Giardiasis is an infection of the intestine caused by parasites. The disease is more common in childhood and is easily treatable with antibiotics. There are approximately 200 million new infections worldwide each year, and giardiasis occurs primarily in tropical countries.
What is giardiasis?
Giardiasis is an intestinal infection caused by single-celled parasites that leads to inflammation and functional limitation of the small intestine. This can result in diarrhea and nausea. The pathogens are transmitted through the excretions of infected humans and animals. Giardiasis is often found in developing countries as a result of poor hygiene. In our latitudes, it is mainly smaller children and people who consume contaminated water who fall ill. Many sufferers become infected with giardiasis while traveling to developing countries.
Causes
The cause of giardiasis is thought to be the parasite Giardia lamblia. Therefore, the disease is often referred to as lambliasis. The same pathogens can also cause giardiasis in dogs and cats. Consequently, these animals can also transmit giardiasis to humans. Affected persons may have become infected through feces, contaminated water, or food that has been associated with the pathogen. The giardiasis pathogen occurs in two forms. Cysts can survive outside the body and are considered to be the cause of giardiasis. Even people who remain symptom-free themselves excrete the pathogen over several months and can thus become at high risk of infection with Giardiasis. The ingestion of as few as ten cysts can trigger an infection with Giardiasis. It is estimated that in countries with poor hygiene, up to 30% of the population is infected with giardiasis.
Symptoms, complaints, and signs
Giardiasis is usually a harmless disease. Many people do not develop any symptoms at all. However, even these people then still excrete the pathogen in the stool for a long time and can thus continue to transmit the disease. However, when symptoms do develop, the most typical symptom is long-lasting and recurrent diarrhea. In addition, those affected often suffer from vague abdominal pain and a feeling of fullness. Not infrequently, the pain is colicky abdominal pain. This is often accompanied by nausea and vomiting. The diarrhea has a foamy, watery consistency. In some cases, the diarrhea is also bloody. Constant flatulence is also one of the typical symptoms. In protracted cases, water may accumulate in the tissues (edema). In particularly severe cases of diarrhea, nutrient absorption in the intestine may be disturbed. As a result, malnutrition is then possible. Rarely, the pancreas and bile ducts may also be affected. Particularly in cases of massive infestation with the parasite Giardia lamblia or in immunocompromised individuals, acute pancreatitis or bile duct inflammation sometimes occurs, leading to severe symptoms. Infection during travel is also typical. If the traveler’s diarrhea is caused by the pathogen Giardia lamblia, it persists as weak diarrhea for several weeks after returning home. In extremely rare cases, mainly in immunocompromised individuals, giardiasis can also be fatal.
Diagnosis and course
For the most part, people infected with giardiasis remain symptom-free. When symptoms do occur, it is about two weeks after infection. Giardiasis is manifested by diarrhea, flatulence, and nausea. Less commonly, fever and vomiting also occur. If giardiasis is suspected, a doctor should be consulted immediately. He will first try to detect the pathogen by means of a stool sample. If this is not successful, several fresh stool samples are taken. An endoscopy of the small intestine also provides certainty. During this endoscopy, a special instrument is inserted through the mouth. It is also possible to take a tissue sample during this examination to detect giardiasis. If the infection is left untreated for more than a week, it can cause damage to the mucosa of the small intestine and interfere with nutrient absorption. Weight loss and anemia may result. In people with a weakened immune system, giardiasis usually takes a more severe course. With drug treatment, the symptoms subside two to three weeks after infection.In individual cases, it is possible for giardiasis to recur.
Complications
In most cases, giardiasis does not cause any particular complications. This disease can be relatively well limited and treated with the help of antibiotics and in most cases leads to a positive course of the disease. The affected persons suffer from discomfort in the region of the abdomen and stomach. There is severe abdominal pain, stomach cramps and diarrhea. Flatulence can also occur and is associated with nausea and vomiting. It is not uncommon for patients to also suffer from a loss of appetite and thus consume less food and fluids. This results in underweight or deficiency symptoms in most cases. Dehydration also has a very negative effect on the patient’s health. Furthermore, fever may also occur. Due to giardiasis, the quality of life of the affected person is extremely reduced. There is fatigue and a general feeling of illness. The immune system is weakened, so that the affected person can also fall ill with other infections or diseases. When giardiasis is treated with the help of antibiotics, there are no particular complications. The symptoms disappear relatively quickly and there is no decreased life expectancy.
When should you go to the doctor?
In most cases, giardiasis can be treated relatively easily and quickly with antibiotics. A doctor should be consulted quickly, as self-healing does not occur and taking antibiotics may well prevent further complications and discomfort. Sufferers should then consult a doctor if they experience diarrhea or severe pain in the stomach and abdominal area. Flatulence or severe nausea with vomiting may also indicate giardiasis and should be investigated if they occur over a long period of time. Likewise, those affected often suffer from loss of appetite and therefore weight loss. Consultation with a physician should also be sought if fever, general fatigue and lassitude are present. Giardiasis can be treated by a general practitioner or by a pediatrician. Only in a few cases is examination by an internist necessary. With early diagnosis and treatment, there is always a positive course of the disease.
Treatment and therapy
If the diagnosis is confirmed and giardiasis is present, treatment is with antibiotics. The drugs kill the bacteria and prevent them from multiplying. In most cases, doctors prescribe the drug metronidazole for giardiasis. The active substance contained in it is converted by the giardiasis pathogens into an intermediate that attacks the DNA of the parasites. Patients should not crush the tablets before taking them, as they have a very bitter taste. Metronidazole should not be used in people with blood disorders and pregnant women. Alcohol consumption should be avoided during therapy, as severe side effects are to be expected. Albendazole or mebendazole are prescribed as alternative medications.
Outlook and prognosis
In people affected by Giardia lamblia, the pathogens do not invasively adhere to the mucosa of the intestine. Thus, the mucosal cells are not destroyed. However, their function may suffer from the infestation. Inflammation is also possible. In a severe course of the disease, malnutrition sometimes occurs. However, the course can also be completely unspecific. There are people who carry the pathogen in their digestive tract but do not show any symptoms of the disease. However, they also excrete cysts over a period of months. If hygiene is poor, these cysts infect other people. In most cases, however, the immune system manages to kill the pathogen within a few weeks. Weakened persons, however, are susceptible, whether due to a previous illness or a poor general or nutritional condition. Here, the prognosis is usually worse than in people with an intact immune system. The first drug of treatment is the germicidal preparation metronidazole. Even with successful treatment, gastrointestinal problems may occur for months. Giardiasis probably triggers irritable bowel syndrome and sometimes even food intolerance. Overall, however, treatment options for Giardia lamblia are now well developed.Germicidal drugs in particular achieve good success rates. Careful, accompanying hygiene measures are important for a positive prognosis. Above all, they should prevent re-infection and have a preventive effect.
Prevention
Children between one and three years of age, persons with decreased gastric acidity, and people who have blood group A are considered to be special risk groups for giardiasis infection. Special care should be taken when traveling abroad. You should wash your hands frequently and always heat food sufficiently. Water should be boiled for at least ten minutes. Beverages should only be drunk from factory sealed containers. In Turkey, India or Egypt, the risk of contracting giardiasis is particularly high.
Aftercare
As a rule, giardiasis does not require follow-up care. However, the inducer should be identified as soon as possible to prevent recurrence of the disease. Contact with the trigger should, of course, be discontinued quickly. In general, early diagnosis has a positive effect on the further course of the disease. Giardiasis is usually treated with antibiotics. The affected person must pay attention to the correct intake of these drugs, whereby antibiotics should not be taken together with alcohol in order not to lose their effect. In case of interactions, a doctor should always be contacted first to prevent them. If the person concerned is pregnant, this should be mentioned during treatment so that a different drug can be chosen for treatment if necessary. A high level of hygiene can also prevent giardiasis and should always be maintained. In this regard, beverages should only be drunk from completely sealed containers. The immune system should not be unnecessarily stressed during this infection in order to speed up healing. Care should also be taken to eat light food so as not to overload the stomach. Usually, complete healing occurs with giardiasis.
This is what you can do yourself
The antibiotic treatment of giardiasis can be supported by some hygienic measures. Affected people should wash their hands regularly and avoid contact with other people. Appropriate precautions prevent the pathogens from being carried or transmitted to other people. In risk areas, infection can be avoided by boiling water and not eating uncooked fruits and vegetables. Alcohol should be avoided during therapy, as the active substances contained can cause severe interactions. In general, attention should be paid to a careful diet without stimulants. Foods such as white bread and rusks as well as chicken broth and soft-boiled vegetables have proven to be effective. It is also important to take it easy, since the body, and especially the immune system, is under great strain during the acute phase of the disease. Any fluid losses due to vomiting and diarrhea should be compensated for by drinking plenty of clean water. In case of severe deficiency symptoms, dietary supplements such as electrolyte solutions or vitamin tablets are recommended. If the giardiasis has not subsided after one week at the latest, a doctor must be consulted. Any complications and unusual symptoms should also be discussed with the responsible medical professional to avoid a severe course.
