Dysentery is an inflammation of the intestines, particularly from the colon.
It may lead to moderate to serious cramps of the stomach and extreme diarrhea in the feces, with mucus to blood.
That can be fatal without sufficient hydration.
The most common cause is infection with the bacillus Shigella, or bacterium.
Fast facts on dysentery
Here are some key points about dysentery. More detail is in the main article.
- Dysentery is an infection of the intestinal tract.
- Symptoms include stomach cramps and diarrhea
- Many people have mild symptoms, but dysentery can be fatal without adequate hydration.
What is dysentery?
Dysentery is an infectious disease related to severe diarrhoea.
Signs and symptoms are generally mild in the United States, and usually vanish within a few days. The majority of people won’t seek medical attention.
However, if a person is seeking dysentery medical assistance in the U.S., the authorities need to be notified. It is a disorder which is notifiable.
There are about 120 million to 165 million cases of Shigella infection worldwide per year, of which 1 million are fatal. About 60 per cent of these deaths in developed countries are children under the age of 5.
Treatment
Reports from the laboratory will show whether the infection is due to Shigella or Entamoeba histolyca.
It will rely on those findings if treatment is required.
Any patient with diarrhea or vomiting should also drink plenty of fluids to avoid dehydration.
If they can not drink, or if there is excess of diarrhea and vomiting, intravenous ( IV) fluid replacement may be required. The patient will be placed on a drip and monitored.
Treatment for mild bacillary dysentery
Mild bacillary dysentery, the type usually seen in well-sanitary developing countries, can typically resolve without care.
The patient can also drink plenty of fluids.
Antibiotic drugs are available in even more severe cases.
Treatment for amoebic dysentery
Amoebicidal drugs are used to treat the histolyca Entamoeba. This can ensure the amoeba does not live inside the body after symptoms have been resolved.
Flagyl, or metronidazole, is also used for the dysentery treatment. It treats parasites and bacteria alike.
If the findings of the laboratory are ambiguous, a mixture of antibiotic and amoebicidal drugs might be given to the patient, depending on how serious their symptoms are.
Symptoms
Dysentery symptoms vary from mild to extreme, depending largely on the level of sanitation in the areas where the infection has spread.
Signs and signs of dysentery tend to be milder in developed countries than in developing nations or tropical areas.
Mild symptoms include:
- a slight stomach-ache
- cramping
- diarrhea
These typically occur 1 to 3 days after infection, and within a week the patient recovers.
Some people may develop resistance to lactose which can last a long time, often years.
Symptoms of bacillary dysentery
Symptoms appear to turn up within 1 to 3 days of infection. Normally there is moderate stomach ache and diarrhea but there is no blood or mucus in the feces. Diarrhea can begin with frequently.
Less commonly, may be:
- blood or mucus in the feces
- intense abdominal pain
- fever
- nausea
- vomiting
Often, symptoms are so mild that a doctor’s visit is not required, and the problem resolves in a few days.
Symptoms of amoebic dysentery
A person with amoebic dysentery may have:
- abdominal pain
- fever and chills
- nausea and vomiting
- watery diarrhea, which can contain blood, mucus, or pus
- the painful passing of stools
- fatigue
- intermittent constipation
They will spread into the bloodstream and infect other organs if amieba tunnel through the intestinal wall.
Ulcers can develop. These will bleed, which can cause blood in the stools.
Symptoms may persist for several weeks.
The amoebae may continue to live within the human host after symptoms have gone away. Then if the person’s immune system is weakened, symptoms can recur.
Treatment decreases the risk of the amoebae surviving.
Causes
Bacillary dysentery, or shigellosis
This form yields the most serious symptoms. It is caused by the bacillus Shigella.
Bad hygiene is the primary cause of this. Due to contaminated food, shigellosis can spread too.
It is the most common form of dysentery in Western Europe and the US in people who did not visit the tropics shortly before infection.
Amoebic dysentery, or amoebiasis
This form is caused by an amieba called Entamoeba histolytica (E. histolytica).
The amoebae join together to form a cyst, and those cysts in human feces emerge from the body.
The amoebae can contaminate food and water in areas with poor sanitation and infect other humans, since they can live outside the body for long periods.
After using the bathroom they can even stay on people’s hands. Good hygiene practice decreases the likelihood that infection will spread.
It is more common in tropics, but occurs at times in parts of rural Canada.
Other causes
Other causes include a parasitic worm infection, chemical irritation, or viral infection.
Diagnosis
The doctor will inform the patient about their symptoms and signs, and will conduct a physical exam.
A stool sample may be requested, especially if the patient has just returned from the tropics.
If symptoms are serious, it may be advised to take diagnostic imaging. This could be an ultrasonic scan or an endoscopy.
Complications
Dysentery problems are rare but they can be serious.
Dehydration: Constant diarrhea and vomiting may cause dehydration quickly. This can fast become life-threatening in infants and young children.
Liver abscess: If amoebae spread to the liver, an abscess can form there.
Postinfectious arthritis: After the infection, joint pain can develop.
Hemolytic uremic syndrome: Shigella dysenteriae can block the entry of red blood cells into the kidneys, leading to anemia, low platelet counts, and kidney failure.
Patients have also had seizures after infection.
Prevention
Much of the dysentery comes from inadequate hygiene.
To reduce the risk of infection, people should regularly wash their hands with soap and water, especially before and after bathroom use and food preparation.
This can minimize up to 35 percent of the incidence of Shigella infections and other forms of diarrhea.
Other steps to take when the risk is higher, for example, when traveling, include:
- Only drink reliably sourced water, such as bottled water
- Watch the bottle being opened, and clean the top of the rim before drinking
- Make sure food is thoroughly cooked
It is better to use purified water to clean the teeth, and to avoid ice cubes, as the water source might not be identified.
