Dysentery

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 sensations 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

Dysentery is a highly infectious disease that spreads via human-to-human transmission, most commonly through the hand-to-mouth route. It is usually caused by:

• Drinking water from contaminated sources
• Eating food from contaminated sources

Patients with dysentery have germs in their stools during diarrhea and for up to one or two weeks after the diarrhea has resolved. Dysentery is highly contagious, as even a small amount of germs can lead to infection. People can get infected by:

• Catching germs on their hands and then touching food or their mouth. This can occur by touching surfaces contaminated with stool from an infected person, such as taps, toilet seats, flush handles, or while changing the diaper of a sick child or caring for a patient.
• Eating foods that are raw, uncooked, or prepared by someone who is infected with dysentery. Fruits and vegetables may also become contaminated if washed with dirty water or grown in soil polluted by human excreta.
• Drinking water contaminated with stool containing the germs. The risk is higher if household water is not properly separated from wastewater.
• Swallowing infected water while swimming in a river, lake, or public swimming pool.
• Engaging in sexual activity that involves direct anal-oral contact with an infected or recently recovered patient.

When experiencing diarrhea, it is crucial to replenish fluids and salts lost from the body rapidly, so it is important to consume as many fluids as possible.

Often, dysentery can be confused with other conditions affecting the gastrointestinal tract due to considerable overlap in the presenting symptoms 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 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 present similar symptoms.

Dysentery can be prevented by following good hygiene practices, such as:

• Always wash hands with soap and water before eating meals and after visiting the toilet.
• Avoid roadside, uncooked, and unhygienic food.
• Thoroughly wash vegetables before cooking.
• Do not eat raw food. When consuming fruits or vegetables, always remove and discard their outer peel.
• Drink only purified or mineral water.
• Avoid ice if you are unsure it is made from clean water.
• Do not use unhygienic toilets.
• Avoid sharing towels and other personal care items.

The treatment for dysentery aims to provide supportive care and to eliminate the causative organisms.

1. 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 for amoebic dysentery. Examples of antibiotics and antiparasitics include:

• Ciprofloxacin
• Azithromycin
• Norfloxacin-Tinidazole
• Ofloxacin-Ornidazole
• Trimethoprim-sulfamethoxazole
• Metronidazole

2. Supportive Care

Antipyretics such as paracetamol are used to treat fever associated 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 medications may worsen dysentery.

Patients with dysentery must consume only light foods that are easy to digest and avoid oily or spicy foods. Raw fruits and vegetables must be thoroughly washed before consumption. Liquid foods, such as coconut water and buttermilk, should be consumed in abundance to prevent dehydration.

If you are suffering from an episode of dysentery, you can do the following to care for yourself at home:

• Drink purified water only.
• Keep yourself hydrated; drink plenty of water or electrolyte solutions.
• Take ample rest.
• When you start feeling better, eat light foods that are easy to digest.
• Wash your hands thoroughly with soap and water before every meal and after using the toilet.

During the episode of diarrhea, be cautious about what to eat and what to avoid. While some foods may be beneficial, certain foods can worsen your symptoms.

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Severe dysentery can cause the following complications:

• Extreme weakness and dehydration
• Hypovolemic shock can occur when the body has lost too much fluid volume, potentially leading to loss of consciousness, coma, or death if not treated promptly.
• Toxic megacolon is a serious and life-threatening condition characterized by excessive distension of the large intestine.
• Secondary infections of the gastrointestinal tract
• Gastrointestinal bleeding may occur from any part of the stomach or intestine, causing stools to turn black.
• Severely low levels of potassium, which can lead to life-threatening changes in heartbeat
• Seizures
• Postinfectious arthritis, where the patient may develop joint pain, eye irritation, and painful urination
• Hemolytic uremic syndrome (HUS) is a type of kidney damage caused by bacteria that produce toxins destroying red blood cells.
• In rare cases, amoebic dysentery can result in liver abscesses, which are collections of pus in the liver, or parasites spreading to the lungs or brain.
• Sepsis or spread of infection is more common in individuals with weakened immune systems due to diseases (like HIV) or medical treatments (like chemotherapy for cancer).

The role of alternative therapies in the treatment of dysentery is limited. Dysentery is known as 'Pravahika' in Ayurveda. They help by eliminating the causative organism, facilitating normal absorption of nutrients in the intestine, and stimulating digestive enzymes to aid easy digestion. These medicines must be taken as prescribed by an Ayurvedic practitioner.

Ayurvedic medicines found to be useful in the treatment of dysentery are:

• Kutajghan Vati
• Bilvadi Churna with Takra
• Chitrakadi Gutika

Dysentery can be serious and can lead to life-threatening complications if left untreated. Hence, it is very important to seek medical help as soon as possible. An episode of dysentery may leave a person feeling very weak and tired. One should rest at home and consume plenty of fluids and electrolytes to prevent dehydration.

At the same time, it is crucial to protect your family from dysentery, as it is highly contagious and can easily spread from person to person. You can follow these tips to prevent passing on the infection to others:

• Handwashing is of utmost importance to stop the spread of infection. Wash your hands thoroughly with soap and water after going to the toilet.
• Clean toilet seats, flush handles, taps, and sinks with detergent and hot water after use, followed by a household disinfectant.
• Wash all dirty clothes, bedding, and towels separately with hot water.

Until you've been completely free from any symptoms for at least 48 hours, you should take the following precautions:

1. If possible, stay isolated from your family.
2. Stay away from work or school.
3. Do not prepare food for others.
4. Do not go in a swimming pool.
5. Avoid sexual contact.