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Friday, August 1, 2008

Some aspects of Giardiasis with homoeopathic mode of treatment

This is a small-intestinal disease due to infestation caused by Giardia lamblia, a flagellate that is found worldwide. Cyst causes infection. It is an important cause of traveller’s diarrhea worldwide usually occurring on return from travel. Prevalence is high throughout the tropics. Many individuals excreting giardia cysts are asymptomatic and hence carriers. Symptoms are produced within 1-2 weeks of ingestion of cysts.

Pathogenesis-The organism colonizes & multiplies within the small-intestine and may remain there without causing any detrimental effects to the host. Otherwise it causes alteration in mucosal architecture. The changes in villous architecture may vary from mild partial villous atrophy to rarely subtotal villous atrophy. The mechanism of producing diarrhea & intestinal malabsorption is ill understood.

Age- Children are mostly affected though adults are not immune to it.

Clinical Features- Children often produce symptoms whereas adults may be asymptomatic. Symptoms are produced within 1-2 weeks of ingestion of cysts. These include diarrhea, often watery in the early stage, nausea, anorexia, abdominal discomfort, distension and pain. Stools gradually become paler and frothy, with the characteristic features of steatorrhoea. There is gradual emaciation which is marked even in previously healthy individuals.

(1) Malabsorption syndrome in severe cases.
(2) Growth retardation in children due to chronic giardiasis.

Laboratory Investigations-

(1) Stool examination-It may show both cysts and trophozoites. But as the parasite may be excreted at irregular intervals, a negative result does not exclude the diagnosis. Stool examination aids in the diagnosis of giardiasis in 80-85% of patients.

(2) Indirect immunofluorescence (IFA) /ELISA- Detection of circulating antibody to G. lamblia can be done.

(3) Invasive method- An alternative method is upper endoscopy with biopsies of the mucosa of the jejunum and aspirate of the duodenum to detect the presence of the parasite in them if other procedures fail to confirm the diagnosis of giardiasis.

Control and prevention- Eradication is difficult because of the substantial human reservoir of asymptomatic cases and remote hope of vaccine development. Improved standards of personal hygiene and water quality are to be maintained. Standard of water quality may be improved by using different types of water purifiers.

Treatment- Homoepathy can be effectively used for its remedy. If flatulence or abdominal discomfort predominate, China ( Cinchona Officinalis) 6 & Carbo.veg (Carbo Vegetabilis) 6 should be alternatively used each 6 times daily for seven days or until the disease is controlled . Aloes 30 should be used six times daily in diarrhea for at least seven days or till the persistence of diarrhea.

Labels- China ( Cinchona Officinalis), Carbo.veg (Carbo Vegetabilis), Aloe, Biopsy, Prevalence,Villous, Atrophy, Water purifier, Cyst, Duodenum, ELISA, Endoscopy, Invasive, Small-intestine, Diagnosis, Giardia lamblia, Abdominal, Method, Infestation, Flagellate, Mucosa, Pathogenesis, Reservoir ,Growth retardation, Indirect immunofluorescence (IFA), Jejunum, Malabsorption syndrome, Diarrhea, Parasite, Flatulence, Steatorrhoea, Stool, Trophozoite.

IN SHORT-Giardiasis is a small-intestinal disease caused by Giardia lamblia & may be asymptomatic or is manifested diarrhea, often watery in the early stage, nausea, anorexia, abdominal discomfort, distension and pain. Treatment is as mentioned above.

But in every case a doctor should be consulted.