Holed diarrhea: possible causes, symptoms, diagnostic tests and treatment

In the article, we will understand why choleretic drugs are prescribed for cholera diarrhea.

Diarrhea, regardless of the reasons that provoked it, causes a lot of inconvenience, and is also a major factor in the development of such a dangerous phenomenon as dehydration. Important nutrients cease to be absorbed, washed out with feces from the intestines. As a result, the body suffers from acute exhaustion.

Holed diarrhea occurs due to excessive intake of bile in the intestines. This is accompanied by acute pain in the right hypochondrium.

Symptoms

Differentiation of this type of diarrhea is carried out according to some external clinical manifestations, which include:

1. Features of feces that are excessively liquid have a saturated green or yellow color. Thick, transparent or gray mucus can be visualized on the stool surface.
2. Pain in the right hypochondrium - the patient complains of stitching and sharp pains in the iliac right region of the abdomen, which can be aggravated by breathing and sudden movements.
3. In the process of defecation, the pain becomes very strong, almost unbearable, which can trigger the development of a shock state.
4. Severe nausea and weight loss.
5. Dry skin and mucous membranes.
6. An increase in body temperature, which indicates the attachment of an infection in the intestine, which is provoked by excessive irritation of the bile of its mucosa.
7. The presence of bile in the feces is the most reliable factor that allows to determine the cholera diarrhea, as well as to establish the main reason for its development.

This and other types of diarrhea, the symptoms of which are similar, require close medical supervision. Otherwise, the probability of a dehydration condition is extremely high, which can lead to death.

The causes of the disease

Holed diarrhea occurs, as a rule, due to the ingress of a large amount of bile acids into the intestinal lumen. A similar process is directly related to the following factors:

1. Gallbladder resection. If this organ is absent, all ducts that emanate from the liver are excreted into the intestine. In this case, the pathological phenomenon is chronic in nature, since it is impossible to stop the production of bile. What other causes of cholera diarrhea are known?
2. Excessive malabsorption syndrome is a polysymptomatic collective disease characterized by impaired absorption of beneficial substances in the intestine, which is caused by accelerated peristalsis.
3. Surgical interventions in the small intestine, in which its innervation and microflora are disturbed, which subsequently provokes an acceleration of fecal transport.
   

Very often, cholastic diarrhea occurs after cholecystectomy, since bile cannot accumulate without the gallbladder, it constantly penetrates the intestines. This pathology is considered as a syndrome that manifests itself after organ removal.

Crohn's disease

In addition, such a disorder of stool with an admixture of bile can cause a very serious systemic pathology - Crohn's disease. This polysymptomatic disease, which is determined by the presence of an inflammatory process in the digestive organs of a chronic nature, is autoimmune in nature.

How is pathology dangerous?

The main danger of cholastic diarrhea is that the main part of all cases has a very unfavorable prognosis, that is, the symptoms can not be eliminated. This provokes the transition of the disease to the chronic stage, which makes the patient a drug hostage.

First Aid Rules

In case of symptoms of such a pathological process, an ambulance should be called, otherwise the condition will worsen, and the clinical picture will acquire new symptoms. First aid involves a plentiful drink, which is taken in small sips. In addition, there will be the use of salt solutions that do not allow dehydration to develop, and the deficiency of lytic substances in the body is replenished. Further therapy is carried out under the supervision of a specialist.

It is strictly forbidden to take antispasmodic and analgesic drugs that distort the clinical picture of the pathology, which, in turn, significantly complicates the diagnosis and provokes imaginary relief, after which, as a rule, an irreversible process follows.

Below, we consider the treatment of cholastic diarrhea, but for now let's talk about diagnosis.

Diagnostic methods for this pathology

It is not possible to independently determine the causes of the pathology. The presence of such a violation is indicated by the presence of bile in the fecal masses. Feces in this case can have an exclusively liquid consistency. The patient, as a rule, is given a referral to the initial and main examination - colonoscopy. With this diagnostic procedure, the presence of bile on the walls of the intestines is observed. It can be observed in quite significant quantities. Directly in the feces, its indicators sometimes exceed 100 mg / g. To determine the diagnosis of the patient can be sent to the following laboratory tests:

• blood and urine tests;
• endoscopy;
• coprogram;
• Ultrasound

Coprogram and positive stercobilin

The norm is considered to be the dense texture of feces, their cylindrical shape, brown color, lack of pungent odor. Microscopic examination of feces should not contain blood cells, connective tissue fibers, starch, fats, parasite eggs, protozoa, or yeast.

How are stercobilin and cholera diarrhea related?

With such a disease, it is considered mandatory to conduct a coprogram - a fecal study, in which the presence or absence of stercobilin in the masses is determined - a pigment substance that gives the feces a characteristic brown color. With such diarrhea, this enzyme in feces, as a rule, is absent.

Below will be described the treatment of chogenic diarrhea drugs.

Drug therapy

The main objective of the treatment is to eliminate the harmful effects of bile acids on the intestinal mucosa, which cause its irritation. It should be noted that therapy in this case should be comprehensive and aimed at neutralizing the main pathogenic factors that provoke diarrhea.

Most often, patients are prescribed adsorbents - these drugs glue the molecules of bile acids, reducing their concentration. In addition, these drugs neutralize them, which reduces the detrimental effect on the intestinal mucosa.

Preparations

Of these, the most common are:

1. Activated carbon, however, it is not used for peptic ulcer. The use of this medication helps to capture nutrients, stopping their absorption. It is used in a therapeutic course for no more than seven days.
2. "Polysorb" - solutions for the preparation of a liquid that has an adsorbing effect.
3. “Karbolen” - removes toxins from the body, trapping bile acid molecules. This medicine contains activated carbon. Before taking, you need to make sure that there is no stomach ulcer.
4. Enterosorbents - this type of medication can reduce the concentration of harmful substances in the intestine, neutralizing and linking them. These funds have an extensive spectrum of action, allowing you to normalize metabolic processes and reduce the level of pathogenic microbes. The most popular medication in this category is Enterosgel, which has a viscous consistency that resembles a gel. The medicine is extremely unpleasant for use, but it has the highest efficiency of all enterosorbents known to date.
5. Antibiotics that are prescribed regardless of whether the patient has a pathogenic microflora in the feces or not. This is due to the fact that with prolonged intestinal irritation, local immunity decreases, that is, the level of beneficial bacteria decreases. The most popular of these agents is Cefazolin, which is used as an intramuscular injection for a five-day course. The medication is well tolerated, practically does not contribute to the development of side effects.
6. Cholagogue medications that help reduce the concentration of excreted bile, which eliminates its harmful effects on the intestines. The most common of choleretics are: “Allohol” - a tool based on natural elements that neutralizes bile acid, “Oxafenamide” - a very strong choleretic, which exhibits a spastic effect and reduces pain.
7. Probiotics - this category of medications normalizes the intestinal microflora, which is necessary with frequent diarrhea. Most often, such funds from this group are used as Linex, Laktiale, Bifiform.
   

Cholenical diarrhea after cholecystectomy

After removal of the gallbladder, the patient's life changes significantly. He needs to constantly follow a diet, exclude fried and fatty foods from the diet. The meat is used only in stewed or boiled form: rabbit, chicken, turkey, veal. In addition, to avoid the development of pathology after cholecystectomy, you can not drink sweet carbonated drinks, strong coffee and cocoa. Alcohol is strictly prohibited, since it significantly increases the load on the liver and stimulates the excessive production of bile.

The patient is prescribed medication for cholera diarrhea after cholecystectomy. In the first weeks of rehabilitation, strong antibiotics, hepatoprotectors and holistetics are used. In the future, maintenance therapy is prescribed, which is aimed at maintaining the body and eliminating the negative manifestations of the absence of the gallbladder.

Alternative methods of treatment

There are recipes for traditional medicine that help to eliminate diarrhea of ​​the chologous nature of the occurrence, that is, provoked by a high amount of bile in the intestine. The most effective and safe of them are:

1. A decoction of sage and chamomile - herbs are taken in equal proportions and poured with two glasses of boiling water. After this, the broth must be insisted until it cools completely and take 3 tablespoons before meals. These herbs normalize the microflora in the intestines and have an anti-inflammatory effect.
2. A decoction of chamomile and oak bark - 3 tablespoons of oak bark are poured with 250 ml of water, brought to a boil, and then 1 spoon of chamomile flowers is added to it. The broth should cool, after which it is filtered and drunk in half a glass twice a day.
3. St. John's wort broth - 100 g of crushed grass is poured with 1 liter of cold water and heated in a water bath. After boiling, the broth must be boiled for another 15 minutes. After cooling, it is filtered and 3 tablespoons are taken every 2-3 hours.
   

Reviews

Holed diarrhea develops mainly in those people who have certain diseases of the gallbladder, or after its removal. In such cases, patients note that this phenomenon is very specific and manifests itself very painfully. They experienced severe pain in the right abdomen, nausea and loose stools. Judging by the information from the reviews, the solution to this problem is to constantly observe the correct diet. Patients note that with the slightest violation of the diet, the first symptoms of cholera diarrhea appear, which is subsequently very difficult to fight. In addition, these people are constantly taking certain medications to normalize the liver, stomach and intestines.