Dysentery

Dysentery causes irritation and inflammation of the intestines that may result in a number of symptoms. The symptoms can vary in intensity among individuals.

The most common symptoms of dysentery are related to disturbances of the digestive system and include:

• Abdominal bloating

• Abdominal pain

• Bloody diarrhea (may also be watery or with mucus)

• Cramping

• Flatulence

• Nausea with or without vomiting

As the dysentery infection progresses, other symptoms, including symptoms of dehydration, may develop. Other possible symptoms include:

• Decreased urine output

• Dry skin and mucous membranes (such as dry mouth)

• Feeling very thirsty

• Fever and chills

• Muscle cramps

• Muscle weakness (loss of strength)

• Weight loss

On rare occasions, dehydration resulting from dysentery may be so severe that a life-threatening situation can develop. Seek immediate medical care (call 911) if you, or someone you are with, have any of the following symptoms:

• Change in level of consciousness or alertness, such as passing out or unresponsiveness

• Change in mental status or sudden behavior change, such as confusion, delirium, lethargy, hallucinations and delusions

• High fever (higher than 101 degrees Fahrenheit)

• Rapid heart rate (tachycardia)

• Severe abdominal pain

• Severe dizziness

The bacteria Shigella and E coli and the amoeba Entamoeba histoly tica are the most common causes of dysentery . These organisms are present in the stool (feces) of infected people and animals. The Entamoeba histolytica may uneventfully reside in the colon, but if it attacks the colon wall, it can cause dysentery. People with weakened immune systems are also more likely to develop amebic dysentery.

Most commonly, dysentery is caused by drinking water or eating food from sources contaminated with feces containing the pathogens. Swimming in contaminated water may also result in dysentery. For this reason, dysentery occurs most frequently in people traveling to developing countries and in children who touch infected human or animal feces without proper hand washing.

Several organisms are known to cause dysentery, most commonly:

• Campylobacter

• Certain types of

  E coli

• Entamoeba histolytica

• Salmonella

• Shigella

A number of factors increase the risk of developing dysentery. Not all people with risk factors will get dysentery. Risk factors for dysentery include:

• Attendance or work in a day care setting

• Close contact with an infected person or animal

• Consumption of untreated water from lakes, rivers or streams

• Fecal to oral contact

• Travel in countries where the infection is common

• Use of public swimming pools

You can lower your risk of developing or transmitting dysentery by:

• Avoiding swallowing water in swimming pools, hot tubs, or other recreational water sources

• Drinking only purified water when backpacking, camping or hiking

• Drinking only purified water when visiting developing countries

• Using purified water for brushing your teeth and washing food when visiting developing countries

• Washing your hands well with soap and water after touching feces, having contact with an infected person or animal, changing diapers, or using the bathroom, and before eating or preparing food

Treatment for dysentery begins with seeking medical care from your health care provider. To determine if you have dysentery, your health care provider may ask you to provide stool samples for laboratory testing.

Antibiotic therapy is the mainstay of treatment for dysentery due to bacterial organisms and is highly effective. It is important to follow your treatment plan for dysentery precisely and to take all of the antibiotics as instructed to avoid reinfection or recurrence.

Antibiotic medications that are effective in the treatment of dysentery caused by bacterial organisms include:

• Ceftriaxone (Rocephin)
• Ciprofloxacin (Cipro)
• Trimethoprim-sulfamethoxazole (Bactrim, Septra)

The most common treatment for amebic dysentery caused by Entamoeba histolytica is metronidazole (Flagyl), an antiparasitic medication.

If you have diarrhea and vomiting, fluid and electrolyte replenishment is also a component of successful treatment.

In addition to following your health care provider’s instructions and taking all medications as prescribed, you can speed your recovery by:

• Ensuring adequate hydration by drinking plenty of water and electrolyte solutions
• Getting plenty of rest

If you have dysentery, it is important to practice good hygiene to avoid spreading the infection to those who have close contact with you. Wash your hands frequently with soap and water after using the bathroom or touching any contaminated bedding or clothing. Avoid use of public pools, hot tubs, or other recreational water facilities until your infection has cleared.

You can help minimize your risk of serious complications by following the treatment plan you and your health care provider design specifically for you. Complications of dysentery include:

• Electrolyte imbalance
• Intestinal obstruction
• Intestinal perforation
• Liver abscess
• Postinfectious arthritis (joint pain, eye irritation, and painful urination)
• Secondary urinary tract infection
• Seizures
• Spread of infection (sepsis, more common in immunocompromised individuals)