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Dyspepsia in infectious diseases
Last reviewed: 07.07.2025
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Currently, in accordance with the recommendations of the consensus meeting of the International Working Group on Improving Diagnostic Criteria for Functional Gastrointestinal Diseases (Rome Criteria II, 1999), dyspepsia is a sensation of pain or discomfort (heaviness, fullness, early satiety) localized in the epigastric region closer to the midline.
Symptoms of dyspepsia
Dyspeptic syndrome is characteristic of acute food poisoning, salmonellosis, escherichiosis, gastrointestinal forms of yersiniosis, rotavirus gastroenteritis and other viral diarrhea, the initial period of botulism, and is possible in the pre-icteric period of viral hepatitis.
Dyspepsia syndrome is also observed in various organic lesions and functional disorders of the gastrointestinal tract. In cases where dyspepsia symptoms are caused by diseases such as peptic ulcer, gastroesophageal reflux disease, malignant tumors, cholelithiasis and chronic pancreatitis, it is customary to speak of organic dyspepsia syndrome. If, upon careful examination of the patient, the above diseases are not detected, it is legitimate to make a diagnosis of functional (non-ulcer) dyspepsia.
Stomach ache
Abdominal pain is one of the main symptoms of acute diarrheal infections. Their localization and nature depend on the predominant localization and prevalence of the inflammatory process in the intestine. Acute enteritis is characterized by cramping pain throughout the abdomen. In acute colitis, the pain is cramping, localized in the iliac regions. In distal colitis (proctosigmoiditis), characteristic of the typical colitic variant of shigellosis, patients are bothered by pain in the left iliac region, and a painful spasmodic sigmoid colon is palpated.
Differential diagnostics
In differential diagnostics of pain syndrome, the most important is the recognition of acute surgical and gynecological pathology, in which the patient's stay in an infectious hospital and delay in surgical intervention can irreparably affect the outcome of the disease. Acute appendicitis, cholecystitis, pancreatitis, intestinal obstruction, thrombosis of the mesenteric vessels, perforation of a hollow organ, disrupted ectopic pregnancy, torsion of the ovarian cyst pedicle, pelvic peritonitis, ovarian apoplexy can occur under the guise of acute intestinal infections.
Pain in the epigastric region, similar to that in gastritis and gastroenteritis variants of acute food toxic infections, is possible in myocardial infarction, most often when it is localized in the area of the posterior wall of the left ventricle, in pneumonia, especially lower lobe. Unlike abdominal pain of other etiologies, in acute diarrheal infections the pain is cramping, there is no clear local soreness and symptoms of peritoneal irritation.
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Vomit
Vomiting in acute diarrheal infections is observed quite often. It can be single, repeated or multiple; scanty or profuse ("vomiting with a full mouth"); with eaten food, with bile, with blood. Vomiting in acute diarrheal infections occurs as a result of inflammatory changes in the mucous membrane, increased permeability of cell membranes due to the action of the endotoxin-LPS of the pathogen and significant release of fluid into the lumen of the upper gastrointestinal tract, reverse peristalsis. Intoxication syndrome, characteristic of most acute diarrheal infections, plays a major role in the development of vomiting. Vomiting due to intoxication is often noted in the initial period of infections that do not belong to the group of acute diarrheal infections (erysipelas, meningococcal infection, tropical malaria). Vomiting may be a symptom of acute surgical and gynecological diseases, toxicosis of the first half of pregnancy, decompensation of diabetes mellitus, withdrawal syndrome in patients with chronic alcoholism and drug addiction, poisoning with salts of heavy metals, poisonous mushrooms, organophosphorus compounds and alcohol substitutes. Taking into account the preceding nausea and immediate relief after vomiting allows us to distinguish its gastritis genesis from cerebral, when these two signs are absent. Cerebral vomiting is characteristic of a hypertensive crisis, subarachnoid hemorrhage, acute cerebrovascular accident.
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Treatment of dyspepsia
The basis of treatment of acute infections accompanied by dehydration is rehydration therapy. It is carried out in order to restore the water-electrolyte and acid-base balance of the body.
Rehydration is carried out with polyionic crystalloid solutions (trisol, chlosol, acesol). Colloidal solutions (hemodez, rheopolyglucin) can be used for detoxification purposes only in the absence of dehydration. In most patients with I-II degrees of dehydration, solutions of oral rehydration salts are used: citraglucosolan, glucosolan, rehydron, rehydration therapy is the basis for the treatment of acute infections accompanied by dehydration syndrome.