Sharp diarrhea – the polietiologichesky syndrome accompanying a current of a number of infectious and noninfectious diseases, which is characterized by a frequent liquid chair. At sharp diarrhea the chair becomes plentiful, watery or kashitseobrazny, it can contain impurity of undigested food, slime; its frequency makes more than three times a day. For definition of the reasons of diarrhea collecting complaints and the anamnesis, the general blood test and a calla, excrements, and also tool researches carry out: kolonoskopiya and irrigoskopiya. Treatment provides a dietotherapy, purpose of antibacterial medicines, anti-diarrheal means, eubiotik, and also performing rehydration therapy.
Sharp diarrhea is a pathological syndrome which is clinically shown by not properly executed or liquid chair more than 3 times a day; at the same time the ease of a chair remains no more than three weeks. If diarrhea proceeds longer than 21 days, speak about its chronic current. Most often diarrhea is caused by bacterial, virus and parasitic factors. Every year in the world more than 2 billion new cases of the diseases (in Russia – about 500) which are followed by sharp diarrhea are registered. Thus, this very widespread manifestation of various pathological processes in gastroenterology, a proktologiya and an infektologiya. At the same time, sharp diarrhea is generally characterized by a favorable current at which lethal outcomes are practically not observed. If diarrhea was caused by sharp intestinal infection, then treatment of such patients has to be carried out in the conditions of an infectious hospital.
Reasons of sharp diarrhea
Sharp diarrhea can develop under the influence of a set of etiofaktor against the background of various pathological processes. Infectious agents, effect of toxins, reception of medicines, ischemic or inflammatory pathology of intestines, and also sharp diseases of bodies of a small pelvis are the main reasons for this state. In the developed countries sharp diarrhea most often arises against the background of a viral infection which causative agents are rotaviruses and adenoviruses. Besides viruses, strains of various bacteria which produce enterotoksina, for example, of a salmonella, colibacillus, a shigella, a kampilobakter and so on can provoke development of a syndrome. In certain cases the elementary microorganisms (lyambliya, blastocysts and others) and intestinal helminths (activators of a strongiloidoz, shistosomoz and angiostrongilez) are the reason of diarrhea.
Sharp diarrhea can develop against the background of reception of various medicines, being side effect of their action on an organism. Emergence of diarrhea can be connected with treatment by antibiotics, magniysoderzhashchy means, antiserotoninovy medicines, digitalisy, anticoagulants and henodezoksikholevy acid. Besides, sharp diarrhea arises at overdose and misuse of depletive, at the same time frustration of a chair can develop both right after reception of a certain medicine, and at increase in its dosage.
Separate form is diarrhea of travelers which is observed at people when moving from regions with high sanitary level to the countries with the low level of sanitation. In this case the enteropatogenny strain of colibacillus is the reason of a diarrheal syndrome. Also sharp diarrhea can develop at patients with AIDS or other forms of immunodeficiencies. Depending on pathogenesis mechanisms, allocate sekretorny, osmolyarny and ekssudativny, hyperkinetic and hypokinetic forms of sharp diarrhea.
Symptoms of sharp diarrhea
Clinical displays of sharp diarrhea depend on prevalence of this or that form of intestinal frustration. At a sekretorny form pathological process is followed by a painless plentiful liquid chair which volume exceeds 1 l a day. This symptomatology is caused by the increased secretion of water and electrolytes in intestines against the background of influence on mucous pathogenic toxins. Displays of sekretorny diarrhea do not depend on character of food and therefore do not pass against the background of starvation.
The Osmolyarny form of sharp diarrhea is shown by increase in total a calla that is caused by existence in intestines of osmotically active components which break absorption of liquid and electrolytes therefore the chair contains the large volume of the undigested remains of food. Osmolyarny diarrhea is observed at reception of laxative medicines or at a maldigestiya. Respectively, symptoms of this form of sharp diarrhea often pass after cancellation of poslablyayushchy means or against the background of starvation.
The Ekssudativny form of sharp diarrhea is characterized by a liquid chair in which a large number of bloody and purulent allocations is noted. Symptoms are a consequence of the increased receipt in intestines of minerals and water in the form of inflammatory exudate that can be observed at pathology of a mucous membrane of a thick gut or increase in pressure in lymphatic vessels of an abdominal cavity. This form of sharp diarrhea is noted at nonspecific ulcer colitis, a divertikulita, dysentery, a disease Krone and so on.
The hyperkinetic form is caused by nevrogenny and hormonal factors. The main symptom of hyperkinetic sharp diarrhea is the frequent chair of liquid or kashitseobrazny character. At this form daily quantity the calla does not exceed 300 g. As a rule, these symptoms are observed at a syndrome of irritation of intestines.
The hypokinetic form of diarrhea is observed at a syndrome of a blind gut or a sklerodermiya when transit of intestinal contents is broken. Excess bacterial growth against the background of which malabsorption of fats and the increased formation of slime in intestines progresses is as a result noted. A symptom of hypokinetic sharp diarrhea is the liquid fetid chair with availability of undigested fats.
Sharp diarrhea often is followed by the general nonspecific intestinal symptoms, such as belly-ache, temperature increase of a body, nausea and vomiting. Also at a frequent plentiful chair dehydration symptoms in the form of dryness of skin, a lowering of arterial pressure and tachycardia can be observed. Besides, in Calais there can be impurity characteristic of defeat of a certain department of intestines. For example, the sharp diarrhea caused by defeat of a small intestine is followed by existence in Calais of the undigested remains of food. The chair at the same time often has a greenish shade and exudes an unpleasant smell. At development of pathological process in a large intestine bloody allocations and the increased amount of slime can be noted.
Diagnosis of sharp diarrhea
Important factor which allows to define the nature of diarrhea is full collecting complaints and the anamnesis. At the same time it is important to find out the frequency and a consistence of a chair, availability in Calais of various impurity or blood from the patient. Point out such symptoms as abdominal pain, vomiting, dryness of skin and high temperature weight of pathological process. These clinical manifestations demand from the proctologist or the infectiologist of bystry purpose of the corresponding therapy. At a conversation with the patient the doctor specifies what medicines he accepted recently as this factor can also lead to development of sharp diarrhea. Diagnostic criterion of sharp diarrhea is emergence of a liquid chair more than 3 times a day no more than three weeks.
For diagnosis of sharp diarrhea laboratory methods, such as the general blood test and a calla are used. These researches allow to confirm inflammatory genesis of process. In particular, the koprogramma defines concentration of leukocytes and erythrocytes that gives the chance to differentiate inflammatory and not inflammatory diarrhea. In the absence of inflammation signs a calla do not carry out. In case of detection of a large number of leukocytes and erythrocytes in a chair the microbiological research of kalovy masses is obligatory. This method allows to reveal pathogenic bacteria which became the reason of development of sharp diarrhea. However in some cases a microbiological research the calla does not yield result as diarrhea is caused by other factors.
From tool methods for establishment of the reason of sharp diarrhea the kolonoskopiya is used. This research gives the chance to reveal inflammatory changes of a mucous gut, and also existence of ulcers and erosion of a wall of intestines. Endoscopy of intestines allows to diagnose colitis, a disease Krone, divertikulit also other diseases which could become the reason of sharp diarrhea. An informative tool method of a research is the contrast X-ray analysis of intestines (irrigoskopiya). This technique gives the chance to determine passage speed by intestines and to suspect inflammatory changes of mucous.
Treatment of sharp diarrhea
Irrespective of the reason which caused sharp diarrhea, all patient appoints a special diet, eubiotik, and also the knitting and adsorbing means. The diet at diarrhea is used for decrease in motility of intestines and reduction of secretion of liquid in a gut gleam. It is very important to exclude products which can lead to irritation and injury of a mucous membrane.
At the expressed loss of liquid and electrolytes with a stake rehydration therapy is carried out. At easy degree of dehydration oral therapy - special saliferous solutions is appointed. At severe forms of diarrhea considerable loss of liquid and electrolytes is observed. In such cases the parenteral regidratation which provides intravenous administration of the balanced salt solutions is used. Antibacterial medicines are appointed only when the syndrome of diarrhea is caused by pathogenic bacteria. At the same time duration of a course of antibiotic treatment can vary from several days to one month.
In treatment of sharp diarrhea an important role is played by the means braking motility of intestines. They reduce secretion of liquid in a gut gleam, thereby slowing down reductions of smooth muscles. Effective anti-diarrheal medicine is loperamide, however it is not recommended to appoint it at inflammatory genesis of diarrhea. Use of eubiotik for restoration of normal intestinal flora is also obligatory.
For prevention of sharp diarrhea it is necessary to follow rules of personal hygiene and to competently store foodstuff. Besides, meat, fish and eggs need to be subjected to careful heat treatment. At timely complex treatment the forecast at this pathological state favorable.