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VERIFIED CONTENTAuthor: Dominika Wilk

Diarrhea happens to everyone once in a while. It is usually the result of an infection and will pass after a few days. However, if it is prolonged beyond two weeks, it indicates a strong infection and poor immunity. See what you need to do then to help the body fight the disease and prevent dehydration.

Diarrheais an infectious condition caused by bacteria, viruses, parasites or toxins that causes us to pass more than 3 stools a day in a semi-solid or liquid consistency. You may pass stools with: abdominal pain, vomiting, fever, and your stools may contain mucus or blood.

Infectious diarrhea - causes

The most common factors causing diarrhea are the viruses mentioned, in particular: rotaviruses, noroviruses, astroviruses, sapoviruses, adenoviruses.

In turn, in the case of bacterial infections, we are dealing with an infection: Campylobcater spp, Salmonella spp., Escherichia coli, Clostridium difficile, Shigella spp, Listeria monocytogenes, Yersinia spp.

Sometimes it can also be caused by parasites such as: Giardia lamblia, Cystoisospora belli, Cryptosporidium paraum.

People are usually infected by contact with an infected person, as well as by eating contaminated food, drinking poisoned water. Infection can also occur while in hospital (nosocomial infection) or by poorly conducted antibiotic therapy that facilitates the activity of bacteria such as Clostridium difficile.

Infectious diarrhea - the mechanisms of its formation

Infectious diarrhea can be caused by various pathogens acting on the intestinal membranes and by disrupting their functioning in different ways.

  • The entero-invasive mechanism underlying diarrhea means that the bacteria have penetrated into the enterocyte (villi) and, through their multiplication, led to inflammation. The inflammatory process, in turn, leads to the appearance of ulcers and leads to bleeding in the intestines. In this case, we may be dealing with blood and mucus diarrhea, where blood and mucus will be visible in the passing stool.
  • Enterotoxic mechanism - bacteria attach to receptors on the surface of the intestinal villi andaffect the production of secondary relays, disrupting the operation of channels and transporters. Then they lead to the increased secretion of chloride into the intestinal lumen and at the same time block the reabsorption of sodium and water. As a result, the diarrhea becomes very watery.
  • Enterotoxic mechanism - bacteria destroy enterocytes, making them unable to absorb water from the intestinal lumen, resulting in watery diarrhea. The damage also causes the enterocytes to release electrolytes from their interior, which further aggravates the symptoms.
  • Mechanism of enteroadherence - bacteria sit tightly on the surface of enterocytes, creating a biofilm, a kind of blockage that prevents intestinal villi from absorbing water and other substances.

Diagnosis of infectious diarrhea

If you have diarrhea associated with dehydration, blood tests are performed to assess the degree of dehydration. These include: morphology, electrolyte level assessment, urea and creatinine concentration tests. In addition, a microscopic examination of the stool for the presence of drug blood cells can be performed.

In the case of acute infectious diarrhea accompanied by disturbing symptoms, it is worth having a stool test that will show (but not always) what pathogen may be the cause of the infection. Symptoms that should prompt you to do this type of test are, for example :

  • bloody and mucous diarrhea,
  • accompanying fever above 38 degrees,
  • very bad stomachache,
  • passing more than 6 stools a day,
  • accompanying dehydration,
  • very severe course of the disease.

The indication for a stool test will also be the age over 70 and the suspicion of general group poisoning. The stool test is performed for the presence of such pathogens as: Campylobacter spp, shigella, Yersinia, Salmonella spp., Escherichia coli, Clostridium difficile.

Immunocompromised or HIV-infected patients should also be tested for: cytomegalovirus, Microsporidia, Cyclospora, Cryptosporidium, Mycobacterium avium complex.

People who are suspected of having traveler's diarrhea and travel to tropical countries and whose stool test has not found a source of infection can undergo molecular testing to diagnose parasite infestation.

The great advantage of this type of test is its high sensitivity and detection of even one copy of DNA or RNA in the infected material.

Treatment of infectious diarrhea

If the diarrhea is mild, the basic recommendation is adequate hydration of the sick person, which involves the regular administration of not only water but also electrolytes. This waythe procedure helps to protect against dehydration, which can be dangerous to he alth and life.

According to the recommendations of the World He alth Organization, oral irrigation should provide irrigating fluid in an amount 1.5 times greater than the volume of faeces excreted throughout the day.

For each liter of fluid, the patient must receive 2.5 g of sodium carbonate, 20 g of glucose, 1.5 g of potassium chloride and 3.5 g of sodium chloride. Common diarrhea medications available at a pharmacy, as well as an easily digestible diet, will also help with mild diarrhea.

If oral irrigation is impossible, because diarrhea is accompanied by vomiting, then it is necessary to supply electrolytes intravenously, usually in a hospital.

The degree of dehydration and the general condition of the patient decide who should be hospitalized during diarrhea. Chronic and debilitating diseases, senile age and infancy are an increased risk factor.

Hospitalization is also required for the following symptoms:

  • weight loss below 10%,
  • disturbance of consciousness,
  • high thirst and very dry mouth,
  • tachycardii,
  • headache,
  • decreased urine volume,
  • bloody diarrhea,
  • suspicions of sepsis or typhoid fever,
  • diarrhea lasting more than 7 days,
  • receiving antibiotics a few days before starting diarrhea.

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