Acute gastroenteritis

　　The genus Salmonella is the main pathogen causing acute gastroenteritis, among which Salmonella typhimurium, Salmonella enteritidis, Salmonella choleraesuis, Salmonella gallinarum, and Salmonella anatidae are more common. Eating raw and cold foods or certain drugs such as salicylates, sulfonamides, certain antibiotics, etc.; or accidentally ingesting strong acids, alkalis, and pesticides can all cause acute gastroenteritis.

　　Acute gastroenteritis includes the following other causes:

　　1. Physical factors: Eating cold, hot, and rough foods can cause the gastric mucosa to be scratched or damaged.

　　2. Chemical factors: Medications (including aspirin, hormones, ibuprofen, certain antibiotics, and blood pressure-lowering drugs), strong alcohol, strong tea, coffee, spices, etc., can stimulate the gastric mucosa, causing erosion and pinpoint bleeding.

　　3. Microbial infection and bacterial toxin contamination: Food contaminated with Salmonella and Staphylococcus aureus toxins, as well as infections with influenza virus and intestinal viruses. Acute gastritis caused by these factors has similarities with bacterial food poisoning.

　　4. Mental and neurological factors: Disruption of mental and neurological function, critical conditions of various acute and severe diseases, as well as the body's变态（allergic）reactions can all cause acute inflammation and damage to the gastric mucosa.

　　The clinical manifestations of acute gastroenteritis in family life usually occur within a few hours to 24 hours after overeating or consuming contaminated food, taking medication that irritates the stomach, or after several hours to 24 hours. There are often situations of collective onset or multiple cases in the family. For example, if contaminated poultry, livestock meat, fish, or shellfish such as crabs and snails grown in saltwater are eaten; or if leftover food or rice contaminated with Staphylococcus aureus is eaten, this disease may be induced.

　　1. Anal sinusitis: If proctitis is not treated in time, it can lead to complications such as anal sinusitis and other anorectal diseases, and there is also a risk of secondary perianal abscess.

　　2. Anal canalitis: This is a complication of the disease, often referred to as anal-rectal inflammation together with proctitis. Anal canalitis that is left untreated for a long time also has the risk of cancerous transformation.

　　3. Intestinal polyps, colon cancer: If proctitis lasts for more than five years, the ulcerated surface of the intestines is prone to abnormal hyperplasia under the long-term stimulation of inflammation, leading to intestinal polyps, and the cancerous rate of intestinal polyps over one centimeter is extremely high.

　　4. Intestinal stricture: It often occurs in cases with extensive lesions and a course lasting 5-25 years or more, mainly affecting the rectum. Clinically, it usually has no symptoms, but in severe cases, it can cause intestinal obstruction. When intestinal stricture occurs in this disease, one should be vigilant about tumors and differentiate between benign and malignant ones.

　　5. Hematochezia: Hematochezia is one of the main clinical manifestations of this disease, and the amount of blood in the stool is also an indicator of the severity of the disease. Chronic bleeding over a long period can lead to iron deficiency anemia.

　　6. Idiopathic ulcerative colitis: The cause of idiopathic ulcerative colitis is unknown and is an immune-related disease, mainly characterized by ulcers, involving the mucosal membrane of the colon, and is more common in young and middle-aged people. Abdominal pain is often prominent in the lower left abdomen or the whole abdomen, accompanied by increased bowel sounds. Symptoms such as decreased appetite, weight loss, and malnutrition may occur. Sigmoidoscopy and biopsy may be performed for diagnosis.

　　7. Intestinal tuberculosis: It starts slowly, mostly located in the lower right abdomen, with intermittent colic pain, increased bowel sounds, frequent changes in defecation habits, dry and loose stools alternating. Mild cases may only have loose stools, while severe cases may have mucous pus stools. Nausea, vomiting, abdominal distension, decreased appetite, and other symptoms may occur. Physical examination shows tenderness in the lower right abdomen. Auxiliary examinations: ESR is accelerated, colon bacillus test is positive, and acid-fast bacilli can be found in stool culture. Fiberoptic colonoscopy is recommended to confirm acute gastroenteritis.

　　The stomach is the main digestive organ of the human body. Acute gastroenteritis is a common disease, mainly manifested as epigastric pain, discomfort, decreased appetite, nausea and vomiting, and sometimes diarrhea. Severe acute gastritis can also cause symptoms such as hematemesis and melena.

　　Acute gastroenteritis usually starts suddenly, with main symptoms of nausea, vomiting, abdominal pain, and diarrhea, which may be accompanied by fever.

　　1. Diarrhea: This is the most common symptom of acute gastroenteritis, with varying degrees of severity. Prolonged diarrhea or excessive amount of diarrhea can easily lead to dehydration, oliguria, and fever. Excessive loss of water can lead to poor skin elasticity, sunken eyes, thirst, oliguria, and other symptoms. In severe cases, blood pressure may drop and the extremities may become cold.

　　Some children may have symptoms such as convulsions and high fever without diarrhea, and parents should be vigilant. The child may have acute gastroenteritis or toxic bacterial dysentery, and it is recommended to see a doctor as soon as possible.

　　2. Abdominal pain: Acute gastroenteritis is primarily manifested as abdominal pain, with epigastric pain located centrally or slightly to the left of the navel, presenting as intermittent exacerbation or persistent dull pain, accompanied by abdominal fullness and discomfort. Some patients may experience severe pain. It is mostly manifested in the upper abdomen and umbilical area, sometimes with mild dull pain and sometimes with severe pain that is difficult to bear, mostly intermittent, and patients often hear abdominal rumbling themselves.

　　3. Nausea and vomiting: Patients with strong reactions may experience vomiting, and the vomit often has a sour smell.

　　Severe vomiting and diarrhea can lead to dehydration, acidosis, and even shock; in addition, symptoms such as headache, fever, chills, and muscle pain may also occur in acute gastroenteritis.

　　5. Hematemesis and melena: A few patients have blood丝 in their vomit or coffee-colored vomit, and the stool is black or the occult blood test is positive. This indicates that there is bleeding in the gastric mucosa.

　　Improving food, drinking water hygiene, and fecal management, and vigorously eliminating flies are fundamental measures to prevent the disease. Food in the refrigerator should be kept separate, and it should be re-boiled and thoroughly cooked before eating. Wash hands before meals and after defecation, disinfect vegetables and fruits before eating raw, and choose clean and hygienic restaurants when going out on vacation are all effective preventive measures that should be noted.

　　1. Pay attention to hygiene: Keep food, utensils, containers, refrigerators, and other food storage places and environments clean.

　　2. Do not eat unclean food: Do not eat food that has rotted or deteriorated. It is best not to store cooked meals overnight, and fruits and vegetables should be washed clean before eating.

　　3. Avoid stimulation: Eat light foods and avoid刺激性 foods such as chili, coffee, strong tea, etc. At the same time, it is also necessary to avoid the stimulation of drugs, such as non-steroidal anti-inflammatory drugs, which can severely stimulate our gastrointestinal mucosa.

　　4. Strengthen exercise and pay attention to warmth: In the summer and autumn seasons, weather changes are severe. Everyone should change their clothes in a timely manner, especially after entering autumn, and pay attention to keeping warm, covering the blanket well when resting. Strengthen physical exercise to improve physical immunity. For patients with acute gastroenteritis, bed rest and attention to warmth are also necessary.

　　5. During the acute stage, patients often have symptoms such as vomiting and diarrhea, resulting in significant fluid loss. Therefore, it is necessary to replenish fluids, and it is appropriate to provide liquid foods such as fresh fruit juice, lotus root powder, rice gruel, and egg soup. Drink more water and dilute salt water as appropriate.

　　Routine stool examination and stool culture; blood white blood cell count can be normal or abnormal

　　(1) Parasitic infections such as hookworm, schistosomiasis, tapeworm, and filarial nematodes can cause parasitic diseases with an increase in peripheral blood eosinophils, each with its own clinical manifestations.

　　(2) Gastrointestinal cancer and malignant lymphoma can also have an increase in peripheral blood eosinophils, but it is secondary and should have other manifestations of cancer and lymphoma.

　　(3) Eosinophilic granuloma mainly occurs in the stomach and large and small intestines, presenting as localized masses. Pathological tissue examination shows that eosinophilic granuloma is mixed with connective tissue matrix. Allergy history is rare, and the number of white blood cells and eosinophils in peripheral blood usually does not increase.

　　(4) Eosinophilic granulomatosis not only involves the intestines but also extensively affects other visceral organs such as the brain, heart, lungs, and kidneys, with a short course and poor prognosis, often resulting in death within a short period of time.

　　Acute gastroenteritis is a stage of acute congestion, edema, inflammation, and exudation in the intestines. At this time, intestinal peristalsis is active or in a spastic state, and its digestive and absorptive functions are relatively weak. Therefore, within 8-12 hours after the onset, patients can eat liquid foods such as rice porridge, lotus root powder, egg paste, thin noodles, and stewed thin noodles. If diarrhea is severe or sweating is excessive, it is appropriate to give the patient more soup and water, such as rice gruel, vegetable soup, fruit juice, and dilute salted water, to supplement the deficiency of water, vitamins, and electrolytes in the body.

　　Due to the pathological and physiological changes of the gastrointestinal tract, especially the intestines, the intestines are very sensitive to food at this time. Therefore, it is necessary to pay special attention to diet control and eat light, soft, warm foods. It is advisable to avoid eating fatty meat, fried, cold and hard foods, as well as high-fiber foods such as celery, chive, garlic sprout, etc. After 2-3 days in the recovery period, one can eat meals as usual. Patients with acute gastroenteritis should also avoid certain foods until they feel better. In most cases, simplifying the diet can effectively control enteritis. In mild cases, proper diet alone can cure the disease.

　　To alleviate the symptoms of acute gastroenteritis, it is recommended to initially adopt a liquid diet. Drink plenty of water to avoid dehydration caused by diarrhea. However, attention should be paid to rehydration, do not just drink plain water. It is best to drink an electrolyte solution with appropriate salt and water to avoid the phenomenon of cramps caused by insufficient body electrolytes.

　　If you feel better the next day, to avoid gastrointestinal fermentation and bloating, you can eat light fluid and semi-liquid foods such as congee and porridge. Try to avoid greasy and citrus foods, and reduce the intake of sucrose as they may worsen the condition. Pay attention to food hygiene. Avoid high-fat fried, smoked, and preserved fish and meat, vegetables and fruits with high fiber content, food and spices, etc.

　　Do not drink liquids immediately after vomiting, wait at least half an hour, and then take small amounts of liquids frequently.

　　Dairy products such as ice cream should not be consumed as they can exacerbate diarrhea. Only after the symptoms of acute enteritis disappear can patients include solid foods in their diet. The symptoms of enteritis usually subside within 3-5 days.

　　In addition, fasting cannot be used to 'rapidly clean the intestines', such as intravenous infusion can be fasting for one to two meals under the guidance of a doctor. However, it is forbidden to use fasting to clean the intestines in daily life, which is easy to cause dehydration and upset the internal balance.

　　Western medicine treatment generally includes different therapies such as general treatment, symptomatic treatment, antimicrobial treatment, and oral medications.

　　(1) General treatment: Try to rest in bed, take oral glucose-electrolyte solution to supplement the loss of body fluids. If there is persistent vomiting or obvious dehydration, then intravenous glucose salt solution of 5%-10% should be supplemented with other related electrolytes. Encourage intake of light fluid or semi-liquid foods to prevent dehydration or treat mild dehydration.

　　(2) Symptomatic treatment: Antiemetics can be injected when necessary: for example, intramuscular injection of chlorpromazine 25-100mg/day. Antispasmodics: such as belladonna 8n kanchan 11 times, three times a day. Laxatives: such as 1 bag of Simeticon per dose, two to three times a day.

　　(3) Antimicrobial treatment: The efficacy of antibiotics in the treatment of acute gastroenteritis is controversial. For infectious diarrhea, appropriate targeted antibiotics can be selected, such as 0.3g of coptis chinensis taken orally, three times a day, or 80,000u of gentamicin taken orally, three times a day, etc. However, it should be prevented from antibiotic abuse.