Dysentery

Dysentery is a serious gastrointestinal condition marked by inflammation of the intestines, primarily the colon, leading to severe diarrhoea often mixed with blood or mucus. It is commonly caused by infections with bacteria or parasites and is prevalent in areas with poor sanitation, inadequate access to clean water, and insufficient healthcare resources.

Despite being preventable and treatable, dysentery continues to affect millions of people globally, particularly in developing countries. Children, the elderly, and individuals with compromised immunity are especially vulnerable. Timely diagnosis and treatment are essential to prevent complications such as dehydration, malnutrition, and even death.

This guide explores dysentery in detail—from its causes and symptoms to treatment, prevention strategies, and support for those affected.

Dysentery refers to an inflammatory disorder of the intestine, particularly the colon, resulting in severe diarrhoea that often contains blood, mucus, or pus. It typically arises due to infections caused by bacteria or protozoa, though viruses or chemical irritants can occasionally be responsible.

The condition is a major contributor to morbidity and mortality in under-resourced regions. In most cases, dysentery is transmitted through contaminated food or water, making it a public health challenge in areas lacking sanitation.

Worldwide Prevalence

According to the World Health Organization (WHO), dysentery is responsible for millions of cases of illness and hundreds of thousands of deaths each year, particularly among children under the age of five. Shigellosis, one of the primary bacterial causes of dysentery, accounts for over 165 million cases annually, mostly in developing countries.

Prevalence in India

Dysentery remains a major health burden in India. Studies estimate that bacterial dysentery accounts for up to 13% of all cases of childhood diarrhoea. Poor sanitation, overcrowding, and inadequate access to clean drinking water contribute significantly to its prevalence, especially in rural and urban slum areas. Seasonal outbreaks are common, particularly during the monsoon.

There are two main types of dysentery:

1. Bacillary Dysentery:
   
   • Caused by bacteria, especially the Shigella species.
   • Characterised by bloody diarrhoea, high fever, and abdominal cramps.
2. Amoebic Dysentery:
   
   • Caused by the protozoan parasite Entamoeba histolytica.
   • More common in tropical and subtropical regions.
   • Can become chronic and lead to complications like liver abscesses.

The primary causes of dysentery are infections transmitted through contaminated food, water, or direct contact with faecal matter.

Common Pathogens:

• Bacteria: Shigella, Salmonella, E. coli, Campylobacter
• Parasites: Entamoeba histolytica
• Viruses: Less commonly involved, but rotavirus and norovirus may cause similar symptoms.

Contributing Factors:

• Poor sanitation and hygiene practices
• Drinking unclean water
• Eating contaminated food
• Close contact with infected individuals
• Malnutrition, which weakens immunity

The symptoms of dysentery can range from mild to severe, depending on the type of infection and the individual’s overall health.

Common Symptoms:

• Watery or bloody diarrhoea
• Abdominal cramps and pain
• Fever and chills
• Nausea and vomiting
• Fatigue and weakness
• Dehydration (dry mouth, reduced urination, sunken eyes)
• Tenesmus (frequent urge to defecate with little stool passage)

In severe cases, dysentery can lead to rapid dehydration and electrolyte imbalances, making prompt treatment crucial.

Diagnosing dysentery involves a combination of clinical assessment and laboratory tests.

Diagnostic Methods:

• Stool examination: To detect blood, mucus, parasites, or bacteria.
• Stool culture: Helps identify the specific bacterial strain.
• Microscopy: Useful for detecting Entamoeba histolytica cysts or trophozoites.
• Blood tests: To assess dehydration and systemic infection.
• PCR (Polymerase Chain Reaction): For rapid identification of pathogens.

Early diagnosis allows for targeted treatment and helps prevent the spread of infection.

Treatment depends on the cause and severity of the disease.

General Treatment:

• Hydration therapy: Oral rehydration salts (ORS) to replace lost fluids.
• Nutritional support: Easily digestible food and adequate calories to support recovery. You can check Vitamins Supplements on Dawaadost.

Specific Treatment:

• Bacterial Dysentery:
  
  • Antibiotics such as ciprofloxacin, azithromycin, or cefixime. (Aady 500mg Tablet)
• Amoebic Dysentery:
  
  • Anti-parasitic medications like metronidazole followed by a luminal agent (Metris 500mg Infusion)

Hospitalisation:

• Needed for severe dehydration, persistent vomiting, or complications.
• Intravenous fluids and antibiotics may be required.

Self-medication is discouraged as inappropriate treatment can worsen the condition or cause drug resistance.

While conventional treatment remains essential, some alternative remedies may help manage mild symptoms:

• Probiotics: Can restore healthy gut flora.
• Herbal teas: Ginger or peppermint may soothe abdominal cramps.
• Isabgol (psyllium husk): Helps bulk stools in mild cases.
• Turmeric milk: Known for anti-inflammatory properties.

Always consult a healthcare professional before using alternative remedies, especially in children or elderly individuals.

Certain factors increase the risk of developing dysentery:

• Poor sanitation and hygiene
• Travelling to endemic areas
• Consuming street food or untreated water
• Immunocompromised conditions (HIV/AIDS, chemotherapy)
• Malnutrition
• Young children and the elderly
• Crowded living conditions (e.g., refugee camps)

If untreated or inadequately treated, dysentery can lead to serious complications:

• Severe dehydration and electrolyte imbalance
• Malnutrition due to poor nutrient absorption
• Intestinal perforation (rare but serious)
• Liver abscess in amoebic dysentery
• Sepsis (systemic infection)
• Recurrent infections in immunocompromised individuals

Prompt medical attention and adherence to treatment reduce the risk of long-term effects.

Living with dysentery, especially if chronic or recurring, requires practical management strategies:

• Stick to a soft, bland diet (e.g., rice, bananas, boiled potatoes).
• Drink small amounts of water frequently.
• Use ORS to stay hydrated.
• Avoid dairy and high-fibre foods until recovery.
• Get plenty of rest.
• Follow the full course of prescribed medication.

Monitor for warning signs and seek medical help if symptoms worsen.

1. "It’s just regular diarrhoea."
   
   
   • Dysentery involves inflammation and often blood or mucus in the stool.
      
2. "Only children get it."
   
   
   • While common in children, adults are also at risk, especially in poor sanitary conditions.
      
3. "It doesn't need medical treatment."
   
   
   • Untreated dysentery can lead to serious complications and even death.
      
4. "Boiling water is unnecessary."
   
   
   • Boiling or filtering water is essential in areas with contaminated supplies.
      
5. "All diarrhoea should be treated with antibiotics."
   
   
   • Only bacterial or amoebic dysentery requires antibiotics. Misuse can lead to resistance.

Seek immediate medical attention if you experience:

• Blood or mucus in stools
• High fever
• Signs of dehydration (dry mouth, dizziness, low urine output)
• Persistent vomiting
• Severe abdominal pain
• Symptoms lasting more than three days

Early intervention improves recovery and prevents complications.

• What is the likely cause of my symptoms?
• Do I need antibiotics or antiparasitic medication?
• How can I prevent recurrence?
• What should I eat or avoid during recovery?
• When should I return for follow-up?
• Is my condition contagious to family members?

Support involves both care and empathy:

• Help them stay hydrated with ORS and fluids.
• Prepare easy-to-digest meals.
• Maintain cleanliness in the patient’s surroundings.
• Encourage medication adherence.
• Monitor for signs of complications.
• Be emotionally supportive, especially if the illness is prolonged.

Dysentery remains a major global health issue, especially in developing nations like India. Although it is largely preventable and treatable, lack of awareness and inadequate sanitation continue to drive its spread. Early diagnosis, appropriate treatment, and proper hygiene are key to managing and controlling dysentery.

Empowering communities with information and access to clean water and medical care can significantly reduce the burden of this disease. Whether you’re a patient, caregiver, or health worker, understanding dysentery is essential in protecting yourself and others.