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Everything you need to know about Amoebic Dysentery (Amoebiasis)

Many people who have spent a tropical vacation with a bad stomach bug might have had dysentery which is a painful intestinal infection. This painful intestinal infection is usually caused by bacteria or parasites. Dysentery is usually defined as diarrhea which there is blood, pus, and mucous, usually accompanied by abdominal pain.

Types of dysentery

1. Amoebic dysentery or intestinal Amoebiasis:

Amoebic dysentery is caused by a single-celled, microscopic parasite living in the large bowel.

2. Bacillary dysentery

Bacillary dysentery is caused by invasive bacteria

Both kinds of dysentery occur mostly in hot countries because poor hygiene and sanitation. They increase the risk of dysentery by spreading the parasite or bacteria which cause it through food or water contaminated from infected human feces.

Amebiasis or amoebic dysentery is a common parasitic enteral infection caused by any of the amoebas of the Entamoeba group. Amoebiasis can affect with no symptoms or mild to severe symptoms including abdominal pain, diarrhea, or bloody diarrhea.

Severe complications may include inflammation and perforation resulting in peritonitis. People affected may develop anemia.

Fast facts on dysentery:

The following are some key points about Amoebic dysentery.

• Amoebic Dysentery is an infection of the intestinal tract
• Symptoms include stomach cramps and diarrhea
• Many people have mild symptoms, but dysentery can be fatal without adequate hydration.

What is Amoebic Dysentery?

Amoebic dysentery, also known Amoebiasis, is an infection to large intestine caused by any of the amoebae, a microscopic one-celled parasite. These parasites live in the large intestine and they travel in the feces of infected people and can pollute water supplies in places where sanitation is poor.

These parasites can pollute or contaminate fruits and vegetables grown in areas where human feces are used as fertilizer. Amoebic dysentery is mostly transmitted in areas where poor sanitation allows contamination of drinking water and food with faeces. In these areas, about 40% of people may have amoebic dysentery.

Transmission can also occur through person-to-person through the dirty hands of infected people who don’t wash their hands often or properly and also when hands are washed in contaminated water.

Amoebic Dysentery is present all over the world but most cases occur in the developing countries. About 480 million people are infected with Amoebic Dysentery and this result in the death of between 40,000 to 110,000 people a year. The very first case of amoebic dysentery was documented in 1875 and in 1891.

Causes of Amoebic dysentery

After amoeba enters the body through the mouth, they travel down into the digestive system and settle in the large intestine. Harmless strains of the parasite live there without causing any damage. This amoeba may invade the wall of the intestine, leading to amoebic dysentery finally cause small abscesses and ulcers to form.

Amoebic dysentery typically results from poor sanitation where people who don’t have dysentery come into contact with fecal matter from people who have dysentery.

This contact may be through:

• contaminated food
• contaminated water and other drinks
• poor hand washing by infected people
• swimming in contaminated water, such as lakes or pools
• physical contact

Signs & Symptoms of Amoebic Dysentery

The most common symptoms occur during infection by Amoebic Dysentery generally beginning within two to 15 days of exposure to the amoeba, signs and may continue for several weeks. Symptoms include

• Sudden onset of high fever and chills
• Abdominal pain
• Cramps and bloating
• Flatulence (passing gas)
• Urgency to pass stool
• Feeling of incomplete emptying
• Loss of appetite
• Weight loss
• Headache
• Fatigue
• Dehydration
• Nausea and vomiting
• Watery diarrhea, which can contain blood, mucus, or pus
• Painful passing of stools
• Intermittent constipation

The Amoebic Dysentery may continue living within the human after symptoms have gone and the symptoms may persist when the person’s immune system is weaker.

Who gets amoebiasis?

Anyone can get this disease but amoebiasis is most common in:

1. People who have traveled to tropical places that have poor sanitary conditions
2. Immigrants or travelers from tropical countries that have poor sanitary conditions
3. People who live in institutions that have poor sanitary conditions
4. Men who have sex with men
5. Pregnant women
6. Postpartum women
7. Neonates
8. Malnourished individuals
9. Individuals who are on corticosteroids
10. Individuals with malignancies

Dos and Don’ts of Amoebic Dysentery

Amoebic dysentery is highly transmittable and can be passed on if you don’t take the right care. The following are some dos and don’ts to follow and maintain a healthy life.

• Avoid intake of water or food that is doubtful, hand wash before eating
• Avoid drinks with ice cubes.
• Avoid drinks that aren’t bottled and sealed
• Avoid food and beverages from street vendors
• Avoid peeled fruit or vegetables, unless you peel them yourself
• Avoid unpasteurized milk, cheese, or dairy products.
• Do hand wash, avoid eating contaminated food.
• Diarrhea Patient should drink plenty of fluids
• Be careful when changing a sick baby’s diaper
• Do not swallow water when swimming

Risk factors of Amoebic Dysentery

Amoebic dysentery is common in the countries with underdeveloped sanitation. It is most common in the Indian subcontinent, some parts of Central and South America and some parts of Africa. It is very rare in developed countries like the United States. People with the greatest risk for Amoebic dysentery include:

• Poor sanitary conditions
• They can spread into the bloodstream and infect other organs.
• Ulcers can develop and these may bleed, causing blood in stools.

Complications of Amoebic Dysentery

Amoebic dysentery is often fatal. People with amoebic dysentery may experience some problems and other complications include:

• Inflammation and ulceration may result in peritonitis.
• The affected people may develop anemia due to loss of blood.
• Amoebic liver abscesses.

The most common complication results when parasites spread to the liver causing amoebic dysentery. In this case, you may have a high fever and experience heavy weight loss and right shoulder or upper abdominal pain.

If the infection of the bowel is active, the intestinal ulcerations may lead to bowel damage and sometimes cause death. The parasites may cause infection in the lungs, brain, and other organs.

Investigations for Amoebic Dysentery

• Stool Test
• Antibody blood test or confirmation
• Scanning

Medical advice for Amoebic Dysentery

A very severe infection like Amoebic Dysentery can be fatal within 24 hours. However, the vast majority of infections is self-limited and resolve spontaneously without treatment.

• Consult your doctor whenever you have continuing diarrhea especially if it contains blood and mucus.
• Visit a doctor the same day if you have severe abdominal pain, especially in the right upper side and a fever.
• See your doctor when you have non-bloody diarrhea that is frequent and symptoms of dehydration such as dizziness.

Diagnosis for Amoebic Dysentery

The doctor will ask the patient about their signs and symptoms and carry out a physical examination and a stool sample may be requested when the patient has recently returned from the tropics.

If symptoms are severe such as a liver abscess, diagnostic imaging may be recommended which can be an ultrasound scan or an endoscopy.

An ultrasound scan: In this scan where high-frequency sound waves are used to create an image of part of the inside of your body, such as your liver. This will help your doctor to identify the exact problem inside your body.

Blood test: A blood sample may be tested for antibodies which are infection-fighting proteins that are likely to be present if you have amoebic dysentery.

Colonoscopy: A colonoscopy is a type of endoscopy that is used to examine your intestines.

Treatment for Amoebic Dysentery

The treatment against all stages of the disease requires medications. If you don’t observe any symptoms then you don’t require treatment but infected individuals can spread the parasite to others and in this case, treatment can be considered.

If left untreated, the disease can lead to heavy loss of fluids, dehydration, and eventually death. Apart from E. histolytica, it is not needed to take Treatment for other Entamoeba infections.

Consult your doctor immediately if you have any of the above symptoms without delay. Your doctor will likely do some tests to know the reason for your disease. These tests results will reveal whether the infection is due to Shigella or Entamoeba histolyca infection. The treatment will depend on these results.

If they are unable to drink or if diarrhea and vomiting are profuse, intravenous (IV) fluid replacement may be necessary where the patient with diarrhea and vomiting will be placed on a drip and monitored carefully.

• Amoebicidal medications are used to treat Entamoeba histolyca. These will make sure that the amoeba does not survive inside the body after symptoms have resolved.
• If your Amoebic Dysentery is due to bacteria and parasites, there are some other medications treats both bacteria and parasites. These medications can help relieve cramps and diarrhea. You should avoid drugs that slow down the intestines and can make the condition worse.
• If lab results are uncertain, depending on the severity of the symptoms the patient may be given a combination of antibiotic and amoebicidal medications. Early treatment reduces the risk of the amoebae surviving in the body.

Prevention for Amoebic Dysentery

To prevent amebic dysentery you need to be careful about what you eat and drink while visiting an area where it is common. When traveling to these areas, you should:

• Maintain good personal, food and environmental hygiene.
• Adopt the following 5 Food Safety Keys to handle food, i.e.
• Choose (Choose safe raw materials)
• Clean (Keep hands and utensils clean)
• Separate (Separate raw and cooked food)
• Cook (Cook thoroughly)
• Safe Temperature (Keep food at safe temperature) to prevent foodborne diseases.
• Wash hands carefully with liquid soap and water before handling food or eating, and after using the toilet or handling faecal matter.
• Drink only boiled water from the mains or bottled drinks from reliable sources and bottled water, if the seal is unbroken
• Avoid drinks with ice of unknown origin.
• Do not patronize illegal hawkers and purchase fresh food from hygienic and reliable sources
• Only eat thoroughly cooked food.
• Avoid eating raw vegetables and wash and peel fruit by yourself
• Stay away from infected persons and asymptomatic carriers from handling food and from providing care to children, elderly and immunocompromised people.
• Refrain from work or school
• Seek medical advice if you are suffering from gastrointestinal symptoms such as diarrhea.
• Separate food and water from faeces in order to include improved sanitation.

Approach Considerations

Most individuals with amebiasis may be treated on an outpatient basis because the treatment of amebiasis includes pharmacologic therapy, surgical intervention, and preventive measures, as appropriate.

The following are the several clinical scenarios that may favor inpatient care:

• Severe colitis and hypovolemia requiring intravenous (IV) volume replacement
• Liver abscess that is of uncertain etiology or is not responding to empiric therapy
• Fulminant colitis requiring surgical evaluation
• Peritonitis and suspected amebic liver abscess rupture

The following consultations may be helpful in treating Amoebic Dysentery:

• Infectious disease specialist
• General surgeon
• GI specialist

Follow-up stool examination after therapy completion is recommended in order to ensure the intestinal eradication and no special diet is recommended.

Deterrence and Patient Education

• Avoid drinking contaminated water.
• Use bottled water when traveling.
• Purify water with tetraglycine hydroperiodide.
• Avoid consumption of raw salads and fruits.
• Peel off the skin of the fruit if possible.
• Thoroughly wash all vegetables before cooking.

Recommendations for Travellers

• There is no vaccine against amoebiasis.
• All travelers are potentially at risk.
• Risk is highest in those visiting areas with poor sanitation and hygiene.
• To reduce the risk of infection, all travelers should practice careful food and water hygiene and personal hygiene.

Home remedies for amoebic dysentery

Home remedies for amoebic dysentery include

• Take bael fruit and remove the kernel from the dry seeds of this fruit. Add mango seed kernel in equal quantity along with one teaspoon of each kernel is to be grinded together. ¼ th of the mixture preferably with one cup of rice gruel daily for 5 days.
• Neem -the Margosa tree is considered to be few of the effective home remedies for amoebiasis. There are neem capsules and syrup available in the market through that you can take for a certain period and refer the leaflet and follow the instructions given on the label to start the course.
• Apricot is another wonderful home remedy for amebic dysentery. Extract the juice from apricot leaves and take in little-diluted quantity as this helps in binding the stools and stops dysentery.
• Black pepper, asafetida and cumin seeds help in digestion and hence, can be considered as a good home remedy for amoebiasis. Take a pinch of all the extracts or powder from these spices and add it into the glassful of lemon water.
• Buttermilk is one of the most trusted homemade remedies for amebic dysentery.
• Add cumin seed powder to augment the therapy.
• Swallow Methi seeds (Fenugreek seed) with water after 3-4 hours time interval to stop dysentery. However, this is commonly included in all ayurvedic home remedies.
• Take the Bilva (Aegle marmelos) pulp with Lassi (Whey) to stop blood dysentery.
• Boil two spoonfuls of Dhania (Coriander) and drink it to cure dysentery.
• Mix Methi seeds powder in curd and use 3-4 times a day. This is another very effective dysentery treatment.
• Mix Kali Mirch (Peppercorns) powder with Natural honey and lick to stop dysentery.
• Eat pure butter of cow milk and after that drink Lassi(whey) to stop blood dysentery.
• Mix some warm Jeera (Black Cumin) with a ripe banana to get rid of dysentery.
• Mix sendha namak and Loaf sugar in lemon juice and drink 3-4 times a day to stop dysentery.
• Grind the pip of Mango fruit and use with Lassi(whey) to cure dysentery.
• Use decoction of Sonth  (Sonti, Dried ginger) in dysentery treatment.
• Take 30 Gram Anar (Pomegranate) external pulp and 4 cloves and grind and mix this powder with two glasses of water and filter. Take this filtrate 3-4 times a day to cure dysentery.

FAQs of Amoebic Dysentery

How to prevent amebic dysentery quickly?

• You can treat it or at least slow it down. Avoid dehydration by drinking lots of clear fluid with no alcohol or caffeine. Probiotics like yogurt can shorten the length of diarrhea symptoms.

What food is good for amebic dysentery?

• When you are affected with amebic dysentery, it is better to stick to a bland diet (bananas, rice, and soda crackers) and avoid milk products.

How can I get relief from amebic dysentery?

• Over-the-counter painkillers can help relieve pain and fever. It is better to avoid anti-diarrhoeal medications because they can make things worse. You should stay at home until at least two days after the last episode of diarrhea to reduce the risk of passing the infection on to others.

How long does amoebic dysentery last?

• In mild cases of amoebic dysentery may last 4 to 8 days and severe cases may last within 3 to 6 weeks. Amoebic dysentery symptoms begin within 2 to 10 days of infection. In children, the sickness will start with fever, nausea, vomiting, abdominal cramps, and diarrhea.

Can amebic dysentery be cured?

• Drug treatment can cure amebic dysentery within a few weeks. However, because the medication cannot keep you from getting infected again, repeat episodes of amebic dysentery may occur if you continue to live in or travel to areas where amoebas are found.

What triggers amebic dysentery?

• Amebic dysentery is a parasitic infection of the intestines caused by the protozoan Entamoeba histolytica, simply “E. histolytica”. The symptoms of amebic dysentery include loose stool, abdominal cramping, and stomach pain. However, most people with this won’t experience significant symptoms.

How long does it take for amebic dysentery to kill you?

• It takes two to 15 days for symptoms to appear after entering the body. Death of a person usually happens three to seven days after symptoms appear. Only some of the patients worldwide have been reported to have survived the infection.

How long does amoebic dysentery stay alive?

• The incubation period varies from a few days to several months. It usually takes 2 – 4 weeks. They can survive for up to a month in soil and for up to 45 minutes under fingernails. Very often it spreads to other parts of the body such as the lungs or brain.

What happens if amoebic dysentery is left untreated?

• If left untreated, amoebic dysentery can lead to severe dehydration and further lead to many complications. See your doctor immediately if you have the symptoms of amoebic dysentery, then your doctor will order diagnostic testing to determine which bacteria are present and causing the problem. This includes a blood test and lab tests of a stool sample.

Is amoebic dysentery deadly?

• Amoebic dysentery is deadly when there is no Proper treatment of the underlying infection of amoebic dysentery. Insufficiently treated amoebiasis can live for years and later lead to severe, potentially fatal, complications.

What is the difference between diarrhea and amoebic dysentery?

• They can be differentiated in terms of symptoms. The stool of diarrhea is watery with or without cramps and pain but in amoebic dysentery, patient complaints about mucoid stool (presence of mucus in stool) that is presented with blood.

Who can get amoebic dysentery?

• Children are most at risk of amoebic dysentery, but anyone can be affected by this at any age. It can easily spread through person-to-person contact and by contaminated food and drink.