Giardiasis, symptoms and treatment regimen in adults. Than to treat Giardiasis

Giardiasis - a common parasitic infection caused by the flagellate protozoan of the class. First intestinal parasites as pathogens studied and described by Russian scientist D. Giardia in 1859 and was subsequently named after him.

Parasites may exist in two forms: the fixed (cysts) and mobile (vegetative). According to statistics, a person enough to get out of the environment only 10 cysts to become infected and after a while begin to allocate a huge amount of giardia during defecation. At first, the disease is often asymptomatic carrier and parasites, without knowing it, to infect people around them.

To successfully fight the infection, you need to know about it as much as possible. Let's find out what is giardiasis, learn all about the ways of infection, the characteristic symptoms of the disease and treatment options.

Statistics

According to WHO, each year Giardia infects about 200 million people (Asia, Africa, Latin America).

Intensive rate per 100,000 population: in Russia - 90.0 (of the population) and 350.0 (for children under 14 years); in the United States, Vermont - 42.3, NY - 20.3 (1992-1997). Clinical manifestations of giardiasis are registered almost 500 million patients per year worldwide.

How do you get?

Giardia penetration path into the body:

1. Water - can become infected when consuming enough purified water from the tap or water from open water;
2. Contact-household - pathogens accumulate on the surface of everyday items: toys, dishes, linens, clothing;
3. Food - sources of infection are a variety of foods. Especially giardiasis often detected after eating the food without heat treatment: vegetables, fruits and berries.

Typically, giardiasis in children and adults occurs after contact with a sick person, however, scientists have found that in rodents, dogs and cats can also act as carriers of parasites. In addition, Giardia are often found in polluted waters, and even chlorinated water from the tap. In order to begin to develop giardiasis, man enough to swallow 10 cysts and parasites have low gastric acidity.

What happens after infection?

To infect enough to swallow a few tens of cysts (the patient per day by millions of singles out, so you can imagine what is the probability of infection of others, provided it does not comply with the rules of personal hygiene). Once in the small intestine cyst each divided into two halves, of which two are formed respectively giardia, which also begin to actively proliferate.

Further development of parasitic infestation can go in two scenarios:

• Developed symptoms.
• Man becomes an asymptomatic carrier.

A number of factors affect the likelihood of developing clinical giardiasis:

• the state of human immunity;
• gastric acidity (low acidity promotes high activity of Giardia and Giardiasis manifestation);
• problems with the release of bile (if it is not enough in the small intestine, Giardia will be easier to settle down in the body).

In the case of carriage of purgation of the parasite can pass spontaneously, without any treatment. The only condition - should not happen autoinfection, that is, a person should carefully observe good personal hygiene.

If Giardia settled down and began to multiply, the first thing that happens in the gut - a violation of the wall digestion, whereby there are various intestinal disorders and symptoms in the body lack certain substances. In addition, giardia can affect the intestinal peristalsis by stimulating nerve endings. From this there are painful abdominal cramps.

People who are prone to allergies, products secreted by parasites in the process of life, sensitize the body, so patients develop a variety of allergic reactions. These same products also poison the man, causing the appearance of symptoms of intoxication.

symptoms of giardiasis

Almost half the people know that infected with Giardia, only as a result of fecal lamblia cysts. In other words, the patient does not even suspect that he giardiasis. In other cases, there may be some signs of the disease.

Acute period lasts for five days, but sometimes it may take a week. If an adult has an immunodeficiency, the acute phase of giardiasis usually longer, and all of these symptoms to the full. Sometimes symptoms occur acute phase biliary dyskinesia. If children with giardiasis body temperature rises and the growing signs of intoxication, that for adult patients with a similar clinical picture is not characteristic.

characterized by the following symptoms for acute stage of giardiasis:

1. Nausea, lack of appetite, frequent belching.
2. Bloating, flatulence, rumbling in the intestine, excessive gas evolution.
3. Loss of body weight.
4. In the right subcostal area and the umbilical painful sensations arise. At the same pain in the navel marks every second patient, and about 15% of people point to the pain in the right upper quadrant. Pain is often associated with eating, so they are not associated with giardiasis.
5. In the mouth there is a bitter or sour taste.
6. May develop diarrhea. In this chair becomes speeded up, may occur from 3 to 5 times per day. If at the beginning of the acute period of the character liquid stool and watery, then later it thickens and becomes fat.
7. Enhanced salivation.
8. There is fatigue and unexplained weakness.
9. Deteriorating performance.
10. Rashes appear.
11. Avitaminosis. Its symptoms is to improve brittle nails, hair loss, peeling skin, and so forth.

A week later, giardiasis or independently passes or becomes chronic.

chronic giardiasis

If Giardia parasites in adults for a long time, it will be observed signs of immunosuppression, and symptoms of intoxication. Thus periodically inflamed lymph nodes, tonsils are increased, the body temperature rises to subfebrile marks.

Symptoms suggestive of chronic giardiasis in adults:

1. The patient continues to lose weight.
2. Hair thinning, become brittle, lose their natural shine.
3. General well-being suffers. Often suffer from headaches, appears excessive sleepiness and irritability. Such a state leads to a deterioration in working capacity.
4. Disorders of the digestive system. the patient chair becomes unstable, frequent constipation are replaced by the same frequent diarrhea. Appetite is reduced, disturbs periodically bloating and rumbling in the gut.
5. Skin rashes begin to disturb the patient more often, even if the earlier a person suffering from allergies do not. There phenomenon dermatitis or urticaria. Angioedema in adults against the backdrop of giardiasis is extremely rare, more likely to develop asthmatic bronchitis or asthma. The main features of allergy against giardiasis are: long duration, lack of response to receiving antihistamines, frequent relapses.
6. Deteriorating skin color, may develop mild jaundice. In the first place becomes jaundiced neck, face, axillary folds, abdomen.
7. Especially hard on the background of giardiasis in adults urticaria occurs, disrupting the patient's quality of life. Moreover, it occurs without any background errors in the diet without medication and so forth. It is often accompanied by urticaria phenomena blepharitis.
8. With giardiasis associated xerosis in which the patient shelled heel, especially during the cold season.
9. It suffers the mucosa of the oral cavity. The man often aphthous stomatitis, in the corners of the mouth appear perleches, inflamed border of lips.
10. Perhaps the isolated involvement of the palms and soles, when the skin starts peeling off from the tips of the phalanges. Fingers resemble senile. Before palms the process, as a rule, does not reach.
11. For chronic giardiasis keratosis pilaris is characterized by the appearance of the skin spot swelling. Mostly affected skin shoulders. It is covered with flaky white crust or rounded plaques, prone to flaking increased.

Another indirect sign of giardiasis in adults is intolerant of whole cow's milk, as these parasites affect enterocytes responsible hydrolysis of carbohydrate components of food. This also explains the increased flatulence.

complications

For giardiasis usually passes without complications. However, toxic shock can occur when a massive invasion. With long-term chronic infectious process may develop anemia associated with malabsorption of vitamins.

Diagnostics

Required methods of diagnosis in suspected giardiasis:

1. Morphological examination of a biopsy sample taken during endoscopy.
2. PCR diagnostics stool to detect the pathogen antigens in the test biomaterial.
3. Duodenal intubation with microscopic analysis of the content. Also confirms the presence of Giardia in duodenal juice.
4. Immunodiffusion - new more specific as compared to the immune diagnostic ELISA method based on studying the precipitation reaction and allows to identify antibodies to the pathogen.
5. Immunoassay blood test - laboratory selection of specific serum IgM class antibodies to Giardia.
6. Immunoelectrophoresis - combined method of combining immunoprecipitation and electrophoresis. We investigate the antigenic composition of the biomaterial.
7. Immunosorbent ELISA assay. It is used in the diagnosis of giardiasis and other infections.
8. Protozoologicheskoe examination of feces. In the study of microscopic native or Lugol-stained smears of freshly feces found trophozoites and cysts of Giardia. For reliability required multiple tests conducted by 2 to 7 times the interval between delivery of a 1- 2 days.

Diagnosis and treatment of giardiasis is engaged in infectious disease. Recognition of this protozoal infestations difficult due to the variety of clinical manifestations and nonspecific. Diagnosis requires a mandatory laboratory confirmation.

How to treat giardiasis?

In acute forms of giardiasis in adults can use a one-step treatment regimen course antiparasitic therapy.

• The drug of choice is metronidazole treatment course of 5-7 days. Adults appoint 250 mg, for children - 15 mg / kg / day. in 3 divided doses every 8 hours (without chewing, during or after eating or drinking milk).
• Another reception mode in adults: 2.0 g at one time within 3 days or at 0.5 g / day. within 10days. According to clinical and pharmacological articles in the treatment of giardiasis specific recommended dosage: for adults -.. 500 mg 2 times a day for 5-7 days, for children 3-5 years, 250 mg / day, 5-8 years at 375 mg / day over 8 years - 500 mg / day. in 2 hours, 5 days treatment course.
• Note that at this time the use of metronidazole and other nitroimidazole derivatives, as well as Furazolidone is losing its relevance with the emergence of a large number of resistant strains parasites.

Chronic giardiasis begin treatment with antiparasitic drugs impractical because it may cause toxic and allergic complications and exacerbation of clinical symptoms disease. Therefore, treatment in such cases should be carried out in three stages:

1. The first stage - the elimination of toxicity, improve the enzymatic activity of the intestine, correction of immune status. Depending on the degree of disease symptom step 1 is carried out for 1-2 weeks, and includes: a diet that is aimed at creating conditions that can impair reproduction lamblia (porridge, dried fruits, vegetables, vegetable oil); limiting carbohydrate intake; reception choleretic drugs; enterosorbents appointment; fermentoterapiya (based on coprogram); antihistamines.
2. The second stage - antiparasitic therapy drugs acting on the simplest: trihopol (metronidazole), furazolidone, tiberal (ornidazole). Receiving antihistamines and ehnterosorbentov continues throughout protivolyamblioznoy therapy.
3. The third stage - increase the body's defenses and the creation of conditions that prevent the reproduction lamblia in the intestine and gall bladder. To this end, it assigned a diet that improves peristalsis (cereal porridge, vegetable and fruit puree, baked apples, fresh fruit and vegetables, dairy products). For correction vegetable adaptogens appointed immune response multivitamin complexes. To eliminate intestinal dysbiosis fermentopathy prescribe probiotics, prebiotics, enzyme preparations. The third phase takes an average of 2-3 weeks.

To reduce the toxic effect of the decay products lamblia influenced etiotrop treatment in children older than 5 years recommended 1-2 times a week at tyubazh Dem'yanov with mineral water, 25-30% solution of magnesium sulfate, sorbitol, xylitol. This action prevents the absorption of toxic products and weakens manifestations reaction Jarisch - Gepksgeymera. Simultaneously with the specific treatment of patients assigned excessive drinking and diet. In identifying the syndrome maldigestion and malabsorption appointed fermentoterapiya, in identifying intestinal dysbacteriosis perform corresponding correction.

Additional drug therapy

For the impact on pathogenic intestinal microflora normally assigned Enterol (1 - 2 capsule or sachet with powder 2 times a day for a week) or Intetriks (4 capsules daily for four days). To combat dysbiosis apply probiotics (Narine, Lineks, Bio Gaia Bifiform et al.). In liver injury shows gepatoprotektory (Gepabene, Karsil) and cholagogue (Allohol). Also, to improve the performance of the gallbladder can be used drugs such as Hofitol or holosas. By the way, these means little increase urination, which contributes to the speedy elimination of toxins.

If the results indicate coprogram enzyme deficiency, the prescribed Mezim, Festal, Creon or Pancreatin. Even in the absence of clinical symptoms of allergic reaction requires reception antihistamines. It Aerius, Claritin, Telfast, Tsetrin. Suffice it 1 - 2 tablets a day. Sometimes, after the use of these drugs can be drowsiness. That is why it is recommended to take them in the afternoon before going to bed.

Acute and chronic giardiasis is most often seen in people with weakened immune systems. Therefore, after the end of antiparasitic therapy is necessary to identify the cause of the disorders of the immune system. In some cases, we need more support immunomodulatory drug (Polioksidoniy, Likopid).

food rules

Diet for giardiasis in adults on the first preparatory step, is made on the basis of products that slow reproduction lamblia. It is recommended to limit to a minimum the use of carbohydrates (sweets and pastry dishes) and give preference to protein foods and foods high in fiber. During this period, the patient should eat:

• Dried fruits;
• Fresh and cooked vegetables;
• Lean meat;
• A variety of cereals;
• Vegetable oil.

In the third, the recovery phase, the daily menu is made on the basis of products that improve bowel movements. In the diet include:

• Fermented products (kefir, yogurt, cheese);
• Cooked lean meat and lean fish;
• Kashi (oat, buckwheat, barley);
• Fruit and vegetable purees;
• Fresh fruits and vegetables (cabbage, carrots, apples, pears);
• Berries (cranberries, lingonberries);
• Baked apples;
• Greenery.

From the diet should completely exclude bread, pastry, confectionery and sweets, whole milk, pasta. It is recommended to give up the sausages, canned meat and animal fats. Cereal can be eaten rice, buckwheat, barley.

The patient should be observed enhanced drinking regime to rapidly clear the body of toxins. It is useful to drink sour cranberry juice, cranberries, green tea with lemon, fresh juices (carrot, beet, birch).

Traditional recipes

Here are a few popular recipes of traditional treatment of giardiasis, helps to remove giardia from the body:

• Prepare the broth krovohlebi (6 g herb per cup of water, boil for 10 minutes), which is taken once a day before meals. Dosage - 100 ml;
• 100 ml beet juice are mixed in equal proportions with carrot juice, brandy and honey. The mixture is thoroughly mixed and taken three times a day for half an hour before meals;
• Take green walnuts, cut them into smaller pieces and pour 1 liter of vodka. Tincture comes to the condition in a dry, dark place for two weeks. The medicine is used three times a day for one teaspoon.

prophylaxis of giardiasis

Preventive measures are divided into measures aimed at suppressing the source of infection and parasite transmission mechanism of rupture of the media to healthy people.

1. Under the measures, aimed at identifying the source of infection is meant carriers and patients with giardiasis and their subsequent treatment. Protozoologicheskoe examination is recommended to carry out among the staff of children's institutions, employees of food and similar food business, children.
2. To break parasites transmission mechanism is necessary to provide an organized collection of household and agricultural effluents with their further purification. It requires protection of soil and water contamination from potentially infective waste. This group of measures include quality control measures drinking water.
3. In addition to the social prevention of parasitic diseases is important to personal hygiene, food storage rules and techniques of cooking. When using water of natural sources, it must be pre-boiled. Fresh fruits and vegetables before consumption need to be sure to wash under running water.

Compliance with preventive measures reduce the risk of contracting giardiasis, and infectious and parasitic diseases of other etiology.

Forecast

When giardiasis favorable prognosis. Giardiasis often has a chronic course, but carrying out adequate therapy facilitates complete freedom from pathogens.