Dehydration – Symptoms & causes

Overview

Dehydration occurs when you use or lose more fluid than you take in, and your body doesn’t have enough water and other fluids to carry out its normal functions. If you don’t replace lost fluids, you will get dehydrated.

Anyone may become dehydrated, but the condition is especially dangerous for young children and older adults.

The most common cause of dehydration in young children is severe diarrhea and vomiting. Older adults naturally have a lower volume of water in their bodies, and may have conditions or take medications that increase the risk of dehydration.

This means that even minor illnesses, such as infections affecting the lungs or bladder, can result in dehydration in older adults.

Dehydration also can occur in any age group if you don’t drink enough water during hot weather — especially if you are exercising vigorously.

You can usually reverse mild to moderate dehydration by drinking more fluids, but severe dehydration needs immediate medical treatment.

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Symptoms

Thirst isn’t always a reliable early indicator of the body’s need for water. Many people, particularly older adults, don’t feel thirsty until they’re already dehydrated. That’s why it’s important to increase water intake during hot weather or when you’re ill.

The signs and symptoms of dehydration also may differ by age.

Infant or young child

• Dry mouth and tongue
• No tears when crying
• No wet diapers for three hours
• Sunken eyes, cheeks
• Sunken soft spot on top of skull
• Listlessness or irritability

Adult

• Extreme thirst
• Less frequent urination
• Dark-colored urine
• Fatigue
• Dizziness
• Confusion

When to see a doctor

Call your family doctor if you or a loved one:

• Has had diarrhea for 24 hours or more
• Is irritable or disoriented and much sleepier or less active than usual
• Can’t keep down fluids
• Has bloody or black stool

Causes

Sometimes dehydration occurs for simple reasons: You don’t drink enough because you’re sick or busy, or because you lack access to safe drinking water when you’re traveling, hiking or camping.

Other dehydration causes include:

• Diarrhea, vomiting. Severe, acute diarrhea — that is, diarrhea that comes on suddenly and violently — can cause a tremendous loss of water and electrolytes in a short amount of time. If you have vomiting along with diarrhea, you lose even more fluids and minerals.
• Fever. In general, the higher your fever, the more dehydrated you may become. The problem worsens if you have a fever in addition to diarrhea and vomiting.
• Excessive sweating. You lose water when you sweat. If you do vigorous activity and don’t replace fluids as you go along, you can become dehydrated. Hot, humid weather increases the amount you sweat and the amount of fluid you lose.
• Increased urination. This may be due to undiagnosed or uncontrolled diabetes. Certain medications, such as diuretics and some blood pressure medications, also can lead to dehydration, generally because they cause you to urinate more.

Risk factors

Anyone can become dehydrated, but certain people are at greater risk:

• Infants and children. The most likely group to experience severe diarrhea and vomiting, infants and children are especially vulnerable to dehydration. Having a higher surface area to volume area, they also lose a higher proportion of their fluids from a high fever or burns. Young children often can’t tell you that they’re thirsty, nor can they get a drink for themselves.
• Older adults. As you age, your body’s fluid reserve becomes smaller, your ability to conserve water is reduced and your thirst sense becomes less acute. These problems are compounded by chronic illnesses such as diabetes and dementia, and by the use of certain medications. Older adults also may have mobility problems that limit their ability to obtain water for themselves.
• People with chronic illnesses. Having uncontrolled or untreated diabetes puts you at high risk of dehydration. Kidney disease also increases your risk, as do medications that increase urination. Even having a cold or sore throat makes you more susceptible to dehydration because you’re less likely to feel like eating or drinking when you’re sick.
• People who work or exercise outside. When it’s hot and humid, your risk of dehydration and heat illness increases. That’s because when the air is humid, sweat can’t evaporate and cool you as quickly as it normally does, and this can lead to an increased body temperature and the need for more fluids.

Complications

Dehydration can lead to serious complications, including:

• Heat injury. If you don’t drink enough fluids when you’re exercising vigorously and perspiring heavily, you may end up with a heat injury, ranging in severity from mild heat cramps to heat exhaustion or potentially life-threatening heatstroke.
• Urinary and kidney problems. Prolonged or repeated bouts of dehydration can cause urinary tract infections, kidney stones and even kidney failure.
• Seizures. Electrolytes — such as potassium and sodium — help carry electrical signals from cell to cell. If your electrolytes are out of balance, the normal electrical messages can become mixed up, which can lead to involuntary muscle contractions and sometimes to a loss of consciousness.
• Low blood volume shock (hypovolemic shock). This is one of the most serious, and sometimes life-threatening, complications of dehydration. It occurs when low blood volume causes a drop in blood pressure and a drop in the amount of oxygen in your body.

Prevention

To prevent dehydration, drink plenty of fluids and eat foods high in water such as fruits and vegetables. Letting thirst be your guide is an adequate daily guideline for most healthy people.

People may need to take in more fluids if they are experiencing conditions such as:

• Vomiting or diarrhea. If your child is vomiting or has diarrhea, start giving extra water or an oral rehydration solution at the first signs of illness. Don’t wait until dehydration occurs.
• Strenuous exercise. In general, it’s best to start hydrating the day before strenuous exercise. Producing lots of clear, dilute urine is a good indication that you’re well-hydrated. During the activity, replenish fluids at regular intervals and continue drinking water or other fluids after you’re finished.
• Hot or cold weather. You need to drink additional water in hot or humid weather to help lower your body temperature and to replace what you lose through sweating. You may also need extra water in cold weather to combat moisture loss from dry air, particularly at higher altitudes
• Illness. Older adults most commonly become dehydrated during minor illnesses — such as influenza, bronchitis or bladder infections. Make sure to drink extra fluids when you’re not feeling well.

Dehydration – Symptoms & causes

Overview

Dehydration occurs when you use or lose more fluid than you take in, and your body doesn’t have enough water and other fluids to carry out its normal functions. If you don’t replace lost fluids, you will get dehydrated.

Anyone may become dehydrated, but the condition is especially dangerous for young children and older adults.

The most common cause of dehydration in young children is severe diarrhea and vomiting. Older adults naturally have a lower volume of water in their bodies, and may have conditions or take medications that increase the risk of dehydration.

This means that even minor illnesses, such as infections affecting the lungs or bladder, can result in dehydration in older adults.

Dehydration also can occur in any age group if you don’t drink enough water during hot weather — especially if you are exercising vigorously.

You can usually reverse mild to moderate dehydration by drinking more fluids, but severe dehydration needs immediate medical treatment.

Products & Services

Symptoms

Thirst isn’t always a reliable early indicator of the body’s need for water. Many people, particularly older adults, don’t feel thirsty until they’re already dehydrated. That’s why it’s important to increase water intake during hot weather or when you’re ill.

The signs and symptoms of dehydration also may differ by age.

Infant or young child

• Dry mouth and tongue
• No tears when crying
• No wet diapers for three hours
• Sunken eyes, cheeks
• Sunken soft spot on top of skull
• Listlessness or irritability

Adult

• Extreme thirst
• Less frequent urination
• Dark-colored urine
• Fatigue
• Dizziness
• Confusion

When to see a doctor

Call your family doctor if you or a loved one:

• Has had diarrhea for 24 hours or more
• Is irritable or disoriented and much sleepier or less active than usual
• Can’t keep down fluids
• Has bloody or black stool

Causes

Sometimes dehydration occurs for simple reasons: You don’t drink enough because you’re sick or busy, or because you lack access to safe drinking water when you’re traveling, hiking or camping.

Other dehydration causes include:

• Diarrhea, vomiting. Severe, acute diarrhea — that is, diarrhea that comes on suddenly and violently — can cause a tremendous loss of water and electrolytes in a short amount of time. If you have vomiting along with diarrhea, you lose even more fluids and minerals.
• Fever. In general, the higher your fever, the more dehydrated you may become. The problem worsens if you have a fever in addition to diarrhea and vomiting.
• Excessive sweating. You lose water when you sweat. If you do vigorous activity and don’t replace fluids as you go along, you can become dehydrated. Hot, humid weather increases the amount you sweat and the amount of fluid you lose.
• Increased urination. This may be due to undiagnosed or uncontrolled diabetes. Certain medications, such as diuretics and some blood pressure medications, also can lead to dehydration, generally because they cause you to urinate more.

Risk factors

Anyone can become dehydrated, but certain people are at greater risk:

• Infants and children. The most likely group to experience severe diarrhea and vomiting, infants and children are especially vulnerable to dehydration. Having a higher surface area to volume area, they also lose a higher proportion of their fluids from a high fever or burns. Young children often can’t tell you that they’re thirsty, nor can they get a drink for themselves.
• Older adults. As you age, your body’s fluid reserve becomes smaller, your ability to conserve water is reduced and your thirst sense becomes less acute. These problems are compounded by chronic illnesses such as diabetes and dementia, and by the use of certain medications. Older adults also may have mobility problems that limit their ability to obtain water for themselves.
• People with chronic illnesses. Having uncontrolled or untreated diabetes puts you at high risk of dehydration. Kidney disease also increases your risk, as do medications that increase urination. Even having a cold or sore throat makes you more susceptible to dehydration because you’re less likely to feel like eating or drinking when you’re sick.
• People who work or exercise outside. When it’s hot and humid, your risk of dehydration and heat illness increases. That’s because when the air is humid, sweat can’t evaporate and cool you as quickly as it normally does, and this can lead to an increased body temperature and the need for more fluids.

Complications

Dehydration can lead to serious complications, including:

• Heat injury. If you don’t drink enough fluids when you’re exercising vigorously and perspiring heavily, you may end up with a heat injury, ranging in severity from mild heat cramps to heat exhaustion or potentially life-threatening heatstroke.
• Urinary and kidney problems. Prolonged or repeated bouts of dehydration can cause urinary tract infections, kidney stones and even kidney failure.
• Seizures. Electrolytes — such as potassium and sodium — help carry electrical signals from cell to cell. If your electrolytes are out of balance, the normal electrical messages can become mixed up, which can lead to involuntary muscle contractions and sometimes to a loss of consciousness.
• Low blood volume shock (hypovolemic shock). This is one of the most serious, and sometimes life-threatening, complications of dehydration. It occurs when low blood volume causes a drop in blood pressure and a drop in the amount of oxygen in your body.

Prevention

To prevent dehydration, drink plenty of fluids and eat foods high in water such as fruits and vegetables. Letting thirst be your guide is an adequate daily guideline for most healthy people.

People may need to take in more fluids if they are experiencing conditions such as:

• Vomiting or diarrhea. If your child is vomiting or has diarrhea, start giving extra water or an oral rehydration solution at the first signs of illness. Don’t wait until dehydration occurs.
• Strenuous exercise. In general, it’s best to start hydrating the day before strenuous exercise. Producing lots of clear, dilute urine is a good indication that you’re well-hydrated. During the activity, replenish fluids at regular intervals and continue drinking water or other fluids after you’re finished.
• Hot or cold weather. You need to drink additional water in hot or humid weather to help lower your body temperature and to replace what you lose through sweating. You may also need extra water in cold weather to combat moisture loss from dry air, particularly at higher altitudes
• Illness. Older adults most commonly become dehydrated during minor illnesses — such as influenza, bronchitis or bladder infections. Make sure to drink extra fluids when you’re not feeling well.

symptoms, causes, complications, treatments

1. How dehydration occurs
2. Causes of dehydration
3. Additional factors
4. What happens when you get dehydrated
5. Dewatering types
6. Symptoms
7. Diagnostics
8. Dehydration treatment
9. Prophylaxis
10. Making a rehydrating solution at home

Image by Freepik

Dehydration is a state of increased loss of moisture from the body. Otherwise, this condition is called dehydration or exsicosis. It is characterized by thirst, dry skin, decreased urine output. As the moisture deficit increases, the patient’s blood pressure decreases, the skin becomes pale, there are disturbances in consciousness, pathological changes in the blood composition – an increase in hematocrit. This is the name for an increase in the volume of red blood cells relative to the volume of the liquid part of the blood.

Dehydration is a dangerous condition in which the body needs an urgent restoration of water and electrolyte balance.

How dehydration occurs

Dehydration occurs when the liquid drops to 40–50 ml/kg. In this case, body weight decreases by 4-5% due to the loss of water. In the body, it is found in the blood, cells of organs and tissues, and intercellular space. If water loss as a result of exsicosis reaches 20-25%, tissue ischemia begins – a violation of the blood supply to organs and tissues due to an increase in hematocrit.

Causes of dehydration

Exicosis most often occurs against the background of various diseases and pathological conditions. Among them:

• intestinal infections that cause vomiting and upset stools;

• burns of the second or more degree, in which there is an extensive release of exudate;

• diseases that are accompanied by fever and increased sweating;

• insufficient fluid intake with food;

• diseases accompanied by shortness of breath, in which the body loses moisture due to the release of water vapor.

The most common cause of dehydration is intestinal infections. Up to 48% of all clinical cases of exsicosis are associated with such diseases. They pose the greatest danger to young children. Frequent vomiting and loose stools lead to rapid loss of moisture, which causes dehydration. In countries with a low standard of living and a high incidence of intestinal infections, excoses are one of the main causes of death in young children under the age of 5–6 years.

With extensive burns, a large amount of exudate is released. If the patient does not receive fluid replacement therapy, a fluid deficiency develops.

Increased sweating at elevated body temperature requires control of the drinking regimen. This is especially important if the patient is in a warm room.

Insufficient fluid intake with meals can lead to dehydration if a person voluntarily or deliberately restricts drinking. About one and a half liters of water the body loses per day with sweat, defecation and urination. If the fluid intake is below normal, exsicosis develops.

Dehydration associated with shortness of breath occurs in patients with respiratory and cardiac pathologies. This phenomenon in healthy people is observed when traveling to high mountainous areas due to changes in the composition of the air.

Additional factors

Even healthy people who live in hot regions, do intensive sports or physical labor in hot weather, and stay in the mountains face a moisture deficiency in the body. To avoid dehydration, it is necessary to consume enough water, fresh vegetables and fruits.

Patients taking diuretics and people on mechanical ventilation are also at risk. To prevent exsicosis, patients on mechanical ventilation are injected with saline solutions and moisten the respiratory mixture that enters the body.

What happens when you get dehydrated

When the body loses a lot of moisture, blood viscosity changes first of all. It increases against the background of a decrease in plasma volume. This negatively affects the blood supply to organs and tissues, including the brain. Dehydration leads to an electrolyte imbalance, a decrease in the amount of mineral salts. A decrease in the concentration of potassium, calcium and sodium ions leads to disruption in the work of the heart.

A patient with severe dehydration has acidosis, which is characterized by an acid-base imbalance. The pH formula shifts to the acid side. This leads to repeated vomiting, after which the person develops metabolic alkalosis. It is manifested by various disorders in the work of the respiratory and cardiovascular systems.

Dewatering types

The classification of exicoses includes their division into several groups depending on the severity of the course, the cause of the development of the pathology, the presence or absence of complications.

The severity of dehydration is mild, moderate and severe. It can be caused by external and internal causes, pass with complications and without them.

When choosing therapy, experts pay attention to the ratio of the loss of mineral salts and water. On this basis, three forms of dehydration are distinguished:

• hypoosmolar. It is characterized by a rapid loss of salts with a slow development of water deficiency. This leads to the rapid onset of negative symptoms from the central nervous system. The patient’s blood circulation is disturbed, signs of a neurological disorder appear;

• hyperosmolar. Fluid loss occurs faster than electrolyte loss. Due to this, their concentration increases. With this kind of dehydration, pronounced symptoms appear only with a significant deficit of moisture;

• isosmolar. The loss of water and salts is about the same. The patient has a decrease in the amount of urine excreted, may decrease blood pressure (BP) and central venous pressure.

Symptoms

Each degree of dehydration is characterized by special signs:

• mild degree. The patient is thirsty, the pulse remains normal, may become more frequent. Skin and mucous membranes are unchanged. On the part of the nervous system, there may be signs of anxiety and anxiety;

• average degree. Externally, the pathology is manifested by dry skin and mucous membranes, a decrease in diuresis. The eyes become sunken, the patient’s pulse quickens, the pressure is increased or decreased by about 20% of the usual values. From the side of the central nervous system, both anxiety and lethargy can be observed;

• severe degree. Pronounced fluid deficiency causes neurological disorders. The patient is very lethargic and practically does not react to anything. Breathing becomes difficult, blood pressure is greatly reduced, tachycardia is characteristic. The skin looks pale and has a bluish tint, it is cold to the touch.

Moderate to severe dehydration increases the risk of complications. First of all, they are associated with the formation of blood clots due to the high viscosity of the blood. When a thrombus clogs the vessels of vital organs, the patient may die or receive irreversible negative changes. Some people who survive severe dehydration develop chronic headaches, weakness, and reduced muscle mobility. Children have cognitive impairment.

Diagnostics

At the first signs of dehydration, it is necessary to contact a medical institution to a general practitioner, a general practitioner, a pediatrician. If dehydration is severe, an ambulance must be called to hospitalize the patient in a medical facility.

For the diagnosis of exicosis, the following are used:

• visual examination and questioning of the patient for the presence of vomiting, diarrhea;

• measurement of arterial and central venous pressure;

• blood test for electrolytes and hematocrit.

A decrease in central venous pressure and an increase in hematocrit above the age norm indicate fluid deficiency.

Treatment for dehydration

With mild dehydration, the patient is treated at home. With moderate and severe fluid deficiency, which are accompanied by changes in the central nervous system, circulatory disorders, hospitalization and intensive treatment are necessary.

The main ways to eliminate exsicosis are:

• the use of rehydrating solutions or large amounts of liquid with the addition of salt to restore water and electrolyte balance;

• intravenous infusion of glucose and saline solutions. It is used in conditions that are accompanied by severe vomiting. Fluid therapy will make up for the lack of fluid if the patient cannot drink it by mouth due to frequent vomiting.

Severe dehydration may require intensive care with a ventilator. With signs of tissue ischemia, neuroprotectors, potassium preparations, drugs to maintain the work of the heart are prescribed.

Treatment is continued until normalization of blood circulation and diuresis. To achieve stable results, it is important to identify the exact cause of the pathological condition and eliminate it.

As a rule, with a slight dehydration, it is possible to completely normalize the patient’s condition within 1-2 days. In moderate and severe dehydration, the prognosis depends on the severity. In some cases, the risk of developing serious violations of body functions, up to irreversible processes, increases.

Prevention

To avoid dehydration, you need to know what factors provoke it, and take appropriate safety measures. This is, first of all, adequate intake of water and fluids. Its volume is from 1.5 liters per day and increases with intense physical exertion, in hot weather.

If the patient has diarrhea or vomiting, rehydration solutions should be used to prevent dehydration. You can buy them at a pharmacy or make your own at home. Pharmacy rehydrating solutions contain potassium chloride, sodium chloride and other mineral salts.

The funds are available in the form of a powder that dissolves in water and is taken orally to prevent water and electrolyte disorders. Powders contain flavoring additives, due to which the use of the drug does not cause discomfort in adults and children.

In addition to powders, rehydrating agents are available as infusion solutions.

Making a rehydrating solution at home

If it is not possible to buy a pharmacy product, it can be seen as a home analogue. To prepare the drink, you need a tablespoon of salt, a teaspoon of soda and two tablespoons of sugar. This mixture must be dissolved in one liter of warm boiled water. The solution can be taken by adults and children. It is drunk in small sips every 10-20 minutes. The mixture can be stored for a day. If signs of dehydration persist the next day, a new portion of the solution should be prepared.

This recipe is recommended and approved by WHO experts. The main advantage of home rehydration is the availability of ingredients that can be found in the home of every family.

Intestinal infection: signs, symptoms and treatment

Contents:

• Classification
• Particular supporting clinical symptoms
• Diagnosis and treatment of intestinal infections
• Prevention of intestinal infection
• Treatment

Acute intestinal infections (AII) is a polyetiological group of infectious diseases accompanied by intoxication, impaired motility of the gastrointestinal tract with the development of diarrhea, and in some cases vomiting and dehydration, and the possible development of an inflammatory reaction.

Ways of transmission:

• household contact;
• food;
• water.

Transmission mechanism:

• fecal-oral

Symptoms of intestinal infection:

• vomiting;
• diarrhea;
• temperature;
• pain along the gastrointestinal tract;
• weakness;
• signs of dehydration.

Classification

According to the localization of the lesion of the gastrointestinal tract with diarrhea of ​​infectious genesis, the following syndromes are distinguished:

• acute enteritis;
• acute colitis;
• acute gastroenteritis;
• acute enterocolitis;
• acute gastroenterocolitis.

According to the severity of the course of the disease, there are:

• mild course;
• moderate;
• severe course.

According to the degree of dehydration (dehydration):

• I degree dehydration – loss of body weight does not exceed 3%;
• II degree dehydration – loss of body weight 4-6%;
• III degree dehydration – loss of body weight 7-9%;
• IV degree dehydration – weight loss of 10% or more.

The severity of the intestinal infection is assessed by the severity of the intoxication syndrome and the degree of dehydration.

Partial supporting clinical symptoms

With dysentery:

1. Acute onset of the disease with hyperthermia and headache.
2. The presence of cramping pains in the abdomen with their subsequent localization in the area of ​​the sigma.
3. On palpation of the abdomen, there is pain in the left iliac region with spasm and induration of the sigmoid colon.
4. The presence of tenesmus up to rectal prolapse, in young children, as the equivalent of tenesmus, redness of the face.
5. Stools are not abundant with an admixture of mucus, streaks of blood, pus, odorless, like “rectal spitting”.

In case of salmonellosis occurring as gastroenteritis:

1. Acute onset of the disease with high fever, vomiting, pain in the abdomen.
2. On palpation of the abdomen, there is pain in the epigastrium and around the umbilicus.
3. Stools are copious, watery, fetid with an admixture of greenery, like “swamp mud”.

Cholera:

1. The onset of the disease with the appearance of loose stools against the background of normal (or subfebrile) body temperature and the presence of rumbling in the abdomen.
2. Dehydration develops rapidly with the addition in severe cases of vomiting, tonic-clonic convulsions, cyanosis, thirst, a sharp decrease in skin turgor; laboratory data indicate hemoconcentration.
3. Stools are plentiful, watery, odorless, outwardly “rice water” (light liquid with flakes).

Escherichiosis:

This is a group of diarrhea caused by five serogroups of Escherichia coli:

• enterotoxigenic;
• enteroinvasive;
• enteropathogenic;
• enterohemorrhagic;
• enteroadhesive.

Enteroinvasive and enterotoxigenic Escherichia also cause disease in adults, while other pathogens cause disease only in children of the first and second year of life.

In diseases caused by enterotoxigenic Escherichia coli, profuse watery, colorless stools with flakes are observed. The onset of the disease can be acute with the appearance of vomiting and the development of exsicosis against a background of normal or subfebrile temperature. Dehydration sets in fairly quickly.

In case of escherichiosis caused by enteroinvasive intestinal bacteria, there is a high temperature with scanty stools mixed with mucus, pus, blood, abdominal pain, headache. The disease occurs not only in children, but also in adults and clinically resembles dysentery.

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Staphylococcal enterocolitis:

1. The disease occurs mainly in children under one year of age with a characteristic epidemiological history (presence of purulent foci in a child, mastitis in a mother, consumption of infected food, prolonged antibiotic treatment, etc. ).
2. Gradual development of intestinal dysfunction against the background of subfebrile temperature and moderate intoxication.
3. Dysfunction is observed for a long time while maintaining the source of infection.
4. Liquid stools with an admixture of mucus, sometimes streaked with blood.

Staphylococcal food poisoning:

1. Indication of eating food in which staphylococcus is well multiplied (cakes, creams, pastries, salads with mayonnaise). Most often, the disease is of a group nature.
2. Rapid development of the disease with persistent, debilitating vomiting against the background of high temperature with the addition of secretory diarrhea.
3. Quite often there are cramps in the calf muscles.
4. Liquid, watery stool without pathological impurities.

Campylobacteriosis:

1. Acute onset with fever, pain in the abdomen, mainly around the umbilicus, preceded by bowel dysfunction and intoxication.
2. Enlargement of the liver and involvement of the pancreas.
3. Pain in the abdomen is localized around the navel and in the right iliac region, they are persistent, sometimes so intense that they require the exclusion of surgical pathology.
4. Stools are plentiful, “foamy”, fetid with an admixture of mucus and greenery, and from the 2-3rd day and blood, but without signs of distal colitis (no tenesmus, spasm of the sigmoid colon).

Intestinal yersiniosis:

1. Acute onset of the disease with the development of a variety of symptoms (skin rash, pain in the joints, enlarged liver and spleen) or only in the form of diarrheal syndrome.
2. Pain in the abdomen is localized around the navel and along the mesenteric lymph nodes, mainly in the right iliac region, which requires differential diagnosis with acute appendicitis.
3. Stool 3-6 times a day, liquid, fecal, fetid without pathological impurities in the first days of the disease, later it can be enterocolitis.

Pseudomembranous colitis:

1. The disease is caused by Clostridium difficile in adults and children older than 2 years due to irrational antibiotic therapy (clindamycin, ampicillin, cephalosporins, etc.) and cytostatics due to inhibition of normal intestinal microflora.
2. During treatment with antibiotics, fever, pain in the abdomen, frequent stools.
3. On palpation of the abdomen, there is tenderness around the navel and along the large intestine. The chair is liquid, plentiful with the release of films, which consist of a clot of fibrin and mucus. Continued antibiotic treatment worsens the condition of patients, intestinal dysfunction increases.
4. The disease has a wide range of clinical manifestations, from mild to severe with complications such as intestinal perforation, megacolon and peritonitis.

Viral diarrhea

In rotavirus gastroenteritis, an acute onset of the disease is observed: fever, vomiting as the initial symptom of the disease and copious watery stools with rumbling along the small intestine against the background of scant respiratory symptoms (moderate hyperemia and granularity of the soft palate and arches, congestion nose) or without respiratory syndrome.

In adenoviral and enterovirus infections, there are a number of characteristic symptoms that are not associated with intestinal manifestations. Dehydration rarely develops.

Amoebiasis

The onset of the disease is gradual with the appearance of pain in the abdomen and an increase in the frequency of bowel movements against the background of normal or subfebrile temperature.

1. On palpation of the abdomen, there is pain along the large intestine with induration of the caecum and sigmoid colon.
2. Fluid stools with sticky glassy mucus, pink colored (“raspberry jelly”) or bloody.

Cryptosporidiosis:

1. Clinical and laboratory evidence confirms that the patient is immunodeficient (HIV infection, congenital T-cell immunodeficiency).
2. Prolonged diarrhea (2 months or more), not amenable to treatment with antibacterial drugs and leading to exhaustion of patients.
3. Abundant, watery stool without pathological impurities, 5-10 times a day.
4. In people with a normal immune system, cryptosporidiosis begins acutely and proceeds as gastroenteritis or enteritis with a stool frequency of no more than 10 times and spontaneous recovery within 2 weeks.

Giardiasis:

1. Presence of nausea, discomfort in the epigastrium, loss of appetite against the background of normal temperature.
2. On palpation of the abdomen, rumbling, pain in the epigastrium and around the navel.
3. Stools are liquid, watery, without pathological impurities 2-6 times a day without a tendency to normalize against the background of antibacterial treatment.

Diagnosis and treatment of intestinal infections

Standard for examination of patients with AII:

• Complete blood count (normocytosis or leukocytosis with a stab shift, sometimes up to 40-50% in dysentery and an increase in red blood cells and hemoglobin in severe dehydration) with the determination of hematocrit.
• Complete urinalysis (may have toxic changes and high specific gravity with dehydration).
• Sowing feces for dysentery, salmonellosis, escherichiosis, pathogenic staphylococcus aureus, yersiniosis, opportunistic flora, as well as epidemic and clinical indications for cholera and examination of feces for rotavirus antigens (ELISA) and enteroviruses.
• Coprological examination of feces allows you to clarify the predominant part of the intestine that has been affected.
• Serological blood test in the dynamics of the disease (RNHA in case of suspected dysentery, salmonellosis, campylobacteriosis, yersiniosis, etc.).
• Sowing of vomit and wash water for pathogenic microflora.
• Biochemical blood test with determination of K, Na, Ca, Cl, total protein, urea, creatinine, CBS.
• Examination of feces for cryptosporidiosis, amebiasis (vegetative forms of amoebae in warm feces), balantidiasis, giardiasis, helminthic infestations according to indications.
• Blood culture for sterility and blood culture with persistent fever and suspected typhoid fever, salmonellosis, staphylococcal sepsis.
• Duodenal sounding for suspected giardiasis.
• Sigmoidoscopy or colonoscopy for diarrhea over two weeks with blood in the stool.
• Fibrogastroscopy.
• Ultrasound of the abdominal organs.

Prevention of intestinal infection

1. Use only pre-washed chicken eggs for cooking.
2. Meat of all kinds must be cooked before consumption.
3. Heat treatment (boiling) of dairy products purchased from individuals.
4. Store food in separate containers in the refrigerator.
5. Avoid prolonged storage of finished products.
6. Use separate kitchen utensils for cooked and raw foods.
7. Wash fruits and vegetables before eating.
8. Practice good personal hygiene.
9. Pay attention to expiration dates, release dates of products purchased in stores.
10. Avoid buying products from private markets.
11. When swimming in ponds and pools, keep water out of the mouth.