What Is Acrodermatitis Enteropathica?

Enteritis is enteritis and colitis caused by bacteria, viruses, fungi and parasites. The clinical manifestations are mainly abdominal pain, diarrhea, watery stools or mucus pus and bloody stools. Some patients may have fever and severe sensation after urgency, so it is also called infectious diarrhea. Enteritis is divided into acute and chronic types according to the duration of the disease. The course of chronic enteritis usually lasts for more than two months. Clinically common chronic bacterial dysentery, chronic amoebic dysentery, schistosomiasis, non-specific ulcerative colitis, and limited enteritis.

Basic Information

English name

enteritis

Visiting department

Gastroenterology

Common causes

Infections caused by bacteria, viruses, fungi and parasites, etc.

Common symptoms

Nausea and vomiting, diarrhea or chronic chronic, recurrent abdominal pain, etc.

Causes of enteritis

Viral enteritis

Viral enteritis is found in enteritis caused by canine distemper virus, canine parvovirus, canine and feline coronavirus, and the like.
In viral enteritis, rotavirus is the main cause of diarrhea in infants and young children, and Norwalk virus is the main cause of viral viral gastroenteritis in adults and older children.

2. Bacterial enteritis

For bacterial enteritis, enteritis caused by Escherichia coli, Salmonella, Yersinia (causing enterocolitis), Bacillus hairy, Campylobacter jejuni, Clostridium (canine hemorrhagic gastroenteritis), etc.
Bacterial enteritis is most commonly caused by dysenteriae, followed by Campylobacter jejuni and Salmonella.

3. Fungal enteritis

Fungal enteritis can be seen in enteritis caused by histoplasma, algae, aspergillus, candida albicans, etc.
Fungal enteritis is caused most by Candida albicans.

4. Parasitic intestines

For parasitic enteritis, enteritis caused by flagellates, coccidia, toxoplasma, roundworms, hookworms and so on.
Enteritis caused by parasites is more common in amoeba.

5. Diet-induced enteritis

Contaminated or spoiled food, irritating chemicals, poisoning of certain heavy metals, and certain allergies can cause enteritis.

6. Enteritis caused by antibiotics

Abuse of antibiotics can cause intestinal flora imbalance or enteritis caused by antibiotic-resistant strains.

Clinical manifestations of enteritis

Acute enteritis

In China, the incidence is higher in summer and autumn, and there is no gender difference. The general incubation period is 12 to 36 hours. Nausea, vomiting, and diarrhea are the main symptoms of acute enteritis.

2. Chronic enteritis

The clinical manifestations are chronic chronic or recurrent abdominal pain, diarrhea, and indigestion. Severe cases may have mucus or watery stools.

The severity of diarrhea varies, and those with mild bowel movements have 3 to 4 times of daily defecation, or diarrhea and constipation alternately; those with severe diarrhea can have it every 1 to 2 hours, and even have fecal incontinence. Some patients may have nocturnal diarrhea and / or postprandial diarrhea. When the rectum is severely affected, a sudden sensation may occur. The faeces are mostly mushy, mixed with a lot of mucus, often with pus and blood.

Some patients have blood in their stools, and their lesions are limited to the rectum. They are called hemorrhagic proctitis. The blood or stool is discharged separately, or attached to the surface of normal or dry feces. It is often mistaken for hemorrhoid bleeding. Proctitis patients often also discharge mucus and bloody stools, and even have fecal incontinence. If the lesion spreads above the rectum, blood is often mixed with feces or bloody diarrhea occurs.

Examination revealed mild tenderness around the umbilicus or lower abdomen, hyperactive bowel sounds, and prolapse of the anus.

Enteritis examination

1. X-ray barium inspection

Acute phase is generally not suitable for barium examination. Special attention is paid to the possibility of intestinal dilatation and perforation when barium enema is used for severe ulcerative colitis. Barium enema is of great value in the diagnosis and differential diagnosis of this disease. Barium enema examination can be used to determine the proximal colonic disease during the clinical quiescence period. Those with clonal disease should be excluded from barium meal examination of the whole digestive tract. Air-barium double contrast method is easier to find superficial mucosal lesions.

2. Endoscopy

Most clinically, the lesions are in the rectum and sigmoid colon. Sigmoidoscopy is very valuable. For patients with chronic or suspected whole colon, a full colonoscopy should be performed. Generally, no clean enema is used, and those with severe acute stage should be listed as taboo to prevent perforation.

Enteritis diagnosis

Varies by pathogen. Generally, preliminary judgment should be made based on medical history and clinical manifestations. Further diagnosis depends on laboratory tests. Bacterial enteritis can be used as vomit and stool culture, and the pathogen can be diagnosed. Some pathogenic bacteria such as salmonella can be used for blood culture. Viral enteritis can be examined with electron microscope, immunoelectron microscopy, immunofluorescence, and serological examinations such as complement binding test, enzyme-linked immunosorbent assay and radioimmunoassay for virus antigens and antibodies. Parasitic enteritis can be directly examined by microscopy to look for pathogens and their eggs. Fungal enteritis can be smeared directly from stool and examined for fungi under the microscope or for stool fungal culture.

Enteritis complications

Complications vary according to the cause of intestinal inflammation. The main complications include: bleeding, perforation, toxic intestinal dilatation, polyposis or canceration.

Enteritis treatment

Pathogen treatment

Viral enteritis generally does not require pathogen treatment and can heal itself. For bacterial enteritis, it is best to choose antibacterial drugs based on the results of bacterial drug sensitivity tests. When suffering from bacterial dysentery, dysentery bacillus is widely resistant to commonly used antibacterials. Generally, compound sulfamethoxazole (compound neonomine), piperidine, gentamicin, amikacin, etc. Campylobacter jejuni enteritis can be treated with erythromycin, gentamicin, and chloramphenicol. Yersinia enterocolitica colitis generally uses gentamicin, kanamycin, compound sulfamethoxazole, tetracycline, chloramphenicol and the like. Antibiotics are not required for patients with mild salmonella enteritis, and chloramphenicol or compound sulfamethoxazole may be used for severe patients. Aggressive E. coli enteritis is treated with neomycin, colistin, and gentamicin, with good results. Enteritis caused by amebic dysentery, flagellates and trichomonas can be treated with metronidazole (metridium). Schistosomiasis can be treated with praziquantel. Candida albicans enteritis is administered orally with nystatin, which has a good effect. Patients with systemic fungal infections should be treated with amphotericin B.

Symptomatic treatment

Replenish fluids and correct electrolytes and acidosis. Those who are mildly dehydrated and not vomiting can take oral rehydration. The oral solution recommended by WHO is sodium chloride, sodium bicarbonate, potassium chloride, glucose or sucrose, and water. For severe dehydration or vomiting, normal saline, isotonic sodium bicarbonate and potassium chloride solutions, and glucose can be administered intravenously.

Reduces bowel movements and secretions. Atropine, Belladonna, Prubensin can be applied in small amounts to reduce intestinal peristalsis, and to relieve pain and diarrhea. You can also use chlorpromazine, which has a sedative effect, and can inhibit the excessive secretion of intestinal mucosa caused by enterotoxin, reducing the number of stools and the amount of stool.

Prognosis of enteritis

Acute enteritis generally has a good prognosis. After prolonged and appropriate treatment of chronic enteritis, the prognosis is good.

Enteritis prevention

To strengthen exercise and strengthen physical fitness. Do not eat the meat and offal of sick animals. Meat, poultry, eggs, etc. must be cooked before consumption. Do not eat spoiled food, do not drink raw water, eat hot fruits and vegetables to wash, and develop a good habit of washing hands before and after meals. Strengthen food hygiene management. Foods that have deteriorated and are contaminated with Salmonella are not allowed to be sold. Pay close attention to the hygiene of food preparation to prevent food from being contaminated. Do water protection, drinking water management and disinfection.