Call for advice about diarrhea. Diarrhea in an adult (diarrhea) - what to do, treatment

General information about diarrhea (diarrhea)

Diarrhea is the rapid release of liquid stools.

Most people experience an upset stomach from time to time and this is usually not a cause for serious concern. However, diarrhea is very uncomfortable and lasts from a few days to a week.

Causes of diarrhea

There are many various reasons diarrhea, but the most common, both in adults and children, is gastroenteritis, an infection of the gastrointestinal tract.

These infectious diseases can be brought with you from travel, especially to regions with poor public hygiene standards. This is called traveler's diarrhea.

Other causes of diarrhea (diarrhea) can be anxiety, food allergy medications, or underlying (chronic) illnesses such as irritable bowel syndrome.

Treatment of diarrhea (diarrhea)

In most cases, diarrhea will go away without treatment within a few days and you won't need to see a doctor.

However, diarrhea can cause dehydration, so you should drink plenty of fluids (often in small sips). It is necessary to prevent dehydration in infants and young children.

To replenish fluid losses, you can buy oral rehydration solutions at the pharmacy, which are suitable for both adults and children.

Start eating solid foods as soon as you can. If you are breastfeeding breast milk, and he has diarrhea, try not to change the feeding regimen.

Stay at home for at least two days after your last episode of diarrhea to avoid infecting others.

There are medications to treat diarrhea, such as loperamide. However, they are not usually required, and most should not be given to children.

Diarrhea prevention

Diarrhea is often the result of an infectious disease. You can reduce your risk of diarrhea by practicing good hygiene:

• wash your hands thoroughly with soap and warm water after using the toilet, before eating and preparing food;
• after each episode of diarrhea, clean the toilet bowl, flush handle and toilet seat with a disinfectant;
• use separate towels, cutlery and crockery.

It is also important to take good care of food and water hygiene while traveling, such as avoiding poorly treated tap water and undercooked food.

When to See a Doctor

Seek medical attention if diarrhea attacks are very frequent or severe, or are accompanied by other symptoms, such as:

• blood in the stool;
• constant vomiting;
• signs of dehydration, including drowsiness, irregular urination, and dizziness;

Also see your doctor if your or your child's bowel problems do not go away for a particularly long time, as this may indicate a more serious illness.

In case of poor general health and frequent need to empty the bowels, call the doctor at home by calling the territorial clinic. Or find other clinics where you can call a therapist or pediatrician at home.

Symptoms of diarrhea (diarrhea)

Diarrhea is the rapid passing of loose or watery stools. Some people may also have other symptoms, depending on the cause of the diarrhea.

Additional symptoms:

• stomach colic;
• nausea and vomiting;
• headache;
• lack of appetite.

Excessive loss of water in the stool can also lead to dehydration, which can have serious consequences if not recognized and treated in time.

Signs of dehydration

Signs of dehydration in children:

• irritability or drowsiness;
• infrequent urination;
• pallor or marbling of the skin;
• cold hands and feet;
• the child looks and feels worse.

Signs of dehydration in adults:

• feeling of fatigue and loss of energy;
• lack of appetite;
• nausea;
• pre-fainting state;
• dizziness;
• dry tongue;
• sunken eyes;
• muscle cramps;

Loose frequent stools in infants

Call your pediatrician right away if your baby has had six or more episodes of diarrhea in the last 24 hours, or if he or she has vomited three or more times in the last 24 hours.

Also seek medical attention if your nursing baby shows signs of dehydration.

Diarrhea in children older than one year

Talk to pediatrician if your child has the following symptoms:

• six or more episodes of diarrhea in the last 24 hours;
• diarrhea and vomiting at the same time;
• watery stool;
• blood in the stool;
• severe or prolonged abdominal pain;
• signs of dehydration;
• bowel disorder lasts more than 5-7 days.

Diarrhea in adults

Call your GP at home if you have diarrhea and the following symptoms:

• blood in the stool;
• incessant vomiting;
• severe weight loss;
• copious watery stools;
• diarrhea occurs at night and interferes with sleep;
• you have recently taken antibiotics or been in the hospital;
• symptoms of dehydration;
• very dark or black stools - this may indicate bleeding in the stomach.

Also seek medical attention if diarrhea persists for more than 2-4 days.

Causes of diarrhea (diarrhea)

Insufficient absorption of fluid from the intestinal lumen or its excessive secretion (secretion) by the intestinal walls leads to the appearance of frequent liquid stools.

Acute diarrhea (diarrhea)

As a rule, diarrhea is a symptom of gastroenteritis, which can have the following causes:

Other possible causes of short-term diarrhea include:

• sense of anxiety;
• excessive alcohol consumption;
• food allergy;
• damage to the lining of the intestine as a result of radiotherapy.

Medications

Diarrhea can also be a side effect of certain medicines, including the following:

• antibiotics;
• antacids containing magnesium;
• some chemotherapy drugs;
• non-steroidal anti-inflammatory drugs (NSAIDs);
• selective serotonin reuptake inhibitors;
• statins (drugs to lower cholesterol);
• laxatives (drugs that help with constipation).

The package leaflet that accompanies the medicinal product must indicate whether any of the side effects diarrhea (diarrhea). You can also read about your drug in the Pharmaceutical Formulary.

Chronic diarrhea (diarrhea)

Diseases that cause long-term diarrhea include:

• irritable bowel syndrome - a poorly understood disease that disrupts the functioning of the intestines;
• inflammatory bowel disease - diseases that cause inflammation in the digestive system, such as Crohn's disease and ulcerative colitis;
• celiac disease is a disease digestive system, in which there is an adverse reaction to gluten;
• chronic pancreatitis - inflammation of the pancreas;
• diverticular disease - a disease characterized by the appearance of small sac-like protrusions on the walls of the intestine;
• colorectal cancer - can cause diarrhea and blood in the stool.

Chronic diarrhea can also occur after gastric surgery, such as gastrectomy. This is an operation to remove part of the stomach, which, for example, is performed with a cancerous tumor.

Diagnosis of diarrhea

In most cases, it is not necessary to find out the exact causes of diarrhea, since the bowel disorder resolves on its own in a few days, and only symptomatic remedies are used in the treatment. But for prolonged or severe diarrhea, an examination may be required.

The following are diagnostic methods that a doctor can perform.

General inspection

To determine the cause of a bowel disorder, your doctor may ask the following questions:

• what is the consistency and color of the stool, is there mucus or blood in it;
• How often do you need to go to the toilet?
• do you have other symptoms, such as heat(heat);
• whether there was contact with a sick person or a trip abroad, as this may indicate infection with an infectious disease;
• whether you recently dined out, as this may indicate food poisoning;
• what medications are you taking;
• whether you have recently experienced stress or anxiety.

The doctor will definitely examine the tongue, skin and visible mucous membranes, probe the abdomen and check for edema.

Fecal analysis

To find out the cause of diarrhea, you may have a stool test if:

• diarrhea does not go away for more than two weeks;
• there is pus or blood in the stool;
• there is general symptoms: dehydration, fever, etc.;
• you have a weakened immune system (for example, with HIV infection);
• you have recently been abroad;
• you have recently been in the hospital or taken antibiotics.

If a serious infectious disease is suspected, the doctor general practice may refer you for a consultation with an infectious disease specialist. In some cases, hospitalization in an infectious diseases hospital is required. Use our service to choose an infectious diseases hospital and discuss the possibility of hospitalization there with your doctor in advance.

Blood tests

If you suspect that your diarrhea is caused by a chronic condition, your doctor may refer you for a blood test.

A complete blood count reveals signs of inflammation and anemia. Biochemical analysis blood helps to determine the condition internal organs: liver, pancreas, gallbladder.

Rectal examination (examination of the rectum)

If the diarrhea persists and no cause can be found, your doctor may recommend a digital rectal examination, especially if you are over 50 years of age.

During a rectal exam, your doctor will insert a gloved finger into your anus to check for abnormalities. This is an effective method for diagnosing diseases of the intestines and anus.

Additional examinations

If the diarrhea persists and the doctor cannot determine the cause, you may be referred for additional tests, such as the following:

• sigmoidoscopy - an instrument called a sigmoidoscope (a thin flexible tube with a small camera and a light bulb at the end) is inserted into the intestine through the anus;
• colonoscopy is a similar procedure in which the entire colon examined with a longer tube.

Treatment of diarrhea (diarrhea)

Diarrhea usually goes away without treatment within a few days, especially if it was caused by an infection. However, there are remedies that relieve the symptoms.

In children, diarrhea usually resolves within 5 to 7 days and rarely lasts longer than 2 weeks. In adults, diarrhea usually begins to resolve after 2-4 days, although some infectious diseases it can last a week or longer.

Diarrhea symptoms can be relieved by following the tips below.

Drink plenty of fluids

It is best to drink plenty of liquids that contain water, salt, and sugar, such as water with juice, soda drinks, and broth. If you drink enough fluids, the urine will be almost clear, light yellow in color.

It is also necessary to prevent dehydration in infants and young children. Give children water even if they are vomiting. It is better to drink a little liquid than none at all. Juices and carbonated drinks should not be given to children as they may worsen the condition.

If a breastfed baby develops bowel problems, continue breastfeeding as usual.

Food hygiene

Following the rules of food hygiene will help to avoid food poisoning and diarrhea associated with it. This can be done by following these guidelines:

• wash your hands, kitchen surfaces and utensils regularly with hot water and soap;
• do not keep raw and cooked food together;
• store food in the refrigerator;
• prepare food carefully;
• never eat food with expired validity.

Vaccination against rotavirus infection

Rotavirus is a virus that often causes diarrhea in children.

Now children are vaccinated against rotavirus infection in the form of drops that are buried in the child's mouth. In Russia, vaccination is carried out according to epidemic indications (with a high risk of infection) free of charge.

Traveler's diarrhea

There is no vaccine that can protect you from everyone possible causes traveler's diarrhea. Therefore, going abroad, you need to follow the rules of food hygiene.

If you are in a country with low hygiene standards, follow these guidelines:

• do not drink tap water - it must be boiled for at least one minute;
• do not use ice cubes and do not eat ice cream;
• do not eat raw or poorly cooked seafood, meat, chicken;
• avoid foods that may contain raw eggs, such as mayonnaise, pastry cream;
• refuse unpasteurized milk and dairy products, such as cheese;
• do not eat fruits and vegetables with damaged skins;
• refrain from ready-made salads.

It is generally safe to eat and drink the following:

• hot food that has undergone heat treatment;
• bottled water, soda and alcohol;
• fruits and vegetables that you wash and clean yourself;
• tea or coffee.

If you are planning a trip abroad, please read the relevant travel advisories in advance.

Localization and translation prepared by Napopravku.ru. NHS Choices provided the original content for free. It is available from www.nhs.uk. NHS Choices has not been reviewed, and takes no responsibility for, the localization or translation of its original content

Copyright notice: “Department of Health original content 2019”

All materials on the site have been checked by doctors. However, even the most reliable article does not allow taking into account all the features of the disease in a particular person. Therefore, the information posted on our website cannot replace a visit to the doctor, but only complements it. Articles are prepared for informational purposes and are advisory in nature.

Diarrhea (it is called the usual word "diarrhea") is an unpleasant symptom of many pathologies that have a completely different genesis and causative factor. Diarrhea is considered to be a condition characterized by frequent defecation with a change in stool parameters. With diarrhea in parallel, patients often complain of concomitant unpleasant symptoms: colic, abdominal pain, vomiting,. The greatest danger is diarrhea for children, since with diarrhea they quickly become dehydrated, which carries a very serious complications up to and including death.

There are a number of factors that can cause diarrhea in both adults and children. These include:

• Problems with intestinal motility.
• Infectious diseases of the gastrointestinal tract, which become a source of toxins in the intestines. Such diseases include: enteroviruses, cholera, food poisoning,.
• Violations in the intestinal microflora against the background of taking anticancer drugs, with HIV disease.
• Irritable bowel syndrome, which is formed with disorders of a neuropsychic nature.
• Enzyme deficiency and fermentopathy.
• Pathologies of an autoimmune nature: non-specific ulcerative colitis, Crohn's disease.
• Hereditary pathologies, which are based on intolerance to certain foods or substances. Such congenital conditions include: celiac disease, pancreatitis (chronic and acute), lactose deficiency, cirrhosis of the liver.

Causes of diarrhea with blood in an adult

Diarrhea with blood can occur as a result of various factors. The admixture of blood in the feces in itself already causes anxiety in a person. The reasons for its appearance in the stool can be the following:

• diverticulitis – inflammatory process in the lower intestine. This cause is most common in people after 45-50 years.
• Hypodynamia- an inert lifestyle, constantly sedentary work, when a person moves little and there is a lack of movement, sedentary work.
• Ulcerative-erosive processes in the gastrointestinal tract in the upper sections can also provoke the appearance of blood impurities in stool ah (ulcerative and in the stage of exacerbation or chronicity).
• Haemorrhoids,. In this case, the blood in the feces will be in the form of clots or streaks, and always scarlet in color, since the source of bleeding is close (the blood simply does not have time to clot). In parallel with this symptom, the patient feels discomfort, pain in anus, itching, burning, etc., but diarrhea will be a sign of concomitant pathology, but the appearance of blood is evidence of hemorrhoids.
• . It can provoke both the appearance of diarrhea in the patient, and the presence of blood in the stool.
• Bleeding. Diarrhea with blood in an adult may indicate internal bleeding in the stomach, esophagus, duodenum. In this case, the chair will be dark in color, "tarry". The cause of bleeding can be: cirrhosis of the liver, peptic ulcer, stomach cancer, esophageal varicose veins.
• Chronic pathologies in the form of Crohn's disease and ulcerative colitis often provoke the appearance of blood streaks (bright) and clots in the stool.
• Infectious diseases. If diarrhea with blood is accompanied by fever, colic, abdominal pain, then you should definitely seek medical help. This clinic can be seen with dangerous diseases that require immediate treatment: salmonellosis, dysentery, etc.

Types of diarrhea

Regarding the course of diarrhea, it happens:

• chronic, when diarrhea persists for a three-week period;
• acute, in which diarrhea disappears up to 3 weeks.

Based on the mechanism of development, diarrhea is classified as follows:

• hypokinetic- with it, the feces are mushy or liquid, there are few of them, there is a fetid odor - all this is the result of a reduced speed of food moving through the intestines;

• hypersecretory - diarrhea is watery and profuse, which is the result of increased excretion of salts and water into the intestines;
• hyperkinetic - loose stools or loose stools mushy, formed with an increase in the speed of movement of digested food through the intestines;

• hyperexudative- it is formed when liquid seeps into the intestinal lumen, which in most cases is already inflamed, such diarrhea is characterized by watery, but not abundant stools, in which blood and mucus may be present.
• osmolar - this is diarrhea as a result of a decrease in the absorption of salts and water by the intestinal walls, in which there can be a lot of bowel movements, they are fatty and contain residues undigested food.

Symptoms of diarrhea

Diarrhea can be accompanied by a number of other signs, which ultimately allows the doctor to differentiate the patient's illness from a number of others based on the current clinical picture. In particular, diarrhea can be:

• quickened stool;
• fecal incontinence;
• foul-smelling stools;
• color change;
• liquid watery or mushy consistency of stools;
• the presence in the stool of the remnants of semi-digested food;
• admixture of blood;
• the presence of mucus.

In parallel, the patient may experience additional symptoms of diarrhea:

• rise in body temperature (from 37 to 40C);
• (may have a spasmodic, dull, pulling, cutting character).

With profuse diarrhea, dehydration often occurs, the symptoms of which will be:

• weakness in the body;
• thirst;
• dry mucous membranes;
• downgrading blood pressure;
• dizziness;
• tachycardia;
• fainting state;
• "flies" before the eyes;
• cachexia is an extreme degree of dehydration.

AT childhood causes of diarrhea are slightly different than in adults. They are often associated with malnutrition and intestinal infections. Diarrhea in children can occur as a result of such reasons:

Important: often in children, diarrhea is the result of indigestion of certain types of foods or their quantities. The inability of the child's gastrointestinal tract to digest and assimilate this or that food is manifested by diarrhea after taking it. In this case, the rejection of this food is the treatment of the disease.

Diarrhea in infants may have several other causes due to the nature of its nutrition (breast or artificial feeding). These include:

• untimely introduction of complementary foods (very early);
• artificial feeding;
• the introduction of the wrong products in the form of complementary foods;
• non-compliance with the required interval between the introduction of a new product;
• infection with intestinal infections;
• large portions of complementary foods;
• intolerance to the introduced products;
• the use of some food by the nursing mother;
• lactase deficiency, in which diarrhea in those who are charmed is observed from the first days of life;
• cystic fibrosis - characterized by profuse diarrhea (liquid) with an unpleasant odor and greasy sheen;
• ARI, in addition to catarrhal phenomena in the nasopharynx, also often provokes diarrhea in infants.

Causal factors diarrhea during pregnancy is the same as in adults. The only difference is the expression clinical picture, since during this period of a woman's life, any illnesses, infections, poisonings are much more difficult.

note: diarrhea during pregnancy can be Negative consequences Therefore, it is very important to seek medical help as soon as the first symptoms appear.

In this case, the duration of pregnancy and the cause of diarrhea are of paramount importance. Diarrhea during pregnancy early dates may be the result of toxicosis, which is quite common. It does not pose a danger to the fetus, because the bacteria that provoke it do not leave the intestines. Severe poisoning can become a threat to the fetus if there is severe intoxication of the mother's body and toxins penetrate the placenta into the fetus.

Especially dangerous is poisoning by the poisons of fungi, which bypass the placental barrier and cause various kinds of defects in the development of the embryo. Diarrhea during early pregnancy is dangerous if the frequency of defecation becomes more than 5 times in 24 hours. If there is diarrhea and vomiting, then this further complicates the situation and requires immediate medical attention. The consequences of severe diarrhea in a pregnant woman can be:

• spontaneous miscarriage;
• decrease in blood pressure in the mother;
• accession kidney failure in a pregnant woman;
• the formation of congenital anomalies in the fetus.

note: after the 30th week, diarrhea most often causes a virus or late toxicosis. Complications of this situation can be premature birth and thrombosis, so if you have symptoms of diarrhea, you should see a doctor. Sometimes diarrhea from 38 to 40 weeks of gestation is a sign of a natural cleansing of the body and an early birth.

The disease may be very different reasons and be a manifestation of many pathologies. To make an accurate diagnosis, it is necessary to scheduled examination and be sure to tell your doctor about the accompanying symptoms. Diagnosis of diarrhea includes:

If necessary or if indicated, the doctor may prescribe the following tests:

The most informative may be instrumental research how:

• colonoscopy - optical examination of the mucous membrane of the large intestine;
• EGDS - endoscopic examination of the esophagus, stomach and duodenum;
• taking material from the stomach for the presence of bacteria Helicobacter pylori;
• - examination of the colon by X-ray method;
• ultrasound abdominal cavity- allows you to evaluate the work of the digestive tract;
• Sigmoidoscopy is an endoscopic examination of the rectum and sigmoid colon.

Diarrhea: treatment and prevention of dehydration

Water diarrhea in an adult involves treatment, which consists of an integrated approach. It is important not only to eliminate the symptoms, but also the cause that caused diarrhea. Diarrhea treatment includes:

MEANS FOR ELIMINATION OF INFECTION

The treatment of diarrhea should be comprehensive: first of all, it is necessary to get rid of the cause of the indisposition and, in parallel, start the process of restoring the disturbed intestinal microflora. The drug "Ekofuril" will help to cope with both tasks. Active substance"Ekofurila" - nifuroxazide. Ecofuril is not absorbed and acts on the cause of diarrhea - microbes, only in the intestines, reduces the amount of toxins produced by pathogenic microorganisms, this provides an improvement general condition person with diarrhea. The prebiotic lactulose, an excipient of the drug, creates a breeding ground for the growth of its own beneficial bacteria in the intestine. Capsules or suspension "Ecofuril" are recommended to be taken for 5-7 days, but even after the end of the intake medicinal product the action of the prebiotic continues and therefore does not require additional courses of pro- and prebiotics in recovery period. Ecofuril® for children over 3 years old and adults is available in capsules, and for children aged 1 month to 3 years - in the form of a suspension with a banana flavor. This medicine is not recommended during pregnancy and you should consult your doctor.

To avoid dehydration, it is important to follow these rules:

1. Drinking plenty of water is the basis of the treatment of diarrhea, because without it, all other drugs will be ineffective.
2. Drink more fluids immediately after the onset of diarrhea.
3. It is allowed to drink such drinks with diarrhea: ready-made saline pharmaceutical solutions (Rehydron), rosehip broth, raisin compote, chamomile decoction.
4. It is forbidden to drink juice, milk, soda, sweet tea with diarrhea.
5. It is necessary to drink after each act of defecation.
6. The amount of liquid you drink should be approximately 150 to 300 ml at a time.
7. If there is vomiting and diarrhea, then you should drink in small sips, otherwise heavy drinking in one gulp can provoke a vomiting attack.
8. It is not necessary to eat during diarrhea, it is important to drink a lot, but if the patient wants to eat, then you should not refuse him.
9. BRYAS - the optimal diet on the first day of diarrhea - banana - rice - apple (baked) - crackers.

note: when there is relief in the patient's condition, then from the 2nd or 3rd day it is already possible to introduce meat and yogurt into the diet, but low-fat, as well as cereals and pasta.

What to do at home with diarrhea

If diarrhea occurs, general medical prescriptions should be followed, which will alleviate the patient's condition, improve the functioning of the gastrointestinal tract. They include:

1. Refusal to eat certain foods (fatty meat, eggs in any form, milk, hot spices, soda, cabbage, cucumbers, radishes).

Diarrhea(indigestion, diarrhea) is a symptom that characterizes a certain type of indigestion. The term "diarrhea" refers to such a condition of the patient, in which bowel movement, accompanied by the release of loose stools, occurs more than twice a day. Varies according to clinical development acute form diarrhea, the duration of which is not more than two weeks, and chronic form, which lasts more than two weeks.

Diarrhea is the second most common complaint among children, who went to the doctor (in the first place - high temperature).

As a rule, the occurrence of diarrhea is associated with disorders of the gastrointestinal tract, however, diarrhea may be accompanied by some other diseases that are not associated with lesions of the digestive system.

In the normal state, food that enters digestive organs, is digested. The process of digestion of food occurs due to the action of various enzymes that break down food components into monosaccharides, amino acids, fatty acids, i.e. on the simple substances. During digestion, food moves through the intestines from duodenum to the anus. In different parts of the intestine, different stages of digestion occur. So, in the small intestine, food and water are broken down and absorbed, in the large intestine, the formation of feces and the absorption of certain groups of vitamins synthesized by the intestinal flora occur.

There are several main points of the digestive processes.
1. The digestive process is significantly affected quantity and quality of food. So, a lot of hard-to-digest food (it is a food rich in vegetable fiber and fats) is not fully digested, which leads to an acceleration of intestinal motility and increases the growth of bacteria.

2. The quality of the digestive processes determines the state of the digestive tract. On the one hand, the digestive process is affected by the amount of enzymes secreted by the pancreas, stomach and liver. On the other hand, how food digested by the stomach is absorbed depends on the condition of the intestinal mucosa.

If there are not enough enzymes, the absorption of food is not complete. In the event that the intestinal mucosa is affected, the digested substances are not able to be absorbed. When undigested substances accumulate in the intestinal cavity, the secretion of electrolytes and water occurs, that is, the release of water from the blood into the intestinal cavity. Great importance during the digestive process, it has intestinal peristalsis, with the help of which food masses move along the intestines, which ultimately leads to their removal from the body. When peristalsis decreases, constipation occurs, and when it increases, diarrhea occurs.

3. The digestive process in the large intestine is affected quantitative and qualitative composition of microflora. The large (and partly small) intestines of a healthy person are inhabited by special types"beneficial" bacteria. Their main function is the processing of food residues that have not been digested, and the release of some substances useful for the body.

There are cases when changes occur in the quantitative and qualitative composition of the normal intestinal microflora. The consequence of this is that microbes that can cause disease (pathogenic) settle in such an “altered” intestine. Diarrhea can be one of the manifestations of such a violation of the microflora.

Mechanisms for the development of diarrhea

As a rule, several of these mechanisms are involved in the appearance of diarrhea, because if any one condition of proper digestion is violated, this affects the work of others. Most common causes diarrhea: intestinal dysbacteriosis, acute intestinal infections, acute intestinal infections, chronic diseases organs of the gastrointestinal tract.

Diarrhea in acute intestinal infections

Diarrhea caused by disease-causing microbes may continue long time and in some cases poses a threat to human life. Sometimes the work of normal intestinal microflora can lead to diarrhea, if a large number of undigested food enters the large intestine. In this case, diarrhea will end simultaneously with bowel movement.

There are two main types of diarrhea in AII:
1. Diarrhea with watery stools. This type of diarrhea is characteristic of AII, the appearance of which was caused by bacteria or viruses that secrete toxins (for example, vibrio cholerae). At the same time, the composition of the feces includes salts and water secreted by the intestinal mucosa, which has been exposed to viruses and toxins.
2. Diarrhea with bloody cases. This type of diarrhea occurs with dysentery, salmonellosis. It is caused by bacteria that penetrate the intestinal mucosa and destroy it.

In acute intestinal infections, as a rule, there is acute diarrhea. In a number of diseases, which, in particular, include dysentery, the acute form of diarrhea can develop into a chronic one.

Diarrhea with intestinal dysbacteriosis

Diarrhea in chronic diseases of the gastrointestinal tract

Diarrhea can be a constant symptom of diseases such as inflammation of the small intestine (chronic enteritis), inflammation of the large intestine (chronic colitis), Crohn's disease, ulcerative colitis, which are accompanied by damage to the intestinal mucosa. With these diseases, diarrhea appears due to the fact that the processes of absorption of nutrients from the intestinal cavity are disturbed. Sometimes diarrhea can be caused by diseases of the liver and pancreas.

A symptom such as diarrhea can also occur in a number of diseases that are not directly related to dysfunction of the digestive tract. For example, diarrhea can appear with, with hepatitis, with overstrain or emotional stress, with poisoning or overheating in the sun. With these diseases, the appearance of diarrhea is mainly due to the fact that intestinal motility is accelerated.

In some cases, diarrhea can be caused by a lack of vitamins. (niacin, vitamin B2, vitamin F). As an adverse reaction to medication, diarrhea may occur when taking antiarrhythmic drugs ( quinidine sulfate), antibiotics, drugs designed to lower blood pressure, antacids, as well as overdose of laxatives or after ingestion of magnesium preparations.

Warning symptoms of diarrhea

If at least one of the above symptoms is present, this is a serious reason to immediately seek medical help.

Diagnosis and treatment of diarrhea

The modern stage of treatment of diarrhea involves the solution of these three problems simultaneously.

First you need to determine the cause of the diarrhea. This event is extremely important, because it helps to prescribe a treatment that eliminates the cause of the disease (the so-called etiotropic therapy). It is often difficult to determine the cause of diarrhea. Significantly facilitate the diagnosis procedure and the appointment of competent treatment allows determining the nature of diarrhea (watery or bloody stools).

If possible, the diagnosis can be clarified using a method such as stool microscopy (it allows you to clarify whether certain types of pathogenic bacteria are present in the stool). Less commonly, and mainly for epidemiological purposes, a method such as seeding on nutrient media is used. Next, we will look at the main types of diarrhea and the methods by which they are treated.

Watery diarrhea

If the patient has mild or mild watery diarrhea moderate, treatment should be organized in the following main areas: preventing dehydration of the body and replenishing the water-salt balance. In achieving these goals, it is effective to apply solutions such as Oralit and Regidron.

After the thirst is eliminated (for a short time you need to use 3-5 glasses of solution), the solution should be taken half a glass after each stool or 3-4 glasses in 12 hours, until the diarrhea stops.

During diarrhea, indigestible foods or foods containing fiber (for example, raw vegetables and fruits) should be avoided, fruit juices (mainly apple and grape), dairy products, sweet and salty foods should be abandoned, since these foods can only exacerbate diarrhea. At the same time, it is allowed to use baked fruits and vegetables, strong tea, crackers. Tea made from St. John's wort will be especially useful.

Adults with acute diarrhea can take medicines such as No-shpa or Loperamide. Children with diarrhea take loperamide Not recommended.

Bloody diarrhea

Rehydration therapy is carried out according to the scheme we have already described. With bloody diarrhea, this line of treatment is also very important, but, compared with antimicrobial treatment, it is in second place. Based on the fact that many microbes have recently become resistant to antibiotics of the “classic type”, the use of drugs from the fluoroquinolone group will be effective. (Ciprofloxacin, Norfloxacin, Ofloxacin). In some cases, it may apply Cotrimoxazole and Metronizadol. In any case, before taking this or that drug, it is necessary to study the instructions for use and consult with your doctor.

In what cases should you immediately consult a doctor? Even considering that the treatment of complicated diarrhea of ​​moderate or mild severity is usually carried out at home, it must be borne in mind that in some cases diarrhea can be a sign of a serious illness, the treatment of which requires urgent hospitalization of the patient and the provision of quality medical care. Diarrhea can be extremely dangerous for the elderly and children.

You need to see a doctor if:
An increase in body temperature is noted against the background of diarrhea above 38 degrees;
Acute diarrhea manifested itself in an elderly person or a child under one year old;
If there is also abdominal pain or severe vomiting during acute diarrhea;
Black, tar-like feces or dark brown vomit containing fresh blood (this may indicate bleeding from the duodenum or stomach ulcer);
Diarrhea persists for more than three days despite treatment;
If during acute diarrhea develops severe dehydration or the patient has a violation of consciousness;
Against the background of taking medications for diarrhea, adverse reactions occur (nausea, allergic skin rashes, irritability, sleep disturbance, abdominal pain, dark urine);
If diarrhea sometimes manifests itself for no apparent reason.

During the appointment with the doctor, you need to tell him about all current or previous diseases, operations (even about visits to the dentist), as well as about how the treatment was organized.

Treatment with folk remedies

Effectively help with diarrhea: rice porridge or rice water. You need to boil them in water, hard-boiled, without adding salt.

For gastrointestinal disorders you can use the following remedy: dried chamomile flowers (one tablespoon) in one glass of boiling water. Infuse for four hours in a thermos, then strain. Drink two tablespoons four times a day after meals.

During bloody diarrhea recommended: fees - a decoction of the rhizome of burnet, cinquefoil erect (according to 25 grams), 50 grams of shepherd's purse grass; infusion - by 50 grams of burnet, rhizomes of highlander snake; decoction - 10 grams of comfrey per 200 milliliters of milk, insist for an hour, take two tablespoons four to five times a day.

Do not take loperamide for invasive diarrhea (i.e. diarrhea with blood or pus).

Despite various prohibitions and restrictions, loperamide is useful in the treatment of a number of diarrheas:

• hyperkinetic diarrhea: irritable bowel syndrome, "bear disease" (nervous diarrhea due to stress - for example, at a wedding, etc.), but doses should be minimal,
• secretory diarrhea,
• Crohn's disease,
• in complex treatment diarrhea during chemotherapy malignant tumors etc.

In other cases, it is better to avoid loperamide or at least consult a specialist.

Loperamide is available in capsules 2 mg. The instructions recommend taking 2 capsules first, and then 1 capsule after each liquid stool. However, practice shows that in mild cases, more than 1 capsule is not required, otherwise constipation will occur for 1-3 days. The maximum permitted dose is 8 capsules per day.

Galavit for the treatment of intestinal infections

In the late 1990s, a safe and effective universal anti-inflammatory immunomodulator was created in Russia. Galavit. Among the many indications for use - treatment of any infectious diarrhea accompanied by elevated temperature and symptoms of toxicity weakness, headache, dizziness, nausea, vomiting, palpitations). Galavit normalizes the activity of hyperactive macrophages, reduces excessive inflammatory response and accelerates recovery.

Galavit well compatible with others medicines(including with traditional treatment intestinal infections), is well tolerated and has a minimum of side effects (allergies are occasionally possible). It is safe and allowed healthy people except for pregnancy and breastfeeding. Galavit is not recommended for children under 6 years of age, because. they did not check.

Clinical studies of Galavita with diarrhea were carried out in adults and children over 12 years of age with intramuscular injection according to the scheme: 200 mg once, then 100 mg twice a day until relief (disappearance) of symptoms of intoxication. However, oral administration is more convenient and in a safe way treatment.

Galavit

Dosage forms for treatment with Galavit:

• adults and children over 12 years old: 25 mg tablets, 100 mg ampoules, 100 mg rectal suppositories;
• children 6-12 years old: ampoules of 50 mg, rectal suppositories of 50 mg, there are no tablets with a “children's” dose;
• children under 6 years of age: not indicated.

In acute intestinal infections, the initial dose of Galavit for adults and children over 12 years of age is 2 tab. 25 mg once, then 1 tab. 3-4 times a day until symptoms disappear intoxication within 3-5 days (but usually one day of admission is enough). Please note that Galavit tablets should be placed under the tongue (!) and kept there until completely dissolved (10-15 minutes). In children 6-12 years old, intramuscular injections or rectal suppositories are used at a dose of 50 mg.

So, with acute diarrhea no temperature and symptoms of intoxication (weakness, nausea, vomiting, headache, palpitations, etc.) RECOMMENDED (adult dosages):

1. 1 sachet per 0.5 glass of water 3 times a day in breaks (!) between meals and other medicines for 2-4 days,
2. enterol 1-2 capsules morning and evening 1 hour before meals with a small amount of liquid for 7-10 days.

For diarrhea with elevated temperature and symptoms of intoxication to the above treatment need add:

• necessarily - galavit under the tongue, 2 tablets. once, then 1 tab. 3-4 times a day until the symptoms of intoxication disappear for 3-5 days,
• optional - inside 200 mg every 6 hours for 3 days.

With large losses of fluid, it is necessary rehydration:

• or dissolve in clean water according to the instructions and drink often, but little by little. However, if the patient has repeated vomiting that does not allow him to take liquid inside, you should call an ambulance and go to the hospital.

If you are clearly something got poisoned, you feel sick, before taking medication it is desirable gastric lavage(drink 1 liter of warm water, then bend over and press your fingers on the root of the tongue; then the whole procedure can be repeated). If the cause of nausea is food poisoning, after gastric lavage, you will immediately feel relief. After that, you can take the enterosorbent inside ( smecta, polyphepan, enterosgel, atoxil, polysorb).

If a after 3 days your diarrhea persists, you should consult your doctor to determine its cause. Remember that diarrhea can be a sign of quite serious and even fatal diseases (even with some forms of cancer). If a chronic diarrhea(lasts more than 3 weeks), you should immediately go to the doctor, be examined and find out the cause. It is highly desirable to remember after which it arose, this will help to choose the right treatment. For example, if after taking antibiotics, then it should be treated as dysbacteriosis.

AVOID the following medications unless absolutely necessary:

• Activated carbon- it is ineffective and outdated drug;
• - relieves symptoms of diarrhea, but does not cure. When intestinal infection loperamide enhances self-poisoning of the body. It is forbidden to small children and is dangerous for infectious diarrhea. Reception of loperamide is possible only with chronic diarrhea after consultation with a doctor (for example, after removal of the gallbladder, irritable bowel syndrome, etc.). Take it for severe diarrhea only in emergency situations or if you are well aware of what you are doing;
• antibiotics and antibacterial drugs - they should be taken as prescribed by a doctor, since they themselves can cause diarrhea due to dysbacteriosis. Allowed Exception - .

Diarrhea is usually treated at home. Need to see a doctor in the following cases:

• no effect of treatment for more than 3 days,
• diarrhea developed in a child under one year old or in an old (debilitated) person,
• diarrhea is accompanied by a temperature above 38 ° C (the aforementioned Galavit is highly effective in these cases),
• occurrence unclear adverse reactions for treatment ( allergic rash on the skin, irritability, sleep disturbances, yellowness of the skin and sclera, dark urine, etc.),
• worried about constant stomach ache,
• (!) black stool (tar type) may indicate bleeding from the upper gastrointestinal tract,
• (!) vomiting dark brown masses or with impurities of fresh blood is possible with bleeding from the stomach or esophagus,
• (!) observed impaired consciousness or severe dehydration(dry mouth, weakness, dizziness, cold skin, little and dark urine strong smell, wrinkled skin and sunken eyes).

In the last three cases (!) you need not just to see a doctor, but immediately call an ambulance and be prepared to send the patient to the hospital.

Prevention of acute intestinal infections

Wash everything in a row: vegetables and fruits, hands after using the toilet and before eating. Use clean water and fresh produce.

Use the refrigerator and freezer - bacteria multiply more slowly in the cold. True, there is one exception - salmonella feel great on chicken eggs in the refrigerator.

In the home first aid kit, in the country and on long trips, have (per 1 person):

• smecta (5 sachets),
• enterol (bottle of 30 capsules or more),
• galavit (plate for 10 tablets),
• rehydron or gastrolith,
• loperamide (2 capsules for emergency cases).

To prevent diarrhea when traveling or during antibiotic therapy, it is recommended to take Enterol 1-2 capsules daily in the morning during the entire trip or taking antibiotics.

Diarrhea is usually treated with home care. In some cases, more severe diarrhea, requires the patient to call " ambulance or contact the branch emergency care nearest hospital in the following situations:

• if a person has diarrhea along with a high fever, moderate to severe pain in the stomach, or dehydration that cannot be controlled;
• if there is blood in the diarrhea (may be bright red or may look like black, thick tar); or
• if the person is sleepy and not behaving normally (others may notice this and take the person to the emergency room).

See a healthcare professional if the person does not know how to treat diarrhea and has any of these complications:

• vomiting and inability to tolerate any food or drink;
• signs of dehydration;
• high fever, significant abdominal pain, frequent loose stools, or bloody diarrhea;
• if a patient with diarrhea is in old age or has serious underlying medical problems, especially diabetes, diseased heart, kidney or liver, or HIV;
• parents or caregiver need advice on preventing dehydration in newborns and infants;
• symptoms do not improve within two to three days or seem to get worse; or
• if diarrhea develops after traveling within one's own country or foreign travel.

Diarrhea: diagnosis

Acute diarrhea can be treated at home. Bloating and diarrhea usually subside in two to three days without special medical treatment.

Diarrhea: self-care at home and remedies

Diarrhea: treatment in adults

• Adults should drink plenty of fluids to stay hydrated.
• Replenishing water loss (due to diarrhea) is important. Avoid milk, as milk can make diarrhea worse. Sports drinks (such as Gatorade or Powerade) may be helpful because they replenish the body's electrolytes in addition to providing hydration.
• If the victim is able to eat, avoid fatty foods. Adults, children, toddlers should follow the "BRAT" diet (bananas, rice, applesauce and toast). BRAT diet (diarrhea diet) is a combination of foods used for decades to treat diarrhea. If early diarrhea is accompanied by nausea, the person may suck on lozenges until the nausea stops. After the diarrhea subsides, you should avoid alcoholic beverages and spicy foods for two days.
• People should continue their normal activities if they are mildly ill with diarrhea, however strenuous exercise should be avoided as exercise and sports increase the risk of dehydration.
• Pregnant women with diarrhea should definitely avoid dehydration, so they should consult their doctor.

Diarrhea: treatment in children

Dehydration in children and toddlers can be a big concern.

• Infants and toddlers pose particular problems with diarrhea due to their increased risk of dehydration. Parents should offer them a bottle of water as often as possible. Solutions such as Pedialyte may be more attractive than water. These fluids contain essential electrolytes that are lost with diarrhea. Never use saline tablets as they can make diarrhea worse.
• Children with frequent stools, fever or vomiting should stay at home and avoid going to school or Kindergarten until these symptoms disappear. This allows the child to rest and recover from diarrhea, and also protects other children from exposure to a possible infection.
• As mentioned earlier, newborns, infants and children should be encouraged to follow the "BRAT" diarrhea diet (bananas, rice, applesauce and toast). The BROT diet (diarrhea diet) is a combination of foods used for decades to treat diarrhea.

Diarrhea: treatment

To replace fluids, if a patient is dehydrated and unable to eat or drink, healthcare professionals will often start intravenous intervention. This decision often leads to rapid relief of the patient's condition.

Antibiotics

Antibiotics are not effective for treating diarrhea caused by viruses. Even more severe diarrhea caused by bacteria usually goes away within a few days without antibiotics. Antibiotics even make some cases of bacterial diarrhea worse, especially those caused by the E coli bacteria (a common source of food poisoning).

Your doctor may recommend various antidiarrheal medications. These drugs, such as loperamide (Imodium) and bismuth subsalicylate (Pepto-Bismol, etc.) may help some people with diarrhea, but other medications should be avoided at the same time. Antidiarrheal drugs are not usually recommended for infants and children with diarrhea.

hospitalization for diarrhea

If a person has severe diarrhea, especially if accompanied by dehydration, the person may need to be hospitalized to receive an IV.

Medications for diarrhea

• The use of anti-motility medications, although controversial, does provide relief from diarrhea. These drugs slow down intestinal movement. These include loperamide (Imodium) and bismuth subsalicylate (Pepto-Bismol, Kaopectate, etc.). Such anti-motor drugs are not recommended for infants and children under 5 years of age.
• Otherwise, for healthy adults who do not have severe diarrhea, loperamide is likely to be safe and effective in reducing daily stool count and overall duration of diarrhea.
• Bismuth salicylate is also helpful and may be more effective than loperamide when vomiting accompanies diarrhea.
• Adults with other serious medical problems and those with severe diarrhea (fever, abdominal pain, or bloody stools) should seek medical advice before using medication.
• Many solutions are available to prevent salt deficiency in the body with diarrhea.
• Oral electrolytes are available at any pharmacy (Pedialyte, Rehydralyte, Naturalyte).

Follow label directions, which may say take 1 teaspoon every 15 minutes. If the child remains at the original dose, increase the dose to 1 tablespoon every 15 minutes until the diarrhea stops.

Diarrhea: natural remedies

Some plant leaves contain tannins, which are considered a remedy for diarrhea. The simplest blackberries, blueberries, and raspberries in tea can help stop diarrhea. Don't eat fresh blueberries because they can make diarrhea worse. Pregnant women should avoid high doses of tannin. Chamomile tea can also act as a remedy for diarrhea.

NOTE: If diarrhea remedies are used that include homeopathy, herbs, nutritional supplements, acupressure, aromatherapy and other alternative or additional methods treatment, please be aware that these products and methods are not officially, scientifically recognized for the treatment or prevention of disease. But their interactions with medications can help get rid of diarrhea. Inform your doctor about each medication and vitamin before taking any medication or remedy. It is recommended that you keep a list of all medications you take in your wallet or purse in case of an emergency.

Diarrhea: next steps

• Avoid dehydration. Follow the advice of a medical professional.
• Call your doctor again if your diarrhea worsens, if you develop a high fever, abdominal pain, or if you have bloody stools.

Prevention of diarrhea

Many cases of diarrhea are passed from person to person. The following measures can help avoid diarrhea, a viral or bacterial infection:

• Caregivers of sick children or adults in any setting should thoroughly wash their hands after changing diapers, bathing, or helping around the house.
• To prevent a child's diarrhea from becoming persistent, children should be instructed to wash their hands frequently, especially after going to the toilet.
• The practice of safe food handling. Always wash your hands before and after preparing food.
• Be careful when cooking raw poultry or meat. Food must be cooked at the recommended temperatures. Avoid raw or rare meats and poultry. Utensils that come into contact with raw food should be cleaned with soap and hot water.
• Raw fruits and vegetables should only be eaten by washing thoroughly in clean water.
• Unpasteurized (raw) milk can be contaminated with bacteria and should be completely eliminated from the diet. Unpasteurized fruit juice should be avoided because the fruit may be in contact with contaminated faeces from animals in the garden.

Diarrhea: treatment prognosis

• The effects of diarrhea should improve two to three days after onset. loose stool may persist longer than other symptoms.
• Serious illnesses are usually seen in people who suffer from severe dehydration, especially infants, the elderly, or other people with significant medical conditions.