My husband was raised in a family of avid backpackers. They’d take these weeklong trips, even his mom, even into her fifties. If I could change two things about her, they would be backpacking and being so dang skinny. She was a tough act to follow. (“Even when my mom was pregnant, no one could tell.” I ask you, does a pregnant-or-not wife really need to hear that?) Naturally, Aaron took our children on a few backpacking trips, but not as many due to being diabetic. His health suggested that day hikes and campsites with coolers or refrigeration for the insulin were the way to go.
Unfortunately, he failed to impress upon them the importance of purifying their drinking water, even if the water is dazzlingly clear at a really high altitude. Fortunately, no one’s gotten sick because of it. I do hope they’ll become more responsible as adults, but I’m not holding my breath. So it’s time to learn about another form of dysentery.
From the Ship’s Medicine Chest and Medical Aid at Sea:
Amoebic dysentery is caused by Entamoeba histolytica, a parasite that infects the bowel. Amoebiasis tends to be a chronic diarrheal illness that on occasion produces an acute colitis which is indistinguishable from salmonellosis or shigellosis. The diagnosis requires laboratory identification of the amoeba in the feces. Usually a fever is present and abscesses may form in the liver or elsewhere, which may prove fatal in exceptional cases.[1]
SYMPTOMS
Healthy people are often asymptomatic. In children, immunocompromised, or malnourished individuals, amoebiasis may cause severe diarrhea or dysentery.[2]
Symptoms in afflicted patients include the following:
Intermittent diarrhea, often alternating with constipation[3]
Abdominal cramps[4]
Frequent, often unproductive, bowel movements[5]
Loose, but usually not watery stools with lots of mucus, and sometimes stained with blood[6]
In severe cases, there will be a lot of blood, and the patient may be very weak and ill
Usually there is no fever[7] (Yes, this contradicts the Ship’s Medicine Chest)
Amebic dysentery is distinguished from bacterial dysentery (Shigella) in that the latter begins more suddenly, the stools are more watery, and fever almost always is present.[8]
PREVENTION
Institute basic sanitation measures before problems arise. Make and use latrines, protect drinking water from contamination, and practice sound hygiene. Eat a nutritious diet and avoid fatigue and drunkenness. [9]
TREATMENT
Conventional
Metronidazole, 750 mg orally, 3x per day, 5-10 days[10]
In children, give 35-50 mg/kg/day orally in 3 divided doses for 10 days. Do not exceed the adult dosage, regardless of weight[11]
Metronidazole, plus tetracycline if possible[12]
Herbal
Garlic[13]
Japanese barberry[14]
Oil of oregano capsules, 600 mg/ 6 weeks[15]
COMPLICATIONS
If the amebas set up housekeeping in the liver, the developing abscess causes tenderness or pain in the right upper quadrant of the stomach. [16] Pain may radiate into the right chest and worsens when the patient walks. If a patient with these symptoms starts coughing up brown liquid, this indicates that an amebic abscess is draining into the lung.[17]
CAUTIONS. Pregnant women should not use metronidazole. Drinking alcohol while using metronidazole will induce vomiting.
[1] The Ship’s Medicine Chest and Medical Aid at Sea, 1978, 151.
[2] David Werner, Where There Is No Doctor, 1996, 145.
[3] David Werner, Where There Is No Doctor, 1996, 145.
[4] David Werner, Where There Is No Doctor, 1996, 145.
[5] David Werner, Where There Is No Doctor, 1996, 145.
[6] David Werner, Where There Is No Doctor, 1996, 145.
[7] David Werner, Where There Is No Doctor, 1996, 145.
[8] David Werner, Where There Is No Doctor, 1996, 145.
[9] David Werner, Where There Is No Doctor, 1996, 145.
[10] Joseph Alton, et al., Survival Medicine Handbook, 2021, 638.
[11] Joseph Alton, et al., Survival Medicine Handbook, 2021, 638.
[12] David Werner, Where There Is No Doctor, 1996, 145.
[13] Rebecca L. Johnson, et al., National Geographic Guide to Herbs, 2010, 155.
[14] Kimball Chatfield, Medicine from the Mountains, 1997, 10.
[15] Rebecca L. Johnson, et al., National Geographic Guide to Herbs, 2010, 155.
[16] David Werner, Where There Is No Doctor, 1996, 145.
[17] David Werner, Where There Is No Doctor, 1996, 145.
I suspect that "Healthy people are often asymptomatic" means that "Healthy ADULTS...".
ReplyDeleteChildren under 3 can dehydrate in the blink-of-an-eye.
Infant mortality in Late-1800s Dublin, Ireland ran about 20% (one-in-five) and most of it linked back to communal latrines and lack of running water to wash hands after using them.
You are absolutely correct. I'll make that correction. Thank you.
DeleteI had amoebic dysentery as a young healthy adult in India. It is no joke. I have literally never been so acutely ill in my life before or since. Thankfully, the Indian doctor gave me the correct treatment right away.
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