How does diarrhea manifest? Causes of persistent diarrhea
Diarrhea (diarrhea ) is a condition in which a person has a fairly frequent or one-time bowel movement, during which a liquid stool is released. In an adult healthy person From 100 to 300 g of feces are excreted per day. Its amount varies depending on the amount of fiber contained in the food and the amount of remaining undigested substances and water. If the duration of the disease remains within two to three weeks, then in this case there is acute diarrhea . If a person has loose stools for more than three weeks, diarrhea becomes chronic. At chronic diarrhea The patient also experiences systematically profuse stools. In this situation, the weight of feces will exceed 300 g per day. Diarrhea occurs when the water content in a person's stool increases dramatically - from 60 to 90%. If the absorption of nutrients from food is impaired, patients are diagnosed with polyfecal : An unusually large amount of feces is released, which consists of food debris that remains undigested. If intestinal motility is impaired, the stool will be very loose and frequent, but in general its weight will not exceed 300 g per day. That is, even in the case of an initial analysis of the characteristics of the course of diarrhea, it is possible to find out what the cause of such a pathology is and, therefore, facilitate the process of establishing a diagnosis and selecting subsequent therapy.
Diarrhea of any kind is a pathological process in which the absorption of water and electrolytes in the intestine is impaired. In view of this, with diarrhea of any kind, approximately the same picture is observed. Both the large and small intestine have a very high capacity for water absorption. So, every day a person consumes about two liters of liquid. In general, about seven liters of water enter the intestines, taking into account saliva , , intestinal And , . In this case, only 2% of the total volume of liquid is excreted with feces, the rest is absorbed directly in the intestine. If the amount of liquid in the stool changes even very slightly, the stool becomes too hard. If there is too much fluid in the colon, a person experiences diarrhea. This disease manifests itself due to disorders in the digestive process, problems with absorption, secretion and intestinal motility. In the case of diarrhea, the small and large intestine are perceived as a single physiological unit.
Types of diarrhea
At secretory diarrhea There is an increased secretion of electrolytes and water into the intestinal lumen. In more rare cases, the cause of this type of diarrhea is a decrease in the absorption functions of the intestine. Thus, secretory diarrhea occurs when cholera , Escherichiosis , salmonellosis . But sometimes a similar condition also occurs in patients with certain non-infectious pathologies. If a patient has this type of diarrhea, the osmotic pressure of the blood plasma is higher than the osmotic pressure of the feces. The patient produces watery and fairly abundant feces, their color is green. Causes of occurrence secretory diarrhea are the active process of secretion of sodium and water in the intestine. The occurrence of this process is provoked by bacterial toxins, enteropathogenic viruses, a number of drugs and other biological active substances. Thus, secretory diarrhea can be provoked by long chain fatty acids And bile free acids , laxatives , which contain anthraglycosides , Castor oil .
At hyperexudative diarrhea sweating occurs plasma , mucus , blood into the intestinal lumen. This condition is typical for patients suffering from infectious and inflammatory bowel diseases ( shigellosis , salmonellosis , campylobacteriosis , clostridiosis ). Also, this type of diarrhea typically manifests itself in non-communicable diseases, such as nonspecific ulcerative colitis , . The osmotic pressure of blood plasma is higher than the osmotic pressure of feces.
The osmotic pressure of fecal matter is lower than the osmotic pressure of blood plasma. The stool is liquid, there is an admixture of pus, blood, and mucus.
At hyperosmolar diarrhea the patient has a malabsorption of certain nutrients in the small intestine. Metabolic processes in the body are noticeably disrupted. This type of diarrhea occurs with excessive use of saline laxatives. The osmotic pressure of fecal matter is higher than the osmotic pressure of blood plasma. This condition is characterized by loose and profuse stools, in which particles of undigested food are found.
At hyper- And hypokinetic diarrhea The patient has disturbances in the transit of intestinal contents. The cause of this condition is decreased or increased intestinal motility . Very often, this condition is typical for people suffering from irritable bowel syndrome, as well as for those who use too many laxatives and antacids. The osmotic pressure of fecal matter in this condition is the same as the osmotic pressure of blood plasma. The stool is not particularly abundant, with a liquid or mushy consistency. Two the latter type diarrhea occurs only in patients with non-infectious diseases.
Causes of diarrhea
The occurrence of diarrhea is influenced by the following phenomena: intestinal secretion , too much high pressure V intestinal cavity , intestinal exudation , violations in progress transportation intestinal contents . All these mechanisms have a certain connection, but a certain type of disease is characterized by the predominance of the corresponding type of disorder.
Symptoms of diarrhea
Acute diarrhea occurs with various types of infections, inflammation in the intestines and due to exposure to certain medications. As a rule, diarrhea occurs in combination with a number of other manifestations: it may be , bloating , stomach ache , weakness , feeling of chills , increase in body temperature .
Symptoms of an infectious type of disease are general malaise , manifestations , bad , vomit . Very often, the causes of diarrhea are poor quality food, as well as travel (the so-called tourist diarrhea occurs). The appearance of loose stools with elements of blood indicates the presence of damage in the intestinal mucosa. Their occurrence is provoked by some pathogenic microbes or with enteropathogenic properties. The patient's condition with this form of the disease is severe due to septic symptoms and pain in the abdominal area.
Some medications can also cause diarrhea. Level the body can be assessed already through examination of the patient. If there is a significant loss of electrolytes and water in the body, then dry skin is observed, a decrease in its turgor, and may also appear. hypotension . Due to noticeable calcium losses in the body, there may be a tendency to cramps .
In case of chronic diarrhea, that is, a disease lasting more than three weeks, the examination should first of all be aimed at finding out the reasons for its occurrence. The specialist examines the medical history and conducts all relevant stool examinations. During the diagnostic process, it is important to establish the duration of diarrhea, determine the volume of stool per day, the frequency and severity of intestinal motility, and weight fluctuations. If there is a disease of the small intestine, the stool will be bulky, watery or greasy. Colon diseases are accompanied by frequent stools, but they will be less abundant, containing pus, blood, and mucus. With pathology of the colon, diarrhea, as a rule, will be accompanied by pain in the abdomen.
Diagnosis of diarrhea
During the diagnostic process, a routine physical examination is performed. In this case, the specialist carefully examines the condition of the patient’s bowel movements and conducts a proctological examination. If the patient's stool is found blood , There is , or , then we can assume that the patient has Crohn's disease . In the process of microscopic examination of stool, it is important to determine in it inflammatory cells, fat, the presence of eggs and protozoa.
Using the sigmoidoscopy method, it is possible to diagnose, pseudomembranous colitis . To establish a diagnosis of “acute diarrhea,” the doctor is guided primarily by the patient’s complaints, medical history, proctological examination, and physical examination. The laboratory performs macro- and microscopic examination of stool samples.
If, during the process of establishing a diagnosis, it turns out that there is no inflammation in the intestines, then, most likely, diarrhea in this case will be associated with malabsorption. In some cases, the occurrence of acute diarrhea is provoked by enteroviruses. If viral enteritis is suspected, the doctor must make sure whether the symptoms and manifestations of this condition coincide. Thus, with viral enteritis, there is no blood and inflammatory cells in the stool, antibacterial therapy is ineffective during the treatment process, and the patient can recover spontaneously. The specialist must note all the described features during the differential diagnosis of various types of intestinal diseases.
In the process of diagnosing chronic diarrhea, first of all, it is determined whether there is a connection between the occurrence of diarrhea and infections or inflammations. To do this, stool tests are carried out - microscopic , bacteriological , sigmoidoscopy . Also, to exclude inflammation, the pathogenetic mechanism of diarrhea should be determined. Often, a period of time on a specific diet for diarrhea helps to establish the correct diagnosis.
Treatment of diarrhea
Some approaches to treating diarrhea are common to all four types of the disease. Thus, symptomatic medications and drugs with antibacterial action are equally effective. First of all, changes in eating style are practiced. So, a diet for diarrhea involves consuming foods that help inhibit peristalsis and reduce the secretion of water and electrolytes. At the same time, it is important to exclude those products whose properties suggest an increase in the motor-evacuation and secretory functions of the intestine.
Treatment of diarrhea includes administration antibacterial drugs , which are designed to restore intestinal eubiosis. Patients with acute diarrhea should take antibiotics , antimicrobial And sulfonamides drugs , antiseptics . The most preferred treatment for diarrhea is one that does not disturb the balance of intestinal microflora.
An alternative medicine for diarrhea is bacterial drugs , the course of treatment of which lasts up to two months. Used as symptomatic agents adsorbents , which neutralize organic acids and also prescribe astringents And enveloping facilities.
Diarrhea is also treated with the help of drugs that regulate motility and reduce intestinal tone. And to eliminate the state of dehydration of the body it is used rehydration . If the patient is diagnosed with an acute condition, then rehydration is carried out orally; in rare cases, crystalloid polyionic solutions are infused intravenously for rehydration.
The doctors
Medicines
Intestinal suffering is usually represented by two opposing types - diarrhea And . Moreover, the first one causes a lot of trouble, because of which it is impossible to even leave the house. Usually,
(official name diarrhea) is a malaise that is expressed by frequent and very loose, watery stools. She is, of course, unpleasant. But most importantly, it can be an indicator of a fairly serious disease caused by intestinal infections or food poisoning.
The main danger - as its consequence - dehydration , because of which the patient may even die. Of course, at the first signs of diarrhea, you need to consult a doctor and make a correct diagnosis. The specialist will prescribe treatment in accordance with the characteristics of your body, but, perhaps, the main thing for all patients remains severe.
Both with the treatment prescribed by the doctor and at the first signs of diarrhea, even before going to the hospital, you should drink as much mineral water as possible without carbon, fruit juice, any juice and other liquid. The exception is dairy products and coffee.
How to get rid of diarrhea?
Along with drug treatment(if the infectious nature of the disease or food poisoning is revealed), it is not only possible, but also necessary to resort to folk remedies. For example, for hundreds of years now people have been getting rid of diarrhea in the following way: chicken stomach cut off the yellow shell, wash it well and dry it, then crush it with a wooden masher or rolling pin to a powder. Take this powder 1 tbsp. spoon - adults, and 1/2 tbsp. spoon - children. Wash down big amount water. Apply once a day.
Even easier to use potato starch : 1 tbsp. Dilute a spoon in a glass of cooled boiled water and drink. Adults can resort to one more simple recipe: dilute 1 teaspoon of salt in less than half a glass of vodka and consume immediately.
At home, it’s quite easy to prepare another version of the drug: cut a raw onion crosswise (not at the root) and put it in a glass of hot tea (not strong, without sugar). Insist this way onion 10 minutes, then drink.
A solution prepared from two components also helps well - cinnamon and red capsicum pepper . Possessing excellent astringent properties, such decoction It also helps remove it from the body gases.
Very common among people are decoctions from the walls, infused in alcohol for 2-3 days, and from the peel grenade, brewed with boiling water. Berries mixed with honey can also help - viburnum, cranberry swamp And of course, rice or, more precisely, rice congee (1:7 - ratio of cereal and cold water, boil until half-baked). Just use unbroken rice.
Diarrhea during pregnancy
Diarrhea occurs quite often when . There are a number of reasons for this condition to occur in pregnant women. So, sometimes diarrhea occurs due to diseases of the intestines or the gastrointestinal tract as a whole. In some cases, the cause of diarrhea in pregnant women is common ailments. However, during pregnancy, a woman’s body becomes especially susceptible to various infections, so infectious diseases and local poisoning can provoke diarrhea. Thus, pregnant women have a high sensitivity to toxins. However, diarrhea can also be caused by disruptions in work nervous system, and the presence of worms, and insufficient production of enzymes in the body. Often the cause of diarrhea is becoming pregnant.
In some cases, diarrhea may not pose a danger to a woman, performing the function of a kind of cleansing of the body before the upcoming childbirth . However, the causes of diarrhea should be closely monitored. After all, if this condition arose due to food or other poisoning, then it is very dangerous for both the unborn child and the woman.
During pregnancy, treatment of diarrhea should be carried out only under the close supervision of a doctor, who will definitely take into account all individual aspects. At the same time, the specialist adjusts the patient’s diet, prescribing her special diet. For the expectant mother, it is very important to constantly maintain a drinking regime, consuming a sufficient amount of liquid, because dehydration is an undesirable condition for the fetus and mother.
Diet, nutrition for diarrhea
List of sources
- Ivashkin V.T., Sheptulin A.A., Sklyanskaya O.A. Diarrhea syndrome - M.: GEOTAR-MED, 2002.
- Guide to gastroenterology: in three volumes / Ed. F.I. Komarov and A.L. Grebneva. T.Z.-M.: Medicine.-1996.
- Belousova E.A., Zlatkina A.R. Diarrhea syndrome in the practice of a gastroenterologist: pathophysiology and differentiated approach to treatment. - 2008.
- Treatment of diarrhea. - Tutorial for doctors and other categories of senior health workers. - WHO, 2006.
Nowadays, digestive disorders can occur in every person almost every day, and not all episodes of bowel upset require medical care. How do you know if diarrhea is a symptom of a serious illness? Additional symptoms or properties of diarrhea itself will help with this:
Diarrhea + bloating when eating certain foods– may indicate an allergy to these products or an enzyme deficiency ( lactase deficiency, celiac disease).
Diarrhea + bloating not related to the nature of food taken– more often observed in Irritable Bowel Syndrome. In which neuropsychic factors ( overwork, stress) lead to disruption of the entire nervous system.
Diarrhea + vomiting + abdominal tenderness– often found in food poisoning, salmonellosis, and enterovirus infections. In this case, only a personal consultation with an infectious disease specialist can help make a diagnosis.
Diarrhea + dehydration– this symptom may indicate a dangerous infectious disease. In such cases, consultation with a surgeon and infectious disease specialist is necessary. Treatment of such patients at home is impossible; hospitalization is required.
Diagnosis of the causes of diarrhea
Diagnosis of the causes of diarrhea is difficult in some cases - there are so many diseases that manifest themselves with this symptom. However, a number of clinical, laboratory and instrumental methods are used to identify the causes of diarrhea.
Clinical examination of a patient with diarrhea
Includes a conversation to identify possible causative factors:
- When did the diarrhea start?
- Does any other family member have diarrhea?
- What food was consumed the day before?
- Do people who consumed the same food have diarrhea?
- Is there pain? Nature of pain?
And some other questions may be asked by your doctor during diagnosis.
Feeling and tapping the abdomen– allows you to identify pain in a specific location. Tapping helps identify bloating and its location.
Laboratory examinations
Coprogram– studying the appearance of stool, studying the structure and composition of stool under a microscope helps to identify diseases such as: pancreatic enzyme or liver failure,
Bacteriological analysis of stool is the method of choice in diagnosing intestinal dysbiosis or infectious diseases that lead to diarrhea.
Treating diarrhea at home ( for adults)
Only if the above-described symptoms of diarrhea are not identified, treatment at home is possible.
This requires adherence to a gentle daily regimen, balanced nutrition, replenishment of water and salts lost by the body, and the use of medications.
Replenishing lost water and minerals
What drink?
In order to avoid dehydration, it is necessary to replenish all substances and water removed from the body. To do this, it is better to use water with minerals dissolved in it. Solutions of drugs such as Regidron, Ringer Lock, Gidrovit, Orasan are better suited for these purposes.
Under no circumstances should you use sparkling water, sweet water, or juices when dehydrated.
How much to drink?
It is recommended to replenish all volumetric water consumption during illness. Therefore, it is advisable to drink 200-300 ml after each trip to the toilet. saline solution. If the consumption of saline solution repeatedly leads to vomiting, then you need to seek help from a doctor - it is necessary to identify the cause of vomiting and regular droppers with electrolyte solutions will be used to prevent dehydration.
What to eat?
Naturally, with diarrhea, it is necessary to consume foods that strengthen.
Food products such as ripe bananas, crackers, and boiled rice have a good effect.
Spices, fried foods, sweets, and dairy products must be excluded during the treatment of diarrhea.
Medicines to treat diarrhea
Antibiotics
Antibiotics attack bacteria living in the intestines, slowing down the growth of bacteria or leading to death. Drugs in this group are used for intestinal infectious diseases or severe cases of intestinal dysbiosis. The use of antibiotics to treat diarrhea is possible only as prescribed by a general practitioner or infectious disease specialist.
Drugs that slow down intestinal motility ( loperamide)
Loperamide actively changes intestinal motility - slowing down the movement of intestinal contents. The drug can be prescribed for diarrhea of a neurogenic nature, for inflammatory non-infectious intestinal pathology. The drug is prescribed only by the attending physician and requires monitoring of the patient's condition, as it has a number of serious side effects.
Enterosorbents
These substances exert their therapeutic effect in the intestinal lumen. The stricture of enterosorbent granules is such that their surface has the ability to absorb ( absorb) certain substances from the intestinal lumen.
Drugs are prescribed for allergic, toxic-infectious or toxic intestinal damage.
Temperature
An elevated temperature accompanies diarrhea if it is caused by an inflammatory process. If diarrhea develops due to viral and bacterial infections, the temperature can rise to very high limits ( up to 38 – 39 degrees). Also, a high rise in temperature is observed with food poisoning.
Tenesmus
Tenesmus is a painful urge to defecate. Most of all they are typical for intestinal infections, for example, for dysentery or for colitis.
Vomit
Vomiting also often accompanies diarrhea. Typically, this symptom occurs with diarrhea caused by food poisoning or infection.
Weakness
Weakness and malaise are caused by dehydration due to diarrhea. So, with diarrhea, water also leaves the body along with feces. Water provides the most important functions of the body and accounts for 60 to 70 percent. If the percentage of water in the body decreases, then it begins to suffer. In this case, all organ systems suffer without exception. Therefore, even a small loss of water is difficult for a person to bear, and he experiences weakness.
Subsequently, if emergency measures are not taken, the body’s salts leave along with the water. Lack of salts further increases weakness, malaise and lethargy.
Chronic, periodic diarrhea is a manifestation of pathologies such as irritable bowel syndrome, chronic colitis, Crohn's disease. At chronic diarrhea Extraintestinal symptoms are also present. Intestinal symptoms for chronic diarrhea are the same as for acute diarrhea.
Extraintestinal symptoms of chronic diarrhea are:
- nausea;
Anemia
Anemia is a low number of red blood cells and hemoglobin in the blood. It develops as a result of enteropathy, which is observed with frequent diarrhea. Thus, with chronic diarrhea, damage occurs to the intestinal mucous layer, through which normally absorbed useful to the body substances. As a result, the body experiences a lack of iron, folic acid and other microelements. The type of anemia depends on what substance the body “lacked” the most. If it is iron, then iron deficiency anemia develops, if it is vitamin B12, then B12 deficiency anemia. Anemia, in turn, is accompanied by symptoms such as poor skin condition, brittle hair and nails.
Nausea
With colitis, Crohn's disease and other diseases that are accompanied by chronic diarrhea, nausea is an integral companion.
Loss of appetite
Many intestinal pathologies, which are characterized by chronic diarrhea, lead to loss of appetite. First of all, this is due to constant nausea and periodic vomiting. At later stages, when anemia sets in, appetite decreases due to impaired metabolism.
It should be borne in mind that loose stools are not a separate disease, but are a symptom of a pathological process developing in the body.
What are the main causes of diarrhea in adults?
Exists a large number of factors that can trigger the development of diarrhea.
Causes of diarrhea can be:
- infectious lesions intestines;
- tuberculosis of the alimentary tract;
- food poisoning;
- allergic reactions;
- irritable bowel syndrome;
- dysbacteriosis;
- chronic diseases of the gastrointestinal tract;
- emotional disorders;
- unbalanced diet;
- change of usual cuisine, water.
Tuberculosis of the alimentary tract
With this pathology, the parts most often affected are the small intestine and the cecum. Diarrhea due to tuberculosis is not permanent and occurs periodically. As the disease progresses, stool disorder is accompanied by pain, localized to the navel.
Food poisoning
Often the cause of loose stools is food poisoning ( infection not by bacteria, but by their metabolic products, which are most often formed in spoiled food products). Excessive alcohol consumption can also cause intoxication of the body. Alcohol contains substances that stimulate the intestines, causing them to contract faster. Sources of nutritional intoxication most often are food products that have expired or those that were prepared without taking into account the necessary sanitary standards.
Products that most often cause poisoning are:
- dairy and fermented milk products;
- confectionery with cream;
- cooked sausage products;
- meat pates;
- salads with mayonnaise or sour cream;
- tomato juice.
Allergic reaction
Diarrhea can be caused by individual intolerance to a certain product. Unlike other allergy symptoms ( respiratory or skin), which occur quickly after consuming an allergen product, loose stools can develop only after 5 – 6 hours. This fact makes it difficult to diagnose the allergic nature of diarrhea.
Irritable bowel syndrome
With this disease, digestive disorders are not caused by damage to the intestine itself. People with an unstable psyche and a high level of emotionality are most susceptible to this pathology. The syndrome is characterized by loose stools, which bother patients after eating, most often in the first half of the day. Exacerbation of the disease and the development of acute diarrhea in half of the patients is associated with severe stress, excitement, and anxiety.
Dysbacteriosis
An imbalance in the ratio of beneficial and harmful microflora in the intestines can be caused by taking a number of antibacterial drugs, dietary habits, or other factors. A decrease in the number of bacteria that are responsible for the process of digestion and absorption of food leads to a disorder of intestinal functions, which is manifested by diarrhea.
Chronic diseases of the gastrointestinal tract
In the practice of a gastroenterologist ( a doctor who specializes in diagnosing and treating the digestive system) diarrhea is one of the most common complaints of patients. Chronic inflammatory processes affecting digestive system, provide negative impact on the intestines and cause disruption of its functionality.
Chronic diseases in which diarrhea develops are:
- gastritis ( inflammation of the gastric mucosa);
- stomach or duodenal ulcer;
- duodenitis ( inflammatory lesion of the duodenal mucosa);
- enterocolitis ( inflammation of the small and large intestines);
- biliary dyskinesia ( gallbladder motility disorder);
- cholecystitis ( gallbladder inflammation);
- pancreatitis ( inflammatory process in the pancreas);
- Crohn's disease ( formation of ulcers on the intestinal mucosa and other parts of the gastrointestinal tract);
- ulcerative colitis ( intestinal inflammation).
Rectal cancer
With a cancerous tumor located in the rectum, diarrhea is one of the most common symptoms. This pathology is characterized by the appearance of a small amount of blood in the stool and a false urge to defecate.
Liver diseases
One of the liver diseases in which stool disorders develop is hepatitis ( inflammation of liver tissue). Diarrhea is a symptom of all forms of this disease, but most often and most acutely manifests itself in viral hepatitis A. With other types of hepatitis, loose stools occur periodically, most often as a result of intolerance fatty foods. Another disease in which patients may suffer from diarrhea is cirrhosis of the liver ( pathological changes in liver tissue).
Emotional disorders
The activity of the gastrointestinal tract, like other organ systems, is controlled by the nervous system. In stressful situations, the nervous system is stressed, which affects the activity of the intestines. Therefore, anxiety often causes diarrhea. The symptom disappears after the person stops experiencing stress and anxiety.
Unbalanced diet
An unhealthy diet with a lot of rough food of plant origin can cause diarrhea. Also, the appearance of loose stools can be facilitated by the abuse of hot seasonings, spices, and carbonated drinks. The activity of the gastrointestinal tract can be disrupted by non-compliance with a certain regimen when eating food. Often the cause of diarrhea is an insufficient amount of vitamins that ensure the proper functioning of the stomach and intestines. The development of the disorder is caused by a deficiency of substances such as phylloquinone ( vitamin K), riboflavin ( vitamin B2), niacin ( vitamin PP).
Change of usual cuisine, water
The body's reaction to new food and water in the form of loose stool is called traveler's diarrhea. Stool disorder may appear 3 to 7 days after changing your usual environment. In most cases, this symptom goes away on its own when you return home or refuse food ( food and water) locally produced.
What are the main causes of diarrhea in children?
Diarrhea in children develops as a result of a number of reasons that lead to disruption of the normal functioning of the digestive system.
The main causes of diarrhea in children are:
The main infectious agents of inflammatory bowel processes that lead to diarrhea in a child are:
- adenovirus;
- salmonella;
- dysentery bacillus;
- coli;
- tapeworms ( bull tapeworm, pork tapeworm).
The main ways infectious agents enter the child’s digestive tract are:
- dirty hands;
- contaminated food;
- contaminated household items and household items;
- contact with sick children ( in case of intestinal viruses).
Genetic diseases of the gastrointestinal tract
Many genetic diseases of the gastrointestinal tract in children lead to disruption of the digestion process and the development of diarrhea.
The main genetic diseases of the digestive tract are:
- lactase deficiency;
- maltase deficiency;
- sucrase deficiency;
- atrophy of the intestinal mucosa.
For normal absorption of substances in the intestine, food must be well digested by intestinal enzymes. The lack of these enzymes leads to insufficient breakdown of food into easily digestible substances. In this case, food remains in the intestinal lumen and is quickly excreted. This condition is popularly called food allergy.
The most common problem in children is lactase deficiency ( lack of intestinal enzyme lactase), which causes diarrhea when milk and some dairy products are consumed. Less common are maltase enzyme deficiency ( substance involved in the digestion of grains), sucrase ( substance that breaks down sugar).
The absorption process in the intestine can also be disrupted due to congenital atrophy of the child’s intestinal mucosa. In this case, the absorption of all substances is difficult.
Acute food poisoning
Often in children, diarrhea develops as a result of acute food poisoning, due to the action of toxic substances that enter the gastrointestinal tract.
The main sources of acute food poisoning in children are:
- expired products;
- spoiled fruits and vegetables;
- stale meat and fish;
- spoiled dairy products;
- toxic substances ( arsenic, insecticides, organophosphates);
- alcoholic drinks;
- medications ( antibiotics, magnesium and potassium preparations, barbiturates);
- poisonous plants and fruits.
When a child eats “bad” food, a large amount of toxic substances enter the gastrointestinal tract. Toxins cause inflammation of the stomach and intestinal mucosa, increase peristalsis and slow down water absorption. In children, toxins are absorbed very quickly, and diarrhea also develops quickly.
Poor nutrition
Poor nutrition of a child leads to disruption of the digestive system. Constant digestive disorders cause the development of diarrhea.
The most common eating disorders in children are:
- binge eating;
- eating too many fruits and vegetables;
- abuse of herbs, spices, garlic and hot pepper;
- abuse of salty and acidic foods;
- too fatty food ( fatty meats and fish, oils).
Large volumes of food eaten put pressure on the walls of the digestive tract, causing accelerated peristalsis. Food passes too quickly and does not have time to be digested. Nutrients and water are absorbed in small quantities, remaining in the intestinal lumen. As a result, diarrhea with particles of poorly digested food appears. The rough skins of vegetables and fruits cause similar problems as a result of intestinal irritation from the rough fibers.
Spicy, sour or salty foods also greatly irritate the child's intestines, leading to the development of diarrhea.
Feeding a child too fatty foods leads to disruption of the liver and gallbladder. A large amount of bile and free fatty acids accumulate in the lumen of the digestive tract. They stimulate the accumulation of water in the intestinal cavity, causing diarrhea.
Why does a baby develop diarrhea?
Diarrhea in an infant develops due to the introduction of new foods into the diet that the child’s digestive system cannot digest normally. Also, stool disorder is a symptom of various pathological processes developing in the child’s body.
The causes of diarrhea in infants are:
- introduction of complementary foods;
- artificial feeding;
- intestinal infections;
- other factors.
Introduction of complementary foods
Changes in the color and consistency of stool are a common reaction of the body to the introduction of new foods into the children's diet. Often the feces become green color when feeding a child vegetable or fruit dishes. A change in the color of feces is not a sign of diarrhea and is normal. Indigestion is indicated by such signs as the child’s constant desire to empty the intestines, the appearance of a sour smell in the stool, and a watery or foamy consistency of the feces.
The causes of diarrhea when introducing complementary foods are:
- untimely introduction of complementary foods;
- non-compliance with dosage recommendations;
- too short pauses between new products;
- intolerance to certain products.
Late introduction of complementary foods
Diarrhea in an infant can be caused by introducing complementary foods too early. Experts recommend introducing new foods after the child reaches five months of age. At this point, the necessary enzymes for digesting adult food are formed in the intestines. Since childhood maturation is an individual aspect, in addition to age, the advisability of introducing complementary foods is also determined by several factors.
Signs that a baby is ready for complementary feeding are:
- the child’s weight increases by 2 times from the moment of birth;
- the child does not push out the spoon with his tongue;
- the baby can sit independently, tilt his body, turn his head;
- the child holds an object in his hand and puts it in his mouth;
- The baby shows interest in adult food and tries to taste it.
Failure to follow dosage recommendations
When switching to adult food, you must follow the recommendations for increasing the dosage of each individual product. If the portion increase is not done in a timely manner, it can cause dysfunction of the digestive system. Diarrhea in such cases occurs because in a short period of time the necessary enzymes do not have time to mature in the child’s intestines. Therefore, the dose of a new product should be increased 5–7 days after it was introduced into the diet for the first time. Thus, the average amount of cottage cheese recommended by pediatricians per day is from 5 to 10 grams. Within six months, the dose of cottage cheese can only be increased to 40 - 50 grams.
Too short pauses between new products
Each new product should be offered to the child a week after the introduction of the previous product. Violating this rule can cause diarrhea in the baby. When transferring a baby to a fundamentally new type of complementary feeding, it is necessary to maintain a pause of at least 3–4 weeks. Types of complementary foods are vegetable, grain, dairy, meat, fish.
Intolerance to certain products
Allergies to certain foods can cause diarrhea in infants. The most common cause of allergic reactions during complementary feeding is intolerance ( partial or complete) gluten. This pathology is called celiac disease. With this disease, loose stools are provoked by porridge ( wheat, barley, rye), bread, cookies. With celiac disease, diarrhea in an infant becomes chronic and is accompanied by symptoms such as poor weight gain and skin rashes.
Artificial feeding
In children who are bottle-fed, digestive disorders in the form of diarrhea are observed more often than in infants who are fed mother's milk. This is explained by the fact that a neutral or slightly acidic environment predominates in the children's intestines, which disrupts the digestion of proteins and fats. The composition of fats in breast milk is simpler and in addition it contains enzymes that facilitate the digestion process ( lipases). Therefore, with artificial feeding, especially with overfeeding, infants develop diarrhea.
Intestinal infections
Diarrhea in infants is often caused by intestinal infections. When bacteria or viruses enter a child's body, an acute digestive disorder develops, which is accompanied by intense loose stools, which may contain blood, mucus, and foam. Often the infection occurs with vomiting, fever, crying, and refusal to eat.
The causative agents of intestinal infections are:
- rotavirus– the infection begins with vomiting, followed by diarrhea and fever;
- enterovirus– the disease is characterized by a wave-like increase in temperature and foamy, loose, green stools;
- salmonella– the infection is manifested by a sharp increase in temperature, bloating and diarrhea, which may contain mucus and blood;
- shigella(provoke dysentery) – initially loose stools with the progression of the disease become similar to lumps of gray mucus with inclusions of blood;
- coli– infection is accompanied by intense diarrhea and severe abdominal pain;
- staphylococcus– the infection is manifested by foamy liquid stools and a fever above 38 degrees.
Infection most often occurs through the oral-fecal route if personal hygiene rules are not observed. Also, pathogenic bacteria can enter the body along with low-quality products or dirty water. Infection of an infant is possible through contact with carriers of the infection.
Other factors
In addition to infections and feeding errors, various external and internal factors can cause diarrhea in an infant.
Causes of diarrhea include:
- dysbacteriosis– often loose stools are a consequence of taking antibacterial drugs that disrupt the normal composition of the intestinal microflora;
- maternal consumption of certain foods(while breastfeeding) – diarrhea in infants often occurs after eating cucumbers, beets, or pears;
- teething– stool disorder in such cases is called physiological diarrhea;
- lactase deficiency ( lactose intolerance) – manifests itself as diarrhea in newborns from the first days of life;
- cystic fibrosis(a disease that affects organs that secrete mucus, including the intestines) – this pathology is characterized by copious loose stools with a greasy sheen and a strong unpleasant odor;
- helminthic infestations– accompanied by loose stools, which may alternate with constipation;
- acute respiratory diseases– in children under the age of one year, diarrhea often develops against the background of colds.
Why is diarrhea dangerous during pregnancy?
The degree of danger of diarrhea during pregnancy is determined by such factors as the cause that caused the syndrome and the characteristics of its course. Also great importance has a gestational age at which this syndrome develops.
Impact of diarrhea on early stages pregnancy
Weak and short-lived diarrhea at the beginning of pregnancy, which is accompanied by toxicosis, is a common occurrence. The bacteria and viruses that provoke it do not leave the intestines, and therefore do not pose a great threat to the fetus. In some cases, when diarrhea is caused by severe poisoning, intoxication is possible female body and penetration of toxins to the fetus. Thus, mushroom poisoning while pregnant is extremely dangerous. Poisons, penetrating the placental barrier, can cause various disorders in the development of the embryo.
The greatest danger in the first trimester of pregnancy is diarrhea, in which a woman visits the toilet more than 5 times a day. The danger of this condition increases when a bowel disorder is combined with vomiting.
The consequences of severe diarrhea are:
- the formation of congenital developmental anomalies in the fetus;
- spontaneous abortion;
- decreased blood pressure in women;
- renal failure in the expectant mother.
The danger of diarrhea in late pregnancy
Diarrhea at the 30th week of pregnancy is most often a symptom of late toxicosis rather than a viral disease. If an intestinal disorder is accompanied by frequent bowel movements, the woman should see a specialist, as this can provoke intense uterine contractions and premature birth. In addition, severe diarrhea, as in the initial stages, can cause dehydration of the female body. Fluid deficiency can provoke thrombosis ( blockage of blood vessels) and other dangerous conditions. In the third trimester of pregnancy, drugs that are contraindicated in earlier stages are allowed. Therefore, timely consultation with a doctor will quickly eliminate diarrhea and its accompanying symptoms.
This syndrome is most dangerous in the period from 35 to 37 weeks of gestation. Diarrhea can cause labor to begin, which can lead to the birth of a premature baby.
Another factor that causes this disorder is the pressure that the fetus puts on the digestive organs of a pregnant woman.
Regardless of the circumstances that caused diarrhea, the main danger is the rapid development of dehydration. At this stage, the woman begins to move less, and the fetus needs a large amount of fluid. These factors, combined with diarrhea, provoke severe dehydration and the risk of various complications. The body of a pregnant woman stops supplying the fetus with necessary nutrients, resulting in starvation.
Doctors react most calmly to diarrhea that develops from 38 to 40 weeks of pregnancy. Most often, the syndrome occurs against the background of a woman’s normal condition and indicates a natural cleansing of the body and impending childbirth.
How does chronic diarrhea occur?
Chronic diarrhea is manifested by stool disorder that lasts more than 3 weeks. In this case, the patient is concerned about the frequent urge to defecate, in which the daily weight of feces exceeds 300 grams.
- pathological changes in feces;
- discomfort in the abdominal area;
- nausea, vomiting;
- nervous system disorders;
- deterioration of the condition of nails, skin, hair;
- weight loss;
- exhaustion of the body.
The nature and intensity of these symptoms depend on the cause against which chronic diarrhea develops.
Pathological changes in feces
The color and consistency of stool, as well as the number of urges to defecate, may vary with chronic diarrhea. In diseases of the small intestine, the patient is bothered by copious watery or fatty stools. With pathologies of the large intestine, the mass of feces is not so abundant, and they may contain mucous, blood or purulent inclusions. If the cause of chronic diarrhea is diseases of the rectum, patients experience a frequent urge to defecate, while the mass of bowel movements is insignificant.
Other stool changes include:
- Watery stool– can cause viral infections of bacterial or viral origin. Appearance stool may resemble rice water.
- Liquid black stool– the cause may be bleeding in the stomach, esophagus or intestines caused by an ulcer or tumor formation. The blood reacts with digestive enzymes, causing the stool to turn black.
- Yellow chair– can develop while taking a number of medications. It is also very often observed in young children due to infections or diseases of the digestive system, as a result of which food is poorly digested.
- White feces– white feces can be a manifestation of chronic diarrhea, which develops against the background of gallbladder pathologies and jaundice. The reason for the coloring of the stool is White color Some medications may become
- Green chair– feces of this color are most often the result of increased fermentation processes in the intestines due to dysbiosis, dysentery or other intestinal infections.
Discomfort in the abdomen
Patients with chronic diarrhea experience discomfort in the abdominal area, which can vary in type, duration, intensity, and location. With irritable bowel syndrome, patients complain of sharp twisting pains that become less severe after defecation. Painful cramps in the abdomen both before and after bowel movements are observed with intestinal inflammation. Pain in the lower abdomen after eating is manifested by diarrhea due to peptic ulcers. Pain that occurs periodically on the right or left side is characteristic of Crohn's disease. Stool disorder in chronic pancreatitis occurs together with pain, which is localized in the upper abdomen and has a girdling character. When chronic diarrhea develops against the background of putrefactive and fermentative processes in the intestines, it is accompanied by rumbling and bloating due to intense formation of gases in the intestines.
Nausea and vomiting
Often chronic diarrhea, caused by diseases of the gastrointestinal tract, is accompanied by vomiting, which does not bring relief to the patient. When infection penetrates, diarrhea is accompanied by nausea, and the body temperature rises to 38 degrees.
Nervous system disorders
Often this disorder causes sleep problems and other nervous system disorders.
Manifestations of chronic diarrhea are:
- insomnia at night;
- daytime sleepiness;
- irritability;
- frequent mood changes;
- increased fatigue;
- unreasonable anxiety;
- lethargy, apathy.
Deterioration of hair, skin, nails
Chronic diarrhea is often manifested by deterioration of the condition of the skin, hair, and nails. An increase in the activity of the sebaceous glands leads to increased oiliness of the hair and skin, and the appearance of small pimples. Due to vitamin deficiency, hair may begin to fall out, nails may break or peel.
Weight loss
In some cases, chronic diarrhea is accompanied by weight loss. This manifestation is typical for patients in whom the syndrome develops against the background chronic pancreatitis, Crohn's disease or certain pancreatic pathologies.
Exhaustion of the body
Chronic diarrhea is manifested not only by dysfunction of the gastrointestinal tract, but also by disturbances in the functioning of other body systems. Patients complain of general physical discomfort, which is most severe in the morning. The lack of appetite characteristic of this syndrome causes a decrease in the overall tone of the body. With diarrhea, the time it takes for food to pass through the intestines is reduced, causing vitamins and useful material do not have time to assimilate. This, combined with poor nutrition, fluid loss and other disorders, can cause severe exhaustion of the body.
Is diarrhea accompanied by fever?
Diarrhea may be accompanied by fever, but not in all cases. In children, unlike adults, diarrhea is almost always accompanied by an increase in body temperature ( sometimes even to critical levels). Depending on the factors that caused diarrhea and the severity of the disease, a hyperthermic reaction ( temperature increase) of the body manifests itself in different ways.
| Causes of diarrhea | Body temperature | Temperature characteristic | |||||||||||||||||
| Functional disorders of the central nervous system:
| 36.6 – 37 degrees. | Most often, the temperature remains within normal limits. Diarrhea can rarely be accompanied by a short-term increase in total body temperature to 37.5 degrees. | |||||||||||||||||
| Acute food poisoning | From 37 to 38.5 degrees. | A body temperature of 37.1 – 37.5 degrees appears within 6 – 12 hours after eating “bad” foods. In accordance with the severity of the intoxication syndrome, the temperature can increase to 38.5 degrees. A continued increase in body temperature from 38.6 degrees is rarely observed. | |||||||||||||||||
| Acute and chronic inflammatory processes in the gastrointestinal tract (GIT):
| Can vary from 37.1 to 38.5 degrees. | For pancreatitis ( inflammatory process in the pancreas) diarrhea may be accompanied by a temperature that does not rise above 38.1 degrees. For chronic hepatitis ( inflammation of the liver tissue) diarrhea is accompanied by a moderate increase in temperature, maximum – 37.5 degrees. Acute hepatitis can occur with severe diarrhea and high fever. With appendicitis ( inflammation of the appendix) diarrhea is accompanied by low-grade fever ( 38 – 38.5 degrees). Complicated appendicitis with peritonitis can cause diarrhea with fever above 39 degrees. With enterocolitis ( inflammation of the small and large intestines) body temperature can vary from 37.5 to 39.5 degrees or more. Highest temperature ( 39.5 – 40.5 degrees) is observed with massive lesions of the intestinal mucosa with severe intoxication syndrome. |
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| Viral infections of the digestive system:
| 37 – 38 degrees. | Body temperature during viral infections of the gastrointestinal tract usually does not exceed 38 degrees, but the patient feels it as a fever with aches and pain in the muscles, increased sweating and a feeling of cold. This temperature may accompany diarrhea for 2 to 3 days. | |||||||||||||||||
| Bacterial infections of the digestive system:
| Above 38.5 - 39 degrees. | Bacterial infections of the gastrointestinal tract are characterized by diarrhea with a very high body temperature. With severe intoxication syndrome, fever can reach 40.5 - 41 degrees. | |||||||||||||||||
|
The basic rules of nutrition for diarrhea are:
Drinking liquids Drinks you can and cannot drink if you have diarrhea Food consumption Healthy foods to eat if you have diarrhea
Food should be eaten in small portions in order to reduce pressure on the walls of the stomach and intestines. To ensure that the body receives the required daily dose of nutrients and does not “starve”, the frequency of meals is increased to 4–5 times a day. If you have diarrhea, you should definitely exclude from your diet all foods that irritate the digestive system. You should mainly avoid fatty foods, fried foods, fresh vegetables and fruits. You should also forget about spices, garlic, savory sauces and sweets. What to do if diarrhea is accompanied by vomiting?
The main points that must be performed first in case of diarrhea accompanied by vomiting are:
Cleansing the gastrointestinal tract and the body as a whole In the first one to two days, you should not try to stop diarrhea and vomiting with medications ( antidiarrheals and antiemetics). Immediately after the first attacks appear, the stomach must be rinsed thoroughly. To do this, the patient must drink about one and a half liters of water in a short period of time and induce vomiting. Along with the water, the remaining “bad” food that has not yet had time to be digested will come out of the stomach. The water should be boiled and slightly warm so as not to cause further irritation of the stomach walls. Another good way to wash the stomach is potassium permanganate dissolved in water. A couple of granules of potassium permanganate are enough for a liter of boiled water. Every 30 to 60 minutes, drink half a glass of this solution. The main medications that can be used to reduce intoxication are:
All these drugs are called sorbents because they adsorb ( absorb) contains the remains of toxins and waste. Replenishing lost fluids and essential minerals The main liquids that can be consumed for diarrhea with vomiting are:
The liquid should be drunk every hour and after each attack of diarrhea and vomiting. Its volume should be 250 - 300 milliliters per dose. Special medications that are used for vomiting and diarrhea include:
These preparations contain essential minerals ( potassium, magnesium, sodium, chlorine and calcium), which must be replenished in the body first. Solutions are prepared according to instructions and used throughout the day. Eliminate any irritants to the digestive system Foods that should absolutely not be eaten if you have diarrhea and vomiting are:
A patient with severe diarrhea accompanied by vomiting should limit food intake in the first two days, even to the point of fasting. When attacks of diarrhea and vomiting become rare, food is introduced, but with a strict diet. The patient can eat porridge with water. Rice porridge is especially useful. It does not irritate the stomach and normalizes peristalsis of the digestive tract. You can add a little salt to porridge, but exclude butter and milk. Also, for diarrhea and vomiting, you can eat white bread crackers and bananas. Food portions should be small but frequent. What to do if you have diarrhea with fever?
Pathologies in which diarrhea with fever is noted are:
The patient can take a number of measures to alleviate his condition. But the patient’s main actions should be aimed at monitoring his condition. If a number of factors are identified, you should immediately consult a doctor. Food poisoning The first thing to do if there is a possibility of food poisoning is to rinse the stomach. For washing, a weak solution of potassium permanganate can be used, a solution baking soda (2 teaspoons of soda per 2 liters of water) or table salt solution ( 2 tablespoons per 4 liters of water). The total volume of solution required for washing is 8 - 10 liters. Liquid temperature is from 35 to 37 degrees. First, you should drink 3 to 6 glasses of the solution, and then induce vomiting yourself. To do this, use your middle and index fingers to tickle the root of your tongue. Next, you need to drink water again and induce vomiting. Repeat the procedure until the flowing water becomes clear. After washing, the patient must be kept at rest and refrain from eating for the next 24 hours. To remove toxins, you need to take activated carbon or another type of sorbent. Fluid deficiency should be restored using special saline solutions ( rehydrona, oralit). Accepted this remedy at the rate of 10 milliliters per kilogram of body weight after each act of defecation. Subsequently, for a week you must follow a gentle low-calorie diet and drink at least 3 liters of water per day. If diarrhea and fever do not decrease within 6 hours after gastric lavage, you should immediately consult a doctor. Other reasons for seeking medical help are:
Pancreatitis If pancreatitis is suspected, the patient should consult a doctor. Before the doctor’s visit, you should refuse to eat and remain calm, refusing sudden movements. A position in which the patient sits with the torso tilted forward will help reduce the intensity of pain. Gastroenteritis First aid measures are:
If all symptoms persist for more than a day, it is necessary to seek professional medical help. What medications are there for diarrhea?
The following types of medicines for diarrhea are available:
As a rule, there are specific medications for each type of diarrhea. For example, intestinal antiseptics are used for bacterial diarrhea; for irritable bowel syndrome - drugs that slow down intestinal motility. But several medications can also be used at the same time. For example, adsorbents, astringents, and probiotics. Tricyclic antidepressants, which slow down intestinal motility, and herbal antidiarrheals are also used. | Synthetic antidiarrheals:
|
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| Diarrhea after using antibiotics | Drugs that normalize intestinal microflora, as well as probiotics, are prescribed. Drugs from the first group have both an antidiarrheal effect and a moderate antimicrobial effect. Therefore, they are prescribed for other types of diarrhea. For example, with recurrent colitis, with long-term feeding through a tube. Probiotics contain beneficial microflora that are destroyed by antibiotics. As a rule, they are prescribed simultaneously with antibiotic therapy. In this case, severe dysbiosis does not develop. If this measure was not taken, then probiotics are prescribed later and in larger dosages. | Agents that normalize intestinal microflora:
|
If you have diarrhea, you should eat only certain foods and dishes. Nutrition of a patient with severe intestinal disorder ( diarrhea) must obey a number of rules.
If a patient has diarrhea accompanied by vomiting, then it is necessary to provide first “first aid” in order to alleviate the general condition.
If you have diarrhea with fever, you should not take medications to relieve these symptoms. The tactics of first aid depend on the cause that led to the development of this disorder. This is explained by the fact that loose stools and fever are not independent diseases, but signs of pathological processes developing in the body.
There is a varied range of medications that are used to treat diarrhea. The choice of a particular medication depends on the cause that caused the disorder.Diarrhea can be a symptom of the most various diseases, for example, lactase deficiency or hormonally active tumors. However, it does not always require the use of medications. Sometimes you just need to eliminate a certain product. For lactase deficiency, such products are dairy products, for celiac disease - products containing gluten, for phenylketonuria - products containing phenylalanine.
What foods can you eat if you have diarrhea?
For diarrhea, you can eat foods that do not provoke fermentation and rotting in the intestines. Food should not irritate the digestive organs and require large resources for its digestion. Properly selected products will help avoid dehydration and deficiency of substances necessary for the patient’s rapid recovery.
Foods that can be eaten are:
- unsweetened fruits and berries;
- vegetables with a small amount of fiber;
- cereals;
- eggs;
- lean fish and meat;
- flour products.
In order for nutrition during diarrhea to bring a healing effect, you must adhere to a number of rules when preparing dishes. The amount and other features of eating recommended foods depend on the intensity and other characteristics of diarrhea.
Fruits and berries
- Banana– a product that can be eaten for any form of diarrhea. The potassium contained in the fruit promotes rapid recovery, and a sufficient amount of moisture prevents dehydration. In the absence of individual intolerance, it is recommended to consume bananas 1 - 2 pieces every 3 - 4 hours.
- Apples– contain pectin and a large amount of organic acids. These substances promote the removal of toxins and have an astringent and antimicrobial effect. Raw apples contain coarse fiber, which can irritate the intestinal mucosa. Therefore, these fruits should be consumed baked. You can also make compote from apples.
- Quince– has astringent and fixing properties, therefore it is recommended for disorders of the digestive tract. Quince decoction has the greatest effect. To prepare it, 200 grams ( medium sized fruit) ripe quince should be cut into small slices and pour 4 glasses ( liter) boiling water. Leave for a couple of 15 - 20 minutes, then cool and drink the infusion every hour, 100 - 200 milliliters.
Drinks made from berries that are rich in tannins are useful for diarrhea ( tannins). Tannins stop the inflammatory process in the intestines and normalize the secretory function of the gastrointestinal tract.
- persimmon;
- dogwood;
- black currant;
- bird cherry;
- blueberry;
- thorn
In addition to compotes and decoctions of blueberries, black currants, and bird cherry, you can prepare jelly, which has not only a nutritional, but also a medicinal effect. The starch contained in jelly acts as a sorbent, absorbing harmful substances in the intestines. To cook jelly, add 200 grams of berries to 2 liters of water and bring to a boil. After this, you need to add 4 tablespoons of starch to the composition ( diluted with water to the consistency of sour cream). After 3 - 5 minutes, remove the jelly from the heat, cool and drink throughout the day.
Vegetables
In case of acute diarrhea, vegetables should be excluded from the diet. After 2–3 days, you should begin to gradually introduce vegetable dishes into the menu to prevent vitamin deficiency. The main rule is to choose crops with minimal fiber content. You should not eat raw or half-raw vegetables. The best heat treatment option is boiling or steaming.
Vegetables that are easy to tolerate for diarrhea are:
- carrot;
- potato;
- pumpkin;
- zucchini;
- cauliflower;
- asparagus;
- green beans.
Vegetables can be cooked vegetable soups, meatballs, casseroles. Due to its mushy consistency, purees and soufflés made from vegetables are well digested for diarrhea.
Cereals
The most recommended cereals for diarrhea are buckwheat, oatmeal and rice. Dishes prepared from them are a source of carbohydrates, which the body needs to fight diarrhea. In the first days of the disorder, you should prepare porridge from cereals with plenty of water. Subsequently, rice and buckwheat can be used as an additional ingredient for first courses. An effective remedy for diarrhea, a decoction made from rice is used, which has a complex effect on the body.
The effects of rice water are:
- enveloping and protecting the intestinal walls from irritation;
- normalization of peristalsis;
- thickening of stool due to fluid absorption;
- reduction of flatulence and reduction of bloating;
- replenishment of nutritional deficiencies.
To prepare the decoction, bring half a liter of water to a boil, add 2 teaspoons of washed rice and simmer for 45 minutes. Next, strain the broth and take 50 milliliters every 2 to 3 hours.
Eggs
Eggs ( chicken and quail) help normalize the consistency of stool. For diarrhea, it is recommended to eat no more than 2 eggs per day that have undergone special heat treatment. Raw, fried or hard-boiled eggs can worsen the patient's condition. Therefore, steam omelettes or soft-boiled eggs should be included in the menu of a patient with diarrhea. You can also use egg whites when preparing first courses.
Meat and fish
Meat and fish contain large amounts of protein, which the body needs for diarrhea. These products should be introduced into the diet 3–4 days after the first symptoms of the disorder appear. To reduce the load on the organs of the digestive system, meat should be cleaned of fat, films, and tendons before consumption. The fish must be cleaned of skin and bones.
- chicken breast;
- turkey fillet;
- veal tenderloin;
- pollock fillet;
- cod fillet;
- pike perch fillet.
Steam cutlets, meatballs, and souffles are prepared from meat or fish. Pre-grinding makes the product easier to digest, and steaming allows you to preserve all the valuable properties of the dish.
Flour products
At the initial stage of the disorder ( first 2 – 3 days) You should eat bread made from wheat flour, dried in the oven. When relief occurs, the diet can be diversified with pasta made from durum wheat.
What diseases cause bloody diarrhea?
Bloody diarrhea is a symptom of inflammatory processes and other pathological conditions gastrointestinal tract. The color, consistency, smell and other characteristics of blood impurities in liquid feces are determined by the reasons for its occurrence. The closer the source of bleeding is to the anus, the lighter the color of the blood.
Causes of loose stools with blood can be:
- haemorrhoids ( dilatation and inflammation of the veins of the lower segment of the rectum);
- cracks anus;
- intestinal polyps ( benign formations);
- inflammation of diverticula ( pouch-like protrusions of the walls of the rectum or colon);
- chronic inflammatory diseases;
- infectious intestinal diseases;
- bleeding of the upper digestive system;
- dysbacteriosis;
- malignant tumors of the colon.
Haemorrhoids
The cause of bloody diarrhea may be damage to hemorrhoidal cones during multiple bowel movements. In this case, bleeding is manifested by drops of bright red blood, which can be in the stool, on linen, or on toilet paper. The scarlet tint is explained by the fact that the damage is close and the blood does not have time to clot or react with digestive enzymes. When a node ruptures, copious amounts of blood are released, which can flood the toilet. In most cases, patients are not bothered by any pain.
Anal fissures
Loose stool with blood due to cracks in the lower part of the rectum, accompanied by severe pain in the anus. A small amount of red blood is released at the time of bowel movement or immediately after it. In this case, the blood does not form streaks or clots and does not mix with feces. Also, with this pathology, a small amount of mucus or its complete absence is found in the stool.
Intestinal polyps
The presence of blood in liquid feces can cause polyps in the intestines. Bleeding occurs when tumors are damaged or an inflammatory process occurs. In this disease, the blood is mixed with feces, which also contain mucus impurities.
Inflammation of diverticula
Diverticulitis ( inflammation of diverticula) and the accompanying diarrhea with blood most often develops in patients whose age ranges from 50 to 60 years. If diverticula are located in the sigmoid colon, inclusions of blood have a bright red tint. With lesions of diverticula located in the right segments of the large intestine, the blood may be dark, sometimes black.
Chronic inflammatory diseases
A symptom of such a chronic disease as Crohn's disease ( inflammatory processes in various parts of the digestive tract) bloody diarrhea often appears. Often this symptom indicates another chronic disease - ulcerative colitis ( purulent inflammation of the colon). A distinctive feature of these diseases is chronic diarrhea, which is accompanied by severe abdominal pain and an increase in body temperature. The act of defecation is accompanied by profuse bleeding of scarlet color.
Bleeding in the upper digestive system
Diarrhea and blood in its composition may indicate damage to the stomach, esophagus, and duodenum. The blood is black in color and smells bad. Stool mixed with black, foul-smelling blood is called melena. Blood acquires its color and smell due to its long stay in the digestive system, during which it is exposed to bacteria.
Diseases that cause diarrhea with black blood are:
- cancerous tumors in stomach or duodenum;
- mucosal defects ( ulcers) stomach or duodenum;
- varicose veins of the esophagus;
- pathological changes in the structure of liver tissue ( cirrhosis).
Infectious intestinal diseases
Often, disorders in the form of bloody diarrhea are a manifestation of diseases caused by infection. In this case, patients are worried about attacks of acute abdominal pain and high body temperature. One of the common infectious diseases is dysentery. The causative agents of the disease are bacteria of the genus Shigella, which infect the lower segment of the colon. With dysentery, the patient suffers from intense diarrhea with blood, in which the frequency of the urge to defecate can reach 30 times a day. Often the desire to evacuate is false and is accompanied by severe discomfort. Often with dysentery, diarrhea turns green. In addition to blood, clots of pus and mucus may be found in the stool.
Malignant tumors of the colon
Blood during bowel movements is one of the most frequently detected and persistent symptoms of malignant neoplasms of the colon, which in most cases are cancerous tumors. Thus, bleeding preceding stool or inclusions of blood in stool occur in more than half of patients, both in early and later late stages diseases. The second most common sign of colon cancer is stool abnormalities, which often manifest as diarrhea. Bleeding is characterized by its inconsistency and insignificant volume. In later stages of cancer, mucus and pus may be added to the blood. This is explained by the development of concomitant inflammatory diseases. Often, diarrhea with blood in cancer is accompanied by symptoms such as false urge to defecate, low-grade fever ( about 37 degrees), bloating.
Other causes of bloody diarrhea may include:
- proctitis ( inflammatory lesion of the rectal mucosa) – blood is detected in the form of clots throughout the stool;
- cryptite ( inflammation of the recesses in the anal canal) – characterized by blood inclusions bright color;
- ischemic colitis ( disruption of the blood supply to the intestinal wall) - blood is released in small quantities and can be either dark or light in color.
How to treat diarrhea after antibiotics?
Treatment of diarrhea after antibiotics is carried out comprehensively and is aimed at restoring intestinal functions. Also, the goal of treatment is to eliminate the symptoms and consequences of this disorder.
Treatments for diarrhea after antibiotics include:
- compliance dietary nutrition;
- taking medications that correct the composition of the intestinal microflora;
- prevention of dehydration and intoxication of the body.
Taking medications to correct intestinal microflora
To normalize the composition and properties of the intestinal microflora, patients are prescribed special medications. Depending on the composition and effect, such drugs are divided into several categories.
The types of drugs are:
- probiotics– include cultures of living microorganisms;
- prebiotics– contain substances that stimulate the activity of beneficial microflora;
- synbiotics– combination preparations consisting of probiotics and prebiotics.
The therapeutic effect of these drugs is to create favorable conditions for the growth of beneficial intestinal microflora and inhibit the activity of pathogenic microorganisms. The active components of these drugs take part in the production of vitamins and create an environment for their effective absorption. Also, taking such medications helps to better break down food and remove toxic substances from the body.
Probiotics
Once in the intestines, the microorganisms that make up this group of drugs multiply, which helps restore all functions of the microflora. Based on their composition and mechanism of action, there are 4 categories of probiotics.
The groups of probiotics are:
- First generation drugs ( monobiotics) – contain one type of beneficial bacteria that are part of the normal microflora. The most common living components for the production of these drugs are colibacteria, bifidobacteria, and lactobacilli.
- Second generation drugs ( antagonists) – are made on the basis of bacilli and yeast fungi, which inhibit the activity of harmful microorganisms. Not being part of the microflora, the components of such drugs do not take root in the intestines and are eliminated naturally.
- Third generation probiotics ( multicomponent) – include several types of beneficial bacteria that begin to grow and multiply in the intestines.
- Fourth generation drugs ( sorbed) – consist of representatives of normal microflora, which are fixed on a special carrier ( sorbent). The use of a sorbent significantly increases the effectiveness of the drug.
Prebiotics
Prebiotics are made from substances that provide nutrition for beneficial microorganisms. The components used are fiber, pectin, sorbitol, xylitol and other carbohydrates. Prebiotics are prescribed in combination with probiotics.
Synbiotics
This category of drugs contains both live microorganisms ( probiotics), as well as ingredients for their favorable reproduction ( prebiotics). Today, synbiotics are considered the most effective for treating diarrhea after antibiotics.
Dietary adherence
The goal of a diet for diarrhea is to reduce the load on the digestive system and provide the body with the necessary substances for a speedy recovery. At severe diarrhea It is necessary to consume foods that do not irritate the intestinal mucosa and have a strengthening effect.
- hard-boiled eggs;
- steam omelettes;
- slimy porridges from semolina, buckwheat, rice;
- rice water;
- berry and fruit jelly;
- baked apples;
- white bread crackers.
When preparing porridges, cereals must be boiled thoroughly and enough water used to ensure that their consistency is viscous. For jelly, you should use non-acidic berries and fruits, diluting the juice with water if necessary.
After 2–3 days, the menu can include dishes prepared from lean meats and fish. These can be steamed cutlets, boiled meatballs, souffles, casseroles. After a few days, it is recommended to diversify your diet with vegetable dishes. You can use carrots, potatoes, and cauliflower to make soups, purees and stews. It is not advisable to eat white cabbage, sweet peppers, legumes, and mushrooms when you have diarrhea. Brown bread, carbonated drinks, coffee, and spices also stimulate intestinal motility. Therefore, such products can be introduced into the diet 10 days after complete recovery. In addition, for this period it is necessary to avoid fatty, salty, pickled foods. Gradually and carefully you should include dairy products in your diet.
Fermented milk products enriched with live bacteria will help restore the composition of the intestinal microflora after diarrhea. Microorganisms are contained in special kefir, yoghurts, and starter cultures. The manufacturer indicates the presence of bacteria on the product packaging. Preference should be given to brands that have a short shelf life. You can eat such products after complete normalization of stool.
Prevention of dehydration and intoxication of the body
To prevent poisoning and dehydration, a patient with diarrhea needs to drink enough fluids. You can drink weakly brewed green and black tea, herbal infusions, and juices diluted with water. Adding a small amount of lemon juice to the drink will improve the patient's condition due to its antiseptic effect. Compotes made from quince, pear, blueberry, and bird cherry are useful for diarrhea.
What folk remedies exist for diarrhea?
There are many folk remedies for diarrhea. They not only calm the “raging” digestive system, but also restore its normal functioning. Also the positive side folk remedies is their harmlessness in relation to the normal intestinal microflora. Thus, they rarely cause dysbiosis ( imbalance of intestinal microflora).
All folk remedies from diarrhea can be divided into several groups.
The main three groups of folk remedies that help with diarrhea are:
- specially prepared food products;
- medicinal drinks;
- infusions and decoctions of medicinal plants.
Specially prepared foods that help with diarrhea
When a patient suffers from diarrhea, he must follow a special diet. All food should be gentle, that is, it should not irritate the gastrointestinal tract. Some “gentle” products also have medicinal properties and are used as folk remedies for diarrhea.
The main products that are used as folk remedies for diarrhea are:
- goat fat;
- fresh apples;
- bananas;
- millet cereal;
- chicken stomachs.
Methods for preparing and using products as a folk remedy for diarrhea
| Product | Cooking method | How to use | |
| Dose | Frequency | ||
| Rice |
| approximately 100 grams) rice. | Up to three times a day. |
| Goat fat |
| Before meals, eat two teaspoons of the mixture or one teaspoon of the pure product. | Three to four times a day. |
| Fresh apples | 12 fresh medium-sized apples, peeled and chopped using a grater. | Eat approximately 100–130 grams at a time ( visually the size of a peeled apple). | Every one and a half to two hours ( 8 – 12 times a day). |
| Bananas | Fresh. | You need to eat one or two medium bananas at a time. | Up to five times a day. |
| Millet cereal |
| Eat half a glass at a time ( approximately 130-150 grams) millet porridge. | Twice a day. |
| Chicken stomachs | Rinse chicken gizzards hot water and remove the yellow film from them. Rinse the film well under water and squeeze lightly. Then place the films on a plate and leave them in the sun to dry. Dried films must be crushed into powder using a rolling pin. | You need to swallow one teaspoon of powder and wash it down with liquid. | Once a day. |
Medicinal drinks for diarrhea
Various healing drinks are used as folk remedies for diarrhea, which can be drunk all day without restrictions. They not only eliminate bouts of diarrhea, but also replenish lost fluid from the body.
Products that can be used to prepare anti-diarrhea drinks are:
- oatmeal and rye bread;
- blueberries;
- black tea and onion;
- burnet grass;
- blackberry branches.
Methods for preparing and using drinks as a folk remedy for diarrhea
| Product | Cooking method | How to use | |
| Dose | Frequency | ||
| Oatmeal and rye bread | Pour oatmeal with cold water in a ratio of one to one ( one glass of oatmeal per glass of water). Add a slice of crumbled rye bread. Then wrap the vessel in a towel and leave in a warm place. After 12 hours, strain the mixture into a saucepan and bring to a boil. | Unlimited. | |
| Rice
| One glass of rice is poured with 6 - 7 glasses of settled water and brought to readiness. Separately drain the rice water and cool slightly. | Drink half a glass of warm broth. | 5 times a day with an interval of 2.5 - 3 hours. |
| Blueberry fruit | Blueberry jelly is being prepared. To do this you need:
| Drink one glass of jelly slowly. | Unlimited. |
| Black tea and onion | One onion is peeled and cut halfway crosswise. Then weak black tea is brewed and the onion is dipped into it. The tea should steep for 10 minutes. | Drink one glass at a time. | Optional. |
| Burnet herb | The dried burnet herb should be broken from root to flower and placed in a jar. Pour one liter of boiling water and close the lid. After 40 minutes, strain the infusion. Pour the remaining herb again with a liter of boiling water and leave for two hours. Take a new burnet branch every day. | On the first day, drink slowly, one liter of decoction at a time. On the second day, drink 250 milliliters. | On the first day 2 times, then 4 times a day. |
| Blackberry branches | Pour boiling water over a tablespoon of chopped blackberry branches and brew for 3 – 5 minutes. | Drink like tea. | No limits. |
Infusions and decoctions from medicinal plants
Various infusions and decoctions of medicinal plants and fruits are used as a folk remedy for diarrhea.
The most commonly used herbs for diarrhea are:
- Oak bark;
- bird cherry fruits;
- pomegranate peels;
- walnut leaf;
- walnut partitions.
Infusions and decoctions as a folk remedy for diarrhea
| Product | Cooking method | How to use | |
| Dose | Frequency | ||
| Oak bark | Infusion of oak bark
Oak bark is crushed and poured with boiling water. The ratio of ingredients is one tablespoon of bark per quarter liter of water. Leave for 60 minutes. Then strain. | Drink two teaspoons. | 6 times a day. |
| Decoction of oak bark
Oak bark is crushed and filled with water. The ratio of ingredients is one tablespoon of bark per 300 - 400 milliliters of water. Place over high heat until it boils. Then reduce the heat and simmer for 15 minutes. | Swallow one tablespoon. | 3 times a day. | |
| Bird cherry fruits | A decoction is prepared from bird cherry fruits. Bird cherry is added to boiling water - one tablespoon per quarter liter of water. Leave on low heat for half an hour, then cool. | Drink half a glass of broth. | 2 – 3 times a day. |
| Pomegranate peel | The pomegranate must be washed and cleaned well. Then cut off the white pulp from the peel and dry the peels. A decoction is prepared from crushed dry peels. One tablespoon of crusts should be poured with one liter of boiling water and left in a water bath for half an hour. |
|
|
| Walnut leaf | An infusion is being prepared. The green leaf is crushed and poured with one glass of boiling water. The infusion is kept for 3 – 5 minutes. | Up to one glass of infusion. | Up to three times a day. |
| Walnut partitions | An infusion of dried partitions is prepared. 30 grams of partitions are crushed and poured into a glass of 70 percent alcohol. The infusion is kept for 3 days with periodic shaking. | Take 8-10 drops with water before meals. | Maximum 4 times a day. |
In medicine, the term diarrhea, or as it is called in everyday life, diarrhea, means frequent or single bowel movements with the release of liquid feces.
The causes of this disorder are so varied that almost everyone can suffer from it at least once. In medicine, there are 4 types of diarrhea, differing in the mechanism of development of this disease. Depending on the causes of diarrhea, diarrhea can be acute or chronic.
Read about diarrhea during pregnancy.
Diarrhea (diarrhea) is called acute when bowel movements occur more than twice a day, the stool is liquid and it lasts no more than 2-3 weeks. At the same time, there is no recurrence of such phenomena in the medical history.
Causes of acute diarrhea
There are a huge number of factors that cause diarrhea. The main ones are the following:
- inflammatory processes in the intestines
- intestinal diseases
- , eating poor quality food
- taking medications
- travel (tourist diarrhea).
Infectious diarrhea
Acute infectious diarrhea is characterized by the following symptoms:
- general malaise
- fever
- lack of appetite
- vomit.
Vomiting mainly occurs with foodborne infections caused by staphylococci. For patients with salmonellosis and dysentery, its appearance is not typical.
The most common causative agents of acute diarrhea are and. They are contagious and are transmitted both from person to person and through household items and dirty products.
If blood appears in loose stools, this may indicate damage to the intestinal mucosa by pathogenic microbes such as Shigella, with enteropathogenic properties. The possibility of venereal disease of the rectum should be kept in mind.
Acute bloody diarrhea may be the first manifestation and. In this case, severe abdominal pain and a serious clinical condition occur.
Diarrhea from antibiotics
Diarrhea when taking antibiotics is caused by a disturbance in the bacterial flora of the intestines. As a rule, it does not worsen a person’s general condition and stops after stopping the medication. However, sometimes during antibiotic therapy it can develop, which is characterized by sudden severe watery diarrhea with high fever, and possibly blood in the stool.
Traveler's diarrhea
Most often, travelers' diarrhea is detected in people visiting countries with unfavorable epidemiological conditions.
The disease is caused by consuming food and water contaminated with feces. The causative agents are most often Escherichia coli, enteroviruses, and less often - Shigella, amoeba and Giardia.
The disease is not transmitted directly from one person to another. Sources of infection are meat, eggs, milk, culinary products, and water.
Traveler's diarrhea begins acutely. Symptoms such as:
- nausea
- vomit
- rumbling
- transfusion
- stomach ache
- diarrhea.
In the case of a viral infection, the disease is accompanied by headache and muscle pain.
Treatment requires a gentle diet with the exception, first of all, of raw vegetables and fruits. Intestinal antiseptics should be taken. It is important to skillfully determine the dose of drugs so as not to cause irritable bowel syndrome.
As a preventive measure, it is necessary to strictly observe the rules of personal hygiene, wash food thoroughly, do not buy food from hand, and do not drink raw water.
What to do if you have stomach pain and diarrhea?
If diarrhea is not accompanied by fever and a noticeable deterioration in condition, then it is often enough to change your diet, drink herbal astringent decoctions or take an antidiarrheal drug. Nutrition and will be described in the article later.
But it is important not to miss the onset of a serious illness, therefore, in case of diarrhea with high fever or the presence of blood in the stool, bacteriological examinations of stool and stool are necessary. This will determine whether the cause of diarrhea is dysentery, ulcerative colitis, or pseudomembranous colitis, which is a complication when taking antibacterial drugs. 
Chronic form
Diarrhea is chronic if it lasts more than 3 weeks. They talk about the chronic form and in the case of too much stool, more than 300 g per day. Although if a person consumes a lot of plant fiber, then this weight may be normal.
With chronic diarrhea, the body constantly loses fluids, electrolytes and other nutrients. Therefore, at the same time, many people suffer from insufficient weight, deficiency of vitamins and microelements and related complications. It is very important to quickly find the cause of diarrhea and begin treatment. It is especially important to make a quick diagnosis in children, since chronic diarrhea in children can cause developmental delays.
Causes
The main causes of chronic diarrhea are not only diseases of the gastrointestinal tract, but also a number of other factors.
Diarrhea accompanies diseases such as diabetes, endocrine disorders, and scleroderma. It is associated with impaired motor function. Sometimes diarrhea is the first clearly visible sign of these diseases. Therefore, it is important to make an accurate diagnosis. For example, with hyperthyroidism, the main manifestation of the disease in the first stages can also be prolonged diarrhea, while the main signs of the disease (a constant feeling of heat, irritability or weight loss with a good appetite) may recede into the background and not be taken into account by the patient.
Surgical interventions
The cause of chronic diarrhea in patients who have undergone gastric or intestinal resection may be bacterial contamination of the small intestine and disruption of its motor function.
After removal of the pancreas, diarrhea occurs, as with chronic alcoholism and frequent exacerbations of chronic pancreatitis. This is due to a deficiency of all pancreatic enzymes.
Gastrointestinal diseases and diarrhea
Diarrhea accompanies Crohn's disease and ulcerative colitis. Loose stools in such patients are usually profuse, foul-smelling, with floating fat. If you previously had or, then it is possible to assume Crohn's disease. These diseases may have extraintestinal manifestations such as arthritis or skin lesions.
Diarrhea can also be accompanied by diseases such as chronic gastritis of the stomach, diseases of the pancreas, hepatobiliary system, endocrine glands, as well as allergic reactions and hypo- and avitaminosis. Inflammation of diverticula can also be the cause.
Tumors and diarrhea
Tumors of the rectum and colon may also present with diarrhea. The absence of other causes of this disorder in older patients and the presence of blood in the stool support this assumption.
In patients with carcinoid syndrome, the disease may be accompanied by episodes of profuse watery diarrhea. If the tumor is large enough and there are no liver metastases, this may be the only symptom of the disease.
Survey
In case of chronic diarrhea, it is necessary to conduct an examination to determine the degree of dehydration of the body and identify the connection with systemic diseases. Moreover, both a comprehensive diagnosis of organs and macro- and microscopic examinations of feces are necessary. In modern medicine, there are clear diagnostic algorithms for acute and chronic diarrhea.
Functional diarrhea
There are also functional intestinal disorders, which are manifested by chronic diarrhea without organic and biochemical lesions. It is believed that heredity and psycho-emotional stress play a significant role in the occurrence of functional diarrhea.
The main signs to establish functional diarrhea:
- no diarrhea at night
- morning stool (usually after breakfast)
- strong uncontrollable urge to defecate.
So, the main distinguishing feature of this disorder is the clear dependence of the rhythm of bowel movements on the time of day. As a rule, this is repeated emptying in the morning or early afternoon. At the same time, during the first stool, feces may be more dense and voluminous, then its volume decreases and it becomes liquid. Often the act of defecation is accompanied by a feeling of incomplete bowel movement.
The diagnosis is made by excluding other causes of diarrhea. This type of diarrhea is typical for. 
When should you see a doctor?
If diarrhea is not accompanied by a significant deterioration in the general condition of the body, then you can get by with home remedies. However, in some cases it is necessary to see a doctor:
- diarrhea in children under 12 years of age and elderly people over 75 years of age
- diarrhea during pregnancy
- diarrhea in people with weakened immune systems
- diarrhea as a side effect or drug intolerance
- fever
- bloody diarrhea
- complaints within three months after traveling abroad
- if diarrhea continues for more than three days.
Diet
For intestinal diseases accompanied by diarrhea, it is necessary to follow a diet that will help inhibit peristalsis and reduce the secretion of water and electrolytes into the intestinal lumen.
Peristalsis usually ensures that food entering the intestines moves forward and is digested as it goes. During the digestion process, more and more water is removed from food, and the stool takes on a normal, firm consistency. With diarrhea, the intestines are often “overactive”—they contract too much to quickly flush harmful bacteria, viruses, or toxins out of the body. At the same time, the food lump passes too quickly, the water does not have time to be absorbed, and too much water remains in the intestines. This is the cause of watery diarrhea. In addition, there is no time to absorb nutrients from food.
To restore peristalsis, mechanically and chemically gentle food is first necessary. Meets these requirements. It is prescribed during periods of exacerbation.
When the acute period ends, a diet is prescribed. This diet is similar to No. 4b, but all products are given in unground form. With this diet, baking foods in the oven is allowed. Additionally, ripe tomatoes, salad with sour cream, sweet berries and raw fruits are allowed.
How to get rid of diarrhea at home?
To restore peristalsis, you can take probiotics or medicinal charcoal. If there is a large loss of water, if there are no pharmaceutical means to retain fluid in the body, you can drink salted water.
Compliance simple rules will help normalize stool.
- Proven remedies for diarrhea include finely pureed with peel, raw apples. The pectin they contain binds water and toxins in the intestines.
- Carrot soup: When carrots are cooked, cellular structures are destroyed and ingredients appear that prevent intestinal bacteria from entering the intestinal mucosa. In addition, the salt in the soup and the carrots contain important minerals. Carrot juice and grated raw carrots can also help.
- Bananas are a particularly valuable home remedy for diarrhea - like apples, they contain pectin. In addition, they provide the body with minerals such as potassium and magnesium. Bananas must be thoroughly mashed before eating.
- Black or green tea: When brewed for more than 3 minutes, the tea produces a sufficient amount of tannins, which have a calming effect on the intestines.
- Low-fat clear broth or decoction: returns energy and minerals to the body. You can cook a small amount of pasta, rice or potatoes in it until soft. You need to drink the broth in small sips.
- Decoctions of herbs and dried berries: pour 2 to 3 teaspoons of dried blueberries, chamomile, blackberry leaves or dill seeds into a quarter liter of boiling water and bring to a boil. They help protect the intestinal mucosa from pathogens.
- In addition, liquids even out the hydrobalance.
- Still water and herbal teas are best. Chilled drinks are poorly tolerated by the intestines. The liquid should be at least room temperature. But warm tea has a particularly beneficial effect on the stomach and intestines.
If you have diarrhea, it is very important to drink a lot
What should you not eat if you have diarrhea?
- raw vegetables (except carrots)
- Foods that cause gas, such as onions, beans, leeks, cabbage
- fatty sausages, such as salami
- fats, full-fat dairy products
- fried foods
- foods containing acids, such as citrus fruits, vinegar
- alcohol.
Often after answering the question: “What do you eat when you have diarrhea?”, the question follows: “When can you eat normally?”
After eliminating the infection, you can gradually switch to your usual diet, as soon as the intestines no longer create any problems (diarrhea, nausea and vomiting).
For chronic diarrhea caused by nutritional diseases, the diet is followed in the long term. This applies, for example, to lactose or fructose intolerance.
Normally, the volume of feces averages 200 g/day, and the water content in feces is 60-75%. With diarrhea, the volume of feces increases due to an increase in the proportion of water in it. The composition of the solid components of stool may also change.
Absorption and secretion of water in the intestine
During fasting, the intestines contain very little water. With a normal diet (3 meals per day), about 9 liters of liquid enter the small intestine per day. Of this, 2 liters come from food and drinks, the rest consists of liquids secreted into the lumen of the gastrointestinal tract along its entire length. Of these 9 liters, 90% is absorbed in the small intestine. Of the remaining 1-2 liters, 90% is absorbed in the colon. The absorption of all fluid in the lumen of the colon and dehydration of feces is prevented by the presence of non-absorbable osmotically active substances contained in food (for example, some carbohydrates) and produced by the intestinal flora. Due to this, 100-200 gets into the feces. ml of water per day. Thus, approximately 98% of the water entering the gastrointestinal tract daily is absorbed in the intestines. Feces on average contain 100 ml of water, 40 mmol/l sodium, 90 mmol/l potassium, 16 mmol/l chlorine, 30 mmol/l bicarbonate, as well as organic anions formed during bacterial fermentation of non-absorbable carbohydrates. There is no dilution mechanism in the gastrointestinal tract, so stool osmolality cannot be less than plasma osmolality. In fact, stool osmolality is usually higher than plasma osmolality due to the fact that bacteria continue to break down non-absorbable carbohydrates into osmotically active substances after defecation.
Water transport in the intestinal epithelium occurs passively due to the osmotic gradient, which is created by the active transport of electrolytes (for example, Na+ and SG ions) and other substances such as carbohydrates and amino acids. The absorption of ions occurs mainly in the epithelial cells located at the ends of the intestinal villi. Secretion of ions occurs in the crypts. The main actively absorbed ion is sodium, the main secreted ion is chlorine. Active transport of sodium occurs in the intestine via Na + ,K + -ATPase in the basolateral membranes of intestinal epithelial cells. Water is absorbed along with sodium. Active secretion of chlorine ions is also carried out through Na + ,K + -ATPase, but located in the basolateral membranes of crypt cells. Water is secreted into the intestinal lumen along with chloride ions.
If, for any reason, the absorption of sodium and water ions or increased secretion of chloride ions and water into the intestinal lumen is impaired, diarrhea occurs.
Causes of diarrhea
There are four main mechanisms behind diarrhea.
- Osmotic diarrhea. In the intestinal lumen, the amount of poorly absorbed osmotically active substances is increased.
- Secretory diarrhea. Increased secretion of chlorine and water into the intestinal lumen; At the same time, the absorption of sodium and water may also be impaired.
- Inflammatory diarrhea. Mucus, blood and protein from inflamed areas of the mucosa enter the intestinal lumen.
- Peristalsis disorders. Contact of intestinal contents with the mucosa is increased or decreased.
Osmotic diarrhea
Causes of osmotic diarrhea
Osmotic diarrhea is caused by the ingestion of poorly absorbed osmotically active substances, such as carbohydrates or divalent ions such as magnesium or sulfate, into the gastrointestinal tract. An increase in the osmolality of intestinal contents leads to the passage of water through the epithelium of the duodenum and jejunum into the intestinal lumen (to dilute the chyme). Together with water, sodium enters the intestinal lumen from the plasma along a concentration gradient, which again causes an influx of water, despite the fact that the osmolality of the intestinal contents and plasma has already equalized. The epithelium of the ileum and colon, on the contrary, is poorly permeable to sodium and osmotically active substances. It has an active ion transport system that operates even with a high electrochemical gradient, due to which sodium and water are reabsorbed. Thus, after intestinal contents enter the ileum and colon, part of the water is absorbed and a partial “correction” of the disorders occurs. Since the volume of fluid entering the colon still exceeds its absorption capacity, diarrhea occurs.
In case of lactase deficiency, food lactose is not absorbed in the small intestine and enters the large intestine, where it is broken down by intestinal microflora. This also produces osmotically active substances, which increases the osmotic load and causes diarrhea.
Symptoms and signs of osmotic diarrhea
Osmotic diarrhea stops with fasting. The calculated stool osmolality is less than the osmolality measured by the decrease in the freezing point of the solution. This osmotic anion gap occurs due to the presence of poorly absorbed osmotic active substances in the feces. An anion gap greater than 50 mOsm/kg indicates osmotic diarrhea. Determining stool pH can help diagnose osmotic diarrhea. Carbohydrates in feces provide an acidic environment, magnesium hydroxide is alkaline, and poorly absorbed salts containing magnesium ions or sulfate are neutral.
Secretory diarrhea
Causes of secretory diarrhea
Loose stools of more than a liter per day are caused by increased secretion of water through the mucous membrane into the intestinal lumen. In most cases, this is due to a simultaneous increase in active secretion and partial suppression of absorption in the intestine. The intestinal mucosa is often normal upon histological examination.
Symptoms and signs of secretory diarrhea
Secretory diarrhea is characterized by the following symptoms:
- Large volume of feces (more than 1 l/day).
- Watery stool.
- There is no blood or pus in the stool.
- Diarrhea continues even if the patient does not eat anything for 24-48 hours. However, if the absorption of fatty acids is impaired or if laxatives are abused, diarrhea goes away with the cessation of taking these substances.
- Fecal osmolality is close to plasma osmolality; There is no anion gap.
Inflammatory diarrhea
With inflammation and ulceration of the mucous membrane, mucus, blood and pus enter the intestinal lumen and are excreted with feces. This may increase the osmotic load. If the mucous membrane is affected over a large area, the absorption of ions, other solutes and water may also be impaired, which leads to an increase in the volume of feces. In addition, inflammation releases prostaglandins, which stimulate secretion in the intestines and can increase peristalsis, which also contributes to the development of diarrhea. The severity of diarrhea and general symptoms depends on the degree of mucosal damage.
The cause of inflammation can be:
- Crohn's disease, ulcerative colitis (idiopathic inflammation).
- Infections caused by microorganisms that penetrate the mucosa or produce cytotoxins,
- Vasculitis.
- Ionizing radiation.
- Abscess formation (diverticulitis, infection of a malignant tumor).
Peristalsis disorders
Diarrhea can be caused by either increased or decreased peristalsis.
- With increased peristalsis of the small intestine, the contact of chyme with the absorptive surface decreases. As a result, the volume of fluid entering the colon may exceed its ability to be absorbed, resulting in diarrhea. Due to decreased contact of chyme with the wall of the small intestine, the absorption of fats and bile acids is impaired, as a result of which they enter the large intestine, causing secretory diarrhea. Intestinal peristalsis can increase, leading to diarrhea, for example, with thyrotoxicosis, carcinoid, dumping syndrome.
- When the peristalsis of the small intestine is weakened, bacteria that live in the large intestine can colonize it. This may interfere with the digestion and absorption of fats, carbohydrates and bile acids, which leads to secretory and osmotic diarrhea. This explains the diarrhea that occurs when diabetes mellitus, hypothyroidism, systemic scleroderma, amyloidosis, after truncal vagotomy.
- Increased peristalsis of the colon with premature emptying is the main cause of diarrhea in irritable bowel syndrome.
- Dysfunction of the anal sphincters due to neuromuscular diseases, as a result of inflammation, scarring and after rectal surgery can lead to fecal incontinence, which patients sometimes mistake for diarrhea.
Clinical classification of diarrhea
The clinical classification of diarrhea takes into account its duration, conditions of occurrence, and characteristics of the patient’s sexual life. Diarrhea with a sudden onset, lasting no more than 2-3 weeks, is considered acute. If diarrhea lasts longer than 3 weeks, it is called chronic. If diarrhea develops during or after antimicrobial therapy, pseudomembranous colitis caused by Clostridium difficile should be excluded.
Acute diarrhea
Acute diarrhea is most often caused by infection.
Food poisoning occurs when you eat food that contains bacterial toxins. Reproduction of the bacteria themselves in the body is not necessary. The disease usually begins acutely but does not last long. Food poisoning occurs in small outbreaks without further spread.
Diarrhea caused by the proliferation of microorganisms in the intestines can be divided into two groups: with and without mucosal invasion. Most often, such diarrhea develops 1-2 days after ingestion of food or water contaminated with pathogenic microorganisms. In some cases, animals serve as the reservoir of infection.
Diarrhea that occurs during or immediately after a trip is usually infectious in nature.
The risk of contracting intestinal infections is higher among homosexuals. They should definitely exclude amebiasis, giardiasis, dysentery, gonococcal proctitis, damage to the rectum due to syphilis, lymphogranuloma venereum (caused by Chlamydia trachomatis), herpetic damage to the rectum and perianal area. In HIV-infected people, diarrhea can also be caused by cytomegalovirus, Cryptosporidium spp. and fungi of the genus Candida.
Chronic and recurrent diarrhea
For diarrhea lasting more than 3 weeks, additional examination is necessary.
Infections. Diarrhea caused by bacterial and viral infections usually lasts no more than 3 weeks and goes away on its own. For infections caused by Campylobacter spp. and Yersinia spp., diarrhea can last for several months, but rarely becomes chronic. Amebiasis, giardiasis, and intestinal damage due to tuberculosis can take a chronic form.
Absorption disorders
Diseases of the small intestine may be accompanied by diarrhea of varying severity. Diarrhea in these cases is usually caused by a combination of several mechanisms.
Causes of diarrhea can be:
- Celiac disease and sprue.
- Amyloidosis.
- Whipple's disease.
- Lymphomas.
- Carcinoid.
- Radiation enteritis.
- Lymphangiectasia.
- Bowel resection or anastomosis.
Zollinger-Ellison syndrome. Increased secretion of gastrin by the tumor leads to hyperchlorhydria. The amount of hydrochloric acid exceeds the absorption capacity of the proximal small intestine; excess acid neutralizes bicarbonates and inhibits enzymes secreted by the pancreas into the duodenum.
After gastrectomy, gastrectomy, ileo- and jejunostomy The cause of diarrhea may be a decrease in the time during which the mucous membrane is in contact with chyme, and its poor mixing with digestive juices, which leads to malabsorption.
Bacterial overgrowth in the small intestine is observed in diabetes mellitus, systemic scleroderma, amyloidosis, blind loop syndrome, large and multiple diverticula of the small intestine. Diarrhea is caused by the breakdown of carbohydrates, fats and bile acids by bacteria.
Disaccharase deficiency. Lactase deficiency to varying degrees is observed in many adults, especially blacks, Asians, natives of Southern Europe and Jews. In such people, even small amounts of dairy products can cause diarrhea.
Endocrine diseases
- Thyrotoxicosis.
- Diabetes.
- Adrenal insufficiency.
- Carcinoid.
- Medullary thyroid cancer.
- Hormone-active tumors of the pancreas.
- Tumors secreting VIP.
- Gastrinoma.
Neoplasms. Under wasps can develop with villous polyps, intestinal obstruction and fecal blockages caused by colon cancer.
Medicines. When determining the causes of chronic diarrhea, you should always remember that the patient may be taking laxatives and other medications.
Irritable bowel syndrome. This condition is very common and can only be manifested by periodic diarrhea, constipation, or alternating between them. Most patients also complain of cramping abdominal pain and flatulence. belching and mucus in the stool.
Fecal incontinence and frequent bowel movements. They can be observed when the function of the anal sphincters is impaired due to anal fissure, perirectal fistula, inflammation of the perianal tissues, soft tissue ruptures during childbirth, anal intercourse or other trauma, diabetic neuropathy, neuromuscular diseases. Sometimes patients mistake these phenomena for diarrhea.
Diagnosis of diarrhea
Anamnesis
When interviewing the patient, it is necessary to get a clear idea of the nature of the diarrhea. Find out how long the diarrhea lasts, what is the frequency, consistency, color and volume of stool, and whether the diarrhea is associated with food intake. It is also important to find out whether the patient suffers from other diseases (exacerbation of which can cause diarrhea), whether he has general symptoms, whether he has traveled anywhere recently, what medications or drugs he is taking, as well as the characteristics of his sexual life.
Taking an anamnesis helps determine whether the pathological process is localized in the small or large intestine. If a lot of stool is produced, it is liquid, watery or greasy, and contains the remains of undigested food, diarrhea is most likely caused by damage to the small intestine. The patient may complain of pain in the umbilical or right iliac region or periodic cramping pain in the abdomen.
With frequent stools in small portions mixed with mucus, the descending colon or rectum is most likely affected. The stool is usually pasty, brown in color, and may contain blood and mucus. The pain is usually mild or absent altogether and is localized in the lower abdomen or sacral area. After bowel movements or passing gas, the pain may temporarily decrease.
Blood in the stool may indicate inflammation, vascular damage, infection or tumor. White blood cells in stool are a sign of inflammation.
If diarrhea resolves with fasting, it is likely to be osmotic in nature, although secretory diarrhea caused by malabsorption of fats and bile acids may also resolve with fasting. Profuse diarrhea that does not stop during fasting is most likely secretory. If diarrhea continues at night, organic intestinal damage is likely.
Nutrition. You need to find out if diarrhea is associated with the consumption of milk and other dairy products, soft drinks, candy or chewing gum that contain sorbitol.
Physical examination
It is important to assess the general condition of the patient, the degree of dehydration, the presence of fever and other general symptoms of intoxication. With chronic diarrhea, a number of symptoms are possible that may indicate the cause of the diarrhea, including enlarged thyroid gland, rash, arthritis, neuropathy, orthostatic hypotension, vascular bruit on auscultation of the abdomen; with digital rectal examination - signs of paraproctitis (pain, fluctuation), fistulous tract, mass formation in the rectum or fecal stones.
Laboratory and instrumental studies
They start with a general blood test with calculation of the leukocyte formula to determine the levels of electrolytes, BUN and creatinine. A biochemical blood test and urine test can also help identify the cause of diarrhea.
Sigmoidoscopy and colonoscopy carried out without preliminary bowel preparation. Aspiration can be used to obtain stool samples for microscopic examination and culture. For acute diarrhea or travelers' diarrhea, sigmoidoscopy is most often not needed.
- bloody diarrhea:
- diarrhea of unknown etiology;
- chronic inflammatory bowel diseases, pseudomembranous colitis, pancreatic diseases, laxative abuse (melanosis of the colon).
3. X-ray examination. As a rule, the studies described above are sufficient to identify the causes of diarrhea. But in case of chronic or recurrent diarrhea, X-ray contrast examination of the small and large intestines can help identify the location and extent of intestinal damage. It must be remembered that after the barium suspension enters the intestines, stool examination for the presence of protozoa, helminths and their eggs, as well as stool culture for several weeks will not produce results, since the barium suspension affects the intestinal microflora.
4. Other studies. At. Chronic diarrhea may require other tests to evaluate malabsorption, intestinal bacterial overgrowth, or hormonal imbalances.
Treatment of diarrhea
Acute diarrhea with dehydration and electrolyte disturbances is one of the leading causes of death, especially in children in developing countries. Rehydration by administering fluids orally or intravenously can prevent the death of the patient. For oral rehydration, a simple solution containing sodium, potassium and glucose salts is suitable. Water in the small intestine is absorbed along with sodium and glucose, the cotransport of which is not impaired even with the most severe diarrhea.
It is also important to alleviate the patient’s condition - this will improve his well-being and reduce the time spent on sick leave or the number of missed classes at school. Drugs used to treat diarrhea can be divided into the following groups according to their mechanism of action: adsorbents; agents that inhibit gastrointestinal secretion; opioids; M-anticholinergics; antimicrobial agents.
Adsorbents(attapulgite, aluminum hydroxide) do not affect the course of the disease, but make the stool harder. This allows the patient to better control bowel movements and reduce their frequency.
Drugs that inhibit gastrointestinal secretion. Bismuth subsalicylate. This drug has been shown to suppress the secretory activity of Vibrio cholerae, Shigella spp. and enterotoxigenic strains of Escherichia coli, and when taken prophylactically, prevents infections caused by these bacteria. Bismuth subsalicylate in the form of a suspension is taken orally, 30 ml every 30 minutes - a total of 8 times. Chewable tablets are just as effective as the suspension.
Opioids widely used for both acute and chronic diarrhea. By weakening peristalsis, they slow down the passage of intestinal contents, which promotes more complete absorption of fluid. They can be used for moderate diarrhea, but should not be prescribed for fever and other signs of intoxication, as well as bloody diarrhea. If the patient's condition does not improve, or even worsens, opioids are discontinued.
This group of drugs includes paregoric, loperamide and diphenoxylate/atropine. Unlike the latter, loperamide does not contain atropine and has fewer side effects on the central nervous system.
M-anticholinergics in most cases, they are useless for diarrhea. In some cases, dicycloverine provides relief from irritable bowel syndrome.
Antimicrobial agents. In case of severe diarrhea with intoxication, stool culture is performed to determine the pathogens. It is necessary to use the drug that is most active against this pathogen. In some cases, with severe diarrhea, if laboratory tests cannot be performed, empirical therapy with drugs active against Shigella spp is prescribed. and Campylobacter spp. (ciprofloxacin, TMP/SMX, erythromycin). Not long ago, the antibiotic rifaximin appeared on the pharmaceutical market for the treatment of travelers' diarrhea. It is not absorbed in the intestines, and therefore is especially effective for intestinal infections.
The use of antibiotics for infections caused by enterohemorrhagic strains of Escherichia coli is a controversial issue, since, according to some data, the risk of hemolytic-uremic syndrome increases with antibiotic therapy. However, if diarrhea is severe, antibiotics can be prescribed if you are careful.
Drug prevention of traveler's diarrhea. Prophylactic administration of bismuth subsalicylate, doxycycline, TMP/SMX, as well as norfloxanine and ciprofloxacin in most cases can prevent traveler's diarrhea. Prevention begins from the first day of the trip.
The FDA recently approved rifaximin for the treatment of traveler's diarrhea.
Drug prevention of traveler's diarrhea is not justified in most cases. All drugs have some side effects and contribute to the development of resistance in the bacteria inhabiting the intestines. This may make it difficult to treat another condition, such as a urinary tract infection. For persons traveling on a business trip, drug prophylaxis is carried out for 2-5 days, provided that they are familiar with the possible side effects. The exception is rifaximin. It is effective in preventing traveler's diarrhea when taken daily throughout the trip. At a dose of 200 mg 3 times a day orally, it is recommended for those who travel to regions where the risk of intestinal infections caused by Escherichia coli and other pathogens is high.
Chronic and recurrent diarrhea. Treatment of chronic and recurrent diarrhea is determined by the etiology and pathogenesis of the underlying disease. Occasionally, when the diagnosis cannot be established, empirical treatment is performed. Limit the consumption of foods containing lactose, gluten, and long-chain fatty acids; Prescribe pancreatic enzymes, H2 blockers, cholestyramine, clonidine and antimicrobial agents (for example, metronidazole). If all this does not help, opioids are prescribed with caution to alleviate the patient's condition.
Diarrhea is not a disease, but a symptom that can be caused by various reasons. Usually the causes of diarrhea are quickly identified. Diarrhea is often accompanied by abdominal cramps or high fever.
In adults, diarrhea is rarely dangerous. In children of different ages and in the elderly, diarrhea can cause, which can lead to serious consequences.
Causes
Causes of chronic diarrhea may include:
Symptoms
Adults can try to cope with the problem on their own if they have too frequent bowel movements, without an increase in body temperature and with good general health. You should definitely consult a doctor if diarrhea appears after a trip to Africa, Asia and other remote regions, or if the cause of diarrhea is exotic food, water from unknown sources, incl. reservoirs and wells.
If there is a high body temperature, nausea, vomiting, if there is blood in the stool, or if there is a severe constant (more than 2 hours), you should immediately seek medical help.
Complications
- dehydration (dry lips and tongue, feeling thirsty, rapid breathing, rare urination).
What can you do
Drink more liquid, preferably warm or room temperature (water, broth). Avoid alcohol, coffee, milk and fruit juices. If your baby has diarrhea, continue to breastfeed. When formula feeding, replace cow's milk clean water. You need to drink in small portions, in small sips.
Do not eat if you have no appetite, indigestion or abdominal cramps.
When your appetite returns, it is recommended to eat bananas, rice, dried white bread, processed grains (oatmeal, for example), potatoes, boiled or baked vegetables, and lean meat in small quantities.
Until the intestinal condition is completely normalized, avoid fresh fruit, green vegetables, alcohol, fatty, spicy and fried foods.
If you have prolonged diarrhea, especially when accompanied by weight loss, you should immediately consult a doctor.
If necessary, over-the-counter antidiarrheal medications can be used for temporary relief. However, these products are not recommended for long-term use, because they can increase the duration diarrhea or cause more serious problems. (Caution: Products containing salicylate may temporarily darken the tongue or stool.)
Contact your doctor if you think your diarrhea may be related to a drug you are taking. Diarrhea is a common side effect of nonsteroidal anti-inflammatory drugs (NSAIDs), antibiotics, and antidepressants.
Call your doctor right away if diarrhea lasts more than 2 days in children or more than 5 days in adults, or if you have signs of dehydration, severe abdominal cramps or pain, or dark, bloody, or mucous stools. Infants and the elderly with any of the above symptoms should be taken to the hospital.
What can a doctor do?
In most cases, diarrhea goes away on its own within 2 days. If a liquid diet doesn't help, your doctor may prescribe medications to slow down your bowel movements. However, such drugs are not recommended for children.
The doctor must determine and treat the cause of the diarrhea. If necessary, refer you to the hospital for tests and treatment.
Preventive measures
Wash your hands after using the toilet, changing your baby, and before eating. Hands should be washed with warm water and soap. After cooking, especially if you have handled raw meat, be sure to wash your hands thoroughly.
Be careful with food. Unpasteurized dairy products, eggs, poultry and meat can contain bacteria that can cause diarrhea and other gastrointestinal problems. The meat must undergo complete heat treatment. Wash cutting boards and knives thoroughly.
Avoid eating unpasteurized dairy products, especially those of unknown origin. Do not leave cooked foods in a warm place for a long time, as... this can provoke the proliferation of dangerous bacteria.
If you have diarrhea, you should not work as a cook, waiter, etc. until the diarrhea goes away completely.
If you travel, do not drink raw water or any untreated water, especially of unknown origin. Drink better water well-known manufacturers, packaged in bottles or cans. To purify local water, it must be boiled for 15 minutes; you can also add tablets or drops of chlorine or use a special filter. When using chlorine and iodine tablets, read the instructions carefully and follow them.
Also, under no circumstances should you eat unwashed fruits and vegetables (it is advisable to wash them only in clean water and very thoroughly, or even better, peel them). Avoid fruits such as melons, which are often pumped with water from the inside to increase their weight.
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