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Dysentery

Dysentery (UK: /ˈdɪsəntəri/ DISS-ən-tər-ee, US: /ˈdɪsəntɛri/ DISS-ən-terr-ee), historically known as the bloody flux, is a type of gastroenteritis that results in bloody diarrhea. Other symptoms may include fever, abdominal pain, and a feeling of incomplete defecation. Complications may include dehydration.

The cause of dysentery is usually the bacteria from genus Shigella, in which case it is known as shigellosis, or the amoeba Entamoeba histolytica; then it is called amoebiasis. Other causes may include certain chemicals, other bacteria, other protozoa, or parasitic worms. It may spread between people. Risk factors include contamination of food and water with feces due to poor sanitation. The underlying mechanism involves inflammation of the intestine, especially of the colon.

Efforts to prevent dysentery include hand washing and food safety measures while traveling in countries of high risk. While the condition generally resolves on its own within a week, drinking sufficient fluids such as oral rehydration solution is important. Antibiotics such as azithromycin may be used to treat cases associated with travelling in the developing world. While medications used to decrease diarrhea such as loperamide are not recommended on their own, they may be used together with antibiotics.

Shigella results in about 165 million cases of diarrhea and 1.1 million deaths a year with nearly all cases in the developing world. In areas with poor sanitation nearly half of cases of diarrhea are due to Entamoeba histolytica. Entamoeba histolytica affects millions of people and results in more than 55,000 deaths a year. It commonly occurs in less developed areas of Central and South America, Africa, and Asia. Dysentery has been described at least since the time of Hippocrates.

The most common form of dysentery is bacillary dysentery, which is typically a mild sickness, causing symptoms normally consisting of mild abdominal pains and frequent passage of loose stools or diarrhea. Symptoms normally present themselves after 1–3 days, and are usually no longer present after a week. The frequency of urges to defecate, the large volume of liquid feces ejected, and the presence of blood, mucus, or pus depends on the pathogen causing the disease. Temporary lactose intolerance can occur, as well. In some occasions, severe abdominal cramps, fever, shock, and delirium can all be symptoms.

In extreme cases, people may pass more than one liter of fluid per hour. More often, individuals will complain of diarrhea with blood, accompanied by extreme abdominal pain, rectal pain and a low-grade fever. Rapid weight loss and muscle aches sometimes also accompany dysentery, while nausea and vomiting are rare.

On rare occasions, the amoebic parasite will invade the body through the bloodstream and spread beyond the intestines. In such cases, it may more seriously infect other organs such as the brain, lungs, and most commonly the liver.

Dysentery results from bacterial or parasitic infections. Viruses do not generally cause the disease. These pathogens typically reach the large intestine after entering orally, through ingestion of contaminated food or water, oral contact with contaminated objects or hands, and so on. Each specific pathogen has its own mechanism or pathogenesis, but in general, the result is damage to the intestinal linings, leading to the inflammatory immune responses. This can cause elevated physical temperature, painful spasms of the intestinal muscles (cramping), swelling due to fluid leaking from capillaries of the intestine (edema) and further tissue damage by the body's immune cells and the chemicals, called cytokines, which are released to fight the infection. The result can be impaired nutrient absorption, excessive water and mineral loss through the stools due to breakdown of the control mechanisms in the intestinal tissue that normally remove water from the stools, and in severe cases, the entry of pathogenic organisms into the bloodstream. Anemia may also arise due to the blood loss through diarrhea.[citation needed]

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inflammation of the intestine causing diarrhea with blood
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