Dysentery Overview

Dysentery is a gastrointestinal disease. It causes severe diarrhea that contains blood or mucus. According to studies, there are about 1.7 billion cases of dysentery every year in the world. Causes include bacterial or parasitic infections. Though many people with dysentery feel better after a few days without medical treatment, it can be fatal. Dysentery is considered a presumptive condition for many veterans. 

Dysentery Types

  • Amoebic dysentery (amoebiasis):The parasite Entamoeba histolytica (E. histolytica) is one of the main causes of amoebic dysentery. Other parasites that cause amoebic dysentery include Balantidium coli (B. coli) and strongyloidiasis.
  • Bacillary dysentery:A bacterial infection causes bacillary dysentery.

Dysentery Signs and Symptoms

With all dysentery, you will experience rapid dehydration. If you have severe dysentery, complications may include extreme inflammation, widening (dilation) of your large intestine and acute kidney disease.

Symptoms of rapid dehydration may include:

  • Confusion
  • Dark-colored pee or difficulty peeing
  • Dizziness or lightheadedness
  • Dry mouth, dry eyes, dry cough
  • Headache
  • Muscle cramps
  • Swollen feet

Mild symptoms of amoebic dysentery may include:

  • Diarrhea
  • High fever
  • Nausea and vomiting
  • Weight loss
  • Upset stomach
  • Parasite may move to other areas of body and cause abscess (rare)

Symptoms of bacillary dysentery may include:

  • Diarrhea containing blood or mucus
  • High fever
  • Nausea and vomiting
  • Painful stomach cramps (abdominal pain)

Dysentery Risk Factors

The parasitic and bacterial infections that cause dysentery are very contagious. People usually transfer the parasite or bacteria to each other when poop (fecal matter) from an infected person gets into another person’s mouth. Transmission can occur during:

  • Food preparation by someone who doesn’t wash their hands or has poor hygiene.
  • Drinking contaminated water.
  • Sexual contact, especially involving the anus.

Bacillary dysentery occurs when foreign bacteria enter your body, and the infection becomes severe. Some of the most common bacteria that cause bacillary dysentery include:

  • Shigella, which leads to shigellosis.
  • Salmonella, which causes salmonella.
  • Campylobacter, which causes campylobacteriosis.
  • Escherichia coli, which leads to  coli infection.
  • Amoebiasis occurs when a particular parasite enters your body.

Possible long-term complications include:

  • Postinfectious arthritis: This affects about two percent of people who get a particular strain of the Shigella bacteria called S. flexneri. These people can develop joint pain, eye irritation, and painful urination. Postinfectious arthritis can last for months or years.
  • Blood stream infections: These are rare and most likely to affect people with weak immune systems, such as people with HIV or cancer.
  • Seizures: Sometimes young children can have generalized seizures. It isn’t clear why this happens. This complication generally resolves without treatment.
  • Hemolytic uremic syndrome (HUS):One type of Shigella bacteria, S. dysenteriae, can sometimes cause HUS by making a toxin that destroys red blood cells.
  • In rare cases, amebic dysentery can result in liver abscess or parasites spreading to the lungs or brain.

Dysentery Treatment

Rehydration: The most crucial aspect, using oral rehydration therapy or, in severe cases, intravenous fluids. Mild shigellosis is usually treated just with rest and plenty of fluids. Over-the-counter medication, such as bismuth subsalicylate (Pepto-Bismol), can help relieve cramps and diarrhea. You should avoid drugs that slow down the intestines, such as loperamide (Imodium) or atropine-diphenoxylate (Lomotil), which can make the condition worse.

Antibiotics: Prescribed by a doctor to kill the bacteria or parasite causing the infection. Severe shigellosis can be treated with antibiotics, but the bacteria that causes it are often resistant. If your doctor prescribes an antibiotic and you don’t see improvement after a couple of days, let the doctor know. Your strain of Shigella bacteria may be resistant, and your doctor may need to adjust your treatment plan.

Hospitalization: May be necessary for severe cases that cannot be managed with oral fluids. Amebic dysentery is treated with metronidazole (Flagyl) or tinidazole (Tindamax). These drugs kill the parasites. In some cases, a follow-up drug is given to make sure all the parasites are gone.

In severe cases, your doctor may recommend an intravenous (IV) drip to replace fluids and prevent dehydration.

Other Resources and Support

https://www.cdc.gov/parasites/causes/

https://www.va.gov/disability/eligibility/former-pows/

https://my.clevelandclinic.org/health/drugs/23567-dysentery

https://www.healthline.com/health/digestive-health/dysentery