Symptoms and treatment of enteritis in children

A distinctive feature of the acute course of the disease is the presence of light yellow liquid stool with rechecked food pieces, if the presence of viral etiology is observed, then the smell from just unpleasant turns into sharp-putrid.

Symptoms of this disease are represented by such manifestations:

  • frequent defecation - up to 15-20 hikes toilet per day,
  • flatulence, manifested by rumbling and bloating,
  • pain in the navel, especially noticeable on a full stomach,
  • brilliant appearance of feces,
  • watery and frothy feces,
  • fever,
  • increased vomiting,
  • noticeable weight loss associated with refusal to eat
  • headache,
  • sleep disturbance,
  • fatigue
  • dry epidermis,
  • muscle pain,
  • tremor of limbs
  • brittle nails,
  • hair loss.

We have examined the symptoms of acute enteritis; now we turn to the study of methods of treatment of this ailment.

Treatment of acute enteritis

To treat a child for acute enteritis should pediatrician and in a hospital. Self-treatment should be avoided, as this is fraught with unforeseen complications and the transition of the disease from the acute to the chronic stage.

Principles of treatment of children's enteritis with an acute form of the disease are as follows:

  1. Drug, which includes taking such drugs as:
  • to normalize the water-salt balance of the body,
  • enterosoconating - to remove toxins and reduce bloating,
  • enzyme - to enhance digestive function,
  • probiotic - to improve the microflora of the stomach,
  • fortified,
  • antidiarrheal - to normalize the fecal component,
  • antispasmodic - to reduce colic and gas,
  • anti-inflammatory (only with bacterial enteritis).
  1. Physiotherapy:
  2. Phytotreatment: decoctions of plants: pomegranate peels, calendula, chamomile and bird cherry infusions, plantain juice.
  3. Sanitary resort.

But before the start of therapeutic measures it is necessary to review the child’s food table: the food should be warm, lean, light, but at the same time high-calorie. It is necessary to eat at least 5 times a day in small portions.

Acute enteritis in children is the treatment of symptoms - this is quite a long process and parents need to approach it responsibly.

Symptoms of enteritis in children

The main symptom of enteritis in children is diarrhea. Fecal masses of the child become abundant, have a light yellow color and contain particles of undigested food mixed with mucus. In some cases, fecal masses acquire a gray color, have a clayy appearance and characteristic luster, in this case, the child can assume a violation of the process of digestion of fats. During the course of putrefactive processes in the intestinal cavity, the feces acquire a fetid odor, with the predominance of fermentation processes, the fecal masses become foamy.

The child usually complains of pain during bowel movements, stool frequency during exacerbation of enteritis in some cases reaches 20 times a day. In addition, children have increased gas formation, rumbling in the abdominal area, pain. Palpation reveals tenderness in the navel.

In addition to local manifestations of pathology, patients have symptoms characteristic of metabolic disorders and functional changes in some organs and systems. The most severe enteritis occurs in young children.

When making a diagnosis, they pay attention to the intolerance of some products, especially milk, as well as the history of intestinal infections.

Treatment of enteritis in children

Treatment of enteritis in children requires an integrated approach. The patient must adhere to a certain diet: the diet of the child must contain a significant amount of protein, the patient must receive fats in physiological amounts, but carbohydrate intake should be limited. It is necessary to exclude milk and foods rich in fiber.

In severe cases, the child is prescribed antibiotics, parenteral nutrition, and is recommended to take B vitamins, vitamin C and folic acid.

Be sure to be treated with enzyme preparations. After antibiotic therapy, it is recommended to take medications that normalize the intestinal microflora, as well as bacteriophages. Envelopes, sorbents, infusions and decoctions of medicinal plants give a good effect.

After long-term treatment, the prognosis of the disease is favorable.

Expert Editor: Pavel Alexandrovich Mochalov | D.M.N. general practitioner

Education: Moscow Medical Institute. I. M. Sechenov, specialty - “Medicine” in 1991, in 1993 “Occupational diseases”, in 1996 “Therapy”.

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What is enteritis?

Enteritis is called acute or chronic inflammation of the intestinal mucosa, as a result of which irreversible dystrophic changes occur in this organ. The first sign of a serious illness is frequent diarrhea in a child. In addition, an alarming rumbling in the abdomen, his swelling and unpleasant sensations in the navel area join. In the most severe cases, the disease becomes the cause of the development of such complications as hypovitaminosis and adrenal insufficiency.

Pathology very often occurs as a result of the defeat of the intestinal environment by worms, bacteria or protozoan parasites. For enteritis, it is also characteristic of its development under the influence of aggressive chemical agents, and the disease can also occur against the background of nutritional disorders.

Enteritis may be acute or chronic. Acute enteritis affects the development of the disease at the beginning, and chronic develops against the background of an advanced disease. The disease occurs against the background of inflammation of the stomach (gastroenteritis) or colon (enterocolitis). In children, enteritis is most often a sign of another disease, but can also act as an independent disease.

Causes of the development of the disease in children

The causes of the disease are the following factors:

  • toxic effects on a small organism of toxic substances in the form of heavy metals and fungi,
  • worm infestation,
  • long-term use of drugs,
  • not complying with basic hygiene
  • poor processing of fresh fruits and vegetables before they are consumed,
  • lack of protein food in the diet of the baby,
  • rotavirus infection
  • somatic diseases of the digestive organs, malformations and enzymopathy,
  • operational consequences
  • heavy foods, such as spicy or fatty foods,
  • radiation,
  • allergy,
  • intestinal disorders.

Enteritis is always subject to weaker organisms. The disease can overtake those children in whom the body is experiencing avitaminosis, are often supercooled, constantly catch cold, or are overwhelmed with infectious diseases, use an excessive amount of food with fiber.

How is enteritis transmitted?

Enteritis is transmitted through dirty hands through the fecal-oral route, as well as through poorly processed vegetables and water. The infection is very resistant to the acid secreted by the gastric juice, so it easily penetrates and multiplies in the red blood cells of the small intestine.

The wall of the intestine as a result of the adverse effects on it swells and can no longer normally cope with its functions in the absorption of nutrients. Consequently, digestion is disturbed, and in general, a favorable environment for the reproduction of bacteria appears.

Symptoms of the disease

Enteritis always declares itself through a list of the following symptoms in a child:

  • loose stools several times a day
  • flatulence,
  • rumbling belly
  • fecal masses change their structure, particles of undigested food become visible in them,
  • in infants the stool acquires a watery consistency,
  • feces become greasy and shiny
  • colic or dull pains in the navel after eating,
  • nausea and vomiting.

At the same time, the baby loses weight dramatically, loses weight, his appetite disappears, there is great fatigue and fatigue. Sleep is getting worse, hair and nails become brittle, skin and mucous membrane dries out, muscle pains appear, and swelling occurs. Headaches, moods, loss of appetite and mood - constant companions of the patient with enteritis of the child.

Treatment of enteritis is a complex therapy. Parents should review the baby's diet, conduct high-quality oral rehydration, use enterosorbents prescribed by the doctor, enzymes, probiotics, vitamins and antipyretic drugs.

If the infection is bacterial in nature, then it is appropriate to feed the child with antibiotics in order to avoid severe dysbiosis. Enemas can be useful, but not in all cases. But sometimes the enemas are not reaching the small intestine, they only injure the mucous membrane and do not give any result at all.

Functional disorders of digestion are treated with antidiarrheal drugs that prevent the release of toxins from the body. As probiotics, doctors prescribe Linex, Enterosermine, antispasmodics (Spasmalgon, Paracetamol). To eliminate the painful flatulence in the intestines Simetion is used and include in the diet food supplements and vitamin complexes.

Folk remedies

As folk remedies you can use:

  • Chamomile infusion. 1 tbsp. flowers pour 200 ml. boiling water, insist about 4 hours and strain. 4 times a day, give the child 2 tbsp. after meal.
  • Broth their pomegranate peels. 20 g of dry crusts boil on low heat for half an hour. Strained decoction take 2 tbsp. twice a day after meals.
  • Calendula decoction. 1 hl dry grass insist about 30 minutes in a glass of boiling water. Take a warm infusion of a teaspoon during the day at any convenient time.

Opinion Komarovsky

The doctor does not recommend self-treatment, and at the first signs of enteritis, lead the baby to the doctor. Depending on the main factors of the disease, the course of the disease and its type, individual treatment is prescribed.

Komarovsky recommends paying particular attention to food, so that the baby has only easily digestible foods on the table.

Special attention, according to the doctor, should be paid to strengthening the immunity of the child. Tempering procedures, gymnastics and fresh air should be fundamental not only during the treatment of the disease, but also after the recovery of the little patient.

Prevention

To prevent the child from getting sick, you need to be taken to a pediatrician regularly for examination. It is especially important to observe this point if the child has a tendency to functional disorders of the gastrointestinal tract and dysbacteriosis is manifested on this background.

Sleep, bododania and nutrition - the most important components of the child's health and strengthen its immunity.

There is no vaccination against enteritis, therefore, children often doctors recommend vaccination against rotovirus infection, which is a common cause of the disease.

Enteritis is common in children. The cause of the pathology can be viral infections, comorbidities, allergies, toxins and other factors. The disease is manifested by bright clinical symptoms, according to which a diagnosis can be made. Treatment consists of following a diet and conservative therapy. It is important to show the child to the doctor in time, make a diagnosis and start treatment to avoid serious complications.

The role of the small intestine in digestion

The small intestine is associated with several important structures of the digestive system, in addition to the large intestine and stomach. In the small intestine, in particular in the duodenal, the pancreas and gallbladder release their contents. Although digestion and absorption begin in the mouth and build up in the stomach, most of these processes take place in the small intestine.

Along with the digestive enzymes of the stomach, pancreas, and bile from the gallbladder, the small intestine also has its own enzymes that promote digestion. They are produced by enterocytes (cells in the epithelium of the intestinal mucosa). These enzymes include: isomaltase, maltase, sucrase, lactase for the breakdown of carbohydrates, peptidase for protein digestion, and lipase for fat. The small intestine releases approximately 2 liters of enzymes, water and mucus daily.

However, its function, which is of paramount importance, is the absorption of most nutrients. When the small intestine becomes inflamed, its absorbing function is severely impaired, and to a large extent this determines the clinical manifestation.

Due to inflammation, edema of the intestinal wall occurs, which leads to impaired absorption of nutrients from the lumen. Water-electrolyte exchange between tissue spaces and the intestinal lumen is not regulated, and a lot of water and electrolytes are released into the small intestine. In addition, epithelial cells can be destroyed, and ulcers are sometimes formed. In addition to pathological changes on the wall, the microenvironment in the small intestine is also disturbed, which favors the reproduction of pathogenic microorganisms.

Viral enteritis

Rotavirus group A is the cause of 25–65% of cases of severe enteritis in infants. Acute infections caused by group C rotavirus are also quite common throughout the world.

After rotavirus, the most significant cause of acute enteritis in children is norovirus.

Astrovirus infection is associated with 2 to 9% of cases of infant enteritis in the world, making it the third, after rotavirus and calicivirus, the most common cause of the disease.

Researchers have long recognized that some intestinal adenoviruses are an important cause of infant enteritis. Studies confirm that they cause 2-6% of cases.

Bacterial enteritis

Bacteria can cause gastroenteritis directly, infecting the intestinal lining. Individual bacteria, such as Staphylococcus aureus, produce a toxin that causes symptoms.

Salmonellosis, dysentery and campylobacteriosis are the three main causes of bacterial enteritis worldwide.

Dysentery disease has a higher level in summer and autumn, and campylobacteriosis usually occurs in the summer months. Yersiniosis occurs most often in winter and in colder climates.

Salmonella infection occurs when contaminated with bacteria and food and water, as well as contact with poultry or turtles.

Campylobacteriosis develops as a result of the consumption of raw or not fully cooked poultry meat and other animals. Infants who do not eat these foods may become infected when they come into contact with the bird. Campylobacteriosis is also associated with the consumption of non-pasteurized milk or polluted water. Infection can spread to people when they come into contact with the stool of an infected pet (for example, cats or dogs). Usually campylobacteriosis is not transmitted from person to person.

Shigella bacteria usually spread from an infected person to another. Shigella is present in the stool of an infected child while he is sick, and for up to 1 to 2 weeks after infection. Dysentery can become infected by drinking spoiled food, contaminated drinking water, or bathing in a polluted body of water.

Organisms such as E coli and Clostridium belong to the normal intestinal flora, but their pathogenic strains can cause enteritis.

Other causes of enteritis

Parasites: lamblia and cryptosporodia

These tiny microorganisms less often cause enteritis. A child becomes infected with one of them by drinking polluted water. Pools are the usual places for contact with these parasites.

Autoimmune diseases

In an autoimmune disease, immune cells attack healthy tissue in the intestines, which causes chronic enteritis in children. These diseases usually have no known cause and are caused by environmental factors and genetics. One such case is inflammatory bowel disease, known as Crohn's disease.

Radiation exposure

Enteritis develops when radiation damages healthy intestinal cells, and it becomes inflamed. This condition is usually relieved a few weeks after the end of therapy. But sometimes the symptoms are chronic and persist for more than one month.

Injury

Damage to the small intestine can make it susceptible to infection, which leads to inflammation. It is usually associated with invasive procedures and surgery.

Medications

There are some medications that can cause enteritis. These include ibuprofen and naproxen sodium.

Excess bacterial growth

This is another cause of enteritis. The buildup of bacteria in the small intestine is sometimes observed in diabetes, chronic pancreatitis, damage to the intestines and the use of certain drugs.

Symptoms of enteritis range from mild to severe. They may develop several hours after the bacteria or virus has entered the small intestine, or they may not appear within a few days.

Common signs and symptoms of enteritis:

  • a slight increase in body temperature, usually less than 37.7 ° C,
  • nausea with or without vomiting
  • spasmodic abdominal pain. Discomfort worsens soon after eating,
  • mild to moderate diarrhea.

Frequent watery stools are more characteristic of viral enteritis, and stools with blood or mucus indicate a bacterial pathogen. Similarly, prolonged diarrhea (> 14 days) corresponds to a parasitic or non-infectious cause of the disease.

More serious signs and symptoms of enteritis:

  • blood in the vomit or stool (this is never normal, and the affected child should be immediately shown to the doctor),
  • vomiting longer than 48 hours
  • fever above 40 ° C,
  • bloating
  • more severe abdominal pain,
  • dehydration.

Confusion, weakness, decreased urination, dry mouth, dry skin, and the absence of tears and sweat are characteristic symptoms of this condition.

Drug treatment

The goal of pharmacotherapy is to alleviate the disease, prevent complications and prevent it. Antidiarrheal drugs are contraindicated due to lack of benefit and high risk of adverse effects.

Antibiotics are not prescribed if parasites and bacteria are not identified as the cause of the infection. Antibiotics are suggested for some bacteria, namely Campylobacter, Shigella and Vibrio cholerae, if they are correctly identified using laboratory tests. Otherwise, antibiotic use may exacerbate some infections.

Antibiotics are not treated with Salmonella. The body is able to fight and get rid of the infection without these drugs, thanks to maintenance therapy, which includes fluid intake and rest.

After antibacterial treatment, it is recommended to take drugs that normalize the intestinal microflora. Various sorbents also give a good effect.

Diet with enteritis in children

A diet of bananas, rice, applesauce and toast is recommended for enteritis. This diet is a priority during recovery.

When feeding dairy products containing lactose, closely monitor the signs of malabsorption (violation of the absorption of substances).

Breast milk contains many substances that promote the growth of the intestinal flora and counteract bacteria, so it is recommended that breastfeeding be continued throughout the illness for infants.

Conclusion

The prognosis of enteritis in most children infected with a virus and bacterium is favorable, with good quality hydration. Because babies usually dehydrate faster and sometimes more difficult to rehydrate orally, the prognosis will vary depending on the degree of dehydration and the effectiveness of rehydration attempts.

Classification

Enteritis in children can occur in two forms:

  • acute - this course of the disease occurs very often, compared with chronic enteritis in children. In most cases, against the background of this disease, several more disorders develop. The main causes of this type of illness are intestinal viral infections and pathogenic bacteria,
  • chronic - characterized by periods of subsidence and recurrence of the onset of symptoms.

In turn, the acute form of the disease can be divided depending on the spread of the pathological process. It can be in the form of:

  • gastroenteritis - with the defeat of the stomach,
  • enterocolitis - with involvement in colon disease,
  • gastroenterocolitis - with the combination of signs of both forms.

In addition, there are several types of this disease:

  • parvovirus,
  • coronavirus,
  • granulomatous,
  • rotavirus enteritis.

But not all of them are dangerous to humans.

A typical type of enteritis in childhood is rotavirus. Children are most susceptible to rotavirus infection. Often it is diagnosed in babies up to three years old and, quite rarely, in elderly people. The clinical picture of the disease is similar to acute enteritis.

There are several ways to infect a child with rotavirus:

  • upon contact with the carrier,
  • through contaminated water or food,
  • when using household appliances.

This condition requires immediate treatment to a medical facility. It is worth noting that the disease is well treatable and does not cause complications. Improvement of the patient’s condition is observed on the sixth day of therapy, but to consolidate the effect, therapeutic measures continue for two weeks. A distinctive feature of this type of illness is that after recovery, the child is immune to the disease, which completely eliminates its occurrence in the future.

A rare type of disease to which children can be exposed is granulomatous enteritis or Crohn's disease. Its symptomatic manifestation is fully consistent with the course of chronic enteritis. The danger lies in the fact that in children under five such a disease is asymptomatic. The most difficult to diagnose such a disease in newborns.

Symptomatology

The external manifestation of the disease will differ depending on the form of the disease.

The following symptoms are characteristic of the acute form of the disease:

  • violation of the stool, which is expressed in diarrhea. The urge to defecate can reach twenty times a day,
  • appearance of characteristic rumbling in the stomach,
  • increase in the size of the abdomen,
  • greasy feces,
  • watery stools
  • the occurrence of pain in the navel - often expressed after eating food,
  • bouts of nausea ending in profuse vomiting
  • weight loss, which is caused by refusal to eat,
  • increased fatigue
  • dry skin,
  • headache,
  • increase in body temperature
  • fragility of nail plates,
  • increased hair loss,
  • sleep disturbances
  • tremor,
  • muscle pain
  • stomatitis.

With a severe course of the acute form of enteritis in children, the main symptoms will be supplemented:

  • internal hemorrhages
  • severe dehydration, with profuse diarrhea and vomiting. This condition is dangerous for the life of the child,
  • anemia,
  • violation of the structure of the walls of the affected organ.

With the chronic course of such a disease, the nature of the symptoms will be somewhat changed. Thus, the clinical picture will be:

  • appearance of diarrhea only after a meal,
  • pathological impurities in the feces, in particular blood,
  • discomfort during the process of defecation,
  • a slight manifestation of pain,
  • the appearance in the language of white plaque, which covers the entire surface of this body,
  • tremor of limbs
  • heart palpitations
  • bouts of severe dizziness,
  • increased gas formation.

Often, children are diagnosed with an acute form of this disease, which is caused by non-compliance with the rules of hygiene and food processing.

Diagnostics

In order for the clinician to establish the final diagnosis, as well as to understand how to treat enteritis in a child, several diagnostic measures will be required.

Primary diagnosis aims to:

  • interviewing the patient or his parents,
  • medical history and history of the patient’s life,
  • performing a thorough physical examination.

This will provide an opportunity not only to identify the causes of the formation of such a disorder, but also to assess the severity of the patient’s general condition.

The basis of the diagnosis of enteritis in children is laboratory research. These include:

  • general analysis and blood biochemistry
  • general urine analysis,
  • urine analysis for ketone bodies,
  • microscopic examination of the feces of the child - while paying attention to the consistency and smell, as well as the presence of particles of fat, blood and undigested food,
  • specific test for determining rotavirus infection,
  • bacteriological stool culture - detection of pathological bacteria that provoked an intestinal infection,
  • serological studies.

In case of suspected chronic enteritis, in addition, ultrasound and radiography of the abdominal organs with contrast enhancement, endoscopic examination with biopsy of the intestinal mucosa can be prescribed.

The appearance of symptoms of enteritis in children is a signal to immediately contact a medical institution or call an ambulance brigade. After the diagnosis, the child will be given first aid and prescribed treatment.

Treatment of enteritis in children is often performed in a hospital. Indications for hospitalization of the child are:

  • patient age up to one year
  • acute course of enteritis,
  • the presence of concomitant diseases.

Therapy of this disease is performed using such conservative methods as:

  • the use of drugs
  • adherence to diet therapy.

Rules of therapeutic nutrition are:

  • reducing the amount of food consumed three times,
  • feeding the infant only with breast milk. For babies on artificial feeding - adapted mixtures,
  • the diet of patients of six months should consist of mucous porridges on a water basis, kissels, vegetable purees, milk-free mixtures,
  • enrichment of the diet with baked fruits and boiled vegetables with pectin content,
  • cooking only by steaming or boiling,
  • exclusion from the menu of whole milk and fiber-rich foods, fatty meats and fish, bread and confectionery, smoked foods and soda, chocolate and ice cream.

Drug therapy includes taking:

  • antibacterial substances, since in most cases enteritis in children is caused by the influence of bacteria and parasites,
  • salt solutions aimed at rehydration,
  • enterosorbents,
  • enzyme substances
  • probiotics
  • drugs, to eliminate the symptoms of the disease,
  • vitamin complexes.

Complications

With a severe course of the acute form of the disease a high chance of the formation of the following complications of enteritis in children:

  • perforation of the intestinal wall,
  • internal hemorrhages
  • severe dehydration
  • development of iron deficiency or B12-deficiency anemia,
  • coma.

Some of the complications pose a threat to the life of the patient.

Watch the video: What is Crohn's Disease? (December 2019).

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