What is Dysentery?
Dysentery is an infection of the intestines which results in inflammation and diarrhea.
There are two types of dysentery: Bacillary Dysentery, caused by bacteria from the shigella group; and amoebic dysentery (amoebiasis), which is the result of infestation by a tiny, single-celled parasite. The onset of bacillary dysentery is sudden, usually a few days after infection. The different strains of the bacteria vary greatly in virulence. Shigella Sonnei Dysentery, which causes most of the outbreaks in the United Kingdom, is the least serious and may pass unnoticed, except as a transient attack of diarrhea.
The symptoms of amoebic dysentery take around three weeks to develop while these may appear outwardly less severe than some cases of bacillary dysentery, this form of the disease may persist, seeming to fade away and then recurring at intervals after the initial attack.
What are the symptoms of Dysentery?
Passing of blood, mucus and pus in faeces
Nausea and vomiting
How is Dysentery Spread?
Both types of Dysentery are caused by infected faeces, contaminating food and water. The infection is spread by flies or by humans, usually on hands, utensils, or toilet sears.
Dysentery is common in hot, humid countries where large numbers of people who are poor and often malnourished live together in crowded unsanitary conditions.
The disease is relatively rare in U.K. It is usually brought back by travelers, but outbreaks can occur at home. Vulnerable situations include nurseries, where young children are not properly toilet trained and do not understand the rules of hygiene, or in old people’s homes, where there is poor management of incontinent residents.
How is Dysentery Diagnosed and Treated?
The most common symptom of Dysentery is diarrhea, which can strike with great severity. The faeces may be watery and as the organisms attack the wall of the intestines, may often contain mucous, pus, or blood. Other symptoms include pain in the abdomen, fever and a feeling of general illness.
Diagnosis is usually confirmed either by rectal swabs or by examination of the faeces. Treatment involves replacing the fluid lost through the diarrhea and if appropriate, a course of drugs.
When Should I See My Doctor?
You should see your doctor if you see persistent, severe diarrhea, and feel generally unwell.
What will the Doctor Do?
The doctor will question you about the onset and severity of your symptoms and any recent travels, to differentiate the symptoms from those of Gastroenteritis, or food poisoning, such as salmonella poisoning (salmonellosis). The abdominal pain can sometimes be mistaken for acute appendicitis.
Drugs to stop the vomiting may be prescribed although antibiotics may also be administered to combat bacillary Dysentery; these are generally used with great caution now a days because of the risk of creating resistant strains of bacteria. Drugs to kill the parasites are usually prescribed in cases of amoebic Dysentery.
If dehydration becomes serious, the patient may be admitted to hospital for intravenous drip therapy.
The doctor will follow up treatment with regular tests on the faeces to make sure that the offending organisms have been completely eradicated.
This is particularly important for anyone whose job involves handling food.
What Can I do Myself?
If the doctor advises that the patient can remain at home, the most stringent hygiene rules must be observed. All surfaces in the toilet should be kept scrupulously cleaned and disinfected.
It is vital that everyone living in the house takes precautions, such as washing their hands very carefully after using the toilet and before preparing food, because some people can be symptom less carriers, passing on the organisms without being affected themselves.
It is essential that everyone with diarrhea should drink plenty of clear fluid to replace that lost due to illness. The doctor may prescribe a rehydration solution to replace lost salts and provide glucose for energy. Start eating bland foods once the diarrhea has stopped.
What Can I do to Avoid Dysentery?
Most people catch dysentery while traveling or living in tropical climates, so you should take the greatest care with food and drink in these areas. Drink only boiled, bottled or chemically purified water, avoid ice in drinks, and always peel fruit and vegetables before eating. Similarly, ask how salads and other uncooked foods you may be served have been washed, and avoid restaurants or shops where flies congregate.
Is Dysentery Dangerous?
A very mild attack of Dysentery may pass relatively unnoticed. But it can have more serious consequences.
With bacillary Dysentery, bacteria can penetrate the wall of the intestines to enter the blood stream and cause blood poisoning, with symptoms such as fever, aches and pains, and generalized weakness.
The parasite of the amoebic Dysentery can be carried by the blood to the liver, where it causes abscesses and possibility permanent liver damage. In serious cases, an operation to drain the pus from the abscesses may be needed.
However, Dysentery is not usually fatal in western countries. With prompt treatment and proper care most healthy adults can make a full recovery from the disease.
Dysentery presents most risk to the young, and old, and those debilitated by illness or poor diet.
It is important that treatment is sought to destroy the bacteria or parasites, so that there is no long term damage to the patient and no risk of passing on the disease.