Sprue after acute enteritis - Diseases of digestive organs at children
Page 42 of 73 SPRUE AFTER ACUTE ENTERITIS
Most of children with chronic diarrhea and easy disturbances of absorption have no the diseases listed in tab. 12-10 and 12-11. Such children, especially at early age, are seldom sick seriously, but constantly feel discomfort because of the changes of a small intestine which arose after acute, most often infectious, enteritis.
As the small bowel is usually quickly recovered after an acute disease, long malabsorption testifies to that, something continues to work a disturbing factor, or the regeneration mechanism is broken. The persistent infection can be such factor. However, except for Giardia lamblia, the majority of the pathogenic microorganisms infesting a mucous membrane eliminirutsya quickly; it does not occur only at immunodeficiency. Disturbance of absorption of sugars leads to their accumulation and fermentation in a gut cavity. The organic acids injuring a mucous membrane are as a result formed. The proteins which are especially contained in milk can injure a mucous membrane by means of immunological reactions. This mechanism is most probable after acute injury of a mucous membrane when recovery process is broken for many reasons, including malabsorption and treatment by antibiotics.
Clinical manifestations. At children aged from 6 months till 3 flyings the disease begins sharply with watery diarrhea in combination with fever and vomiting or without them; after this there is persistent diarrhea. The general condition of the patient satisfactory, there is no deficit of nutrients in an organism if very rigid dietary restrictions are only not introduced. Diarrhea amplifies at the use of the food rich with sugars; Calais contains the increased amount of sugars and organic acids; on skin of buttocks excoriation sites are visible. As a rule, activity of disaccharidases is reduced, in hard cases transport of monosugars (glucose) and ions is broken; the easy steatorrhea is noted.
Treatment. The specific means accelerating process of a reparation of a mucous membrane of intestines do not exist. Therefore it is important not to break the natural course of recovery by unjustified intervention. Excessively active inspection can negatively affect the emotional sphere of the child and strengthen alarm of parents. Defective food conducts to a growth inhibition and for the second time breaks reparative processes and functions of a digestive tract. Anti-diarrheal drugs contribute to normalization a calla at an easy chronic current, but they can cause staz intestinal contents and by that to promote an infection persistirovaniye.
Patients and their parents need psychotherapeutic support. The sugar use, in particular in the form of giperosmolyarny fruit juice, it is necessary to limit; juice needs to be diluted with water half. At a lactose intolerance it is necessary to reduce or for some time to stop the milk use. Adequate food is supported at the expense of foodstuff with the low content of sugars (meat, grain).
Intolerance of food proteins see in appropriate sections.