What happens in the gut
The mucous membrane of the small intestine is covered with villi, which greatly increase the absorption surface. During inflammation, the villi are damaged, the cells lose enzymes, and the permeability of the wall increases. Water and electrolytes, which are normally reabsorbed, remain in the lumen, and the stool becomes large and watery. Undigested carbohydrates are fermented by bacteria, causing bloating and loud rumbling. If inflammation persists for a long time, the absorption of proteins, fats, iron, vitamin B12 and fat-soluble vitamins is impaired, and weight loss and deficiencies develop.
- Damage to the villi of the mucous membrane
- Impaired absorption of water and electrolytes
- Temporary lack of intestinal enzymes
- Fermentation of undigested carbohydrates
- With a long course - deficiency of vitamins and protein
Reasons
Acute enteritis is most often infectious. It is caused by viruses, including rotavirus and norovirus, as well as bacteria from underprocessed food and contaminated water. A separate situation is traveler's diarrhea. Non-infectious causes include taking non-steroidal anti-inflammatory drugs and some antibiotics, radiation therapy to the abdominal area, and impaired blood supply to the intestine in older people. Chronic inflammation is characteristic of celiac disease, Crohn's disease, cow's milk protein allergy in children, and parasitic infections such as giardiasis.
- Viral infections: rotavirus, norovirus
- Bacterial intestinal infections
- Parasites, including Giardia
- Painkillers and antibiotics
- Radiation therapy to the abdomen
- Celiac disease and Crohn's disease
- Impaired blood supply to the intestine
Symptoms
In acute enteritis, the stool is profuse, watery, often without blood, cramping pain around the navel, bloating, rumbling, sometimes nausea and vomiting, and fever. Frequent urges with a small volume of stool and blood indicate damage to the colon. The danger is dehydration: weakness, dry mouth, thirst, rare urination, dizziness when standing up; in children and the elderly it develops faster. With chronic enteritis, weight loss, bloating, oily light stools, weakness, brittle nails and signs of anemia come to the fore.
- Copious watery stools
- Cramping pain around the navel
- Bloating and rumbling
- Nausea, vomiting, fever
- Weakness, thirst, rare urination
- Weight loss and deficits in chronic conditions
What examinations are needed
In case of acute enteritis with a mild course, examination is usually not required: an assessment of the condition and drinking regime is sufficient. Tests are prescribed for high fever, blood in the stool, severe dehydration, the elderly, and those with weakened immunity. Then they take a coprogram, stool culture, complete blood count and C-reactive protein, and evaluate electrolytes. If diarrhea lasts longer than two weeks or is accompanied by weight loss, the examination is expanded: celiac disease, inflammatory bowel disease, giardiasis are excluded, and endoscopy with biopsy is performed.
- Coprogram
- Culture of stool for intestinal group
- Complete blood count and C-reactive protein
- Assessing electrolytes during dehydration
- Tests for celiac disease with prolonged course
- Endoscopy with small bowel biopsy
- Examination for parasites
Treatment and nutrition
In case of acute enteritis, the main thing is to replenish fluids and salts: drink often and little by little, it is better to use special rehydration solutions, and not just water or sweet drinks. You can eat according to your appetite: boiled rice, potatoes, bananas, crackers, low-fat soups; temporarily limit milk, fatty foods and raw vegetables. Antibiotics for watery diarrhea are in most cases not needed and are prescribed by a doctor only when indicated. Antimotility agents are contraindicated in cases of blood in the stool and high fever. In case of chronic enteritis, the underlying disease is treated and deficiencies are compensated.
- Rehydration solutions fractionally, in small portions
- Eating according to appetite without prolonged fasting
- Temporary restriction of milk, fatty and raw vegetables
- Antibiotics only as prescribed by a doctor
- Avoiding antimotility agents for bleeding and fever
- Treatment of the underlying disease in chronic course
- Correction of iron and vitamin deficiency