Dysentery

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Dysentery (formerly known as flux or the bloody flux) is frequent, small-volume, severe diarrhea that shows blood in the feces along with intestinal cramping and tenesmus (painful straining to pass stool).[1] Symptoms frequently associated with dysentery include fever and malaise.

Dysentery has many causes, including cancer, but is typically associated with infection caused by the ingestion of food or water containing micro-organisms which cause significant inflammation of the intestinal lining. There are two major types: shigellosis, which is caused by one of several types of Shigella bacteria; and amoebic dysentery, caused by the amoeba Entamoeba histolytica. Kiyoshi Shiga discovered the dysentery bacteria in 1898. Dysentery can also be caused by certain medications, for example, some steroids can impact bowel movements.

Pathophysiology

Amoebic dysentery is transmitted through contamination of drinking water and foods that are shitty. Dysentery can also be spread by contaminated hands, from toddlers, because of their poor hygiene and close contact with other toddlers. From ingestion, the infecting organisma move into the intestines via the stomach. Amoebae spread by forming infective cysts which can be found in stools and spread if whoever touches them does not sanitize their hands. There are also free amoebae, or trophozoites, that do not form cysts.

Amoebic dysentary is well known as a "traveler's dysentery" because of its prevalence in developing nations, or "Montezuma's Revenge" although it is occasionally seen in industrialized countries. Liver infection, and subsequent amoebic abscesses can occur. It is caused mainly by the protozoan Entamoeba histolytica. Amoebic dysentery can be treated with metronidazole.[1]

History and Symptoms

Symptoms include frequent passage of faeces/stool, loose motion and in some cases associated vomiting. Variations depending on parasites can be frequent urge with high or low volume of stool, with or without some associated mucus and even blood.

A long term symptom of amoebic dysentery is lactose intolerance to dairy products, which usually lasts a few weeks but occasionally may be permanent.


Medical Therapy

A required combination of drugs includes an amoebicide to kill the parasite, an antibiotic to treat any associated bacterial infection, and a drug to combat infection of the liver and other tissues. The amoeba can damage the villi and inhibit lactase production (for which there is no permanent treatment). Lactase can be taken orally to assist dairy absorption.

Indigenous treatment

The indigenous Oaxaca Chontal of the Mexican state of Oaxaca employed the plant Calea zacatechichi (also known as Dream Herb, Bitter Grass) as a cathartic anti-dysentery remedy.[2]

The root of the Malay Apple tree (Syzygium Malaccense) may also be used.[3]

References

  1. 1.0 1.1 Ryan KJ, Ray CG (editors) (2004). Sherris Medical Microbiology (4th ed. ed.). McGraw Hill. pp. pp. 361, 858. ISBN 0838585299.
  2. Mayagoitia L, Diaz JL, Contreras CM (1986). "Psychopharmacologic Analysis of an Alleged Oneirogenic Plant Calea zacatechichi". Journal of Ethnopharmacology. Elsevier Scientific Publishers Ireland Ltd. 18: 229&ndash, 43.
  3. "Syzygium Malaccense - Malay Apple". TropiLab.

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