Functional diarrhea symptoms. Chronic diarrhea - description, causes, symptoms (signs), diagnosis, treatment

is a continuous or periodic disorder of intestinal functions, manifested by an increase in bowel movements up to 3 or more times a day with the discharge of liquid or pasty stools. There are no abdominal pains. Possible urgency, rumbling, flatulence and a feeling of incomplete bowel movement. Mucus impurities are often found in stool. Functional diarrhea is diagnosed based on complaints, medical history, endoscopic and radiological examination methods, ultrasound, balloonography, laboratory tests and other techniques. Treatment – ​​elimination of provoking factors, diet, drug therapy, psychotherapy.

ICD-10

K59.1

General information

Functional diarrhea is a constant or episodic increase in bowel movements with the passage of insufficiently formed stools. Along with irritable bowel syndrome (IBS), functional constipation, functional bloating and nonspecific bowel disorder, functional diarrhea is included in the group of functional diarrhea intestinal disorders. It differs from IBS in the absence of pain and discomfort in the abdomen associated with the act of defecation. Like other functional disorders, functional diarrhea is characterized by the severity of the psychosomatic component and a tendency to persistent recurrent course. Despite the absence of organic pathology, it is difficult for patients to tolerate due to the variety of clinical symptoms and unfavorable psycho-emotional background.

It is a widespread pathology. Diagnosed in 1.5-2% of residents of developed countries. Can affect people of any age and gender. Functional diarrhea most often affects people over 40 years of age. Among young and middle-aged people, there is a predominance of male patients. In old age, the gender distribution changes; after 70 years, women suffer from functional diarrhea more often than men. There are no data on incidence in children. Treatment is carried out by specialists in the field of clinical proctology and psychotherapy.

Reasons

The reasons for the development of functional diarrhea are not precisely understood. Experts believe that the increase intestinal motility and increased frequency of bowel movements arise due to two main circumstances: the first is a disorder of the nervous regulation of intestinal activity, caused by psychological and emotional stress (acute and chronic stress); second - increased sensitivity of nerve endings located in the intestinal wall to pressure feces.

In patients with functional diarrhea, even slight stretching of the intestinal wall causes the urge to defecate. If the patient’s psycho-emotional state is unfavorable, the motor activity of the intestine increases even more, and the intestinal wall becomes even more sensitive to irritants. As a result, functional diarrhea occurs or becomes more pronounced before exams, transition to new job, during periods of difficulties in relationships with relatives and in other situations related to high level uncertainty and accompanied by severe anxiety. The impetus for the development or exacerbation of functional diarrhea can be both negative and positive experiences, for example, a wedding, appointment to a higher position, etc.

Pathogenesis

It has been established that with functional diarrhea there is an increase in intestinal motility, as a result of which intestinal contents move faster through the digestive tract. The consequence of the accelerated passage of contents is an increase in bowel movements and a deterioration in the absorption of fluid in the lower parts of the colon. Normally, stool contains 60-70% water. In patients with functional diarrhea, the water content in the stool increases to 75-90%, depending on the amount of liquid, the stool becomes pasty, thin or watery.

Symptoms of diarrhea

The main signs of functional diarrhea are an increase in the frequency of bowel movements and a change in stool consistency. To make a diagnosis, it is necessary that these symptoms appear at least six months before the start of diagnosis, persist for at least 3 months, are observed in ¾ of bowel movements and are not accompanied by discomfort or pain in the abdomen. Along with the above clinical manifestations With functional diarrhea, rumbling and flatulence are often observed.

The stool is liquid or pasty, the urge usually occurs quite consistently in the morning and repeats several times during the day, immediately after eating. Less often, the desire to defecate appears before eating. At night there is no urge. In most cases, bowel movements with functional diarrhea become more frequent up to 3-5 times a day, less often - up to 6-8 times a day. The more often the act of defecation occurs, the smaller the volume and lower the density of feces. False and imperative urges are usually observed with a significant increase in bowel movements; as a rule, these symptoms are mild or moderate.

In the stool of patients with functional diarrhea, mucus impurities are often detected. Mucus can be mixed with fecal matter or located in the form of smears on the surface. In some cases, mucus may be discharged almost without fecal impurities. There is no blood or pus in the stool with functional diarrhea. No steatorrhea was observed. Abdominal bloating and moderate pain on palpation without clear localization of pain are detected. Sometimes the zone maximum pain is in projection sigmoid colon.

Diagnostics

When conducting a detailed interview with the patient, preliminary diagnosis of functional diarrhea, as a rule, does not cause difficulties. During the interview, the proctologist reveals the existence of a connection between the exacerbation of the disease and stressful situations, determines the time of the urge to appear (after eating), notes the absence pain syndrome before and during bowel movements. The coprogram of a patient with functional diarrhea indicates the absence of inflammation of the large intestine. Fat is not detected in stool. To make a final diagnosis of “functional diarrhea,” it is necessary to exclude other diseases accompanied or complicated by diarrhea.

Due to the need for exclusion large quantity various pathological conditions the examination plan for functional diarrhea includes many instrumental studies, including colonoscopy, gastroscopy, plain radiography abdominal cavity, irrigoscopy, Dopplerography of abdominal vessels, ultrasound of the abdominal organs and balloonography. The list of laboratory tests includes general blood and urine tests, biochemical analysis blood, coprogram, stool tests for dysbacteriosis and bacterial culture, etc.

The plan of necessary diagnostic measures is drawn up individually. To identify somatic pathology and clarify the list of studies, a patient with suspected functional diarrhea is referred for consultation to an endocrinologist, urologist and gynecologist. To determine the significance of the psycho-emotional component and evaluate mental state The patient is prescribed a consultation with a psychotherapist.

Differential diagnosis of functional diarrhea is carried out with irritable bowel syndrome, intolerance to various food products, infectious colitis, inflammatory diseases colon (nonspecific ulcerative colitis, Crohn's disease), side effect when taking medicines, diarrhea due to AIDS and diarrhea caused by endocrine diseases and neuroendocrine tumors.

Treatment of functional diarrhea

Treatment is carried out on an outpatient basis. The doctor, together with the patient, identifies factors that contribute to the appearance and persistence of symptoms of functional diarrhea, and then draws up a plan to eliminate or reduce the significance of these factors. It may be necessary to adjust the diet (food composition, frequency and regularity of consumption, etc.) and take probiotics to eliminate dysbiosis. Important role plays a role in reducing anxiety and stress levels, so a patient suffering from functional diarrhea is advised to eliminate stress-producing influences if possible and seek help from a psychotherapist.

When selecting a diet, the doctor recommends that the patient completely eliminate foods that cause food allergies, causing increased intestinal motility and bloating. With functional diarrhea, aggravated side effects reception medicines, the gastroenterologist replaces the drug that causes frequent bowel movements, or refers the patient to a doctor of the appropriate profile for correction drug therapy one disease or another. If diarrhea persists, a patient with functional diarrhea is prescribed antidiarrheal drugs(loperamide and its analogues), adsorbents, antacids, etc. If the above are ineffective therapeutic measures in some cases antidepressants are used.

Information: DIARRHEA (diarrhea) - frequent (more than 2 times a day) discharge of liquid feces associated with accelerated passage of intestinal contents due to increased peristalsis, impaired absorption of water in the large intestine and excretion by the intestinal wall significant amount inflammatory secretion or transudate. In most cases, diarrhea is a symptom of acute or chronic colitis or enteritis. Infectious diarrhea is observed with dysentery, salmonellosis, food toxic infections, viral diseases (viral diarrhea), amebiasis, etc. Alimentary diarrhea can occur with poor nutrition or if you are allergic to certain foods. Dyspeptic diarrhea is observed when the digestion of food masses is impaired due to secretory insufficiency of the stomach, pancreas of the liver or insufficient secretion of certain enzymes by the small intestine. Toxic diarrhea accompanies uremia, mercury and arsenic poisoning. Drug-induced diarrhea can be a consequence of suppression of the physiological intestinal flora and the development of dysbiosis. Neurogenic diarrhea is observed when the nervous regulation of intestinal motor activity is disrupted (for example, diarrhea that occurs under the influence of excitement, fear). The frequency of stool varies, and stools are watery or mushy. The nature of bowel movements depends on the disease. So, with dysentery, the feces first have a dense consistency, then become liquid, scanty, mucus and blood appear in it; with amebiasis - contains glassy mucus and blood, sometimes the blood permeates the mucus and the stool takes on the appearance of raspberry jelly. Diarrhea may cause abdominal pain, a feeling of rumbling, transfusion, bloating, and tenesmus. Mild and short-lived diarrhea has little effect on the general condition of patients; severe and chronic diarrhea leads to exhaustion, hypovitaminosis, and pronounced changes in organs. To establish the cause of diarrhea, coprological and bacteriological examination. The severity of diarrhea can be judged by the speed of passage (promotion) of carbolene through the intestines (the appearance of black color in stool after a patient takes carbolene after 2-5 hours instead of the normal 20-26 hours) or barium sulfate during x-ray examination. If cholera, salmonellosis, or foodborne toxic co-infection are suspected, patients are subject to immediate hospitalization in the infectious diseases department. Treatment is aimed at eliminating the cause of the diarrhea. For example, for hypovitaminosis, appropriate vitamins are administered parenterally; for gastric achylia, gastric juice or its substitutes, in case of pancreatic insufficiency - pancreatin or panzinorm, festal, etc. For diarrhea not associated with infection, a gentle diet is indicated (limitation of carbohydrates, refractory fats of animal origin), frequent fractional meals, chewing food thoroughly. Calcium carbonate, bismuth preparations, tanalbin are used as symptomatic remedies; decoctions of oak bark, St. John's wort, serpentine rhizomes, cinquefoil or burnet, bird cherry fruits, blueberry infusion, alder fruits, chamomile flowers, belladonna tincture, etc. For diarrhea caused by dysbacteriosis, colibacterin, lactobacterin, bificol, bifidumbacterin are prescribed. Viral diarrhea is becoming particularly relevant in modern medical practice. Children's presenter etiological factor rotavirus causes acute infectious diarrhea. Most often, rotavirus diarrhea is observed in children under 2 years of age in the form of sporadic cases; epidemics of rotavirus infection are possible, more often in winter. In adults, rotavirus is rarely the causative agent of gastroenteritis and the process caused by it is erased. Acute diarrhea in adults is most often caused by the Norwolk virus. The latent period for rotavirus infection is from one to several days. The onset of viral gastroenteritis is acute - with vomiting, severe in children; then diarrhea occurs, as well as general symptoms infections: headaches, myalgia, fever, but these phenomena are usually moderate. Abdominal pain is not typical for viral gastroenteritis. Swelling and inflammation in the wall small intestine caused by a virus, lead to impaired secretion and absorption of fluid rich in sodium and potassium. Diarrhea is watery in nature; the fluid lost with diarrhea contains little protein, but a lot of salts. This pattern is reminiscent of secretory diarrhea caused by Vibrio cholerae or E. coli enterotoxins; it can lead to massive fluid loss, exceeding 1 liter per hour in an adult. With viral diarrhea, the large intestine is not affected and there are no leukocytes in the stool; viral diarrhea in adults lasts 1-3 days, in children - twice as long. Severe dehydration can threaten the patient's life. Therapy comes down mainly to replacing lost fluid. This replacement can be carried out by infusion, using a drink containing glucose and salts (glucose stimulates sodium absorption). Liquid is administered at the rate of 1.5 liters per 1 liter of stool, but the main control is the visible filling of the vessels of the skin and mucous membranes. Antibiotic therapy for watery diarrhea does not change the duration of the disease.

Version: MedElement Disease Directory

Functional diarrhea (K59.1)

Gastroenterology

General information

Brief description

Functional diarrhea - a continuous or recurrent syndrome characterized by the passage of soft (mushy) or watery stools in at least 75% of bowel movements, without abdominal pain or discomfort, with a frequency of more than 3 times a day. In this case, symptoms arose at least six months before diagnosis and persisted for at least the last 3 months before diagnosis.

For children, functional diarrhea is defined as painless defecation 3 or more times a day of large amounts of unformed stool, lasting 4 or more weeks, with onset during the newborn period or preschool years. At the same time, there is no growth retardation if the diet is sufficiently high in calories.

The defining criterion for functional diarrhea is not the frequency of stool, but the water content in it. If the normal water content in stool is 60-70%, then loose stool It is commonly defined as containing 85% water, and watery stools as containing 90% or more.
Since stool frequency correlates with the rate of passage of mass through the intestines, stool mass is inversely proportional to the frequency of bowel movements.

Note. Excluded from this subcategory: " " - K58.0.

Etiology and pathogenesis

The etiology and pathogenesis of functional diarrhea have not been established.
The pathophysiological picture indicates increased peristalsis of the colon, most often in response to mental reactions (anxiety, depression).
The most common (although not undisputed) idea is the following about the pathophysiology of functional diarrhea.

Functional diarrhea is based on accelerated transit of intestinal contents associated with increased motor activity intestines.

Motor dysfunction is associated with two main factors:

1. Increased sensitivity of the receptor apparatus of the intestinal wall to stretching leads to the urge to defecate, which occurs even with slight distension of the intestine.

2. Neuropsychic factors (psycho-emotional stress) lead to disruption central regulation motor secretory and other intestinal functions, which in turn entails hyperkinetic intestinal dyskinesia, increased excitability and contractile activity of the intestinal muscles, both at rest and under the influence of emotional and nutritional stress.

Epidemiology

Age: mostly mature

Sign of prevalence: Common

Sex ratio(m/f): 1.2

Overall, the incidence of functional diarrhea is slightly higher than that of irritable bowel syndrome with diarrhea.

Region. The greatest prevalence is observed in industrialized countries and regions. According to various estimates, it averages 1.5-2%, with a range of 0.9-4.8% and higher.

Floor. In some studies, a slight predominance of men was noted, with this ratio leveling out and even exceeding in favor of women in the group of patients over 70 years of age.

Age. Distributed in all age groups, however, the peak incidence occurs at the age of 40-80 years, especially at the age of 60-80 years. The incidence in those aged 18–29 years was significantly lower. Middle age A patient with functional diarrhea is defined as 48 years old.

Children. Reliable statistics for childhood absent.

Risk factors and groups

Risk factors have not been reliably determined.

Possible risk factors:
- stress;
- increased BMI Body mass index (BMI) is a value that allows you to assess the degree of correspondence between a person’s weight and his height and, thereby, indirectly assess whether the weight is insufficient, normal or excessive. Body mass index is calculated using the formula: I= m/h², where: m is body weight in kilograms, h is height in meters, and is measured in kg/m²
;
- family history of functional diarrhea.

No significant association was found between functional diarrhea and living conditions, education, occupation, total monthly household income, smoking, alcohol consumption or frequency of exercise.

Clinical picture

Clinical diagnostic criteria

Morning or afternoon diarrhea; frequent bowel movements; imperative urge to defecate; bloating; feeling of incomplete bowel movement; flatulence; rumbling in the stomach

Symptoms, course

Adults

The most common symptoms of functional diarrhea are:
- pasty, soft or watery stools (82%);
- more than 3 bowel movements per day (41%);
- imperative urge to defecate (30%).

The amount (frequency) of watery or loose stools should exceed 75% of the total number of bowel movements.
Symptoms must be constant for 3 months and persist for at least 6 months before diagnosis.
Defecation usually occurs in the morning and/or afternoon.

Other symptoms in one in three patients included:
- feeling of incomplete emptying after defecation (26%);
- feeling of fullness in the stomach, bloating (22%);
- admixture of mucus during bowel movements (9%).

Children. Diagnostic criteria

More than 4 weeks of painless daily repeated bowel movements 3 or more times unformed chair, together with all the following characteristics:
- onset of symptoms between 6 and 36 months of life;
- defecation occurs during wakefulness;
- there is no developmental delay if energy needs are adequately met.

Clinical symptoms	Characteristic
Pain and/or discomfort in the abdomen (localized more often in the lateral and lower abdomen)	Paroxysmal character Short-lived There may be distensional pain, a feeling of fullness and heaviness in the lower abdomen
Change in stool frequency	2-4 times a day, during periods of exacerbation it may be more often - usually in the afternoon and morning watch
Change in stool consistency	- liquid - mushy - there may be a heterogeneous nature of stool: dense followed by mushy and liquid
Presence of impurities in stool	Not typical
Increased intestinal volume	Not typical
Alternating constipation and diarrhea	Characteristic
Incomplete bowel movement	Characteristic
Bloating, flatulence, rumbling	Characteristic
Pain on palpation	In the sigmoid region or along the large intestine

Diagnostics

The diagnosis of functional diarrhea is made by excluding organic pathology and secondary functional disorders(at endocrine pathology, when using laxatives or other medications with a laxative effect).

Clinical signs, suggesting the functional nature of diarrhea:

No diarrhea at night;

Morning stool (usually after breakfast);

An imperative urge to defecate.

Examination program(similar to the examination program for patients with irritable bowel syndrome)

Method	Feasibility	Multiplicity
Sigmoidoscopy	Rule out ulcerative colitis, rectal tumors	One time
Esophagoduodenoscopy with mucosal biopsy duodenum	Rule out celiac disease, Whipple's disease	One time
X-ray examination stomach and small intestine	Rule out small intestinal tumors	One time
Colonofibroscopy with biopsy and examination of the distal parts ileum or irrigoscopy	Rule out Crohn's disease, colon tumors, diverticulosis	One time
Ultrasound of the abdominal organs and intestinal loops	Rule out diseases of the liver, gallbladder, pancreas, changes in the intestinal lumen (narrowing, dilatation)	One time
Gastric pH-metry	Eliminate hypo-, hypersecretion	One time
Dopplerography of abdominal vessels	Rule out abdominal ischemia syndrome	One time
Sphincteromanometry (for constipation)	Diagnostic value	One time
Electromyography of muscles pelvic floor(for constipation)	Diagnostic value	One time
Ballonography	Diagnostic value	One time
Electrocolonography	Diagnostic value	One time
Enterography	Rule out lymphoma	One time

Specialist consultations

Specialist	Feasibility	Multiplicity
Endocrinologist	Thyrotoxicosis	One time
Gynecologist	Gynecological diseases	One time
Urologist	Prostatitis, impotence	One time
Neuropsychiatrist	Psycho-emotional disorders
Physiotherapist	Evaluation of treatment effectiveness	Twice: before and after treatment

Laboratory diagnostics

There are no specific changes.

Laboratory diagnostics includes:

Indicator	Feasibility	Multiplicity*
General analysis blood	Screening	One time
General urine test	Screening	One time
Coprogram	Screening	One time
Feces for dysbacteriosis	Screening	One time
Bacteriological analysis of stool	Rule out acute intestinal infection	Three times
Stool analysis occult blood	Differential diagnosis with inflammatory or oncological diseases colon	Three times
Total blood bilirubin, AST, ALT, ALP, GGTP	Exclude concomitant disease liver	One time
Immunological study of biological samples of patients using the coaglutination reaction to antigens of intestinal infections	Avoid acute intestinal infections (residual effects or history)	One time
Study of blood serum by reaction method indirect hemagglutination for antibody titers to intestinal infections	Rule out a history of acute intestinal infections	One time
Study of serum immunoglobulins	Possible reductionexclude hypogammaglobulinemia	One time
Hormone research thyroid gland	Rule out hyperthyroidism Hypothyroidism	One time
Study of intestinal hormones in blood serum (vasoactive intestinal peptide, gastrin) in severe diarrhea.	Differential diagnosis with hormonally active tumors	One time
Hydrogen breath test with lactose	Determine the degree of bacterial contamination of the small intestine. Rule out lactase deficiency	One time

* If the indicator deviates from the norm, the study is repeated after treatment.

A visual assessment of stool using the Bristol scale is also necessary.

Differential diagnosis

1. Irritable bowel syndrome with diarrhea(IBS-D). Symptoms of functional diarrhea are similar to IBS-D, but are distinguished by less severe manifestations and, first of all, the absence of abdominal pain.
The combination of periodic diarrhea and constipation with abdominal pain is characteristic of IBS-D, while painless frequent diarrhea in small portions is characteristic of functional diarrhea. In relation to children differential diagnosis can be difficult.

2. Food-associated diarrhea. Trial selective diet therapy (exclusion of certain foods) can exclude disaccharidase deficiency, celiac disease, nutritional and allergic enterocolitis. Guessing can be confirmed by a biopsy and the study of specific antibodies, the level of eosinophils, IgE and other indicators.

4.Non-infectious colitis(Crohn's disease, ulcerative colitis; microscopic, toxic colitis; Whipple's disease; tropical sprue and others) are characterized by blood in the stool, weight loss, specific changes in imaging, specific markers, etc.

5. Steatorrhea. Changes in blood and stool.

6. Diarrhea with AIDS. HIV markers, identification of specific flora.

7. Drug-induced diarrhea . Anamnesis.

8. Hormonal problems (hyperparathyroidism, hormone-producing tumors, etc.). Determination of blood parameters, visualization methods.

Complications

Complications of functional diarrhea have not been described.
As a possible complication, irritation of the skin of the anus with watery stool can occur, mainly in young children.
None of the patients with functional diarrhea had signs of electrolyte imbalance, dehydration, protein-energy malnutrition, or physical or mental retardation.

Treatment abroad

  Diarrhea is called one-time or frequent bowel movements feces of liquid consistency. Diarrhea is a symptom that signals a malabsorption of water and electrolytes in the intestines. Normally, the amount of feces excreted per day by an adult varies between 100-300 grams, depending on the characteristics of the diet (the amount of plant fiber consumed, poorly digestible substances, liquids). If intestinal motility increases, stool may become more frequent and thinner, but its quantity remains within normal limits. When the amount of liquid in the stool increases to 60-90%, we speak of diarrhea.
  There are acute diarrhea (lasting no more than 2-3 weeks) and chronic. In addition, the concept of chronic diarrhea includes a tendency to periodically have large stools (more than 300 grams per day). Patients suffering from malabsorption of various nutrients tend to produce polyfecal matter: the excretion of large amounts of stool containing undigested food debris.

Clinical features of diarrhea.

  In clinical practice, acute and chronic diarrhea are distinguished.
  Acute diarrhea (duration up to 2-3 weeks).
  The causes of acute diarrhea are most often infections and inflammation of the intestines, as well as medications. In acute diarrhea, the stool is frequent, loose (watery), and may contain mucus and bloody streaks. Diarrhea is often accompanied by bloating, pain, nausea and vomiting. As a rule, patients have reduced appetite and weight loss. Debilitating loose stools contribute to the rapid loss of water by the body, which results in symptoms of dehydration: dryness skin, mucous membranes, fatigue, weakness. Diarrhea due to intestinal infections is often accompanied by an increase in body temperature.
  During the survey, it is often possible to identify previous use of low-quality or unusual food and medications.
  Bloody streaks in the stool indicate damage to the intestinal mucosa, which often occurs with shigellosis, infection with campylobacter or enteropathogenic E. coli. In addition, acute bloody diarrhea may be due to Crohn's disease, ulcerative colitis.
  Chronic diarrhea.
  Diarrhea lasting more than 3 weeks is considered chronic. It may be a consequence various pathologies, identification of which is the main task for determining treatment tactics. History data associated with the disease can provide information about the causes of chronic diarrhea. clinical symptoms and syndromes, physical examination.
  Special attention pay attention to the nature of the stool: frequency of defecation, daily dynamics, volume, consistency, color, presence of impurities in the stool (blood, mucus, fat). The survey reveals the presence or absence accompanying symptoms: tenesmus ( false urges to defecation), abdominal pain, flatulence, nausea, vomiting.
  Pathologies small intestine manifested by copious watery or greasy stools. Diseases of the large intestine are characterized by less abundant stool; streaks of pus or blood and mucus may be present in the stool. Most often, diarrhea with lesions of the large intestine is accompanied by pain in the abdomen. Diseases of the rectum are manifested by frequent, scanty stools as a result of hypersensitivity to stretching of the intestinal walls, tenesmus.

Diarrhea (diarrhea)- a very common phenomenon in children, in which frequent and loose stools are observed. Diarrhea can be caused for various reasons and lead to dehydration and digestive disorders. Term "diarrhea" translated from Greek means “to flow through.”

Normally healthy child In the first year of life, the stool is light and mushy; the frequency can range from once every few days to several times a day and even correspond to the number of feedings. In children receiving artificial nutrition or on mixed feeding, the stool is thicker, from once every one or two days to three to four times a day. Signs of diarrhea may include increased frequency of bowel movements, as well as changes in the consistency of stool; they become watery, often turn greenish, and may contain streaks of blood. General condition the child is getting worse.

After three years, diarrhea is considered to be a volume of stool exceeding 200 g per day, its character also changes, it becomes liquid or pasty with a frequency of more than 2 times a day, diarrhea may be accompanied by increased gas formation. A very dangerous stool can be very loose, abundant, with greens, and which occurs more often than 6-10 times a day.

If diarrhea does not stop within 2-3 weeks, then this is considered chronic diarrhea.

Causes leading to diarrhea in children

Eating disorder- Very common reason diarrhea in children. For example, eating too much fiber can cause acute diarrhea. In children of the first year of life, bowel dysfunction occurs when the rules for introducing complementary foods are violated, and in children who are on breastfeeding, violation of the mother's diet.

Sometimes diarrhea is allergic reaction on the consumption of food products if they are intolerant. Excluding these products from the diet will normalize digestion and normalize stool.

The process of teething in children early age may be accompanied by diarrhea.

Taking certain medications, such as laxatives, antibiotics, drugs containing bile acids, non-steroidal anti-inflammatory drugs, antacids, etc., can also cause diarrhea.

The most common intestinal infections that cause diarrhea are rotavirus infection(pathogen - Rotavirus), salmonellosis (pathogen - Salmonella), campylobacteriosis (pathogen - Campylobacter), escherichiosis (pathogen - Escherichia coli), bacillary dysentery(causative agent - bacteria of the genus Shigella), amoebic dysentery (causative agent - dysenteric amoeba).

Very often, diarrhea occurs in a child while traveling. There is even a term "travelers' diarrhea". Most cases are caused by bacteria found on the handles of train and airplane toilets. Changes in diet, climatic conditions, and stress can also have an adverse effect. Typically, travelers' diarrhea develops 2-3 days after the start of the trip.

There is diarrhea that is not associated with any organic damage to the digestive organs. This - functional diarrhea. It is associated with impaired intestinal motility and is not accompanied by pain.

What to do if a child has diarrhea?

The most important thing to know is that diarrhea in children very quickly leads to dehydration of the body, which in turn leads to disruption of vital functions. important organs. Therefore, there is no need to self-medicate, but you should urgently consult a doctor.

If it is not possible to call a doctor, then you should immediately begin to replenish the lost fluid. To do this, you can use ready-made solutions, such as Regidron or Hydrovit, or prepare the solution yourself (for 1 liter of boiled water, 1 teaspoon of salt, 1 tablespoon of sugar, 0.5 teaspoon of soda).

For children infancy The number of feedings should be increased, and water should be given in between. The amount of hydration solution you should give your baby depends on his weight, as well as the severity of the dehydration. The solution should be continued until the child's normal bowel movements are completely restored. If the child is on artificial feeding, the nutritional mixture should be diluted more.

Along with the liquid, it is necessary to give the child drugs that have protective properties against the intestinal mucosa, are absorbed and removed from the body. pathogenic microflora, toxins and gases, for example, Smecta, Enterosgel, etc.

During the period of illness, you should follow a diet. It is necessary to exclude difficult to digest foods, raw vegetables and fruits, and fruit juices from the diet. During the acute period, it is better not to give your child whole milk. You can feed your child slimy soups, rice water, dried bread, crackers, and baked potatoes.

Treatment of diarrheadepends on the cause of its occurrence. At bacterial infection appoint antibacterial drugs, for diarrhea caused by inflammation in the colon, anti-inflammatory drugs are prescribed. For dysbacteriosis diarrhea, drugs that restore intestinal microflora are needed.

The main thing in diagnosis of diarrhea in children identify its causes. To do this, the doctor must examine the child and also find out what preceded this condition. A stool test is required.