Progress in the diagnosis and treatment of acute gastrointestinal injury in sepsis

Zheng Shuyun

doi:10.3969/j.issn.1672-8521.2025.04.001

Abstract：Acute gastrointestinal injury in sepsis,due to its high incidence and mortality rate,directly affects the prognosis of sepsis patients and has attracted increasing attention from clinicians.As the pathogenesis and pathological process of sepsis are extremely complex and have not yet been fully clarified,the existing evaluation tools or methods for acute gastrointestinal dysfunction are difficult to comprehensively and accurately reflect the changes in gastrointestinal function,and there is a lack of reliable,real-time assessment methods and diagnostic criteria.Currently,the diagnosis of acute gastrointestinal injury in sepsis mainly relies on clinical manifestations such as loss of appetite,nausea,vomiting,abdominal distension,gastric retention and reflux of intestinal fluid.The intestinal barrier function is evaluated by detecting the content of specific biomarkers in blood or excreta,such as intestinal fatty acid-binding protein(I-FABP),citrulline,endotoxin,fecal calprotectin,and fecal secretory immunoglobulin A(sIgA).Gastrointestinal ultrasound,with its advantages of objectivity,dynamics,real-time performance,and convenience,has become a major auxiliary examination method for evaluating acute gastrointestinal injury.The treatment of gastrointestinal function injury emphasizes providing reasonable nutritional support,probiotic supplementation,and using prokinetic drugs on the basis of eliminating the cause,controlling infection,maintaining vital signs and the stability of important organ functions,which can achieve significant therapeutic effects.Traditional Chinese medicine has a unique role in improving gastrointestinal symptoms and restoring gastrointestinal function.The integrated approach of combining traditional Chinese and Western medicine presents a promising strategy for the prevention and treatment of septic gastrointestinal injury.