Dysentery

Individuals with dysentery shed germs in their stool during diarrhea and for up to one to two weeks afterward. The disease is highly contagious, and even a small amount of germs can lead to infection. Common transmission methods include:

• Touching contaminated surfaces (e.g., taps, toilet seats, or handles) and then touching food or the mouth, particularly after caring for an infected person or changing their diaper.
• Eating food that is raw, undercooked, or prepared by someone infected with dysentery. Fruits and vegetables may also become contaminated if washed with unclean water or grown in soil polluted with human waste.
• Drinking water contaminated with fecal matter. The risk increases if water sources are not properly separated from waste water.
• Swallowing infected water while swimming in lakes, rivers, or public pools.
• Engaging in sexual activity involving anal-oral contact with an infected person or someone who has recently recovered from the disease.

Due to the overlap of symptoms with other gastrointestinal conditions, dysentery can be easily confused with other diseases.

To confirm a diagnosis, lab tests are required to identify the causative organisms, such as Shigella or Entamoeba histolytica. Stool examination and stool culture can detect these microorganisms and determine their sensitivity to antibiotics.

Supportive tests like a complete blood count (CBC) may be performed to assess the severity of the infection and rule out other possible causes of similar symptoms.

Dysentery can be avoided by maintaining proper hygiene practices, such as:

• Always wash hands with soap and water before eating and after using the restroom.
• Avoid consuming unhygienic, uncooked, or roadside food.
• Wash vegetables thoroughly before cooking.
• Do not eat raw food; peel fruits and vegetables before eating.
• Drink only purified or mineral water.
• Avoid consuming ice unless you are certain it was made from clean water.
• Avoid using unclean toilets.
• Refrain from sharing personal hygiene items, such as towels.

Specialists to Visit

If you experience symptoms of dysentery, it is important to consult a doctor to avoid serious health issues. Children may require care from a pediatrician, while adults should visit:

• General physician
• Gastroenterologist

The treatment for dysentery focuses on supportive care and eliminating the causative organisms:

Antibiotics and antiparasitics

Depending on the cause of dysentery, your doctor may recommend antibiotics for bacterial dysentery or antiparasitics for amoebic dysentery. Examples of medications include:

• Ciprofloxacin
• Azithromycin
• Norfloxacin-Tinidazole
• Ofloxacin-Ornidazole
• Trimethoprim-sulfamethoxazole
• Metronidazole

Supportive care

To manage symptoms like fever, antipyretics such as paracetamol are used. Oral rehydration salts (ORS) help prevent dehydration. Anti-diarrhea drugs, such as loperamide, should only be used as per a doctor's advice, as they may worsen the condition.

If left untreated, severe dysentery can lead to:

• Extreme weakness and dehydration
• Hypovolemic shock due to severe fluid loss, which can result in unconsciousness or even death without timely treatment
• Toxic megacolon, a serious condition where the large intestine expands excessively
• Secondary gastrointestinal infections
• Gastrointestinal bleeding, which may cause black stools
• Low potassium levels, leading to life-threatening heart arrhythmias
• Seizures
• Post-infectious arthritis, causing joint pain, eye irritation, and painful urination
• Hemolytic uremic syndrome (HUS), a kidney complication resulting from bacterial toxins damaging red blood cells
• Rarely, amoebic dysentery can lead to liver abscesses or spread to the lungs or brain
• Sepsis, especially in those with weakened immune systems

Alternative treatments for dysentery are limited, though Ayurveda offers some remedies to help manage the condition. Known as 'Pravahika' in Ayurveda, these treatments aim to eliminate the causative organism, aid nutrient absorption in the intestines, and stimulate digestive enzymes. Ayurvedic medicines prescribed by a certified practitioner may include:

• Kutajghan Vati
• Bilvadi Churna with Takra
• Chitrakadi Gutika

If you're dealing with dysentery at home, it's important to consume light, easily digestible foods and avoid spicy or fatty foods. Raw fruits and vegetables should be thoroughly washed before eating. Drink plenty of liquids such as coconut water and buttermilk to stay hydrated.

To manage dysentery at home:

• Drink purified water only.
• Stay hydrated by drinking plenty of water or electrolyte solutions.
• Take enough rest.
• Eat light, easy-to-digest foods when you feel better.
• Wash your hands with soap and water before every meal and after using the toilet.

Dysentery can lead to serious complications if left untreated, making it essential to seek medical help promptly. During an episode, individuals may feel weak and fatigued, so it is important to rest and maintain proper hydration.

To prevent spreading the infection to others, follow these guidelines:

• Wash hands thoroughly with soap and water after using the toilet.
• Disinfect toilet seats, flush handles, taps, and sinks with detergent and hot water.
• Wash clothes, bedding, and towels separately using hot water.
• If symptoms persist, take the following precautions until you are symptom-free for at least 48 hours:

1. Stay isolated from family members
2. Avoid work or school
3. Refrain from preparing food for others
4. Avoid swimming pools
5. Avoid sexual activity