Amoebic dysentery

The Amoebic dysentery, Latin Amebiasis, describes an infection of the human intestinal tract caused by amoeba. This article deals with the causes, diagnosis, course, treatment and prevention of amoebic dysentery.

What is amoebic dysentery?

Amoebic dysentery is a diarrheal disease that occurs primarily in tropical and subtropical areas such as Thailand, Kenya, Vietnam or India. The infection is caused by a type of amoeba that lodges in the human colon and continues to multiply there through cell division. Every year around 100,000 people die as a result of such an infection. Doctors differentiate between three different forms of amoebic dysentery:

1. Symptom-free infestation: The affected patient does not feel any symptoms of the infection. However, the amoeba live in his digestive tract and are eliminated through his bowel movements. Despite the lack of symptoms, the patient can become the carrier of the infection.

2. Invasive amebiasis: The pathogens attack the human digestive tract and trigger the formation of abscesses and ulcers there.

3. Extraintestinal amebiasis: Advanced form of amoebic dysentery, the pathogens also attack organs outside the digestive tract such as the liver, heart, spleen or urinary tract.

causes

The main cause of amoebic dysentery is the pathogen Entamoeba histolytica. It belongs to the family of protozoa and the subgroup of rhizopods. Entamoeba histolytica is transmitted primarily through contaminated drinking water and general unsanitary living conditions. The incubation period varies depending on the case and can take a few days or several months from infection with the pathogen to the onset of the disease.

Symptoms, ailments & signs

In the vast majority of cases, patients infected with the amoeba E histolytica do not show any symptoms. Intestinal amebiasis, on the other hand, manifests itself through various signs that can be used to diagnose the disease. After a gradual onset, slimy, bloody diarrhea and abdominal cramps occur after a few weeks.

The stool is jelly-like and is often described as frothy. Constipation, severe pressure pain in the lower abdomen and nausea can also occur. Weight loss occurs with long-term illnesses. Fever and chills are also typical symptoms of amoebic dysentery.

Externally, the disease is noticeable, among other things, through the changed complexion. The patients usually have pale, blemished skin and often sunken eyes. Some patients also experience redness and, if the liver is affected, symptoms of jaundice. With complications such as an intestinal rupture or an amoebic liver abscess, further complaints arise.

Mostly stomach cramps, severe pain and diarrhea occur. Loss of drive, tiredness and chronic gastrointestinal complaints are also typical symptoms of chronic intestinal amebiasis. A typical symptom is repeated vomiting of bloody and slimy bile.

Diagnosis & course

Amoebic dysentery is diagnosed by doctors using stool and blood samples. If typical symptoms such as bloody diarrhea, cramps, fever occur, the responsible pathogens are identified by examinations with the microscope.

In a few cases colonoscopies or ultrasound examinations of the abdomen are used to diagnose amoebic dysentery. When examining stool, it should be noted that the pathogens are very sensitive despite their high risk of infection. For this reason, fresh stool should always be used during diagnostic examinations.

The course of amoebic dysentery can usually be assessed as harmless if the disease is diagnosed and treated early. If the disease is treated professionally in good time, in most cases it will subside without consequences.

If the infection is discovered too late and treated too late, however, serious to fatal complications can result. These include perforation of the intestine, inflammation of the peritoneum and inflammation of the intestinal mucosa.

Complications

A very rare but also extremely dangerous complication of amoebic dysentery is the so-called toxic megacolon, which often causes severe vomiting, high fever and a state of shock in the patient. In general, dangerous complications of amoebic dysentery are rare. In severe cases, a rupture of the intestine is possible, which is often associated with peritonitis.

Necrotic colitis can also occur; inflammation of the lining of the colon that causes tissue to die. Colitis is accompanied by fever symptoms and bloody diarrhea. A rare complication of amoebic dysentery is the toxic megacolon; an enlargement and obstruction of the colon.

A megacolon leads to a rapid deterioration in the general condition and is associated with nausea and vomiting, among other things. As the disease progresses, the large intestine enlarges and, as a result, an intestinal perforation occurs. The amoebic dysentery can also create lumps on the intestinal walls and lead to constipation. In rare cases, the amoeba enter the bloodstream and cause extratestinal amoebiasis.

Amebiasis is associated with chronic diarrhea and the formation of abscesses; as the disease progresses, liver abscesses, a weakening of the immune system and sometimes an outbreak of the infection in the chest or heart occur. If the amoebic dysentery is treated early, however, there are usually no serious complications.

When should you go to the doctor?

Amoebic dysentery must always be medically clarified and treated. A doctor's visit is advisable if typical symptoms of an infectious disease are noticed after a long-haul trip. You should see a doctor immediately with cramping abdominal pain, weight loss and a painful bowel movement. If this is accompanied by bloody, slimy diarrhea and fever, it is most likely an amoebic dysentery or another infectious disease that requires medical attention.

A visit to the doctor is recommended in the first few hours of the illness. Otherwise, serious complications, such as an amoebic liver abscess or circulatory collapse, can lead to further symptoms. In general, if the diarrhea lasts longer than three days, a doctor must be consulted. If you develop severe weakness and dizziness, or if you notice bloody or purulent stools, which may be associated with a high fever, you should consult a doctor immediately. People with an immune deficiency or a corresponding medical history should go to the doctor to deal with amoebic dysentery as well as children, the elderly and pregnant women.

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Treatment & Therapy

A simple amoebic infestation of the intestinal tract diagnosed in good time can be treated very quickly and successfully with various types of antibiotics. As a rule, the medication is administered intravenously under constant observation by medical specialists.

In the further course of the disease, the antibiotics can also be administered in tablet form if they are successful.

In the case of infections and abscesses in various human organs caused by amoeba, on the other hand, a separate therapy by the doctor is necessary; here it is quite possible that the patient will have to take medication for a longer period of time.

In the event of complications during the course of the disease and severe abscess infestation in the organs, surgical treatment of the amoebic dysentery may also be necessary in individual cases.

Outlook & forecast

As a rule, those affected suffer from severe discomfort in the abdomen and intestines due to amoebic dysentery. It is not uncommon for severe abdominal pain and cramps in the stomach to occur. It is also not uncommon for diarrhea and bloody stools to occur. The bloody stool can lead to a panic attack and significantly impair the patient's quality of life. Furthermore, those affected suffer from general exhaustion and tiredness.

The patient's resilience drops significantly due to the amoebic dysentery. If there is no treatment, it can also lead to an intestinal breakthrough in the further course of the disease. Likewise, the patients often suffer from vomiting and nausea. The patient's everyday life is significantly impaired by the amoebic dysentery.

With the help of antibiotics, the symptoms can be treated and limited relatively well. As a rule, there are no particular difficulties or problems. If there is an infection in the internal organs, longer therapy is usually necessary. As a rule, life expectancy is not reduced if amoebic dysentery is treated early.

prevention

To prevent infection with the highly infectious amoebic dysentery, one should pay more attention to hygienic living conditions in the endangered tropical and subtropical areas. Tap water should never be used for drinking, making ice cubes or brushing teeth.

If hygienically bottled mineral water is not available, the tap water must be boiled for at least five minutes in order to kill any pathogens it may contain. Raw fruits and vegetables should only be eaten peeled.If symptoms such as diarrhea, severe abdominal pain or fever occur, a doctor should be consulted so that the disease can be diagnosed and treated as early as possible.

Aftercare

There is no immunity after infection with amoebic dysentery. The typical symptoms can recur. Patients can only prevent re-infection by taking precautionary measures. Doctors provide information about possible causes as part of the initial diagnosis. Before setting off, travelers can also get information from their family doctor about the risks in tropical countries, where amoebic dysentery mainly occurs.

Compliance with drinking water hygiene is the most important preventive measure to prevent recurring complaints. If the infection is repeated, those affected can request a diagnosis at an early stage. This serves to avoid complications. The disease is milder as a result.

The most important method is the stool examination. Antibodies in the blood also provide information about amoebic dysentery. Antibiotics promise rapid treatment success. Other remedies are sometimes prescribed for severe abdominal pain. There is no common aftercare that provides practical tips.

Since there is hardly any infection with amoeba dysentery in Germany, existing knowledge leads a shadowy existence. Tourists from exotic destinations are the main risk group. Using high quality hotels and restaurants is the best way to prevent traffic. You cannot be vaccinated against amoebic dysentery. Preventive intake of certain medications does not make sense.

You can do that yourself

Medical treatment is necessary if amoebic dysentery is suspected. Antibiotics (tinidazole, nitroimidazole, metronidazole, etc.) can then be administered under medical supervision. Subsequent treatment with other antibiotics (paromomycin, diloxanide furoate) is usually necessary.

Accompanied by these measures, the symptoms can be alleviated with antispasmodic medicinal herbs and medicinal plants such as angelica, bergamot or columbine. It is also advisable to drink enough and to take care of the body for the first seven to ten days after the infection. Those affected should especially drink herbal teas made from peppermint, fennel, chamomile or blueberry.

Grated apples, carrot soup, rusks and gruel help against acute diarrhea. What should be avoided during amoebic dysentery: very fatty or spicy dishes, sweets and legumes. In addition, alcohol, caffeine and other drinks and foods that could further irritate the digestive tract should be avoided.

However, if there are severe symptoms, a doctor must initiate further treatment steps. Often, for example, cysts form during amoebic dysentery, which must be surgically removed. In the case of severe complaints, home remedies and self-measures should first be discussed with the family doctor.