Dysentery, Causes, Diagnosis, Treatment, Prevention, Complications
Definition of Dysentery
Dysentery is an infection of the intestine that causes watery diarrhea accompanied by blood or mucus. In contrast to ordinary diarrhea, dysentery can cause severe diarrhea that needs to be treated in a hospital.
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| Dysentery, Causes, Diagnosis, Treatment, Prevention, Complications |
Dysentery is caused by a bacterial or parasitic infection. This condition is highly contagious and can cause serious illness. In addition, complications that can arise due to dysentery are not limited to the digestive system, but can also have a broad impact.
Therefore, dysentery sufferers must get proper treatment from an early age. However, it would be even better if the causes and risk factors for dysentery could be known so that this disease could be prevented.
Causes of Dysentery
Based on the cause, dysentery can be divided into two types, namely:
- Bacterial dysentery, which is dysentery caused by a bacterial infection
- Amoebic dysentery, which is dysentery due to infection with ameba parasites
Dysentery generally occurs in environments with poor sanitation, for example areas that lack clean water and areas with inadequate household waste disposal systems.
The spread of dysentery occurs due to a lack of public awareness to maintain personal hygiene, for example not washing hands after going to the toilet or before eating.
Dysentery Symptoms
Dysentery generally lasts 3–7 days and is characterized by the following symptoms:
- Diarrhea containing water, which may be accompanied by blood or mucus
- stomach cramps
- Nausea and vomiting
- Fever
Dysentery Treatment
Not all cases of dysentery require treatment from a doctor. Mild bacterial dysentery generally gets better without treatment in 3–7 days. Handling is enough to rest and maintain body fluid intake.
Meanwhile, severe dysentery can be treated with drugs to relieve symptoms and kill germs that cause infection. The patient may also need to be hospitalized to get enough fluids.
Several types of drugs used to relieve symptoms are bismuth subsalicylate and paracetamol. Meanwhile, drugs to kill the cause of infection are antibiotics, such as ciprofloxacin and metronidazole.
Causes of Dysentery
Dysentery is caused by a bacterial infection or amoeba in the intestine. After entering through the mouth, the bacteria or amoeba will multiply and attack the cells in the large intestine, causing symptoms of dysentery.
Based on the cause of infection, dysentery can be divided into two types, namely:
Bacterial Dysentery
The most common bacteria that cause dysentery are Shigella bacteria. There are 4 types of Shigella bacteria that cause dysentery, namely:
- Shigella sonnei
- Shigella boydii
- Shigella flexneri
- Shigella dysenteriae
Of the 4 types of bacteria above, Shigella dysenteria is the cause of dysentery with the most severe symptoms.
Apart from Shigella, other bacteria can also cause dysentery, for example:
- Campylobacter
- E. coli enterohemorrhagic (EHEC) or enteroinvasive (EIEC) type
- Salmonella
Amebic dysentery
This type of dysentery is caused by an amoeba (a single-celled parasite) named Entamoeba histolytica which is commonly found in tropical areas. However, not everyone infected with this parasite will experience dysentery.
Most amoebic infections will lead to amebiasis, which is characterized by diarrhea and mild abdominal cramps. Only about 10–20% of people with amoeba infection will experience dysentery with bloody diarrhea.
Bacteria and ameba that cause dysentery can come out through the patient's feces. If a person with dysentery does not wash their hands properly after defecating, the microorganisms that cause dysentery on their hands can contaminate all surfaces they touch. As a result, other people can be infected.
A person can be exposed to microorganisms that cause dysentery due to:
- Eating food contaminated with bacteria or amoebae
- Make direct physical contact with sufferers
- Touching or using items used by sufferers
- Drinking raw water contaminated with the patient's feces
Dysentery Risk Factors
Dysentery can happen to everyone. However, there are several factors that can increase a person's risk of developing dysentery, namely:
- Very young (children) or very old (elderly over 65 years old)
- Have a family member or relative who is suffering from dysentery
- Not maintaining good personal and environmental hygiene
- Have an immune system disorder, for example due to taking drugs that suppress the immune system (immunosuppressants), undergoing chemotherapy, or suffering from HIV
- Have anal sex habits
Dysentery Symptoms
The symptoms that appear in the two types of dysentery are not much different. The following is an explanation of the symptoms of each type of dysentery:
Bacterial Dysentery
Symptoms of bacterial dysentery usually appear 1–3 days after infection and can last 3–7 days. However, in some sufferers, this condition can occur without any symptoms.
Symptoms that generally appear in bacterial dysentery include:
- Watery diarrhea which may be accompanied by blood or pus
- Fever
- Stomach ache
- Nausea and vomiting
Amebic dysentery
Amoeba infection generally causes no symptoms. When they do appear, symptoms often appear 2–4 weeks after the person is exposed to the amoeba. These symptoms include:
- Watery diarrhea that can be accompanied by mucus or blood
- Abdominal cramps or pain
- Nauseous
- Weight loss
- Fever
In more severe cases, amebic dysentery can also lead to serious conditions, such as liver abscesses or accumulation of pus in the liver. This condition can cause other complaints, such as pain in the upper right abdomen and enlarged liver.
When to See a Doctor
Check with your doctor if you have bloody diarrhea or diarrhea that doesn't get better in 2 days. Immediately go to the emergency room if diarrhea is also accompanied by the following complaints:
- Unbearable pain in the stomach or rectum
- High fever (>390C)
- Weakness, thirst, and no energy (dehydration)
In children, dysentery can cause dehydration more quickly. Therefore, seek medical help immediately if diarrhea in children does not improve within 24 hours. If not treated immediately, severe dysentery can cause complications, and can even be life-threatening.
Diagnostics of dysentery
Diagnosing dysentery begins with asking questions regarding the symptoms experienced, food consumed, daily habits, and family history with similar symptoms.
Next, the doctor will carry out a physical examination, including measuring the patient's body temperature, heart rate, blood pressure, and weight. The doctor will also check the patient's skin for signs of dehydration and press on the abdomen to detect where it hurts.
After that, the doctor will carry out supporting examinations to make a diagnosis. The types of inspections that will be carried out include:
- Examination of stool samples in the laboratory, to find out whether dysentery is caused by bacteria or amoebae
- Examination of antibiotic resistance, to find out which type of antibiotic is suitable for the patient
- CT scan or ultrasound of the abdomen, to check for complications of liver abscess that may occur in amoebic dysentery
- Blood tests, to see general signs of infection, anemia, and to know liver function
If the results of the above examinations are doubtful, additional tests such as colonoscopy and intestinal biopsies can be performed. In this procedure, the doctor will insert an endoscope (a tube equipped with a camera and light) through the anus to see the condition of the intestine and take a small piece of intestinal tissue.
Dysentery Treatment
Mild bacterial dysentery can heal in 3-7 days with adequate rest and maintaining body fluid intake. Important things to note include:
- Prevent dehydration by increasing fluid consumption, such as water or isotonic drinks
- Give rehydration fluids, such as ORS, to the child whenever he has diarrhea or vomiting
- Eat dense, low-fiber foods, such as chicken, rice, or eggs
- Avoid consuming fatty foods, dairy products, high-fiber foods such as vegetables and fruit, and spicy foods for several days
- Taking drugs that can be purchased freely at pharmacies such as bismuth subsalicylate to relieve stomach cramps and diarrhea, and paracetamol to relieve pain and fever
It should be noted that diarrhea medications that slow the action of the intestines, such as loperamide, can make symptoms worse. Therefore, this drug should only be consumed if it is recommended by a doctor.
If dysentery does not improve with the above independent therapy, treatment by a doctor is needed. The action that will be taken by the doctor is giving dysentery drugs which are of the antibiotic type, such as:
- Ciprofloxacin, in patients with bacterial dysentery
- Metronidazole, in amebic dysentery patients
In certain cases, the doctor may prescribe two types of antibiotics to ensure that there are no amoebae that cause dysentery in the body.
In patients who are severely dehydrated, the doctor will provide replacement fluids through an IV. This method can restore fluids and nutrients needed by the body more quickly than through drinking.
Apart from that, infusions can also be used to give medicines to patients who cannot take medicine because of vomiting.
Dysentery complications
Complications that can occur due to dysentery include:
- Dehydration
Severe diarrhea and vomiting can lead to severe dehydration. This can be life-threatening if not treated immediately, especially in children.
- Low potassium levels
Potassium levels can become very low because potassium is excreted with water during vomiting or diarrhea. This condition can cause life-threatening heart rhythm disturbances.
- Hemolytic uremic syndrome
Hemolytic uremic syndrome can occur when toxins produced by Shigella bacteria enter the bloodstream. This poison can damage red blood cells and vessels in organs, especially the kidneys.
- Blood infection
Bacteria or ameba that cause dysentery can enter the bloodstream. This condition is rare and generally only affects people with weak immune systems, such as people with HIV/AIDS or cancer.
seizures Although rare, diarrhea can sometimes cause seizures in children.
- Postinfectious arthritis
This condition is experienced by about 2% of people with dysentery which is caused by the bacterium Shigella flexneri. Symptoms include eye irritation, joint pain, and pain when urinating. These complaints can be felt for several months or years.
- Liver abscess
Amoeba can spread from the intestine and cause liver abscess. In more severe conditions, amoebae can also spread to the brain and lungs.
- Megacolon
Megacolon can occur if an infection causes severe inflammation. This inflammation can cause the large intestine to expand and thin, even to the point of rupture.
- Rectal prolapse
When dysentery causes very severe diarrhea, the muscles in the rectum can weaken. This can cause the rectum or the end of the large intestine to protrude from the rectum.
Dysentery Prevention
Maintaining cleanliness is the main step in preventing the spread of dysentery. If you live with someone who has dysentery, pay attention to the following:
- Wash your hands frequently with soap and water, especially before eating, cooking or preparing food, after using the toilet, and after touching people with dysentery or objects around them.
- Reduce or if possible avoid contact with dysentery sufferers.
- Do not use the same towel as someone known to have dysentery.
- Use hot water to wash clothes with dysentery.
- Clean shared toilets using disinfectants after each use by people with dysentery.
If you have dysentery, it is advised to stay at home and not do things that can cause the spread of this disease, such as preparing food, swimming and having sex, for at least 48 hours after the symptoms end.
Meanwhile, to prevent dysentery in general, take the following steps:
- Always wash your hands with water and soap or hand sanitizer before eating.
- Avoid eating fruits peeled by other people, unless you are sure that your hands have been properly washed.
- Avoid eating foods that are less hygienic.
- Try to only drink water in tightly closed bottles or drink water that has been boiled until it boils.
- Avoid swallowing water while doing activities in lakes, rivers or public swimming pools.
- Do not use ice cubes for drinks, especially if the source of the water used to make the ice cubes is not guaranteed to be clean.
- Use water that has been boiled to a boil or water that has been disinfected and filtered for various purposes, especially for brushing your teeth.
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