Causes, symptoms and treatment of acute intestinal infections. Intestinal infections: causes, diagnosis, treatment Symptoms and consequences of intestinal infection

Intestinal infections are a group of diseases that are united by a single route of transmission of the causative agent of the disease, as well as its localization in the body - the intestines.

The causative agents of intestinal infections can be outside the intestines for a long time. Getting outside with faeces, pathogenic bacteria remain in water or soil and, under certain conditions, penetrate into the body of a new "owner".

Infection usually occurs when eating unwashed vegetables, fruits, berries or poor-quality foods or water.

Since the main environment for the vital activity of pathogenic bacteria is the intestine, the first sign of such diseases is diarrhea, and therefore, WHO classifies all infections of this type as diarrheal diseases.

ICD-10 code

ICD-10 code

A00-A09 Intestinal infections

Statistics

According to the World Health Organization, intestinal infections cause the death of more than two million people worldwide every year, most of them children. Diseases of this group are widespread and in some countries infant mortality from intestinal infection is up to 70% of the total mortality of children under 5 years of age.

Epidemiology

As already mentioned, intestinal infections spread from sick or carriers of dangerous bacteria to healthy people. An infected person is dangerous from the onset of the disease, as the condition improves, the contagiousness also decreases, however, in some cases, a person can be dangerous for a long time.

In the course of research, it was proved that the release of pathogenic bacteria can remain even after recovery, which occurs due to pathological processes in the intestines. When a person stops spreading the infection can only be determined after a bacteriological study.

In the spread of infection, patients with erased forms are of great importance, since such people are not diagnosed and they continue to be in the team, spreading dangerous bacteria.

Also, small children who do not yet have basic hygiene skills and who suffer from erased forms of intestinal infections can easily infect the environment and objects.

To newborn children, the disease is often transmitted from the mother.

Carriers of pathogenic bacteria are quite rare, however, such people also contribute to the spread of infection.

Of all types of intestinal infections, salmonellosis can be distinguished, since animals also participate in its spread. Most often, the disease is transmitted from domestic animals (cows, dogs, cats, horses, etc.), as well as from rodents.

The main source of infection are birds, especially waterfowl. Salmonella bacteria are present not only in the organs, as in most animals, but also in the shell and contents of eggs. At the same time, birds remain carriers of dangerous bacteria longer, unlike animals.

Intestinal infection can occur both singly and in the form of epidemic outbreaks, while the disease can reach large-scale dimensions, for example, as in the case of cholera. In the summer-autumn period, a high level of most intestinal infections is observed, in the winter period, the level of viral diarrhea increases.

Causes of an intestinal infection

Intestinal infections begin to develop when a pathogen enters the body (intestine). As already mentioned, the causative agent of infection can enter the body when drinking contaminated water (from the tap, spring, etc.), as well as with unwashed vegetables, fruits, etc.

Pathogenic microorganisms outside the body actively multiply, especially in warm and humid conditions. Foods that are stored outside the refrigerator, especially meat and sour-milk products, are of great danger in this regard.

In the summer, intestinal diseases pose a great danger, because in the heat, food deteriorates faster, especially meat and fish, and various insects can also carry the infection from infected feces. Incubation period of intestinal infection

The incubation period is the period from the moment pathogenic microorganisms enter the intestine until the first symptoms of the disease appear. In other words, this is the latent period of the disease, when the infection has already occurred, but there are no signs of the disease.

Gastrointestinal infections most often appear 12 to 36 hours after infection, in some cases the latent period can last up to 12 days.

There are three main ways of transmission of intestinal infections: through food, water and household contact.

Most often, an intestinal infection is transmitted through food contaminated with microorganisms or that have undergone insufficient thermal and hygienic treatment. The source of the disease can be both people and animals (large and small cattle, poultry, rodents, etc.). From the carrier, the infection can get into milk (dairy products), eggs, fruits, vegetables.

Transmission of the disease through water is slightly less common. Basically, infection occurs through the use of poor-quality water. Usually this happens as a result of a burst of water or sewer pipes.

With household contact, the infection can spread from the carrier through dirty hands or various objects (towels, toys).

Causative agents of intestinal infections are pathogenic bacteria that enter the environment with feces and contaminate food or water. There are also bacteria that are excreted in the urine or vomit, such as food poisoning bacteria or cholera.

The main source of infection is an infected person or a carrier of a pathogenic infection. A bacteriocarrier is called an almost healthy person, in whose body there are pathogenic microorganisms that are released into the external environment.

Usually carriers of the infection are people with weakened immune systems, who have had an intestinal infection, as well as with chronic diseases of the gastrointestinal tract or gallbladder.

Healthy people can also spread infections, in whose bodies pathogenic microbes have entered, but have taken root in it and do not harm their “owner”.

Faeces with pathogens can become a source of infection. Quite often, the disease spreads through dirty hands and objects - if the hands of a patient or carrier of an infection are contaminated with feces, then everything he touches becomes a source of infection. If a healthy person touches contaminated objects, then he can transfer pathogenic bacteria to food and become infected. Therefore, experts urge to wash hands as often as possible, especially after going to the toilet.

Intestinal infections can be spread through toys, handrails on public transport, basket handles in a supermarket, and so on.

Symptoms of an intestinal infection

Symptoms of intestinal infections depend on the type of pathogen, but there are common signs by which you can understand the cause of poor health: weakness, poor appetite, abdominal pain.

The action of pathogens in the intestine does not appear immediately; when bacteria or viruses enter the gastrointestinal tract, they undergo an “incubation period”, which can last from 10 to 50 hours.

The appearance of the first signs of the disease depends on the activity of pathogenic microflora in the body, on average, the first symptoms appear 12 hours after infection.

A slight malaise at the beginning is replaced by severe pain in the abdomen, vomiting, and frequent loose stools. In addition, the temperature rises, chills, increased sweating and other signs of fever appear, loss of consciousness is possible.

These symptoms indicate a strong intoxication of the body due to the vital activity of pathogenic bacteria, frequent vomiting and loose stools lead to dehydration of the body, which leads to irreversible consequences (impaired kidney function, changes in the cardiovascular system).

Intestinal infections in childhood and old age can be fatal.

intestinal infection syndrome manifests itself in the form of fever, weakness, pallor of the skin (with some infections against the background of high temperature), a decrease in pressure, in severe cases of the disease, coldness of the hands and feet is observed, in children under one year old, intoxication can cause neurological disorders.

In addition, diarrhea and vomiting that occur with intestinal infections can lead to dehydration.

Depending on the causative agent of the disease, intestinal infections can rise in temperature(37ºС and above).

Some infections occur without a rise in temperature (cholera) or with a slight short-term increase (staphylococcus aureus).

Diarrhea almost always accompanies intestinal infections. Once infected, diarrhea may take hours (for food poisoning) or days (for bacterial infection) to appear.

Some bacteria can be dangerous to human life, so when the first signs of an intestinal disease appear, you should immediately consult a doctor, especially if the stool is very watery or contains blood.

Acute intestinal infections represent a group of diseases that mainly affect the intestines. The cause of infection is pathogenic bacteria and viruses. In most cases, such diseases provoke severe food poisoning, which is accompanied by diarrhea, vomiting, fever, and abdominal pain.

If symptoms of an acute intestinal infection appear, you should urgently seek medical help and undergo a course of treatment in a hospital.

The course of an intestinal infection

Different types of intestinal infections have different symptoms and can proceed in different ways, for example, rotavirus infections are mild, cause not only loose stools, vomiting, but also cold symptoms, liquid stools with blood impurities appear in dysentery, the disease is usually severe, with severe abdominal pain, with salmonellosis, dark green stools.

But in some cases, the causative agent of the infection remains unknown, and doctors indicate in the diagnosis that the etiology of the disease has not been established.

Almost all intestinal infections proceed in the same way, where one period of the disease is gradually replaced by another:

• the incubation period is the time from the onset of infection to the moment the first symptoms appear, this period depends on the individual characteristics of the organism and can take from several hours to several days. At this stage, the first signs of an intestinal infection may be lethargy, fatigue.
• acute period - lasts from 1-2 days to two weeks. This period is characterized by the appearance of diarrhea, abdominal pain, vomiting, fever.

It is worth noting that some people carry the infection with one main symptom, i.e. only with vomiting or only with diarrhea, the disease can also occur with or without fever.

• recovery period - begins after diarrhea, diarrhea and other signs of the acute stage of the disease stop. Recovery of the body can take a long time (up to several years), if the treatment was ineffective or completely absent. During this period, the body is especially susceptible to viruses and bacteria, a high probability of re-infection with an intestinal infection or a cold. The course of the disease in the acute and recovery stages depends on the causative agent of the disease, the number of bacteria or viruses that have entered the body, the person's condition before infection (weakened immunity, concomitant diseases, impaired intestinal microflora, etc.), as well as timely treatment.

Complications of intestinal infections

If there is no necessary treatment for the disease, then a state of shock caused by dehydration or waste products of the pathogenic flora may develop.

In addition, intestinal infections can provoke inflammation in abdominal cavity, intestinal bleeding, violation of the intestinal microflora, heart failure, inflammation of the joints.

Allergy after intestinal infection may result from an immune system reaction to bacteria or viruses. It usually appears as a skin rash.

Viral infections can increase intestinal permeability, which increases the risk of future food allergies.

Also, allergic reactions can occur while taking medications, especially after taking antibiotics.

The recovery period after an intestinal infection can take a long time, the digestive system is disrupted and it takes a certain time to restore all functions. To help the body, enzyme preparations are prescribed that improve digestion, prebiotics and probiotics, which contain beneficial bacteria to normalize the intestinal microflora.

Weakness is one of the symptoms of an intestinal infection. Malaise occurs as a result of the action of toxins that poison the entire body and may persist for some time after the disappearance of the main symptoms of the disease (vomiting, diarrhea, fever). Usually, the recovery period with proper and timely treatment takes several days. Other factors are also important, for example, the state of immunity, dysbacteriosis, concomitant diseases, which can increase the recovery period of the body after an illness.

Weakness after infection can be associated with prolonged vomiting, diarrhea, and fever, which deprive the body of important nutrients and disrupt metabolic processes.

Vomit often occurs with intestinal infections, it develops due to disruption of the digestive tract and poisoning of the body with microbial toxins.

Vomiting appears in the acute period of the disease, as the recovery progresses, this symptom gradually disappears, during the recovery period of the body, as a rule, vomiting does not bother a person.

The reappearance of a symptom, especially against the background of weakness, fever, diarrhea, may indicate a re-development of the disease or a new infection.

Often this situation occurs in a hospital, especially vulnerable are small children who have poor personal hygiene and contact in the hospital with other children who have other infections.

Abdominal pain due to intestinal infection caused by pathogenic microorganisms that have entered and actively multiply in the intestines. Depending on the pathogen, soreness can be of varying intensity and be of a different nature - aching, spasms, sharp, etc.

After recovery, abdominal pain may persist for some time, which is associated with the consequences of the vital activity of bacteria and the restoration of the normal functioning of the gastrointestinal tract.

Often, pain is accompanied by loose stools (1-2 times a day), which is associated with inadequate functioning of the digestive system after an infection, this condition should not cause concern, however, if other symptoms appear (fever, frequent loose stools, nausea, vomiting), one should consult with a doctor.

Diagnosis of intestinal infection

If an intestinal infection is suspected, the doctor first of all finds out the time of the first symptoms, possible risk factors that could provoke the disease (bathing in reservoirs, poor-quality water, missing food, contact with animals or birds, etc.). Concomitant diseases that could increase the risk of contracting an intestinal infection (alcoholism, HIV, etc.) are also being clarified.

Symptoms of an intestinal infection are inherent in a number of other diseases, therefore, during the initial examination, it is impossible to make an accurate diagnosis and additional studies are prescribed (blood, urine, feces, bakposev) that will help determine the causative agent of the infection and determine an effective course of treatment.

Analysis for intestinal infections necessary to identify the causative agent of the disease and the selection of an antibiotic that can overcome the infection. Usually, without analysis, the treatment of intestinal infections is protracted, since the drug sensitivity of bacteria to antibiotics or other drugs may vary from patient to patient.

As already mentioned, intestinal diseases can be of a viral or bacterial nature, it is quite difficult to make a correct diagnosis and prescribe an effective treatment based on the symptoms.

For this reason, tests are important in intestinal infections.

Microbiological analysis of feces reveals the causative agent of intestinal infection. This analysis is also called seeding, it is based on the examination of feces under a microscope, followed by seeding. Under a microscope, it is not always possible to determine the type of infection, since there may be a small amount of bacteria in the sample being studied, therefore, after that, a stool sample is sown in a special device that maintains the temperature that is optimal for bacteria to multiply. At this stage, when the active growth of bacterial colonies begins, microorganisms that inhabit the intestine are detected.

A few days later, a sample of pure cultures is again examined under a microscope to accurately identify disease-causing bacteria.

If pathogenic microorganisms are found in the feces, an analysis is carried out for bacterial sensitivity to antibacterial drugs. At this stage, various groups of antibiotics are introduced into the colony of bacteria and it is noted how quickly and in what quantity the bacteria die after exposure to a particular drug.

The results of the analysis indicate the causative agent of the infection and other bacteria found in the intestine, as well as what type of antibiotics the pathogens are sensitive to.

Analysis by PCR (polymesar chain reaction) allows you to determine the type of infection by a small fragment of RNA or DNA of pathogens in any fluid produced by the human body. This study allows you to identify both bacterial and viral infections.

PCR analysis is quantitative and qualitative. In a quantitative study, the number of pathogens in the feces is revealed, in a qualitative study, the type of infectious agent is revealed.

Differential Diagnosis

In differential diagnosis, diseases that are not suitable for symptoms are excluded, which ultimately allows the diagnosis of one possible disease.

There are various systems, programs that carry out differential diagnostics, both complete and partial.

The main, but not exclusive, symptom of an intestinal infection is diarrhea; it is the differential diagnosis that makes it possible to exclude errors and improper treatment.

Before making a diagnosis, the specialist finds out the patient's age, the nature and frequency of bowel movements, vomiting, pain intensity, and seasonality is also taken into account.

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You can not drink water from the tap, from a spring, river, street pump, etc.

Before use, you need to wash fruits, vegetables, berries well. When buying melons, watermelons, preference should be given to whole fruits; in incised, wrinkled, cracked places, harmful microorganisms multiply rapidly.

Buy meat, milk and dairy products only in stores. If you bought raw milk in the market, be sure to boil it.

During the trip, food should be stored in separate bags.

You can not swim in prohibited places, while swimming it is important not to swallow water.

Prevent food from landing or crawling insects, which are the main carriers of dangerous infections.

Quarantine is carried out in order to prevent further spread of infection among children in childcare facilities, employees, etc. Such measures help stop the infection of dangerous infections, and quarantine can be introduced within a kindergarten, school, any institution, as well as at the state level with the closure of borders only for the entry or exit of citizens, but also for the import or export of products.

Prognosis of intestinal infection

Early detection of infection, proper therapy contribute to a complete recovery without severe complications. It should be remembered that after an illness, the body's defenses are weakened and it is defenseless against viruses and infections, which requires additional precautions (do not overcool, do not expose yourself to nervous shocks, stress, etc.).

With a severe development of the disease, toxic shock syndrome, pulmonary edema, renal or heart failure, DIC, etc. are possible.

Intestinal infections are the most common diseases in the world, pathogenic bacteria are especially dangerous in the summer season, when favorable conditions are formed for the active reproduction of pathogenic microflora.

As a rule, the acute period of the disease passes in a few days, subject to proper treatment (plentiful drinking, taking enterosorbents and drugs to restore water and electrolyte balance). It is worth noting that it is impossible to take antiemetic and antidiarrheal drugs for intestinal infections, as this will stop the cleansing of the body from pathogenic microorganisms and toxins and lead to even greater intoxication.

If after 2-3 days there has been no improvement, you should seek medical help and undergo a full examination in case of infection with dangerous infections.

With improper treatment, relapses often occur, and the disease can become chronic, while the person becomes dangerous to others.

It is necessary to immediately consult a doctor if diarrhea occurs in children under one year old, with severe vomiting, when a person cannot even take a sip of water without a gag reflex, with urinary retention, blood in the stool, high temperature, which does not decrease when taking antipyretics, with loss consciousness.

How to treat an intestinal infection?

It is impossible to determine the causes of infection either on your own or during a visual examination by a specialist. Only laboratory analysis can determine the strain of bacteria. However, the sooner treatment begins, the sooner relief will come.

Before starting the treatment of an intestinal infection, it is important to establish the cause of the disease in order to exclude the possibility of non-infectious poisoning (for example, poisonous mushrooms or berries, pesticides, household chemicals). Therefore, it is important to remember what the patient and his relatives ate, what water he drank, whether he took medication, whether he was in contact with any chemicals. In the case of an intestinal infection and in case of poisoning with toxic products, the symptoms will be similar: nausea, chills, weakness, vomiting, abdominal pain, diarrhea, blood in the stool. In the case of an infection, the body temperature rises, but in case of poisoning, it usually remains normal.

Intestinal infections can be both relatively harmless and deadly. In the first case, the body's immunity is able to overcome bacteria on its own, subject to diet and bed rest. However, an acute intestinal infection can develop rapidly, poisoning the body and destroying its tissues, and in such a situation, powerful antibiotics cannot be dispensed with.

In what cases urgently call a doctor?

There are quite a few reasons to call an ambulance for poisoning:

• if there is poisoning, and not an intestinal infection, the symptoms may be: difficulty breathing, muscle stiffness, impaired vision, speech and orientation in space, lack of urine;
• the disease during the day is accompanied by profuse watery diarrhea, including blood inclusions;
• symptoms are observed in a child under 3 years old, in a pregnant woman;
• the patient is undergoing cancer treatment, has AIDS, hepatitis, or is a carrier of HIV (in this case, even a mild intestinal infection is deadly);
• signs of dehydration, such as dry mucous membranes, cracked lips, very dark urine or no urine, baby crying without tears, are not relieved by drinking plenty of water;
• the patient has yellowed eye whites and skin;
• rash appeared, swollen joints.

Proper nutrition

Most often, intestinal infections are provoked by dairy products that were stored in violation of the temperature regime, and food containing raw or half-baked eggs and meat, seafood and fish.

Ready meals (soups, cereals and other side dishes) become dangerous after 12 hours if stored at room temperature. Sausage, ham, smoked meats, even if properly stored, can lead to intestinal infections.

If the food has an unpleasant odor, even a mild one, traces of mold, bubbles or foam, plaque, a strange taste (for example, bitterness or signs of fermentation appear), it should never be consumed. You need to rinse your mouth thoroughly, take activated charcoal. Do not eat canned food if the lid of the jar is swollen or gas is released when opened. As a general rule, you need to eat enough spoiled food to get an intestinal infection: a small piece is not harmful to health, but some germs, such as botulinum pathogens or salmonella, can cause infection even if a person spit out food.

It is a big misconception that boiling makes spoiled food safe. Many bacteria, multiplying in food, release dangerous toxins that cause poisoning even after the product has been sterilized.

The manifestation of the disease

The very first signs of an intestinal infection are nausea and vomiting. They appear a few hours (rarely - days) after infection. Very rarely, this symptom is absent, but most often intestinal infections begin with it.

Diarrhea is preceded by cramps or cramps in the abdomen. These pains usually accompany the illness until the patient gets better.

Poisoning with toxins produced by microorganisms can cause allergic reactions up to anaphylactic shock, so the presence of a rash and swelling is a good reason to call an ambulance.

A characteristic feature of an intestinal infection is high fever, chills, weakness, headache.

Features of therapeutic measures

Intestinal infection in adults is treated as follows: first, the patient needs to induce vomiting, and then give 2-3 glasses of warm water to drink. If vomiting continues, drink until the liquid is clear and free of food debris. Water dilutes stomach acid and makes vomiting less painful. With a mild intestinal infection, after these measures, the patient's well-being improves significantly, and in 2-3 days he can fully recover. During this period, you need to eat light carbohydrate puree foods and drink plenty of fluids to prevent dehydration. To restore the water-salt balance and blood glucose levels, you can take special powders that can be bought at a pharmacy, or a prepared solution of salt and sugar (1 tsp of salt and 5 tsp of sugar per 1 liter of water).

You should not drink juices from sweet fruits and carbonated drinks because of their irritating effect on the mucous membranes. Coffee and tea increase dehydration, so it is better to refuse them not only during illness, but also for the entire recovery period. Alcohol, including alcohol-based medicines, is strictly prohibited. Diarrhea and vomiting severely dehydrate the body, and the effectiveness of treatment depends on how long this condition lasts.

When treating an intestinal infection, the following foods should be excluded from the diet:

• any heavy fatty foods, foods containing raw eggs, fish and seafood;
• milk and dairy products, cheese;
• baking, sweets, fruits;
• delicacies and exotic foods.

At the beginning of the disease, the patient may completely refuse food. There is nothing to worry about, provided that he drinks enough fluids.

There are medicines that help eliminate the symptoms of an intestinal infection (cramps, abdominal cramps, diarrhea), but it must be borne in mind that they do not eliminate the cause and may even aggravate the disease. After all, vomiting and diarrhea are a defensive reaction of the body trying to get rid of pathogens. Therefore, it is advisable not to take any drugs without a doctor's prescription. The exception is activated charcoal, which will help the body remove toxins faster.

With severe vomiting, antiemetic drugs may be prescribed, but this is only when treating an intestinal infection in a hospital.

With diarrhea, Loperamide can be used, but only if the patient is in a satisfactory condition at the end of the disease (for example, when the patient is unable to stay at home). It is not used to treat dangerous infections, as it makes it difficult to cleanse the body of toxins.

Despite the fact that at the very beginning of the disease it is impossible to determine which microorganism provoked it, intestinal infections are most often treated with antibiotics. It is desirable that this be a broad-spectrum drug of the latest generation, since patients sometimes suffer even more from the complications caused by the wrong medicine than from the infection itself. Therefore, antibiotics should be prescribed by doctors and taken strictly according to the instructions.

Taking antipyretics for intestinal infections without medical supervision is undesirable. It is necessary to bring down the temperature only if the fever is poorly tolerated by the patient. If an intestinal infection occurs without an increase in temperature, then either the diagnosis is incorrect and non-infectious food poisoning occurs, or the patient's immune system is weakened and the body does not fight infection.

As a rule, the temperature lasts no longer than 2 days, but if it does not subside or even rises, you should seek medical help.

Therapy in children and pregnant women

To avoid complications and dangerous consequences, it is necessary to consult a gastroenterologist as soon as possible for help.

Children suffer from intestinal infections much more difficult than adults. This is due to the fact that their poorly formed immunity is not yet able to cope with pathogenic microorganisms. If signs of the disease are observed in a child under 3 years old, it is necessary to call an ambulance. But this does not mean that older children do not need to call a doctor - medical monitoring for intestinal infections is necessary for children of any age. In general, the approach to treatment is the same as for infection in adults.

During pregnancy, any signs of an intestinal infection should be reported to the doctor. Self-medication can lead to unpredictable consequences, and a competent doctor should decide how to treat an intestinal infection during this period.

Preventive measures

To minimize the risk of exposure to disease-causing germs, make it a habit to thoroughly wash your hands regularly throughout the day, and properly handle and store food. Cooked food should be put in the refrigerator immediately after cooling, it is impossible to defrost food at room temperature. It is better to refuse the use of eggs, seafood and fish that have not undergone heat treatment.

Fruits, vegetables, berries, mushrooms and herbs should be thoroughly washed with plenty of warm running water and wiped dry with a clean cloth. Dairy products are best consumed immediately after opening the package, follow the expiration dates and storage conditions. Even with slight signs that the food is spoiled, it is better to throw it away. In no case do not use canned food bought from hand.

Water, if it is in doubt, must be boiled. When traveling to exotic countries, you can only drink branded bottled water.

For pregnant women, prevention of poisoning and infection is especially important. It is advisable to restrain your gastronomic whims: for example, some during pregnancy want to eat raw minced meat or exotic fruits.

Children should be taught from a very early age to wash their hands after going to the toilet, when returning from the street, when they are visibly dirty, and every time before eating. The child needs to form the habit of washing fruits, vegetables, berries, greens before eating. It is important that children understand that food should not be taken from strangers, parents should control any gifts and edible gifts brought by guests.

If the family has a small child, then it is necessary to have in the first aid kit a powder for preparing a solution against dehydration and a supply of activated charcoal. Treatment of an intestinal infection should begin immediately after the onset of the first symptoms.

Infection is a terrible, and familiar word to many. But avoiding infection is almost impossible. Intestinal infection is one of the most common diseases in the world. It affects people at any age, proceeds in an acute form, and can be very dangerous for children.

Basic information about the disease

Acute intestinal infections are a broad group of diseases that affect the gastrointestinal tract. The disease develops due to infection of the body with various pathogenic microorganisms.

How does the disease manifest itself? After infection, microbes do not begin to act immediately. The first symptoms may appear after 10-50 hours. But then the disease begins to proceed very intensively.

1. The most dangerous intestinal infections are dysentery, salmonellosis, staphylococcus aureus.
2. Gastrointestinal infections are more often diagnosed in the summer.
3. The main mechanism of transmission of intestinal infections is fecal-oral.

How is the disease transmitted between people? Infection is possible through common household items, handshakes, toys in preschool institutions. Rotaviruses are transmitted by airborne droplets.

How long does an intestinal infection last? With timely medical care, the main symptoms disappear in 3-5 days. For a complete cure, it will take at least 10-14 days.

Intestinal infections are divided into: bacterial and viral. In the international medical classification, the code for intestinal diseases is ICD 10.

Intestinal infections are second in frequency only to respiratory diseases.

The reasons

Pathogenic microorganisms most often enter the body with dirt.

Classification of the causes of the disease:

• non-observance of hygiene rules - dirty kitchen surfaces, rodents and insects, unwashed hands;
• improper storage of products - microorganisms from raw meat and seafood get on other products during cooking, using the same cutting board, when stored on the same shelf in the refrigerator;
• poor heat treatment - pathogenic microorganisms die only at temperatures above 70 degrees;
• a long stay of cooked food outside the refrigerator - room temperature leads to the rapid multiplication of bacteria;
• stale, poor quality products.

Symptoms

The main and most dangerous symptom of the disease is severe diarrhea. Against its background, dehydration of the body develops, which leads to serious consequences. In adults, an intestinal infection may not appear for a long time. Initially, skin rashes, itching may appear.

The main signs of the disease are:

• bacteria cause cramps and pain in the abdomen;
• loss of appetite;
• with helminthic invasion, constipation occurs;
• sleep worsens - during illness, irritability increases, which leads to a deterioration in the quality of sleep;
• weakened immunity - bacteria do not allow the body to absorb the necessary nutrients;
• Grinding of teeth - often this symptom occurs in children at night.

Against the background of poisoning, anemia may develop. A yeast infection causes depression and headaches. Intestinal infections are often accompanied by nausea and vomiting.

Types and names of bacterial intestinal infections

How are these infections transmitted? Through unwashed hands, vegetables, fruits, foods without proper heat treatment, untreated water.

Salmonellosis enters the body with meat, butter, milk, eggs. Infection can occur from sick people and animals. The disease is severe, especially in children.

1. The disease is characterized by high temperature, fever, stools are liquid, greenish in color, with an unpleasant odor.
2. The disease is often accompanied by toxic shock, which can cause cerebral edema, heart failure, and kidney failure.

Staphylococcus aureus is caused by bacteria that reside in the intestines. But when immunity is weakened, the microflora is disturbed, bacteria begin to multiply rapidly.

The infection develops slowly, it is often confused with the common cold - a low temperature is accompanied by a runny nose and sore throat. In the future, there is pain in the abdomen, vomiting, blood and mucus are present in the liquid stool.

Infection occurs through confectionery with cream, stale salads, dairy products.

This disease is difficult to treat. Since staphylococcus bacteria quickly mutate, they become resistant to antibiotics.

Typhoid bacteria enter the body with food and water, through the feces and urine of infected people.

During the disease, extensive foci of inflammation occur in the intestines, which may be accompanied by ulcers, bleeding, intestinal rupture.

The incubation period of the disease is 1-2 weeks. The initial stage of the disease is characterized by high fever, aching joints, sore throat and poor appetite. Then the stomach starts to hurt, nosebleeds appear, urination becomes painful. Severe forms are accompanied by delirium, numbness, coma.

Escherichiosis

The disease is caused by E. coli. The disease always proceeds in an acute form, affects the intestines.

This infection is very susceptible to children under one year old, premature infants on artificial feeding.

The infection is spread by sick children who release pathogens into the environment in large numbers. Bacteria remain active in the external environment for several months.

What are viral intestinal infections

Rotaviruses and enteroviruses enter the body when hygiene rules are not followed, poorly processed foods, by airborne droplets.

Intestinal (stomach) flu, rotavirus gastroenteritis is the most common viral intestinal disease. An infected person is dangerous to others until a complete cure. Therefore, epidemics of intestinal flu often occur in preschool and educational institutions.

A viral infection with intestinal syndrome often affects children, they are difficult to tolerate this disease. But every time the disease is easier, because the body develops protection.

The acute form of the disease is characterized by severe pain, light-colored diarrhea mixed with blood. The temperature quickly reaches 39 degrees, accompanied by frequent bouts of vomiting, runny nose and sore throat.

Rotaviruses do not tolerate high temperatures, so it is recommended for patients to bring down the temperature only above 38 degrees. Viruses live on dirty hands and food, they do not die in chlorinated water.

During the incubation period, this intestinal disease proceeds without diarrhea and other usual symptoms of the disease.

Other types of viral intestinal infection:

• enterovirus infection - occurs in an acute form with a high temperature, can affect muscles, skin, heart, nervous system;
• adenovirus infection - rare, the disease affects the nose and eyes.

More than half of the cases of intestinal infections occur in children. The clinical picture of the disease is more vivid, the main signs are similar to those in adults.

The main mechanism of infection is poor quality drinking water and dairy products, dirty hands, vegetables and fruits, from a sick adult.

Every year, about 1 million children under the age of two die from acute intestinal infections worldwide.

The most common intestinal infections in children under one year old:

• intestinal flu (rotavirus infection);
• salmonellosis;
• enterovirus;
• dysentery;
• escherichiosis

Regardless of the type of pathogen, the symptoms of the disease are manifested by abdominal pain, fever, and vomiting. There is a disorder of the stool, while mucus, blood, pus may be present in the feces. The baby has chills.

Dehydration always accompanies intestinal infections in infants and older children. There is dryness in the mouth, constant thirst, the amount of urine decreases. Against the background of poor appetite, weight loss occurs. Prolonged dehydration leads to weakness, drowsiness. The fontanel may fall, the eyes and skin dry up.

1. The child should be given more water or electrolyte solution to drink. Water the baby should be in small portions, but often.
2. Enterofuril is an effective treatment for intestinal infections in children. You can give it to children older than one month. Dosage form of release - capsules and suspension.

In case of severe dehydration and a temperature above 39 degrees, you should immediately call a doctor.

A diet after an intestinal infection for children should include boiled buckwheat, rice and oatmeal cooked in water.

1. Meat should be introduced gradually, only dietary varieties are allowed - rabbit, turkey, chicken.
2. From fermented milk products, low-fat cottage cheese without sugar, kefir is ideal.

After the recovery of children under one year old, you should refrain from introducing new complementary foods for at least 2 weeks.

Most often, intestinal infections during pregnancy do not pose a danger to the baby and mother, since the inflammatory process is localized only in the intestines. But with a lack of fluid, the process of delivering oxygen to the fetus is disrupted.

Symptoms and causes of the disease are similar to the course of the disease in adults.

How to treat intestinal infection in pregnant women

Dysentery and salmonellosis require antibiotic treatment - cefazolin, amoxicillin.

Smecta is the most effective and safe drug to eliminate diarrhea. At least three sachets of medicine must be taken per day.

With untimely treatment, a chronic intestinal infection develops.

How to Treat an Intestinal Infection in Adults

The causative agents of intestinal infections do not affect the treatment regimen. Therapy begins even before the results of the analysis for intestinal infections. For the initial diagnosis, the clinical picture of the disease and the appearance of the stool are used.

Diagnosis necessarily includes a stool test, which shows the presence of rotavirus infection in children.

Purpose of treatment:

• to overcome harmful microorganisms - antibiotics are used for this;
• restore the normal functioning of the stomach and intestines;
• prevent dehydration;
• eliminate diarrhea.

Treatment will be ineffective if the patient does not adhere to a special diet.

Antibiotics

For treatment in adults, antibiotics of the fluoroquinolone group are used - ciprofloxacin, norfloxacin. These antibacterial drugs for intestinal infections are very effective because they are well absorbed by the intestines.

Levomecithin is an antibiotic that has been proven over the years, which eliminates pathogenic microflora in the intestines, and normalizes stools.

To eliminate dehydration, patients are often prescribed droppers with saline solutions. Effective preparations for oral use are rehydron, glucosalan.

Diarrhea is eliminated with the help of enterosorbents - smectite, activated carbon, carbolong.

Effective pills for treatment:

• probiotics to restore normal microflora - linex, acylol;
• enzymes - creon, mezim;
• intestinal antiseptics - enterol, interix.

How to eat right - diet

During an exacerbation of the disease, patients are advised to fast to prevent the development of bacteria. Rice and oatmeal without salt have a calming effect on the intestines.

What can you eat with a mild form of the disease? In this case, it is recommended to maintain the usual diet, but reduce the amount of food by 30%.

Sick children under four months old should not have sour-milk mixtures on the menu. In the acute form of the disease, infants should be given a mixture enriched with bifidobacteria, lactobacilli.

The diet for intestinal infections in children and adults implies the complete exclusion of the following products:

• some dairy products - whole milk, yogurt, fermented baked milk, cream;
• black bread;
• vegetables - beets, beans, peas;
• citrus fruit;
• broths on meat and fish.

What can you eat with an intestinal infection? The patient's menu should contain a lot of mucous soups, pureed cereals, jelly, rosehip broth. Blueberries and bird cherry, pumpkin, carrots contribute well to recovery.

Bread should be dried, be sure to drink plenty of water. All food should be boiled, steamed.

With intestinal infections, appetite often disappears - it is impossible to force feed.

Prevention

The basis of preventive measures is the hygiene of the digestive organs - thorough and frequent washing of hands, heat treatment of food, regular cleansing of the intestines and stomach.

You should avoid dishes with sour cream and mayonnaise, fatty creams in the hot season. Food should always be stored in the refrigerator in compliance with the rules of the commodity neighborhood. But even in the refrigerator, food cannot be stored forever.

1. All products must be fresh, without signs of rot.
2. Vegetables, fruits must be thoroughly washed with hot water, preferably peeled.
3. Tap water is prohibited. You can drink only purified or mineral water.

Intestinal infections are frequent and very dangerous diseases that can knock down the whole family. Protecting yourself from the disease is quite simple - cleanliness, hygiene rules, the use of fresh food and purified water.

All these rules should be strictly observed by adults, accustomed to follow their children.

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The environment is inhabited by millions of microorganisms, including bacteria and viruses. In the course of normal life, a person always comes into contact with pathogenic microflora. Microbiology has about 10 thousand different bacteria. When harmful microbes enter the human body, under the condition of weakened immunity, some infectious diseases and inflammatory processes may develop. Infections, viruses, bacteria sooner or later meet on the way of each person. Infectious diseases are the most frequent and widespread diseases of the gastrointestinal tract, both in childhood and in adults.

An intestinal infection is a disease that is characterized by the fact that harmful microbes settle in the intestines, which provoke a violation of the digestive processes. Infectious bowel diseases include: salmonellosis, cholera, dysentery, rotavirus, staphylococcal infection and others.

The Salmonella bacterium causes the development of a disease such as salmonellosis. Salmonella enter the small intestine, attach to its walls, causing severe intoxication. Salmonellosis develops rapidly, from 6 hours to 3 days after the bacterium enters the body. Salmonellosis is accompanied by a disorder of the functions of the nervous system, a violation of vascular tone. The disease is contagious. Salmonellosis is quite difficult to tolerate in childhood.

In addition to salmonellosis, bacteria of the genus Salmonella provoke a disease such as typhoid fever. The disease is characterized by intoxication, fever, skin rashes. The bacterium infects the lymphatic system of the small intestine.

Escherichiosis is an infectious disease caused by Escherichia coli. These bacteria are present in the body of every person and make up the normal intestinal microflora. However, as a result of the mutation, harmful strains of bacteria are produced that have a negative effect on the body. They can cause diarrhea, dysbacteriosis, and if they enter the abdominal cavity, they can provoke the development of peritonitis.

The stomach flu is caused by a rotavirus infection that is transmitted in a variety of ways. Infection leads to inflammation of the mucous membrane of the stomach and small intestine, which provokes the development of diseases such as enteritis, gastritis. The toxic effect of viruses leads to disruption of the digestive processes, which is accompanied by vomiting, diarrhea. Rotavirus infection is accompanied by an increase in body temperature, which is a protective reaction of the immune system to a pathogenic pathogen. This feature distinguishes intestinal flu from other viral diseases, diseases of the digestive tract. The infection will also provoke inflammation of the respiratory system.

Staphylococcal infections are caused by the bacteria Staphylococcus aureus. Getting into the body through the skin, mucous membranes, airborne droplets, they begin to produce toxic substances, which causes serious harm to the body. However, staphylococcus bacteria are prone to mutation, so they become not susceptible to certain types of antibiotics, which greatly complicates treatment.

Dysentery is an infectious disease caused by the Shigella bacteria. They mainly affect the large intestine, causing irritation and intoxication. Poisonous waste products of bacteria are absorbed into the blood and have a negative effect on the digestive organs, as well as the cardiovascular, nervous systems.

Cholera is caused by Vibrio cholerae that affects the small intestine. The disease is very dangerous because it can cause dehydration and lead to death.

Enterovirus infection is caused by enteroviruses, which include several types of viruses. The disease is characterized by the fact that the virus, entering through the respiratory tract, settles on the mucous membranes and causes inflammation and diseases such as pharyngitis, tonsillitis. Then, with the blood, they are carried throughout the body, affecting the nerve and muscle tissues. Enteroviruses are capable of provoking the appearance of various pathologies: myalgia, encephalitis, serous meningitis, enteroviral diarrhea, and others.

Causes of infection in the intestines

Bacteria involved in the digestive process live in the human body, namely in the intestines. If foreign microorganisms enter, and the immune defense is weak, this leads to intestinal infections. The cause of infections in adults and children is contact with a carrier of the disease. The incubation period begins before the initial symptoms of the disease appear and can last up to 14 days after cure. Therefore, violation of personal hygiene rules and other factors can increase the risk of contracting an infection through contact, even with apparently healthy people.

The infection has several ways of transmission:

• fecal-oral. Microorganisms are found in feces and in case of insufficient hand hygiene after defecation, the hands of a carrier person become the object of the spread of bacteria that remain on all surfaces, objects, products that he touches. Insects can also carry the infection;
• contact - household, when using objects, accessories, utensils, toilet facilities, products, etc., common with the carrier of the infection;
• food, water - the infection can get on food, water. As a result of improper or insufficient processing of products (not washed vegetables, berries, fruits, insufficient heat treatment of meat, dairy, fish products), as well as the ingress of running water from taps, reservoirs, can contribute to the penetration and reproduction of pathogenic bacteria. Salmonella is possible in meat, eggs, fish, dairy products, so it is not recommended to consume these products raw or poorly processed;
• airborne droplet. This type of distribution is typical for viruses. When sneezing, breathing, coughing, rotaviruses and other germs can be transmitted. Viruses enter the respiratory tract of a person, as well as on common objects;
• infections can be carried by wild and domestic animals, blood-sucking insects (lice, mosquitoes, fleas).

The following categories of people are most susceptible to intestinal infections:

• children under 3 years of age - which is associated with an unstable immune system, the presence of vaccinations, which for a short period of time weaken the protective functions of the body, as well as neglect of the rules of personal hygiene. Due to their age, children cannot fully form the skills of processing hands and products;
• elderly people - due to physiological age-related changes in the elderly, immunity decreases, which increases the likelihood of various inflammatory and infectious diseases;
• people with bad habits. Alcohol and tobacco adversely affect all body systems, and also provokes suppression of the immune system.

Symptoms of an intestinal infection caused by various pathogens may differ from each other.

Intestinal infection: symptoms, diagnosis and treatment

In children and adults, the signs of the disease can manifest themselves in different forms and have different symptoms, but an acute intestinal infection is characterized by the presence of some common symptoms:

• pain in the lower abdomen, cramping in nature;
• pain during bowel movements;
• violation of the stool (watery, frothy discharge with a greenish or light brown color, there may be blood, mucus);
• diarrhea (up to 10-15 times a day);
• nausea, profuse vomiting, especially after eating or drinking;
• with some types of infection in the intestines, there is an increase in body temperature up to 38-39 degrees, chills, body aches;
• general malaise, weakness, dizziness;
• loss of appetite, sleep disturbance;
• some types of infection may be accompanied by the appearance of a cough, runny nose, and other symptoms that occur with respiratory viral diseases (which is typical for rotavirus infection).

In infants and older toddlers, the symptoms are similar. In young children with infectious diseases, dryness, signs of dehydration appear, as a result of which the fontanel sinks, and a sharp weight loss occurs. Children become lethargic, overly capricious. Children carry the infection most severely, the disease has a rapid pace of development.

If signs of an intestinal infection are detected, the patient is subject to immediate hospitalization in a medical institution.

Diagnostics

When establishing a diagnosis, physicians need to exclude other pathologies that have similar symptoms. It is necessary to conduct a comprehensive study, namely:

• Bacteriological examination of feces, vomit, washings from the stomach. Also, the remains of food or water, which could cause infection, are taken for research.
• A serological blood test, for this purpose, blood serum is used to determine the causative agent of an intestinal infection.
• Sigmoidoscopy is a procedure in which a special device is used to examine the mucous membrane of the rectum.
• Colonoscopy - used to evaluate the surface layer of the intestine.
• PCR analyzes of biological materials to determine the type of infection.

Treatment

When determining the causative agent of an intestinal infection, the doctor will draw up a clear scheme of how to treat the disease. Patients must be isolated from others, for the period of treatment they are recommended bed rest.

First, the patient needs to eliminate toxins and their negative impact on the body. For this purpose, sorbents are used, such as Smecta, Enterosgel, Polyphepan, activated carbon. Medical treatment includes:

1. Appointment of an antibiotic to fight the virus and other pathogenic microorganisms (Levomecitin, Ciprofloxacin).
2. To prevent diarrhea, you can use drugs such as Filtrum, Laktofiltrum, Baktisuptil.
3. Appointment of antiseptic intestinal preparations to prevent the spread of pathogenic microflora (Enterol, Enterofuril, Intetrix).
4. To restore the water-salt balance and prevent dehydration, Regidron and Behydron solutions are used.
5. In order to improve digestive processes and restore metabolism, enzymes are used - Creon, Mezim, Pancreatin, Ermital).
6. To restore the normal intestinal microflora, you need to use the probiotics Linex, Bifidumbacterin, Acepol.
7. Antiemetic drugs help reduce the frequency of vomiting and alleviate the condition (Cerukal, Motilium).
8. To eliminate the accompanying symptoms, antipyretics (Paracetamol, Nurofen), painkillers (No-shpa) can be used.
9. Immunomodulators to increase immunity and body defenses.

At the first sign of intestinal infections, do not self-medicate. It is not recommended to take medications to eliminate diarrhea (Loperamide, Immodium). Delayed fecal masses can provoke the accumulation of pathogenic organisms in the intestine. It is also contraindicated to take pain medications, because the exclusion of one of the symptoms will complicate the correct diagnosis. It is also not recommended to take phytopreparations, homeopathy, non-drug preparations without making a diagnosis, establishing the causative agent of the infection and recommendations of the attending physician.

Diet for intestinal infections

In addition to complex drug therapy, patients are prescribed a special diet. In the acute period, fasting is recommended for patients in order to exclude further reproduction of bacteria, reduce factors that can cause intestinal irritation.

Then it is allowed to take such products: light chicken broth, cereals without adding oil, steamed vegetables, dried bread. To prevent dehydration, the patient is advised to drink plenty of fluids. For this, boiled water (water with the addition of salt), unsaturated dried fruit compotes, herbal teas, rosehip decoctions, jelly are suitable.

With an intestinal infection, it is forbidden to use:

• spicy, fried, smoked, fatty, salty foods;
• dairy products - yogurt, fermented baked milk, milk, cream;
• fruits, berries, raw vegetables;
• carbonated drinks;
• baking, baking, confectionery;
• semi-finished products;
• pickles, marinades, spices.

When treating the disease, you must follow all the recommendations of the doctor. An intestinal infection can cause serious complications such as dehydration, toxic shock, kidney failure, pneumonia, and even death.

Prevention:

To prevent intestinal infections in adults and children, you need to follow some rules:

1. Observe the rules of personal hygiene: wash hands before eating, after each visit to the toilet, after visiting public places.
2. Keep dishes, household utensils, work surfaces, bathrooms clean.
3. Carefully process the food you eat, wash vegetables, berries, fruits, conduct the correct heat treatment of meat, milk, eggs, fish.
4. Monitor the quality of products, observe the terms and rules of storage in the refrigerator, do not use products with signs of decay, fermentation for cooking. You should also not buy products of dubious origin that do not have sanitary certificates.
5. Avoid long-term storage of perishable products, as well as products that have been at room temperature for a long time.
6. Do not drink raw tap water, but use boiled or distilled water.
7. Swim only in bodies of water that comply with sanitary and hygienic standards, avoid getting water in your mouth, take a shower after swimming in a body of water, and do not eat food without treating your hands.

Acute intestinal infections (AII) are a large group of infectious diseases caused by various bacteria and viruses. They are united by a similar nature of manifestations in the form of a violation of the normal functioning of the gastrointestinal tract and the presence of signs of intoxication.

The source of infection with intestinal infections is a sick person, a bacteriocarrier and animals. Infection occurs by the fecal-oral route.

Infection occurs by eating contaminated food; in close contact with a patient with an intestinal infection or a bacteriocarrier. Infection is facilitated by non-compliance with the rules of personal hygiene - dirty hands, the use of unwashed or thermally untreated foods, unboiled water from open reservoirs.

Common clinical manifestations in intestinal infections.

1. Damage to the gastrointestinal tract can manifest itself as:

1) gastritis, when the lining of the stomach becomes inflamed. It is manifested by pain and discomfort in the epigastric region, nausea, vomiting, or heartburn;

2) enteritis, when the small intestine is mainly involved in the pathological process. Enteritis can be manifested by diffuse pains in the abdomen, bloating and rumbling along the intestines, copious watery stools, almost without impurities of mucus or blood;

3) colitis, when various sections of the large intestine are affected, which can be manifested by cramping abdominal pain, especially often noted in the left iliac region, false urge to defecate, frequent, loose stools, in which there is a significant admixture of mucus and blood;

4) the isolated manifestation of only one syndrome is rare, usually with intestinal infections they are combined in the form of gastroetheritis, enterocolitis or gastroenterocolitis. If blood appears in the stool, then it is hemocolitis or enterohemo-colitis.

2. Intoxication is noted in the vast majority of all intestinal infections. When it rises body temperature, there is a headache, vomiting. The child becomes lethargic and refuses to eat.

3. Dehydration (exicosis) is the appearance of fluid deficiency in the vascular system, in the tissues of the body and is manifested by dry skin and mucous membranes, thirst, disturbances in the functioning of the cardiovascular system, up to the development of shock conditions in severe forms of the disease.

4. Hepatosplenomegaly (enlargement of the liver and spleen).

5. A rash is not observed in all intestinal infections. Its appearance is characteristic of diseases such as staphylococcal infection, yersiniosis and enterovirus infection.

6. Exhaustion, anemia, hypovitaminosis develop in severe, long-term, complicated intestinal infections.

Dysentery

Dysentery is an infectious disease caused by bacteria belonging to the genus Shigella. It proceeds with a predominant lesion of the lower parts of the large intestine and signs of general toxicosis.

Dysentery is a typical representative of the group of intestinal infectious diseases. The source of infection can only be a person with dysentery, who begins to pose a danger to others on the 1st day of illness, since the pathogen is released into the environment at this time most intensively.

The main routes of infection are contact-household, water and alimentary.

The risk of contracting dysentery increases dramatically with crowding in residential areas, with poor sanitary and hygienic conditions.

Anyone can get dysentery, but more than half of the cases occur in children under 4 years of age. Immunity after suffering dysentery is formed very short, no more than 12 months. That is, there is a risk of recurrence.

The entrance gate of infection is the gastrointestinal tract, where the pathogen is introduced and multiplies.

Clinic. The incubation period is no more than 2-3 days after infection, if the infection occurs by food, then this period is reduced to hours, and with the contact-household route, the disease can develop after 7 days.

Usually, the onset of the disease is acute, but sometimes a prodromal period is possible, which is manifested by malaise, chilliness, or headache.

The severity of dysentery is mild, moderate, severe and very severe.

In dysentery, the large intestine is most affected.

As a rule, at the beginning of the disease, quite severe pains in the abdomen appear, and then frequent, loose stools join. In addition, dysentery sometimes begins with general manifestations - the patient develops weakness, lethargy, headache, fever.

The most pronounced symptoms of the disease become 2-3 days of illness. With a mild form of dysentery, local manifestations prevail over the general ones.

The most pronounced signs of dysentery have a moderate form of the disease. An acute onset is characteristic - the body temperature rises to 38-39 degrees, which is accompanied by chills, the duration of which is about 2-3 days. Weakness appears, headache worries, appetite decreases. Disorder of the intestine joins in the next 2-3 hours from the onset of the disease, and manifests itself in the form of discomfort in the lower abdomen, rumbling, periodic, cramping pain in the lower abdomen, stool becomes more frequent from 10 to 20 times a day. At first, the stool retains a fecal character, then impurities of mucus and blood appear in it, the volume of feces begins to decrease, and they acquire the character of the so-called “rectal spitting”, in the form of mucus and blood. Frequent urge to defecate is characteristic. The skin turns pale, a thick brown coating appears on the tongue. On the part of the circulatory system, tachycardia, a drop in blood pressure are noted. One of the main signs of dysentery is spasm and pain on palpation of the sigmoid colon in the left iliac region.

Intoxication with a moderate form of dysentery lasts about 4-5 days. The stool takes on a formalized character, usually by the 8-10th day of illness, with a smooth course of dysentery, but the disease can be delayed up to 3-4 weeks.

The mild and severe forms differ from the moderate only in the severity of the symptoms.

The severe form of dysentery is characterized by more pronounced and prolonged intoxication and severe intestinal damage. The chair can become more frequent up to 35-40 times a day. The phenomena of hemocolitis are quite pronounced, when blood appears in the feces.

Gastroenterocolitic (damage to the entire gastrointestinal tract) and gastroenteric (damage to the stomach and small intestine) variant of dysentery is characterized by a short incubation period. The onset of the disease is sudden and stormy, in parallel, the phenomena of toxicosis and intestinal manifestations develop. Vomiting appears, stools are very frequent, profuse, watery, mixed with blood and mucus, diffuse pains in the abdomen are noted. In the future, the volume of feces decreases, there are false urges to defecate.

Of the complications, it should be noted the development of infectious-toxic shock, shock from dehydration (hypovolemic), acute heart failure, toxic expansion of the colon, peritonitis, intestinal bleeding, intestinal perforation, dysbacteriosis, myocarditis, reactive polyarthritis.

Chronic dysentery. The duration of the disease is more than 3 months, which is due to the presence of one pathogen in the human body. General manifestations are mild. Disorders of the intestines are less pronounced, compared with an acute course, but significant disorders develop on the part of other organs and systems of the body in the form of anemia, hypovitaminosis, severe dysbacteriosis and dystrophic disorders.

yersiniosis

Yersiniosis is a group of acute infectious diseases, which are characterized by a variety of manifestations. When they affect the gastrointestinal tract, musculoskeletal system, liver and other organs, there are phenomena of general intoxication and a protracted course.

The causative agent of the disease belongs to the genus Yersinia.

Yersinia is able to exist for a long time in the environment - in the soil (up to 4 months) and in water (from a month or more).

Animals and birds are the main source of infection. The possibility of infection from humans remains highly questionable.

Most of the Yersinia falls on vegetables that are stored in cellars, vegetable stores and are highly perishable. The pathogen accumulates on vegetables and in the environment. Vegetables pose the greatest danger for infection at the end of winter and in spring.

Yersiniosis can affect people of any age, but most often, children aged 2-3 months and older people who have reduced immunity get sick. Also, children aged 4–9 years often get sick.

The incidence of yersiniosis has a distinct autumn-spring seasonality. The peak incidence occurs every 2-3 years. In countries with a cool climate, yersiniosis is more common.

Clinic. The incubation period is about 3-10 days. Initially, after the first signs of the disease, after a temporary improvement on the 13-15th day, about a third of patients again worsen.

Forms of yersiniosis can be: eczematous (skin lesions predominate), arthritic (the leading sign is joint damage), icteric (involvement in the liver process), meningeal (with inflammation of the meninges) and mixed. In rare cases, yersinia sepsis develops.

These variants are characterized by common features in the form of an acute onset, the presence of intoxication (chills appear, body temperature rises to 38-40 ° C) and signs of damage to the gastrointestinal tract, which is manifested by nausea, vomiting, pain in the stomach and the appearance of liquefied stools. From the first days of the disease, patients are worried about muscle and joint pain, there is hyperemia of the sclera, conjunctiva and soft palate. Characterized by the appearance of a "crimson" tongue and a rash on the skin.

The duration of the disease, in most cases, does not exceed 1.5 months, and with a protracted course of yersineosis - 3 months.

food poisoning

Food poisoning is a collective concept that includes a diverse group of diseases, but combines their two common features.

1. The main route of spread is alimentary, when the pathogen enters the body with infected food. Most often food toxic infections are caused by streptococci, staphylococci, proteus, enterococci, salmonella.

2. The main reason for the development of food poisoning is not the microorganisms themselves, but the toxins they release.

Most often, pathogens enter food products during their preparation, storage, transportation and sale. Often contaminated products appearance and smell practically indistinguishable from normal products.

Most pathogens are able to produce toxins not only in food, but also in the human body. With the destruction of pathogens in the gastrointestinal tract, additional portions of the toxin are released.

Clinic. Toxins released by pathogens cause inflammation of the mucous membrane of the stomach and intestines. The developed inflammatory process in the mucous membrane leads to increased intestinal motility, to impaired absorption and digestion of food, to the development of dysbacteriosis.

All these disorders are manifested by abdominal pain, nausea, frequent vomiting and diarrhea. At the beginning of the disease, the stool becomes more frequent up to 10-15 times a day, at first it looks like liquid feces, and then becomes watery, plentiful and fetid. All of these symptoms may appear as early as 2-4 hours after eating contaminated foods.

At the next stage of the disease, toxins secreted by microbes from the intestines begin to be absorbed into the blood, as a result of which almost all organs and systems of the body are affected. Such as the heart, central nervous system, liver, which is the filter of the whole organism, purifying the blood of any toxic substances. As a result, all manifestations of food poisoning develop: body temperature rises, the patient is shivering, tachycardia is noted, arterial hypotension appears, and there is a risk of seizures. Frequent vomiting and diarrhea lead to the development of severe dehydration.

Most patients, by the beginning of the second day from the onset of the disease, begin to notice relief, and the next 2–3 days only general weakness remains.

Extremely rarely, especially if timely treatment has not been started, toxic or hypovolemic (due to dehydration) shock develops, quite often leading to death.

salmonellosis

Salmonellosis is an infectious disease caused by bacteria from the genus Salmonella, which has various manifestations. Most often, in the first place, the gastrointestinal tract is affected, which is expressed in the development of gastroenteritis and enterocolitis.

The causative agents include a large group of Salmonella. Most salmonella can cause disease in both humans and animals and birds. Bacteria are able to persist in the external environment for a long time. In meat and dairy products, salmonella not only persist, but also multiply, while the appearance and taste of the products do not change. When salted and smoked, salmonella does not die, and when frozen, the survival time of microbes in products even increases.

Domestic animals and birds are the main sources of infection, but humans can also be an additional source of infection. In animals, salmonellosis occurs as an acute disease. The most dangerous animals are bacteria carriers, without signs of disease.

Man, as a source of infection, poses the greatest danger to infants, who have increased sensitivity to all infectious diseases.

Infection with salmonellosis occurs in the alimentary way, when foods that are infected with a large number of salmonella are eaten. The reason for the abundant contamination of products is usually disturbed cooking, when infected products, especially meat, are in conditions suitable for the reproduction of the pathogen. The highest incidence of salmonellosis is observed in the warm season.

Clinic. The incubation period after infection can range from 6 hours to 3 days (usually 12-24 hours). If the outbreak occurred in an organized community, this period is extended to 3-8 days.

Salmonellosis can occur in various forms, of the most common can be noted.

1. Gastrointestinal form, which affects mainly the intestines and stomach.

2. Generalized form, in which typhoid-like and septic variants are distinguished.

3. Bacteriocarrier, when there are no clinical manifestations of the disease.

The gastrointestinal form of salmonellosis is the most common.

The disease is characterized by an acute onset, the temperature, especially in severe forms) rises to 39 ° C and above, the patient is shivering, general weakness appears, headache, nausea, vomiting, pain in the epigastric and umbilical region is noted. Then comes diarrhea. The most pronounced symptoms of salmonellosis for 2-3 days.

In a mild form of the disease, the body temperature does not rise above 38 ° C, a single vomiting, the stool becomes liquid and watery, its multiplicity does not exceed 5 times / day, diarrhea persists for 1-3 days, fluid deficiency is not more than 3% of body weight.

The moderate form of salmonellosis is characterized by a rise in body temperature to 38–39 ° C, a febrile period up to 4 days, diarrhea up to a week, repeated vomiting, increased stools up to 10 times a day, tachycardia, lowering blood pressure, fluid deficiency up to 6% of body weight.

In severe form, the temperature may exceed 39 ° C, the febrile period lasts 5 or more days. Severe symptoms of intoxication, repeated vomiting continues for several days. The frequency of stools exceeds 10 times a day, the stool becomes plentiful, watery, fetid. An admixture of mucus may appear in the stool, diarrhea lasts more than a week. The liver and spleen increase, yellowness of the skin and sclera appears, cyanosis, tachycardia, and blood pressure decreases. Damage to the kidneys occurs, as a result of which urination decreases, protein, erythrocytes and cylinders are determined in urine tests, and renal failure may develop.

Typhoid form of salmonellosis. With this form, the onset of the disease is acute. Intestinal disorders, fever and symptoms of general intoxication appear. Within 1-2 days, intestinal dysfunction stops, and the temperature continues to remain high, the phenomena of general intoxication progressively increase, which is manifested by a febrile reaction lasting from 1 to 3 weeks, lethargy, and apathy. A blistering rash appears on the skin, bradycardia is noted, a decrease in blood pressure, bloating, an enlarged liver and spleen.

Septic form of salmonellosis. It is one of the most severe variants of the course of salmonellosis.

The onset of the disease is acute, in the first days it resembles a typhoid-like form. In the following days, the patient's condition worsens. The fever is permanent, septic foci are formed in various organs. The defeat of the musculoskeletal system is manifested by osteomyelitis, arthritis, the cardiovascular system - endocarditis, aortitis, the lymphatic system - tonsillitis, cervical purulent lymphadenitis, the central nervous system - meningitis (especially in children).

Escherichiosis

Escherichiosis is a group of infectious diseases caused by pathogenic Escherichia coli (Escherichia), occurring with symptoms of intoxication, fever, and is mainly affected by the gastrointestinal tract, less often, the urinary, biliary tract, and other organs can be involved in the process. Perhaps the development of sepsis, more often infants get sick.

Escherichiosis, in its course, is in many ways reminiscent of dysentery, bacteria are able to invade and multiply in the intestinal cells.

The main route of distribution of Escherichia is fecal-oral. Human infection occurs by ingestion of contaminated food and water.

Clinic. Under the influence of Escherichia, an inflammatory process develops in the small intestine, which is expressed in signs of an intestinal infection, usually in children of the first year of life and newborns.

The main symptoms of the disease are severe abdominal pain, vomiting, watery stools without blood. The course of these diseases is particularly severe and lasts 2 weeks or more.

E. coli can be of several varieties, depending on this, the disease can manifest itself in various ways.

When affected by enteroinvasive E. coli, the upper sections of the large intestine are usually affected. Clinically, this is characterized by severe pain in the abdomen, profuse watery diarrhea. There may be blood in the stool.

Under the influence of enterotoxigenic Escherichia coli, cholera-like forms of intestinal infections develop in people of any age. Clinically, these forms are distinguished by the appearance of frequent, watery stools, which quickly lose their fecal character and the rapid development of dehydration.

Enterohemorrhagic Escherichia are the cause of the development of diarrhea with an admixture of blood, which is called hemorrhagic colitis. In addition, the complete absence of fever, the addition of symptoms of kidney failure and a pronounced drop in the number of platelets in the blood are characteristic.

Intestinal infections caused by enteroadhesive Escherichia are much less common and in their course resemble moderate forms of dysentery.

With all varieties of escherichiosis, there is a development of signs of intoxication, in many respects similar to intoxication in other bacterial intestinal infections. The severity of intoxication determines the severity of the condition of the sick child.

Complications. The most common complication of escherichiosis, which can develop with an intestinal infection, is caused by enterohemorrhagic Escherichia coli, is hemolytic-uremic syndrome, which can be recorded in 5–10% of patients. This syndrome is characterized by toxic destruction of red blood cells, resulting in anemia and acute renal failure (ARF). Signs of acute renal failure usually appear at the end of the first week after the onset of the earliest signs of intestinal disease.

Cholera

Cholera is an acute intestinal infection, the main feature of which is the defeat of the small intestine, which is accompanied by a violation of water-salt metabolism with varying degrees of dehydration of the body, which occurs due to massive loss of fluid with vomiting and copious watery stools. The disease is considered a particularly dangerous infection and can quickly spread among the population.

Vibrio cholerae causes cholera. There are two main ones - the classic one, which causes Asian cholera and El Tor.

The main way of infection with cholera is water, when they use unboiled water from open reservoirs.

After passing the stomach, the vibrio enters the small intestine, where it colonizes and multiplies on the surface of the intestinal epithelium. However, in sick people, vibrio can be found in any part of the gastrointestinal tract.

Having reached a certain concentration during reproduction, the vibrio causes disease.

With the development of the disease, there is a loss of a huge amount of fluid and salts of sodium, potassium, chlorides and bicarbonates. Vibrio cholerae affects people of all ages. The disease is most severe in people who abuse alcohol, who have had surgery to remove part of the stomach, and in young children.

Clinic. The incubation period for cholera can range from several hours to 5 days, but the average is 2-3 days. If a person took antibiotics for prophylactic purposes, but still fell ill, the incubation period can be extended to 9-10 days.

Cholera has a sudden onset. The most pronounced manifestation of cholera is diarrhea, which appears first. The stool characteristic of cholera looks like a watery, cloudy white liquid, with flakes floating in it. The stool is similar in appearance to rice water and has no odor. One of the first signs of cholera is muscle weakness and cramps in the calf muscles. In the future, profuse frequent vomiting joins the liquid watery stool.

With cholera, several degrees and stages of dehydration are distinguished.

I degree. With this degree, there is a loss of body weight in the range of 1-3%. Diarrhea and vomiting become more frequent from 2–3 to 5–6 times a day, and the duration of these disorders is 1–3 days. The state of health of patients usually suffers a little. The patient may feel a slight general weakness, thirst, dry mouth. The color of the skin and mucous membranes does not change, the pulse rate, blood pressure, urination remain within normal limits.

II degree of dehydration characterizes a body weight deficit in the range of 4-6%. The stool becomes more frequent up to 15–20 or more times a day, sometimes there is a slight pain in the epigastric region, diarrhea is accompanied by frequent vomiting. General and muscle weakness, dryness of the skin and mucous membranes become more pronounced, the tongue is dry and a white coating appears on it. There is a constant cyanosis of the lips and mucous membranes, hoarseness and roughness of the voice. In rare cases, there may be short-term convulsions of the masticatory muscles and muscles of the feet, hands and legs. In many patients, tachycardia is recorded, blood pressure decreases, and the volume of urine excreted decreases.

The body weight deficit at III degree of dehydration is already 7–9%. The chair can become more frequent up to 25–35 or more times a day, vomiting is repeated. This degree is characterized by a sharp general weakness, indomitable thirst. Cramps of the muscles of the limbs and abdomen become frequent and painful. The skin and mucous membranes are constantly cyanotic. The skin is cold to the touch. The patient's voice is hoarse, almost silent. Body temperature can drop to 35.5 °C. There is a sharp decrease in blood pressure, tachycardia, shortness of breath, patients almost completely stop urinating. Attention is drawn to the sharpening of facial features, sunken cheeks and eyes.

With IV degree of dehydration, there is a loss of more than 10% of body weight. Characterized by the rapid development of signs of cholera with very frequent diarrhea and vomiting. The condition of the patients is extremely serious. Signs of dehydration reach their maximum severity. Facial features are sharpened, widespread cyanosis of the skin and mucous membranes, the skin is cold to the touch and covered with sticky sweat. Around the eyes there is a pronounced cyanosis, "hands of a laundress", a suffering facial expression. Spasms of all muscle groups develop, they are often repeated and very painful. Body temperature drops below 35 ° C, the voice is completely absent. The work of the cardiovascular system is sharply disturbed: tachycardia, heart sounds are deaf, the pulse and blood pressure cease to be determined, breathing is rapid, shallow.

Viral intestinal infections

Intestinal infections caused by viruses are a group of various acute infectious diseases that are combined by signs of general intoxication and a predominant lesion of the stomach and small intestine (singly or in combination), i.e., most often manifested by gastroenteritis or enteritis. Other organs and systems of the body are also affected.

Most often, the gastrointestinal tract is affected by a rotavirus infection, followed by 2 types of intestinal adenoviruses in frequency.

Less commonly, gastrointestinal disturbances can be caused by enteroviruses and reoviruses.

Reproduction of rotaviruses occurs in the upper part of the small intestine.

Reoviruses are similar in structure to rotaviruses in many ways.

Reoviruses multiply in the mucous membrane of the small intestine and upper respiratory tract, so these parts of the body are affected first. Reoviruses can infect animals.

Adenoviruses mainly affect the respiratory tract, and only two types of adenoviruses cause diarrhea. In addition to the upper respiratory tract, adenoviruses also affect the small intestine.

Among enteroviruses that can cause diarrhea, Coxsackie viruses deserve attention.

All diarrhea-causing viruses are persistent in the environment. Enteroviruses are able to survive well in water. All viruses tolerate low temperatures well, even freezing.

Most of all, intestinal viruses affect children, but adults also get sick.

The source of infection with rotavirus infection is a sick person or a virus carrier. Most of the viruses the patient excretes with the stool. The main route of infection is the fecal-oral route, when infection occurs with food, through dirty hands. Another route of infection is airborne. The maximum rise in incidence occurs in the autumn-winter period.

The main difference between reovirus infection is that you can get infected not only from humans, but also from animals. This infection is usually contracted from virus carriers, since most often the disease is asymptomatic. The airborne route is the main way for the spread of infection. But the pathogen is able to be transmitted through water, food and through household contact.

Adenovirus infection is contracted from sick people, and sometimes from virus carriers. The main route of infection is airborne, transmission through dishes and common items is possible. The peak incidence is in the autumn-winter period.

The greatest danger when infected with an enterovirus infection is the virus carrier. The fecal-oral route of infection is the main one, although airborne droplets are also of no small importance. A combination of these infection mechanisms is possible.

Clinic. The incubation period for rotavirus infection ranges from 15 hours to 3–5 days, but does not exceed 7 days. In rare cases, it can be extended up to 9 days.

The vast majority of patients become ill with rotavirus infection during the first day. In half of the patients, the disease is mild. Gastroenteritis is the main manifestation of rotavirus infection. In addition to frequent loose stools, patients develop vomiting. But vomiting doesn't always happen.

Vomiting is not particularly frequent and lasts, on average, about a day. After the cessation of vomiting, the stool becomes frothy, watery and acquires a yellowish-greenish color. The chair does not happen more than 10-15 times a day. The duration of diarrhea is 3 to 5 days. Patients may experience abdominal pain. The intensity of the pain is moderate, it is felt in the upper abdomen or in the entire abdominal cavity. Pain is not always felt, usually there is discomfort in the abdomen.

Signs of intoxication are expressed moderately. Not everyone has a fever. If fever occurs, the temperature does not exceed 38 ° C. The duration of the febrile period is 1-3 days. The most common symptom is intoxication, which is manifested by weakness, loss of appetite. Possible short-term fainting. The phenomena of intoxication disappear earlier, before the normalization of the stool. Every second patient has pharyngitis, in the form of hyperemia of the posterior pharyngeal wall, a rare cough. Upper respiratory tract infections are more common with reovirus infection.

Adenovirus infection is characterized by prolonged intoxication and fever. In many patients, the temperature rises above 38 ° C and the febrile reaction lasts from 5 to 7 days. The defeat of the gastrointestinal tract is manifested by signs of gastroenteritis or enteritis. The stool becomes liquid, watery, its multiplicity is 5-7 times a day. In addition to diarrhea, in some cases vomiting is noted during the first 1–2 days. A typical symptom of an adenovirus infection is an enlarged lymph node. Sometimes the liver and spleen are enlarged (hepatosplenomegaly), conjunctivitis often develops.

A type of enterovirus infection, in which the gastrointestinal tract is predominantly affected, in most cases it has a mild course. Intoxication, as with all viral diarrhea, is combined with damage to the gastrointestinal tract in the form of moderate enteritis, which is manifested by loose, watery stools up to 5-7 times a day. But with this infection, other organs and systems of the body are also involved in the pathological process: patients develop a rash, mainly on the limbs, the upper parts of the respiratory tract are affected, tonsillitis is characteristic, in which transparent vesicles (vesicles) appear in the throat, and everyone has an enlarged liver and spleen.

Treatment of intestinal infections

Diet of patients with intestinal infections. Patients with intestinal diseases are prescribed a sparing diet. Preference is given to products that slow down the motor activity of the intestines and contain a large amount of tannin, which is found in blueberries, bird cherry, strong tea, viscous products such as slimy soups, pureed cereals, cottage cheese, kefir and kissels. You can eat crackers, and steam dishes from lean meat and fish. It is forbidden to eat fried and fatty foods, raw vegetables and fruits.

Gastric lavage. This procedure is an indispensable component of the treatment of food poisoning. Gastric lavage is carried out at any time from the onset of the disease, due to the ability of infectious agents to persist for a long time in the cells of the mucous membrane of the gastrointestinal tract.

Therapy aimed at reducing intoxication and replenishing fluid in the body.

Replenishment of fluid in mild or moderate dehydration in intestinal infections is sufficient to be carried out only by oral administration of appropriate solutions. Currently, solutions such as re-hydron, citroglucosolan are used.

Oral (through the mouth) fluid replacement (rehydration) for dehydration is carried out in two stages.

1. In primary rehydration, the main goal is to replenish the deficit of water and salts, which is present at the beginning of treatment. This procedure is carried out during the first 4-6 hours. The calculation of the required volume of fluid for the initial stage of rehydration depends on the degree of dehydration and weight.

Primary rehydration with a mild degree of dehydration is carried out for 4 hours, and with an average degree - 6 hours.

2. The second stage of rehydration is maintenance.

This step replaces the ongoing loss of water and electrolytes that occurs with vomiting and diarrhea and provides additional fluid requirements. With maintenance rehydration, for every next 6 hours, such a volume of fluid is injected as the patient lost over the previous 6 hours. To determine this volume, losses with diarrhea, vomiting, and also with hyperthermia are counted - for each degree in excess of 37-10 ml / kg.

If there is shortness of breath - for every 20-30 breaths in excess of the age norm - 10 ml / kg.

The solution can be drunk from a cup in sips or tablespoons at the required interval.

In addition to special solutions for rehydration, you can partially use just drinking, mineral water, herbal infusions and tea.

The disease can be accompanied by severe intoxication with any degree of dehydration, therefore, immediate infusion, detoxification therapy (administration of therapeutic solutions intravenously) is required.

It is customary to start infusion therapy with the introduction of colloidal solutions - fresh frozen plasma, Albumin, Reo-polyglucin, Hemodez, etc.

To compensate for the deficiency of water and salts, glucose-salt solutions are used, glucose is used in the form of a 5-10% solution.

Salt solutions are used in the form of polyionic solutions, "Quartasoli", "Trisoli", potassium chloride solution (potassium chloride concentration in the solution cannot exceed 1%), 4% sodium bicarbonate solution.

During the first 6–7 hours, the patient needs to inject a volume of fluid approximately equal to the estimated fluid deficit, usually up to 50% of the fluid is injected intravenously, in severe conditions accompanied by frequent vomiting, the part of the fluid injected intravenously reaches 70–80% of the volume.

Infusion therapy is necessarily carried out under the control of diuresis, i.e., the amount and speed of urine output is taken into account.

In case of potassium deficiency, a solution of potassium chloride diluted with glucose or saline is introduced. With acidosis (increased acidity of the blood), a 4% solution of sodium bicarbonate is injected.

Other directions of treatment of intestinal infections.

One of the main directions in the treatment of intestinal infections is therapy that helps to reduce the frequency of stool and its normalization.

For this purpose, indomethacin is prescribed for diarrhea.

During the first day, this drug is administered orally. In some cases, indomethacin may be prescribed the next day. In addition to reducing diarrhea, indomethacin is able to stop disorders of the heart.

To reduce the diarrheal syndrome, calcium preparations are sometimes used in combination with vitamin B2 (ergocalciferol). Calcium is prescribed in the form of intravenous injections of a 10% solution of calcium gluconate for 3 days.

Great importance in the treatment of diarrhea in patients with intestinal infections is attached to the use of drugs such as. These, first of all, include activated carbon, produced in tablets or in powder form.

Close in mechanism of action is a complex preparation of activated carbon KM, consisting of activated carbon, white clay, and sodium salt of carboxymethylcellulose. This drug has a higher activity. It is produced in the form of tablets taken orally.

A good effect is noted from the use of carbolong, which contains powder from activated stone charcoal.

One of the widely used sorbents is polyphepan. The drug is obtained by processing lignin, which is a hydrolysis product of the constituent substances of wood. It is taken orally, in the form of granules, which are well stirred in water before use.

The most effective sorbent is smecta, which has a pronounced enveloping effect. Smecta is able to protect the intestinal epithelium from damage. The release form of the drug is a powder packaged in bags. To use the contents of 1 sachet, dissolve in 100 ml of water and drink little by little over several hours. The drug has no contraindications, it can be prescribed to children of any age.

Another group of antidiarrheal drugs includes drugs that have an opioid effect. Representatives of this group are loperamide and trimebutine. The peculiarity of opiates is that they are able to inhibit intestinal peristalsis. They are usually given to older children and adults with diarrhea, in capsule form.

Trimebutin, used in tablets, has a positive effect on intestinal motility, normalizing the smooth muscles of the entire gastrointestinal tract.

Not so long ago, for the treatment of diarrhea, somatostatin was used, which has a normalizing effect on the processes of absorption and secretion in the intestine. Under the influence of this hormone, there is an increase in the rate of absorption of water and salts in the small intestine, the frequency of stool and fecal mass decrease. The drug solution is available in ampoules for subcutaneous administration.

With intestinal infections, dysbacteriosis almost always develops, or this condition is the result of the use of antibiotics. In the complex treatment of dysbacteriosis, agents that normalize the intestinal flora are used - bifidum-bacterin, coli-bacterin, bifikol, lineks, etc. (for more details, see rehabilitation).

Intestinal antiseptics. Previously, the following drugs of this group were used to treat intestinal infections - intesto-pan, intetrix and enterosedive.

Recently, ercefuril (nifuraxazide), which is a derivative of nitrofuran, has been used in the treatment of intestinal infections of diseases. This drug acts mainly in the intestinal lumen and is used to treat diarrhea caused by bacteria.

Quite often, from the drugs of this group, furazolidone is used. The most sensitive to furazolidone of the causative agents of intestinal infections are the bacteria of dysentery, typhoid fever, paratyphoid A and B. In addition, the resistance of bacteria to this drug develops slowly.

Antibiotics. Antibiotics are prescribed only for moderate and severe forms of intestinal infections.

In the treatment of intestinal infections from antibiotics, groups of penicillins, cephalosporins, monobactams, carbapenems, aminoglycosides, tetracyclines, polymyxins, quinolone drugs, nitrofurans, sulfonamides can be used.

Cephalosporins are one of the largest class of antibiotics. They have a wide antibacterial spectrum of action and low toxicity. The most commonly used for the treatment of intestinal infections are: cefotaxime (can be produced under the name klaforan, cefabol, etc.), routes of administration - intramuscularly or intravenously; ceftriaxone (also called longacef, rocefin, cefaxone, etc.), is also administered intravenously and intramuscularly.

There are three generations of quinolones. Registered in Russia are drugs belonging to the first and second generations. Fluoroquinolones have a broad antimicrobial spectrum of action. Widely used for intestinal infections: ciprofloxacin (also called cyprinol, ciprobay, ciprolet, etc.), ofloxacin (other names - zanocin, tarivid), norfloxacin (nolicin, normax), Lomoflox (lomefloxacin, maxakvin). All of these drugs are taken orally, or administered intravenously.

Of the tetracyclines, doxycycline (also called vibramycin, doxal, and tetradox) is commonly used and has a broad spectrum of activity. This drug can be prescribed only to children over 8 years of age, is contraindicated in pregnant and lactating women, patients suffering from severe liver disease and kidney failure. Available in the form of capsules for oral administration.

Aminoglycosides include drugs such as streptomycin, neomycin, kanamycin, netromycin, gentamicin, tobramycin, amikacin.

Antibiotics of this group are capable of toxic effects on the kidneys, can lead to deafness. Mainly used in the treatment of adults. When prescribing to children, special care is taken, therefore, two methods of dosing drugs are used: traditional, when the drug is administered 2 times a day and a single administration of the entire dose. In the treatment of intestinal infections, the following are usually prescribed: gentamicin (garamycin), netromycin, amikacin (selemycin, farcycline). Mostly these drugs are administered intravenously or intramuscularly.

Treatment of cholera, as a particularly dangerous infection, has its own characteristics.

All patients with cholera must be hospitalized and isolated to prevent the spread of infection.

In addition to symptomatic treatment, which is aimed at eliminating fluid deficiency, both orally and intravenously, antibiotics are prescribed to patients with cholera, which helps to reduce the duration of diarrhea and water-salt loss. Inside, antibacterial drugs such as doxycycline, tetracycline, levomycetin succinate, erythromycin, ciprolet (ciprofloxacin) can be prescribed.

The average course of antibiotic treatment is 3 to 5 days.

Inside antibiotics can be used only after elimination of dehydration and in the absence of vomiting, which can be achieved after 4-6 hours from the start of therapy. With severe dehydration, tetracycline and chloramphenicol are administered intravenously during the first hour of treatment, and then, the drugs begin to be given orally.

In the prevention of acute intestinal infections, there are three main areas that depend on the links of the epidemiological chain that determine the spread of infection. These include:

1) impact on the source of infection;

2) interruption of propagation paths;

3) reducing the body's susceptibility to infection. source of infection. Activities aimed at the full

and early detection and neutralization of the causative agent of intestinal infections are the main means in combating the spread of diseases. All children who suffer from intestinal dysfunctions, from the onset of the disease, are subject to bacteriological examination and isolation. Patients are usually isolated in specialized hospitals and, only occasionally, isolation at home is allowed, subject to the sanitary and epidemiological regime. It is forbidden to leave infected children in organized children's groups. Isolation is terminated after complete recovery and the presence of negative results of subsequent bacteriological control.

Children who have had dysentery are allowed to be discharged only after normalization of the stool, at normal temperature for three days and if there is a negative result of bacteriological examination, which is carried out not two days after stopping the course of antibiotics.

Patients with chronic dysentery should continue treatment in special sanatoriums (if this is not possible, they are discharged home) after relief of exacerbations, with normal stools and temperatures for 10 days, and also if there is a negative result of bacteriological examination, which is carried out 2 days after the abolition of antibacterial treatment.

Patients with dysentery in the stage of convalescence are under dispensary observation, which is carried out by the clinic for 1 month. Patients who have had protracted and chronic forms of the disease are observed up to 3 months.

Patients who have had coli infection are discharged from the hospital after clinical recovery and a negative bacteriological examination. Convalescents who have survived salmonellosis are discharged after clinical recovery and in the presence of a double negative result of bacteriological examination.

To identify the sources of infection, it is necessary to conduct a bacteriological study of feces from people who have been in contact with the patient. In cases of dysentery and salmonellosis, everyone around of any age is examined. If there were cases of coli infection and staphylococcal infection, all children of 1–2 years of age are examined, and mothers of newborns are also examined in maternity hospitals. If carriers are identified, they are isolated (at home or in a hospital) and subjected to prophylactic treatment.

In order to identify probable sources of infection, a bacteriological examination is carried out for all children who are again admitted to children's institutions, as well as children entering hospitals. Adults who work in children's institutions, kitchens, and shops are also subject to preventive examinations. They are examined upon admission to work, and in the future - periodically during scheduled medical examinations. If carriers are identified, they are suspended from work.

Distribution routes. In the focus of infection, current, and then, after hospitalization or recovery of the patient, final disinfection is performed. Very important among preventive measures are the disinfection of toilets, pots in preschool and school institutions, the fight against flies, the improvement of children's institutions, properly organized water supply and maintenance of the sewerage system, strict control over the anti-epidemic regime, especially in food blocks, control over storage and food processing.

In preventing the spread of intestinal infections, great importance is attached to sanitary and educational work among the population, in particular among the parents of children. Prevention of salmonellosis, in addition to the above, additionally includes activities carried out by the veterinary service in the distribution network, especially with regard to the supervision of the storage and sale of meat products. In order to prevent the possibility of the spread of staphylococcal infection, persons with pustular skin diseases are suspended from caring for infants and from work in catering establishments. With intestinal infections of a viral nature, the main preventive measure is the isolation of sick children until they recover.

The possibility of increasing specific immunity with the help of active immunization is very limited. For several years, attempts were made to use active immunization with the Bezredka vaccine against dysentery, but due to low efficiency, it was no longer used. Considerable importance is attached to the use of bacteriophages for the prevention, which are used in children's schools (up to 10 years old) and preschool institutions that are disadvantaged in terms of high incidence during the period when the highest seasonal rise in incidence is noted. The most effective phage scheme is to conduct a prophylactic course among children and staff of institutions every 3 days.

Particular attention should be paid to improving non-specific protective mechanisms, creating conditions that ensure the possibility of harmonious physical and neuropsychic development of children, adequate feeding of infants, etc.

Rehabilitation

Diet therapy during convalescence in intestinal infections. Food should be mechanically and chemically gentle and contain a sufficient amount of proteins, fats, carbohydrates and vitamins. Quite reasonably, spicy, spicy dishes, smoked foods are excluded from the diet, and the use of coarse vegetable fiber is limited. If there is a violation of the absorption of carbohydrates, the so-called disaccharidase deficiency, then a diet is prescribed in which milk sugar, lactose, is excluded. It is better to give preference to lactose-free mixtures, such as NAN Lactose-Free. Porridges are best cooked on vegetable broths, the use of vegetable dishes made from zucchini, cauliflower, potatoes has a good effect. The appointment of cottage cheese dishes, three-day kefir is recommended. The appointment of clinical nutrition is widely used, which contains fermented milk lactobacterin, bifi-lact, anacid bifilakt. You can use the addition of biologically active additives (BAA), such as BAA-1L (with lysozyme), BAA-1B (with bifidumbacterin), BAA-2 (with lysozyme and bifidum-bacterin).

specific bacteriophages. They are prescribed within 5-7 days if the pathogen is re-isolated.

Probiotics. They are prescribed from 2 weeks to 2-3 months, subject to the abolition of antibacterial drugs, specific bacteriophages, lactoglobulins. When prescribing, it is imperative to monitor the indicators of intestinal microbiocenosis. In this case, it is rational to prescribe bifidumbacterin, lactobacterin, bifikol, colibacterin, bifilong, travis, bactisubtil, biosporin, nutrolin B, acipol, enterol 250, biobacton, bifiform, acylact.

Enzyme therapy. Indications for the appointment of enzyme therapy are pronounced symptoms of secondary fermentopathy. Therapy is prescribed in the form of both mono- and polyenzymes. Treatment is monitored by coprocytogram.

Of the enzymes, the following are most often prescribed:

Oraza - for 2-4 weeks, pancreatin - 4-6 weeks, mezim-forte - a course of up to 2 months, creon - for 2 weeks, festal, digestal, panzinorm forte - also a course of 2 to 4 weeks.

Phage therapy. With persistent isolation of pathogens of intestinal infections from feces in high concentrations, it is rational to prescribe specific bacteriophages. The following preparations are used: pyobacteriophage combined, pyoceaneus, bacteriophage polyvalent Klebsieleus purified, bacteriophage Klebsieleus pneumonia purified, staphylococcal bacteriophage, coliproteic bacteriophage, intesti bacteriophage, dysentery bacteriophage with pectin base, dysentery bacteriophage with acid-resistant coating, polyvalent salmonella.

The duration of the course of treatment with bacteriophages, on average, is 1 month, but may be longer, depending on the results of bacteriological examination of feces.

Phytotherapy. The bactericidal purpose has the appointment of decoctions and infusions of herbs such as St. John's wort, calendula, eucalyptus, yarrow, cinquefoil, sage, lingonberry, plantain. To increase the secretory activity of the gastrointestinal tract, yarrow, wormwood, plantain, and cabbage juice are prescribed. In order to correct immunity, a decoction of nettle, plantain, succession, lemon balm is used. With an unstable, rapid stool, you can give rice broth, a decoction of bird cherry fruits.

Hypericum decoction.

Required: chopped St. John's wort - 1 tbsp. l. Preparation and application. Pour chopped herbs with 1 cup boiling water, cook for 10 minutes, strain.

Take 50 ml 4 times a day 30 minutes before meals (daily

This decoction has a good effect in diseases of the digestive system and during the period of recovery from intestinal infections.

Infusion of calendula.

Required: calendula flower baskets - 1 tbsp. l.

Preparation and application. Brew flower baskets with 1 glass of boiling water, leave for 40 minutes, wrap warmly, strain.

Take 1 tbsp. l. 3 times a day for 0.5 hours before meals after an intestinal infection and with beriberi C.

A decoction of eucalyptus leaves.

Required: eucalyptus leaves - 2 tsp.

Preparation and application. Brew leaves with 1 cup of boiling water, bring to a boil, boil for 1-2 minutes, insist until cool, strain.

Take 1 tsp. 3 times a day after meals with unstable stools.

A decoction of yarrow herb.

Required: yarrow herb - 1 tbsp. l.

Preparation and application. Brew grass with 1 cup of boiling water, simmer for 15 minutes over low heat, leave for 1 hour, strain.

Take 1 tbsp. l. 3-4 times a day after meals. Potentilla decoction.

Required: crushed cinquefoil leaves - 1 tbsp. l.

Preparation and application. Pour a glass of boiling water over the crushed rhizomes of the plant with roots, boil for 15 minutes, strain.

Take 1 tbsp. l. 3-4 times a day 1-1.5 hours before meals for gastrointestinal diseases, and can also be used for rheumatism and gout.

Infusion of cinquefoil rhizomes.

Required: crushed rhizomes of Potentilla - 1 tbsp. l.

Preparation and application. Brew chopped rhizomes with 1 cup of boiling water, insist, wrapped warmly, 3 hours, strain.

Take 1 tbsp. l. as a choleretic agent after suffering gastritis and enteritis, when there is a reduced acidity of gastric juice.

Infusion of sage leaves.

Required: chopped sage leaves - 1 tbsp. l.

Preparation and application. Sage leaves pour a glass of boiling water, leave for 20 minutes, cool, strain. The infusion is good for 2-3 days. Store in a cool place.

Take 1 tbsp. l. 3 times a day with unstable stool.

Infusion of lingonberry leaves.

Required: lingonberry leaves - 1 tbsp. l.

Preparation and application. Pour 100 ml of boiling water over lingonberry leaves for 2 hours, then strain.

Take 1-2 tbsp. l. 3-4 times a day before meals for diseases of the gastrointestinal tract. It can also be used for diseases of the kidneys, liver, bedwetting, gout, rheumatism.

Infusion of cranberries.

Required: cowberry fruits - 200 g.

Preparation and application. Pour the fruits in a colander with boiling water, then insist in 400 ml of chilled boiled water for 6 hours.

Take 100 ml 4 times a day before meals for constipation, due to dysbacteriosis, gastritis, colitis.

Infusion of leafy lingonberry branches.

Required: chopped deciduous lingonberry sprigs - 1 tbsp. l.

Preparation and application. Brew raw materials with a glass of boiling water, leave for 30 minutes, strain.

Take 2 tbsp. l. 4-5 times a day to increase the body's resistance.

A decoction of lingonberry leaves.

Required: lingonberry leaves - 2-3 tbsp. l.

Preparation and application. Boil the leaves in 3 cups of water for 10 minutes, then leave for 1 hour and strain. Drink 200 ml 3 times a day before meals for gastritis, colitis. The decoction has a good effect on colds, coughs.

Infusion of plantain leaves.

Required: dried plantain leaves - 100 g.

Preparation and application.

Brew 500 ml of boiling water dried leaves, leave for 2 hours, strain.

Take 1 tbsp. l. 3 times a day before meals with gastritis that developed after intestinal infections, when there is low acidity, hemorrhoids.

Infusion of psyllium seeds.

Required: psyllium seeds 25 g.

Preparation and application. Brew 200 ml of boiling water seeds, shake for a long time, strain.

Drink 1 tbsp. l. 3 times a day 15–20 minutes before meals for constipation caused by intestinal dysbacteriosis after intestinal infections.

Cabbage juice.

Preparation and application. Cabbage juice is obtained by pressing from fresh leaves. white cabbage. It has a pleasant smell and delicate taste. The patient should drink raw juice after taking a light meal, depending on age, from 200 ml to 1 liter per day. The intake of juice contributes to the disappearance of sensations such as sour belching and pain. The course of treatment is 4-5 weeks.

A decoction of the leaves of wormwood and sage.

Required: wormwood leaves - 2 tbsp. l., sage leaves - 2 tbsp. l.

Preparation and application. Mix in equal proportions the leaves of wormwood and sage. 2 tbsp. l. boil the mixture in 400 ml of water for 30 minutes, strain.

Take 1 tbsp. l. after 2-3 hours with lesions predominantly of the large intestine.

A decoction of nettle roots.

Required: crushed roots and rhizomes of wormwood - 1 tbsp. l.

Preparation and application. Boil raw materials in 200 ml of sugar syrup or honey for 15 minutes.

Take 1 tbsp. l. 5-6 times a day after suffering gastritis, colitis. Can be used for coughs, urolithiasis, furunculosis, rashes and acne.

Melissa herbal infusion.

Required: lemon balm herb - 1.5 tbsp. l.

Preparation and application. Brew 180 ml of boiling water grass, insist, wrapped warmly, 1 hour, strain.

Drink this dose 3-4 times a day for disorders of the gastrointestinal tract associated with constipation.

Melissa tincture.

Required: lemon balm herb - 1 tbsp. l.

Preparation and application. Pour 100 ml of alcohol or 1 glass of vodka grass, leave for 2 weeks in a dark place, strain.

Take 15 drops 3 times a day for gastrointestinal diseases and bloating.

Rice decoction for diarrhea.

Required: rice - 1 tea cup.

Preparation and application. Pour rice with 6-7 cups of water, put on low heat and boil. Cool the resulting broth, strain.

Give a child 1β cups, an adult a cup every two hours for diarrhea.

A decoction of bird cherry fruits.

Required: bird cherry fruits - 1 tbsp. l.

Preparation and application. Pour the fruits with a glass of boiling water, cook on low heat for 10 minutes, leave for 1-2 hours, strain.

Drink 1/2 cup 2-3 times a day as an astringent for diarrhea.

Vitamin therapy. Multivitamins and vitamin complexes such as junior lifepack +, nutrimax +, sveltform +, mystic, passilat, coopers can be used. The course of treatment is 1.5–2 months.

Immunomodulatory therapy. It is prescribed after severe invasive intestinal infections.

1. Methyluracil is available in tablets for oral administration 3-4 times a day after meals. The course of treatment is up to 1 month.

2. Sodium nucleinate is prescribed in drops 3-4 times a day for 2-3 weeks.

3. Lysozyme is produced in the form of a dry substance, it is prescribed 20-30 minutes before meals 3-4 times a day for 7-10 days.

4. Immunal (or echinacea tincture) is prescribed in drops 3 times a day for 1 month.

5. Cycloferon is available in tablets and in solutions for injection it is prescribed 1 time per day according to the scheme: 1-2-4-6-8th day of treatment.

Treatment of intestinal dysbiosis, which occurs as a complication of intestinal infections or antibiotic treatment.

Therapy of intestinal dysbacteriosis should be complex. A protective regime is organized, which includes the creation of a favorable psychological environment, the patient should be in the fresh air for a long time, sleep should be long, and the diet should correspond to the age of the child.

Diet. The diet of children who have developed intestinal dysbacteriosis should be complete in terms of calories and the content of the main food ingredients. Food should be taken at the same hours, it is desirable to adhere to the rhythm of digestion. Nutrition should be, if possible, varied, food can be saturated with vitamin complexes: junior lifepack +, mystic, passilate, sveltform +, chromvital +, etc.

It is desirable to include in the diet foods that stimulate the intestinal microflora. These products include products, which are used in the preparation of wheat, rice, corn, buckwheat, millet. From vegetables, cabbage, carrots, zucchini, pumpkin, tomatoes can be noted. In addition, it is desirable to use fresh fruits, meat and fish of low-fat varieties, dairy products, vegetable fats. The best food for young children is mother's milk, which contains all the necessary nutrients, as well as substances that support the microflora and immunoglobulins that protect the intestinal mucosa. If the mother does not have breast milk, then it is preferable to use adapted milk formulas with probiotic supplements for feeding (Nutrilak, prenutrilak, NAS 6-12 with bifidobacteria). For children older than a year, it is rational to prescribe kefir, yogurt, "Biolact", "Bifidok", "Narine". The treatment regimen for intestinal dysbacteriosis consists of 3 successive stages.

First stage. At this stage, the main task is to change the chemical processes in the intestine and eliminate the conditionally pathogenic flora. To suppress the vital activity of conditionally pathogenic microorganisms, it is advisable to prescribe bacteriophages. They are viruses of microbes and, unlike chemotherapeutic drugs, have a selective effect on specific types of bacteria, moreover, they do not affect the normal microflora.

Staphylococcal bacteriophage is a sterile phagolysate filtrate that has the ability to destroy the corresponding species of staphylococci. May be given to children of any age. Available in solutions for oral administration, for therapeutic enemas and in the form of suppositories, for injection into the rectum. It is prescribed 2-3 times a day.

Coliproteus bacteriophage contains components that are active against the most common serological groups of pathogenic Escherichia and Proteus.

Klebsiella polyvalent bacteriophage and Klebsiella bacteriophage contain filtrates of phagolysates of Klebsiella pneumonia, ozena, rhinoscleroma and Klebsiella resistant to antibiotics.

Pseudomonas aeruginosa bacteriophage (pyocyaneus) contains phagolysate, which is capable of destroying Pseudomonas aeruginosa.

Pyobacteriophage combined has in its composition components that are capable of destroying staphylococci, streptococci, Escherichia, Proteus and Pseudomonas aeruginosa.

Coliproteus, Klebsiella, Pseudomonas bacteriophage, pyobacteriophage are prescribed to children in the same age dosage as staphylococcal bacteriophage.

The Intestibacteriophage contains phagolysates that destroy both pathogenic pathogens of intestinal infections, in the form of Shigella, Salmonella, pathogenic Escherichia, and opportunistic pathogens - Enterococci, Staphylococci, Proteus, Pseudomonas aeruginosa. Children in the age dosage of intestibacteriophage are prescribed 3 times a day orally and 1 time in an enema. The drug is given 1 hour before meals. The initial course of treatment is 5-7 days.

To improve the cleansing of the intestines from pathogenic flora, the appointment of specific lactoglobulins is justified. The drug is a purified fraction of globulins, which are obtained from the colostrum of cows. The therapeutic effect of the drug is associated with the presence of specific antibodies to pathogenic Escherichia, to Proteus, Klebsiella and Staphylococcus aureus. The drug is prescribed orally 2-3 times a day for half an hour before meals. The duration of the course of treatment is 5 days.

A good effect is the use of a complex immunoglobulin preparation (CIP). The therapeutic effect is associated with the content of immunoglobulins in it of 3 main classes (1d O, 1d M, 1d A). This drug acts on both pathogenic and opportunistic flora. KIP can be prescribed to children, starting from the first month of life, 1-2 times a day, half an hour before meals. The course of treatment is 5 days.

Second phase. It consists in colonizing the intestines with normal microflora by prescribing live bacterial preparations (probiotics). This takes into account the age, the state of the intestinal microflora. The duration of treatment depends on the severity of dysbacteriosis and ranges from 1 to 3 months.

Probiotics are preparations containing live, dried bacteria that maintain or restore the normal composition of the intestinal microflora.

The group of probiotics includes the following drugs:

1) bifidumbacterin dry - consists of a suspension of living bifidobacteria. One dose of the drug contains at least 10 units of live bifidobacteria;

2) bifidumbacterin forte - is a preparation that contains a dried microbial mass of live bifidobacteria and a sorbent - activated carbon. One dose of the drug contains at least 10 units of bifidobacteria;

3) lactobacterin dry - is a monocomponent preparation, which contains the microbial mass of live active lactobacilli;

4) dry colibacterin contains a dried microbial mass of live bacteria of Escherichia coli;

5) bifikol dry - the preparation contains cultures, co-grown, Escherichia coli and bifidobacteria;

6) bifilong - consists of their biomass of two varieties of bifidobacteria;

7) bifiform - is a combined preparation that contains bifidobacteria and enterococci. In addition, the drug has antagonistic activity against pathogenic and opportunistic microorganisms;

8) in biobacton - contains a culture of acidophilus bacillus, which is characterized by high antimicrobial and acid-forming properties;

9) acipol - live acidophilic lactobacilli and heated kefir fungi. The drug is characterized by high acid-forming and antagonistic activity. Kefir fungi act as immunomodulators that stimulate the body's defenses;

10) acylact - is a complex preparation that contains 3 varieties of acidophilic lactobacilli. When taking this drug, the growth of lactobacilli and bifidobacteria in the intestine is stimulated;

11) Linex - is a multicomponent drug that has the ability to inhibit the growth of opportunistic bacteria. In addition, it improves the absorption of monosaccharides and stabilizes the cells of the intestinal epithelium;

12) bactisubtil - is a drug that contains spores of specific bacteria. The vegetative forms of such bacteria secrete enzymes involved in the breakdown of carbohydrates, fats and proteins, promote the synthesis of vitamins P and K, suppress the growth of Escherichia, Staphylococcus, Streptococcus, Proteus;

13) dry biosporin consists of live microbial cells of bacilli, which tend to inhibit the growth of pathogenic and opportunistic bacteria;

14) Nutrolin B is a combined preparation consisting of lactobacilli and PP vitamins;

15) Enterol 250 contains lyophilized yeast Saccharomyces boulardii. This drug restores the normal intestinal microflora and has a pronounced antidiarrheal effect. In addition, the drug inhibits the growth of pathogenic and opportunistic microorganisms;

16) travis contains two varieties of lactobacilli, bifidobacteria and one strain of streptococcus. The drug has an antagonistic effect on some pathogenic and opportunistic bacteria.

Third stage. The task of this stage is to increase the nonspecific protective reactions of the body, resulting in the formation of normal intestinal microflora. To stimulate the growth of microorganisms of the normal intestinal flora, preparations of various groups are used. This is achieved by prescribing calcium pathoge (stimulating the growth of bifidobacteria), pamba (promoting the growth of lactobacilli, normal rods and bifidobacteria), hilak forte, which helps restore normal intestinal microflora, lactulose, which enhances the growth of bifidobacteria.