Patients with secretory diarrheal syndrome is a common and at the same time difficult problem in the practice of a gastroenterologist. It is not always possible to correctly determine the cause of the disease, respectively, in a timely and competent way to choose a course of treatment. The term "diarrhea" refers to frequent bowel movements with the release of liquid feces. Secretory diarrhea differs from other types in that there is an increased secretion of water and electrolytes with a painless discharge of intestinal contents.
Symptomatics
The main symptoms of secretory diarrhea include:
- increase in body temperature to 37-37.8 degrees;
- there is a slight intoxication of the body;
- spastic pain is minimal;
- no false urge to defecate; electrolyte imbalance is disturbed (detected in the course of laboratory tests);
- there is an admixture of greenery in the feces, watery stools withoutsmell.
Pathogenesis
The pathological process accumulates in the small intestine. Due to the activation of enterocyte adenylate cyclase by enterotoxins, an increase in intracellular cyclic adenosine monophosphate occurs. As a result of this process, the transport of sodium and calcium ions is disrupted, followed by their accumulation in the intestinal lumen, after which water accumulates, and, consequently, the appearance of abundant loose stools. The pathogenesis of secretory diarrhea is similar to the pathological process of salmonellosis and cholera.
Diagnosis
Initially, doctors determine the type of diarrhea by asking the patient about bowel frequency and stool consistency. This information allows you to determine the level and etiology of the lesion. The second step in diagnosis is the history taking. The results of the analyzes will allow to determine concomitant diseases, the patient's dietary habits, the presence of intolerance to dairy products, the use of medications, as well as the operations performed on the gastrointestinal tract.
Laboratory studies of secretory diarrhea in children and adults begin with the determination of the number of leukocytes and erythrocytes in the feces. Bacteriological studies of feces and sigmoidoscopy are also carried out, thanks to which it is possible to establish a connection between the disease and parasitic invasion, non-specific inflammation of the intestine and various infections.
Consequences of the disease
Due to the secretory type of diarrhea, dehydration occurs due toviolations of homeostatic regulation of water volume. Also, electrolyte metabolism fails, acidosis, hypokalemia and hyponatremia develop (rapid loss of potassium and sodium by the body). Diarrhea is characterized by mild malabsorption (malabsorption in the small intestine) and dilution of digestive enzymes.
Causes of disease
Secretory diarrhea occurs due to an increase in the amount of bacterial toxins, bile acids, pathogenic viruses, prostaglandins and other biologically active substances. Depending on the nature of the appearance, the causes of the disease are divided into two types:
- Infectious.
- Non-infectious.
Non-infectious secretory diarrhea can be caused by:
- Hereditary predisposition to increase the level of sodium secretion. This phenomenon occurs due to the fact that a gene mutation occurs, which is directly responsible for creating the brush border of enterocytes. Quite often, this can be observed in women during multiple pregnancies.
- Tumours that contribute to the production of hormones that upset the balance of secretion.
- Taking strong laxatives.
- Increased levels of arsenic s alts, toxins and fungi in the body.
- Pancreatic cholera, which promotes the growth of tumors of the pancreas and intestinal mucosa of a malignant type. This pathology causes high hypochlorhydria, which slows down the production of hydrochloric acid in the organs of the gastrointestinal tract.intestinal tract.
- Modular thyroid carcinoma, due to which there is a violation of the secretion of water and s alts by enterocides.
- Chloride diarrhea of hereditary type.
- Carcinoid syndrome that affects the tissues of the bronchi and intestines. This pathology appears due to the release of large amounts of serotonin and bradykinin.
Infectious sectoral diarrhea occurs as a consequence of cholera. In this case, the daily volume of feces increases to 10 liters during defecation. This leads to fluid-electrolyte imbalance.
Treatment of secretory diarrhea
To alleviate the patient's condition, doctors use:
- enzyme therapy, that is, poly- and monoenzymes are prescribed in cases of symptoms of secondary fermentopathy;
- phage therapy - the use of bacteriophages with the constant release of UPM from feces;
- probiotic therapy - the use of probiotic preparations for violations of microbiocenosis;
- phytotherapy as an auxiliary treatment option (prescribe decoctions of St.
- vitamin therapy - taking a vitamin-mineral complex.
Treatment of secretory diarrhea after surgery involves bed rest for the entire period of rehabilitation, followed by a transition to half-bed. To restore the water and electrolyte balance, rehydration is carried out using saline solutions for oral administration. In severe diarrhea accompanied by persistent vomiting, parenteraldrug administration.
Diet
In addition to medical treatment of secretory diarrhea, you should follow simple dietary rules to speed up the healing process:
- Limit the consumption of spicy and spicy dishes, smoked meats, as well as food from coarse vegetable fiber.
- Milk sugar - lactose - is completely excluded from the daily diet. In this case, patients can use lactose-free formulas.
- Patients should eat cereals cooked with vegetable broths, as well as more vegetable food, such as potatoes, cauliflower or zucchini.
- If necessary, and only after consulting a doctor, biologically active additives (lysozyme, bifidumbacterin) are introduced into the diet.
- The following foods should be completely excluded from the diet: garlic, onions, plums, melons, spinach, sorrel, turnips, radishes, wheat and barley porridge, white cabbage, beets, mushrooms, apricots.
Children pediatricians recommend the use of fermented milk mixtures, for example, acidophilic and propionic acidophilic milk, kefir, etc. With secretory diarrhea in children, it is worth limiting the consumption of spicy, smoked and fried foods, as well as from obligate allergens. Depending on the form of the course of the disease, the frequency of feeding can increase up to 6-10 times a day, depending on age.
Secretory diarrhea in children
Diarrhea is considered a common pediatrica disease that kills up to 1.5 million people every year. With diarrhea in children, liquid and watery stools are observed. Indigestion is accompanied by anorexia, rapid weight loss, vomiting, stomach pain, bleeding, and fever due to fever. The disease manifests itself much more severely than in adults.
Anxiety symptoms in children can be considered:
- bloody stool;
- vomiting bile;
- pallor;
- tachycardia;
- hypodynamia;
- bloating.
Treatment of diarrhea in children is aimed at eliminating the specific signs of the disease. Oral rehydration is mandatory with a solution that contains complex carbohydrates or glucose. Such solutions do not include juices, carbonated and sports energy drinks. You can buy special solutions at a pharmacy without a doctor's prescription. The drug solution is used by children in small quantities up to 5 times a day. Gradually, the volumes of the drink increase depending on tolerance.
Before proceeding with the treatment of the pathological process, you should consult with your doctor. Self-selection of ineffective drug therapy can significantly worsen the state of he alth.
