{"id":8259,"date":"2023-09-07T19:34:51","date_gmt":"2023-09-07T17:34:51","guid":{"rendered":"https:\/\/www.cgs-cls.cz\/?p=8259"},"modified":"2024-06-18T12:05:07","modified_gmt":"2024-06-18T10:05:07","slug":"pristup-k-prujmum-predevsim-cestovatelskym-v-situaci-vypadku-nekterych-leciv","status":"publish","type":"post","link":"https:\/\/www.cgs-cls.cz\/pristup-k-prujmum-predevsim-cestovatelskym-v-situaci-vypadku-nekterych-leciv\/","title":{"rendered":"P\u0158\u00cdSTUP K&nbsp;PR\u016eJM\u016eM (P\u0158EDEV\u0160\u00cdM CESTOVATELSK\u00ddM) V&nbsp;SITUACI V\u00ddPADKU N\u011aKTER\u00ddCH L\u00c9\u010cIV"},"content":{"rendered":"<p><strong>\u010cesk\u00e1 Gastroenterologick\u00e1 spole\u010dnost zd\u016fraz\u0148uje, \u017ee nen\u00ed d\u016fvod k\u00a0panice, a \u017ee existuj\u00ed \u00fa\u010dinn\u00e1 \u0159e\u0161en\u00ed. <\/strong><\/p>\n<p><strong>\u010cGS poskytuje tento stru\u010dn\u00fd a praktick\u00fd n\u00e1vod, jak obdobn\u00fdm pot\u00ed\u017e\u00edm \u010delit<\/strong><\/p>\n<p><strong>\u00a0<\/strong><strong>\u00a0<\/strong><\/p>\n<p>V sou\u010dasnosti \u010del\u00edme s\u00e9rii dotaz\u016f spojen\u00fdch s&nbsp;nedostupnost\u00ed n\u011bkter\u00fdch voln\u011b prodejn\u00fdch l\u00e9k\u016f na pr\u016fjmov\u00e1 onemocn\u011bn\u00ed (typu l\u00e9ku Endiaron), kter\u00e1 mnoz\u00ed st\u00e1le je\u0161t\u011b pova\u017euj\u00ed za jedin\u00fd osv\u011bd\u010den\u00fd a bezpe\u010dn\u00fd p\u0159\u00edpravek, p\u0159edev\u0161\u00edm v&nbsp;souvislosti s&nbsp;takzvan\u00fdmi cestovatelsk\u00fdmi pr\u016fjmy. \u00a0U 40\u201360&nbsp;% cestovatel\u016f se r\u016fzn\u00e9 formy tr\u00e1vic\u00edch obt\u00ed\u017e\u00ed (zvl\u00e1\u0161t\u011b v&nbsp;m\u00e9n\u011b ekonomicky rozvinut\u00fdch zem\u00edch) objev\u00ed. Tyto pr\u016fjmy b\u00fdvaj\u00ed zp\u016fsobeny nej\u010dast\u011bji bakteriemi a jejich produkty (toxiny), d\u00e1le viry i parazity. Dobrou zpr\u00e1vou je, \u017ee naprost\u00e1 v\u011bt\u0161ina t\u011bchto obt\u00ed\u017e\u00ed odezn\u00edv\u00e1, a\u010dkoliv je tlumen\u00ed n\u011bkter\u00fdch nep\u0159\u00edjemn\u00fdch p\u0159\u00edznak\u016f vhodn\u00e9.<\/p>\n<p><strong>\u00a0<\/strong><\/p>\n<p><strong><u>Co je to cestovatelsk\u00fd pr\u016fjem: \u00a0\u00a0<\/u><\/strong><\/p>\n<p>Pr\u016fjem a p\u0159idru\u017een\u00e9 symptomy (zvracen\u00ed, bolesti b\u0159icha) vznikl\u00e9 v\u00a0souvislosti s\u00a0cestov\u00e1n\u00edm \u010di turistikou do m\u00e9n\u011b ekonomicky rozvinut\u00fdch zem\u00ed. Obvykle je p\u016fsob\u00ed bakteri\u00e1ln\u00ed toxiny, bakterie, viry a parazit\u00e9, mohou b\u00fdt v\u0161ak tak\u00e9 d\u016fsledkem dietn\u00ed chyby \u010di \u010dasov\u00e9ho posunu.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Jak\u00e9 jsou hlavn\u00ed symptomy onemocn\u011bn\u00ed: <\/strong><\/p>\n<ul>\n<li>pr\u016fjmy (4 -10&nbsp;dn\u00ed po p\u0159\u00edjezdu), odezn\u00edvaj\u00ed do t\u00fddne, definujeme je jako \u010detn\u011bj\u0161\u00ed a m\u011bk\u010d\u00ed stolice (\u010dasto vodnat\u00e9)<\/li>\n<li>pocity na zvracen\u00ed, zvracen\u00ed<\/li>\n<li>nechutenstv\u00ed<\/li>\n<li>k\u0159e\u010de v\u00a0podb\u0159i\u0161ku<\/li>\n<li>teplota<\/li>\n<li>pocity nadmut\u00ed<\/li>\n<li>mal\u00e9 mno\u017estv\u00ed \u010derstv\u00e9 krve ve stolici<\/li>\n<\/ul>\n<p><strong>\u00a0<\/strong><\/p>\n<p><strong>Kdy je nutn\u00e1 konzultace l\u00e9ka\u0159e: <\/strong><\/p>\n<ul>\n<li>obt\u00ed\u017ee &gt; 10&nbsp;dn\u00ed<\/li>\n<li>hore\u010dka &gt; 38,5&nbsp;\u00b0C<\/li>\n<li>dehydratace (zmatenost, spavost, \u00fanava, suchost sliznic, svalov\u00e9 k\u0159e\u010de)<\/li>\n<li>velk\u00e9 mno\u017estv\u00ed vodnat\u00fdch pr\u016fjm\u016f, krvav\u00fdch pr\u016fjm\u016f<\/li>\n<li>zahu\u0161t\u011bn\u00e1 mo\u010d a jej\u00ed velice mal\u00e9 mno\u017estv\u00ed<\/li>\n<li>zesilov\u00e1n\u00ed bolesti b\u0159icha<\/li>\n<li>neschopnost standardn\u00edho p\u0159\u00edjmu potravy a tekutin<\/li>\n<\/ul>\n<p><strong>\u00a0<\/strong><\/p>\n<p><strong>L\u00e9\u010dba onemocn\u011bn\u00ed <\/strong><\/p>\n<p><strong><u>1.&nbsp;samol\u00e9\u010dba (ev. konzultace l\u00e9k\u00e1rn\u00edka):<\/u><\/strong><\/p>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li>samol\u00e9\u010dba <span style=\"color: #ff0000;\"><strong>pouze p\u0159i m\u00edrn\u00fdch p\u0159\u00edznac\u00edch.<\/strong><\/span><\/li>\n<li>z\u00e1kladem je <span style=\"color: #ff0000;\"><strong>rehydratace<\/strong><\/span> (voda, or\u00e1ln\u00ed rehydrata\u010dn\u00ed roztoky z&nbsp;l\u00e9k\u00e1rny), dom\u00e1c\u00ed roztok (8 \u010dajov\u00fdch l\u017ei\u010dek cukru a 1 l\u017ei\u010dka kuchy\u0148sk\u00e9 soli do litru p\u0159eva\u0159en\u00e9 vody, \u0161\u0165\u00e1va ze 2 pomeran\u010d\u016f) &#8211; dosp\u011bl\u00ed 250\u2013500 ml tohoto roztoku za hodinu, d\u011bti 125\u2013250 ml\/hodinu<\/li>\n<li><span style=\"color: #ff0000;\"><strong>dieta:<\/strong><\/span> slan\u00e9 suchary, b\u00edl\u00fd chleba, va\u0159en\u00e1 r\u00fd\u017ee nebo brambory, ban\u00e1ny a strouhan\u00e1 jablka, v\u00fdvary<\/li>\n<li>POZOR: p\u0159i intenzivn\u011bj\u0161\u00edch pr\u016fjmech omezit diuretickou l\u00e9\u010dbu a sn\u00ed\u017eit d\u00e1vky antihypertenziv<\/li>\n<li>symptomatick\u00e1 l\u00e9\u010dba\n<ul>\n<li><strong>st\u0159evn\u00ed desinficiencia<\/strong> (<span style=\"color: #ff0000;\"><strong>ENDIARON <\/strong><\/span>\u2013 nepat\u0159\u00ed k&nbsp;l\u00e9k\u016fm prvn\u00ed volby, ne\u00fa\u010dinn\u00e9 na virov\u00e9 pr\u016fjmy!, \u00a0ne\u00fa\u010dinn\u00e9 na pr\u016fjmy zp\u016fsoben\u00e9 p\u016fvodci Campylobacter jejuni<em>,\u00a0 Salmonella enterica<\/em>)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><strong><u>alternativy\u00a0 <\/u><\/strong><\/p>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li><strong>adsorbencia<\/strong> (nav\u00e1\u017e\u00ed toxiny a viry) \u2013 <span style=\"color: #ff0000;\"><strong>AKTIVN\u00cd UHL\u00cd, SMECTA<\/strong><\/span> (bez kontraindikac\u00ed)<\/li>\n<li><strong>probiotika <\/strong>(Lactobacilly, Saccharomyces boulardii)<\/li>\n<li><strong>antimotilika <\/strong><strong>(<span style=\"color: #ff0000;\">IMODIUM, REASEC<\/span>) <\/strong>\u2013 v\u00a0samol\u00e9\u010db\u011b opatrn\u011b, rozhodn\u011b ne u krvav\u00fdch pr\u016fjm\u016f a vysok\u00fdch teplot, velmi rychl\u00fd n\u00e1stup \u00fa\u010dinku, po kr\u00e1tkou dobu<\/li>\n<li>podp\u016frn\u011b , antisekretolitika (nap\u0159. <strong><span style=\"color: #ff0000;\">HIDRASEC<\/span>) <\/strong>u vodnat\u00fdch, virov\u00fdch pr\u016fjm\u016f<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><strong><u>2.&nbsp;l\u00e9\u010dba (konzultace l\u00e9ka\u0159e viz v\u00fd\u0161e) <\/u><\/strong><\/p>\n<p>krom\u011b v\u00fd\u0161e uveden\u00e9ho a v\u00a0z\u00e1vislosti na klinick\u00e9m stavu a dal\u0161\u00edch nemocech desinficiencia (<strong><span style=\"color: #ff0000;\">ERCEFURYL<\/span> <\/strong>\u2013 u\u00a0cestovatel\u016f pom\u011brn\u011b obl\u00edben\u00fd, p\u0159esv\u011bd\u010div\u00e9 klinick\u00e9 d\u016fkazy o\u00a0jeho \u00fa\u010dinku chyb\u00ed ev. ATB (nap\u0159. <span style=\"color: #ff0000;\"><strong>NORMIX<\/strong><\/span> \u2013 velmi dob\u0159e tolerov\u00e1n, bez vlivu na mikrofl\u00f3ru, lok\u00e1ln\u00ed \u00fa\u010dinek ve st\u0159ev\u011b, vynikaj\u00edc\u00ed spektrum \u00fa\u010dink\u016f proti n\u011bkter\u00fdm cestovatelsk\u00fdm pr\u016fjm\u016fm) a dal\u0161\u00ed.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Prevence onemocn\u011bn\u00ed <\/strong><\/p>\n<p>a\/ v\u00fdb\u011br<span style=\"color: #ff0000;\"> <strong>j\u00eddla a pit\u00ed<\/strong> <\/span>(preferovat va\u0159en\u00e9 a hork\u00e9 potraviny, ovoce se <em>slupkou, pasterizovan\u00e9 ml\u00e9\u010dn\u00e9 v\u00fdrobky<\/em>, balen\u00e9 n\u00e1poje bez ledu, preferovat hork\u00e9 n\u00e1poje \u010daj a k\u00e1vu)<\/p>\n<p>POZOR: <strong>alkohol ani led<\/strong> nesterilizuje potraviny<em> \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u201ecook it, wash it, peel it or forget it!\u201c<\/em><\/p>\n<p>b\/ rizikov\u00e9 jsou sal\u00e1ty, om\u00e1\u010dky, bufety<\/p>\n<p>c\/ doba p\u0159\u00edpravy j\u00eddla (va\u0159en\u00ed alespo\u0148 3 minuty)<\/p>\n<p><span style=\"color: #ff0000;\"><strong>d\/ preventivn\u00ed pod\u00e1v\u00e1n\u00ed ATB <\/strong><\/span>pouze <span style=\"color: #ff0000;\"><strong>po konzultac\u00edch s\u00a0l\u00e9ka\u0159em<\/strong><\/span> u nemocn\u00fdch se z\u00e1va\u017en\u00fdmi chronick\u00fdmi onemocn\u011bn\u00edmi (Crohnova choroba, poruchy imunity apod) &#8211; rizika ATB l\u00e9\u010dby nedosahuj\u00ed rizik zhor\u0161en\u00ed st\u0159evn\u00edho onemocn\u011bn\u00ed<\/p>\n<p>Z \u0161etrn\u011bj\u0161\u00edch ATB s&nbsp;minim\u00e1ln\u00edmi vedlej\u0161\u00edmi \u00fa\u010dinky lze preferovat rifaximin (200 mg 3 x d). Jedn\u00e1 se o l\u00e9k na recept, konzultace l\u00e9ka\u0159e nutn\u00e1.<\/p>\n<p><span style=\"color: #ff0000;\"><strong>e\/ preventivn\u00ed pod\u00e1v\u00e1n\u00ed protipr\u016fjmov\u00fdch l\u00e9k\u016f a chemoterapeutik<\/strong><\/span> se <span style=\"color: #ff0000;\"><strong>nedoporu\u010duje<\/strong><\/span>, jejich p\u0159\u00ednos nep\u0159eva\u017euje mo\u017en\u00e1 rizika pod\u00e1v\u00e1n\u00ed<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u010cesk\u00e1 Gastroenterologick\u00e1 spole\u010dnost zd\u016fraz\u0148uje, \u017ee nen\u00ed d\u016fvod k\u00a0panice, a \u017ee existuj\u00ed \u00fa\u010dinn\u00e1 \u0159e\u0161en\u00ed. \u010cGS poskytuje tento stru\u010dn\u00fd a praktick\u00fd n\u00e1vod, jak obdobn\u00fdm pot\u00ed\u017e\u00edm \u010delit \u00a0\u00a0 V&nbsp;sou\u010dasnosti \u010del\u00edme s\u00e9rii dotaz\u016f spojen\u00fdch s&nbsp;nedostupnost\u00ed n\u011bkter\u00fdch voln\u011b prodejn\u00fdch l\u00e9k\u016f na pr\u016fjmov\u00e1 onemocn\u011bn\u00ed (typu l\u00e9ku Endiaron), kter\u00e1 mnoz\u00ed st\u00e1le je\u0161t\u011b pova\u017euj\u00ed za jedin\u00fd osv\u011bd\u010den\u00fd a bezpe\u010dn\u00fd p\u0159\u00edpravek, p\u0159edev\u0161\u00edm v&nbsp;souvislosti <a class=\"read-more\" href=\"https:\/\/www.cgs-cls.cz\/pristup-k-prujmum-predevsim-cestovatelskym-v-situaci-vypadku-nekterych-leciv\/\">[&#8230;]<\/a><\/p>\n","protected":false},"author":1,"featured_media":8260,"ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false},"categories":[1],"tags":[],"class_list":["post-8259","post","type-post","status-publish","has-post-thumbnail","hentry","category-uncategorized"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.cgs-cls.cz\/api\/wp\/v2\/posts\/8259","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.cgs-cls.cz\/api\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.cgs-cls.cz\/api\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.cgs-cls.cz\/api\/wp\/v2\/users\/1"}],"version-history":[{"count":0,"href":"https:\/\/www.cgs-cls.cz\/api\/wp\/v2\/posts\/8259\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.cgs-cls.cz\/api\/wp\/v2\/media\/8260"}],"wp:attachment":[{"href":"https:\/\/www.cgs-cls.cz\/api\/wp\/v2\/media?parent=8259"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.cgs-cls.cz\/api\/wp\/v2\/categories?post=8259"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.cgs-cls.cz\/api\/wp\/v2\/tags?post=8259"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}