| Dysentery is a general term for inflammation of the intestines that results in severe or bloody diarrhea. The inflammation is usually caused by bacterial toxins, viruses, protozoa, or worms but can also be caused by chemical irritants. Dysentery is typically contracted through contaminated food or water but can also be transmitted from one individual to another and via feces from infected individuals.
The two most common types of dysentery are bacillary dysentery and amebic dysentery. Bacillary dysentery, most often caused from infection by the bacterium Shigella, is also called shigellosis. Other bacterial agents responsible for dysentery include Vibrio cholerae, Escherichia coli, Clostridium difficile, Salmonella, Campylobacter jejuni, and Yersinia enterocolitica.
Amebic dysentery is most often caused by infection by the microscopic parasite Entamoeba histolytica, which can exist in two forms, either as free amebae or as infective cysts. This infection is also more common in tropical, subtropical, and developing countries. Ninety percent of carriers are asymptomatic.
Viruses such as the rotavirus and the Norwalk virus can also cause dysentery.Risk: Shigellosis is most common in developing countries, where it is present most of the time (endemic). Severe crowding and poor sanitation contribute to the spread of the disease. Bacillary dysenteries also occur each year in the US. In developed countries such as the US, amebic dysentery is most common in immigrants from countries where the disease is common; in homosexual men; and in residents of institutions such as prisons, nursing homes, and institutions for the developmentally disabled. With less impact on the workplace, diarrhea imposes the most severe suffering on the very old and the very young. Incidence and Prevalence: Each year in the US there are approximately 18,000 cases of shigella enteritis ("Shigella Enteritis"). The prevalence for amebiasis in the US approaches 4% (Horga). |
Source: Medical Disability Advisor
| History: Those exposed may experience mild, severe, or no symptoms at all. The upper extreme is noted in cholera patients, who may eliminate over a quart of fluid an hour. More often, individuals complain of abdominal pain, nausea, frequent watery (often foul-smelling) diarrhea accompanied by blood and mucus, fever, and rectal pain. Vomiting, generalized muscle aches, and rapid weight loss can also accompany dysentery. Rarely, the amebic parasite will invade the body beyond the intestines and spread through the bloodstream, more seriously infecting other organs such as the liver, lungs, and brain. Physical exam: The skin, mouth, and lips may appear dry due to dehydration. Lower abdominal tenderness may be present. Tests: Cultures of stool samples are examined to identify the organism causing dysentery. Often several samples must be obtained because the number of amoeba changes from day to day. Blood tests are used to measure abnormalities in the levels of essential minerals and salts (electrolytes). |
Source: Medical Disability Advisor
| Treatment may not be necessary for mild cases of dysentery. For more severe cases, or cases caused by Shigella, cholera, Salmonella, C. difficile, Giardia, amebae, or sexually transmitted diseases, antibiotics are used to kill the responsible microorganisms. Identification of the organism that is causing the dysentery is important to determine the correct antibiotic. Symptoms such as dehydration are treated by fluid replacement, either orally or intravenously.
Antidiarrheal medications such as diphenoxylate (Lomotil) and loperamide (Imodium) are not recommended because they can actually aggravate the diarrhea by prolonging contact of the pathogen with the lining of the intestines.
It is important for individuals with dysentery, as well as those having contact with that individual, to practice careful personal hygiene. Handwashing after defecation and before handling food is especially important. |
Source: Medical Disability Advisor
| With proper treatment, most cases of bacterial and amebic dysentery will subside within 10 days, and most individuals will recover fully within 2 to 4 weeks after beginning treatment. The prognosis for untreated disease varies with the immune status of the individual and the severity of disease. Extreme dehydration will prolong recovery and put the individual at greater risk for serious complications. |
Source: Medical Disability Advisor
| Dehydration is a common complication of diarrhea. Sepsis, seizures, kidney failure, and hemolytic uremia are rare complications of dysentery. |
Source: Medical Disability Advisor
| The individual may require quarantine for up to 1 week. Food handlers need to be infection-free before they resume working. Accommodations and extended medical restrictions may be required for severe dehydration or untreated cases of severe disease. |
Source: Medical Disability Advisor
| If an individual fails to recover within the expected maximum duration period, the reader may wish to consider the following questions to better understand the specifics of an individual's medical case. Regarding diagnosis:
- Has individual complained of abdominal pain, nausea, frequent watery (often foul-smelling) diarrhea accompanied by blood and mucus, fever, and rectal pain? Were there vomiting, generalized muscle aches, and rapid weight loss?
-
Are skin, mouth, and lips dry? Is the abdomen tender?
-
Were cultures of stool samples examined? Has the causative organism been positively identified? Were blood tests done to measure abnormalities in the levels of essential minerals and salts (electrolytes)?
-
Has diagnosis of dysentery been confirmed?
Regarding treatment:
- Was culture and sensitivity done to determine the most effective antibiotic to use?
-
Are the organisms causing dysentery resistant to the antimicrobial drugs used? Is a change in antibiotics warranted?
-
Is individual experiencing a reaction to the current medication?
-
Should diagnosis be revisited?
-
If not able to replace fluid loss orally, has individual received intravenous rehydration?
-
Is individual self-treating with over-the-counter antidiarrheal medication?
Regarding prognosis:
- Did individual delay seeking treatment?
-
How much longer than expected have symptoms persisted?
-
Does individual continue to be exposed to infective organisms or chemicals that may be causing the dysentery?
-
Does individual have an underlying condition that may affect recovery?
|
Source: Medical Disability Advisor
| Horga, Maria A., and Thomas R. Naparst. "Amebiasis." eMedicine. Eds. Michael D. Nissen, et al. 1 Jul. 2004. Medscape. 16 Dec. 2004 <http://emedicine.com/ped/topic80.htm>. "Shigella Enteritis." MedlinePlus. National Library of Medicine. 16 Dec. 2004 <http://www.nlm.nih.gov/medlineplus/ency/article/000295.htm>. |
Source: Medical Disability Advisor
| Feedback |
| Send us comments, suggestions, corrections, or anything you would like us to hear. If you are not logged in, you must
include your email address, in order for us to respond. We cannot, unfortunately, respond to every comment.
If you are seeking medical advice, please contact your physician. Thank you! |
Send this comment to:
Sales
Customer Support
Content Development
|
|
| |
|
|
|
|
|
This publication is designed to provide accurate and authoritative information in
regard to the subject matter covered. It is published with the understanding that
the author, editors, and publisher are not engaged in rendering medical, legal,
accounting or other professional service. If medical, legal, or other expert assistance
is required, the service of a competent professional should be sought. We are unable to respond to requests for advice.
Any Sales inquiries should include an email address or other means of
communication.
|