept under observation for 2-3 weeks. Treatment of dysentery in children should begin as soon as possible. In children, dysentery can lead to severe dehydration, which is very dangerous for the child. If the child has diarrhea and a fever: give the child as much liquid as possible before going to the doctor!
Complications of dysentery
Possible complications in dysentery: infectious-toxic shock, infectious-toxic encephalopathy, intestinal perforation with the development of peritonitis, pneumonia, etc. Depending on the severity, changes in the mucous membrane of the colon of varying severity are detected (catarrhal, catarrhal, hemorrhagic, erosive, ulcerative, fibrinous). The most typical for complications of dysentery are hemorrhagic and erosive changes against the background of inflammation of the mucous membrane.
Diagnosis of dysentery
The proof of the dysenteric nature of the disease is the isolation of shigella from the feces, but this is possible only in 50% of patients (more often during outbreaks). To confirm the diagnosis, immunological methods are also used to detect antigens of pathogens and their toxins in saliva, urine, coprofiltrates, blood, and antibodies to Shigella. For the diagnosis of chronic dysentery, it is important to indicate the transferred acute dysentery during the last 3 months. Dysentery must be differentiated from acute colitis of another etiology (salmonella, etc.), as well as amoebiasis, balantidiasis, ulcerative colitis, colon cancer.
Treatment of dysentery
Treatment of patients with dysentery can be carried out both in an infectious diseases hospital and at home. Hospitalize patients with moderate and severe forms, children under the age of 3 years, debilitated patients, and also if it is impossible to organize treatment at home; according to epidemiological indications, children attending preschool institutions, food workers, people living in hostels are hospitalized.
In the treatment of dysentery, nitrofurans (furazalidon, furadonin 0.1 g 4 times a day, ersefuril 0.2 g 4 times a day), oxyquinolines (nitroxoline 0.1 g 4 times a day, intetrix according to 1-2 tablets 3 times a day), cotrimaxazole (biseptol 2 tablets 2 times a day), fluoroquinolones (ofloxacin 0.2-0.4 g 2 times a day, ciprofloxacin 0.25-0.5 g 2 times a day), aminoglycosides, cephalosporins. For mild dysentery, nitrofurans, cotrimaxazole, oxyquinolines are used for treatment, for moderate dysentery, fluoroquinolones, for severe dysentery, fluoroquinolones (if necessary, in combination with aminoglycosides), cephalosporins in combination with aminoglycosides.
With Flexner's and Sonne's dysentery, a polyvalent dysenteric bacteriophage is used. With dehydration, dehydration is carried out, with severe intoxication - detoxification therapy. With severe pain syndrome, antispasmodics (noshpa, papaverine) are used to stop spasm of the colon; astringents (vikalin, vikair, tannacomp) are shown. Assign a complex of vitamins, including ascorbic acid (500-600 mg per day), nicotinic acid (60 mg per day), thiamine and riboflavin (9 mg per day). To correct the intestinal biocenosis, bacterial preparations are used (with severe colitis syndrome - biosporin, bactisubtil, flonivinBS, with severe enteric syndrome - enterol; on the 6th day of bacteriotherapy, linex, bifidumbacterin, vitaflor, etc. are prescribed).
With a protracted course of the disease, stimulating therapy is carried out - for 5-7 days, pentoxyl is prescribed at 0.25 g 3 times a day, or jetiluracil at 0.5 g 3 times a day, or sodium nucleinate at 0.1 g 3 times a day, or Dibazol 0.02 g 3 times a day. Careful identification and treatment of concomitant diseases is necessary to prevent recurrence of dysentery. The prognosis is favorable. The transition to chronic forms is observed with perfect therapy relatively rarely (12%).
Diet for dysentery
During the treatment of dysentery, the patient must adhere to a diet. In severe cases of the disease on the first day, you need to observe hunger, you can drink only water-salt solutions. Then they switch to diet number 4. A prerequisite for dietary nutrition for dysentery is the exclusion of whole milk from the diet. A diet for dysentery must be observed for at least 3 weeks.
Prevention of dysentery is associated primarily with sanitary and hygienic measures. Sanitary supervision of food industrial enterprises, dairy farms, catering establishments. Control of sanitary improvement of preschool institutions, public and residential institutions. Sanitary supervision of drinking water supply, nutrition of the population. The purpose of all these measures is to prevent the transmission of all intestinal infections. In this regard, great importance is attached to sanitary and educational work. Personal prevention of dysentery is reduced to careful observance of the rules of personal hygiene. In a word, dysentery is a disease of dirty hands! Wash your hands with soap often, beat the flies!
Questions and answers on the topic "Dysentery"
Question: hello my son is 4 years old, he was diagnosed with amoebic dysentery, the infectious disease specialist prescribed drugs, alas, the week as panos with mucus does not end, tell me, the recovery process is still long and does it give a side effect? (((
Answer: Recovery of children occurs in the absence of complications (usually three or four weeks from the onset of the disease). But complete recovery of the mucosa lasts up to 3 months or longer. Violation of the diet threatens to exacerbate.
Question:My son is 6 months old. Feces were always mushy, sometimes yellow, sometimes green. Diarrhea started two days ago. Water and mucus come out. He has not been pooping normally for a day now, and sometimes streaks of blood appear (or rather more often) in diarrhea. I went to the clinic, but then there was no blood yet, they said dysbacteriosis. He screams a lot when he vilifies and the butt is all red with irritation, he doesn’t even let him touch it. I don't know how to be. I'm afraid it might be dysentery.
Answer: It is very unlikely that the child has dysentery. You need to take him to the doctor as soon as possible for examination and fecal analysis.
Question:I am 21 years old. Came back 6 days ago. On the 2nd day after arrival, severe diarrhea began, in the first two days, only a couple of times a day, I drank loperamide. It did not help, and on the 3rd day the condition worsened, the diarrhea became very liquid and often, the temperature was 38 degrees, she began to drink bactisubtil, an infusion of cinquefoil, chamomile and rehydron for dehydration. The next day and until now, the temperature is 37 degrees, diarrhea a couple of times a day and bloating. I only eat rice, toast, chicken broth. Prompt, than it is treated and what it can be? For 5 days already exhausted.
Answer: See a doctor as soon as possible! You may have dysentery that requires special antibiotic treatment. In no case do not take Loperamide anymore, it is categorically contraindicated in cases of suspected intestinal infection.
Question:For the 5th day, my son has loose stools up to 10 times a day, its consistency changes from green with mucus to normal, slightly liquid. The process of emptying is painful, the doctor came, wrote out a smecta, we already drank it, we are taking a course of enterofuril, the temperature today has risen to 39. They put, first, salmonella. Question - according to complaints, what does it look like?
Answer: The symptoms you describe are indeed characteristic of an intestinal infection (salmonellosis or dysentery). The child should be hospitalized as soon as possible and treated in a hospital setting.
Question:I've had severe stomach pains and diarrhea almost every hour for three days now. I woke up at night from them. Today in the morning I had a slight headache in the area of the temples, I found a temperature of 37.8, but by 14 o'clock it had dropped to 36.9. How long will the pain last? Is it serious? How to be treated? whether to see a doctor?
Answer: Your condition is indeed very serious. From the description of your symptoms, you may have an intestinal infection (possibly dysentery) that requires immediate treatment. You should call an ambulance or see a doctor as soon as possible. The appearance of a headache in your case is most likely caused by severe dehydration. During the entire period of diarrhea treatment, try to drink as much as possible (at least 2-3 liters of mineral water per day).
Question:Diarrhea appeared at night 3 days ago. By the evening of the next day, the temperature rose to 37.5. And now diarrhea and fever, weakness continue. Sometimes pain in the lower abdomen, rumbling in the intestines. There was no vomiting or nausea. I took coal, I think that's why the feces are dark, green-black. I didn't notice any blood in the stool. Yesterday and today I drank 1 glass of potassium permanganate solution. Help!
Answer: You should see a doctor as soon as possible, because if you have dysentery (which, according to the symptoms, it really can be), then the situation can be very serious and you need the help of specialists. Try to drink more water and continue taking activated charcoal before you see a doctor.
Question:Hello. I have a question. My mother fell ill at 6 o'clock in the morning, the temperature was 37 and once an hour she went to the toilet with diarrhea, the next day my father fell ill, he also had a temperature of 38 and diarrhea, on the 3rd day my sister also got sick - a temperature of 37 and diarrhea, the first day they had weakness. After that, I fell ill, early in the morning my temperature was 39.8, the weakness was terrible, and this is how the second day I go to the toilet every half an hour. Mucus comes out and, as if offal, it's all slightly red. Parents and sister began to feel better on the 2nd day, but I'm worried about what's wrong with me. I called the doctor - she said to take Furazolidone 4 tablets a day for both me and my parents. I overate a lot of all sorts of strengthening tablets of the intestinal flora - no result. How to strengthen the state, I went 100 times in two days. and gases and mucus, I don’t know what to do. Please let me know what can be done, thanks in advance. I am 20 years old.
Answer: The symptoms described by you are characteristic of an intestinal infection (it is possible or probable it is a dysentery). You should continue the treatment prescribed by your doctor, and if the diarrhea does not go away within the next 2 days, call your doctor again. The most important point of treatment for you now is frequent and plentiful drinking (a glass of water after each urge to go to the toilet), taking enterosorbents (for example, Smecta) and an antibiotic. There is no point in taking drugs that restore microflora now. All beneficial bacteria and substances that are in these medicines are excreted with diarrhea. it is better to start the course of treatment with these drugs only after the end of diarrhea.
Question:Hello, my wife is 39 weeks old, 4 weeks ago she was in an infectious diseases clinic with vomiting, fever, she was discharged from there after 3 days, as she lay down, two days later the tests were ready. Dysentery was diagnosed. The infectious disease doctor at the clinic does not prescribe treatment for her, arguing that she does not want to feed her with antibiotics, that they will have a harmful effect on the child, but only takes tests for dysentery every week, and every time it is confirmed. We have an agreement with a doctor in a regular maternity hospital where we would like to give birth, but she is not ready to accept her with dysentery, only if there is a written confirmation from an infectious disease specialist that she can give birth in a regular maternity hospital. The doctor in the consultation wants to put her in an infectious disease clinic. But we don’t want to go there, because we don’t know the doctors there and how everything will be. 1) Is there any possibility to give birth in an ordinary maternity hospital with the doctor we want? After all, the incubation period of dysentery is 7 days. 2) Is it possible, if the infectious disease specialist prescribes treatment, to recover from dysentery before the birth. 3) What threatens childbirth if the desentery does not end? 4) Tomorrow to take tests, but they will be ready in only 5 days, by that time the birth may already begin, what can you advise? Sincerely, Rushan
Answer: Hello! By law, they do not have the right to hospitalize people with dysentery in an ordinary maternity hospital, since there are healthy women there. Before childbirth, dysentery cannot be cured, especially since childbirth can begin at any moment, even tomorrow. You have no options, you will have to give birth in an infectious maternity hospital.
Question:My wife was diagnosed with dysentery at 4 weeks pregnant! What to do? What to treat?
Answer: Treat without fail, according to the recommendations of the infectious disease specialist and with the choice of the safest drugs for the fetus.
Question:Three weeks ago I got sick with ARVI. The temperature was under 40. Runny nose and cough. A week later, diarrhea with mucus and blood, that is - that is not. They lay for three days in the infectious disease. Now they seem to say that it is dysentery, but so far it is in question! And in the evening the nurses (calling the infection) said that there was nothing. And we have diarrhea without blood and the temperature has risen to 38.8. There are a lot of teeth at the top that are ready to come out. Salivating sea (OCEAN). what can you advise?
Answer: Most likely, a real increase in temperature and profuse salivation are associated with teething - within 2-3 days the teeth should erupt and the temperature returns to normal. If diarrhea with blood recurs, be sure to tell your doctor about it.
Functional diarrhea, that is, diarrhea after each meal, is a frequent phenomenon that causes a lot of serious inconvenience to patients. However, often people refuse to go to the doctor with such an unpleasant problem, hoping that it will disappear on its own, or trying to alleviate their condition with medication.
There can be quite a few reasons for this condition, and only a doctor can accurately determine the cause of the disease and prescribe the appropriate treatment. Diarrhea is not a harmless phenomenon, so you should not refuse professional treatment.
The main causes of diarrhea after eating
If frequent loose stools are observed immediately after eating, this indicates functional disorders in the functioning of the intestines: the food bolus quickly moves along the gastrointestinal tract, while the food is not properly digested and absorbed.
There may be several reasons for this condition:
- Disorders of the nervous system. This condition is known as "bear disease" or irritable bowel syndrome. The patient may encounter it during a period of prolonged stress, for example, the syndrome may occur in students during a session. Neurogenic diarrhea is usually only part of a complex of symptoms; prolonged stress can lead to vegetovascular dystonia and various neuroses.
- Infectious bowel disease. This is a more dramatic, but possible reason: the body seeks to free the intestines from food that it considers dangerous. To eliminate the painful condition, it is necessary to cope with its cause with medical methods.
- Dysbacteriosis. This is a violation of the intestinal microflora, which can develop after prolonged use of antibiotics or a violation of the diet. If the body can't handle the digestion of food, it tends to get rid of it, which can lead to diarrhea.
Intestinal upset can also result from eating unfamiliar or spoiled foods. In this case, it lasts no more than 1-2 days, and if the process does not stop, you must consult a doctor.
Diarrhea not only brings discomfort and interferes with daily life: frequent loose stools lead to dehydration and leaching of essential trace elements such as magnesium and potassium. It is especially dangerous for children, so young patients should be taken to the doctor as soon as possible.
Diagnostic methods
How do you know when it's time to see a specialist? First of all, you need to pay attention to the nature of the disease. If there is no pus and blood in the stool, this indicates the absence of serious intestinal lesions.
If it has a greasy appearance and a sharp unpleasant odor, this is a sign of the presence of fat in the feces, that is, the digestion of food is not completed. The doctor will ask the patient in detail about the frequency of stools, about the appearance of urges at night and about the diet.
Signs of infection will be fever, bloating, nausea, deterioration in general well-being. If there is a suspicion of an intestinal infection, the doctor may suggest treatment in a hospital to exclude infection of others.
A series of tests will be assigned to confirm or deny the presence of an infection. Much more often, the cause of persistent diarrhea is a nervous breakdown, so the body reacts to prolonged overexertion.
In this case, the urge is observed in the morning immediately after breakfast and in the afternoon after meals, and at night the patient sleeps peacefully without feeling any discomfort. Blood and stool tests do not reveal any signs of infection or other bowel problems.
The most effective method of treatment in this case will be to eliminate the cause of stress: as soon as the state of the nervous system returns to normal, all somatic manifestations of nervous disorders will go away by themselves.
However, the diagnosis of "neurogenic diarrhea" can only be made after all studies confirming the absence of dysbacteriosis and infectious diseases. It is quite difficult to diagnose such a condition in children: they are often embarrassed to talk about the problem, and problems with school or in communicating with peers can lead to severe manifestations of a nervous breakdown.
Folk and drug treatments for functional diarrhea
What to do if an unpleasant condition takes you by surprise, and the problem has to be solved immediately? There are a number of folk remedies that will help eliminate the manifestations of diarrhea and have a beneficial effect on intestinal health:
- Can be used to treat a decoction of oak bark. It is brewed with boiling water, you can take the decoction in a glass immediately after eating. You can use it twice a day, for example, in the morning and in the evening. Usually a few doses are enough to cope with the disruption of the intestines.
- A simple recipe for diarrhea: plain buckwheat porridge without salt. It is necessary to eat a few spoons of porridge on an empty stomach, and there will be no further problems with diarrhea.
- Against diarrhea in children, you can use the following remedy: you need to grind one nutmeg, then the resulting powder is dissolved in a glass of milk. The mixture should be given in a teaspoon, it should be taken every 4 hours.
- Strong tea, a decoction of acorns and some other folk remedies also have fixing properties. Among them is an extreme recipe: a teaspoon of salt dissolves in 100 g of vodka. The drug should be taken immediately after a meal.
If possible, you must first consult a doctor: diarrhea is one of the protective reactions of the body, and with its help the intestines are cleansed of toxic substances. If you interfere with this process, serious intoxication is possible: an infection or poisoning can be the cause of diarrhea.
If the intestinal disorder has arisen for the first time, it is recommended not to interfere with the cleansing process, providing the patient with a warm, plentiful drink to prevent dehydration. The intake of activated charcoal will help, in addition, therapeutic starvation is necessary.
Since the food is still not digested properly, eating it again is like throwing coal into a firebox. Fasting with plenty of fluids is recommended for about a day. If diarrhea is observed constantly at about the same time, the patient is not bothered by nighttime urges, but they occur immediately after meals, most likely it is a neurological disorder, and it is desirable to eliminate its cause as soon as possible.
During a period of stress, the doctor may prescribe sedatives, and with prolonged neurosis and severe stress, antidepressants. Diarrhea in this case is only one of the manifestations of the disease, and complex treatment of the nervous system will be required.
How to treat diarrhea you will learn from the video:
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Most people empty their digestive tract once or twice a day. The frequency of once in a couple of days is also not considered a deviation.
Few people manage to avoid malfunctions in the digestive tract - constipation or diarrhea. The cause is single pathologies or serious diseases.
But what if immediately after eating you need to run to the toilet in a big way?
Of course, this introduces certain complications into life, but is it an alarming sign? Only a doctor can answer.
Reasons for going to the toilet after eating
A person who knows that after lunch or dinner he will need to look for a toilet does not feel free. He can’t always be at home, where the bathroom is located at a distance of several steps?
The reasons for this state of affairs are varied. First of all, frequent urination after eating can be explained by irritable bowel syndrome (IBS). It is characterized by a complex of functional disorders of food digestion in the gastrointestinal tract. In this case, there is no organic lesion of the intestine itself.
IBS occurs in people between the ages of 25 and 45 and is more common in women. In addition to constant trips to the toilet after eating, you have to endure the following symptoms:
- discomfort and pain in the lower abdomen;
- the stool becomes offensive and runny. It contains a lot of mucus;
- increased gas formation and flatulence.
New Year's video recipe:
In addition to IBS, the cause of the urge to defecate after eating can be:
- Thyrotoxicosis(hyperthyroidism) - an increase in the hormonal activity of the thyroid gland.
- Acute and chronic colitis, which occurs in the area of the mucosa of the large intestine.
- Crohn's disease- pathology of the gastrointestinal tract with an unclear etiology. It takes place in a chronic form and can affect all parts of the digestive system. The disease is a type of inflammatory diseases of the gastrointestinal tract.
- Polyposis- single or multiple polyps appear on the mucous membranes of the stomach and intestines - benign formations. The disease is more common in men. Polyps need to be removed promptly so that they do not turn into a malignant form.
- colorectal cancer. Under these ailment is meant a malignant tumor of the rectum (rectum) or large intestine (colon).
- Intestinal dysbacteriosis- clinical and laboratory syndrome, the appearance of which is caused by pathological changes in the structure of the intestinal microflora. This applies to both qualitative and quantitative composition.
- Tuberculosis of the intestine- a chronic infectious disease that occurs under the action of mycobacteria. They affect the intestinal wall and contribute to the formation of specific granulomas that destroy the digestive organs.
- Worm infestation- ingestion of worms of various types. The products and results of their vital activity have a destructive effect on the internal organs and worsen the functioning of the digestive system.
The reason for visiting the toilet after eating may be insufficient production of bile in the body. In this case, the feces become oily and shiny, lose their color and become almost colorless. Frequent bowel movements lead to bleeding of the anus. In a short time, the quality of vision noticeably decreases in a person, and the bone tissue turns into fragile and brittle. A complex of such symptoms signals possible pathologies of the biliary tract, liver or duodenum.
It is possible that the reason for the urge to go to the toilet are not physiological reasons. They should be looked for in changes in the psychological state. Neuroses and increased stress can upset the usual work of the gastrointestinal tract.
How to get rid of the problem?
Illnesses force me to visit the toilet several times a day. Most often, a person's stool is sparse. Its external signs change. This refers to the color, smell and consistency of stools. It is very bad when clots or specks of blood appear in them.
It is necessary to respond to obvious signs of the disease immediately. A visit to a gastroenterologist becomes urgent. The doctor will prescribe tests and studies to make the correct diagnosis:
- analysis of blood, urine and feces;
- Ultrasound of the abdominal cavity;
- colonoscopy - examination of the intestine;
- fibrogastroscopy - the study of the state of the stomach, esophagus and duodenum 12;
- rectoscopy - examination of the rectum.
If you suspect an intestinal infection, it is possible that you will need to go to hospital.
If the blood, stool and urine tests are normal, and the ultrasound results do not indicate the presence of serious problems, a more detailed examination can be dispensed with. Minor drug therapy will bring the condition back to normal. Of course, the doctor will definitely acquaint you with the main recommendations regarding the daily menu.
Traditional medicine as a help
When visits to the toilet after eating do not stop, diarrhea continues for a long time - dehydration of the body occurs and the excretion of useful substances, without which normal activity is impossible.
In addition to medical treatment, you can use the following methods:
- Prepare a strong infusion of oak bark. It should be poured with a glass of boiling water a tablespoon of dry raw materials. The bark is infused for about an hour. Then the drink must be filtered and taken one (two) teaspoons throughout the day. This amount of infusion is enough for one day. The next day you need to cook fresh.
- Make an alcohol tincture. Finely chop a teaspoon of oak bark and pour 0.4 vodka. It is necessary to prepare the tincture in advance, since it will take a week for the bark to be soaked with alcohol properly. In the morning and evening, take 20 drops of the finished product. Oak bark is an excellent astringent, so it effectively helps with problems with the gastrointestinal tract, hemorrhoidal bleeding. The infusion is able to stop the constant urge to visit the toilet after eating.
- Infusion of small-scale canadian. It is necessary to pour a teaspoon of this dried and chopped herb into a saucepan. Pour in 0.25 liters of boiling water, cover and leave for 20 minutes. Then the product must be filtered. Drink one cup of infusion after each meal.
- Extreme recipe: dissolve a teaspoon of salt in 100 grams of vodka. The remedy should be taken immediately after a meal.
Fixing properties are in strong black tea, a decoction of acorns and alcohol tincture of green nuts.
A young newly-made mother treats her baby with special trepidation and even some fear. After all, she knows almost nothing and does not know how, and caring for a newborn causes her many questions and concerns. Many moms are faced with the problem when their baby pushes and blushes, and at the same time he may still grunt or growl. As a rule, such a spectacle does not inspire optimism in them.
It is very good and right that you pay attention to such manifestations. But just do not rush to do anything: it is likely that everything is fine with the baby, and your actions can only harm him. Why does a newborn push, and what to do in this case? Let's try to figure it out.
Don't rush to heal
The fact that a newborn baby is pushing does not mean anything bad. Almost all (or very many) babies do this up to 3-4 months and even longer, and doctors explain this behavior in different ways.
The most common version: the baby cannot go to the toilet in a different way, because his abdominal muscles are not yet developed, like the anal muscle. Despite the fact that the baby blushes and makes sounds that scare you, he can feel quite comfortable with this. Just to poop or even pee, he has to push himself a little. In addition, the newborn is in a horizontal position all the time, and even gravity cannot help him in this matter. In addition, soft, mushy stools do not exert enough pressure on the anus to make bowel movements easy and effortless.
Some experts believe that straining and groaning is associated with imperfect work of the gastrointestinal tract. While the intestine is populated by bacteria, forming its own microflora, and while it is learning to digest food, the baby experiences new, incomprehensible feelings, as if getting used to the ongoing natural processes.
It is not surprising that the child blushes at the same time - do not worry. If you want to help the baby in any way, then press the legs to the tummy or make him a bicycle to activate the bowels and facilitate the movement of feces.
Pediatricians also advise putting the baby to the chest: perhaps he is worried about something or experiences some kind of discomfort. The fetal position will help to calm the baby: roll it up and hug it to you. Doctors suggest that by pushing, the baby expresses his displeasure. Maybe he doesn't like something or something bothers him. Just try to find out the cause of the disturbances and eliminate it (feed, change clothes, go for a walk). By the way, there is also an opinion that in this way newborns express any emotions, because they still do not know how to do it differently. This is a kind of first language of a baby: he is trying to convey something to you - and he is pushing, and maybe even grunting.
If, apart from straining, nothing else bothers you, then most likely there is no reason for concern. The main thing is that the baby feels good: he slept peacefully, ate enough, emptied himself regularly. However, it is likely that the newborn is pushing due to disorders of the digestive system. In this case, the baby behaves quite restlessly: cries, rushes about, presses his knees to his tummy, kicks his legs.
When to help a child
To push and at the same time to freak out and cry a newborn is forced by intestinal colic. Almost all new parents face this problem. Do not rush to treat the baby, even with such harmless, as it seems to you, means, like dill water. Start by adjusting your diet. Eliminate salt, sugar, flour, legumes, cabbage, cucumbers, sweet peppers, radishes, grapes and other foods that cause gas formation from the diet.
If the baby is an artificial one, then it is extremely important to choose the right milk formula (perhaps it is because of her that the baby swells). Formula-fed babies should be supplemented with water.
Make sure that the baby does not swallow air during feeding: properly apply it to the breast and hold the bottle with the formula correctly.
Analyze all the latest changes and appointments - yours and children's - and try to find the cause of the formation of gases in the child. For example, mothers of some children note that colic and straining in their children appeared after the introduction of vitamin D3.
To stimulate the work of the digestive tract and in order to release the swallowed air, lay the baby on the tummy as often as possible between or before feedings, and then lift it up and carry it in a “column”, in an upright position. Do a massage of the abdomen, stroking it with the palm of your hand clockwise, tighten the legs, slightly pressing them on the stomach.
Local heat will help relieve spasms: press the baby to your stomach to your stomach or put a heated diaper on his tummy.
And only if all these methods have been tried, but have not yielded results, turn to the help of drugs and remedies, after consulting with your doctor (most often in such cases, children are prescribed Espumizan).
Constipation or malnutrition?
A little worse if the baby has constipation. Naturally, at the same time, the baby will push, making considerable efforts to poop. Do not allow this, but if it was not possible to avoid constipation, then immediately correct the feeding and principles of caring for the newborn.
If the child is breastfed, then the regularity and consistency of the stool will largely depend on the diet of the mother. Therefore, often it is enough just to change your menu - and the child will stop pushing to poop. Be sure to drink plenty of fluids and include fresh kefir in your diet.
The situation is different with the artificial ones. It is not uncommon for children to have a stool in response to formula milk. It can be very difficult to choose the right mixture, and, perhaps, it will not be possible without the help of specialists.
In addition, unfortunately, our care and guardianship can turn into a number of problems for the baby. It is worth panicking several times ahead of time and putting a vent tube or a cleansing enema to the child unnecessarily, as soon the baby simply will not be able to fart and poop on their own. You should be extremely careful with this and think three times before resorting to such methods.
In fact, babies very rarely get constipated. Mother's milk in the best way meets the abilities of the digestive system of the newborn, therefore, as a rule, there are no difficulties with stools in “milk” babies - they walk “large” much more often than artificial ones. Constipation is more prone to infants who are on artificial feeding.
If a newborn suffers from constipation, then during a bowel movement he strains a lot, blushes and growls, he may even cry or be naughty - an attempt to poop brings some discomfort and even pain to the baby.
But keep in mind that we are talking about constipation only when the baby does not walk “by big” for more than 2 days and he certainly has a hard stool (like pebbles). If the baby poops infrequently, but the feces have the usual consistency - soft, mushy, and at the same time the baby is underweight, then most likely we are talking about the so-called "hungry constipation". This is observed when a newborn does not receive enough milk. A situation arises when he simply has nothing to defecate due to constant malnutrition. In this case, it is necessary to supplement the baby, pediatricians assure.
Summing up, I would like to once again turn to young mothers: do not rush to treat your children. Sometimes medications do more harm than good. And problems with the tummy, because of which the baby is pushing and blushing, can almost always be solved without medication. Moreover, many pediatricians consider this phenomenon normal in newborns. The baby can push until he starts to get solid food (by the way, from now on it is important that there is enough dietary fiber in the children's menu). The main thing is that nothing bothers him at the same time.
