Hemorrhagic enteritis

　　Hemorrhagic enteritis, the exact cause of which has not yet been clarified up to now, but the combination of bacterial infection and the atopic reaction of the child's body may be the main cause of the disease. Firstly, bacterial infection, in which Clostridium perfringens type C is most common among intestinal bacterial infections, but most children do not grow bacteria in their feces, and antibiotic treatment is not effective. The second atopic reaction refers to the fact that bacteria, their toxins, and food can all cause the body to produce type I and type III atopic reactions, and children often have other allergic diseases, such as eczema, urticaria, asthma, and so on. In addition, some experts say that some children lack proteases in the intestines, which makes the beta toxin of Clostridium perfringens type C easy to cause necrotic changes in the intestinal mucosa, leading to the occurrence of this disease. However, in summary, all current studies have not yet reached a definitive conclusion, and the above are all speculations by experts. The specific cause of the disease still needs to be further studied by relevant research. Therefore, if we want to prevent the disease from the cause, we still need to pay more attention to ourselves in our daily lives.

　　The complications of hemorrhagic enteritis are divided into five stages according to the severity:

　　The first stage is the gastroenteritis type, which is seen in the early stage of the disease with abdominal pain, watery diarrhea, low fever, which may be accompanied by nausea and vomiting.

　　The second stage refers to toxic shock, which is characterized by high fever, chills, drowsiness, delirium, and shock, which often occurs within 1 to 5 days of onset.

　　The third stage is the peritonitis type, which is characterized by marked abdominal pain, nausea, vomiting, abdominal distension, and signs of acute peritonitis. The involved intestinal wall may necrose or perforate, and there may be hemorrhagic exudate in the peritoneal cavity.

　　The fourth stage is the intestinal obstruction type, manifested by abdominal distension, abdominal pain, frequent vomiting, cessation of defecation and flatus, disappearance of bowel sounds, and the appearance of abdominal distension.

　　The fifth stage is the intestinal hemorrhagic type, mainly manifested by bloodwater-like or dark red feces, which can reach 1 to 2 liters, with obvious anemia and dehydration. Each stage of these complications cannot be ignored, as they represent a certain degree of disease severity, and also serve as a warning that attention should be paid. Since hemorrhagic enteritis is a disease with certain risks, it is necessary to be more cautious and deal with different complications. In necessary cases, go to the hospital in time to ensure your health.

　　Hemorrhagic enteritis is an acute onset disease, the most common initial symptom is sudden abdominal pain, which is often located around the umbilicus. In the early stage, it often manifests as gradually increasing cramping pain around the umbilicus or in the upper abdomen, which then gradually turns into persistent pain throughout the abdomen with intermittent exacerbation. Diarrhea can occur after the onset of abdominal pain. Initially, the stool is paste-like with fecal matter, and then gradually becomes watery yellow, followed by water-like or red bean soup and jam-like, even blood-like or dark red blood clots. The stool is less and has a foul smell. There is no urgent need to defecate. The amount of bleeding is not fixed, with mild cases only having diarrhea, or only positive occult blood in the stool without bleeding; severe cases can reach several hundred milliliters of bleeding per day. The duration of diarrhea and hematochezia is short, only 1 to 2 days, and can last up to one month, and can present intermittently or repeatedly. Severe diarrhea can lead to dehydration and metabolic acidosis. In addition, nausea and vomiting often occur simultaneously with abdominal pain and diarrhea. The vomit can be watery yellow, coffee-like, or bloodwater-like, and can also vomit bile. General malaise, weakness, and fever can occur after the onset of the disease. Fever, usually between 38 to 39°C, a few can reach 41 to 42°C, but fever usually subsides within 4 to 7 days, and it is rare to last for more than 2 weeks. In rare cases, abdominal distension and visible intestinal loops may occur. In this case, there may be significant tenderness around the umbilicus and in the upper abdomen. Early bowel sounds may be hyperactive, and then may weaken or disappear.

　　To prevent hemorrhagic colitis, attention should be paid to dietary hygiene, do not eat deteriorated and deteriorated food, avoid overeating and eating excessive raw, cold, and greasy foods. Timely treatment of intestinal parasitic diseases.

　　1. Pay attention to the combination of work and rest, do not overwork; patients with fulminant, acute onset, and severe chronic type should rest in bed.

　　2. Pay attention to clothing, keep warm and cool; appropriately engage in physical exercise to enhance physical fitness.

　　3. Generally, soft, easily digestible, nutritious, and sufficient calorie foods should be eaten. It is recommended to eat small and frequent meals, and to supplement a variety of vitamins. Do not eat raw, cold, greasy, and high-fiber foods.

　　4. Pay attention to food hygiene, avoid intestinal infections that may trigger or worsen the disease. Avoid smoking, alcohol, spicy foods, milk, and dairy products.

　　7. Keep a pleasant mood, avoid mental stimulation, and relieve various mental stresses.

　　The main laboratory tests for hemorrhagic colitis mainly include three items:

　　1 Blood routine examination shows that the manifestation of hemorrhagic colitis in blood routine items is an increased count of peripheral blood leukocytes, even up to 40×10^9/L or more, mainly with an increase in neutrophils, and often with nuclear left shift. Red blood cells and hemoglobin are often reduced.

　　2 Stool examination shows that the manifestation of hemorrhagic colitis is dark red or bright red in appearance, or strong positive occult blood test, and a large number of red blood cells are seen under the microscope, with occasional detachment of mesenteric tissue. There may be a small or moderate amount of pus cells.

　　3 X-ray examination shows that the disease is manifested as intestinal paralysis or mild to moderate intestinal dilation on abdominal plain film. Barium enema examination shows thickened intestinal wall, significant edema, and disappearance of colonic pouches. In some cases, gas between intestinal walls may be observed, which is a sign of partial intestinal wall necrosis caused by bacterial invasion of the colon; or ulcerative or polypoid lesions and rigidity may be seen. In some cases, intestinal spasm, stricture, and cystic gas in the intestinal wall may also occur. In summary, all situations should be checked in regular hospitals, and doctors are sure to make a reasonable judgment about your condition.

　　It is recommended that the diet be light, and greasy foods should not be eaten to avoid discomfort.

　　In addition, eat more yellow fruits, because these fruits have a high content of carotene and have antioxidant physiological activity. Oranges, mangoes, persimmons, and other fruits contain a lot of beta-carotene. While papaya, watermelon, and other fruits contain lycopene.

　　Secondly, eat more fruits rich in vitamin C. Strawberries, kiwi, lemons, and other fruits contain a lot of vitamin C.

　　Due to vomiting and diarrhea, decreased appetite in patients with hemorrhagic enteritis, dehydration, electrolyte disorder (such as potassium deficiency, sodium deficiency, etc.) and acidosis often occur. Therefore, the total volume and composition of infusion should be reasonably determined according to the condition. The daily fluid replacement for children is about 80ml/kg to 100ml/kg, and for adults, 2000 to 3000ml/d, among which 5% to 10% glucose solution accounts for about 2/3 to 3/4, normal saline accounts for about 1/3 to 1/4. It is appropriate to add 0.5% sodium bicarbonate solution to correct acidosis. In the presence of urine, add an appropriate amount of potassium chloride. At the same time, this disease is prone to shock, which is the main cause of patient death. Early detection and timely treatment of shock are important links in the treatment of this disease, and blood volume should be rapidly replenished and microcirculation improved. In addition to crystalloid solutions, appropriate plasma, fresh whole blood, or human serum albumin and other colloidal fluids should be administered. For those whose blood pressure does not rise, it is appropriate to select vasoreactive drugs such as 654-2. To alleviate toxic symptoms, suppress allergic reactions, and assist in correcting shock, hydrocortisone can be administered intravenously for 3 to 5 days, with an adult dose of 200 to 300mg/d, or dexamethasone 5 to 10mg/d; children use hydrocortisone at a dose of 4 to 8mg/kg per day, or dexamethasone 1 to 2.5mg/d. Of course, this method also has certain applicability. Adrenal cortical hormones have the risk of aggravating intestinal bleeding and inducing intestinal perforation, so they should be used with caution. In summary, in the treatment methods of Western medicine, whether it is the dosage of drugs or the focus of drug replacement, it is necessary to adjust according to the situation at any time.