Giardia intestinal - lamblia (giardia) intestinalis- the causative agent of giardiasis is anthroponosis.
For the first time Giardia was described by a professor of Kharkov University, a Czech by origin, D.F. Giardiasis in 1859 Giardiasis is widespread among the world's population. Children are especially susceptible to this disease, the infection of which is 50-80%. With age, the level of infection decreases and by the age of 16-17 it reaches the level usual for adults (10-15%). The intensity of Giardia infestation is very high, especially in hot climates. They are more common in the Transcaucasus.
Geographic spread- everywhere.
Localization- duodenum, bile ducts of the liver.
Morphological characteristics. It exists in two forms: 1. Vegetative form - pear-shaped trophozoite (12-14x5-10 microns), has bilateral symmetry, a double set of organelles (2 nuclei, axonemes, 4 pairs of flagella). In the center there is an axostyle, osmotic nutrition, asexual reproduction. There is a suction disc on the flattened side. 2. Cystic form (8.8 - 12.7 microns): a) immature (2-nuclear); b) mature (4-core).
Development cycle.
The source of infection is a person who excretes lamblia cysts with feces (up to 300 million cysts per day). The spread of lamblia is facilitated by unfavorable sanitary and hygienic conditions. Depending on the specific situation, infection can occur through dirty hands, various food products, especially those consumed without heat treatment (vegetables, berries, etc.), water, and household items.
Invasive form(cyst) gets to the person through the mouth. The vegetative form develops in the duodenum and bile ducts. In the large part of the intestine, the conditions for the life of lamblia become less favorable, therefore lamblia are encystised, covered with a dense membrane. With feces, cysts are excreted into the external environment.
Pathogenic action: violation of the functions and absorption capacity of the intestine (impairment of the absorption of fats, carbohydrates and vitamins). Characterized by mechanical irritation, the release of cytotoxins in the intestine. Possibly asymptomatic course of the disease - carriage. Painful sensations in the right hypochondrium are possible. Toxic products of decay or metabolism of lamblia can be the cause of general disorders in the form of deterioration of the general condition, anemization, nervous, mental and other disorders, upset stomach and intestinal secretion. The life span of lamblia in the intestine is 30-40 days.
Source of infection- a sick person and a carrier.
Diagnostics. Detection of cysts in feces and vegetative forms in duodenal juice during probing. Immunoassay methods (specific antibodies can be detected in the blood serum of patients with giardiasis and cyst carriers).
Cysts live in the environment for a long time. Resistant to disinfectants found in chlorinated water. Dispute lifespan:
- in reservoirs 3 months;
- water in pipelines - 1 month;
- sea - 1.5 months in warm weather, 3 months in winter;
- on the surface of household items and personal belongings - 3 months;
- feces - until it dries up;
- soil - 3 months;
- urine - 3 days.
I die instantly when boiled. The invasion of water occurs through the entry of a sick person's feces into the source. For food from the soil, from a sick person. People with weak immunity, problems with the digestive tract, children under 10 years old are susceptible to invasions.
In the process of activity, lamblia secrete excrement, which provokes the development of toxicosis. The composition of the blood changes, the metabolism is disturbed. Intestinal cells that do not receive the necessary substances are destroyed. Microcracks, atrophy, inflammation appear on the mucous membrane of the digestive organ. Intestinal dysbiosis develops with all the negative consequences.
Waste products, toxins, dead lamblia enter the bloodstream. As a result, there is an allergic reaction on the skin. It is often diagnosed as atopic dermatitis, urticaria, eczema. And also the pathology of the respiratory tract - asthma.
Localization of lamblia in adults
The diagnosis and treatment of giardiasis is carried out by an infectious disease doctor. The doctor builds on the patient's complaints, symptoms of the disease, existing pathologies, prescribes an examination. Verification without laboratory testing is impossible. To identify the causative agent of giardiasis, it is necessary to donate feces, blood. The analysis of feces allows you to identify the presence of cysts in the human body, and antibodies are determined by blood analysis. Currently, modern research methods quickly identify the presence of the pathogen. However, at the initial stage of the disease, verification can be difficult - the analysis of feces is negative. To obtain a reliable result, the study is carried out several times - from 3 to 5. In severe cases, feces are taken from the intestine using a special procedure.
Giardiasis is characterized by several forms of diseases. According to the degree of activity and the frequency of manifestations of symptoms, an acute form is distinguished, a chronic one. The acute form is characterized by the rapid, noticeable development of giardiasis. It is in such cases that patients seek qualified help. The chronic form of giardiasis is disguised as the pathology of other diseases, it is diagnosed in most cases by accident.
Forms of giardiasis:
- subclinical - takes 50% of all cases;
- asymptomatic - 25%;
- manifest - up to 44%.
The latter form of the disease also has its own classification. Depends on the place of localization of lamblia.
The clinical manifestation of symptoms depends on the presence in the body of other diseases of a chronic nature, general health.
Giardia in adults: symptoms
Since the disruption of the intestines reduces immunity, irritates the nervous system, an adult develops tearfulness, loss of strength, weakness, irritability, and a bad mood. According to the World Health Organization, 40% of the world's population is infected with giardiasis. In most cases, they learn about it by chance, due to the complex specifics of the symptoms of giardiasis. A sick person seeks help from specialists with complaints of other diseases, the provocateurs of which are Giardia. Treatment does not give the desired effect, since the true causative agent of the infection continues to develop further in the intestines. In general, the symptoms of giardiasis can be divided into several groups.
Disruption of the digestive tract
In adults, symptoms of giardiasis, with acute manifestations: vomiting, nausea, diarrhea with foamy feces, bloating, pain without a specific localization in the abdomen. With mild manifestations or in a chronic form, the patient has constant nausea, with periodic pain in the stomach, pancreas. Inflammatory bowel syndrome with rumbling, bloating, and pain around the navel is present. Bad breath, plaque on the tongue. Appetite decreases or food addictions change - you want something sweet. Heartburn periodically appears. At the onset of the disease, stools are frequent, liquid - up to 5 times a day. Then it becomes semi-shaped. Diarrhea alternates with constipation. The duration of the acute phase is no more than 7 days.
Biliary tract disorder
Occurs when the liver ducts, gallbladder pathways are damaged. Symptoms for giardiasis: pain in the right hypochondrium, a bitter taste in the mouth. There are manifestations of pancreatitis, gastritis, cholecystitis. In 50% of patients, changes in the work of the pancreas are noted.
Disruption of the nervous system
Symptoms for giardiasis: violation of the intestinal microflora, unpleasant manifestations of gastrointestinal diseases affect the state of the nervous system. A person has chronic headache, weakness, fatigue, irritability, poor sleep at night, drowsiness during the day. Mood worsens, irritability and aggressiveness appear. Along with this - tearfulness, impressionability, decreased self-esteem. Dizziness attacks often occur.
Toxic - allergic symptoms of giardiasis in adults
Blood with toxins, feces of lamblia causes allergies, which is manifested by dermatitis, itching, redness, swelling, burning. In rare cases, Quincke's edema develops. Allergy is chronic with frequent relapses. Treatment with antihistamines, corticosteroids is temporary. Acne on the face of unknown etiology can also be a symptom of giardiasis. Giardia affects the skin condition indirectly. By their presence, they disrupt the metabolism, weaken the body, give the opportunity to develop other pathogens. Disruption of bowel function causes allergies, rashes on the skin of the face, back. The constant presence of toxins only deepens the problem. Inflammation of the adenoids may occur. Other manifestations of the disease are rhinitis, conjunctivitis, cheilitis, bronchial asthma, and other pathologies of allergic origin.
The mixed form of giardiasis brings all the manifestations of the disease into one group. You should be tested for Giardia if there is:
With such symptoms, you should go to an infectious disease specialist.
Giardiasis in adults: treatment
After confirming the diagnosis, the infectious disease doctor prescribes treatment. Qualified therapy consists of several stages. In this case, the main condition is careful observance of the rules of hygiene, cleaning the house, boiling bedding, ironing underwear with an iron and steam. If giardiasis is found in one of the family members, everyone living under one roof, including pets, should be treated at the same time.
Preparatory stage of treatment
Main treatment
It is aimed at strengthening the immune system, restoring the vital forces of the body, and restoring the normal functioning of internal organs. To restore the intestinal microflora, probiotics are taken - Enterol, Laktiale. Khilak, Bifidumbacterin, Linex and others. To maintain the body, they drink vitamins. They adhere to the same diet, but introduce more vegetables, fruits, which contain a large amount of natural vitamins, useful microelements. To strengthen immunity, in severe cases, immunomodulators are taken, in all others - herbal collection. At the recovery stage, folk remedies play a very important role.
Concomitant therapy of pathologies
Attention should be paid to the condition of the liver. The internal organ has undergone severe stress. If there are no alarming manifestations of the pathology of this organ, traditional medicine can be taken to maintain the liver. Among the pharmacy products, you can use Carsil, Essentiale, Ovesol, Galstena, Gepabene.
Pathology of the biliary tract, cholecystitis are treated with antibacterial agents - Tetracyclines, Penicillins, Macrolides. The entire biliary tract with cholecystitis is relaxed by Platyphyllin, Papaverine, Odeston.
To calm the nervous system take tincture of motherwort, valerian.
Treatment takes 1 month on average. In severe cases, a second course is carried out. To get rid of giardiasis forever, it is necessary to strengthen the immune system, observe the rules of hygiene, process food well before eating, and drink raw water from trusted sources. As a preventive measure, you should clean the body once a year. For these purposes, folk remedies are well suited, for example, pumpkin seeds, garlic, onions, herbal flocks of wormwood, tansy, and cloves.
Giardiasis is widespread everywhere - at least 20% of the world's population suffer from giardiasis. About 200 million people are infected in the world every year. More than 80% of the incidence occurs in children under 14 years of age.
Giardia (described in 1859 by D.F. Lambl) exist in the form of vegetative forms and cysts. Vegetative forms about 10-18 microns in size have a peculiar pear-shaped shape (top view), and in the lateral projection - bucket-like. Cysts 8–12 in size are oval in shape.
The main localization of lamblia in the human body is the small intestine. Fixing on the surface of the epithelium, they receive nutrients,
located in the lumen of the intestine, on the surface of cells, from the space between the microvilli of the brush border.
The damaging effect of lamblia is diverse: they close the absorption surface of the small intestine and intercept the nutrients entering it; cause mechanical and toxic damage to the epithelium on the large surface of the intestine. The consequence of this is a violation of the absorption of almost all food components (proteins, fats, carbohydrates, vitamins and minerals). The processes of digestion and the state of the microbiocenosis of the gastrointestinal tract are disrupted. The action of toxins leads to a violation of the barrier functions and an increase in the permeability of the intestinal wall, as a result of which toxic substances begin to enter the body from the lumen of the intestine, affecting the central nervous system, as well as compounds that can cause allergic reactions.
In the course of their life, the vegetative forms of lamblia gradually descend through the intestine, cysts are formed in its thick section,
which are excreted from the body. The cyst formation process takes about 10-12 hours.
Once again in the intestines of a person or animal, two trophozoites (vegetative forms of lamblia) are formed from the cyst within 10-15 minutes, which are later capable of independent reproduction by binary fission.
The source of the invasion is a person with giardiasis, as well as some domestic (dogs, calves, pigs) and wild (beavers, muskrats) animals. The transmission mechanism of the invasion is fecal-oral. Propagation paths:
- water (through the water of open reservoirs and pools, tap water);
- contact-household (especially in children's institutions, where the pathogen is transmitted with the participation of staff, and the hands of children and staff, toys, carpets, floors, toilets play an important role as transmission factors);
- food.
In the environment, lamblia cysts are well preserved, especially at a temperature of + 2–6 ° C and a relative humidity of 80–100%. In sandy soil, cysts remain viable for up to 12 days, in black soil up to 75 days, in running water - more than 80 days (at temperatures from + 4 ° C to + 20 ° C), in wastewater - up to 120 days, on various surfaces - up to 20 days, in dairy products - up to 112 days. The death of the pathogen occurs during boiling and freezing (up to –13 ° C and below).
In the clinical course of giardiasis (after an incubation period lasting from 1 to 4 weeks), symptoms of gastrointestinal lesions predominate.
tract: diarrhea, flatulence, abdominal pain, nausea, vomiting, loss of appetite. Intoxication of varying degrees, a feature of which is the depressed, depressive state of the patient, irritability, tearfulness, headaches, dizziness, sleep disturbance are possible. Often there is a small temperature (subfebrile condition). Allergic manifestations (allergic dermatoses) are often observed. In blood tests, eosinophilia is possible, with the progression of the disease - hypochromic anemia. The acute period lasts for several days, then the clinical manifestations subside with the transition of the disease to the chronic stage. The course of chronic giardiasis is recurrent (undulating).
Diagnosis of giardiasis includes blood tests to determine specific antibodies by ELISA (enzyme-linked immunosorbent assay), feces (by
enrichment and staining with Lugol's solution) and bile, which is obtained by duodenal intubation and immediately examined.
Of course, a clinical examination is also necessary: general and biochemical blood tests, ultrasound examination of the abdominal organs,
coprogram, often an additional analysis of feces for dysbiosis is carried out.
Giardiasis is a disease that occurs when single-celled protozoa Giardia enters the human body. Giardia is a pear-shaped cage. At one end it has 4 pairs of flagella (organelles of movement) and a suction cup, which allows it to firmly adhere to the intestinal epithelium. Giardia reproduces by dividing. The division process lasts 5 - 20 minutes, therefore, for the development of the disease, it is enough for 1 - 10 protozoan cysts to enter the body, and after a short time there are many more of them.
How can you get giardia?
The source of infection is a person - the carrier of these protozoa or some animals that are in close contact with people (dogs, cats, pigs, cattle and others). The mechanism of infection is fecal-oral. To understand how Giardia is transmitted, you need to know that Giardia cysts enter the environment with the feces of the carrier. For further development, they must enter with water, soil or unwashed fruits and vegetables from the gastrointestinal tract of a healthy person through the mouth. The ways of transmission of lamblia include contact-household, food and water. Giardia gets from person to person, for example, in kindergartens through contaminated toys, bedding or underwear.
Where do lamblia live in the human body? What happens in the body when infected with lamblia?
Once in the human body, cysts attach to the epithelial cells of the small intestine, most often the duodenum or jejunum. Having sucked tightly, they begin to absorb nutrients from the intestinal lumen. Enterocytes (intestinal epithelial cells) cease to function. At the site of attachment of the protozoa, edema and inflammation develop. Waste products and decay products of lamblia poison the body, as a result of which the defenses (immunity) are weakened, a secondary and opportunistic infection is added. As a result, secondary appendicitis, colitis, biliary dyskinesia and dysbiosis may develop.
How does giardiasis manifest?
In 70% of cases in adults, asymptomatic carriage of lamblia is observed. Detection of lamblia in a laboratory study also confirms the diagnosis of giardiasis. To date, there are three forms of this disease: intestinal, hepatobiliary and allergo-dermatological. The intestinal form of the disease is manifested by the following symptoms:
- diffuse, paroxysmal pain in the umbilical region, often accompanied by nausea; as a rule, the pain is not associated with food intake;
- dyspepsia (decreased appetite, belching, heartburn, feeling of fullness in the abdomen);
- instability of the stool - constipation can be replaced by frequent liquid foamy stools.
Symptoms of the hepatobiliary form of the disease:
- pain in the right hypochondrium;
- bitterness in the mouth;
- belching with a bitter aftertaste;
- nausea, sometimes vomiting.
Against the background of any of these forms, with a long course of the disease, astheno-neurotic changes occur in the body: weakness, fatigue, headache or dizziness, mood swings from irritability and tearfulness to fits of laughter, sleep disturbance. The allergic-dermatological form of giardiasis is manifested by persistent indomitable itching, frequent urticaria, attacks of bronchial asthma, allergic conjunctivitis. Symptoms resolve quickly after specific treatment (metronidazole).
How to identify giardiasis?
The variety of clinical manifestations of the disease, as well as their non-specificity, necessitate laboratory confirmation of the diagnosis. Of the methods for diagnosing giardiasis, the following are used today.
With feces, active trophozoites and cysts enter the external environment. The latter have a dense shell that protects against the negative effects of environmental factors.
How does acute giardiasis manifest?
It is in babies that the signs of damage to the digestive organs are most pronounced. The first symptoms of giardiasis in children and adults are manifested:
- bloating, increased gas production;
- overlapping of the tongue;
- a significant increase in the size of the liver, which is detected by the doctor during percussion and palpation, ultrasound scanning.
The patient suffers from acute pains around the umbilical region, lower abdomen, right hypochondrium. Unpleasant belching appears, appetite worsens.
Disturbances in the functioning of the nervous system are manifested by the appearance of an astheno-neurotic complex. Uncharacteristic previously severe headaches, increased irritability appear, and the quality of sleep worsens. A person gets tired very quickly, even without strong physical or mental stress.
The condition of the skin changes with giardiasis. She becomes dry, pale. Especially noticeable is the lack of blush on the face, as well as the appearance of dark circles under the eyes. The hepatobiliary form of the lesion, in which a large number of lamblia is present inside the bile ducts, leads to an icteric skin tone.
Signs of lamblia in the liver of a child
The kid starts to get sick more often. A tendency to inflammation, asthma develops, and pronounced allergic reactions appear.
On a note! Parents need to closely monitor the behavior and well-being of the child.
It is necessary to show the child to the doctor as soon as possible and undergo an examination in order to detect lamblia, if at least two or three of the following symptoms are observed:
- temperature at 37 degrees (especially in the evenings) for 14 or more days;
- digestive problems - constipation or, conversely, loose stools;
- teeth grinding at night - this phenomenon is caused by the action of giardiasis toxins on the central nervous system;
- lethargy, drowsiness, trouble concentrating;
- pallor of the skin;
- abdominal pain of inconsistent localization, often under the ribs on the right, near the navel;
- choking cough;
- a tendency to motion sickness in transport, attacks of dizziness, surges in blood pressure;
- rhinitis that occurs when weather conditions change, body position changes.
During the examination of the baby, the doctor discovers an increase in the size of the spleen, liver, and lymph nodes. A general blood test with a leukocyte formula shows an increased content of eosinophils.
How do lamblia manifest in the liver in adults
During the examination, the doctor reveals the signs of hepatolienal syndrome in the patient. It is manifested by hepatomegaly (an increase in the size of the liver), splenomegaly (hypertrophy of the spleen). The patient has a narrowing of the bile ducts (dyskinesia), which is accompanied by stagnation of biologically active fluid. Cholecystitis gradually develops.
There are dyspeptic disorders - constipation, which are replaced by diarrhea with loose and fatty stools. In patients with giardiasis, enteritis, duodenitis, enterocolitis are diagnosed.
A sick person complains that the stomach is swollen, and suddenly there is a loud rumbling in it. Pains appear in the intestines, from the liver, around the navel. Massive invasion provokes heartburn, belching.
On a note! In addition to disorders of the digestive organs, lamblia in the liver in adultsprovokeproblemswe are in workother systems.
The skin in adults with giardiasis becomes pale with a yellow tint. The dermis becomes dry and flaky. Small painful cracks may appear in the corners of the mouth. Such symptoms are associated with a deterioration in the absorption of nutrients from the digestive tract, as well as the influence of toxins that enter the bloodstream with giardiasis.
The acute phase of giardiasis in adults lasts 7-10 days. After this, recovery occurs or the pathological process becomes chronic. It is characterized by the following manifestations:
- weight loss;
- deterioration in performance in combination with increased irritability or apathy;
- appearing from time to time attacks of diarrhea, increased gas formation.
With prolonged giardiasis invasion, intoxication increases. All new health disorders are being identified:
- hypertrophy of the nasopharyngeal tonsils;
- an increase in the size of the lymph nodes;
- subfebrile condition, persisting for a long time;
- recurrent or sluggish conjunctivitis, blepharitis, cheilitis;
- decrease in the body's resistance to infectious agents.
Even in the presence of several of the listed manifestations of giardiasis invasion in the liver at once, the true cause of the deterioration of well-being in adults is often not diagnosed for a long time. The reason for this is the similarity of the symptoms of giardiasis with the manifestations characteristic of other diseases.
How is giardiasis diagnosed?
The survey involves such procedures.
| Laboratory methods | Research features | Instrumental methods | Research features |
|---|---|---|---|
| Identification of cysts in feces | Sometimes it is required to take the test again (2-3 times) | Fibrogastroduodenoscopy, portion of bile "A" | A laborious and tedious method for the patient, rarely used today |
| Detection of antigens to lamblia in feces, tissue samples obtained by biopsy | Highly informative method, detects antigens even during periods when cysts do not come out with feces. Available only in laboratories in major cities | Ultrasound examination of the liver, biliary tract | Shows the presence of dyskinesia, signs of duct inflammation |
| Polymerase chain reaction for the determination of individual lamblia DNA | Highly informative, but expensive analysis, not widely used | Contrast medium cholecystography | Allows you to detect cholestasis, dyskinesia |
| Detection of immunoglobulins M, G, A in venous blood | Indirect diagnostic method. A false positive result is possible if there are blastocysts, intestinal amoeba in the body | ||
| Complete blood count with leukocyte count | Indirect method. Allows you to suspect giardiasis with repeated detection of a high rate of eosinophils |
Video - Giardia in children and adults
How to get rid of lamblia in the liver
It is necessary to treat giardiasis if the diagnosis is confirmed by research. Therapy involves an integrated approach in several stages.
Treatment is aimed at eliminating signs of intoxication, improving the enzymatic activity of the digestive glands, cleansing the intestines, and normalizing the state of the immune system. The preparatory period usually lasts 10-14 days. During this time, the patient is advised to adhere to a special diet that restricts the use of proteins and foods high in simple carbohydrates. Patients need to give up sweets, flour, confectionery, smoked meats. The diet should be dominated by:
- cereal dishes;
- dried fruits;
- fresh vegetables and fruits;
- unrefined vegetable oils.
The third stage involves recovery from drug therapy. At this time, the body's defenses are strengthened, conditions are created in the organs of the digestive and hepatobiliary systems in which Giardia does not multiply.
Patients are assigned an appointment:
- adaptogenic preparations of herbal origin;
- vitamin and mineral complexes;
- pre-, probiotics;
- enzymatic agents.
To assess the effectiveness of the treatment, the patient is prescribed tests immediately after the end of the course. Re-diagnostics need to go through a month later.
Video - The main symptoms of giardiasis
How to avoid Giardia infestation
Prevention of giardiasis consists in observing the rules of hygiene. Adults should stick to them themselves and teach their children to do so.
You can avoid infection if:
- do not drink unboiled water from the water supply system, open sources;
- thoroughly wash fruits and vegetables before eating;
- wash hands with soap and water before eating;
- carry out antihelminthic treatment of animals every six months;
- take antihelminthic drugs (recommended by a doctor) for adults and small family members in spring and autumn.
On a note! For prophylactic purposes and as ancillary to drug therapy, you can take antihelminthic agents based on folk recipes.
One of the most affordable of these is sauerkraut pickle. Adults are recommended to drink 100 ml of it half an hour before a meal. The duration of the course is 10-12 days.
Before using folk remedies against lamblia for prophylactic purposes, you need to consult a doctor. Many recipes contain alcohol, plants with toxic properties. Their uncontrolled intake can only worsen the state of health.
