Diseases

Intestinal inflammation (enteritis) - symptoms, causes and therapy

Intestinal inflammation (enteritis) - symptoms, causes and therapy


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Enteritis: An acute inflammation in the small intestine

If there is an isolated inflammation of the small intestine, it is called enteritis. Most often there are combined inflammations of the gastrointestinal tract (gastroenteritis) or inflammation of the small and large intestine (enterocolitis). The most common are bacterial or viral infections that cause a relatively short diarrhea. If the course is uncomplicated, increased fluid intake and electrolyte administration are sufficient as a treatment. In addition, many home remedies and light food can help to alleviate temporary symptoms. The infections are usually extremely contagious.

Definition

The technical term enteritis refers to inflammation of the small intestine. However, this often does not occur in isolation. If the stomach is also affected, one speaks of gastroenteritis (colloquially also gastrointestinal infection or gastrointestinal flu). If there is also inflammation of the colon, this combination is called enterocolitis.

In most cases, bacterial or viral infections are the cause of acute enteritis. Not only the pathogens themselves can trigger the disease, but also released toxins (bacterial toxins). The pathogenic germs are often transmitted via contaminated food (food infection, food poisoning). Other ways of infection are also possible.

Inflammatory bowel diseases (IBD) represent their own clinical pictures and affect different areas of the gastrointestinal tract. So they do not fall under the name of enteritis. These include, for example, ulcerative colitis or Crohn's disease (enteritis terminalis, enteritis regionalis chron).

Symptoms

The disease usually begins with discomfort and loss of appetite for those affected. This is typically followed by combative abdominal pain (intestinal cramps) with diarrhea (diarrhea). Depending on the trigger, mucus or blood can also be added to the excretion. Sometimes nausea and vomiting also occur. At the same time, accompanying symptoms such as a general state of exhaustion with fever, dizziness and headache can occur.

In most cases, the symptoms subside within a few days. However, some pathogens can also cause symptoms over a longer period of time. If there is excessive fluid and electrolyte loss, there is a risk of dehydration. This complication occurs particularly in children. If this is not dealt with quickly, it can lead to dangerous consequences.

Other possible complications that can occur depending on the pathogen and course are damage to the intestine, loss of function of the kidneys, circulatory problems (circulatory shock) and possibly also sepsis. These serious consequences occur very rarely. Affected people with an immunodeficiency represent a risk group.

Causes

Acute intestinal inflammation can have different triggers. Most often, they are infections with certain viruses or bacteria that are ingested through contaminated food. Infections caused by smear or droplet infection are less common. Many different germs can cause disease.

Bacterial infections

The most common bacteria that cause intestinal inflammation in temperate latitudes include the following pathogens:

  • Salmonella,
  • Campylobacter,
  • Escherichia coli,
  • Yersinia,
  • Shigellen,
  • Clostridia.

In the case of Campylobacter, infected poultry meat in particular is the most important source of infection. Fresh chicken meat is very often contaminated with Campylobacter bacteria if you buy it in retail stores. The pathogens can survive on the food for some time, but cannot multiply here. If the meat is not heated sufficiently, the bacteria can lead to illness when consumed. Acute Campylobacter infections are reported to be reportable diseases according to the Infection Protection Act.

But raw vegetables or raw eggs can also contain harmful germs. Salmonella, for example, often reproduce in large numbers on these fresh foods or the uncooked dishes prepared with them. If there is no appropriate kitchen hygiene and there is insufficient cooling, an infection occurs when eating. Contagion through drinking water or poor hygiene from person to person is rare.

Enterohaemorrhagic Escherichia coli (EHEC) and Shigella are among the bacteria that produce toxins (bacterial toxins) and can cause more complicated disease courses.

Viral infections

Most viral diseases in Germany are caused by noroviruses or rotaviruses. Adenovirus and various enteroviruses are also common pathogens in intestinal inflammation.

Noro and rotaviruses are excreted in a large number of infected people and are therefore highly contagious. The diseases are usually transmitted via only the smallest traces of excretion residues by means of smear infection. It happens again and again that there are major outbreaks in community facilities. Compliance with strict hygiene measures is extremely important here. In addition, regulations of the Infection Protection Act apply, i.e. there is an obligation to provide information and children under the age of six as well as certain sick people must stay away from facilities or their workplace (insofar as this has to do with food) for some time.

Other disease triggers

In addition to viruses and bacteria, there are other pathogen groups, which are only very rarely identified as the cause of intestinal inflammation. These include mushrooms and unicellular organisms (amoeba, giardia).

Another rare trigger is ionizing radiation, which is used for cancer therapy, for example.

Diagnosis

As a rule, an appointment in a general practice is sufficient to make a diagnosis. In most cases, the typical symptoms that can usually be determined from the medical history and clinical examination already provide information about the presence of the disease. During the physical examination, special attention is paid to signs of dehydration in order to prevent this possible complication early.

In rare cases, for example if there is bloody diarrhea or if the person is weakened or susceptible to complications, examinations for pathogen detection are carried out. This can be stool tests or, in certain situations, blood and urine tests. In addition, ultrasound or an endoscopy (colonoscopy) can be used if the condition of the affected person is otherwise difficult to assess and treat.

Treatment

Therapy is usually only symptomatic. The most important measure is an increased drinking amount (in the form of water or unsweetened tea) to compensate for the loss of fluid. Since the increased loss of fluid as a result of the diarrhea can also result in an electrolyte loss, this deficiency is counteracted or prevented by means of additionally supplied electrolytes. Especially in children with severe diarrhea and vomiting, it is advisable to add electrolytes.

Another cause-specific treatment is rarely used. Medications are not standard therapy for an uncomplicated infection. Under certain circumstances and in complicated situations, antibiotics can also be administered if there is evidence of bacterial intestinal inflammation. This is always an individual medical decision.

Antiemetics for nausea and vomiting, as well as parasympatholytics for intestinal cramps and pain relievers are rarely administered.

Naturopathic treatment

Naturopathy offers many ways to relieve diarrhea. In order to compensate for the loss of electrolyte during watery bowel movements, powder from the pharmacy is not always required, even mixed electrolyte solutions with the appropriate proportions of salts and sugar show a quick effectiveness.

[GList slug = "10-home remedies for stomach intestine flu"]

During the acute phase, attention should be paid to easily digestible food (light food). In addition, apples and internal applications of healing earth, ginger or sage are among the tried and tested home remedies when it comes to treating complaints of a gastrointestinal infection. (tf, cs)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dr. rer. nat. Corinna Schultheis

Swell:

  • Pschyrembel: Clinical dictionary. 267th, revised edition, De Gruyter, 2017
  • Robert Koch Institute (ed.): RKI guide - Campylobacter enteritis, as of January 21, 2019, rki.de
  • Robert Koch Institute (ed.): RKI Guide - Norovirus Gastroenteritis, as of June 11, 2019, rki.de
  • Professional Association of German Internists (publisher): www.internisten-im-netz.de - Salmonella infection (accessed: 07/17/20), internisten-im-netz.de
  • Federal Center for Health Education (Hrsg.): Www.infektionsschutz.de - pathogen profiles (available: July 17th, 2019), infektionsschutz.de
  • German Society for Gastroenterology, Digestive and Metabolic Diseases (ed.): S2k Guideline Gastrotinestinal Infections and Whipple's Disease, as of January 31, 2015, AWMF registry no. 021-024, awmf.org
  • Epple, Hans-Jörg and Zeitz, Martin: Enteritis infectiosa, in: Der Internist, edition 9/2011

ICD-Codes for this illness: A04, A08, A09, K52.9ICD-Codes are internationally valid encodings for medical diagnoses. You can find e.g. in doctor's letters or on disability certificates.


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