Treatment of lamblia in children

Giardiasis is an infectious disease that belongs to the group of invasive pathologies. The causative agent is parasitic unicellular lamblia from the flagellate genus. It is diagnosed during routine preventive examinations. Treatment of lamblia in children is carried out in several stages.

Pathogenesis of the disease

The Giardia organism consists of one cell, 4 pairs of long flagella for movement, a suction cup, with the help of which it is captured and held in the host's body. The shape of the cell is pear-shaped. The external environment is considered to be unfavorable conditions for life. The cell organism is transformed into cysts - dense immobile bodies covered with a protective membrane. The coating helps them survive under the influence of sunlight, high and low air temperatures. After excretion from the intestines with feces, they remain viable and are pathogenically dangerous for 3 months.

Entering the human body through the mouth, they are absorbed into the mucous membrane. Being in the intestine, lamblia shed their dense protective membranes and pass into the active stage of reproduction. The life cycles of the lamblia organism have 2 phases: immobile, or cystic, mobile (vegetative) in the host's body. For every 10 hours, their number doubles. Numbers reach up to a million organisms per 1 cm² of intestine.

The main habitats are reservoirs with stagnant waters, sewers, animal feces. Infection occurs through contact with these media. The disease develops in adults and children, but the child's body is more susceptible to infection. The organism of lamblia is localized in the upper parts of the small intestine.

The mechanism of development of the disease consists in the destruction of the natural microflora of the intestines of humans and animals. Nutrients for the functioning of lamblia are obtained from the intestinal mucosa. As a result, the body does not receive the necessary trace elements, minerals, vitamins and amino acids formed during metabolic processes. A violation of the general metabolism develops, characteristic symptoms appear.

For children, the process is dangerous by the destruction of the normal microflora of the intestinal tract, which leads to dysbiosis, vitamin deficiency, and decreased immunity. The child becomes susceptible to infectious and viral diseases, often gets sick.

Giardiasis infection

Giardia enter the child's body while resting near lakes, rivers, in sandpits through grains of sand with cysts. There are several ways of infection:

1. Contact and household - upon contact with the surface on which the parasite lives. Habitat: toys, dishes, towels, doorknobs, railings. By touching an infected object, hands become a habitat for parasites. They enter the gastrointestinal tract when eating food without preliminary hygienic treatment of hands. Children become infected faster by placing toys in the oral cavity, from where cysts spread to subsequent departments.
2. Water - through the aquatic habitats of the parasite. It enters the child's body during accidental swallowing of a large amount of water while swimming in a pond. Drinking untreated water from water pipes is a risk factor. Poorly treated tap water may contain trapped Giardia eggs. They are destroyed after boiling.
3. Food - through contaminated food. In the immobile stage of life, cysts fall on the surface of vegetables and fruits. They penetrate into the host's body when eating poorly washed fruits. For complete destruction, vegetables and fruits should be washed with boiled water. They are stored in the carcass of infected livestock after slaughter if the meat has not been properly heat treated.
4. Insects and animals. Pets can carry eggs on the coat. On contact with an animal without proper subsequent handling of the hands, Giardia enters the child's mouth. Flies carry cysts on their paws, from where they then get onto food.

Rapid growth and reproduction occurs with a diet rich in glucose and carbohydrates. Their vital activity slows down if the diet is enriched with protein and plant foods.

Clinical manifestations

Giardiasis occurs in 2 forms: acute and chronic. Asymptomatic disease is rare. Manifestations are associated with metabolic disorders, intestinal dysbiosis. Intoxication of the body develops.

The initial stage of the disease is characterized by an acute form of the course. Symptoms of malaise, weakness, fatigue, headache appear. Due to the general intoxication manifestations, it is difficult to make an accurate diagnosis. The increase in body temperature persists for a long time at the level of subfebrile digits 37 C. At the same time, there are no other signs of an infectious or viral process.

Dyspeptic syndrome is the main symptom that allows the doctor to suspect a parasitic infection. The child complains of nausea, vomiting rarely occurs. A one-time vomiting is regarded as poisoning or an eating disorder and does not cause a visit to a doctor. Stool disturbance in the form of diarrhea with impurities of foam, undigested food particles joins. The stage is accompanied by painful sensations in the abdomen.

The main symptoms are:

• flatulence, not associated with excessive use of gas-forming products;
• strong peristalsis, rumbling in the abdomen, regardless of the time of eating;
• lymphadenopathy - an increase in peripheral lymph nodes due to the inflammatory process;
• hyperthermia;
• plaque on the tongue;
• bad breath;
• stool change.

Lack of timely therapy leads to the development of vitamin deficiency, all types of anemia, including iron deficiency. This is due to metabolic disruptions as a result of a violation of the intestinal microflora.

Differential diagnosis is more difficult to diagnose the chronic stage. Giardial lesion spreads to internal organs and systems, symptoms of metabolic disorders appear:

• pale skin;
• sores in the corners of the mouth;
• dryness and flaking of the skin;
• bruising under the eyes;
• poor appetite;
• rash on the skin of an allergic type, accompanied by itching;
• insomnia.

The deterioration of the state is manifested by a change in the psychoemotional state of the child, accompanied by a deterioration in mood. Apathy and lack of interest is replaced by sharp tearfulness, turns into a breakdown.

The severe stage of vitamin deficiency and metabolic disorders leads to a delay in the growth and development of the child. Due to a decrease in the activity of the immune system, children are more susceptible to respiratory viral diseases, influenza, infections and viruses. Other diseases join: bronchial asthma, chronic bronchitis, dermatitis.

Diagnosis

The disease is similar in symptoms to many other diagnoses. Due to the general intoxication symptoms, a careful differential diagnosis is required. Giardiasis is mistaken for food poisoning, intestinal infection, viral disease, allergic reaction.

Giardiasis must be recognized in the early stages of the disease. In its acute form, the pathogen is only absorbed into the mucous membrane, and begins to actively multiply only in the intestine. The body is not poisoned by toxins and waste products of parasites, other organs and systems are not affected.

Investigations for suspected parasitic infection include laboratory analyzes of the biological environment of the body and instrumental examination methods:

1. Analysis of feces for a coprogram - the study of the composition of feces for the presence of parasitic organisms of all types. Giardia is not always found in feces, therefore, it will be necessary to donate feces for research several times within 2-3 weeks.
2. Serological blood test - the study of the chemical composition of the blood for the presence of antibodies to lamblia. Determination is possible only in the early stages of the disease.
3. Duodenal intubation to study the composition of bile for the presence of cysts. In childhood, the examination is difficult due to the capriciousness of the child.

To differentiate from other diseases of the gastrointestinal tract, additional ultrasound scans of the stomach, gallbladder, and intestines are prescribed. This is necessary to exclude organ pathology.

Video - Giardia and giardiasis

Treatment stages

The therapy plan consists of several stages. Antiparasitic drugs are used to treat the disease.

1. The first stage is preparatory. The duration depends on the severity of the symptoms and the severity of the intoxication. Average duration is from 2 weeks to 1 month. The preparation of the body consists in increasing its protective properties, activating immunity, improving the functioning of the gastrointestinal tract, reducing the manifestations of poisoning the body with toxins. Together, these factors restore the functions of the body, which is an unfavorable environment for the life of lamblia. For this purpose, the patient is prescribed a special diet enriched with vitamins and limited carbohydrates. To improve the function of the digestive tract, enzymatic preparations, sorbents are taken: Smecta, Polysorb. To activate the production of bile - antispasmodics No-Shpa, Drotaverin and choleretic drugs Allohol, Mannitol.
2. The antiparasitic or medication stage involves the use of medication. The course is made up of drugs Metronidazole, Tinidazole, Furazolidone, Mepacrine, Nemozole. After the start of therapy, a deterioration in the patient's condition is observed due to intoxication with the decay products of parasites. To improve the patient's well-being, antihistamines, detoxification solutions intravenously (drip) are added to the main therapy. Laxatives are used to remove dead lamblia from the intestines.
3. Recovery, or immunostimulating stage. This stage is aimed at normalizing the functions of all systems and organs, returning the patient to the usual way of life. It consists in dietary nutrition, increased intestinal motility, enrichment with vitamins. To remove toxins, it is recommended to consume mineral waters daily.

The child's body is more difficult to tolerate infection with parasitic unicellular organisms. The medical stage of treatment is longer than in adults. If pain in the abdominal cavity appears, accompanied by a deterioration in the child's condition, therapy should not be stopped. After the critical moment, remission follows.

Antiparasitic drugs

The average duration of the drug stage of treatment is 20 days. The course consists of 3 main groups of drugs: antiparasitic, choleretic, antispasmodics. The first 10 days are taken antispasmodic drugs No-Shpa, Drotaverin, Flamina. Adults - 2-3 tablets per day, the child's dose is calculated by the doctor, based on the child's body weight.

The appointment of treatment by an infectious doctor occurs after receiving the results of the analysis for the coprogram. The study of feces allows you to determine the approximate number of multiplying parasites. The choice of the drug depends on the stage of the disease, the degree of damage to the internal organs.

Antiparasitic drugs for children should have the following properties:

• high activity;
• security;
• the minimum number of side effects;
• good tolerance.

Table. Basic drugs

Name	Image	Description and reception
Metronidazole or Trichopolum	Trichopolus	High activity, penetrates into tissues and biological environment of the infected organism. Has a toxic effect on anaerobic forms of parasites, destroys the structure of their DNA cells. Available in tablet form and solutions for injection. Absorbed into the blood 3 hours after ingestion and intestines, excreted from the body after 9 hours. Disadvantages: many side effects, causes addiction of parasites to the chemical composition
Nemozole or Albendazole	Albendazole	Benzimidazole tablets, often used to treat children. Appointed children over 2 years old at the rate of 10 mg of the drug per 1 kg of child's weight, course - 5 days. During the minimum time giardia is destroyed. Side effects are minimal: allergic reactions due to individual intolerance components, nausea
Nifuratel or Macmiror	McMiror	A broad spectrum agent from the group Tiberal or Ornidazole Decaris Tinidazole Furazolidone nitrofurans. Depressing vital activity parasites, fungi, bacteria. Allowed for children with 2 months at the rate of 15 mg per 1 kg of the child's weight, course - 2 tablets per day for 7 days. After absorption of active ingredients destroy pathogenic microorganisms and are quickly eliminated kidneys through urine. Side effects are reduced to minimum: nausea, vomiting, skin rash
Tiberal or Ornidazole	Ornidazole	The drug of the nitromidazole group with high an indicator of efficiency. Mechanism of action consists in oppression of the genetic structure DNA of the parasite, which leads to complete death. It is prescribed at the rate of 30 mg per 1 kg of weight for children up to 35 kg, 1.5 g per 1 kg of body weight for children over 35 kg. Taking one tablet one time at bedtime
Dekaris and Vermox	Decaris	Antiparasitic drug, paralyzing lamblia. After the death of microorganisms excreted in the feces. Appointed once after food. Vermox is an anthelmintic drug, influencing the cysts of lamblia. The active component of the tablets interferes with parasites are the process of glucose absorption, which leads to their death
Tinidazole	Tinidazole	Antiprotozoal agent, applies only from 12 years old at 50 mg per 1 kg of body weight once
Furazolidone	Furazolidone	Nitrofuran antibacterial drug row. The course consists of a weekly intake of 10 mg n a1 kg of weight 4 times a day

Throughout the course of therapy, medications are replaced, the first to be used are broad-spectrum pills. Ornidazole or Nifuratel, then Albendazole or Tinidazole. The need for a third course is determined by the doctor.

Video - Symptoms and treatment of giardiasis

Folk breeding methods

Alternative medicine recipes are aimed at destroying pathogenic microorganisms and parasites with the help of medicinal plants. Decoctions from one plant or collection from several are used.

On a note! It is allowed as an adjunct, combined with the main treatment after consulting a doctor.

Recipes:

1. Infusion of birch leaves: 2 tbsp. Pour 2 cups of water over tablespoons of dry leaves, boil. Take 4 times daily before meals.
2. Collection of flowers of tansy, immortelle and St. John's wort: 1 tbsp. a spoonful of collecting raw materials for 2 cups of boiling water, leave for 30 minutes, drink half of the resulting portion within 2 weeks.
3. Dandelion root: pour 2 tbsp. spoons of 0.5 liters of water, use for 10 days.
4. A mixture of St. John's wort, oregano and corn stigmas: 1 teaspoon each dried St. John's wort and oregano, 2 tbsp. pour spoons of stigmas with 1.5 cups of boiling water, leave for 2 hours; take 3 times daily before meals.

To increase the child's immunity at the recovery stage of treatment, they give ready-made herbal tinctures of Echinacea, Eleutherococcus.

Video - How to treat giardia in an adult and a child

Diet and prevention

A properly structured diet is one of the foundations of the correct therapy for giardiasis in children. It is required to eat food enriched with protein and pectin. This nutrient helps to inhibit the growth of lamblia. The abundance of carbohydrates creates favorable conditions for the life and reproduction of parasites.

Dairy, fermented milk drinks, light carbohydrates, sweets are prohibited. Alkaline mineral waters, fresh juices, poultry meat are recommended. Vegetables and fruits should make up the majority of your diet. They are necessary for good intestinal motility, enrichment of a depleted body with vitamins.

Prevention of giardiasis consists in observing personal and household hygiene products. It is necessary to monitor the cleanliness of the child's hands, properly handle food, use boiled water.

Attention! Delaying seeking medical attention is life-threatening. Complications of giardiasis are inflammation of the gastrointestinal mucosa, allergic dermatitis, metabolic disorders.