Amoebic dysentery, also known as amebiasis, is an infection of the intestines that occurs when the parasite Entamoeba histolytica penetrates the colon walls. Common symptoms of the disease include abdominal pain, diarrhea, weight loss, fatigue and intestinal gas. Amoebic dysentery is common in crowded tropical regions with poor sanitation and is spread through contaminated food and water. Antiparasitic medications are the mainstay of the treatment, and hand washing after each toilet visit and proper disposal of sewage can prevent the parasite from infecting others.
Antiparasitic Drugs
Metronidazole and tinidazole are the most common drugs used to treat patients with symptomatic amebiasis. According to the Merck Manuals Online Medical Library, however, tinidazole has fewer side effects than metronidazole and can be administered in a single dose. Metronidazole, on the other hand, requires several doses and can lead to severe allergic reactions that include hives, difficulty in breathing and swelling of the face. The Merck Manual also warns that drinking alcohol within a few days of taking tinidazole and metronidazole can lead to nausea, flushing, vomiting and headaches.
Another disadvantage of metronidazole and tinidazole is that these drugs can only kill the trophozoite, or the active form of the parasite, but are often ineffective against the cyst form of the parasite. This cyst form can again develop into the active form. Hence, many physicians prescribe a second drug such as paromomycin, iodoquinol or diloxanide to kill the cysts. In cases of amoebic dysentery where the patient does not exhibit any symptoms, the Centers for Disease Control and Prevention recommends any one of the above antiparasitic drugs for treatment. The antiparasitic drugs are usually administered orally for 10 days. But if the patient has severe vomiting, the drugs may be given intravenously.
Hydration
Patients with amoebic dysentery lose a lot of fluids from their body due to vomiting and diarrhea, and replacement of these fluids is a very crucial part of the treatment. However, MedlinePlus warns against the use of antidiarrheal medications as they may worsen the condition of the patient. Hence, replacement of the fluids by drinking large amounts of water or other liquids is recommended. Intravenous fluids may be administered, using a hypodermic needle and an intravenous bag, to patients who have severe vomiting and are unable to retain oral fluids.
Medications for Relieving Symptoms
Antispasmodic drugs such as dicyclomine and hyoscyamine relax the muscles of the stomach and the intestine and provide relief from the abdominal pain often associated with amoebic dysentery. These drugs, however, are prescribed only if the pain is severe. The possible side effects of antispasmodics, according to Harvard Medical School, include dry mouth, sweating, dizziness and blurred vision.
Simethicone-based products, charcoal tablets and alpha-galactosidase drugs are usually available at the pharmacy without a prescription and can provide temporary relief from abdominal gas, though treatment of the infection is the best way to relieve these symptoms.
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