Dr. Long Chelsea98.com Wisdom Week Million Dragon Health Education
World Digestive Health Day (World Digestive Health Day) was established by the World Gastroenterology Organization (WGO) in 2005. The date is May 29 every year to remind people to pay attention to the warnings issued by the body. Pay attention to intestinal health: only intestines can live long.
The intestinal microbes in the intestine regulate the secretion of neurotransmitters and cytokines in the intestine. The intestinal tract "has an accident", and all health problems come; the intestinal tract "strikes", problems with digestion and absorption, immunity, and nervous system in the body will cause body odor, bad breath, dull skin, skin allergies, rashes and pigment spots, and irritability , Depression and so on. A large number of studies have shown that intestinal health is closely related to the risk of type II diabetes, Alzheimer's disease, and heart disease.
Current status of global diarrheal diseases
Diarrheal disease is one of the top five causes of death in the world. According to data released by the World Health Organization, among adults in resource-rich areas, diarrhea is often a “nuisance disease” among healthy people. Infectious diarrhea is a group of diseases with a high incidence. It is estimated that the number of patients affected by the disease is as high as 3-50 billion every year. Most cases of acute diarrhea in adults are caused by infectious causes. In industrialized countries, relatively few patients die from diarrhea, but the high incidence of diarrhea is still an important aspect of health care expenditure. However, the incidence of diarrhea has remained high for the past 20 years.
According to data from the World Health Organization (WHO) and the United Nations International Children’s Emergency Relief Fund (UNICEF), approximately 1,900,000 children under the age of 5 die from diarrhea each year, mainly in developing countries. The mortality rate of 18% among children under 5 years old means that more than 5000 children die from diarrhea every day. Among all children who died of diarrhea, 78% occurred in Africa and Southeast Asia. Young children in low- and middle-income countries suffer from diarrhoeal diseases on average 2.9 times a year, causing stunted growth and increasing the risk of other infectious diseases such as respiratory infections.
Children under 5 years of age suffer from acute diarrhea about 3 times a year on average. From a global perspective, in this age group, acute diarrhea is the second leading cause of death (after pneumonia). The incidence and mortality of diarrhea are the highest among children of this age group. This is particularly prominent in China-since then the risk rate decreases with age. In countries with limited resources, other direct consequences of diarrhoea for children include stunting, malnutrition and cognitive impairment. The World Health Organization formulated a global diarrhoeal disease control plan in 1978 and formally implemented it in 1980. It has achieved good results in the third world and can reduce more than 1 million child deaths every year.
The burden of food-borne diseases is huge: almost one in 10 people gets sick every year, and 33 million healthy life-years are lost. Salmonella is one of the four major causes of diarrhea in the world. According to statistics, among the various types of bacterial food poisoning in the world, food poisoning caused by Salmonella often tops the list. More than 100 million people worldwide are infected with Salmonella every year, and about 155,000 of them will die.
Salmonella is a common food-borne pathogen. In 1885, a man named Salmon discovered this type of bacteria in a swine cholera, so he named it Salmonella. Some Salmonella spp. are exclusively pathogenic to humans, some are only pathogenic to animals, and some are pathogenic to both humans and animals. Salmonella belongs to the genus of Gram-negative bacilli in the Enterobacteriaceae. Mainly parasites in the intestines of humans and animals, it enters the capillaries and lymphatic vessels through intestinal mucosal epithelial cells, and infects the whole body through blood and lymphatic circulation. Outside of the body, it is also everywhere. It can survive for several weeks in a dry environment and several months in water, and its vitality is very tenacious. In many European and American countries, infections caused by food such as vegetables are also very serious due to eating habits and other reasons. At the same time, it can also be spread from animals (pets such as cats, dogs, birds and reptiles such as tortoises) to humans. Human-to-human transmission can also be carried out through the fecal-oral route.
Most salmonellosis symptoms are mild, but sometimes life-threatening. The severity of the disease depends on host factors and the serotype of Salmonella. People with weakened immunity, including the elderly, pregnant women, infants and young children, are especially prone to develop severe illness. Among the more than 2500 serotypes of Salmonella, some such as Salmonella typhimurium, Salmonella enteritidis, and Salmonella choleraesuis are extremely lethal. Salmonella can be killed at 100°C.
Diarrhea disease status in China
Infectious diarrhea broadly refers to diarrhea caused by intestinal infections of various pathogens. Here, it only refers to infectious diarrhea other than cholera, bacterial and amoebic dysentery, typhoid fever and paratyphoid fever. Category C infectious diseases specified in ". This group of diseases can be caused by a variety of pathogens such as viruses, bacteria, fungi, and protozoa. It has a wide spread and high incidence rate, and is an important disease that endangers people's health.
Since the 1980s, China's economy and health conditions have made considerable progress, but due to its weak foundation, it is still a developing country. The Department of Epidemic Prevention (now the Department of Disease Control) of the Ministry of Health of China organized household surveys in 20 provinces and cities across the country. After analysis, it is estimated that the annual incidence of diarrhea is about 0.7 times per person, and the annual incidence of children under 5 is 1.9 times. /people;Correct21According to surveys in various provinces and cities, there are 8.36100 million people suffer from diarrhea, of which 5Children under the age of 3Billion person-times. Another survey showed that the mortality rate of children under 5 years of age in China from 1996 to 2006 had a significant downward trend, but the gap between various regions was widening.
The results of surveillance and prevention and control of norovirus infectious diarrhea in China show that the number of reports of norovirus diarrhea outbreaks nationwide from 2006 to 2013 has increased year by year. A total of 56 cases were reported, with 4979 cases of illness, and an average of 89 cases per outbreak, the main pathogen Types include GⅠ and GⅡ. Among the cases of diarrhea in children under 5 years old who were hospitalized at sentinel hospitals for viral diarrhea monitoring, the norovirus detection rate rose from 11.2% in 2007 to 20.3% in 2011, and 15.3% in 2012. In addition,Bacterial food poisoning in China has70%-80%Caused by Salmonella.
At the end of 2019, a new type of coronavirus (COVID-19) infection occurred in Wuhan. Respiratory transmission is the main mode of transmission. With the development of the epidemic, patients with atypical new type of coronavirus infection with diarrhea and vomiting gastrointestinal symptoms have gradually been reported. Intestinal feces COVID-19 has been found to be positive in China, suggesting that the new coronavirus is transmitted through the fecal-oral route in addition to the traditional respiratory transmission.
In the "Healthy China Action (2019-2030)", focusing on pneumonia, diarrhea, anemia, asthma, dental caries, poor eyesight, psychological and behavioral problems, etc., promote appropriate technologies for the comprehensive management of childhood diseases, with emphasis on the management of diarrheal diseases problem.
Diarrhea disease status in the United States
In the United States, expert guidelines for the diagnosis and treatment of acute diarrhea include the guidelines of the American Society of Infectious Diseases and the guidelines of the American Gastroenterology Society. Statistics show that the highest number of non-bacterial diarrhea virus outbreaks of 90% in the United States each year are related to norovirus. In addition, in European and American countries, norovirus is also one of the frequently circulating viruses. According to statistics, more than 20 million Americans are infected with norovirus each year, and the death toll is about 500-800. Generally speaking, its fatality rate is very low. However, its main symptoms are acute gastroenteritis and viral diarrhea, which is very painful for the patient, so many people need to be hospitalized.
Viral gastroenteritis, also called gastrointestinal cold (gastrointestinal flu), is an infection of the stomach and intestines caused by a virus. The main clinical manifestations of gastrointestinal influenza are mainly gastrointestinal symptoms such as diarrhea and vomiting, and its transmission route, like other influenzas, is from the respiratory tract infection. People with severe dehydration may need to receive intravenous drip (IV) in the hospital. However, bacteria (Salmonella, Escherichia coli, etc.), parasites (Giardia, etc.), drugs, etc., are not the cause of viral gastroenteritis. According to the US Centers for Disease Control and Prevention (CDC), the cause of the winter stomach flu of 80% is Norovirus, and the onset period is from November to April each year. Recent studies indicate that one in every 100 to 200 people in the United States is affected by celiac disease. As people’s awareness of celiac disease has increased, patients have been diagnosed early, and blood screening methods have improved.
It was reported on August 14, 2020 that Salmonella infections occurred in the United States and Canada. The outbreak in the United States has expanded to 43 states in the United States. According to statistics from the US CDC, as of August 11, there have been a total of 640 Salmonella cases, including 85 hospitalized patients. The US CDC determined that the outbreak originated from red onions from Thomson International Inc., an agricultural product supplier in Bakersfield, California. These onions are distributed to wholesalers, restaurants and retail stores across the country. It is reported that,Salmonella causes approximately135Million infections and 2.65Ten thousand hospitalizations.
Diarrheal disease status in Canada
The latest study of the "Celiac Disease Association of Canada" pointed out that the diagnosis of the disease by Canadian hospitals and research institutions is seriously lagging behind. High risk for mild symptoms or atypical symptoms
For the population, there are now a variety of effective blood testing methods to test the endomuscular membrane (EMA) and transglutaminase (tTG). Recent studies indicate that one in every 100 to 200 people in the United States is affected by celiac disease. As people’s awareness of celiac disease has increased, patients have been diagnosed early, and blood screening methods have improved. The resulting data show that the prevalence of the disease in Canada is similar to that in the United States.
In 2006, a gastrointestinal flu epidemic occurred at Mount Allison University in New Brunswick, eastern Canada. If the inflammation is caused by a viral infection, it is called viral gastroenteritis, which often causes the patient to vomit and/or diarrhea. Viral gastroenteritis is often referred to as a "gastrointestinal cold", but this condition is not caused by influenza viruses. Viruses that cause viral gastroenteritis include: rotavirus, curtavirus, adenovirus, calicivirus, astrovirus, and a group of Norwalk-like viruses. Viral gastroenteritis is the most common cause of infectious diarrhea. Most infections caused by viral enteropathogens are asymptomatic (but can also be contagious). Among symptomatic infections, watery diarrhea is the most common symptom. Epidemiologists remind citizens to take preventive measures and learn about the prevention methods and symptoms of stomach flu.
On August 14, 2020, salmonella infections broke out in the United States and Canada, and 5 provinces in Canada fell. As of the 7th, the Public Health Agency of Canada has reported a total of 239 cases, 29 of which were hospitalized. The US CDC determined that the outbreak originated from red onions from Thomson International Inc., an agricultural product supplier in Bakersfield, California. These onions are distributed to wholesalers, restaurants and retail stores across the country and Canada. Salmonella infections occur several times a year in Canada. The Public Health Agency of Canada pointed out that anyone can be infected with Salmonella, but young children under the age of 5, pregnant women, the elderly, and people with weak immune systems are at high risk. Symptoms of Salmonella infection may last for several days and include fever, chills, diarrhea, abdominal pain and headache, nausea and vomiting. The Public Health Agency of Canada suspects that the source of Salmonella infection is people's contact with snakes and rodents. The Public Health Agency of Canada recommends that anyone with the above symptoms contact their healthcare staff.
In 2011, the Canadian government allocated 55,000 Canadian dollars to prevent tourists from diarrhea. Living in the "Northland" shrouded in snow and ice all year round, Canadians like to travel to the island countries of Central and South America most. Mexico, Cuba, and the Dominican Republic are the top three favorite tourist destinations for Canadians. Among them, about 550,000 Canadian tourists go to Dominica for vacation every year. However, this country has recently been classified as a high-risk country. In the first half of 2019 alone, 28 Canadians have died tragically in this country. Most of the reasons are diarrhea caused by local food hygiene and drinking water hygiene.
Prevention and treatment of diarrhea
The prevention and treatment of diarrhea is relatively simple.With current technology and existing prevention and control interventions, if these interventions can be adopted in most cases, it is estimated that they can be avoided92%Died of diarrhoeal disease. Etiological treatment and symptomatic treatment are both important. Before the cause is clear, painkillers and antidiarrheals should be used with caution to avoid misdiagnosis and delay of the condition by covering up the symptoms.
1, Etiological treatment
(1) Antibiotic treatment: Choose corresponding antibiotics according to different causes;
(2) Efficacy and nutritional preparations: such as lactose intolerance, dairy products should not be used, adult celiac disease should be fasted with wheat products; chronic pancreatitis can be supplemented with a variety of digestive enzymes, probiotics, seal oil, etc.; drug-related diarrhea should Discontinue related drugs immediately. Please consult the Canadian registered dietitian and registered health manager-Boshilong.
Regarding whether to use antibiotics:
(1) Invasive diarrhea caused by hemorrhagic Escherichia coli (O157H7 serotype), if antibiotics are used, it will significantly increase the risk of hemolytic uremic syndrome, that is, the risk is greater than the benefit, so antibiotics should not be used;
(2) The majority of Salmonella infections other than Salmonella typhi can heal spontaneously. After the use of antibiotics for people over 1 year old with normal immune function, it may cause long-term infection and excretion of bacteria in the patient's intestine;
(3) Enteritis caused by Campylobacter jejuni, Listeria, etc., in most cases, is a mildly self-limiting process that does not require the use of antibiotics and can heal itself, but severe infections require antibiotic treatment;
(4) Shigella infections, although ordinary patients can heal themselves, the use of antibiotics can shorten the course of the disease and reduce the occurrence of hemolytic-uremic syndrome (Shigella can also cause hemolytic-uremic syndrome, but antibiotics can reduce the occurrence );
(5) Salmonella typhi infection must be treated with antibiotics.
If you have the following symptoms, you need to use antibiotics:
(1) Poor general condition, poor mental state, poor response to external stimuli, no eating or drinking, and refusal to eat;
(2) Impaired consciousness, drowsiness, lethargy, or convulsions;
(3) Petechiae and ecchymosis appear on the skin, bruising or mottling on the limbs, reduced urine output or even anuria;
(4) Respiration and heart rate increase significantly (more than 2 standard deviations higher than the normal value of the corresponding age);
(5) Abdominal pain is accompanied by mucus pus and blood in the stool, the blood white blood cell count is higher or lower than the normal value of the corresponding age (or the ratio of immature neutrophils is greater than 10%), stool methylene blue staining shows polymorphonuclear white blood cells, body temperature ≥39℃ Or lower than 36°C (all the conditions in this article must be met);
(6) Immune function is impaired (such as congenital immune dysfunction, taking hormones or immunosuppressive agents, patients with leukemia, etc.), or the age of onset is less than 1 year old.
(1) General treatment: correct water, electrolyte, acid-base balance disorders and nutritional imbalances. Supplement liquids as appropriate, supplement vitamins, amino acids, fat emulsions and other nutrients;
(2) Mucosal protective agent: Dioctahedral montmorillonite, sucralfate, etc.;
(3) Probiotics: such as bifidobacteria, probiotics puree, etc.;
(4) Antidiarrheal agents: select corresponding antidiarrheal agents according to specific conditions;
(5) Others: 654-2, propaline bromide, atropine, etc. have antispasmodic effects, but should be used with caution in patients with glaucoma, prostatic hypertrophy, and severe inflammatory bowel disease.
About Oral Rehydration Salt (ORS):
The most critical treatment for diarrheal disease is to use water, salt and sugar solutions to rehydration, preferably oral rehydration. Diluted fruit juices and flavored soft drinks, combined with salted crackers and broth, or other soups may also meet the needs of patients with mild illness for liquid and salt. The electrolyte concentration in the solution used to replenish after sweating (eg, Gatorade) is not equivalent to the oral rehydration solution (ORS), but it may be sufficient for patients with diarrhea who have no other problems and do not have hypovolemia. enough.
In the past 30 years, methods that can significantly reduce the fatality rate have been widely adopted in developing countries including oral rehydration salts (ORS), improved breastfeeding rates, improved nutrition, better health care, and higher measles vaccination coverage rate. In some countries, such as Bangladesh, the reduction in mortality has nothing to do with the improvement of water sources, sanitation facilities or personal hygiene, but is mainly related to the improvement of disease treatment.
Zinc supplementation is an extremely important treatment for diarrheal diseases. Since 2004, zinc supplementation plus oral rehydration salt has been the only treatment for all diarrhea diseases recommended by WHO and UNICEF. WHO/UNICEF recommends zinc supplementation as part of the routine treatment of diarrhoeal diseases. The results of some randomized placebo controlled trials (RCT) have shown that zinc supplementation can shorten the onset of diarrhea and reduce its overall severity. The treatment plan recommended by WHO/UNICEF was proposed after extensive review of the results of these trials.
ORS and improved nutrition may have a greater effect in reducing the mortality rate of diarrhea than in reducing the incidence. Although there have been some improvements in nutrition, poor living conditions and no significant improvement in water sources, sanitation facilities, and personal hygiene may be the reason for the insignificant decrease in the incidence of diarrhea. Breastfeeding alone (which can prevent diarrhea), continuous breastfeeding for up to 24 months, and improved supplementary food supplementation (through improved nutrition), combined with interventions such as improving the public health environment are considered to reduce the incidence and death of diarrhea at the same time rate. It is recommended to routinely supplement zinc in children with diarrhea to reduce the incidence of disease, but it is not currently implemented in many countries.
When dealing with patients with acute diarrhea, the first thing to do is to adopt general measures, such as rehydration and maintenance of nutrition, and adjust diet if necessary. If the symptoms make the patient very distressing, it may be beneficial to treat the symptoms with medication. Most patients do not need antibiotic treatment because acute diarrhea is usually self-limiting. Nevertheless, empirical and specific antibiotic therapy may still be suitable for certain situations, including: patients with severe illness; patients with symptoms and signs suggesting invasive bacterial infection; patients with high risk of complications.
3, The choice of drugs
(1) If you decide to treat acute diarrhea, you will generally use oral fluoroquinolones for 3-5 days, such as ciprofloxacin (500mg, twice a day), levofloxacin (500mg, once a day) or Norfloxacin (400 mg twice a day; there is no such drug in the United States). For patients who cannot receive fluoroquinolone drugs or are suspected of being at risk of infection by fluoroquinolone-resistant pathogens (eg, patients who have diarrhea after traveling to Southeast Asia, or patients who have diarrhea during an outbreak of drug-resistant pathogens), azithromycin can be used instead ( 500mg, orally, once a day, treatment for 3 days), or erythromycin (500mg, orally, 2 times a day, treatment for 5 days). Most studies on empirical treatment of acute diarrhea have evaluated fluoroquinolones, and studies on travelers’ diarrhea have also fully established the effectiveness of these drugs.
(2) For patients who want to receive symptomatic treatment, if there is no fever or only low fever, and the stool is not bloody, the anti-kinetic drug loperamide (loperamide hydrochloride) can be used with caution. The initial dose of loperamide is 2 tablets (4 mg), and then 2 mg is used for one irregular stool. The daily dose does not exceed 16 mg, and the continuous use does not exceed 2 days. For patients with clinical features suggestive of dysentery (fever, mucus-like stools or bloody stools), due to concerns that anti-kinetic drugs will cause more serious illness, or that such infections will prolong the course of the disease, unless antibiotics are also given to the patient, Otherwise we will avoid the use of antikines. For such patients, bismuth subsalicylate can be used as an alternative medicine (trade name Pepto-Bismol; 30mL or 2 tablets at a time, once every 30 minutes, 8 times in a row), but the effect of this medicine is slightly worse, and it is possible Causes salicylate poisoning, especially in patients taking aspirin (for whatever reason) and pregnant women. If there is another antisecretory drug racecadotril, symptomatic treatment with this drug is also effective, but there is no such drug in the United States.
Although antikinetics are effective, they should be used with caution. Several randomized controlled studies have found that compared with placebo, loperamide can reduce the number of watery stools or shorten the time required for diarrhea to stop (generally about 1 day). Compared with single antibiotics, antibiotics combined with loperamide can also shorten the time for symptoms to resolve. Diphenoxylate (trade name Lomotil) is another antikinetic option, but it is not as well studied as other drugs and may cause central opioid side effects or cholinergic side effects. The dose of diphenoxylate is 2 tablets (4mg), 4 times a day, and continuous use does not exceed 2 days. Patients should also be warned that anti-kinetic therapy may mask the actual amount of fluid loss, because fluid may accumulate in the intestine. Therefore, active fluid replacement should be used when using antikinetic drugs. In addition, people are still worried that when anti-kinetic drugs are used for certain types of dysentery diseases (such as Shigella infection), they will prolong the duration of fever, diarrhea and pathogen excretion. Therefore, anti-kinetic drugs should be avoided for this type of disease. patient.
(3) Probiotics (probiotics). Certain beneficial bacteria can help maintain the non-pathogenic flora in the intestines, or help non-pathogenic flora re-colonize in the intestines; these probiotics can also be used as alternative treatments. Researchers have found that Lactobacillus GG can shorten the duration of childhood infectious diarrhea, while Saccharomyces boulardii may effectively shorten the duration of C. difficile infection. There is little value in using probiotics along with antibiotics.
Recommended non-prescription antidiarrheal drugs in North America:
Imodium Multi-Symptom Relief Caplets, antidiarrheal tablets
Imodium AD Diarrhea Relief Caplets, soothing and antidiarrheal tablets
Pepto Bismol, antidiarrheal medicine
Pepto Bismol Upset Stomach Relief Medicine, antidiarrheal medicine
Pepto Bismol Liquid, antidiarrheal syrup
Kaopectate, antidiarrheal medicine
Kaopectate Max Multi-Symptom Relief, mint antidiarrheal syrup
Pedialyte Electrolyte Powder Strawberry Lemonade, Strawberry Lemonade
In a broad sense, antidiarrheal drugs can include any drugs that treat diseases that cause diarrhea, such as antibiotics, anti-inflammatory drugs, and so on. There are three types of antidiarrheal drugs in a narrow sense according to their principles: inhibiting intestinal peristalsis, promoting water and electrolyte reabsorption, and adsorbents. The efficacy of the first two types of drugs is often concentrated in one drug, that is, the commonly used antidiarrheal drugs can not only inhibit intestinal peristalsis, but also promote reabsorption, the latter is similar to the adsorption of activated carbon, which can adsorb water and toxins. On it. These drugs can only be used for short-term applications, such as important activities such as the college entrance examination. Long-term application will have dependence, but will lead to constipation.
The most kind reminder: please follow the doctor's advice and don't take antidiarrheal drugs casually. There are no safe, effective, and proven drugs for diarrhea caused by viruses. In fact, antibiotic drugs can make diarrhea worse. They interfere with healthy bacteria living in the gastrointestinal tract. There are many problems with prescription and over-the-counter drugs for diarrhea. Some drugs can cause drowsiness, increased stomach cramps, or other diseases. Other medicines may not be safe for children. Do not give your child any anti-diarrhea medicine without consulting a doctor. Generally speaking, the best treatment for diarrhea is to let your child drink enough fluids to prevent dehydration.
(1) Ordinary diet
Maintaining adequate nutrition during an acute diarrhea episode is important to promote intestinal epithelial cell turnover; if the patient is anorexia, or has vomiting or nausea, it is not harmful to only ingest fluids in the short term. Patients with watery diarrhea need to eat cooked, high-fiber starch foods and cereals with no iodized salt, such as sweet potatoes, taro, yam, pumpkin, millet, quinoa, and oats; patients can also eat avocado, banana, soup and boiled Cooked vegetables. After severe diarrhea, you should also avoid eating high-fat foods until the intestinal function returns to normal.
Foods to avoid during diarrhea: avoid drinking milk or dairy products; avoid spicy and greasy foods; avoid high-fat or greasy foods, such as fried foods; avoid high-fiber foods, such as citrus fruits (oranges, grapefruits, etc.) ); Avoid extremely sweet foods, such as cakes and biscuits; avoid high-sugar foods, including refined rice noodles and high-sugar beverages.
Other dietary advice: Drinking water should be tap water, and it is best to drink after boiling; buy fresh food from a reliable place, do not patronize unlicensed hawkers; avoid eating high-risk food, such as raw shellfish seafood, etc.; shellfish seafood should be washed and rinsed with water , And soak in clean water for a period of time until it is naturally purified; if the internal organs do not need to be retained, they should be removed; if there is a need to retain leftover cooked food, it should be refrigerated and eaten as soon as possible; thoroughly reheated before eating, spoiled food Should be discarded.
(2) Soothing and antidiarrheal food therapy
-Lemonade without sugar, three tablespoons twice a day;
-Lemon juice with a few grains of rose salt, two tablespoons at a time can relieve pain;
-Make a cup of cinnamon tea;
— Make a cup of green tea or scented tea: Pour the tea into another cup, add a tablespoon of vinegar, and drink the vinegar tea. One cup of tea can continue to brew two more times. Drink three cups of vinegar tea to stop the diarrhea. This prescription cures diarrhea and is not suitable for bacterial diarrhea;
Other soothing and antidiarrheal foods: Bananas, apples, pomegranates, fresh peaches, bayberry, wine, cooked carrots, apple puree, chicken, etc.
(3) Foods beneficial to intestinal health
— Foods rich in probiotics and prebiotics;
-Foods rich in dietary fiber;
Foods harmful to intestinal health: High-salt foods, high-fat foods, high-sugar foods, fried foods, irritating foods, alcohol, espresso and other irritating beverages, too spicy foods, etc. will stimulate the intestines, cause gastrointestinal mucosal damage and gastrointestinal dysfunction.
(4) Nutritional management of leaky gut syndrome
— Strictly avoid foods that cause intestinal leakage and cause body inflammation. This includes:
- Cereals, especially wheat, barley, and rye. These cereals contain a lot of gluten protein and plant coagulation protein;
- Other cereals, barley, oats, rye, buckwheat, millet, corn, etc. should also be avoided as much as possible;
- Dairy products, such as fresh milk, yogurt, cheese, milk powder. Many people are sensitive to milk protein, and many people cannot digest the lactose in milk, which further aggravates intestinal leakage;
- Eggs, many people are sensitive to egg whites, which will increase inflammation after eating them. You can try to introduce egg yolk after the autoimmune symptoms have completely disappeared;
- Sugar and snacks with high sugar content, because sugar can promote the proliferation of harmful bacteria and accumulate more toxins in the intestines, thereby further increasing intestinal leakage. It is recommended that patients eat less sweets and eat a small amount of fresh fruit every day, which is beneficial to supplement vitamins, minerals and dietary fiber;
- Beans, including soybeans, tofu, mung beans, red beans, etc. Beans contain a lot of plant coagulation proteins, which can strongly expand the intercellular space of the intestinal wall and cause intestinal leakage. Need to fast or eat less;
- Solanaceous vegetables, such as tomatoes, eggplants, potatoes, peppers. Because it is rich in lectins and saponin, and capsicum also has capsaicin. These substances can strongly stimulate the intestines and aggravate leaky gut;
- Alcohol can greatly expand the cell space of the intestinal wall and cause intestinal leakage;
- Nuts and seeds, such as peanuts, almonds, walnuts, sunflower seeds, pumpkin seeds, these foods themselves are very healthy. However, for autoimmune patients, the immune system itself is already full of problems, and these nut seeds are prone to allergies, which means that they may directly cause autoimmune reactions;
- Seed vegetable oils, such as soybean oil, peanut oil, rapeseed oil, salad oil, etc., contain excessive amounts of Omega-6. Long-term consumption of large amounts of these oils can cause inflammation of the body. It is recommended to eat olive oil with monounsaturated fatty acids to reduce inflammation as much as possible, and to obtain saturated animal fats from meat, such as lard. In addition, you can take fish oil seal oil to supplement Omega-3.
— Foods that patients with autoimmune diseases should eat include: Different kinds of fresh vegetables (excluding tomatoes, potatoes, peppers, green and red peppers, eggplants), root foods (such as pumpkin, sweet potatoes, purple potatoes, taro, lotus root) instead of rice noodles staple food, protein-rich meat ( Pig, cattle, sheep, chicken, fish, shrimp), appropriate amount of animal organs (especially liver), bone soup, olive oil, a small amount of iodine-rich seaweed laver, appropriate amount of fermented vegetables rich in probiotics, and appropriate amount of low sugar fruit.
— In addition to choosing the right food,You can also eat more healthy fermented vegetables (such as sauerkraut) to get probiotics, Balance the intestinal flora.
— You can take L-glutamine) To repair damaged intestines, Reduce inflammation.
— If the intestine is infected by bacteria or parasites, active treatment is required.
— Frequently used anti-inflammatory drugs, such as aspirin, have a great stimulating effect on the intestinal tract and need to be avoided or replaced with other drugs.
(5) Nutritional management of infants and children with diarrhea
In the first few months of life, it is normal for many breastfed babies to have loose stools. If the baby has a sudden increase in stool, it may be diarrhea. Other signs of diarrhea include mucus or blood in the stool. Smelly stool is also a sign of diarrhea. If you think your baby has diarrhea, please continue to increase the number of feedings. When your baby has diarrhea, please do not stop breastfeeding. Milk powder-fed babies should continue to consume the usual milk powder when they have diarrhea. Do not dilute milk powder. If the baby does not vomit, provide more milk powder according to the baby's needs. Increase feeding frequency.
If your baby has diarrhea after eating solid foods, please continue to maintain his normal diet. If the baby is vomiting, give the baby milk powder or oral rehydration solution as described above. If you have not vomited for at least 4 hours, you can give him some simple food. Include low-sugar, easily digestible foods such as cereal or mashed bananas. The baby's normal diet should be restored the next day. If it is mild diarrhea, you can limit your child's intake of fruit juice, ginger ale and other soft drinks. These drinks contain sugar that can make diarrhea worse. Caffeine-containing beverages, such as cola, can also cause more severe diarrhea. If you have frequent diarrhea and loose stools, let your child drink enough fluids. If your child shows signs of dehydration, they should be given oral rehydration solutions. Many children do not like to drink oral rehydration solution because it is salty. Some children like to eat oral sugared yogurt rehydration. You can also try mixing fruit juice with rehydration solution to increase the taste of oral rehydration solution. Use a 1:2 ratio (1 part juice to 2 parts rehydration). If oral rehydration is not available, give your child an electrolyte sports drink, such as Gatorade. Please consult with your doctor or dietitian before giving these treatments to your child. If your child is vomiting, do not feed your child solid food and let your child drink enough liquids. Let your child drink 1 or 2 teaspoons of liquid every 5 minutes. When the child can drink, gradually increase. If you stop vomiting for more than 4 hours, start feeding your child solid food again. Many children can digest simple starchy foods more easily after vomiting or diarrhea. Such foods include cereal, bread, biscuits, rice, noodles, potatoes and bananas. Children should insist on eating solid foods when they have diarrhea. Good nutrition helps restore health.
Diarrhea in children 3 years of age or older
If the diarrhea is mild, limit your child's intake of fruit juice, ginger ale, and other soft drinks. These drinks contain sugar that can make diarrhea worse. Caffeine-containing beverages, such as cola, can also cause more severe diarrhea. If you have frequent diarrhea and loose stools, let your child drink enough fluids. Most children over 3 years old can drink regular liquid or sports drinks when they have diarrhea; yogurt or liquid probiotic puree may also be a better choice.
(6) Nutritional management of gastrointestinal influenza
— The way to feel better is to bring an over-the-counter pain reliever; if you have severe stomach pain, try to relieve the pain with medicine. Of course, you can also choose digestive enzymes, probiotics, or coenzyme Q10;
- Add water. The most persistent and dangerous signal of gastrointestinal influenza is the flow of body fluids, whether through vomiting or diarrhea;
— Eat less irritating, mushy foods. Avoid eating foods that do not need to be digested to stimulate an inflamed stomach;
— Advance food planning. If you vomit a lot, try to avoid foods that may cause discomfort or pain, such as potato chips or spicy food;
— Do not take antibiotics. Because gastroenteritis is caused by viruses, not bacteria, antibiotics will not make you feel better.
(7) Nutritional management of dysentery
— During dysentery, you need to eat some low-fat and low-residue foods. The intake of fatty foods should be controlled at about 40 grams, otherwise it will increase the burden on the stomach. And it's best not to eat whole grains, cold melons and fruits, and cold dishes. Also pay attention to keeping the abdomen warm, add clothing in time when it is cold, and apply warm baby to the abdomen when necessary.
-During the dysentery epidemic season, you can eat raw garlic cloves appropriately, 1-3 cloves each time, 2-3 times a day; you can also eat purslane and mung beans to prevent infection. In addition, it is necessary to take preventive measures, manage water and feces, and eliminate flies every day to control the spread and prevalence of dysentery.
(8) Several special ways to improve intestinal health
- Gluten-free diet. At first, it was aimed at celiac disease, by restricting gluten foods such as wheat, barley and rye to improve the flora and slowly repair the intestines. Because there are many people with potential gluten allergies (the U.S. is expected to be 10%), there is no special harm, and it is relatively fashionable, so many people use it.
- SCD diet. This diet plan treats gastrointestinal diseases and brain abnormalities in children with autism by restricting disaccharides and polysaccharide carbohydrates. At the same time, this diet plan is also irritable bowel syndrome, ulcerative colitis, and Crohn's disease. Diet plan. The intestinal tract is seriously damaged, and the basic diet to completely repair the intestine. The SCD diet is widely used in inflammatory bowel autoimmune disease (IBD).
- GAPS diet. It was developed on the basis of the SCD diet. The purpose of this diet is to (1) treat leaky gut, (2) correct the imbalance of intestinal flora, reduce harmful bacteria in the intestines, and (3) supplement nutrient-rich foods to balance the immune system (we know that the body’s The immune system 70% is in the intestine). The GAPS diet emphasizes the intake of nutrient-rich foods such as bone broth, animal offal, healthy fats (extra virgin olive oil, coconut oil, animal fat), and foods rich in probiotics such as fermented vegetables. Although the GAPS diet allows home-made fermented yogurt, it also emphasizes that many people may be sensitive to the casein and whey protein in yogurt. Therefore, it is recommended that patients consume homemade fermented yogurt with caution.
- AIP diet therapy. By removing the food and life stress that induce inflammation in the body, it can fundamentally treat autoimmune diseases. In a nutshell, it is to remove all foods that can cause inflammation, such as all grains (especially wheat, barley, rye pasta), other grains, eggs, dairy products, sugar, beans, solanaceous vegetables, alcohol , Vegetable oils, nuts and seeds. While removing these foods, choose fresh vegetables, meat, offal, bone broth, fermented vegetables, seafood, and low-sugar fruits.
- FODMAPs diet. Fodmaps is an acronym for a group of food molecules (mainly sugars). These food molecules are short-chain carbohydrates that can be fermented and are not easily absorbed by the intestine. The low FODMAP diet refers to avoiding a diet that consumes more short-chain carbohydrates. It is worth mentioning that not everyone’s stomach is sensitive to high FODMAP foods, and eating high FODMAP foods is not the root cause of irritable bowel syndrome. They only aggravate or induce gastrointestinal symptoms, especially It is for those who are sensitive to their stomachs. More and more studies have found that a low FODMAPs diet may alleviate functional gastrointestinal symptoms in patients with irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD).
- Light fast. At the beginning, a new method of weight loss appeared, that is, to control the diet every day for 2 non-consecutive days of the week, and to eat freely for the remaining 5 days without control. In fact, eating and drinking has become the "normal" of most people's lives. The daily energy intake generally exceeds the standard. Therefore, many people also choose light fasting for health care, so that the intestines can be properly rested and adjusted to reduce the heavy burden of the intestines, inflammation and intestinal toxicity. The influence of the brain. As many people know, light fasting does not only mean weight loss, but also protects the brain, anti-aging; controls diabetes and lowers blood sugar; detoxifies and purifies organs; improves immune function; prevents cancer; improves mood, resists depression and Longevity and other functions.
- Living diet. Living diet refers to eating raw fruits, vegetables, sprouts, nuts and other foods that are grown without using chemical fertilizers and pesticides, so that the human body can maximize the intake of nutrients such as enzymes, vitamins, antioxidants, cellulose, and plant proteins in fruits and vegetables. , To promote the environmental protection and health of the human body, is a diet and lifestyle that can provide life energy for the human body, promote physical and mental health, and return to nature. It is also a relatively fashionable, pursuing a simple and natural lifestyle.
- Ayurveda is a life science, Indian medicine. Diet is part of it. Together with cleansing methods, oil therapy, yoga, psychotherapy, etc., it can achieve a balance of body and mind, as well as a healthier lifestyle and way of thinking.
All the above methods are very effective for some people, but some may be allergic or have different reactions. Please consult Dr. Long, Shanghui Zhou.com to see the details of his unique and personalized "Three-dimensional Detoxification, Body Sculpting and Immune Repair Course", and many real customers Testimonials from chelsea98.com.
(9) Functional nutritional preparation
Commonly used functional nutritional preparations include: calcium, magnesium, zinc, minerals, VB, VC, curcumin, proanthocyanidins, coenzyme Q10, seal oil, dietary fiber, aloe, digestive enzymes, spirulina, probiotics, Antrodia cinnamomea and so on. For specific personalized collocation and consumption, please consult us. The length of the reason is not expanded.
5, Chinese Medicine
In the concept of Chinese medicine, diarrhea can be subdivided into "loose stools", "watery stools", "frequent stools", and "involuntary stools", because the etiology and pathogenesis are different and the treatment methods are different.
(1) Loose stools: that is, the stools are unrealistic, and the diarrhea is as thin as sauce or duck feces, which is called "Liuxie", also known as "Liuxie". It is mostly caused by the inability of spleen to be able to move, and it can also be seen in damp and hot betting, irritability, and if the stool is dark and dark, it is another matter. It belongs to the category of "blood in the stool".
(2) Stool watery diarrhea: It is called "watery diarrhea", also known as "water diarrhea", "smooth diarrhea". It is mostly caused by cold and dampness, careless eating, and the onset is very urgent; there are also chronic watery diarrhea caused by spleen and kidney yang deficiency, which is characterized by "morning diarrhea" and "five-geng diarrhea", as the name implies, pull once a day at dawn.
(3) Frequent defecation: stool twice or three times a day, the stool is normal, and there is no discomfort, which is a manifestation of insufficient breath. If you are used to this, do not make symptoms.
(4) Stool incontinence: It is common in chronic diarrhea that does not heal, and large intestine slippage, which should be solidified under the dialectical treatment of "stool watery diarrhea". However, there are also cases where the deficiency of the kidney yang cannot restrain the two stools, which is not the effect that can be achieved by solid astringency, and the main purpose is to warm the kidney.
In traditional Chinese medicine, chronic diarrhea is referred to as "diarrhea", "湜溏", "飧 Xie", "濡 Xie", "Dong Xie", "Note Xia", "Hou Xie", "Huang Xie" and so on. Among them, loose stools are called diarrhea, and those with slow stools are called diarrhea, and those with clear stools that are urgent, called diarrhea.
The treatment of diarrhea in Chinese medicine is generally limited to the treatment of chronic functional diarrhea. The main pathogenesis of functional diarrhea is motility, so most of the treatment of diarrhea in Chinese medicine is by affecting the motility of the gastrointestinal tract. Specifically, by affecting the tension of the smooth muscles of the gastrointestinal tract. Traditional Chinese medicine has a long history of treating functional diarrhea, including irritable bowel syndrome, and many herbs that can relieve the symptoms of diarrhea have been discovered.
Berberine is extracted from Rhizoma Coptidis, which is a common medicine used in traditional Chinese medicine prescriptions to treat diarrhea. The herbal cinnamon and cloves, which are commonly used to treat diarrhea, contain eugenol, which is the main ingredient that exerts antidiarrheal effects and is a strong analgesic at the same time. But eugenol is hepatotoxic, if you use it to treat diarrhea, it will be more than a loss. At the same time, the coumarin in cinnamon has attracted the attention of foreign drug regulatory authorities due to liver toxicity and dicoumarin, which can be converted by external fungi into blood coagulation status. Some components of aconitine in aconite will also combine with the ion channels of the intestinal epithelium to increase ion influx, thereby inhibiting secretion. However, because ion channels are not only on the intestinal epithelium, but also on the heart and nerve cells, the diarrhea improves, but the heart begins to beat quickly, leading to death from severe arrhythmia.
therefore,Some experts suggest: It is not recommended to use Chinese medicine for any type of diarrhea. However, Chinese medicine focuses on conditioning. The treatment of chronic diarrhea is inseparable from the spleen and dampness: the empirical evidence is mostly based on the diagnosis and treatment of dampness, and divided into damp heat, summer dampness, cold dampness, etc., and the treatment is based on light penetration and dampness, clearing heat and dampness, dispelling cold and dampness; Symptoms are usually differentiated from Yin and Yang, which are subdivided into Yang deficiency, Yin deficiency, and Yin and Yang deficiency. The treatment is to build the middle to help transport, warm the yang and nourish the kidney, and nourish yin to relieve diarrhea. The doctor's medication should be carefully considered and individualized treatment. The most clinically used drugs are tonic for the spleen and stomach, but they should not blindly invigorate the spleen and stomach, but should not blindly replenish the qi and block the Qi machine. When the movement is combined with static, appropriate qi products should be prepared according to the situation. In addition, the heat-clearing should not be too bitter and cold to avoid defeating the stomach; There is a fear of staying in the remaining evil; too much diuresis due to light seepage, fear of damage to the yang.
Quickly stop diarrhea, and acupoint therapy may be effective: Tianshu, Shenque, Zhongwan, Zusanli, Xiali. (Due to space reasons, the explanation will not be carried out. Please follow the WeChat official account of "Huizhou Wealth", and you will see more original blog posts of high-quality Dr. Long on the website: chelsea98.com/blog/)
6, Health management of diarrhea
(1) When diarrhea, you must pay attention to these two things: First, use antidiarrheal drugs as long as you have diarrhea. Diarrhea is sometimes a protection for the body, because it can promptly expel harmful bacteria, viruses and the toxins produced by the intestinal tract, which is beneficial to the human body; second, do not eat or drink during diarrhea. When diarrhea occurs, the digestion and absorption itself is impeded, and the human body is in a state of lack of nutrients. If you do not take in nutrients at this time, it will easily lead to excessive water loss, electrolyte imbalance, malnutrition, and cause anemia, reduced immunity, and dirty Various problems such as damage to organs.
(2) Learn to relax, reduce stress in life, have a good relationship with family, friends, colleagues, superiors, and be happy every day. Accept the disease calmly and believe that you will get better. You can try meditation, yoga, and Tai Chi to ease your worries. In fact, many patients have the experience of getting worse under pressure. For chronic diseases such as autoimmune diseases, stress relief may be the most critical factor besides diet.
(3) Have enough sleep, don't stay up late, try to fall asleep before 11 o'clock every day, give the immune system enough rest and restore its balance.
(4) Moderate exercise can help reduce inflammation in the body, but be careful not to exercise too much. Aerobic exercises such as walking and jogging are good.
(5) Observe or monitor your own physical changes: stool characteristics, whether there is dehydration, heart rate, body temperature, blood pressure and blood sugar, etc.
(6) Prevention is the best treatment: wash your hands before meals and divide meals during the meal; separate raw and cooked dishes when preparing dishes, and eat fresh and fully heated seafood; cook the food well, avoid eating raw food, etc. , These are good recipes for you to enjoy delicious food and stay away from diarrhea.
(7) When cooking food, wear clean, such as washable apron, and wear a hat and mask; keep the floor, kitchen utensils, cooking utensils and kitchen utensils clean, and dispose of garbage properly.
(8) Keep your hands clean and trim your nails frequently; do not handle cooked food with bare hands; if necessary, wear gloves; handle animal food, wear gloves.
(9) Before eating or handling food, wash your hands with soap or detergent and water, and wash your hands after going to the toilet or changing diapers.
(10) Perishable food should be covered and stored in a refrigerator or refrigerator; raw and cooked food, especially seafood, should be handled and stored separately (preserved food in the upper layer of the refrigerator or refrigerator, and raw food in the lower layer) to avoid cross contamination The refrigerator or refrigerator should be cleaned and snow melted regularly, and the temperature should be maintained at 4 degrees Celsius or below.
(11) People with diarrhea and asymptomatic carriers should not handle food and take care of children.
The intestine is the body's most important nutrient digestion and absorption organ, the body's most important detoxification organ, and the body's largest immune organ. Moreover, the intestine is called the "second brain"-the intestinal brain. In addition to attaching importance to intestinal digestion, detoxification, and the relationship with the brain, the immune function of the intestine is the most important thing to pay attention to, because the human intestine accounts for about 70% of the immune system, which is the body's defense against harmful bacteria, viruses and viruses in the environment. The first line of defense against toxins. From the previous introduction and analysis, diarrhea itself has a very close relationship with the health of the human immune system. Therefore, most of the causes of diarrhea are problems with our defense mechanism. To protect the intestines is to protect our frontline defenses!
Investigation on the incidence of lactose intolerance in newborns with non-infectious diarrhea
Epidemic status of norovirus infectious diarrhea in my country and suggestions for prevention and control measures
Analysis of death, diagnosis and treatment of children under 5 years of age from diarrhea in China from 1996 to 2006
Investigation of Blastocystis hominis infection in 1354 outpatients with diarrhea
Clinical study of 357 cases of gastrointestinal cancer associated with postoperative diarrhea
Treatment of adult acute diarrhea in resource-rich areas
World Gastroenterology Organization Global Guidelines: Acute Diarrhea in Adults and Children: A Global Perspective (2012)
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Chelsea98.com-Wise Weeks Million Dragon's Great Health Dr. Kyle Long, Registered Dietitian, Registered Health Manager-Sincere, Clear, and Efficient Personalization to Improve FAH Financial Quotient and Health Quotient Education-From Hui Zhou Intelligent Financial Education Group