Dysentery is an infection of the intestine that causes diarrhea accompanied by blood or mucus. This condition generally lasts 3 to 7 days, characterized by abdominal cramps, nausea and vomiting, and fever. Dysentery is a disease that commonly occurs in environments with poor sanitation, for example due to limited clean water or a place with poor waste disposal. The spread of dysentery occurs due to the lack of public awareness to maintain personal hygiene, such as not washing hands after from the toilet or bathroom.
Symptoms of Dysentery
Symptoms that appear in both types of dysentery are not much different, including diarrhea accompanied by blood or pus, nausea and vomiting, and abdominal pain. In bacterial dysentery, sufferers also experience abdominal cramps and fever . Symptoms of bacterial dysentery usually appear 1-7 days after the patient is infected, and can last for 3-7 days.
Whereas in patients with dysentery caused by ameba, patients will experience fever and chills, loss of appetite and weight loss, and rectal bleeding. Symptoms can appear 10 days after the patient is infected.
Ameba dysentery can also cause sufferers to experience pain during bowel movements. This condition occurs due to ameba damaging the walls of the large intestine, and causing wounds and bleeding. In some cases, ameba can enter the bloodstream and spread to other organs, especially the liver. If this condition occurs, it can cause a collection of pus in the liver, which is called a liver abscess.
Symptoms of ameba dysentery can take up to several weeks. If not treated immediately, ameba can live in the intestine for even a few years. Besides being able to cause the spread of infection, this condition can cause dysentery often to recur.
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Causes of Dysentery
Based on the cause, dysentery can be divided into two types, namely:
- Bacterial dysentery. This type of dysentery can be caused by various types of bacteria, including Campylobacter , enterohemorrhagic type E-coli (EHEC), Salmonnella , or Shigellla bacteria.
- There are 4 types of Shigella bacteria that cause dysentery, namely Shigella boydii, Shigella sonnei, Shigella flexneri, and Shigella dysenteriae . Shigella sonnei is the most common cause of dysentery, while Shigella dysenteriae is the most severe cause of dysentery.
- Ameba dysentery. This type of dysentery is caused by ameba (one-celled parasite) named Entamoeba histolytica .
Bacteria and ameba that cause dysentery live in the patient's faeces, but can spread if the patient does not maintain good hygiene. Spread can occur if the sufferer does not wash his hands until it is completely clean. For example, hands that are not washed after from the toilet will cause bacteria in the hands to stick to the surface of the object being touched.
The bacteria on the contaminated object can accidentally enter through the mouth of another person. This happens when someone touches the mouth without washing hands first, after touching a contaminated object. From the mouth, the bacteria will multiply and attack cells in the large intestine, then cause symptoms of dysentery.
Bacteria and ameba that cause dysentery can also spread through food and water contaminated with human waste. This condition is common in areas with poor hygiene. Distribution is also vulnerable in areas with limited availability of clean water and inadequate waste disposal sites, or in areas that still use human waste as fertilizer.
Diagnosis of Dysentery
The diagnosis of dysentery is done by taking the patient's stool sample, to find out whether dysentery is caused by bacteria or ameba. Other tests will be performed if dysentery causes a liver abscess, including by taking a blood sample or abdominal ultrasound , to see the condition of the liver.
The examination method that can also be done is a colonoscopy . In this procedure, the doctor will insert a hose equipped with a camera and lamp (endoscope) through the anus, to see the condition of the intestine. Please note, before undergoing a colonoscopy, patients will be asked to take a special diet for several days. Patients will also be given laxatives before undergoing an examination, and sedatives to help patients relax.
Treatment of dysentery
Mild bacterial dysentery can heal itself in a few days, with adequate rest and maintaining body fluid intake. It is important to drink frequently, even in small amounts, especially in children. However, avoid giving children fruit juice or soft drinks, because it can make diarrhea worse. If the patient is severely dehydrated , the doctor will provide replacement fluids through an IV.
In elderly patients or who are prone to dehydration, the doctor will give ORS. ORS serves to replace salt, sugar, and minerals that are lost from the body due to dehydration. Please note, even though it is able to handle and prevent dehydration, ORS does not treat diarrhea.
In addition to maintaining body fluids, it is important to eat small, light solid foods. But avoid heavy, fatty, and spicy foods. Giving solid food to dehydrated children should be delayed, until signs of dehydration have stopped. If the child does not want or has difficulty eating, still fulfill the child's fluid needs until the appetite returns to normal.
In addition to the method above, patients can also use over-the-counter medicines. Several types of drugs that can be used include bismuth subsalisilat to relieve stomach cramps and diarrhea, and paracetamol to relieve pain and fever. Avoid using drugs that slow down the intestines, such as loperamide , because it will worsen symptoms.
In severe bacterial dysentery, the doctor will prescribe antibiotics such as ciprofloxacin . However, giving antibiotics risks making the bacteria that causes diarrhea resistant to antibiotics prescribed. Immediately contact your doctor if symptoms persist, even after taking antibiotics. As for treating ameba dysentery, doctors will prescribe drugs such as metronidazole , to kill parasites that cause diarrhea.
Complications of dysentery
Dysentery in infants and children quickly causes dehydration. Therefore, it is recommended to drink a lot to replace lost body fluids. It is important to pay attention to signs of dehydration, especially if the child is under 1 year of age, or under 2 years old but with a low birth weight. Beware of the possibility of dehydration if the child has 5 times diarrhea and 2 times vomiting within 24 hours, or suddenly stops breastfeeding.
Besides dehydration, other complications that can occur due to dysentery are:
- Uremic hemolytic syndrome. Uremic hemolytic syndrome occurs due to the bacteria Shigella dysenteriae producing poisons that damage red blood cells.
- Blood infection. This condition is rare, and generally only affects someone with a weak immune system, such as people with HIV / AIDS or cancer.
- Seizures . It is unknown why seizures can occur. However, this complication is rare.
- Postinfectious arthritis . This condition affects about 2% of people with dysentery caused by the bacteria Shigella flexneri . Symptoms can be felt for several months or years, including eye irritation, joint pain, and pain when urinating.
- Liver abscess. Although rare, ameba dysentery can cause liver abscesses, which can also spread to the brain and lungs.
Prevention of Dysentery
Maintaining cleanliness is the main step in preventing dysentery, especially by doing the following:
- Diligently wash your hands with water and soap, especially before eating, cooking or preparing food, after from the toilet, and after changing the baby's diaper.
- As much as possible, avoid contact with people with dysentery.
- Don't use the same towel as someone who is known to suffer from dysentery.
- Use hot water to wash clothes for people with dysentery.
- Avoid swallowing water when swimming in public facilities.
- Clean the toilet with a disinfectant after each use.
Tighter precautions must be taken if you are traveling to an area prone to the spread of dysentery, including:
- Avoid eating fruits that are peeled by other people.
- Try to only drink water in bottles that are still tightly closed, or drink boiled water to boil.
- Don't use ice cubes for drinks, because they can be made from contaminated water.
- Use cooked water to boil or water that has been disinfected and filtered, for various purposes, especially for brushing your teeth.