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

In an adult organism, various disorders and failures may appear in the process of bowel function, one of which is diarrhea. It is also called "diarrhea", and it is a frequent defecation of liquid stools. It occurs both with a small poisoning and with the appearance of a serious, possibly chronic, disease. In the first case, diarrhea will go away on its own almost without 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, and general weakness. If you take the disease lightly and do not start treatment, then diarrhea will lead to dehydration, the appearance of intractable acute and chronic diseases.

In most cases, diarrhea can be cured with a standard, well-known set of manipulations. However, sometimes home methods are not enough, sometimes the situation is worsened by many popular remedies. The answer to the question "what to do if diarrhea does not go away for 4 days?" Definitely, see a doctor immediately.

Why does diarrhea occur?

Diarrhea in adults can appear for the following reasons:

Poisoning with stale food.
Treatment with medications that cause diarrhea.
Individual intolerance to certain foods.
The reaction of the organism to neurosis.
acclimatization of the body.

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

1. Dysentery.

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

3. Salmonellosis.

4. Tuberculosis of the intestine.

5. Enzymatic deficiency.

6. Exacerbation of a chronic disease (colitis, dysbacteriosis).

7. Inflammation of one of the organs of the gastrointestinal tract.

First aid

If an unpleasant disease has become protracted, then it would be best to consult a doctor to diagnose the disease and find out the causes of its occurrence, however, with prolonged diarrhea in an adult, it is quite possible to start treating yourself:

1. You need to drink any sorbent preparation that will help the sick gastrointestinal tract (Smecta, Filtrum-Stee, activated charcoal).

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

3. Taking herbal teas will help replenish the supply of nutrients, vitamins and minerals lost during the disease process. If diarrhea with fever, linden or currant tea, which has an antipyretic and diaphoretic effect, will have a positive effect.

4. Statement of a cleansing enema. The water that comes out during diarrhea washes out not only beneficial trace elements, but also various pathogenic bacteria and toxins. Through diarrhea, the body tries to get rid of toxins. Using an enema cleansing will help flush out any bacteria that didn't come out in the stool. This will prevent the possibility of their reverse absorption into the intestinal wall and the recurrence of the problem. Washing should also be done because it has an additional beneficial effect - lowering elevated body temperature due to the absorption of water.

Enema treatment includes the use of not only pure water, but also decoctions of various 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 the observance of a special diet. The diet with includes the use of a large amount of neutral liquid.

During prolonged diarrhea, you need to follow the rules of nutrition:

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

2. Foods rich in fiber (baked apples, bananas, dried fruits) are required in the diet. From bread, preference is given to white or bran.

3. Porridge from cereals should be made mucous or semi-mucilaginous. Large grains are strictly prohibited, as they can injure already irritated intestinal walls.

4. Low-fat meat and fish are allowed.

In the treatment of diarrhea are prohibited:

Fresh vegetables and fruits.
Seasonings, large amounts of sugar and salt, green tea, coffee.
All types of canned, smoked and dried products.
Any carbonated drinks, all types of dairy products.
Fatty, junk food that interferes with the normalization of the intestines.

Medication treatment for diarrhea

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

With diarrhea of any type, they will definitely be assigned:

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

If 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 studies and analyzes. Adults and children are selected individually. The patient must drink them in a course.

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 is stable at levels above 38 ° during the day, does not go astray with antipyretics.

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

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

5. Not passing pain and cramps in the abdomen.

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

7. Illness affects consciousness.

If you have any of the above symptoms, you should immediately go to the hospital. In this case, large-scale diagnostics and laboratory tests are carried out, on the basis of which treatment will be prescribed.

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

When diarrhea does not stop within a week, the resulting dehydration becomes dangerous for a person. There is a sharp weight loss, during this period it is very important to control the amount of urination. Anxiety is:

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

Against the background of the general condition, the patient develops:

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

Chronic diarrhea can lead to coma and even death. Therefore, in the absence of positive dynamics, you should immediately seek professional help.

Causes

Prolonged diarrhea can be triggered by the following diseases:

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

What to do

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

Diarrhea with nausea

It develops against the background of the following conditions:

poisoning;
dry food;
binge eating;
digestive disorders;
gallbladder dyskinesia.

The first action will be gastric lavage. For this, the patient is seated near the pelvis and allowed to drink 2 liters of warm water in one gulp. If you drink the liquid in small sips, it will be absorbed by the body and there will be no desired effect. You can additionally stimulate the root of the tongue with your finger. It is necessary to ensure that in the vomit, in addition to water, there are food residues. 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 get a mucosal burn. After washing, the patient must take the sorbent. If the condition does not improve, you need to call an ambulance.

Temperature with diarrhea

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

Drink plenty of fluids. Drinks should be unsweetened, warm and non-carbonated. Poisons of medicinal herbs help well - chamomile, St. John's wort, wild rose, mint. Vomiting does not need to be controlled - it brings relief.
At the time of treatment, a diet must be observed. No fatty, fried foods. Pickles, spicy, smoked and sweets are prohibited. A fasting day is recommended.
Follow the chair. Seek medical attention immediately if traces of blood appear.

Diarrhea with blood

Blood traces in the feces can indicate certain pathologies in the body:

Anal fissures, hemorrhoids. There are streaks or fresh blood clots in the stool.
The dark color of the excrement indicates the presence of a stomach ulcer or hidden bleeding of the digestive tract.
Blood can appear with an acute bacterial infection - cholera, salmonellosis, dysentery.

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

Diarrhea with vomiting

This combination is typical for food poisoning. Accompanied by dizziness, abdominal cramps, weakness throughout the body. It develops 2 hours after poor quality food, bacterial infection, toxic poisons enter the body.

Healing steps:

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

You can restore power after 1.5 days. First, the patient is offered crackers with tea, then porridge on the water, low-fat soups, cottage cheese, boiled eggs are introduced into the diet.

severe diarrhea

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

antibiotics ("Tetracycline", "Ampicillin");
nitrofuran drugs ("Furazolin", etc.);
sulfa drugs.

The patient is put on a light diet. Boiled or steam food, spices, fresh bread, fiber, dairy products are excluded. Allowed cereals, eggs, vegetable and cereal soups.

Abdominal pain

Talks about enterocolitis, colic, overeating or gastritis. Fasting is recommended during the day, then the patient is prescribed table number 4. In infectious cases, antibiotics are prescribed. With functional disorders of the gastrointestinal tract, antispasmodics are taken - No-shpu, Drotaverin, etc. Patients with an ulcer can starve 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) - rapid, repeated loose stools. Diarrhea is usually accompanied by pain, rumbling in the abdomen, flatulence, tenesmus. Diarrhea is a symptom of many infectious diseases and inflammatory processes of the intestine, dysbacteriosis, and neurogenic disorders. Therefore, the diagnosis and treatment of the underlying disease plays an important role in the prevention of complications. The loss of a large amount of fluid during profuse diarrhea leads to a violation of the water-salt balance and can cause heart and kidney failure.

Diarrhea (diarrhea)

Diarrhea is called a single or frequent bowel movement with liquid stools. Diarrhea is a symptom that signals a malabsorption of water and electrolytes in the intestine. Normally, the amount of feces excreted per day by an adult varies between 100-300 grams, depending on the characteristics of the diet (the amount of vegetable fiber consumed, poorly digestible substances, liquids). In the case of increased intestinal motility, the stool may become more frequent and thin, but its amount remains within the normal range. When the amount of fluid in the feces increases to 60-90%, then they talk about diarrhea.

There are acute diarrhea (lasting no more than 2-3 weeks) and chronic. In addition, the concept of chronic diarrhea includes a tendency to periodically plentiful stools (more than 300 grams per day). Patients suffering from malabsorption of various nutrients have a tendency to polyfaeces: the excretion of large amounts of stool containing undigested food debris.

Causes of diarrhea

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

A significant factor contributing to the development of diarrhea is a violation of intestinal motility (hypokinetic and hyperkinetic diarrhea) and, as a result, a change in the rate of transit of intestinal contents. Strengthening of motility is facilitated by laxatives, magnesium salts. Motor function disorders (weakening and strengthening of peristalsis) occur with the development of irritable bowel syndrome. In this case, they talk about functional diarrhea.

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

Diarrhea may 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

There are the following types of diarrhea: infectious (with dysentery, salmonellosis, amebiasis, food poisoning and entroviruses), alimentary (associated with disorders in the diet or an allergic reaction to food), dyspeptic (accompanies digestive disorders associated with insufficiency of the secretory functions of the digestive system: liver, pancreas, stomach; as well as with insufficient secretion of enzymes in the small intestine), toxic (with arsenic or mercury poisoning, uremia), drug (caused by drugs, drug dysbacteriosis), neurogenic (with changes in motility due to impaired nervous regulation associated with psycho-emotional experiences).

Clinical Features of Diarrhea

In clinical practice, acute and chronic diarrhea are distinguished.

Acute diarrhea

chronic diarrhea

Diarrhea that lasts more than 3 weeks is considered chronic. It can be the result of various pathologies, the identification of which is the main task for determining treatment tactics. History data, concomitant clinical symptoms and syndromes, and physical examination can provide information about the causes of chronic diarrhea.

Particular attention is paid to the nature of the stool: the frequency of defecation, daily dynamics, volume, consistency, color, the presence of impurities in the feces (blood, mucus, fat). When questioned, the presence or absence of concomitant symptoms is revealed: tenesmus (false urge to defecate), abdominal pain, flatulence, nausea, vomiting.

Pathologies of the small intestine are manifested by abundant watery or fatty stools. For diseases of the large intestine, less abundant stools are characteristic, streaks of pus or blood, mucus may be noted in the feces. 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 increased sensitivity to stretching of the intestinal walls, tenesmus.

Diagnosis of diarrhea

Acute diarrhea, as a rule, is characterized by a very pronounced loss of fluid and electrolytes in the feces. On examination and physical examination of the patient, signs of dehydration are noted: dryness and a decrease in skin turgor, an increase in heart rate and a decrease in blood pressure. With a pronounced calcium deficiency, the symptom of a "muscle roller" becomes positive, there may be convulsions.

With diarrhea, the patient's stool is always carefully examined, in addition, it is desirable to carry out a proctological examination. Identification of an anal fissure, fistula, paraproctitis may suggest the presence of Crohn's disease. With any diarrhea, a comprehensive study of the digestive tract is performed. Instrumental endoscopic techniques (gastroscopy, colonoscopy, irrigoscopy, sigmoidoscopy) allow you to examine the inner walls of the upper gastrointestinal tract and large intestine, detect mucosal damage, inflammation, neoplasms, bleeding ulcers, etc.

Microscopy of feces reveals a high content of leukocytes and epithelial cells in it, which indicates the presence of inflammation of the mucous membrane of the digestive tract. The detected excess of fatty acids is a consequence of malabsorption of fats. Together with the remnants of muscle fibers and a high content of starch in the stool, steatorrhea is a sign of malabsorption syndrome. Fermentation processes due to the development of dysbacteriosis contribute to a change in the normal acid-base balance in the intestine. 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 adenoma of the pancreas). In addition, prolonged secretory diarrhea may be the result of the development of hormone-producing tumors (for example, vipoma). Laboratory blood tests are aimed at identifying signs of an inflammatory process, biochemical markers of liver and pancreas dysfunction, hormonal disorders that can be causes of chronic diarrhea.

Treatment of diarrhea

Diarrhea is a symptom of many diseases, therefore, in the choice of 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, an infectious disease specialist, or a proctologist. It is imperative to seek medical attention if you have diarrhea that lasts more than 4 days, or if you notice streaks of blood or mucus in the stool. In addition, symptoms that should not be ignored are: tarry stools, abdominal pain, fever. If there are signs of diarrhea and there is a possibility of food poisoning, it is also necessary to consult a doctor as soon as possible.

Treatment for diarrhea depends on the type of diarrhea. And it includes the following components: dietary nutrition, antibacterial therapy, pathogenetic treatment (correction of malabsorption in case of enzyme deficiencies, reduction of gastric secretion, drugs that normalize intestinal motility, etc.), treatment of the consequences of prolonged diarrhea (rehydration, restoration of electrolyte balance).

With diarrhea, foods are introduced into the diet that help reduce peristalsis, reduce the secretion of water into the intestinal lumen. In addition, the underlying pathology that caused diarrhea is taken into account. Diet components should correspond to the functional state of digestion. Products that promote the secretion of hydrochloric acid and increase the rate of evacuation of food from the intestines are excluded from the diet for the duration of acute diarrhea.

Antibiotic therapy for diarrhea is prescribed to suppress the pathological flora and restore normal eubiosis in the intestine. With infectious diarrhea, broad-spectrum antibiotics, quinolones, sulfonamides, nitrofurans are prescribed. The drugs of choice for intestinal infections are drugs that do not adversely affect the intestinal microbiocenosis (combined drugs, nifuroxazide). Sometimes, with diarrhea of various origins, eubiotics may be prescribed. However, more often such treatment is prescribed after the signs of diarrhea subside to normalize the intestinal flora (eliminate dysbacteriosis).

As symptomatic agents, adsorbents are used, enveloping and astringent agents that neutralize organic acids. To regulate intestinal motility, loperamide is used, in addition, acting directly on the opiate receptors of the small intestine, reducing the secretory function of enterocytes and improving absorption. A pronounced antidiarrheal effect is exerted by somatostatin, which affects the secretory function.

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

Prevention of diarrhea

Diarrhea prevention includes body hygiene and nutrition. Washing hands before eating, thoroughly washing raw vegetables and fruits, and properly cooking food help avoid food poisoning and intestinal infections. In addition, it is worth remembering the need to avoid drinking raw water, unfamiliar and suspicious food, food products 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. The lack of fluid, vitamins and minerals affects the work of all organs.

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

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

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

To reduce the production of mucus, 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 a course of treatment with hormonal drugs (Metipred, Prednisolone).

Chronic diarrhea can often begin due to the development of diseases of the digestive system. Pathology of the liver and pancreas lead to a deficiency of enzymes that are involved in the process of digestion of food. In this case, in the patient's stool, you can notice pieces of not fully digested meat fibers (the phenomenon of creatorrhea).

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

To reduce the frequency of bowel movements, antidiarrheal drugs are used. Among them are , . However, these drugs should not be taken for intestinal infections.

Treatment for prolonged diarrhea

This complicates the treatment of diarrhea, since some of the pathogens will remain in the body longer. Somatostatin and Octreotide are used to reduce bowel activity. But these are 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. They help with spasms in the intestines (Papaverine,).

After passing the tests in some patients, pathogens of intestinal diseases are detected. To destroy bacteria, the patient is prescribed antibiotics. However, they do not cause any harm to viral infections.