Don't take acute diarrhea lightly; it can be fatal if not properly treated

Author: Gong Fangchen: Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine

Reviewer: Chen Erzhen, Chief Physician, Ruijin Hospital, Shanghai Jiaotong University School of Medicine

Mao Enqiang, Chief Physician, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine

Mr. Yan is busy with work and rarely cooks for himself. He mainly eats takeout or eats in stores for three meals a day. On weekdays, he likes to prepare some cold dishes and cooked food in advance and put them in the refrigerator for quick consumption after get off work. One summer night, Mr. Yan ate overnight smashed cucumbers and braised pork liver purchased from a delicatessen. The next day, he felt bloated and painful in his stomach, which could not be relieved, accompanied by nausea and vomiting. He went to the pharmacy to buy some medicine, but the symptoms did not improve. Soon, Mr. Yan had diarrhea again, defecating up to 10 times that day, had no strength, soreness all over, thirsty, and no urination. His family found that he was in a very poor mental state, his speech was incoherent, and he had a fever, so they immediately called 120. When Mr. Yan arrived at the emergency room of the hospital, his vital signs were unstable and he was in a state of severe shock. Considering that Mr. Yan was in a critical condition, the doctor transferred him to the intensive care unit for treatment after emergency treatment. Subsequent examinations found that Mr. Yan was infected with E. coli because of eating overnight and unclean food, and the bacteria quickly entered the blood, causing bacteremia, triggering septic shock, and causing damage to multiple important organs such as the heart, liver, and kidneys. When the human body is infected with bacteria or viruses, the body will try to fight them, just like fighting a war. But if the battle becomes too intense, the body will stimulate a strong immune inflammatory response to fight the infection, but these immune inflammatory responses will also harm the body itself. The result is like the body is caught in an internal melee, which eventually leads to a drop in blood pressure and organ dysfunction, with life-threatening consequences. Fortunately, after active treatment, Mr. Yan's organ functions were restored and he was discharged from the hospital. But afterwards, he still felt scared when he recalled this experience. From then on, he paid special attention to food hygiene and never dared to eat overnight or unclean food again.

It took only 48 hours for Mr. Yan to go from acute diarrhea to emergency treatment. Many people may find it hard to believe. Is acute diarrhea really that dangerous?

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1. Can acute diarrhea really be fatal?

Acute diarrhea is a common clinical symptom, usually referring to diarrhea with an acute onset and a course of less than 4 weeks. Diarrhea can be loose stools, watery stools, mucous stools, purulent stools, or bloody stools, and may be accompanied by systemic symptoms such as nausea, vomiting, abdominal pain, or fever. The severity of diarrhea is related not only to the cause of the disease, but also to the individual's underlying disease, age, and physical condition.

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In addition to gastrointestinal symptoms, severe diarrhea may also lead to electrolyte imbalance, dehydration, and even shock and damage to important organs such as liver and kidney function, all of which may be life-threatening. In this case, Mr. Yan experienced typical diarrhea caused by intestinal pathogen infection, and also experienced shock, pathogen spread through the blood, and damage to important organs throughout the body, which is very dangerous. If you experience symptoms such as dehydration, unbearable thirst, decreased urine volume, mental fatigue, or irritability after diarrhea, you must seek medical attention in time to avoid delaying the condition and causing serious consequences.

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2. What are the common causes of acute diarrhea?

1. Pathogen infection is one of the main causes of acute diarrhea, including viruses, bacteria and parasites. Common viruses include rotavirus, norovirus and adenovirus. Common bacteria include Salmonella, Escherichia coli and Shigella. In addition, parasitic infection may also cause acute diarrhea, common parasites include roundworms, hookworms and amoeba. These pathogens are usually transmitted to the human body through food, water or contact.

2. Unclean food is also a common cause of acute diarrhea, especially in summer, when some foods are prone to spoilage, such as seafood, vegetables and fruits. Eating spoiled food may cause food poisoning and diarrhea.

3. Non-bacterial food poisoning is also one of the causes of acute diarrhea, including chemical food poisoning (such as arsenic, mercury, organophosphorus pesticides, etc.) and biological food poisoning (such as poisonous mushrooms, pufferfish, raw fish bile, etc.). In addition to gastrointestinal symptoms, these poisonings may also manifest as symptoms such as damage to the nervous system and liver and kidney function. Suspicious food, vomitus and stool samples can detect poisons.

3. What should we do if acute diarrhea occurs?

1. Keep rest and pay attention to the disinfection of utensils to prevent cross infection.

2. Eat a light diet, choose easily digestible liquid or semi-liquid food, and avoid eating raw, cold, greasy and irritating food.

3. Acute diarrhea causes loss of body water and electrolytes. The first thing to do is to rehydrate orally. You can drink more sugar and salt water or oral rehydration salts.

4. If diarrhea symptoms do not improve, diarrhea occurs frequently, and is accompanied by fever, abdominal pain, nausea, vomiting, dry mouth, palpitations, fatigue, poor spirits, etc., seek medical attention promptly.

5. If multiple people experience acute diarrhea at the same time, samples of suspicious food and other substances can be collected and informed to the attending doctor when seeking medical treatment so that the cause can be diagnosed or special tests can be conducted if necessary.

4. How to prevent acute diarrhea?

There are more opportunities for the feces of animal hosts, patients and carriers to contaminate food and water, which is the main source of infection for infectious diarrhea. Some bacteria such as Vibrio, Aeromonas and Pseudomonas are mainly found in water environments. Vibrio is salt-tolerant and is mainly transmitted through seafood; Aeromonas and Pseudomonas are mainly transmitted through freshwater products. In addition, norovirus can also be transmitted through seafood. Therefore, in daily life, we should develop good living habits, such as paying attention to the hygiene of drinking water, cooking food and separating it from raw food, developing good hand hygiene habits, reducing contact with patients with intestinal infectious diseases, washing and changing clothes and utensils frequently, etc. In the process of food processing, we should pay attention to cleanliness and hygiene, avoid eating unclean or spoiled food, and not eat food that has not been properly cooked or produced from unknown sources. In summer and autumn, we should strengthen the prevention and control of flies and cockroaches to prevent food from being bitten; in addition, we should clean the food in the refrigerator regularly to avoid long-term storage of food and cause spoilage.

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Although acute diarrhea is relatively common and most people can recover through dietary adjustment and symptomatic treatment, a small number of people may experience serious or even life-threatening conditions, so acute diarrhea cannot be ignored.