Dysentery (patient information)

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Overview[edit | edit source]

Dysentery is bloody diarrhoea, i.e. any diarrhoeal episode in which the loose or watery stools contain visible red blood. Dysentery is most often caused by Shigella species (bacillary dysentery) or Entamoeba histolytica (amoebic dysentery).

What are the symptoms of Dysentery ?[edit | edit source]

Symptoms include:

• Acute (sudden) abdominal pain or cramping
• Acute (sudden) fever
• Blood, mucus, or pus in stool
• Crampy rectal pain (tenesmus)
• Nausea and vomiting
• Watery diarrhea

What causes Dysentery ?[edit | edit source]

• Enterohemorrhagic E. coli
• Campylobacter
• Salmonellaspp.
• Shigella
• Entamoeba histolytica
• Medications
• Cancer
• Yersinia

Who is at highest risk?[edit | edit source]

Outbreaks of shigellosis are associated with poor sanitation, contaminated food and water, and crowded living conditions.

Shigellosis is common among travelers in developing countries and workers or residents of refugee camps.

The condition is most commonly seen in day care centers and group living places.

When to seek urgent medical care?[edit | edit source]

Call your provider if diarrhea does not improve, if there is blood in the stool, or if there are signs of dehydration.

Go to the emergency room if the following occur in a person with shigellosis:

• Confusion
• Headache with stiff neck
• Lethargy
• Seizures

Such symptoms are most common in children.

Diagnosis[edit | edit source]

• Dehydration with fast heart rate and low blood pressure
• Abdominal tenderness
• Elevated white blood cell count
• Stool culture
• White blood cells in stool

Treatment options[edit | edit source]

The goal of treatment is to replace fluids and electrolytes (salt and minerals) lost in diarrhea.

Medications that stop diarrhea are generally not given because it make cause the infection to take longer to go away.

Self-care measures to avoid dehydration include drinking electrolyte solutions to replace the fluids lost by diarrhea. Several varieties of electrolyte solutions are now available over the counter.

Antibiotics can help shorten the length of the illness and help prevent it from spreading to others in group living or day care situations. They may also be prescribed for patients with severe symptoms. Frequently used antibiotics include sulfamethoxazole and trimethoprim (Bactrim), ampicillin,ciprofloxacin (Cipro), or azithromycin.

If you have diarrhea and cannot drink fluids by mouth because of severe nausea, you may need medical attention and fluids through a vein ( intravenously).This is especially common in small children.

Persons who take diuretics ("water pills") may need to stop taking such medicines if they have acute shigella enteritis. Never stop taking any medicine without first talking to your health care provider.

Medications to avoid[edit | edit source]

Patients diagnosed with acute dysentry should avoid using the following medications:

• Loperamide
  If you have been diagnosed with acute dysentry, consult your physician before starting or stopping any of these medications.

Where to find medical care for Dysentery ?[edit | edit source]

Directions to Hospitals Treating Dysentery

What to expect (Outlook/Prognosis)?[edit | edit source]

Often the infection is mild and goes away on its own. Most patients, except malnourished children and those with weakened immune systems, have an excellent outlook.

Possible complications[edit | edit source]

Complications may include

• Dehydration - severe
• Hemolytic-uremic syndrome (HUS), a form of kidney failure with anemia and clotting problems
• Reactive arthritis

About 1 in 10 children with severe shigella enteritis develop neurological problems including febrile seizures or brain disease (encephalopathy) withheadache, lethargy, confusion, and stiff neck.

Prevention[edit | edit source]

Prevention involves the proper handling, storage, and preparation of food, in addition to good cleanliness. Hand washing is the most effective preventive measure. Avoid contaminated food and water.