Dysentery
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2008-07-12T17:13:18Z
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'''Dysentery''' (formerly known as '''flux''' or the '''bloody flux''') is an infection of the digestive system that results in severe [[diarrhea]] containing mucus and blood in the [[feces]]. Dysentery is typically the result of unsanitary water containing [[micro-organisms]] which damage the [[intestines|intestinal lining]]. There are two major types of dysentery due to micro-organisms: '''amoebic dysentery''', and '''bacillary dysentery''' mainly due to one of three bacteria. Dysentery can also be caused by certain medications; for example, some steroids can impact bowel movements.<ref name=Apel>{{cite book | author = Apel, Melanie Ann (author) | title = Amebic Dysentery (Epidemics) | edition = 1st ed. | publisher = Rosen Publishing Group | pages = pp. 13 | year = 2003 | isbn=0823941965 }}</ref>
==Amoebic dysentery==
{{main|Amoebiasis}}
'''Amoebic dysentery''' (or '''amebic dysentery''') is caused by the [[amoeba]] ''[[Entamoeba histolytica]]''.
Amoebic dysentery is transmitted through contaminated food and water. 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 dysentery is well known as a "traveler's dysentery" because of its prevalence in developing nations, or "[[Montezuma's Revenge (medicine)|Montezuma's Revenge]]" although it is occasionally seen in industrialized countries. [[Liver]] infection, and subsequent amoebic abscesses can occur. Bleeding in stools may occur.
==Bacillary dysentery==
Bacillary dysentery is mostly commonly associated with three bacterial groups:
* [[Shigellosis]] is caused by one of several types of ''[[Shigella]]'' [[bacterium|bacteria]].
* [[Campylobacteriosis]] caused by any of the dozen species of ''[[Campylobacter]]'' that cause human disease
* [[Salmonellosis]] caused by ''[[Salmonella enterica]]'' (serovar ''Typhimurium'').
== Symptoms and complications ==
Symptoms include frequent passage of feces/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.
Once recovery starts, early refeeding is advocated avoiding foods containing lactose due to temporary [can persist for years] [[lactose intolerance]].<ref name="pmid359524">{{cite journal |author=DuPont HL |title=Interventions in diarrhoeas of infants and young children |journal=J. Am. Vet. Med. Assoc. |volume=173 |issue=5 Pt 2 |pages=649–53 |year=1978 |pmid=359524 |doi=}}</ref><ref name="pmid2664748">{{cite journal |author=DeWitt TG |title=Acute diarrhoea in children |journal=Pediatr Rev |volume=11 |issue=1 |pages=6–13 |year=1989 |pmid=2664748| doi = 10.1542/pir.11-1-6}}</ref>
== Treatment ==
The first and main task in managing any episode of dysentery is to maintain fluid intake using [[oral rehydration therapy]]. If this can not be adequately maintained, either through nausea and vomiting or the profuseness of the diarrhoea, then hospital admission may be required for [[intravenous]] fluid replacement. Ideally no antimicrobial therapy is started until microbiological microscopy and culture studies have established the specific infection involved. Where laboratory services are lacking, it may be required to initiate a combination of drugs including an amoebicidal drug to kill the [[parasite]] and an [[antibiotic]] to treat any associated bacterial [[infection]].
Amoebic dysentery can be treated with [[metronidazole]]. Mild cases of bacillary dysentery are often self-limiting and do not require antibiotics,<ref name="BNF">{{cite book |title=British National Formulary |edition=Ed.53 |date=March 2007 |chapter=Antibacterial drugs - Summary of antibacterial therapy |pages=p.276}}</ref> which are reserved for more severe or persisting cases; ''campylobacter'', ''shigella'' and ''salmonella'' respond to [[ciprofloxacin]] or [[macrolide]] antibiotics.<ref name="BNF"/>
== Miscellaneous references ==
{{trivia|date=July 2008}}
* The band [[blink-182]] has a song called "[[Dysentery Gary]]" in which diarrhea is mentioned.
* [[Elie Wiesel]], a renowned Holocaust survivor, described in his book ''[[Night (book)|Night]]'' his father suffering from dysentery while imprisoned in Buchenwald, a concentration camp of Nazi Germany during the [[Holocaust]].
* [[O. Uplavici]] was the fictional author of the article ''About dysentery'' whose name persisted in science literature for fifty years.
* Additionally, dying of dysentery has become a [[pop culture]] reference to the 1980s computer game, ''[[The Oregon Trail (computer game)|The Oregon Trail]]''. The disease was one of several afflictions the player could die from, prompting the phrase, "You have died of dysentery."
* [[Lars Eighner]] writes about experiencing dysentery at least once a month during the time he lived as a homeless man [[dumpster diving]].
* [[John McCain]] suffered from dysentery while a POW.
* In the [[Woody Allen]] movie ''[[Annie Hall]]'', Allen's character jokes that two leading intellectual magazines, ''[[Dissent (magazine)|Dissent]]'' and ''[[Commentary Magazine|Commentary]]'', had merged to form Dysentery. An oblique reference to intellectual pretense.
* In the movie ''[[Pulp Fiction (film)|Pulp Fiction]]'', Captain Koons played by [[Christopher Walken]] informs a young Butch Coolidge ([[Bruce Willis]]) that his father had died from dysentery after concealing a wrist watch inside of his rectum for five years.
* [[Harrison Ford]] apparently suffered from the condition while filming ''[[Raiders of the Lost Ark]]'' in [[Tunisia]]; this partially resulted in his suggesting that rather than have an elaborate fight with a sword-wielding assassin, [[Indiana Jones]] should just shoot him - a now famous gag in the movie.
* In the video game ''[[Gears of War]]'' for the [[Xbox 360]], the character Baird says "We are going to get Dysentery from this shit!" referring to the food of the stranded people.
* In the film ''[[Mrs. Doubtfire]]'', [[Robin Williams]] jokes that it would be terrible if his ex-wife came down with amoebic dysentery, leading to a gross and vague description of the illness by his son.
* In the book ''[[On the Road]]'', the main character [[Sal Paradise]] suffers from dysentery at the end of his time in Mexico.
* Dysentery is a frequently-mentioned malady in the TV series ''[[M*A*S*H]]''.
* The [[Tom Lehrer]] song "In Old Mexico" (on the album ''[[An Evening Wasted with Tom Lehrer]]'') has the lines "We ate, we drank, and we were merry/And we got typhoid and dysentery."
* The English Privateer Sir [[Francis Drake]] died from dysentery in 1596.
* [[John of England]] died from dysentery in 1216.
* A few years ago, Sainsbury's Supermarkets Ltd caused an outbreak of dysentery at their Haywards Heath branch, this caused one death and many other people suffered from it. Sainsbury's are still paying out compensation that has gone into millions of pounds. It was thought but wasn't verified that this was brought to the branch by a colleague that worked on the salad counter, who had poor hygeine standards.
==See also==
*[[Gastroenteritis]]
==References==
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[[Category:Infectious diseases]]
[[Category:Water-borne diseases]]
[[Category:Conditions diagnosed by stool test]]
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