Medicines for Dysentery

What it is

Dysentery is an intestinal infection that causes diarrhoea containing blood (and often mucus), along with tummy cramps and, often, fever. It is caused by infection of the gut, and there are two main types: bacillary dysentery, caused by certain bacteria (most commonly Shigella bacteria), which is the most common type; and amoebic dysentery, caused by an amoeba (a type of parasite, Entamoeba histolytica), which is more common in tropical areas. Dysentery is spread mainly through consuming food or water contaminated with the infection, and through poor hygiene (the infection is passed on through contact with the faeces of an infected person, for example via contaminated hands, food, water, or objects), so good hand hygiene is important in preventing its spread. It can occur in the UK, but is often related to travel to areas with poorer sanitation, particularly the amoebic type. The main symptoms of dysentery are diarrhoea containing blood and/or mucus, tummy cramps and pain, and often a fever, along with feeling generally unwell, feeling sick, and needing to go to the toilet frequently and urgently. The bacillary (bacterial) type often comes on quite quickly and, in many cases, is relatively short-lived, settling within a week or so, though it can be more severe; the amoebic type can come on more gradually and may last longer or, if untreated, recur or occasionally cause complications. As with any diarrhoeal illness, the main risk is dehydration from the fluid lost, so staying hydrated is the priority. Many cases of bacillary dysentery are mild to moderate and improve with rest, fluids, and good hygiene, without needing specific treatment; antibiotics are used for more severe cases or certain situations. Amoebic dysentery needs specific treatment with medicines to clear the parasite. Because dysentery causes bloody diarrhoea and can sometimes be more serious, and because the type affects treatment, it is important to seek medical advice — particularly for bloody diarrhoea, severe or persistent symptoms, or relevant travel. The key messages are that dysentery is an intestinal infection causing diarrhoea with blood or mucus, cramps, and fever (usually from contaminated food or water or poor hygiene), that staying hydrated is key, and that some cases (and amoebic dysentery) need specific treatment.

How it is treated

Dysentery is managed by staying hydrated and with good hygiene, with specific treatment (antibiotics or anti-parasite medicines) for certain cases; identifying the type guides treatment, and medical advice is important given the bloody diarrhoea. Because dysentery causes bloody diarrhoea (blood and/or mucus in the stool) with cramps and often fever, and because the type (bacterial or amoebic) affects treatment, it is important to seek medical advice, particularly for bloody diarrhoea, severe or persistent symptoms, feeling very unwell, or relevant travel to areas with poorer sanitation. Assessment may include testing a stool (poo) sample to identify the cause (bacterial or amoebic), which guides treatment, and it is helpful to mention any relevant travel. As with any diarrhoeal illness, the priority is staying hydrated: drinking plenty of fluids, and using oral rehydration solutions where helpful, to replace the fluids and salts lost, which is especially important for young children, older people, and those who are more vulnerable to dehydration; rest and, as appetite returns, eating help recovery. Good hand hygiene is very important, both to aid recovery and, crucially, to prevent spreading the infection to others (washing hands well, particularly after using the toilet and before handling food); people who are unwell should not prepare food for others and, in certain jobs (such as food handling or healthcare), should stay off until well and follow relevant guidance. Treatment then depends on the type and severity: many cases of bacillary (bacterial) dysentery are mild to moderate and settle with fluids, rest, and hygiene without antibiotics, while antibiotics are used for more severe cases, or in certain situations (guided by the identified cause); amoebic dysentery needs specific anti-parasite medicines to clear the infection, and completing this treatment is important, as untreated amoebic infection can persist or cause complications. Anti-diarrhoeal medicines are generally not recommended in dysentery (with blood in the stool and fever). It is important to seek medical help for severe or persistent symptoms, significant dehydration, high fever, or if the person is very young, elderly, pregnant, or has a weakened immune system. Preventing dysentery, particularly when travelling in areas with poorer sanitation, involves being careful with food and water and good hand hygiene. The reassuring messages are that dysentery is usually managed with staying hydrated, rest, and good hygiene, that many bacterial cases settle without specific treatment while more severe cases and amoebic dysentery need specific treatment, and that good hand hygiene prevents spread; so staying hydrated, seeking medical advice for bloody diarrhoea and relevant travel, and good hygiene are the keys to managing it.