Sharp gastroenteritis – an acute inflammatory disease of a mucous membrane of a stomach and intestines of the virus, bacterial, alimentary or allergic nature. Carry nausea and vomiting, diarrhea, belly-aches, fever, change of a consistence and coloring to the main symptoms of a disease a calla, the phenomena of intoxication and dehydration. For statement of the correct diagnosis there is enough carrying out EGDS, laboratory tests (the general blood test, a koprogramm, bacteriological crops a calla). Treatment is conservative: diet, plentiful drink, enterosorbents, fermental medicines, if necessary dezintoksikatsionny and infusional therapy, antibiotics.
The sharp gastroenteritis is very widespread pathology affecting both children's, and adult population. The first mentions of a gastroenteritis of the infectious nature as to the reason of epidemic flash, treat the end of the 19th century. Further researches in the field of gastroenterology allowed to establish not only the infectious, but also alimentary and allergic nature of this disease. Today a gastroenteritis of the bacterial and virus nature continues to take the second place on prevalence after respiratory viral infections, and in the countries with low economic level often is a cause of death from dehydration and intoxication.
Incidence of a gastroenteritis of the allergic nature also gains steam in connection with universal change of habits of food, hobby for snacks and fast food, high prevalence of food allergy, especially among the children's population. It should be noted that among children of younger age about 5-8% have the food allergies which are shown damage of a stomach and small intestine.
Reasons of a sharp gastroenteritis
It is possible to refer infection with enterotropny viruses and bacteria, the alimentary reasons, food allergy to etiologichesky factors of a sharp gastroenteritis.
Can lead consumption of kontaminirovanny products, non-compliance with rules of hygiene and cooking, drink of not boiled water from unchecked sources to infection with intestinal infections and development of a sharp infectious gastroenteritis, infection with a contact and household way. The sharp gastroenteritis is caused by salmonellas, shigellas, campylobacters, a rotavirus, noravirusy and other activators. Improper feeding, the antibiotic treatment breaking normal intestinal microflora can act as a provocative factor. Microorganisms, breeding in a gleam of a stomach and small intestine, affect a mucous membrane and intensify secretion of liquid and electrolytes. Nausea, vomiting, diarrhea develops. Waste products of infectious agents get to a blood-groove and are carried on all organism, provoking the expressed intoxication and fever. The greatest value in development of a sharp gastroenteritis the rotavirus has today (causes about a half of all cases in summertime and to 90% of cases – in winter). Distinctive feature of a rotavirusny infection is simultaneous damage of a nasopharynx with the SARS phenomena.
Also the toksikoinfektion caused by consumption of low-quality products, which is especially combined with violations of a diet (the use of spicy, fried, extractive food) can lead to development of a sharp gastroenteritis. Hit in food of toxins is usually connected with the wrong storage and preparation of products because of what opportunistic flora begins to breed strenuously, allocating a large number entero-and cytotoxins. The specified toxins can have sufficient heat stability not to collapse at heat treatment. Getting into a GIT, they cause heavy injury of a mucous membrane of a stomach and intestines in several hours after the use of low-quality products. Fortunately, not all opportunistic microorganisms are capable to a toksinoobrazovaniye therefore not always the high bacterial obsemenennost of food leads to development of a sharp gastroenteritis.
Tendency to food allergy and frequent sharp allergic gastroenteritis is in the future formed still vnutriutrobno when at the child the immune system begins to ripen. The first months after the birth are critical for formation of the healthy immune response of digestive tract to receipt of various anti-genes with food. If during this period rules of feeding, introduction of feedings up are violated, cookings for the child – in the future at it the abnormal reaction to the use of some products which is shown development of a sharp gastroenteritis can be created. The allergy to cow's milk, eggs, fish, bean and cereal cultures is most widespread. Refer accommodation in ecologically adverse region to risk factors of a gastroenteritis of the allergic nature, family predisposition, existence of the accompanying allergic diseases, treatment of antibacterial medicines (not less than three courses within five years).
Symptoms of a sharp gastroenteritis
Usually the clinic of a sharp gastroenteritis develops quickly, within several hours or days from the moment of influence of an etiologichesky factor. The shortest incubatory period at a sharp gastroenteritis of the toxic and allergic nature, an infectious form of a disease can be developed within five days after contact with the sick person, the use of low-quality food or water.
Most often the nausea and vomiting (usually single, in hard cases – repeated and exhausting) which is followed by pains in an epigastriya and around a navel, swelling and abdominal murmur, appetite loss are the first signs of a sharp gastroenteritis. Diarrhea usually joins later. The chair repeated (to ten times a day), liquid, foamy, gets pathological coloring (bright yellow, greenish, orange, dark green), contains lumps of undigested food. Most often the kcal does not contain impurity of slime and blood.
For a sharp gastroenteritis of the allergic nature a patognomonichny sign is the beginning of a disease from sharp belly-aches, the vomiting giving relief. After vomiting the general state quickly enough improves. At a toxic etiology of a sharp gastroenteritis fever usually short-term, develops at the beginning of a disease. At a sharp gastroenteritis of the infectious nature temperature can increase in several hours from the beginning of vomiting and diarrhea and to keep within several days.
At emergence of the first symptoms of a sharp gastroenteritis it is necessary to address the gastroenterologist because in the absence of adequate treatment development of the expressed dehydration is possible: integuments and mucous membranes become dry, extremities cold; language is laid over by a raid; the skin fold finishes slowly. At survey bradycardia, arterial hypotension, weakness attracts attention, development of a collapse and spasms is possible.
Depending on the volume of clinical manifestations mark out three severity of a sharp gastroenteritis: easy (there is no temperature, vomiting and diarrhea arise not more often than three times a day, dehydration does not develop), moderate severity (fever is not above 38,5 °C, vomiting and diarrhea to ten times a day, symptoms of moderate dehydration), heavy (malignant fever, vomiting and diarrhea is more often than 15 times per day, signs of defeat of TsNS, the expressed dehydration).
Diagnostics of a sharp gastroenteritis
If at the patient the clinic of a sharp gastroenteritis develops, it is necessary to ask urgently for medical care for establishment of an etiology and severity of a disease, purpose of necessary treatment. All patients with the medium-weight and heavy course of a disease demand hospitalization. In a hospital for confirmation of the diagnosis consultation of the endoscopist, a number of laboratory researches is appointed.
When carrying out EGDS nonspecific inflammatory changes in a mucous membrane of a stomach and initial departments of a small intestine are visualized. Specific signs of a sharp enterokolit do not exist, however the endoscopic research will allow to exclude a disease Krone, nonspecific ulcer colitis at patients with allergic genesis of a disease.
The general blood test (also the shift of a formula is characteristic of a sharp gastroenteritis to the left), a koprogramm, a bacteriological research a calla with definition of sensitivity of the allocated microflora to antibiotics is without fail carried out. At suspicion on a toksikoinfektion allocation of a strain of activators at one patient does not allow to consider this microorganism an etiologichesky factor yet. Allocation of the same activator is required from all who used a low-quality product and have clinic of a sharp gastroenteritis.
In cases of heavy dehydration definition of indicators of red blood (level of a gematokrit, hemoglobin and erythrocytes increases against the background of a blood condensation), electrolytes (because of vomiting and diarrhea there is a bystry loss of potassium, chlorine that can lead to development of spasms), nitrogenous slags is surely carried out (the prerenalny sharp renal failure is shown by increase in level of urea and creatinine).
Treatment and prevention of a sharp gastroenteritis
Treatment of easy forms of a sharp gastroenteritis can be carried out on an outpatient basis. In this case to the patient the semi-bed rest, a strict diet with a mechanical and chemical shchazheniye, plentiful drink, enterosorbents and fermental medicines is appointed.
If the medium-weight or heavy current of a sharp gastroenteritis is diagnosed for the patient, treatment has to be carried out in the conditions of a hospital for prevention of critical dehydration or its adequate treatment. Except the listed above directions of treatment, use massive infusional therapy for completion of deficiency of liquid and electrolytes, removal of toxins from an organism. Also at a heavy current of a sharp gastroenteritis antibacterial medicines are usually appointed (empirically or taking into account bacteriological crops).
The forecast at a sharp gastroenteritis usually favorable. At development of heavy dehydration and lack of adequate medical care the disease can lead to a lethal outcome. Interruption of a course of antibacterial therapy at infectious genesis of a sharp gastroenteritis often leads to formation of a bakterionositelstvo and infection of people around.
Prevention of a sharp gastroenteritis consists in observance of all rules of personal hygiene, the principles of healthy food and safe cooking. It is necessary to watch closely expiration dates of perishable goods, not to buy privately the provisions which did not undergo the state quality control, not to drink water from doubtful reservoirs.