What supportive care measures should be implemented for patients with dysentery to prevent complications such as dehydration?

Supportive care measures for patients with dysentery to prevent dehydration include:

• Encourage fluid intake: Patients should be encouraged to drink plenty of fluids to prevent dehydration, avoiding fruit juices and carbonated drinks which can worsen diarrhoea.
• Use oral rehydration solutions (ORS): Administer low-osmolarity ORS frequently and in small amounts to replace fluid losses, especially in those at increased risk of dehydration.
• Continue usual feeds: For children, continue breastfeeding or other milk feeds during rehydration and after rehydration, reintroducing usual solid foods once tolerated.
• Monitor for signs of dehydration: Watch for symptoms such as irritability, lethargy, decreased urine output, pale or mottled skin, and cold extremities, and seek medical help if these develop.
• Use intravenous fluids if necessary: In cases of clinical dehydration, shock, or persistent vomiting, intravenous isotonic fluids (e.g., 0.9% sodium chloride with or without 5% glucose) should be administered carefully with expert advice, monitoring electrolytes and clinical response.
• Provide safety netting advice: Inform patients or carers about red flag symptoms and when to seek urgent medical care.

These measures aim to maintain hydration, prevent complications, and support recovery in dysentery patients.

All recommendations are based on the NICE guideline CG84 on diarrhoea and vomiting caused by gastroenteritis in children under 5, which is applicable to supportive care principles in dysentery to prevent dehydration. ¹