2023 Author: Philip Bishop | [email protected]. Last modified: 2023-08-25 07:54
Dysentery in children and adults
Dysentery is an intestinal infection that can be caused by amoebae or shigella, therefore it is classified as shigellosis and amebiasis. Shigella were first discovered by the Japanese Kiyoshi Shiga, and amoeba, as causative agents of dysentery, by the Russian scientist Lesh F. A.
Amoebiasis is rare in Russia, to a greater extent this disease is common in countries with hot climates, for example, in India or Mexico. Dysentery has characteristic symptoms. It is important to know and be able to distinguish them from other manifestations of intestinal infections. This will allow you to start treatment on time.
The disease is manifested by vomiting, symptoms of general intoxication of the body, nausea, belching, heartburn, diarrhea, abdominal pain, etc. More details about the manifestations of dysentery will be discussed later.
You need to understand that it will not be possible to make a correct diagnosis only on the basis of the symptoms of the disease. You will need to conduct an examination, donate feces for bacterial culture, and blood for serological tests.
- Causes of dysentery in adults and children
- Dysentery symptoms
- Symptoms of dysentery in children
- How to distinguish dysentery from other intestinal disorders?
- Dysentery treatment
Causes of dysentery in adults and children
Dysentery is spread by people who suffer from an acute or chronic form of infection. Also, its distributors are bacteria carriers.
- A person suffering from an acute form of dysentery will be very contagious, especially in the first days after the first symptoms appear. The acute course of the disease can persist for 3 months. At this time, a person continues to release pathogenic flora into the environment.
- If the patient suffers from a chronic form of the disease, then he will release shigella during the stage of exacerbation of the pathology. The duration of its course can be 3 months.
- People who are carriers of the infection can shed bacteria over time. In this case, the symptoms of the disease will be blurred, or may be absent altogether.
Infection with dysentery occurs with inaccuracies in hygiene, as well as due to the consumption of food that is seeded with pathogenic flora.
The infection is transmitted by the fecal-oral route. It is implemented in the following ways:
- On water. This is how Flexner's dysentery spreads.
- Alimentary way. Most often, this method spreads dysentery to the Zone.
- Contact-household way. In this way, Grigoriev-Shiga dysentery spreads.
If a person does not follow the rules of personal hygiene and uses household items on which there are infectious agents, then he will certainly become infected.
Flies are the spread of the disease. Bacteria can live on food (in this regard, dairy products are especially dangerous), on fruits and vegetables, on dirty hands, on any household items used by a sick person.
People are extremely susceptible to dysentery pathogens. In this regard, their age and gender do not matter. However, it is predominantly young children who suffer from the disease. This is due to their low level of personal hygiene skills. The likelihood of infection increases in people who suffer from acute and chronic pathologies of the gastrointestinal tract, as well as from intestinal dysbiosis.
Outbreaks of dysentery are recorded mainly in people during the warm season: in summer and autumn. During these periods, the conditions for the reproduction of pathogenic flora are especially favorable.
After a person gets sick with dysentery, he develops immunity. However, it persists for a year, and will also be active exclusively against one type of pathogen, and there are many of them.
The microflora, which can cause the development of dysentery, can remain active for 45 days. When germs enter dairy and certain other foods, they will multiply.
The first symptoms of the disease appear after the microbes reach the intestines and begin to divide there, releasing toxic substances. These toxins enter the bloodstream and poison the human body. They negatively affect the state of the liver, intestines, blood vessels, central nervous system. When the small intestine is affected, deep ulcerative defects form on it.
From the moment of infection until the first symptoms of the disease appear, it can take from several hours to several days. The average incubation period is 2-3 days.
The symptoms of dysentery are the following:
- Acute onset, accompanied by intoxication of the body. The patient's body temperature rises, his head begins to hurt. The person is nauseous, the appetite is completely lost, blood pressure may decrease.
- The belly hurts in the navel area. At first, the pain is weak and diffuse, but as the pathogenic flora multiplies, it takes on the character of contractions. The pain extends to the lower abdomen, to the pubis. The left side hurts more. When the intestines are full, the pain increases.
- The appearance of a false urge to empty the intestines. At the same time, going to the toilet does not end with an act of defecation. Pain in the rectum may appear. They are able to disturb a person for a few more minutes after emptying. At the same time, the pain is pulling, radiating to the region of the sacrum.
- The chair becomes more frequent. It occurs more than 10 times a day. Blood streaks and mucus can be found in the stool.
In 20% of cases, the disease proceeds according to the gastroenteric type. At the same time, an increase in body temperature and disorders in the work of the digestive system occur simultaneously. The stool immediately becomes liquid. Starting from the 2nd day of illness, a person develops symptoms of colitis. Since the diarrhea is intense and often accompanied by vomiting, the patient's symptoms of dehydration increase. He becomes lethargic, apathetic. Blood pressure decreases, the skin and mucous membranes dry out. The amount of urine decreases.
The disease can have a different course. Sometimes dysentery is easily tolerated and a person has only weakness and malaise. In other cases, the pathology requires hospitalization of the patient, as it is accompanied by the development of fever, pallor of the skin, incessant vomiting and disturbances in the functioning of the nervous system.
If the disease becomes chronic, then the intoxication of the body is not observed. However, diarrhea develops, and the stool is green. Against the background of chronic instability of the stool, a person develops dysbiosis. If the patient receives timely and correct therapy, then the disease does not become chronic. This only happens when there is no medical attention.
Symptoms of dysentery in children
Unlike adults, children have a slightly different course of dysentery. The child has a general intoxication of the body, the stomach begins to ache, but diarrhea does not develop. Feces are excreted in small quantities, while blood and mucus are always visible in them. The child's health worsens, the body temperature rises, and the head begins to hurt. The child refuses to eat. Colitis syndrome with blood in the stool occurs in 90% of children with dysentery. However, its manifestations do not always have an acute course.
When the first day of illness has passed, the character of the stool changes. During bowel emptying, not feces can be excreted, but mucous greenish masses. They may show blood.
If adults have a false urge to empty the intestines, then the child has a relaxation of the anus, increased anxiety and crying. In children under 3 years of age, the belly is swollen. In older toddlers, on the contrary, he is drawn into.
The toxic form of the disease in infants does not often develop. Symptoms of intoxication in infants are mild, since their immunity does not respond to toxins released by microbes. To a greater extent, dysentery for infants is dangerous due to dehydration of the body. With loose stools and vomiting, babies lose significant amounts of fluid. Moreover, dehydration develops very quickly.
Watery stools and vomiting lead to weight loss as metabolic processes are disrupted in the body. This, in turn, threatens problems in the functioning of the cardiovascular system, intestinal paresis and other serious health consequences.
Symptoms of staphylococcal dysentery in combination with salmonella infection will manifest such symptoms as:
- Severe intoxication of the body.
- Incessant vomiting.
- Bloating and offensive stools.
In a severe course of the disease, dysentery can be accompanied by seizures, fainting, cyanosis of the skin, meningitis, tachycardia, arrhythmia, a drop in blood pressure, muffled heart sounds, etc.
How to distinguish dysentery from other intestinal disorders?
Dysentery can resemble other bowel diseases, so it is important to know the main differences:
Salmonellosis and food poisoning. The disease begins with frequent vomiting, which is repeated several times. The pain is concentrated in the epigastric region. Cramps on the left side of the abdomen do not occur, since the large intestine is not affected by food poisoning. Tenesmus is also absent. When a patient develops salmonellosis, the feces acquire a greenish tint, resembling the appearance of swamp mud.
- Amoebiasis. With amebiasis, the disease does not have such pronounced symptoms as with dysentery. Body temperature may rise, but not significantly. Blood and mucus in the stool will be present, in appearance they resemble raspberry jelly. When analyzed, a huge number of amoebas can be found in the secretions.
- Cholera. The first symptoms of cholera are: diarrhea, profuse vomiting, a slight increase in body temperature, tenesmus. The feces are liquid, resembling rice water in appearance. The symptoms of dehydration develop quickly, which makes the disease worse.
- Typhoid fever. With this disease, spastic colitis develops, the body temperature rises to significant levels, it persists for a long time. A roseola-type rash appears on the skin.
Colitis. The disease has a non-infectious nature. It occurs against the background of intoxication of the body with chemistry. In addition, colitis can be a companion of gastritis, cholecystitis, uremia, and diseases of the small intestine. The exacerbation of colitis does not depend on the time of year, the disease is not contagious, does not lead to pronounced changes in the organs of the digestive system.
- Hemorrhoids. In a patient, blood is released from the anus, but the large intestine does not become inflamed. Blood appears only at the end of the act of defecation.
- Rectal cancer. Symptoms of intoxication of the body occur only during the disintegration of the tumor. In the same period, blood appears, diarrhea develops. Oncopathologies do not have an acute course, they give metastases to other organs and lymph nodes.
If the disease develops in a child under 3 years old, then he is admitted to a hospital. Adult patients can be left on outpatient treatment if they feel comfortable enough to do so.
- Furazolidone is the drug of choice in the treatment of mild dysentery. If the disease takes on a complex form, then it is possible to cope with it with broad-spectrum antibiotics: fluoroquinolones, cephalosporins, aminoglycosides.
- From the first day of illness, you need to take drugs to prevent the development of dehydration: Regidron, Oralit, Glucosolan. One sachet of the selected medicine is diluted in a liter of water and offered to the child every 5 minutes, 1 teaspoon. The daily dose is calculated according to the formula 110 ml x 1 kg of weight.
- Eubiotics, allowing to prevent the development of intestinal dysbiosis. You need to take them for at least 3 weeks. It can be drugs such as: Bifidumbacterin, Bifiform, Linex, Rioflora Immuno.
- The doctor can prescribe to the patient drugs to increase immunity, vitamins, antispasmodics, etc.
- When the acute phase of dysentery is arrested, it will be necessary to use drugs that accelerate the regeneration of the mucous membranes. They make microclysters with them. It can be rosehip oil, sea buckthorn oil, Vinilin and chamomile.
- Medicines such as Smecta, Polysorb, Polyphepan, Filtrum STI, etc., help to remove harmful substances from the body.
- To improve the processes of food digestion, Festal, Creon, Mezim, Pancreatin are used.
- If the disease becomes chronic, the patient should be sent for physiotherapy. He is shown taking eubiotics, staging microclysters.
Diet is required during treatment. The patient is offered slimy soups, rice broth, mashed potatoes, unsalted boiled porridge. If the child refuses to eat, you cannot force him to eat. It is important to ensure that he drinks water. You can also offer him sugar-free tea, milk whey. It is forbidden to eat baked goods, meat dishes, coffee, semi-finished products, sausages, smoked meats, cheeses, etc. From the 5th day from the onset of the illness, it is allowed to eat kefir, meatballs, omelet, boiled fish.
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
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