Dysentry
Dysentry is an intestinal infection that causes severe diarrhoea with blood. It is characterized by inflammation of the intestines, chiefly the colon. In some cases, mucus may be in the stool. This usually lasts for 3 to 7 days. It can be caused by parasite or bacteria.
Types –
• Bacterial dysentry
It is caused by infection with bacteria from Shigella, Campylobacter, Salmonella or entero haemorrhagic E. coli.
Diarrhoea from Shigella is also known as Shigellosis.
• Amoebic dysentry or intestinal amoebiasis
It is caused by a single celled parasite that infects the intestine. It is also known as Amoebiasis. Amoebic dysentry is less common in the developed world. It is usually found in tropical areas that have poor sanitary conditions.
Symptoms –
Symptoms can show up 1-3 days after you get infected. In some people, the symptoms take longer to appear.
Each type of dysentry has slightly different symptoms.
Bacillary dysentry causes symptoms like –
• Diarrhoea with belly cramps
• Fever
• Nausea and vomitting
• Blood or mucus in the diarrheoa
Amoebic dysentry usually doesn’t cause symptoms. If you do feel sick, you will notice problems 2-4 weeks after you are infected, such as-
• Nausea and vomitting
• Watery diarrhoea
• Fever and chills
• Belly cramps
• Painful passing of stools
• Weightloss
• Fatigue
• Intermittent constipation
• Ulcers can develop. These may bleed, causing blood in stools
Symptoms may persists for several weeks.
Causes-
The bacteria Shigella and E.coli and the amoeba Entamoeba histolytica are the most common cause of dysentry. These organisms are present in the stool of infected people and animals.
The Entamoeba histolytica may uneventfully reside in the colon, but if it attacks the colon wall, it can cause dysentry. People with weakened immune systems are also more likely to develop amoebic dysentry.
Most commonly, dysentry is caused by drinking water or eating food from sources contaminated with faeces containing the pathogens.
Swimming in contaminated water may also result in dysentry.
Common causes of dysentry includes –
Several organisms are known to cause dysentry, most commonly –
• Camphylobacter
• Certain types of E.coli
• Entamoeba histolytica
• Salmonella
• Shigella
Risk Factors –
A number of factors increase the risk of developing dysentry. Not all people with risk factors will get dysentry. Risk factors for dysentry includes –
• Attendance or work in a day care setting
• Close contact with an infected person or animal
• Fecal to oral contact
• Physical contact
• Use of public swimming pools
• Travel in countries where such an infection is common
• Consumption of untreated water form lakes, rivers or streams
Complications –
Complications of dysentry includes –
• Electrolyte imbalance
• Intestinal obstruction
• Intestinal perforation
• Secondary urinary tract infection
• Seizures
• Liver abscess
• Post infectious arthritis, eye irritation and painful urination
• Spread of infection (sepsis, more common in immunocompromised individuals)
• Shigella dysentry can cause the red blood cells to block the entrance of the kidneys, leading to anemia, low platelet count and kidney failure.
Diagnosis –
Dysentry symptoms look like a lot ofother intestinal illnesses, including a common stomach virus. A lab technician will need to look at a sample of patients stool under a microscope to see if you have dysentry and if so, what type.
If symptoms are severe, diagnostic imaging may be recommended. This could be an ultrasound scan or an endoscopy.
Treatment –
Lab results will reveal whether the infection is due to Shigella or Entamoeba histolytica infection. Line of treatment will depend on these results.
However, any patient with diarrhoea or vomitting should drink plenty of fluids to prevent dehydration.
If they are unable to drink, or if diarrhoea and vomitting are profuse, intravenous (IV) fluid replacement may be necessary. The patient will be placed on a drip and monitored.
Mild Shigellosis is usually treated just with rest and plenty of fluids. Over-the-counter medication, such as bismuth subsalicylate can help relieve cramps and diarrhoea. You should avoid drugs that slow down the intestines, such as loperamide and lomotil which can make the condition worse.
Severe Shigellosis can be treated with antibiotics such as Cefatriaxone, Ciprofloxacin, Trimethoprim-sulfamethoxszole.
Amoebic dysentry is treated with metronidazole a tinidazole. These drugs kill the parasites.
In severe cases, your doctor may recommend an intravenous (IV) drip to replace fluids and prevent hydration.
Precautions –
Dysentry is very contagious.
• Stay at home from work or school until you have been diarrhoea-free for at least 48 hours to avoid passing the infection to others.
• Wash your hands often and don’t prepare food for anyone else for atleast 2 days after your symptoms clear up.
• Avoid sex until you feel better.
• Once the infection is gone, Clean your house well to kill the germs. Wash your sheets, towels and clothes in hot water.
• Disinfect toilet seats, flush handles, sink handles, doorknobs and other places you often touch.
Ayurvedic Perspective –
In Ayurveda, dysentry can be correlated with Pravahika.
When the vitiated Vata pulls this accumulated Kapha in a downward direction and tries to eliminate it, the stools get excreted in a small or large quantity. The excretion of stool and mucus takes place with difficulty and the person is compelled to strain or force the stools out. In this attempt, patient will feel pain in the abdomen and rectum. There will be a general sense of incomplete evacuation of bowel. This condition is called Pravahika.
Treatment principles of dysentry
• To rectify the digestion and metabolism process and destroy ama by administration of Deepana and Pachana aushadhis such as panchkola, ajwain, hingu, Jeeraka, takra, katuki, ela, dhaniya etc.
• Langhana (lightening therapies and medicines)
• To destroy the krimi using hubs such as kutaja, vidanga,vacha, palasha beej, shunthi, pippli, haritaki etc.
• To check loose stools, to check the loss of water, electrolytes, blood and mucus (stambhana) with herbs such as bilwa, patha, dadima etc.
• To flush off the toxins (AMA) and infection
• Diet and lifestyle changes
Ayurvedic formulations –
• Kiratadi Churna
• Dadimasthtak Churna
• Laghu gangadhara Churna
• Lavana bhaskar Churna
• Balachaturbhadra Churna
• Hingwadi Churna
• Bhunimbadi Kwatha
• Kutaja ghan Vati
• Raskarpura
• Shanka Vati
• Punarnava Mandur
• Jeerakarhishta
• Mustarhishta
• Changeri ghrita
• Kutajarhishta
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