From dehydration to persistent symptoms, it is important to determine if one has a typical case of diarrhoea or if it may be an indication of a serious intestinal infection. In an interview with HT Lifestyle, Dr Sudhakar Ranpise, senior consultant, internal medicine, Surya Sahyadri Hospital, decodes the difference between normal diarrhoea and a serious gut infection.
What is normal diarrhoea?
Dr Sudhakar highlighted that normal diarrhoea is often due to a viral illness, too much food, intolerance to a particular food, or a temporary stomach bug. Symptoms are usually mild, with no more than loose stools, mild discomfort in the abdomen, and the condition goes away with adequate hydration and electrolyte replacement.
When does diarrhoea turn into serious gut infection?
However, when diarrhoea is severe and lasts over two to three days, has a high fever, severe abdominal cramping, involves blood or mucus in the stool or shows signs of dehydration, there is a risk that you may have a more serious intestinal infection which would require medical treatment.
He recommended visiting a physician with a detailed history of the onset of symptoms; what food you have recently eaten; whether or not you have had any travel outside of your home within the previous two weeks; and what contact you may have had with others who have had similar symptoms. This information can be used to help your doctor differentiate between normal diarrhoea and the possibility of a bacterial infection.
What is Shigella?
Dr Sudhakar said, “One emerging concern in recent years is Shigella, a bacterium responsible for bacillary dysentery. Shigella is highly contagious; ingestion of even a small number of bacteria can lead to infection because it spreads easily by the faecal-oral route.”
He highlighted that transmission can happen from having direct person-to-person contact, consuming food or water that has been contaminated, or coming into contact with surfaces or objects that have come into contact with an infected person (e.g., doorknobs, computer keyboards).
Food handlers and caregivers who take care of the patients are usually very common vectors of transmission. Moreover, the bacteria can be found in a person’s stool and can be shed for up to two weeks after the person has a Shigella infection has fully resolved (meaning they are no longer symptomatic).
Diarrhoea caused by Shigellosis presents as either severe diarrhoea (watery or bloody), fever, abdominal cramps, and urgent and/or frequent need to pass faeces. Symptoms usually start 1-3 days after exposure and last up to 7 days in duration; most patients recover without antibiotics. However, those with severe or prolonged illness (especially due to infection by an antibiotic-resistant strain) may require specific therapies.
Preventive measures
Here are preventive measures you can take to protect yourself:
1. Before eating, after using the restroom, and after changing diapers, one should thoroughly wash their hands using soap and warm running water.
2. One should practice safe food and water handling by drinking only treated/bottled water, washing fresh fruits and vegetables thoroughly before consuming them, and cooking food thoroughly.
3. It is essential to maintain a clean and sanitary environment in places where children and caregivers gather. This includes frequent cleaning and disinfecting surfaces and equipment that are used by children and caregivers.
4. Avoidance of swallowing recreational water, like that in untreated ponds or lakes.
5. Post‑infection precautions, including staying home from school, work, or food service roles until cleared by local health guidance, and avoiding sexual contact for at least two weeks after diarrhoea resolves to reduce spread.
