Dysentery

1. What causes dysentery
2. Infection features
3. The disease types: classification
4. Main signs of the disease
5. Childish dysentery
6. Diagnostics
7. How to treat dysentery
8. Prevention

Dysentery is a disease known to mankind for a long time. Previously, its prevalence was very high. In the Middle Ages, when dysentery caused epidemics, millions of people of different ages and social status died. At present, this infectious disease is no longer deadly dangerous, since the cause is known and effective therapeutic schemes are developed.

Nevertheless, with respect to dysentery, there should be some caution. After all, if treating was started untimely or was not performed intensively, the disease often takes a complicated course or goes into a chronic form. Childish dysentery refers to potentially life-threatening conditions, since it can quickly lead to severe dehydration.

What causes dysentery

Currently, there are 2 types of this disease:

• Amoebic dysentery or amoebiasis. It is caused by infection, a special histolytic amoeba - the simplest single-celled organism that can form false-legged legs. It was this type of disease that was discovered first, the causative agent was discovered by the Russian scientist F. A. Lesh. At present, amoebiasis is relatively rare, primarily in areas featuring unfavorable epidemic situation and hot climate.
• Bacterial dysentery or shigellosis. It is caused by several types of shigella. These immovable rod-shaped bacteria were discovered by the Japanese scientist Kiyoshi Shiga and named in his honor. Shigellosis is much more common, and now it is mainly diagnosed in people of different ages with symptoms of dysentery.

Shigella adapt to changing environmental conditions very well, sufficiently resistant to acting physical and chemical factors. If necessary, they can transform into spherical L-forms with a protective compacted cell wall. These bacteria also feature high adaptability to acting antibacterial agents, which creates certain difficulties in treating dysentery.

A favorite location of shigella is mucosa (epithelium) of the large intestine. But these bacteria not only have a damaging effect, but also produce exotoxins. Their points of application are the nervous system, intestinal wall cells. And when shigella is destroyed, endotoxin releases, which negatively affects performing nervous and cardiovascular systems.

There are more than 40 shigella serotypes. But the most pathogenic and common are 4 species: Shigella Sonnei, dysentery (Shigella dysenteriae), Flexner (Shigella flexneri) and (Shigella boydii).

Infection features

Dysentery refers to the so-called anthropogenous infections. This means source of infection is only a person. Moreover, it has not only obvious signs of acute or chronic form, but also can be a hidden (malosymptomatic) carrier of pathogens. Even reconvalescent (recovering from a recent illness) can produce dangerous bacteria.

Transferring infection occurs in fecal-oral route. Shigella with feces of a sick (or simply infected) person enter the environment. Here they can live for a long time. Other person gets the infection when the pathogen enters the digestive system with food, water through unwashed hands. Each type of Shigella has its own preferred ways of transferring.

The disease types: classification

Depending on the type and duration of the disease, there are:

• Acute dysentery (shigellosis). The duration of the symptoms is from several days to three months.
• Chronic dysentery. It is diagnosed with a duration of the disease over 3 months.

By the severity of symptoms, dysentery is divided into light, medium and heavy.

Main signs of the disease

ШShigellosis is an intestinal infection. Therefore, with developing disease, the disordered colon function signs are predominant. Tthe intoxication happens by acting toxins produced by shigella.

The main symptoms of dysentery in adults include:

• Syndrome diarrhea, i.e. frequent and liquid stool. An urge to defecate is very strong, it can occur 20 or more times a day. At first the stool is copious and semi-formal faece. Further it gets more lean, watery-mucous, often bloody.
• Vomiting and nausea. Basically, they appear with acting toxins on the emetic center of the brain. Absorption and water excretion in the intestine have a certain value.
• Painful abdomen, which is called abdominal syndrome. They appear with inflamed intestinal wall, its disordered peristalsis (rhythmic contractions), accumulated excessive fluid in the intestine lumen. The pain intensifies before defecation and can be felt mainly in the left side of the abdomen. After a while it features tenesmus - sharply painful unproductive urges. This is a sign of pronounced inflamed colon and rectum wall, which usually develops 2-3 days after the disease starts.
• Intoxication. Patients suffering from dysentery are concerned with headache, weakness, common moderate to severe muscle pain. The appetite is bad, the working capacity goes down, the concentration of attention worsens, the body temperature rises.
• Dehydration associated with excessive loss of fluid in diarrhea and vomiting. Decreasing water consumption by a sick person is of certain value too. Mucous membranes and skin get dry, intoxication intensifies, weakness grows, blood pressure lowers. With severe dehydration, the brain and vital organs suffer. This kind of complication is the greatest danger for young children, elderly and somatically weakened people.

Pronounced symptoms depend on the severity of the disease. In adults, dysentery often occurs in a fairly mild form. At the same time, a person considers emerging symptoms as a sign of mild food poisoning. In many cases, the ill do not consult the doctor and continue to work, becoming a source of infection for their colleagues and casual acquaintances.

And with a severe form of dysentery, the symptomatology is pronounced and prone to progression. Diarrhea and intoxication rapidly develop, and soon there is pronounced dehydration and signs of deterioration of the brain and heart. This kind of condition requires an early hospitalization up to the time of placing him/her in the intensive care unit.

Childish dysentery

In children, the symptoms of dysentery are the same as in adults. The disease usually makes its debut with diarrhea. The child has abundant diluted stool, soon mucous clots of a white-green color appear in the feces. Signs of dehydration appear quickly enough too. And the younger the child, the higher the risk of developing critical fluid deficiency is.

Main manifestations of pronounced dehydration in one-year old babies:

• The baby is sluggish, drowsy, irritable, moody. Intoxication can also reveal itself in this way, but occured dehydration aggravates the condition.
• The lips and mucous membranes of the mouth dry up. The skin looks flabby, when folded, it does not straighten out.
• The face seems to have lost weight, the fontanel sinks down in young children.
• Muscular weakness appears. The imbalance of minerals connected with dehydration occurred can lead to developing seizures.
• One-year old babies often experience frequent regurgitation, thermoregulation disorders, feet and hands get cold. Sleep gets bad featuring frequent awakenings.
• With severe dehydration, confused consciousness appears periodically.

Dehydration is a certain danger to baby's life. It is not always possible to eliminate it at home. Therefore, treating childish dysentery is preferably performed in a hospital.

Diagnostics

All intestinal infections have similar general symptoms, and the type of pathogen can only be recognized by laboratory tests. Since dysentery belongs to a group of epidemically dangerous diseases, tests for elimination are prescribed for all people suffering from diarrhea. In addition, they are carried out for the benefit of recently cured patients to exclude shigella carrier.

Laboratory diagnosis of dysentery includes:

• Threefold bacteriological research of feces (plating). However, the laboratory answers in a week or longer.
• Immunological methods for revealing specific antibodies to shigella in the blood of the patient. Most often, PCR (polymerase chain reaction) is applied.
• Coprological survey of feces. It allows to evaluate the severity of the inflammatory reaction of the intestinal wall, its features include appearing mucus, leukocytes and erythrocytes in feces.

The survey for existing dysentery is conducted in some professionals, even if signs of intestinal disturbance are absent. This is necessary to exclude shigellosis carriers and allows to control epidemic situation. For example, medical personnel, teachers and educators, employees from public catering establishments are diagnosed in this way from time to time.

How to treat dysentery

Treating dysentery in adults and children is carried out according to the general scheme, taking into account the severity of the patient's condition. Complex therapy includes:

• Replenishment of lost fluid and minerals. In light cases of quite increased drinking regime, and in the acute period of the disease it is recommended to use saline solutions. With severe dehydration, intravenous infusions are usually prescribed too.
• Using enterosorbents to bind toxins in the intestines, reduce the severity of diarrhea and vomiting.
• Antibiotic therapy. The decision to use antimicrobial agents should be taken only by a doctor. Self-treating is fraught with forming antibiotic-resistant forms of the disease and turning into a chronic form. With mild symptomatology, it is often possible to do without aoolying antibacterial agents. In this case, after recovery, the lack of shigella in the stool is controlled.

If necessary, symptomatic therapy is prescribed to relieve the patient's condition and correct arising complications. Following diet therapy is of great importance.

ЭEnterosorbents are a very important component of complex therapy against dysentery in adults and children. They can reduce the severity of intoxication and intestinal disorders. In this case, preference is given to products of natural origin with high absorption capacities. Most often, Filtrum® is prescribed as an enterosorbent. It is not absorbed by the digestive tract and does not irritate the inflamed intestinal wall, it can be used even in one-year old babies.

Prevention

In general, dysentery (shigellosis) belongs to the group of "diseases of dirty hands". Personal prophylaxis of infection includes mandatory washing hands before meals, after goint out, visits to toilet, places of common use. When cooking, sufficient heat treatment of the products is necessary. And vegetables, fruit and berries used in raw form should be washed before consumption.

People who care for dysentery patients, are recommended to treat dishes, household items, bedding, and the patient`s room with antiseptic solutions. After every contact with the patient and surrounding objects, these people should thoroughly wash their hands. And if they notice first signs of infection, they need to consult the doctor.

Those who are ill with dysentery should not go to work or preschool and school. Their return to usual way of life is possible only after laboratory confirmation of absent shigella in their stool.

Important: Before using, read the instructions or consult your doctor.