Diarrhea throughout the day. Causes and treatment of chronic diarrhea in adults

In an adult body, during the work of the intestines, various disorders and failures, one of which is diarrhea. It is also called "diarrhea", and it is frequent bowel movements liquid feces. It occurs both with minor poisoning and with the appearance of a serious, possibly chronic, disease. In the first case, diarrhea will go away on its own with almost no treatment in 2-3 days, but in other cases, diarrhea lasts four days or more, and may be accompanied by other dangerous symptoms such as fever, pain in the stomach and intestines, general weakness. If you do not take the disease seriously and do not start treatment, then diarrhea will lead to dehydration and the appearance of intractable acute and chronic diseases.

In most cases, diarrhea can be cured using a standard, well-known set of manipulations. However, sometimes home methods are not enough, sometimes the situation worsens from many popular means. The answer to the question “what to do if diarrhea does not go away for 4 days?” The answer is clear: consult a doctor immediately.

Why does diarrhea occur?

Diarrhea in adults can occur for the following reasons:

• Poisoning from stale food.
• Treatment with medical supplies, causing diarrhea.
• Individual intolerance to certain foods.
• The body's reaction to neurosis.
• Acclimatization of the body.

If diarrhea continues for the fourth day, then most likely the patient may be diagnosed with one of the following diseases:

1. Dysentery.

2. Intestinal infection ( stomach flu, rotavirus, cholera).

3. Salmonellosis.

4. Intestinal tuberculosis.

5. Enzyme deficiency.

6. Exacerbation chronic illness(colitis, dysbacteriosis).

7. Inflammation of one of the organs gastrointestinal tract.

First aid

If unpleasant disease has become protracted, it would be best to consult a doctor to diagnose the disease and find out the reasons for its occurrence, however, long-term diarrhea in an adult can be treated independently:

1. You need to drink any sorbent drug that will help the diseased gastrointestinal tract (Smecta, Filtrum-Sti, activated angle).

2. Since diarrhea is very dangerous due to dehydration, you need to drink large amounts boiled water or weak, unsweetened tea.

3. Drinking herbal teas will help replenish the supply lost during the disease nutrients, vitamins and minerals. If diarrhea with fever, positive impact Linden or currant tea will have an antipyretic and diaphoretic effect.

4. Performing a cleansing enema. Water released during diarrhea not only washes away useful microelements, but also various pathogenic bacteria and toxins. Through diarrhea, the body tries to get rid of toxins. Using an enema cleanse will help remove bacteria that was not passed through the stool. This will prevent them from being reabsorbed into the intestinal walls and causing the problem to reoccur. Washing should also be done because it has an additional beneficial effect - reducing elevated temperature body by absorbing water.

Enema treatment includes the use of not only clean water, but also various decoctions medicinal herbs(chamomile, sage, oak). For them, make a solution at room temperature. For adults, enemas with a volume of 750 ml to 2 liters are used.

Diet for diarrhea

An important factor in the treatment of loose stools is adherence to a special diet. The diet includes consumption large quantity neutral liquid.

During prolonged diarrhea, you need to follow the following dietary rules:

1. The basis of the diet is liquid food, low-fat soups and broths, light mashed puree.

2. The diet requires foods rich in fiber (baked apples, bananas, dried fruits). For bread, preference is given to white or bran.

3. Cereal porridges should be made mucous or semi-mucous. Large grains are strictly prohibited, as they can injure already irritated intestinal walls.

4. Lean meat and fish are allowed.

When treating diarrhea, the following are prohibited:

• Fresh vegetables and fruits.
• Seasonings, large quantities sugar and salt, green tea, coffee.
• All types of canned, smoked and dried foods.
• Any carbonated drinks, all types of dairy products.
• Fat, junk food, interfering with the normalization of intestinal function.

Treatment of diarrhea with medications

Before deciding how to treat diarrhea, you must first find out the cause of the disease.

For diarrhea of ​​any type, the following will definitely be prescribed:

• Sorbents (Activated carbon, Smecta).
• Preparations that restore ionic balance after dehydration (Regidron).
• Antidiarrheals (Loperamide, Imodium).
• Pro- and prebiotics that restore the balance of intestinal microflora (Bifiform, Linex).

If the diarrhea was caused by a disease of an infectious nature, then the specialist doctor will prescribe for admission:

• Antibiotics (tetracyclines, macrolides, amoxicillins).
• Intestinal antiseptics (Furazolidone, Ftalazol, Sulgin).

These drugs should not be used for self-medication. Doing this is strictly contraindicated because they are selected according to the results of research and analysis. They are selected individually for adults and children. The patient must take a course of them.

Consultation and examination with a doctor is necessary when:

1. Three days after the start of treatment, it still does not help.

2. The temperature remains stably above 38° throughout the day and is not reduced by antipyretics.

3. Taking antidiarrheal medications causes rejection, allergies, skin rash and other reactions, including those of a psychosomatic nature.

4. The appearance of blood in the stool or the coloring of liquid stool in dark brown or black.

5. Not passing painful sensations and pain in the stomach.

6. Signs too severe dehydration: sunken eyes, dry tongue, bad breath.

7. The disease affects consciousness.

If you have at least one of the symptoms listed above, you need to urgently go to the hospital. In this case, extensive diagnostics are carried out and laboratory tests, on the basis of which treatment will be prescribed.

Diarrhea brings a lot of inconvenience. Associated symptoms can potentially distinguish dangerous condition from ordinary poisoning and understand what to do if diarrhea does not go away.

When diarrhea does not stop for a week, the resulting dehydration becomes dangerous for a person. Happening sudden loss weight, during this period it is very important to control the amount of urination. An alarming manifestation is:

• change in the color and concentration of urine;
• break between urination at 8 hours.

In the background general condition the patient develops:

• disorientation;
• depression;
• nervousness;
• dry mucous membranes;
• dizziness.

Prolonged diarrhea can cause comatose state and even death. Therefore, in the absence of positive dynamics, you must immediately seek professional help.

Reasons

Prolonged diarrhea can be caused by the following diseases:

• salmonellosis;
• intestinal infection;
• exacerbation of chronic CT diseases (colitis, dysbacteriosis, etc.);
• enzyme deficiency;
• dysentery;
• intestinal tuberculosis.

What to do

The decision on treatment is made after analysis clinical picture. Prolonged diarrhea is accompanied by certain symptoms that have their own causes. Based on this information, a decision is made on subsequent therapy.

Diarrhea with nausea

Develops against the background of the following conditions:

• poisoning;
• dry food;
• overeating;
• digestive problems;
• gallbladder dyskinesia.

The first action will be gastric lavage. For this, the patient is seated near the pelvis and given 2 liters to drink in one gulp. warm water. If you drink the liquid in small sips, it will be absorbed by the body and the desired effect will not occur. You can additionally stimulate the root of the tongue with your finger. It is necessary to ensure that in addition to water, the vomit contains food remains. The procedure is repeated until all the food comes out.

To speed up the process, you can add a tablespoon of salt or soda to the water. It is better not to use potassium permanganate: its concentration is difficult to track, and in case of an overdose, the patient may receive a burn to the mucous membrane. After washing, the patient must take the sorbent. If the condition does not improve, you must call an ambulance.

Temperature accompanied by diarrhea

It manifests itself in infectious diseases or even a simple cold. The diagnosis is established by the totality of symptoms. To improve the patient's condition it is recommended:

1. Drink plenty of fluids. Drinks should be unsweetened, warm and non-carbonated. Poisons of medicinal herbs - chamomile, St. John's wort, rose hips, mint - help well. There is no need to hold back vomiting - it brings relief.
2. During treatment, a diet must be followed. No fat ones fried foods. Pickles, spicy, smoked and sweets are prohibited. A fasting day is recommended.
3. Watch the chair. If traces of blood appear, consult a doctor immediately.

Diarrhea with blood

Traces of blood in the stool may indicate certain pathologies in the body:

• Cracks anus, haemorrhoids. There are streaks or fresh blood clots in the stool.
• The dark color of excrement indicates the presence of a stomach ulcer or hidden bleeding of the gastrointestinal tract.
• Blood may appear during acute bacterial infection- cholera, salmonellosis, dysentery.

You cannot self-medicate. Blood doesn't just appear in stool. It is necessary to diagnose and determine the cause of the symptom. For infections, fluoroquinolone drugs are prescribed.

Diarrhea with vomiting

This combination is typical for food poisoning. Accompanied by dizziness, abdominal cramps, weakness throughout the body. Develops 2 hours after food enters the body low quality, bacterial infection, toxic poisons.

Treatment steps:

• Rinse the stomach after an attack of vomiting.
• Take absorbent ( activated carbon, "Polysorb", "Sorbex, etc.).
• Refuse to eat and drink plenty of fluids.
• If a bacterial infection is detected, a course of antibiotics is prescribed.

Power can be restored after 1.5 days. First, the patient is offered crackers with tea, then porridge with water, low-fat soups, cottage cheese, and boiled eggs are introduced into the diet.

Severe diarrhea

Occurs when infectious diseases- salmonellosis, dysentery. Requires treatment in infectious diseases hospital. Complex of drugs:

• antibiotics (“Tetracycline”, “Ampicillin”);
• nitrofuran drugs (“Furazolin”, etc.);
• sulfonamide drugs.

The patient is put on a gentle diet. The food is boiled or steamed, spices are excluded, fresh bread, fiber, dairy products. Porridge, eggs, vegetable and cereal soups are allowed.

Abdominal pain

Talks about enterocolitis, colic, overeating or gastritis. Fasting for 24 hours is recommended, then the patient is prescribed table No. 4. At infectious nature antibiotics are prescribed. At functional disorders The gastrointestinal tract takes antispasmodics - “No-shpu”, “Drotaverine”, etc. Patients with ulcers can fast only under the supervision of a doctor.

Video “How to treat persistent diarrhea”

From this video you will learn what causes prolonged diarrhea and how to deal with it.

Diarrhea(diarrhea) – frequent, repeated loose stool. Diarrhea is usually accompanied by pain, rumbling in the abdomen, flatulence, and tenesmus. Diarrhea is a symptom of many infectious diseases and inflammatory bowel processes, dysbiosis, neurogenic disorders. That's why important Diagnosis and treatment of the underlying disease play a role in preventing complications. Loss of large amounts of fluid during profuse diarrhea leads to disruption of the water-salt balance and can cause heart and kidney failure.

Diarrhea (diarrhea)

Diarrhea is defined as single or frequent defecation of loose stool. Diarrhea is a symptom that signals a malabsorption of water and electrolytes in the intestines. Normally, the amount of feces excreted per day by an adult varies between 100-300 grams, depending on the characteristics of the diet (amount consumed vegetable fiber, poorly digestible substances, liquids). If intestinal motility increases, stool may become more frequent and thinner, but its quantity remains within normal limits. When the amount of liquid in stool increases to 60-90%, then they talk about diarrhea.

There are acute diarrhea (lasting no more than 2-3 weeks) and chronic. Moreover, the concept chronic diarrhea there is a tendency to periodically have large stools (more than 300 grams per day). Patients suffering from malabsorption of various nutrients tend to produce polyfecal matter: the excretion of large amounts of stool containing undigested food debris.

Causes of diarrhea

With severe intoxication in the intestine, excess secretion of water with sodium ions occurs into its lumen, which helps to dilute the stool. Secretory diarrhea develops with intestinal infections (cholera, enteroviruses), taking certain medicines and biologically active additives. Osmolar diarrhea occurs with malabsorption syndrome, insufficient digestion of sugars, excessive osmotic consumption active substances(laxative salts, sorbitol, antacids, etc.). The mechanism of development of diarrhea in such cases is associated with an increase osmotic pressure in the intestinal lumen and fluid diffusion along the osmotic gradient.

A significant factor contributing to the development of diarrhea is impaired intestinal motility (hypokinetic and hyperkinetic diarrhea) and, as a consequence, a change in the rate of transit of intestinal contents. Laxatives and magnesium salts help enhance motility. Impaired motor function (weakening and strengthening of peristalsis) occurs with the development of irritable bowel syndrome. In this case they talk about functional diarrhea.

Inflammation of the intestinal walls causes the exudation of protein, electrolytes and water into the intestinal lumen through damaged mucosa. Exudative diarrhea accompanies enteritis, enterocolitis of various etiologies, intestinal tuberculosis, acute intestinal infections (salmonellosis, dysentery). Often with this type of diarrhea there is blood and pus in the stool.

Diarrhea can develop as a result of taking medications: laxatives, antacids containing magnesium salts, certain groups of antibiotics (ampicillin, lincomycin, cephalosporins, clindamycin), antiarrhythmic drugs(quindiline, propranol), digitalis preparations, potassium salts, artificial sugars (sorbitol, mannitol), cholestyramine, chenodeoxycholic acid, sulfonamides, anticoagulants.

Classification

Distinguish the following types diarrhea: infectious (with dysentery, salmonellosis, amoebiasis, food toxic infections and entroviruses), nutritional (associated with dietary disorders or allergic reaction on food products), dyspeptic (accompanies digestive disorders associated with insufficiency of secretory functions of organs digestive system: liver, pancreas, stomach; as well as in case of insufficiency of enzyme secretion in the small intestine), toxic (with arsenic or mercury poisoning, uremia), medicinal (caused by taking drugs, drug dysbiosis), neurogenic (with changes in motility due to impaired nervous regulation associated with psycho-emotional experiences).

Clinical features of diarrhea

IN clinical practice distinguish between acute and chronic diarrhea.

Acute diarrhea

Chronic diarrhea

Diarrhea lasting more than 3 weeks is considered chronic. It may be a consequence various pathologies, identification of which is the main task for determining treatment tactics. History data associated with the disease can provide information about the causes of chronic diarrhea. clinical symptoms and syndromes, physical examination.

Particular attention is paid to the nature of the stool: frequency of bowel movements, daily dynamics, volume, consistency, color, presence of impurities in the stool (blood, mucus, fat). The survey reveals the presence or absence accompanying symptoms: tenesmus (false urge to defecate), abdominal pain, flatulence, nausea, vomiting.

Pathologies small intestine manifest as profuse watery or fatty stools. Diseases of the large intestine are characterized by less abundant stool; streaks of pus or blood and mucus may be present in the stool. Most often, diarrhea with lesions of the large intestine is accompanied by pain in the abdomen. Diseases of the rectum are manifested by frequent, scanty stools as a result of hypersensitivity to stretching of the intestinal walls, tenesmus.

Diagnosis of diarrhea

Acute diarrhea is usually characterized by a very pronounced loss of fluid and electrolytes in the feces. During examination and physical examination of the patient, signs of dehydration are noted: dryness and decreased turgor skin, increased heart rate and decreased blood pressure. With severe calcium deficiency, the symptom of a “muscle roll” becomes positive, and convulsions may occur.

In case of diarrhea, the patient's stool is always carefully examined, in addition, it is advisable to carry out a proctological examination. Detection of anal fissure, fistula, paraproctitis may suggest Crohn's disease. For any diarrhea produce comprehensive study organs digestive tract. Instrumental endoscopic techniques(gastroscopy, colonoscopy, irrigoscopy, sigmoidoscopy) allow you to examine internal walls upper sections gastrointestinal tract and large intestine, detect damage to the mucosa, inflammation, neoplasms, bleeding ulcerations, etc.

Fecal microscopy reveals a high content of leukocytes and epithelial cells, which indicates the presence of inflammation of the mucous membrane of the digestive tract. Detected excess fatty acids is a consequence of impaired fat absorption. Together with the remains of muscle fibers and high content starch in the stool, steatorrhea is a sign of malabsorption syndrome. Fermentation processes due to the development of dysbiosis contribute to changes in normal acid-base balance in the intestines. To identify such disorders, intestinal pH is measured (normally 6.0).

Persistent diarrhea in combination with excessive gastric secretion is characterized by Zollinger-Ellison syndrome (ulcerogenic pancreatic adenoma). In addition, prolonged secretory diarrhea may be the result of the development of hormone-producing tumors (for example, VIPoma). Laboratory research blood tests are aimed at identifying signs inflammatory process, biochemical markers of liver and pancreas dysfunction, hormonal disorders which may cause chronic diarrhea.

Treatment of diarrhea

Diarrhea is a symptom of many diseases, so when choosing medical tactics The main role is played by the identification and treatment of the underlying pathology. Depending on the type of diarrhea, the patient is referred for treatment to a gastroenterologist, infectious disease specialist or proctologist. It is imperative to apply for medical care, if there is diarrhea that lasts more than 4 days, or streaks of blood or mucus are noticeable in the stool. In addition, symptoms that cannot be ignored are: tarry stools, abdominal pain, fever. If there are signs of diarrhea and there is a possibility of food poisoning, you should also consult a doctor as soon as possible.

Therapy aimed at eliminating diarrhea depends on its type. And includes the following components: dietary food, antibacterial therapy, pathogenetic treatment(correction of malabsorption during enzyme deficiencies, decreased gastric secretion, drugs that normalize intestinal motility, etc.), treatment of consequences prolonged diarrhea(rehydration, restoration of electrolyte balance).

In case of diarrhea, foods are introduced into the diet that help reduce peristalsis and reduce the secretion of water into the intestinal lumen. In addition, the underlying pathology that caused the diarrhea is taken into account. Diet components must match functional status digestion. Products that promote secretion hydrochloric acid and increasing the rate of evacuation of food from the intestines, for a while acute diarrhea excluded from the diet.

Antibiotic therapy for diarrhea is prescribed to suppress pathological flora and restore normal eubiosis in the intestines. Antibiotics are prescribed for infectious diarrhea wide range, quinolones, sulfonamides, nitrofurans. The drugs of choice for intestinal infections are drugs that do not provide adverse influence on intestinal microbiocenosis ( combination drugs, nifuroxazide). Sometimes with diarrhea of various origins Eubiotics may be prescribed. However, more often such treatment is prescribed after the signs of diarrhea have subsided to normalize intestinal flora(elimination of dysbacteriosis).

As symptomatic remedies adsorbents are used that envelop and astringents, neutralizing organic acids. Loperamide is used to regulate intestinal motility; in addition, it acts directly on the opiate receptors of the small intestine, reducing the secretory function of enterocytes and improving absorption. Somatostatin, which affects secretory function, has a pronounced antidiarrheal effect.

At infectious diarrhea drugs that reduce intestinal motility are not used. Loss of fluid and electrolytes during prolonged and severe diarrhea requires rehydration measures. Most patients are prescribed oral rehydration, but in 5-15% of cases there is a need for intravenous administration electrolyte solutions.

Prevention of diarrhea

Prevention of diarrhea includes measures of physical hygiene and nutrition. Washing hands before eating, washing thoroughly raw vegetables and fruits and proper culinary processing of products help to avoid food poisoning And intestinal infections. In addition, it is worth remembering the need to avoid the use raw water, unfamiliar and suspicious food, food that can cause an allergic reaction.

Chronic diarrhea can begin due to various long-term diseases of the digestive system. Often, such diarrhea does not go away for several weeks, causing a lot of inconvenience to the patient, although it is not accompanied by symptoms of intoxication and fever.

What is the danger of prolonged diarrhea?

With diarrhea, the stool becomes more liquid. causes dehydration of the body. Lack of fluid, vitamins and minerals affects the functioning of all organs.

A person gradually loses strength; with prolonged diarrhea, calcium and phosphorus, which are necessary for bone tissue, are lost.

If diarrhea does not go away for a week or longer, this indicates a possible infection. viral infections, for example, rotavirus diarrhea. The patient loses his appetite, and attacks of vomiting and nausea begin. Chronic diarrhea is a sign of serious illnesses some internal organs.

People with pancreatic pathology suffer from indigestion. Patients are diagnosed with pancreatitis and cystic fibrosis. Patients complain of pain, weakness and intolerance to fatty and meat food. Indigestion may last for several months.

To reduce mucus production, the patient is recommended to take anti-inflammatory drugs (Diclofenac, Indomethacin), but in a very short course - no longer than 3 days.

Chronic diarrhea can be caused by Crohn's disease. In some cases it is necessary to undergo treatment hormonal drugs(Metypred, Prednisolone).

Chronic diarrhea can often begin due to the development of diseases of the digestive system. Pathologies of the liver and pancreas lead to a deficiency of enzymes that take part in the process of digesting food. In this case, pieces of incompletely digested meat fibers can be seen in the patient’s stool (creatorhea phenomenon).

You can compensate for the lack of enzymes with drugs such as Creon.

To reduce the frequency of bowel movements used antidiarrheal drugs. These include,. However similar drugs should not be taken for intestinal infections.

Treatment of long-term diarrhea

This complicates the treatment of diarrhea, since some of the pathogens will remain in the body longer. To reduce intestinal activity, Somatostatin and Octreotide are used. But this is serious drugs, and they are prescribed only by a doctor, and they are expensive: for example, the cost of a package of 5 ampoules of Octreotide for subcutaneous administration is 2000 rubles. Help with spasms in the intestines (Papaverine,).

After testing, pathogens are identified in some patients intestinal diseases. To destroy bacteria, the patient is given an appointment antibacterial drugs. However, they do not cause any harm to viral infections.