home Audience 3 Dysentery symptoms in adults treatment. Treatment of dysentery in adults. Chronic dysentery: symptoms of pathology

Dysentery symptoms in adults treatment. Treatment of dysentery in adults. Chronic dysentery: symptoms of pathology

Dysentery is an area of study for gastroenterologists. Dysentery in adults is as common as in children. The disease equally occurs at any age, in patients of any gender. The main difference between dysentery in adults is the different intensity of symptoms (depending on the general condition of the body). In children, the nature of the disease is often rapid, accompanied by rapid dehydration and requires immediate hospitalization. Symptoms of dysentery in adults are rapid, develop rapidly, worsening the general condition of the patient. Dysentery is a highly contagious disease, so its spread is quite fast. Dysentery requires medical intervention and rapid relief of foci of invasion.

The nature of the disease

acute form

Acute dysentery is characterized by a rapid, often primary episode of the disease. The symptoms of the disease are pronounced, intensity and degree of impact on the patient's body are determined by the duration of the disease, the features of the general clinical history. There are several forms of acute dysentery:

The first signs of dysentery in an adult depend on the form of the disease, the classification of pathogens. Each type of acute lesion is characterized by specific symptoms.

Chronic form

The chronic course of the disease often occurs after inadequate treatment of the acute form. or during its long course. Usually, chronic dysentery occurs with a general weakened immunity of the patient, with regular non-compliance with preventive measures, with several episodes of infectious lesions of the intestines and other epigastric organs.

Often clinical manifestations are a reflection of the form of the course of the disease. The chronic form rarely has severe symptoms, when in the acute course the patient experiences strong signs of the disease. Types of dysentery can occur as a result of the penetration of a specific environment into the patient's body.

Etiological factors

Infectious inflammation of the intestine can be caused by several factors, which boil down to non-compliance with hygiene standards in everyday life. Dysentery in adults occurs in one direct way - fecal-oral, but the routes of infection can vary considerably. Thus, the main routes of infection are distinguished:

Clinical picture

Signs of the onset of an infectious disease are often characterized by the intensity of manifestations, strongly affecting the general well-being of patients of any age. The symptomatic picture for dysentery has several stages:

First stage;
peak of illness
decrease in intoxication;
recovery.

The initial stage is understood as the incubation period with a gradual increase in general signs of intoxication. The height of the disease is characterized by pronounced symptoms, depending on the form of the course of dysentery. Fading is reduced to a gradual recovery. It is worth noting that recovery occurs 2 weeks after the fading period, because even after a visible improvement in well-being, the patient continues to be a carrier. Among the main signs of dysentery are:

The disease is characterized by primary symptoms of colitis:

the appearance of tenesmus (the urge to defecate with severe pain);
dryness of the oral mucosa;
decreased acidity of digestive juices;
symptoms of intoxication grow rapidly, accompanied by vomiting, liquefaction of the stool (up to 15 urges per day).

Soreness after the act of defecation is not eliminated. The stool contains bloody or mucous inclusions, which indicates the development of dysbacteriosis. Usually, an increase in temperature, a decrease in blood pressure is a harbinger of intestinal disorders, but with a gastroenteric variant of the manifestation of the disease, a complex of symptoms occurs simultaneously. With severe intoxication and with a high frequency of urges, dehydration may develop, which is dangerous due to a decrease in urine output, often requiring infusion therapy.

Chronic dysentery during periods of exacerbation involves frequent stools with a greenish foamy structure, liquid or mushy consistency. With the chronicity of the disease, patients note a strong loss in weight. Timely diagnosis and exclusion of possible concomitant pathologies can significantly reduce the risks of dangerous complications (typhoid fever, peritonitis, inflammatory lung diseases), stop the development of pathogenic conditions.

Differential Diagnosis

Diagnostic measures are necessary for a quick diagnosis, exclusion of serious pathological conditions with similar symptoms. The main research methods include the following:

patient complaints;
study of clinical history;
blood test (biochemical);
analysis of feces, urine (detailed);
Ultrasound of the abdominal organs;
visual examination of the patient's body (presence or absence of a rash).

Food poisoning. In this condition, there is no severe cramping pain in the iliac part of the peritoneum due to the absence of damage to the large intestine. There is also no urge to defecate.
Salmonellosis. With salmonellosis, feces have a shade of marsh mud, light or dark greenish in color.
Amoebiasis. The disease is not accompanied by fever, febrile syndrome. Fecal masses include blood and mucous components that resemble raspberry-colored jelly. The main causative agent is an amoeba.
Cholera. The disease is not accompanied by pronounced signs of colitis, it begins with severe diarrhea, vomiting, and the color of feces resembles rice water. There are no false urges to defecate.
Typhoid fever. The disease has no signs of specific colitis, but a pink rash appears, severe hyperthermia, and the large intestine cavity is affected.
Intestinal colitis. If colitis is of a non-infectious nature, then it often occurs due to toxic lesions of the body with uremic syndrome, with the pathological development of the small intestine, cholecystitis, gastritis of various nature. Usually the disease has no seasonality and special antecedent factors against the background of the general health of the patient.
Haemorrhoids. With inflammation of the hemorrhoids, as well as with advanced hemorrhoids after the act of defecation, the appearance of bloody inclusions in the feces can be noted. The disease proceeds without pronounced inflammatory foci in the rectum.
oncogenic formations. Colon cancer is accompanied by severe diarrhea with blood. The character of the stool is regular. There are symptoms of general intoxication, but the rapid nature of the disease, as in dysentery, is absent.

Timely determination of dysentery and the type of its pathogen allows you to draw up the necessary treatment plan, speed up the patient's recovery, and eliminate the risks of complications of the disease.

Dysentery and pregnancy

The gestational period in women of any trimester, complicated by the course of dysentery, is a serious complication of pregnancy. The expectant mother has severe weakness, fever, signs of general intoxication, vomiting and nausea. The main danger of the condition is a strong contraction of the uterine cavity, which can lead to miscarriage or premature birth. Attacks of false urge to defecate provoke prolapse of the rectum as a result of frequent pulling.

Treatment of dysentery must be carried out within the walls of a hospital under the constant supervision of specialists who know everything about dysentery. After a thorough diagnosis and other studies (drawing up a general obstetric and gastroenterological history), the general clinical status of the patient is determined, and appropriate treatment is prescribed. Treatment of dysentery includes taking antibacterial drugs, taking into account the individual characteristics of the patient.

All drugs should be as safe as possible for the fetus and expectant mother.. Bed rest, plenty of warm fluids, a balanced diet and medications are the key to successful therapy. The disease presents dangerous consequences for the fetus due to the possibility of intrauterine infection.

Treatment tactics

Treatment of dysentery can be carried out both at home and in a hospital. Hospitalization is usually required for a aggravated course of the disease, with a pronounced symptomatic picture.. Hospitalization is also necessary if it is impossible to treat at home, without proper patient care. The main treatment course involves treatment with the following drugs:

antibiotics (from the group of fluoroquinols, aminoglycosides, cephalosporins);
saline solutions (regidron, glucosolan, oralit and others);
eubiotics (tablets bactisubtil, primadophilus, linex and others);
absorbents and enterosorbents (polysorb, enterosgel, polyphepan, smectin).

If necessary, it is recommended to use antispasmodic drugs, astringents and vitamin remedies for dysentery. In parallel, you need to drink plenty of water, take immunomodulators, various enzyme complexes, for example, festal, creon, mezim. Metiluracil is effective. Intestinal infection and its chronic forms are also treated with microclysters, physiotherapy procedures. It is important for patients to follow a special diet that excludes fatty, spicy and other aggressive foods. It is unacceptable to consume alcohol, coffee, dairy and sweet products. Good nutrition should be resumed only after a 2-3-week course of treatment. The diet after the disease should be enriched with vitamins, satisfying and healthy.

Traditional medicine methods

Before treating the disease at home, you should consult with a specialist. Treatment of dysentery in adults with folk remedies can alleviate the condition of patients, enhance the effect of certain drugs, and has a beneficial effect on the intestinal microflora. The main recipes include:

propolis on alcohol with water;
burdock juice;
infusions of chamomile, thyme, calendula;
golden mustache, water;
garlic and onions (garlic infusions);
cherries or grapes;
hemorrhagic root.

Herbs and medicinal extracts at home must be made with special knowledge. Many doctors practice traditional medicine along with prescribed medication. It is worth noting that dysentery is not treated only with homemade recipes. Medical treatment is much faster than non-traditional methods. In infectious inflammation of the gastrointestinal tract, timeliness and speed are very important to exclude relapses in the chronic form and complications in a protracted acute process. The duration of the disease also depends on the speed of the treatment started.

Forecast and preventive measures

The prognosis is mostly favorable, with timely complex treatment of acute forms of dysentery, chronicity of the pathology occurs extremely rarely. In some cases, after infection, residual functional disorders of the large intestine (postdysenteric colitis) may persist.

General measures for the prevention of dysentery include the observance of sanitary and hygienic standards in everyday life, in food production and at public catering establishments, monitoring the state of water sources, cleaning sewage waste (especially disinfection of wastewater from medical institutions).

Patients with dysentery are discharged from the hospital no earlier than three days after clinical recovery with a negative single bacteriological test (material for bacteriological examination is taken no earlier than two days after the end of treatment). Food industry workers and other persons equated to them are subject to discharge after a double negative result of bacteriological analysis.

If dysentery has been diagnosed, treatment should begin as soon as the diagnosis is made. Dysentery is an infectious disease that affects the gastrointestinal tract, mainly the colon. The cause of this disease is bacteria of the genus Shigella.

Dysentery (disease of dirty hands) is similar in its symptoms to other intestinal infections. However, there are also some differences. With the development of this disease, patients complain of the presence of mucus and blood in the stool, diarrhea, pain in the abdomen and fever.

Medical treatment

When the temperature rises to 39 degrees, the patient must urgently call the doctors. The patient should be isolated, and after visiting a shared toilet, the stool should be thoroughly washed off. If there are acute symptoms of dysentery in adults, then before the arrival of an ambulance, the victim should drink plenty of fluids. This will help avoid dehydration. During the day you need to drink at least 2 liters of water. You should drink liquid often, but in small portions (no more than 50 ml). Today in pharmacies you can buy a very effective remedy Regidron, which fights dehydration. If it was not at hand, then the saline solution can be prepared independently at home. To prepare a healthy liquid in 1 liter of hot water, you need to dissolve 1 tablespoon of salt and 2 tablespoons of sugar. You need to drink this remedy every hour in small sips. Also, with dysentery, boiled water, berry jelly, sweet weak tea and compotes are allowed. In a severe form of the above ailment, the patient may need intravenous fluids.

In no case should you take antidiarrheal medicines on your own. Mild dysentery can be treated at home. With a more severe course of the disease, the patient must be taken to the infectious diseases hospital.

Treatment of dysentery in adults primarily involves taking antibacterial agents. In the fight against the above unpleasant symptoms, tetracycline antibiotics and drugs of the fluoroquinolone group are very popular. Such medicines must be taken orally before meals. In severe forms of the disease, doctors prescribe antibiotics intravenously. The course of treatment, as a rule, does not last more than 7 days.

To get rid of toxins that appear after the destruction of bacteria, adsorbents are prescribed by doctors. Smecta and Enterosgel are very popular. Signs of dysentery are also treated with enzyme preparations that are aimed at improving digestion. In such situations, doctors, as a rule, prescribe drugs such as Creon and Mezim. As mentioned above, this ailment causes severe pain and spasms. To eliminate these symptoms, patients are prescribed antispasmodics. No-shpa and Papaverine hydrochloride have proven themselves well.

After a long-term use of antibacterial and other drugs that adversely affect the condition of the intestinal walls, doctors must prescribe medications to normalize the microflora of this organ. To normalize the composition of the intestinal microflora, it is necessary to take courses of eubiotics.

Diet food

Dysentery should be treated not only with medications, but also with special dietary nutrition. Therapeutic diet plays an important role in the treatment of any gastrointestinal ailments. In the acute period of the disease, patients should strictly monitor what they eat, exclude all harmful foods from their diet and drink plenty of fluids. The diet can be expanded only after the patient feels better.

Basic principles of dietary nutrition:

For the treatment of dysentery, well-cooked or cooked food in a double boiler and oven is suitable. From fried foods at the time of treatment must be abandoned.

So that rough food does not injure the intestinal walls, it must be thoroughly chopped.

You should drink as much liquid as possible (at least 6 times a day in small portions).

Patients should not eat vegetables containing coarse fiber (potatoes, carrots, cauliflower).

Useful berries and fruits without peel.

Low-fat varieties of meat and fish can be safely eaten with dysentery.

Diet food for the above disease includes dairy products and dried bread.

Under the ban were smoked, spicy, fatty, pickled and salty dishes.

At the time of treatment, doctors recommended to give up drinks such as carbonated water, coffee and cocoa.

Doctors advise to adhere to the above rules for 30 days after stopping treatment.

If dysentery has been diagnosed, the symptoms will go away in the shortest possible time only if all the necessary medicines are taken and the diet is followed. In this case, it will turn out not only to get rid of the disease much faster, but also to reduce the risk of complications.

Folk remedies

You can fight the signs of dysentery not only with medications, but also with traditional medicine. And this is hardly surprising, because traditional medicine has a large number of useful properties. As practice shows, the positive effect after using home remedies for dysentery appears after a short period of time.

Homemade medicines, the main component of which are medicinal herbs and plants, are very popular. For the preparation of useful products, both one type of plant and whole fees can be used.

The above disease in an adult can be cured with the help of burdock leaves. 3 times a day before meals, you must take orally 1 tablespoon of the juice of this plant.

The following collection is considered very effective: 10 g of wild rosemary flowers and leaves should be mixed with 25 g of finely chopped marshmallow roots. The resulting mixture must be brewed in 1 liter of boiling water for 60 minutes. The finished consistency must be filtered and drunk 1 spoonful every 2 hours.

Dried dove berries have excellent antidysenteric properties. 100 g of raw materials should be poured with 500 ml of boiling water, set aside for 60 minutes and strain.

Experts advise to boil blackberries and drink the resulting liquid as tea. As practice shows, positive results appear the very next day.

And how to treat dysentery with oak bark? 50 g of finely chopped oak bark should be poured with 800 ml of cold boiled water and wait at least 8 hours. Ready tincture must be filtered and drunk throughout the day in small sips.

The following collection is no less popular: 2 parts of plantain must be mixed with 1 part of goose cinquefoil and highlander. 100 g of the resulting mixture should be poured with 2 glasses of hot water, wait 30 minutes and drink 150 ml of healing liquid 4 times a day. It is best to drink this tincture immediately before meals.

50 g of crushed burnet root should be poured with 1 cup of boiling water, boiled over medium heat for 30 minutes and strained. 1 spoonful of the finished medicinal product must be diluted in ¼ cup of pure water and taken orally 6 times a day. Such a medicine will help to cope even with acute dysentery.

Blackberry leaves will help with dysentery.

50 g of blackberry twigs and leaves must be placed in a bowl with 400 ml of hot water. The resulting consistency should be placed on the fire, boiled for 5 minutes, wrapped in a warm blanket for 40 minutes and strained. Drink this remedy should be half a glass 2 times a day.

Other Helpful Home Remedies

Many dysentery patients use the following home remedy: several skins from chicken ventricles should be dried on a clean sheet of paper for 24 hours (you should choose a sunny place). Dry films should be crushed to a powder and taken in small portions 2 times a day. Healing powder should be washed down with water. This tool will help get rid of even the most severe diarrhea. The rest of the powder should be stored in a box in a cool place.

Few people know, but you can get rid of the above disease with the help of potato starch. Preparing a remedy is quite easy: 50 g of potato starch should be diluted in 0.5 liters of cool water. The resulting liquid should be drunk in 1 dose. Positive results will appear within a few days.

"How to treat dysentery in children?" is a question that concerns parents. Experts advise treating unpleasant symptoms in children with rice water. Porridge, boiled in water, hard-boiled without adding salt, very well and quickly helps not only children, but also adults to get rid of diarrhea.

To eliminate unpleasant symptoms, doctors advise buying an alcohol extract of propolis in a pharmacy. In 400 ml of warm water, dilute 1 small spoonful of the extract. Drink at least 3 glasses of this liquid per day. Treatment with alcohol extract of propolis should be carried out for 1 week. This time is quite enough for positive results to be felt.

To speed up the healing process, eat a little honey daily. The thing is that this product contributes to the rapid removal of dysentery bacillus from the stool. Because of this, recovery comes much faster.

The following mixture can replace medicinal tablets: 1 egg white must be mixed with 1 glass of cognac and 1 spoonful of juice from the leaves of a golden mustache. All ingredients must be beaten with a mixer and taken orally 3 times a day, 1 spoonful.

The following recipe is no less popular: 50 g of purified birch charcoal powder must be mixed with an equal amount of garlic powder. Every day you need to take orally ½ g of the resulting consistency (3 times a day).

With inflammation of the gastrointestinal tract, doctors recommend eating oatmeal porridge. To prepare such a porridge, 100 g of flakes should be poured with 1 liter of cool water, set aside for 4 hours and simmer until the mixture thickens. A very tasty and healthy dish is ready.

Amebiasis can be treated with pomegranate peels. First you need to dry a few pomegranate peels. After that, they must be crushed to a powder state. 1 small spoonful of powder should be infused in 400 ml of boiling water for 40 minutes. During the day you need to drink at least 2 glasses of healing liquid. You need to drink such a remedy in small sips throughout the day.

Conclusion

Before you start treating dysentery in yourself or your child at home, you should consult with your doctor. The thing is that home remedies often cause various complications.

Dysentery is an acute infectious lesion of the large intestine caused by gram-negative Shigella rods. Therefore, doctors call dysentery shigellosis. It is characterized by general symptoms: acute onset, diarrhea, high fever, intoxication of the body. But similar disorders can be caused by other types of microorganisms. For effective treatment, it is necessary to determine the type of infection and correctly choose antibiotics for dysentery.

The effectiveness of the treatment of the disease depends on the correct choice of antibacterial drugs. But laboratory studies to identify the type of pathogen and test its sensitivity to antibiotics are performed only in a hospital, and last from 3 days.

The disease develops rapidly, so the correct actions of the patient in the first hours after the onset of symptoms can reduce the intensity of the development of dysentery and accelerate further treatment.

Before the arrival of the doctor, the patient should adhere to the following recommendations:

Plentiful liquid drinking. An analogue of an isotonic solution is prepared: a tablespoon of sodium chloride (common salt) is added to a liter of water.
Ensure isolation from others, perform sanitary and hygienic measures to disinfect dishes, furniture, door handles, etc.
Provide disposable toilet seat pads.
With cramping pain, do not take drugs that inhibit peristalsis.
If the body temperature reaches critical values (up to 39 ° C), antipyretic drugs are taken.
If the patient does not have the opportunity to quickly get to see a doctor, the use of bacteriostatic antibiotics, described below, is temporarily indicated.

After examination in the infectious diseases hospital, the patient, depending on the severity of dysentery, can be placed in a hospital or sent for outpatient treatment.

Antibiotic regimen

The main means for pathogenic therapy of the disease (affecting the pathogen) are antibiotics. According to the mode of action, they are divided into bacteriostatic (prevent the reproduction of bacteria) and bactericidal (kill bacteria by blocking the respiratory processes or destroying the cell membrane).

The most affordable drug for the treatment of the disease is furazolidone. In small doses it works as a bacteriostatic, in large doses it acts as a bactericide. Take every 6 hours for 0.1-0.15 g.

Quinolones, fluoroquinolones

Nalidixic acid, Ofloxacin is prescribed for the treatment of moderate and severe forms of the disease or when the patient is unable to undergo laboratory tests. These are effective broad-spectrum drugs that help with various forms of intestinal infection. Taken twice a day for 0.2–0.4 g.

Pharmaceutical antibiotic of this group is known as Levomycetin. The usual regimen is 0.25–0.5 g every 6 hours. In especially severe cases of the disease, the doctor may increase the daily dose to 4 g.

To this substance, many strains of bacteria show resistance, so the appointment of tetracycline is justified in the presence of positive laboratory tests for the sensitivity of the pathogen. Take 0.25 g every 6 hours.

After taking antibiotics of this group, the intestinal microflora is not disturbed, which is important for maintaining the patient's immunity to fight the disease. For the treatment of dysentery, the following drugs are used:

Chlorhinaldol. Take 0.2 g every 6 hours.
Intetrix. It is used when dysentery is combined with a fungal infection (candidiasis), which often joins against a background of weakened immunity.

Bacteriostatics of this group are used for monotherapy of mild dysentery or in combination with antibacterial drugs of the quinolone group in severe cases. Co-trimoxazole, Biseptol are taken twice a day. The dosage is calculated depending on the body weight of the patient and the functional state of the liver.

The standard treatment regimen is 5 to 7 days. After the symptoms of the disease disappear (usually this period is 5 days), the drugs are taken for another 2 days.

The need for the use of antibacterial agents is determined by the doctor. They can cause dysbacteriosis and reduce immunity.

Treatment with aminoglycosides (streptomycin, gentamicin), polypeptides (capreomycin) is not used. These drugs are included in the protocols for the treatment of deadly infections that are prone to developing resistance (tuberculosis, Pseudomonas aeruginosa, etc.).

Features of the treatment of children

A feature of the treatment of dysentery in children is the restriction of the use of antibiotics. Preference is given to bacteriostatics (furazolidone) and penicillin preparations (Ampicillin, Ampiox). Antibiotics should be taken only in severe forms of the disease.

A sick child should be taken to the hospital to determine the type of infection. For a child's body, the use of polyvalent bacteriophages is very effective. Since in mild forms of dysentery, the child's body is difficult to tolerate intoxication, the treatment of the disease should be carried out in a hospital under the supervision of a doctor. For the relief of neurological disorders, intravenously administered Mannitol (saline), glucocorticosteroids. To increase immunity, the child is prescribed multivitamin preparations, probiotics.

Dysentery is an infectious disease characterized by damage to the gastrointestinal tract, mainly the large intestine.

The disease is caused by bacteria of the genus Shigella. When microbes are destroyed, a toxin is released, which plays an important role in the development of the disease and determines its manifestations.

The causative agents of dysentery are characterized by high survival in the external environment. Depending on the temperature and humidity conditions, they last from 3-4 days to 1-2 months, and in some cases up to 3-4 months or even more. Under favorable conditions, shigella are capable of reproduction in food products (salads, vinaigrettes, boiled meat, minced meat, boiled fish, milk and dairy products, compotes and jelly).

Causes

Dysentery is transmitted only from a person through food, water contaminated with feces, and also by contact.

The source of the causative agent of infection in dysentery are patients, as well as bacterial carriers that excrete shigella into the external environment with feces. Patients with dysentery are contagious from the onset of the disease. The duration of the release of the pathogen by patients, as a rule, does not exceed a week, but can be delayed up to 2-3 weeks.

The greatest sensitivity to infection in persons with blood type A (II).

The leading factor in the development of the disease is the entry of bacterial poisons into the blood. First of all, the nervous, as well as the cardiovascular system, adrenal glands and digestive organs are affected.

Shigella can be in the stomach from several hours to several days (in rare cases). After overcoming the acid barrier of the stomach, Shigella enter the intestines. In the small intestine, they attach to intestinal cells and release a toxin that causes increased secretion of fluid and salts into the intestinal lumen. Shigella actively move, causing an inflammatory process in the small intestine, which is maintained and aggravated by the action of the toxin produced by Shigella. Shigella toxin enters the bloodstream and causes the development of intoxication.

Shigella enter the colon a little later, but massively. This leads to a more significant action of toxins.

Recovery from dysentery is usually accompanied by the release of the body from the pathogen. However, in case of insufficiency of the immune system, the cleansing of the body from the pathogen is delayed up to 1 month or more. A carrier state is formed, and in some of those who have been ill, the disease becomes chronic.

After the illness, a short-term immunity is formed.

The incubation period is 1-7 (on average 2-3) days, but can be reduced to 2-12 hours.

The form, variant and severity of the course of dysentery depend on the ways and methods of infection, the number of microbes that have entered the body, and the level of the body's immunity.

Manifestations of dysentery

The disease begins quickly. At the beginning, a syndrome of general intoxication develops, characterized by fever, chills, a feeling of heat, weakness, loss of appetite, headache, and a decrease in blood pressure.

The defeat of the gastrointestinal tract is manifested by pain in the abdomen, at first dull, diffused throughout the abdomen, having a permanent character. Then they become more acute, cramping, localized in the lower abdomen, often on the left. The pain usually gets worse before a bowel movement.

Mild form of dysentery

With a mild course of the disease, the fever is short-term, from several hours to 1-2 days, the body temperature, as a rule, rises to 38 ° C.

Patients are concerned about moderate pain in the abdomen, mainly before the act of emptying the intestines.

The stools have a mushy or semi-liquid consistency, the frequency of defecation is up to 10 times a day, the admixture of mucus and blood is not visible. Intoxication and diarrhea persist for 1-3 days. Full recovery occurs in 2-3 weeks.

Moderate form

The onset of this form of dysentery is rapid. Body temperature with chills rises to 38~39°C and stays at this level from several hours to 2-4 days.

Patients are concerned about general weakness, headache, dizziness, lack of appetite. Intestinal disorders, as a rule, join in the next 2-3 hours from the onset of the disease.

Patients develop periodic cramping pains in the lower abdomen, frequent false urge to defecate, a feeling of incomplete defecation. The frequency of stool reaches 10-20 times a day. The stools are scanty, often consisting only of mucus streaked with blood.

There is increased irritability, pallor of the skin. Tongue covered with thick white coating, dryish. Intoxication and diarrhea last from 2 to 4-5 days. Complete healing of the intestinal mucosa and normalization of all body functions occur no earlier than 1-1.5 months.

Severe form

The severe course of dysentery is characterized by a very rapid development of the disease, pronounced intoxication, and profound disturbances in the activity of the cardiovascular system.

The disease begins very quickly. Body temperature with chills quickly rises to 40 ° C and above, patients complain of severe headache, severe general weakness, increased chilliness, especially in the limbs, dizziness when getting out of bed, complete lack of appetite.

Often there is nausea, vomiting, hiccups. Patients are concerned about abdominal pain, accompanied by frequent urge to defecate and urinate. Stool more than 20 times a day, often the number of bowel movements is difficult to count ("stool without counting"). The peak period of the disease lasts 5-10 days. Recovery is slow, up to 3-4 weeks, complete normalization of the intestinal mucosa occurs after 2 months or more.

The diagnosis of chronic dysentery is established if the disease lasts more than 3 months.

Complications

The most common complications of the disease are:

toxic shock,
infectious-toxic damage to the nervous system,

Diagnostics

The diagnosis is based on the results of the examination of the patient. Of great diagnostic importance is the examination of feces, in which it is possible to detect an admixture of mucus with streaks of blood.

Laboratory confirmation of dysentery is carried out by bacteriological and serological methods. The bacteriological method (seeding of shigella from feces) with a 3-fold study provides confirmation of the diagnosis in 40-60% of patients.

Accelerated diagnosis of acute intestinal diarrheal infections can be carried out by detecting antigens of pathogens and their toxins in biosubstrates - saliva, urine, feces, blood. For this purpose, immunological methods with high sensitivity and specificity are used: enzyme immunoassay (ELISA), latex agglutination reaction (RAL), coagglutination reactions (RCA), immunofluorescence (RIF), polymerase chain reaction (PCR).

Treatment of dysentery

Treatment of patients with dysentery should be complex and strictly individualized. Bed rest is necessary, as a rule, only for patients with severe forms of the disease. Patients with moderate forms are allowed to go to the toilet. Patients with mild forms are prescribed a ward regimen and physiotherapy exercises.

One of the most important components in the complex therapy of intestinal patients is therapeutic nutrition. In the acute period, with significant intestinal disorders, table No. 4 is prescribed; with an improvement in the condition, a decrease in intestinal dysfunction and the appearance of appetite, patients are transferred to table No. 2, and 2-3 days before discharge from the hospital - to the general table.

It is necessary to prescribe an antibacterial drug to a patient taking into account information about the “territorial landscape of drug resistance”, i.e. sensitivity to it of the shigella allocated from patients in the given district recently. Combinations of two or more antibiotics (chemotherapy) are prescribed only in severe cases.

The duration of the course of treatment for dysentery is determined by the improvement in the patient's condition, the normalization of body temperature, and the reduction of intestinal disorders.

With a moderate form of dysentery, the course of therapy can be limited to 3-4 days, with severe - 4-5 days. Mild intestinal dysfunction (mushy stools up to 2-3 times a day, moderate flatulence) that persists during early recovery should not be a reason to continue antibiotic treatment.

Patients with mild dysentery at the height of the disease, which occurs with an admixture of mucus and blood in the stool, are prescribed one of the following drugs:

nitrofurans (furazolidone, furadonin 0.1 g 4 times a day,
ersefuril (nifuroxazide) 0.2 g 4 times a day),
cotrimoxazole 2 tablets 2 times a day,
oxyquinolines (nitroxoline 0.1 g 4 times a day, intetrix 1-2 tablets 3 times a day).

In moderate dysentery, drugs of the fluoroquinolone group are prescribed: ofloxacin 0.2 g 2 times a day or ciprofloxacin 0.25 g 2 times a day;

cotrimoxazole 2 tablets 2 times a day;
Intetrix 2 tablets 3 times a day.

In severe dysentery, prescribe

ofloxacin 0.4 g 2 times a day or ciprofloxacin 0.5 g 2 times a day;
fluoroquinolones in combination with aminoglycosides;
aminoglycosides in combination with cephalosporins.

With Flexner's and Sonne's dysentery, a polyvalent dysenteric bacteriophage is prescribed. The drug is available in liquid form and in tablets with an acid-resistant coating. Take 1 hour before meals inside 30-40 ml 3 times a day or 2-3 tablets 3 times a day.

With mild dysentery, fluid loss is compensated for by one of the ready-made formulations (citroglucosalan, rehydron, gastrolith, etc.). These solutions are given to drink in small portions. The amount of liquid drunk should be 1.5 times greater than its loss with feces and urine.

In severe intoxication, intravenous drip infusion of a 10% solution of albumin, gemodez and other crystalloid solutions (trisol, lactasol, acesol, chlosol), 5-10% glucose solution with insulin is indicated. In most cases, the introduction of 1000-1500 ml of one or two of these solutions is sufficient to achieve a significant improvement in the patient's condition.

To bind and remove the toxin from the intestine, one of the enterosorbents is prescribed - polyphepan 1 tablespoon 3 times a day, activated charcoal 15-20 g 3 times a day, enterodesis 5 g 3 times a day, Polysorb MP 3 g 3 times a day per day, smecta 1 sachet 3 times a day or others.

To neutralize toxins, enzyme preparations are used: pancreatin, panzinorm in combination with calcium preparations.

In the acute period of diarrhea to eliminate spasm of the colon, the use of:

drotaverine hydrochloride (no-shpa) 0.04 g 3 times a day,
papaverine hydrochloride 0.02 g 3 times a day.

With a significant pain syndrome, no-shpu is prescribed, 2 ml of a 2% solution intramuscularly or 1-2 ml of a 0.2% solution of platyfillin hydrotartrate subcutaneously.

During the entire period of treatment, patients are prescribed a complex of vitamins.

In order to correct the intestinal biocenosis, biosporin, bactisporin, bactisubtil, flonivin-BS are prescribed 2 doses 2 times a day for 5-7 days. When choosing a drug, preference should be given to modern complex drugs - linex, bifidumbacterin-forte, vitaflor, etc. The drugs are prescribed in a standard dosage. With good tolerance in the recovery period, sour-milk therapeutic and dietary bifido- and lacto-containing products are shown, which have a high therapeutic efficacy.

Treatment of patients with chronic dysentery (recurrent and continuous) is carried out in an infectious diseases hospital. Treatment includes:

fluoroquinolones ciprofloxacin 0.5 g 2 times a day or ofloxacin 0.2 g 2 times a day for 7 days;
immunotherapy depending on the state of immunity - thymalin, thymogen, levamisole, dibazol, etc.;
panzinorm, festal, pancreatin, pepsin, etc.;
increased daily doses of vitamins;
treatment of concomitant diseases, helminthic and protozoal intestinal invasions;
to restore the intestinal biocenosis, biosporin, bactisporin, linex, bifidumbacterin-forte, vitaflor, lactobacterin are prescribed; these drugs are prescribed in a standard dosage for 2 weeks after etiotropic therapy simultaneously with pathogenetic agents.

The prognosis for the treatment of patients with dysentery is usually favorable.

Prevention

Those who have been ill with acute dysentery are discharged from the hospital no earlier than 3 days after clinical recovery (normalization of body temperature, stool, disappearance of signs of intoxication, abdominal pain, spasm and tenderness of the intestine), in the absence of pathological changes in laboratory tests. Chemoprophylaxis in contacts with sick persons is not carried out.

Dysentery is a general infectious disease caused by dysentery bacteria. The most common cause of the disease is shigella . Amoebic dysentery appears as a result of infection gnstolytic amoeba . With the development of this disease in humans, mainly the mucous membrane of the large intestine is affected.

Most often, dysentery is diagnosed in children aged two to seven years. But the disease can affect people from any age group. Less often, signs of dysentery are recorded in infants, since the child has a strong one in the first months, which he inherited from his mother. As a rule, in infants, the disease can develop if the causative agent of dysentery was contained in water or food.

The symptoms of dysentery are mainly manifested in the summer. The infection spreads quickly, and if basic hygiene rules are not followed, the child may need treatment for dysentery. That is why the prevention of the disease consists, first of all, in strict adherence to general hygiene standards.

Amoebic dysentery

Amoebic dysentery (amoebiasis ) causes gnstolytic amoeba. Infection occurs when mature cysts of the histolytic amoeba enter the gastrointestinal tract through the mouth. A person can become infected if they drink raw water that has been contaminated, as well as by eating contaminated foods. Most often this disease is diagnosed in areas where the climate is very hot.

With this form of dysentery, the incubation period can last up to 30 days. There are three forms of the disease: extraintestinal , intestinal , cutaneous amoebiasis . The most common is intestinal amoebiasis. In turn, this form is subdivided into amoebic colitis And amoebic dysentery . With amoebic colitis, a person's appetite decreases, bloating is manifested, constantly alternating constipation And diarrhea . After the act of defecation, the patient constantly experiences the feeling that the intestines have not been completely emptied. The stool has a mushy texture, it contains mucus. Sometimes blood may also be found. The temperature in an acute state rises slightly and for a short period.

With amoebic dysentery, patients note severe pain of a aching or cramping nature, loose stools with blood and mucus, general weakness and malaise. The chair can appear up to 10 times a day. For 3 to 5 days, a moderately elevated body temperature persists. There is also bloating and plaque on the tongue. Sometimes doctors also note an enlarged liver.

With both varieties of amoebiasis, a person's ability to work, anemia, and poor sleep are reduced. In the process of rectal examination, ulcers are found in the distal colon, ulcers of the mucous membrane.

With extraintestinal amebiasis, the liver is most often affected, and amoebic hepatitis develops. Cutaneous amebiasis develops, as a rule, with an intestinal form.

Pericolitis, intestinal, intestinal obstruction, lung abscesses, subdiaphragmatic abscesses can develop as complications of amoebiasis.

Diagnosis is based on epidemiological data. The doctor examines the anamnesis in detail, examines the patient. Also an informative research method is sigmoidoscopy and parastoscopic studies of the patient's feces.

Treatment of amoebic dysentery involves compliance with diets , the use of pathogenetic and symptomatic drugs. Also, if necessary, patients are prescribed antihistamines, vitamins.

How is dysentery transmitted?

The causative agents of the disease are rod-shaped. They instantly die at a temperature of 100C, at a temperature of 60C they can last for about half an hour. In the feces, the pathogen dies after a few hours.

The infection spreads from patients with acute and chronic forms of the disease. Also, infection is possible from bacterial excretors, which are people with a mild course of the disease. Such patients, due to the ease of symptoms, do not go to the doctor. The infection can be transmitted through food and drink, and it is also carried by flies. Transmission of the pathogen can also occur through dirty hands.

Symptoms of dysentery

There are two forms of dysentery - acute And chronic . In the acute form of the disease, a person can get sick from 3-4 days to three months. If the disease lasts longer, then we are talking about a chronic form of dysentery. Duration in both cases can vary from 18 hours to 5 days.

If the patient has a moderate course of the disease, then its symptoms are more pronounced. Initially, a person feels weakness and malaise, he may be a little shivering. Later, cramping pains appear in the left side of the lower abdomen. The stool is liquid, with blood and mucus, its frequency sometimes reaches 25 times a day. In the first two days of the development of dysentery, the frequency of stool increases. In addition, the patient's body temperature rises, which can reach 39 degrees, he is worried about a headache. The temperature drops in 2-5 days.

In most patients, abdominal pain does not subside for a long time. Sometimes the pain does not subside even for a while. As a rule, the stomach hurts in the lower left part, however, some patients note that the pain is diffuse. Often also noted. In a severe form of acute dysentery, the onset of the disease is always violent. The patient is worried about very severe pain in the lower abdomen, which has a cramping character. The chair is liquid and very frequent, vomiting, nausea can be observed, the body temperature rises rapidly. In the feces, in addition to mucus and blood, pus can be detected. The patient's pulse quickens, blood pressure decreases, observed. Severe dysentery can last up to 6 weeks. If adequate treatment of the disease is not carried out, it can become chronic.

In a child with dysentery, the stool is immediately plentiful, but then its appearance changes, lumps of gray-green mucus appear in it. At this time, the child's body is very dehydrated. If the baby has dry mucous membranes, then we are talking about a significant loss of fluid. Parents should also be aware of the fact that dehydration is more dangerous the younger the child.

In severe dysentery, the baby may develop cardiovascular failure , appear convulsions ,consciousness is disturbed . In this case, urgent hospitalization is important.

In a sick baby with dysentery, the limbs become cold, he constantly burps. Sleep is very restless and bad.

Diagnosis of dysentery

To diagnose dysentery in a patient, a bacteriological culture of feces is carried out in the laboratory. For the accuracy of the result of the study, the analysis is carried out three times. However, this method is not always suitable for diagnosis, since the results appear only after a week. In order to speed up the diagnosis of dysentery, it is practiced to determine the causative agent of the disease and toxins in the blood and feces.

In this case, immunological methods are used. To determine the presence of shigella, the polymerase chain reaction method is used.

In the process of establishing a diagnosis, the patient also undergoes a fecal analysis (coprogram). If there is a large amount of mucus in the test material and at the same time the number of leukocytes is increased and erythrocytes are present, then, most likely, the integrity of the intestinal mucosa is violated.

Treatment of dysentery

In the process of treating dysentery, the most important point is the destruction of pathogens. It is also necessary to restore the normal water-salt balance and ensure detoxification of the body. If the disease is severe, then the patient is treated in a hospital. Mild dysentery can be treated on an outpatient basis.

Effectively fight shigella medications belonging to nitrofuran series , and quinolines , fluoroquinolones . When prescribing antibacterial drugs, the doctor must be guided by the characteristics of a particular case. After all, it is important to take into account the sensitivity of the Shigella species to the specific drug being prescribed. The patient takes antibacterial drugs for 3-4 days if he is diagnosed with a moderate form of the disease. If we are talking about a severe form of the disease, then antibacterial agents are prescribed for 5 days.

During this period, the patient's general condition gradually improves, the temperature returns to normal, the nature and frequency of stools also normalize. After the course of antibiotic therapy ends, the patient still has mild bowel dysfunction for several days. The chair remains liquid, its frequency is no more than three times a day. But at this time, antibiotics are no longer necessary.

If the patient is diagnosed with a mild degree of the disease, then he is shown to drink plenty of water. The fact is that in the process of vomiting and diarrhea, the body loses fluid and salts. The most optimal drink will be water with the addition of soda, salt and sugar. You can also add a special preparation to the water rehydron . You need to drink in small portions and often. In severe patients, special solutions are administered intravenously in order to restore the water-salt balance.

In order to remove toxins from the body in the treatment of dysentery, a course of treatment with enzyme preparations is prescribed. The patients take calcium preparations . In addition, enterosorbents are used for treatment: Activated carbon , enterosorb , . They help to remove toxins from the intestines of the patient. The course of treatment also includes high doses of vitamins.

If there is a need to relieve a strong pain attack, then other drugs that relieve spasm are used for this purpose.

In the treatment of this disease, the right approach to nutrition is important. You can not eat those foods that enhance the fermentation processes in the intestines. These are milk, legumes, black bread, cucumbers, beets, cabbage.

When treating babies, special attention should be paid to nutrition. If the child refuses to eat categorically, then it is not recommended to force-feed him. During the period when the child feels better and has an appetite, it is advisable to reduce the amount of food by half and increase it gradually. This will allow not to overload the body of a recovering baby. But the child should drink as much as possible. Compotes, fruit drinks are ideal for this.

Some folk methods of treating dysentery are also practiced. However, they can be used only after the approval of the attending physician. You can prepare an infusion of oak bark, a decoction of honeysuckle flowers, an infusion of yarrow flowers. An effective remedy for the treatment of dysentery is the root of burnet, from which an infusion is also prepared. Also used are decoctions and infusions of plantain herb, fruits of bird cherry, blueberry, blackberry leaves.

The doctors

Medications

To prevent the disease, it is very important to comply with all sanitary and hygienic standards. In order to prevent mass infection of the population, strict sanitary supervision is carried out over enterprises that produce food products and provide public catering. It is equally important to control the water supply. All these measures are aimed at preventing the mass spread of intestinal infections.

Personal prevention measures are, first of all, regular and thorough hand washing. In addition, it is important to get rid of flies in the room in time and prevent them from coming into contact with food. Parents should make every effort to protect the child from infection with pathogens. It should be ensured not only that the child washes his hands after using the toilet and walks, but also to prevent the use of unwashed fruits and vegetables.

Diet, nutrition for dysentery

List of sources

Shuvalova E.P. "Infectious Diseases". - M.: Medicine. - 2001;
Pokrovsky, V.I. Bacterial dysentery / V.I. Pokrovsky, N.D. Yushchuk. - M.: Medicine, 1994;
Shakhmardanov M.Z., Luchshev V.I., Kornilova I.I., Sokolova L.V., Onukhova M.P. Shigellosis Flexner (clinic, diagnosis, treatment). Methodological recommendations of the Ministry of Health of the Russian Federation. M: Publishing house "Germes-MTK". 2000;
Yushchuk N.D., Brodov L.E. Acute intestinal infections: diagnosis and treatment. - M., 2001.