The Effect of Giardia Lamblia Infestation on the Gastro‐intestinal Tract

Abstract

Five patients with Giardia Iamblia infestation are presented, all of whom showed evidence of malabsorption. Marked mucosal damage, found in two cases, was reversible within four weeks of commencement of mepacrine therapy. One patient, who failed to respond to this therapy, was treated successfully with a course of metronidazole. The pathogenesis of malabsorption in Giardia Iamblia infestation is discussed. It is suggested that the malabsorption results from mucosal damage consequent on a " toxic effect " exerted by the organism.Giardia Iamblia infestation is common in Australia. A careful search for the parasite is recommended in patients who have experienced abdominal pain and diarrhrna, particularly where there is evidence of malabsorption.

Giardiasis: clinical and therapeutic aspects.

“…We found no evidence of any other gut pathogen in our patients. Malabsorption in giardiasis has been reported from a variety of geographical locations (Amini, 1963;Yardley et al, 1964;Antia et al, 1966;Alp and Hislop, 1969;Moore et al, 1969;Tewari and Tandon, 1974). The comparative paucity of reports probably relates ,to the fact that giardiasis is most common in countries where physicians' time and hospital facilities cannot be expended on the study of an easily treatable gastrointestinal infection.…”

“…In experimental infections of prison volunteers, Rendtorff (1954) found that spontaneous eradication of the parasite was the rule but clinical experience indicates that patients may be infected and symptomatic for several years (Alp and Hislop, 1969). It is likely that immunological mechanisms may be involved in the process of eradication (Hermans et al, 1966;Ament and Rubin, 1972).…”

Giardiasis: Nutritional Implications

“…Radiographic studies based on a limited number of cases have reported the reversal of several patterns, ineluding mucosal edema, a "sprue-like" pattern, dilatation of the duodenum and jejunum, and other "motor disorders," following successful treatment of the giardial infection [17,18]. A picture of the histologic alterations related to Giardia in the human intestine emerged with the application of increasingly sophisticated morphologic investigations of material from intestinal biopsies.…”

“…Fourteen of 23 children infected with Giardia had reversible o(-)xylose malabsorption in another series [64]. The prevalence of abnormal absorption of xylose in human giardiasis has generally been reported in the range of 23070 to 55070 [18,23,24,32,63]. In some series, however, malabsorption of xylose has been virtually nonexistent [40,59,65].…”

“…Please address requests for reprints to Dr. Noel W. Solomons, International Food and Nutrition Program, Massachusetts Institute of Technology, Room 20A-201, 18 Vassar Street, Cambridge, Massachusetts 02139. 859 lamblia cysts showed no correlation between the dose administered, fecal excretion of organisms, and symptomatic response.…”