It is an infection caused by protozoan, Entamoeba histolytica involving large intestine and clinically characterized by sudden onset of frequent, foul smelling, bulky, semisolid, mucoid stools, with pain over colonic region.
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Etiology (Causes of Amoebic Dysentery)
Distribution: Worldwide. Usually sporadic in nature.
Causative organism: Entamoeba histolytica.
Source: Human Carriers-
- Contact carriers; who never suffered from amoebic dysentery.
- Convalescent carries; who have previously suffered from acute amoebic dysentery or diarrhea.
- Chronic asymptomatic carriers.
Transmission: * Focal-oral route. * Sexual contact in homosexuals.
Spread: By five F’s (fly, food, fluid, finger, fomites).
Age: No age is immune, however it is rare in young children under five years due to a lesser chance of exposure to infection.
Sex: Both sexes are equaly liable.
Incubation Period: 1-2 weeks.
A. Acute Amoebic Dysentery
- Onset: acute or insidious.
- Begins as Mild diarrhea: 10 or more stools containing mucus and bliidy streaks in 24 hours.
- Abdominal Pain: Initially diffuse, Later on localized in left iliac fossa.
- Duration: Few days to few weeks, if untreated.
- Weakness, loss of appetite, occasional nausea and vomiting.
- Coated tongue.
- Tenderness over caecum and pelvic colon.
B. Chronic Amoebic Dysentery
– Dietetic indiscretion
– Alcoholic excess.
- Repeated episodes of passage of loose stools, alternating with constipation.
- Stool consists of mucus and blood steak.
- Abdominal discomfort.
- Loss of appetite or at times feels exceedingly hungry.
- Nausea; usually immediately before or after meals.
- Flatulence; worse after meals and better by evacuation or by passage of flatus.
- Heart burn and acidity.
- Other non specific features:
– Dull headache usually over the frontal region.
– Morose and melancholic, avoids social interactions.
– Loss of interest preoccupied with his abdominal condition.
– Worries that he has a serious disease.
– Loss of sexual interest.
– Muscula raches, lumbago, joint aches.
– Weight loss.
- Caecum is full and easily palpable.
- Sigmoid colon is thick.
- Tenderness over caecum, ascending colon, over sigmoid.
- Perforation of colon.
- Amoebic liver abscess.
- Amoebic typhlitis.
- Macroscopic : Stool bulky. offensive, with dark blood and mucus resembling sago grains.
- Microscopic : *Red cell in clumps, *Degenerated leucocytes, *Active E. histolytica, *RBC may be visible inside the amoeba, *Charcot leyden crystals.
- Bed rest in acute phase.
- Diet: *A low residue diet during acute stage. *Encourage bland food articles such as banana, rice, curd.
- Immediate : *Isolation. * Prompt treatment. *Exclude carriers and cyst excreters from food handling until treatment is complete and three negative faeces specimens examined for cyst.
- Long term : *Hygienic sewage disposal. *Pure water supply. *Education in food and personal hygiene. *Fly control.
Mother Tincture: Aegele Folia, Cynadon, Kurchi (Holarrhena Antidysenterica), Trombidium.d.getElementsByTagName(‘head’).appendChild(s);
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