21.05.2021 – 13:02
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Patients: Lambliaza (dangerous intestinal infection), how it is treated
Doctor: Lambliaza is a small bowel infection caused by the parasite, Giardia intestinalis, or otherwise known as Giardia lamblia, is the most common cause of parasitic gastrointestinal syndromes, which in statistical figures represents a prevalence of about 20% to 30% in the world population .
Giardia lamblia exists in two forms, the active form otherwise called trophozoite and the inactive one, called the cystic form. These 2 biological forms of the parasite dynamically generate each other, thus providing the symptomatology of the disease (it is precisely the active trophozoite that damages the enterocytes of the small intestine, thus becoming responsible for the signs and symptoms of the disease) and transmission or spread of infection (it is the inactive form, the cyst which has the attribute to resist for a long time environmental conditions, but also gastric acidity after swallowing, then transformed into trophozoites). Giardia-Lamblia cysts are present in the feces of infected persons. In this way the infestation by this parasite is a consequence of contamination of food or water with feces or by direct fecal-oral route. It has been shown in fact that only 10 cysts are enough to cause infection. Cysts also survive in the waters of lakes or streams, (this makes lambliasis the most common parasitic, water-borne parasitic disease, which does not spare domestic or wild animals (although the mechanism of transmission of the disease from animals to humans eruptions of lambliasis from pool, water parks or winter pools are also known (this is more a consequence of infected people than of polluted water sources).
diagnostic
The best way to diagnose this infection is through antigen testing in the stool. What is identified with this test is the protein of Giardia lamblia and more than 90% of infected people are diagnosed by this test.
Another diagnostic tool is microscopic observation of the parasite. In order to identify all infected, this examination is repeated with three different samples from each patient. Compared to the antigen test, it requires more time and has a lower detection rate. But microscopic observation has its advantages as it allows us to identify pathogens other than lamblias, which have caused diarrheal syndromes in certain patients.
treatment
The most widely used treatment to date for giardiasis is imetronidazole (Flagyl) for 5-10 days. It has a good efficacy, about 75% to 100%, but is usually associated with significant side effects such as nausea, epigastric pain and headaches.
Currently metronidazole along with two other drugs, Tinidazole and Quinacrine are also drugs approved by the FDA (Food and Drug Administration) for the treatment of Lambliasis.
Occurs in some cases, treatment with each of these preparations, fails to eradicate this parasite. In such cases, the preparation may be modified, used for a longer period of time or combined with another preparation (eg quinacrine and metronidazole).
prevention
• The first step starts with controlling the water consumed. Drinking water is considered as such when it has been subjected to careful testing by the relevant instances.
• If there is no safety of drinking water testing then boiling and then filtering must be applied.
• Avoid exposure behaviors (use of ice from untreated water, brushing teeth, brushing fruits and vegetables)
• Careful hand washing (before eating, after using the toilet, changing diapers or touching pets) also remains the best, safest preventative measure.
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