HERBAL REMEDIES FOR DYSENTERY BY BABALAWO OBANIFA-OBANIFA EXTREME DOCUMENTARIES

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HERBAL REMEDIES FOR DYSENTERY BY BABALAWO OBANIFA-OBANIFA EXTREME DOCUMENTARIES
                                  

In this work Babalawo Obanifa will document varieties of herbal formula available in Yoruba herbal medicine for treatment of dysentery. The term for dysentery in Yoruba Herbal Medicine is known as Igbe Sooro. The nomenclature for the herbal formula for treatment of dysentery is known as Oogun Dida Igbe Sooro. This shall document in detail varieties of herbal formula available in Yoruba Herbal medicine for such purpose. The work will examine what is dysentery, it causes, symptoms treatment and prevention from orthodox medicine perspective. While the concluding part will document in detail varieties of herbal remedies available in Yoruba herbal medicine for the treatment of dysentery.However it is instructive to note that Information made available in this work should not be regarded as substitute to the service of qualified trained health practitioner where the service of one is required. In an attempt to give scientific explanation of what is dysentery. We shall rely  solely on the work of Adam Felman titled, everything you should known about dysentery. The work has been medically review by  Alana Biggers, M.D., MPH on June 23, 2017  and published on www.medicalnewstoday.com . According to the aforementioned source, Dysentery is an infectious disease associated with severe diarrhea. signs and symptoms are normally mild and usually disappear within a few days. Most people will not seek medical attention.

Each year worldwide, there are between 120 million and 165 million cases of Shigella infection, of which 1 million are fatal. Over 60 percent of these fatalities are children under 5 years old in developing countries.

Treatment

Laboratory results will reveal whether the infection is due to Shigella or Entamoeba histolyca infection.

If treatment is necessary, it will depend on these results.

However, any patient with diarrhea or vomiting should drink plenty of fluids to prevent dehydration.

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

Treatment for mild bacillary dysentery

Mild bacillary dysentery, the kind commonly found in developed countries with good sanitation, will normally resolve without treatment.

However, the patient should drink plenty of fluids.

In more severe cases, antibiotic drugs are available.

Treatment for amoebic dysentery

Amoebicidal medications are used to treat Entamoeba histolyca. These will ensure that the amoeba does not survive inside the body after symptoms have resolved.

Flagyl, or metronidazole, is often used to treat dysentery. It treats both bacteria and parasites.

If lab results are unclear, the patient may be given a combination of antibiotic and amoebicidal medications, depending on how severe their symptoms are.

Symptoms

The symptoms of dysentery range from mild to severe, largely depending on the quality of sanitation in the areas where infection has spread.
In developed countries, signs and symptoms of dysentery tend to be milder than in developing nations or tropical areas.
Mild symptoms include:

• a slight stomach-ache
• cramping
• diarrhea

These usually appear from 1 to 3 days after infection, and the patient recovers within a week.
Some people also develop lactose intolerance, which can last for a long time, sometimes years.

Symptoms of bacillary dysentery

Symptoms tend to appear within 1 to 3 days of infection. There is normally a mild stomach ache and diarrhea, but no blood or mucus in the feces. Diarrhea may be frequent to start with.
Less commonly, may beTrusted Source:

• blood or mucus in the feces
• intense abdominal pain
• fever
• nausea
• vomiting

Often, symptoms are so mild that a doctor's visit is not required, and the problem resolves in a few days.

Symptoms of amoebic dysentery

A person with amoebic dysentery may have:

• abdominal pain
• fever and chills
• nausea and vomiting
• watery diarrhea, which can contain blood, mucus, or pus
• the painful passing of stools
• fatigue
• intermittent constipation

If amoeba tunnel through the intestinal wall, they can spread into the bloodstream and infect other organs.
Ulcers can develop. These may bleed, causing blood in stools.
Symptoms may persist for several weeks.
The amoebae may continue living within the human host after symptoms have gone. Then, symptoms may recur when the person's immune system is weaker.
Treatment reduces the risk of the amoebae surviving.
The World Health Organization (WHO) identifiesTrusted Source two main types of dysentery.
Bacillary dysentery, or shigellosis
This type produces the most severe symptoms. It is caused by the Shigella bacillus.
Poor hygiene is the main source. Shigellosis can also spread because of tainted food.
In Western Europe and the U.S., it is the most common type of dysentery in people who have not visited the tropics shortly before infection.
Amoebic dysentery, or amoebiasis
This type is caused by Entamoeba histolytica (E. histolytica), an amoeba.
The amoebae group together to form a cyst, and these cysts emerge from the body in human feces.
In areas of poor sanitation, the amoebae can contaminate food and water and infect other humans, as they can survive for long periods outside the body.
They can also linger on people's hands after using the bathroom. Good hygiene practice reduces the risk of spreading infection.
It is more common in the tropics, but it sometimes occurs in parts of rural Canada.

Other causes

Other causes include a parasitic worm infection, chemical irritation, or viral infection.

Diagnosis

The doctor will ask the patient about their signs and symptoms and carry out a physical examination.
A stool sample may be requested, especially if the patient has recently returned from the tropics.
If symptoms are severe, diagnostic imaging may be recommended. This could be an ultrasound scan or an endoscopy.

Complications

Complications of dysentery are few, but they can be severe.
Dehydration: Frequent diarrhea and vomiting can quickly lead to dehydration. In infants and young children, this can quickly become life-threatening.
Liver abscess: If amoebae spread to the liver, an abscess can form there.
Postinfectious arthritis: Joint pain may occur following the infection.
Hemolytic uremic syndrome: Shigella dysenteriae can cause the red blood cells to block the entrance to the kidneys, leading to anemia, low platelet count, and kidney failure.
Patients have also experienced seizures after infection.

Prevention

Dysentery mostly stems from poor hygiene.
To reduce the risk of infection, people should wash their hands regularly with soap and water, especially before and after using the bathroom and preparing food.
This can reduce the frequency of Shigella infections and other types of diarrhea by up to 35 percentTrusted Source.
Other steps to take when the risk is higher, for example, when traveling, include:

• Only drink reliably sourced water, such as bottled water
• Watch the bottle being opened, and clean the top of the rim before drinking
• Make sure food is thoroughly cooked

It is best to use purified water to clean the teeth, and avoid ice cubes, as the source of the water may be unknown.
Herbal Remedies for Dysentery in Yoruba Herbal Medicine as Document By Babalawo Obanifa
1.
Suku agbado (corn cobs)
Ewe patanmon(leaves of Landophia Owariensis)
Odidi ataare (A whole alligator pepper)
Preparation
You will burn the aforementioned item together and grind to fine  powder.
Usage
Patient suffering from dysentery will be adding it to eko gbigbona (hot corn meal)
2.
Ewe Efinrin nla (basil leaves /Occimum grattissimum)
Ogiri Ijebu (unidentified )
Preparation
You will squeeze the juice  of  Ewe Efinrin nla (basil leaves /Occimum grattissimum) with water. You will mix Ogiri Ijebu (unidentified),
Usage
Person suffering from   Dysentery will drink it.
3.
Ewe Orikotene tutu(fresh leaves of Brysocarpus Coccineus)
Preparation
Squeeze the leaves with water .
Usage
The patient will be drinking it to stop dysentery
4.
Ewe  Odundun tutu (fresh leaves of  Resurrection plants)
Preparation
You will use water to squeeze Ewe  Odundun tutu (fresh leaves of  Resurrection plants)
Usage’
The dysentery patient will be drinking it.
5.
Eepo igi Oriri (fresh bark stem of  Oriri /Uniedntfied)
 Preparation
Soak it in water.
Usage
The dysentery patient will be drinking it.
6.
Egbo ewuro( Roots of bitter leaves plants /Verlonia Amygdalina)
Ewe eepin (leave of sand paper tree /Fiscus Experate )
Oko ataare(clove of alligator pepper/Aframomum melegueta)
Efunle (Evolvolus aisinoides)
Preparation
You will  grind everything together.
Usage
Dysentery patient will be drinking it .
7.
Ewe ewuro (bitter leaves  /Verlonia amygdalina)
Alubosa Ayu (garlic /Allium sativum)

Preparation
You will grind the two aforementioned item together and mixed it with honey.
Usage
The person with dysentery will be licking it.
8.
Obi gbanja (Cola nitida)
Iyere (guineaa pepper/Piper guinensis)
Preparation
You will grind the aforementioned item together.
Usage
dysentery patient will be adding it  to hot corn meal
9.
Ewe arunkuna (unidentified)
Efun
Ataare meta (three pod of fruits of alligator pepper)
Preparation
You will grind the aforementioned item together.
Usage
dysentery patient will be adding it  to hot corn meal
10.
Epo Igi omon (fresh stem bark of Omon)
Preparation
You will  boil the stem bark of Omon with water. use the water to cook unripe plantain as porridge and eat it.
11.
Ewe Alukerese(fresh leaves of Ipomea Invulucrata)
Preparation
You will squeeze the aforementioned leaves to obtain it juice.
Usage
Put it on finger nails and toes of patient with Dysentery
12.
Ewe Koleorogba tutu (fresh leaves of Koleoorogba)
You will squeeze the aforementioned leaves to obtain it juice.
Usage
Put it on finger nails and toes of patient with Dysentery
13.
Ododo Ewe Agunmona (tender leaves of Culcasia scandens)
Preparation
Grind it to fine paste and use it to cook dry cat fish and eat it when you have dysentary
14.
Egbo Airanku (roots of Airanku/Unidentified )
Preparation
Grind it to fine paste and use it to cook dry cat fish and eat it when you have dysentery
15.
Eepo Ara Igbo(bark stem  of Bridelia Micrantia)

Eepo Igi Aaka/Akika (Bark stem of  Cynometra Megalophilia)
Preparation
Grind it to fine powder and mix it with red palm oil
Usage
dysentery patient will be licking it.

References

https://www.medicalnewstoday.com/articles/171193.php#prevention

·         Amebiasis. (2014, January)
health.ny.gov/diseases/communicable/amebiasis/fact_sheet.htm

·         Amebiasis. (n.d.)
pharmacology2000.com/Chemotherapy/Antiparasitic/ameba2.htm

·         Bowen, A. (2017, May 31)
wwwnc.cdc.gov/travel/yellowbook/2016/infectious-diseases-related-to-travel/shigellosis

·         Debnath, A., Parsonage, D., Andrade, R., He, C., Cobo, E., Hirata, K., … & Reed, S. (2012, December 1). A high throughput drug screen for Entamoeba histolyca identifies a new lead and target. Nature medicine, 18, 6, 956-960
ncbi.nlm.nih.gov/pmc/articles/PMC3411919/

·         Dysentery. (n.d.)
who.int/topics/dysentery/en/

·         Epidemic dysentery health update: A supplement to issue no. 55. (1993, December - 1994, February). A supplement guide to dialogue on diarrhoea, 55, 1-6
rehydrate.org/dd/su55.htm

·         Harding, M. (2016, May 25). Shigellosis
patient.info/doctor/shigellosis

·         Hemolytic uremic syndrome in children. (2015, June)
niddk.nih.gov/health-information/kidney-disease/children/hemolytic-uremic-syndrome

·         Oral rehydration therapy. (2014, April 21)
rehydrate.org/ors/ort.htm

·         Schlein, L. (n.d.). WHO world water day report
who.int/water_sanitation_health/takingcharge.html

·         Shigella - Shigellosis. (2017, March 31)
cdc.gov/shigella/general-information.html

·         Traa, B., Fischer Walker, C.L., Munos, M., & Black, R. (2010, March 23). Antibiotics for the treatment of dysentery in children. International journal of epidemiology, 39, suppl 1
academic.oup.com/ije/article/39/suppl_1/i70/700550/Antibiotics-for-the-treatment-of-dysentery-in

·         Vyas, J. (2015, May 1). Amebic liver abscess
medlineplus.gov/ency/article/000211.htm

·         Walsh, M. (2011, September 19). Shigellosis
infectionlandscapes.org/2011/09/shigellosis.html

Copyright :Babalawo Pele Obasa Obanifa, phone and whatsapp contact :+2348166343145, location Ile Ife osun state Nigeria
IMPORTANT NOTICE :As regards the article above no part of this article may be reproduced or duplicated in any form or by any means, electronic or mechanical including photocopying and recording or by any information storage or retrieval system without prior written permission from the copyright holder and the author Babalawo Obanifa, doing so will be deem unlawful and will attract legal consequences.



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 RECURSOS HERBARIOS PARA LA DISENTERÍA DE BABALAWO OBANIFA-OBANIFA DOCUMENTARIOS EXTREMOS



 

 En este trabajo, Babalawo Obanifa documentará las variedades de fórmula a base de hierbas disponibles en la medicina herbal Yoruba para el tratamiento de la disentería.  El término para disentería en Yoruba Herbal Medicine se conoce como Igbe Sooro.  La nomenclatura de la fórmula herbal para el tratamiento de la disentería se conoce como Oogun Dida Igbe Sooro.  Esto documentará en detalle las variedades de fórmula a base de hierbas disponibles en la medicina herbaria Yoruba para tal fin.  El trabajo examinará qué es la disentería, sus causas, el tratamiento de los síntomas y la prevención desde la perspectiva de la medicina ortodoxa.  Si bien la parte final documentará en detalle las variedades de remedios herbales disponibles en la medicina herbaria yoruba para el tratamiento de la disentería, sin embargo, es instructivo señalar que la información disponible en este trabajo no debe considerarse como un sustituto del servicio de un profesional de la salud calificado y capacitado.  donde se requiere el servicio de uno.  En un intento de dar una explicación científica de lo que es la disentería.  Nos basaremos únicamente en el trabajo de Adam Felman titulado, todo lo que debe saber sobre la disentería.  El trabajo ha sido revisado médicamente por Alana Biggers, M.D., MPH el 23 de junio de 2017 y publicado en www.medicalnewstoday.com.  Según la fuente mencionada anteriormente, la disentería es una enfermedad infecciosa asociada con diarrea severa.  Los signos y síntomas son normalmente leves y generalmente desaparecen en unos pocos días.  La mayoría de las personas no buscarán atención médica.

 Cada año en todo el mundo, hay entre 120 millones y 165 millones de casos de infección por Shigella, de los cuales 1 millón son fatales.  Más del 60 por ciento de estas muertes son niños menores de 5 años en países en desarrollo.

 Tratamiento


 Los resultados de laboratorio revelarán si la infección se debe a la infección por Shigella o Entamoeba histolyca.

 Si el tratamiento es necesario, dependerá de estos resultados.

 Sin embargo, cualquier paciente con diarrea o vómitos debe beber muchos líquidos para evitar la deshidratación.

 Si no pueden beber, o si la diarrea y los vómitos son profusos, puede ser necesario el reemplazo de líquidos por vía intravenosa (IV).  El paciente será colocado en un goteo y monitoreado.

 Tratamiento para disentería bacilar leve

 La disentería bacilar leve, el tipo comúnmente encontrado en países desarrollados con buen saneamiento, normalmente se resolverá sin tratamiento.

 Sin embargo, el paciente debe beber muchos líquidos.

 En casos más severos, hay antibióticos disponibles.

 Tratamiento para disentería amebiana

 Los medicamentos amebicidas se usan para tratar Entamoeba histolyca.  Esto asegurará que la ameba no sobreviva dentro del cuerpo después de que los síntomas se hayan resuelto.

 Flagyl, o metronidazol, a menudo se usa para tratar la disentería.  Trata bacterias y parásitos.

 Si los resultados de laboratorio no son claros, se le puede dar al paciente una combinación de antibióticos y medicamentos amebicidas, según la gravedad de sus síntomas.

 Síntomas

 Los síntomas de la disentería varían de leves a graves, dependiendo en gran medida de la calidad del saneamiento en las áreas donde se ha propagado la infección.

 En los países desarrollados, los signos y síntomas de disentería tienden a ser más leves que en los países en desarrollo o las áreas tropicales.

 Los síntomas leves incluyen:

 un ligero dolor de estómago

 calambres

 diarrea

 Estos generalmente aparecen de 1 a 3 días después de la infección, y el paciente se recupera dentro de una semana.

 Algunas personas también desarrollan intolerancia a la lactosa, que puede durar mucho tiempo, a veces años.

 Síntomas de disentería bacilar

 Los síntomas tienden a aparecer dentro de 1 a 3 días de la infección.  Normalmente hay un leve dolor de estómago y diarrea, pero no hay sangre ni moco en las heces.  La diarrea puede ser frecuente para comenzar.

 Menos comúnmente, puede ser Confiado Fuente:

 sangre o moco en las heces

 dolor abdominal intenso

 fiebre

 náuseas

 vómitos

 A menudo, los síntomas son tan leves que no se requiere una visita al médico, y el problema se resuelve en unos pocos días.

 Síntomas de disentería amebiana

 Una persona con disentería amebiana puede tener:

 dolor abdominal

 fiebre y escalofríos

 náuseas y vómitos

 diarrea acuosa, que puede contener sangre, moco o pus

 el doloroso paso de las heces

 fatiga

 estreñimiento intermitente

 Si el túnel de la ameba atraviesa la pared intestinal, pueden extenderse al torrente sanguíneo e infectar otros órganos.

 Se pueden desarrollar úlceras.  Estos pueden sangrar, causando sangre en las heces.

 Los síntomas pueden persistir durante varias semanas.

 Las amebas pueden continuar viviendo dentro del huésped humano después de que los síntomas hayan desaparecido.  Entonces, los síntomas pueden reaparecer cuando el sistema inmunitario de la persona es más débil.

 El tratamiento reduce el riesgo de supervivencia de las amebas.

 La Organización Mundial de la Salud (OMS) identifica a la fuente confiable dos tipos principales de disentería.

 Disentería bacilar o shigelosis

 Este tipo produce los síntomas más severos.  Es causada por el bacilo Shigella.

 La mala higiene es la fuente principal.  La shigelosis también se puede propagar debido a la comida contaminada.

 En Europa occidental y los EE. UU., Es el tipo de disentería más común en personas que no han visitado los trópicos poco antes de la infección.

 Disentería amebiana o amebiasis

 Este tipo es causado por Entamoeba histolytica (E. histolytica), una ameba.

 Las amebas se agrupan para formar un quiste, y estos quistes emergen del cuerpo en las heces humanas.

 En áreas de saneamiento deficiente, las amebas pueden contaminar los alimentos y el agua e infectar a otros humanos, ya que pueden sobrevivir durante largos períodos fuera del cuerpo.

 También pueden quedarse en las manos de las personas después de usar el baño.  Las buenas prácticas de higiene reducen el riesgo de propagación de infecciones.

 Es más común en los trópicos, pero a veces ocurre en partes de las zonas rurales de Canadá.

 Otras causas

 Otras causas incluyen una infección parasitaria por gusanos, irritación química o infección viral.

 Diagnóstico

 El médico le preguntará al paciente sobre sus signos y síntomas y le realizará un examen físico.

 Se puede solicitar una muestra de heces, especialmente si el paciente ha regresado recientemente de los trópicos.

 Si los síntomas son graves, se pueden recomendar imágenes de diagnóstico.  Esto podría ser una ecografía o una endoscopia.

 Complicaciones

 Las complicaciones de la disentería son pocas, pero pueden ser graves.

 Deshidratación: la diarrea y los vómitos frecuentes pueden conducir rápidamente a la deshidratación.  En bebés y niños pequeños, esto puede convertirse rápidamente en una amenaza para la vida.

 Absceso hepático: si las amebas se extienden al hígado, allí se puede formar un absceso.

 Artritis posinfecciosa: puede producirse dolor en las articulaciones después de la infección.

 Síndrome urémico hemolítico: Shigella dysenteriae puede causar que los glóbulos rojos bloqueen la entrada a los riñones, lo que conduce a anemia, recuento bajo de plaquetas e insuficiencia renal.

 Los pacientes también han experimentado convulsiones después de la infección.

 Prevención

 La disentería proviene principalmente de una mala higiene.

 Para reducir el riesgo de infección, las personas deben lavarse las manos regularmente con agua y jabón, especialmente antes y después de usar el baño y preparar la comida.

 Esto puede reducir la frecuencia de las infecciones por Shigella y otros tipos de diarrea hasta en un 35 por ciento Fuente confiable.

 Otros pasos a seguir cuando el riesgo es mayor, por ejemplo, al viajar, incluyen:

 Solo beba agua de origen confiable, como agua embotellada

 Observe cómo se abre la botella y limpie la parte superior del borde antes de beber

 Asegúrese de que la comida esté bien cocida

 Es mejor usar agua purificada para limpiar los dientes y evitar los cubitos de hielo, ya que la fuente del agua puede ser desconocida.

 Remedios herbales para la disentería en la medicina herbaria yoruba como documento por Babalawo Obanifa

 1)

 Suku agbado (mazorcas de maíz)

 Oveja patanmon (hojas de Landophia Owariensis)

 Odidi ataare (Una pimienta de cocodrilo entera)

 Preparación

 Quemarán juntos el artículo mencionado anteriormente y se molerán hasta obtener un polvo fino.

 Uso

 El paciente que padece disentería lo agregará a eko gbigbona (harina de maíz caliente)

 2)

 Oveja Efinrin nla (hojas de albahaca / Occimum grattissimum)

 Ogiri Ijebu (no identificado)

 Preparación

 Exprimirá el jugo de Ewe Efinrin nla (hojas de albahaca / Occimum grattissimum) con agua.  Mezclarás Ogiri Ijebu (no identificado),

 Uso

 La persona que sufre de disentería lo beberá.

 3)

 Oveja tutú Orikotene (hojas frescas de Brysocarpus Coccineus)

 Preparación

 Exprime las hojas con agua.

 Uso

 El paciente lo tomará para detener la disentería.

 4)

 Oveja Odundun tutu (hojas frescas de plantas de resurrección)

 Preparación

 Usarás agua para exprimir el tutú Ewe Odundun (hojas frescas de las plantas de Resurrección)

 Uso "

 El paciente disentería lo beberá.

 5)

 Eepo igi Oriri (tallo de corteza fresca de Oriri / Uniedntfied)

 Preparación

 Remojarlo en agua.

 Uso

 El paciente disentería lo beberá.

 6)

 Egbo ewuro (Raíces de plantas de hojas amargas / Verlonia Amygdalina)

 Eepin de oveja (licencia de árbol de papel de lija / Gasto de Fiscus)

 Oko ataare (clavo de aligátor / Aframomum melegueta)

 Efunle (Evolvolus aisinoides)

 Preparación

 Molerán todo juntos.

 Uso

 Paciente disentería lo beberá.

 7)

 Oveja ewuro (hojas amargas / Verlonia amygdalina)

 Alubosa Ayu (ajo / Allium sativum)


 Preparación

 Molerás los dos elementos antes mencionados y los mezclarás con miel.

 Uso

 La persona con disentería lo lamerá.

 8)

 Obi gbanja (Cola nitida)

 Iyere (guineaa / Piper guinensis)

 Preparación

 Molerás el artículo antes mencionado juntos.

 Uso

 paciente disentería lo agregará a la harina de maíz caliente

 9)

 Oveja arunkuna (no identificado)

 Efun

 Ataare meta (tres vainas de frutas de cocodrilo)

 Preparación

 Molerás el artículo antes mencionado juntos.

 Uso

 paciente disentería lo agregará a la harina de maíz caliente

 10)

 Epo Igi omon (corteza de tallo fresca de Omon)

 Preparación

 Hervirás la corteza del tallo de Omon con agua.  usa el agua para cocinar plátano verde como avena y cómelo.

 11)

 Oveja Alukerese (hojas frescas de Ipomea Invulucrata)

 Preparación

 Exprimirá las hojas antes mencionadas para obtener jugo.

 Uso

 Póngalo en las uñas de los dedos de manos y pies de pacientes con disentería.

 12)

 Oveja Koleorogba tutu (hojas frescas de Koleoorogba)

 Exprimirá las hojas antes mencionadas para obtener jugo.

 Uso

 Póngalo en las uñas de los dedos de manos y pies de pacientes con disentería.

 13)

 Ododo Oveja Agunmona (tiernas hojas de escándalos de Culcasia)

 Preparación

 Muela hasta obtener una pasta fina y úsela para cocinar pescado seco para gatos y cómelo cuando tenga disizontal

 14)

 Egbo Airanku (raíces de Airanku / No identificado)

 Preparación

 Muela hasta obtener una pasta fina y úsela para cocinar pescado seco para gatos y cómelo cuando tenga disentería

 15)

 Eepo Ara Igbo (tallo de corteza de Bridelia Micrantia)


 Eepo Igi Aaka / Akika (tallo de corteza de Cynometra Megalophilia)

 Preparación

 Molerlo hasta obtener un polvo fino y mezclarlo con aceite de palma rojo

 Uso

 paciente disentería lo estará lamiendo.

 Referencias

 https://www.medicalnewstoday.com/articles/171193.php#prevention

 Amebiasis  (2014, enero)
 health.ny.gov/diseases/communicable/amebiasis/fact_sheet.htm

 Amebiasis  (n.d.)
 pharmaology2000.com/Chemotherapy/Antiparasitic/ameba2.htm

 Bowen, A. (31 de mayo de 2017)
 wwwnc.cdc.gov/travel/yellowbook/2016/infectious-diseases-related-to-travel/shigellosis

 Debnath, A., Parsonage, D., Andrade, R., He, C., Cobo, E., Hirata, K., ... & Reed, S. (2012, 1 de diciembre).  Un examen de drogas de alto rendimiento para Entamoeba histolyca identifica un nuevo líder y objetivo.  Medicina natural, 18, 6, 956-960
 ncbi.nlm.nih.gov/pmc/articles/PMC3411919/

 Disentería.  (n.d.)
 who.int/topics/dysentery/en/

 · Actualización de la salud de la disentería epidémica: un suplemento a la edición no.  55. (1993, diciembre - 1994, febrero).  Una guía complementaria para el diálogo sobre diarrea, 55, 1-6
 rehydrate.org/dd/su55.htm

 Harding, M. (25 de mayo de 2016).  Shigelosis
 patient.info/doctor/shigellosis

 Síndrome urémico hemolítico en niños.  (Junio ​​de 2015)
 niddk.nih.gov/health-information/kidney-disease/children/hemolytic-uremic-syndrome

 Terapia de rehidratación oral.  (21 de abril de 2014)
 rehydrate.org/ors/ort.htm

 Schlein, L. (sin fecha).  Informe del día mundial del agua de la OMS
 who.int/water_sanitation_health/takingcharge.html

 Shigella - Shigellosis.  (2017, 31 de marzo)
 cdc.gov/shigella/general-information.html

 Traa, B., Fischer Walker, C.L., Munos, M. y Black, R. (2010, 23 de marzo).  Antibióticos para el tratamiento de la disentería en niños.  Revista internacional de epidemiología, 39, supl. 1
 academic.oup.com/ije/article/39/suppl_1/i70/700550/Antibiotics-for-the-treatment-of-dysentery-in

 Vyas, J. (2015, 1 de mayo).  Absceso hepático amebiano
 medlineplus.gov/ency/article/000211.htm

 Walsh, M. (19 de septiembre de 2011).  Shigelosis
 infectionlandscapes.org/2011/09/shigellosis.html

 Copyright: Babalawo Pele Obasa Obanifa, teléfono y contacto de WhatsApp: +2348166343145, ubicación Ile Ife osun state Nigeria
 AVISO IMPORTANTE: en lo que respecta al artículo anterior, ninguna parte de este artículo puede reproducirse o duplicarse de ninguna forma ni por ningún medio, electrónico o mecánico, incluida la fotocopia y la grabación, o por cualquier sistema de almacenamiento o recuperación de información sin el permiso previo por escrito del titular de los derechos de autor y  el autor Babalawo Obanifa, hacerlo será considerado ilegal y traerá consecuencias legales.


  Clique no Vedio acima para assistir e baixar 5 remédios caseiros eficazes para tratamento de disenteria

  RECURSOS HERBAIS DE DISENTERIA POR DOCUMENTÁRIOS EXTREMOS BABALAWO OBANIFA-OBANIFA



  

  Neste trabalho, Babalawo Obanifa documentará variedades de fórmulas à base de plantas disponíveis na medicina herbal iorubá para tratamento de disenteria.  O termo para disenteria na medicina herbal de Yoruba é conhecido como Igbe Sooro.  A nomenclatura da fórmula à base de plantas para o tratamento da disenteria é conhecida como Oogun Dida Igbe Sooro.  Isso deve documentar detalhadamente as variedades de fórmulas de ervas disponíveis na medicina herbal iorubá para esse fim.  O trabalho examinará o que é disenteria, causa, tratamento e prevenção de sintomas na perspectiva da medicina ortodoxa.  Embora a parte final documente em detalhes as variedades de remédios fitoterápicos disponíveis na medicina herbal iorubá para o tratamento da disenteria, é instrutivo notar que as informações disponibilizadas neste trabalho não devem ser consideradas como substitutas do serviço de um profissional de saúde qualificado.  onde o serviço de um é necessário.  Na tentativa de dar uma explicação científica do que é disenteria.  Vamos confiar apenas no trabalho de Adam Felman intitulado, tudo o que você deve saber sobre disenteria.  O trabalho foi revisado clinicamente por Alana Biggers, M.D., MPH em 23 de junho de 2017 e publicado em www.medicalnewstoday.com.  Segundo a fonte mencionada, o disenteria é uma doença infecciosa associada à diarréia grave.  sinais e sintomas são normalmente leves e geralmente desaparecem dentro de alguns dias.  A maioria das pessoas não procura atendimento médico.

  Todos os anos no mundo, existem entre 120 e 165 milhões de casos de infecção por Shigella, dos quais 1 milhão são fatais.  Mais de 60% dessas mortes são crianças menores de 5 anos em países em desenvolvimento.

  Tratamento


  Os resultados laboratoriais revelarão se a infecção é devida à infecção por Shigella ou Entamoeba histolyca.

  Se o tratamento for necessário, dependerá desses resultados.

  No entanto, qualquer paciente com diarréia ou vômito deve beber bastante líquido para evitar a desidratação.

  Se eles não puderem beber, ou se houver diarréia e vômito profusos, pode ser necessária a reposição de líquidos por via intravenosa (IV).  O paciente será colocado em um gotejamento e monitorado.

  Tratamento para disenteria bacilar leve

  A disenteria bacilar leve, o tipo comumente encontrado em países desenvolvidos com bom saneamento, normalmente desaparece sem tratamento.

  No entanto, o paciente deve beber bastante líquido.

  Em casos mais graves, estão disponíveis antibióticos.

  Tratamento para disenteria amebiana

  Medicamentos amebicidas são usados ​​para tratar Entamoeba histolyca.  Isso garantirá que a ameba não sobreviva dentro do corpo após a resolução dos sintomas.

  Flagyl, ou metronidazol, é freqüentemente usado para tratar a disenteria.  Trata bactérias e parasitas.

  Se os resultados do laboratório não forem claros, o paciente pode receber uma combinação de antibióticos e medicamentos amebicidas, dependendo da gravidade dos sintomas.

  Sintomas

  Os sintomas da disenteria variam de leve a grave, dependendo em grande parte da qualidade do saneamento nas áreas onde a infecção se espalhou.

  Nos países desenvolvidos, os sinais e sintomas de disenteria tendem a ser mais leves do que nos países em desenvolvimento ou nas áreas tropicais.

  Sintomas leves incluem:

  uma leve dor de estômago

  cólicas

  diarréia

  Estes geralmente aparecem de 1 a 3 dias após a infecção, e o paciente se recupera dentro de uma semana.

  Algumas pessoas também desenvolvem intolerância à lactose, que pode durar muito tempo, às vezes anos.

  Sintomas de disenteria bacilar

  Os sintomas tendem a aparecer dentro de 1 a 3 dias após a infecção.  Normalmente, há uma leve dor de estômago e diarréia, mas não há sangue ou muco nas fezes.  Diarréia pode ser frequente para começar.

  Menos comumente, pode ser confiável

  sangue ou muco nas fezes

  dor abdominal intensa

  febre

  náusea

  vômito

  Muitas vezes, os sintomas são tão leves que a visita de um médico não é necessária e o problema desaparece em alguns dias.

  Sintomas de disenteria amebiana

  Uma pessoa com disenteria amebiana pode ter:

  dor abdominal

  febre e calafrios

  náuseas e vômitos

  diarréia aquosa, que pode conter sangue, muco ou pus

  a dolorosa passagem de fezes

  fadiga

  constipação intermitente

  Se a ameba passar pelo túnel através da parede intestinal, elas podem se espalhar pela corrente sanguínea e infectar outros órgãos.

  Úlceras podem se desenvolver.  Estes podem sangrar, causando sangue nas fezes.

  Os sintomas podem persistir por várias semanas.

  As amebas podem continuar vivendo no hospedeiro humano após o desaparecimento dos sintomas.  Em seguida, os sintomas podem ocorrer quando o sistema imunológico da pessoa estiver mais fraco.

  O tratamento reduz o risco de as amebas sobreviverem.

  A Organização Mundial de Saúde (OMS) identifica a Fonte Confiável dois tipos principais de disenteria.

  Disenteria bacilar ou shigelose

  Este tipo produz os sintomas mais graves.  É causada pelo bacilo Shigella.

  A falta de higiene é a principal fonte.  A shigelose também pode se espalhar por causa de alimentos contaminados.

  Na Europa Ocidental e nos EUA, é o tipo mais comum de disenteria em pessoas que não visitaram os trópicos pouco antes da infecção.

  Disenteria amebiana ou amebíase

  Esse tipo é causado por Entamoeba histolytica (E. histolytica), uma ameba.

  As amebas se agrupam para formar um cisto, e esses cistos emergem do corpo nas fezes humanas.

  Em áreas de falta de saneamento, as amebas podem contaminar comida e água e infectar outros seres humanos, pois podem sobreviver por longos períodos fora do corpo.

  Eles também podem permanecer nas mãos das pessoas depois de usar o banheiro.  Boas práticas de higiene reduzem o risco de propagação de infecções.

  É mais comum nos trópicos, mas às vezes ocorre em partes da região rural do Canadá.

  Outras causas

  Outras causas incluem infecção por vermes parasitas, irritação química ou infecção viral.

  Diagnóstico

  O médico perguntará ao paciente sobre seus sinais e sintomas e fará um exame físico.

  Uma amostra de fezes pode ser solicitada, especialmente se o paciente retornou recentemente dos trópicos.

  Se os sintomas forem graves, a imagem diagnóstica pode ser recomendada.  Pode ser uma ultra-sonografia ou uma endoscopia.

  Complicações

  As complicações da disenteria são poucas, mas podem ser graves.

  Desidratação: Diarréia e vômito freqüentes podem levar rapidamente à desidratação.  Em bebês e crianças pequenas, isso pode rapidamente se tornar fatal.

  Abscesso hepático: se as amebas se espalharem para o fígado, um abscesso pode se formar ali.

  Artrite pós-infecciosa: Podem ocorrer dores nas articulações após a infecção.

  Síndrome hemolítico-urêmica: Shigella dysenteriae pode fazer com que os glóbulos vermelhos bloqueiem a entrada dos rins, levando a anemia, baixa contagem de plaquetas e insuficiência renal.

  Os pacientes também sofreram convulsões após a infecção.

  Prevenção

  O disenteria tem origem principalmente na falta de higiene.

  Para reduzir o risco de infecção, as pessoas devem lavar as mãos regularmente com água e sabão, especialmente antes e depois de usar o banheiro e preparar a comida.

  Isso pode reduzir a frequência de infecções por Shigella e outros tipos de diarréia em até 35% da fonte confiável.

  Outras etapas a serem tomadas quando o risco é maior, por exemplo, ao viajar, incluem:

  Beba apenas água de origem confiável, como água engarrafada

  Observe a garrafa sendo aberta e limpe a parte superior da borda antes de beber

  Verifique se os alimentos estão bem cozidos

  É melhor usar água purificada para limpar os dentes e evitar cubos de gelo, pois a fonte da água pode ser desconhecida.

  Remédios à base de plantas para disenteria na medicina herbal iorubá como documento Por Babalawo Obanifa

  1

  Suku agbado (espigas de milho)

  Patanmon de ovelha (folhas de Landophia Owariensis)

  Odidi ataare (uma pimenta de jacaré inteira)

  Preparação

  Você queimará o item mencionado acima e triturará até pó fino.

  Uso

  O paciente que sofre de disenteria o adicionará ao eko gbigbona (farinha de milho quente)

  2)

  Ovelha Efinrin nla (folhas de manjericão / Occimum grattissimum)

  Ogiri Ijebu (não identificado)

  Preparação

  Você espremerá o suco de Ewe Efinrin nla (folhas de manjericão / Occimum grattissimum) com água.  Você misturará Ogiri Ijebu (não identificado),

  Uso

  A pessoa que sofre de disenteria vai beber.

  3)

  Tutu de ovelha Orikotene (folhas frescas de Brysocarpus Coccineus)

  Preparação

  Esprema as folhas com água.

  Uso

  O paciente vai beber para parar a disenteria

  4)

  Tutu de ovelha Odundun (folhas frescas de plantas da Ressurreição)

  Preparação

  Você usará a água para espremer o tutu Ewe Odundun (folhas frescas das plantas da Ressurreição)

  Uso "

  O paciente com disenteria vai beber.

  5)

  Eepo igi Oriri (caule fresco de Oriri / Uniedntfied)

  Preparação

  Mergulhe na água.

  Uso

  O paciente com disenteria vai beber.

  6

  Egbo ewuro (raízes de plantas de folhas amargas / Verlonia Amygdalina)

  Ovelha eepin (licença da árvore de papel de areia / Fiscus Experate)

  Oko ataare (dente de pimenta de jacaré / Aframomum melegueta)

  Efunle (Evolvolus aisinoides)

  Preparação

  Você vai moer tudo juntos.

  Uso

  Paciente disenteria vai beber.

  7)

  Ovelha ewuro (folhas amargas / Verlonia amygdalina)

  Alubosa Ayu (alho / Allium sativum)


  Preparação

  Você vai moer os dois itens mencionados acima e misturar com mel.

  Uso

  A pessoa com disenteria vai lambê-lo.

  8)

  Obi gbanja (Cola nitida)

  Iyere (pimenta da Guiné / Piper guinensis)

  Preparação

  Você triturará o item acima mencionado.

  Uso

  paciente disenteria irá adicioná-lo à farinha de milho quente

  9

  Ovelha arunkuna (não identificada)

  Efun

  Ataare meta (três vagens de frutas de pimenta jacaré)

  Preparação

  Você triturará o item acima mencionado.

  Uso

  paciente disenteria irá adicioná-lo à farinha de milho quente

  10)

  Epo Igi omon (casca de caule fresco de Omon)

  Preparação

  Você ferverá a casca do caule de Omon com água.  use a água para cozinhar a banana verde como mingau e comê-la.

  11)

  Ovelha Alukerese (folhas frescas de Ipomea Invulucrata)

  Preparação

  Você vai apertar as folhas acima mencionadas para obter suco.

  Uso

  Coloque nas unhas das mãos e dos pés dos pacientes com Disenteria

  12)

  Tutu de ovelha Koleorogba (folhas frescas de Koleoorogba)

  Você vai apertar as folhas acima mencionadas para obter suco.

  Uso

  Coloque nas unhas das mãos e dos pés dos pacientes com Disenteria

  13)

  Ododo Ewe Agunmona (folhas tenras de Culcasia scandens)

  Preparação

  Moa-o para colar bem e use-o para cozinhar peixe-gato seco e comê-lo quando tiver disizontal

  14)

  Egbo Airanku (raízes de Airanku / Não identificado)

  Preparação

  Moa para colar bem e use-o para cozinhar peixe-gato seco e comê-lo quando tiver disenteria

  15

  Eepo Ara Igbo (caule de casca de Bridelia Micrantia)


  Eepo Igi Aaka / Akika (caule de casca de Cynometra Megalophilia)

  Preparação

  Moa em pó fino e misture com óleo de palma vermelho

  Uso

  paciente disenteria vai lambê-lo.

  Referências

  https://www.medicalnewstoday.com/articles/171193.php#prevention

  Amebíase.  (2014, janeiro)
  health.ny.gov/diseases/communicable/amebiasis/fact_sheet.htm

  Amebíase.  (n.d.)
  pharmacology2000.com/Chemotherapy/Antiparasitic/ameba2.htm

  Bowen, A. (2017, 31 de maio)
  wwwnc.cdc.gov/travel/yellowbook/2016/infectious-diseases-related-to-travel/shigellosis

  Debnath, A., Parsonage, D., Andrade, R., He, C., Cobo, E., Hirata, K., ... & Reed, S. (2012, 1 de dezembro de 2012).  Uma triagem de drogas de alto rendimento para Entamoeba histolyca identifica um novo lead e alvo.  Medicina natural, 18, 6, 956-960
  ncbi.nlm.nih.gov/pmc/articles/PMC3411919/

  Disenteria.  (n.d.)
  who.int/topics/dysentery/en/

  · Atualização em saúde da disenteria epidêmica: um suplemento ao número n.  55. (1993, dezembro - 1994, fevereiro).  Um guia complementar para o diálogo sobre diarréia, 55, 1-6
  rehydrate.org/dd/su55.htm

  Harding, M. (2016, 25 de maio).  Shigelose
  Patient.info/doctor/shigellosis

  Síndrome hemolítico-urêmica em crianças.  (Junho de 2015)
  niddk.nih.gov/health-information/kidney-disease/children/hemolytic-uremic-syndrome

  Terapia de reidratação oral.  (21 de abril de 2014)
  rehydrate.org/ors/ort.htm

  Schlein, L. (n.d.).  Relatório mundial do dia da água da OMS
  who.int/water_sanitation_health/takingcharge.html

  Shigella - Shigelose.  (31 de março de 2017)
  cdc.gov/shigella/general-information.html

  Traa, B., Fischer Walker, C. L., Munos, M., & Black, R. (2010, 23 de março).  Antibióticos para o tratamento da disenteria em crianças.  Revista Internacional de Epidemiologia, 39, suppl 1
  academic.oup.com/ije/article/39/suppl_1/i70/700550/Antibiotics-for-the-treatment-of-dysentery-in

  Vyas, J. (2015, 1 de maio).  Abscesso hepático amebiano
  medlineplus.gov/ency/article/000211.htm

  Walsh, M. (2011, 19 de setembro).  Shigelose
  infecçãolandscapes.org/2011/09/shigellosis.html

  Direitos autorais: Babalawo Pele Obasa Obanifa, telefone e whatsapp: +2348166343145, localização Ile Ife osun state Nigeria
  AVISO IMPORTANTE: No que diz respeito ao artigo acima, nenhuma parte deste artigo pode ser reproduzida ou duplicada de qualquer forma ou por qualquer meio, eletrônico ou mecânico, incluindo fotocópia e gravação ou por qualquer sistema de armazenamento ou recuperação de informações sem a permissão prévia por escrito do detentor dos direitos autorais e  o autor Babalawo Obanifa, fazê-lo será considerado ilegal e atrairá consequências legais.



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  RECOURS AUX HERBES POUR LA DYSENTERIE PAR BABALAWO OBANIFA-OBANIFA EXTREME DOCUMENTARIES



  

  Dans ce travail, Babalawo Obanifa documentera les variétés de formules à base de plantes disponibles en phytothérapie Yoruba pour le traitement de la dysenterie.  Le terme de dysenterie en phytothérapie Yoruba est connu sous le nom d'Igbe Sooro.  La nomenclature de la formule à base de plantes pour le traitement de la dysenterie est connue comme Oogun Dida Igbe Sooro.  Cela documentera en détail les variétés de formules à base de plantes disponibles dans la médecine à base de plantes Yoruba à cette fin.  Le travail examinera ce qu'est la dysenterie, ses causes, le traitement et la prévention des symptômes du point de vue de la médecine orthodoxe.  Alors que la partie finale documentera en détail les variétés de remèdes à base de plantes disponibles en phytothérapie yoruba pour le traitement de la dysenterie, il est toutefois instructif de noter que les informations mises à disposition dans ce travail ne doivent pas être considérées comme un substitut au service d'un professionnel de la santé qualifié et qualifié.  où le service d'un est requis.  Dans une tentative de donner une explication scientifique de ce qu'est la dysenterie.  Nous nous baserons uniquement sur le travail d'Adam Felman intitulé, tout ce que vous devez savoir sur la dysenterie.  Le travail a été examiné médicalement par Alana Biggers, M.D., MPH le 23 juin 2017 et publié sur www.medicalnewstoday.com.  Selon la source susmentionnée, la dysenterie est une maladie infectieuse associée à une diarrhée sévère.  les signes et les symptômes sont normalement légers et disparaissent généralement en quelques jours.  La plupart des gens ne demanderont pas de soins médicaux.

  Chaque année dans le monde, il y a entre 120 millions et 165 millions de cas d'infection à Shigella, dont 1 million sont mortels.  Plus de 60% de ces décès sont des enfants de moins de 5 ans dans les pays en développement.

  Le traitement


  Les résultats de laboratoire indiqueront si l'infection est due à une infection par Shigella ou Entamoeba histolyca.

  Si un traitement est nécessaire, cela dépendra de ces résultats.

  Cependant, tout patient souffrant de diarrhée ou de vomissements doit boire beaucoup de liquide pour éviter la déshydratation.

  S'ils sont incapables de boire, ou si la diarrhée et les vomissements sont abondants, un remplacement de liquide intraveineux (IV) peut être nécessaire.  Le patient sera placé sous perfusion et surveillé.

  Traitement de la dysenterie bacillaire légère

  La dysenterie bacillaire légère, du type que l'on trouve couramment dans les pays développés avec un bon assainissement, disparaîtra normalement sans traitement.

  Cependant, le patient doit boire beaucoup de liquides.

  Dans les cas plus graves, des antibiotiques sont disponibles.

  Traitement de la dysenterie amibienne

  Les médicaments amibicides sont utilisés pour traiter Entamoeba histolyca.  Ceux-ci garantiront que l'amibe ne survit pas à l'intérieur du corps après la disparition des symptômes.

  Le flagyl, ou métronidazole, est souvent utilisé pour traiter la dysenterie.  Il traite à la fois les bactéries et les parasites.

  Si les résultats de laboratoire ne sont pas clairs, le patient peut recevoir une combinaison d'antibiotiques et de médicaments amibicides, selon la gravité de leurs symptômes.

  Symptômes

  Les symptômes de la dysenterie varient de légers à graves, en grande partie en fonction de la qualité de l'assainissement dans les zones où l'infection s'est propagée.

  Dans les pays développés, les signes et les symptômes de la dysenterie ont tendance à être plus doux que dans les pays en développement ou les régions tropicales.

  Les symptômes bénins comprennent:

  un léger mal de ventre

  crampes

  la diarrhée

  Ceux-ci apparaissent généralement 1 à 3 jours après l'infection et le patient se rétablit dans la semaine.

  Certaines personnes développent également une intolérance au lactose, qui peut durer longtemps, parfois des années.

  Les symptômes de la dysenterie bacillaire

  Les symptômes ont tendance à apparaître dans les 1 à 3 jours suivant l'infection.  Il y a normalement de légers maux d'estomac et de la diarrhée, mais pas de sang ou de mucus dans les selles.  La diarrhée peut être fréquente au départ.

  Moins fréquemment, peut être fiable Source:

  sang ou mucus dans les fèces

  douleur abdominale intense

  fièvre

  nausée

  vomissements

  Souvent, les symptômes sont si légers que la visite d'un médecin n'est pas nécessaire et le problème se résout en quelques jours.

  Les symptômes de la dysenterie amibienne

  Une personne atteinte de dysenterie amibienne peut avoir:

  douleur abdominale

  fièvre et frissons

  nausées et vomissements

  diarrhée aqueuse, qui peut contenir du sang, du mucus ou du pus

  le passage douloureux des selles

  fatigue

  constipation intermittente

  Si les amibes traversent la paroi intestinale, elles peuvent se propager dans la circulation sanguine et infecter d'autres organes.

  Les ulcères peuvent se développer.  Ceux-ci peuvent saigner et provoquer du sang dans les selles.

  Les symptômes peuvent persister plusieurs semaines.

  Les amibes peuvent continuer à vivre dans l'hôte humain après la disparition des symptômes.  Ensuite, les symptômes peuvent réapparaître lorsque le système immunitaire de la personne est plus faible.

  Le traitement réduit le risque de survie des amibes.

  L'Organisation mondiale de la santé (OMS) identifie Source fiable deux principaux types de dysenterie.

  Dysenterie bacillaire ou shigellose

  Ce type produit les symptômes les plus graves.  Elle est causée par le bacille Shigella.

  Une mauvaise hygiène en est la principale source.  La shigellose peut également se propager à cause de la nourriture contaminée.

  En Europe occidentale et aux États-Unis, il s'agit du type de dysenterie le plus courant chez les personnes qui n'ont pas visité les tropiques peu de temps avant l'infection.

  Dysenterie amibienne ou amibiase

  Ce type est causé par Entamoeba histolytica (E. histolytica), une amibe.

  Les amibes se regroupent pour former un kyste, et ces kystes émergent du corps dans les excréments humains.

  Dans les zones de mauvaise hygiène, les amibes peuvent contaminer la nourriture et l'eau et infecter d'autres humains, car elles peuvent survivre pendant de longues périodes à l'extérieur du corps.

  Ils peuvent également s'attarder sur les mains des gens après avoir utilisé les toilettes.  De bonnes pratiques d'hygiène réduisent le risque de propagation de l'infection.

  Il est plus fréquent sous les tropiques, mais il se produit parfois dans certaines régions du Canada rural.

  Autres causes

  Les autres causes incluent une infection par un ver parasite, une irritation chimique ou une infection virale.

  Diagnostic

  Le médecin interrogera le patient sur ses signes et symptômes et procédera à un examen physique.

  Un échantillon de selles peut être demandé, surtout si le patient est récemment revenu des tropiques.

  Si les symptômes sont graves, l'imagerie diagnostique peut être recommandée.  Cela peut être une échographie ou une endoscopie.

  Complications

  Les complications de la dysenterie sont peu nombreuses, mais elles peuvent être graves.

  Déshydratation: une diarrhée et des vomissements fréquents peuvent rapidement entraîner une déshydratation.  Chez les nourrissons et les jeunes enfants, cela peut rapidement mettre la vie en danger.

  Abcès du foie: Si les amibes se propagent au foie, un abcès peut s'y former.

  Arthrite post-infectieuse: Des douleurs articulaires peuvent survenir à la suite de l'infection.

  Syndrome hémolytique et urémique: Shigella dysenteriae peut provoquer des globules rouges bloquant l'entrée des reins, entraînant une anémie, une faible numération plaquettaire et une insuffisance rénale.

  Les patients ont également connu des convulsions après l'infection.

  La prévention

  La dysenterie provient principalement d'une mauvaise hygiène.

  Pour réduire le risque d'infection, les gens doivent se laver les mains régulièrement avec du savon et de l'eau, surtout avant et après avoir utilisé les toilettes et préparé les aliments.

  Cela peut réduire la fréquence des infections à Shigella et d'autres types de diarrhée jusqu'à 35% Source fiable.

  D'autres mesures à prendre lorsque le risque est plus élevé, par exemple en voyage, comprennent:

  Ne buvez que de l'eau de source fiable, comme de l'eau en bouteille

  Regardez la bouteille s'ouvrir et nettoyez le haut du bord avant de boire

  Assurez-vous que les aliments sont bien cuits

  Il est préférable d'utiliser de l'eau purifiée pour nettoyer les dents et d'éviter les glaçons, car la source de l'eau peut être inconnue.

  Remèdes à base de plantes pour la dysenterie en phytothérapie yoruba comme document de Babalawo Obanifa

  1.

  Suku agbado (épis de maïs)

  Patanmon de brebis (feuilles de Landophia Owariensis)

  Odidi ataare (Un piment alligator entier)

  La préparation

  Vous allez brûler l'élément susmentionné ensemble et le broyer en poudre fine.

  Utilisation

  Un patient souffrant de dysenterie l'ajoutera à eko gbigbona (farine de maïs chaud)

  2.

  Ewe Efinrin nla (feuilles de basilic / Occimum grattissimum)

  Ogiri Ijebu (non identifié)

  La préparation

  Vous presserez le jus d'Ewe Efinrin nla (feuilles de basilic / Occimum grattissimum) avec de l'eau.  Vous mélangerez Ogiri Ijebu (non identifié),

  Utilisation

  Une personne souffrant de dysenterie en boira.

  3.

  Brebis Orikotene tutu (feuilles fraîches de Brysocarpus Coccineus)

  La préparation

  Pressez les feuilles avec de l'eau.

  Utilisation

  Le patient le boit pour arrêter la dysenterie

  4.

  Ewe Odundun tutu (feuilles fraîches de plantes de résurrection)

  La préparation

  Vous utiliserez de l'eau pour presser le tutu d'Ewe Odundun (feuilles fraîches de plantes de résurrection)

  Utilisation »

  Le patient atteint de dysenterie en boit.

  5.

  Eepo igi Oriri (tige d'écorce fraîche d'Oriri / Uniedntfied)

  La préparation

  Trempez-le dans l'eau.

  Utilisation

  Le patient atteint de dysenterie en boit.

  6.

  Egbo ewuro (Racines de plantes à feuilles amères / Verlonia Amygdalina)

  Ewe eepin (congé de papier sablé / Fiscus Experate)

  Oko ataare (clou de girofle d'alligator / Aframomum melegueta)

  Efunle (Evolvolus aisinoides)

  La préparation

  Vous allez tout moudre ensemble.

  Utilisation

  Le patient de dysenterie le boit.

  7.

  Brebis ewuro (feuilles amères / Verlonia amygdalina)

  Alubosa Ayu (ail / Allium sativum)


  La préparation

  Vous allez moudre les deux éléments susmentionnés ensemble et les mélanger avec du miel.

  Utilisation

  La personne atteinte de dysenterie va la lécher.

  8.

  Obi gbanja (Cola nitida)

  Iyere (piment de Guinée / Piper guinensis)

  La préparation

  Vous meulez ensemble l'élément susmentionné.

  Utilisation

  un patient atteint de dysenterie l'ajoutera à un repas de maïs chaud

  9.

  Ewe arunkuna (non identifié)

  Efun

  Ataare meta (trois gousses de fruits de piment alligator)

  La préparation

  Vous meulez ensemble l'élément susmentionné.

  Utilisation

  un patient atteint de dysenterie l'ajoutera à un repas de maïs chaud

  10.

  Epo Igi omon (écorce fraîche de tige d'Omon)

  La préparation

  Vous ferez bouillir l'écorce de tige d'Omon avec de l'eau.  utilisez l'eau pour faire cuire la banane plantain non mûre et mangez-la.

  11.

  Brebis Alukerese (feuilles fraîches d'Ipomea invulucrata)

  La préparation

  Vous presserez les feuilles susmentionnées pour obtenir du jus.

  Utilisation

  Mettez-le sur les ongles et les orteils du patient atteint de dysenterie

  1 2.

  Ewe Koleorogba tutu (feuilles fraîches de Koleoorogba)

  Vous presserez les feuilles susmentionnées pour obtenir du jus.

  Utilisation

  Mettez-le sur les ongles et les orteils du patient atteint de dysenterie

  13.

  Ododo Ewe Agunmona (feuilles tendres de Culcasia scandens)

  La préparation

  Broyez-le en pâte fine et utilisez-le pour cuisiner du poisson de chat sec et le manger lorsque vous avez une dysizontale

  14.

  Egbo Airanku (racines d'Airanku / non identifié)

  La préparation

  Broyez-le en pâte fine et utilisez-le pour cuisiner du poisson-chat sec et le manger lorsque vous souffrez de dysenterie

  15.

  Eepo Ara Igbo (tige d'écorce de Bridelia Micrantia)


  Eepo Igi Aaka / Akika (tige d'écorce de Cynometra Megalophilia)

  La préparation

  Broyer en poudre fine et mélanger avec de l'huile de palme rouge

  Utilisation

  le patient souffrant de dysenterie va le lécher.

  Les références

  https://www.medicalnewstoday.com/articles/171193.php#prevention

  Amibiase.  (2014, janvier)
  health.ny.gov/diseases/communicable/amebiasis/fact_sheet.htm

  Amibiase.  (n.d.)
  pharmacology2000.com/Chemotherapy/Antiparasitic/ameba2.htm

  Bowen, A. (31 mai 2017)
  wwwnc.cdc.gov/travel/yellowbook/2016/infectious-diseases-related-to-travel/shigellosis

  Debnath, A., Parsonage, D., Andrade, R., He, C., Cobo, E., Hirata, K.,… & Reed, S. (2012, 1er décembre).  Un dépistage de drogue à haut débit pour Entamoeba histolyca identifie un nouveau plomb et une nouvelle cible.  Médecine de la nature, 18, 6, 956-960
  ncbi.nlm.nih.gov/pmc/articles/PMC3411919/

  Dysenterie.  (n.d.)
  who.int/topics/dysentery/en/

  · Mise à jour sur la santé de la dysenterie épidémique: un supplément au numéro no.  55. (1993, décembre - 1994, février).  Un guide supplémentaire pour le dialogue sur la diarrhée, 55, 1-6
  rehydrate.org/dd/su55.htm

  Harding, M. (25 mai 2016).  Shigellose
  patient.info/doctor/shigellosis

  Syndrome hémolytique et urémique chez les enfants.  (2015, juin)
  niddk.nih.gov/health-information/kidney-disease/children/hemolytic-uremic-syndrome

  Thérapie de réhydratation orale.  (2014, 21 avril)
  rehydrate.org/ors/ort.htm

  Schlein, L. (s.d.).  Rapport de la journée mondiale de l'eau de l'OMS
  who.int/water_sanitation_health/takingcharge.html

  Shigella - Shigellose.  (2017, 31 mars)
  cdc.gov/shigella/general-information.html

  Traa, B., Fischer Walker, C.L., Munos, M., et Black, R. (2010, 23 mars).  Antibiotiques pour le traitement de la dysenterie chez les enfants.  Revue internationale d'épidémiologie, 39, suppl 1
  academic.oup.com/ije/article/39/suppl_1/i70/700550/Antibiotics-for-the-treatment-of-dysentery-in

  Vyas, J. (1 mai 2015).  Abcès hépatique amibien
  medlineplus.gov/ency/article/000211.htm

  Walsh, M. (2011, 19 septembre).  Shigellose
  infectionlandscapes.org/2011/09/shigellosis.html

  Copyright: Babalawo Pele Obasa Obanifa, contact par téléphone et Whatsapp: +2348166343145, emplacement Ile Ife Osun, Nigeria
  AVIS IMPORTANT: En ce qui concerne l'article ci-dessus, aucune partie de cet article ne peut être reproduite ou dupliquée sous quelque forme ou par quelque moyen que ce soit, électronique ou mécanique, y compris la photocopie et l'enregistrement ou par tout système de stockage ou de récupération d'informations sans l'autorisation écrite préalable du titulaire du droit d'auteur et  l'auteur Babalawo Obanifa, ce faisant, sera jugé illégal et entraînera des conséquences juridiques.



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 ЛЕКАРСТВЕННЫЕ СРЕДСТВА ДЛЯ ДИСЦЕНТРИИ БЕЗОПАСНЫМИ ДОКУМЕНТАЦИЯМИ BABALAWO OBANIFA-OBANIFA



 

 В этой работе Бабалаво Обанифа задокументирует разновидности травяных формул, доступных в фитотерапии йоруба для лечения дизентерии.  Термин дизентерия в фитотерапии йоруба известен как игбе сооро.  Номенклатура травяной формулы для лечения дизентерии известна как Oogun Dida Igbe Sooro.  Это должно подробно описать разновидности травяных формул, доступных в Йоруба Фитотерапия для таких целей.  В работе будет рассмотрено, что такое дизентерия, ее причины, симптомы, лечение и профилактика с точки зрения ортодоксальной медицины.  Хотя в заключительной части будут подробно документированы различные растительные лекарственные средства, доступные в фитотерапии йоруба для лечения дизентерии, однако полезно отметить, что информация, представленная в этой работе, не должна рассматриваться как замена услуги квалифицированного квалифицированного врача.  где требуется обслуживание одного.  В попытке дать научное объяснение, что такое дизентерия.  Мы будем полагаться исключительно на работу Адама Фелмана под названием «Все, что вы должны знать о дизентерии».  23 июня 2017 года Алана Биггерс, доктор медицинских наук, доктор медицинских наук, рецензировала эту работу и опубликовала ее на сайте www.medicalnewstoday.com.  Согласно вышеупомянутому источнику, дизентерия является инфекционным заболеванием, связанным с тяжелой диареей.  признаки и симптомы обычно слабо выражены и обычно исчезают в течение нескольких дней.  Большинство людей не будут обращаться за медицинской помощью.

 Ежегодно в мире регистрируется от 120 до 165 миллионов случаев заражения шигеллой, из которых 1 миллион приводит к летальному исходу.  Более 60 процентов этих смертей составляют дети в возрасте до 5 лет в развивающихся странах.

 лечение


 Лабораторные результаты покажут, является ли инфекция причиной инфекции Shigella или Entamoeba histolyca.

 Если лечение необходимо, это будет зависеть от этих результатов.

 Тем не менее, любой пациент с диареей или рвотой должен пить много жидкости, чтобы предотвратить обезвоживание.

 Если они не могут пить или если диарея и рвота обильные, может потребоваться внутривенная (IV) замена жидкости.  Пациент будет помещен на капельницу и контролируется.

 Лечение легкой бактериальной дизентерии

 Легкая бактериальная дизентерия, которая обычно встречается в развитых странах с хорошими санитарными условиями, обычно проходит без лечения.

 Тем не менее, пациент должен пить много жидкости.

 В более тяжелых случаях доступны антибиотики.

 Лечение амебной дизентерии

 Амебицидные препараты используются для лечения Entamoeba Histolyca.  Это гарантирует, что амеба не выживет в организме после устранения симптомов.

 Флагил, или метронидазол, часто используется для лечения дизентерии.  Лечит как бактерии, так и паразиты.

 Если результаты лабораторных исследований неясны, пациенту может быть назначена комбинация антибиотиков и амебицидных препаратов, в зависимости от того, насколько серьезны их симптомы.

 симптомы

 Симптомы дизентерии варьируются от легкой до тяжелой, в значительной степени в зависимости от качества санитарии в районах распространения инфекции.

 В развитых странах признаки и симптомы дизентерии, как правило, слабее, чем в развивающихся странах или тропических районах.

 Легкие симптомы включают в себя:

 небольшая боль в животе

 спазмы

 понос

 Обычно они появляются через 1–3 дня после заражения, и пациент выздоравливает в течение недели.

 У некоторых людей также развивается непереносимость лактозы, которая может длиться долго, иногда годы.

 Симптомы бактериальной дизентерии

 Симптомы проявляются в течение 1-3 дней после заражения.  Обычно наблюдается легкая боль в желудке и диарея, но в кале нет крови или слизи.  Диарея может начаться часто.

 Реже может быть Доверенный Источник:

 кровь или слизь в кале

 сильная боль в животе

 лихорадка

 тошнота

 рвота

 Часто симптомы настолько слабы, что посещение врача не требуется, и проблема решается в течение нескольких дней.

 Симптомы амебной дизентерии

 Человек с амебной дизентерией может иметь:

 боль в животе

 лихорадка и озноб

 тошнота и рвота

 водянистая диарея, которая может содержать кровь, слизь или гной

 болезненное прохождение стула

 усталость

 прерывистый запор

 Если амеба проходит через кишечную стенку, они могут распространиться в кровоток и заразить другие органы.

 Язвы могут развиваться.  Они могут кровоточить, вызывая кровь в стуле.

 Симптомы могут сохраняться в течение нескольких недель.

 После исчезновения симптомов амебы могут продолжать жить в организме человека.  Затем симптомы могут повториться, когда иммунная система человека слабее.

 Лечение снижает риск выживания амеб.

 Всемирная организация здравоохранения (ВОЗ) выделяет из доверенных источников два основных типа дизентерии.

 Бациллярная дизентерия или шигеллез

 Этот тип вызывает самые серьезные симптомы.  Это вызвано бациллой шигеллы.

 Плохая гигиена является основным источником.  Шигеллез также может распространяться из-за испорченной пищи.

 В Западной Европе и США это самый распространенный тип дизентерии у людей, которые не посещали тропики незадолго до заражения.

 Амебная дизентерия или амебиаз

 Этот тип вызван Entamoeba histolytica (E. histolytica), амеба.

 Амебы группируются вместе, образуя кисту, и эти кисты выходят из организма в человеческом кале.

 В районах с плохими санитарными условиями амебы могут загрязнять пищу и воду и заражать других людей, поскольку они могут выживать в течение длительного времени вне организма.

 Они также могут задерживаться на руках у людей после пользования ванной.  Надлежащая гигиеническая практика снижает риск распространения инфекции.

 Это чаще встречается в тропиках, но иногда встречается в некоторых районах сельской Канады.

 Другие причины

 Другие причины включают паразитарную инфекцию червя, химическое раздражение или вирусную инфекцию.

 диагностика

 Врач спросит пациента об их признаках и симптомах и проведет медицинский осмотр.

 Образец стула может быть запрошен, особенно если пациент недавно вернулся из тропиков.

 Если симптомы серьезны, может быть рекомендована диагностическая визуализация.  Это может быть ультразвуковое сканирование или эндоскопия.

 осложнения

 Осложнений дизентерии немного, но они могут быть серьезными.

 Обезвоживание: частая диарея и рвота могут быстро привести к обезвоживанию.  У младенцев и детей младшего возраста это может быстро стать опасным для жизни.

 Абсцесс печени. Если амебы распространяются на печень, там может образоваться абсцесс.

 Постинфекционный артрит: после инфекции может возникнуть боль в суставах.

 Гемолитический уремический синдром: Shigella dysenteriae может заставить красные кровяные клетки блокировать вход в почки, что приводит к анемии, низкому количеству тромбоцитов и почечной недостаточности.

 Пациенты также испытывали судороги после заражения.

 профилактика

 Дизентерия в основном связана с плохой гигиеной.

 Чтобы снизить риск заражения, люди должны регулярно мыть руки с мылом и водой, особенно до и после посещения ванной комнаты и приготовления пищи.

 Это может снизить частоту инфекций шигеллы и других видов диареи на 35 процентов.

 Другие шаги, которые нужно предпринять, когда риск выше, например, во время путешествия, включают в себя:

 Пейте только воду из надежных источников, такую ​​как вода в бутылках

 Посмотрите, как открывается бутылка, и очистите верхнюю часть обода перед тем, как пить

 Убедитесь, что еда тщательно приготовлена

 Лучше всего использовать чистую воду для чистки зубов и избегать кубиков льда, так как источник воды может быть неизвестен.

 Фитопрепараты от дизентерии в йоруба Фитотерапия как документ Бабалаво Обанифа

 1.

 Суку Агбадо (початки кукурузы)

 Эве Патанмон (листья Landophia Owariensis)

 Одиди Атааре (Целый перец аллигатора)

 подготовка

 Вы сожжете вышеупомянутый предмет вместе и измельчите до мелкого порошка.

 использование

 Пациент, страдающий дизентерией, будет добавлять его в эко гиббона (горячая кукурузная мука)

 2.

 Ewe Efinrin nla (листья базилика / Occimum grattissimum)

 Огири Ижебу (неопознанный)

 подготовка

 Вы будете сжимать сок Ewe Efinrin nla (листья базилика / Occimum grattissimum) с водой.  Вы будете смешивать Ogiri Ijebu (неопознанный),

 использование

 Человек, страдающий дизентерией, будет пить его.

 3.

 Пачка Ewe Orikotene (свежие листья Brysocarpus Coccineus)

 подготовка

 Сожмите листья с водой.

 использование

 Пациент будет пить его, чтобы остановить дизентерию

 4.

 Ewe Odundun tutu (свежие листья Воскресенских растений)

 подготовка

 Вы будете использовать воду, чтобы выжать пачку Ewe Odundun (свежие листья Воскресенских растений)

 Использование ’

 Пациент с дизентерией будет пить его.

 5.

 Eepo igi Oriri (стебель свежей коры Oriri / Uniedntfied)

 подготовка

 Замочите это в воде.

 использование

 Пациент с дизентерией будет пить его.

 6.

 Egbo ewuro (Корни листьев горьких растений / Верлония Амигдалина)

 Ewe eepin (листья наждачной бумаги / Fiscus Experate)

 Око Атааре (гвоздика перца аллигатора / Aframomum melegueta)

 Efunle (Evolvolus aisinoides)

 подготовка

 Вы будете размалывать все вместе.

 использование

 Пациент с дизентерией будет пить его.

 7.

 Ewe ewuro (горькие листья / верлония миндалина)

 Alubosa Ayu (чеснок / Allium sativum)


 подготовка

 Вы размолотите два вышеупомянутых предмета и смешаете их с медом.

 использование

 Человек с дизентерией будет лизать его.

 8.

 Оби гбаня (кола нитида)

 Айер (Гвинейский перец / Piper Guinensis)

 подготовка

 Вы помолите вышеупомянутый предмет вместе.

 использование

 пациент с дизентерией будет добавлять его в горячую кукурузную муку

 9.

 Эве арункуна (неопознано)

 Efun

 Ataare meta (три стручка плодов перца аллигатора)

 подготовка

 Вы помолите вышеупомянутый предмет вместе.

 использование

 пациент с дизентерией будет добавлять его в горячую кукурузную муку

 10.

 Epo Igi omon (свежая стеблевая кора Омон)

 подготовка

 Сварите стеблевую кору Омон с водой.  использовать воду, чтобы приготовить незрелый подорожник как кашу и съесть его.

 11.

 Эве Алукересе (свежие листья Ipomea Invulucrata)

 подготовка

 Вы сожмете вышеупомянутые листья, чтобы получить это сок.

 использование

 Положите его на ногти и пальцы ног пациента с дизентерией

 12.

 Пачка эве колеорогба (свежие листья колеорогба)

 Вы сожмете вышеупомянутые листья, чтобы получить это сок.

 использование

 Положите его на ногти и пальцы ног пациента с дизентерией

 13.

 Ододо Эве Агунмона (нежные листья Culcasia scandens)

 подготовка

 Измельчите его до мелкой пасты и используйте для приготовления сухой кошачьей рыбы и ешьте, когда у вас есть горизонталь

 14.

 Эгбо Айранку (корни Айранку / Неопознанные)

 подготовка

 Измельчите до мелкой пасты и используйте его для приготовления сухой рыбы-кошки и употребления ее в пищу при дизентерии.

 15.

 Eepo Ara Igbo (стебель коры Bridelia Micrantia)


 Eepo Igi Aaka / Akika (ствол коры Cynometra Megalophilia)

 подготовка

 Измельчить до мелкого порошка и смешать с красным пальмовым маслом.

 использование

 пациент дизентерии будет лизать его.

 ссылки

 https://www.medicalnewstoday.com/articles/171193.php#prevention

 · Амебиаз.  (Январь 2014 г.)
 health.ny.gov/diseases/communicable/amebiasis/fact_sheet.htm

 · Амебиаз.  (Н.Д.)
 pharmacology2000.com/Chemotherapy/Antiparasitic/ameba2.htm

 Боуэн А. (2017, 31 мая)
 wwwnc.cdc.gov/travel/yellowbook/2016/infectious-diseases-related-to-travel/shigellosis

 Debnath, A., Parsonage, D., Andrade, R., He, C., Cobo, E., Hirata, K.,… & Reed, S. (2012, 1 декабря).  Высокопроизводительный скрининг на наркотики для Entamoeba histolyca идентифицирует новое лидерство и цель.  Природная медицина, 18, 6, 956-960
 ncbi.nlm.nih.gov/pmc/articles/PMC3411919/

 · Дизентерии.  (Н.Д.)
 who.int/topics/dysentery/en/

 · Обновление информации об эпидемической дизентерии: дополнение к выпуску №.  55. (1993, декабрь - 1994, февраль).  Дополнительное руководство к диалогу по диарее, 55, 1-6
 rehydrate.org/dd/su55.htm

 Хардинг, М. (2016, 25 мая).  шигеллез
 patient.info/doctor/shigellosis

 Гемолитический уремический синдром у детей.  (Июнь 2015 г.)
 niddk.nih.gov/health-information/kidney-disease/children/hemolytic-uremic-syndrome

 Пероральная регидратационная терапия.  (2014, 21 апреля)
 rehydrate.org/ors/ort.htm

 Schlein, L. (n.d.).  Доклад ВОЗ о Всемирном дне воды
 who.int/water_sanitation_health/takingcharge.html

 Шигелла - шигеллез.  (2017, 31 марта)
 cdc.gov/shigella/general-information.html

 Traa, B., Fischer Walker, C.L., Munos, M. & Black, R. (2010, 23 марта).  Антибиотики для лечения дизентерии у детей.  Международный журнал эпидемиологии, 39, Suppl 1
 academic.oup.com/ije/article/39/suppl_1/i70/700550/Antibiotics-for-the-treatment-of-dysentery-in

 Vyas, J. (2015, 1 мая).  Амебный абсцесс печени
 medlineplus.gov/ency/article/000211.htm

 Уолш М. (2011, 19 сентября).  шигеллез
 infectionlandscapes.org/2011/09/shigellosis.html

 Авторское право: Babalawo Pele Obasa Obanifa, телефон и WhatsApp контакт: +2348166343145, местоположение Ile Ife osun штат Нигерия
 ВАЖНОЕ УВЕДОМЛЕНИЕ. Что касается статьи выше, ни одна часть этой статьи не может быть воспроизведена или воспроизведена в любой форме или любым способом, электронным или механическим, включая фотокопирование и запись, или любой системой хранения или поиска информации без предварительного письменного разрешения от владельца авторских прав и  Автор Бабалаво Обанифа, сделав это, будет признан незаконным и повлечет за собой юридические последствия.



 单击上面的视频，观看并下载5种有效的家庭疗法以治疗肠胃不适

 BABALAWO OBANIFA-OBANIFA极端文档对肠胃不适的草药疗法



 

 在这项工作中，Babalawo Obanifa将记录约鲁巴草药中可用于治疗痢疾的各种草药配方。 约鲁巴草药中的痢疾一词被称为Igbe Sooro。 用于治疗痢疾的草药配方的术语称为Oogun Dida Igbe Sooro。 为此，应详细记录约鲁巴草药中可用的各种草药配方。 这项工作将从正统医学的角度检查什么是痢疾，它的病因，症状的治疗和预防。 虽然结论部分将详细记录约鲁巴草药可用于治疗痢疾的各种草药，但有启发性的是要注意，这项工作中提供的信息不应被视为替代合格的经过培训的保健医生的服务 需要一个人服务的地方。 为了对痢疾做出科学的解释。 我们将仅依靠亚当·费尔曼（Adam Felman）的著作，即有关痢疾的一切知识。 该工作已由医学博士Alana Biggers于2017年6月23日进行医学审查，并发表在www.medicalnewstoday.com上。 根据上述资料，痢疾是一种与严重腹泻有关的传染病。 体征和症状通常较轻，通常会在几天内消失。 大多数人不会寻求医疗护理。

 全世界每年有约1.2亿至1.65亿例志贺氏菌感染病例，其中100万是致命的。 这些死亡中超过60％是发展中国家的5岁以下儿童。

 治疗方法


 实验室结果将揭示感染是由于志贺氏菌还是组织性变形杆菌感染。

 如果需要治疗，将取决于这些结果。

 但是，任何腹泻或呕吐患者都应喝大量液体以防止脱水。

 如果他们无法喝酒，或者大量腹泻和呕吐，则可能需要更换静脉输液。 患者将被滴下并进行监测。

 轻度细菌性痢疾的治疗

 轻度细菌性痢疾是发达国家中常见的一种环境卫生良好的细菌性痢疾，通常无需治疗即可解决。

 但是，患者应多喝水。

 在更严重的情况下，可以使用抗生素药物。

 阿米巴痢疾的治疗

 杀虫药用于治疗组织型变形虫。 这些将确保症状消除后变形虫不会在体内存活。

 鞭毛或甲硝唑通常用于治疗痢疾。 它同时治疗细菌和寄生虫。

 如果实验室结果尚不清楚，则可以根据患者症状的严重程度，给患者使用抗生素和杀螨药的组合。

 病征

 痢疾的症状从轻度到严重不等，主要取决于感染扩散地区的卫生质量。

 在发达国家，痢疾的体征和症状往往比发展中国家或热带地区温和。

 轻度症状包括：

 轻微的胃痛

 抽筋

 腹泻

 这些通常在感染后1至3天出现，患者在一周之内康复。

 有些人还会出现乳糖不耐症，这种病会持续很长时间，有时甚至持续数年。

 细菌性痢疾的症状

 感染后1到3天内往往会出现症状。 通常有轻度的胃痛和腹泻，但粪便中没有血液或粘液。 腹泻可能始于频繁。

 不太常见，可能会被信任

 粪便中有血液或粘液

 剧烈的腹痛

 发烧

 恶心

 呕吐

 通常，症状是如此轻微，以至于不需要医生就诊，问题在几天内就解决了。

 阿米巴痢疾的症状

 患有阿米巴痢疾的人可能有：

 腹痛

 发烧和发冷

 恶心和呕吐

 水样腹泻，可能含有血液，粘液或脓液

 大便的痛苦传递

 疲劳感

 间歇性便秘

 如果变形虫穿过肠壁，它们会扩散到血液中并感染其他器官。

 溃疡会发展。 这些可能会流血，导致大便带血。

 症状可能持续数周。

 症状消失后，变形虫可能继续生活在人类宿主内。 然后，当人的免疫系统较弱时，症状可能会再次出现。

 治疗降低了变形虫存活的风险。

 世界卫生组织（WHO）将受信任的来源分为两种主要的痢疾类型。

 细菌性痢疾或志贺菌病

 这种类型产生最严重的症状。 它是由志贺氏杆菌引起的。

 卫生差是主要来源。 由于食物的污染，志贺氏菌也可能传播。

 在西欧和美国，这是在感染前不久没有去过热带地区的人们中最常见的痢疾。

 阿米巴痢疾或阿米巴病

 这种类型是由变形虫Entamoeba histolytica（E. histolytica）引起的。

 变形虫群一起形成一个囊肿，这些囊肿在人的粪便中从体内出现。

 在卫生条件差的地区，变形虫会污染食物和水，并感染其他人类，因为它们可以在体内长时间生存。

 使用完浴室后，它们也可能缠在人们手上。 良好的卫生习惯可减少传播感染的风险。

 它在热带地区更为常见，但有时会在加拿大农村的部分地区发生。

 其他原因

 其他原因包括寄生虫感染，化学刺激或病毒感染。

 诊断

 医生将询问患者有关他们的体征和症状，并进行身体检查。

 可能需要粪便样本，特别是如果患者最近从热带地区回来时。

 如果症状严重，则可能建议进行诊断成像。 这可以是超声扫描或内窥镜检查。

 并发症

 痢疾的并发症很少，但可能很严重。

 脱水：频繁的腹泻和呕吐会迅速导致脱水。 在婴幼儿中，这可能很快威胁生命。

 肝脓肿：如果变形虫扩散到肝脏，则脓肿会在肝脏形成。

 感染后关节炎：感染后可能会出现关节痛。

 溶血性尿毒症综合征：痢疾志贺氏菌可引起红细胞阻塞肾脏入口，导致贫血，血小板计数低和肾衰竭。

 感染后患者还会出现癫痫发作。

 预防措施

 痢疾主要源于卫生条件差。

 为了减少感染的风险，人们应定期用肥皂和水洗手，尤其是在使用浴室和准备食物之前和之后。

 这样可以将志贺氏菌感染和其他类型的腹泻的频率降低多达35％。

 风险较高时（例如旅行时）采取的其他步骤包括：

 仅饮用可靠来源的水，例如瓶装水

 观察被打开的瓶子，并在饮用前清洁边缘的顶部

 确保食物彻底煮熟

 最好使用纯净水清洁牙齿，避免冰块，因为水的来源可能是未知的。

 Babalawo Obanifa撰写的约鲁巴草药痢疾的草药疗法

 1。

 Suku agbado（玉米芯）

 母羊patanmon（Landophia Owariensis的叶子）

 Odidi ataare（整个鳄鱼皮胡椒）

 准备工作

 您将上述物品一起燃烧，然后磨成细粉。

 使用方法

 患有痢疾的患者将其添加到eko gbigbona（热玉米粉）中

 2。

 母羊Efinrin nla（罗勒叶/ Occimum grattissimum）

 小g入生（身份不明）

 准备工作

 您将用水将母羊Efinrin nla（罗勒叶/ Occimum grattissimum）的汁液榨干。 您将混合Ogiri Ijebu（身份不明），

 使用方法

 患有痢疾的人可以喝。

 3。

 母羊Orikotene短裙（Brysocarpus Coccineus的新鲜叶子）

 准备工作

 用水挤压叶子。

 使用方法

 病人将喝它以止痢

 4。

 母羊Odundun芭蕾舞短裙（复活植物的新鲜叶子）

 准备工作

 您将用水挤压母羊Odundun芭蕾舞短裙（复活植物的新鲜叶子）

 用法’

 痢疾患者会喝它。

 5，

 Eepo igi Oriri（Oriri的新鲜树皮茎/ Uniedntfied）

 准备工作

 浸入水中。

 使用方法

 痢疾患者会喝它。

 6。

 Egbo ewuro（苦叶植物的根/ Verlonia Amygdalina）

 母羊eepin（离开的纸沙树/ Fiscus Experate）

 Oko ataare（鳄鱼胡椒丁/ Aframomum melegueta）

 Efunle（Evolvolus aisinoides）

 准备工作

 您将一起研磨所有东西。

 使用方法

 痢疾患者会喝它。

 7。

 母羊ewuro（苦叶/ Verlonia杏仁）

 Alubosa Ayu（大蒜/大蒜）


 准备工作

 您将把上述两个物品一起研磨，并与蜂蜜混合。

 使用方法

 痢疾患者会舔它。

 8。

 Obi gbanja（可乐尼迪达）

 艾耶尔（几内亚胡椒/墨西哥胡椒）

 准备工作

 您将一起研磨上述项目。

 使用方法

 痢疾患者将其添加到热玉米粉中

 9。

 母羊arunkuna（身份不明）

 埃芬

 Ataare meta（扬子鳄胡椒三果荚）

 准备工作

 您将一起研磨上述项目。

 使用方法

 痢疾患者将其添加到热玉米粉中

 10。

 Epo Igi omon（Omon的新鲜茎皮）

 准备工作

 您将用水煮开欧蒙的茎皮。 用水煮熟的车前草作为稀饭并吃掉。

 11。

 母羊Alukerese（Ipomea Invulucrata的新鲜叶子）

 准备工作

 您将挤压上述叶子以获得果汁。

 使用方法

 将其放在痢疾患者的指甲和脚趾上

 12

 母羊Koleorogba短裙（Koleoorogba的新鲜叶子）

 您将挤压上述叶子以获得果汁。

 使用方法

 将其放在痢疾患者的指甲和脚趾上

 13

 Ododo母羊Agunmona（Culcasia scandens的嫩叶）

 准备工作

 将其研磨成细糊状，并用它煮干的猫鱼，并在患dyszonzontal时食用

 14。

 Egbo Airanku（Airanku的根源/身份不明）

 准备工作

 将其研磨成细糊状，用它煮干猫鱼，并在痢疾时食用

 15

 Eepo Ara Igbo（Bridelia Micrantia的树皮茎）


 Eepo Igi Aaka /秋香（Cynometra Megalophilia的树皮茎）

 准备工作

 将其研磨成细粉，并与红棕榈油混合

 使用方法

 痢疾患者会舔它。

 参考文献

 https://www.medicalnewstoday.com/articles/171193.php#prevention

 阿米巴病。  （2014年1月）
 health.ny.gov/疾病/communicable/amebiasis/fact_sheet.htm

 阿米巴病。  （未注明）
 pharmacology2000.com/Chemotherapy/Antiparasitic/ameba2.htm

 鲍恩·A（2017年5月31日）
 wwwnc.cdc.gov/travel/yellowbook/2016/infectious-diseases-related-to-travel/shigellosis

 Debnath，A.，Parsonage，D.，Andrade，R.，He，C.，Cobo，E.，Hirata，K.，＆Reed，S.（2012年12月1日）。 高通量肠溶菌的药物筛选可确定新的潜在客户和靶标。 自然医学，18，6，956-960
 ncbi.nlm.nih.gov/pmc/articles/PMC3411919/

 痢疾。  （未注明）
 who.int/topics/痢疾/ en /

 ·流行性痢疾的健康状况更新：发行证号的补充。  55.（1993年12月-1994年2月）。 腹泻对话补充指南，55，1-6
 rehydrate.org/dd/su55.htm

 哈丁，M。（2016年5月25日）。 志贺氏菌
 Patient.info/医生/志贺氏菌病

 小儿溶血性尿毒症综合征。  （2015年6月）
 niddk.nih.gov/健康信息/肾脏疾病/儿童/溶血性尿毒症综合征

 口服补液疗法。  （2014年4月21日）
 rehydrate.org/ors/ort.htm

 Schlein，L.（未注明）。 世卫组织世界水日报告
 who.int/water_sanitation_health/takingcharge.html

 志贺氏菌-志贺氏菌病。  （2017年3月31日）
 cdc.gov/shigella/general-information.html

 Traa，B.，Fischer Walker，C.L.，Munos，M.和Black，R.（2010年3月23日）。 抗生素用于治疗儿童痢疾。 国际流行病学杂志，39，增刊1
 Academic.oup.com/ije/article/39/suppl_1/i70/700550/抗生素在痢疾的治疗

 Vyas，J.（2015年5月1日）。 阿米巴肝脓肿
 medlineplus.gov/ency/article/000211.htm

 Walsh，M.（2011年9月19日）。 志贺氏菌
 fectionlandscapes.org/2011/09/shigellosis.html

 版权：Babalawo Pele Obasa Obanifa，电话和whatsapp联系人：+2348166343145，地点：尼日利亚Ile Ife osun国家
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 इस काम में बाबलावो ओबनिफा पेचिश के इलाज के लिए योरूबा हर्बल दवा में उपलब्ध हर्बल फार्मूला की किस्मों का दस्तावेजीकरण करेंगे।  योरूबा हर्बल मेडिसिन में पेचिश शब्द को Igbe Sooro के नाम से जाना जाता है।  पेचिश के इलाज के लिए हर्बल फार्मूला के लिए नामकरण को Oogun Dida Igbe Sooro के नाम से जाना जाता है।  यह इस तरह के उद्देश्य के लिए योरूबा हर्बल दवा में उपलब्ध हर्बल फार्मूला की विस्तृत किस्मों का दस्तावेज होगा।  काम की जांच करेगा कि पेचिश क्या है, यह कारण, लक्षण उपचार और रूढ़िवादी चिकित्सा के दृष्टिकोण से रोकथाम है।  जबकि समापन भाग पेचिश के इलाज के लिए योरूबा हर्बल दवा में उपलब्ध हर्बल उपचारों की विस्तृत किस्मों में दस्तावेज़ करेगा।  जहां एक की सेवा आवश्यक है।  पेचिश क्या है, इसका वैज्ञानिक विवरण देने के प्रयास में।  हम केवल एडम फेलमैन के काम पर भरोसा करेंगे, जो आपको पेचिश के बारे में जानना चाहिए।  23 जून, 2017 को अलाना बिगर्स, एमएड, एमपीएच द्वारा काम की समीक्षा की गई है और www.medicalnewstoday.com पर प्रकाशित किया गया है।  उपर्युक्त स्रोत के अनुसार, पेचिश गंभीर दस्त से जुड़ी एक संक्रामक बीमारी है।  संकेत और लक्षण सामान्य रूप से हल्के होते हैं और आमतौर पर कुछ दिनों के भीतर गायब हो जाते हैं।  ज्यादातर लोग चिकित्सा पर ध्यान नहीं देंगे।

 हर साल दुनिया भर में, शिगेला संक्रमण के 120 मिलियन से 165 मिलियन मामले हैं, जिनमें से 1 मिलियन घातक हैं।  विकासशील देशों में 5 साल से कम उम्र के इन घातक बच्चों में से 60 प्रतिशत से अधिक बच्चे हैं।

 इलाज


 प्रयोगशाला के परिणाम से पता चलेगा कि संक्रमण शिगेला या एंटामोइबा हिस्टोलिका संक्रमण के कारण है या नहीं।

 यदि उपचार आवश्यक है, तो यह इन परिणामों पर निर्भर करेगा।

 हालांकि, दस्त या उल्टी के साथ किसी भी रोगी को निर्जलीकरण को रोकने के लिए बहुत सारे तरल पदार्थ पीने चाहिए।

 यदि वे पीने में असमर्थ हैं, या यदि दस्त और उल्टी विपुल हैं, तो अंतःशिरा (IV) द्रव प्रतिस्थापन आवश्यक हो सकता है।  रोगी को ड्रिप पर रखा जाएगा और उसकी निगरानी की जाएगी।

 हल्के बेसिलरी पेचिश का इलाज

 हल्के बेसिलरी पेचिश, आमतौर पर अच्छी स्वच्छता के साथ विकसित देशों में पाए जाते हैं, सामान्य रूप से उपचार के बिना हल करेंगे।

 हालांकि, रोगी को बहुत सारे तरल पदार्थ पीने चाहिए।

 अधिक गंभीर मामलों में, एंटीबायोटिक दवाएं उपलब्ध हैं।

 अमीबी पेचिश के लिए उपचार

 एंटोइबायडल दवाओं का उपयोग एंटामोइबा हिस्टोलिका के इलाज के लिए किया जाता है।  ये सुनिश्चित करेंगे कि लक्षणों को हल करने के बाद अमीबा शरीर के अंदर जीवित न रहे।

 फ्लैगिल या मेट्रोनिडाजोल का उपयोग अक्सर पेचिश के इलाज के लिए किया जाता है।  यह बैक्टीरिया और परजीवी दोनों का इलाज करता है।

 यदि लैब के परिणाम स्पष्ट नहीं हैं, तो रोगी को एंटीबायोटिक और अमीबीकाइडल दवाओं का संयोजन दिया जा सकता है, जो इस बात पर निर्भर करता है कि उनके लक्षण कितने गंभीर हैं।

 लक्षण

 पेचिश के लक्षण हल्के से गंभीर तक होते हैं, काफी हद तक उन क्षेत्रों में स्वच्छता की गुणवत्ता पर निर्भर करता है जहां संक्रमण फैल गया है।

 विकसित देशों में, पेचिश के लक्षण और लक्षण विकासशील देशों या उष्णकटिबंधीय क्षेत्रों की तुलना में मामूली होते हैं।

 हल्के लक्षणों में शामिल हैं:

 हल्का पेट-दर्द

 ऐंठन

 दस्त

 ये आमतौर पर संक्रमण के 1 से 3 दिन बाद दिखाई देते हैं, और रोगी एक सप्ताह के भीतर ठीक हो जाता है।

 कुछ लोग लैक्टोज असहिष्णुता भी विकसित करते हैं, जो लंबे समय तक, कभी-कभी वर्षों तक रह सकते हैं।

 बेसिलरी पेचिश के लक्षण

 संक्रमण के 1 से 3 दिनों के भीतर लक्षण दिखाई देने लगते हैं।  आम तौर पर एक हल्का पेट दर्द और दस्त होता है, लेकिन मल में कोई रक्त या बलगम नहीं होता है।  अतिसार की शुरुआत अक्सर हो सकती है।

 आमतौर पर कम, स्रोत सौंपा जा सकता है:

 मल में रक्त या बलगम

 तीव्र पेट दर्द

 बुखार

 मतली

 उल्टी

 अक्सर, लक्षण इतने हल्के होते हैं कि डॉक्टर की यात्रा की आवश्यकता नहीं होती है, और समस्या कुछ दिनों में हल हो जाती है।

 अमीबिक पेचिश के लक्षण

 अमीबी पेचिश वाले व्यक्ति में हो सकता है:

 पेट में दर्द

 बुखार और ठंड लगना

 मतली और उल्टी

 पानी दस्त, जिसमें रक्त, बलगम या मवाद हो सकता है

 मल के दर्दनाक गुजर

 थकान

 आंतरायिक कब्ज

 यदि आंतों की दीवार के माध्यम से अमीबा सुरंग है, तो वे रक्तप्रवाह में फैल सकते हैं और अन्य अंगों को संक्रमित कर सकते हैं।

 अल्सर विकसित हो सकता है।  इनसे खून निकल सकता है, जिससे मल में खून आ सकता है।

 लक्षण कई हफ्तों तक जारी रह सकते हैं।

 अमीबा मानव लक्षणों के जाने के बाद भी रह सकता है।  फिर, लक्षणों की पुनरावृत्ति हो सकती है जब व्यक्ति की प्रतिरक्षा प्रणाली कमजोर होती है।

 उपचार अमीबा के जीवित रहने के जोखिम को कम करता है।

 विश्व स्वास्थ्य संगठन (डब्ल्यूएचओ) ने दो मुख्य प्रकार के पेचिश के स्रोत की पहचान की है।

 बेसिलरी पेचिश, या शिगेलोसिस

 यह प्रकार सबसे गंभीर लक्षण पैदा करता है।  यह शिगेला बैसिलस के कारण होता है।

 गरीब स्वच्छता मुख्य स्रोत है।  दागी भोजन के कारण शिगेलोसिस भी फैल सकता है।

 पश्चिमी यूरोप और अमेरिका में, यह उन लोगों में सबसे आम प्रकार का पेचिश है, जो संक्रमण से कुछ समय पहले उष्णकटिबंधीय में नहीं गए थे।

 अमीबिक पेचिश, या अमीबासिस

 यह प्रकार एंटामोइबा हिस्टोलिटिका (ई। हिस्टोलिटिका), एक अमीबा के कारण होता है।

 अमीबा समूह एक पुटी बनाने के लिए एक साथ होता है, और ये अल्सर मानव मल में शरीर से निकलते हैं।

 खराब स्वच्छता के क्षेत्रों में, अमीबा भोजन और पानी को दूषित कर सकती है और अन्य मनुष्यों को संक्रमित कर सकती है, क्योंकि वे शरीर के बाहर लंबे समय तक जीवित रह सकते हैं।

 वे बाथरूम का उपयोग करने के बाद लोगों के हाथों पर भी झूल सकते हैं।  अच्छे स्वच्छता अभ्यास से संक्रमण फैलने का खतरा कम हो जाता है।

 यह उष्णकटिबंधीय में अधिक आम है, लेकिन यह कभी-कभी ग्रामीण कनाडा के कुछ हिस्सों में होता है।

 अन्य कारण

 अन्य कारणों में परजीवी कृमि संक्रमण, रासायनिक जलन या वायरल संक्रमण शामिल हैं।

 निदान

 डॉक्टर रोगी से उनके संकेतों और लक्षणों के बारे में पूछेंगे और एक शारीरिक जांच करेंगे।

 एक मल के नमूने का अनुरोध किया जा सकता है, खासकर यदि रोगी हाल ही में उष्णकटिबंधीय से वापस आ गया है।

 यदि लक्षण गंभीर हैं, तो नैदानिक ​​इमेजिंग की सिफारिश की जा सकती है।  यह एक अल्ट्रासाउंड स्कैन या एक एंडोस्कोपी हो सकता है।

 जटिलताओं

 पेचिश की शिकायत कम होती है, लेकिन वे गंभीर हो सकती हैं।

 निर्जलीकरण: बार-बार दस्त और उल्टी से निर्जलीकरण हो सकता है।  शिशुओं और छोटे बच्चों में, यह जल्दी से जीवन के लिए खतरा बन सकता है।

 यकृत फोड़ा: यदि अमीबा यकृत में फैलता है, तो एक फोड़ा वहां बन सकता है।

 संधिवात गठिया: संक्रमण के बाद जोड़ों का दर्द हो सकता है।

 हेमोलिटिक यूरीमिक सिंड्रोम: शिगेला पेचिश का कारण किडनी के प्रवेश द्वार को अवरुद्ध करने के लिए लाल रक्त कोशिकाएं हो सकती हैं, जिससे एनीमिया, कम प्लेटलेट काउंट और गुर्दे की विफलता हो सकती है।

 संक्रमण के बाद मरीजों को भी दौरे का अनुभव हुआ है।

 निवारण

 पेचिश ज्यादातर खराब स्वच्छता से उपजी है।

 संक्रमण के जोखिम को कम करने के लिए, लोगों को अपने हाथों को साबुन और पानी से नियमित रूप से धोना चाहिए, विशेष रूप से पहले और बाद में बाथरूम का उपयोग करने और भोजन तैयार करने के बाद।

 यह शिगेला संक्रमण और अन्य प्रकार के दस्त की आवृत्ति को 35 प्रतिशत तक बढ़ा सकता है।

 जोखिम अधिक होने पर अन्य कदम, उदाहरण के लिए, यात्रा करते समय, शामिल हैं:

 केवल बोतलबंद पानी जैसे कि खट्टे पानी का सेवन करें

 बोतल को खोला जा रहा है, और पीने से पहले रिम के शीर्ष को साफ करें

 सुनिश्चित करें कि भोजन पूरी तरह से पकाया गया है

 दांतों को साफ करने के लिए शुद्ध पानी का उपयोग करना सबसे अच्छा है, और बर्फ के टुकड़ों से बचें, क्योंकि पानी का स्रोत अज्ञात हो सकता है।

 योरूबा हर्बल दवा में पेचिश के लिए हर्बल उपचार बाबलावो ओबनिफा द्वारा दस्तावेज़ के रूप में

 1।

 सुक्कु एगबेडो (मकई योनी)

 ईवे पेटनमोन (लैंडोफ़िया ओवेरीन्सिस के पत्ते)

 ओदिदी अतारे (एक संपूर्ण मगरमच्छ काली मिर्च)

 तैयारी

 आप उपरोक्त वस्तु को एक साथ जलाएंगे और महीन पाउडर को पीसेंगे।

 प्रयोग

 पेचिश से पीड़ित रोगी इसे इको गबिबोना (गर्म मकई भोजन) में शामिल करेगा

 2।

 Ewe Efinrin nla (तुलसी के पत्ते / समसामयिक grississimum)

 ओगिरी इजेबू (अज्ञात)

 तैयारी

 आप पानी के साथ Ewe Efinrin nla (तुलसी के पत्तों / समसामयिक grississimum) का रस निचोड़ लेंगे।  आप ओगिरी इजेबु (अज्ञात) का मिश्रण करेंगे,

 प्रयोग

 पेचिश से पीड़ित व्यक्ति इसे पीएगा।

 3।

 ईवे ओरकोटेने टुटू (ब्राइसोकार्पस कोकीन के ताजा पत्ते)

 तैयारी

 पानी से पत्तियों को निचोड़ें।

 प्रयोग

 पेचिश को रोकने के लिए रोगी इसे पी रहा होगा

 4।

 ईवे ओडुंडन टूटू (पुनरुत्थान पौधों की ताजा पत्तियां)

 तैयारी

 आप Ewe Odundun टूटू (पुनरुत्थान पौधों की ताजा पत्तियों) को निचोड़ने के लिए पानी का उपयोग करेंगे

 उपयोग '

 पेचिश का रोगी इसे पी रहा होगा।

 5।

 एपो इगी ओरीरी (ओरिरी / अनइंडेंटफाइड की ताजा छाल का तना)

 तैयारी

 इसे पानी में भिगो दें।

 प्रयोग

 पेचिश का रोगी इसे पी रहा होगा।

 6।

 ईग्बो इवुरो (कड़वे पत्तों के पौधे / वर्लोनिया अमिग्डालिना)

 ईवे ईपिन (सैंड पेपर ट्री / फिकस प्रयोग छोड़ें)

 Oko ataare (मगरमच्छ काली मिर्च / Aframomum melegueta की लौंग)

 Efunle (एवोल्वोलस ऐसिनोइड्स)

 तैयारी

 आप सब कुछ एक साथ पीस लेंगे।

 प्रयोग

 पेचिश का रोगी इसे पी रहा होगा।

 7।

 ईवे इवुरो (कड़वे पत्ते / वर्लोनिया अमिग्डालिना)

 अलुबोसा आयू (लहसुन / एलियम सतिवम)


 तैयारी

 आप उपरोक्त दोनों वस्तुओं को एक साथ पीसकर शहद के साथ मिलाएंगे।

 प्रयोग

 पेचिश वाला व्यक्ति इसे चाट जाएगा।

 8।

 ओबी गांजा (कोला नाइटिडा)

 इयेरे (गिनी पेप्पर / पाइपर गाइनेंसिस)

 तैयारी

 आप उपरोक्त वस्तु को एक साथ पीस लेंगे।

 प्रयोग

 पेचिश रोगी इसे गर्म मकई खाने में शामिल करेगा

 9।

 ईवे अरकुना (अज्ञात)

 Efun

 अतारे मेटा (तीनों फलों के एलीगेटर काली मिर्च)

 तैयारी

 आप उपरोक्त वस्तु को एक साथ पीस लेंगे।

 प्रयोग

 पेचिश रोगी इसे गर्म मकई खाने में शामिल करेगा

 10।

 एपो इगी ओमोन (ओमन का ताजा तना छाल)

 तैयारी

 आप पानी के साथ ओमोन की स्टेम छाल उबाल लेंगे।  दलिया के रूप में अनियंत्रित पौधा पकाने के लिए पानी का उपयोग करें और इसे खाएं।

 11।

 ईवे अलुकेरसे (इपोमेआ इनुलुक्राता के ताजे पत्ते)

 तैयारी

 आप इसे प्राप्त करने के लिए उपरोक्त पत्तियों को निचोड़ लेंगे।

 प्रयोग

 डिसेंटर के साथ रोगी की अंगुली के नाखून और पैर की उंगलियों पर इसे लगाएं

 12।

 ईवे कोलेरोगबा टूटू (कोल्लूरोगबा के ताजा पत्ते)

 आप इसे प्राप्त करने के लिए उपरोक्त पत्तियों को निचोड़ लेंगे।

 प्रयोग

 डिसेंटर के साथ रोगी की अंगुली के नाखून और पैर की उंगलियों पर इसे लगाएं

 13।

 Ododo Ewe Agunmona (क्यूलसिया स्कैंडेन्स की कोमल पत्तियां)

 तैयारी

 इसे महीन पेस्ट में पीसें और इसका उपयोग सूखी बिल्ली की मछली पकाने के लिए करें और इसे तब खाएं जब आपको दस्त हो

 14।

 एग्बो एयरंकू (एयरंकू / अज्ञात की जड़ें)

 तैयारी

 इसे महीन पीस लें और इसका उपयोग सूखी बिल्ली की मछली पकाने और पेचिश होने पर खाने के लिए करें

 15।

 एपो आरा इग्बो (ब्रिडेलिया मिक्रान्टिया की छाल का तना)


 ईपो इगी आका / अणिका (सिनोमेट्रा मेगालोफिलिया की छाल का तना)

 तैयारी

 इसे महीन पाउडर में पीसें और इसे लाल ताड़ के तेल के साथ मिलाएं

 प्रयोग

 पेचिश रोगी इसे चाट जाएगा।

 संदर्भ

 https://www.medicalnewstoday.com/articles/171193.php#prevention

 · अमीबारुग्णता।  (2014, जनवरी)
 health.ny.gov/diseases/communicable/amebiasis/fact_sheet.htm

 · अमीबारुग्णता।  (एन.डी.)
 pharmacology2000.com/Chemotherapy/Antiparasitic/ameba2.htm

 बोवेन, ए। (2017, 31 मई)
 wwwnc.cdc.gov/travel/yellowbook/2016/infectious-diseases-related-to-travel/shigellosis

 देबनाथ, ए।, पार्सनेज, डी।, एंड्रेड, आर।, ही, सी।, कोबो, ई।, हिरता, के।, ... और रीड, एस। (2012, 1 दिसंबर)।  एंटामोइबा हिस्टेलिका के लिए एक उच्च थ्रूपुट दवा स्क्रीन एक नई लीड और लक्ष्य की पहचान करती है।  प्रकृति चिकित्सा, 18, 6, 956-960
 ncbi.nlm.nih.gov/pmc/articles/PMC3411919/

 · पेचिश।  (एन.डी.)
 who.int/topics/dysentery/en/

 · महामारी अपच स्वास्थ्य अद्यतन: कोई अनुपूरक जारी करने के लिए।  55. (1993, दिसंबर - 1994, फरवरी)।  दस्त पर एक पूरक गाइड, 55, 1-6
 rehydrate.org/dd/su55.htm

 हार्डिंग, एम। (2016, 25 मई)।  Shigellosis
 patient.info/doctor/shigellosis

 बच्चों में हेमोलिटिक यूरीमिक सिंड्रोम।  (2015, जून)
 niddk.nih.gov/health-information/kidney-disease/children/hemolytic-uremic-syndrome

 मौखिक पुनर्जलीकरण चिकित्सा।  (2014, 21 अप्रैल)
 rehydrate.org/ors/ort.htm

 श्लेन, एल। (N.d.)।  डब्ल्यूएचओ विश्व जल दिवस की रिपोर्ट
 who.int/water_sanitation_health/takingcharge.html

 शिगेला - शिगेलोसिस।  (2017, 31 मार्च)
 cdc.gov/shigella/general-information.html

 ट्रा, बी।, फिशर वॉकर, सी। एल।, मुनोस, एम।, और ब्लैक, आर। (2010, 23 मार्च)।  बच्चों में पेचिश के इलाज के लिए एंटीबायोटिक्स।  महामारी विज्ञान की अंतर्राष्ट्रीय पत्रिका, 39, suppl 1
 academic.oup.com/ije/article/39/suppl_1/i70/700550/Antibiotics-for-the-treatment-of-dysentery-in

 व्यास, जे। (2015, 1 मई)।  अमीबिक यकृत फोड़ा
 medlineplus.gov/ency/article/000211.htm

 वाल्श, एम। (2011, 19 सितंबर)।  Shigellosis
 infectionlandscapes.org/2011/09/shigellosis.html

 कॉपीराइट: बबालावो पेले ओबासा ओबनिफा, फोन और व्हाट्सएप संपर्क: 13:48166343145, स्थान इले इफ ओसुन राज्य नाइजीरिया
 महत्वपूर्ण सूचना: जैसा कि इस लेख के किसी भी भाग के ऊपर दिए गए लेख को किसी भी रूप में या किसी भी माध्यम से इलेक्ट्रॉनिक या यांत्रिक रूप से पुन: प्रस्तुत या दोहराया नहीं जा सकता है, फोटोकॉपी और रिकॉर्डिंग सहित या किसी भी जानकारी के भंडारण या पुनर्प्राप्ति प्रणाली द्वारा कॉपीराइट धारक से पूर्व लिखित अनुमति के बिना।  लेखक बबालावो ओबनिफा, ऐसा करना गैर-कानूनी होगा और कानूनी परिणामों को आकर्षित करेगा।



  انقر فوق Vedio أعلاه لمشاهدة وتنزيل 5 علاجات فعالة للوطن لعلاج DYSENTERY

  العلاجات العشبية للخلل في مستخلصات بابلو أوفنيفا-أبانيفا



  

  في هذا العمل ، سيقوم Babalawo Obanifa بتوثيق أنواع مختلفة من التركيبة العشبية المتوفرة في الأدوية العشبية اليوروبا لعلاج الزحار.  يُعرف مصطلح الزحار في Yoruba Herbal Medicine باسم Igbe Sooro.  يُعرف تسميات الصيغة العشبية لعلاج الزحار باسم Oogun Dida Igbe Sooro.  هذا يجب أن يوثق بالتفصيل أنواع من العشبية الصيغة المتاحة في الأدوية العشبية اليوروبا لهذا الغرض.  سوف يدرس العمل ما هو الزحار ، أنه يسبب ، علاج الأعراض والوقاية من منظور الطب الأرثوذكسي.  بينما يوثق الجزء الختامي بالتفصيل أنواع العلاجات العشبية المتوفرة في طب الأعشاب اليوروبا لعلاج الزحار ، إلا أنه من المفيد ملاحظة أن المعلومات التي يتم توفيرها في هذا العمل يجب ألا تعتبر بديلاً عن خدمة ممارس صحي مؤهل مؤهل  حيث خدمة واحدة مطلوبة.  في محاولة لإعطاء تفسير علمي لما هو الزحار.  يجب أن نعتمد فقط على عمل آدم فيلمان بعنوان ، كل ما يجب أن تعرفه عن الزحار.  تمت مراجعة العمل طبياً بواسطة Alana Biggers ، M.D. ، MPH في 23 يونيو 2017 ونشر على www.medicalnewstoday.com.  وفقًا للمصدر المذكور أعلاه ، يعتبر الزحار مرضًا معديًا يرتبط بالإسهال الحاد.  العلامات والأعراض خفيفة عادةً وتختفي عادةً في غضون بضعة أيام.  معظم الناس لن تسعى الرعاية الطبية.

  كل عام في جميع أنحاء العالم ، هناك ما بين 120 مليون و 165 مليون حالة إصابة بشيجيلا ، منها مليون قاتلة.  أكثر من 60 في المائة من هذه الوفيات هم أطفال تقل أعمارهم عن 5 سنوات في البلدان النامية.

  علاج


  سوف تكشف نتائج المختبر ما إذا كانت العدوى ناتجة عن عدوى Shigella أو Entamoeba histolyca.

  إذا كان العلاج ضروريًا ، فسوف يعتمد على هذه النتائج.

  ومع ذلك ، فإن أي مريض مصاب بالإسهال أو القيء يجب أن يشرب الكثير من السوائل لمنع الجفاف.

  إذا لم يتمكنوا من الشرب ، أو إذا كان الإسهال والقيء غزيرًا ، فقد يكون من الضروري استبدال السوائل عن طريق الوريد.  سيتم وضع المريض على بالتنقيط ومراقبته.

  علاج الزحار العصوي المعتدل

  الزحار العصوي المعتدل ، وهو النوع الشائع في البلدان المتقدمة التي تتمتع بالصرف الصحي الجيد ، سوف يتحلل عادة دون علاج.

  ومع ذلك ، يجب على المريض شرب الكثير من السوائل.

  في الحالات الأكثر شدة ، تتوفر أدوية المضادات الحيوية.

  علاج الزحار الأميبي

  تستخدم أدوية مبيد الأميال لعلاج إنتامويبا هيستوليكا.  سيضمن ذلك عدم بقاء الأميبا داخل الجسم بعد حل الأعراض.

  وغالبا ما يستخدم فلاجيل ، أو ميترونيدازول ، لعلاج الزحار.  يعالج كل من البكتيريا والطفيليات.

  إذا كانت نتائج المختبر غير واضحة ، فقد يتم إعطاء المريض مجموعة من الأدوية المضادة للمضادات الحيوية والأميبيكية ، وهذا يتوقف على مدى حدة الأعراض.

  الأعراض

  تتراوح أعراض الزحار ما بين خفيفة إلى حادة ، ويعتمد ذلك إلى حد كبير على نوعية الصرف الصحي في المناطق التي انتشرت فيها العدوى.

  في البلدان المتقدمة ، تميل علامات وأعراض الزحار إلى أن تكون أكثر اعتدالا من البلدان النامية أو المناطق المدارية.

  تشمل الأعراض الخفيفة:

  معدة طفيفة في المعدة

  التشنج

  الإسهال

  تظهر هذه الأعراض عادة من يوم إلى ثلاثة أيام بعد الإصابة ، ويسترد المريض عافيته خلال أسبوع.

  يصاب بعض الأشخاص أيضًا بعدم تحمل اللاكتوز ، والذي قد يستمر لفترة طويلة وأحيانًا سنوات.

  أعراض الزحار العصوي

  تميل الأعراض إلى الظهور خلال يوم إلى ثلاثة أيام من الإصابة.  عادة ما يكون هناك ألم خفيف وإسهال في المعدة ، ولكن لا يوجد دم أو مخاط في البراز.  قد يكون الإسهال متكررًا للبدء به.

  أقل شيوعًا ، قد يكون مصدرًا موثوقًا به:

  الدم أو المخاط في البراز

  آلام شديدة في البطن

  حمى

  غثيان

  قيء

  في كثير من الأحيان ، تكون الأعراض خفيفة لدرجة أن زيارة الطبيب غير مطلوبة ، ويتم حل المشكلة في غضون بضعة أيام.

  أعراض الزحار الأميبي

  قد يعاني الشخص المصاب بالدوسنتاريا الأميبية من:

  آلام في البطن

  حمى وقشعريرة

  الغثيان والقيء

  الإسهال المائي ، والذي قد يحتوي على دم أو مخاط أو صديد

  وفاة مؤلمة من البراز

  تعب

  الإمساك المتقطع

  إذا نفق الأميبا من خلال جدار الأمعاء ، فإنها يمكن أن تنتشر في مجرى الدم وتصيب الأعضاء الأخرى.

  قرحة يمكن أن تتطور.  هذه قد تنزف ، مما تسبب في الدم في البراز.

  قد تستمر الأعراض لعدة أسابيع.

  قد تستمر الأميبات في العيش داخل العائل البشري بعد ظهور الأعراض.  ثم ، قد تتكرر الأعراض عندما يكون الجهاز المناعي للشخص أضعف.

  العلاج يقلل من خطر الأميبا على قيد الحياة.

  تحدد منظمة الصحة العالمية (WHO) مصدرًا موثوقًا به نوعين أساسيين من الزحار.

  الزحار العصوي ، أو داء الشيغيلات

  هذا النوع ينتج الأعراض الأكثر حدة.  سببها عصيات شيجيلا.

  سوء النظافة هو المصدر الرئيسي.  يمكن أن ينتشر مرض الشيغيلة أيضًا بسبب الطعام الملوث.

  في أوروبا الغربية والولايات المتحدة ، يعد هذا النوع الأكثر شيوعًا من الزحار لدى الأشخاص الذين لم يزروا المناطق الاستوائية قبل فترة وجيزة من الإصابة.

  الزحار الأميبي ، أو الأميبا

  ويتسبب هذا النوع عن طريق التحلل النسجي (E. histolytica) ، الأميبا.

  مجموعة الأميبا معًا لتشكيل كيس ، وهذه الخراجات تخرج من الجسم في براز بشري.

  في مناطق سوء الصرف الصحي ، يمكن أن تتسبب الأميبا في تلوث الطعام والماء وإصابة البشر ، حيث يمكنها البقاء لفترات طويلة خارج الجسم.

  يمكنهم أيضًا تعليق أيدي الناس بعد استخدام الحمام.  ممارسة النظافة الجيدة تقلل من خطر انتشار العدوى.

  إنها أكثر شيوعًا في المناطق الاستوائية ، ولكنها تحدث أحيانًا في أجزاء من المناطق الريفية في كندا.

  أسباب أخرى

  الأسباب الأخرى تشمل عدوى الدودة الطفيلية ، تهيج كيميائي ، أو عدوى فيروسية.

  التشخيص

  سوف يسأل الطبيب المريض عن علاماتهم وأعراضهم وإجراء الفحص البدني.

  قد يتم طلب عينة من البراز ، خاصة إذا كان المريض قد عاد مؤخرًا من المناطق الاستوائية.

  إذا كانت الأعراض شديدة ، فقد يوصى بالتصوير التشخيصي.  قد يكون هذا الفحص بالموجات فوق الصوتية أو التنظير.

  مضاعفات

  مضاعفات الزحار قليلة ، لكنها قد تكون شديدة.

  الجفاف: الإسهال المتكرر والقيء يمكن أن يؤدي بسرعة إلى الجفاف.  عند الرضع والأطفال الصغار ، يمكن أن يصبح هذا بسرعة مهددة للحياة.

  خراج الكبد: إذا انتشرت الأميبات في الكبد ، فقد يتشكل الخراج هناك.

  التهاب المفاصل المعدي: قد يحدث ألم المفاصل بعد الإصابة.

  متلازمة انحلال اليوريميك: يمكن أن تسبب الزحار الشيجيلا خلايا الدم الحمراء في سد مدخل الكلى ، مما يؤدي إلى فقر الدم وانخفاض عدد الصفائح الدموية وفشل كلوي.

  كما عانى المرضى من نوبات بعد الإصابة.

  منع

  الزحار ينبع في الغالب من سوء النظافة.

  للحد من خطر الإصابة ، يجب على الناس غسل أيديهم بانتظام بالماء والصابون ، وخاصة قبل وبعد استخدام الحمام وإعداد الطعام.

  هذا يمكن أن تقلل من وتيرة العدوى Shigella وغيرها من أنواع الإسهال بنسبة تصل إلى 35 في المئةالمصدر الموثوق به.

  تشمل الخطوات الأخرى التي يجب اتخاذها عندما تكون المخاطر أعلى ، على سبيل المثال ، عند السفر:

  لا تشرب سوى مصادر مياه موثوقة ، مثل المياه المعبأة في زجاجات

  راقب الزجاجة التي يتم فتحها ، وقم بتنظيف الجزء العلوي من الحافة قبل الشرب

  تأكد من طهي الطعام جيدًا

  من الأفضل استخدام المياه النقية لتنظيف الأسنان ، وتجنب مكعبات الثلج ، حيث قد يكون مصدر الماء غير معروف.

  العلاجات العشبية للزحار في الطب العشبي اليوروبا كوثيقة بقلم Babalawo Obanifa

  1.

  سوكو أغادو (مكعبات الذرة)

  نعناع البط (أوراق لاندوفيا أوارينسيس)

  Odidi ataare (فلفل تمساح كامل)

  إعداد

  سوف تحرق العنصر المذكور أعلاه معًا وتطحنه إلى مسحوق ناعم.

  استعمال

  سيقوم المريض الذي يعاني من الزحار بإضافته إلى eko gbigbona (وجبة الذرة الساخنة)

  2.

  Ewe Efinrin nla (أوراق الريحان / الحد الأقصى للجرعة)

  أوجيري إيجيبو (مجهول)

  إعداد

  سوف تضغط على عصير Ewe Efinrin nla (أوراق الريحان / الحد الأقصى للوشية) بالماء.  سوف تخلط أوجيري إيجيبو (مجهول) ،

  استعمال

  الشخص الذي يعاني من الزحار سوف يشربه.

  3.

  إوي أوريكوتين توتو (أوراق جديدة من بريسوكاربوس كوكسينوس)

  إعداد

  ضغط الأوراق بالماء.

  استعمال

  سيشربه المريض لوقف الزحار

  4.

  إوي Odundun توتو (أوراق جديدة من النباتات القيامة)

  إعداد

  سوف تستخدم الماء للضغط على Ewe Odundun tutu (الأوراق الطازجة لنباتات القيامة)

  الاستخدام

  مريض الزحار سيشربه.

  5.

  Eepo igi Oriri (الجذع الطازج لـ Oriri / Uniedntfied)

  إعداد

  نقعها في الماء.

  استعمال

  مريض الزحار سيشربه.

  6.

  Egbo ewuro (جذور نباتات الأوراق المريرة / Verlonia Amygdalina)

  نعجة eepin (إجازة من شجرة ورق الرمل / Fiscus Experate)

  Oko ataare (القرنفل من فلفل التمساح / Aframomum melegueta)

  Efunle (Evolvolus aisinoides)

  إعداد

  سوف تطحن كل شيء معًا.

  استعمال

  مريض الزحار سيشربه.

  7.

  إيوي إيورو (أوراق مريرة / فيرلونيا أميغدالينا)

  Alubosa Ayu (الثوم / الآليوم sativum)


  إعداد

  سوف تطحن العنصرين المذكورين أعلاه معًا وتخلطهما مع العسل.

  استعمال

  الشخص المصاب بالدوسنتاريا سوف يلعقها.

  8.

  أوبي غبانجا (كولا نيتيدا)

  Iyere (فلفل غينيا / بايبر غينينسيس)

  إعداد

  سوف تطحن العنصر المذكور أعلاه معًا.

  استعمال

  مريض الزحار سيضيفه إلى وجبة الذرة الساخنة

  9.

  نعجة أرونكونا (مجهولة الهوية)

  EFUN

  Ataare meta (ثلاثة جراب من فلفل التمساح)

  إعداد

  سوف تطحن العنصر المذكور أعلاه معًا.

  استعمال

  مريض الزحار سيضيفه إلى وجبة الذرة الساخنة

  10.

  Epo Igi omon (لحاء جذعي طازج لـ Omon)

  إعداد

  سوف تغلي اللحاء الجذري لأومون بالماء.  استخدام الماء لطهي الموز غير ناضج كما عصيدة وتناولها.

  11.

  إيوي الأوكريسي (الأوراق الطازجة لإيبوميا إينفولوكراتا)

  إعداد

  سوف تضغط على الأوراق المذكورة أعلاه للحصول عليها عصير.

  استعمال

  ضعه على أظافر الأصابع وأصابع المريض مع الزحار

  12.

  Ewe Koleorogba tutu (أوراق جديدة من Koleoorogba)

  سوف تضغط على الأوراق المذكورة أعلاه للحصول عليها عصير.

  استعمال

  ضعه على أظافر الأصابع وأصابع المريض مع الزحار

  13.

  Ododo Ewe Agunmona (أوراق رقيقة من Culcasia scandens)

  إعداد

  قم بطحنها حتى لصقها جيدًا واستخدمها لطهي أسماك القطة الجافة وتناولها عندما يكون لديك خلل

  14.

  Egbo Airanku (جذور Airanku / مجهول)

  إعداد

  قم بطحنها حتى لصقها جيدًا واستخدمها لطهي أسماك القطة الجافة وتناولها عندما يكون لديك الزحار

  15.

  إيبو آرا إغبو (جذع اللحاء لبرديا ميلانيا)


  Eepo Igi Aaka / Akika (جذع اللحاء Cynometra Megalophilia)

  إعداد

  قم بطحنه إلى مسحوق ناعم وامزجه بزيت النخيل الأحمر

  استعمال

  سوف يكون الزحار المريض لعق ذلك.

  مراجع

  https://www.medicalnewstoday.com/articles/171193.php#prevention

  · داء الزخار.  (2014 ، كانون الثاني)
  health.ny.gov/diseases/communicable/amebiasis/fact_sheet.htm

  · داء الزخار.  (بدون تاريخ)
  pharmacology2000.com/Chemotherapy/Antiparasitic/ameba2.htm

  بوين ، أ. (2017 ، 31 مايو)
  wwwnc.cdc.gov/travel/yellowbook/2016/infectious-diseases-related-to-travel/shigellosis

  Debnath، A.، Parsonage، D.، Andrade، R.، He، C.، Cobo، E.، Hirata، K.، ... & Reed، S. (2012، December 1).  تحدد شاشة العقاقير ذات الإنتاجية العالية لـ Entamoeba histolyca قيادة وهدفًا جديدين.  طب الطبيعة ، 18 ، 6 ، 956-960
  ncbi.nlm.nih.gov/pmc/articles/PMC3411919/

  · الزحار.  (بدون تاريخ)
  who.int/topics/dysentery/en/

  تحديث صحة الزحار الوبائي: ملحق لإصدار رقم  55. (1993، December - 1994، February).  دليل ملحق للحوار حول الإسهال ، 55 ، 1-6
  rehydrate.org/dd/su55.htm

  هاردينج ، م. (2016 ، 25 مايو).  العصبوي
  patient.info/doctor/shigellosis

  متلازمة الورم الانحلالي عند الأطفال.  (2015 ، يونيو)
  niddk.nih.gov/health-information/kidney-disease/children/hemolytic-uremic-syndrome

  علاج الجفاف عن طريق الفم.  (2014 ، 21 أبريل)
  rehydrate.org/ors/ort.htm

  شلاين ، ل.  تقرير يوم المياه العالمي لمنظمة الصحة العالمية
  who.int/water_sanitation_health/takingcharge.html

  شيجيلا - داء الشيغيلة.  (2017 ، 31 مارس)
  cdc.gov/shigella/general-information.html

  Traa، B.، Fischer Walker، C. L.، Munos، M.، & Black، R. (2010، March 23).  المضادات الحيوية لعلاج الزحار عند الأطفال.  المجلة الدولية لعلم الأوبئة ، 39 ، ملحق 1
  academic.oup.com/ije/article/39/suppl_1/i70/700550/Antibiotics-for-the-treatment-of-dysentery-in

  Vyas، J. (2015 ، 1 مايو).  خراج الكبد الأميبي
  medlineplus.gov/ency/article/000211.htm

  والش ، م (2011 ، 19 سبتمبر).  العصبوي
  infectionlandscapes.org/2011/09/shigellosis.html

  حقوق الطبع والنشر: Babalawo Pele Obasa Obanifa ، الهاتف واتساب whatsapp: +2348166343145 ، موقع Ile Ife osun ولاية نيجيريا

  إشعار هام: فيما يتعلق بالمادة أعلاه ، لا يجوز إعادة إنتاج أو تكرار أي جزء من هذه المادة بأي شكل أو بأي وسيلة ، سواء كانت إلكترونية أو ميكانيكية ، بما في ذلك التصوير والتسجيل أو بأي نظام لتخزين المعلومات أو استرجاعها دون إذن كتابي مسبق من صاحب حقوق الطبع والنشر و  المؤلف Babalawo Obanifa ، القيام بذلك سوف يعتبر غير قانوني وسوف يجلب عواقب قانونية.

Vide Below For Work Of Various Medical authors and Health practitioners on Treatment of Dysentery

Everything you should know about dysentery
Medically reviewed by Alana Biggers, M.D., MPH on  June 23, 2017 — Written by Adam Felman
Treatment
Symptoms
Causes
Diagnosis
Complications
Prevention
What is dysentery?

Dysentery is an infectious disease associated with with severe diarrhea.

In the United States, signs and symptoms are normally mild and usually disappear within a few days. Most people will not seek medical attention.

If a person seeks medical help for dysentery in the U.S., however, the authorities must be informed. It is a notifiable disease.

Each year worldwide, there are between 120 million and 165 million cases of Shigella infection, of which 1 million are fatal. Over 60 percent of these fatalities are children under 5 years old in developing countries.

Treatment

Laboratory results will reveal whether the infection is due to Shigella or Entamoeba histolyca infection.

If treatment is necessary, it will depend on these results.

However, any patient with diarrhea or vomiting should drink plenty of fluids to prevent dehydration.

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

Treatment for mild bacillary dysentery

Mild bacillary dysentery, the kind commonly found in developed countries with good sanitation, will normally resolve without treatment.

However, the patient should drink plenty of fluids.

In more severe cases, antibiotic drugs are available.

Treatment for amoebic dysentery

Amoebicidal medications are used to treat Entamoeba histolyca. These will ensure that the amoeba does not survive inside the body after symptoms have resolved.

Flagyl, or metronidazole, is often used to treat dysentery. It treats both bacteria and parasites.

If lab results are unclear, the patient may be given a combination of antibiotic and amoebicidal medications, depending on how severe their symptoms are.

Symptoms

The symptoms of dysentery range from mild to severe, largely depending on the quality of sanitation in the areas where infection has spread.

In developed countries, signs and symptoms of dysentery tend to be milder than in developing nations or tropical areas.

Mild symptoms include:

a slight stomach-ache
cramping
diarrhea
These usually appear from 1 to 3 days after infection, and the patient recovers within a week.

Some people also develop lactose intolerance, which can last for a long time, sometimes years.

Symptoms of bacillary dysentery

Symptoms tend to appear within 1 to 3 days of infection. There is normally a mild stomach ache and diarrhea, but no blood or mucus in the feces. Diarrhea may be frequent to start with.

Less commonly, may beTrusted Source:

blood or mucus in the feces
intense abdominal pain
fever
nausea
vomiting
Often, symptoms are so mild that a doctor's visit is not required, and the problem resolves in a few days.

Symptoms of amoebic dysentery

A person with amoebic dysentery may have:

abdominal pain
fever and chills
nausea and vomiting
watery diarrhea, which can contain blood, mucus, or pus
the painful passing of stools
fatigue
intermittent constipation
If amoeba tunnel through the intestinal wall, they can spread into the bloodstream and infect other organs.

Ulcers can develop. These may bleed, causing blood in stools.

Symptoms may persist for several weeks.

The amoebae may continue living within the human host after symptoms have gone. Then, symptoms may recur when the person's immune system is weaker.

Treatment reduces the risk of the amoebae surviving.

Causes


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The most common type of dysentery is caused by the Shigella bacillus.
The World Health Organization (WHO) identifiesTrusted Source two main types of dysentery.

Bacillary dysentery, or shigellosis

This type produces the most severe symptoms. It is caused by the Shigella  bacillus.

Poor hygiene is the main source. Shigellosis can also spread because of tainted food.

In Western Europe and the U.S., it is the most common type of dysentery in people who have not visited the tropics shortly before infection.

Amoebic dysentery, or amoebiasis

This type is caused by Entamoeba histolytica (E. histolytica), an amoeba.

The amoebae group together to form a cyst, and these cysts emerge from the body in human feces.

In areas of poor sanitation, the amoebae can contaminate food and water and infect other humans, as they can survive for long periods outside the body.

They can also linger on people's hands after using the bathroom. Good hygiene practice reduces the risk of spreading infection.

It is more common in the tropics, but it sometimes occurs in parts of rural Canada.

Other causes

Other causes include a parasitic worm infection, chemical irritation, or viral infection.

Diagnosis

The doctor will ask the patient about their signs and symptoms and carry out a physical examination.

A stool sample may be requested, especially if the patient has recently returned from the tropics.

If symptoms are severe, diagnostic imaging may be recommended. This could be an ultrasound scan or an endoscopy.

Complications

Complications of dysentery are few, but they can be severe.

Dehydration: Frequent diarrhea and vomiting can quickly lead to dehydration. In infants and young children, this can quickly become life-threatening.

Liver abscess: If amoebae spread to the liver, an abscess can form there.

Postinfectious arthritis: Joint pain may occur following the infection.

Hemolytic uremic syndrome: Shigella dysenteriae can cause the red blood cells to block the entrance to the kidneys, leading to anemia, low platelet count, and kidney failure.

Patients have also experienced seizures after infection.

Prevention

Dysentery mostly stems from poor hygiene.

To reduce the risk of infection, people should wash their hands regularly with soap and water, especially before and after using the bathroom and preparing food.

This can reduce the frequency of Shigella infections and other types of diarrhea by up to 35 percentTrusted Source.

Other steps to take when the risk is higher, for example, when traveling, include:

Only drink reliably sourced water, such as bottled water
Watch the bottle being opened, and clean the top of the rim before drinking
Make sure food is thoroughly cooked
It is best to use purified water to clean the teeth, and avoid ice cubes, as the source of the water may be unknown.

What Is Dysentery?

Dysentery is an intestinal infection that you can get if you eat food that's been prepared by someone who's got the illness.

The disease can cause bloody diarrhea. There are two types. Amoebic dysentery comes from a parasite called Entamoeba histolytica. You're more likely to get this kind if you travel to a tropical location that has poor sanitation.

The second type, called bacillary dysentery, comes from bacteria called Shigella. Diarrhea from Shigella is also called shigellosis. It's the most common type of dysentery. About 500,000 people in the U.S. are diagnosed with it every year.

How You Get It

You might get this infection if the person who prepared your food is sick and didn't properly wash their hands. Or you can get dysentery if you touch something that has the parasite or bacteria on it, such as a toilet handle or sink knob. Swimming in contaminated water, such as lakes or pools, is another way you might catch dysentery.

You can sometimes carry the bug that causes dysentery for weeks or years without knowing it. You can still pass the infection to other people, even if you don't have symptoms.

CONTINUE READING BELOW

Symptoms

Symptoms usually show up 1 to 3 days after you get infected. In some people, the symptoms take longer to appear. Others never get symptoms.

Each type of dysentery has slightly different symptoms.

Bacillary dysentery causes symptoms like:

Diarrhea with belly cramps
Fever
Nausea and vomiting
Blood or mucus in the diarrhea
Amoebic dysentery usually doesn't cause symptoms. If you do feel sick, you'll notice problems 2 to 4 weeks after you're infected, such as:
Nausea
Diarrhea
Belly cramps
Weight loss
Fever
Rarely, amoebic dysentery leads to more serious problems like liver abscess, which is a collection of pus in the liver. Symptoms include:

Nausea and vomiting
Fever
Pain in the upper right part of the belly
Weight loss
Swollen liver
Diagnosis

Dysentery symptoms look like a lot of other intestinal illnesses, including a garden-variety stomach virus. A lab technician can look at a sample of your diarrhea under a microscope to confirm that you have this infection.

How You Treat It

Most people with bacillary dysentery don't need treatment. The infection usually passes on its own within a week.

CONTINUE READING BELOW

While you wait for the infection to clear, you can do a few things to help you feel better. Drink plenty of water or "rehydration" drinks, like sports drinks, to bring back the fluid you lost through diarrhea.

Medicine with bismuth subsalicylate (Pepto-Bismol) may ease symptoms like belly cramps and diarrhea. You can also take an over-the-counter pain reliever like acetaminophen to manage painful cramps.

Don't take an over-the-counter diarrhea medicine like loperamide (Imodium) unless your doctor recommends it. These medications can make dysentery worse.

A severe Shigella infection that doesn't clear up on its own in a few days may need treatment with antibiotics. In that case, see your doctor.


If you have amoebic dysentery with symptoms, you can take medicine to kill the parasites in your blood, intestines, and liver. You'll stay on these medications for about 10 days. Doctors treat amoebic dysentery that doesn't cause symptoms with drugs such as iodoquinol or diloxanide furoate.

Dysentery is very contagious. Stay home from work or school until you've been diarrhea-free for at least 48 hours to avoid passing the infection to others. Wash your hands often and don't prepare food for anyone else for at least 2 days after your symptoms clear up. Also avoid sex until you feel better.

Once the infection is gone, clean your house well to kill the germs. Wash your sheets, towels, and clothes in hot water. Disinfect toilet seats, flush handles, sink handles, doorknobs, and other places you often touch.

CONTINUE READING BELOW



When to Get Medical Help

Most of the time you don't need prescription medicine to treat dysentery. The infection should clear on its own within a week.

Call your doctor if diarrhea, cramps, and other symptoms are severe, or if they don't get better within a week. Let your doctor know if you recently traveled to a country where dysentery is common.

How to Prevent Dysentery

If you visit a tropical or less developed country where dysentery spreads, follow these tips:

Drink and brush your teeth with bottled or canned water only, not tap water.
Order your drinks without ice.
Only eat raw fruits and vegetables that have a peel.
Cook any produce that you can't peel.
Don't eat food from street vendors.
When someone close to you has dysentery:

Wash your hands often with soap and warm water or use hand sanitizer.
Don't share towels, cups, or other personal items with the person who has dysentery.
Wash your hands before you cook or eat.
What Is Dysentery and How Is It Treated?
Medically reviewed by Suzanne Falck, MD on June 27, 2017 — Written by Shelia Buff
Types
Causes and risk factors
Diagnosis
Treatment
Complications
Outlook
Prevention
What is dysentery?

Dysentery is an intestinal infection that causes severe diarrhea with blood. In some cases, mucus may be found in the stool. This usually lasts for 3 to 7 days.

Other symptoms may include:

abdominal cramps or pain
nausea
vomiting
fever of 100.4°F (38°C) or higher
dehydration, which can become life-threatening if left untreated
Dysentery is usually spread as a result of poor hygiene. For example, if someone who has dysentery doesn’t wash their hands after using the toilet, anything they touch is at risk.

The infection is also spread through contact with food or water that has been contaminated with fecal matter. Careful hand washing and proper sanitation can help prevent dysentery and keep it from spreading.

Types of dysentery

Most people who experience dysentery develop either bacterial dysentery or amebic dysentery.

Bacterialdysentery is caused by infection with bacteria from Shigella, Campylobacter, Salmonella, or enterohemorrhagic E. coli. Diarrhea from Shigella is also known as shigellosis. Shigellosis is the most common type of dysentery, with about 500,000 casesTrusted Source diagnosed in the United States each year.

Amebic dysentery is caused by a single-celled parasite that infects the intestines. It’s also known as amebiasis.

Amebic dysentery is less common in the developed world. It’s usually found in tropical locales that have poor sanitary conditions. In the United States, most cases of amebic dysentery occur in people who have traveled to an area where it’s common.

What causes dysentery and who is at risk?

Shigellosis and amebic dysentery typically result from poor sanitation. This refers to environments where people who don’t have dysentery come into contact with fecal matter from people who do 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
Children are most at risk of shigellosis, but anyone can get it at any age. It’s easily spread through person-to-person contact and by contaminated food and drink.

Shigellosis mostly spreads among people who are in close contact with an infected person, such as people:

at home
in day care centers
in schools
in nursing homes
Amebic dysentery is primarily spread by eating contaminated food or drinking contaminated water in tropical areas that have poor sanitation.

How is dysentery diagnosed?

If you or your child has symptoms of dysentery, see your doctor. If left untreated, dysentery can lead to severe dehydration and become life-threatening.

At your appointment, your doctor will review your symptoms and any recent travels. You should note any travels outside of the country. This information can help your doctor narrow down the possible cause of your symptoms.

Many conditions can cause diarrhea. If you don’t have other symptoms of dysentery, your doctor will order diagnostic testing to determine which bacteria are present. This includes a blood test and a lab test of a stool sample.

Your doctor may also perform addition testing to decide whether an antibiotic will help.

Treatment options

Mild shigellosis is usually treated just with rest and plenty of fluids. Over-the-counter medication, such as bismuth subsalicylate (Pepto-Bismol), can help relieve cramps and diarrhea. You should avoid drugs that slow down the intestines, such as loperamide (Imodium) or atropine-diphenoxylate (Lomotil), which can make the condition worse.

Severe shigellosis can be treated with antibiotics, but the bacteria that causes it are often resistant. If your doctor prescribes an antibiotic and you don’t see improvement after a couple of days, let the doctor know. Your strain of Shigella  bacteria may be resistant, and your doctor may need to adjust your treatment plan.

Amebic dysentery is treated with metronidazole (Flagyl) or tinidazole (Tindamax). These drugs kill the parasites. In some cases, a follow-up drug is given to make sure all the parasites are gone.

In severe cases, your doctor may recommend an intravenous (IV) drip to replace fluids and prevent dehydration.

Possible complications

In some cases, dysentery can lead to complications. These include:

Postinfectious arthritis: This affects about 2 percentTrusted Source of people who get a particular strain of the Shigella bacteria called S. flexneri. These people can develop joint pain, eye irritation, and painful urination. Postinfectious arthritis can last for months or years.

Blood stream infections: These are rare and most likely to affect people with weak immune systems, such as people with HIV or cancer.

Seizures: Sometimes young children can have generalized seizures. It isn’t clear why this happens. This complication generally resolves without treatment.

Hemolytic uremic syndrome (HUS): One type of Shigella bacteria, S. dysenteriae,  can sometimes cause HUS by making a toxin that destroys red blood cells.

In rare cases, amebic dysentery can result in liver abscess or parasites spreading to the lungs or brain.

Outlook

Shigellosis usually goes away within a week or so and doesn’t require prescription medications. If you have shigellosis, avoid preparing food for other people and don’t go swimming. People who have shigellosis and work with children, in food preparation, or in healthcare should stay home until the diarrhea has stopped. If you or a partner has shigellosis, avoid having sex until the diarrhea has stopped.

Most people with amebic dysentery are sick for anywhere from a few days to several weeks. If you suspect amebic dysentery, it’s important to get immediate medical attention. Your doctor must prescribe medication to get rid of the parasite that causes this type of dysentery.

How to prevent dysentery

Shigellosis can be prevented through good sanitation practices, such as:

frequent hand washing
being careful when changing a sick baby’s diaper
not swallowing water when swimming
The best way to prevent amebic dysentery is to be careful about what you eat and drink while visiting an area where it’s common. When travelling to these areas, you should avoid:

drinks with ice cubes
drinks that aren’t bottled and sealed
food and beverages sold by street vendors
peeled fruit or vegetables, unless you peel them yourself
unpasteurized milk, cheese, or dairy products
Safe sources of water include:

bottled water, if the seal is unbroken
carbonated water in cans or bottles, if the seal is unbroken
soda in cans or bottles, if the seal is unbroken
tap water that has been boiled for at least one minute
tap water that has been filtered through a 1-micron filter with chlorine or iodine tablets added

Antibiotics for the treatment of dysentery in children
Beatrix S Traa,1 Christa L Fischer Walker,2,* Melinda Munos,2 and Robert E Black2
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This article has been cited by other articles in PMC.
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Abstract
Background Ciprofloxacin, ceftriaxone and pivmecillinam are the antibiotics currently recommended by the World Health Organization (WHO) for the treatment of dysentery in children; yet there have been no reviews of the clinical effectiveness of these antibiotics in recent years.

Methods We reviewed all literature reporting the effect of ciprofloxacin, ceftriaxone and pivmecillinam for the treatment of dysentery in children in the developing countries. We used a standardized abstraction and grading format and performed meta-analyses to determine the effect of treatment with these antibiotics on rates of treatment failure, bacteriological failure and bacteriological relapse. The CHERG Standard Rules were applied to determine the final effect of treatment with these antibiotics on diarrhoea mortality.

Results Eight papers were selected for abstraction. Treatment with ciprofloxacin, ceftriaxone or pivmecillinam resulted in a cure rate of >99% while assessing clinical failure, bacteriological failure and bacteriological relapse.

Conclusions The antibiotics recommended by the WHO—ciprofloxacin, ceftriaxone and pivmecillinam—are effective in reducing the clinical and bacteriological signs and symptoms of dysentery and thus can be expected to decrease diarrhoea mortality attributable to dysentery.

Keywords: Ciprofloxacin, ceftriaxone, pivmecillinam, diarrhoea, dysentery, morbidity, mortality, treatment
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Background
Dysentery is a major cause of childhood morbidity and mortality in developing countries. Most dysentery cases in the tropics are caused by Shigella,1 whereas dysentery in the developed countries is usually caused by Salmonella.2 Death rates as high as 6.2% have been reported during epidemics of Shigella dysenteriae type 1.3 The provision of effective anti-microbial therapy is important especially for reducing the prevalence of Shigella and other organisms causing dysentery in children. Decreasing the bacterial load excreted by a child with dysentery also reduces the probability of fecal–oral transmission to close contacts, such as neighbours, friends or members of the child’s household.4 Anti-microbial therapy is particularly important in developing countries, where prolonged diarrhoea episodes, including dysentery, can significantly decrease the growth and nutritional status in the affected children.5,6

The World Health Organization (WHO) recommends that all episodes of diarrhoea with blood in the stool be treated with antibiotics. The WHO currently recommends treatment with ciprofloxacin (a quinolone) or one of the three second-line antibiotics, pivmecillinam, azithromycin and ceftriaxone (a third-generation cephalosporin).7 Here, we review the scientific evidence supporting the WHO-recommended antibiotics ciprofloxacin, ceftriaxone and pivmecillinam for the effective treatment of dysentery.

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Methods
We systematically reviewed all literature published between 1 January 1990 and 31 January 2009 to identify the studies describing the efficacy of ciprofloxacin, ceftriaxone and pivmecillinam for the treatment of dysentery in children aged ≤5 years. Following CHERG Systematic Review Guidelines (ref. methods paper), we searched PubMed, Cochrane Libraries and all WHO Regional Databases, including literature published in other languages.

We limited the search to studies of antibiotic use in cases of bloody diarrhoea. Search terms included various combinations of ‘ciprofloxacin’, ‘ceftriaxone’, ‘amdinocillin pivoxil’, ‘pivmecillinam’, ‘diarrhoea’, ‘infantile diarrhoea’, ‘dysentery’, ‘Shigella’ and ‘Salmonella’. Studies were included if they reported the effect of the antibiotics on severe morbidity as observed by decreased blood in the stool or tha’, ‘infantile diarrhoea’, ‘dysentery’, ‘Shigella’ and ‘Salmonella’. Studies were included if they reported the effect of the antibiotics on severe morbidity as observed by decreased blood in the stool or the effect of the antibiotics on Shigella and/or Salmonella bacteraemia, in the stool of paediatric dysentery cases.

We abstracted data describing study identifiers and context, study design and limitations, intervention specifics and outcome effects, into a standardized abstraction form from any publications that met final inclusion and exclusion criteria (ref. methods paper). Outcome effects examined were categorized as ‘clinical failure’, ‘bacteriologic failure’ and ‘bacteriologic relapse’. Clinical failure was defined as an absence of marked improvement in, or worsening of, illness with the presence of bloody mucoid stools, more than a trace of blood in stool, abdominal pain, tenesmus and/or fever. Bacteriological failure was defined as failure to clear an enteropathogen isolated from an individual on admission to the study, by the end of the treatment period. Bacteriological relapse was defined as the reappearance of an enteropathogen in stool after that enteropathogen was cleared by treatment.

Each study was assessed and graded according to the CHERG adaptation of the GRADE technique. Randomized trials received an initial score of ‘high’. We deducted half a grade point for each study design limitation. One- to two-point grade increases were allotted to studies with statistically significant strong levels of association (>80% reduction). Any study with a very low final grade was excluded on the basis of inadequate study quality.

We conducted a meta-analysis and used the DerSimonian–Laird pooled relative risk and corresponding 95% confidence interval because there was heterogeneity in the study design. We also ran, but did not report, the Mantel–Haenszel pooled relative risk and corresponding 95% CI. All analyses were conducted using STATA 10.0 statistical software.8

We summarized the evidence by outcome, including qualitative assessments of the study quality and quantitative measures, according to the standard guidelines for each outcome.9 We applied the CHERG Rules for Evidence Review10 to the collective diarrhoea morbidity outcomes to estimate the effects of ciprofloxacin, ceftriaxone and pivmecillinam on eliminating severe morbidity due to diarrhoea in children with dysentery.

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Results
We identified 586 titles from searches conducted in all databases (Figure 1). After screening titles and abstracts, we reviewed 31 papers for the identified outcome measures of interest. Because very few studies reported data exclusively for children aged ≤5 years, we expanded our study population to include children aged up to 16 years. Eight papers were included in the final dataset with some papers contributing data for multiple antibiotics or more than one outcome measure (Supplementary Table 1). We found eight studies that reported on clinical failure (12 unique data points),1,11–17 with most studies evaluating clinical failure status 3 days after treatment was initiated (range 3–6 days). Four studies reported on bacteriological failure (six unique data points),11,14–16 and five reported on bacteriological relapse (seven unique data points)10–12,14,15 (Table 1). All abstracted studies were randomized controlled treatment studies. We identified very few studies with limitations based on study design and execution.


Figure 1
Synthesis of study identification to review effect of ciprofloxacin, ceftriaxone and pivmecillinam on diarrhoea treatment failure, bacteriological failure and bacteriological relapse

Table 1

Quality assessment of trials of antibiotics for the treatment of diarrhoea

Quality assessment
Summary of findings
Directness
No. of events
No. of studies (ref) Design Limitations Consistency (based on the heterogeneity of the meta-analysis) Generalizability to population of interest Generalizability to interven

RCT, Randomized controlled trial.

In Table 1, we report the quality assessment of trials by study outcome as well as results from corresponding meta-analyses. Based on 12 data points from eight studies, treatment with one of the three antibiotics resulted in a clinical failure rate of 0.1% (95% CI −0.2 to 0.5%). Based on six datasets abstracted from four studies evaluated in this review, the effect size of antibiotic therapy on a child’s relative risk of bacteriological failure is 0% (−0.1 to 0.1%). Seven datasets from five studies indicate that the effect size of antibiotic therapy on a child’s relative risk of bacteriological relapse is 0.0% (−0.1 to 0.1%). Assuming treatment failure rate to be an extremely conservative proxy for dysentery deaths not preventable with prompt antibiotic treatment, it can be estimated that treatment of dysentery with ciprofloxacin, ceftriaxone or pivmecillinam will reduce diarrhoea mortality attributable to dysentery by 99% (Figure 2).


Figure 2
Application of the CHERG Guidelines for the effect of antibiotics on dystenteric morbidity and mortality

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Discussion
Diarrhoeal disease, including dysentery, is a major cause of morbidity and mortality among children in developing countries. This systematic review of the literature summarizes the evidence supporting the use of the antibiotics recommended by WHO: ciprofloxacin, ceftriaxone and pivmecillinam. It also suggests that the bacteria isolated from a stool sample of a child with dysentery rarely relapses if the child has received full-course treatment with one of these antibiotics, and the disease-causing bacteria is sensitive to the antibiotic. Reducing a child’s risk of bacteriological relapse is beneficial, because the likelihood of subsequent episodes of dysentery occurring in that child, and of transmission occuring to others, are reduced as a result.

The studies contibuting data in this review were conducted in middle- and low-income countries increasing their generalizability to paediatric populations in countries with the highest diarrhoea mortality rates. Extrapolating clinical failure to mortality, our meta-analyses indicate that >99% of dysentery deaths can be prevented with ciprofloxacin, ceftriaxone or pivmecillinam treatment. For application in the Lives Saved Tool, it is essential to extrapolate severe morbidity to mortality, although this leap has many limitations. Children with functioning immune systems do not always progress to death as a result of dysentery. It is possible for some children to successfully fight the infection without antibiotics and make a full recovery. In addition, many children who present for medical care and are prescribed one antibiotic are put on a second-line treatment if the first choice fails, thus further reducing the treatment failure rate.

Nearly, all studies were conducted in a clinic or hospital, where staff could monitor treatment. In a community or outpatient setting, the therapeutic effect of the antibiotics reviewed here may not be as great as our analyses indicate, because caregivers may not comply with the dosage and duration specifications of the treatment. Caregivers may also fail to manage the dehydration that often accompanies diarrhoea, thereby increasing a child’s risk of death.

The 99% reduction in diarrhoea mortality that we estimate is attributable to the treatment of dysentery with ciprofloxacin, ceftriaxone or pivmecillinam and assumes antibiotic susceptibility. The variability in the types of dysentery-causing organisms that occur worldwide18 and their sensitivity to the antibiotics recommended for treatment by the WHO may decrease the generalizability of the findings presented in this review. Because bacteria that cause dysentery can acquire resistance to antibiotics, drugs used for treatment should be selected based on resistance patterns prevalent in the community. Future research with regard to site-specific antibiotic resistance may provide additional data and help refine recommendations for national or local planning.

There is strong evidence in favour of the continued use of the antibiotics recommended by WHO—ciprofloxacin, ceftriaxone and pivmecillinam—to reduce morbidity and mortality in children with dysentery.

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Supplementary data
Supplementary data are available at IJE  online.

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Funding
US Fund for UNICEF from the Bill & Melinda Gates Foundation (grant 43386 to ‘Promote evidence-based decision making in designing maternal, neonatal and child health interventions in low- and middle-income countries’). MKM is supported by a training grant from the U.S. National Institutes of Health (grant T32HD046405 for ‘International Maternal and Child Health’).

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Acknowledgement
We thank our colleagues at WHO and UNICEF for their review of the manuscript and valuable feedback.

Conflict of interest: None declared.

KEY MESSAGES

The evidence supporting antibiotics for the treatment of dysentery includes 8 studies demonstrating a benefit on clinical and bacteriologic outcomes.

Antibiotics for the treatment of diarrhea results in a cure rate of 99%.

Antibiotics for the treatment of dysentery is critical to reducing dysentery deaths and should be easily accessible especially in areas where dysentery rates are high.
References
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Shigella Infection Medication
Updated: Apr 03, 2018
Author: Jaya Sureshbabu, MBBS, MRCPCH(UK), MRCPI(Paeds), MRCPS(Glasg), DCH(Glasg); Chief Editor: Russell W Steele, MD  more...
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Medication Summary
Various antimicrobial agents are effective in the treatment of shigellosis, although options are becoming limited because of globally emerging drug resistance. Resistance of Shigella species to sulfonamides, tetracyclines, ampicillin, and trimethoprim-sulfamethoxazole (TMP-SMX) has been reported worldwide, and these agents are not recommended as empirical therapy.
The World Health Organization (WHO) recommends that all suspected cases of shigellosis based on clinical features be treated with effective antimicrobials (antibiotics). [24] The choice of antimicrobial drug has changed over the years as resistance to antibiotics has occurred, with different patterns of resistance being reported around the world. Evidence is insufficient to consider any class of antibiotic superior in efficacy in treating Shigella dysentery. The following antibiotics are used to treat Shigella  dysentery:
Beta-lactams: Ampicillin, amoxicillin, third-generation cephalosporins (cefixime, ceftriaxone), and pivmecillinam (not available in the United States)
Quinolones: Nalidixic acid, ciprofloxacin, norfloxacin, and ofloxacin
Macrolides: Azithromycin
Others: sulfonamides, tetracycline, cotrimoxazole, and furazolidone.

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Dysentery
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Edit
Dysentery is a type of gastroenteritis that results in diarrhea with blood.[1][7] Other symptoms may include fever, abdominal pain, and a feeling of incomplete defecation.[2][8][5] Complications may include dehydration.[3]

A person with dysentery in a Burmese hospital, 1943
Specialty
Infectious disease
Symptoms
Bloody diarrhea, abdominal pain, fever[1][2]
Complications
Dehydration[3]
Duration
Less than a week[4]
Causes
Usually Shigella or Entamoeba histolytica[1]
Risk factors
Contamination of food and water with feces due to poor sanitation[5]
Prevention
Hand washing, food safety[4]
Treatment
Drinking sufficient fluids, antibiotics  (severe cases)[4]
Frequency
Common in the developing world[6]
Deaths
> million a year[6]
The cause is usually Shigella, in which case it is known as shigellosis, or Entamoeba histolytica.[1] Other causes may include certain chemicals, other bacteria, other protozoa, or parasitic worms.[2] It may spread between people.[4] Risk factors include contamination of food and water with feces  due to poor sanitation.[5] The underlying mechanism involves inflammation of the intestine, especially of the colon.[2]

Efforts to prevent dysentery include hand washing and food safety measures while traveling in areas of high risk.[4] While the condition generally resolves on its own within a week, drinking sufficient fluids such as oral rehydration solution is important.[4] Antibiotics such as azithromycin may be used to treat cases associated with travelling in the developing world.[8] While medications used to decrease diarrhea such as loperamide are not recommended on their own, they may be used together with antibiotics.[8][4]

Shigella results in about 165 million cases of diarrhea and 1.1 million deaths a year with nearly all cases in the developing world.[6] In areas with poor sanitation nearly half of cases of diarrhea are due to Entamoeba histolytica.[5] Entamoeba histolytica affects millions of people and results in greater than 55,000 deaths a year.[9] It commonly occurs in less developed areas of Central and South America, Africa, and Asia.[9] Dysentery has been described at least since the time of Hippocrates.[10]

Signs and symptoms Edit

The most common form of dysentery is bacillary dysentery, which is typically a mild sickness, causing symptoms normally consisting of mild gut pains and frequent passage of stool or diarrhea. Symptoms normally present themselves after 1–3 days, and are usually no longer present after a week. The frequency of urges to defecate, the large volume of liquid feces ejected, and the presence of blood, mucus, or pus depends on the pathogen causing the disease. Temporary lactose intolerance can occur, as well. In some caustic occasions, severe abdominal cramps, fever, shock, and delirium can all be symptoms.[2][11][12][13]

In extreme cases, people may pass more than one liter of fluid per hour. More often, individuals will complain of diarrhea with blood, accompanied by abdominal pain, rectal pain and a low-grade fever. Rapid weight loss and muscle aches sometimes also accompany dysentery, while nausea and vomiting are rare. On rare occasions, the amoebic parasite will invade the body through the bloodstream and spread beyond the intestines. In such cases, it may more seriously infect other organs such as the brain, lungs, and most commonly the liver.[1


Mechanism Edit


Cross-section of diseased intestines. Colored lithograph c. 1843
Dysentery results from bacterial, or parasitic  infections. Viruses do not generally cause the disease.[7] These pathogens typically reach the large intestine after entering orally, through ingestion of contaminated food or water, oral contact with contaminated objects or hands, and so on.

Each specific pathogen has its own mechanism or pathogenesis, but in general, the result is damage to the intestinal linings, leading to the inflammatory immune responses. This can cause elevated physical temperature, painful spasms of the intestinal muscles (cramping), swelling due to fluid leaking from capillaries of the intestine (edema) and further tissue damage by the body's immune cells and the chemicals, called cytokines, which are released to fight the infection. The result can be impaired nutrient absorption, excessive water and mineral loss through the stools due to breakdown of the control mechanisms in the intestinal tissue that normally remove water from the stools, and in severe cases, the entry of pathogenic organisms into the bloodstream. Anemia may also arise due to the blood loss through diarrhea.

Bacterial infections that cause bloody diarrhea are typically classified as being either invasive or toxogenic. Invasive species cause damage directly by invading into the mucosa. The toxogenic species do not invade, but cause cellular damage by secreting toxins, resulting in bloody diarrhea. This is also in contrast to toxins that cause watery diarrhea, which usually do not cause cellular damage, but rather they take over cellular machinery for a portion of life of the cell.[15]

Some microorganisms – for example, bacteria of the genus Shigella – secrete substances known as cytotoxins, which kill and damage intestinal tissue on contact. Shigella is thought to cause bleeding due to invasion rather than toxin, because even non-toxogenic strains can cause dysentery, but E. coli with shiga-like toxins do not invade the intestinal mucosa, and are therefore toxin dependent.

Definitions of dysentery can vary by region and by medical specialty. The U. S. Centers for Disease Control and Prevention (CDC) limits its definition to "diarrhea with visible blood".[16] Others define the term more broadly.[17] These differences in definition must be taken into account when defining mechanisms. For example, using the CDC definition requires that intestinal tissue be so severely damaged that blood vessels have ruptured, allowing visible quantities of blood to be lost with defecation. Other definitions require less specific damage.

Amoebic dysentery Edit
Main article: Amoebiasis
Amoebiasis, also known as amoebic dysentery, is caused by an infection from the amoeba Entamoeba histolytica,[18] which is found mainly in tropical areas.[19] Proper treatment of the underlying infection of amoebic dysentery is important; insufficiently treated amoebiasis can lie dormant for years and subsequently lead to severe, potentially fatal, complications.

When amoebae inside the bowel of an infected person are ready to leave the body, they group together and form a shell that surrounds and protects them. This group of amoebae is known as a cyst, which is then passed out of the person's body in the feces and can survive outside the body. If hygiene standards are poor – for example, if the person does not dispose of the feces hygienically – then it can contaminate the surroundings, such as nearby food and water. If another person then eats or drinks food or water that has been contaminated with feces containing the cyst, that person will also become infected with the amoebae. Amoebic dysentery is particularly common in parts of the world where human feces are used as fertilizer. After entering the person's body through the mouth, the cyst travels down into the stomach. The amoebae inside the cyst are protected from the stomach's digestive acid. From the stomach, the cyst travels to the intestines, where it breaks open and releases the amoebae, causing the infection. The amoebae can burrow into the walls of the intestines and cause small abscesses and ulcers to form. The cycle then begins again.

Bacillary dysentery Edit
Main article: Bacillary dysentery
Dysentery may also be caused by shigellosis, an infection by bacteria of the genus Shigella, and is then known as bacillary dysentery (or Marlow syndrome). The term bacillary dysentery etymologically might seem to refer to any dysentery caused by any bacilliform  bacteria, but its meaning is restricted by convention to Shigella dysentery.

Other bacteria Edit
Some strains of Escherichia coli cause bloody diarrhea. The typical culprits are enterohemorrhagic Escherichia coli, of which O157:H7 is the best known.

A clinical diagnosis may be made by taking a history and doing a brief examination. Treatment is usually started without or before confirmation by laboratory analysis.

Physical exam Edit
The mouth, skin, and lips may appear dry due to dehydration. Lower abdominal tenderness may also be present.[14]

Stool and blood tests Edit
Cultures of stool samples are examined to identify the organism causing dysentery. Usually, several samples must be obtained due to the number of amoebae, which changes daily.[14] Blood tests can be used to measure abnormalities in the levels of essential minerals and salts.[14]

Efforts to prevent dysentery include hand washing and food safety measures well traveling in areas of high risk.[4]

Vaccine Edit
Although there is currently no vaccine which protects against Shigella infection, several are in development.[20][21] Vaccination may eventually become a part of the strategy to reduce the incidence and severity of diarrhea, particularly among children in low-resource settings. For example, Shigella is a longstanding World Health Organization (WHO) target for vaccine development, and sharp declines in age-specific diarrhea/dysentery attack rates for this pathogen indicate that natural immunity does develop following exposure; thus, vaccination to prevent this disease should be feasible. The development of vaccines against these types of infection has been hampered by technical constraints, insufficient support for coordination, and a lack of market forces for research and development. Most vaccine development efforts are taking place in the public sector or as research programs within biotechnology companies.

Treatment Edit

Dysentery is managed by maintaining fluids using oral rehydration therapy. If this treatment cannot be adequately maintained due to vomiting or the profuseness of diarrhea, hospital admission may be required for intravenous fluid replacement. In ideal situations, no antimicrobial therapy should be administered until microbiological microscopy and culture studies have established the specific infection involved. When laboratory services are not available, it may be necessary to administer a combination of drugs, including an amoebicidal drug to kill the parasite, and an antibiotic to treat any associated bacterial infection.

If shigellosis is suspected and it is not too severe, letting it run its course may be reasonable — usually less than a week. If the case is severe, antibiotics such as ciprofloxacin or TMP-SMX may be useful. However, many strains of Shigella are becoming resistant to common antibiotics, and effective medications are often in short supply in developing countries. If necessary, a doctor may have to reserve antibiotics for those at highest risk for death, including young children, people over 50, and anyone suffering from dehydration or malnutrition.

Amoebic dysentery is often treated with two antimicrobial drugs such as metronidazole  and paromomycin or iodoquinol.[22]

Prognosis Edit

With correct treatment, most cases of amoebic and bacterial dysentery subside within 10 days, and most individuals achieve a full recovery within two to four weeks after beginning proper treatment. If the disease is left untreated, the prognosis varies with the immune status of the individual patient and the severity of disease. Extreme dehydration can delay recovery and significantly raises the risk for serious complications.[23]

Epidemiology Edit

Insufficient data exists, but Shigella is estimated to have caused the death of 34,000 children under the age of five in 2013, and 40,000 deaths in people over five years of age.[20] Amoebiasis infects over 50 million people each year, of whom 50,000 die.[24]

History Edit

The seed, leaves, and bark of the kapok tree have been used in traditional medicine by indigenous peoples of the rainforest regions in the Americas, west-central Africa, and Southeast Asia in this disease.[25][26][27] Bacillus subtilis was marketed throughout America and Europe from 1946 as an immunostimulatory aid in the treatment of gut and urinary tract diseases such as rotavirus and Shigella,[28] but declined in popularity after the introduction of consumer antibiotics.


A Red Army soldier dies of dysentery after eating unwashed vegetables. This is a common way of contracting dysentery. From a health advisory pamphlet given to soldiers.
685 – Constantine IV, the Byzantine emperor, died of dysentery in September 685.
1183 – Henry the Young King died of dysentery at the castle of Martel on 11 June 1183.
1216 – King John of England died of dysentery at Newark Castle on 18 October 1216.[29]
1270 – Saint Louis IX of France died of dysentery in Tunis while commanding his troops for the Eighth Crusade on 25 September 1270.
1307 – King Edward I of England caught dysentery on his way to the Scottish border and died in his servants' arms on 6 July 1307.
1322 – King Philip V of France died of dysentery at the Abbey of Longchamp (site of the present hippodrome in the Bois de Boulogne) in Paris while visiting his daughter, Blanche, who had taken her vows as a nun there in 1322. He died on January 3, 1322.
1376 – Edward the Black Prince son of Edward III of England and heir to the English throne. Died of apparent dysentery in June, after a months-long period of illness during which he predicted his own imminent death, in his 46th year.
1422 – King Henry V of England died suddenly on 31 August 1422 at the Château de Vincennes, apparently from dysentery,[30] which he had contracted during the siege of Meaux. He was 35 years old and had reigned for nine years.
1536 – Erasmus, Dutch renaissance humanist and theologian. At Basel.[31]
1596 – Sir Francis Drake, vice admiral, died of dysentery on 28 January 1596 whilst anchored off the coast of Portobelo.[32]
1605 – Akbar, ruler of the Mughal Empire of South Asia, died of dysentery. On 3 October 1605, he fell ill with an attack of dysentery, from which he never recovered. He is believed to have died on or about 27 October 1605, after which his body was buried at a mausoleum in Agra, present-day India.[33]
1675 – Jacques Marquette died of dysentery on his way north from what is today Chicago, traveling to the mission where he intended to spend the rest of his life.[34]
1676 – Nathaniel Bacon died of dysentery after taking control of Virginia following Bacon's Rebellion. He is believed to have died in October 1676, allowing Virginia's ruling elite to regain control.[35]
19th century – As late as the nineteenth century, the 'bloody flux' it is estimated, killed more soldiers and sailors than did combat.[17] Typhus and dysentery decimated Napoleon's Grande Armée in Russia. More than 80,000 Union soldiers died of dysentery during the American Civil War.[36]
1827 – Queen Nandi kaBhebhe, (mother of Shaka Zulu) died of dysentery on October 10, 1827.[37]
1896 – Phan Đình Phùng, a Vietnamese  revolutionary who led rebel armies against French colonial forces in Vietnam, died of dysentery as the French surrounded his forces on January 21, 1896.[38]
1930 – The French explorer and writer, Michel Vieuchange, died of dysentery in Agadir on 30 November 1930, on his return from the "forbidden city" of Smara. He was nursed by his brother, Doctor Jean Vieuchange, who was unable to save him. The notebooks and photographs, edited by Jean Vieuchange, went on to become bestsellers.[39][40]
1942 – The Selarang Barracks incident in the summer of 1942 during World War II  involved the forced crowding of 17,000 Anglo-Australian prisoners-of-war (POWs) by their Japanese captors in the areas around the barracks square for nearly five days with little water and no sanitation after the Selarang Barracks POWs refused to sign a pledge not to escape. The incident ended with the surrender of the Australian commanders due to the spreading of dysentery among their men.[41]

Cholera, a bacterial infection of the small intestine which produces severe diarrhea.

References Edit

^ a b c d "Dysentery". who.int. Archived from the original on 5 December 2014. Retrieved 28 November 2014.
^ a b c d e "Dysentery" at Dorland's Medical Dictionary
^ a b "WHO EMRO | Dysentery | Health topics". www.emro.who.int. Retrieved 15 November 2019.
^ a b c d e f g h "Dysentery". nhs.uk. 18 October 2017. Retrieved 15 November  2019.
^ a b c d Marie, C; Petri WA, Jr (30 August 2013). "Amoebic dysentery". BMJ clinical evidence. 2013. PMID 23991750.
^ a b c "Dysentery (Shigellosis)" (PDF). WHO. November 2016. p. 2. Retrieved 15 November 2019.
^ a b "Controlling the Spread of Infections|Health and Safety Concerns". www.cdc.gov. Retrieved 15 November 2019.
^ a b c Tribble, DR (September 2017). "Antibiotic Therapy for Acute Watery Diarrhea and Dysentery". Military medicine. 182 (S2): 17–25. doi:10.7205/MILMED-D-17-00068. PMID 28885920.
^ a b Shirley, DT; Farr, L; Watanabe, K; Moonah, S (July 2018). "A Review of the Global Burden, New Diagnostics, and Current Therapeutics for Amebiasis". Open forum infectious diseases. 5 (7): ofy161. doi:10.1093/ofid/ofy161. PMID 30046644.
^ Grove, David (2013). Tapeworms, Lice, and Prions: A compendium of unpleasant infections. OUP Oxford. p. PT517. ISBN 9780191653452.
^ DuPont, H. L. (1978). "Interventions in diarrheas of infants and young children". J. Am. Vet. Med. Assoc. 173 (5 Pt 2): 649–53. PMID 359524.
^ DeWitt, T. G. (1989). "Acute diarrhoea in children". Pediatr Rev. 11 (1): 6–13. doi:10.1542/pir.11-1-6. PMID 2664748.
^ "Dysentery symptoms". National Health Service. Archived from the original on 23 March 2010. Retrieved 22 January 2010.
^ a b c d "Dysentery-Diagnosis". mdguidelines.com. Archived from the original on 14 July 2011. Retrieved 17 November 2010.
^ Ryan, Jason (2016). Boards and Beyond: Infectious Disease (Version 9-26-2016 ed.).
^ "Laboratory Methods for the Diagnosis of Epidemic Dysentery and Cholera" (PDF). WHO/CDS/CSR/EDC/99.8. Centers for Disease Control and Prevention. Atlanta, Georgia 1999. Archived from the original (PDF) on 5 March 2012.
^ a b "Dysentery". TheFreeDictionary's Medical dictionary.
^ WHO (1969). "Amoebiasis. Report of a WHO Expert Committee". WHO Technical Report Series. 421: 1–52. PMID 4978968.
^ Amebic+Dysentery at the US National Library of Medicine Medical Subject Headings (MeSH)
^ a b Mani, Sachin; Wierzba, Thomas; Walker, Richard I (2016). "Status of vaccine research and development Shigella". Vaccine. 34 (26): 2887–2894. doi:10.1016/j.vaccine.2016.02.075. PMID 26979135.
^ "WHO vaccine pipeline tracker". World Health Organization. Archived from the original on 25 July 2016. Retrieved 21 July 2016.
^ "Chapter 3 Infectious Diseases Related To Travel". CDC. 1 August 2013. Archived from the original on 14 July 2014. Retrieved 9 June 2014.
^ mdguidelines.com. "Dysentery-Prognosis". Archived from the original on 14 July 2011. Retrieved 17 November 2010.
^ Byrne, Joseph Patrick (2008). Encyclopedia of Pestilence, Pandemics, and Plagues: A-M. ABC-CLIO. pp. 175–176. ISBN 978-0-313-34102-1.
^ "Kapok Tree". Blue Planet and Biomoes. Archived from the original on 22 February 2012. Retrieved 7 February  2012.
^ "Ceiba pentandra". Human Uses and Cultural Importance. Archived from the original on 15 February 2012. Retrieved 7 February 2012.
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External links Edit

Classification
D
ICD-10: A09.0, A03.9, A06.0, A07.9ICD-9-CM: 004, 007.9, 009.0MeSH: D004403

Dysentery

Dysentery is an infection of the intestines that causes diarrhoea containing blood or mucus.

Other symptoms of dysentery can include:

painful stomach cramps
nausea or vomiting
a fever of 38C (100.4F) or above
Dysentery is highly infectious and can be passed on if you don't take the right precautions, such as properly and regularly washing your hands.

Types of dysentery

There are two main types of dysentery:

bacillary dysentery or shigellosis – caused by shigella bacteria; this is the most common type of dysentery in the UK
amoebic dysentery or amoebiasis – caused by an amoeba (single-celled parasite) called Entamoeba histolytica, which is mainly found in tropical areas; this type of dysentery is usually picked up abroad
Treating dysentery

As dysentery usually clears up on its own after three to seven days, treatment isn't usually needed.

However, it's important to drink plenty of fluids and use oral rehydration solutions (ORS) if necessary to avoid dehydration.

Over-the-counter painkillers, such as paracetamol, can help relieve pain and a fever. Avoid antidiarrhoeal medications, such as loperamide, because they can make things worse.

You should stay at home until at least 48 hours after the last episode of diarrhoea to reduce the risk of passing the infection on to others.

How you can avoid passing on dysentery

Handwashing is the most important way to stop the spread of infection. You're infectious to other people while you're ill and have symptoms.

Take the following steps to avoid passing the illness on to others:

Wash your hands thoroughly with soap and water after going to the toilet. Read more about how to wash your hands.
Stay away from work or school until you've been completely free from any symptoms for at least 48 hours.
Help young children to wash their hands properly.
Don't prepare food for others until you've been symptom free for at least 48 hours.
Don't go swimming until you've been symptom free for at least 48 hours.
Where possible, stay away from other people until your symptoms have stopped.
Wash all dirty clothes, bedding and towels on the hottest possible cycle of the washing machine.
Clean toilet seats and toilet bowls, and flush handles, taps and sinks with detergent and hot water after use, followed by a household disinfectant.
Avoid sexual contact until you've been symptom free for at least 48 hours.
As shigella is easily passed on to others, you may need to submit stool (poo) samples to be given the all clear to return to work, school, nursery or a childminder.

The type of shigella you have and whether or not you or others are in a risk group will influence how long you need to stay away.

Risk groups are people in certain occupations – including healthcare workers and people who handle food – as well as people who need help with personal hygiene and very young children. Your environmental health officer will be able to advise you about this.

When to see your GP

It's not always necessary to see your GP if you have dysentery because it tends to clear up within a week or so.

However, you should see your GP if your symptoms are severe or they don't start to improve after a few days. Let them know if you've been abroad recently.

If your symptoms are severe or persistent, your GP may prescribe a short course of antibiotics. If you have very severe dysentery, you may need treatment in hospital for a few days.

Reducing your risk of catching dysentery

You can reduce your risk of getting dysentery by:

washing your hands with soap and warm water after using the toilet and regularly throughout the day
washing your hands before handling, eating or cooking food
avoiding sharing towels
washing the laundry of an infected person on the hottest setting possible
Read more about food safety and home hygiene.

If you're travelling to a country where there's a high risk of getting dysentery, the advice below can help prevent infection:

Don't drink the local water unless you're sure it's c

sure it's clean (sterile) – drink bottled water or drinks in sealed cans or bottles.
If the water isn't sterile, boil it for several minutes or use chemical disinfectant or a reliable filter.
Don't clean your teeth with tap water.
Don't have ice in your drinks because it may be made from unclean water.
Avoid fresh fruit or vegetables that can't be peeled before eating.
Avoid food and drink sold by street vendors, except drinks in properly sealed cans or bottles.
Read more about food and water safety abroad.

What causes dysentery?

Bacillary and amoebic dysentery are both highly infectious and can be passed on if the faeces (poo) of an infected person gets into another person's mouth.

This can happen if someone with the infection doesn't wash their hands after going to the toilet and then touches food, surfaces or another person.

In the UK, the infection usually affects groups of people in close contact, such as in families, schools and nurseries.

There's also a chance of picking up the infection through anal or anal-oral sex ("rimming").

In developing countries with poor sanitation, infected faeces may contaminate the water supply or food, particularly cold uncooked food.

Page last reviewed: 8 February 2017
Next review due: 8 February 2020

Acute Bacterial Dysentery in Children
 AUTHORS

Manijeh Khalili 1 , *
1  Children and Adolescents Health Research Center, Zahedan University of Medical Sciences, Aliebn-E-Abitaleb Hospital, Zahedan, IR Iran

*  Corresponding author: Manijeh Khalili, Children and Adolescents Health Research Center, Zahedan University of Medical Sciences, Aliebn-E-Abitaleb Hospital, Zahedan, IR Iran. Tel: +98-5413214220, Fax: +98-5413236722, E-mail: Dr_khalili2000@yahoo.com
How to Cite: Khalili M. Acute Bacterial Dysentery in Children, Int J Infect. 2014 ; 1(3):e21589. doi: 10.17795/iji-21589.

Keywords
Child  Diarrhea Shigella

Copyright © 2014, Infectious Diseases and Tropical Medicine Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
Dysentery is an infectious gastrointestinal disorder, characterized by inflammation of the intestines, mainly the colon. World Health Organization (WHO) defines dysentery as any episode of diarrhea in which there is blood in loose and watery stool. Dysentery can mainly spread among people through contaminated food and water as well as poor sanitation. There are several numbers of bacteria that can cause acute dysentery, including Shigella, Salmonella, Campylobacter, and Escherichia coli (E. coli) (1-3). Dysentery is a major cause of childhood morbidity and mortality, especially in developing countries in Africa, Asia, and Central and Latin America. Most dysentery cases in tropical areas are caused by Shigella; but in developed countries, they are usually caused by Salmonella (1, 2). Death rates as high as 6.2% have been reported during epidemics of Shigella dysenteriae type 1 (3). Use of effective antimicrobial treatments is important, especially for reduction of the prevalence rate of Shigella and other organisms causing dysentery in children. On the other hand, reduction of the bacterial load excreted by a child’s stool also decreases the probability of fecal-oral transmission to close contacts, such as friends, members of the child’s household, and neighbors (4). Antimicrobial therapy is very important in developing countries, where prolonged and recurrent episodes of dysentery can diminish the nutritional status and growth in affected children (3-5). Although, it is possible for some immune-component children to successfully fight against the infection without antibiotics and get a full recovery. However, WHO recommends that all the dysentery episodes should be treated with antibiotics, especially in younger children, aged people, and anyone with an immunodeficiency syndrome, because the chances of bacteremia and sepsis are higher in these groups (6, 7). It is also proposed that the bacteria isolated from the stool sample of a child with dysentery rarely relapse if the child has received a full-course treatment with one of the effective and sensitive antibiotics. Emergence of multidrug-resistant (MDR) Shigella spp. (resistance to more than two first-line oral drugs, such as ampicillin, co-trimoxazole, and ciprofloxacin) is of a growing concern in the world. The drug of choice for treatment of severe infections with these MDR strains is ceftriaxone (8-10). Meanwhile, the use of azithromycin rather than ceftriaxone as an empiric antibiotic for cases of severe dysentery prior to culture and sensitivity test results may be considered in areas where MDR strains are reported to minimize the morbidity associated with the disease (9, 10). WHO recommends treatment with ciprofloxacin (not for children less than eight years ols) or one of the three second-line antibiotics, pivmecillinam (pivmecillinam is the pivaloyloxymethyl ester of mecillinam and is only considered to be active against Gram-negative bacteria), azithromycin, and ceftriaxone (a third-generation cephalosporin) (8, 9). Therefore, since some bacteria can acquire resistance to antibiotics, drugs should be selected based on the resistance patterns prevalent in the community. It is estimated that the 99% reduction in diarrhea mortality is associated with the treatment of dysentery with ciprofloxacin, ceftriaxone or pivmecillinam and it may even be more important to perform antibiotic susceptibility test before the treatment (10-12). Therefore, dehydration is more likely to occur in children under one year old (particularly those under six months old), in infa
Therefore, dehydration is more likely to occur in children under one year old (particularly those under six months old), in infants who stopped breastfeeding due to illness, or in children with severe diarrhea and vomiting, and it is recommended to rehydrate them through oral or intravenous (IV) routes. The child should continue with a normal diet and usual drinks. In addition, the child should also be encouraged to drink extra fluids. However, fruit juices or fizzy drinks must be avoided, as they can worsen the diarrhea. For babies aged less than six months who are at increased risk of dehydration, breast or bottle feeds should be encouraged as normal. Hence, children are more likely to develop complications and even death. Prompt treatment with an effective antibiotic and rehydration are very important in children with dysentery.
References
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Guerin PJ, Brasher C, Baron E, Mic D, Grimont F, Ryan M, et al. Case management of a multidrug-resistant Shigella dysenteriae serotype 1 outbreak in a crisis context in Sierra Leone, 1999-2000. Trans R Soc Trop Med Hyg. 2004; 98(11) : 635 -43 [DOI][PubMed]
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Amieva MR. Important bacterial gastrointestinal pathogens in children: a pathogenesis perspective. Pediatr Clin North Am. 2005; 52(3) : 749 -77 [DOI][PubMed]
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Nath R, Saikia L, Choudhury G, Sharma D. Drug resistant Shigella flexneri in & around Dibrugarh, north-east India. Indian J Med Res. 2013; 137(1) : 183 -6 [PubMed]
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el Bushra HE, Bin Saeed AA. Intrafamilial person-to-person spread of bacillary dysentery due to Shigella dysenteriae in southwestern Saudi Arabia. East Afr Med J. 1999; 76(5) : 255 -9 [PubMed]
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Kabir I, Butler T, Khanam A. Comparative efficacies of single intravenous doses of ceftriaxone and ampicillin for shigellosis in a placebo-controlled trial. Antimicrob Agents Chemother. 1986; 29(4) : 645 -8 [PubMed]
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Boyce JM, Hughes JM, Alim AR, Khan M, Aziz KM, Wells JG, et al. Patterns of Shigella infection in families in rural Bangladesh. Am J Trop Med Hyg. 1982; 31(5) : 1015 -20 [PubMed]
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World Health Organization . Guidelines for the control of shigellosis, including epidemics due to Shigella dysenteriae type 1. 2005;
8.
Oommen S, Pillai PM, Sushamabai S, Paul PJ. Cefotaximase and AmpC-producing Shigella flexneri in case of dysentery from southern India. Indian J Med Microbiol. 2013; 31(1) : 77 -9 [DOI][PubMed]
9.
Tajbakhsh M, Garcia Migura L, Rahbar M, Svendsen CA, Mohammadzadeh M, Zali MR, et al Antimicrobial-resistant Shigella infections from Iran: an overlooked problem? J Antimicrob Chemother. 2012; 67(5) : 1128 -33 [DOI][PubMed]
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Varghese SR, Aggarwal A. Extended spectrum beta-lactamase production in Shigella isolates - a matter of concern. Indian J Med Microbiol. 2011; 29(1) : 76 -8 [DOI][PubMed]
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Pivmecillinam.
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Das SK, Ahmed S, Ferdous F, Farzana FD, Chisti MJ, Leung DT, et al. Changing emergence of Shigella sero-groups in Bangladesh: observation from four different diarrheal disease hospitals. PLoS One. 2013; 8(4)[DOI][PubMed]


Dysentery
   
About this Condition
The Facts
Causes
Symptoms and Complications
Making the Diagnosis
Treatment and Prevention
The Facts
Many people have spent a tropical vacation with a bad stomach bug. They might have had dysentery, a painful intestinal infection that is usually caused by bacteria or parasites. Dysentery is defined as diarrhea in which there is blood, pus, and mucous, usually accompanied by abdominal pain.

There are two main types of dysentery. The first type, amoebic dysentery or intestinal amoebiasis, is caused by a single-celled, microscopic parasite living in the large bowel. The second type, bacillary dysentery, is caused by invasive bacteria. Both kinds of dysentery occur mostly in hot countries. Poor hygiene and sanitation increase the risk of dysentery by spreading the parasite or bacteria that cause it through food or water contaminated from infected human feces.

Causes
Dysentery can have a number of causes. Bacterial infections are by far the most common causes of dysentery. These infections include Shigella, Campylobacter, E. coli, and Salmonella species of bacteria. The frequency of each pathogen varies considerably in different regions of the world. For example, shigellosis is most common in Latin America while Campylobacter is the dominant bacteria in Southeast Asia. Dysentery is rarely caused by chemical irritants or by intestinal worms.

Intestinal amoebiasis is caused by a protozoan parasite, Entamoeba histolytica. The amoeba can exist for long periods of time in the large bowel (colon). In the vast majority of cases, amoebiasis causes no symptoms - only 10% of infected individuals become ill. It is uncommon except in the world's tropical zones, where it is very prevalent. People can become infected after ingesting feces that contain somebody's excreted parasites. People are at high risk of acquiring the parasite through food and water if the water for household use isn't separated from waste water. The parasites can also enter through the mouth when hands are washed in contaminated water. If people neglect to wash properly before preparing food, the food may become contaminated. Fruits and vegetables can be contaminated if washed in polluted water or grown in soil fertilized by human waste.

The Shigella and Campylobacter bacteria that cause bacillary dysentery are found all over the world. They penetrate the lining of the intestine, causing swelling, ulcerations, and severe diarrhea containing blood and pus. Both infections are spread by ingestion of feces within contaminated food and water. If people live or travel in an area where poverty or overcrowding may interfere with good hygiene and sanitation, they are at risk of being exposed to invasive bacteria. Young children (ages 1 to 4) living in poverty are most likely to contract shigellosis, campylobacteriosis, or salmonellosis.

Having sex that involves anal contact may spread amoebic and bacillary dysentery. This is especially true if the sex included direct anal or oral contact, or oral contact with an object (e.g., fingers) that touched or was in the anus of an infected person.

person.

Symptoms and Complications
The main symptom of dysentery is frequent near-liquid diarrhea flecked with blood, mucus, or pus. Other 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
vomiting
dehydration
Other symptoms may be intermittent and may include recurring low fevers, abdominal cramps, increased gas, and milder and firmer diarrhea. You may feel weak and anemic, or lose weight over a prolonged period (emaciation). Mild cases of bacillary dysentery may last 4 to 8 days, while severe cases may last 3 to 6 weeks. Amoebiasis usually lasts about 2 weeks.

Bacillary dysentery symptoms begin within 2 to 10 days of infection. In children, the illness starts with fever, nausea, vomiting, abdominal cramps, and diarrhea. Episodes of diarrhea may increase to as much as once an hour with blood, mucus, and pus in the child's stool. Vomiting may result in rapid and severe dehydration, which may lead to shock and death if not treated. Signs of dehydration include an extremely dry mouth, sunken eyes, and poor skin tone. Children and infants will be thirsty, restless, irritable, and possibly lethargic. Children may also have sunken eyes and may not be able to produce tears or urine, the latter appearing very dark and concentrated.

Complications from bacillary dysentery include delirium, convulsions, and coma. A very severe infection like this can be fatal within 24 hours. However, the vast majority of infections are self-limited and resolve spontaneously without treatment.

People with amoebic dysentery may experience other problems associated with amoebiasis. The most frequent complication results when parasites spread to the liver, causing an amoebic abscess. In this case, you would have a high fever and experience weight loss and right shoulder or upper abdominal pain. If the infection of the bowel is especially virulent, the intestinal ulcerations may lead to bowel perforation and death. The parasites may rarely spread through the bloodstream, causing infection in the lungs, brain, and other organs.


Making the Diagnosis
If a doctor suspects dysentery, a stool sample usually will be required for analysis. For bacterial infections such as shigella, the diagnosis is made by culture of the stool. Unfortunately, such cultures are not available in most developing countries and the diagnosis is made clinically on the basis of symptoms. Amoebiasis is often diagnosed by finding parasites under a microscope. An antibody blood test helps to confirm the diagnosis of amoebic dysentery or liver abscess.

The E. histolytica has an identical "twin brother," Entamoeba dispar, a harmless amoeba that looks identical to E. histolytica  under the microscope. It never produces symptoms and does not require treatment. In developing countries, the distinction is not usually made - individuals found to have amoebae in their stools are treated whether or not it is clear that the infection is causing symptoms. Of those diagnosed with amoebae in their stools, 90% have the harmless E. dispar.

Treatment and Prevention
Antiparasitic medications such as metronidazole* and iodoquinol, are commonly used to treat dysentery caused by amoebiasis. Antibiotics like ciprofloxacin, ofloxacin, levofloxacin, or azithromycin are used to treat the organisms causing bacillary dysentery. People with prolonged diarrhea should consult with their doctor. If you travel, you should carry a one- to three-day self-treatment antibiotic regimen such as ciprofloxacin and use it in the case of sudden moderate-to-severe diarrheal illness. Bismuth subsalicylate (Pepto-Bismol®) can also be helpful for some travelers. In addition, use the antidiarrheal medication loperamide to slow the bowel and prevent dehydration. Consult your doctor for children under 2 years of age.

It is most important to replace the fluids lost from diarrhea. In mild cases, soft drinks, juices, and bottled water will be enough. More severe diarrhea should be treated with solutions that contain electrolytes such as potassium, salt, and sucrose. For severe diarrhea, commercial oral rehydration solutions are usually needed. These solutions are available in packets for easy travel. People should try to consume enough fluids so that clear-to-light yellow urine is produced every 3 to 4 hours. While affected with dysentery, it is better to stick to a bland diet (bananas, rice, soda crackers) and avoid milk products.

Dysentery can be prevented to some extent by practising careful personal hygiene.

People who travel to or live in areas with high rates of dysentery should follow the following advice:

Always use a condom for any sexual activity involving anal contact and wash carefully before and after sexual activity.
Do not eat any foods cooked in unhygienic circumstances, such as from street vendors.
Only eat cooked foods that have been heated to a high temperature. Do not eat cooked foods that have cooled.
Do not eat raw vegetables. Avoid species of fruits without peels. Open fruits with peels yourself.
Drink only commercially bottled or boiled water. Do not use ice unless it has been made from purified water.
Use only bottled or boiled water to wash and to cook food in, to wash hands, and to brush teeth.
Consider traveling with an alcohol-based hand sanitizer.

*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For information on a given medication, check our Drug Information database. For more information on brand names, speak with your doctor or pharmacist.

All material copyright MediResource Inc. 1996 – 2019. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/condition/getcondition/Dysentery

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Definition of Dysentery

Dysentery is an intestinal inflammation that usually takes place in the in the colon, and can result in severe diarrhoea with mucus or blood in the faeces.

There are two types of dysentery:

Bacillary dysentery which is caused by Shigella, a type of bacteria. Amoebic dysentery (amoebiasis) which is caused by Entamoeba histolytica, a type of amoeba found in the tropics, thereby affecting people in tropical countries.

Symptoms of Dysentery

The most common signs and symptoms of dysentery include:

Abdominal painNauseaVomitingFatigueFeverChillsWatery diarrhoea which may contain blood, mucus or pusPainful passing of stoolsIntermittent constipation
If you have any/some/all of the above symptoms, prompt medical attention is advised.

Risks of Dysentery

You are more at risk of getting dysentery if:

You drink water from contaminated sourcesYou eat undercooked food, especially seafood or meatYou have an existing condition that weakens the immune system such as diabetes, organ transplant, AIDS, etc.You have or are undergoing ChemotherapyYou consumed improperly stored foodYou live in areas with poor sanitationHave or are travelling to developing countries
Diagnosis of Dysentery

In order to confirm a diagnosis of dysentery, your doctor will ask you about your symptoms and then carry out a physical exam.

If the problem is not diagnosed in the physical exam, the following tests may be recommended:

UltrasoundEndoscopy
Treatment of Dysentery

Once the diagnosis of dysentery is confirmed, treatment will be given depending on the severity of the symptoms. If symptoms are not severe and the doctor determines it is Bacillary dysentery (Shigella), there is little or no medication required and the illness goes away within a week.

If your doctor diagnoses amoebic dysentery, you will be probably start with a 10-day course of an antimicrobial medication, such as Flagyl (metronidazole). Diloxanide furoate, paromomycin , or iodoquinol, depending on the severity of symptoms.

Research shows that an estimated 165 million people worldwide may be infected by bacillary dysentery, and 1.1 million people die from the infection every year (1).

Dysentery is one of the most common gastrointestinal ailments. Without adequate care and timely intervention, it may lead to death. Hence, it is important to seek treatment on time. In this article, we will discuss the causes of dysentery, natural ways to ease the symptoms, and how you can prevent it.

Table Of Contents

What Is Dysentery?
Types Of Dysentery
How Does Dysentery Spread?
What Causes Dysentery?
What Are The Symptoms Of Dysentery?
How Is Dysentery Diagnosed?
Dysentery OTC Treatment
Natural Ways To Manage Dysentery
Precautions
Prevention Tips
What Is Dysentery?

Dysentery is a digestive problem  characterized by loose and watery stool containing blood. It is accompanied by intestinal inflammation and stomach cramps. It can cause discomfort for a few hours or days. However, in some cases, it is known to last longer.

Dysentery may be caused by shigella bacteria (shigellosis) and ameba. Bacillary dysentery is mild, while amebic dysentery is mostly severe and requires immediate medical intervention. Patients typically contract two types of dysentery. They are discussed below.

Types Of Dysentery

Acute Dysentery: Acute dysentery lasts for less than two weeks or 14 days. It is characterized by abdominal pain and loose motions. In rare cases, pus is observed in the stools.
Chronic Dysentery: Chronic dysentery lasts for more than 30 days. If acute dysentery is not treated on time, it can turn chronic. The general health of the individual gets disturbed, and it can prove to be dangerous in the long run.
Some complications of dysentery are postinfectious arthritis, generalized seizures, and hemolysis of red cells due to antibody formation. Amoebic dysentery may cause a liver abscess, which requires prolonged medical treatment and hospitalization for drainage.

How Does Dysentery Spread?

Dysentery typically spreads as a result of poor sanitary conditions and habits. The infection spreads through contact with food or water that has been contaminated with excreta.

Shigellosis (bacterial dysentery) is spread through close contact with an infected person and infection with contaminated food and drinks. Amoebic dysentery is primarily spread by eating contaminated food or drinking contaminated water in tropical areas that have poor sanitation.

What Causes Dysentery?

Dysentery is caused by Shigella bacteria or an ameba called Entamoeba histolytica. The most common cause of dysentery is poor sanitary conditions. Stale food, contaminated water, and exposure to human excreta are other causes of dysentery (2).

People living in overcrowded areas with poor standards of sanitation and regions of tropical climate are susceptible to contaminated food and water. This forms an easy channel for one to catch an infection that can cause dysentery. This infection can also be transferred through carriers, such as house flies, water, or food, and, in some cases, physical contact with another person carrying the infection (3).

What Are The Symptoms Of Dysentery?

Abdominal pain
Loose motions and tenesmus (the urge to empty the bowels)
Dehydration
Nausea and vomiting
Fever
Convulsions (in rare cases) (4).
How Is Dysentery Diagnosed?

Dysentery can cause severe dehydration. Hence, it is imperative that you consult your doctor at the earliest. This condition can become potentially life-threatening if left untreated.

You will be asked if you traveled recently. Any travels out of the country can help your doctor determine the cause of dysentery. Since there are many factors that can cause dysentery, you might be asked to undergo a blood and stool test that can help determine the presence of bacteria. Depending on the results, you will be prescribed a course of antibiotics to eliminate the bacterial infection.

Dysentery OTC Treatment

There are several OTC medication options to help treat dysentery:

Bismuth subsalicylate (known as Pepto-Bismol) has an antisecretory effect on the digestive system (5). It can help relieve cramps and reduce frequent bowel movements. Avoid taking medicines like Loperamide that decrease peristalsis or bowel movement and can aggravate your condition (6).
Your doctor will prescribe a dose of antibiotics if you have a severe case of shigellosis.
The most important aspect of dysentery is to take care of dehydration. You

TREATMENT OF DYSENTERY.
JAMA. 1899;XXXII(13):717-718. doi:10.1001/jama.1899.02450400035009
This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.

Abstract
In the present state of knowledge, dysentery can scarcely be looked upon as a specific disease. Pathologically it may be considered a form of colitis of varying degree and extent and dependent upon a number of exciting causes. Thus, there have been described catarrhal, tropic or amebic and diphtheric varieties. The symptomatology has been rather more uniform, the distinctive clinical manifestations being frequent, small, sometimes ineffective stools, containing often mucus and blood, together with tormina and tenesmus.

Recovery may take place spontaneously. The best treatment consists in the removal of the offending cause and the restoration of the bowel to its previous condition. For this purpose magnesium sulphate has proved useful, as has also irrigation of the bowel. Other remedies of repute are ipecacuanha, which has found great favor among the physicians of British India, and mercuric chlorid. A single large dose of mercuric chlorid may be given at the

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Dysentery
PATHOLOGY
WRITTEN BY: The Editors of Encyclopaedia Britannica
See Article History
Dysentery, infectious disease  characterized by inflammation of the intestine, abdominal pain, and diarrhea  with stools that often contain blood and mucus. Dysentery is a significant cause of illness and death in young children, particularly those who live in less-developed countries. There are two major types: bacillary dysentery and amebic dysentery, caused respectively by bacteria and by amoebas.

Bacillary dysentery, or shigellosis, is caused by bacilli of the genus Shigella. Symptomatically, the disease ranges from a mild attack to a severe course that commences suddenly and ends in death caused by dehydration and poisoning by bacterial toxins. After an incubation period of one to six days, the disease has an abrupt onset with fever  and the frequent production of watery stools that may contain blood. Vomiting  may also occur, and dehydration soon becomes obvious owing to the copious loss of bodily fluids. In advanced stages of the disease, chronic ulceration of the large intestine causes the production of bloody stools.

The most severe bacillary infections are caused by Shigella dysenteriae type 1 (formerly Shigella shigae), which is found chiefly in tropical and subtropical regions. S. flexneri, S. sonnei, and S. boydii are other Shigella bacilli that cause dysentery. Other types of bacterial infections, including salmonellosis  (caused by Salmonella) and campylobacteriosis (caused by Campylobacter), can produce bloody stools and are sometimes also described as forms of bacillary dysentery. The treatment of bacillary dysentery is based on the use of antibiotics. The administration of fluids and, in some cases, blood transfusions may be necessary.

Amebic dysentery, or intestinal amebiasis, is caused by the protozoan Entamoeba histolytica. This form of dysentery, which traditionally occurs in the tropics, is usually much more chronic and insidious than the bacillary disease and is more difficult to treat because the causative organism occurs in two forms, a motile one and a cyst, each of which produces a different disease course. The motile form causes an acute dysentery, the symptoms of which resemble those of bacillary dysentery. The cyst form produces a chronic illness marked by intermittent episodes of diarrhea and abdominal pain. Bloody stools occur in some patients. The chronic type is the more common of the two and is marked by frequent remissions and exacerbations of symptoms. The chronic form may also produce ulcerations of the large intestine and pockets of infection in the liver. Both forms of amebic dysentery are treated with drugs that specifically kill the amebic parasites that thrive in the intestines.

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Dysentery is transmitted through the ingestion of food or water that has been contaminated by the feces of a human carrier of the infective organism. The transmission is often by infected individuals who handle food with unwashed hands. The spread of amebic dysentery is often accomplished by people who are carriers of the disease but who at the time show no symptoms. Dysentery is commonly found when people are crowded together and have access only to primitive sanitary facilities. Spread of the disease can be controlled by boiling drinking water and by adequately disposing of human waste to avoid the contamination of food.

The diagnosis and treatment of chronic dysentery
H. Jocelyn Smyly, M.A., M.D., F.R.C.S.I.
Transactions of The Royal Society of Tropical Medicine and Hygiene, Volume 24, Issue 1, 30 June 1930, Pages 39–66, https://doi.org/10.1016/S0035-9203(30)90626-8
Published: 30 June 1930
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Summary
1.
A series of cases of chronic bacillary dysentery is reported, the duration varying from one month to ten years. B. dysenteri˦ was recovered from 56 cases. The appearances found by sigmoidoscopy are described.
2.
In the treatment of chronic dysentery good results have been obtained from colon lavage with Dakin's solution.
3.
Six cases treated surgically are reported and discussed.
Topic: dysentery irrigation sigmoidoscopy colon diagnosis shigella infections
Issue Section: Communications

Advances in Medicine
Volume 2016, Article ID 3194010, 6 pages
http://dx.doi.org/10.1155/2016/3194010
Clinical Study
Efficacy of Synbiotics for Treatment of Bacillary Dysentery in Children: A Double-Blind, Randomized, Placebo-Controlled Study
Manijeh Kahbazi, Marzieh Ebrahimi, Nader Zarinfar, Mohammad Arjomandzadegan, Taha Fereydouni, Fatemeh Karimi, and Amir Reza Najmi
Infectious Diseases Research Centre (IDRC), Arak University of Medical Sciences, Arak, Iran

Received 21 April 2016; Revised 29 August 2016; Accepted 9 October 2016

Academic Editor: Aliya Naheed

Copyright © 2016 Manijeh Kahbazi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Bacillary dysentery is a major cause of children’s admission to hospitals. To assess the probiotic and prebiotic (synbiotics) effects in children with dysentery in a randomized clinical trial, 200 children with dysentery were studied in 2 groups: the synbiotic group received 1 tablet/day of synbiotic for 3–5 days and the placebo group received placebo tablets (identical tablet form like probiotics). The standard treatment was administered for all patients. Duration of hospitalization, dysentery, fever, and the weight loss were assessed in each group. It was concluded that there was no significant difference in both groups in the baseline characteristics. The mean duration of dysentery reduced (). The mean duration of fever has been significantly reduced in the synbiotic group ( days) in comparison to the placebo group ( days) (). Average amount of weight loss was significantly lower in the synbiotic group in comparison to that in the placebo group ( grams and  grams, resp.; ). There was no significant difference in the mean duration of hospitalization in both groups (). The use of synbiotics as an adjuvant therapy to the standard treatment of dysentery significantly reduces the duration of dysentery, fever, and rate of weight losses. The trial is registered with IRCT201109267647N1.

1. Introduction

Bacillary dysentery is a disease in the category of acute infectious diarrhea. This is mostly spread by the following Gram-negative bacteria: Shigella flexneri, S. dysenteriae, S. boydii, and S. sonnei [1]. Shigella is a pathogen transmitted through the fecal-oral route, primarily via person-to-person contact. Shigellosis in children has variable symptoms ranging from a mild, self-limited diarrhea without inflammation to a severe, inflammatory, bloody diarrhea with high fever, abdominal cramps, vomiting, lack of appetite, toxic appearance, painful defecation, and other extraintestinal complications [2]. Shigellosis is estimated to be responsible for about 170 million cases and 14,000 deaths worldwide annually and such a burden is a major health problem with socioeconomic consequences [3]. Estimation of the disease inflictions remains largely speculative because only a small percentage of patients seek medical treatments and are diagnosed through stool cultures [4]. The most common microorganisms diagnosed in developing countries are S. flexneri and S. dysenteriae, but S. sonnei frequently causes community-wide outbreaks in industrialized countries [5]. The widely accepted definition of probiotics is as follows: “the live microorganisms which when administered in adequate amounts confer a health benefit on the host” [6]. Probiotics are mostly species of the Lactobacillus, Bifidobacterium, and Streptococcus genera. Also, in some studies, yeasts, such as Saccharomyces boulardii, have also been suggested and are used as probiotics [7–9]. In some in vitro studies, Lactobacillus acidophilus has been effective against some intestinal pathogen elements such as Shigella, Salmonella, Staphylococcus, Proteus, Klebsiella, Pseudomonas, E. coli, Clostridium perfringens, and Vibrio. The positive effects of Lactobacillus acidophilus on the gastrointestinal system are due to adhesion and colonization to the intestinal mucosa, competition for adhesion sites on gut, or other tissue surfaces to prevent pathogens colonization, stimulation of mucosal and systemic immunities, production of antibacterial factors, and special bacteriocin, including acidophilin, lactocidin, acidolin, lactolin, organic acids (lactic acid), and the reduction of PH [10–15]. Probiotics have been used for many purposes, but they are most extensively studied in connection with acute infectious diarrhea, but further research in different age groups and various doses of different probiotics is required to evaluate the impact of probiotics on management of infectious dysentery [9, 16, 17]. Prebiotics are dietary fiber which trigger the growth and activate the activity of a limited number of bacteria in the intestinal flora. In addition, prebiotics can increase the effects of probiotics because of their synbiotic relationships. Synbiotics are combinations of probiotics and prebiotics which can synergistically promote the growth of beneficial bacteria or newly added species in the colon [18]. In this study, we investigated the effects of Lactobacillus GG (probiotic) plus prebiotic fructooligosaccharides on dysentery in 1-month–5-year-old children.

2. Materials and Methods

The study was conducted between October 2011 and October 2012 at Amirkabir Hospital, Arak, Iran, with a catchment area of 1500000 people.

2.1. Description of Participants

The inclusion criteria were male and female patients between the ages of 1 and 60 months who presented with acute dysentery to the PICU or Pediatric Emergency of the Amirkabir Hospital. Participants were patients at the same level of economic conditions who had experienced loose stools with mucus or blood and frequency of more than three times a day for less than two weeks, white blood cell (WBC) count ≥ 5/high-power-field (HPF) in the stool exam (SE), positive stool culture of Shigella spp. with or without the presence of fever, abdominal pain, dehydration, anorexia, and vomiting. The criteria for exclusion from the study

2.2. Clinical Management

All patients were examined by a pediatrician. The degree of dehydration, stool appearance, stool consistency, stool frequency, weight loss, duration of dysentery, and fever were recorded. All patients in both groups received the same standard routine treatment such as oral and/or intravenous fluid therapy, antibiotic treatment (Ciprofloxacin, 15 mg/kg, twice a day and for 3 days, orally) and nutritional support. And breastfeeding was promoted.

2.3. Randomization, Masking Procedure, and Study Design

In a double-blind manner, the patients were randomized and divided into the placebo and synbiotic groups. Randomization sequence was generated by a computer-generated randomization table in blocks of 4. Except for the study coordinator, all investigators and patients remained blinded to the randomization process until the study was completed. Each patient was given a different code. Parents and the patients were not informed about their allocation status (the synbiotic or placebo group). Placebos and synbiotics were provided by a pharmacist in packages with the same form and were labeled with the code letter A or B. In the production of placebo tablets, the preservative substances and artificial colors had not been used. Also, there was no fermented substance in the tablet. The same as the synbiotic tablets, the placebo tablets did not have any taste. In the PICU or hospital emergency room, the researcher, in a direct and double-blinded manner, supervised the patients to take the tablets properly. The patients in the synbiotic group were given 1 tablet/day of synbiotic tablets (Lactol®), containing probiotic material (bacillus coagulant, 150 million spores per serving) and prebiotic material (fructooligosaccharides, 100 mg per serving) for a period of 3–5 days.

2.4. Ethical Approval

The protocol has been written based on guidelines for good clinical practice (GCP) for trials on pharmaceutical products. The protocol approval was obtained from the clinical human research and ethical review committee at the Arak University of Medical Sciences, Iran. The purpose of the study, its objectives, potential benefits, risks, and inconveniences, alternative treatment that may be available, and the subject’s rights and responsibilities were explained to the parents. After reading the consent form to the parents in presence of a third party, written informed consent (in accordance with the current revision of the Declaration of Helsinki) was obtained from every parent who wanted their children to participate in the study [19].

2.5. Data Analysis

At the end of the study, the study coordinator informed the researcher about the content, synbiotics or placebo, of the packages. Statistical analyses were performed using SPSS (version 12.0., Chicago, USA). An independent sample of -test was administered. Mean ± standard deviation, standard error, Chi squared test, and its non-parametric equivalent (Mann-Whitney) were used to analyze the difference between two groups and find the drug efficacy.  was considered statistically significant.


3. Results

Out of the patients admitted to the pediatric emergency, 200 patients (out of 961 screened patients) were included in the study. The age of participants was between 1 month and 5 years. The patients were divided into two groups in a double-blind manner; 100 patients were assigned to the synbiotic group and 100 to the placebo group. Before the treatment, there was no difference between the groups in terms of age, gender, degree of dehydration, frequency of stools, or initial period of dysentery. The mean and SD of participants ages were  months and  in the synbiotic and placebo groups, respectively (). In the synbiotic group, there were 54 females (54%) and 46 males (46%). In the placebo group, there were 62 females and 38 males (62% and 38%, resp.; ). Table 1 shows the baseline characteristic information related to both synbiotic and placebo groups. Based on these results, age and sex distributions in both synbiotic and placebo groups were similar and no difference was observed among them. Therefore, it can be said that general characteristics of participants do not have any negative influence on the obtained results of the study.


Table 1: General characteristics of patients in both synbiotic and placebo groups.
In this study, a comparison between various levels of dehydration shows that, in both synbiotic and placebo groups, a small portion of patients were affected by acute dehydration. In synbiotic group, 84 participants (84%) were affected by minor dehydration, 15 participants (15%) were affected by medium dehydration, and 1 participant (1%) was affected by severe dehydration. In placebo group, 71 participants (71%) were affected by minor dehydration, 25 participants (25%) were affected by medium dehydration, and 4 participants (4%) were affected by severe dehydration (Table 1). The results show that there is no significant relationship between dehydration mean in synbiotic and placebo groups at the beginning of the study (). The results obtained by Kolmogorov-Smirnov test show that data distribution is normal. So, the use of independent sample -test is permissible. The demographic findings, mean and standard deviation of duration of dysentery, duration of fever, duration of hospitalization, and the amount of weight loss following the intervention are summarized in Table 2. The mean duration of dysentery was significantly reduced in the synbiotic group when compared to the placebo group ( days versus  days, resp.). Duration of fever after starting treatment was reduced significantly () in children receiving synbiotics ( days) compared with those in the placebo group (  days). There was no statistical difference between groups in the mean of hospitalization (  in synbiotic group versus  in placebo group; ). At the end of the study, Patients taking synbiotics were less likely to have weight loss ( grams in the synbiotic group versus  grams in the placebo group). There was no death or severe clinical complications during the course of the trial and no adverse effects related to synbiotics were observed.


Table 2: Mean and standard deviation of patient characteristics during the study.

The present study confirmed the positive effects of probiotics and prebiotics on the treatment of children affected by dysentery. The results of this study showed that routine treatment of dysentery in combination with three to five days of synbiotics reduced the duration of dysentery, duration of fever, and weight changes in children aged between 1 and 60 months. Treatment of acute infectious dysentery is mainly designed to compensate for the dehydration and the loss of electrolytes [20] and to protect the normal gastrointestinal microenvironment [21, 22].

Probiotics are used for this purpose to retrieve the deteriorated normal intestinal microflora. The most investigated probiotics in this field are Lactobacilli and Saccharomyces boulardii [9]. In spite of the fact that there are numerous studies about probiotics as a treatment for infectious diarrhea, there are some unsolved problems related to the dysentery description, remission criteria, probiotic type, probiotic potent dose, study quality, and probiotic effectiveness evaluation [23]. Recent studies using different probiotics have shown variable effects and meta-analyses show uncertain results due to inequality of studies [24–26]. This suggests that each probiotic has its unique efficacy, so each probiotic needs to be tested to assess its efficacy in specific conditions [27].

Recent systematic reviews recommend further studies of probiotics in an outpatient setting [24, 28]. There are some meta-analyses which have assessed the results of probiotics in the treatment of AGE. In a recent meta-analysis, in order to evaluate the efficacy of probiotics in the treatment of AGE, data was collected from 63 randomized controlled trials [RCTs] and 8014 subjects. 56 out of all those RCTs were carried out in infants and young children. Forty-six RCTs assessed a single probiotic, and 17 RCTs tested a combination of different probiotics. Lactobacillus GG, S. boulardii, and Enterococcus lactic acid bacteria strain SF68 were the most common probiotics used in studies. The Cochrane Review suggested that Lactobacillus GG can reduce the duration of diarrhea about 27 hours, stool frequency on the second day, and the probability of diarrhea lasting 4 days. The authors have suggested that more assessments are needed to help clinicians in the use of particular probiotic regimens in specific patient groups [29].

According to a research on the impact of Lactobacillus reuteri DSM 17938 on acute infectious diarrhea in a pediatric outpatient setting, it was shown that probiotics had a positive impact on the length of hospitalization and diarrhea. The positive impact on the length of diarrhea was consistent with the findings of the present study [30]. In another study, Golam H. Rabbani et al. studied the impact of green banana on clinical severity of childhood shigellosis. They found that cooked green banana had a positive impact on the length of hospitalization among all age groups. The impact on diarrhea reduction in treatment group was consistent with the findings of the present study [31]. There was no data of weight changes of participants and the impact on the duration of fever was not consistent with the results obtained in the present study.

Ashraf et al. conducted a clinical trial in 2001. In that study, children with confirmed shigellosis were given hyperimmune bovine colostrums in addition to receiving routine treatment. The impact of hyperimmune bovine colostrum on the duration of fever, duration of anorexia, duration of abdominal pain, duration of tenesmus, duration of diarrhea after inclusion, duration of blood in stool, stool frequency on day 3, stool frequency on day 5, cumulative stool frequency in 5-day therapy, number of positive stool cultures on day 3, and number of positive stool cultures on day 5 was investigated in that study. Values were not significantly different between groups. They concluded that HBC as an adjuvant is unable to show any beneficial effect in reducing t

There is a randomized double-blinded, placebo-controlled clinical trial study performed by Chen et al. (2010) on 304 children aged 3 months to 6 years with acute infectious diarrhea. The patients received Bio-Three (a mixture of Bacillus mesentericus, Enterococcus faecalis, and Clostridium butyricum) or placebo for one week in Chang Gung Children’s Hospital in Northern Taiwan. In comparison to the placebo group, the Bio-Three group presented a significant reduction in the severity and duration of diarrhea and the duration of hospital stay, although no reduction of the duration of fever was observed [34]. The Working Group on Probiotics of the European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) described that the use of probiotics should be considered as an adjuvant therapy to ORS in the management of acute gastroenteritis [9, 24].

In the literature, the properties of probiotics have been recognized as a safe and beneficial adjunct to many treatments for infections [35–38]. In our study, no adverse effect toward synbiotics has been reported as well; but recently it has been a matter of intense debate so that in a review article it has been concluded that since there may be different strains of different probiotics with different properties it is possible to have different results of efficacy or adverse effects [39].

Conclusion

Dysentery is one of the most common diseases among children. This disease has harmful impacts on children, family, and society. Due to harmful consequences in terms of economy, human loss, and also the lack of definite treatment which leads to the resistant form of the disease, using probiotics can be beneficial. The findings of this study indicate the beneficial effects of Lactobacillus as an adjunct to standard treatment on the children affected by dysentery, shortening duration of fever and duration of dysentery. Besides, many studies have confirmed the lack of side effects of probiotics. Therefore, it seems that using probiotics/prebiotics as a tool of side treatment in areas affected by dysentery can be beneficial to improve children’s health.

Competing Interests
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Dysentery
Date posted: 08 Aug 2017

Dysentery is a bacterial or amoebae infection of the intestine that causes diarrhoea with blood or mucus in it. Dysentery is commonly spread due to poor hygiene and often people become infected from eating contaminated food. Discover the common causes of dysentery, how it is spread and how to avoid it at home and abroad.

Causes

There are two main causes of dysentery:

Bacillary dysentery (shigellosis) is caused by the bacteria shigella which is found in faeces and is therefore most common in countries with poor sanitation.
Amoebic dysentery (amoebiasis) is caused by a single celled parasite called Entamoeba histolytica which is mainly found in tropical areas.
Both types of dysentery are usually passed on through poor hygiene and eating contaminated food.

Symptoms

Common symptoms include:

Diarrhoea containing blood or mucus
Stomach cramps
Nausea
Vomiting
Abdominal pain
High temperature
Prevention Tips

Wash your hands regularly:

With soap and clean water especially before handling, preparing or eating food, and after using the toilet.

Limit contact with infected people:

Try to use separate towels, bedding, cups and cutlery until they are well again.

Avoid drinking tap water if you are in a high risk area:

Make sure water is purified by boil it or treating with a chemical disinfectant. Alternatively drink bottled water instead.

Be careful with what you eat if you are in a high risk area:

Avoid raw fruit or vegetables unless they are still peeled, like a banana. Avoid milk, cheese or dairy products unless they have been pasteurised to kill bacteria. Food prepared by street vendors should also be avoided as you can’t be sure that it has been prepared safely. Unless you know the source, don’t take ice cubes in your drinks, these could have been made from the tap water.

Myths and Truths

Q. Tap water is safe drinking water

Not necessarily. In many countries around the world sanitation can be poor and hygiene rules less strict. Harmful germs and bacteria can sometimes find their way into local water sources and contaminate tap water. To stay safe check that the water in you have access to is is safe to drink and if unsure, boil tap water before using it or stick to bottled water wherever you can.

Q. I have a strong stomach so I won't get sick

It’s true that your immune system can get used to dealing with types of bacteria that you encounter every day. You may also have tried some adventurous food on holiday. But no one is naturally immune to dysentery, typhoid, cholera or hepatitis – the germs commonly responsible for food poisoning. Take steps to maintain good personal hygiene  and avoid food that has been prepared in unsanitary areas.


Medical Clinics of North America
Volume 66, Issue 3, May 1982, Pages 623-638
Bacillary Dysentery: Mechanisms and Treatment

Author links open overlay panelMyron M.LevineM.D., D.T.P.H.*
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https://doi.org/10.1016/S0025-7125(16)31411-0
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Dysentery
By Healthgrades Editorial Staff
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Introduction Symptoms Causes Treatments

Introduction
What is dysentery?
Dysentery broadly refers to infectious gastrointestinal disorders characterized by inflammation of the intestines, chiefly the colon. The World Health Organization (WHO) defines dysentery as any episode of diarrhea in which blood is present in loose, watery stools.


Dysentery is spread among humans through contaminated food and water. Once a person is infected, the infectious organism lives in the intestines and is passed in the stool of the infected person. With some infections, animals can also be infected and spread the disease to humans.

Common bacterial causes of dysentery in the United States include infections with the bacteria Shigella and some types of Escherichia coli (E coli). Other less common bacterial causes of bloody diarrhea include Salmonella and Campylobacter infections. Dysentery is associated with environmental conditions where poor sanitation is prevalent. For example, childcare institutions and developing countries have higher rates of Shigella. Amebic dysentery, caused by the parasite Entamoeba histolytica, is most commonly found in tropical areas with crowded living conditions and poor sanitation.

The signs and symptoms of dysentery can last five to seven days or even longer. The course of the illness varies among individuals, as do symptoms. Some people suffering with dysentery have mild symptoms, while others may have severe diarrhea with or without vomiting that can pose a risk of dehydration. Fortunately, dysentery can be treated with antibiotics and antiparasitic medications.

Untreated dysentery can lead to severe dehydration. Severe dehydration and electrolyte imbalances can result in shock or coma and may be life-threatening. Seek immediate medical care (call 911) if you, or someone you are with, have symptoms of severe dehydration such as confusion, lethargy, loss of consciousness, cold skin, or decreased urine output. Seek prompt medical care if you develop diarrhea and vomiting and believe you may have been exposed to contaminated food or water


Symptoms
What are the symptoms of dysentery?
Dysentery causes irritation and inflammation of the intestines that may result in a number of symptoms. The symptoms can vary in intensity among individuals.

Common symptoms of dysentery
The most common symptoms of dysentery are related to disturbances of the digestive system and include:

Abdominal bloating
Abdominal pain
Bloody diarrhea (may also be watery or with mucus)
Cramping
Flatulence
Nausea with or without vomiting
Other symptoms of dysentery
As the dysentery infection progresses, other symptoms, including symptoms of dehydration, may develop. Other possible symptoms include:

Decreased urine output
Dry skin and mucous membranes (such as dry mouth)
Feeling very thirsty
Fever and chills
Muscle cramps
Muscle weakness (loss of strength)
Weight loss
Serious symptoms that might indicate a life-threatening condition
On rare occasions, dehydration resulting from dysentery may be so severe that a life-threatening situation can develop. Seek immediate medical care (call 911) if you, or someone you are with, have any of the following symptoms:

Change in level of consciousness or alertness, such as passing out or unresponsiveness
Change in mental status or sudden behavior change, such as confusion, delirium, lethargy, hallucinations and delusions
High fever (higher than 101 degrees Fahrenheit)
Rapid heart rate (tachycardia)
Severe abdominal pain
Severe dizziness

Causes
What causes dysentery?
The bacteria Shigella and E coli and the amoeba Entamoeba histolytica are the most common causes of dysentery. These organisms are present in the stool (feces) of infected people and animals. The Entamoeba histolytica may uneventfully reside in the colon, but if it attacks the colon wall, it can cause dysentery. People with weakened immune systems are also more likely to develop amebic dysentery.

Most commonly, dysentery is caused by drinking water or eating food from sources contaminated with feces containing the pathogens. Swimming in contaminated water may also result in dysentery. For this reason, dysentery occurs most frequently in people traveling to developing countries and in children who touch infected human or animal feces without proper hand washing.

Common causes of dysentery include:
Several organisms are known to cause dysentery, most commonly:

Campylobacter
Certain types of
E coli
Entamoeba histolytica
Salmonella
Shigella
What are the risk factors for dysentery?

Common causes of dysentery include:
Several organisms are known to cause dysentery, most commonly:

Campylobacter
Certain types of
E coli
Entamoeba histolytica
Salmonella
Shigella
What are the risk factors for dysentery?
A number of factors increase the risk of developing dysentery. Not all people with risk factors will get dysentery. Risk factors for dysentery include:

Attendance or work in a day care setting
Close contact with an infected person or animal
Consumption of untreated water from lakes, rivers or streams
Fecal to oral contact
Travel in countries where the infection is common
Use of public swimming pools
Reducing your risk of dysentery
You can lower your risk of developing or transmitting dysentery by:

Avoiding swallowing water in swimming pools, hot tubs, or other recreational water sources
Drinking only purified water when backpacking, camping or hiking
Drinking only purified water when visiting developing countries
Using purified water for brushing your teeth and washing food when visiting developing countries
Washing your hands well with soap and water after touching feces, having contact with an infected person or animal, changing diapers, or using the bathroom, and before eating or preparing food

Treatments
How is dysentery treated?
Treatment for dysentery begins with seeking medical care from your health care provider. To determine if you have dysentery, your health care provider may ask you to provide stool samples for laboratory testing.

Antibiotic therapy is the mainstay of treatment for dysentery due to bacterial organisms and is highly effective. It is important to follow your treatment plan for dysentery precisely and to take all of the antibiotics as instructed to avoid reinfection or recurrence.

Antibiotics for the treatment of dysentery
Antibiotic medications that are effective in the treatment of dysentery caused by bacterial organisms include:

Ceftriaxone (Rocephin)
Ciprofloxacin (Cipro)
Trimethoprim-sulfamethoxazole (Bactrim, Septra)
The most common treatment for amebic dysentery caused by Entamoeba histolytica is metronidazole (Flagyl), an antiparasitic medication.

If you have diarrhea and vomiting, fluid and electrolyte replenishment is also a component of successful treatment.

What you can do to improve dysentery
In addition to following your health care provider’s instructions and taking all medications as prescribed, you can speed your recovery by:

Ensuring adequate hydration by drinking plenty of water and electrolyte solutions
Getting plenty of rest
If you have dysentery, it is important to practice good hygiene to avoid spreading the infection to those who have close contact with you. Wash your hands frequently with soap and water after using the bathroom or touching any contaminated bedding or clothing. Avoid use of public pools, hot tubs, or other recreational water facilities until your infection has cleared.
What are the potential complications of dysentery?
You can help minimize your risk of serious complications by following the treatment plan you and your health care provider design specifically for you. Complications of dysentery include:

Electrolyte imbalance
Intestinal obstruction
Intestinal perforation
Liver abscess
Postinfectious arthritis (joint pain, eye irritation, and painful urination)
Secondary urinary tract infection
Seizures
Spread of infection (sepsis, more common in immunocompromised individuals)

Antibiotics for the treatment of dysentery
Antibiotic medications that are effective in the treatment of dysentery caused by bacterial organisms include:

Ceftriaxone (Rocephin)
Ciprofloxacin (Cipro)
Trimethoprim-sulfamethoxazole (Bactrim, Septra)
The most common treatment for amebic dysentery caused by Entamoeba histolytica is metronidazole (Flagyl), an antiparasitic medication.

If you have diarrhea and vomiting, fluid and electrolyte replenishment is also a component of successful treatment.

What you can do to improve dysentery
In addition to following your health care provider’s instructions and taking all medications as prescribed, you can speed your recovery by:

Ensuring adequate hydration by drinking plenty of water and electrolyte solutions
Getting plenty of rest
If you have dysentery, it is important to practice good hygiene to avoid spreading the infection to those who have close contact with you. Wash your hands frequently with soap and water after using the bathroom or touching any contaminated bedding or clothing. Avoid use of public pools, hot tubs, or other recreational water facilities until your infection has cleared.
What are the potential complications of dysentery?
You can help minimize your risk of serious complications by following the treatment plan you and your health care provider design specifically for you. Complications of dysentery include:

Electrolyte imbalance
Intestinal obstruction
Intestinal perforation
Liver abscess
Postinfectious arthritis (joint pain, eye irritation, and painful urination)
Secondary urinary tract infection
Seizures
Spread of infection (sepsis, more common in immunocompromised individuals)

Dysentery

Epidemic Dysentery
Health Update: A supplement to Issue no. 55 - December 1993-February 1994


The international newsletter on the control of diarrhoeal diseases

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pdf version of this Issue

Supplement contents
Epidemic dysentery
Definitions
A comparison of epidemics of dysentery and cholera
Detecting and managing an epidemic of Sd1
Drug dosages for treating dysentery caused by Sd1
Clinic supplies for 100 persons with dysentery
Refugee crisis spreads disease
South Asia also affected by Sd1
Supportive treatment is vital
Prevention strategies
There is much information in this issue that is valuable and useful. Online readers are reminded, however, that treatment guidelines and health care practices change over time. If you are in doubt, please refer to WHO's up-to-date Dehydration Treatment Plans.


Pages 1-6 Epidemic dysentery
A supplement to Dialogue on Diarrhoea Online Issue 55 - December 1993-February 1994

DDOnline Epidemic dysentery supplement to DD55  Page 1 2


HEALTH UPDATE Epidemic dysentery Epidemics of bloody diarrhoea are currently sweeping through Africa, resulting in the deaths of many adults and children. This DD supplement looks at what causes epidemic dysentery and provides guidelines on preventing and managing epidemics.

Pages 1-6 Epidemic dysentery
A supplement to Dialogue on Diarrhoea Online Issue 55 - December 1993-February 1994

DDOnline Epidemic dysentery supplement to DD55  Page 1 2


HEALTH UPDATE Epidemic dysentery Epidemics of bloody diarrhoea are currently sweeping through Africa, resulting in the deaths of many adults and children. This DD supplement looks at what causes epidemic dysentery and provides guidelines on preventing and managing epidemics.





People in refugee camps with limited water and sanitation facilities are particularly at risk of infection during a dysentery epidemic. Dysentery - bloody diarrhoea - is one of the most dangerous types of diarrhoea. In general. it is more severe and more likely to result in death than other forms of acute diarrhoea. Large scale outbreaks (epidemics) of dysentery are a particular threat to public health. The death rate can be as high as 15 per cent, and health care services are severely stretched during epidemics. Even when correctly treated, about 5 per cent of people with dysentery can die during an epidemic. The bacterium responsible for epidemic dysentery is Shigella dysenteriae type 1 (Sd1 ) (1). S. dysenteriae is one of four species of Shigella. The others are Shigella flexneri, Shigella sonnei and Shigella boydii. These species are usually less dangerous than Sd1 and they do not cause large epidemics. Disease caused by Sd1 tends to be more common in infants, and elderly and malnourished people. Mortality is also highest in these groups. Since Sd1 was first identified late last century, extensive epidemics have been reported in Africa, Asia and Latin America. An epidemic of Sd1 in Latin America between 1969 and 1973 was responsible for more than 500,000 cases of dysentery and 20,000 deaths. Recently, a series of epidemics has been affecting countries in eastern, central and southern Africa including Rwanda, Burundi, Malawi, Zambia, Zimbabwe, Swaziland and Mozambique. There are no reliable data yet on the situation in Tanzania, Zaire and Angola, but it is likely that Sd1 epidemics are also present in those countries. Political upheaval in Burundi in October and November 1993 caused more than 650,000 people to flee to neighbouring Tanzania and Rwanda, taking dysentery with them. Sd1 is one of the main causes of death in refugee camps in countries who share a border with Burundi.


DEFINITIONS

dysentery
bloody diarrhoea
epidemic dysentery
large-scale outbreaks of bloody diarrhoea, almost always caused by Shigella dysenteriae type 1 (Sd1)
endemic dysentery
a normal incidence of bloody diarrhoea, caused by a range of organisms including Shigella.
Shigella
a genus of bacteria with four species - Shigella dysenteriae, Shigella flexneri, Shigella boydii and Shigella sonnei. Shigella causes the most serious episodes of bloody diarrhoea
shigellosis
infection caused by one of the Shigella species, often (but not always) associated with bloody diarrhoea
DDOnline Epidemic dysentery supplement to DD55  1 Page 23

Epidemic dysentery

Clinical features The main clinical sign of infection with Sd1 is bloody diarrhoea. Other symptoms can include abdominal cramps, fever, or severe pain during defecation. However, bloody diarrhoea during a dysentery epidemic is the only sign needed for diagnosing infection with Sd1. Most cases are uncomplicated and self-limiting, lasting up to seven days. But dysentery caused by Sd1 can also result in severe complications including persistent diarrhoea (diarrhoea lasting 14 days or more), septicaemia (blood poisoning), rectal prolapse, and haemolytic-uraemic syndrome (HUS). HUS is a serious condition affecting the kidneys and blood clotting system. Transmission Sd1 is extremely virulent - only a few bacteria need to be swallowed to cause illness. As few as 10 -100 organisms can cause disease in adults. Because of this, Sd1 is thought to be transmitted often through direct person to person contact. For example, a person with faecally-contaminated hands can pass Sd1 bacteria to another person's hands. The second person may swallow the germs and become ill with dysentery. (This is unlike cholera which is mainly spread through contaminated food or water, and is rarely spread by direct person to person contact.) Sd1 can also be transmitted through contaminated food and water. Epidemics tend to occur during hot. humid and rainy seasons. although this is not always the case. In epidemic areas, up to one-third of the population can be infected, especially in crowded areas with inadequate sanitation, poor hygiene and limited supplies of safe water. Other causes of dysentery While large-scale outbreaks of dysentery are almost always caused by Shigella dysenteriae type 1, other types of bloody diarrhoea are often present (endemic) in communities without reaching epidemic proportions. The most severe episodes of endemic dysentery are caused by other species of Shigella - Shigella flexneri, Shigella boydii and Shigella sonnei. Other pathogens causing endemic dysentery in children include: Campylobacter jejuni, invasive strains of Escherichia coli, non-typhoid Salmonella strains and Entamoeba histolytica. This DD supplement concentrates on Shigella dysenteriae type 1 because it is the cause of epidemic dysentery. Guidelines available soon WHO has recently revised its guidelines for the control of epidemics due to Shigella dysenteriae type 1. WHO recognises that current knowledge regarding Sd1 is incomplete and further research is needed. But much can be done to reduce the incidence and deaths caused by Sd1. The guidelines describe the disease, its clinical features and epidemiology. and propose strategies for control and prevention. They provide the basis for the information in this supplement, especially pages="#page3">3-4. The guidelines also explain steps health managers and workers faced with dysentery epidemics can take to organise and use their resources effectively. The material for this supplement was written by Dr Ronald Waldman, CDR, WHO, CH-1211 Geneva 27, Switzerland with assistance from Dr Olivier Fontaine and Dr Leila Richards. 1. The cause of epidemic dysentery during the lost half of this century has always been Shigella dysenteriae type 1 (Sd1) with one possible exception - an outbreak of epidemic dysentery in Swaziland in 1992 where E. coli O157 was reported as the cause; howe

Detecting and managing an epidemic of Sd1

Laboratory tests on a small number of stool samples need to be carried out at the start of a dysentery outbreak to find out which anti-microbials are Iikely to be effective. Anti-microbial sensitivity then needs to be monitored monthly. However, laboratory tests should not be used to diagnose individual cases of dysentery during an epidemic.

SURVEILLANCE Outbreaks of dysentery can only be detected early if a system for observing and reporting disease has been established. This is called disease surveillance. A simple case record (showing the date, name, age and address of each patient; the clinical diagnosis; and the treatment provided) should be kept at every health facility, and information from case records should be reported regularly to the local health authorities. This would ensure that outbreaks of epidemics were detected early. An epidemic should be suspected if there is a rapid increase in the daily or weekly number of cases of bloody diarrhoea, or if increased deaths from bloody diarrhoea are reported in a community. When an epidemic is suspected, health workers should immediately notify their supervisors and request assistance from them. LABORATORY ANALYSIS When epidemic dysentery has been reported, all efforts should be made to confirm the cause (which, in almost all cases, will be Shigella dysenteriae type 1) by laboratory tests. The role of the laboratory during an epidemic of dysentery is two-fold: to confirm the diagnosis and to establish which drugs the organism responds to. For these purposes, only a small number (e. g. 10-15 samples every 3-4 weeks) of stool samples need to be collected, transported and tested. Special care needs to be taken in transporting stool samples containing S. dysenteriae type 1 from outlying areas to central laboratories. This is because Sd1 organisms die quickly if they are not stored correctly. Samples need to be kept in a special medium for transportation and refrigerated. The guidelines available soon from WHO contain more information about appropriate supplies and equipment for laboratories and how to transport stool specimens. The laboratory should not be used to diagnose all cases of dysentery during an epidemic. Once the organism causing the epidemic has been established, and an effective anti-microbial to treat it identified, all cases of bloody diarrhoea should be treated with that anti-microbial. PRIORITY TREATMENT The treatment for epidemic dysentery is anti-microbial drugs. Early treatment shortens the duration of illness and reduces the risk of serious complications and death. Ideally, all people with blood in their stools should be given anti-microbial treatment. Unfortunately, during an epidemic effective drugs may not be available for all patients with dysentery. It may be necessary to reserve treatment for those who are most likely to die if they are not treated. Those most at risk are of dying from dysentery are:

children less than two years old
elderly people
patients who are obviously malnourished
patients with complications such as dehydration or fever
To avoid situations where treatment with drugs needs to be restricted, WHO will assist national authorities to identify less expensive sources of effective drugs. CHOOSING AN EFFECTIVE ANTI-MICROBIAL Choosing the appropriate anti-microbial drug is not always easy. Over the last few years. the organism causing epidemic dysentery -S. dysenteriae type 1 - has become increasingly resistant to a variety of drugs. In some instances, only expensive or less widely available drugs are effective. Wherever possible, laboratory tests should be done to find out which drugs Sd1 responds to (called establishing anti-microbial sensitivity). Drugs to which Sd1 bacteria are resistant in the laboratory should never be used to treat patients. Even if Sd1 responds to a drug in a laboratory, the drug still needs to be assessed for clinical effectiveness in patients.

DDOnline Epidemic dysentery supplement to DD55  3 Page 45

Epidemic dysentery

The WHO guidelines suggest the following course of action:

When laboratory confirmation or information about anti-microbial sensitivity is NOT available, the anti-microbial drug of choice is currently nalidixic acid. It is low-cost, has few side effects, and is widely available in most countries.
When laboratory confirmation or information about anti-microbial sensitivity is possible, three key anti-microbials - nalidixic acid, ampicillin and trimethoprim-sulphamethoxazole (cotrimoxazole) - should be tested for sensitivity.
When laboratory tests show that strains are resistant to nalidixic acid, ampicillin and cotrimoxazole, other anti-microbials such as pivmecillinam (amdinocillin pivoxil), ciprofloxacin and norfloxacin are likely to be effective against Sd1. However, these drugs are very expensive, so are not suitable for widespread use during an epidemic.
Ineffective anti-microbials Sd1 has been consistently resistant to a wide variety of other anti-microbials, including sulphonamides, streptomycin, tetracyclines and chloramphenicol. These should not be used unless Sd1 has clearly been shown to be sensitive to them.
A number of other drugs have never been shown to be effective in patients, despite laboratory tests sometimes showing Sd1 bacteria are sensitive to them. These include: furazolidone, gentamicin, and cephalosporins. When Sd1 is resistant to all available anti-microbials. cases of dysentery should be managed with supportive therapy alone -oral rehydration and appropriate feeding (see="#page6">page 6). MONITORING IMPROVEMENT When a drug is effective, obvious improvement - increased appetite, decreased number of stools, less blood in the stool, less fever, and less abdominal pain - normally occurs within 48 hours. Patients who do not show signs of improvement 48 hours after the start of treatment should be examined again. Treatment should change to an alternative anti-microbial to which Sd1 is likely to respond. This is because laboratory tests of anti-microbial sensitivity are not 100 per cent accurate. Failure of treatment does not mean that the illness is caused by another organism, and drugs for other organisms such as amoebiasis should not be given. LONGER TERM MEASURES After an epidemic has subsided, surveillance should continue to ensure that occasional cases of shigellosis are promptly detected and treated. Efforts should be made to improve personal and domestic hygiene, water supplies and sanitation facilities to try to prevent further epidemics (see prevention,="#page6">page 6). Preparations should be made for dealing with epidemics at both national and district level. If further epidemics occur, control measures should be taken rapidly and efficiently. Action to prepare for epidemics should include the following:

supplies of oral rehydration salts, intravenous fluids and anti-microbials should be available at district and health facility level (see="#Clinic supplies">list of supplies below)
laboratories should be equipped and staff trained to identify the cause of dysentery and to find out anti-microbial sensitivity patterns .
health care workers should be trained in case management of epidemic dysentery.
The experience gained during the course of one epidemic of dysentery should be used to strengthen the capacity of national diarrhoeal disease programmes to deal with all forms of diarrhoea.

MAIN POINTS

The case definition of dysentery is diarrhoea with visible blood in stools.
A dysentery epidemic should be suspected if there is a rapid increase in the number of cases, or deaths in a community from bloody diarrhoea.
The cause of epidemic dysentery is almost always Shigella dysenteriae type 1.
Anti-microbial treatment is required. Carry out laboratory tests on a small number of stool samples to verify the cause of dysentery and establish what drugs the organism is sensitive to. If testing is not possible, nalidixic acid

DDOnline Epidemic dysentery supplement to DD55  4 Page 56

Epidemic dysentery

Refugee crisis spreads disease

Studies in one of the African countries worst hit by the current epidemics - Burundi - have indicated possible risk factors for becoming ill with dysentery. Over the last twelve years the east African state of Burundi has experienced regular annual outbreaks of dysentery, peaking in the rainy seasons (September to December). In 1992 and 1993 particularly severe epidemics swept across the country. In 1992, almost 80,000 cases were reported - a national incidence of 14.2 cases per 1,000 people.

Dysentery is a major cause of death in refugee camps on the Burundi-Rwanda border This year. a refugee crisis has increased the severity of the epidemic. As a result of political and social upheaval, hundreds of thousands of Burundians have fled to neighbouring Rwanda, Tanzania and Zaire, and spread the epidemic to refugee camps.



WHO and the United Nations High Commission for Refugees are working with other relief organisations to coordinate a response to the epidemic. Three studies in Burundi between 1990 and 1993 show that epidemic dysentery is a serious problem with high mortality rates, and that a rapidly changing pattern of sensitivity to drugs makes treatment difficult. In 1990, Ries et al. collected 189 stool samples from patients in Gitega province with bloody diarrhoea. An organism causing dysentery was isolated in 125 samples. Of these, 66 per cent were Shigella dysenteriae type 1 (Sd1), and a further 25 per cent were other Shigella species. Sd1 strains were resistant to nalidixic acid, ampicillin, cotrimoxazole. tetracycline and chloramphenicol. The only drugs Sd1 responded to - ciprofloxacin, pivmecillinam and ceftriaxone - were expensive and were not available in large quantities at short notice. A community survey of 9,300 inhabitants in the same province was conducted by Birmingham et al. in February to September 1992. The incidence of bloody diarrhoea during the epidemic was found to be 13.9 per 1,000 people. Incidence increased with age. Possible risk factors for becoming ill included: use of a cloth rag for anal cleansing following defecation; recent loss of weight; and little or no schooling. In March 1993, Murray et al. followed up 775 patients who had reported to health facilities in Muramvya province with bloody diarrhoea in the previous six months. Seven per cent of patients (including many who had received treatment) had died. The median interval between the onset of symptoms and death was 13 days. The researchers also collected 133 stool samples, 35 per cent of which yielded Sd1. Significantly, the resistance pattern to drugs had changed.* While Sd1 was still resistant to ampicillin and cotrimoxazole, it was now sensitive to nalidixic acid, as well as the more expensive drugs found to be effective before - ciprofloxacin, pivmecillinam and ceftriaxone. This meant that nalidixic acid was the clear drug of choice. The Burundi studies show that anti-microbial sensitivity patterns can change rapidly. Therefore, active laboratory monitoring systems need to be established before the onset of an epidemic. The studies also indicate that much more needs to be found out about risk factors and transmission. Adapted from Manirankunda, L et al.. 1993. The epidemiology of bacillary dysentery in Burundi. Bulletin Epidémiologique du Burundi, July-September. *Although the studies were done in different provinces, there is no reason to suggest that sensitivity patterns would differ from province to province during a nationwide epidemic. South Asia also affected by Sd1 During a south Asian epidemic in 1976, Shigella dysenteriae type 1 spread from south India to Sri Lanka. Sd1 is now endemic in Sri Lanka, with epidemics occurring periodically. Problems of civil unrest and migration of refugees from 1985-1992 led to a sharp increase in cases of dysentery, with the number of cases more than tripling (from 79 cases per 100,0


Supportive treatment is vital

In addition to life-saving anti-microbial treatment, all patients with dysentery caused by Sd1 need to drink more and to continue normal feeding. INCREASING FLUIDS It is crucial for people with dysentery to drink more liquids (including plain water) in order to prevent dehydration. Readily available home fluids (such as yoghurt drinks; water in which a cereal has been cooked; unsweetened tea; green coconut water; and fresh, unsweetened fruit juice) are good choices. If possible, dysentery patients should also be given a fluid that contains salt, e. g. salted soup, salted rice fluid or oral rehydration fluid. Patients with dysentery should be assessed regularly for signs of dehydration. The key signs are: increased thirst; restlessness; irritability; and loss of skin elasticity (when the skin is pinched and released it does not flatten immediately). If dehydration becomes severe, a patient may become lethargic or unconscious and be unable to drink. If the patient shows signs of dehydration, they should be given rehydration fluid immediately. There are three main types of rehydration fluid: oral rehydration salts (ORS) solution, sugar-salt solution (SSS) and cereal-based solutions. Oral rehydration fluid should be given at a steady rate in small amounts. Children under two years old should receive at least l/4 - 1/2 cup of rehydration fluid after each loose stool. Older children should receive at least 1/2 - 1 cup. Children over 10 years old should drink as much rehydration fluid as they want. For more information about oral rehydration therapy, see="dd52.htm">DD52. CONTINUING FEEDING Continuing to give nutritious food to people with dysentery is very important. A major complication of dysentery is weight loss and rapid worsening of nutritional status. This is because people with dysentery often have reduced appetites, yet their bodies need more nutrients than usual in order to fight infection, repair tissue damage, and replace nutrients lost during diarrhoea.

Eating well can ensure a good recovery after a dysentery attack.

Even when patients survive dysentery, resultant malnutrition may increase their vulnerability to other life-threatening illnesses. In general, the same foods should be given during dysentery as those a patient eats when he or she is well. Meals may need to be given in smaller amounts more frequently. and carers should gently but persistently encourage people with dysentery to eat. If possible, food rich in potassium such as spinach, avocado pears, bananas and coconut water should be given. Even if patients are well fed, they may have lost weight and be malnourished after the dysentery episode is over. Providing an extra meal every day for two weeks can help to restore lost weight.



If infants with dysentery are normally breastfed, mothers should continue to breastfeed them frequently. If infants under four months old normally receive other foods in addition to breastmilk, these should also be continued during an episode of dysentery and mothers encouraged to breastfeed frequently. However, after the dysentery episode health workers should find time to encourage these mothers to practise exclusive breastfeeding until their infants are at least four months old. For more information about feeding during diarrhoea, including when diarrhoea lasts 14 days or more, see="dd53.htm">DD53. Prevention strategies Like other forms of diarrhoea, Sd1 infection is spread through human faeces. When people become infected with Sd1, they excrete large numbers of Sd1 organisms in their stools. If germs from these stools come into contact with food or water, other people can swallow them and become infected. In addition, Sd1 bacteria are so infectious that sufficient organisms to cause disease can be spread from one person's hands to another's The only proven ways of preventing infection and transmission of all forms of Shigella are handwashing with soap and breastfeeding. Methods for preventing other forms of diarrhoea are also likely to reduce transmission of Sd1, although there is no research showing this. These methods include: the promotion of commercial and household food hygiene; the provision of adequate supplies of clean water for drinking; and the safe disposal of human faeces. Handwashing Thorough handwashing with soap appears to be the single most effective way to prevent transmission of all forms of Shigella. The key times for handwashing are: after defecation; after cleaning a child who has defecated or after disposing of their stools; and before preparing or eating food. Health care workers should wash their hands before and after examining each patient and before giving ORS or food to a patient. It is now known that people are more likely to wash their hands if they have easy access to a plentiful supply of water. Water for washing and drinking should be stored in different containers. If soap is not available, ash or mud can be used. If possible, in areas affected by dysentery epidemics, soap should be distributed to families who cannot afford it. After handwashing, hands should be dried with a clean cloth or left to dry naturally in the air. Hands should not be dried with a dirty cloth. Breastfeeding Breastfed infants are much less likely to get dysentery than other infants. If breastfed infants do get dysentery, their illness is likely to be much milder than in infants who are not breastfed. For more information about prevention, see DDs="dd54.htm">54,="dd45.htm">45 and="dd44.htm">44.

Epidemic dysentery
Health Update - A supplement to Issue no. 55
December 1993 - February 1994


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Ciprofloxacin, ceftriaxone and pivmecillinam are the antibiotics currently recommended by the World Health Organization (WHO) for the treatment of dysentery in children; yet there have been no reviews of the clinical effectiveness of these antibiotics in recent years. We reviewed all literature reporting the effect of ciprofloxacin, ceftriaxone and pivmecillinam for the treatment of dysentery in children in the developing countries. We used a standardized abstraction and grading format and performed meta-analyses to determine the effect of treatment with these antibiotics on rates of treatment failure, bacteriological failure and bacteriological relapse. The CHERG Standard Rules were applied to determine the final effect of treatment with these antibiotics on diarrhoea mortality. Eight papers were selected for abstraction. Treatment with ciprofloxacin, ceftriaxone or pivmecillinam resulted in a cure rate of >99% while assessing clinical failure, bacteriological failure and bacteriological relapse. The antibiotics recommended by the WHO--ciprofloxacin, ceftriaxone and pivmecillinam--are effective in reducing the clinical and bacteriological signs and symptoms of dysentery and thus can be expected to decrease diarrhoea mortality attributable to dysentery.


Cbe 1Ropal I!octetp of tDebtcitne.
President-Dr. FREDERICK TAYLOR.
(December 20, 1915.)
A Lecture on the Treatment of Dysentery.
By Lieut.-Colonel Sir RONALD Ross, K.C.B., F.R.S.1
MR. PRESIDENT AND GENTLEMEN,
My object in this lecture is not to detail my own experiences and
opinions upon the very large subject of the treatment of dysentery so
much as to elicit the experiences and opinions of the many medical men
who are at present treating cases in Britain, in order that we may be
able to compare notes and, if possible, to consolidate our methods in
this important branch of practice. Fortunately, for some centuries past
Britain has remained almost entirely free from this serious disease and
probably entirely free from the amcebic form of it, except in regard
to patients who have been infected elsewhere. The result has been
that medical men in England have not been able themselves to collect
experiences, and now perhaps find themselves called upon to treat large
numbers of cases suffering from a malady with which they are not
familiar. But we must remember that nothing in the whole range of
clinical practice requires greater experience, skill and judgment than the
treatment of dysentery in all its stages. In fact, this subject has been
almost the principal pre-occupation of physicians in Egypt, Greece, and
Italy, and other warm climates for thousands of years. In classical times
the treatment, of course empirical, consisted largely of the use of oils,
essential oils, wine and dieting, not to mention some of the curious
remedies which our predecessors were apt to advocate. In what may be
XRecently Consulting Physician on Tropical Diseases, Mediterranean Expedition

Dysentery (Infectious Diarrhea) — Causes and Treatment
Last update July 23, 2019
 (Votes: 3, average: 3.67) 0
Table of Contents

Definition of Dysentery
Epidemiology of Dysentery
Etiology of Dysentery
Complications of Dysentery
Clinical Presentation of Dysentery
Diagnostic Workup for Dysentery
Treatment of Dysentery
References
Are you more of a visual learner? Check out our online video lectures and start your infectious diseases course now for free!
Definition of Dysentery
Amoebic dysentery is a disease that is caused by Entamoeba histolytica and presents with bloody mucous diarrhea (dysentery) that lasts less than two weeks in duration. Other common causes of dysentery include Campylobacter, Shigella, and salmonella.

Epidemiology of Dysentery
The identification of the etiology of dysentery is important because the clinical course of the disease is usually more severe compared to non-bloody diarrhea. Therefore, the reported number of cases of dysentery is usually classified according to the causative organism.


Salmonella is the most common cause of dysentery with an estimated 1 million cases per year. The second most common cause of dysentery is campylobacter, which is responsible for approximately 845,000 new cases per year in the United States. Shigella is associated with more severe illness but is responsible for a significantly lower number of cases compared to the other common causes, only 131,000 cases per year.

It is important to note that these figures include all cases affected by the given organism and not only true bloody-diarrhea cases. Approximately, 36% of people infected with shigella are going to develop dysentery. On the other hand, 65% of the patients who present with salmonella are at risk of developing dysentery.

E. coli O157:H7, which produces shiga-toxin, is significantly associated with dysentery as approximately 85% of the infected population would develop bloody diarrhea.

Dysentery is more common in children, but the condition can also happen in adults.

Etiology of Dysentery
The most commonly identified organisms of dysentery are shigella, salmonella, campylobacter, and Entamoeba histolytica. Fortunately, most laboratories are able to identify these causative organisms from a single stool culture.

While bacterial causes of dysentery are common, the protozoan Entamoeba histolytica should be also excluded in these patients. Other less common organisms include Aeromonas, Plesiomonas, and Yersinia enterocolitica. Yersinia enterocolitica is not a trivial etiology as approximately 65% of the cases are expected to develop bloody diarrhea.

Complications of Dysentery
In addition to acute dehydration, more specific complications of dysentery are common and should be identified early and prevented if possible.

First, patients with dysentery are more likely to require hospitalization, compared to people with non-bloody diarrhea. Hospitalization puts the patient at risk of acquiring hospital-based infections which are caused by multi-resistant organisms.

Shigella-related dysentery, especially in children, can be associated with significant mortality. Patients who are malnourished are at a significantly higher risk of developing severe dysentery and possibly die from diarrheal illness.

Shigella is also associated with ileus, toxic mega-colon and intestinal obstruction in children. Patients can also develop seizures, headaches, and become confused or lethargic. Urinary tract infections, as a complication of Shigella, are common.


Non-typhoid salmonella and campylobacter are invasive organisms that can cause bacteremia, especially in the immunocompromised.

Shiga-toxin producing E. coli and Shigella spp can cause hemolytic-uremic syndrome. This condition is characterized by acute hemolysis leading to anemia and thrombocytopenia and renal failure. Thus, patients may present with dyspnea, bleeding tendencies, and uremic features.

Campylobacter associated dysentery might be associated with Guillain-Barré syndrome. One-third of the patients develop neurological disturbances. Reactive arthritis is also commonly associated with salmonella and campylobacter dysentery.

Clinical Presentation of Dysentery
The most important clinical presentation of dysentery is the passage of grossly bloody stools. Patients are also usually ill and have a fever.

The immunocompromised might develop bloody diarrhea without significant systemic illness, or might develop severe invasive disease. Patients with hemolytic-uremic syndrome develop acute renal failure, pallor and might become short of breath.

People coming from the developing world are more likely to have amoebic dysentery, rather than bacterial dysentery. Children who develop bloody diarrhea might be severely dehydrated.

Diagnostic Workup for Dysentery
Once a patient presents to the emergency department with bloody stools, it is usually beneficial to actually identify the causative organism rather than starting empirical therapy. The choice of investigations depends largely on the immunologic state of the patient.

Immune-competent patients should undergo stool analysis and culture. A stool culture can identify shigella, campylobacter, salmonella, E. coli, and E. histolytica.

The immunocompromised population are at risk of developing cytomegalovirus dysentery in addition to Clostridium difficile related dysentery. Therefore, testing for cytomegalovirus and for C. difficile toxins is indicated.

Fecal leukocytes are common in dysentery. Patients with invasive pathogens might also develop leukocytosis.

Patients with severe disease, who appear toxic, might have developed complications such as toxic mega-colon. In that case, abdominal computerized tomography is useful as it can visualize the colon and exclude the condition.

Finally, patients who are suspected to have the hemolytic-uremic syndrome should undergo renal function testing and a peripheral blood smear in addition to complete blood counting. These tests help identify this severe complication.

Treatment of Dysentery


Patients who present with very high fever and severe dysentery should be put on empirical antibiotic therapy until the results are back from the stool culture.

Patients with suspected shigella, salmonella or campylobacter infection should receive azithromycin because this antibiotic covers these three organisms. Adults with suspected salmonella infection are better off with ciprofloxacin, rather than azithromycin.

Patients with Clostridium difficile dysentery should receive oral Vancomycin. These patients are usually immunocompromised or have a recent history of hospital admission.

Children and adults with recent travel history to the developing world are at risk of amoebic rather than bacterial dysentery. These patients should receive tinidazole or metronidazole. It is important to note that Entamoeba histolytica can be easily identified with stool analysis, therefore, specific treatment with metronidazole or tinidazole is usually possible early in the disease.

Finally, patients with a confirmed diagnosis of Shiga-toxin producing E. coli should receive azithromycin or rifaximin. While the organism is sensitive to other antibiotics, other antibiotics are thought to be responsible for the increased production of the shiga-toxin by the bacteria; hence, an increased risk of developing the hemolytic-uremic syndrome.

Additionally, the current diagnostic approaches, even though are helpful and easy to perform, are considered as costly to the developing world where diarrheal illness is more common. Therefore, the identification of the causative organism and specific treatments are usually difficult to obtain in areas where dysentery is endemic.

About the Lecturio Medical Online Library
Our medical articles are the result of the hard work of our editorial board and our professional authors. Strict editorial standards and an effective quality management system help us to ensure the validity and high relevance of all content. Read more about the editorial team, authors, and our work processes.

Diagnosis
Many kinds of germs can cause diarrhea. Knowing which germ is causing an illness is important to help guide appropriate treatment. Healthcare providers can order laboratory tests to identify Shigella  germs in the stool (poop) of someone who is sick.

Treatment
Most people will recover from shigellosis without treatment in 5 to 7 days. People who have shigellosis should drink plenty of fluids to prevent dehydration. Contact your healthcare provider if you, or one of your family members, have a fever, bloody diarrhea, severe stomach cramping or tenderness, are dehydrated, or feel very sick. People who are in poor health or who have weakened immune systems, such as from HIV/AIDS or chemotherapy treatment for cancer, also should contact their healthcare provider because they are more likely to get sick for a longer period of time.

In some people, bismuth subsalicylate (for example, Pepto-Bismol) can help to relieve symptoms 1,2.
People with shigellosis should not use anti-diarrheal medication, such as loperamide (for example, Imodium) or diphenoxylate with atropine (for example, Lomotil). These medications may make symptoms worse 3.
Healthcare providers may prescribe antibiotics for some people who have severe cases of shigellosis.  Antibiotics such as ciprofloxacin (common treatment for adults), and azithromycin (common treatment for children) are useful for severe cases of shigellosis because they can help people get better faster 4. However, some antibiotics are not effective against certain types of Shigella bacteria. Healthcare providers can order laboratory tests to determine which antibiotics are likely to work.
People who have shigellosis should follow their healthcare provider’s advice. If your healthcare provider prescribes antibiotics, let them know if you do not get better within a couple of days after starting the medication. They can do more tests to learn whether your type of Shigella bacteria can be treated effectively with the antibiotic you are taking. If not, your doctor may prescribe another type of antibiotic.

People who have shigellosis should follow their healthcare provider’s advice. If your healthcare provider prescribes antibiotics, let them know if you do not get better within a couple of days after starting the medication. They can do more tests to learn whether your type of Shigella bacteria can be treated effectively with the antibiotic you are taking. If not, your doctor may prescribe another type of antibiotic.

For more information on antibiotic resistance, visit the Antibiotic-Resistant Shigella page.

For information on medical management of shigellosis and counseling patients with drug-resistant shigellosis, visit the Information for Healthcare Professionals page.

Antibiotic Resistance and Shigella Infections
References

Pathophysiology of gastrointestinal infections: the role of bismuth subsalicylate. Scottsdale, Arizona, 11-14 February 1988. Proceedings. Rev Infect Dis. 1990;12 Suppl 1:S1-119.
Steffen R. Worldwide efficacy of bismuth subsalicylate in the treatment of travelers’ diarrhea. Rev Infect Dis. 1990;12 Suppl 1:S80-6.
DuPont HL, Hornick RB. Adverse effect of lomotil therapy in shigellosis.External JAMA. 1973;226(13):1525-8.
Christopher PR, David KV, John SM,and Sankarapandian V. Antibiotic therapy for Shigella  dysentery.External Cochrane Database Syst Rev. 2010;(8):CD006784


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DYSENTERY

Dysentry is caused by infection of the intestines resulting in severe diarrhea with the presence of blood and mucus in the feces. It is an intestinal inflammation, especially in the colon, that can lead to severe diarrhea with mucus or blood in the feces.
Dysentery is spread among humans through contaminated food and water. Once a person is infected, the infectious organism lives in the intestines and is passed in the stool of the infected person. With some infections, animals can also be infected and spread the disease to humans.
Types of Dysentery
Bacillary dysentery, caused by Shigella, a bacterium.
Amoebic dysentery (amoebiasis) this is caused by Entamoeba histolytica.

Blood in the feces


Causes of Bacillary dysentery
Bacillary dysentery, which is also known as shigellosis, is caused by four species of the genus Shigella: S. dysenteriae,S. sonnei, the mildest species and the most common form of Shigellafound in the United States,  S. boydii  and S. flexneri.
Causes of amoebic dysentery

Poor hygiene: is the main cause of bacillary dysentery infection. However, it can also spread because of tainted food.
Amoebic dysentery: is usually caused by infection with the Entamoeba histolytica amoeba.
Amoebic dysentery is more common in the tropics while bacillary dysentery is more common elsewhere.
The amoeba group together and form a cyst, the cysts come out of the body in human feces. In areas of poor sanitation, these cysts (which can survive for a long time), can contaminate food and water, and infect other humans. The cysts can also linger in infected people's hands after going to the toilet. Good hygiene practice reduces the risk of infecting other people.

Symptoms/Signs of Dysentery
Symptoms usually appear from one to three days after the person has become infected - this is called the incubation period.
Pain may be a symptom while a rash may be a sign.
Abdominal bloating
Abdominal pain
Bloody diarrhea (may also be watery or with mucus)
Cramping
Flatulence
Nausea with or without vomiting
Other possible symptoms include:
1. Decreased urine output
2. Dry skin and mucous membranes (such as dry mouth)
3. Feeling very thirsty
4. Fever and chills
5. Muscle cramps
6. Muscle weakness (loss of strength)
7. Weight loss
How to Prevent Dysentery
1. Avoiding swallowing water in swimming pools, hot tubs, or other recreational water sources
2. Drinking only purified water when backpacking, camping or hiking
3. Drinking only purified water when visiting developing countries
4. Using purified water for brushing your teeth and washing food
5. Washing your hands well with soap and water after touching feces, having contact with an infected person or animal, changing diapers, or using the bathroom, and before eating or preparing food

How to Diagnose Dysentery
1. Blood tests: There are many blood tests that can be done for diagnosis having a high degree of accuracy.
2. Proctosigmoidoscopy or Colonoscopy: These are special procedures done when the diagnosis is not clear after stool and blood tests. This involves the use of a thin, lighted instrument inserted into the rectum and colon to view them directly and tissue samples are taken for laboratory examination.
3. Stool tests: The stool samples should be done in the laboratory to confirm the presence of E. histolytica.
4. Ultrasound: If there are complications and involvement of the abdominal organs, then further investigations, such as ultrasound, may be necessary to confirm the diagnosis.

How to Treat Dysentery
Treatment for dysentery begins with seeking medical care from your doctor. To determine if you have dysentery, your doctor can ask you to provide stool samples for laboratory testing. Antibiotic therapy is the mainstay of treatment for dysentery due to bacterial organisms and is highly effective. It is important to follow your treatment plan for dysentery precisely and to take all of the antibiotics as instructed to avoid recurrence.
Antibiotics for the treatment of dysentery caused by bacterial organisms include:
Ceftriaxone (Rocephin)
Ciprofloxacin (Cipro)
Trimethoprim-sulfamethoxazole (Bactrim, Septra)
The most common treatment for amebic dysentery caused by Entamoeba histolytica is metronidazole (Flagyl), an antiparasitic medication.

Home Remedies
Arjuna: is made of the bark of the herb provides relief from dysentery. This drink can be taken in doses of 15 to 30 grams. The bark has cooling effect. It arrests bleeding. It provides relief from fever.
Bael fruit/Wood apple: is a natural coolant which arrests dysentery. Unripe or half ripe fruit is good for digestion. This fruit strengthens the stomach and promotes its action.
Banyan: Soak leaf



Banyan: Soak leaf buds in water overnight. Drink this infusion in morning for better results. The leaf buds arrests bleeding or secretion.
Black nightshade: Black nightshade corrects the disordered processes of nutrition. It includes digestion, absorption, utilization and excretion of food substances. It restores the normal function of the system. It reduces the pain and irritation. They also improve the appetite. An infusion made of the plant is useful for dysentery.
Butea: Seeds and leaves of butea have medicinal properties. The leaves are effective in arresting the secretion and bleeding. The gum is mild and useful for children and women in delicate conditions. The leaves can be chewed as it is to treat the disease.  An infusion of the gum as rectal enema will provide instant relief. Fresh juice of the leaves also can used for treating this disease.
Curry leaves: Curry leaves strengthen the stomach and promotes its action. Tender curry leaves mixed with honey is very effective for dysentery.
Coriander seeds: An herbal decoction can be made of two tablespoons of dried out coriander seeds. This can be taken with water or buttermilk. This helps in soothing the irritation in intestinal layer. Coriander seeds also help in reducing mucus in the stool.
Lemon: Peel and slice about three lemons. Add about 250ml of water to it and boil for a few minutes. Strain this infusion. This infusion should be taken thrice daily.
Pomegranate rind: Take about 60gm of pomegranate rind and boil it 250ml of milk. Remove it from fire when one third of milk has evaporated. This should be given in three equal doses at regular intervals. This will provide relief from dysentery.
Musk melon: Sometimes dysentery may be accompanied by soft and mucilaginous secretion in the intestines. Some of the portion may be left stuck inside. If this condition persists for a long time, it may force the intestine to contract. In such cases musk melon is very effective. The fruit has properties which expel the matter with faeces.
One tablespoon of the pulp of the fruit mixed with enough amount of jaggery should be given thrice a day. In chronic cases, 15 gm of unripe fruit pulp should be roasted over the fire. Mix 250ml of water or buttermilk to this pulp. Add jaggery to sweeten the infusion. Drink this thrice a day. 15 gm of the pulp can be mixed with equal amount of dried ginger. Then 250ml of buttermilk can be mixed to it.  The patient can drink this thrice day.
Onion: Cut onion into small pieces and mix it with curd. Add equal parts of tender peepal tree leaves, coriander leaves and sugar. Chew this slowly.


How to Treat Dysentery
Co-authored by Danielle Jacks, MD
Updated: October 2, 2019
Dysentery is a serious condition characterized by ongoing diarrhea and stomach cramps. It can be caused by both bacteria and amoeba. While bacillary dysentery is typically mild and does not always require medical interventions, amoebic dysentery is generally severe and requires immediate treatment from a doctor. Treating both types of dysentery comes down to a few simple rules, though: follow your doctor’s instructions regarding medication, rehydrate frequently, and rest until your symptoms subside.


1
See your doctor immediately if your symptoms are severe. While bacillary dysentery tends to be milder than the amoebic variety, severe symptoms should not be taken lightly. Call your doctor or go to the emergency room immediately if you are experiencing severe pain, watery diarrhea, or blood in your stool.[1]

Replenish your fluids. One of the major dangers of dysentery is fluid loss. If you have bacillary dysentery, regularly drinking bottled water, sports drinks, and juice should help you stay hydrated. You should drink enough so that you are able to urinate every 3 to 4 hours. Your urine should be a clear or light yellow color.[2]
Start with your recommended 8 glasses of fluids a day. If this is not enough to keep you hydrated, increase your fluid intake by 2 or 3 glasses at a time.
If you are struggling to stay hydrated on your own, you may need a commercial oral rehydration solution. Call your doctor to ask for a recommendation.
You can make your own rehydration drink by mixing 6 teaspoons (24 g) of sugar, ½ teaspoon (3 g) of salt, and 1 US quart (0.95 L) of water.
If you have profuse diarrhea, then you will also need to rehydrate with electrolytes.
Watch for symptoms of dehydration including lethargy, dizziness, headaches, muscle cramps, infrequent urination, dry mouth, weakness, confusion, apathy, and an increased heart rate.[3]

3
Eat a bland diet. A bland diet is recommended while you are experiencing dysentery symptoms. Foods like unflavored crackers, rice, non-citrus fruits, bread, pasta, oatmeal, peanut butter, pudding, eggs, brothy soups, and steamed or baked chicken and fish are all recommended.[4]
Some medical professionals recommend avoiding dairy products and foods with high fat content while you are still experiencing symptoms.

4
Plan 5–7 days for recovery. Most bacillary dysentery runs its course in about a week. Plan a full week to recover. This should include taking time off from work or school and resting at home. This prevents the bacteria from spreading and allows your body time to recover.[5]
While you recover, be sure to wash your hands frequently. Avoid doing things like making meals for your family, as this could also increase their risk of getting the bacteria.[6]

Managing Amoebic Dysentery

1
Ask your doctor for an amoebicidal medication. If your doctor diagnoses you with amoebicidal dysentery, only a prescription can treat your condition.[7] Ask your doctor to prescribe an amoebicidal medication, and take the full course, following your doctor’s instructions as precisely as possible.[8]
Even if you stop experiencing symptoms before you finish your prescription, continue to take your medication. Just because your symptoms stop doesn’t mean the disease is fully treated yet.


2
Rehydrate often. The risk of dehydration can be even more critical for amoebic dysentery. Your doctor may prescribe IV fluids depending upon your condition. If you are not hospitalized, you will need a commercial rehydration drink to replenish your water, sugar, and electrolytes. These can be purchased from most pharmacies.[9]
Some drinks come pre-made, while others come as a powder you can mix into water. Follow the package instructions carefully if you buy the powdered variety. Use bottled water when possible.

3
Go to the emergency room for severe symptoms. Amoebic dysentery can be severe and potentially life-threatening. If you feel severely dehydrated, you have blood in your stool, you are running a high fever, or you have cramps and pains that prevent you from moving or functioning, seek treatment at a hospital immediately.[10]

Determine whether you are at risk for dysentery. The largest dysentery risk is living or spending extended periods of time in areas that lack proper sanitation. If you live in or have recently visited an underdeveloped or developing country, your chances of contracting dysentery are much greater. If you have been high-risk area and feel any symptoms, contact your doctor immediately.[11]
People who live in group housing or participate in extended group activities have an increased risk as these situations make the bacteria easier to spread. Outbreaks are common at daycares and community centers, community pools, nursing homes, jails, and barracks.
Toddlers are also typically at a higher risk than adults.



Look for symptoms of bacillary dysentery. Bacillary dysentery generally appears within 1 to 3 days of infection and often has symptoms mild enough that no medical intervention is required. The most common symptoms are a mild stomach ache or cramps and diarrhea. Other symptoms may include:[12]
Blood or mucus in your feces
Severe abdominal pain or cramping
Fever
Nausea
Vomiting

Check for symptoms of amoebic dysentery. Typically the more severe form of this condition, amoebic dysentery can last for several weeks. Left untreated, it may cause ulcers, eat through intestinal walls, and spread through the bloodstream into other organs. Symptoms may include:[13]
Watery diarrhea
Mucus, blood, or pus in your stool
Severe abdominal pain or cramping
Fever and/or chills
Pain when passing stool
Fatigue
Intermittent constipation


Warnings
If you are a child, older than 70, suffer from cardiac disease, have an immunocompromised condition like HIV, have inflammatory bowel disease, or are pregnant, seek medical care immediately since you’re at a higher risk.
Don’t take antimotility drugs, such as Imodium, while you have dysentery since you could prolong the disease and make it more severe.


Dysentery

Contents

Introduction
Symptoms
Causes
Diagnosis
Treatment
Prevention
Introduction

Dysentery is an infection of the intestines that causes diarrhoea containing blood or mucus.

Diarrhoea is the passing of three or more watery stools a day. Other symptoms of dysentery include:

stomach cramps
nausea (feeling sick)
vomiting
Read more about the symptoms of dysentery.

When to see your doctor

It is not always necessary to see a doctor because dysentery often clears up within a few days.

However, see your doctor if you have diarrhoea containing blood or mucus that last longer than a few days. Tell them if you have recently been abroad, particularly if it was to a country with poor sanitation.

Treatment is not always needed, but it is important to drink plenty of fluids to replace those that have been lost through diarrhoea.

Dysentery is a notifiable disease. This means that if a doctor diagnoses the condition, they must inform the local authority.

Read more about how dysentery is diagnosed.

Types of dysentery

There are two main types of dysentery:

bacillary dysentery or shigellosis - caused by shigella bacteria, this is the most common type of dysentery in the UK
amoebic dysentery or amoebiasis - caused by an amoeba (single-celled parasite) called Entamoeba histolytica, found mainly in tropical areas, so this type of dysentery is picked up abroad
Both types of dysentery are commonly passed on through poor hygiene and people often become infected by eating contaminated food. Read more about the causes of dysentery.

Preventing dysentery

To minimise the risk of catching the condition, you should:

wash your hands with soap and water after using the toilet
wash your hands before handling, eating or cooking food
wash the laundry of an infected person on the hottest setting possible
If travelling to an area with poor sanitation:

drink bottled water (make sure the seal is intact)
do not have ice in your drinks
do not eat fresh fruit or vegetables that cannot be peeled before eating
avoid eating food or drink bought from street vendors (except drinks from properly sealed cans or bottles)
Read more about preventing dysentery.

How common is dysentery?

Outbreaks of bacillary dysentery are common.

Amoebic dysentery is rare in developed countries. People are most likely to become infected while travelling in parts of the world where the disease is common, such as parts of Africa, South America and India.

Outlook

Amoebic dysentery is more serious than bacillary dysentery, but both types will often resolve themselves without treatment.

In very rare cases, fatalities do occur. However this is more common in developing countries where sanitation is often poor and people do not have access to medical treatment.


Symptoms

Most people who get dysentery only have mild symptoms which often clear up within a few days.

Bacillary dysentery

Symptoms of bacillary dysentery usually begin one to seven days after infection. Common symptoms are mild stomach pains and bloody diarrhoea. These symptoms last for three to seven days and many people do not need to visit their doctor.

There is usually a lot of diarrhoea to begin with, followed by smaller amounts that are passed frequently and sometimes painfully.

In more severe cases, symptoms can include:

watery diarrhoea that contains blood or mucus
nausea or vomiting (feeling or being sick)
severe abdominal pain
stomach cramps
a high temperature (fever) of 38C (100.4F) or over
Amoebic dysentery

Dysentery that is caused by an amoeba (a single-celled parasite) is called amoebic dysentery or amoebiasis. Amoebic dysentery mainly occurs in tropical areas.

In some cases, amoebic dysentery does not cause any symptoms. However, an infected person will pass cysts (amoebas that are surrounded by a protective wall) in their stools when they go to the toilet, and can infect their surroundings (see causes of dysentery for more information).

If you do experience symptoms, they may start up to 10 days after you originally became infected. Symptoms of amoebic dysentery include:

watery diarrhoea, which can contain blood
mucus or pus
nausea
vomiting
abdominal pain
fever and chills
bleeding from your rectum (back passage)
loss of appetite and weight loss
If you have amoebic dysentery, it is likely you will have blood in your diarrhoea. This is because the amoebas attack the walls of the large intestine, causing ulcers (sores) to develop that can bleed. The passing of stools may be painful.

Occasionally, the parasite can enter the bloodstream and spread to other organs in the body, particularly the liver, leading to the formation of an abscess (liver abscess). Symptoms of a liver abscess include:

fever and weakness
abdominal swelling and pain
cough
nausea (feeling sick)
jaundice
loss of appetite
weight loss
The symptoms of amoebic dysentery usually last a few days to several weeks. However, without treatment, even if the symptoms disappear, the amoebas can continue to live in the bowel for months or even years. This means that the infection can still be passed on to other people and that the diarrhoea can return.


Causes

Bacillary dysentery (shigellosis) is caused by shigella bacteria. Amoebic dysentery is caused by an amoeba (a single-cell parasite) usually found in tropical areas.

Bacillary dysentery

There are four types of shigella:

Shigella sonnei
Shigella flexneri
Shigella boydii
Shigella dysenteriae: this produces the most severe symptoms
The shigella bacteria are found in faeces and are spread through poor hygiene; for example, by not washing your hands after having diarrhoea.

If you do not wash your hands, you can transfer the bacteria to other surfaces. The bacteria can then infect someone else if they touch the surface and transfer the bacteria to their mouth. The bacteria will travel from the mouth to the bowel, invading the cells that line the large bowel. The bacteria multiply, killing the cells and producing the symptoms of dysentery.

Most cases of bacillary dysentery are spread within families and in places where people are in close contact with one another, such as in schools, nurseries, military bases and day centres. The condition can be spread for up to four weeks after a person has become infected.

Dysentery is also spread through food that has been contaminated with human faeces (stools), particularly cold, uncooked food, such as salad. This is more likely to happen in countries where:

there is poor sanitation
water supplies and sewage disposal are inadequate
human faeces are used as fertiliser
Severe dysentery is more common in developing countries.

The time between coming into contact with the bacteria and the symptoms starting (the incubation period) is usually one to seven days.

Amoebic dysentery

Amoebic dysentery (amoebiasis) is caused by an amoeba (a single-celled parasite) called Entamoeba histolytica. It is mainly found in tropical areas so it is usually picked up abroad.

When the amoebas inside the bowel of an infected person are ready to leave the body, they group together and a shell surrounds and protects them. This group of amoebas is known as a cyst.

The cyst passes out of the person's body in their faeces and is able to survive outside the body. If hygiene standards are poor; for example, if the person does not dispose of their faeces hygienically, it can contaminate the surroundings, such as nearby food and water.

If another person then eats or drinks food or water that has been contaminated with faeces containing the cyst, they will also become infected with the amoeba. Amoebic dysentery is particularly common in parts of the world where human faeces are used as fertiliser.

After entering the person's body through their mouth, the cyst will travel down into their stomach. The amoebas inside the cyst are protected from the stomach's digestive acid. From the stomach, the cyst will travel to the intestines where it will break open and release the amoebas, causing the infection. The amoebas are able to burrow into the walls of the intestines and cause small abscesses  and ulcers to form. The cycle then begins again.

The amoebas that cause dysentery can also be sexually transmitted during mouth-to-anus contact.

Diagnosis

Diagnosis

You should visit your doctor if you have diarrhoea containing blood or mucus that lasts longer than a few days. Tell your doctor if you have recently been abroad, particularly if it was to a tropical country with poor sanitation where amoebic dysentery is common, such as India or Africa.

Stool sample

Dysentery is diagnosed by testing a sample of your stools (faeces) to see whether it contains the bacteria or amoebas that cause dysentery.

Other investigations

Other investigations may be used if dysentery has caused further problems, such as a liver abscess (see complications of dysentery), or to rule out other conditions, such as inflammatory bowel disease.

Further tests could include:

an ultrasound scan - where high frequency sound waves are used to create an image of part of the inside of your body, such as your liver
a blood test - a blood sample may be tested for infection-fighting proteins called antibodies that are likely to be present if you have amoebic dysentery
a colonoscopy - a type of endoscopy used to examine your bowels
Treatment

Dysentery usually clears up after a few days and no treatment is needed. However, it is important to replace any fluids that have been lost through diarrhoea.

Treating diarrhoea

Diarrhoea can be treated by:

drinking plenty of fluids
taking oral rehydration solutions (ORS)
eating when you are able to
Information and advice about each of these is provided briefly below, but for more detail see treating diarrhoea.

Drinking fluids
If you have diarrhoea and vomiting, you should drink plenty of fluids to replace those that have been lost and to avoid dehydration. Take small, frequent sips of water.

It is very important that babies and small children do not become dehydrated. You should make sure that your child takes frequent sips of water even if they vomit. Taking a small amount of fluid is better than not taking any at all. Avoid giving your child fruit juice or fizzy drinks because these can make their diarrhoea worse.

In severe cases of diarrhoea, fluid may need to be given through a drip into the arm in hospital.

Oral rehydration solutions (ORS)
If you are particularly vulnerable to the effects of dehydration; for example, because you are 60 years of age or over, your doctor or pharmacist may suggest using an ORS. An ORS may also be recommended for your child if they are dehydrated or at risk of dehydration.

ORS usually come in sachets that are available without a prescription from your local pharmacist. You dissolve them in water and they help to replace salt, glucose and other important minerals that your body loses through dehydration.

Rehydration drinks can't cure diarrhoea but they can help treat or prevent dehydration. Don't use homemade salt or sugar drinks.

Advice about eating
Expert opinion is divided over when and what you should eat if you have diarrhoea. However, most experts agree that you should eat solid food as soon as you feel able to. Eat small, light meals and avoid fatty, spicy or heavy foods.

If you feel that you're unable to eat, it should not do you any harm, but make sure that you continue to drink fluids and eat as soon as you can.

If your child is dehydrated, avoid giving them any solid food until they have drunk enough fluids. Once they have stopped showing signs of dehydration; for example, they have become less irritable and started passing urine more frequently, your child can start to eat their normal diet.

If your child is not dehydrated, you should offer them their normal diet. If they refuse to eat, continue to offer drinks and wait until their appetite returns.

Antibiotics for bacillary dysentery

If you have moderate to severe dysentery that is caused by the shigella bacteria, antibiotics may be recommended to shorten the length of time that your symptoms last.

Treating amoebic dysentery

If you have amoebic dysentery (amoebiasis), your doctor may prescribe an antibiotic called metronidazole. They will let you know how long you need to take it for, which will usually be around five days. Tinidazole is a possible alternative medicine.

After you have finished taking the antibiotics, you should be given a course of diloxanide (a medicine that kills the more resistant amoebic cysts forms). You will need to take diloxanide for 10 days.

Prevention

Dysentery is spread as a result of poor hygiene.

To minimise the risk of catching the condition, you should:

wash your hands with soap and water after using the toilet and regularly throughout the day, particularly after coming into contact with an infected person
wash your hands before handling, eating or cooking food
wash your hands before handling babies and feeding children or elderly people
keep contact with an infected person to a minimum
avoid sharing towels
wash the laundry of an infected person on the hottest setting possible
Travel advice


Good hygiene and proper sanitation are an enormous challenge for people living in poor conditions in developing countries where there is little or no access to fresh water and disinfectant.

If you're travelling to a country that has a high risk of contamination by the amoeba that causes dysentery, the advice below can help prevent infection.

Don't drink the local water unless you're sure that it's sterile (clean). Safe alternatives are bottled water or fizzy drinks from sealed cans or bottles.
If the water is not sterile, boil it for several minutes or use chemical disinfectant or a reliable filter.
Don't drink from public water fountains or clean your teeth with tap water.
Don't have ice in your drinks because it may be made from the local water.
Don't eat fresh fruit or vegetables that can't be peeled before eating.
Don't eat or drink milk, cheese or dairy products that haven't been pasteurised (a process that involves heating to destroy unwanted micro-organisms).
Don't eat or drink anything sold by street vendors (except drinks from properly sealed cans or bottles).

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Water-Borne Diseases: Cholera and Dysentery: Epidemic Dysentery
Epidemic Dysentery

Water-Borne Diseases: Cholera and Dysentery
Introduction
Cholera: Scourge of the Poor
Epidemic Dysentery
Dysentery is an inflammation of the intestine characterized by the frequent passage of feces with blood and mucus. Like cholera, dysentery is spread by fecal contamination of food and water, usually in impoverished areas with poor sanitation. Epidemics are common in these areas. A four-year epidemic in Central America, starting in 1968, resulted in more than 500,000 cases and more than 20,000 deaths. Since 1991, dysentery epidemics have occurred in eight countries in southern Africa (Angola, Burundi, Malawi, Mozambique, Rwanda, Tanzania, Zaire, and Zambia).

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Epidemic dysentery is a major problem among refugee populations, where overcrowding and poor sanitation facilitate transmission. Epidemics are characterized by severe disease, high death rates, person-to-person spread, and multiple antibiotic resistance. Worldwide, approximately 140 million people develop dysentery each year, and about 600,000 die. Most of these deaths occur in developing countries among children under age five. In the United States, only about 25,000 to 30,000 cases occur each year.

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In sub-Saharan Africa, diarrheal diseases are a leading cause of death in children under age five. It is estimated that each child has five episodes of diarrhea per year and that 800,000 of those children will die from diarrhea and associated de-hydration.
Dysentery's Roots

Dysentery is most commonly caused by one of two different organisms: One is a bacterium called Shigella;  the other is caused by an amoeba. Shigella  is the most important cause of bloody diarrhea because it destroys cells that line the large intestine, which leads to mucosal ulcers in the intestine. The mucosal ulcers cause the bloody diarrhea. Ingesting as few as 10 to 100 bacteria, which can be contained in a tiny amount of infected food or water, can cause disease.

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Amoebic dysentery is prevalent in regions where human excrement is used as fertilizer. The amoebas that cause dysentery can form cysts, which are like bacterial spores that can become inactive and highly resistant to environmental conditions. In other words, they can live a long time outside the body and then reactivate and cause disease when conditions become favorable.

Cysts and live amoebas are excreted in the feces of an infected person, but only the cysts can survive outside the body. The amoebic infection is milder in comparison with bacterial dysentery. Despite this, amoebic dysentery is more difficult to treat and cure; bacterial dysentery responds better and more quickly to treatment.

Both types of dysentery infect people of diverse age, sex, and ethnic backgrounds, although children are more susceptible.

Potent Fact
The two primary causes of dysentery are the Shigella bacterium and an amoeba. Shigella can cause severe disease and epidemics, although it responds well to treatment. Dysentery caused by the amoeba is milder than its bacterial cousin, although it is quite difficult to treat and cure and often becomes chronic.
Symptoms

Patients with bacterial dysentery often have fever, abdominal cramps, rectal pain, and bloody stools. Occasionally, large portions of the intestinal membrane pass with particularly foul-smelling stool containing yellowish white mucus and/or blood. In nearly half the cases, Shigella does not cause bloody diarrhea.

When amoeba cysts are ingested with contaminated food or water, they germinate and develop into live amoebas in the intestine. The disease remains mild if the amoeba stay confined within the intestines. Like bacterial dysentery, invasion of the intestinal wall leads to fever, abdominal and rectal pain, and bloody diarrhea. Amoebic dysentery may occur in a chronic form when the amoebas invade blood vessels of the intestine and are carried to other parts of the body, causing amoebic abscesses of the liver and brain. About 40 percent of all untreated cases eventually cause nonintestinal infections, such as amoebic hepatitis.

Diagnosing Dysentery

Dysentery is diagnosed from rectal swabs that show evidence of dysentery-causing Shigella bacteria or amoeba.

Disposing of Dysentery

Bacterial dysentery often subsides by itself, although treatment using antibiotics is recommended to prevent recurrence. Having drug-susceptibility tests performed before beginning treatment is important to determine which antibiotics will work best, because many organisms have become drug resistant. Shigella first began to acquire resistance in the 1940s and has become resistant to several classes of drugs since then.

Treating the dehydration that accompanies dysentery is also important. These symptoms should be treated with oral rehydration salts or, if severe, with intravenous fluids.

A combination of drugs is used to treat amoebic dysentery: an amoebicide to eradicate the organism from the intestinal tract, and an antibiotic to eliminate potential secondary bacterial infections.

Eradicating the Epidemic

Early detection and notification of epidemic dysentery, especially among adults, allows for speedy reaction to help fight the disease's spread. Hand-washing with soap and water can reduce secondary transmission of Shigella  infections among household members. And among larger groups, such as within refugee camps, the most effective strategies to control transmission of epidemic Shigella are to …

Distribute soap.
Provide clean water.
Promote hand-washing before eating or preparing food and after defecation.
Install and maintain proper sewage systems or treatment facilities.
Developing a Vaccine

There are no vaccines for dysentery, although there is a strong need, particularly because drug resistance often limits treatment options. There are currently several potential vaccines in the evaluation stages.

Contaminated water causes millions and millions of cases of disease every year. We have discussed cholera and dysentery in this section, but there are other diseases, too. Improved sanitation is key to controlling these diseases, but until conditions improve, it is important for victims to receive proper treatment and to be sure to prevent the severe dehydration that often occurs with diarrheal disease.


Excerpted from The Complete Idiot's Guide to Dangerous Diseases and Epidemics © 2002 by David Perlin, Ph.D., and Ann Cohen. All rights reserved including the right of reproduction in whole or in part in any form. Used by arrangement with Alpha Books, a member of Penguin Group (USA) Inc.


Published: 18 November 2016
The changing epidemiology of bacillary dysentery and characteristics of antimicrobial resistance of Shigella isolated in China from 2004–2014

Zhaorui Chang, Jing Zhang, […]Qiaohong Liao
BMC Infectious Diseases volume 16, Article number: 685 (2016) Cite this article

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Abstract
Background
Bacillary dysentery caused by bacteria of the genus Shigella is a significant public health problem in developing countries such as China. The objective of this study was to analyze the epidemiological pattern of bacillary dysentery, the diversity of the causative agent, and the antimicrobial resistance patterns of Shigella spp. for the purpose of determining the most effective allocation of resources and prioritization of interventions.

Methods
Surveillance data were acquired from the National Infectious Disease Information Reporting System (2004–2014) and from the sentinel hospital-based surveillance system (2005–2014). We analyzed the spatial and temporal distribution of bacillary dysentery, age and sex distribution, species diversity, and antimicrobial resistance patterns of Shigella spp.

Results
The surveillance registry included over 3 million probable cases of bacillary dysentery during the period 2004–2014. The annual incidence rate of bacillary dysentery decreased from 38.03 cases per 100,000 person-years in 2004 to 11.24 cases per 100,000 person-years in 2014. The case-fatality rate decreased from 0.028% in 2004 to 0.003% in 2014. Children aged <1 year and 1–4 years were most affected, with higher incidence rates (228.59 cases per 100,000 person-years and 92.58 cases per 100,000 person-years respectively). The annual epidemic season occurred between June and September. A higher incidence rate of bacillary dysentery was found in the Northwest region, Beijing and Tianjin during the study period. Shigella flexneri was the most prevalent species that caused bacillary dysentery in China (63.86%), followed by Shigella sonnei  (34.89%). Shigella isolates were highly resistant to nalidixic acid (89.13%), ampicillin (88.90%), tetracycline (88.43%), and sulfamethoxazole (82.92%). During the study period, isolates resistant to ciprofloxacin and cefotaxime increased from 8.53 and 7.87% in 2005 to 44.65 and 29.94% in 2014, respectively.

Conclusions

dysentery has undergone an obvious decrease from 2004 to 2014. Priority interventions should be delivered to populations in northwest China and to individuals aged <5 years. Antimicrobial resistance of Shigella  is a serious public health problem and it is important to consider the susceptibility profile of isolates before determining treatment.

Open Peer Review reports
Background
Bacillary dysentery, which is primarily transmitted by the fecal-oral route via contaminated food, water, or person-to-person contact [1–5], is an important enteric infectious disease caused by Shigella  spp. The major symptoms of bacillary dysentery include diarrhea, fever, abdominal pains, tenesmus and stool with blood or mucus [6]. Annually, there are 165 million reported or confirmed cases of bacillary dysentery and 1.1 million deaths worldwide, predominantly in developing countries [7]. In mainland China, the annual morbidity and mortality of bacillary dysentery ranked in the top ten of 39 notifiable infectious diseases from 2004 to 2014.

Bacillary dysentery can be caused by four Shigella species: S. dysenteriae, S. flexneri, S. boydii, and S. sonnei [8]. Shigella sonnei is the most prevalent Shigella species in developed countries. In developing countries, S. flexneri tends to be predominant, while S. dysenteriae and S. boydii are comparatively rare [7]. With the overuse of antibiotics, antimicrobial resistance has been increasing among Shigella isolates in recent years, limiting the possibilities for suitable empirical antibiotic treatments [9]. Knowledge of the disease burden and epidemiological characteristics of bacillary dysentery is helpful for allocating resources and prioritizing interventions. Therefore, in this study, we investigated the temporal and spatial distribution of bacillary dysentery, determined the high-risk populations of bacillary dysentery, and determined the predominant circulating species and antimicrobial resistance patterns of Shigella based on existing data sources from the National Infectious Disease Information Reporting System (NIDRS) from 2004 to 2014 and the sentinel-based bacillary dysentery surveillance system from 2005 to 2014 in China.

Methods
National surveillance for bacillary dysentery
Bacillary dysentery was added to the list of notifiable diseases in China in 1956. From 1956 to 2003, the number of cases and deaths by province were reported monthly to the Chinese Center for Disease Control and Prevention (China CDC). After 2004, the NIDRS, an internet-based notifiable infectious disease reporting system, was established [10]. Thereafter, all probable and confirmed cases along with individual data were reported online to the China CDC by clinicians within 24 h of diagnosis. Clinicians diagnose bacillary dysentery cases according to the unified diagnosis criteria issued by the Chinese Ministry of Health. A probable case of bacillary dysentery was defined as a patient with the following clinical features: fever, chills, abdominal pain, tenesmus, bloody or mucus stool or stool containing >15/high power field (HPF) leukocytes or purulent cells, and microscopically discernible red blood cells and phagocytic cells. A confirmed case was defined as a patient with Shigella spp. isolated from a stool specimen [11]. The individual data includes gender, date of birth, address, case classification (probable or confirmed), date of onset, and date of death (if applicable). All data used in this study for bacillary dysentery cases reported from 1 January 2004 to 31 December 2014 in China were acquired from the NIDRS.

Sentinel hospital-based bacillary dysentery surveillance
Sentinel hospital-based bacillary dysentery surveillance was established in 2005 to monitor the predominant circulating species and antimicrobial resistance patterns of Shigella in China. The surveillance system consists of 20 sentinel hospitals distributed in Beijing, Gansu, Qinghai, Shanxi, Henan, Heilongjiang, Anhui, Fujian, Guizhou, and Shangh


Sentinel hospital-based bacillary dysentery surveillance
Sentinel hospital-based bacillary dysentery surveillance was established in 2005 to monitor the predominant circulating species and antimicrobial resistance patterns of Shigella in China. The surveillance system consists of 20 sentinel hospitals distributed in Beijing, Gansu, Qinghai, Shanxi, Henan, Heilongjiang, Anhui, Fujian, Guizhou, and Shanghai. This coverage represents variation in geographical features, economic development, and sanitary conditions. A national surveillance protocol and laboratory testing assays were developed by the China CDC and are used by all sentinel sites [12].

Specimen collection and testing
In each sentinel hospital, fecal specimens were collected from patients with diarrhea and clinically suspected dysentery who had not been given daily antimicrobial treatment. Fresh fecal samples were inoculated in Cary-Blair medium (most frequently, Qingdao Hope Bio-Technology Co., Ltd, Shandong, China) and sent to the regional CDC laboratory within 4 h. Stool samples were streaked onto XLD agar and SS agar and then incubated at 37 °C for 18–24 h. Colorless and transparent colonies were screened using triple sugar iron agar and motility indole-urea agar. Presumptive positive colonies were then confirmed using API 20E strips (bioMérieux, Marcy l’Etoile, France). All confirmed isolates were serotyped using commercial antisera (Denka Seiken Co. Ltd., Tokyo, Japan).

More than 300 fecal specimens were collected at each sentinel hospital every year, among which at least 30 specimens were selected for isolation and identification of bacteria each month in the epidemic season (May–October) and 10 specimens in the non-epidemic season (November–April). Sampling was designed to ensure that >50% of samples selected for isolation and identification of bacteria were from children.

Antimicrobial susceptibility
The ability of different Shigella  isolates to resist the inhibitory effects of different antibiotics was tested by the provincial CDCs. At least 30% of the confirmed Shigella  isolates, which cover different species, were selected for antimicrobial susceptibility testing each month. Minimal inhibitory concentrations of the following nine antimicrobial agents were determined using the agar dilution method according to the Clinical and Laboratory Standards Institute (CLSI) guidelines [13]. As such, ampicillin, amoxicillin, cefotaxime, cephalothin, gentamicin, nalidixic acid, ciprofloxacin, tetracycline, sulfamethoxazole. Escherichia coli  (American Type Culture Collection strain 25922) was used for quality control. Susceptible and non-susceptible isolates were identified according to the criteria used for enterobacteria as suggested by the CLSI.

Data analysis
We included cases with illness onset reported to the NIDRS from 1 January 2004 to 31 December 2014 in the analysis. We not only calculated a crude incidence rate (number of cases divided by the corresponding population), a case-fatality rate (number of deaths divided by the number of probable and confirmed cases), and age-specific rates by sex (number of cases occurring in a specific age group divided by the corresponding population for each sex), but we also determined the seasonal patterns and geographic distribution of bacillary dysentery. Population data for the study period were extracted from the National Bureau of Statistics of China [14]. In addition, we analyzed the proportions of Shigella spp. isolated from laboratory-confirmed cases of bacillary dysentery and the resistance rates of Shigella collected from sentinel hospitals during 2005–2014. The Cochran-Armitage trend test was used to examine the temporal trends in the annual morbidity of bacillary dysentery, the proportion of bacillary dysentery cases by age groups, and the antimicrobial resistance of Shigella  isolates. The index Z > 0 denotes an increasing trend in the annual morbidity of bacillary dysentery, the proportion of bacillary dysentery cases by age groups, and the antimicrobial resistance of Shigella  isolates, whereas Z < 0 denotes a decreasing trend. The trend was considered to be significant when P was < 0.05. A chi-square test was used to examine whether the sex-specific incidence in children younger than 5 years was significantly different between male and female individuals, with a significance level of α = 0.05. We conducted all analyses with SAS 9.4 (SAS Institute Inc., Cary, USA).

We used a seasonal index to understand seasonal patterns of bacillary dysentery in China. This index was calculated by month as the average case count for the given month divided by the average monthly case count during the entire 11 years of surveillance from 2004 to 2014 [15]. No obvious seasonal pattern was expected if the seasonal index of each month was close to 1.