Diagnosis of Giardiasis

Giardiasis is a parasitic disease that belongs to the group of intestinal infections. The causative agent, penetrating the human body, causes damage to the digestive organs( intestines, duodenum, liver).The disease is common both among adults and in children's groups.

According to statistics, giardiasis is detected by a survey of 3-15% of the adult population and 30-40% of organized children, including schoolchildren. The indicator is higher in underdeveloped countries. Timely diagnosis of Giardiasis is allowed in time to carry out antiparasitic treatment and relieve people of the development of chronic pathology of the gastrointestinal tract.

What properties of the pathogen should be considered in the diagnostic methods?

The first to describe the cause of the disease is the Russian doctor D.F.Lymble in 1859, with his name and associated the name of the parasite and disease. In European countries, this role is given to the Frenchman A.Jiard, so you can find the name of the disease as "giardiasis".

Giardia is the simplest unicellular flagellate microorganism. Parasitises mainly in the initial sections of the small intestine of a person( duodenum and jejunum).It can exist in two forms: vegetative( trophozoite) and spores( cysts).Under a microscope, it is not difficult to recognize them by the characteristic pear-shaped form, suckers and four pairs of flagella.

Parasites are quite mobile, perform oscillatory and circular motions

Lamblias feed through the shell by sucking the necessary substances from the intestines, taking them away from the body of the infected person. Reproduction is carried out quickly by division, doubling occurs every 10-12 hours. Cysts of lamblia are provided with a double-contour capsule, oval in shape.

They are found only in the large intestine, they stand out with the patient's feces into the external environment, where they remain viable for a long time. This feature makes it relatively easy to organize the diagnosis of Giardiasis for the study of stool. A person becomes infected through unwashed hands, vegetables from the garden, water, contaminated food, in the home by a fecal-oral route. Possible carriers of cysts are domestic animals, flies, cockroaches.

For what symptoms can you suspect lambliasis?

To detect giardiasis, you need to know the symptoms of the disease and consider possible forms of flow. Anticipated diagnosis arises in the doctor when analyzing the patient's complaints, examination. The disease is acute and chronic. An important feature is considered to be almost asymptomatic carriage in ¼ patients, mild manifestations - in half the cases( subclinical course).

Only in 25% of infected are typical symptoms of giardiasis( manifest flow).Depending on the prevalence of signs of damage to organs and systems, it is customary to distinguish four forms of the disease:

• intestinal - manifested by the disorder of the functioning of the small and large intestine as duodenitis, enteritis and gastroenteritis, causes duodenal gastral reflux;
• biliary-pancreatic - symptoms of giardiasis in adults and children are similar to the clinic of inflammation and dyskinesia of the gallbladder, the pathways, pancreatitis;
• extraintestinal - differs by toxic and allergic signs, is accompanied by nonspecific astheno-neurotic syndrome, vegetovascular dystonia;
• mixed - on the symptoms it is difficult to diagnose the variant of the lesion in the diagnosis, an analysis for lambliasis is necessary for confirmation.

Symptoms of Giardiasis usually appear 1-3 weeks after infection. This is the duration of incubation of cysts before transformation into a vegetative form. In the acute phase of inflammation, patients complain:

• for non-intense pain around the navel, in the hypochondrium right;
• decreased appetite;
• nausea;
• severity in the epigastric region;
• belching;
• enhanced gas formation in the abdomen;
• predisposition to diarrhea( stool up to 5 times a day, watery, frothy, then acquires a greasy shine), diarrhea can alternate with constipation.

If the lambliasis passes into a chronic stage, the patients noticeably lose weight, become irritable, suffer from increased fatigue, weakness, unstable signs of gastroduodenitis, dyskinesia of the intestine, jejunita( inflammation of the jejunum).The severity of intoxication depends on the massive amount of cysts entering the human body, the duration of the disease.

Possible temperature increase, inflammation of regional lymph nodes, adenoids. The action of toxins with giardiasis on the nervous system is due to a sharp change in mood, irritability, dizziness, lowering blood pressure.

In childhood, neurologists detect neural tics, obsessive movements( hyperkinesis), a tendency to fainting. Skin changes consist in increased dryness with peeling, itchy rashes in the form of vesicles, keratosis, hives, other types of dermatitis.

In children, giardiasis causes skin lesions by the type of neurodermatitis

It is necessary to suspect lambliasis in patients with persistent blepharitis and conjunctivitis( inflammation of the eyelids and membranes of the eye).Allergic manifestations sometimes reach asthmatic bronchitis and bronchial asthma.

How is lambliasis diagnosed by laboratory methods?

From the clinical symptoms of giardiasis, it can be seen that patients with such manifestations can be treated for a long time from a gastroenterologist, neurologist, oculist, dermatologist, allergologist-immunologist. Ultrasound, cholecystography will only confirm the presence of damage to the hepatobiliary system, but will not help in identifying the cause.

General laboratory methods are not very specific for Giardiasis, but show the level of disorders:

• In general, blood analysis is usually alarmed by monocytosis and eosinophilia.
• Among biochemical tests, a decrease in the blood protein( both albumins and globulins) is detected, the growth of the enzyme alkaline phosphatase.
• In the analysis of stool, there are found coprologic signs of inflammation and digestion disorders: many fat inclusions, undigested fibers, mucus, leukocytes, erythrocytes.

The modern level of diagnosis requires mandatory parasitological analysis for giardiasis. Taking into account the stage-by-stage development of the microorganism, the diagnosis should be confirmed by the detection in the feces of the lympis cysts, in the contents of the duodenum - vegetative forms. To do this, microscopy of the smears of the material is carried out.

Since adolescence, it is possible to detect lamblia in bile by a microscopic method, it is examined after duodenal sounding. This procedure in children is impossible. Microorganisms are found on the glass( in vitro) by characteristic signs, to improve the detection of Giardiasis, a special color is used.

Infectionists recommend for more accurate detectability to consider the cyclicity of reproduction and allocation of parasite forms with feces. For this purpose it is better to pass the analysis repeatedly for a month from three to five times with interruptions of 1-2 weeks.

Detection of parasites depends on the training of specialists, the correctness of the collection of material and the time of delivery to the laboratory

. The method is simple in carrying out is not expensive. The feces are taken to a special sterile container. It is necessary to take suspicious clumps of mucus, particles with a changed color. Cysts are detected on delivery within 24 hours. Detect the vegetative form of lamblia is much more difficult, because they die 60 minutes after defecation. Hence, the material should be delivered as soon as possible or the fence should be made in a medical institution.

The study of feces on intestinal flora is of utmost importance. The calculation shows the ability of lamblia to reduce the proportion of bifido- and lactobacilli, stimulate the growth of other microorganisms, activate the appearance of pathogenic staphylococci, streptococci, fungi.

More sensitive methods of diagnosis

The complexity of differential diagnosis, the search for a source of infection( in the family, children's team) requires the identification of minimal changes in asymptomatic lambliasis.

Enterotest with

thread The patient is allowed to swallow a gelatin capsule with a nylon thread. In the intestine, the capsule dissolves, and the existing parasites attach themselves to the filament. At the exit from the calves, it is subjected to microscopy. This way it is possible to increase the probability of parasite isolation.

Features of immunological diagnosis of Giardiasis

The causative agent of Giardiasis has pronounced antigenic properties. Allergic mood is most pronounced in infants with diathesis. By the degree of sensitization of the body, infection is diagnosed by immunological methods. The reliability of the obtained results reaches 80%.

The theoretical basis of the technique consists in compulsory formation in 2-4 weeks after infection of specific antibodies in the blood serum of the patient in response to the introduction of a foreign microorganism( antigen).Before taking blood from the vein, the patient is advised not to eat for 8 hours, only drinking water is allowed.

Antibodies are immunoglobulins( Ig).In the analysis, two types are most significant: IgM - indicate an acute phase of inflammation caused by Giardia, IgG - react more to the chronic form of the disease, high concentrations of both immunoglobulins - should be considered as an exacerbation of chronic giardiasis.

The immunoassay analysis loses its specificity when comparing the results with other parasitic infections, therefore its informativity is not considered very accurate.

The method of polymerase chain reaction( PCR)

The most informative technique in the diagnosis of giardiasis, since it allows 100% confidence in the presence of a very small amount of genematerial lamblia in the human body. The method is absolutely specific, does not give false positive results.

Blood, urine, feces, duodenal contents, saliva, sputum can serve as a material for identifying lambliasis. Blood for analysis must be passed on empty stomach. The result is given no more than two days. Positive - confirms the presence of a person in the body lamblia.

Biopsy study of the

If the patient needs to more accurately establish the degree of lesion, exclude tumor growth, then duodenogastroscopic examination is performed. Fine-fiber optics at the end of the probe allows you to visually inspect the mucous membrane of the stomach and duodenum. It is mandatory to take material for a biopsy from five points. The smear and microscopy make it possible to detect the presence of lamblia and cysts in the upper intestine.

Is it possible to identify infection with lamblia in folk ways?

Folk remedies can not be correctly diagnosed. Lamblias are not worms, they are not visible to the eye. Not even experienced healers are advised to assert about the contamination of the appearance of feces. There are suggestions on the use of herbal remedies in treatment, but not for diagnosis. The best option is to pass the tests offered by the doctor.

Who needs a preventive examination?

Among the population, you can identify a group of high-risk, subject to the risk of infection. When there are symptoms of intestinal damage, they need to first analyze the lambliasis. Special attention is required by:

• people engaged in field work, cottage and vegetable garden, subsidiary farming;
• veterinarians and lovers of cats, dogs, rabbits;
• children and adults with insufficient protein nutrition, fasted, low-calorie diets;
• babies with congenital underdevelopment of bile ducts;
• chronic patients with a tendency to decrease the acidity of gastric juice and a lack of digestive enzymes( with chronic gastritis, peptic ulcer, condition after removal of part of the stomach).

It is necessary to identify and treat Giardiasis without delay. Prolonged course of specific inflammation contributes to the development of chronic diseases of an allergic nature, causing severe disturbances in the digestive organs. Little children with giardiasis develop poorly physically and mentally. Therefore, the examination can not be neglected if the doctor recommends it.