What is Amoebic Dysentery?
Amoebic dysentery is a tropical bowel disease which is transmitted through contaminated drinking water or food. Nearly ten percent of the world’s population are infected with the parasite. Especially travelers to tropical and subtropical countries may become infected.If amoebic dysentery is not treated , amoebas may spread to organs throughout the body and cause death. Here you can read everything you need to amoebic dysentery.
What is Amoebic Dysentery?
The amoebic dysentery is caused by the protozoa’’ “Entamoeba histolytica’’. This is not only ameoba that infects humans, but this is one makes them sick. E. Dispar and E. Moshkovskii are species of ambeo which frequently occur.
About ten percent of people worldwide carry the parasites in itself, each year only 70,000 to 100,000 people die from the effects of amoebiasis. Not every infected become ill from amoebic dysentery. More than 90 percent of the parasite carriers never develop symptoms.
How do I become infected with amoebic dysentery?
Infected people get amoebic cysts mostly from drinking water or foods. These cysts get into the drinking water or on food that will be eaten raw, and can infect others through the consumption of contaminated food or water. Transmission is most likely:
- Fruit and raw vegetables
- Water and soft drinks
- Ice cream or sorbet
In general, wet-dark environment is ideal for cysts. In such habitats,cysts survive for several weeks in the drinking water or food. A short travel in high-risk countries is enough to infect with amoebic dysentery.
The amoebic dysentery is transmitted fecal-orally. Amoebiasis can be transmitted to humans where no high hygiene standards prevail. This is particularly true for developing countries.It is also seen in Western countries.
Amoebic Dysentery Symptoms
Most people who are infected with the amoeba E. Histolytica show no symptoms at all. Approximately ten percent of cases develop a “amebiasis” in which the amoebae penetrate the intestinal wall and settle here. In only one percent of the cases, amoebae enter the bloodstream and colonize organs such as the liver. These organs are formed with abscesses which can restrict the organ function and lead to death.If it spreads from intestine to other areas of the body , it is called “extra-intestinal amoebiasis”.
The beginning of amoebic dysentery is more insidious. One to several weeks after infection occurs, there can be bloody diarrhea and abdominal cramps. it can also lead to blockages and severe tenderness in the lower abdomen.In addition, amoebic dysentery may cause to weight loss,fever and chills in severe cases.
As in Western countries, other diagnoses such as bacterial inflammations, diarrhea, or appendicitis more common than amoebic dysentery.That is why, you should inform the doctor on any tropical trip. If the amebiasis is not recognized, the problems persist. They are easily confused with inflammatory bowel diseases such as Crohn’s disease or ulcerative colitis. In both diseases, it is a false reaction of the immune system against the gut which also leads to repeated diarrhea, and abdominal pain.
In the case of a misdiagnosis, further complications arise by the amoebic dysentery. The inflammation may cause the nodes in the intestinal wall that interfere with stool passage. This is the case called by doctors ‘’ an Ileus’’.It can get worse and intestine can be perforated which can have serious consequences for the patient and his life. There is also the danger that the amoebae enter the bloodstream.This case is also called’’ extra-intestinal amoebiasis’’.
Extra Intestinal Amebiasis
The amoebae enter the bloodstream and can reach all organs. Most often, they migrate from the intestine to the liver. This happens months to years after infection and can also occur without prior symptoms of diarrhoea and frequent abdominal pain. In the liver the amoebae will form an abscess.
A liver abscess due to amoebic dysentery is accompanied by high fever and severe pain under the right ribs.Pain can radiate right shoulder or ribs. Although the amoebae move through the intestine to the liver, it is only at 30 percent of the abscess patients to diarrhea. This means that even without abdominal pain and diarrhea is an amoebic infection possible.
Amoebic Dysentery Causes and Risk Factors
If you look at all of the routes of Transmission of amoebic dysentery, it is clear that the main risk factor lies in the hygienic conditions of the respective region. When traveling in affected regions should be paid particular attention to hygiene during the drinking water and food. Individual behavior in tropical and subtropical countries makes up a large part of the risk of illness.
Another infection route is oral-anal intercourse. A risk group for such an infection are men who have sex with men, although naturally heterosexual couples can be infected with the corresponding sex practices as well. This takes the cyst directly from the rectum in the mouth of the sexual partner.
In addition to homosexual couples, amoebic dysentery can be seen in :
- Small children
- Pregnant woman
- Patients under cortisone therapy
- Immunocompromised patients
- Undernourished people
These people often have more severe complications such as an abscess than other patients. Early diagnosis and consistent treatment can prevent spread of amoebas.
Amoebic Dysentery Investigation and Diagnosis
Doctors use some tests to diagnose amoebic dysentery. Most important is the direct contact with the patient.Doctors may ask the following questions:
- Have you recently in tropical countries?
- Do you have diarrhea, and if so, how long?
- Is your diarrhea bloody-slimy?
A real proof of amoebic dysentery is only possible via a stool sample. However, you can see the difference between the malicious E. histolytica and other types of Amoeba in the stool. A blood test is available that can determine the difference. The blood test is important, even if extra-intestinal Amebiasis is suspected. Newer methods allow for a direct detection of E. histolytica DNA in stool.
The mucous membrane in the intestine is damaged, doctors can see these violations also in a colon mirroring (colonoscopy). Other organs also can be affected by amoebic dysentery which can be detected by ultrasound and a computed tomography (CT).
It plays an important role in the treatment of amoebic dysentery to treat damaged intestinall wall and infection.if they are treated , there will be no complications and will also prevent the spread of amoebiasis efficiently.
Infestation with no symptoms: Amoebae can be detected in stool without symptoms and no evidence of organ damage.In this case,treatment with the antibiotic paromomycin for at least five days is sufficient. The substance is not absorbed into the body,it just kills amoeba only in the intestine.
Infection of the intestinal wall (Intestinal Amoebiasis): The amoebas have infected the intestinal wall is usually bloody mucoid diarrhoea. This is the case, amoebic dysentery is treated in addition to paromomycin with metronidazole. This is an another antibiotic which kills the amoebas in the intestinal wall.
Amebic abscess: If there is an abscess , metronidazole is also used for treatment.If there are abscess which has burst , surgery must be performed. If abscess are detected in time and treated consistently, abscess regresses over several weeks. If the person concerned is seriously ill, it must be decided how to save the life of the patient which depending on the organ and patient’s condition.
Amoebic Dysentery Disease Progression and Prognosis
The history of amoebic dysentery can be very diverse. The infection with E. histolytica does not make every human being sick. Even if one becomes ill, the complaints range from simple diarrhea to a life-threatening liver abscess. In any case, a known infection should be treated consistently to protect patient and public. Nowadays, amoebic dysentery is completely curable disease. Before even a century, amoebic dysentery was a major health problem.
If the amoebic dysentery is not treated, it contributes to the spread of the disease and can eventually lead to the dangerous organ involvement. he two drugs against amoebic dysentery are well tolerated and provide complete cure if the disease is detected early enough.
How to prevent Amoebic Dysentery
If you want to prevent amoebic dysentery, you should take following rules when travelling:
- Peel raw fruits before consumption.
- Boil vegetables
- Do not eat raw meat and raw seafood.
- Do not drink water from the tap
- Boil water before brush your teeth.
- You should also avoid ice cubes or homemade water ice and Sorbet.
- You need to use different condoms during sexual intercourse.
With these precautions, you can reduce the probability of an amoebic dysentery infection.