Acute diarrhea in the elderly: Can not be underestimated

Hot weather in the summer with the immune, digestive functions . reduce, making the elderly susceptible to bacterial infections, including acute diarrhea. The characteristics of the weather and physiology in the elderly will create conditions for microorganisms to grow if combined with unhygienic eating and drinking conditions. The situation of continuous dehydration due to diarrhea and inadequate water and electrolyte replacement is one of the fatal risks for the elderly.

The causes of acute diarrhea in the elderly

Acute diarrhea is a pathological symptom that goes beyond loose stools, 3 times / day or more (going out with a large amount of stool and lots of water). Bacterial diarrhea is mainly caused by bacteria and their toxins. For the elderly, the digestive system function is decreasing, they feel that chewing is also more difficult, the digestive juices are released slowly and less than when they were younger. In addition, many people suffer from chronic gastrointestinal diseases such as gastric ulcer - duodenum, so the food needs to be well cooked and soft. Only a small advantage can cause them to get into the digestive tract and cause acute diarrhea. The main causes of acute diarrhea in the elderly are:

Food- borne infections: Food poisoning infections can be divided into two categories: Eating food containing bacteria has the ability to break into the intestinal mucosa and cause illness like Salmonella (S. typhi murium and S. enteritidis) is the most common disease. Within 12 - 36 hours after eating, patients show signs of sudden fever, epigastric abdominal pain or around the umbilical cord, no adulteration, repeated diarrhea, rotten stool, plenty of water. Stool sometimes has mucus, blood, similar to stool caused by dysentery syndrome. Severe cases of electrolyte disorders due to dehydration (dry lips, sunken eyes, thirst). If not diagnosed and treated promptly, patients can die from vascular collapse. Ingesting food containing bacterial toxins already formed in food and this toxin causes disease (toxins of golden staph,

E.coli bacteria cause acute diarrhea.
(Photo: SK & D)

Clostridium botulinum and Vibrio parahaemolyticus). Symptoms of diarrhea several times a day, abdominal pain, no fever, nausea and vomiting. If not treated promptly, it will lead to dehydration and death.

Syndrome of dysentery : Bacillary dysentery caused by Shigella bacteria, symptoms of the disease are fever, abdominal cramps, straining, going beyond fish blood or like meat washing water. These cases require early treatment with specific antibiotics but attention should be paid to the antibiotic resistance of bacteria. This syndrome is also caused by strains of Escherichia Coli (E. Coli), which have 3 strains that can cause diarrhea to penetrate with dysentery syndrome: cramping, straining and loose bowel blood. Including E. Coli causing intestinal pathology; E. Coli toxin invades the intestine; E.Coli toxin causes intestinal bleeding. Another cause of dysentery in older people is Yesinia enterocolica, the source of which is water and contaminated food such as milk, vegetables, meat, causing gastroenteritis or mesenteric lymphadenitis. When infected with severe abdominal pain, diarrhea, fever and bloody stools.

Cholera diarrhea : this is a disease caused by the bacterium Vibrio cholerae. Clinical manifestations go many times a day, fecal lethargy like rice water, no abdominal pain, no fever. It is because of the manifestation of this disease that the elderly or subjective, so that the disease gets worse, can be fatal if not properly diagnosed and treated. Another danger is that the disease can cause epidemics, the subject of infection is everyone, in which children and the elderly are most at risk.

Treatment and prevention like?

Acute diarrhea leads to dehydration and electrolyte disorders, so treatment is mainly rehydration and electrolytes. For mild dehydration, oral rehydration when drinking, usually use oresol, or use porridge, boiling water to cool enough salt and sugar. If severe dehydration, when the water loss is greater than 5% of body weight or when drinking is not effective, then rehydration by intravenous infusion.

Total fluid infusion over 24 hours will include body weight loss and normal water needs every day. Infusion is mainly saline and sweet isotonic solution. If hypokalemia must compensate potassium. Antibiotics are indicated for patients with signs of infectious diarrhea (leukocytosis) or patients with immune response lesions. For bacilli dysentery, Salmonella, E.coli using quinolone antibiotics such as Ciprofloxacin, ofloxacin, pefloxacin for 5-7 days. With bacteria Campylobacter jejuni for erythromycin in case of infection. With cholera bacteria taking tetracyclin or chloramphenicol or biseptol.

Due to the physiological characteristics of the elderly, the preventive issue should be particularly important. Foods need to be cooked thoroughly, you should not regret food that has been left for a long time, and should not eat street food. Hands should be washed before eating and after using the toilet. People who travel are very susceptible to diseases, so pay special attention to hygiene, if there are signs of disease need to rehydrate or go to a medical facility, do not arbitrarily use drugs anti-diarrhea because it will be more difficult for treatment if hospitalized.

Doctor Nguyen Van Dung