Giardiasis: Symptoms, Treatment, and Diagnosis
Jun 20, 2018
Giardiasis is a parasitic disease, the causative agent of which is the unicellular parasite lamblia intestinal.In the human body, it lives in the small intestine( it is the vegetative form of the parasite), in the thick, because of unsuitable conditions, it turns into a cyst and is subsequently removed from the feces into the external environment, where it expects a "meeting" with the new owner.
Infection of a person with Giardia can not be clinically manifested.Therefore many people, not guessing, carry in themselves this parasite.Thus, according to the WHO, 10-20% of the world's population is invaded by Giardia.The number of infected is much higher in developing states( in some of them about 35% of the population suffer from giardiasis).Russia and Ukraine, alas, also have high rates of giardiasis.Table of contents: How can I become infected with Giardiasis?What happens after infection?Giardiasis: symptoms Giardiasis in children Diagnosis Treatment principles for Giardiasis Prevention
How can I become infected with Giardiasis?
Sources of lamblia( mature cysts) are sick people and carriers, as well as some mammals( eg dogs)."Grab" lambliasis can be, drinking dirty water, eating unwashed vegetables and fruits, without washing your hands before eating, after contacting a sick person or animal.That is, this disease by the mechanism and pathways of infection is very similar to intestinal infections.
What happens after infection?
For infection, it is enough to swallow several dozen cysts( the sick person allocates them in a million for a day, so you can imagine what the probability of contamination of others is if they do not follow the rules of personal hygiene).After entering the small intestine, each cyst is divided into two halves, of which two lamblia are formed, which also begin to multiply actively.
Further development of parasitic infestation can go according to two scenarios:
- A person will become an asymptomatic carrier.
- Symptoms will appear.
The probability of developing a clinical lambliasis is affected by a number of factors:
- the state of human immunity;
- presence of problems with the secretion of bile( if it is not enough in the small intestine, lamblia will be easier to settle down in the body);
- gastric acidity( low acidity promotes high lamblia activity and giardiasis manifestation).
In the case of carriage, cleansing of the intestine from the parasite can go away spontaneously, without any treatment.The only condition is that self-infection should not occur, that is, a person must carefully observe the rules of personal hygiene.
If lamblias have got accustomed and actively multiply, the first thing that happens in the intestine is a violation of parietal digestion, which results in various intestinal disorders and signs of a lack of certain substances in the body.In addition, lamblia can influence intestinal peristalsis by irritating nerve endings.This causes painful spasms in the abdomen.
In people prone to allergies, the products released by parasites in the process of vital activity sensitize the body, so patients develop various allergic reactions.These same products also poison a person, causing the appearance of symptoms of intoxication.
Separately it is necessary to consider the relationship of giardiasis and pathologies of the hepatobiliary system.Quite often the network can be found information that lamblia live in the gallbladder and can cause it to clog and inflame.In fact, lamblia on the liver and bile ducts do not affect and do not live in bile.On the contrary, dysfunction of the biliary tract, accompanied by a decrease in the secretion of bile in the intestines, promotes the active life of lamblia.
Clinical manifestations of Giardiasis are manifold.They can all be grouped into three syndromes:
- Syndrome of intoxication and lesions of the nervous system.
Gastrointestinal syndrome is manifested by the following symptoms:
- Unstable stool( loose stools several times a day, diarrhea is usually lingering).
- A meteorism.
- Pain in the abdomen.
Allergic syndrome is characterized by rash appearance on the skin( as atopic dermatitis, urticaria) and various pathological conditions on the part of the respiratory tract( bronchial obstruction, etc.).
The syndrome of intoxication and lesions of the nervous system can be recognized by the following symptoms:
- Subfebrile condition.
- Sleep disturbance.
- Decreased performance.
- Grinding of teeth( bruxism), which occurs with prolonged intoxication.
Giardiasis in children
In children's groups, according to various authors, about 30% of children are infected with Giardia.Such high rates are due to close contact and poor compliance with hygiene rules.
Clinically, giardiasis in childhood is also manifested by intestinal disorders, allergic skin and respiratory reactions.In addition, toddlers in comparison with adults are much more likely to develop signs of intoxication, symptoms of polyhypovitaminosis and almost always develop protein-energy deficiency.That is, patients with giardiasis poorly gain weight and even lose it, are characterized by pallor of the skin, increased irritation, weakness, lethargy and the rapid occurrence of fatigue.In addition, they often have bruxism( gnashing their teeth at night).
Doctors recommend to undergo laminar analysis if the following indications are given:
- Chronic diseases of the gastrointestinal tract.
- A persistent increase in the blood of eosinophils( this is also one of the manifestations of an allergic syndrome).
- Combinations of neurocirculatory dystonia and intestinal disorders.
For the diagnosis of Giardiasis, two methods are used:
- Coprological examination( examination of feces under a microscope).To make this study more informative, doctors use various provocative techniques, for example, prescribe to the patients choleretic medicinal or plant remedies that provoke the release of bile into the intestine.Thus, an unfavorable environment for lamblia is created, so they quickly turn into cysts and are excreted.
- Serological blood tests( detection of specific immunoglobulins).
For more accurate diagnosis it is necessary to perform both these studies, since cysts are not always excreted with feces, and immunoglobulins are not detected in all patients.
Principles of treatment of GiardiasisWe recommend to read:
Treatment of Giardiasis is a long process.At the first stage of treatment activities( preparatory), patients need:
- Carefully observe personal hygiene( so that no self-infection occurs).
- Adhere to a diet aimed at creating in the intestines unfavorable for lamblia conditions.To do this, restrict carbohydrates, completely exclude dairy products, necessarily introduce into the diet vegetable oil, bran, baked apples, dried fruits, acidifying drinks( cranberry and cranberry fruit).
- Take prescribed medicines: antispasmodics, preparations for cleansing the intestines and biliary system, enzymes, antihistamines, complex preparations of B vitamins, etc.
The second stage of is etiotropic therapy aimed at eradicating the parasite.Various drugs are used - McMiore, Ornidazole, Nemosol, etc.
At the third stage of ( rehabilitation), measures are taken to restore normal microflora, strengthen local immune defenses of the intestine and the whole organism as a whole.Prebiotics, probiotics, enzyme preparations, plant adaptogens, multivitamin complexes are used.At this stage, a diet is also important.Patients are advised to eat lean meat, sour-milk products, cranberries, cranberries, cereals, dried fruits, but digestible carbohydrates should be further limited( sugar, most sweets and pastries are included).
Since cysts of lamblia are allocated by patients and carriers with feces, all preventive measures in the home, in children's institutions, in food enterprises should be aimed at ensuring that food, water, household items are not contaminated by feces, and on the tableGot what can contain cysts of the pathogen( dirty vegetables, fruits, etc.).In addition, you need to monitor your personal hygiene - thoroughly wash your hands after the toilet, after the street, before preparing food and before eating it.
Zubkova Olga Sergeevna, medical reviewer, epidemiologist-doctor