GASTROENTERITIS

From Big Medical Encyclopedia

GASTROENTERITIS (gastroenteritis; Greek gaster a stomach + enteron a gut + - itis) — the kliniko-morphological syndrome caused by pathological process (is more often an inflammation) mucous membranes of a stomach and a small bowel. As usually in a wedge, practice the combined damage of a mucous membrane of intestines takes place, G. consider as a version gastroenterocolitis (see). At the same time by official statistics of G. it is considered as an independent nosological form. Acute G. more often is a syndrome of a number of infectious diseases or is caused by effect of toxins, poisons (e.g., heat-resistant enterotoxins, poisonous mushrooms), and also arises under the influence of an allergy.

Hron. It is necessary to differentiate with hron, gastritis (see), hron, enteritis and hron, a coloenteritis (see. Enteritis , coloenteritis). Also the gastroenterocolitis — the combined damage of a stomach and intestines is quite often possible.

Infectious is caused by various high-pathogenic and weak and pathogenic activators (E. coli, V. of proteus, Vibrio parahaemolyticus, Cl. perfringens, stafilokokka, enterococci, viruses, etc.).

For acute G.'s clinic typically acute or most acute beginning, emergence of nausea, repeated vomiting, the speeded-up plentiful watery excrements with impurity of slime, occasionally blood, symptoms of intoxication, a fever, weakness, dizziness, a headache, temperature increase. The incubation interval at infectious G. more often short — several hours, is more rare than 1 — 5 days.

Treatment is usually carried out in the conditions of an infectious hospital and consists in a gastric lavage, purpose of a diet. For heavy patients Disintoxication and antibacterial therapy is shown.

At a gastroenteritis at children the overeating, unusually spicy or rough food, the use of unripe fruit, etc. can be an etiology, in addition to above-mentioned factors. Sometimes the heavy intoxication reminding a picture of toxic dyspepsia develops (see. Dyspepsia ), at a cut vomiting arises even after drink of water; the oliguria, a proteinuria is observed, in urine acetone and cylinders appear. Against the background of sharp dehydration and disturbance of electrolytic balance there can be signs of irritation of a meninx, spasms, symptoms of defeat of cardiovascular system (dullness of cordial tones, a frequent and low pulse, decrease in the ABP). At easy disease the condition of the child quickly improves, at heavy — process of recovery is dragged out. G.'s symptoms meet in an initial stage of many diseases of children's age, including appendicitis and invagination: the intensive and accruing abdominal pains, the low-expressed intoxication in an initial stage at appendicitis, a delay of a chair and gases, satisfactory condition and standard temperature at invagination of intestines. The differential diagnosis with infectious and somatic diseases is carried out taking into account a wedge, by pictures of data of the general and epid, the anamnesis and materials of laboratory inspection.

Sick children are hospitalized in an infectious hospital. In mild cases appoint a bed rest, a water and tea diet to 6 — 12 hours, then easily assimilable food with restriction of fats and celluloses; transfer to usual food in several days. At a severe form of G. after a gastric lavage appoint a water and tea diet to 18 — 24 hours. At the expressed dehydration reasonablly drop administration of salt solutions taking into account a condition of water-salt balance and acid-base equilibrium. According to indications appoint subcutaneously Cordiaminum, caffeine; add strophanthin or Korglykonum to infusional liquid. Antibacterial drugs are used taking into account sensitivity of the activator to them. Purpose of eubiotik (Enteroseptolum, Mexaformum), vitamins, especially groups C and B, excitants (pentoxyl, a transfusion of plasma) is obligatory, for blood, an injection of gamma-globulin, etc.

Forecast usually favorable.


Bibliography: Blyuger A. F., Novitsky I. N. and Terebkova 3. F. Salmonellez, Riga, 1975, bibliogr.; B at-d and I am F. E N. Food toxicoses, toxicoinfections and their prevention, page 99, M., 1972, bibliogr.; Nisevich N. I. both Avanesova of A. G. Dizenteriya and other intestinal infections at children of early age, M., 1962, bibliogr.; The guide to gastrointestinal diseases at children, under the editorship of N. I. Nisevich, page 316, M., 1969; The Guide

to infectious diseases, under the editorship of

A. F. Bilibin and G. P. Rudnev, page 163, M., 1962; G of hectare of d at G.F. and. To e u sch G. T. Pathogenesis of bacterial diarrheas, New. Engl. J. Med., v. 285, p. 831, 891, 1971, bibliogr.

V. I. Pokrovsky, V. P. Mashilov; B. M. Vitebsky (ped.).

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