Intestinal infection with damage to the mucous membrane of the distal colon, the causative agents of which are microbes of shigella, is called dysentery, or shigellosis. Bacteria are rod-shaped in shape, their other name is dysentery bacillus. The development of the disease occurs as follows. Initially, microorganisms develop in the small intestine and then penetrate into the epithelial tissues of the large intestine, where they actively multiply, capturing the entire surface of the intestine. As a result, epithelial cells die, and ulcers form in their place. In addition, bacteria secrete a toxic substance, which also leads to cell death and provokes an increased excretion of water and electrolytes by the intestines. The poison has a negative effect on the work of the adrenal glands and the nervous system, causing severe poisoning of the body.
Clinical picture of a typical form of dysentery (colitis variant)
Starts sharpsymptoms of intoxication are manifested by fever, headache, loss of appetite, lowering blood pressure. From the digestive tract, the following clinical symptoms of dysentery are visible:
- Constant dull pain all over the abdomen.
- Then it becomes cramping and more acute. Location - lower abdomen.
- Before a bowel movement, pain intensifies.
- In the area of the rectum there are also pains of the pulling type with recoil to the sacrum. They are formed during a bowel movement and continue for several minutes after it.
- False urges and feeling of incomplete bowel emptying after defecation.
- Stool frequency more than 10 times a day.
- There is blood and mucus in the stool.
Forms of dysentery:
- If mild - fever disappears after a few hours or can last up to two days. Stool up to ten times a day, there may be no impurities of mucus and blood. Abdominal pain is mild, false urges are rare.
- With moderate - all signs are more pronounced. The temperature rises to 39 degrees and lasts up to four days, the pressure decreases. Defecation up to 20 times a day, feces with mucus and blood.
- In severe dysentery, the symptoms are: hyperthermia or hypothermia. The patient is lethargic, weakened. The dermis becomes pale, the heart rate increases. There is severe diarrhea. Feces in the form of bloody mucus.
- With very severe possibledevelopment of toxic shock or toxic encephalopathy.
Clinical picture in gastroenterocolitis variant of dysentery
In this case, symptoms of acute gastritis appear: vomiting, nausea, epigastric pain. On the first day, signs of colitis are mild or absent. False urge to defecate, as well as mucus and blood in the feces are absent. These symptoms appear a day or two after infection. The severity of the condition depends on the degree of dehydration. If the current is erased, then all signs are minimal.
Subclinical forms of the disease are diagnosed only by the results of bacteriological examination. The clinic is expressed poorly. Patients do not show any complaints, considering themselves quite he althy.
Signs of dysentery in adults
The incubation period lasts from several hours to five days. On the second or third day after the infection enters the body of the individual, the first signs appear. The disease begins acutely, the symptoms of dysentery in adults are as follows:
- The temperature rises to 40 degrees.
- Pressure is dropping.
- No appetite.
- Nausea appears.
- Diarrhea.
- Vomiting.
- Cramps and pain in the abdomen.
- Repeated urge to defecate. The feces of a liquid consistency changes to mucous, mixed with blood. In the acute form of the disease, urges are possible up to 50 times during the day. However, not all of them end in emptying, that is, there are false urges. The patient is exhausted, general fatigue is felt,there is thirst and loss of appetite. The condition is deteriorating rapidly.
Gastroenteric variant of the disease is also known, which is rare. It is characterized by the simultaneous onset of the main symptoms of dysentery in adults: fever, intoxication, diarrhea. The disease begins with vomiting and liquid watery stools. After two days, colitis may develop. Then dehydration appears, lethargy, blood pressure decreases, the amount of urine separated decreases.
Dysentery in pregnant women
This pathology is dangerous for both the unborn baby and the woman. Premature birth occurs in 40% of cases of diagnosing dysentery. A negative infectious effect on the uterus provokes contractions, causing early delivery or miscarriage. The risk of bleeding increases. During childbirth, the baby becomes infected from the mother. One of the serious and dangerous consequences is the birth of a dead child or the death of a woman.
Treatment
Efficiency of treatment of symptoms of dysentery in adults and children depends on its timeliness. An untreated infection becomes chronic, which can be cured only in a round-the-clock hospital. Of the medicines, the following groups of drugs are prescribed:
- antibacterial;
- sorbents;
- rehydration and detoxification;
- anti-inflammatory;
- antipyretic;
- immunomodulators;
- probiotics;
- enzymatic;
- vitamins.
Complications andpreventive measures
The ineffectiveness of therapy, as well as the lack of treatment of symptoms of dysentery in adults and children provoke dangerous consequences:
- colon dilatation leading to death;
- sepsis;
- ulcerative lesions of the intestinal mucosa that provoke bleeding;
- hemolytic-uremic syndrome.
Prevention is personal hygiene. Washing hands after using the toilet, public places, walking, before eating. Careful processing of products before their use. If someone in the family is sick with dysentery, then disinfection of the premises is required.
Dysentery in children
In another way, it is called the disease of unwashed or dirty hands. The causative agent of this infectious disease is Shigella, a toxic microorganism that enters the digestive tract from the external environment. The intestines are subjected to the main striking blow. Dysentery ranks first in terms of distribution among other intestinal infections. The age group from two to seven years is most susceptible to this disease.
The reason for this phenomenon is a weakened immune system and non-compliance with the usual rules of personal hygiene. Immunity after the disease is unstable, the child can become infected repeatedly. In children up to a year, it is very difficult due to severe intoxication and dehydration of the body. There are several forms of the disease:
- Easy. Symptoms of dysentery in children under one year of age are as follows: diarrhea, increasedtemperature. Intoxication lasts about three days. In two weeks there is a complete recovery.
- Medium heavy. This form in infants begins rapidly. It is manifested by chills, fever, poisoning of the body. On the fifth day, intoxication subsides. Recovery occurs in a month.
- Heavy. Against the background of the strongest intoxication of the body, a violation of the activity of the cardiovascular system is observed. The therapy is long, up to three months.
Causes of dysentery
Symptoms of the disease provoke pathogenic enterobacteria. In shape, these are small sticks, ranging in size from 1 to 3 microns, with mobility. They secrete endo- and exotoxins in the course of their life. They are afraid of high temperatures and ultraviolet radiation. Humid environment and low temperature are favorable factors for their development. The rise in incidence is mainly observed in the summer. Infection occurs by oral-fecal or household contact.
The baby's bad habit of pulling dirty hands and objects into the mouth contributes to the rapid spread of infection. It is also carried by insects. There are cases when the infection does not develop, there is no clinic, and pathogenic microorganisms, once in the body, die or are excreted with feces. This pattern is observed in babies with a strong immune system.
Signs of disease
The disease appears in the first hours after infection, but the incubation period can last up to seven days. The severity of toxicity depends onthe number of bacteria in the large intestine. Symptoms of dysentery in children are as follows:
- hyperthermia;
- vomiting several times a day;
- diarrhea 20 or more times a day, greenish discharge containing blood mixed with mucus;
- dehydration;
- false urge to defecate observed on the fourth day of illness;
- pain in the left side of the abdomen;
- impaired consciousness;
- anemia;
- seizures (rare).
Features of dysentery in children
In 90% of cases, babies under one year old develop colitis of varying severity, which occurs along with a disorder of the digestive system. Loose stools may be absent, however, in the discharge there are remnants of unprocessed food, greenish and bloody inclusions, and mucus. In contrast to the symptoms of dysentery in children aged 2 years and older, babies have a bloated stomach, and discomfort appears during the act of defecation. A feature of the disease at this age is the undulating course of dysentery, i.e. with relapses and exacerbations. Re-infection exacerbates clinical manifestations. Undermined immunity is considered a prerequisite for the development of other intestinal infections caused by rotovirus, staphylococcus, amoeba. Pathology provokes pneumonia for a long time.
Dysentery symptoms in children as young as 2 years old lead to rapid dehydration, resulting in:
- heart rhythm disorder;
- clouded mind;
- kidney failure;
- lossweight;
- fatal.
It is important to seek qualified medical help at the first symptoms of the disease.
Treatment
The treatment of symptoms of dysentery in children will depend on the form of the disease, as well as age. Therapy can be carried out both on an outpatient and inpatient basis. At home, children older than two years of age and with a mild form of the disease receive treatment. Babies up to a year undergo therapy in a hospital setting. The course of treatment is up to three weeks and includes:
- bed rest;
- diet food;
- infusion therapy, antibacterial, antispasmodic drugs, as well as probiotics and vitamin complexes.
Feeding children with dysentery
Therapeutic diet is very important in this disease. In the acute phase, food hunger is recommended. In the first days of infection, the child is allowed to drink tea or water for 12 hours. If the baby has a normal weight, then fasting is extended to a day. Then they gradually begin to give allowed food:
- steamed fish and meat;
- vegetable and fruit puree;
- cereals cooked without adding milk;
- vegetable soups;
- introduce fermented milk products very carefully, observing the child's condition.
If the baby is breastfed, then the mother must follow the diet. The volume of fluid consumed for the entire period of therapy is almost doubled. It is recommended to give up legumes, raw vegetables and fruits, fresh milk,wheat and rye bread.
Complications and preventive measures
The consequences of the disease are manifested in untimely and improper treatment. The most common are:
- pneumonia;
- anemia;
- peritonitis;
- pericolitis;
- rectal prolapse;
- intestinal bleeding;
- hypotrophy.
The most effective method of prevention is teaching the baby:
- observe the rules of personal hygiene;
- don't bring your hands to your mouth;
- don't suck your fingers;
- wash hands before eating.
These simple rules will protect your child from contracting dysentery.
Acute and chronic dysentery
The development of the disease in the acute stage goes through the following stages:
- Small intestinal. During this period, there is a fever, pain in the upper abdomen, copious stools.
- Colonic stage of dysentery. Symptoms: in the stool there is mucus, blood, pus. The consistency of feces is liquid. Possible false urge to defecate. Chair up to fifty times a day. The pain becomes cramping and moves to the lower abdomen. The patient rapidly loses weight, the dermis becomes thinner, the limbs become cold to the touch, the facial features become sharp, there is a strong thirst.
Timely started therapy allows you to stop the disease at the first stage. The symptoms of dysentery depend on the individual's age and he alth status. In one case, the disease may be mild and limited to diarrhea. In the other, it is observedsevere course, severe dehydration and even dystrophy. The second variant occurs in children, the elderly and debilitated individuals.
The chronic form is diagnosed when the duration of the disease is more than three months. It flows in the form of a recurrent or continuous course.
Intoxication in this case is absent, but the following symptoms of chronic dysentery occur:
- daily greenish liquid stool mixed with mucus, blood;
- abdominal pain;
- false urge to defecate;
- weight loss.
These symptoms appear a few months after recovery. It provokes the development of a chronic form of the disease, exhaustion, beriberi, overwork, general weakness. Exacerbations are caused by a violation of the diet, stress. Patients with chronic dysentery are a source of infection.
Treatment of symptoms of dysentery at any stage is the replenishment of fluids, s alts and vitamins in the body, as well as a therapeutic diet. Of the drugs, drugs with antibacterial, anti-inflammatory, astringent, antispasmodic effects, probiotics and enzymes are shown.
Amebic dysentery
Amebiasis is an intestinal infection that develops as a result of the penetration of the simplest unicellular organism (amoeba) into the digestive system. This parasite causes deep damage to the walls of the large intestine and provokes the so-called amoebic dysentery, which is quite widespread in the southern regions.
Symptomsamoebic dysentery
The duration of the incubation period is from seven days to three months. The disease begins acutely. Characteristic symptoms:
- painful urge to defecate;
- diarrhea;
- feces liquid mixed with blood and mucus, the first is a large amount, the color of the stool is crimson;
- weight is dropping rapidly, stomach empties;
- haggard look;
- lack of appetite;
- headache;
- pain in the left side of the abdomen;
- dry dermis;
- Intestinal bleeding occurs when the intestinal wall is deeply damaged.
This condition is very dangerous and can be fatal.
The acute period lasts up to one and a half months, and then it passes into the chronic stage. Periods of exacerbation are replaced by long-term remission. Symptoms of dysentery in this case are as follows: constipation and diarrhea alternate, sometimes blood appears again in the stool. The disease exhausts the child, malnutrition is observed, anemia develops against the background of a large loss of fluid and blood.
Complications and treatment
Consequences of amoebic dysentery:
- narrowing of the intestinal lumen as a result of scarring of ulcerative lesions;
- single or multiple abscesses of internal organs;
- appendicitis;
- paraproctitis;
- peritonitis;
- tumor in the intestinal lumen.
Therapy is carried out in the conditions of the infectious diseases department in a round-the-clock hospital. Antiprotozoal courses are prescribed,antimicrobial agents, as well as blood substitutes and preparations containing iron. Infusion therapy is carried out. He alth food fortified with proteins and vitamins. Surgical treatment is indicated for liver abscess. After the disease, the children are under dispensary observation by an infectious disease doctor in the clinic at the place of residence for a year.
Preventive measures
Prevention of the symptoms of dysentery is the observance of the rules of sanitation and hygiene. In endemic areas, only boiled or filtered water is recommended, including for washing dishes, brushing teeth, and washing your face. Protect products from flies. Wash fruits and vegetables thoroughly.
Observe the rules of personal hygiene. Dysentery is a dangerous disease. You can prevent infection by following simple rules.
