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Medical foods at an acute coloenteritis

The disease represents acute inflammatory defeat thin (enteritis) and thick (colitis) of guts which proceeds with simultaneous involvement in pathological process of a stomach (gastroenterocolitis) more often. The majority of cases of an acute coloenteritis proceeds in the form of a catarrh of thin and thick guts; less often fibrinous, necrotic and purulent coloenterites meet.

Alimentary disturbances play the leading role in development of a disease. They are reduced to penetration into a small bowel with food of various infectious activators and their toxins (a salmonella, streptococci, staphylococcus, causative agents of dysentery, cholera, flu, etc.), toxic agents of not bacterial nature (poisonous mushrooms, bitter kernels of fruit stones, the sprouted potatoes, poisonous fish products etc.), chemical poisons (arsenic, salts of heavy metals, strong acids, alkalis etc.). The overeating, the use of too spicy, rough food, hard alcoholic drinks, very cold liquids, strongly irritating spices, incompatible foodstuff etc. matter. Poisonings with some drugs are among other etiological moments (mercury, salicylates, laxatives, etc.) the allergy (intolerance of some products, drugs), and also is more rare the found factors (heavy burns, freezing injuries, the massive ionizing radiations etc.).

The diarrhea and vomiting conduct to the expressed dehydration of an organism, hyponatremia, hypochloraemia, hypopotassemia. Absorption or are formed of guts of toxic products which get with food there as a result of fermentative and putrefactive processes, conducts to intoxication of all organism. Disturbance enzymatic, vsasyvatelny, motive and other functions of a small bowel, and also frequent involvement in pathological process of a stomach is led to disturbance of digestion of the major feedstuffs.

Medical foods at a coloenteritis are directed to reduction of inflammatory and dystrophic changes in a mucous membrane of guts, recovery of the broken functions of guts, prevention in them fermentative and putrefactive processes and a korrigirovaniye of exchange disturbances. In this regard first of all the maximum mechanical, chemical and thermal shchazheniye of guts is necessary. It is reached appointment at the beginning of a disease, after carrying out urgent actions (a gastric lavage, giving laxative, cleansing enemas, introduction cordial etc.) one-two "hungry" days. These days in addition to parenteral administration of liquid (5% glucose, isotonic solution of sodium of chloride) plentiful drink (6 — 8 glasses a day) slightly sweetened or without sugar of warm tea with bilberry juice, a lemon or addition of one tablespoon of red wine is recommended. It is caused by organism dehydration in connection with a diarrhea and vomiting. Liquid promotes also removal of toxins from an organism. Instead of tea broths of a dogrose or bilberry, apples compotes, pears or blackcurrant can be used in a warm look. All these liquids possess the knitting action that contributes to normalization of a chair. For the second day reception of the liquids stated above can be replaced with an apple diet (1 — 1,5 kg of the mature apples of a soft and not acid grade wiped without peel in 4 — 6 receptions). The apple diet is especially favorable at bent to putrefactive processes in guts.

In the next 2 — 3 days the diet is gradually expanded at the expense of the products which are not irritating a gut and not secretomotor digestive juices and the movement of guts. To such dishes mucous broths from rice, oat or semolina grain treat with addition of a small amount of butter, meat mash, the wiped cottage cheese, 2 — 3-day fermented milk products (kefir, curdled milk), kissels and bilberry, currant, cherry, raspberry, strawberry jelly, various puddings, juice from a quince, garnet, oranges, tangerines. Further, in process of improvement of a condition of the patient, the diet is even more expanded at the expense of the wiped porridges, steam meatballs, quenelles, frikadely, cutlets, well boiled thoroughly fish. Thus gradual transition to a medical diet No. 4 is carried out. It provides some restriction of salt (8 g) that has protivospalitelny effect. However in the first days of a disease in connection with a hyponatremia and a hypochloraemia because of a diarrhea and vomiting it is necessary to enter enough sodium of chloride in the parenteral way.

In a diet No. 4 the amount of fats (70 g) is a little limited that is reasonable as fats (especially refractory) are among hardly assimilable products. They slow down gastric secretion and promote emptying of guts. At the same time at acute coloenterites the diarrhea and a tendency to decrease in gastric secretion are already observed. Enter the increased amount of the vitamins (especially ascorbic acid — 100 — 150 mg and Niacinum — 60 — 70 mg) promoting reparative processes and recovery of the broken functions.

The use of the products rich with calcium salts (cottage cheese, not acute grades of the wiped cheese) is shown. Salts of calcium possess the knitting, antiinflammatory and desensibilizing action.

Milk, salty, hot, cold dishes, crude and boiled fruit, vegetables, tinned and marinated products, spices, rye bread, dough products, greasy and fried food, honey, carbonated drinks are excluded.

Food is eaten in a warm look fractionally — 5 — 6 times a day. However the diet No. 4 has low energy value. Therefore it is possible to appoint it for a short time (3 — 5 days) on condition of observance of a bed rest. Further, in process of elimination of symptoms of a disease and expansion of the motive mode sick it is necessary to transfer to better and various nutrition (diets No. 4b, 2, 5a, 4v, 15).

In cases of prolonged acute enteritis and at subnutrition of patients it is necessary to transfer to a special enteritny diet (E. A. Beyul) which characteristic is provided at the description of chronic enteritis.
If in process of elimination of a disease the lock develops, its elimination is promoted by one-day lactic products (kefir, curdled milk), beet and carrot juice, the wiped boiled vegetables (carrots, beet, a cauliflower, pumpkin).

Careful implementation of dietary recommendations is an important measure of prevention of transition of an acute coloenteritis in chronic.

 
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