Dysentery Treatment in Delhi, India

Dysentery is an intestinal infection that causes severe diarrhoea with the presence of blood and mucus in the stool. It is often associated with pain, fever, and abdominal cramps. While dysentery can be severe and lead to dehydration and other complications, it is usually treatable with prompt medical care. It is important to seek medical attention if symptoms are severe or persistent to prevent complications.

Dysentery, a gastrointestinal infection characterised by severe diarrhoea often containing blood or mucus, can be attributed to different types of pathogens. The two main types are bacillary dysentery, caused by bacteria, and amoebic dysentery, caused by a parasite.

Bacillary Dysentery

Bacillary dysentery is predominantly caused by bacteria from the genus Shigella. These bacteria are highly contagious and typically spread through the faecal-oral route. This means that transmission occurs when contaminated food or water, tainted with Shigella bacteria from infected individuals' faeces, is ingested. Poor hygiene practices, such as inadequate handwashing after using the toilet, significantly contribute to its spread.

Amoebic Dysentery

In contrast, amoebic dysentery is caused by a parasite known as Entamoeba histolytica. This parasite exists in two main forms: a motile trophozoite stage within the intestines and a cyst stage that can survive outside the body, particularly in contaminated environments. Transmission of Entamoeba histolytica occurs similarly through the ingestion of food or water contaminated with cysts shed in the faeces of infected individuals. This mode of transmission is closely linked to poor sanitation practices and inadequate hygiene.

Understanding the distinct causes of bacillary and amoebic dysentery is crucial for effective prevention strategies and treatment protocols. By addressing the specific pathogens responsible and their respective transmission pathways, healthcare providers and individuals can better manage and prevent outbreaks of dysentery in communities.

Dysentery risk factors include:

• Poor Sanitation and Hygiene: Lack of clean water and hand hygiene, contaminated food and water.
• Travel to Endemic Areas: Regions where dysentery is common, such as parts of Africa, Asia, and Latin America.
• Crowded Living Conditions: Environments with compromised sanitation, like refugee camps.
• Age and Immune Status: Young children, the elderly, and those with weakened immune systems.
• Malnutrition: Weaker immune systems due to poor nutrition.
• Exposure to Contaminated Food: Raw or undercooked food, food prepared without proper hygiene.
• Lack of Access to Medical Care: Delayed or inadequate treatment.
• Certain Medications: Medications that suppress the immune system.

Preventive measures include improving sanitation and hygiene, access to clean water, handwashing, and avoiding risky foods, especially when travelling to endemic areas.

Dysentery, an intestinal infection, manifests with a range of symptoms that can vary depending on the type and severity of the infection. Understanding these symptoms is crucial for timely recognition and treatment:

• Severe Diarrhoea: The hallmark symptom of dysentery is frequent, watery stools that may occur urgently and unexpectedly.
• Bloody Diarrhoea: Particularly with bacillary dysentery, diarrhoea may contain blood and mucus due to inflammation of the intestinal lining.
• Abdominal Cramps: Intense cramping and abdominal pain are common, contributing to discomfort.
• Nausea and Vomiting: Many patients experience nausea and vomit, which can lead to dehydration.
• Fever: A fever, ranging from mild to high-grade, often accompanies dysentery as the body fights the infection.
• Dehydration: Severe diarrhoea and vomiting can lead to dehydration, characterised by thirst, dry mouth, decreased urination, dizziness, and fatigue.

If you experience symptoms of dysentery or suspect an infection, seek medical attention promptly. Early intervention can help manage symptoms effectively and prevent complications, especially in vulnerable populations.

Diagnosing dysentery involves a combination of clinical evaluation, laboratory tests, and sometimes imaging studies to identify the cause and severity of the infection. Here’s what one can expect during the diagnostic process:

• Medical History and Symptoms: The doctor will start by taking a detailed medical history and asking about the patient’s symptoms. Key symptoms of dysentery include frequent, watery stools that may contain blood or mucus, abdominal pain, fever, and dehydration. The doctor will also inquire about recent travel, dietary habits, and any potential exposure to contaminated food or water.
• Physical Examination: A physical examination helps assess the patient’s overall condition, checking for signs of dehydration, abdominal tenderness, and other related symptoms. The doctor will look for indicators such as dry mouth, decreased urine output, rapid heart rate, and low blood pressure.
• Stool Sample Analysis: The primary diagnostic test for dysentery is the analysis of a stool sample. The sample is examined for the presence of blood, mucus, white blood cells, and pathogens like bacteria, amoebas, or parasites. Common pathogens include Shigella, Entamoeba histolytica, and certain strains of E. coli.
• Blood Tests: Blood tests may be performed to check for signs of infection, inflammation, and dehydration. Complete blood count (CBC), electrolyte levels, and kidney function tests can provide valuable information about the patient’s health status.
• Culture and Sensitivity Tests: If bacterial dysentery is suspected, stool cultures can identify the specific bacteria causing the infection. Sensitivity tests help determine the most effective antibiotics for treatment.
• Serological Tests: In cases of amoebic dysentery, serological tests may be used to detect antibodies against Entamoeba histolytica in the blood.
• Imaging Studies: In severe or complicated cases, imaging studies such as abdominal X-rays or CT scans may be ordered to assess the extent of intestinal damage and rule out other conditions.
• Sigmoidoscopy or Colonoscopy: In certain cases, especially if the diagnosis is unclear or if there is severe illness, the doctor may perform a sigmoidoscopy or colonoscopy. These procedures involve using a flexible tube with a camera to examine the inside of the colon and take biopsy samples if necessary.

By combining these diagnostic methods, healthcare providers can accurately diagnose dysentery, identify its cause, and develop an appropriate treatment plan tailored to the patient’s needs. Early and accurate diagnosis is crucial for effective treatment and preventing complications associated with dysentery.

Treating dysentery involves addressing the underlying cause of the infection, relieving symptoms, and preventing complications such as dehydration. Here are the primary treatment options:

Rehydration Therapy

• Oral Rehydration Solutions (ORS): The first line of treatment for dysentery is to prevent and treat dehydration. ORS, which contains a balanced mix of salts and sugars, helps replenish lost fluids and electrolytes.
• Intravenous Fluids: In severe cases of dehydration, intravenous (IV) fluids may be necessary to quickly restore fluid balance.

Antibiotics

• Bacterial Dysentery: For bacterial causes of dysentery, such as Shigella or certain strains of E. coli, antibiotics may be prescribed. Common antibiotics include ciprofloxacin, azithromycin, and metronidazole as per the stool culture sensitivity assessment.
• Amoebic Dysentery: In cases caused by Entamoeba histolytica, metronidazole or tinidazole is typically used, followed by a luminal agent like paromomycin to eliminate any remaining amoebas in the intestines.

Antiparasitic Medications

• Parasitic Dysentery: For dysentery caused by parasites other than amoebas, such as Giardia lamblia, specific antiparasitic medications like nitazoxanide or tinidazole may be prescribed.

Pain and Fever Management

• Over-the-counter medications such as acetaminophen or ibuprofen can help manage fever and relieve abdominal pain. However, aspirin should be avoided, especially in children, due to the risk of Reye’s syndrome.

Probiotics

• Probiotics, which are beneficial bacteria, can help restore the natural balance of the gut microbiome and may aid in recovery, especially after antibiotic treatment.

Dietary Adjustments

• Fluid Intake: Encouraging the patient to drink plenty of fluids, including clear broths, herbal teas, and diluted fruit juices, can help maintain hydration.
• Bland Diet: A bland diet, including foods like bananas, rice, applesauce, and toast (BRAT diet), may help ease digestive symptoms. Avoiding spicy, fatty, or high-fibre foods can reduce irritation to the intestines.

Rest

• Adequate rest is essential to support the body's immune response and recovery from infection.

Avoiding Antidiarrheal Medications

• Medications like loperamide (Imodium) should generally be avoided in dysentery, as they can slow down the elimination of the infectious organisms from the intestines and potentially worsen the condition.

Follow-up Care

• Follow-up visits with a healthcare provider are important to ensure that the infection has been fully resolved and to monitor for any potential complications.

Practising good hygiene, such as regular handwashing with soap and water, especially after using the bathroom and before handling food, is crucial to prevent the spread of dysentery. Patients should also avoid sharing personal items and should disinfect contaminated surfaces.

If left untreated or not properly managed, dysentery can lead to several serious complications, including:

• Dehydration: This is the most common complication, especially in young children and the elderly. Frequent diarrhoea and vomiting can lead to a significant loss of fluids and electrolytes, causing weakness, dizziness, and even kidney failure in severe cases.
• Electrolyte Imbalance: Diarrhoea disrupts the balance of electrolytes (sodium, potassium, chloride) in the body, leading to muscle cramps, weakness, irregular heartbeat, and even seizures.
• Malnutrition: Dysentery can make it difficult to absorb nutrients from food, leading to malnutrition, especially in children with prolonged infection.
• Post-infectious Arthritis (PIA): This is a rare complication associated with some strains of Shigella bacteria (bacterial dysentery). It causes joint pain, inflammation, and stiffness, typically affecting large joints like knees and hips. Symptoms can last for months or even years.
• Bloodstream Infections: This is a rare but serious complication that can occur in people with weakened immune systems. The bacteria causing dysentery enters the bloodstream and can spread to other organs.
• Hemolytic Uremic Syndrome (HUS): This is a rare complication that affects the kidneys, especially in children. It can cause kidney failure, low blood cell count, and bleeding problems.

Dysentery is preventable with proper hygiene and sanitation practices. Here are some key steps to take:

• Frequent Handwashing: This is the single most effective way to prevent the spread of dysentery. Wash your hands thoroughly with soap and water after using the toilet, before eating or preparing food, and after changing diapers.
• Safe Water Consumption: Drink only bottled or purified water when travelling to areas with high rates of dysentery. Avoid tap water unless you're certain it's safe.
• Food Safety: Practise safe food handling practices. Wash fruits and vegetables thoroughly before eating. Avoid raw or undercooked foods, especially shellfish.
• Proper Sanitation: Ensure proper sewage disposal and avoid contact with contaminated water. This is particularly important in areas with poor sanitation infrastructure.
• Travel Precautions: Be mindful of food and water hygiene when travelling, especially to regions with high prevalence of dysentery. Consider consulting a healthcare professional before travel for specific recommendations on avoiding dysentery.

By following the above preventive measures, one can significantly reduce their risk of contracting dysentery and maintain good health.

Is dysentery contagious?

Yes, dysentery is highly contagious. It can spread through direct contact with an infected person, contaminated food or water, and poor hygiene practices.

When should I see a doctor for dysentery?

Seek medical attention if you experience severe diarrhoea with blood or mucus, high fever, persistent abdominal pain, dehydration, or if symptoms last more than a few days.

What medications are used to treat bacterial dysentery?

Antibiotics such as ciprofloxacin, azithromycin, or metronidazole are commonly used to treat bacterial dysentery, depending on the specific bacterial cause.

What are the side effects of antibiotics for dysentery?

Side effects of antibiotics can include nausea, vomiting, diarrhoea, abdominal pain, allergic reactions, and, in some cases, antibiotic resistance.

What dietary changes should be made during dysentery treatment?

Consume easily digestible foods such as bananas, rice, applesauce, and toast (BRAT diet). Avoid dairy, fatty, and spicy foods. Stay hydrated with oral rehydration solutions (ORS).

How can dehydration from dysentery be prevented?

Prevent dehydration by drinking plenty of fluids, including water, ORS, and clear broths. Avoid caffeinated and sugary drinks.

Can dysentery recur after treatment?

Yes, dysentery can recur if re-exposed to the causative agents or if the initial infection wasn't fully treated. Maintaining good hygiene and sanitation practices can help prevent recurrence.

Can children be treated for dysentery at home?

Mild cases can be managed at home with proper hydration and dietary care. However, seek medical advice for severe symptoms, persistent diarrhoea, or signs of dehydration.

Is there a vaccine for dysentery?

Currently, there is no widely available vaccine for dysentery. Preventive measures focus on improving sanitation and hygiene.

Can dysentery lead to long-term health issues?

Untreated or severe dysentery can lead to long-term health issues such as chronic diarrhoea, malnutrition, and, in rare cases, post-infectious irritable bowel syndrome (IBS).

Why choose Max Hospital for dysentery treatment?

Max Hospital offers comprehensive care with experienced medical professionals, state-of-the-art facilities, and personalised treatment plans to effectively manage and treat dysentery.

Can dysentery affect pregnant women differently?

Yes, dysentery can be more severe in pregnant women due to potential dehydration and nutritional deficiencies, which can affect both the mother and the unborn baby. Prompt treatment is essential.

What role does sanitation play in controlling dysentery outbreaks?

Sanitation plays a crucial role in preventing dysentery. Access to clean water, proper sewage disposal, and good personal hygiene practices are essential to control and prevent outbreaks.

Reviewed By Dr. Sagar Patil Consultant - Gastroenterology & Hepatology on 22 July 2024.