Intestinal infection is a fairly large group of acute intestinal infectious pathologies that differentiate with each other as an agent, but has similar properties, represented by a certain symptomatology. Intestinal group infections in almost all episodes of infection is accompanied by a sharp temperature jump and the development of a characteristic intestinal syndrome, which can often become the basis for severe dehydration, especially in children.
The transmission of intestinal infections is directly related to the alimentary route of infection (through the mouth), which can become possible not only when the most basic rules of hygiene are not observed directly, but also when food products are exposed to infection by pathogens. Gastrointestinal infections belong to extremely common pathologies, which are often detected not only among the child population, but also among adult patients. Often, antibiotics for intestinal infections are the main component in its treatment. After recovery for an extremely short period of time, the formation of a type-specific immune response is established, however, it is extremely short-lived and unstable.
Pathogens of intestinal infections
The intestinal group of infections is quite large and diverse in its etiology, that is, depending on the source of the disease. The following types of intestinal infections are distinguished:
- Viral agents such as enteroviruses, adenoviruses, rotaviruses, reoviruses, viruses belonging to the Norfolk group and coronoviruses act as a source of the development of the disease.
- Various bacterial agents act as a source of the disease, which causes the development of infectious pathologies such as yersiniosis (yersinia), dysentery (shigella), salmonella (salmonella), escherichiosis (coliculus escherichia ), pseudomonas aeruginosa, campylobacteriosis (Campylobacter), protheus, clostridia, cholera (cholera vibrio), klebsiella, botulism (botulinum toxin), staphylococcus and many others.
- Type of intestinal infection, in which the main pathogen are fungi (most often the genus Candide).
It should be noted that such a dangerous infectious disease, like botulism, is most often referred to as a type of food-borne disease along with staphylococcal toxin. And diseases caused by protozoa and fungal agents are also somewhat separated from the total mass of pathogens, however, they all form part of a large group called species of intestinal infections.
Thus, the etiology of intestinal infections is represented by viruses and bacteria, and protozoa, and fungi, which makes this pathology quite diverse, primarily in terms of clinical symptoms.
All of the above bacteria and viruses can affect a person of any age, sex and race. Nevertheless, despite the presence of a characteristic clinical picture for each disease under certain conditions, for example, a sufficiently powerful immune defense of the organism of the infected, the infection can be erased or with a mildly expressed response in the form of manifested symptoms.
Causes of intestinal infections
In the human intestine, there is a huge number of all kinds of microorganisms that can coexist for a long time together. All this microflora is usually divided into optional and obligate. Obligatnaya flora is considered mandatory for normal functioning of the intestine and is represented by lactobacilli, bifidobacteria, peptococci, E. coli, fusobacteria and many others. Its percentage in the body reaches about 97%. The remaining approximately 3% belongs to the facultative flora, that is, to those microorganisms that are able to participate in the digestive processes in a healthy organism, but even with a slight deviation in its functioning they are able to suppress the obligate flora, to start actively multiplying and becoming pathogenic for humans. The optional flora is represented by fungi, staphylococci, proteus, klebsiella and other conditionally pathogenic organisms. As a result of the development of the symptoms suitable for their active reproduction, the intestinal syndrome may develop.
But, in addition, in the human body there are enough protective mechanisms directed against foreign bacterial and viral agents that can cause the development of intestinal infection. So, in the human saliva there is a special substance called lysozyme, which has an important bacteriostatic effect with respect to foreign agents. Hydrochloric acid produced by cells of the gastric mucosa is also able to resist and neutralize harmful microorganisms. The mucous membrane of the human intestine produces a special secretory immunoglobulin of class A, which actively takes part in protecting the body, forming its immunity.
However, even in spite of these numerous protective mechanisms, sometimes a person is unable to resist the development of intestinal infection, since there are a significant number of predisposing factors to it, such as advanced age, weakened immunity, diseases of the stomach, intestines, violation of personal hygiene or their non-compliance , children on artificial feeding, poor heat treatment of food, hot season and a lot of other reasons.
Whatever the types of intestinal infections, but their source is a sick person with an erased form of the disease or a pronounced disease, as well as a direct carrier. It should be noted that the danger of intestinal infection is that an infected adult or child will remain dangerous to others throughout the period of formation, manifestations of pathological symptoms, and in case of infection with viral agents even within 14 days after recovery. Infectious agents enter the environment with excrement, vomiting.
Transmission of intestinal infections is carried out through an alimentary pathway of infection, and the ways of infection of humans are fecal-oral, air-drip and household. As the transmission factors are mainly various food products, dishes, dirty hands, door handles, dirty toys, and also often swimming in open water. Extremely active dissemination among people of these infections contributes to the high resistance of bacteria and viruses in nature, the ability to tolerate low temperatures well. But still the main reason for this high morbidity is a violation in keeping the hands clean before meals, after walking, after going to the toilet, with direct care of the patient for this pathology, that is, failure to take important preventive measures to prevent infection.
Symptoms and signs of intestinal infection
Despite the fact that the etiology of intestinal infections is extremely diverse, the incubation period for these diseases is quite short and lasts from 6 hours to a maximum of 2 days. All gastrointestinal infections are accompanied by the formation of the following typical syndromes: intestinal and infectious-toxic. Depending on the type of pathogen, from the immune response of the body, they can manifest themselves in varying degrees of severity.
1. Infectious-toxic syndrome acts as almost always mandatory for infection by any type of infectious agent of this type, however, it can manifest itself in several ways. The main component of this syndrome is the temperature with intestinal infection, which can be subfebrile, that is, about 37 ° C or more, but also reach high figures, for example, 38-39 ° C. However, there are cases of several atypical currents of intestinal infection, when the temperature may not even rise, but this occurs infrequently. The temperature of intestinal infection in almost all episodes of the disease occurs together with a clinic of intoxication, such as the development of weakness, nausea, and sometimes chills. Almost always with an infectious-toxic syndrome, and the development of intestinal infection, sometimes it can last without manifestation of the intestinal syndrome up to 1 day, but, perhaps, even longer.
2. Intestinal syndrome is characterized by the appearance of such pathological conditions as colitis, enterocolitis, gastritis, gastroenteritis or gastroenterocolitis. The etiology of intestinal infections is directly related to the manifestations of intestinal syndrome: in the case of dysentery, symptomatology of enterocolitis usually occurs, in food poisoning, gastritis and gastroenteritis, and in case of salmonellosis there is a picture of gastroenterocolitis and gastroenteritis. Let's consider all the manifestations in more detail:
- The basis of enteritis syndrome is symptomatology associated only with a violation of the stool, which may vary depending on the type of causative agent of intestinal infection and the severity of the course of the disease.
- The manifestation of the disease with gastritis syndrome is represented by the development of epigastric pains, accompanied by nausea, often vomiting. Vomiting is most often characterized by short-term relief.
- At the heart of the syndrome of colitis are developing pains in the lower abdomen, persistent pain during defecation, the presence of blood, mucus in the stool, and lack of relief after the act of defecation.
- The syndrome of gastroenteritis, as a rule, combines the symptoms of gastritis and enteritis with typical abdominal pains, accompanied by nausea, vomiting, the development of frequent loose stools of different colors, which directly depends on the type of infectious agent.
- Entericolitic syndrome is represented by pains in the region of the entire abdomen and with a thin rapid stool.
- Gastroenterocolitis is represented by a clinic of a loose stool, vomiting with diffuse pain in the abdomen. It is often enough when the act of defecation is observed mucus and blood.
It should be noted that children always tolerate any infection with an intestinal infection quite hard and much more difficult than adults. They have a sufficiently high risk of dehydration, always a more severe course of infection, which can even cause lethality. The first signs of dehydration of the body should be familiar to each adult, so that in case of a child's illness, it is time to seek qualified medical care. Dehydration of the body can develop as a result of intense fluid loss during vomiting, liquid stool. It is accompanied by a decrease in body weight, constant thirst, dryness of the mucous membranes, a decrease in blood pressure, a rapid pulse , a decrease in the skin turgor. It is rare that dehydration shock develops in the development of severe dehydration of the body and disruption of the cardiovascular system. Sufficiently serious conditions, such as acute renal failure, pneumonia, infectious-toxic shock , any intestinal group of infections can become complicated.
Diagnosis and analysis of intestinal infections
Even with direct communication with the patient, carrying out an examination, clarifying the complaints, one can assume that there is an infectious agent belonging to the group of intestinal infections. It is also important to clarify the presence of any similar symptoms in someone from the patient's inner circle, information about eating foods that are poorly processed, not washed, and not properly heat treated. However, it is quite difficult to determine which pathogen is the cause of the developed pathology, and as a result, quite often the final diagnosis can be made only after obtaining laboratory data. The main tests for intestinal infections include:
- Conducting an express test for possible infection with rotavirus infection , which consists in examining the patient's stool. This method is convenient for a quick enough result - within 10 minutes.
- Bacteriological method of investigation, which is based on the use of sowing the obtained feces, the gastric washings of the patient, vomit to specific nutrient media in balloons and the subsequent production of colonies of microorganisms of a pathogenic species. You can talk about the expected result already on day 3 after sowing, but still the final result can be obtained only after 5 days.
- The method of Polymerase Chain Reaction in the fluids of a biological nature is fairly fast, with the result obtained on the day of the study.
- Serological diagnostic methods are successfully used, such as enzyme immunoassay, indirect haemagglutination reaction, hemagglutination reaction. For them, blood is taken from the infected, however, this should be done not on the very first day of infection, but a little later, as the techniques are based on the possibility of obtaining data on antibody titers formed in the blood against various pathogens of intestinal infections. It is advisable to conduct a diagnostic diagnostic fence after 10 days.
- With the use of instrumental diagnostic methods such as irrigoscopy, colonoscopy, sigmoidoscopy, it is possible to obtain only data on existing changes in the intestine of the patient, which are also different for different types of infections.
Quite often the defining moment in the presentation of a presumptive diagnosis is information from the patient about the nature of the stool. Thus, in dysentery, stools are usually observed with impurities of blood, mucus, in salmonellosis - stools of the type of marsh type, that is, green, cholera characterized by a watery stool, with rotavirus infection a foamy liquid stool of brown color with an unpleasant odor. This information can only be a hint in diagnosing a doctor, since it is fundamentally wrong to be guided only by the nature of the chair when diagnosed.
The main diagnostic signs of possible infection with intestinal infection include complaints about a loose stool, as a rule, frequent, frequent changes in its color, fever with predominance of symptoms of intoxication, abdominal pain, vomiting and nausea, and the fact of the presence of the same or similar complaints in contact persons and the fact about the possible use of poor quality food.
It is very important to diagnose intestinal infection in time and choose the appropriate treatment tactics, as well as to be able to conduct differential diagnosis with other pathologies similar in the clinic. A very important point is the obligatory consultation of the surgeon in case of doubt in the diagnosis, especially if there are abdominal pains. Differential diagnosis of intestinal infection most often needs to be carried out with poisoning fungi, Crohn's disease , all kinds of tumors that can affect the human intestine, with ulcerative colitis, acute appendicitis and other pathologies.
Treatment of intestinal infection
An extremely important stage in the treatment of acute intestinal infections is the correct and timely organization of the treatment-protective regime in relation to the infected person. In the case of infection with mild severity, the inability to isolate the patient for the period of the disease, it is possible to conduct therapy at home.
When children under the age of three are ill, in case of severe type of infection, adults are recommended to have mandatory hospitalization with referral only to the infectious department. Children who live in orphanages, as well as adults and children from small villages, hostels are necessarily sent to the hospital. It is necessary to observe bed rest especially for the period of active symptoms. It is very important to follow a diet or diet number 4 , based on sparing foods recommended for the period of development of diseases with pathologies of the gastrointestinal tract. It is necessary to exclude all sharp, fried and fatty foods, canned food, alcohol, it is also recommended to limit any dairy products. It is recommended to switch to a general table very slowly, since the intestine needs to be restored and reconstructed.
The very first and important point in the treatment of any intestinal infection is the maximum recovery of fluid loss that occurs when vomiting, loose stools, high temperature. These changes are based on the process of rehydration of the body, which is aimed at eliminating the emerging symptoms and complete replenishment of fluid losses. With a severe or moderate condition of the patient, this can be done by the method of detoxification therapy intravenously drip. Calculation of the required amount of fluid is carried out based on the following data: from 30 to 50 ml per kg of the total weight of the child or 30 ml per kg of adult weight. It is recommended to use for the oral rehydration Powder Regidron, which can be purchased in the pharmacy network. Breeding it should be strictly according to the recommended instructions and eat 1 tablespoon throughout the symptoms of vomiting and loose stools every 15 minutes. If a child or an adult is uncomfortable drinking Regiodron, then you can replace it with ordinary boiled water or mineral, but without gases. Intravenous-drip, as a rule, the solution of Enterodesis, Regidron is prescribed, this therapy with the use of drip administration can be carried out only in a hospital. You should always closely monitor the volume of the liquid being drunk, especially the baby, for the general well-being of the patient and take appropriate measures in case of worsening.
As symptomatic drugs it is recommended to appoint enterosorbents, which due to their action are able to remove toxins from the body of the patient. These include drugs such as Enterosgel, White or Black Coal, Polyphepanum. A good effect is possessed by drugs belonging to the group of probiotics, for example, Lineks, Hilak-Forte, Bifidumbacterin. In any disturbance of the digestive processes, especially those associated with intestinal infection, the use of Smecta also helps. It would be superfluous to prescribe enzymatic preparations, such as Mezim, Pancreatin, Creon. Antiemetic action, as well as a drug that normalizes the work of the intestine, have Metoclopromide, Molillium.
It is very important for the first symptomatology of any syndrome, characteristic of intestinal infection, to start using adsorbents and conducting rehydration therapy.
One of the important stages in the treatment of intestinal infection is the fastest possible establishment of the type of pathogen for the possible purpose of antibacterial drugs.
Antibiotics for intestinal infection, as a rule, are appointed from the group of fluoroquinolones, but it can be taken only upon the recommendation of an observing doctor, as they are known to affect only microorganisms of bacterial origin. Modern probiotics, such as, for example, Lineks, can be prescribed from the very first day of taking antibacterial drugs.
There are several important rules that must be strictly observed when suspected of intestinal infection:
1. It is not allowed to take painkillers, since later they can interfere with the correct diagnosis of the development of surgical pathology.
2. Do not use hot water bottles on the abdominal area.
3. Do not perform enemas.
4. Do not take antidiarrhoeal drugs without first consulting a doctor.
Very rarely, with intestinal infections, it is possible to observe a significant deterioration in the patient's condition with the formation of septic forms. But, nevertheless, in case of suspicion of infection with any intestinal infection, it is necessary to apply for medical advice to assess the state of the organism and to prescribe adequate treatment. Sometimes, with certain diseases belonging to this category of pathologies, even lifelong carriage may form, and at best a sufficiently long asymptomatic course.
The prognosis with timely diagnosis and conducting the correct therapy is almost always favorable.
Diet with intestinal infection
A very important stage for the fastest recovery of a patient is considered to be proper nutrition when infected with any kind of intestinal infection. And immediately it is important to note that you can not completely abandon all meals and arrange hungry days, as they can only worsen and further weaken the patient's body. The purpose of the diet for infecting intestinal infection is to reduce the burden on the intestine, to protect it as much as possible and to allow it to recover more quickly.
Highlights of the diet:
- The food you eat should only be boiled, steamed, if necessary, it should be ground, chopped, imparted a puree consistency;
- It is important that the food is easily digestible, non-caloric, varied;
- It is best to consume food in a warm form and divide it by 5-6 times.
For the duration of the disease it is forbidden to eat any berries, fruits, as well as juices from them, raw vegetables, pastries, sweets, as well as cabbage, beans, beets and cucumbers. Of the meat consumed, it is preferable to exclude its fatty varieties, such as pork, goose, duck, and also fatty fish.
It is necessary to exclude from the diet of whole milk, as it will only promote active intestinal peristalsis. It is allowed to take in food lactic acid products with a high content of bifidobacteria, lactobacilli. It is also not recommended to eat black bread, and replace it with white dried. With a gradual improvement in the body's condition, cessation of vomiting, you can gradually, but very carefully enter the meat in the form of steam cutlets, fish of low-fat varieties, omelet, croutons, porridges cooked only on the water, mucous soups, broths.
When recovering from an intestinal infection, it is recommended to actively lean in the food plan on potatoes, apples, carrots, as they contain in their composition a significant amount of pectin, which affects the process of recovery of the intestinal mucosa and promotes the elimination of toxins.
In the case of infants, it is recommended to remove all introduced lures and leave only breast milk or milk formula. In relation to the mixture, a certain change must also be applied: it is better to use lactose-free or low-lactose mixtures for the period of the disease. It should be noted that the one-time intake of food should be reduced. It is necessary to follow the rule of increasing the number of meals and reducing the volume. With the gradual recovery of the body's functions, it is recommended to increase the volume of food intake for one feeding, and also to return gradually to the usual diet. But still, for some time after recovery, you need to offer the child porridge, cooked half with milk and water, egg yolk, add butter to dishes.
Thus, it is possible to distinguish several main groups of products permitted for use in cases of intestinal infection:
- Porridges cooked on the water (with diarrhea, preference should be given to rice);
- Meat, steamed (better to choose chicken, turkey, veal);
- From vegetables it is allowed to take boiled potatoes, pumpkin, zucchini, and everything in a boiled form;
- White dried bread, crackers, crackers;
- Mucous broths, low-fat vegetable soups;
- It is obligatory to drink a lot of liquid: mineral water, but only without gas, usual, but necessarily boiled water, compote of dried apples, broth of wild rose, strong black tea.
Prevention of intestinal infection
There is no specific prophylaxis against at least some pathogen related to the intestinal infection group, presented as vaccines. Therefore, the main way to protect against infection is to comply with measures of nonspecific prevention, which include:
- Compliance with thorough hand hygiene after visiting all kinds of public places, immediately after returning from the street, always after the toilet;
- Always boil water taken from a tap before eating it, and boiling milk;
- Do not eat raw eggs and do not allow it to children;
- Always conduct a good heat treatment of any food, especially meat products;
- Always monitor the shelf life of purchased and consumed products and never take them for food at the end and especially not allow them to be given to small children;
- Compulsory thorough washing of any vegetables, fruits, even harvested from their garden, preferably using boiled hot water;
- It is important to store all perishable food in the refrigerator almost immediately after their purchase or preparation, especially in hot weather;
- Support for optimal sanitation in an apartment, house, with the obligatory maximum observance of cleanliness, ensuring hygiene of rest.
In case of occurrence of an episode of infection of one of the members of the family by any type of causative agent of intestinal infection, mandatory isolation of the infected into a separate room is recommended, with separate cutlery and utensils for it to be treated separately.
? Intestinal infections - which doctor will help ? At the slightest suspicion of the disease, any intestinal infection should immediately consult a doctor like an infectious disease specialist.