Dysentery: Symptoms, Causes, and Treatment in the UK

Dysentery is an inflammatory disease of the intestine, specifically the colon, which results in severe diarrhoea containing blood or mucus. While many people confuse it with standard food poisoning or a simple stomach bug (gastroenteritis), dysentery is distinct due to the presence of blood and the intensity of the abdominal cramping.

In the United Kingdom, dysentery primarily presents in two forms: Bacillary dysentery (Shigellosis) and Amoebic dysentery. Bacillary dysentery is the most frequent variety seen in British patients and is caused by Shigella bacteria. Amoebic dysentery is caused by a single-celled parasite called Entamoeba histolytica and is usually 'imported' by travellers returning from parts of the world with poor sanitation.

Symptoms usually begin one to three days after infection. For most people in the UK, the illness is mild and resolves within a week, but for others, it can be debilitating. Key symptoms to look out for include:

• Bloody diarrhoea: This is the hallmark of the condition, often accompanied by mucus or pus.
• Painful stomach cramps: These can be intense and are often felt shortly before needing the toilet.
• Tenesmus: A distressing feeling that you need to pass stools even when your bowels are empty.
• Nausea and vomiting: This can make keeping fluids down difficult, increasing the risk of dehydration.
• High temperature: Many patients experience a fever of 38°C or above.

The bacteria or parasites that cause dysentery are spread through the faecal-oral route. This sounds unpleasant, but it essentially means the infection is passed on when someone swallows something contaminated by the faeces of an infected person. In the UK, common routes of transmission include:

• Poor hand hygiene: Failing to wash hands thoroughly after using the bathroom or before handling food.
• Contaminated food or water: This is particularly common with salads or raw vegetables washed in contaminated water.
• Close contact: The infection spreads easily in environments like schools, nurseries, and care homes.

According to NICE (National Institute for Health and Care Excellence) guidance, Shigella sonnei is the most common cause in the UK and usually results in a relatively mild illness compared to other strains found abroad.

If you suspect you have dysentery, it is important to seek medical advice to ensure you are managing the infection correctly and to prevent it from spreading. You can speak to an online doctor in the UK for a consultation if you are experiencing persistent diarrhoea or abdominal pain.

An online GP can assess your symptoms, provide advice on oral rehydration therapy, and issue a sick note if you are unable to work. They will also guide you on the '48-hour rule'—staying away from work or school for at least 48 hours after your last episode of diarrhoea. If symptoms are severe or persistent, the doctor may request that you provide a stool sample at your local surgery to identify the specific pathogen and determine if antibiotics are necessary.

The primary goal of treatment is to prevent dehydration. Most cases of bacillary dysentery are 'self-limiting', meaning the body’s immune system will clear the infection without specific medication.

Fluid Replacement

Drink plenty of water or herbal teas. If you are at higher risk of dehydration, use oral rehydration sachets (available from pharmacies) which contain a specific balance of salts and sugars to help your body absorb water more efficiently.

Medication

Avoid using anti-motility medicines like loperamide (Imodium) if you have bloody diarrhoea or a fever. These drugs slow down the gut, which can actually make dysentery worse by keeping the toxins in your system longer. Paracetamol can be taken to manage pain and fever.

Antibiotics

Antibiotics are generally reserved for severe cases or for patients with underlying health conditions. Your GP will only prescribe these if a stool test confirms a bacterial cause that requires them, as many strains are now resistant to common antibiotics.

Dysentery is highly infectious. To protect your household and the wider community, follow these steps:

• Wash hands: Use soap and warm water frequently, especially after using the toilet and before preparing food.
• Separate towels: Ensure the infected person has their own towel and flannel.
• Clean bathrooms: Regularly disinfect toilet handles, flush buttons, and taps.
• Laundry: Wash the infected person's clothes and bedding on the hottest setting possible.