Dysentery (patient information)

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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).

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

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

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.

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.

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

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.

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.

Directions to Hospitals Treating Dysentery

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.

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 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.