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Gastroenteritis - translated from Latin means “inflammation of the stomach and small intestine.” This is an inflammatory lesion of the mucous membranes of these organs (GIT). If gastroenteritis is detected, symptoms and treatment in children need to be identified and treated promptly. If the process is started, the child will experience exicosis (loss of fluid due to intense stool and profuse vomiting).

It is known that any pathology in the body can disrupt its functioning and cause complications. Therefore, it is very important to know the symptoms and treatment of gastroenteritis in children. Young children are at greatest risk of developing complications, because... they rapidly develop dehydration, which becomes severe in a short time, resulting in death.

Among the complications of gastroenterocolitis are:

• exicosis of various degrees;
• decrease in circulating blood volume;
• infectious-toxic shock;
• organ dysfunction;

An adult can also get gastroenteritis.

Causes of the disease

The occurrence of this disease in children can be caused by pathogenic microorganisms.

• viruses ( , );
• bacteria (Shigella, Proteus, Salmonella, Escherichia coli);
• protists (for example,);
• helminths.

In half of the cases, gastroenteritis in children occurs due to viral infections - most often due to rotavirus.

In addition, a nutritional form of the disease is possible, which occurs when fruits or vegetables are taken together with fermented milk products. Also, an allergy to any food product can contribute to the occurrence of gastroenteritis of varying severity.

This form of the disease does not pose a danger to the child. To cure it, it is necessary to adjust the diet and quality of nutrition.

How is infection possible?

The most common methods of infection are:

1. Contact and household route, if personal hygiene is not observed.
2. Water. Occurs directly through water that is contaminated. This route of transmission of infection is widespread.
3. The fecal-oral route is through dirty hands or contact with feces.
4. Nutritional path. You can become infected through contaminated foods. As practice shows, dairy products are more likely to cause disease.

It is important to know that within a week after recovery, people are carriers of the bacteria and can infect healthy people.

Predisposing factors

Not all children are affected by gastrointestinal pathology (gastritis, enteritis). Most often, those who have predisposing factors are susceptible to the disease.

These include:

• unwillingness or inability to maintain personal hygiene. If children do not learn to wash their hands before eating from childhood, then they are automatically at risk;
• Children under one year of age are also at risk. This is due to the fact that their body is not yet strong enough, and there is not the required amount of immunoglobulins;
• unsatisfactory processing of food products: meat, fish, as well as eggs, vegetables and fruits.

Infection is possible after contact with a sick person.

Parents should carefully handle child care items and food products. During breastfeeding, the mother is obliged to properly care for the mammary glands.

Classification of the disease

The disease can occur in mild, moderate or severe form, and a distinction is made between acute and chronic gastroenteritis.

1. With a mild course of the pathology, the temperature is not always expressed. Symptoms of intoxication (nausea, vomiting) are mild. The stool is not profuse, but quite frequent.
2. In the moderate form of the disease, the temperature is low-grade. The frequency of loose stools and vomiting reaches 10 times a day.
3. In the latter degree of severity, the patient experiences hyperthermia. Symptoms of intoxication are pronounced; bowel movements can reach up to 15 times a day. As a result, grade 3 exicosis develops. Patients lose appetite, body weight decreases by 5%.

The difference between acute and chronic gastroenteritis is that the first form occurs unexpectedly and is accompanied by all the characteristic symptoms. The second form is associated with a violation of the diet and quality of nutrition.

Symptoms of acute gastroenteritis in children are individual, here is the main list of signs:

• abdominal pain of varying degrees;
• nausea and vomiting;
• flatulence, intestinal rumbling;
• intense, repeated vomiting mixed with bile;
• intestinal upset, frequent loose stools;
• low-grade or febrile temperature, which is accompanied by muscle soreness;
• symptoms of intoxication (loss of appetite, malaise, weakness);
• severe signs of dehydration;
• if the process is started, then a decrease in weight is noted.

If your child exhibits any of the previously described signs, you should immediately contact a medical specialist.

What symptoms should you be wary of?

In order to notice gastroenteritis in children in time, it is advisable for every parent to know the symptoms.

If the symptoms of the disease develop rapidly, then you should think about an acute form of gastroenteritis. The initial sign of the disease is the appearance of nausea, after which repeated vomiting and frequent loose bowel movements are noted. Diarrhea can occur up to 20 times a day and lasts for 7 days. The baby suffers from pain in the umbilical ring area.

In severe forms of the disease, the temperature rises to 40 degrees. However, it happens that it is no more than 37.5. In parallel with these symptoms, there is a lack of appetite, headache, asthenia and pallor.

At first, vomit contains undigested lumps of food, and then contains bile. The stool in children is mushy and gradually becomes liquid. Feces are swampy or whitish in color. Sometimes streaks of blood appear.

Laboratory research methods include stool culture on various nutrient media. In addition, a CBC is required to detect leukocytosis, serological studies and OAM.

Instrumental diagnostic methods: FGDS, ultrasound of the abdominal organs.

Treatment

Treatment of the disease can be carried out on an outpatient basis. In case of severe disease - in a hospital setting.

Treatment must be correct and comprehensive. It includes a therapeutic diet and medication.

It is not recommended to feed the patient in the first 24 hours. On the second day, the daily amount of food is half the age norm. If the baby is fed with mother's milk, the children's doctor does not prohibit putting him to the breast. Only feeding should be frequent, not plentiful.

If the child is bottle-fed, then the single serving is reduced in volume, but feeding is carried out more often. Doctors recommend fermented milk mixtures for sick children.

Older children are prescribed broths, boiled vegetables and porridge with water. Gradually the diet is expanded to normal.

The main thing in this therapy is to prevent the development of dehydration or eliminate it. To do this, use oral rehydration or a water-tea break.

1st degree of exicosis - for 4-6 hours the child is prescribed fluid intake - 50 ml multiplied by the child’s body weight. Then the required amount of liquid is given every hour for 6 hours.

Stage 2 – the volume of liquid should be 80 ml, multiplied by the baby’s weight. As with stage 1, desoldering lasts for 6 hours.

The intake of saline solutions is alternated with water or sweet tea. For example, Regidron solution is combined with sweet tea in equal proportions.

The famous children's doctor Komarovsky recommends drinking plenty of fluids for any disease, this ensures detoxification of the body.

Drug therapy

Antibacterial agents are prescribed medicinally. The most commonly used antibiotics are: Enterofuril, Furazolidone, Gentamitacin.

From a number of cephalosporins - Ceftriaxone.

Antiviral drugs are used for viral etiology of the disease. The following drugs are prescribed: “Anaferon”, “Kagocel”, “Ergoferon”.

Enterosorbents are used to cleanse the intestines.

• From fibrous – Polysorb.
• Natural – Smecta.
• Carbon - Activated carbon.

To stabilize the intestinal microflora, pro- and prebiotics are used. “Bifidumbacterin”, “Lactobacterin”, “Bifiform”.

To improve the absorption of food and accelerate digestion, enzymes are prescribed - “Mezim”, “Creon”.

When restoring water and electrolyte balance, medications are used that are purchased in pharmacies without a prescription. Doctors categorically prohibit giving apple juice to a child during illness, because it will worsen diarrhea. The diet is gradually normalized, including rice, bananas, and potatoes. Dairy products, soda and confectionery should be avoided.

Infants and children need rest during illness, because... During the pathological process, they spend a lot of effort and energy.

There is no need to give anti-diarrhea medications or aspirin. Before using antipyretics, it is advisable to consult a specialist.

20 minutes after the attack of vomiting, the child is given some liquid - breast milk or an adapted formula.

Diet for gastroenterocolitis

The main point in the treatment of “stomach and intestinal flu” is proper and balanced nutrition.

Do not use:

• fried, spicy and fatty foods;
• chips, crackers and fast food;
• soda;
• milk and products containing it;
• baked goods and confectionery products.

In the first 24 hours of therapy, it is necessary to exclude food, but if this is not possible, then you can eat some white bread crackers and tea.

What you can eat:

• meat and fish (low-fat),
• fresh fruits and vegetables,
• hard boiled eggs,
• broths,
• porridge on water.

Prevention and prognosis

If treatment is started on time, the outcome is favorable. Basically, acute inflammation of the stomach and intestines resolves within a week.

Alexandra is a regular expert on the PupsFull portal. She writes articles about pregnancy, parenting and education, child care and child health.

Articles written

Intestinal diseases in children occur almost as often as colds. Inflammation of the digestive organs leads to many unpleasant consequences. The most well-known of these is dehydration due to severe vomiting and diarrhea. Parents should know what to do to relieve symptoms. Such manifestations are characteristic of a wide variety of diseases that require a specific approach to treatment. One of them is gastroenteritis. In a child, especially a very young one, the condition worsens very quickly. It is important to seek help from a doctor in time.

Content:

Characteristics of the disease

If your baby suddenly starts to have a stomach ache, nausea and severe vomiting, then the cause is most likely acute inflammation that has arisen in the gastrointestinal tract. Gastroenteritis is an inflammatory process in the mucous membranes of the stomach and small intestine. If the process extends to the large intestine, the disease is called gastroenterocolitis.

Most often, damage to the mucous membranes occurs due to the entry of infectious agents (bacteria, viruses, protozoan microorganisms). However, gastroenteritis can also be non-infectious in nature.

Children especially often experience gastrointestinal disorders and other symptoms of inflammation. Before the age of 3 years, a similar disease occurs in every child and can recur several times. This is explained by the peculiarities of the development of the children's immune system (it is much weaker than that of adults). The child’s body is much less protected from the penetration of various infectious agents.

In addition, due to the peculiarities of the children's digestive system, babies produce much less gastric juice than adults. The acidity of the stomach and intestines is not sufficient to completely suppress the proliferation of pathogens.

Microbes more easily penetrate the child’s circulatory system through the thin walls of blood vessels. The infection quickly penetrates the blood and spreads to various organs. This causes the rapid appearance of acute symptoms of poisoning of the body and the development of complications.

Depending on the cause of the disease and the type of pathogen, the incubation period ranges from 2 hours to 5 days. During this period, the baby is contagious to others, as well as during the development of symptoms, as well as for 10 days after recovery, when infectious agents are detected in the feces.

Complications and consequences of gastroenteritis

A serious complication of gastroenteritis can be dehydration, which leads to thickening of the blood and a decrease in its total volume, disruption of the structure of brain cells and the immune system.

Inflammation of the mucous membranes of the stomach and intestines makes normal digestion and absorption of food impossible. As a result, a deficiency of essential nutrients is created in the body, which affects the functioning of other organs. The consequence of this, as well as poisoning by toxins, can be disruption of the heart, damage to the brain, liver and kidneys.

The main factor that provokes intestinal infection in children is non-compliance with hygiene rules. Pathogenic microorganisms enter the baby's mouth from dirty hands that are not washed after using the toilet, coming in from outside, or interacting with a pet.

Types of infectious gastroenteritis

Depending on the type of infectious agents that caused the disease, gastroenteritis is divided into several types:

1. Viral. The cause of the disease is the penetration of various viruses into the child’s body. There are 2 types of viral gastroenteritis, taking into account the predominant multiplication of pathogens in certain organs: rotavirus and astrovirus infection (viral multiplication occurs mainly in the intestines) and coronavirus, adenoviral infection (pathogens enter the respiratory system from the air, actively multiply, and then infect the intestines).
2. Bacterial. The cause of gastroenteritis is damage to the stomach and intestines by bacteria such as salmonella, shigella, pathogenic E. coli, staphylococcus and others.
3. Gastroenteritis caused by protozoan microorganisms such as Giardia, dysenteric amoebas, cryptosporidium.

Warning: A child can become infected from adults if they do not follow basic hygiene rules: they do not wash their hands after changing the baby’s diapers, or play with him without washing his hands after returning from outside. Infection is also possible if, when starting breastfeeding, the mother does not disinfect the nipple.

Causes of non-infectious (alimentary) gastroenteritis

Disorders of the stomach and intestines may be of a nutritional nature.

The cause of inflammation of the mucous membranes and the occurrence of gastroenteritis is the simultaneous consumption of incompatible products (for example, cucumbers and milk). In infants, a similar reaction occurs when a new product is introduced into complementary foods. Substances that cause digestive upset can enter the baby's body through breast milk if the nursing mother eats fatty foods.

The cause of allergic gastroenteritis is the baby’s intolerance to certain food components (for example, gluten or lactose). Allergies sometimes manifest themselves to the most common foods: sweets, sausages, sausages.

Intestinal dysbiosis occurs after a child is poisoned by toxins contained in spoiled food. Poisoning also occurs when consuming plant products treated with herbicides or grown with fertilizers. Dysbacteriosis is often caused by treatment with antibiotics and some other medications.

Symptoms of gastroenteritis

Gastroenteritis of a bacterial and viral nature is most severe in children. Manifestations of the disease gradually become more severe. In the absence of proper therapy, complications arise that affect the brain, nervous system, heart, liver, and kidneys. The severity of the first manifestations and the duration of the incubation period depend on the type of pathogen, the state of immunity and the age of the patient.

Acute form of the disease

Manifested by the following symptoms:

• loose greenish stools with a pungent odor;
• there is mucus in the stool, sometimes diarrhea alternates with constipation;
• increased gas formation in the intestines, rumbling in the stomach due to dilution of feces;
• pain in the stomach and navel;
• nausea, vomiting (signs of body intoxication);
• headache and drop in blood pressure;
• weakness, drowsiness, apathy.

The child loses his appetite. The baby refuses to breastfeed and suddenly loses weight.

A sign of poisoning of the body with toxins and the occurrence of an inflammatory process is an increase in temperature (from slight to significant). In this case, a feverish state occurs, the child sweats profusely. This further increases dehydration.

Signs of complications

They can be strong fluctuations in the baby's body temperature during the day. When the temperature drops, cold sweat appears on his forehead. As the fever increases, the patient's arms and legs begin to twitch. The skin turns pale.

There is dizziness, in which the child cannot remain in an upright position. Blood pressure drops sharply.

Dryness and dullness of the skin indicate dehydration. Typical signs include urinating too infrequently. Urine becomes thicker and darker.

There is a lack of tears when crying. The patient experiences a feeling of dryness in the nose and throat (due to lack of moisture in the mucous membranes). The heart rate increases and the child becomes weak.

In infants, the fontanelle sinks. Dehydration is extremely dangerous for such a baby. Even if his body loses only 10% of fluid, death may occur due to failure of the heart and other vital organs.

Severity of gastroenteritis

The severity of the disease is assessed by the frequency of stool and the intensity of vomiting in the patient.

Mild course– the child has loose bowel movements and vomits about 3 times a day. Body temperature is normal. There are no signs of dehydration.

Moderate severity– such episodes are repeated 4-10 times a day. The temperature rises to 38°-38.5°. The degree of dehydration is insignificant. It manifests itself as dry skin and thirst.

Severe degree– the number of episodes of diarrhea and vomiting is more than 10. There is an increase in body temperature to 40°. Convulsions and loss of consciousness are possible. Symptoms of dehydration increase.

The percentage of body fluid loss and the degree of dehydration can be determined by comparing the child’s weight before illness and during illness.

The inflammatory process occurs in both acute and chronic forms. With a chronic disease, children periodically experience stomach pain, diarrhea and vomiting. Poor absorption of vitamins and other nutrients by the body leads to poor development of the child. Schoolchildren's memory weakens and they begin to lag behind in their studies.

Diagnostics

When making a diagnosis, the doctor takes into account the symptoms of the disease and palpates the small patient’s abdomen. Bloating, soreness, rumbling in the abdomen, accompanied by nausea and vomiting, are signs that require clarification of the diagnosis.

General blood and urine tests are performed. An increased content of leukocytes in them indicates the presence of an inflammatory process. A low level of hemoglobin in the blood indicates tissue hypoxia and intoxication of the body. The occurrence of pathologies of internal organs is judged by the content of red blood cells and platelets in the blood.

The pediatrician refers the child to a gastroenterologist. A bacteriological examination (culture) of feces and vomit is carried out to determine the type of bacteria and their sensitivity to antibiotics.

Microscopic analysis of blood and feces allows you to detect lamblia, amoebas and other protozoan microorganisms. By analyzing stool, you can find out if your baby has worms.

The type of viral infection is clarified using PCR methods (the DNA of pathogens is determined) and ELISA (analysis for antigens to pathogenic microorganisms). Carrying out analyzes makes it possible to select the most suitable drugs.

Video: Treatment of intestinal infections

Treatment of gastroenteritis

In mild cases, it is carried out at home. If signs of severe complications occur (high fever, convulsions, severe dehydration), the child is hospitalized.

It is important to provide emergency assistance to the patient. To eliminate dehydration, the hospital administers an intravenous infusion of saline with glucose to restore the water-salt balance. Antiemetics are prescribed to relieve nausea and vomiting and restore the ability to drink water and eat food.

The following drugs are used:

1. Antibiotics (polymyxin, furazolidone, gentamicin), if gastroenteritis in children is found to be of bacterial origin. They are prescribed in strictly individual doses and for a short time, so as not to increase intestinal dysbiosis.
2. Agents that increase the content of beneficial lacto- and bifidobacteria in the intestinal microflora. Such drugs (Linex, Hilak Forte, Bifidumbacterin) are prescribed to mitigate the effects of antibiotic treatment and to restore intestinal function.
3. Antiviral (kagocel, anaferon) and other antimicrobial agents.
4. Sorbents for absorbing toxins (enterosgel, polysorb).
5. Diuretics to speed up the cleansing of the body from harmful substances.
6. Painkillers (antispasmodics).
7. Non-steroidal anti-inflammatory drugs.
8. Enzymes that improve food digestion (mezim, creon).

Note: You should not try to treat your child at home by giving him bowel strengthening agents. This will not help eliminate the inflammatory process and intoxication of the body. In this case, the picture of the disease may be confused, which will make it difficult to determine the cause of the disorder and prescribe effective treatment.

To restore strength and increase immunity, vitamins and immunostimulants are prescribed. Compliance with the diet during the acute period of the disease and during the next 2-4 weeks after recovery is of great importance.

A breastfed baby needs to be breastfed more often. If the baby has almost been transferred to a regular diet, then in the first days of illness he can be given low-fat yogurt, diluted with rice water. Then, after a couple of days, he is fed with low-fat chicken broth, as well as porridge cooked in water. Then sweetened tea with white crackers and boiled vegetables are introduced into the diet.

Food for a small child must be cooked every day to keep it fresh. It is not recommended to feed your baby meals prepared for adults (very salty, containing various flavoring additives). This can cause irritation of the mucous membrane and the occurrence of alimentary gastroenteritis.

Your baby should not be given foods containing large amounts of animal fats. Meat and eggs must be thoroughly boiled. It is better to use bottled water for drinking.

Video: Principles of feeding and treatment for intestinal infectious diseases

Damage to the mucous membrane of the stomach and the walls of the small intestine leads to a disease called gastroenteritis. This is a very dangerous damage to internal organs, causing complications and sometimes death. Gastroenteritis in children occurs more often than in adults, and usually occurs in an acute form.

The risk group for the occurrence of the disease includes children aged 1 month to 3 years. The pattern is due to the failure of a small child to comply with hygiene rules. It’s rare to see a child running into the kitchen to wash a plucked apple or a found apricot. The infection that causes the disease is transmitted in various ways:

• Through water;
• When touched.

The occurrence of an inflammatory process in the stomach and small intestine in children occurs for various reasons:

• Infectious. This includes infection with viruses, bacteria, and protozoan microorganisms.
• Non-infectious. This is the ingestion of worms, food allergens, poisonous mushrooms, and toxins from fish products. Medications (some types) are dangerous.

Also acting as provoking factors are:

• A large amount of food with a high content of coarse fiber.
• Spicy food.
• Carbonated drinks from the refrigerator.
• Hypothermia of the body.
• Imbalance of microflora in the intestinal tract.
• Low vitamin content.

In a newborn, the onset of the disease is possible due to breastfeeding, when the mother ate the wrong product or there is food in complementary foods that causes inflammation.

Pathogenic microorganisms entering the stomach disrupt the integrity of the epithelial layer. As a result, inflammation occurs, the nerve endings are irritated by the products of the process, and the child feels pain, nausea and vomiting. The impact affects not only the mucous membrane of the upper epigastric organ. Inside the small intestine, the villi are damaged, the digestive process is altered, moisture is not absorbed, and the balance of electrolytes and nutrients is disrupted. The pressure inside the canal of the thin section of the tract increases. Against this background, diarrhea occurs with frequent stools of a liquid consistency.

Forms of diseases

Medicine distinguishes two forms of gastroenteritis: acute and chronic. The first type manifests itself with intense symptoms in the period from 7 to 10 days. The second type is characterized by alternating occurrence of symptoms: periods of exacerbation and periods of rest.

In turn, the acute form of the disease occurs due to the influence of the following factors:

• Viral. The main period when infection occurs is winter. The first symptoms appear 1-3 days after infection. Symptoms of the disease are often accompanied by a cold: sore throat, runny nose and dry cough.
• Bacterial. Occurs as a result of pathogenic bacteria entering the body. The incubation period lasts a day after infection. The peak of the disease occurs in the warm period of the year. The child has intoxication and gastrointestinal dysfunction.
• Toxic. The disease is provoked by toxic substances contained in household chemicals, alcoholic beverages, poisonous mushrooms, etc.

The inflammatory process of the acute form of the disease has three degrees, divided by severity:

1. Easy stage. The child's body temperature is normal and there is no vomiting. Diarrhea occurs 3 to 5 times a day. There is no dehydration of the body.
2. Middle stage. Body temperature rises and reaches 39 degrees. The baby complains of abdominal pain. Vomiting and diarrhea become more frequent (up to 10 times). Together with feces and vomiting, the body rapidly loses moisture and the amount of electrolytes decreases. The first signs of dehydration appear: dry mouth, constantly thirsty, tachycardia. As a result of this stage, 3% of the total body weight is lost.

1. The third stage is difficult. The mark on the thermometer reaches the number 41. The vomit contains particles of bile secretion, the urge to go to the toilet increases up to 20 times. Symptoms of dehydration intensify: dry mucous membranes and skin. The number of urinations decreases, and the volume of fluid during the process decreases. Convulsions and loss of consciousness appear. The mucous membranes change color and become bluish.

If medical attention is not provided after symptoms appear, symptoms of dehydration may develop. The mucous membrane in the oral cavity becomes dry, and the skin also feels dry. A child's body reacts to moisture loss much faster than an adult. The consequences are more serious, and irreversible processes often occur.

Diagnostics

When visiting a doctor, the first thing that is diagnosed is swelling of the internal organs responsible for digesting food. Determined by palpation of painful areas. In this case, a preliminary diagnosis is made: intestinal dyspepsia syndrome. The inflamed mucous membrane responds to the doctor’s actions by rumbling, and a transfusion of the stomach is felt.

Further diagnostics include the following tests:

• Examination of stool for the presence of bacteria and digestive disorders.
• General blood test.
• Analysis of red blood cell content (hematocrit).
• Blood test for antibodies. Using the analysis, the causative agent of gastroenteritis is determined.
• General urine analysis.

The onset of the disease can occur independently or be a consequence of another intestinal disease: cholera or salmonellosis.

If there is a suspicion that gastroenteritis is present in a child’s body in a chronic form, then instrumental examination methods are prescribed:

• Fibroesophagogastroduodenoscopy of the upper epigastric organs. The method allows you to clarify the reasons that provoke pain and discomfort.
• Ultrasound examination of the internal organs of the alimentary tract. This method makes it more likely to diagnose gastroenteritis in children.

• Determination of the acidity of the contents of the juice in the stomach (PH-metry).

Treatment

The effectiveness of therapy depends on the correct diagnosis and accurate identification of the causative agent of the disease. However, it is worth considering the duration of maturation of the infection in the body. This may delay treatment. Pathogenic microorganisms in the intestines can multiply quickly and provoke dehydration of the child’s body, so doctors begin therapy immediately. For this purpose, antibiotics are used that act on a wide range of viruses and bacteria.

Diet

The child is transferred to a gentle diet and plenty of fluids. If the disease is detected in an infant, this is not a reason to refuse breastfeeding. On the contrary, breast milk will help the baby cope with the disease faster. Dr. Komarovsky recommends adhering to the following rules when preparing the diet of a sick baby:

• Small portion sizes. Food should enter the body in small doses so as not to overload it.
• The food should be familiar. Exotic foods are not allowed during treatment of the disease.
• Simple composition. This means that the liquid and cereals must be one-component. Concentrated juices, which contain several types of ingredients, are excluded from the diet, as are cereals. For a child suffering from gastroenteritis, it is better to give salted water, weak tea with a small amount of sugar. For children under one year old, porridge should consist of either one type of fruit or one type of vegetable.
• The food is passed through a grater until it reaches the consistency of puree. Products undergo heat treatment; raw foods are not allowed.

• Bread, flour and confectionery products should be excluded from the menu. White bread is allowed: 10 grams in stale form.
• Liquid food is welcome, but low-fat.

Medicines

With moderate and severe gastroenteritis, you cannot do without the help of medications.

After the examination, the following medications are prescribed:

• Antacid drugs aimed at enveloping the walls of the stomach and intestinal tract, protecting them from irritation.
• Products with antibacterial effects. Assigned after determining the type of pathogen.
• Glucose. It is administered through a vein via a dropper in case of severe dehydration, when the baby completely refuses to eat.
• Multivitamins. They help replenish the reserves of nutrients due to the child’s refusal to eat.

Folk remedies

Therapy with medicinal herbs and other folk recipes is encouraged only if the disease is not in a severe stage. Various astringents are used: oak, wormwood, licorice. They contain natural antibacterial substances. Rowan berries, cranberries, flax seeds, mint leaves are also used as soothing, enveloping agents. Also, the listed herbs have antiseptic properties and stimulate the digestive process.

Prevention

The following measures can be taken to prevent the development of the disease:

• Wash your hands after going outside and using the toilet.
• When preparing food for a child, follow the cooking technology. Store correctly.
• I cook food with bottled or tap water.

• A person with gastroenteritis should be isolated from healthy people and the premises should be disinfected.

Preventing the disease is better than treating dangerous complications.

Thank you

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

Gastroenteritis– a disease characterized by inflammation of the mucous membrane of the stomach and small intestine. The disease is manifested by abdominal pain, nausea, vomiting, and frequent loose stools. These phenomena may be accompanied by fever, weakness and muscle pain.

Causes of gastroenteritis. The development of gastroenteritis is associated with various factors: bacteria, viruses (intestinal or stomach flu), protozoan microorganisms, aggressive chemicals or allergens in food. However, in most cases, gastroenteritis is an infectious disease. The patient poses a danger to others and must be isolated.

Prevalence of gastroenteritis. Gastroenteritis is one of the most common diseases. In terms of incidence, it is second only to ARVI and influenza. It is believed that 20% of people experience gastroenteritis of varying severity each year. This is especially true for susceptible categories - children of early and preschool age, pregnant women and the elderly. The disease is particularly prevalent in low-development countries where hygiene practices are poor and people lack access to quality food and drinking water.

Outbreaks of gastroenteritis occur at any time of the year. In the summer, bacterial forms predominate, and in the cold season, viral forms (adenoviral gastroenteritis) predominate.

Why is gastroenteritis dangerous? Acute infectious gastroenteritis is life-threatening due to the risk of dehydration. Chronic gastroenteritis in severe cases is the reason for transfer to disability. It happens that gastroenteritis is not an independent disease, but a syndrome that occurs with dangerous intestinal infections - cholera, dysentery, salmonellosis.

Anatomy of the stomach and small intestine

Let's look at the parts of the digestive tract that are affected by gastroenteritis.

The stomach is a pouch-like extension in which food accumulates. In the stomach it is processed by acidic gastric juice and acquires a liquid consistency. This is where the initial stage of digestion occurs.

The stomach wall consists of three layers:

• Mucous membrane has three layers:
  • columnar glandular epithelium lines the inner surface of the stomach;
  • The lamina propria is represented by loose fibrous tissue located between the glands;
  • The glands of the stomach produce the components of gastric juice. Types of glands: cardiac, fundic, pyloric, as well as mucous and endocrine cells.
• Muscularis , ensuring the mixing of food masses with gastric juice and the promotion of its contents into the intestines.
• Serosa , performing a protective function.

Small intestine- a section of the digestive system located between the stomach and large intestine. It provides the basic processes of digestion and absorption of food. In its lumen, the food mass is processed by bile and digestive enzymes of the pancreas and small intestine. As a result, nutrients become suitable for absorption.

The small intestine consists of three sections:

• duodenum;
• jejunum;
• ileum.

The small intestine has the same membranes as the stomach:

• Mucous membrane , lining the inner surface, is covered with villi and has a folded surface. Its components:
  • circular folds - transverse folds on the surface of the mucosa;
  • intestinal villi - finger-shaped outgrowths of the mucous membrane;
  • intestinal glands that produce components important for digestion (Brunner's, Lieberkühn's).
• Muscularis has 2 layers: longitudinal and circular. This structure ensures the movement of contents towards the colon;
• Serosa is the outer cover and provides a protective function.

The small intestine maintains a neuro-reflex connection with the stomach. With its help, the size of the portion of food gruel coming from the stomach to the intestine, the acidity of gastric juice, the amount of digestive enzymes, etc. are regulated.

Causes of gastroenteritis

Gastroenteritis can be provoked by various factors of infectious and non-infectious etiology. Microorganisms and chemicals have an irritating effect on the mucous membrane of the stomach and small intestine, disrupting its function:

• Viruses:
  • rotaviruses;
  • caliciviruses;
  • intestinal adenoviruses;
  • astroviruses;
  • coronaviruses.
• Bacteria:
  • campylobacter;
  • shigella;
  • salmonella;
• Protozoa:
  • intestinal lamblia;
  • dysenteric amoeba;
  • Cryptosporidium.
• Helminths:
  • crooked heads.
• Toxic substances:
  • mushrooms - fly agarics, false honey mushrooms;
  • arsenic, sublimate;
  • fish products – burbot liver, mackerel caviar.
• Food allergens:
  • eggs;
  • strawberries;
  • crabs.
• Medicines:
  • non-steroidal anti-inflammatory drugs;
  • antibiotics;
  • sulfa drugs;
  • bromine and iodine preparations.

Predisposing factors contributing to the development of gastroenteritis:

• cold drinks;
• plentiful roughage foods rich in fiber;
• spicy seasonings;
• alcoholic drinks;
• vitamin deficiency;
• general hypothermia.

What happens in the body during gastroenteritis? Once entering the body, viruses or bacteria settle on the epithelium of the mucous membrane of the stomach and small intestine. They penetrate the cells and damage them, causing inflammation of the mucous membrane.

• Nausea and vomiting at an early stage occur when sensitive nerve endings in damaged areas of the mucosa are irritated. Further vomiting is caused by toxins circulating in the blood.
• Damage to the intestinal villi disrupts the digestion and absorption of food - undigested particles appear in the stool.
• Osmotic pressure increases and water is released into the intestinal lumen. These processes lead to the development of diarrhea (diarrhea).
• Toxins formed in the intestines enter the blood and cause a deterioration in general condition and an increase in temperature.

Similar processes occur when toxic substances or allergens enter the gastrointestinal tract.

Symptoms of gastroenteritis

The symptoms of gastroenteritis are similar to each other, regardless of the causes of the disease.

Symptom	Mechanism of occurrence	Manifestations
Abdominal pain	Damage to the mucous membrane of the stomach and intestines causes irritation of the nerve endings and a reflex spasm, which is accompanied by severe pain.	As a rule, the disease begins acutely. The pain is cramping in nature and intensifies before defecation (bowel movement).
Nausea	It develops when the body is poisoned by waste products of the pathogen or chemicals.	An unpleasant sensation occurs in the epigastric region between the costal arches below the sternum. It is accompanied by deep, irregular breathing, drooling and increased sweating.
Vomit	The digestive system's response to inflammation and toxins produced during illness. Once in the blood, they activate the vomiting center located in the medulla oblongata. It commands the abdominal muscles and diaphragm to contract, causing the contents of the stomach to vomit.	Vomiting in mild forms is one-time. In severe cases, the disease is multiple, leading to significant loss of fluid and dehydration of the body.
Diarrhea	Impaired absorption of fluid in the small intestine leads to a 3-fold increase in the amount of fluid in the intestinal contents. Under the influence of infectious or chemical factors, the secretion of water into the intestinal lumen increases, the processes of digestion and absorption of food are disrupted. This leads to faster bowel movements.	Frequent loose stools from 2 to 15 times a day. Lasts 3 or more days, leading to dehydration and massive loss of minerals. The stool is copious, watery, sometimes foamy, mixed with mucus. The stool is greenish with salmonellosis, in the form of rice water with cholera, with amoebiasis mixed with blood.
Dyspeptic symptoms - indigestion	The motility of the gastrointestinal tract is impaired. Contractions of the muscle layer accelerate, which leads to rapid evacuation of intestinal contents.	Unpleasant sensations in the stomach and small intestine. Belching with air or stomach contents is a sign of reverse gastrointestinal peristalsis. Lack of appetite or feeling of accelerated satiety. Rumbling in the stomach, accompanied by pain. Abdominal bloating with minimal passing of gas.
Fever	A rise in temperature is caused by bacterial or viral toxins entering the blood.	Temperature rises to 39 degrees. Fever is accompanied by weakness and chills. With a mild course of the disease, the temperature remains normal.
Symptoms of general intoxication	Poisoning by toxins formed during the life of the pathogen, its death, or toxic substances that enter the intestines.	General weakness, weakness, dizziness, decreased muscle tone, lack of appetite, drowsiness, headache.
Respiratory symptoms are a characteristic sign of rotavirus gastroenteritis	Viruses that cause gastroenteritis can infect the mucous membranes of the upper respiratory tract.	Nasal congestion, runny nose, sore throat, dry cough.

The course of the disease depends on the age of the patients. Infants up to 3 months and adults are more susceptible to the disease. Children from 6 months to 3-4 years and people over 50 suffer from a severe form of the disease.

Classification. Forms and stages of gastroenteritis

Classification by shape:

• Acute gastroenteritis(acute intestinal infection) is divided according to severity:
  • First degree– diarrhea 3-5 times a day, single or repeated vomiting, normal temperature, no signs of dehydration.
  • Second degree– diarrhea and vomiting 5-10 times a day, abdominal pain, fever up to 38.5 o C, signs of mild dehydration – thirst, dry mouth, rare urination, rapid heartbeat, loss of up to 3% of body weight.
  • Third degree– diarrhea and vomiting up to 15 times a day, fever up to 40 o C, severe signs of dehydration: pale skin, bluish tint on the tips of the fingers, nose, earlobes, cramps of the calf muscles, dizziness, lightheadedness, rare minor urination, impaired consciousness, loss of 4-6% body weight.
• Chronic gastroenteritis: diarrhea, nausea, signs of dyspepsia. Local mucosal lesions lead to chronic malabsorption, which is accompanied by weight loss, weakness, increased fatigue, irritability, and sleep disturbances.

According to the factor that caused the disease:

• Viral gastroenteritis– inflammation of the mucous membrane of the stomach and intestines caused by viruses.
  Seasonality – incidence increases in winter.
  The source of the disease is a sick person.
  The incubation period is 1-3 days.
  Most often occurs in children from 3 months to 3 years.
  The transmission mechanism is airborne with droplets of mucus from the respiratory tract when talking or coughing. Fecal-oral – through dirty hands, contaminated food, water, objects on which the patient’s discharge has come into contact. The patient continues to shed the virus in feces for 30 days after recovery.
  The symptoms of viral gastroenteritis are described above. A runny nose, sore throat, and dry cough are also typical. With adequate treatment, symptoms disappear after 1-3 days.
  Immunity – after an illness, specific antiviral immunity is formed. When re-infected, the disease occurs in a milder form.


• Bacterial gastroenteritis– inflammation of the mucous membrane of the digestive organs associated with the entry of bacteria and/or their toxins into the gastrointestinal tract. These include such severe infectious diseases as cholera and salmonellosis.
  Seasonality - the incidence increases in the summer-autumn period, when high temperatures promote the growth of bacteria in food and water.
  The source of the disease is a sick person, a bacteria carrier, animals, contaminated food and water.
  The route and mechanism of transmission are food, water, contact. In terms of epidemics, the most dangerous are meat and dairy products, which are a good breeding ground for bacteria, greens and vegetables, which can be contaminated with soil particles
  The incubation period is from 2 to 24 hours.
  Affects all categories of the population. Children and the elderly are especially sensitive - their enzyme activity is reduced.
  Symptoms The disease is more severe than with viral gastroenteritis. Acute onset, sharp chills and fever, nausea and repeated vomiting, cramping pain in the abdomen, in the navel area. Diarrhea – frequent watery stools with mucus and greens. Symptoms last 5-10 days.
  Immunity. After infection with certain bacteria (Shigella, Salmonella), post-infectious immunity develops, which, however, does not protect against re-infection.


• Toxic gastroenteritis occurs when consuming toxic substances, of which there are more than 50. Among them are alcohol, non-steroidal anti-inflammatory drugs, herbal infusions, household chemicals and salts of heavy metals, drugs used for fluoroscopy.
  It develops when ingesting substances containing aggressive toxic components.
  Seasonality - at any time of the year.
  Develops in the first 48 hours from the moment the substance enters the body.
  Symptoms Pain in the stomach and left side of the abdomen, nausea, vomiting, frequent stools mixed with blood or melena (black stool resembling tar). Symptoms persist for 2-5 days.
  Immunity does not develop.


• Helminthic gastroenteritis. Worms cause chronic gastroenteritis. They damage the mucous membrane of the small intestine, causing infiltrates and dysfunction of the gastrointestinal tract.
  Seasonality. The number of infections increases in the summer-autumn period. Manifestations of the disease throughout the year.
  The source of the disease is sick people and animals.
  The route of infection is through consumption of foods containing eggs or larvae of helminths.
  The disease develops several weeks or months after infection.
  Symptoms The disease occurs in a mild form, characterized by nausea, frequent mushy or liquid stools, bloating accompanied by rumbling, increased or lack of appetite.
  Immunity does not develop.


• Eosinophilic gastroenteritis. Inflammation of the digestive organs caused by consumption of foods that cause allergies. Islet lesions are characteristic - the formation of infiltrates containing a large number of eosinophils. During allergization, eosinophils (a type of leukocyte) migrate into the mucous membrane of the digestive organs, disrupting their structure and function.
  The cause may be citrus fruits, exotic fruits, strawberries, crabs, peanuts. Allergies can be caused by dairy products and grains without the enzymes needed to digest them (lactose intolerance).
  Seasonality is not expressed.
  Gastroenteritis develops during the first 24 hours after consuming the product.
  Symptoms are nausea, possibly vomiting, pain in the left half of the abdomen, rumbling, frequent heavy stools, normal temperature. May be accompanied by the appearance of a rash. The duration of the disease is 1-3 days, provided that the allergen is excluded.
  Immunity does not develop.
  Treatment is the elimination of foods that cause the disease. Short courses of corticosteroid hormones (prednisolone 20-40 mg).


• Alimentary gastroenteritis. Digestive disorder caused by excessive consumption of fatty or spicy foods, which irritate the mucous membrane of the digestive organs. Caused by unusual foods seasoned with hot spices and alcohol.
  Symptoms are pain in the stomach, upper abdomen and around the navel, worsening before bowel movements, nausea, refusal to eat. Symptoms last 1-3 days if you follow a diet.
  Immunity does not develop.

Diagnosis of gastroenteritis

The diagnosis of gastroenteritis is based on an analysis of the symptoms of the disease and the causes that caused it. The doctor collects anamnesis and conducts a survey: “Which food consumption may be associated with the development of the disease?”, “Are there cases of a similar disease in the patient’s environment?” A significant role is given to identifying the pathogen using laboratory methods.

1. Examination by a doctor

The disease is treated by a gastroenterologist or infectious disease specialist. He palpates the patient’s abdomen, which helps to identify inflamed areas of the intestine and promptly detect liver enlargement or inflammation of the appendix.
At the appointment, the doctor clarifies:

• When did the first symptoms appear?
• What are the signs of the disease - temperature, frequency and character of stool, presence of vomiting?
• Was there any deviation from your usual diet?
• What food does the patient associate with the appearance of the disease?
• Are there similar cases of the disease in his environment?

2. Laboratory research methods aimed at identifying the causative agent of the disease.

• Clinical A blood test reveals signs of general inflammation:
  • acceleration of ESR;
  • increased eosinophils in allergic (eosinophilic) gastroenteritis;
  • leukocytosis (increased level of white blood cells) – indicates inflammation;
  • signs of hemoconcentration - blood thickening during dehydration - a decrease in the amount of water and an increase in the amount of hemoglobin and formed elements (cells) of the blood.
• Serological blood test – detects antibodies to the pathogen:
  • An increase in antibody titer of 4 or more times indicates a pathogen.
• Coprogram- stool examination. Identifies signs indicating damage to the mucous membrane of the upper intestine, as well as impaired digestion and absorption of food. Traces are found in the stool:
  • occult blood;
  • mucus;
  • muscle fibers;
  • undigested fiber, fats and starches.
• General Urinalysis may indicate dehydration:
  • increased specific gravity of urine;
  • the presence of ketones, protein, single red blood cells.
• Microscopic and bacteriological examination to identify the causative agent of the disease. Test material:
  • vomit;
  • gastric lavage water;
  • contents of the duodenum.

3. Instrumental research methods used for chronic gastroenteritis.

Treatment of gastroenteritis

Treatment of gastroenteritis largely depends on the causative agent of the disease. For mild forms caused by viruses, following a diet and drinking plenty of fluids is sufficient. Severe bacterial forms require isolation of the patient in the infectious diseases department.

Indications for hospitalization for gastroenteritis:

• ineffectiveness of the treatment - within 24 hours the degree of dehydration increases, fever persists, and repeated vomiting;
• persistent diarrhea with any degree of dehydration;
• signs of dehydration – the volume of urine excreted is less than 50 ml per day;
• signs of shock development - a decrease in blood pressure below 80 mm. rt. Art., fever above 38.9 degrees, rash resembling sunburn, confusion, thready pulse;
• development of any complications;
• severe concomitant pathologies in the patient;
• the impossibility of isolating the patient at his place of residence - dysfunctional families, communal apartments, boarding schools, barracks.

Treatment with medications

Drug treatment must be prescribed by a doctor. Uncontrolled use of medications can lead to the development of complications - intestinal obstruction, severe dehydration. You can take adsorbents and drink oral rehydration solutions on your own.

Drug treatment of viral gastroenteritis

Group of drugs	Mechanism of therapeutic action	Representatives	Mode of application
	Preparations for the preparation of solutions intended to replenish losses of fluid and minerals. Drinking solutions help fight dehydration and remove toxins. Additionally, they may contain antispasmodic, aseptic and anti-inflammatory components	Gastrolit	The contents of 1 sachet are dissolved in 200 ml of boiled water and cooled. Take 500-1000 ml in the first 4 hours. Further 200 ml after each loose stool
		Orsol	Taken at the rate of 10 mg per kilogram of body weight per hour
Antidiarrheals	They reduce intestinal tone and slow down the rate of movement of food mass. Increases the tone of the anal sphincter	Loperamide	2 tablets after each loose stool. But no more than 8 tablets per day. Do not take for more than 2 days - severe constipation may develop
		Stoperan	2 capsules after each case of diarrhea. No more than 8 capsules per day
Antiviral drugs	Suppress the activity of the virus, weaken the symptoms of the disease	Arbidol	Take 2 tablets orally half an hour before meals. Duration of treatment 3 days
Enzyme preparations	Contain enzymes that break down proteins, fats and carbohydrates. Provide digestion of food when the digestive glands are not functioning properly	Creon	The drug is taken orally with each meal. Dosage based on 10 thousand units of lipase per kilogram of body weight per day
		Pancreatin	Take during meals with plenty of liquid (juice, water). Average daily dose for adults 150,000 units
Adsorbents	Adsorb (absorb) bacteria and toxins located in the intestinal lumen	Smecta	The contents of 1 sachet are dissolved in 100 ml of water. Take 1 sachet 3 times a day
		Activated carbon	Orally an hour before meals, 1 g (4 tablets) 4-5 times a day
Antiemetics	Normalizes the tone of the digestive organs. Have an antiemetic effect, promote the movement of food from the stomach to the intestines	Cerucal	10 mg (1 tablet) 3-4 times a day. Take half an hour before meals
Probiotics	Restore normal intestinal microflora, increase local immunity	Bifidumbacterin	Adults take 1 packet orally 3 times a day 20-30 minutes before meals. The contents of 1 packet are dissolved in 2 teaspoons of non-hot water.
		Bificol	Take orally in the form of a diluted powder, 2-3 sachets 2 times a day, regardless of meals. Course of treatment 3-5 days

Drug treatment of bacterial gastroenteritis

Group of drugs	Mechanism of therapeutic action	Representatives	Mode of application
Antibiotics	Antibiotics prevent the proliferation of bacteria by slowing down the synthesis of their RNA and destroy pathogens. Prescribed for bacterial diarrhea. Not used for viral forms of gastroenteritis	Alpha Normix acts in the intestinal lumen, is practically not absorbed into the blood	Orally, 1-2 tablets every 8 hours. Duration of treatment 5-7 days
		Polymyxin-M sulfate	Orally, 500,000-1,000,000 units 4 times a day. Course 5-10 days
		Levomycetin	Orally, 1 tablet 4 times a day. Take 30 minutes before meals. Duration of treatment 5-15 days
Nitrofuran derivatives	Has an antimicrobial effect: slows down the growth of bacteria and causes the death of the pathogen	Nifuroxazide	2 tablets every 6 hours. Not absorbed from the intestines, can be used during pregnancy
Enterosorbents	They have a detoxifying effect, neutralizing toxins. The drugs absorb them and are removed from the body during bowel movements. Also binds and removes microorganisms	Enterosgel	Inside 3 times a day. Take 1 hour before meals or 2 hours after meals. Single dose 15 g (1 tablespoon). Course of treatment 5-14 days
		Polysorb	Take orally 1 hour before meals or taking other medications. Dissolve 1.2 g of the drug (1 tablespoon) in a glass of boiled water. Daily dose 12 g (10 tablespoons). Course 3-5 days
Oral rehydrators	Restores water and electrolyte balance in the body. Reduce intoxication	Regidron	1 sachet is dissolved in 1 liter of water. For diarrhea and vomiting in small doses up to 3.5 liters per day
Antiemetics	Normalize contractions of the gastrointestinal tract and the passage of food into the small intestine	Motilium	Orally 20 mg (2 tablets) 3-4 times a day
Enzyme preparations	Improve digestion and promote food absorption	Festal	1-2 tablets with meals 3 times a day. The course lasts from several days to several months
		Mezim Forte	Orally, 1-2 tablets before meals 2-4 times a day. Course from 2 days to several months
Probiotics	Restore normal intestinal microflora	Bificol	Before use, dilute 3-5 teaspoons of the drug in the same amount of water. Take 3 times a day 20-30 minutes before meals. Course 2-5 weeks

For bacterial gastroenteritis, antidiarrheals are not prescribed. Natural cleansing of the intestines from pathogens and toxins promotes a speedy recovery. At the same time, care is taken to ensure that the patient does not develop dehydration. To do this, he must receive 2 times more fluid than he loses through diarrhea and vomiting.

To restore mineral balance, you can use oral rehydration solutions sold at pharmacies. You can prepare its analogue at home: dissolve 1 teaspoon of baking soda and salt and 1 tablespoon of granulated sugar in 1 liter of water.

Traditional methods of treating gastroenteritis

• Infusion of mint leaves. It has a bactericidal effect, reduces nausea and bloating, and improves digestion. To prepare the infusion, pour 1 tablespoon of mint leaves into a glass of boiling water. Let it brew for 30 minutes and strain. Take in small portions throughout the day.
• Cranberry decoction. Thanks to the large amount of tannins, it has anti-inflammatory and antimicrobial properties. Tones the body and improves digestion. Strengthens the effect of antibiotics and antimicrobial drugs. Cranberries are contraindicated for people with high acidity of gastric juice and peptic ulcers. To prepare the decoction, mix cranberry leaves and berries in equal proportions. 3 tablespoons of vegetable raw materials are poured into 0.5 liters of hot water. Boil for 10 minutes over low heat, cool and filter. Take 1/2 cup 4 times a day.
• Decoction of St. John's wort herb. Flavonoids, essential oil and resinous substances have a strong bactericidal effect. Tannins provide an astringent and anti-inflammatory effect. St. John's wort relieves spasms and improves the production of digestive enzymes. The decoction is prepared in an enamel bowl at the rate of 1.5 tbsp. (10 g) St. John's wort per 100 mg of water. Heat in a water bath for 30 minutes, 10 minutes. cool, filter and squeeze. The volume is brought to a full glass with boiled water. Take 50-100 ml 3 times a day half an hour before meals.

Diet for gastroenteritis

Diet for gastroenteritis is the main focus of treatment. During the period of diarrhea, it is recommended for patients table No. 4. The food is selected in such a way as to minimize irritation of the intestinal mucosa and eliminate fermentation processes. The diet contains a normal amount of protein - 90 g, a minimum of fat - 70 g, and carbohydrates - 250 g.

Cooking method: The products are boiled in water or steamed, pureed or chopped with a blender.

Diet: 5-6 times a day in small portions.
List of recommended products:

• White bread crackers, stale wheat bread;
• Puree soups with the addition of cereals (rice, semolina). Dumplings, meatballs, and egg flakes are added to soups;
• Vegetables only in the form of decoctions in soups;
• Lean meats and poultry - veal, beef, chicken breast. Cutlets on water, steamed meatballs;
• Low-fat fish, boiled in water or steamed. Products made from minced fish or in pieces;
• Eggs 1-2 per day in the form of a steam omelet or soft-boiled;
• Freshly prepared calcined cottage cheese, pureed unleavened cottage cheese;
• Cereal porridge on water - oatmeal, semolina, buckwheat;
• Butter for first and second courses;
• Fruits – pureed fresh apples;
• Drinks – black or green tea, diluted fruit juices (except grape, plum and apricot). Compotes, jelly, decoctions of dried rose hips, black currants, blueberries.

Excluded:

• Any bakery products other than those listed above;
• Vegetables and fruits in natural or boiled form;
• Snacks;
• Spicy, fatty, fried and baked foods;
• Cold food and drinks;
• Milk, kefir and full-fat dairy products;
• Barley and pearl barley, millet, legumes;
• Cocoa with milk, sweet and carbonated drinks.

Diet No. 4 is followed for 3-5 days. Then move on to diet No. 2.

Table No. 2 is prescribed during the recovery period after acute gastroenteritis and in the chronic form of the disease. The purpose of the diet is to normalize the functioning of the digestive organs and provide the patient with adequate nutrition.

Cooking method: boiled, steamed, baked and fried (without crust) dishes.

In the diet, the amount of carbohydrates is gradually increased to 400 g, and fats to 100 g (25% vegetable). Squirrel 90-100 g.

Allowed dishes:

• Day-old or dried bread, unhealthy bakery products. 2 times a week, cooled savory pies with cottage cheese, meat, jam;
• Soups in a weak broth (meat, fish, mushroom) with finely chopped or pureed vegetables;
• Meat - lean varieties without fascia, tendons and skin: beef, veal, rabbit, chicken, turkey, boiled tongue, milk sausages. Pork and lamb in limited quantities;
• Fish – low-fat varieties. Chopped products or whole piece;
• Milk - fermented milk drinks, cottage cheese and products made from it, cheese, sour cream for dressing dishes;
• Eggs - soft-boiled, in the form of an omelet, fried without crust. Avoid hard-boiled eggs;
• Vegetables – boiled, stewed and baked, in the form of casseroles, fried without crust;
• Cereals - in the form of semi-liquid and crumbly porridges, casseroles, cutlets without crust;
• Appetizers - salads of boiled vegetables and fresh tomatoes with the addition of eggs, lean ham, meat and fish, low-fat aspic, liver pate.

Excludes:

• Spicy and fatty foods;
• Salty and pickled dishes;
• Soups - with millet, beans, peas, okroshka;
• Vegetables – onions, garlic, radishes, sweet peppers, cucumbers, mushrooms;
• Cereals – barley, pearl barley, millet, corn, legumes.

Consequences of gastroenteritis

Every year, more than a million people die from the consequences of gastroenteritis around the world. The main danger is a critical loss of fluid, as a result of which all metabolic processes in the body are disrupted.

Prevention

• Drink only bottled water. Use it to wash fruits.
• Wash your hands as often as possible.
• Use liquid soap; regular soap contains a large number of germs.
• After visiting public places, wipe your hands with wet wipes and treat them with an antiseptic.
• Avoid swimming in stagnant bodies of water that may have been exposed to sewage.
• Don't buy food on the streets. Choose dishes that have been heat-treated and prepared in front of you.
• Avoid rare steaks and other undercooked meats, fish and shellfish.

Vaccination against gastroenteritis

An oral vaccine has been developed to prevent rotavirus gastroenteritis - Rotarix. It is recommended to drop it into the mouth of children in the first six months of life. The vaccine is a weakened rotavirus. Once in the body, they provoke the production of antibodies designed to protect the body from infection.

Scheme. The vaccine is administered twice:

• The first stage is at the age of 6-14 weeks;
• The second stage is 4-10 weeks after the first at the age of 14-24 weeks.

The effectiveness of vaccination. If both stages of vaccination were done before the 1st year, then the effectiveness exceeds 90%. If up to 2 years, then the effectiveness is 85%. Studies have proven that over the course of 2 years the vaccine reliably protects children from developing the disease. In adulthood, they suffer from mild rotavirus infection. They do not develop severe forms of the disease that require hospital treatment.

Side effects. Based on a study of 63,000 vaccinated children, it was found that the vaccine does not cause serious consequences and is safe to use.

What are the symptoms and treatment of gastroenteritis in children?

Gastroenteritis in a child is an acute disease associated with damage to the stomach and small intestine. Manifested by abdominal pain, diarrhea, vomiting, and fever. Gastroenteritis in children is one of the most common diseases. All children experience it up to 3 years of age.

Infectious gastroenteritis in children

From October to March, the most common cause of gastroenteritis in children is rotavirus. It causes about 60% of cases of the disease. You can become infected either through airborne droplets or through dirty hands and objects that have been exposed to particles of feces or vomit.

In the summer months, gastroenteritis is more often associated with foodborne toxic infections associated with the consumption of large quantities of opportunistic microorganisms in food. Particularly dangerous are minced meat products, pates, cakes and pastries with cream, and dairy products.

A child may become infected:

• From a sick person. The patient becomes contagious from the moment the first signs of the disease appear. With viral gastroenteritis, it remains contagious for 5-7 days, with bacterial gastroenteritis - for several weeks or months. Therefore, if rotavirus gastroenteritis occurs in the garden, a large number of children in the group may become infected.
• From the carrier. A carrier is a person who appears healthy but sheds viruses or bacteria. The greatest danger comes from carriers who are involved in food preparation.
• From animals. Bacteria can enter the body through the meat and milk of sick animals. Gastroenteritis caused by Salmonella occurs after consumption of eggs, especially from waterfowl.
• When consuming contaminated food and water:
  • Insufficient heat treatment - dishes are poorly cooked or fried.
  • Bacteria from a sick person or carrier got onto the food after cooking. Such dishes become dangerous after they have been left out of the refrigerator for 2 or more hours - time sufficient for bacteria to multiply.
  • Products that have expired. In this case, the number of bacteria increases sharply, even if the storage conditions were correctly observed.

Non-infectious gastroenteritis in children

• Drug-induced gastroenteritis. It can develop against the background of a common ARVI or influenza. In this case, the first symptoms will be fever, runny nose, sore throat and cough. Diarrhea and nausea appear 12-24 hours after taking antipyretics (Nurofen, Panadol) or antibiotics. These drugs irritate the mucous membrane, and drinking too much makes the stool even more liquid. In this case, it is advisable to use antipyretics in the form of suppositories, and add sorbents to the ARVI treatment regimen.
• Alimentary gastroenteritis associated with overeating, consumption of too fatty, spicy and rough foods, large quantities of berries and fruits. The child does not produce enough digestive enzymes to digest such food. The intestines try to cleanse themselves of it by increasing motility.
• Allergic gastroenteritis develops when consuming foods to which the body is hypersensitive. 0.6% of infants under 4 months develop an allergy to cow's milk, which is included in formula or used in its pure form. In children of preschool and school age, allergens are: strawberries, chocolate, citrus fruits, kiwi, eggs, nuts.

What are the manifestations of gastroenteritis in children?

With gastroenteritis in children the following is noted:

• vomit;
• diarrhea;
• rise in temperature;
• lethargy;
• refusal of food;
• bloating, accompanied by rumbling;
• the tongue is covered with a white coating.

After a few hours or the next day, catarrhal symptoms (runny nose, sore throat, cough) may appear, indicating the rotavirus nature of the disease.

Acute gastroenteritis in children leads to dehydration within the first day. Its signs:

• sunken eyes;
• dry red chapped lips;
• dry mucous membranes of the mouth;
• strong thirst;
• rare scanty urination;
• increased heart rate and breathing;
• sunken fontanel.

If you notice some of these symptoms, you should urgently call a doctor and, before his arrival, take measures to restore the normal volume of fluid in the body. To do this, the child should receive 20 ml of fluid per 1 kg of body weight per hour. So, a 15 kg child should drink 15 x 20 = 300 ml every hour. The liquid should be warm and delivered in small portions of 5-20 ml every 5 minutes. Breastfed children should be applied to the breast every 15-20 minutes.

When does a child need urgent medical attention?

• there are signs of dehydration;
• diarrhea and vomiting continue for more than a day, despite treatment;
• the temperature rose above 39 degrees;
• over the course of 4-5 hours the child’s condition worsens;
• mucus or blood is found in the stool;
• severe weakness and impaired consciousness appeared.

Treatment

1. Rehydration solutions– to restore normal levels of fluid and salts. Helps eliminate toxins. Used to prevent and treat dehydration.

• Humana electrolyte. The contents of 1 sachet are dissolved in 1 glass of boiled water. Dosage regimen: about 500 ml in the first 4 hours - a teaspoon every 5 minutes. In the future, 100-150 ml after each loose stool.
• Regidron. 1 sachet is dissolved in 1 liter of boiled water. The amount of solution depends on the degree of dehydration. In the first 6-10 hours, the child should receive a portion of Regidron that is twice the amount of body weight loss caused by diarrhea and vomiting.

2. Antiviral drugs have antiviral and immunomodulatory effects, which allows them to be used for viral and bacterial gastroenteritis.

• Viferon rectal suppositories are administered into the rectum 2 times a day for 10 days. A single dose is calculated based on the child’s body area.
• Laferobion nasal solution (nasal drops or spray). The child is instilled into each nostril with 5 drops of a drug with an activity of 50–100 thousand IU every 2 hours.

3. Antidiarrheals act on bacteria that cause indigestion. In case of viral gastroenteritis, the development of secondary infection is prevented

rice water and sticky rice porridge;

crackers;

protein steam omelette.

More detailed nutritional recommendations are described above.

Prevention

Prevention of gastroenteritis in children is based on compliance with hygiene rules and careful culinary processing of food:

• Only high-quality and fresh products should be used for cooking.
• Products should be stored in the refrigerator in hermetically sealed containers.
• Vegetables, fruits and herbs must be scalded with boiling water before eating.
• A child under one year old needs to cook before each meal. If this is not possible, then the portion must be brought to a boil.
• It is necessary to wash the child's dishes thoroughly. Bacteria multiply quickly on leftover food.
• Teach your child to wash their hands before eating.

What is chronic gastroenteritis?

Chronic gastroenteritis is a chronic inflammation of the mucous membrane of the stomach and small intestine. May be the result of acute gastroenteritis, food allergies or systematic malnutrition. Impaired absorption and assimilation of food leads to hypovitaminosis, decreased immunity and exhaustion. In severe cases, patients are transferred to disability.

Causes

• poor nutrition;
• abuse of spicy foods and alcoholic drinks;
• food allergies;
• harmful working conditions;
• radiation exposure;
• helminthic infestations.

Symptoms

Signs of the disease worsen after nutritional failures:

• nausea;
• loose stools 4 or more times a day, particles of undigested foods are visible in the stool;
• pain in the upper abdomen and around the navel;
• bloating;
• loss of appetite;
• weight loss.

Treatment of chronic gastroenteritis

Group of drugs	Mechanism of therapeutic action	Representatives	Mode of application
Vitamin preparations	Normalize metabolic processes and improve nutrition of the tissues of the stomach and intestinal walls. Strengthens the immune system and the general condition of the patient’s body.	Pangexavit	1 tablet 3 times a day, for a course of 30 days.
		Undevit	Orally after meals, 2 tablets 3 times a day. Duration 20-30 days.
Antimicrobials	Causes the death of bacteria and protozoa.	Enteroseptol	Orally, 1-2 tablets after meals, for a course of 10-12 days.
		Intestopan	Orally, 1-2 tablets 3 times a day, for a course of 2 weeks. The tablets are crushed and washed down with water.
Astringents	A film is formed on the damaged mucous membrane that protects against irritating substances.	Thealbin (tanalbin)	1 tablet inside. (0.3-0.5 g) 3-4 times a day.

During treatment, it is necessary to follow diet 4 (4-a, b) and completely eliminate alcohol.

Used as an astringent and anti-inflammatory agent decoctions of medicinal plants:

• Oak bark decoction. 2 tbsp. the bark is poured with a glass of boiling water and heated in a water bath for half an hour. Cool, squeeze, add boiled water to 200 ml. Take 1/4 cup 4 times a day on an empty stomach.
• Infusion of bird cherry fruits. 2 tbsp. dried berries are poured into a glass of boiling water. Let it brew for 20 minutes. Accepted according to the same scheme.
• Infusion of blueberry fruits. 2 tsp dry or 4 tsp. pour fresh berries with a glass of cold water and leave overnight. Take 2 tbsp during the day.

Treatment of gastroenteritis mineral waters of low and medium mineralization. The mechanism of action of mineral waters has not been fully studied. As a result of treatment, the production of gastric juice and digestive enzymes is normalized, and inflammation is reduced.

• Ekateringofskaya;
• Zheleznovodskaya;
• Izhevskaya;
• Essentuki No. 4;
• Narzan.

Mineral waters are taken 20-30 minutes before meals in small sips 3-4 times a day, 100-150 ml. The course of treatment is 30-45 days. Treatment can be done at a resort or at home.

Physiotherapy gastroenteritis improves blood circulation and trophism in the tissues of the stomach and small intestine. During treatment, the innervation and functioning of the digestive organs are normalized:

• inductometry is indicated for reduced acidity of gastric juice;
• decimeter therapy for gastritis with increased secretion;
• galvanization and electrophoresis with antispasmodics;
• exposure to diadynamic currents;
• ultrasound therapy;
• paraffin and ozokerite applications;
• heating pads on the area of ​​the stomach and small intestine.

Treatment is carried out in courses of 10-15 procedures every six months.

Prevention of chronic gastroenteritis

• Maintaining a healthy diet;
• adherence to daily routine;
• treatment of diseases of the digestive system.

It is recommended to avoid:

• alcohol consumption;
• overeating;
• excessively spicy and fatty foods;
• occupational hazards.

Does immunity develop after gastroenteritis?

Immunity after gastroenteritis is not stable or long-lasting. The same pathogen can cause recurrent disease after a short period of time.

After rotavirus gastroenteritis, antibodies remain in people’s blood, which ensure an easier course of the disease in adults.

Before use, you should consult a specialist.

Gastroenteritis is an inflammation that affects the mucous membrane of the stomach and small intestine, of an infectious or other nature. This is a fairly common disease among children of all ages, including infants. The causes of acute gastroenteritis in a child can be different.

Classification

Gastroenteritis in children is divided into infectious and non-infectious. According to the course, gastroenteritis is distinguished between acute and chronic.

Infectious gastroenteritis in children, depending on the type of pathogen, is divided into:

• bacterial;
• viral;
• protozoans.

Bacterial gastroenteritis is caused by pathogenic and opportunistic bacteria:

• salmonella;
• dysentery bacilli or Shigella Sonne, Newcastle, Flexner;
• Escherichia coli (enteropathogenic strain);
• Yersinia;
• Proteus;
• campylobacter;
• staphylococcus;
• clostridia, etc.

Gastroenteritis of viral etiology can cause:

• rotavirus;
• cytomegalovirus;
• adenovirus;
• coronavirus;
• astrovirus;
• reovirus, etc.

The causative agents of protozoal gastroenteritis can be the following protozoa:

• cryptosporidium;
• Giardia;
• dysenteric amoeba;
• balantidium coli, etc.

Causes of non-infectious (alimentary) gastroenteritis in children:

• simultaneous consumption of incompatible foods (for example, whole milk and fresh vegetables or herring);
• gasroenteritis in an infant can occur due to improper introduction of complementary foods (a large portion of a new product) or due to improper nutrition of a breastfeeding mother;
• chemical substances that enter the child’s body with food (toxins from mushrooms, seafood, plants) - toxic gastroenteritis;
• individual intolerance to any products (for example, milk lactose) - allergic gastroenteritis;
• a side effect of certain medications (for example, non-steroidal anti-inflammatory drugs).

Non-infectious gastroenteritis usually does not have a significant harmful effect on health, which is not the case with infectious gastroenteritis. The infection is spread by the fecal-oral route. Of the viral infections, the most common is rotavirus gastroenteritis in children.

Pathogens can enter the child’s body:

• with poor quality water;
• with food (in case of violation of cooking rules, expiration dates, storage conditions, consumption of unwashed fruits, etc.);
• in case of non-compliance with hygiene rules;
• when contacting a patient through common objects.

The spread of infection is facilitated by insects (flies, cockroaches) and rodents. Pathogenic or conditionally pathogenic microflora in a child’s body actively multiplies, causing the death of beneficial bacteria (lacto- and bifidobacteria), disrupting the absorption of food and its movement through the intestines.

Predisposing factors for the occurrence of the disease may be:

• early age: immaturity of the digestive system, low level of local immunity of the digestive tract mucosa in newborns;
• non-compliance with hygiene rules by adults caring for the child (they do not wash their hands after changing the baby’s diaper, do not treat toys, do not ensure high-quality treatment of pacifiers, etc.).

Symptoms

Depending on the cause, the incubation period for the disease can last from several hours to 7 days. The onset of the disease is sudden.

Acute (infectious) gastroenteritis in children has the following main symptoms:

1. Pain in the umbilical and epigastric region may be intermittent and spastic.
2. Nausea and repeated repeated vomiting, first of undigested food, then of gastric contents mixed with bile.
3. The stool is increased up to 5-15 times, initially with a mushy consistency, and then watery, profuse, light yellow, foamy, and foul-smelling. Depending on the causative agent of the disease, the stool may have a greenish or orange color.
4. Bloating, rumbling (due to increased gas formation) in the abdomen.
5. Increase in temperature from low-grade (up to 37.5 0 C) to high.
6. Intoxication syndrome, manifested by lethargy, tearfulness, headache, decreased or lack of appetite.
7. Signs of dehydration (as a result of repeated vomiting and frequent watery stools): pale and dry skin, dry tongue with a white, thick coating, thirst.

The disease has 3 degrees of severity - mild, moderate and severe. The severity of the course is assessed by the frequency of the prevailing symptom: if vomiting occurs more often than loose stools, then it is assessed by the frequency of vomiting, and if there is very frequent stool, then by its frequency.

Frequency of leading symptom:

• for mild cases – up to 3 rubles;
• for moderate severity – up to 10 rubles;
• for severe cases - over 10 rubles.

Assessing the severity of the disease is very important, since children can easily develop dehydration with the loss of not only fluid, but also essential microelements, which negatively affects the functioning of internal organs and the brain.

Dehydration is assessed by the percentage reduction in body weight relative to the initial one (before illness):

• 1st stage dehydration – loss of 3-5% of weight;
• 2nd step – loss is 5-10%;
• 3rd step – loss over 10%.

Chronic gastroenteritis develops with prolonged intoxication, poor nutrition, etc. It is characterized by periodic exacerbations of the process, which occur less violently.

Diagnostics

In addition to interviewing parents and the child (at an older age), examining a small patient and the nature of bowel movements, the doctor can rely on laboratory tests in diagnosis.

These include:

• microscopic analysis of stool (coprogram);
• bacterial culture of stool to isolate the pathogen (or virological examination of stool);
• serological blood test to detect antibodies to various types of pathogens and increase their titer (but antibodies are formed from the 5th day of illness, so the results of the study are used to retrospectively confirm the diagnosis);
• PCR to determine the pathogen.

Treatment

When the first symptoms of gastroenteritis are detected in children, treatment should begin as prescribed by a doctor. In mild cases, the treatment course is carried out at home. You cannot treat children on your own. In severe cases, children are hospitalized in the infectious diseases department.

Treatment of gastroenteritis in children should be comprehensive:

1. Diet: fasting is prescribed for 6 hours. Infants are left to breastfeed after it, but it is recommended to make them shorter. For bottle-fed children, the doctor will reduce the serving size. In some cases, an adapted fermented milk mixture is prescribed instead of the usual one.
   After a fasting pause, older children begin their meals with a fermented milk product, then are introduced to porridge cooked in water and slimy soup. The diet is expanded gradually, the serving size and the addition of other products are agreed upon with the doctor.

1. Drinking regime: from the very first hours, the child begins to drink water to prevent the development of dehydration and replenish fluid losses in the body. It is better to use pharmaceutical solutions Regidron, Glucosolan, Oralit, etc. The solution is prepared before use (1 packet per 1 liter of water).
   For dehydration, 1st step. in 6 hours it is necessary to drink liquid in small portions at the rate of 50 ml/kg body weight, at 2nd step. – 80 ml/kg. Further correction is carried out under the guidance of a doctor. In addition to saline solutions, a decoction of raisins, chamomile, and rice decoction are used. In severe cases, with ongoing vomiting, solutions are administered intravenously.

1. Antibacterial drugs: Enterofuril, Nifuroxazide, Furazolidone in age-specific dosages. For bacterial gastroenteritis, antibiotics (Polymyxin, Amikacin, Ceftriaxone, etc.) can be prescribed.

1. For viral gastroenteritis, antiviral drugs Anaferon, Ergoferon, Kagocel are used.

1. Sorbents are used to remove toxins produced by microbes from the child’s body: Smecta, Polysorb, Enterosgel, etc.

1. Probiotics Linex, Hilak-Forte, Lactobacterin, Bifidumbacterin, Bifiform, etc. are used to restore the normal composition of beneficial microflora in the intestines.

1. Enzymatic preparations Creon and Mezim help cope with the digestion and absorption of food in the acute period of the disease.

If you consult a doctor in a timely manner and follow all recommendations, the prognosis is favorable, gastroenteritis ends in recovery.

Gastroenteritis is an inflamed mucous membrane of the stomach and small intestine, infectious and non-infectious in nature. Signs include pain, vomiting, diarrhea, symptoms of intoxication, and fever. Timely consultation with a doctor and comprehensive treatment lead to recovery.