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Dysentery: Causes, Symptoms, Treatment, and Prevention Explained | Max Hospital

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Dysentery: Causes, Symptoms, Treatment and Prevention

By Dr. Rajesh Upadhyay in Gastroenterology, Hepatology & Endoscopy

May 02 , 2024 | 9 min read

Despite increasing awareness about gut health, dysentery continues to be a common digestive issue all over the world. If left untreated, this disorder can lead to various complications ranging from dehydration to sepsis. That’s why it is important to learn about the disorder, so that you can look out for early signs and seek medical intervention if necessary. To help, in this article, we cover all you need to know about dysentery including its definition, causes, symptoms, and treatment options. Let’s begin. 

What is Dysentery?

Dysentery is a gastrointestinal disorder marked by intense diarrhoea, typically accompanied by the presence of blood and mucus in the stool. This condition is often indicative of inflammation within the intestines, particularly affecting the colon. It can cause significant discomfort and distress to those affected.

What are the Types of Dysentery?

Dysentery can be broadly classified into two main types based on the causative agents:

  1. Amoebic Dysentery: Also known as amoebiasis, this type of dysentery is caused by the protozoan parasite Entamoeba histolytica. It is more common in tropical regions with poor sanitation and contaminated water sources. 
  2. Bacillary Dysentery: Bacillary dysentery is caused by various bacteria, with the most common causative agent being Shigella species (hence also referred to as shigellosis). Other bacteria such as Campylobacter and certain strains of Escherichia coli (E. coli) can also cause bacillary dysentery. 

Both types of dysentery present similar symptoms, but they are caused by different pathogens and may require different treatments. Proper diagnosis by a healthcare professional is essential for effective management and treatment.

What are the Symptoms of Dysentery?

Symptoms of dysentery can vary depending on the underlying cause (such as bacterial, parasitic, or viral infection), but common symptoms may include:

  • Severe diarrhoea: Dysentery is characterised by frequent, loose stools that may contain blood and mucus. The diarrhoea is often more severe than typical diarrhoea and may be accompanied by a strong urgency to defecate.
  • Abdominal pain and cramps: Patients with dysentery often experience abdominal discomfort, including cramping, pain, and a feeling of bloating.
  • Fever: Many people with dysentery develop a fever, which may range from mild to high-grade, depending on the severity of the infection.
  • Nausea and vomiting: Some individuals with dysentery may experience nausea and vomiting, which can contribute to dehydration.
  • Dehydration: The persistent diarrhoea associated with dysentery can lead to dehydration, characterised by symptoms such as dry mouth, decreased urine output, thirst, and lightheadedness.
  • Fatigue: Dysentery can cause weakness and fatigue due to dehydration and the body's efforts to fight off the infection.
  • Tenesmus: This is a sensation of incomplete bowel movement or a constant urge to pass stools even when the rectum is empty. It is a common symptom of dysentery.

Note: The symptoms of dysentery can vary in severity depending on factors such as the individual's overall health, the specific pathogen causing the infection, and whether any complications develop. If you suspect you have dysentery or are experiencing symptoms of severe diarrhoea, it's crucial to seek medical attention for proper diagnosis and treatment.

What are the Causes of Dysentery?

Dysentery can be caused by various factors, including bacterial, parasitic, or viral infections. Here are the main causes:

  • Bacterial infections: The most common cause of dysentery is bacterial infections. Bacteria such as Shigella species (which cause shigellosis), Campylobacter species, and certain strains of Escherichia coli (E. coli) can lead to dysentery. These bacteria are typically transmitted through contaminated food, water, or direct contact with infected individuals.
  • Parasitic infections: Dysentery can also be caused by parasitic infections, particularly by the protozoan parasite Entamoeba histolytica. This type of dysentery, known as amoebic dysentery or amoebiasis, is more prevalent in tropical regions with poor sanitation and contaminated water sources.
  • Viral infections: While extreme and rare certain viral infections can also cause dysentery. Viruses such as rotavirus and norovirus can lead to gastroenteritis with symptoms similar to dysentery, including diarrhoea, abdominal cramps, and nausea.

Transmission channels

Regardless of the cause, dysentery can occur through various routes of transmission. These include:

  • Contaminated food and water: Inadequately cooked food or water contaminated with faecal matter containing infectious agents is a common route of transmission for dysentery-causing pathogens.
  • Poor hygiene: Poor personal hygiene practices, such as inadequate handwashing after using the toilet or before handling food, can contribute to the spread of dysentery.
  • Close contact: Close contact with infected individuals, particularly in crowded or unsanitary conditions, increases the risk of transmission of dysentery-causing pathogens.

How is Dysentery Diagnosed?

The diagnosis of dysentery requires a comprehensive approach involving clinical evaluation, laboratory testing, and sometimes imaging studies to identify the underlying cause and guide appropriate treatment. Here's an overview of the diagnostic process:

  • Clinical evaluation: The doctor will first review the patient's medical history, including symptoms and recent travel or exposure to potentially contaminated food or water. A physical examination may also be conducted to assess vital signs and check for signs of dehydration or abdominal tenderness.
  • Stool analysis: A stool sample may be collected and sent to a laboratory for analysis. Microscopic examination of the stool can reveal the presence of blood, mucus, parasites, bacteria, or other pathogens. Stool cultures may also be performed to identify specific bacteria responsible for the infection, such as Shigella or Campylobacter.
  • Blood tests: In some cases, blood tests may be performed to assess for signs of infection, inflammation, or dehydration. Blood tests may include a complete blood count (CBC) to check for elevated white blood cell count (indicating infection) and electrolyte levels to evaluate for dehydration.
  • Imaging studies: In severe cases or when complications are suspected, imaging studies such as abdominal X-rays or ultrasound may be performed to assess for signs of intestinal inflammation, obstruction, or other abnormalities.
  • Diagnostic tests for specific pathogens: If a specific pathogen is suspected based on clinical presentation or epidemiological factors, targeted diagnostic tests may be performed. For example, tests for detecting Entamoeba histolytica antigens or DNA may be conducted if amoebic dysentery is suspected.
  • Endoscopy: In some cases, an endoscopy or colonoscopy may be performed to directly visualise the lining of the colon and obtain tissue samples for further analysis (biopsy). This procedure may be indicated if the diagnosis is unclear or if complications such as inflammatory bowel disease are suspected.

How is Dysentery Treated?

The treatment for dysentery depends on the underlying cause (bacterial, parasitic, or viral) and the severity of symptoms. Here are some general measures that may help in treating dysentery:

  • Fluid replacement: Rehydration is crucial in managing dysentery, especially if diarrhoea is severe and there is a risk of dehydration. Drinking plenty of fluids, such as water, oral rehydration solutions (ORS), clear broths, and electrolyte-rich drinks, can help replace lost fluids and electrolytes. Intravenous fluids may be necessary in severe cases.
  • Antibiotics or antiparasitic medications: If dysentery is caused by bacterial infection, antibiotics such as azithromycin, ciprofloxacin, or trimethoprim/sulfamethoxazole may be prescribed to target the specific bacteria responsible. For amoebic dysentery caused by Entamoeba histolytica, antiparasitic medications such as metronidazole or tinidazole are commonly used.
  • Symptomatic relief: Over-the-counter medications such as loperamide (Imodium) may be used to help control diarrhoea and reduce frequency of bowel movements. However, these medications should be used cautiously and only under medical supervision, as they can sometimes worsen certain types of dysentery.
  • Rest and nutrition: Adequate rest and a bland diet may help alleviate symptoms and support recovery. Avoiding spicy, fatty, or difficult-to-digest foods can help minimise irritation to the inflamed intestines. Gradually reintroducing solid foods as tolerated is important to ensure adequate nutrition.

Note: In some cases, especially if complications develop, hospitalisation may be necessary for close monitoring and intravenous fluid administration.

What are the Complications of Dysentery?

Dysentery can lead to several potential complications, especially if left untreated or if the infection is severe. Some of the complications associated with dysentery include:

  • Dehydration: The persistent diarrhoea associated with dysentery can lead to significant fluid loss, resulting in dehydration. Dehydration can be particularly dangerous, especially in young children, the elderly, and individuals with weakened immune systems.
  • Electrolyte imbalance: Diarrhoea can also cause an imbalance of electrolytes in the body, such as sodium, potassium, and chloride. This imbalance can further exacerbate dehydration and lead to additional health issues.
  • Malnutrition: Prolonged dysentery can interfere with the body's ability to absorb nutrients from food, leading to malnutrition and weakness.
  • Systemic infection: In severe cases, the bacteria or parasites causing dysentery can enter the bloodstream, leading to a systemic infection. This can result in a condition known as sepsis, which is a medical emergency requiring immediate treatment.
  • Rectal prolapse: In rare cases, chronic straining during bowel movements due to dysentery can lead to rectal prolapse, where part of the rectum protrudes through the anus.
  • Hemolytic Uremic Syndrome (HUS): Certain strains of bacteria, such as certain types of Escherichia coli (E. coli), can cause a serious complication known as hemolytic uremic syndrome (HUS). HUS is characterised by the destruction of red blood cells, low platelet count, and kidney failure. It most commonly affects children and can be life-threatening.
  • Spread of infection: Dysentery is highly contagious, especially in settings where proper hygiene practices are not observed. If left untreated, dysentery can contribute to the spread of infection to others.

Untreated dysentery can result in significant morbidity and mortality, particularly in areas with limited access to healthcare or in populations with compromised immune systems. Therefore, prompt diagnosis and appropriate treatment are essential to prevent complications and promote recovery.

How to Prevent Dysentery?

Preventing dysentery involves practising good hygiene and taking precautions to avoid exposure to the pathogens that cause the condition. Here are some effective preventive measures:

  • Handwashing: Wash hands thoroughly with soap and water, especially after using the toilet, changing diapers, and before handling food or eating. Proper handwashing is one of the most effective ways to prevent the spread of dysentery-causing pathogens.
  • Safe food and water practices: Ensure that food is cooked thoroughly, especially meat, poultry, and seafood. Avoid consuming raw or undercooked foods, unpasteurized dairy products, and untreated water from potentially contaminated sources. Drink safe and clean water, including bottled water or water that has been boiled or treated with chlorine or iodine tablets.
  • Practise good personal hygiene: Avoid close contact with individuals who have symptoms of dysentery, and do not share personal items such as towels, utensils, or food with them.
  • Sanitation: Maintain clean and sanitary living conditions, including properly disposing of human waste and sewage, and ensuring that toilets and sanitation facilities are properly constructed and maintained.
  • Travel precautions: If travelling to areas with a higher risk of dysentery, take precautions to ensure food and water safety, such as consuming only bottled or purified water, avoiding street food, and practising good hand hygiene.
  • Vaccination: In some cases, vaccines may be available to prevent certain types of dysentery. For example, vaccines are available for some strains of Shigella bacteria.
  • Proper food handling: Follow safe food handling practices, such as washing fruits and vegetables thoroughly before consumption, storing food at the appropriate temperature, and avoiding cross-contamination between raw and cooked foods.

By following these preventive measures, you can significantly reduce the risk of contracting dysentery and other gastrointestinal infections. It's important to be especially vigilant in settings where sanitation and hygiene may be compromised, such as when travelling or during outbreaks of diarrheal diseases.

Final words

If you or a loved one experience symptoms of dysentery such as severe diarrhoea, abdominal pain, or dehydration, don’t waste time in seeking medical attention. The specialists at Max Healthcare are well-equipped to diagnose and treat dysentery effectively, providing personalised care and support to ensure a speedy recovery. Book a consultation today.