Gastroenteritis: Nutritional Therapy

Acute gastroenteritis (intestinal infections) often occur after gross dietary errors, such as eating large amounts of unripe fruit, fatty or very cold foods, alcohol abuse, certain medications – iron supplements, anti-inflammatories with steroid hormone effects, aspirin – and preparations containing heavy metals. They can further be caused by viruses, bacteria or parasites. The most common cause of acute enteritis is food poisoning. It is caused by eating foods that contain pathogenic germs, such as Salmonella, Campylobacter, Escherichia coli, Yersinia and Listeria. Food poisoning can also occur when food is consumed in which there has been a proliferation of apathogenic germs. Causes of food poisoning occurrence.

Improper storage of food, such as inadequate refrigeration.
Increased consumption of high-value, perishable foods.
Increasing consumption of insufficiently heated foods.
Increase in the centralization of food production
Constant increase in the number of people who participate in communal catering
Global tourism
Increasing number of elderly people with declining immunological defenses.

Consequences of food poisoning

In the case of the strong growth of the germs that do not cause disease, toxic (poisonous)metabolic products of the microorganisms accumulate in large quantities in the food. If the affected food is eaten, the harmful metabolites of these germs cause toxic damage to the mucosa of the small intestine. As a result, there is an absorption insufficiency, that is, an absorption disorder of nutrients and vital substances, so that the body is deficient in particular with:

Vitamin B9
Vitamin B12
Vitamin C
Vitamin E
Beta-carotene and
Iron

Can be supplied. Some clinical symptoms of food poisoning, such as watery diarrhea and vomiting, lead to large losses of fluids, nutrients and vital substances. In particular, the water-soluble vitamins – vitamin C and B group vitamins – and the electrolytes calcium, magnesium, phosphorus, sodium chloride and potassium are affected. Increased oral intake of these critical vital nutrients, as well as high fluid intake, are of important importance to compensate for the losses due to absorption disturbances and increased excretion. In cases of prolonged diarrhea, water and vital substance intake should be parenterally administered so that the nutrients and vital substances pass through the gastrointestinal tract. Once the triggering noxious agent has been eliminated, the gastroenteritis and thus the clinical symptoms subside. No special therapy is necessary for this reason.

Chronic enteritis

Chronic enteritis, like acute enteritis, can result from gross nutritional errors as well as from viruses, bacteria, and parasites.

Acute and chronic enteritis and enteral protein loss syndrome

Impairment of the intestinal mucosa– results in increased intestinal protein loss, as leakage of plasma proteins through the intestinal mucosa into the interior of the intestine exceeds the rate of protein formation. The decrease in circulating plasma proteins is usually accompanied by a severe protein deficiency. The pathological protein loss may be promoted by a concomitant high dietary fat intake. When long-chain fatty acids are absorbed, lymphatic pressure is increased and high amounts of lymphatic fluid enter the intestine. As a result of increased lymphatic concentrations, there is a high enteral protein loss and eventually a decrease in plasma proteins. The increased intestinal protein loss ultimately leads to a decrease in oncotic pressure and thus, depending on the extent of decreased plasma protein concentration-hypoproteinemia-the formation of edema.

Acute and chronic enteritis – vital substance deficiency

Vital substances	Deficiency symptoms
Beta-carotene	Decreased antioxidant protection, increased risk for lipid peroxidation as well as oxidative DNA damage. Weakened immune system Increased risk of skin, lung, prostate, cervical, breast, esophageal, stomach, and colon cancers Reduced skin and eye protection
Vitamin E	Lack of protection against radical attack and lipid peroxidation. Decreases the immune response High susceptibility to infection Disease of muscle cells due to inflammation of muscle tissue – myopathies. Shrinkage as well as weakening of the muscles Disease of the peripheral nervous system, neurological disorders, disorders in neuromuscular information transmission – neuropathies. Reduced number and lifetime of red blood cells. Deficiency symptoms in children Anemia (anemia) Impairment of blood vessels leads to bleeding Disturbances in neuromuscular information transmission. Disease of the retina, visual disturbances – neonatal retinopathy. Chronic lung disease, respiratory distress – bronchopulmonary dysplasia. Cerebral hemorrhage
B group vitamins, such as vitamin B1, B2, B3, B5, B6.	Disorders in the central and peripheral nervous systems lead to Nerve disease in the extremities, pain or numbness of the extremities. Muscle pain, wasting or weakness, involuntary muscle twitching Hyperexcitability of the heart muscle, decrease in cardiac output – tachycardia. Memory loss General state of weakness Impaired collagen synthesis resulting in poor wound healing Insomnia, nervous disorders, sensory disturbances. Impaired response of white blood cells to inflammation. Anemia due to decreased production of red blood cells, white blood cells, and platelets Decreased production of antibodies Impairment of cellular and humoral immune defenses. States of confusion, headaches Gastrointestinal disorders, stomach pain, vomiting, nausea. Deficiency symptoms in children Disorders of protein biosynthesis and cell division. Disorders of the central nervous system Disturbance of nervous function and cardiac insufficiency – beriberi Skeletal muscle atrophy Increased risk of cardiac dysfunction and failure
Folic acid	Mucosal changes in the mouth, intestines, and urogenital tract lead to Indigestion – diarrhea Reduced absorption of nutrients and vital substances Weight loss Blood count disorders Anemia leads to rapid fatigue, shortness of breath, decreased ability to concentrate, general weakness. Impaired formation of white blood cells leads to. Reduction of the immune response to infections. Decreased antibody formation Risk of bleeding due to decreased production of platelets Elevated homocysteine levels increase the risk for Atherosclerosis Coronary artery disease (CAD) Neurological and psychiatric disorders, such as. Memory impairment Depression Aggressiveness Irritability Deficiency symptoms in children Disturbances in DNA synthesis – limited replication – and decreased cell proliferation increase the risk for Malformations, developmental disorders Growth retardation Maturation disorders of the central nervous system. Bone marrow alteration Deficiency of white blood cells as well as platelets. Anemia Injuries to the mucosa of the small intestine Disorders of protein biosynthesis and cell division
Vitamin B12	Decreased vision and blind spots Functional folic acid deficiency Weakened antioxidant protective system Blood count Anemia reduces the ability to concentrate, leads to fatigue, weakness and shortness of breath. Reduction of red blood cells, larger than average and rich in hemoglobin. Impaired growth of white blood cells weakens the immune system Risk of bleeding due to reduced production of platelets. Gastrointestinal tract Tissue atrophy and inflammation of the mucous membranes. Rough, burning tongue Reduced absorption of nutrients and vital substances Loss of appetite, weight loss Neurological disorders Numbness and tingling of extremities, loss of sensation of touch, vibration and pain. Poor coordination of the muscles, muscle atrophy. Unsteady gait Spinal cord damage Psychiatric disorders Memory disorders, confusion, depression Aggressiveness, agitation, psychosis
Vitamin C	Antioxidant deficiency Weakness of blood vessels leads to Abnormal bleeding Mucosal bleeding Hemorrhage into the muscles associated with weakness in heavily used muscles Inflamed as well as bleeding gums (gingivitis). Joint stiffness and pain Poor wound healing Carnitine deficit leads to Symptoms of exhaustion, fatigue, indifference, irritability, depression. Increased need for sleep, decreased performance. Weakness of the immune system with increased risk of infection Decreased oxidation protection increases the risk of heart disease, apoplexy (stroke) Deficiency symptoms in children Weakened immune system Recurrent infections of the respiratory tract, urinary bladder, and the auditory tube, which is connected to the nasopharynx via the tympanic cavity of the middle ear Increased risk of vitamin C deficiency disease – Möller-Barlow disease in infancy -with symptoms such as. Large bruises (hematomas). Pathological bone fractures associated with severe pain Wincing after every slightest touch – “jumping jack phenomenon”. Stagnation of growth
Calcium	Demineralization of the skeletal system increases the risk of Decreased bone density Osteoporosis, especially in women with estrogen deficiency. Bone softening as well as bone deformities – osteomalacia. Tendency to stress fractures of the skeletal system. Muscle cramps, tendency to spasm, increased muscle contraction. Cardiac arrhythmias Blood clotting disorders with increased bleeding tendency Increased excitability of the nervous system, depression. Increased risk of Hypertension (high blood pressure) Deficiency symptoms in children Impaired development of bones and teeth Decreased bone density in the newborn. Decreased mineralization of bones with tendency to spontaneous fractures and bone bending – formation of rickets. Symptoms of rickets Disturbances in the longitudinal growth of bones Deformed skeleton – skull, spine, legs. Atypical heart-shaped pelvis Delayed retention of deciduous teeth, jaw deformity, malocclusion of teeth. Additional vitamin D deficiency leads to Hyperparathyroidism – enlarged parathyroid tissue – and increased production of parathyroid hormones – hyperparathyroidism. Hypercalcemic coma
Magnesium	Increased excitability of muscles and nerves leads to Insomnia, difficulty concentrating Muscle and vascular spasms Numbness as well as tingling in the extremities. Heart palpitations and arrhythmias, feeling of anxiety. Increased risk of Decreased immune response Myocardial infarction (heart attack) Acute hearing loss Deficiency symptoms in children Growth retardation Hyperactivity Insomnia, difficulty concentrating Muscle tremors, cramps Heart palpitations and arrhythmias Decreased immune response
Sodium	Fatigability, possible unconsciousness, apathy, confusion, lack of drive, decreased performance – short-term memory. Nausea, vomiting, loss of appetite, lack of thirst. Hypertension (high blood pressure); tendency to collapse, hyperexcitability of the heart muscle, reduction in cardiac output – tachycardia. Muscle cramps Decreased urination
Potassium	Muscle weakness, muscle paralysis Fatigue, apathy Nausea and vomiting, loss of appetite, constipation, decreased bowel activity to intestinal obstruction. Decreased tendon reflexes Cardiac arrhythmias, cardiac enlargement, tachycardia, dyspnea
Chloride	Acid-base balance disorders Development of metabolic alkalosis Severe vomiting with high salt losses
Phosphorus	Increased mobilization from bone with bone softening as well as bone deformities – osteomalacia. Disturbances in cell formation with impairment of red and white blood cell function. Disorders in the acid-base balance with the formation of metabolic acidosis. Disease of the nerves, which transport informationbetween the central nervous system and theMuscles leads to. Tingling sensation, pain but also paralysis especially in the arms, hands and legs. Deficiency symptoms in children Increased mobilization from the bones – short stature, formation of rickets. Symptoms of rickets Disturbances in the longitudinal growth of bones Deformed skeleton – skull, spine, legs. Atypical heart-shaped pelvis Delayed retention of deciduous teeth, jaw deformity, malocclusion
Iron	Chronic fatigue syndrome (CFS) Loss of appetite Disorders of thermoregulation High susceptibility to infection of the upper respiratory tract Dry skin with itching Decreased concentration and retentiveness Increased lactic acid formation during physical exertion associated with muscle cramps. Increased absorption of environmental toxins Body temperature regulation may be disturbed Anemia (anemia) Deficiency symptoms in children Disturbance of physical, mental and motor development. Behavioral disorders Lack of concentration, learning disorders Disturbances in the child’s intelligence development Loss of appetite High susceptibility to infection of the upper respiratory tract Body temperature regulation may be disturbed
Zinc	Instead of zinc, the toxic cadmium is integrated into the biological processes, resulting in Inflammatory changes in the mucous membranes of the nose and throat. Cough, headache, fever Vomiting, diarrhea, cramping pain in the abdominal regions. Renal dysfunction and increased protein excretion. Osteoporosis, osteomalacia leads. Disturbances in the functioning of the immune system. Inhibition of cellular defense leads to increased susceptibility to infection Wound healing disorders and mucosal changes, as zinc is required for connective tissue synthesis Increased keratinization tendency Acne-like symptoms Progressive, circular hair loss Metabolic disorders, such as. Weight loss despite increased food intake Failure of beta cells in the pancreas – high risk of developing adult-onset diabetes (type II diabetes mellitus) Blood clotting disorders, chronic anemia. Reduction of the sense of smell and taste, reduction of vision, night blindness, sensorineural hearing loss. Fatigue, depression, psychosis, schizophrenia, aggressiveness. Permanent male infertility due to hypofunction of the gonads. Deficiency symptoms in children Low zinc concentrations in plasma and white blood cells cause Malformations and deformities especially of the central nervous system. Growth disorders and retardation with delayed sexual development. Skin changes in the extremities – hands, feet, nose, chin and ear – and natural orifices. Wound healing disorders Hair loss Acute and chronic infections Hyperactivity and learning disability
Selenium	Weight loss, intestinal sluggishness, indigestion. Depression, irritability, insomnia. Memory loss, difficulty concentrating, headaches Immunodeficiency Chronic fatigue syndrome (CFS) Thyroid dysfunction due to deficiency of selenium-dependent deiodases. Decreased activity of glutathione peroxidases leads to an increase in peroxides and thus to increased radical formation and increased formation of pro-inflammatory prostaglandins Joint pain due to pro-inflammatory processes. Increased susceptibility of the mitochondria Male infertility Increased risk of Liver damage Muscle pain and stiffness Keshan disease – viral infections, disease of the heart muscle – cardiomyopathy, heart failure, cardiac arrhythmias. Kashin-Beck disease – degenerative joint disease with disorders of bone and joint metabolism, which can lead to osteoarthritis and severe joint deformities. Deficiency symptoms in children Immunodeficiency Thyroid dysfunction Increased radical formation Increased susceptibility of the mitochondria Increased susceptibility to infections Increases the need for vitamin E
High quality protein	Disturbances in digestion and absorption of vital substances and resulting water and electrolyte losses. Muscle atrophy Tendency to accumulate water in the tissues – edema
Amino acids, such as glutamine, leucine, isoleucine, valine, tyrosine, histidine, carnitine.	Disturbances in the function of nerves and muscles Decreased performance Restricted energy production and resulting fatigue and muscle weakness. Impairment of hemoglobin formation Severe joint pain and stiffness in arthritis patients. High depletion of muscle mass and protein reserves. Insufficient protection against free radicals Weakening of the immune system, since amino acids are the main sources of energy for the immune system Disturbances in the digestive system Fluctuations in blood sugar levels Increased blood lipid and cholesterol levels Cardiac arrhythmias