Dysentery

Dysentery is a painful intestinal infection that causes loose and watery stools along with blood and mucus. It is a highly infectious disease that is caused by bacteria or parasites. Poor sanitation, poor hand hygiene, consuming food and water contaminated with fecal matter and various other factors increase the chances of contracting the disease.

Causes #

Dysentery is a highly infectious disease that spreads via human-to-human transmission and most commonly via the hand-to-mouth route. It is usually caused by drinking water or eating food from sources contaminated with the organisms that cause the dysentery.

Systems #

The symptoms of dysentery may take up to 3 days to manifest once the person contracts the infection. A person suffering from a bout of dysentery will generally experience the following symptoms:

• Loose, watery stools

• Frequent bouts of defecation

• Stools with blood and mucus​

• Pain while passing stools

• Cramping and painful sensation in the stomach

• Bouts of nausea and vomiting

• Fever and chills

• Weakness

• Dehydration

• Decreased urine output

• Dry skin and mucous membranes (such as dry mouth)

• Muscle cramps

• Weight loss

Types #

Bacillary dysentery #

Bacillary dysentery, as the name suggests, is caused by a bacterias.These bacterias include shigella (causes shigellosis), campylobacter (causes campylobacteriosis) and salmonella (causes salmonellosis). The frequency of each bacteria causing dysentery varies from region to region in the world.

Amoebic dysentery #

Amoebic dysentery, as the name suggests is caused by an amoeba (single-celled parasite) known as Entamoeba histolytica.

Diagnosis #

Often, dysentery can be confused with other conditions affecting the gastrointestinal tract. This is because there is considerable overlap in the presenting symptoms of dysentery with other diseases of the stomach and intestine.

• Diagnostic lab tests: A diagnosis of dysentery is confirmed by detecting the presence of causative organisms, such as shigella or Entamoeba histolytica. stool examination R/M and culture stool are lab tests that detect the presence of microorganisms in a stool sample and determine their sensitivity to antibiotics.

• Supportive lab tests: Additional lab tests, such as complete blood count (CBC), may be performed to determine the level of infection in the body and rule out other causes that may cause similar symptoms.

Treatments #

Antibiotics and antiparasitics #

Depending upon the cause of dysentery, your doctor might recommend antibiotics or antiparasitics to treat the infection. Antibiotics are used in the treatment of bacterial dysentery or shigellosis whereas antiparasitic medications are used in the treatment of amoebic dysentery.

Examples of antibiotics & antiparasitics include:

• Ciprofloxacin

• Azithromycin

• Norfloxacin-Tinidazole

• Ofloxacin-Ornidazole

• Trimethoprim-sulfamethoxazole

• Metronidazole

Supportive care #

• Antipyretics such as paracetamol are used to treat fever occurring with dysentery.

• Electrolyte supplements such as oral rehydration salts(ORS) are useful in the prevention and treatment of dehydration.

• Anti-diarrhea drugs such as loperamide must not be used without a doctor’s recommendation as such medicines may worsen dysentery.

Complications #

• Extreme weakness and dehydration

• Hypovolemic shock can occur when the body has lost too much of its fluid volume. Hypovolemic shock can cause a person to lose consciousness and even become comatose. It can even cause death if not treated in time.

• Toxic megacolon is a serious and life-threatening condition in which the large intestine distends excessively.

• Secondary infections of the gastrointestinal tract

• Gastrointestinal bleeding may occur from any part of the stomach or intestine. Bleeding in the gastrointestinal tract causes stools to turn black.

• Severely low levels of potassium which can cause life-threatening changes in heartbeat

• Seizures

• Postinfectious arthritis in which the patient can develop joint pain, eye irritation, and painful urination

• Hemolytic uremic syndrome (HUS) is a type of kidney damage in which the causative bacteria make a toxin that destroys red blood cells

• In rare cases, amoebic dysentery can result in liver abscess i.e, collection of pus in the liver or parasites spreading to the lungs or brain

• Sepsis or spread of infection more commonly in people with weak immune systems due to disease (like HIV) or medical treatment (like chemotherapy for cancer)