Symptoms of Dysentery

The line between ordinary diarrhea and dysentery is drawn in the stool itself: blood or mucus means the bowel wall is inflamed and invaded - that is dysentery, and it needs a doctor.

The core picture:

• Frequent small stools with blood and/or mucus - sometimes dozens of trips a day
• Cramping abdominal pain, often severe
• Tenesmus - the constant, straining urge to pass stool even when little comes out; one of the most characteristic and miserable features
• Fever, often with chills (typical of bacillary dysentery)
• Weakness, nausea, loss of appetite

How the two main types tend to differ:

• Bacillary (Shigella): abrupt onset, high fever, frequent small bloody-mucoid stools, can dehydrate quickly - especially in children.
• Amoebic: slower build, colicky pain, stools with blood and mucus but often less fever; symptoms can wax and wane over weeks. Its feared complication arrives later: an amoebic liver abscess - fever with pain in the right upper abdomen, sometimes weeks after the gut symptoms fade.

Danger signs - get medical help the same day:

• Blood in stool with high fever, or any blood in a small child's stool
• Signs of dehydration: very little urine, sunken eyes, extreme thirst, lethargy, a child who is floppy or unusually sleepy
• Severe, constant abdominal pain or a rigid, board-like abdomen
• The patient is an infant, elderly, pregnant or already weak
• Symptoms lasting beyond 2-3 days or worsening despite ORS

And one rule to write on the wall: no anti-motility medicines (loperamide, "loose-motion stoppers" from the chemist) when there is blood or fever. Slowing an invaded bowel traps the infection inside. Rehydrate with ORS, and see a doctor.