Giardiasis is a protozoal disease caused by lamblia (Lamblia intestinalis), which is characterized by inflammation of the wall of the small intestine and disruption of the processes of digestion and absorption.
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All about Giardia
Giardia was first discovered by Kharkov University professor D.F. Giardia in 1859 in the feces of children suffering from diarrhea. The pathogen Lamblia intestinalis is named after him. However, in foreign literature, another name for the pathogen is often used - Giardia lamblia, and the disease is called giardiasis.
Some types of Giardia parasitize the body not only of humans, but also of dogs, cats, large and small cattle, and rodents.
These protozoa exist in two forms - vegetative and in the form of cysts.
After cysts enter the human body with water or food, 2 motile trophozoites (vegetative form) are formed, which leave the cyst shell and attach to the surface of the epithelium of the small intestine. They reproduce by simple division.
Giardia lives in the small intestine , mainly in the duodenum . Due to intestinal contractions, some of the lamblia are torn off and carried into the lower intestines. Here they again turn into cysts.
When examined, cysts are found already in the initial part of the small intestine, but the largest number of them is concentrated in the cecum.
Unlike vegetative forms, cysts are resistant to the external environment. They live on household items for up to 2 weeks, and in water for up to 80 days.
Giardia cysts are often found in open water bodies near water intakes. Outbreaks of diseases associated with tap water occur in areas where the water is not well filtered and only disinfected with chlorine.
Chlorine-containing disinfectants have no effect on Giardia cysts.
The harmful effects of Giardia on the human body have been confirmed in a number of studies on volunteers.
What is giardiasis?
Giardia infection, which leads to the disease “giardiasis,” is the most widespread among all protozoan infections in Russia.
According to a number of researchers, giardiasis is the cause of the development of such chronic allergic skin lesions as
- neurodermatitis,
- eczema,
- alopecia,
- focal skin depigmentation.
How is Giardia transmitted?
The main source of infection is a person infected with Giardia. A secondary role is played by dogs, cats, cattle (especially calves), and rodents.
In the environment, Giardia cysts can remain viable for up to 120 days.
Boiling, freezing below -13⁰C and ultraviolet irradiation lead to their death. The minimum infectious dose is 10-100 cysts. The period for the release of cysts by a sick person occurs on the 9-12th day after infection. The release of cysts occurs in periods, not constantly. An infected person is most dangerous after the diarrhea has subsided. At this time, he secretes the largest number of cysts (about 1.8 million per 1 g of feces).
Children under 9 years of age are most often infected with giardiasis, boys are 2-3 times more likely.
The mechanism of transmission of Giardia is fecal-oral. The main distribution routes are:
- water,
- contact,
- food.
Infection through water
Giardia cysts remain alive in water at temperatures from 4⁰С to 20⁰С for 3 months. Sometimes outbreaks of the disease occur when drinking water from natural sources, wells, etc. Not all filters are able to purify water from cysts due to the sorbent pores being too large.
Contact and household path
This way of spreading Giardia is possible if there is a sick person in the close environment and non-compliance with hygiene rules. Children in preschool institutions are especially often infected through toys, dirty hands, furniture surfaces and toilet items.
In children who have the habit of holding their fingers in their mouths, biting their nails, pencils, pens, Giardia is detected much more often.
Food route
This path is less significant. Infection can occur through foods that are not cooked.
Flies can infect food. Live cysts can remain in their stomach for 30 hours to several days. In the intestines of cockroaches, cysts remain viable for up to 8 days.
Development of the disease
Giardia cysts enter the mouth, then the esophagus. Stomach acid does not destroy them, and they enter the duodenum. There, from each cyst, 2 vegetative forms of the parasite are formed. Giardia is attached to the surface of the mucous membrane with a suction disk and absorbs digestive products. Thus, Giardia closes the absorption surface of the small intestine and intercepts the nutrients entering it.
Part of the food coma remains undigested and enters the large intestine in this form.
All this leads to the fact that carbohydrates, proteins, fats, vitamins, minerals and trace elements do not enter the body. In addition, the synthesis of enzymes in the intestines is disrupted, which leads to intolerance to a number of foods.
Giardia causes mechanical damage to the intestinal mucosa over a large surface area. A large number of Giardia leads to irritation of the nerve endings of the intestinal wall.
Mechanical damage to the mucous membrane of the small intestine causes activation of opportunistic microflora and leads to the development of severe forms of dysbacteriosis (dysbiosis). Metabolic products secreted by Giardia and dead Giardia are absorbed into the intestines and poison the body. This is manifested by various allergic reactions.
Insufficient consumption of protein foods, a predominantly carbohydrate diet, consumption of large amounts of sucrose, low acidity of gastric juice are factors predisposing to infection with giardiasis.
Symptoms of giardiasis
The symptoms of giardiasis are varied. Severe cases of the disease with fatal outcome are unknown.
According to the WHO classification, the following forms of giardiasis are distinguished:
- giardiasis carriage (latent form),
- Giardiasis (clinically expressed form).
In turn, clinically pronounced giardiasis is of the following types:
- intestinal form (duodenal dyskinesia, duodenitis, enteritis, enterocolitis),
- hepatobiliary form (biliary dyskinesia, cholecystitis),
- Giardiasis as a concomitant disease.
The incubation period is 1-3 weeks.
In the latent form, giardiasis occurs without noticeable manifestations. This form is observed in 74-77% of infected people. In this case, malabsorption in the intestines and decreased immunity occur. But there are no obvious symptoms.
Clinically expressed form of giardiasis
Giardiasis can be acute or chronic. The acute period lasts 5-7 days. In most cases, the acute period subsides and becomes chronic.
The acute period is characterized by the following symptoms:
- watery diarrhea (3-5 times a day, stools are foamy, foul-smelling, with a characteristic oily sheen),
- abdominal pain (in the stomach area, in the right hypochondrium), not associated with food,
- nausea,
- belching,
- heartburn,
- bitterness in the mouth,
- bloating,
- loss of appetite,
- skin itching,
- fast fatiguability,
- decreased vitality.
It is no coincidence that the discoverer of Giardia, D.F. Lambl, called it “a parasite of melancholy and sadness.”
Allergic manifestations are varied:
- pale skin,
- uneven coloring of the skin (multi-colored skin),
- marble white nose skin,
- dirty skin tone
- dark circles under the eyes,
- the tongue is covered with a white coating,
- bad breath.
With a long course of the disease, giardiasis manifests itself with symptoms similar to those of the following diseases:
- duodenal dyskinesia,
- duodenitis,
- enteritis,
- enterocolitis.
Diagnostics
- The most informative method of laboratory research is the detection of vegetative forms of Giardia in the duodenal contents, which is collected during fibrogastroduodenoscopy.
- Fecal smears are examined to detect cysts.
- In the chronic form of the disease, cysts are released periodically, so to establish a diagnosis, it is recommended to examine stool 5-6 times over 2-4 weeks.
- Serological methods are optional. From the 12-14th day of the disease, it is possible to detect IgM to Giardia antigens using immunofluorescence analysis (ELISA). But this study must be confirmed by microscopic methods.
- There may be no changes in the general blood test.
- In a biochemical blood test, the content of gammaglobulins is sometimes increased or there is a tendency to decrease the content of albumin in the blood serum.
- A large amount of mucus, leukocytes and cells of the prismatic intestinal epithelium are found in the duodenal contents and feces.
- Microscopy of stool reveals steatorrhea (large amounts of fat in stool).
- Certain changes can be observed during ultrasound examination of the gallbladder, duodenum, and pancreas.
Drug treatment
Anti-giardiasis drugs have various side effects. Therefore, they should be taken only with a confirmed diagnosis and under the supervision of a doctor.
Treatment with medications is indicated only when a pathogen is detected and clinical manifestations are present.
A highly effective drug is albendazole - adults and children over 12 years old, 0.4 g orally per day; children 2-12 years old - 15 mg/kg body weight per day in one dose 1 hour before meals or 1.5 hours after meals. Course - 5-7 days.
Tinidazole is effective - for adults in a dose of 2 g orally once; children over 12 years old - 50-75 mg/kg body weight per day (no more than 2 g) once after meals. Course - 1 day.
The course of treatment with metronidazole is described in the article about this drug.
Treatment by other means
You can help the body in destroying Giardia and in recovering from the disease by such means as:
- diet,
- choleretic drugs,
- enterosorbents,
- enzyme preparations,
- vitamins,
- pro- and prebiotics.
Diet for giardiasis
The diet is aimed at creating conditions that suppress the reproduction of Giardia. An excess of carbohydrates in food consumed by humans stimulates the growth of Giardia, while the predominance of proteins somewhat inhibits it.
It is necessary to introduce into the diet products that act as sorbents:
- porridge,
- baked apples,
- pears,
- lingonberries,
- cranberries,
- dried fruits,
- vegetables,
- vegetable oil.
You should limit your intake of carbohydrates, especially sweets.
To improve intestinal motility, puree is administered:
- beetroot,
- pumpkin,
- squash,
- carrot,
- from boiled dried fruits (prunes, dried apricots).
Recommended dairy products:
- biokefir,
- bifidok,
- curdled milk,
- Ryazhenka
In addition, you should consume ripe tomatoes, berries and fruits.
Choleretic agents
The use of these drugs reduces congestion in the biliary tract and promotes faster elimination of inflammation.
Such means include:
- 5-10% magnesium sulfate solution,
- egg yolks,
- sorbitol,
- xylitol
Relaxation of the tone of the biliary tract is facilitated by:
- no-shpa,
- platifillin,
- belladonna leaf extract,
- barberry preparations,
- aminophylline.
Detoxification Products
To remove toxins from the body, use:
- lactofiltrum,
- neosmectin,
- smecta,
- enterosgel,
- reaban,
- Polysorb MP.
Remedies for dysbacteriosis
To eliminate dysbiosis and enzymatic disorders of the intestines and pancreas, prebiotics are used in combination with probiotics and enzymatic preparations (Creon, Festal, Enzistal, Mezim-Forte).
Monitoring the effectiveness of treatment for giardiasis is carried out 5-6 days after treatment; 2-3 times scatological analysis (stool analysis) is required with an interval of 1-2 days.
Traditional recipes for giardiasis
Traditional medicine offers several herbal infusions that have a detrimental effect on Giardia.
- St. John's wort: Brew 10 g of dry St. John's wort herb with 1 glass of boiling water and leave. Take 1 tablespoon 2-3 times a day.
- Common wormwood, Chernobyl: pour 1 teaspoon of the herb into 2 cups of boiling water (brew like tea) and drink a glass before meals 3 times a day.
Tansy infusions are also used. But it should be borne in mind that tansy is a poisonous plant and must be used with caution.
Prevention
To avoid infection with Giardia, just follow simple rules:
- personal hygiene,
- protection of products from contamination,
- heat treatment of products,
- clean drinking water,
- disinfection of things in the presence of a sick person,
- For disinfection, a 1-3% solution of chloramine B and boiling water are used.
What diseases require testing for giardiasis?
You should be tested for giardiasis if you have the following ailments:
- diarrhea with unknown cause,
- chronic gastrointestinal diseases,
- intestinal dysbiosis,
- child's retardation in physical development,
- dermatitis, urticaria, eczema, neurodermatitis,
- immunodeficiency state,
- obstructive bronchitis, bronchial asthma,
- allergies with an unknown cause,
- contacts with patients with giardiasis (parasite carriers).
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