Giardia: What Is It, How It Manifests Itself And How To Treat It

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Giardia: What Is It, How It Manifests Itself And How To Treat It
Giardia: What Is It, How It Manifests Itself And How To Treat It

Video: Giardia: What Is It, How It Manifests Itself And How To Treat It

Video: Giardia: What Is It, How It Manifests Itself And How To Treat It
Video: Giardiasis 2024, March
Anonim

Giardia is a single-celled microscopic parasite that can multiply in the human small intestine. When infected with this parasite and the presence of clinical symptoms of the disease, adequate treatment of giardiasis is required. The disease has both mild and severe course. In some cases, carriers of lamblia themselves do not get sick, but they can infect others, since their body serves as a safe container for pathogens.

The content of the article:

  • 1 What is lamblia
  • 2 Forms of existence of lamblia
  • 3 Classification
  • 4 Source of infection with lamblia
  • 5 Symptoms of giardiasis
  • 6 What are lamblia cysts
  • 7 Chronic giardiasis
  • 8 Giardia intestinal
  • 9 Intestinal lamblia - the cause of duodenitis
  • 10 Intestinal giardia - cause of diarrhea
  • 11 Treatment of lamblia in adults
  • 12 Danger of infection with lamblia in children
  • 13 Consequences of parasitism of lamblia in the body
  • 14 Prevention of lamblia

What is lamblia

Giardia is a single-celled parasite that lives in the small intestine and can cause a wide variety of health problems (from gastrointestinal symptoms to allergies and neurocirculatory dystonia).

What is lamblia
What is lamblia

This is a genus of microorganisms, some of which are dangerous intra-intestinal parasites of humans, mammals and birds. These include, for example, lamblia Lamblia Intestinalis, infection with which leads to the development of giardiasis disease.

Like any unicellular organisms, lamblia are microscopic in size: on average, 9x12 microns. The body of the parasite is symmetrical, rounded on one side and pointed on the other. Four flagella allow lamblia to actively move in the human intestine, affecting all new areas.

According to the WHO, giardia is the most common protozoan parasite, to which young children are especially susceptible.

Another interesting feature in the structure of lamblia is the presence of a suction disc, with which the parasite fixes its position, attaching itself to epithelial cells in the gastrointestinal tract. However, Giardia constantly migrates and is fixed only for a short period.

For the development of lamblia in the liver and gastrointestinal tract, oxygen is not needed. Microorganisms feed on nutrients in the human intestine, absorbing them throughout the body surface.

Giardia Intestinalis can exist in two forms - mobile (flagellate, vegetative) and motionless (cyst). What are lamblia cysts? This form allows the unicellular to survive in the environment.

What is lamblia
What is lamblia

Giardia forms a dense shell around themselves, practically insensitive to changes in external conditions. Due to this, microorganisms can easily tolerate negative (up to -13 ° C) and high (up to + 60 ° C) temperatures, exposure to disinfectants (for example, lamblia are resistant to chlorine) and ultraviolet radiation. In water, lamblia cysts live up to 65 days.

The parasite enters the host organism, as a rule, in the form of a cyst, but in the small intestine, lamblia pass into a mobile form, begin to feed and multiply by division.

At the same time, the entire division cycle takes only 15-20 minutes, as a result of which, soon after infection, the invasion becomes massive, and the concentration of the parasite in the intestine becomes terrifying.

Forms of existence of lamblia

Giardia can be found in the body in two main states: active, that is, in the form of trophosiodes, and also in a state of spores - the so-called cysts. In an active state, lamblia cause the greatest harm to the body.

In the human body, lamblia exist in two forms. In the form of a vegetative form, they are found mainly in the upper sections of the small intestine, where they feed on food breakdown products, especially carbohydrate (sweets and flour products).

With massive invasion, giardiasis occurs with severe clinical symptoms, has an acute or chronic course.

When it enters the large intestine, giardia turns into cysts (spore form), which are excreted with feces into the external environment. In humid conditions, in the shade, lamblia cysts retain their vital activity for up to 70 days, in the soil - up to 9-12 days, and with a lack of moisture - 4-5 days.

Giardia cysts are very stable and only die when boiled. Their carriage may not be accompanied by any symptoms. Transmission of cysts occurs orally and is possible only through feces, water and unwashed products.

Classification

  1. Giardiasis (asymptomatic giardiasis) - there are no signs of the disease, but at the same time a person releases lamblia into the environment.
  2. Intestinal form - signs of intestinal dysfunction.
  3. The hepatobiliary form is a violation of the functions of the liver, biliary tract.
  4. Giardiasis as a concomitant disease, when the underlying chronic disease (atopic dermatitis (skin allergy), celiac disease (a genetic disease in which gluten protein causes damage to the mucous membrane of the small intestine, and the absorption process is impaired)) causes a decrease in immunity, and various infections join, for example giardiasis …

The source of infection with lamblia

The typical habitat of lamblia and the source of infection is stagnant water bodies, sewage, poorly treated tap water, patients with giardiasis, domestic animals (cats, dogs). Giardia is invasive (contagious) only in the form of a cyst.

What is lamblia
What is lamblia

When using unboiled water, both from natural sources and tap water, water outbreaks of giardiasis occur.

In children's groups, the transmission of lamblia can occur from an infected child to healthy children.

Infection occurs from a sick person or a carrier of a person, an animal (dog, in nature - from deer or beavers). Infection occurs through the fecal-oral route (when microscopic particles of feces of a sick person enter the mouth): with dirty hands, water, food, and other objects.

Giardiasis symptoms

In adults, the symptoms of Giardia can vary and depend on various factors, such as the amount of Giardia in the body, the duration of the infection, and the age of the patient. Basically, the symptoms of infection with giardiasis in adults are expressed as disorders of the gastrointestinal tract.

The duration of the incubation period for giardiasis is from 1 to 3 weeks. The typical symptom of giardiasis in adults is gastrointestinal syndrome. Since the parasites are localized in the small intestine, this leads to a violation of many functions of the digestive tract.

In the acute form of manifest giardiasis, pain in the navel and / or right hypochondrium prevails, signs of dyspeptic disorders - nausea, belching, bloating, a feeling of fullness in the stomach, loss of appetite, etc. The pains do not depend on food intake, are constant aching character, sometimes spicy. Diarrhea is characteristic with a frequency of bowel movements up to 3-5 times a day.

Watery and frothy stools, observed at the onset of the disease, then become greasy and semi-shaped. Diarrhea often alternates with constipation. The duration of the acute phase is no longer than 7 days, after which recovery occurs or the course of the disease becomes subacute or chronic.

So, let's consider the main manifestations of the intestinal form of giardiasis:

  • ambiguous pain in the right side of the epigastric region;
  • soreness in the navel, not associated with meals;
  • paroxysmal pain with nausea and vomiting;
  • a feeling of full stomach, accompanied by bloating;
  • loss of appetite;
  • belching;
  • steatorrhea - a large amount of fat in the stool (usually with enteritis);
  • heartburn;
  • stool problems: diarrhea (sometimes frothy in nature) can be replaced by constipation and vice versa.

The hepatobiliary form is also common in adult patients. It is usually expressed by cholecystitis (inflammation of the gallbladder), as well as dyskinesia (impaired motor function) of the biliary tract. In these cases, the main symptoms of the disease are:

  • pain in the right hypochondrium;
  • a feeling of bitterness in the mouth;
  • belching with a bitter taste;
  • soreness when touching the abdomen in the gallbladder;
  • cutaneous manifestations of giardiasis are limited to mild jaundice and itching.

General symptoms are also characteristic: pallor of the skin (even with a normal concentration of hemoglobin in the blood), weakness, irritability, bruises under the eyes, "sticking" around the mouth, allergic manifestations.

What are lamblia cysts

Cyst is an inactive form of the existence of giardia (the simplest microorganism belonging to the order diplomonadids). It is in a shell and is designed to spread parasites from person to person and maintain viability in adverse conditions outside the small intestine.

They are not able to reproduce their own kind and move independently. Leaves the body together with feces. It is not always possible to find them in the feces, since there are long, up to 2-3 weeks, intervals when cysts are not formed. Depending on the conditions of the environment in which they find themselves, the lifespan can vary from a few hours to three months.

The inactive form of lamblia is able to survive in adverse conditions for a long time. Cysts enter the body in different ways and lead to infection. They have an oval shell. Depending on maturity - 2 or 4 kernels. The size of lamblia cysts does not exceed 14 microns.

After the introduction of cysts into the body with food or from dirty hands, two active lamblia emerge from the membrane in the duodenum. Cysts enter the body through the fecal-oral route. The source is a sick person or a carrier who excretes up to 3 million parasites with feces at a time.

Life cycle of Giardia cyst:

  • lamblia cysts enter the host's body with food or water;
  • lamblia cysts reach the duodenum, where two trophasites are formed from each cyst;
  • in the duodenum and jejunum, lamblia multiplies. Not all carriers show symptoms of infection;
  • when passing through the colon, transformation into cysts occurs;
  • cysts and trophasites of lamblia leave the host's body with feces;
  • only cysts survive outside the host;
  • Giardia cysts can survive in cold water for weeks to months.

Chronic giardiasis

The neglected form of giardiasis is found mainly in adults and school-age children. It is characterized by a recurrent course.

Consider the signs of chronic giardiasis:

  • deterioration of the general condition of the human body (lag in physical development in the younger generation);
  • dysfunction of the gastrointestinal tract (unstable and irregular stools, aching abdominal pains, nausea, lack of appetite, etc.);
  • cholecystitis and colitis;
  • deterioration of well-being in the form of headaches, malaise, painful thinness, malnutrition;
  • loss of strength and coated tongue;
  • uneven skin color (in case of constipation);
  • allergic reactions (itching on the skin, hives, etc.);
  • bronchial asthma, arthritis and more.

Treatment of giardiasis is quite long. In order to destroy all the lamblia, the number of which in an adult can reach several million, several courses of antiparasitic drugs are required. It is also necessary to restore the intestinal microflora, detoxify.

Giardia intestinal

Intestinal lamblia (lat. Giardia intestinalis, synonyms: Giardia lamblia, Lamblia intestinalis and Giardia duodenalis) is a species of parasitic flagellate protozoa parasitizing in the small intestine of humans and other mammals and birds, the causative agent of human giardiasis.

When infected with intestinal lamblia, giardiasis develops, which manifests itself as the main symptom of diarrhea. Giardiasis is common throughout the world.

Giardia intestinal (often referred to simply as giardia) is the only protozoan species that lives in the lumen of the human small intestine. They attach to the intestinal villi and absorb nutrients and various enzymes, interfering and disrupting the process of membrane digestion.

They have 2 nuclei and 4 pairs of tourniquets, which are organelles of movement and a suction disc, with which it is fixed to the epithelial cells of the intestine. The anterior end of the body of lamblia is wide, rounded, the posterior, and the caudal end is pointed.

Two supporting threads run along the midline of the body of lamblia, which divide the cell into two, symmetrical parts of the same structure. Each of them has one core. The dorsal surface and the tail end of lamblia are covered with a single cytoplasmic membrane.

What is lamblia
What is lamblia

Giardia lacks mitochondria and the Golgi apparatus, there is an endoplasmic reticulum, where the process of synthesis of substances occurs most intensively in the cell. Giardia cytoplasm is transparent. Giardia cysts are oval, their average size is 8 to 12 microns. In the cytoplasm of cysts there are 2 or 4 nuclei and a coiled flagellar apparatus.

On a note! Reproduction occurs by longitudinal division, and their number doubles every 9-12 hours. In the development cycle of lamblia, there are vegetative and cystic stages. The vegetative stage (lamblia trophosis) has a symmetrical pear-shaped shape. Trophosites are actively mobile. The size of trophosites is on average 9 by 12 microns.

Giardia multiplies in places of their greatest accumulation by paired division. The division process takes 15–20 minutes. Giardia is excreted into the external environment with feces, mainly in the form of cysts. Trophozoites can be found only in liquid feces in no more than 5% of patients infested with lamblia.

Giardia is mainly located in the proximal part of the small intestine. Giardia is attached to the mucous membrane by the front of the body, and the posterior end is free. In one place, lamblia remain fixed for a short time. They often detach from the intestinal villi and reattach to them, but in a different place or go into a free state.

Intestinal lamblia - the cause of duodenitis

Giardia can be one of the reasons for the development of chronic duodenitis in children.

What is lamblia
What is lamblia

Giardia parasitizes on the epithelium of the duodenum and jejunum, sucking on the villi and feeding on the products of hydrolysis of carbohydrates, directly leading to inflammatory-dystrophic changes in the duodenal mucosa.

Immunity against Giardia: g homoral (antibodies) and cellular immunity in giardiasis persists for two to six months after recovery. Re-infection with lamblia is possible already half a year after the last episode of the disease.

When treating children with complaints of epigastric pain, it is necessary to examine feces for the presence of lamblia, since giardiasis can be one of the causes of such pain.

In people with reduced immunity (in particular, hypogammaglobulinemia (deficiency of gamma globulins in the blood) and a decrease in the level of immunoglobulin A), the disease can become chronic.

Intestinal lamblia - the cause of diarrhea

Giardia can cause so-called "traveler's diarrhea". They are detected in about 5% of those returning from trips to tropical countries. Due to the different severity of the response of the human body, the clinical picture of infection varies from asymptomatic forms to severe diarrhea with malabsorption.

Giardia lamblia (lamblia) is ubiquitous, and in some countries of the world, the prevalence of infection among young children is close to 100%. Children aged 1 to 5 years are most often infected.

Giardia can cause severe or refractory diarrhea, sometimes malabsorption with fatty stools, abdominal pain and bloating. However, the vast majority of infections are asymptomatic. This makes it very difficult to ascertain whether giardia is the true cause of diarrhea.

For the treatment of diarrhea caused by Giardia lamblia (lamblia), WHO recommends taking metronidazole three times a day for five days at 250 mg for adults and based on 5 mg per kg of body weight for children.

It is permissible to prescribe a single dose of tinidazole (50 mg per kg of body weight orally); the use of a maximum of two doses of ornidazole is allowed in accordance with the recommendations of the manufacturers.

Treatment of giardiasis should be carried out only in case of refractory diarrhea and if Giardia lamblia cysts or trophozoites are found in a stool sample. In acute diarrhea in children, treatment of giardiasis is not performed ("Treatment of diarrhea". WHO, 2006).

Treatment of lamblia in adults

The infection is usually exposed to people from the risk group, with a weakened immune system, low acidity of the stomach, whose body does not actively resist the colonizing parasites.

What is lamblia
What is lamblia

A healthy person can be a carrier of lamblia, and not even suspect it, but serve as a source of infection. In this case, infection can be carried out not only through contact with the carrier, but also through dirty hands, contaminated drinking water, from domestic animals and through stale food.

Antihistamines and enterosorbents are prescribed throughout all three stages of treatment, because the activity of microorganisms leads to severe damage to the body, poisoning by its toxic secretions, but anti-lambliasis drugs also have toxicity directed at lamblia and affecting the human body.

The drug for lamblia in adults is prescribed at the second stage of treatment, since its initial use can lead to the appearance of anaphylactic and toxic reactions in the body, cause an exacerbation of the chronic picture of giardiasis and cause negative consequences.

That is why the prescription of drugs for lamblia for children is carried out with much more caution than for adults, given that microorganisms have managed to develop immunity to some types of lamblia drugs.

Drug therapy for giardiasis is carried out in three stages, each of which is no less important than the next:

  • preparatory (about 2 weeks, with the adoption of enzymatic drugs, enterosorbents, choleretic drugs, antihistamines, strict diet);
  • main (the time of massive antiparasitic therapy, during which drugs for lamblia are prescribed);
  • final (the doctor prescribes drugs to strengthen the body - probiotics and adaptogens, enzyme preparations, multivitamins and a diet that excludes the activity of lamblia).

The danger of infection with lamblia in children

For a child, Giardia can be a serious danger. Often, with giardiasis in children, almost the entire body suffers. With this disease, the development of allergic and toxic reactions, the occurrence of dermatitis, eczema and even asthma attacks are possible.

The danger of lamblia for the child's body is that these protozoa, inhabiting the intestines, take away nutrients, amino acids and vitamins from the child. As a result, the patient rapidly loses weight and has a poor appetite, which negatively affects the development of the child.

Giardia can change the composition of the blood, affect the heart muscle, reduce immunity and disrupt the functioning of the nervous system.

If giardia is diagnosed in children, treatment should begin immediately. The doctor will prescribe a special group of drugs that can destroy these protozoa in the body. With a timely visit to a doctor, giardiasis in children can be eliminated quickly enough. After a course of treatment with antimicrobial drugs, such as nitrofuran derivatives and mitronidazole (trichopol), you should take good care of strengthening the child's immunity.

The consequences of parasitizing lamblia in the body

Parasitism of lamblia in the human small intestine is accompanied by a number of pathological effects:

  • the introduction of lamblia into the mucous membrane of the small intestine causes the development of inflammation in it, which is the result of the toxic effects of the parasite's waste products. As a result of inflammation of the intestinal mucosa, the tissues of the small intestine are damaged, which leads to impaired absorption and insufficient enzymatic activity;
  • the binding of bile acids is disrupted, which causes itching, impaired intestinal motility, dyskinesia of the biliary tract and the development of a chronic inflammatory process in the biliary system;
  • the synthesis of secretory immunoglobulin A decreases, which leads to chronic inflammatory processes in the gastrointestinal tract;
  • long-term activity of lamblia, the effect of their metabolites on the body forms a syndrome of chronic endogenous intoxication and secondary immune deficiency.

Prevention of lamblia

Prevention of lamblia is carried out to comply with the following measures:

  • timely detection of cases of invasion, followed by high-quality treatment of patients with giardiasis;
  • following strict hygiene rules with regular hand washing;
  • use of boiled or bottled water for drinking;
  • preventing the ingress of fecal masses into the environment;
  • compliance with sanitary and hygienic measures in food and water supply establishments;
  • regular examination of people at risk for giardiasis;
  • conducting by local authorities of sanitary and educational work among the population.

There is no vaccine for giardiasis, and the immunity that is developed after the illness is not very stable. Therefore, the risk of reinfection remains high. Giardia is treated by an infectious disease doctor.

Find out more:

  • Medicine for lamblia - schemes and methods of treatment
  • Cleanse the body of parasites with folk remedies
  • Parasites - diagnosis and treatment

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