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Diseases & conditions
Stomach & bowel

Amoebic dysentery

Amoebic dysentery is an infection of the large intestine caused by a parasite called Entamoeba histolytica. It spreads through food and water contaminated with stool. It can cause diarrhoea with blood and mucus and belly pain, and sometimes the parasite spreads to the liver and causes an abscess. It is treated with medicine prescribed by a doctor.

Symptoms

  • Loose stools with mucus or blood
  • Cramping belly pain
  • Frequent urge to pass stool
  • Tiredness and loss of appetite
  • Sometimes fever
Pain under the right ribs with fever, if the liver is affected

When to see a doctor

Get medical help quickly if you notice any of these:

  • Blood in the stool
  • Severe belly pain
  • Fever with pain under the right ribs
  • Signs of dehydration
  • Diarrhoea lasting more than a few days, or in a child, pregnant woman or older person

In an emergency, go to the nearest hospital or clinic straight away.

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Causes

  • Entamoeba histolytica parasite
  • Drinking unsafe water
  • Eating raw vegetables or fruit washed in contaminated water
  • Food prepared by someone who did not wash their hands
  • Poor sanitation

Prevention

  • Drink boiled or treated water
  • Wash hands with soap after the toilet and before eating or cooking
  • Wash raw fruit and vegetables with clean water, or peel them
  • Eat freshly cooked, hot food
  • Use a clean latrine

Treatment

  • A stool test to confirm the cause of bloody diarrhoea
  • Medicine prescribed by a doctor, such as metronidazole, followed by a second medicine to clear the parasite from the gut
  • Drink plenty of fluids; use ORS for dehydration
  • Avoid alcohol while taking metronidazole
  • A liver abscess needs hospital care
  • Do not start antibiotics or other prescription medicines without a doctor

Common questions

Is every bloody diarrhoea amoebic?

No. Bloody diarrhoea is more often caused by bacteria such as Shigella. A stool test and a doctor are needed to choose the right medicine.

Why do I need a second medicine after metronidazole?

Metronidazole kills the parasite in the bowel wall and liver, but some cysts can stay inside the gut. A second medicine clears them and stops the illness coming back.

General information onlyThis guide does not replace an examination by a doctor. Do not start or stop a medicine without a doctor's advice.