Residues of undigested food were found in the stool. Undigested food in the stool of an adult: causes, norm, concomitant diseases.

08.08.2019 -

A small amount of mucus in the stool can only be detected by microscopic examination. But undigested food in an adult’s stool can cause real panic for some.

IN in good condition feces should not contain any inclusions, lumps or pieces of undigested food, mucus, blood, etc.

There are two types of fiber that can be found in the stool of an adult - digestible and indigestible. It should be noted that both species can be found in the stool of an adult.

U healthy person Digestible fiber is not detected in feces. Indigestible fiber is precisely those particles of grains, legumes, skins of vegetables and fruits, hairs and vessels of plants that are often found in the feces of adults.

Such fiber is found in the feces of an adult constantly, depending on the diet. Undigested food in the stool of an adult is a consequence of low acidity gastric juice, diseases of the pancreas, as well as accelerated evacuation of food from the intestines.

In all other cases, temporary inclusions of undigested food are considered normal. Accelerated evacuation of food manifests itself in the form of diarrhea.

Feces reflect all the features of a child’s digestion and nutrition. A coprogram helps to assess changes in bowel movements in children and adults.

Macroscopic examination evaluates the visual characteristics of feces, and microscopic examination evaluates its initial data under a microscope. Normally healthy child From time to time, small particles of undigested rough food (nuts, peels of vegetables, fruits) may appear.

Stool examination

No less common cause the appearance of undigested food particles in a child’s stool is functional dyspepsia. Another common reason for the appearance of food particles in stool is dysbiosis.

Depending on the reasons that led to incomplete digestion of food, the principles for eliminating them can be very diverse. Timely request for medical care will quickly eliminate the cause of undigested food elements in the feces and maintain healthy digestion in the baby.

Normal unsharp, bad smell feces is caused by the presence in the feces of indole, skatole, phenol, cresols and other substances formed as a result of the bacterial breakdown of proteins. The sharp fetid odor of feces is caused by increased decay of proteins and is characteristic of putrefactive dyspepsia.

The presence of fat in feces is observed with severe inflammation of the pancreas; in these cases, the feces acquire a dull sheen and become ointment-like.

Stool analysis (coprogram) in children and adults

Normally, particles of plant food (cucumbers, onions, lettuce, berries, nuts, fruit peels), as well as tendons and pieces of cartilage are released undigested.

Steatorrhea is the presence of fat in the stool in the form of yellowish lumps. The feces acquire a matte shine and have a pasty consistency.

How to take a stool test?

Blood. In a healthy person, there is no blood in the stool and is a pathological impurity. In all doubtful cases, the question of the presence of blood in the stool is resolved chemically or microscopically.

Stones of pancreatic, bile and fecal origin (coprolites) can be found in the stool. Coprolites are formed from closely compressed feces particles, mainly from plant gluten, impregnated with lime salts.

Visible stool

First of all we're talking about about feces and urine. Of course, if, for example, the consistency of a child’s feces is disturbed, this is already a reason for the mother to sound the alarm.

Be aware that undigested food in the stool in some cases indicates the presence of serious disorders, and your task is to respond to them in a timely manner. The whole point is that eating a lot of food plant origin leads to the appearance of small accumulations of indigestible fiber.

Diarrhea can also cause undigested food to appear in the stool. The situation is aggravated by such common digestive disorders as colitis and gastroenteritis.

Stool analysis is an important part of the examination of a patient with intestinal disease. Microbiological examination of stool is carried out if an infectious intestinal disease is suspected.

For stool examination occult blood the patient is prepared on a three-day diet excluding meat and fish products.

Normal stool is sausage-shaped and soft in consistency. With constipation, the stool is dense; with spastic colitis, it has the form of lumps (“sheep feces”). A ribbon-shaped bowel movement may occur due to a tumor in the rectum or sphincter spasm.

The color of stool depends on the presence of bile pigments in it. The smell of feces depends mainly on the presence in it of substances formed during the decay of proteins. Undigested leftovers food may be in normal feces; most often these are particles of plant food (peels and grains of berries, pea grains, etc.) or pieces of cartilage and tendons.

The stomach is the place where food is digested. Its volume in an adult is approximately 2-3 liters. Food enters the stomach through the esophagus, where it is broken down into its components: proteins, carbohydrates and fats. When the body feels the need for food, it gives a signal and the amount of hydrochloric acid increases, which helps break down food. The speed of this process is different: carbohydrates are completely processed in 2 hours, while a similar process for fats takes up to 5 hours.

Deterioration of the stomach, in which it practically stops digesting food, is called dyspepsia and may be accompanied by unpleasant sensations: attacks of nausea, heaviness in the stomach and a feeling of fullness. If you do not take timely effective measures

, the consequences will be very serious.

May appear as follows:
feeling of fullness in the stomach;
bloating, distension;
: vomiting, nausea, heartburn, “hunger” pain;
belching;
after eating, a burning sensation may occur in the chest area;
heaviness and unrelated to food intake;
pain in the upper spine;
sometimes vomiting occurs, causing relief for a short period;

loss of appetite, rapid satiety (associated with undigested food in the stomach). The disease may develop different ways : according to the ulcerative, dyskinetic or nonspecific variant. The dyskinetic variant involves the appearance of a feeling of rapid satiety, overcrowding, and discomfort. With a peptic ulcer, signs of a peptic ulcer are observed, that is, belching, “hungry” or night pain

, heartburn. The nonspecific variant combines signs of both ulcerative and dyskinetic course of the disease.

2 Causes of the disease The most common causes of dyspepsia are poor nutrition and lack of food culture. Dry snacks in conditions of constant stress and haste will certainly affect your health. The selection of foods can affect the functioning of the stomach. There are a number of products that, depending on individual characteristics

Discomfort may occur from fatty, heavy or too spicy foods. Alcohol can also cause problems, as it stimulates the production of hydrochloric acid, thereby increasing the load on the walls of the stomach.

Most people do not tend to carefully examine their own feces, and the design of modern plumbing often interferes with such research. If various kinds of impurities and inclusions are accidentally discovered in excrement, then it makes sense to be wary: some of them may be the first clinical manifestations of pathologies. Individual impurities are a good reason for visiting a doctor and further treatment. medical examination, which necessarily includes testing.

Normal composition, color and consistency of stool

A healthy adult produces an average of 300 g of excrement per day, and defecation usually occurs once a day.

Note:Normally, stool has an almost uniform consistency.

The main components of excrement are:

In the absence of acute and chronic diseases, as well as intestinal disorders, the color of an adult's stool varies from light brown to dark brown.

A change in color is one of the signs of the development of pathology. A greenish tint is one of the symptoms of regional enteritis (Crohn's disease), grey colour indicates problems with the pancreas; light gray or almost white indicates a violation of the functional activity of the liver (in particular, with Botkin’s disease). A yellow tint indicates gallbladder disease.

What are the types of impurities?

The following impurities are most often detected in stool:

leftover food;
slime;
blood;
foreign inclusions;
pus.

The presence of impurities may indicate the development of diseases (sometimes quite serious pathologies digestive system), but often it is due to the nature of the diet.

Residues of food in stool

If you find whole corn kernels or seeds (for example, sunflower seeds) in your feces, this is not a reason to sound the alarm. Some foods are very difficult to digest, especially if they are poorly chewed. Also, digestive enzymes are completely unable to cope with the veins present in meat products, as well as fish bones and fragments of eggshells.

The reason for a visit to the doctor is the presence of undigested meat fibers, as well as cottage cheese or eggs, in the excrement. This sign indicates a lack of digestive enzymes.

Note:the presence of large particles of undigested food is called lientorrhea. When meat fibers are detected, they speak of creatorrhoea.

The reason for the lack of enzymes may be:

insufficient secretion of pancreatic juice (after resection of part of the pancreas or against the background of pancreatitis);
inhibition of enzyme secretion in the intestines;
pronounced atrophy of the gastric mucosa.

Residues of food may appear in the stool during its accelerated evacuation against the background of increased peristalsis. In this case, some foods simply do not have time to be digested and absorbed. This phenomenon is particularly characteristic of irritable bowel syndrome.

If the stool has an oily sheen, this is a sign of steatorrhea, i.e. the presence of a large amount of lipid compounds (fats).

Possible causes of steatorrhea:

a large number of fats in the diet;
diseases of the liver, gall bladder and ducts (cirrhosis, hepatitis, cholecystitis, etc.);
pancreatic diseases (inflammation, strictures, ulcers and tumors);
hemochromatosis (accumulation of iron in organs due to metabolic disorders);
intestinal pathologies (inflammatory, autoimmune and tumor);
endocrine diseases and pathologies of the endocrine glands;
congenital (hereditary) diseases;
systemic manifestations of skin diseases;
Excessive consumption of laxatives.

Mucus in stool

Note:the presence of some mucus in the stool (in the form of lumps or inclusions) is normal for children early age located on breastfeeding. Mother's milk is characterized by high fat content, which the baby's digestive enzymes are not yet able to fully cope with.

In any healthy person, the cells of the intestinal wall produce mucus, which is necessary to facilitate the passage of feces through the lower sections digestive tract. A small amount of colorless (almost transparent) mucus is often normal and is not a cause for concern.

If mucus is released in large volumes or is brown or yellowish in color, this may indicate the following pathologies:

increased intestinal motility;
inflammatory diseases of non-infectious origin;
acute intestinal infections (dysentery, typhoid fever etc.);
benign or malignant formations;

Note:often a large amount of mucus is the first clinical sign development of regional enteritis (). Impurity significant amount mucus is also quite often recorded in chronic constipation.

Based on the degree of distribution of the mucous component in feces, the height of the location of the pathological focus can be determined. If the mucus relatively evenly permeates the excrement, then inflammatory process localized in upper sections intestines, but if impurities are detected on the surface (usually in the form of lumps), then the lower sections are affected.

Bloody feces

The presence of blood in excrement is an absolute reason to consult a doctor, since it can be a clinical manifestation of the following diseases:

autoimmune intestinal pathologies ();
malignant neoplasms of the gastrointestinal tract;
benign tumors of the intestinal walls ();
ischemic colitis;
diseases of infectious origin (dysentery, etc.);
and ulcers of the rectum and rectal area;
intestinal angiodysplasia;
blood pathologies (clotting disorders);
some helminthic infestations (in particular, ascariasis).

Blood volume varies depending on the nature of the disease and the severity of the pathology. Feces often contain only small and inconspicuous veins, but when serious pathologies during defecation, up to 200 ml or more can be released. In this case, we are talking about intestinal bleeding, which requires immediate action.

Note:in some pathologies, during the act of defecation, only blood mixed with intestinal mucus is released.

The color of blood in the stool allows high degree probability of determining the approximate location of the bleeding site. The scarlet color and location of the blood on top of the feces indicates that there is a pathology of the sigmoid, descending or rectum. Fresh blood is also released from cracks anus and hemorrhoids. Darker blood and blood clots, relatively evenly mixed with feces, indicate that the source of bleeding is in the upper parts of the large intestine ( colon) or in small intestine. Black coloring of the stool may indicate that blood is being secreted in the stomach or esophagus (the specific color is due to the fact that the blood has been exposed to hydrochloric acid of the gastric juice).

Note:a reddish tint to the stool or burgundy streaks are not always due to the presence of blood - be sure to remember if you ate beets the day before?

Foreign inclusions

The presence of films in feces may be due to a rather serious pathology of the large intestine - pseudomembranous colitis, often caused by long-term or irrational antibiotic therapy.

Fragments of necrotic tissue are found during decay malignant tumors, as well as with intussusception due to intestinal obstruction.

Upon admission pharmacological drugs in granular forms, their particles are also often detected in the stool. Activated carbon gives excrement a black color.

The so-called feces are sometimes detected. pancreatic, biliary and intestinal stone formations - coprolites. Intestinal compactions (stones) are not true stones, but are highly compacted feces formed due to chronic constipation. This pathology more typical for elderly patients. True coprolites consist of an organic core with gradually growing mineral salts. The presence of such stones in the stool suggests diseases of the pancreas or bile ducts.

Pus in stool

The presence of pus in feces is unconditional evidence of the development of a pathology of inflammatory origin. In most cases, pus is detected in parallel with blood and mucus.

Pus may have a yellowish or greenish tint and appears in the following diseases:

proctitis;
infectious colitis;
ulcerative colitis;
decay (to late stages cancer);
breakthrough of an abscess into the intestinal lumen;
autoimmune intestinal damage (Crohn's disease).

Important:remember that if pus is released during defecation, then self-medication is strictly unacceptable. There can be no talk of a positive effect in this case.

Treatment

The detection of most of the mentioned impurities is the basis for contacting a gastroenterologist at the clinic. The local physician can also refer the patient to a specialized specialist and prescribe a series of tests.

Specialists whose consultation may be needed:

proctologist;
infectious disease specialist;
surgeon;
hematologist;
oncologist.

Important:If a large amount of blood is released against the background of a deterioration in the general condition, an ambulance should be called. Massive bleeding is life-threatening condition and requires hospitalization of the patient in the intensive care unit or intensive care unit.

To make or clarify the diagnosis, in most cases the patient is referred for examination to an endoscopist.

Plisov Vladimir, medical observer

Improper diet, non-compliance with the diet, eating dry food, eating food before bed are factors that lead to the stomach not digesting food. This condition has a characteristic name - dyspepsia. What types of dyspepsia are there, how is diagnosis made and how exactly to treat this disease for adults and children? These questions will be answered in this article.

Digestion in the stomach

The stomach is a kind of tool for processing food. The stomach capacity is about 2.5-3 liters. Food enters it through the esophagus. At the very beginning, food is broken down into fats, proteins and carbohydrates, and what is not digested is sent to the initial section small intestine (duodenum). When a person eats food, special acids are produced in the stomach, which help it to be divided into organic substances and digested. The stomach has walls that reliably protect it from the effects of acids. Food can take anywhere from 15 minutes to several hours to digest. The indicator depends on the composition, calorie content, and heat treatment of food products.

Reasons why the stomach cannot digest food

Fatty, spicy and sour foods can cause heaviness in the stomach.

Common causes of dyspepsia are considered to be poor eating habits and insufficient knowledge of nutritional rules. Eating dry food and snacking on the run will sooner or later have a bad effect on your health. There are some foods that the body simply does not accept and thus rejects, which is why the stomach “stands”. Inconvenience and heaviness in the stomach can appear due to overly fatty, spicy, or sour foods. Alcoholic drinks

can cause a number of inconveniences, since they can stimulate the production of hydrochloric acid, and burden the walls of the stomach with this. The probiotic complex RioFlora belongs to the new generation of probiotics, containing specially selected bacteria that inhibit the growth of pathogenic bacteria, many of which lead to.
intestinal disorders

Dietary supplement Not a medicine.

Here are some other causes of dyspepsia:
slow metabolism when the digestive organs work poorly;
the presence of microbes in the gastric mucosa;
poor stimulation of gastric juice secretion;
alcohol abuse in large quantities (applies to adults);

the presence of a disease - gastritis (can affect both adults and children). There are known cases when it goes astray stomach due to hormonal imbalance (mostly in pregnant women). If a person feels unwell in the morning, experiences heaviness in the stomach long before breakfast, this indicates that he likes to eat heavily at night, which is strictly forbidden to do, since the stomach should rest at night just like the rest human organs. Knowing the reason why the stomach does not process food in any way allows you to start treatment on time, force you to follow a diet, and develop a certain eating routine.

Types of disease

Salmonellosis is an acute intestinal infection caused by Salmonella.

Dyspepsia is divided into two groups: organic and functional. In an organic process, no serious organ damage is detected gastrointestinal tract, only disruptions occur in their work. In functional cases, pathologies of the stomach and intestines are detected. These are much more serious violations. Dyspepsia is also divided by type of disease and depends on the reasons that provoked these diseases. For example, an intestinal infection can become a provoking factor. Dyspepsia caused by it is divided into several types:

Salmonellosis. Accompanied by elevated body temperature, upset stomach, general weakness, and vomiting.
Dysentery. Causes damage to the large intestine, manifested by diarrhea mixed with blood.
Intoxication. It is formed as a consequence of poisoning with some harmful substances, during past infections.

Dyspepsia with a lack of digestive enzymes is divided into types: gastrogenic, hepatogenic, pancreatogenic, enterogenic. In addition to these types of disease, there are others:

nutritional - a consequence of an incorrect lifestyle;
putrefactive - the result of eating too much meat and fish, perhaps not always fresh;
fatty - provoked by an excessive amount of fat in the daily menu;
fermentable form - occurs when products such as beans are used as food, bakery products, sweets, as well as drinks in the form of kvass and beer.

Diagnostics

A blood test will help diagnose the disease.

If the stomach does not digest food, when characteristic manifestations and symptoms of the disease, you should immediately resort to medical care to diagnose and confirm the presence of the disease. Firstly, you need to clearly and clearly, point by point, describe your symptoms and complaints to the specialist. Secondly, the doctor will determine what is best to prescribe - laboratory test or computer. Computer includes ultrasonography, tomography. Laboratory testing involves collecting blood for analysis and checking stool. Additionally, tests are carried out for Helicobacter pylori infection, stomach analysis using an endoscope, and, if necessary, using X-rays.

What to do?

In the event that a disturbance in the functioning of the stomach has caused the presence of another disease (viral type, peptic ulcer, spicy or chronic gastritis etc.), it is necessary to treat the second disease, and at the same time get rid of the symptoms of the first. Treatment of a stomach in which food is poorly digested is prescribed by taking medicines various actions. Diarrhea can be treated with anti-diarrhea medications, and constipation can be treated with laxatives. Fever knocked down by antipyretics.

Medicines

The doctor prescribes medications to eliminate the symptoms of the disease, these include:

enzyme enzymes that promote better functioning of the stomach - “Creon”, “Gastenorm Forte”;
painkillers that help eliminate stomach pain and normal functioning - “Drotaverin”, “Spazmalgon”;
Antihistamines to reduce increased acidity stomach, - “Clemaxin”, “Ranitidine”.

If therapy is needed for a child, other, more gentle drugs are prescribed.

Treatment with folk remedies

When treating, you can use the root, seeds and juice of celery.

Dyspepsia can be successfully treated in children and adults with folk remedies, and recipes. Examples of popular recipes:

Celery. Take 1 tsp. ground celery root, pour 1 liter hot water and leave for 8 hours. Next, filter and drink 2 tbsp. l. during the day. If there is no root, then you can use and make an infusion from celery seeds and juice, the effect will be the same. A child will like celery juice as a medicine.
Dill. The plant is endowed with diversity useful properties, which are long to list. The most significant ones are the ability to improve digestion in children and adults, eliminate bloating and constipation, and have a diuretic effect. To prepare the decoction, take 1 tsp. dill seeds and pour boiling water, then strain and drink a sip throughout the day.
Collection medicinal herbs can help normalize metabolism in the body in both children and adults. Take honey, aloe and red wine. Honey and wine 600 grams each, aloe - 300 grams. Grind aloe, add honey and wine. Mix the ingredients and take 1 tsp. on an empty stomach.

In old age, there is a need for enemas, since with age the metabolism becomes slower, not like in a child, so the digestive organs wear out, frequent constipation occurs, pain and cramps appear in the stomach, and intestinal clogging occurs. It is necessary to force an elderly patient to do an enema at least once a week. Before the procedure, drink a glass of infused wormwood herb, which will have a beneficial effect on the digestion process.

Nutrition correction

With the help of a diet, you can alleviate and improve the condition of an adult and a child, especially during the period of taking medications. It is important to avoid fatty, fried, smoked, spicy, and salty foods. This also includes fast food dishes (hot dogs, pizza, hamburgers, etc.), as they contain a large amount of unhealthy fats. If you approach dietary nutrition with positive attitude, then appetite will improve and, accordingly, the production of gastric juice. Why is it necessary to eat in a quiet, peaceful environment, so that no external stimuli did not distract you from such an important task.

It is important to pay attention to the daily menu. It is recommended to select products good quality, without harmful components such as dyes and preservatives, so as not to burden the stomach. The compatibility of products is important, that is, you should not eat meat and apples at the same time, since meat is digested poorly and takes a long time, and apples quickly. An online food compatibility table will help. If you follow the recommendations, things will soon improve.

Regarding hot drinks, such as coffee or tea, which people are used to drinking immediately after eating, doctors are categorical - this is not recommended. Drinking hot drinks is allowed only an hour after or before meals. These are the rules you must follow for a speedy recovery in order to maintain the health of yourself and your child.

Chronic enteritis often occurs in the form of chronic enterocolitis. Often chronic E. is the outcome of an acute one, but it can also occur independently.
A significant role in the development of the disease is played by infectious agents, protozoal and helminthic infestation, nutritional factors (overeating, dry food, unbalanced in composition, for example, food that is predominantly carbohydrate or lacking vitamins, abuse of spices).

General manifestations of the disease are largely determined by impaired intestinal absorption. IN pathological process As a rule, other parts of the digestive system are involved.
There is a tendency to suppress the secretory acid function of the stomach, epigastric pain and dyspeptic disorders are noted; gastrobiopsy reveals gastric changes, in some cases - atrophic gastritis. A number of symptoms indicate damage to the pancreas (palpation pain, functional impairment).
In some cases, the liver is enlarged, its functions are impaired, and a biopsy reveals dystrophic changes in hepatocytes.
Of the common symptoms that attract attention signs reminiscent of dumping syndrome, which may correspond to symptoms of hyperglycemia (immediately after eating - weakness, sudden heat in the head, a feeling of a rush of blood to the head, palpitations, dizziness, hot sweat, redness of the face, copious amounts of thick saliva, nausea) or hypoglycemia ( the appearance a few hours after eating of severe weakness, dizziness, apathy, pallor, cold sweat, chills, sometimes flickering in the eyes, tinnitus). Increased fatigue, decreased performance, decreased appetite. Weight loss is observed with enteritis in 65-75%, sometimes it is quite significant.
A thorough examination of patients reveals a number of trophic disorders: dry skin, hair loss, increased brittleness of nails. Metabolism is disrupted. Protein metabolism disorders are indicated by hypoproteinemia, dysproteinemia, shifts in the composition of blood amino acids, and hyperaminoaciduria. Disorders of lipid metabolism are confirmed by a decrease in lipids and their fractions in the blood serum.

In mild cases of the disease (grade I), the clinical manifestations are mild and local intestinal symptoms predominate.
In case of illness moderate severity(II degree) intestinal manifestations are significant, general disorders appear, which are not yet clearly expressed.
At severe course(III degree) suffers significantly general state patients, the clinical picture is dominated by general symptoms.

Local intestinal symptoms: bowel disorders, often diarrhea; bowel disturbances may be absent. An increase in the amount of feces (polyfecalia) is typical; remnants of undigested food are often visible to the naked eye; stool smears the toilet (steatorrhea). With diarrhea, stool is not very frequent, usually 4-6 times a day. Flatulence, often bloating is accompanied by bad taste in the mouth, lack of appetite, various painful sensations in the heart area, shortness of breath, headaches, sleep disorders, etc. Rumbling in the stomach, which, like flatulence, is most pronounced in the afternoon. Abdominal pain, mainly in the navel area, sometimes not localized throughout the abdomen.
When the disease is complicated by mesenteric lymphadenitis, the pain becomes constant and localized, intensifying with physical activity. Sometimes patients are bothered by a feeling of fullness and bloating immediately after eating. On examination, a distended abdomen is noticeable. On palpation, pain along the colon, pain at the so-called Porges point, to the left and slightly above the navel (in 44% of patients)

Causes of the disease may be ionizing radiation (radiation radiation), exposure to toxic substances (arsenic, lead, phosphorus), a number of medications (salicylates, indomethacin, corticosteroids, immunosuppressants, some antibiotics with prolonged or uncontrolled use). The disease may occur after gastrectomy or gastrectomy, vagotomy, gastroenteroanastomosis, or with atrophic gastritis. Chronic E. can develop against the background of chronic renal failure, diseases leading to tissue hypoxia (chronic nonspecific diseases lungs, chronic diseases hearts accompanied chronic failure blood circulation), eczema, psoriasis, food allergies, congenital or acquired enzymopathies. The cause of chronic E. may be ischemia of the wall of the small intestine, which occurs due to atherosclerosis or inflammation of the mesenteric vessels (ischemic E.).

Morphologically, chronic E. is manifested by inflammatory and dysregenerative changes in the mucous membrane of the small intestine, and as the process progresses, its atrophy and sclerosis. The entire small intestine or its sections are affected.

The clinical picture of chronic E. consists of two symptom complexes, which should be considered as a manifestation of functional disorders associated with changes in the structure of the mucous membrane of the small intestine. One of them is caused by a violation of the processes of parietal (membrane) and cavity digestion. It is characterized by intestinal manifestations (local enteral syndrome): flatulence, abdominal pain, mainly in the middle part, loud rumbling, diarrhea, less often constipation or their alternation. On palpation, pain is noted in the middle part of the abdomen, as well as to the left and above the navel, at the level of the XII thoracic - I lumbar vertebrae (Porges symptom), “splashing noise” in the area of the cecum (Obraztsov symptom). The stool has a clayey appearance and is characterized by polyfecal matter.

Disorders of sexual function, biliary excretion, exocrine activity of the pancreas, etc. are noted. In chronic enteritis of grade I, intestinal symptoms dominate; Enteritis of the second degree of severity is characterized by a combination intestinal symptoms with blurred pronounced violation metabolic processes; with enteritis III degree pronounced metabolic disorders prevail with the occurrence of often irreversible dystrophic changes internal organs. The symptoms of chronic enteritis in its late stage do not actually differ from the symptoms of other diseases that occur with malabsorption syndrome: celiac disease, exudative enteropathy, Crohn's disease, Whipple's disease, etc. Therefore, it is necessary to especially carefully examine patients with chronic enteritis of grade III severity to exclude these diseases.

At biochemical research blood, hypoproteinemia, hypoalbuminemia, decreased serum levels of vitamins A, B2, B6, B12, C, D, E, K, P, folic acid, calcium, iron, phosphorus, magnesium, a number of microelements, cholesterol, phospholipids are noted , beta lipoproteins, glucose, etc.

Histological examination of the mucous membrane of the small intestine obtained during intestinoscopy or aspiration biopsy, makes it possible to identify its inflammatory infiltration, dysregenerative and atrophic changes, and also to differentiate chronic E. from other diseases of the small intestine.

TREATMENT

Treatment for exacerbation of chronic E. is recommended to be carried out in a hospital. Bed rest is prescribed therapeutic nutrition.
In the first few days, food should be as chemically and mechanically gentle as possible, contain a lot of proteins, a limited amount of fats and carbohydrates (diet No. 4a). Avoid foods rich in fiber and whole milk.
In the future, the content of fats and carbohydrates is gradually increased (diet No. 4b). When the exacerbation subsides, food that is complete in the content of essential substances is allowed, which should remain gentle (diet No. 4c).

Drug therapy includes enzyme preparations, preferably not containing bile acids, and primarily pancreatin, trienzyme, orase, weak choleretic agents. To normalize stool, antidiarrheal drugs (imodium), astringents and enveloping agents, as well as infusions and decoctions of herbs (alder cones, bird cherry fruits, oak bark).

For intestinal dysbiosis, it is prescribed in short courses medicines, affecting one or another microflora (with a predominance of staphylococcus - erythromycin, protea - nevigramon or furazolidone, fungi - nystatin, levorin), then biological drugs(colibacterin, bifidumbacterin, bificol, etc.).

Nitrosorbide, aminophylline, trental are used to stimulate intestinal absorption; to improve metabolic processes - methyluracil, pentoxyl, which simultaneously have an anti-inflammatory effect, with pain syndrome—- substances with an antispasmodic effect (atropine, no-spa, halidor).

Drug correction of metabolic disorders is carried out with anabolic steroids: retabolil, methandrostenolone (Nerobol), as well as vitamins and folic acid; To eliminate electrolyte disturbances, potassium and sodium chloride, calcium gluconate, and magnesium sulfate are administered. In severe cases, intravenous infusions of amino acid mixtures and protein preparations are indicated.

Therapeutic enemas with astringents and adsorbents, antispastic drugs, antiseptics, and agents that enhance reparative processes are indicated. Drugs that normalize intestinal motility are prescribed depending on the nature of motor disorders. Mineral water is prescribed during the period of remission. For colitis with a tendency to constipation, waters such as Essentuki No. 17, Slavyanskaya, etc. are indicated, for a tendency to diarrhea - type Essentuki No. 4. For diarrhea, water is heated, for constipation, take water at room temperature.

Physiotherapeutic treatment: thermal procedures, mud therapy, electrical procedures, therapeutic exercises.

Prevention of chronic E. includes, first of all, timely treatment acute intestinal diseases, rational nutrition, adherence to the regime. It is also necessary to promptly identify and treat those diseases against which chronic E. occurs, and to avoid self-medication.

Enteritis in children can be acute and chronic, There are also special forms, occurring with damage to both the small and large intestines - pseudomembranous enterocolitis and necrotizing enterocolitis of newborns. Acute E. in children usually occurs in the form of acute gastroenterocolitis. Chronic E. can be post-infectious, allergic, a consequence of enzyme deficiency, or post-operative. Often chronic E. is the outcome of acute. The main role in its pathogenesis, in addition to increasing the osmolarity of intestinal contents, intestinal hypersecretion and exudation, is played by the acceleration of the passage of intestinal contents and disruption of cavity and parietal digestion. The activity of many disaccharidases of the small intestine decreases early: lactase, invertase, maltase, etc. All types of metabolism are disrupted, the more pronounced the younger the child and the more severe the disease.

The main local symptom is diarrhea. The stool is copious, light yellow in color, with pieces of undigested food, mixed with mucus. When fats are not digested, feces acquire a gray color, clayey appearance, and shine. The predominance of putrefactive processes causes the fetid odor of feces. During fermentation processes in the intestines, stool becomes foamy. Defecation is painful; during exacerbation, the frequency of stool reaches 10-20 times a day. Other signs of local enteric syndrome are also expressed: flatulence, rumbling, abdominal pain. On palpation of the abdomen, pain in the mesogastrium is determined, and positive symptoms Obraztsov and Porges. General signs diseases are manifested by disorders of all types of metabolism and functional changes other garfish and systems. E. is especially difficult in children younger age. They may develop disaccharidase deficiency and exudative enteropathy.

When making a diagnosis of chronic E., anamnesis (intolerance to certain foods, especially milk, information about intestinal infections), clinical manifestations (abdominal pain, rumbling, flatulence), stool character and results are important. scatological research. Investigate enzymatic, absorption and motor functions small intestine. An important role in diagnosis is played by intestinoscopy with targeted biopsy and subsequent morphological examination of biopsy samples of the mucous membrane of the small intestine. X-ray methods uninformative and unsafe for children.

The treatment is complex. A complete diet is prescribed with a 10-15% increase in protein content, a physiological amount of fat and a restriction of carbohydrates. Avoid foods containing large amounts of fiber, as well as whole milk (diet No. 4). The use of protein enpit and fermented milk lactobacterin enriched with lysozyme is effective. In severe cases, parenteral nutrition is used. Vitamins C, group B are administered, folic acid. Reception shown enzyme preparations(pancreatin, panzinorm, polyzyme, festal). In case of severe course of the process, it is prescribed antibacterial drugs: derivatives of 8-hydroxyquinoline (enteroseptol), nitrofuran series (furadonin, furazolidone), nalidixic acid (nevigramon), as well as sulfasalazine and biseptol. After a course of antibacterial treatment, biological drugs that normalize the intestinal microflora (colibacterin, bificol, lactobacterin, bifidumbacterin) are indicated. Bacteriophages are also used (staphylococcal, pseudomonas, coli-proteus, etc.). Enveloping and adsorbing agents are effective (tanalbin, White clay, bismuth preparations), medicinal plants(chamomile, peppermint, St. John's wort, nettle, blueberries, etc.). The prognosis for long-term treatment is favorable.

Primary prevention is aimed at identifying and active surveillance for children with dysbacteriosis, convalescents after acute intestinal infections for those suffering from functional intestinal disorders, food allergies. Secondary prevention involves early identification of children with E., their registration and observation. In spring and autumn, anti-relapse treatment is administered for a month (diet No. 4, vitamins, enzyme and biological preparations). In remission, but not earlier than after 3 months. after an exacerbation, it is indicated sanatorium treatment at the resorts of Arzni, Caucasian Mineral water, Truskavets, Lake Shira, etc.

Pseudomembranous enterocolitis occurs during oral administration of antibiotics (usually lincomycin, clindamycin, ampicillin and especially cephalosporins). This is due to the increased proliferation of the enterotoxigenic strain Clostridiuni perfringens, which usually lives in the distal part of the intestine. Symptoms appear already in the 1st week of antibiotic therapy. Characterized by diarrhea, which is accompanied by abdominal pain, nausea, vomiting, and flatulence. The stools contain a lot of mucus and, less often, blood. In severe cases, the disease proceeds violently, resembling acute stomach. The diagnosis is based on medical history, clinical manifestations, results endoscopic examination. Sigmoidoscopy and colonofibroscopy make it possible to identify plaques and pseudomembranes consisting of mucus, fibrin, destroyed polymorphic and epithelial cells. In some cases, enterotoxin-producing clostridia are cultured from stool. Treatment includes mandatory withdrawal of antibiotics that caused enterocolitis and parenteral nutrition. Vancomycin is prescribed orally, to which clostridia are usually sensitive; Festal, Digital, and bacterial preparations are used, and detoxification therapy is carried out according to indications. If ineffective drug therapy, increasing intoxication, threat of intestinal perforation, one has to resort to surgical treatment. The prognosis with timely diagnosis and treatment is favorable, but with progression of the process it is serious.

Necrotizing enterocolitis of newborns - serious disease, accompanied by high mortality. Its etiology is unknown. Premature babies and low birth weight newborns are especially susceptible to the disease. Predisposing factors are intestinal ischemia and microcirculation disorders. The process is localized mainly in the distal part of the thin and proximal part colon. The resulting necrosis of the mucous membrane sometimes affects all layers of the intestinal wall, which leads to its perforation and peritonitis.

The disease usually develops in the 1st week of life, but can begin later - in the 2nd month. There is a sudden increase in the abdomen, and as a result of stagnation of food in the stomach, vomiting occurs, first periodically, then constantly. Intestinal peristalsis is enhanced, but absent with perforation. Profuse diarrhea appears, quickly leading to acidosis; the development of shock and disseminated intravascular coagulation is possible. The diagnosis is made based on clinical picture, results x-ray examination. Plain radiographs reveal pneumatosis intestinalis: pneumoperitoneum indicates intestinal perforation. Important role plays for subsequent treatment microbiological examination feces During treatment, the child is transferred to parenteral nutrition. Correction of disturbances in electrolyte balance, acid-base status, and blood coagulation system. Antibiotics (vancomycin, gentamicin) and oxygen therapy are prescribed. If there is no improvement in the child’s condition after 24-48 hours, as well as in case of intestinal perforation, it is indicated surgery- small bowel resection and ileostomy. The prognosis is serious.