The intestinal infection is acute - Causes, Symptoms and Treatment .MF .

August 12, 2017 17:52 | Infectious Diseases

Intestinal infections - one of the most common diseases in the world.The prevalence of the population is extremely high, as in the pediatric age group, and adults.When we speak of an intestinal infection, we mean an acute intestinal disease.

acute intestinal infections (AII) - a group of acute infectious human diseases caused by various infectious agents (mostly bacteria), with alimentary infection mechanism, manifested by fever and intestinal syndrome with possible development of dehydration and severe in the pediatric age group, and in the elderly.
incidence of intestinal infections in the world, and particularly in Russia, is quite high.Every year on the planet fall ill more than 500 million. Man.The incidence in Russia reaches 400 or more cases per 100 thousand. Population.The structure of child morbidity and mortality suggests the third place was acute intestinal diseases.


intestinal infections The digestive tract consists of the mouth, pharynx, esophagus, stomach, small intestine (incl

uding 12 duodenal intestine, the jejunum, ileum), large intestine.The saliva of the mouth there is substance - lysozyme, which has a bacteriostatic effect.This is the first protective barrier.Gastric mucosa has glands that produce gastric juice (consisting of hydrochloric acid and pepsin).Hydrochloric acid is the second barrier to pathogens, which can be lost in it (but it does not always happen).The mucous membrane of the small intestine is covered with numerous fibers involved in membrane digestion, is protective and transport functions.Furthermore, intestinal mucosa contains secretory IgA - IgA, which plays a role in immunity of the human organism.

microflora inhabiting the intestine, is divided into obligate (mandatory to be present in the intestine), which includes bifidobacteria, lactobacilli, Escherichia coli, Bacteroides, fuzobakterii, peptokokki.Obligate flora is 95-98% of all representatives.Function obligate flora - protection at the expense of a competitive presence and participation in the processes of digestion.Another group of microorganisms that inhabit the intestines, called optional (extra) flora, which includes staphylococci, fungi, opportunistic microorganisms (Klebsiella, Streptococcus, Proteus, Pseudomonas aeruginosa, Clostridium and others).Extra flora may also be involved in the process of digestion by production of certain enzymes, but opportunistic at a certain growth can cause the development of intestinal syndrome.The rest of the flora that enters from the outside, called pathogenic and causes severe intestinal infection.

Which pathogens can cause acute intestinal infection?

There are several types of intestinal infections, depending on the etiology:

1. Intestinal bacterial infection : calmonellez (. Salmonellae enteritidis et spp), dysentery (Shigellae sonnae et spp.), Yersiniosis (Iersiniae spp.), Ehsherihioza (Esherihiaecoli enteroinvasive strains), Campylobacter (enteritis caused of Campylobacter), an acute intestinal infection caused by Pseudomonas aeruginosa (Pseudomonas aeruginosa), clostridia (of clostridium), Klebsiella (Klebsiellae), Proteus (Proteus spp.), staphylococcal food poisoning (Staphilococcus spp.), typhoid (Salmonellae typhi), cholera (Vibrio cholerae), botulism (botulinum toxin poisoning) and other.
2. DCI viral etiology (rotavirus, viruses group Norfolk, enteroviruses, coronaviruses, adenoviruses, reoviruses).
3. Fungal infections intestinal (more fungi of the genus Candida).
4. protozoal intestinal infections (giardiasis, amoebiasis).

causes of intestinal infections

source of infection - the patient is clinically expressed or erased form of intestinal infection, as well as the media.Infectious period since the emergence of the first symptoms of the disease and the symptoms of the whole period, and during viral infection - up to 2 weeks after recovery.Patients with isolated pathogens in the environment with feces, vomit, urine less frequently.

infection mechanism - alimentary (ie by mouth).infection Path - fecal-oral (food or water), home, and in some viral infections - airborne.Most pathogens of acute intestinal infections are very stable in the environment, well retain their pathogenic properties in the cold (in a refrigerator, for example).Transfer factors - foods (water, milk, eggs, cakes, meat, depending on the type of intestinal infection), household items (dishes, towels, dirty hands, toys, door handles), swimming in open water.The main place in the spread of infection given to compliance or non-compliance with the rules of personal hygiene (washing hands after using the toilet, patient care, to food, disinfection of household goods, personal selection of dishes and towels ill, reducing the contact to a minimum).

susceptibility to intestinal infections general, regardless of age and gender.The most susceptible to intestinal pathogens - children and the elderly, people with diseases of the stomach and intestines, people suffering from alcoholism.

Factors predisposing to the development of intestinal infections in children: children on artificial feeding, premature babies;violation of the rules of complementary feeding without adequate heat treatment;the warmer months (usually summer);sorts immunodeficiency in children;pathology of the nervous system in the perinatal period.

Immunity after undergoing unstable infection strictly type-specific.

Common symptoms of acute intestinal infections

incubation period (from the date of entering the pathogen until the first signs of illness) lasts from 6 hours to 2 days, sometimes longer.

for almost any intestinal infection characterized by the development of 2 major syndromes, but in varying degrees of severity:

1. infectious-toxic syndrome (ITS), which is manifested by subfebrile temperature (37º and above) to febrile fever (38 °and higher).In some infections, the temperature is not at all (such as cholera), the lack of heat or light intermittent rise of characteristic of food poisoning (staphylococcus, for example).The temperature can be accompanied by symptoms of intoxication (weakness, dizziness, body aches, nausea, sometimes vomiting against high temperature).Most infectious-toxic Sindh is the beginning of an acute intestinal infection lasts until the second syndrome from several hours to days, sometimes longer.

2. intestinal syndrome .Manifestations of gastrointestinal syndrome may be different, but there is a similarity of symptoms.This syndrome can manifest as a syndrome of gastritis, gastroenteritis, enteritis, gastroenterocolitis, enterocolitis, colitis.

syndrome gastritis characterized by the appearance of pain in the stomach area (epigastric), constant nausea, vomiting after meals and drinking water, and it can cause even a sip of the liquid.Vomiting can be repeated, bringing short-lived relief.Perhaps liquefaction chair and in a short period of time, sometimes only once.

gastroenteritis syndrome is accompanied by abdominal pain in the stomach and umbilical region, vomiting, frequent stools at first appearance of pasty character, and then a watery component.Depending on the cause in the stool can change the color (green in salmonellosis, light brown with ehsherihioza, for example), as well as appearing mucus, undigested food residue.

syndrome is characterized by the appearance of enteritis only defecation disorders in the form of frequent watery stools.The frequency depends on the type of pathogen and the extent of its infective dose that has fallen to the particular patient.

gastroenterocolitis syndrome manifested by vomiting and loose stools, abdominal pain becomes diffuse nature and virtually permanent, bowel movements are painful, not bringing relief, often mixed with blood and mucus in the stool.Some acts of defecation with scanty mucous discharge.

enterocolitis syndrome characterized only severe pain around the abdomen perimeter, frequent stools mixed with scanty discharge.

colitis syndrome manifests itself fighting in the lower abdomen, especially on the left, painful bowel movements, meager contents mixed with mucus and blood, false desires on a chair, no relief at the end of defecation.

such syndromes as gastroenteritis, gastroenterocolitis and enterocolitis characteristic of salmonellosis, enterocolitis and colitis - for dysentery, ehsherihioza accompanied by the development of gastro-enteritis - a leading cholera syndrome, gastritis syndrome may be accompanied by food poisoning, but it could be gastroenteritis, viral intestinal infections occuroften in the form of gastroenteritis.

Features acute enteric infections in children

• a more severe course of acute intestinal infection,
• rapid development of symptoms of dehydration,
• a higher proportion of viral infection of the intestine than in the adult age group.

If there is an acute intestinal infection in the baby quickly develops dehydration, demineralization of the body, with the result that there is a high mortality rate;to the same characteristic ability even opportunistic pathogens cause severe process in the intestine in children.

Complications of acute intestinal infections

1) Dehydration (dehydration) - abnormal loss of water and salts in an unnatural way (vomiting, diarrhea).There are 4 degrees of dehydration in adults:
- 1 degree (compensated) - body weight loss of up to 3% of the original; 2 degree (transition) - Body weight loss of 4-6% of the original; 3 degree (subcompensated) - 7-9% of the original; 4 degree (dekmpenchirovannaya) - more than 10% body weight loss from the original.

Children Grade 3: 1 degree (up to 5% weight loss from the original), 2 degree (6-9%), 3 degree (algid) - more than 10% loss of body weight of the original.

worried about dry skin and mucous membranes, thirst, loss of skin elasticity, hemodynamic instability (increased heart rate, decreased blood pressure) In addition to weight loss.Thirst is nevsegda if dehydration occurs soledefitsitny type (this happens more often when repeated vomiting), the thirst can not be.If the water-scarce type of dehydration is thirst - the main symptom.

2) One of the manifestations of lightning dehydration: dehydration shock with possible fatal outcome.There is a profound dehydration and hemodynamic disorder (critical drop in blood pressure).

3) Infectious-toxic shock: occurs against a background of high temperature, usually at the beginning of the disease and is accompanied by a high toksinemiey (high concentration of toxins of bacteria in the blood), serious violations of hemodynamics and potentially lethal.

4) Pneumonia (pneumonia).
5) Acute renal failure .

Differential diagnosis (non-infectious "mask" of intestinal infections)

During the preliminary diagnosis staging in acute intestinal infection the doctor is necessary to differentiate intestinal infection with other diseases and conditions, symptoms of which may also be vomiting and diarrhea (loose stools).An important role is played properly collected history of the disease (history of the disease), in which you need the most detailed description of the symptoms and the timing of their occurrence, severity of complaints and their duration.

gastroenteritis syndrome may be accompanied by mushroom poisoning, heavy metal salts, poisons fish and shellfish.Unlike infectious diarrhea, if the above will not be poisoning ITS (infectious-toxic syndrome) - no temperature, no symptoms of intoxication.

enterocolitis or colitis syndrome (blood in the faeces) occurs when NYaKe (ulcerative colitis), colon tumors, Crohn's disease, diverticular disease, and others.Each of these states have other specific symptoms that characterize the disease.In particular, in Crohn's disease is a chronic diarrhea, prolonged, cramping abdominal pain, weight loss, anemia.At UC - a long low-grade fever, prolonged diarrhea with blood, weight loss, pain in the lower left abdomen, and others.

Most often the practitioner acute intestinal infection should be differentiated from mushroom poisoning, ulcerative colitis, acute appendicitis, colon cancer, thrombosis of the mesenteric vessels, acute intestinal obstruction.

With significant abdominal pain, especially in children, the first step should be a visit to the doctor surgeon ambulance to avoid surgical pathology.

no secret that the appearance of frequent watery stools for most people - not a reason for seeking medical attention.Most of trying different medications and methods to stop diarrhea and to restore the disturbed state of health.At the same time, a simple (as it seems at first glance) intestinal infection can turn into a serious problem with long-term disability.

symptoms, which should see a doctor immediately:

1) early childhood (up to 3 years) and preschool age child;
2) the elderly (over 65 years);
3) loose stools for more than 5 times a day in an adult;
4) repeated vomiting;
5) high fever with diarrhea and vomiting;
6) blood in the stool;
7) cramping abdominal pain of any localization;
8) marked weakness, and thirst;
9) presence of chronic concomitant diseases.

What can not be categorically do with suspected acute intestinal infection:

If there was loose stools, accompanied by abdominal pain and fever, then:

1) Do not use pain relievers.In the case of hidden symptoms of a surgical pathology (cholecystitis, appendicitis, bowel obstruction, etc.) the removal of pain syndrome can complicate diagnosis and defer providing timely specialized care.
2) can not be used on their own fixing means (binders) - such as loperamide or immodium, Lopedium and others.In acute intestinal infection pathogens bulk of concentrated toxins in the intestine, and the use of these drugs contributes to their accumulation, which will exacerbate the patient's condition.The flow of intestinal infection is favorable with timely intestinal emptying the contents together with the toxins of pathogens.
3) Do not make yourself an enema, especially with hot water.
4) Do not apply heat tracing procedures on the stomach (water bottle with hot water, for example), which certainly enhances the inflammatory process, which will exacerbate the patient's condition.
5) If you have symptoms of acute intestinal infections and suspected surgical pathology can not procrastinate and try to treat improvised means (folk, homeopathic, etc).The consequences of delay in seeking medical help can be very sad.

Laboratory diagnosis of acute intestinal infection

preliminary diagnosis exhibited after the clinical and epidemiological survey, which includes contact with patients, possible cases of intestinal infection among the inner circle, eating low-quality products, products without water treatment and heat treatment,failure to observe rules of personal hygiene, as well as the symptoms of the disease (onset of disease, the main symptoms are typical for a particular infection).

Already at this stage may infallible definition of the diagnosis (for example, when the flare nature of the disease and the presence of such patients in the infectious diseases clinic in the presence of specific symptoms - blood in the stool, false desires on a chair, the temperature in dysentery, for example, a rich watery stools without odorand impurities without temperature - cholera), whereby in some cases, after collection of materials for laboratory study has assigned to the specific treatment step prior diagnosis.

experienced doctor in the presence of obvious symptoms may suspect some intestinal infection and prescribe appropriate treatment.Enterosorption used for acute and chronic poisoning in children and adults.An example of a modern, efficient enterosorbent for first aid at various poisoning is Enterosgel.

infectious disease doctor Bykov NI