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December 2, 2012
Dysentery is an infectious disease of the general character which is caused by dysenteric bacteria. Most often development of a disease is provoked by shigellas. Amoebic dysentery is shown as a result of infection with a gnstolitichesky amoeba. At development of this illness in the person generally mucous membrane of a large intestine is surprised.
Dysentery is most often diagnosed for children aged from two till seven years. But the illness can affect people from any age group. Less often symptoms of dysentery are fixed at chest babies as the child has the strong immunity which got to it from mother in the first months. As a rule, at children of chest age the disease can develop if water or food contained the causative agent of dysentery.
Symptoms of dysentery are generally shown in the flying. The infection extends quickly and if the main rules of hygiene are not followed, then treatment of dysentery can be necessary for the child. For this reason prevention of a disease consists, first of all, in strict following to the general hygienic norms.
How dysentery is transmitted?
Infestants have the form of sticks. They instantly perish at a temperature of 100C, at a temperature of 60C can hold on about half an hour. In fecal weight the activator perishes in several hours.
The infection extends from patients with an acute and chronic form of an illness. Also infection is possible from bakteriovydelitel who people with the easy course of an illness are. Such patients in view of ease of symptoms do not see a doctor. The infection can be transmitted through food and drink, also it is carried by flies. Transfer of the activator can happen also through dirty hands.
Two forms of dysentery – acute and chronic are allocated. At an acute form of a disease of people can be ill from 3-4 days to three months. If the illness proceeds longer, then the speech already goes about a chronic form of dysentery. Incubation interval duration in both cases can fluctuate from 18 hours to 5 days.
If at the patient medium-weight disease takes place, then its signs are expressed more sharply. Initially the person feels weakness and an indisposition, can feel feverish him a little. Later colicy pains in the left part of a bottom of a stomach are shown. The chair is liquid, with blood and slime, its frequency sometimes reaches 25 times a day. In the first two days of development of dysentery the frequency of a chair increases. Besides, at the patient the body temperature which can reach 39 degrees increases, he is disturbed by a headache. Temperature falls down in 2-5 days.
At most of patients the abdominal pain does not abate long. Sometimes pain does not abate even for a while. As a rule, the stomach hurts in the left lower part, however some patients note that pain has the poured character. Often also abdominal distention is noted. At a severe form of acute dysentery an onset of the illness always rough. The patient is disturbed by very severe pain in the bottom of a stomach having skhvatkoobrazny character. The chair liquid and very frequent, can be observed vomiting, nausea, body temperature promptly increases. In fecal masses except slime and blood pus can be found. At the patient pulse becomes frequent, the ABP decreases, an asthma is observed. The severe form of dysentery can proceed till 6 weeks. If adequate treatment of an illness was not made, it can pass into a chronic form.
At the patient with dysentery of the child a chair at once plentiful, but then its look changes, in it lumps of slime of gray-green color appear. At this time the organism of the child is very strongly dehydrated. If the kid has dry mucous membranes, then it is already about considerable loss of liquid. Parents have to realize and that fact that dehydration is more dangerous by that, than the child is younger.
At a severe form of dysentery at the kid cardiovascular insufficiency can develop, there are spasms, the consciousness is broken. In this case urgent hospitalization is important.
At the sick baby at dysentery extremities grow cold, he constantly belches. Dream very uneasy and bad.
Diagnosis of dysentery
To diagnose dysentery for the patient, carry out bacteriological crops to laboratories a calla. For result accuracy researches the analysis are conducted three times. However such method is suitable for diagnosis not always as results appear only in a week. For the purpose of acceleration of diagnosis of dysentery definition of antigens to a disease-producing factor and toxins practices in blood and Calais.
In this case immunological methods are used. The polimerazno-chain reaction method is applied to definition of presence of shigellas.
In the course of establishment of the diagnosis to the patient the analysis a calla (koprogramma) is also carried out. If in the studied material there is a large amount of slime and at the same time the number of leukocytes is raised and there are erythrocytes, then, most likely, integrity of a mucous membrane of intestines is broken.
Treatment of dysentery
In the course of treatment of dysentery the most important point is destruction of infestants. It is also necessary to recover normal water-salt balance and to provide an organism detoxication. If the illness proceeds in a severe form, then the patient is treated in a hospital. An easy form of dysentery it is possible to treat on an outpatient basis.
Effectively the medicamentous drugs belonging to a nitrofuran row and also quinolines, ftorkhinolona fight against shigellas. Appointing antibacterial medicines, the doctor surely is guided by features of a specific case. It is important to consider sensitivity of a species of shigellas to the specific appointed drug. The patient accepts antibacterial drugs for 3-4 days if the medium-weight form of an illness is diagnosed for him. If it is about a severe form of a disease, then antibacterial agents are appointed to 5 days.
For this period at the patient the general condition of an organism gradually improves, temperature returns to normal, character and frequency of a chair are also normalized. After antibacterial therapy is graduated, for several days at the patient slight dysfunction of intestines is still noted. The chair remains liquid, its frequency makes no more than three times a day. But at this time to accept antibiotics already there is no need.
If easy degree of a disease is diagnosed for the patient, then plentiful drink is shown it. The matter is that in the course of vomiting and a diarrhea the organism loses liquid and salts. Water with addition of soda, salt and sugar will be the most optimum drink. Also it is possible to add special drug to water regidron. It is necessary to drink in the small portions and it is frequent. The heavy patient for the purpose of recovery of water-salt balance enter intravenously special solutions.
For the purpose of removal from an organism of toxins at treatment of dysentery the course of treatment fermental drugs is appointed. Patients accept Panzinorm, Pancreatinum, calcium drugs. Besides, enterosorbents are applied to treatment: absorbent carbon, enterosorb, smekta. They promote removal of toxins from the patient's intestines. The course of treatment also includes high doses of vitamins.
If there is a need to remove a strong painful attack, then Nospanum, other drugs which remove a spasm is for this purpose used.
At therapy of this disease the correct approach to food is important. It is impossible to use those products which strengthen processes of fermentation in intestines. This milk, bean, black bread, cucumbers, beet, cabbage.
At treatment of kids it is necessary to pay special attention to food. If the child refuses to eat categorically, then violently it is not recommended to feed him. When the child feels better, and he has an appetite, it is desirable to reduce food volume half and to increase it gradually. It will allow not to overload an organism of the recovering kid. And here the child has to drink as much as possible. For this purpose compotes, fruit drinks are ideally suited.
In the period of an illness and after it at the person symptoms of an intestinal dysbiosis are shown. To get rid of this phenomenon, reception of probiotics practices. This group of drugs contains the beneficial bacteria recovering normal microflora. This group includes Bifiform, Lineks, Bifidumbakterin-Forte, Laktobakterin.
Also some national methods of treatment of dysentery practice. However they can be applied only after approval of the attending physician. It is possible to prepare infusion of oak bark, broth of flowers of a honeysuckle, infusion of flowers of a yarrow. An effective remedy for treatment of dysentery is the burnet root from which also prepare infusion. Also broths and infusions of a grass of a plantain big, fruits of a bird cherry ordinary, bilberries ordinary, blackberry leaves are used.
Amoebic dysentery (amebiasis) is caused by a gnstolitichesky amoeba. Infection occurs when mature cysts of a gistolitnchesky amoeba get through a mouth into a digestive tract. The person can catch if drinks unboiled water which was infected, and also at the use of the products infected with the activator. Most often this disease is diagnosed in zones where climate very hot.
At this form of dysentery the incubation interval can proceed till 30 days. There are three forms of a disease: abenteric, intestinal, skin amebiasis. Most often the intestinal amebiasis meets. In turn, this form is subdivided into amoebic colitis and amoebic dysentery. At amoebic colitis at the person appetite decreases, abdominal distention is shown, locks and ponosa constantly alternate. After the act of defecation of the patient constantly feels feeling that guts were emptied not completely. The chair has a kashitseobrazny consistence, at it there is a slime. Sometimes blood can be also found. Temperature in an acute state increases slightly and for the short period.
At amoebic dysentery patients note severe pain of the aching or skhvatkoobrazny character, a liquid chair with blood and slime, the general weakness and an indisposition. The chair can appear to 10 times a day. For from 3 to 5 days moderately increased body temperature remains. Also abdominal distention and a fur is noted. Sometimes doctors note also increase in a liver.
At both versions the amebiasis at the person decreases working capacity, anemia, a bad dream. In the course of rectal inspection ulcers in distal department of a large intestine, an ulcer of a mucous membrane are found.
At an abenteric amebiasis the liver most often is surprised, and amoebic hepatitis develops. The skin amebiasis develops, as a rule, with an intestinal form.
As complications of an amebiasis can develop perikolit, intestinal bleedings, intestinal impassability, abscesses of lungs, subphrenic abscesses.
The diagnosis is established, being guided by epidemiological data. The doctor studies the anamnesis in detail, performs inspection of the patient. Also informative method of research is the rektoromanoskopiya and parazntoskopichesky researches of fecal mass of the patient.
Treatment of amoebic dysentery assumes observance of a diet, use of pathogenetic and symptomatic drugs. Also if necessary the patient appoint antihistaminic drugs, vitamins.
Prevention of dysentery
For prevention of a disease it is very important to respect all sanitary and hygienic rules. Not to allow mass infection of the population, strict sanitary inspection behind the enterprises which let out foodstuff is conducted, provide public catering. It is not less important to control water supply. All these measures are directed to the prevention of mass distribution of intestinal infections.
Measures of personal prevention are, first of all, regular and careful washing of hands. Besides, it is important to get rid of flies indoors in time and not to assume that they contacted to foodstuff. Parents have to provide in every way protection of the child against infection with causative organisms. It is necessary to watch not only that the child washed hands after a toilet and walks, but also not to allow the use of dirty fruit, vegetables.
Section: Gastroenterology Infectious diseases