Diarrhea

Diarrhea, or loose stools, is an increase in the volume of stool due to an increase in water content of more than 300 g/day. However, the understanding of this indicator varies.

Stool consists of 60-90% water. In Europeans, the stool volume is 100-300 g/day in adults and 10 g/kg/day in infants, depending on the amount of food ingredients not absorbed in the intestine (mainly carbohydrates).

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Causes of diarrhea

• consumption of stale or contaminated food or water
• allergic reaction to medications
• individual intolerance to any substance included in the products
• intestinal infections of viral, bacterial or parasitic etiology
• nervous tension, stress
• irritable bowel syndrome. This phenomenon is most often associated with emotional stress, poor nutrition, consumption of too much fatty food, large amounts of caffeine, overeating, and alcohol abuse.
• inflammation of the large and small intestines (enterocolitis), can be either acute or chronic
• insufficient absorption of substances in the small intestine (develops in diseases such as pancreatitis, hepatitis, gastritis, colitis, enteritis). The syndrome of impaired absorption of substances is associated with disturbances in the metabolism of proteins, fats, carbohydrates, minerals, vitamins, as well as water-salt balance.

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Green diarrhea

Green diarrhea occurs when there are problems with the gastrointestinal tract and may be a sign of poisoning of the body or infectious diseases. It should be noted that such a phenomenon as green diarrhea can be a reaction of the body to the use of colored drinks containing artificial colors. Also, a green tint may appear in the feces when taking antibacterial drugs to treat an intestinal infection. In the process of digestion of food, fermentation increases, during which substances are formed that give the feces a green color. With a disease such as dysentery, feces can also acquire a green tint. Accompanying symptoms when feces are colored green can be acute abdominal pain, fever, nausea, vomiting, and a general state of weakness. Liver pathologies can also be the cause of green diarrhea - the breakdown of red blood cells leads to the formation of bilirubin in the liver, which, entering the intestines, gives the feces a green color. For diagnosis, a general stool analysis and bacterial culture of feces are performed. In infants, diarrhea with a green tint can be caused by food rejection. In this case, blood streaks, foam and mucus may appear in the stool. If any symptoms accompany diarrhea in a baby, it is necessary to immediately consult a doctor.

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Diarrhea with blood

Bloody diarrhea may occur with a disease such as hemorrhoids - the formation of nodes near the rectum associated with the expansion of hemorrhoidal veins. Blood in diarrhea may appear when the colon is affected by pathogenic strains, cracks in the anus, oncopathologies of the rectum. Blood in the feces of a bright red color can be released when protrusions of the intestinal wall form. Bloody diarrhea may occur with gastric or intestinal bleeding. Polyps in the intestines can also cause blood in the diarrhea. Concomitant symptoms of bloody diarrhea may include pain in the rectum during or after bowel movement, the presence of mucus in the feces, vomiting, nausea, fever, and abdominal pain. Radiography and endoscopy are used to diagnose the disease; emergency medical care is required in case of heavy bleeding.

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Black diarrhea

Black stool may be observed after taking activated carbon and some vitamin and mineral complexes. Black diarrhea may be a consequence of internal bleeding - from the esophagus, stomach or intestines, which could be provoked by various severe pathologies - ulcers, cancer, polyps or enlarged veins of the esophagus. Associated signs of internal bleeding may be weakness, pale complexion, dizziness, anemia. If black diarrhea appears, you should immediately consult a doctor. For diagnosis, fibroesophagogastroduodenoscopy (examination of the esophagus, gastric cavity and duodenum using a gastroscope, which is inserted into the stomach through the mouth and esophagus) or colonoscopy (probing of the colon) may be prescribed.

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Diarrhea and vomiting

Diarrhea and vomiting are the main symptoms of food poisoning. Acute food intoxication develops as a result of eating foods containing microorganisms or toxic substances of non-microbial origin. In addition to microbial poisoning, there is poisoning. In most cases, diarrhea and vomiting begin one to two hours after eating contaminated food, headache, weakness, and dizziness may occur. To normalize the condition, it is first necessary to increase the removal of harmful substances from the body that have not yet been absorbed, and neutralize the effects of those substances that have already been absorbed, and restore normal functioning of the intestines, liver, and cardiovascular system. In cases of food poisoning, gastric lavage is prescribed, and sorbents are taken orally. The stomach is washed with a large amount of a two- to five-percent soda solution, taking three to four glasses of such a solution orally. To bind and remove harmful substances from the body, take activated carbon, smecta, enterosgel, to prevent dehydration and restore acid-base balance - rehydron. Adults should take Enterosgel in the form of a paste, one tablespoon three times a day, on average - from seven to fourteen days. Regidron is diluted in a liter of boiled water, cooled to a warm state and taken in small portions after each loose stool, shaking the solution before use. About ten milliliters per kilogram of body weight are drunk within one hour. After the symptoms of intoxication have weakened, the dose of the drug is reduced to 5-10 ml / kg of body weight after each bowel movement.

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Chronic diarrhea

Chronic diarrhea is in most cases caused by intestinal dysbacteriosis, in which the composition of the microflora is disrupted. Dysbacteriosis can manifest itself both as a mild malaise and as more serious disorders. With dysbacteriosis, the intestinal walls become vulnerable to various allergens and toxins, and the protective functions of the liver are also reduced. The body absorbs vitamins and minerals worse, metabolic processes worsen, and liver and pancreas disorders occur. The following factors can provoke the development of chronic diarrhea:

• Gastrointestinal diseases.
• Frequent acute respiratory viral infections.
• Presence of allergic reactions.
• Age-related factors that contribute to changes in the properties of microflora.
• Stress, emotional overstrain.
• Unbalanced diet.
• Infectious intestinal pathologies.
• Long-term use of medications, in particular antibacterial drugs.
• Long-term treatment with hormonal drugs, as well as NSAIDs.
• Immunodeficiency states.

Associated symptoms of chronic diarrhea include loss of appetite, nausea, unpleasant taste in the mouth, belching, pain and bloating in the abdomen, weakness, and sleep disturbances. To diagnose the disease, a microbiological study of feces is performed, as well as a coprological study to determine the state of the digestive system. Treatment of chronic diarrhea is primarily aimed at eliminating the causes that cause it.

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Diarrhea with mucus

Diarrhea with mucus can be caused by a disturbance of the intestinal microflora, in which mucus helps to remove pathogenic microorganisms. Mucus in the stool can appear with polyps or hemorrhoids. With this disease, mucus is a shell for feces and does not form a homogeneous mass with them. Additional symptoms of this pathology are itching in the area of the posterior perineum, bloody discharge from the anus. Diverticulitis of the intestine can also provoke the release of mucus during bowel movements. Accompanying symptoms in this case are pain in the lower abdomen, localized mainly in its left part, bloating and excessive gas formation.

Diarrhea with mucus in children may appear as a result of insufficient bowel function. This is usually associated with an incorrect and unbalanced diet. This condition is usually accompanied by general malaise, nausea, and rumbling in the abdomen. Liquid feces with mucus may also be released with irritable bowel syndrome. To differentiate the disease and prescribe treatment, a doctor's consultation and a bacteriological examination of feces are necessary.

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Diarrhea during pregnancy

Diarrhea during pregnancy, which occurs mainly in the early stages, may be associated with hormonal changes in the woman's body due to the onset of pregnancy. To alleviate the condition in such cases, it is recommended to eat boiled rice, blueberries, and bananas. Dried viburnum berries can also alleviate the condition. A glass of viburnum berries should be poured with a liter of boiled hot water and boiled for another ten minutes, then strained and two to three tablespoons of natural honey added to the resulting broth. This medicine should be taken three times a day, 1/3 of a glass, in the absence of allergic reactions. If diarrhea during pregnancy is caused by food poisoning, it is necessary to drink plenty of fluids, you can take rehydron, lactosol, on the first day, complete fasting is recommended. After improvements occur, you can eat some crackers with tea without adding sugar. There is an opinion that diarrhea during pregnancy can be caused by taking vitamin and mineral complexes, drinking unsuitable water. To accurately determine the causes of diarrhea, it is necessary to consult a doctor. Diarrhea with foam

Diarrhea with foam may indicate infectious intestinal pathologies, accompanied by general malaise, vomiting and fever. Diarrhea with foam may be the result of intestinal dysbacteriosis, the development of enterocolitis, the presence of worms in the body. In infants, such a disorder may occur when the intestines reject some food. In addition to foam, mucus or a green tint may appear in the feces. To alleviate the condition, it is necessary to balance the diet and exclude irritating foods from the diet. Consulting a doctor if foam appears in the feces is necessary.

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Diarrhea, vomiting, fever

Diarrhea, vomiting, fever are the main signs of an intestinal infection, the causative agents of which can be bacteria or viruses. An accurate diagnosis can only be made after examining feces, vomit, blood, and water released after gastric lavage. In the first few hours after the appearance of alarming symptoms, it is necessary to drink a large amount of liquid, thereby inducing vomiting and helping to cleanse the stomach. To cleanse the large intestine, an enema with cooled boiled water is given. A dark color of urine may indicate a lack of fluid in the body. Normalization of water-salt balance in intestinal infection is extremely important. For this purpose, you can use, for example, rehydron or regular decoctions of rose hips, raisins. The temperature of the liquid should be equal to body temperature. With repeated spontaneous vomiting, you should drink often, but little by little, so as not to cause distension of the stomach. Refusal to eat and drinking plenty of fluids in case of diarrhea, vomiting and fever are a prerequisite. If you have diarrhea, vomiting and fever, call a doctor immediately. Medication for intestinal infections is carried out in a hospital under strict medical supervision.

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Severe diarrhea

Severe diarrhea can be observed with diarrhea of the small intestine. It can occur both with food poisoning and with intestinal infections. Often, such stool is watery, may contain food residues and occur without pain in the abdomen. Bile acids and peptide molecules can increase the release of water and ions. Severe diarrhea can occur with impaired absorption of bile and fatty acids, for example, with Crohn's disease.

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How is diarrhea recognized?

The fluid and electrolyte status and the degree of dehydration should be assessed. A complete examination with abdominal examination and digital rectal examination for sphincter integrity and obvious and occult blood in the stool is necessary. Extra-abdominal examination findings that help establish the etiology of the disease include skin lesions or hyperemia (labrocytosis), thyroid nodules (medullary thyroid carcinoma), right-sided heart murmur (carcinoid), lymphadenopathy (lymphoma, AIDS), and arthritis (inflammatory bowel disease).

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Instrumental research

Acute diarrhea (less than 4 days) usually does not require investigation. Exceptions include patients with signs of dehydration, bloody stools, fever, severe pain, hypotension, or intoxication, and especially the young or very old. These patients should have a complete blood count and determination of electrolytes, blood urea nitrogen, and creatinine. Stool specimens should be obtained for microscopy, culture, stool white blood cell count, and, if antibiotics have been recently used, Clostridium difficile toxin testing.

Chronic diarrhea (>4 weeks) requires determination of the etiology in patients with impaired immunity or features of severe disease, as it otherwise presents with shorter (1-3 weeks) bouts of diarrhea. Initial stool examination should include culture, stool white blood cells (detected by stool smear or stool lactoferrin assay), microscopic examination for ova and parasites, pH (bacterial fermentation of unabsorbed carbohydrates lowers stool pH to <6.0), fat (Sudan stain), and electrolytes (Na and K). If typical pathogens are not identified, specific tests for Giardia and Aeromonas antigens, Plesiomonas, coccidia, and microsporidia are needed. Sigmoidoscopy or colonoscopy with biopsy are performed to determine whether the disease is inflammatory.

If the diagnosis is not confirmed and Sudan staining for fat is positive, it is necessary to determine the excretion of fat with stool, followed by a radiocontrast study of the small intestine and CT of the abdomen (structural disorders) and endoscopic biopsy of the small intestine (mucosal diseases). If the assessment does not lead to a positive result, it is necessary to examine the structure and function of the pancreas.

The osmotic gap of the stool [290 - 2 x (stool Na + stool K)] indicates whether the diarrhea is secretory or osmotic. An osmotic gap of less than 50 mEq/L indicates secretory diarrhea; a larger gap suggests osmotic diarrhea. Osmotic diarrhea may be caused by surreptitious use of Mg-containing laxatives by patients (determining the Mg level in the stool), which cause carbohydrate malabsorption (diagnosed by a breath hydrogen test, lactase determination, and a nutritional questionnaire).

Secretory diarrhea of unknown cause requires further investigation [e.g. plasma gastrin, calcitonin, VIP, histamine and urinary 5-hydroxyindole acetic acid (5HI-AA) levels] for possible endocrine disorders. Symptoms and signs suggestive of thyroid disease and adrenal insufficiency should be reviewed. Surreptitious abuse of laxatives should be considered; this can be excluded by stool testing for the presence of laxatives.

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Diarrhea: folk remedies

In the treatment of such a disorder as diarrhea, folk remedies can have a fairly effective effect. For this purpose, you can use, for example, rye bread rusks softened with warm water. The rusks are left in the water for fifteen to twenty minutes, after which the resulting mixture is taken internally throughout the day. Peeled walnuts can also be used as a remedy for diarrhea. One tablespoon of nuts is placed in half a liter of boiled hot water and filtered after twenty to twenty-five minutes, after which approximately 150 grams of the decoction is taken once a day. Oak bark also has astringent properties and can help with diarrhea. One teaspoon of oak bark is diluted in one and a half glasses of water and boiled over low heat for ten minutes until a homogeneous liquid is obtained. The resulting decoction is taken three times a day, one tablespoon at a time.

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Diet for diarrhea

The diet for diarrhea is designed to restore normal metabolism of fats, proteins and carbohydrates and the condition of the intestinal mucosa. It is recommended to eat mashed rice and buckwheat cooked in water, steamed meat, vegetable broths. It is prohibited to eat dairy products, spicy and fried foods, smoked foods, alcoholic beverages, juice, soda, cabbage. Undoubtedly, proper nutrition is important in the treatment of diarrhea. An approximate diet for a condition such as diarrhea can be as follows:

• First breakfast - oatmeal cooked in water
• Second breakfast – infusion of dried blueberries
• Lunch - meat broth + semolina or steamed meatballs, rice porridge mashed in water + jelly
• Afternoon snack – rosehip infusion without added sugar
• Dinner – steamed omelette + mashed buckwheat and tea.

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