Dysentery (formerly known as flux or the bloody flux) is frequent, small-volume, severe diarrhea that shows blood in the feces along with intestinal cramping and tenesmus (painful straining to pass stool).Ryan KJ, Ray CG (editors) (2004). Sherris Medical Microbiology, 4th ed., McGraw Hill, pp. 361, 858. ISBN 0838585299.  Additional symptoms frequently associated with dysentery include fever and malaise.

Dysentery has myriad causes, including cancer, but is typically associated with infection caused by the ingestion of food or water containing micro-organisms which cause significant inflammation of the 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.Apel, Melanie Ann (author) (2003). Amebic Dysentery (Epidemics), 1st ed., Rosen Publishing Group, pp. 13. ISBN 0823941965. 

Amoebic dysentery

Main article: Amoebiasis

Amoebic dysentery (or amebic dysentery) is caused by the amoeba Entamoeba histolytica.

Amoebic dysentery is transmitted through contaminated food and water. From ingestion, the infecting organisms move into the intestines via the stomach. 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" although it is occasionally seen in industrialized countries. Liver infection, and subsequent amoebic abscesses can occur.

Bacillary dysentry

Bacillary dysentry is mostly commonly associated with three bacterial groups:

• Shigellosis is caused by one of several types of Shigella 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 lactose intolerance.DuPont HL (1978). "Interventions in diarrheas of infants and young children". J. Am. Vet. Med. Assoc. 173 (5 Pt 2): 649–53. PMID 359524. DeWitt TG (1989). "Acute diarrhea in children". Pediatr Rev 11 (1): 6–13. PMID 2664748<

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Treatment

See also: Amoebiasis#Treatment

The first and main task in managing any episode of dysentry 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 diarrhea, 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 dysentry are often self-limiting and do not require antibiotics, (March 2007) "Antibacterial drugs - Summary of antibacterial therapy", British National Formulary, Ed.53, p.276.  which are reserved for more severe or persisting cases; campylobacter, shigella and salmonella respond to ciprofloxacin or macrolide antibiotics.

Miscellaneous references

• 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. 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.
• The band blink-182 has a song called "Dysentery Gary" in which diarrhea is mentioned.
• John McCain suffered from dysentery while a POW.
• Elie Wiesel, a renowned Holocaust survivor, described in his book Night his father suffering from dysentery while imprisoned in Buchenwald, a concentration camp of Nazi Germany during the Holocaust. He was later beaten to death because of his illness.
• In the Woody Allen movie Annie Hall, Allen\'s character jokes that two leading intellectual magazines, Dissent and Commentary, had merged to form Dysentery. An oblique reference to intellectual pretense.
• In the movie 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 anus for five years.
• Harrison Ford apparently suffered from it while filming Raiders of the Lost Ark in Tunisia; this partially resulted in his suggesting that rather than have an elaborate fight with an 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 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."

See also

• Gastroenteritis

References

This article is licensed under the GNU Free Documentation License. It uses material from Wikipedia

This article is licensed under the GNU Free Documentation License. It uses material from Wikipedia