A common bacterial infection - dysentery in children: symptoms and treatment with medication and a special diet. Prevention and treatment of serum sickness

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In childhood, they are not uncommon and cause a lot of trouble for a sick child and parents.

To always be fully armed, moms and dads should be aware of the first signs of a disease such as dysentery. After all, the sooner it is noticed, the higher the chances of recovering without serious consequences.

Childhood dysentery is an acute intestinal disease caused by various types of Shigella. These pathogens affect only the lower intestines. The second name for this infection is shigellosis.

Shigella are very tenacious: they feel great in the soil, food products, even low temperatures are tolerated with a bang. The only thing that dysentery pathogens are afraid of is high temperatures, various disinfectants and direct sunlight.

The incubation period of the disease varies from 3 to 5 days, then it begins to actively manifest itself and enters the acute phase.

Shigella, entering the body, pass through the entire gastrointestinal tract and settle on the walls of the large intestine. It is there that they begin their active growth.

Dysentery is very important to diagnose, otherwise, the process of dying of the tissues of the large intestine may begin, and, as a result, disruption of the work of all organs up to their dystrophy. This is due to a violation of the water-salt balance during the development of the disease.

The nature of infantile dysentery

Dysentery most often affects children aged 2 to 5 years. The first question of parents when the first signs of the disease appear is what was its source.

Even when all hygiene standards are observed in the family, fruits and vegetables are washed, and hands are constantly treated with a disinfectant solution, the baby can get sick.

The answer to the question is simple: the main the source of infection is a sick child. Moreover, it is dangerous even in the first hours of the disease. The peak incidence usually occurs at 3 years, since it is at this age that kids usually begin to attend kindergarten.

Physicians allocate several ways of contracting dysentery:

• fecal-oral. This is the most common way to get dysentery. A small child, along with feces, releases a large number of shigella, which are the main causative agent of the disease. If we talk about infection through the mouth (oral method), then the main cause here can be poorly washed fruits, vegetables, less often food, during the preparation of which basic sanitary standards were violated.
• Infection through water. A shigella stick can be picked up by swallowing water while swimming in a pool or ponds (especially if the water in them has not been tested by the relevant authorities or there is a ban on swimming at all). And another source of dysentery bacillus is poor-quality drinking water.
• Contact household method. Infection is possible through shared utensils, toys or unwashed hands.

The peak incidence of dysentery occurs in the summer - under the influence of heat, Shigella sticks multiply most intensively.

Parents must understand that there is no absolute protection against dysentery and absolutely any child can get sick. At risk are children with weakened immune systems and concomitant ailments such as SARS. The only way to avoid illness is preventive measures related to hygiene.

Symptoms in children

Timely diagnosis of the disease is the first step towards the correct and appropriate. What are the signs to understand that a child has dysentery?

How the disease manifests itself depends entirely on the nature of the disease: how it proceeds and how extensively the sections of the intestine are affected by the shigella stick.

Common signs of illness considered to be:

1. general malaise, weakness;
2. stomach ache. First of a aching dull character, then they become more and more acute and move into the iliac cavity;
3. temperature up to 40 degrees;
4. diarrhea up to 20 times a day. Often, stools may be green with streaks of mucus;
5. nausea, turning into frequent vomiting;
6. frequent urge to the toilet "in a big way", which are false in nature;
7. palpable rumbling in the abdomen.

In advanced cases of dysentery, the main symptoms are added:

1. convulsions,
2. bluish skin,
3. strong heartbeat.

With frequent vomiting and persistent diarrhea, the child may become dehydrated, which requires immediate hospitalization.

Differences between amoebiasis and shigellosis

Amoebiasis and shigellosis are types of dysentery caused by different microorganisms: amoeba and shigella, respectively. Amoebiasis is more typical for a tropical climate, shigellosis - for a temperate one. In our climate of the middle zone, shigellosis is still more likely to be found.

Amoebiasis has the same signs and symptoms as dysentery. Plus, headaches, a decrease in appetite up to a complete loss of appetite, pain during defecation are added to them.

Amoebiasis is dangerous for its consequences. Amoeba pathogens can affect other organs, as a result of which the child may develop amoebic hepatitis, abscess of the liver, kidneys, spleen. In severe cases, amoebic damage to tissues and brain cells is possible.

Symptoms in children under one year old

We have already said that dysentery is a disease of children under 5 years of age. Wherein it is very rare in children under one year of age. and are difficult to diagnose due to the age-related characteristics of the defecation process (children of the first six months of life often go to the toilet, their stool has a liquid consistency).

Signs of dysentery in infants(a child under one year old) can be considered green loose stools with mucus and traces of blood. In addition, against the background of an atypical stool, a child may experience general lethargy, whims, and insomnia. In this case, you should not postpone a visit to the doctor.

Shigellosis in children under one year old can occur against the background of developing rickets or anemia. Artificial babies are at risk of contracting shigellosis if the technology for preparing the mixture is violated.

The addition of other diseases, for example, SARS, can lead to a protracted course of the disease with a transition to a chronic form and prolonged bacterial excretion. Therefore, during the period of treatment, it is necessary to strictly observe the regimen prescribed by the doctor and, if possible, exclude external contacts.

Useful video

Video about symptoms, prevention and first aid for intestinal infection:

Conclusion

Dysentery is dangerous, however if all hygiene rules are followed, the risk of getting sick can be minimized. With timely treatment, the prognosis for recovery is favorable. Remember that self-medication for any intestinal ailments is fraught with serious consequences.

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Intestinal diseases in a preschool child occur very often due to non-compliance with the basic rules of hygiene. Dysentery in children is a common phenomenon, but amenable to rapid successful treatment with early diagnosis.

What is dysentery

Dysentery is a disease that refers to acute bacterial intestinal infectious diseases of fecal-oral transmission. Its frequent outbreaks are diagnosed in the warm season (summer-autumn), when the diet contains a lot of fresh fruits, berries and vegetables. With insufficient processing before use, Shigella bacteria remain on them, which, if they enter the gastrointestinal tract, provoke the occurrence of dysentery.

The disease is widespread in countries with a high population density and within regions with poor sanitary conditions. In addition to the food factor, water from reservoirs can be a provocateur. Mass outbreaks of dysentery are often associated with sick employees of the catering or water supply systems.

Pathogen

Different regions are characterized by their own varieties of bacteria that cause shigellosis. The causative agent is a dysenteric bacillus. These are enterobacteria of the Shigella group, which gave rise to the second name of the disease. At the same time, it is not necessary that a particular species of Shigella is strictly tied to a particular territory. They are easily transported and travel all over the planet. In total, there are four types of shigella (but there are 12 serotypes, and according to some studies of pathogens, there are up to 100):

• European region - Sonne stick;
• rarer for Europe - Flexner's wand;
• Central Asia and the Far East - Grigoriev-Shiga stick;
• Boyd's wand is universal in location.

Shigella are resistant to being in the external environment. In water, in a vegetative state, they remain active for about a week, in the ground - for three months, in food - for about a month, they tolerate low temperatures and dryness well. Bacteria are destroyed instantly by boiling or using disinfectants, and at a temperature of 60 degrees Celsius they are viable for about half an hour.

Incubation period

The incubation time of an infection is the interval from the entry of the pathogen into the body until the appearance of the primary characteristic symptoms. The incubation period for dysentery is very different for adults and children. Manifestations can occur as early as 2-3 hours after enterobacteria enter the body immediately in an acute form. Erased or latent forms, on the contrary, practically do not appear after the incubation period.

For adults, the time of development of the disease can take from one day to a week, but in most diagnostic cases, dysentery develops in 2-3 days. During this period, a form of the disease is formed - colitis, gastroenterocolitic or a rare severe form - gastroenteric. Dysentery itself in children can take about a month in an acute form (3 months in the case of an acute prolonged course) and more than 3 months in a chronic condition.

Transmission routes

There are three ways of transmitting dysentery:

• contact household;
• food;
• water.

Each type of pathogenic bacteria has its own way of entering the body:

• Ways of transmission based on Shigella Sonne - through food. The most dangerous for distribution are cottage cheese, milk, sour cream, salads.
• The Flexner wand is carried through water from wells, untested springs, and plumbing without first being boiled.
• The causative agent of Grigoriev-Shiga is preserved on household items, toys, fingers.

Symptoms of dysentery in children

The sooner the clinical picture is determined, the more successful the therapy will be. Symptoms may vary depending on the specific pathogen, but the overall symptomatic picture is about the same. The main thing is not to miss the onset of the disease and not to write off the manifestations of shigellosis for banal food poisoning. Therefore, you need to know the main signs:

• general malaise - weakness, lethargy, drowsiness, exhaustion;
• sleep disturbance;
• high temperature with jumps from 37 to 40 degrees during exacerbation;
• vomiting, nausea, inability to eat, decreased appetite or its complete absence;
• frequent diarrhea during the day;
• feces interspersed with mucus, greenery, blood;
• false urge to defecate;
• rumbling in the large intestine;
• stomach ache;
• with a severe course of the disease, hypotension, tachycardia, depression of consciousness, cyanosis of the skin, convulsive spasms occur.

Chronic symptoms in children under one year old against the background of diathesis, rickets, anemia and sometimes breastfeeding:

• medium-satisfactory condition;
• regular loose stools;
• mild toxicity.

chair

The urge to defecate during shigellosis in a child may practically not stop. Chair with dysentery can be up to 30 times a day. The volume of bowel movements does not exceed 500 ml per day. Among the semi-liquid or completely liquid feces, there is thick transparent mucus, blood and, after a while, pus. Acute symptoms are observed for 2-9 days, after which there is a transition to the recovery phase, but sometimes a chronic form occurs if the child's immunity is significantly reduced. In this case, the patient can become a source of spread of bacteria without symptoms.

Reasons

It is easy to become infected with shigellosis, especially for very young children, who have not yet been able to explain the rules of hygiene. Causes of dysentery can be hidden in unwashed fruits and vegetables, dairy products of questionable production, dirty hands and objects that children taste. More rare cases are infection through a reservoir or pool in which disinfection is not carried out properly.

Therefore, adults have the responsibility and duty to monitor the child: do not let him put dirty hands and any objects into his mouth, take a responsible approach to the processing of fruits and berries, control when bathing. Especially carefully you need to choose dairy products. to avoid dysentery and other infectious diseases.

Diagnostics

Confirmation of the diagnosis of shigellosis occurs on the basis of a study of feces and deep laboratory examinations. The bacteriological method of seeding Shigella from feces with a 3-fold analysis makes it possible to determine the diagnosis in 50-60% of patients. The disease is also diagnosed by the presence of enterobacteria antigens in saliva, blood, urine. For additional confirmation, sigmoidoscopy is sometimes used. The main thing in diagnosis is a differential analysis in order to exclude diseases similar in symptoms: cholera, salmonellosis, escherichiosis and others.

Complications

Like any other disease, shigellosis in children has its consequences for the body. Complications can be many:

• dysbacteriosis;
• prolapse of the rectum due to pressure in the peritoneum;
• peritonitis - the exit of intestinal contents through perforation into the abdominal cavity;
• intestinal bleeding and abscesses;
• toxic megacolon - thinning of the intestinal walls, and, as a result, blood intoxication;
• post-dysenteric bowel dysfunction;
• hypovolemia (dehydration);
• pneumonia;
• damage to the kidneys, liver;
• ulcers of the intestinal mucosa;
• infectious diseases against the background of a strong decrease in immunity.

Treatment

Depending on the severity of the course of the disease, treatment is possible on an outpatient basis or in a hospital. A child from a year old can be at home if there are no acute symptoms of shigellosis, and it is important to hospitalize other children who go to kindergarten or school, as well as adults working in the food industry or in contact with children at work. The main rules of home treatment:

• observe the daily routine;
• stick to a diet;
• follow the doctor's recommendations for drug treatment.

No-Shpa or Papaverine are suitable for relieving intestinal spasms. To help restore the intestinal microflora, you can take probiotics and prebiotics. Antibiotics are used only in extreme severe degrees of the disease and only as directed. Hospitalization of a small patient occurs when shigellosis is severe or it is impossible to isolate the patient from possible infection of new carriers.

Enterofuril

Doctors often use Enterofuril for dysentery. This drug, depending on the dosage, has a bacteriostatic or bactericidal property. Dosage for children under 7 years old in the amount of 600 mg of the active substance per day. The drug is not recommended for children under the age of 1 month. In this case, the use of the drug does not depend on the diet of the child. Before use, you need to carefully study the possible contraindications for an allergic reaction. Enterofuril analogues:

• Baktisubtil capsules;
• Ftalazol;
• Enterol powder.

Diet

A strict diet during the treatment of shigellosis will help to overcome the disease more effectively. Foods that provoke gas formation and fermentation in the digestive tract are excluded from the diet: dairy products, whole milk, fatty, salty, fried foods, smoked, spices. You should increase fluid intake due to decoctions, fruit juices, fruit drinks, weak sweet tea, saline solutions. The diet for dysentery should be light food: boiled fish, steam cutlets, soups. To restore the balance of potassium, raisins, baked apples are suitable.

Prevention of dysentery in children

All prevention of dysentery in children lies with the parents and consists in the constant observance of sanitary and hygienic standards. You should control the cleanliness of the baby's hands, the way he washes them. The room must be kept clean and free of infectious agents such as flies. It is important to remember that the sanitary culture of the child is formed on the example of parents and older relatives.

Video

Dysentery is one of the most common bacterial intestinal infections in children. There is a predominant distribution of this disease among children at preschool age. This is probably due to the fact that older children better observe the rules of hygiene, do not put toys and fingers in their mouths. Children make up about 70% of the patients with dysentery.

In order not to confuse dysentery with other intestinal disorders and start treatment on time with the help of specialists, it is important for parents to know the main symptoms of this disease.

Distinguish between bacterial dysentery (shigellosis) and amoebic (amebiasis).

Bacterial dysentery

It looks like the causative agent of dysentery - Shigella.

The predominant spread of the infection is recorded in the summer-autumn period, which can be explained by the large amount of fruit consumed (not always washed enough), favorable conditions in the warm season for the reproduction of bacteria in food products.

Causes of Shigellosis

The causative agent of the disease is enterobacteria from the genus Shigella, hence the second name of dysentery is shigellosis.

Dysentery is caused by 4 types of Shigella:

• Sonne;
• Flexner;
• Grigorieva-Shiga;
• Boyd.

They are named after the scientists who isolated and described these enterobacteria. Varieties of pathogens are characteristic of certain regions. In European countries, dysentery is caused by Sonne's wand, less often by Flexner's wand. In the Central Asian countries and in the Far East, Grigoriev-Shiga dysentery with a more severe course may occur.

Shigella have sufficient stability in the environment, which allows them to survive in water for more than a week, in soil - up to three months, in food - up to four weeks, tolerating low temperatures and drying. They die under the action of disinfectants and direct sunlight, when heated to 60 ° C they die in half an hour, and when boiled - instantly.

The source of infection is a sick person and a healthy bacterial excretor of dysentery bacillus. The pathogen is excreted in the feces. The mechanism of infection with dysentery is fecal-oral, that is, the infection penetrates through the digestive tract.

Ways of transmission of infection: bacteria can enter the body of a child with food, water or when using household items, as well as when personal hygiene is not followed (that is, infection occurs by contact-household). Dysentery is sometimes called the disease of dirty hands. Flies play a role in the transmission of pathogens.

Most often, infection occurs through the use of raw water, foods that are not subjected to heat treatment (for example, salads, raw milk), foods that have expired, and perishable foods that are not stored properly.

The risk of contracting shigellosis increases with the use of unwashed or poorly washed vegetables and fruits. The incidence increases during the ripening period of strawberries, raspberries, grapes. Many parents do not consider it necessary to wash watermelons and melons before giving them to their child.

The disease occurs both in the form of single (sporadic) cases and in the form of outbreaks. A sick person is contagious from the first day of illness. The dysentery bacillus is excreted in large quantities from the patient's body with feces. In family foci, children become infected in 40% of cases. Babies become infected from people caring for them.

With contact-household infection, the infection is transmitted through dishes, dirty linen, toys, towels and other items. If a patient with dysentery does not wash his hands after going to the toilet, then on his hands he transfers the pathogen to all objects with which he comes into contact. Then a healthy child uses these objects, and puts the wand into his mouth with his own hands.

Susceptibility to dysentery in children is very high, especially in the first three years of life. Predisposing factors to the occurrence of dysentery are artificial feeding, malnutrition and in children, unsanitary conditions in the home.

Shigella Grigorieva-Shiga secrete a toxin (exotoxin) during their lifetime, and other types of the pathogen secrete it when the rod dies (endotoxin). Immunity after suffering dysentery is unstable and short-lived. It is possible to re-infect with this disease.

Dysentery is a common disease of the whole organism, but the main pathological process mainly develops in the lower part of the large intestine: the sigmoid colon is affected. Some of the pathogens, when they enter the body, are destroyed in the digestive tract and release endotoxin.

The isolated toxin is absorbed into the blood, affects the vascular wall and increases its permeability, which contributes to the development of pathological changes in the intestine. Shigella multiply in the intestinal mucosa and in the lymph nodes of the mesentery.

The inflammatory process in the mucosa depends on the severity of pathological changes. First, redness and swelling of the mucosa develops with small hemorrhages. Such catarrh develops in mild cases of shigellosis. And in severe cases of infection, superficial necrosis of epithelial cells of the mucosa develops with the formation of ulcers on the intestinal wall after rejection of necrotic cell layers.

With even deeper necrosis, ulcers appear in the thickness of the intestinal wall, followed by scarring. Other microorganisms (fungi, staphylococci, etc.) can also take part in the formation of such ulcers.

The defeat of the intestinal wall leads to a violation of its function: peristalsis increases, stool becomes more frequent, mucus and blood appear in the stool, spasm of the affected intestine occurs. Toxins of the dysentery bacillus cause damage to blood vessels and nerve endings not only in the intestine itself, but also in the central nervous system.

This leads to a reflex dysfunction of other organs of the digestive tract (, stomach, small intestine,); as a result, metabolic processes in the body are disturbed. Toxins and incompletely oxidized metabolic products lead to both damage to the cardiovascular system and dystrophic changes in the internal organs.

Therefore, shigellosis in children should not be taken lightly: the consequences can develop quite serious. Intoxication of the whole organism can even lead to death, especially in small and weakened children.

The recovery process in the intestine, depending on the degree of damage to the mucous membrane, can last several weeks. With a sluggish recovery (in a weakened child's body), the disease can take a chronic course. And the chronic form of the disease leads to hypovitaminosis, malnutrition, the addition of a secondary infection.

Symptoms of shigellosis

The incubation, or latent period for dysentery is on average 2-3 days; the minimum can be several hours, and the maximum - 7 days. The duration of the incubation period depends on the infectious dose of the pathogen: the more microbes have entered the child's body, the faster the manifestations of the disease appear.

Dysentery can occur in a typical and atypical (erased) form, have a smooth and non-smooth (with complications) course. The disease can have a different duration: up to two months in the acute form, up to three months in the protracted form, and longer than three months in the chronic form.

Clinical manifestations of dysentery depend on the type of pathogen, the massiveness of infection, the age of the child, the severity of the course of the disease, the state of the immune system, and the presence of concomitant diseases. Shigellosis can occur in mild, moderate, severe and toxic forms.

Dysentery caused by Sonne's stick is more often characterized in children by a mild, erased course without necrotic changes in the intestinal mucosa. With Flexner's dysentery, the intestines are affected to a greater extent, and the disease is more severe.

The onset of dysentery is acute. The temperature rises to high numbers and lasts for three days. From the very first day of illness, signs of intoxication appear: lack of appetite, vomiting (maybe repeated), lethargy of the child, headache. The child complains of cramping pain in the left iliac region, decreasing after defecation.

The child's stool is frequent, usually more than 5 times (up to 25-30 times in severe cases) per day. At first, the stool is plentiful, then (on the first day or on the second) it becomes scarce, an admixture of mucus and greenery appears, streaks of blood may be noted. In moderate to severe infections, the stool in the following days is a meager spit of green mucus. False painful urges "to the bottom" are also characteristic.

Frequent straining in young children leads to gaping of the anus, and less often even to prolapse of the rectal mucosa. The abdomen is painful when felt along the course of the large intestine, rumbling in the abdomen is noted.

The severity of the disease depends on the severity of the manifestations of intoxication and the degree of changes in the intestinal mucosa.

At mild form the general condition of a sick child practically does not suffer, or is slightly disturbed for a short period of time. Body temperature is usually normal or slightly elevated. The chair is speeded up (up to 8 times a day), has a fecal character with an admixture of a small amount of mucus. There is usually no admixture of blood.

At moderate form intoxication is moderately pronounced: the temperature rises to 39 ° C for 2-3 days, the general well-being of the child worsens, vomiting is noted, abdominal pains intensify cramping. Painful urge to "down" and frequent stools (10 or more times a day) are noted for several days, there is mucus streaked with blood in the stool. Normalization of the stool occurs after 7 (or even 10 days), and an admixture of mucus can also be in the shaped stool.

At severe form Shigellosis is dominated by intestinal symptoms, although intoxication is also expressed in the child. Stool with pathological impurities, speeded up (over 15 times per day). The high temperature during treatment decreases, but is kept within 37.5°C for a long time. Decreased appetite, weakness are also present for a long time.

Recovery and restoration of the intestinal mucosa occurs slowly. With intensive therapy, stool normalization occurs within a week, manifestations of intoxication disappear faster - the disease acquires an abortive course.

At toxic form the main symptom is the manifestation of intoxication in the form of neurotoxicosis. Repeated vomiting, a sharp rise in temperature, a violation of the general condition of the child in the first hours of the disease are sometimes interpreted as food poisoning, because the change in stool characteristic of dysentery may appear later, after a few hours.

The stool quickly changes from copious to scanty, very frequent, with mucus in large quantities and streaked with blood. The abdomen is painful, somewhat sunken, a spasmodic sigmoid colon is palpable.

Severe toxicosis with hypertoxic form can lead to convulsions and loss of consciousness. Disturbances from the cardiovascular system are characteristic: the skin is pale, with a bluish tint, the limbs are cold, blood pressure drops sharply. In some cases, death occurs even before the manifestations of the intestine.

The duration of the disease and its outcome depend not only on the severity of the process, but also on the age of the child, on the correctness and timeliness of treatment, which is why it is so important to contact a sick child for medical help as soon as possible.

Chronic dysentery develops more frequently in children than in adults. It can occur with any form of the disease. Concomitant diseases can contribute to the chronization of the process. A common cause of the chronic course of shigellosis is the re-infection of a child with a dysentery bacillus.

Chronic dysentery can occur with mild intoxication. Lethargy, fatigue are noted, appetite worsens, but the state of health is satisfactory, the temperature is normal. Often disturbed by pain in the lower abdomen, there is a liquefied stool, sometimes with mucus. Rarely, streaks of blood may appear in the stool. Relaxation of the stool is associated with incomplete restoration of the intestinal mucosa.

In addition to the intestines, other digestive organs are usually involved in the process, their enzymatic deficiency develops. Prolonged indigestion leads to the development of malnutrition, anemia, hypovitaminosis.

The above symptoms can be observed continuously: this is called the continuous course of dysentery. In other cases, chronic dysentery takes a relapsing course, when exacerbations and periods of well-being alternate.

Features of the course of dysentery at an early age

In the first year of a child's life, risk factors for the occurrence of dysentery are diathesis, artificial feeding, rickets, and anemia in a baby.

At an early age, the disease has a number of features:

• colitis syndrome develops gradually and can be combined with signs of dyspepsia: the stool retains a fecal character, fetid, plentiful, green, with mucus and undigested lumps; in very rare cases, streaks of blood appear;
• the stomach is not drawn in, but swollen;
• restlessness and crying during bowel movements, gaping anus;
• toxic forms are rare;
• primary infectious toxicosis is poorly expressed, but secondary toxicosis is manifested, caused by a violation of metabolic processes; it develops at a later date and is characterized by disturbances in water and mineral metabolism and the activity of the cardiovascular system;
• more often a secondary bacterial infection develops (, otitis media);
• there is a tendency to chronicity of the process and the undulating course of the disease.

In infants, secondary toxicosis may be associated with the development of a mixed infection, that is, a combination of dysentery with a staphylococcal infection or. In such cases, severe toxicosis develops with a pronounced rise in temperature and a significant decrease in body weight.

Repeatedly repeated vomiting and watery, rather plentiful, stools quickly lead the child's body to dehydration. Severe disorders of protein metabolism are also added to water-mineral disorders. Severe bloating develops (), increased heart rate, may occur, possibly depression of consciousness and.

The undulating course of the disease is most often associated with late treatment. In severe cases, it may develop and.

Complications of bacillary dysentery

As a result of prolonged diarrhea, many children develop intestinal dysbacteriosis.

With an uneven course of dysentery, exacerbations of chronic diseases in children, complications of dysentery itself, and concomitant diseases develop. Complications depend on the degree of damage to the intestinal wall.

With a deep lesion, it may occur:

• intestinal bleeding;
• with the development of peritonitis;
• inflammation of the peritoneum of the colon;
• prolapse of the rectal mucosa;
• cicatricial narrowing of the intestinal lumen;
• development .

Complications in dysentery are also described, the mechanism of development of which in shigellosis is not well understood:

• iritis (inflammation of the iris of the eye);
• iridocyclitis (inflammation of the ciliary body of the eye and iris);
• neuritis (inflammation of the nerves);
• (inflammation of the substance of the brain).

The uneven course of dysentery may also consist in the occurrence of exacerbations of the disease, which can occur at different periods of the disease. An exacerbation is characterized by a deterioration in the condition and the resumption of symptoms after a previous improvement.

A relapse of shigellosis, that is, the appearance of acute symptoms of the disease after recovery, may also develop. The cause of relapse may be the addition of a secondary infection or re-infection. At an early age of a child, otitis, pneumonia and other diseases are a frequent complication as a result of the addition or layering of a secondary infection.

Diagnosis of bacillary dysentery

The diagnosis takes into account the epidemic situation, clinical manifestations and laboratory examination. The main diagnostic signs of dysentery are the frequency and nature of the stool (scanty, green, with an admixture of mucus and streaks of blood), the presence of painful false urges "to the bottom", as well as the acute onset of the disease and intoxication syndrome.

Of the laboratory methods used:

• coprogram, or clinical analysis of feces - examination of feces under a microscope; determines the number of leukocytes, erythrocytes in feces, neutral fats, muscle fibers, fatty acids and bacteria; the method allows to indirectly assess the degree of damage to the intestinal mucosa;
• accurate confirmation of the diagnosis allows you to get a bacteriological method, sowing feces and vomit: isolating the causative agent of the disease and determining its sensitivity to antibiotics;
• serological tests of the studied blood (RNHA, ELISA) make it possible to detect specific antibodies to Shigella in the blood and an increase in their titer in the studied paired sera;
• in doubtful cases, it is possible to use the PCR method to identify the causative agent of the disease;
• sigmoidoscopy: an endoscopic method for examining the rectum and sigmoid colon using a rectoscope inserted through the anus. Allows you to visually identify and assess the condition of the intestinal mucosa. In children with dysentery, it is used extremely rarely.

In the general blood test, there are no changes in the mild form of shigellosis, and in severe forms, an increase in the number of leukocytes is noted. ESR may be normal or slightly elevated.

Treatment of dysentery (shigellosis) in children

Depending on the severity, clinical form of the disease and the age of the child, dysentery is treated on an outpatient basis (at home) or in a hospital.

Outpatient treatment is permissible in case of a mild, erased course of the disease in a child older than a year and under certain epidemiological conditions: the absence of other children of preschool age (attending kindergarten) and adult family members working in catering units, in children's institutions and the water supply system in the family.

Treatment of a child with dysentery should be carried out comprehensively and include:

• mode;
• drug treatment (antibacterial and symptomatic);
• diet food.

In the acute stage of the disease, the child is prescribed bed rest .

Antibacterial treatment used for moderate and severe forms of the disease. For this purpose, antibiotics can be prescribed in accordance with the sensitivity of the isolated bacteria (Gentamicin, Polymyxin M, Ampicillin). But more often nitrofurans (Furazolidone, Nifuroxazide) are used in an age dosage. The use of a specific dysenteric polyvalent bacteriophage is also shown.

With severe intoxication and with symptoms of dehydration in a child, oral (drinking) and parenteral (intravenous solutions) therapy is used. With a mild degree of dehydration, it is enough to give the child plenty of glucose-salt solutions: Glucosolan, Regidron, Oralit, etc. 1 sachet of such a drug should be dissolved in 1 liter of warm boiled water.

You can give your child a decoction of raisins, decoction of chamomile, apple decoction, rice decoction. To prepare rice broth, take rice (1 tsp per 1.5 l of water), boil rice until cooked, filter. You need to drink a child in small portions every 5-10 minutes.

The amount of fluid needed will be calculated by the doctor. It is not recommended to give the child water with disinfectant solutions (for example, calcium permanganate solution): it will not have a detrimental effect on microbes, but may have an additional toxic effect on the child. With significant dehydration, intravenous administration of Ringer's solution, Rheosorbilact and others is used.

With severe pain syndrome, antispasmodics are used (Papaverine, No-shpa). With the manifestation of enzymatic deficiency, Creon, Festal, Pancreatin are used. In order to restore intestinal biocenosis, the use of probiotics (Bifidumbacterin, Lactobacterin, Bifiform and others), prebiotics (Laktofiltrum), vitamin complexes is recommended.

Diet selected according to the age of the small patient. The starvation diet is currently not recommended. After the cessation of vomiting, begin to feed the child. In the first 3 days, children should be fed in small portions (reduced by a third or half), but often. With artificial feeding of the baby, sour-milk mixtures are recommended.

After a year, children are given cereals (oatmeal, rice, semolina), vegetable mucous soups and mashed potatoes, kissels, minced meat or steamed products. You can give your child and applesauce: pectin helps, facilitates bowel movements. In agreement with the attending physician, from the second week of the disease, the diet is gradually expanding. But the child's diet should not include spicy, fried, fatty foods for 2-3 months (depending on the severity of the disease).

Chronic dysentery is treated in the same way as an acute process. The child is considered completely cured after the normalization of the condition and the disappearance of the clinical symptoms of the disease and upon receipt of a negative result of bacteriological culture of feces. This sowing is carried out no earlier than three days after the end of the course of antibiotic therapy. After the discharge of children, an infectious disease specialist observes for a month.

Forecast

With timely and proper treatment of a sick child, dysentery is curable. Recovery of children occurs in the absence of complications (usually three or four weeks from the onset of the disease). But complete recovery of the mucosa lasts up to 3 months or longer.

Violation of the diet threatens to exacerbate. The severe course of the disease, the occurrence of dysentery at an early age of the child and a pronounced toxic syndrome are factors that predispose to a high likelihood of complications.

Prevention of shigellosis

A child with dysentery can be prevented. The main rule for the prevention of "dirty hands disease" is the strict observance of hygiene and sanitary standards.

From early childhood, it is necessary to teach the child to wash his hands (always with soap) before eating, after returning from a walk, after the toilet. A child accustomed to such rules will never eat unwashed vegetables and fruits.

But to instill these rules, to develop these good habits should be by example. The child will not comply with them if he sees that his parents or grandparents do not adhere to them.

Equally important in the prevention of intestinal infections is strict control over the timing of the sale and proper storage of products. It is necessary to explain to the child what is the danger of swallowing water from a reservoir when swimming or diving in it.

Cause of amoebiasis

The cause of the disease is the ingestion of one of the varieties of amoebas into the child's digestive tract. In this case, the histolytic amoeba poses the greatest danger.

It exists in 3 forms:

• an active vegetative form that can exist in two forms: a large vegetative form (BVF) and a small vegetative form (IMF). BVF resides in the thickness of the intestinal wall and consumes red blood cells; when BVF enters the intestinal lumen, it undergoes degenerative changes and turns into IMF, which is found more often in the feces of a sick child.
• inactive form - cysts: the amoeba turns into this form under any adverse conditions; amoebiasis is spread by cysts.

BVF, or tissue form, is present only in the patient. IMF and cysts are found in amoeba carriers. The source of amoebic infection is a person with amoebiasis and a practically healthy carrier of amoebas. The disease is spread by food and water.

More significant is the waterway, in the absence of proper sanitary supervision of water supply. The cause of infection can be a salad of vegetables washed with water from a reservoir. Infection occurs by swallowing contaminated water while bathing.

Flies are also carriers of infection.

If the vegetative form of amoebae gets into the food, then the disease does not develop, because the amoebae die under the action of hydrochloric acid contained in gastric juice. Amoebiasis develops when the product is infected with amoeba cysts.

Amoeba cysts in the intestine turn into a luminal form (IMF). The disease will develop when the luminal form turns into a tissue one. It multiplies in the thickness of the intestinal wall, forms small abscesses (abscesses), which open up and as a result ulcers appear. When these deep ulcers heal, scars form, sometimes causing narrowing of the intestinal lumen.

With blood, amoeba penetrate into the liver or other organs (brain, lungs) and cause the formation of the same abscesses in these organs.

Amoebiasis symptoms

The incubation period is quite long: it lasts from 7 days to 3 months. The onset of the disease is acute. The child may be disturbed by a headache and severe pain in the left side of the abdomen. The temperature is normal. An increase in temperature can be observed with a mixed infection (amebiasis and bacterial infection).

One of the first characteristic signs of amoebiasis is the appearance of bloody diarrhea and painful painful urge to defecate. The stool is liquid or mushy, very frequent, with mucus and blood in large quantities. The mucus has a glassy or jelly-like appearance. Blood is mixed with mucus and as a result this stool resembles "raspberry jelly".

The child's appetite is significantly reduced, the children quickly lose weight, have an emaciated appearance. The skin becomes dry, wrinkled, the stomach is sunken. With a deep lesion of the intestinal wall, intestinal bleeding can occur, sometimes very strong, even leading the child to death.

The acute period of amoebiasis can last up to 1.5 months and then turn into a chronic form. Amoebiasis is characterized by a tendency to chronicize the process. In this case, the alternation of periods of exacerbation with periods of well-being continues for a number of years. Diarrhea alternates with, periodically there is a release of blood with feces. The child's body is depleted, marked hypotrophy is noted, anemia develops.

Complications of amoebic dysentery

In addition to intestinal bleeding, anemia and malnutrition, amoebiasis can lead to such complications:

It is difficult to make a diagnosis only on the basis of clinical manifestations, since bloody diarrhea can also occur with other intestinal diseases. The information that the child was in hot regions or countries with a tropical climate facilitates diagnosis.

For the purpose of diagnosis, sigmoidoscopy is performed (endoscopic examination of the intestinal mucosa using a rectoscope apparatus). With amebiasis, deep ulcers are found with undermined edges and a purulent coating of the bottom. Ulcers, up to 1 cm in diameter, are surrounded by a halo of reddened mucosa.

Abscesses are diagnosed using additional methods: liver - with ultrasound; lungs - during x-ray examination; of the brain during CT or MRI.

Amoebiasis treatment

Children with suspected amebiasis are hospitalized in the infectious diseases department, where an examination is carried out to clarify the diagnosis.

When amoebic abscesses form, treatment is carried out for a longer time until the abscess resolves. In the case of a large liver abscess, surgical treatment is used.

Symptomatic therapy is also carried out: intravenous administration of solutions for water and electrolyte disorders; iron preparations and blood substitutes for anemia. It is equally important to provide a sick child with good nutrition containing a sufficient amount of protein and vitamins. The amount of carbohydrates is recommended to be limited.

Recovered children are under the supervision of an infectious disease specialist for 1 year with the passage of a quarterly control examination. Metronidazole, Furamid, Tetracycline, Delagil are used to treat amoeba carriers.

Prevention of amoebiasis

A reliable method of preventing amoeba infection is to follow the rules of hygiene and sanitation.

It is possible to secure drinking water by boiling, using filters. Keep water in closed containers. The fight against flies, the protection of food products from them is important for the prevention of the disease. When swimming in water bodies, avoid swallowing water. In endemic regions, boiled water should also be used when brushing teeth, washing dishes, and making ice cubes.

Summary for parents

To protect yourself from dysentery, you should follow the rules of personal hygiene, thoroughly wash vegetables and fruits before use, and use only high-quality water for drinking.

Dysentery for children is a dangerous disease. This danger is the higher, the younger the child's age. If your baby has intestinal dysfunction, and even more so bloody diarrhea, you should immediately consult a doctor, as dehydration can develop very quickly.

Dysentery (shigellosis) is especially dangerous for children under 1-7 years old, less often it develops in infancy. It usually affects artificers and immunocompromised children. It belongs to the intestinal group of pathologies, more often occurs in the warm period due to the active reproduction of microbes and a decrease in vigilance regarding the hygiene of children (unwashed fruits, dirty hands, flies).

There are four types of Shigella that cause dysentery, they have slightly different properties and degrees of danger. Shigella Grigorieva is not very common, but it is especially severe, with severe toxicosis and damage to the colon, convulsions, diarrhea and impaired consciousness. With dysentery in children - Shigella Flexner, diarrhea and severe course are strongly pronounced, the intestinal walls are affected by ulcers, it lasts longer than all the others and is most common. Shigella Boyda has a mild form and mild syndromes, the most favorable of all. The Sonne variety can survive for a long time in the external environment, it also manifests itself with damage to the small intestine and stomach.

The source of infection is only a patient who releases microbes with feces into the external environment. Infected through dirty hands, food and drink. It is transmitted with water, food contaminated with fecal effluents, as well as through household contact, through hygiene items and utensils.

In children, it is especially common due to inadequate hygiene skills, licking dirty hands, drinking raw water, eating unwashed fruits. Contributes to the active development of infection imperfection of immunity, violation of the microbial flora of the intestine, bad habits (sucking a finger, biting nails).

The causative agents of Shigella in dysentery in children enter the intestines through the mouth, where they actively multiply and give typical manifestations.

Symptoms

The incubation period for dysentery in children lasts from a day to a week, usually 2-3 days. The first symptoms appear sharply, depending on the degree of aggressiveness of the microbe and the body's resistance, the age of the children. The easiest course will be with Shigella Sonne, the heaviest and longest - Flexner.

Up to a year, the signs begin abruptly, with severe anxiety and crying, pulling the legs to the stomach, bloating, increased heart rate and breathing, frequent green stools with mucus and lumps, frequent vomiting with a fountain, severe dehydration with weight loss, dry mucous membranes and metabolic disorders.

In older children, dysentery gives fever up to 38-39 degrees, severe weakness with malaise, fatigue with headaches and pallor, abdominal pain, lack of appetite, nausea with vomiting, diarrhea with blood, greens and mucus, convulsions. Diarrhea is so frequent that it quickly leads to signs of dehydration. Pain in the abdomen is not sharp, dull and pressing, with the urge to defecate.

Diagnosis of dysentery in a child

The basis of diagnosis is clinical manifestations, data on contact with patients, as well as inoculation of feces on the intestinal group with the identification of shigella of one kind or another.

Complications

The main complications are dehydration, convulsions, the development of toxic shock (these are signs of acute dysentery in children). Fatal outcomes are extremely rare, only in the case of advanced or complicated cases, and perforation of the intestine with ulcerative lesions, severe toxicosis and convulsions.

Treatment

What can you do

Isolation of the child from all other family members, a message to the kindergarten or school about the disease, compliance with the daily routine and good hygiene. At the time of illness, bed rest and a special diet, oral rehydration are indicated. It is necessary to regularly give the child glucose-salt solutions, dried fruit compotes, rice water, raisin water, tea with lemon and sugar. You can give a decoction of chamomile, a decoction of apples, drink every 5-10 minutes in a sip or a tablespoon of liquid.

What does a doctor do

With severe dehydration, hospitalization and intravenous fluids are indicated. With abdominal pain and spasms, antispasmodics are indicated, probiotics and sorbents are used to normalize the flora. In children under 2-3 years of age and in severe forms of dysentery in children, antibiotics and intestinal antiseptics may be prescribed, but their appointment should be based on the sensitivity of pathogens to drugs. As fluid losses are restored, they switch to soldering the child and expanding the diet. In the first days of dysentery in children, a strict diet is shown: only liquid and non-irritating food, tea with crackers, vegetable broths, liquid cereals in water, breast milk or special mixtures for young children. As the condition improves, porridge and vegetable soups, vegetable purees, steam dishes and a gradual return to the usual diet. For a couple of months, the rejection of fatty, spicy and fried foods, fast food and sweets.

It is important to monitor the child's drinking, he should drink more than usual in order to make up for the loss of fluid in the stool. For each bowel movement and vomiting, at least 100 ml of liquid should be added to the drink. Remedies for diarrhea in dysentery are not applicable, toxins and pathogens come out with feces, which means that the body will soon get rid of the infection. To fix the stool, rice water and the use of enterosorbents are shown. Also do not use painkillers and anti-inflammatory drugs. They can, in the presence of a pathogen, mask the symptoms of the disease. If the family can provide proper care for the child, hospitalization is not required for dysentery in children - the doctor gives clinical recommendations, and they should be followed.

Prevention

The basis of preventive measures is eating only wholesome and high-quality products, drinking boiled or bottled water, washing hands before eating and after using the toilet, a ban on bad habits, only personal hygiene products, thorough washing of dishes, checking the quality of products, fighting flies.

In the article you will read everything about the methods of treating a disease such as dysentery in children. Specify what effective first aid should be. How to treat: choose drugs or folk methods?

You will also learn how untimely treatment of dysentery in children can be dangerous, and why it is so important to avoid the consequences. All about how to prevent dysentery in children and prevent complications.

And caring parents will find full information about the symptoms of dysentery in children on the pages of the service. How do the signs of the disease in children at 1.2 and 3 years old differ from the manifestations of the disease in children at 4, 5, 6 and 7 years old? What is the best way to treat dysentery in children?

Take care of the health of your loved ones and be in good shape!

- This is a systemic infectious disease in which inflammatory processes are localized in the large intestine, mainly in the lower section - the sigmoid colon. The vast majority of it affects children of preschool age. In order not to confuse the disease with other intestinal disorders, you need to know what symptoms accompany dysentery in children, and how it is treated.

Dysentery is an intestinal infection caused by gram-negative bacteria of the genus Shigella. The most common 4 types of Shigella:

• Sonne;
• Flexner;
• Grigorieva-Shiga;
• Boyd.

All these types of bacteria cause the development of bacillary dysentery. However, there is another type of disease - or amoebiasis. Its causative agents are amoeba - the simplest microorganisms that affect the large intestine.

The names of bacteria are named after the scientists who managed to describe them. These types of bacteria are common in certain regions. Sonne and Flexner bacteria are more likely to affect residents of European countries. And the inhabitants of the Far East and Central Asia are susceptible to dysentery, which develops under the influence of Shigella Grigorieva-Shiga and Boyd. Amebiasis occurs with equal frequency in all regions and continents.

Dysentery is called "dirty hands disease". This factor explains its prevalence among children. Shigella are very hardy. Once in the water, they are able to maintain vital activity for a week. In the soil, pathogens of dysentery can live safely for 3 months. If the bacteria get on food, they survive for 3 weeks.

Pathogenic microorganisms calmly tolerate exposure to low temperatures. They are preserved on dried fruits. Their death can cause only half an hour of heating at a temperature of 60 ° C or direct exposure to ultraviolet radiation. And in the process of boiling and processing with disinfectants, pathogenic agents die instantly.

Who is the source of infection

Dysentery is transmitted by the oral-fecal route. Shigella only infects humans. Therefore, only a person, namely his feces, can act as a source of infection. Flies that have been in contact with infected feces can become carriers of the disease. Many apparently healthy people can act as carriers of an intestinal infection.

A child can become infected with dysentery in the following ways:

• drinking contaminated water;
• eating dirty vegetables or fruits;
• eating vegetables or fruits washed with contaminated water;
• putting a toy or other object in your mouth that contains bacteria.

Sooner or later, infectious diseases occur in every child. However, all children tolerate them differently. What is it connected with? Immunity plays a decisive role in the development of an infectious disease. Children with strong immunity rarely get sick, and they endure any illness in a mild form. That is why the peak incidence of dysentery occurs in the first three years of a child's life, when the formation of the immune system takes place. The following factors increase the likelihood of infection:

• artificial feeding;
• low weight of the child;
• deficiency of vitamins and nutrients from food;
• chronic forms of diseases of the digestive tract;
• non-compliance with sanitary standards in the room where the child is located.

Epidemics of dysentery occur in the summer-autumn period. The warm season promotes the active reproduction of bacteria.

The duration of the incubation period and signs of dysentery

Dysentery in children can occur in two forms:

• acute;
• chronic.

The body of each child is individual. In some children, the disease can occur with pronounced symptoms, while in others - in an erased form. Therefore, it is important to carefully monitor the condition of the child and respond to his complaints. Thus, it will be possible to recognize the disease in time and prevent its transition into a chronic form. After the bacteria enters the body, the child becomes a carrier of shigella. Outwardly, it may look completely healthy, since the bacteria are pre-incubated, and the disease does not manifest itself in any way.

The duration of the incubation period varies from several hours to 7 days. But in most cases it does not exceed 2-3 days. Further, the child's body temperature rises sharply, which is easily reduced after taking antipyretic drugs, and then rises again. It stays on for about two days. During this period, signs of intoxication appear. These include:

• headache;
• lethargy, general weakness;
• spasmodic pain in the stomach;
• nausea accompanied by vomiting;
• frequent stools, mostly liquid.

Signs of bacterial dysentery

The child experiences severe pain in the stomach, which becomes less intense after a bowel movement. If the disease is mild, the number of defecation acts does not exceed 5 times a day. In more severe conditions, their frequency rises to several tens.

On the first day in the process of defecation, a significant amount of feces comes out. In the future, their volume is significantly reduced. At the same time, various inclusions in the form of greenery, mucus and streaks of blood may be contained in the feces. This occurs as a result of the development of the inflammatory process in the intestinal mucosa. The number of false urges to defecate increases, which is explained by spasm of the sigmoid colon.

When the child's stomach is hot and growls strongly, and touching causes pain. The severity of the symptoms of the disease depends on the severity of the condition:

• with mild shigellosis, the baby's condition practically does not change, and the number of defecation acts does not exceed 8 times a day;
• with an average form, the symptoms are moderate, manifested in a slight increase in body temperature and an increase in bowel movements up to 10 times a day;
• a severe form is accompanied by a significant increase in temperature, severe intoxication and the number of bowel movements more than 15 times a day.

In rare cases, a child develops a toxic form of dysentery, accompanied by convulsions and loss of consciousness. Paleness of the skin helps to recognize it. The baby's nasolabial triangle takes on a bluish tint, which indicates oxygen deficiency. The extremities become cold, indicating poor circulation. The chronic form of the disease occurs with moderately severe symptoms and alternating periods of remission with periods of exacerbations.

Signs of amoebiasis

The incubation period for amoebiasis is much longer. Depending on the degree of infection, it can last from 7 days to 3 months. Amoebiasis has an acute onset. The child is worried about severe pain in the stomach and general malaise. An increase in temperature is observed only if the amoebic form of dysentery is combined with a bacterial one.

Amoebic dysentery can be distinguished by the following manifestations:

• severe pain during the act of defecation, causing crying in a child;
• blood impurities in the feces;
• frequent bowel movements, the number of which exceeds 10 times a day;
• a large amount of mucus in the feces;
• sudden weight loss.

This symptomatology can persist for 1-1.5 months. In the absence of adequate treatment, the disease takes a chronic form.

What steps should be taken if dysentery is suspected?

If the child has symptoms characteristic of amoebic or bacterial dysentery, you should immediately call an ambulance. The child should be examined by an infectious disease specialist. Depending on the severity of the course of shigellosis, treatment can be carried out both in inpatient and outpatient settings. A preliminary diagnosis is made on the basis of complaints and the presence of characteristic symptoms of the disease. To make an accurate diagnosis, the following types of studies are prescribed.

• bacterial culture of feces and vomit;
• laboratory blood tests, including ELISA;
• sigmoidoscopy.

If there is any doubt, a special blood test is prescribed to determine the presence of an antibody titer to the causative agent of dysentery. Only after that the child is selected treatment.

Methods for the treatment of dysentery in children

Children under the age of one year must be placed in a hospital. At an older age, treatment can be carried out at home. Inpatient treatment is indicated in case of diagnosing a severe form of dysentery. Dysentery in children is treated comprehensively. The list of therapeutic measures includes:

• compliance with the daily routine;
• taking antibacterial drugs and medicines that eliminate the symptoms of the disease;
• diet compliance.

In the acute period of the disease, the child must comply with bed rest. Treatment of dysentery is carried out by prescribing the following groups of drugs:

Prolonged vomiting causes dehydration and leads to electrolyte imbalance. This can be avoided if the child is fed with glucose-salt solutions. These include:

These drugs are available in powder form. One sachet is intended for dilution in 1 liter of water. In addition, chamomile infusion, apple and rice decoctions contribute to the restoration of the body. After completing the full course of treatment, it will be possible to avoid the recurrence of shigellosis.

If a child is diagnosed with amoebiasis, he is placed in a hospital. Treatment is with antiprotozoal agents. These include:

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The duration of the course of treatment is 7 days. After that, the same break is made. Then the course of treatment is repeated.

The principle of diet

Previously, the main treatment for dysentery was fasting. Subsequently, this method was considered inappropriate. Moreover, experts have found that fasting contributes to the weakening of the child's body. Modern medicine recommends that you start feeding your baby immediately after vomiting stops. However, you do not need to force the child to eat. He is fed if he asks or does not resist. You need to start eating with smaller portions.

The required amount of food is achieved by increasing the number of meals. If the child is bottle-fed, it is recommended to replace the milk formula with fermented milk. Children older than one year are fed mainly with cereals:

• rice;
• manna;
• oat.

Even after the disappearance of signs of damage to the gastrointestinal tract, it is recommended to follow the diet for at least 3 months. It is possible to expand the list of allowed dishes only in agreement with the pediatrician.

How to prevent the development of the disease

Treatment of any intestinal infections is very long. However, it is not always possible to avoid the development of complications. Dysentery is hard to cure, but Shigella infection is not that hard to prevent. The basic rules of prevention are the observance of elementary hygiene. Vegetables, fruits and berries before use should be poured with boiling water or thoroughly washed with boiled water. It is important to keep an eye on the expiration date of all foods you eat. Compliance with these rules will help prevent the recurrence of shigellosis after treatment. In case of any violations of the digestive function, you should immediately consult a doctor.