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Giardiasis

Giardiasis, also called Giardia enteritis and lambliasis, is a protozoal infection of the small bowel.

Giardiasis occurs worldwide but is most common in developing countries and other areas where sanitation and hygiene are poor.

In the United States, giardiasis most frequently occurs in travelers who have recently returned from endemic areas, campers who drink nonpurified water from contaminated streams, male homosexuals, patients with congenital lgA deficiency, and children in day-care centers. Children in general are more likely to develop giardiasis than adults, probably because of frequent hand-to-mouth activity. Over the past 10 years, the parasite responsible for the disease has been found in municipal water sources, nursing homes, and day-care centers.

The prognosis is good; with treatment, the patient recovers completely. Without treatment, symptoms continue to wax and wane. Also, giardiasis doesn't confer immunity, so reinfections can occur.

Causes

The parasites live and reproduce in human or animal intestines. Once in the intestines, they attach to the inside of the intestinal wall, where they can disrupt the normal function of the intestines and compete for important nutrients. This leads to the symptoms of giardiasis.

  • Disruption of the intestinal surface can reduce the body's ability to absorb nutrients from food passing through the intestines. If not absorbed, nutrients remain in the intestinal tract, where they may contribute to the diarrhea, cramps, and gas associated with giardiasis.
  • The parasite may cause food to move more quickly through the intestines, which can contribute to diarrhea.

Symptoms and Signs

The most common symptoms include:

  • Diarrhea.
  • Abdominal cramps.
  • Nausea and loss of appetite.
  • Passing gas or bloating.
  • Fatigue.

Diagnostic tests

An accurate diagnosis depends on examination of a fresh stool specimen for cysts or examination of duodenal aspirate or biopsy for trophozoites.

Treatment

Giardiasis responds readily to metronidazole. Some patients (such as children) may instead be given furazolidone, but it isn't as effective. If the patient has severe diarrhea and oral fluid intake is inadequate, he may need parenteral fluid replacement to prevent dehydration.

Prevention
  • Wash hands with soap and water after toilet visits, after changing diapers, before preparing food or drink, and before eating.
  • Avoid water or food that might be contaminated.
  • Carefully dispose of sewage waste so as not to contaminate surface water or groundwater.
  • Practice good hygiene with diapered children in day-care centers. Wash hands thoroughly with plenty of soap and warm water after every diaper change, even if wearing gloves.
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