How Do I Choose the Best Treatment for Giardiasis?

Giardia lambliasis is a non-specific and specific host response caused by the mechanical and chemical effects of the infected body on the body. The distribution is worldwide, especially severe in the former Soviet Union, the United States is also close to epidemic, and the number of infected people in developing countries is about 250 million. China is also widely distributed, with infection rates ranging from 0.48% to 10% everywhere. Children are higher than adults, and the incidence is higher in summer and autumn.

Giardia lambliasis is a non-specific and specific host response caused by the mechanical and chemical effects of the infected body on the body. The distribution is worldwide, especially severe in the former Soviet Union, the United States is also close to epidemic, and the number of infected people in developing countries is about 250 million. China is also widely distributed, with infection rates ranging from 0.48% to 10% everywhere. Children are higher than adults, and the incidence is higher in summer and autumn.

After the infection of the human body, the malabsorption syndrome mainly with diarrhea occurs, and the diarrhea presents watery stools, with a large amount, bad breath, and no pus and blood. Children can suffer from diarrhea, malnutrition and other malnutrition, and cause growth retardation. If it is not treated in time, it usually develops into chronic, manifested as periodic thin stools, repeated attacks, and the stool is very stinky, and the course of the disease can last for several years.

Causes of Giardia lamblia

Giardia lamblia infection, the mechanical and chemical effects of the body on the body, causing the body to produce non-specific and specific host responses.

Clinical manifestations of Giardia lamblia

After infection with Giardia in humans, the average incubation period is 1 to 2 weeks, with the longest being 45 days. A considerable part of them do not show any clinical symptoms, and they become infected with worms. They have mild symptoms and severe symptoms. The clinical manifestations are more common in abdominal pain, diarrhea, and anorexia. The typical patients are malabsorption syndromes, mainly diarrhea. There may be explosive watery diarrhea, stench, no pus and blood, containing a large number of fat particles. Children's chronic illness can lead to malnutrition, anemia, and developmental disorders. If parasitic in the biliary system, cholecystitis or cholangitis may occur. If it is not treated in time, it usually develops into chronic, manifested as periodic thin stools, repeated attacks, and the stool is very stinky, and the course of the disease can last for several years. Can be divided into systemic symptoms, biliary system symptoms and gastrointestinal symptoms.

Systemic symptoms

(1) Neurological symptoms such as insomnia, headache, fatigue, dizziness, dark eyes, sweating, increased nerve excitability, and hypertonic reflexes are more common.

(2) Thyroid dysfunction It has been found that some (15.5%) patients with Giardia lamblia have thyroid function changes, of which hyperthyroidism accounts for the majority, basal metabolism increases by 16% to 20%, and some patients can increase 30%, and therefore also have symptoms of hyperthyroidism.

2. Symptoms of the biliary system

Giardia lamblia is parasitic in the biliary system and can cause cholecystitis and cholangitis. The main symptoms are upper abdominal pain, loss of appetite, indigestion, nausea, belching, burning in the stomach, hepatosplenomegaly, tenderness, worsening when eating greasy, and sometimes jaundice.

3. Gastrointestinal symptoms

(1) Duodenitis type duodenal ulcer-like pain, accompanied by anorexia and hypotension. X-ray examinations often show deformation of the ball and even ulcers. The above symptoms can be eliminated after anti-worm treatment.

(2) The symptoms of acute or chronic appendicitis are similar to those of general appendicitis. The removed appendix showed inflammatory lesions, ulcers were sometimes seen on the mucosa, and numerous trophozoites were found between the villi.

(3) Colitis type The main symptoms are dull abdominal pain, exacerbations, with nausea, vomiting, and diarrhea, often misdiagnosed as dysentery.

(4) The type of rectal sigmoiditis is the same as that of general rectal sigmoiditis. With sigmoidoscopy, diffuse congestion, edema, and severe ulcers were seen. The surface of the ulcer was covered with exudative pseudomembrane. A swab examination revealed a large number of trophozoites. No special pathological changes.

The symptoms of acute infection are sudden onset, fulminant diarrhea, watery stools, smelly, and abdominal pain. Therefore, the acute symptoms are similar to acute amoebic dysentery or bacterial dysentery and Salmonella infection, and attention should be paid to identification. Some patients have symptoms of subacute infection, which are mainly manifested by intermittent loose stools, abdominal pain, and loss of appetite. Chronic patients are the most common, with periodic loose stools, recurrent episodes, and very bad stools. Due to the lack of attention from patients, the course of the disease can often take several years. Chronic infections are associated with weight loss and stunted development. Patients often have lactose, xylose, vitamin A and vitamin B _12, and abnormal fat absorption.

Giardia lamblia inspection

Pathogen diagnosis

(1) Fecal examination Use normal saline smear method to check trophozoites, check cysts by iodine staining smears, and also use formaldehyde ether precipitation or zinc sulfate concentration method to check cysts. Cysts are usually checked in shaped stools, while trophozoites are found in watery thin stools. Due to the intermittent nature of cyst formation, it is advisable to perform fecal examinations on the next day and to perform three or more consecutive tests.

(2) Duodenal fluid or bile examination . This method can be used in those who have multiple negative feces to increase the positive detection rate.

(3) Intestinal examination capsule method Let the subject swallow a capsule containing nylon thread, leaving the free end of the thread outside the mouth. After the capsule is dissolved, the nylon thread is loosened and stretched, and reaches the duodenum and jejunum after 3 to 4 hours. The trophozoite adheres to the nylon thread, then slowly pulls out the nylon thread and scrapes the attached lens for microscopic examination.

2. Immunological diagnosis

To assist diagnosis, there are mainly methods such as enzyme-linked immunosorbent assay (ELISA), indirect fluorescent antibody test (IFA), and convection immunoelectrophoresis (CIE). Features suitable for epidemiological investigations.

Giardia lamblia diagnosis

The main symptoms of this disease are abdominal pain, diarrhea, bloating, vomiting, fever, and anorexia. Typical patients present with malabsorption syndrome mainly with diarrhea. Watery stools are present in diarrhea. Pediatric patients may suffer from malnutrition and other anemia due to diarrhea, resulting in growth retardation. Taking the duodenal drainage fluid to check the trophozoite is of great significance in the diagnosis of this disease.

Giardia lamblia treatment

1. Commonly used drugs for treatment are metronidazole, prothioimidazole, and clonidazole. In recent years, praziquantel has been reported to be effective for 2 days.

2. After thorough treatment, no clinical symptoms or signs occur, and no cysts in the stool test are cure.