Giardia: what is it, how it manifests itself and how to treat it

Giardia (international name - Giardia, giardia) is one of the most numerous groups of the simplest eukaryotes (protists). Giardia belongs to the order of diplomonads and have a doubled set of organelles - components of the cellular cytoplasm necessary for the life of the protist. Giardia are parasitic diplomonads, that is, they can live and reproduce only in humans, warm-blooded mammals or birds. Infection with lamblia leads to acute inflammation of the mucous membranes of the small intestine, the main symptoms of which in adults and children are diarrhea, general (systemic) intoxication, as well as skin rashes. In most cases, chronic lamblia invasion occurs against the background of normal body temperature.

Giardia - what is it?

Intestinal lamblia (Giardia lamblia) are the simplest parasitic organisms that enter the human body mainly through the fecal-oral route with food and through dirty hands. They parasitize in the small intestine - the proximal (initial) part of the intestine, in which nutrients and vitamins are absorbed. Once in the small intestine, giardia begin to multiply actively. When creating favorable conditions for this (high content of carbohydrates in the diet), the reproduction process can proceed very quickly: in this case, the symptoms of giardiasis will be the most pronounced, since, sticking to the walls of the intestine with paired flagella, lamblia irritate the nerve receptors, which are contained in large quantities in the mucous membranes shells.

Intestinal lamblia can exist in two forms: mobile and motionless.

Forms of Giardia lamblia

The form	Mobility	Description
Vegetative	Movable	Parasitizes in the small intestine, causing irritation of the mucous membranes and typical symptoms of giardiasis. They have 8 paired flagella and a ventral disc, with which the vegetative lamblia attaches to the intestinal wall.
Cyst	Stationary	This is a temporary (intermediate) form of the protists' existence. Giardia cysts are formed when mobile parasites enter the large intestine, where conditions for their life are unfavorable. The fixed form differs from the vegetative one by the presence of a protective shell.

Note! Giardia leaves the human body together with feces in the form of cysts, which are able to maintain their vital activity for up to 3 weeks (in waste and sewage waters - up to 5 weeks).

Ways and methods of infection

The main route of infection with intestinal lamblia is fecal-oral. In the external environment, parasites can live in the intestines of cattle (for example, cows), domestic animals, birds, and rodents. Giardia cysts secreted with feces can get on the surface of vegetables and herbs, therefore, before cooking and eating any fruit and vegetable products, it must be thoroughly washed with boiled water (if possible, with household or antibacterial soap).

The main causes of infection with lamblia in adults and children:

• eating meat from infected animals;
• insufficient food processing of meat products (in the group of maximum risk for the development of giardiasis includes lovers of steaks and steaks with blood, as well as dishes of raw fish and seafood, for example, sushi);
  

  Meat that has not undergone high-quality heat treatment can be a source of infection with lamblia and other parasites

• non-observance of the rules of personal hygiene (in children, giardiasis, like other parasitic infections, is considered a "disease of dirty hands");
• eating unwashed greens, vegetables and fruits;
• contact with pets that are carriers of giardia.
  

  Giardia is easily spread by contact with pets

If the family has pets, deworming must be carried out at least 2 times a year, even if the animal does not go outside.

Important! Many owners of their own summer cottages believe that it is permissible to consume vegetables and herbs directly from the garden. The main argument for the safety of such behavior is the absence of chemicals during cultivation. This is a misconception, since on the surface of vegetables there can be cysts of intestinal lamblia and other parasites, and the use of such products without hygienic processing can cause giardiasis and other parasitic intestinal infections.

How to understand that a person is infected with lamblia?

Symptoms of giardiasis usually have mild clinical manifestations, and the disease itself is detected accidentally or several months after infection (chronic giardiasis). Giardia infection is especially common in the younger age group, which includes children from 1 to 4-5 years old. The main reason for the high prevalence of giardiasis in patients of this age category is non-compliance (or insufficient skills) of personal hygiene, therefore an important task of the comprehensive prevention of parasitic infections for parents is the timely teaching of children the basics of personal hygiene and hygiene of the environment space.

In most cases, the symptoms of giardiasis in children are erased and are manifested not by intestinal disorders, but manifestations of systemic intoxication, developing against the background of the death of parasites and the release of dangerous toxins. These can be headaches, weakness, drowsiness. Children of school age often experience increased fatigue, irritability, problems with appetite, and poor sleep. Often, against the background of chronic intoxication caused by long-term giardiasis, there are attacks of causeless aggression and anxiety, therefore, behavioral changes, combined with sleep and appetite disorders, are a reason for seeking medical help.

This pathology does not have typical symptoms, and its manifestations can be perceived as signs of gastritis, colitis, gastroenteritis and other inflammatory pathologies of the digestive tract. The most common symptoms of a Giardia infection include:

• upset stool. Giardiasis is characterized by alternation of constipation with sudden diarrhea, lasting about 2-3 days. At the same time, feces have a bright yellow color, a pungent odor and may contain a moderate amount of mucus;
  

  The most common symptoms of giardiasis include stool disorder.

• umbilical pain. The pain can be dull, sharp, dagger-like, or cutting. About 50% complain of cramping pains in the upper abdomen in the navel (the location of the small intestine);
  

  Sharp cramping abdominal pains may also indicate the presence of parasites in the intestines.

• flatulence. Almost 80% of patients (regardless of age) complain of increased gas production, bloating in the abdomen, a feeling of painful bloating and heaviness. Flatulence is almost always accompanied by flatulence - the discharge of intestinal gas in large volumes;
  

  A feeling of fullness in the abdomen, heaviness, increased gas production are the most common manifestations of giardiasis

• rumbling and bubbling in the stomach. These signs can occur immediately after a meal or between meals;
  

  Seething and loud rumbling in the stomach can also be signs of parasitic diseases.

• nausea. Nausea with giardiasis can appear at any time of the day and is usually accompanied by a lack of appetite;
  

  Another unpleasant manifestation of giardiasis is severe attacks of nausea.

• skin rashes. This is one of the main signs of giardiasis in people of any age. The patient may develop multiple acne, milia, boils, acne. Often, against the background of infection, inflammatory skin diseases (dermatitis) occur.
  

  Skin rashes with giardiasis can appear on the face, neck, abdomen and other parts of the body.

Body temperature in the overwhelming majority of cases remains within normal limits. Children with weakened immunity, as well as patients with any chronic diseases, may experience a slight increase in temperature (up to 37.2 ° -37.4 ° C). Febrile fever, when the body temperature rises above 38 ° -38.5 ° C, occurs only against the background severe intoxication of the body with abundant release of toxic substances and a large number of parasites in intestines.

Symptoms in adults

Adult patients tolerate giardiasis more easily than children and adolescents, and the symptoms of the pathology are usually meager and mild. The patient may complain of intermittent appetite disorder, nausea, abdominal pain of moderate intensity, bloating and heaviness. Skin problems, according to doctors, have about 40% of patients diagnosed with chronic giardiasis. When infested with lamblia, the skin has increased pallor, an unhealthy grayish tint, and red flaky spots may appear on its surface. Giardiasis is often accompanied by itching.

One of the typical symptoms of giardiasis in adults is unreasonable weight loss. This is due to the fact that giardia feed on digested food, so a person does not receive enough nutrients and energy.

Note! If a person did not change the diet and did not increase the level of physical activity, but his weight began to decrease at the same time, it is necessary to be tested for diabetes mellitus and intestinal parasitic infections.

How does the disease manifest in infants?

Giardia infection in infants usually occurs after three months of age, when the child is able to hold toys and other objects and often shoves them into the mouth (this behavior is a way of knowing the environment, and is necessary for the general development of the child and his tactile perception). Infected pets, a dirty pacifier or soother, insufficiently sterilized bottles, and other items that can get into your baby's mouth can also be a source of infection.

Giardiasis in infants and children of the first year of life can proceed in different ways, but the overall clinical picture usually has similar symptoms in most patients in this group. It can be:

• restless behavior during feeding (the baby releases the breast and presses the legs to the stomach), which can be mistakenly perceived as a manifestation of lactase deficiency;
• frequent and profuse regurgitation (milk in this case looks like curdled particles);
• atopic dermatitis (diathesis) on the skin of the face and abdomen;
  

  Giardiasis is one of the causes of diathesis in infants

• prickly heat in the groin and armpits;
• frequent, loose stools with a foul-smelling odor and a lot of mucus;
• rumbling and bubbling in the stomach.
  

  Parasitic invasion causes the baby to seethe and loud rumbling in the abdomen, often accompanied by painful sensations

Important! Impaired absorption of vitamins, micro- and macronutrients, as well as essential nutrients in the small intestine leads to the fact that the child does not receive a sufficient amount necessary for full growth and development substances. If the baby has a lag in anthropometric, physical or intellectual indicators, it is necessary to pass feces and urine tests and find out the possible causes.

Examinations and analyzes

The simplest and most informative way to diagnose giardiasis and other parasitic intestinal infections is a biochemical study of feces (coprogram). If the analysis did not show the presence of parasites, an additional serological blood test is prescribed, which allows the detection of specific antibodies 2 weeks after infection.

As methods of auxiliary diagnostics, they can use:

• gastroduodenoscopy;
• study of duodenal contents;
• Ultrasound of the abdominal organs.

Important! Intestinal lamblia can multiply not only in the intestine, but also in the gallbladder, therefore, complex diagnostics may include a study of the motor and evacuation function of the biliary tract. When the bile ducts are occluded by lamblia, the patient will have dyskinesia of the ducts (obstruction, leading to stagnation of bile).

Basic and corrective therapy

A one-stage treatment regimen with antiparasitic drugs is used only in the case of an acute course of pathology and severe intoxication, accompanied by profuse diarrhea, vomiting, and dehydration. Drugs for the treatment of acute giardiasis, as well as their dosage and duration of use, are shown in the table below.

Drug treatment of giardiasis

Drug name	How to use	Duration of treatment
"Metronidazole"	500 mg intravenously at 5 ml / min intervals every 8 hours. On the third day, the patient is transferred to oral dosage forms at a dosage of 500 mg 2-3 times a day.	10 days.
"Furazolidone"	100-150 mg 4 times a day after meals.	5-10 days.
"Tinidazole"	2 g once a day, once.	1 day (if ineffective, it is possible to repeat the treatment after 7-10 days).
Albendazole	400 mg once a day.	5-7 days.

If the patient is diagnosed with chronic invasion by lamblia, the treatment is carried out in several stages and includes not only medical methods, but also adherence to a special sparing diet. The total duration of treatment can be 4 to 8 weeks.

First step

It is necessary to start treatment of chronic giardiasis by taking measures to detoxify, improve the enzymatic activity of the intestines, and increase the body's defenses. Correction of the immunological status is of great importance for the prevention of relapses and the prevention of re-infection.

Drug treatment at this stage includes the following drugs:

• enterosorbents for removing toxins (Polyphepan, Polysorb, Enterosgel);
• digestive enzymes (Festal, Creon, Mezim);
• antihistamines (Suprastin, Loratadin);
• choleretic drugs to prevent stagnation of bile ("Holosas", "Allochol").
  

  Instructions for the use of allochol

Treatment should be combined with a low-carbohydrate diet that limits the intake of simple carbohydrates as food for giardia as much as possible. The patient's diet should have enough vegetables (stewed or steamed), and also sources of complex carbohydrates (cereals, muesli, dried fruits, durum pasta wheat). It is useful to regularly consume vegetable oil, as it facilitates the elimination of parasites from the intestines.

The duration of the first stage is up to 14 days.

Second phase

At the second stage, basic antiparasitic treatment is carried out with the drugs listed in the table above. According to the indications, the continuation of the intake of blockers of H2-histamine receptors (antihistamines) and sorbents may be prescribed.

Stage Three

This stage is aimed at strengthening immunity and eliminating the consequences of prolonged intoxication. From medications at this stage of corrective therapy, the following can be used:

• means for the normalization of intestinal microflora ("Bifidumbacterin", "Bifiform", "Normobact");
• digestive enzymes (Mezim, Festal);
• multivitamin complexes and vitamin and mineral supplements;
• plant adaptogens (ginseng root extract, rhodiola rosea extract, etc.).

The patient must follow a diet with a sufficient content of vegetable fiber and fermented milk products. It is useful to include chopped boiled meat, fruit and vegetable purees, kefir, freshly squeezed juices, cottage cheese in the menu.

The duration of the third stage is up to 2-3 weeks.

Note! It is necessary to take multivitamin complexes to improve the immune status only after biochemical blood test, since an overdose of certain vitamins can adversely affect to health.

Treatment with folk methods

Herbalists offer several proven and safe home remedies for giardiasis.

Cranberry juice

This is the easiest and most effective way to combat giardia without the use of medication. Cranberries and cranberry juice are recommended to be included in the menu every day, and for intensive care, freshly squeezed cranberry juice should be consumed 30-40 ml 4 times a day 1-2 hours before meals. Some suggest mixing the juice with honey, but this is not worth doing, since any carbohydrates are nutritious material for lamblia. Cranberry juice can be replaced with lingonberry juice: these berries have a similar chemical composition, so this will not affect the effectiveness of treatment. Duration of admission is 15 days.

Important! This method of treatment is not suitable for people with high acidity of the stomach and duodenum.

Sauerkraut juice

The juice that sauerkraut secretes is not only a delicious dressing for vegetable salads, but also an excellent way to destroy parasites in the intestines. To cure giardiasis at home, you must:

• mix cabbage juice with potato juice in a 1: 1 ratio (only cabbage juice can be used);
• take half a glass 3 times a day between meals;
• the duration of treatment is 2-3 weeks.

Wormwood tincture

Bitter wormwood is one of the five most effective remedies for combating intestinal parasites. You need to take it as follows:

• Dilute 10 drops of alcoholic tincture of wormwood in a glass of water;
• drink the remedy one hour after eating;
• repeat 2-3 times during the day.

Note! Bitter wormwood is considered a rather toxic plant, therefore, it is not recommended to exceed the indicated dosage regimen in order to avoid toxic and allergic reactions.

A little about prevention

Prevention of giardiasis includes adherence to the rules of personal hygiene, proper preparation of products before preparation, as well as the timely identification and treatment of patients with signs of invasion (including their isolation from healthy people). In children, prevention is aimed at teaching the skills of hygienic care for the skin of the hands and body and monitoring their observance.

• Giardia cysts die within 10 minutes when heated to 70 ° C, therefore it is important to ensure sufficient heat treatment of potentially hazardous products (meat and fish).
  

  Fish and meat can only be eaten after high-quality heat treatment

• When boiled, the parasites are killed immediately.
• Freezing reduces the viability of lamblia, but does not completely kill them. The optimum temperature for freezing food for the prevention of giardiasis is -14 ° C (and below).
• Air drying leads to the death of lamblia within 20-24 hours.
  

  When drying clothes in the fresh air, parasites die within 24 hours

Standard disinfection methods (such as ultraviolet irradiation and chlorination) are not sufficient to kill Giardia. For example, parasite cysts are quite often detected in chlorinated water, so boiling is the best method for preventing giardiasis.

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