"Diarrhea" is extremely common in life. Acute enteritis is the most common disease in "diarrhea". Once people eat improperly, acute enteritis often occurs.

(1) Causes of acute enteritis: (1) Overeating, eating too much high-fat and high-protein food, drinking too much alcohol or cold drinks, or after catching a cold. (2) Eating spoiled and contaminated food, such as food that has not been heated and sterilized overnight, smelly fish and rotten shrimps, stale crabs and seafood, meat products that have been stored in the refrigerator for a long time, fermented and spoiled milk and dairy products. (3) Individual patients develop allergic reactions to food. Acute enteritis is more common in summer and is related to hot weather and perishable food. Acute enteritis will be greatly reduced if the "disease enters through the mouth" is taken care of.

(2) Clinical manifestations of acute enteritis: (1) Abdominal pain and diarrhea are the main features. Most of the pain is around the navel, showing paroxysmal cramping, causing the sensation of defecation, and the abdominal pain is slightly relieved after defecation. Diarrhea is mostly watery stool containing undigested food residues. Generally, diarrhea can occur 7 to 8 times a day, and up to a dozen times at most. After treatment, the condition returns to normal within 1 to 2 days, or at most 2 to 3 days, and the condition progresses relatively well. (2) Hyperactive bowel sounds. If you are close to the patient, you can clearly hear a "gurgling" sound in his abdomen. (3) Some severe patients are accompanied by low-grade fever, nausea and vomiting, and dehydration symptoms. (4) Care should be taken to differentiate acute enteritis from diarrhea caused by other diseases. In general, milder cases of diarrhea are generally acute enteritis. Other diseases require further examination in the hospital to be diagnosed.

(3) Rescue measures: (1) First, rest in bed, keep warm, and fast for 12 hours. Then gradually introduce a small amount of liquid food, such as rice soup, lotus root starch, or gruel, noodle soup, etc., and slowly Return to a normal diet. (2) Appropriate pain relief and diarrhea. Take belladonna tablets by mouth. If the diarrhea is severe, you can eat some burnt steamed buns or rice porridge to reduce diarrhea. (3) Encourage drinking more water. For details, see "Rescue Measures for Acute Gastritis". (4) People with mild illness do not need “anti-inflammatory drugs”. Generally, lactase, berberine, norfloxacin and other drugs can be used. (5) Those with severe diarrhea and dehydration should be sent to the hospital promptly for intravenous infusion treatment.

What is acute enteritis?

Acute enteritis is a common and frequently-occurring disease in summer and autumn. It is mostly caused by microbial infections such as bacteria and viruses. Its main manifestations are abdominal pain, diarrhea, nausea, vomiting, fever, etc. In severe cases, it can cause dehydration, electrolyte imbalance, shock, etc.

The diagnosis of acute enteritis is not difficult. Patients often develop sudden onset in summer and autumn; many have a history of improper diet or accidental ingestion; it has the characteristics of a fulminant epidemic; patients often present with nausea and vomiting. First, diarrhea will occur, ranging from 3 to 5 days, or even dozens of times a day. The stool will be watery, dark yellow or green, with a foul odor, and may be accompanied by symptoms such as abdominal cramps, fever, and body aches. Routine stool examination and stool culture, red and white blood cell counts may be normal or abnormal. Patients present with nausea, vomiting, abdominal pain, and diarrhea at the same time, so it is also called acute gastroenteritis.

What factors are related to the onset of acute enteritis?

(1) Infection by bacteria and toxins

Salmonella and Halobacteria (parahaemolyticus) are often the Vibrio) infections are the most common, and the toxins are common with Staphylococcus aureus, but viruses can also be seen. It often occurs in groups or in families. This disease can be induced by eating contaminated poultry, livestock meat or fish; eating crabs, snails and other seafood where halophilic bacteria grow; or eating leftovers and rice contaminated by Staphylococcus aureus.

(2)Physical and chemical factors

Eating raw and cold food or certain drugs such as salicylates, sulfonamides, certain antibiotics, etc.; or accidentally taking strong acids, strong bases, pesticides, etc. All can cause this disease.

What are the pathological changes of acute enteritis?

The gastrointestinal mucosa is congested, edema, and exudated. The surface is covered with flaky yellow exudate or mucus. The lesions can be localized or Diffuse. There are erosions and bleeding spots on the mucous membrane walls. If the surface epithelial cells are necrotic and shed, and the blood vessels of the membrane propria are damaged, bleeding and plasma extravasation will occur, often with infiltration of neutrophils, lymphocytes, plasma cells and a small amount of eosinophils. In severe cases, there may also be congestion and edema in the submucosa.

The small intestine is the main site of disease in salmonella gastroenteritis, but the colon is also involved, causing dysentery-like symptoms. Salmonella is invasive and causes mucosal inflammation with neutrophil infiltration in the submucosa, sometimes deep into the lamina propria. Inflammatory cells produce and release prostaglandins, which increase adenylyl cyclase activity. Salmonella secretes enterotoxin, which directly stimulates the adenylyl cyclase system, greatly increasing the secretion capacity of intestinal juice, exceeding the intestinal reabsorption capacity, and causing diarrhea.

What are the clinical manifestations of acute enteritis?

(1) Gastrointestinal symptoms: nausea, vomiting, abdominal pain, and diarrhea are the main symptoms of this disease. The onset of vomiting is sudden, often with nausea followed by vomiting, mostly stomach contents. Severe cases may vomit bile or bloody substances. Abdominal pain is more common in the middle and upper abdomen, and in severe cases, paroxysmal colic may occur. Diarrhea manifests as watery stools, ranging from several to dozens of times a day, accompanied by foul odor, mostly dark yellow or green stools, rarely with pus and blood, and without tenesmus.

(2) Systemic symptoms: Generally, systemic symptoms are mild. Severe patients may have symptoms such as fever, dehydration, acidosis, shock, and occasionally acute upper gastrointestinal bleeding.

(3) In terms of physical signs: early or mild cases may not have any physical signs. During physical examination, there may be mild tenderness in the upper abdomen or around the umbilicus, and bowel sounds are often significantly elevated. Generally, patients have a short course of disease and can improve and heal within a few days.

What are the laboratory tests for acute enteritis?

(1) Blood test: The white blood cells in the blood routine can be slightly increased, and the erythrocyte sedimentation rate is slightly increased.

(2) Stool routine or culture: mostly normal, a small amount of white blood cells and red blood cells can also be seen. In the case of bacterial infection, pathogenic bacteria can be found.

What is the basis for the diagnosis of acute enteritis?

The diagnosis of this disease is mainly based on the acute onset, recent history of improper diet or ingestion of drugs that are harmful to the stomach, and Clinical manifestations include nausea, vomiting, abdominal pain, and diarrhea. Normal stool contains mucus and red and white blood cells. Bacterial culture can detect pathogenic bacteria. The white blood cell count was mildly elevated.

What diseases can be distinguished from acute enteritis?

When this disease has upper gastrointestinal bleeding, it should be distinguished from bleeding caused by peptic ulcer, esophageal variceal rupture, etc. Severe abdominal pain occurs in a few cases, which should be differentiated from perforated peptic ulcer, acute cholecystitis, acute peritonitis, acute appendicitis and atypical acute myocardial infarction.

What are the treatment principles for acute enteritis?

(1) Remove the triggers, rest in bed, and eat light and easily digestible food.

(2) If the pathogenic bacteria are found, the drug should be used according to the drug sensitivity test, or 0.1 to 0.2g of berberine or 0.5 to 1.0g of PPA should be taken orally 3 to 4 times a day.

(3) Symptomatic treatment, atropine can be used for abdominal pain. Dehydrated patients should be rehydrated and attention should be paid to correcting electrolyte imbalance and acidosis. Those who experience shock should be treated as if they are in shock.

What are the commonly used drugs for the treatment of acute enteritis?

(1) Antispasmodic and analgesic: Antispasmodic agents can be used for abdominal pain, such as oral atropine 0.3~0.6mg or probenzox 15mg~ 30 mg, or intramuscular injection of 5 to 10 mg of anisodamine, or 1 tube for abdominal pain relief.

(2) Antibacterial and anti-inflammatory: In case of bacterial infection, antibiotic drugs should be used, such as berberine 0.3g, 3 times a day, compound sulfamethoxazole, 1 to 2 tablets each time, 3 to 4 times a day Second-rate. Norfloxacin 0.1 to 0.2, 3 times a day. Gentamicin 160,000 units, taken orally, 3 to 4 times a day. If there is severe vomiting or obvious water loss, give intravenous infusion of glucose saline. In case of acidosis, 5% sodium bicarbonate solution should be administered intravenously. In case of upper gastrointestinal bleeding, fluids or blood transfusions, gastric lavage with ice water, and oral antacids should be given.

How does Chinese medicine understand acute enteritis?

There is no name for acute enteritis in Chinese medicine. According to the main clinical manifestations of this disease, it is vomiting, abdominal pain, diarrhea, cholera, Disease categories such as intestinal syndrome and prolapse syndrome. The causes include seasonal evils, injuries caused by diet, emotional disorders, and weakness of the internal organs, etc., but the main key lies in spleen and stomach dysfunction and gastrointestinal dysfunction.

(1) Feeling the evils of the season

At the turn of summer and autumn, summer dampness evaporates. If the intake is not appropriate, you will feel the filthy and turbid air of summer dampness; , cold evil and foul qi, stagnation in the middle burner, damage the spleen and stomach, imbalance of ascending and descending, and indistinguishability of clear and turbidity, which is the primary disease.

(2) Injuries caused by eating and drinking

Eat too much and remain stagnant; or eat too much fat and sweet food, which contains dampness and heat; or eat raw, cold and unclean things by mistake, damaging the spleen and stomach, causing Failure in transportation and transformation means that the essence of water and grains cannot be absorbed, causing dampness to stagnate instead. Clear qi does not rise, turbid qi does not fall, and vomiting and diarrhea occur, leading to the onset of the disease.

(3) Emotional disorders

Spleen deficiency, or original food stagnation, or original dampness resistance, but it has not caused the disease, and it will return to emotional disorders, depression and irritation, Mental stress causes the liver to lose its ability to regulate and regulate circulation, and the spleen and stomach can be suppressed due to adverse effects on the spleen and stomach. Just as the "Jingyue Complete Book: Diarrhea" says: "Anyone who has diarrhea when he is angry will first grab food when he is angry, causing damage to the spleen and stomach. Therefore, if there is an offense, it will break out as soon as it is triggered. This is the liver and spleen. Diseases of the internal organs are caused by liver wood overpowering earth, and the spleen and spleen being injured.

(4) Weakness of the spleen and stomach

Long-term eating disorders, internal injuries due to fatigue, or lingering illness. All can lead to weakness of the spleen and stomach, because the spleen governs transportation and transformation, and the stomach governs reception. If the spleen and stomach are weak, they cannot receive water and grains and transport and transform subtle substances, so that water turns into dampness, grains turn into stagnation, dampness stagnates internally, and clear and turbidity are not distinguished. Mixing and failing is the root cause.

How does Chinese medicine understand the pathogenesis of acute enteritis?

The spleen is the foundation of acquired life and the source of qi and blood biochemistry. It is located in the middle Jiao and is an earth organ. It likes dryness and hates dampness. It mainly promotes clear qi, the spleen transports and transforms water and grains, and transfers fluid and fluid. The stomach and spleen have an exterior-internal relationship. They mainly receive water and grains. The qi mechanism is descending. It likes moisturizing and hates dryness. The two internal organs are divided into one dry and one damp. One acceptance and one luck can play the function of receiving good luck. In summer and autumn, when summer and dampness are combined, the patient is greedy for cold and cold or eats corrosive things by mistake, which causes injuries to the spleen and stomach, loss of ascending and descending, and indistinguishability of clear and turbidity, which messes up the gastrointestinal tract and causes vomiting and diarrhea.

How to diagnose and treat gastrointestinal damp-heat acute enteritis?

Syndrome manifestations: sudden onset, frequent nausea, vomiting and acid swallowing, epigastric pain, urgent diarrhea, uncomfortable bowel movements, The feces is yellow-brown in color and smelly, the tongue coating is yellow and greasy, and the pulse is slippery and rapid.

Syndrome analysis: Damp-heat in the intestines and stomach is more common in summer. Summer heat and dampness damage the spleen and stomach and disturb the stomach. If turbid qi rises and reverses, nausea and vomiting will occur; if there is heat in the intestines and damp-heat accumulates in the stomach and intestines, then Urgent diarrhea; dampness in the middle burner, unfavorable Qi movement, abdominal pain, yellow and greasy coating, and slippery pulse are all signs of dampness and heat.

Treatment: Clear away dampness and heat and regulate the intestines and stomach.

Recipe: Pueraria lobata Qinlian decoction with additions and subtractions: Pueraria lobata, skullcap, coptis, honeysuckle, lotus leaf, white lentil, licorice, and plantain.

Pueraria lobata and honeysuckle relieve muscles and clear away heat, promote clearing and stop diarrhea; skullcap and coptis are bitter and cold, clearing away heat and drying dampness; poria and plantain strengthen the spleen and remove dampness; lentils and lotus leaves clear away heat and reduce dampness; licorice is sweet. It relieves pain and harmonizes various medicines.

For those with severe abdominal pain, add white peony root and woody incense to regulate qi and relieve the qi; for those with severe vomiting, you can first take Yushu Dan to eliminate turbidity and stop vomiting; for those with food stasis, add Shenqu, malt, and hawthorn. Waiting for digestion products.

How to differentiate and treat cold-dampness block acute enteritis?

Syndrome manifestations: vomiting water, nausea, watery diarrhea, abdominal pain and bowel sounds, aversion to cold and fever, body aches, and thin fur White or white greasy, moist pulse.

Syndrome analysis: At the turn of summer and autumn, people are greedy for coolness and sleep in the open, cold and dampness invade the body, cold evil and foul qi, depression in the middle burner, injury to the spleen and stomach, and vomiting, loose diarrhea or watery stools will be seen; If the cold-dampness is excessive and the spleen and stomach qi are not smooth, abdominal pain and intestinal borborygmus will occur. If the evil is bound to the surface of the muscles and the nutrition and defense are not harmonious, there will be fever, aversion to cold, headache and body aches. White and greasy coating, and a wet or floating pulse are signs of cold-damp accumulation. The sign of obstruction.

Treatment method: dispel evil and turn turbidity, dispel cold and remove dampness.

Recipe: Huoxiang Zhengqi Powder plus or minus: Huoxiang, Dabupi, Angelica dahurica, perilla, Poria, pinellia, Atractylodes, tangerine peel, Magnolia officinalis.

The prescription contains Agastache rugosa, perilla, and Magnolia officinalis to dispel evil and transform turbidity; Pinellia ternata, dried tangerine peel, Poria cocos, Daphne bark and stomach are used to reduce nihilism; Angelica dahurica and perilla are pungent and warm to relieve the surface.

Modifications and subtractions: For those with aversion to cold and fever, add Schizonepeta and Windbreak; for headaches, add Qianghuo and Duhuo; for those with stagnation and abdominal distension, remove Atractylodes and add Liushenqu and Gallus gallus gallus L. for digestion. stagnation.

What is the diagnosis and treatment of acute enteritis of the gastrointestinal type due to food stagnation?

Syndrome manifestations: nausea and anorexia, the more food is eaten, the faster the reaction after vomiting, abdominal pain, foul-smelling diarrhea, Urgency and displeasure, pain subsided after diarrhea, thick and greasy coating, and slippery pulse.

Syndrome analysis: Improper eating, especially eating by mistake, or gluttony over raw or cold food, overeating, resulting in internal stoppage of food, obstruction of the gastrointestinal tract, imbalance of qi movement, and upward and reverse turbid qi. The vomiting is sour and smelly; if the patient eats the food, the diarrhea will smell like a broken egg; if the diarrhea is corroded and goes out, the abdominal pain will be relieved; the tongue coating is thick and greasy, and the pulse is slippery, which is the sign of stopping the food.

Treatment method: harmonize the stomach and lower the inverse, digestion and stagnation.

Prescription: Baohe Pills plus or minus: Jiaoshan hawthorn, fried Liushenqu, Poria, pinellia, tangerine peel, forsythia, radish seed.

In the prescription, hawthorn, Shenqu, radish seed, and poria cocos are used to relieve food and regulate the stomach; tangerine peel and pinellia are used to regulate qi and reduce qi; forsythia is used to eliminate stagnation of heat due to food stagnation.

Modifications and subtractions: If food stagnation resolves heat and the stool is uncomfortable, Zhishi Daozhi Pills can be given; if the stomach is hot and vomiting, ginger, bamboo, and ocher can be added.

How to differentiate and treat acute enteritis due to spleen and stomach weakness

Syndrome manifestations: Insufficient endowment, spleen deficiency, careless diet, easy vomiting and diarrhea, loose stools, vomiting of water, and occasional diarrhea. When the patient rests, he is accompanied by a dull complexion, weakness in the limbs, a pale tongue and a wet pulse.

Syndrome analysis: The body's spleen and stomach are weak, transportation and transformation are neglected, prone to vomiting and diarrhea, and persistent diarrhea; insufficient source of qi and blood, so the complexion is dull and the limbs are weak; pale tongue and wet pulse are all signs of weak spleen and stomach. image.

Treatment method: Strengthen the spleen and replenish qi, and relieve dampness in the stomach.

Recipe: Shenling Atractylodes Powder plus or minus: ginseng, Atractylodes, yam, Poria, lentils, Amomum villosum, barley kernels, Zhigancao.

The prescription contains ginseng, Atractylodes macrocephala, Poria cocos and Zhicao to replenish qi and strengthen the spleen; lentils, barley kernels and yam are used to dilute water; Amomum villosum regulates qi and makes the qi flow up and down, then vomiting and diarrhea can be stopped.

Modifications and subtractions: For those with food stagnation, it is advisable to add Gallus gallus gallus gallinae, hawthorn, Shenqu; for those with abdominal pain who prefer warmth and massage, dry ginger and white peony root can be used; for those with chronic diarrhea and prolapse, Buzhong can be used Qi Yi Pills.

What are the patent medicines and simple prescriptions for the treatment of acute enteritis?

(1) Xianglian Huazhi Pill 1 pill, 2 times a day. It is used for damp-heat stagnation, abdominal pain and diarrhea, or red and white diarrhea with tenesmus. Or flavored Xianglian Pills, which are mainly used to clear away heat and reduce dampness, resolve stagnation and stop diarrhea. For cold-dampness type diarrhea, use Xiangsha Yangwei Pills, 6g each time, twice a day. For those with gastrointestinal stagnation, take Yueju Baohe Pills, 6g each time, twice a day. For those with weak spleen and stomach, take Xiangsha Liujunzi Pills, 6g each time, twice a day. It is sweet and warming, nourishes qi, strengthens the spleen and nourishes the stomach.

(2) Poria 15g, Huanglian 6g, Alisma 5g, barley 15g, Plantago 15g, Pueraria lobata 15g, Talc 15g, Licorice 3g, used for damp-heat diarrhea.

(3) 10g each of Jiao Sanxian, 10g betel nut, 10g white cardamom kernel, 10g radish seed, 10g salvia miltiorrhiza, 6g mint, 10g big belly skin, 9g yuanhu, decoction for drinking, 1 dose per day, mainly for food Gastrointestinal stagnation, abdominal pain and diarrhea.

How to master the principles and methods of traditional Chinese medicine syndrome differentiation and treatment of acute enteritis?

Acute enteritis is caused by real evil, with fierce attacks, sudden onset and sudden changes. The cause is often spleen injury and accumulation of dampness. The spleen governs transportation and transformation, and likes dryness and hates dampness. The stomach governs acceptance, likes moistening and hates dryness. The spleen rises and the stomach falls, the outside and the inside help, drying and dampness complement each other, and the body completes the digestion and absorption function at the same time.

Once the balance of dampness and dampness is out of balance, "dampness prevails, causing diarrhea." The pathogenesis of this disease lies in the failure of the spleen and stomach's transportation and transformation. If the spleen cannot rise enough, it will slip down and cause diarrhea. Acute enteritis is dominated by real evils, so eliminating the evils is the key. Eliminating the evils will lead to good health. Regardless of external factors, food stagnation, or internal injuries, all can lead to internal stasis of dampness evil. The main method of eliminating dampness is to eliminate dampness evil. Methods for dispelling dampness include aromatic aromatic dampness, light exudation and diuretic, bitter cold and dampness, dispelling wind and dampness, pungent to relieve dampness, invigorating the spleen and transporting dampness, warming yang and removing dampness, etc. Medicines should be selected based on syndrome differentiation based on cold, heat, exterior, interior, yin, yang, deficiency, and excess, and then use products that strengthen the spleen and stomach.

Although acute enteritis is caused by real evil, it also varies from person to person. Men, women, old and young have different physical constitutions and should be treated separately. Those who have a weak spleen and are prone to diarrhea, or who have diarrhea that is so weak that their Qi and Yin are damaged, should pay special attention to strengthening the body. They should not focus on the actual damage caused by evil, that is, only think of removing evil as a method, but should master the overall concept of traditional Chinese medicine and the characteristics of dialectical treatment. , syndrome differentiation based on symptoms. The key to its treatment is to supplement the deficiency, warm the cold, eliminate the accumulation of food, clear the dampness and heat, lift the depression, and solidify the slippage. Commonly used methods for this disease include: removing accumulation and digestion, guiding stagnation and attacking, clearing away heat and promoting diuresis, promoting qi and reducing swelling, etc. For those who are weak and suffer from chronic diarrhea, they can use the method of warming the spleen and strengthening the spleen, astringent the intestines to stop diarrhea, nourishing yin and clearing away heat, supporting yang and consolidating diarrhea, etc. Common clinical symptoms of cold, heat, and deficiency syndrome often do not exist simply, so the treatment methods cannot be completely separated, and must be changed according to the condition of the disease. There are a few points to note when using medicine: ① It is a medicine that clears away heat and is bitter and cold, which will stop the disease immediately. It should not be used for a long time, otherwise it will easily damage the spleen and stomach. ② Do not use excessive amounts of agents that are light in infiltration and diuretic. Excessive infiltration and diuresis will lead to dryness and suppression of body fluids and yin. ③ The agent for fixing astringency should not be used too early. It will fix the astringency and converge too early, resulting in lingering stagnation and lingering evils. ④Don’t use too much of the attack agent. Excessive attack will damage the vitality. It should be used with caution especially for the weak.

After the diarrhea stops, stomach qi should be protected, and some herbs such as Shenshu Lingcao can be given to strengthen the spleen and qi. If Qi and Yin are both deficient, resulting in dry mouth and tongue, lack of Qi and laziness in speaking, you can rejuvenate the pulse pulse dispersion to replenish Qi and nourish Yin.

What is the prognosis of acute enteritis and how to carry out preventive health care?

(1) Prognosis: The prognosis of this disease is generally good. Because the gastrointestinal reaction of acute enteritis caused by Salmonella infection is severe and the pathogenic bacteria in the intestine are quickly excreted from the body, therefore, the symptoms of toxemia are generally mild, and most patients recover on their own within a short period of time. Some patients have poor body resistance, suffer from some chronic diseases, or receive adrenocortical hormones, immunosuppressants, etc., resulting in decreased body resistance. Bacteria can invade the blood from the intestinal wall and cause bacteremia, causing a larger infection process. . People with sudden diarrhea should replenish fluids in time and pay attention to correcting the electrolyte acid-base balance, otherwise there will be adverse consequences. Special attention should be paid to the elderly, infants and young children.

(2) Prevention: Actively carry out health education work, and do not eat the meat and offal of dead livestock. Meat, poultry, eggs, etc. must be cooked before eating. Food hygiene management will be strengthened, and spoiled and salmonella-contaminated food will not be sold. Improve canteen hygiene, establish a hygiene management system, and pay careful attention to food production hygiene to prevent food from being contaminated. Do a good job in water source protection, drinking water management and disinfection.

(3) Health care: Strengthen exercise and enhance physical fitness to make the spleen strong and less susceptible to evil. Feel comfortable and maintain balanced gastrointestinal function. Eat a diet to facilitate the absorption and absorption functions of the spleen and stomach. Live carefully and avoid wind and cold. Yin and Yang are balanced and dense, and the spirit is cured.

What are the cure criteria for acute enteritis?

(1) Symptoms and signs disappear.

(2) Severe vomiting or dehydration or acidosis will be corrected after symptomatic treatment. Stool routine and blood routine were normal.