Development of functional gastrointestinal disorders after Giardia lamblia infection.
BACKGROUND
Functional gastrointestinal disorders (FGID) may occur following acute gastroenteritis. This long-term complication has previously not been described after infection with the non-invasive protozoan Giardia lamblia. This study aims to characterize persistent abdominal symptoms elicited by Giardia infection according to Rome II criteria and symptoms scores.


METHODS
Structured interview and questionnaires 12-30 months after the onset of Giardia infection, and at least 6 months after Giardia eradication, among 82 patients with persisting abdominal symptoms elicited by the Giardia infection. All had been evaluated to exclude other causes.


RESULTS
We found that 66 (80.5%) of the 82 patients had symptoms consistent with irritable bowel syndrome (IBS) and 17 (24.3%) patients had functional dyspepsia (FD) according to Rome II criteria. IBS was sub classified into D-IBS (47.0%), A-IBS (45.5%) and C-IBS (7.6%). Bloating, diarrhoea and abdominal pain were reported to be most severe. Symptoms exacerbation related to specific foods were reported by 45 (57.7%) patients and to physical or mental stress by 34 (44.7%) patients.


CONCLUSIONS
In the presence of an IBS-subtype pattern consistent with post-infectious IBS (PI-IBS), and in the absence of any other plausible causes, we conclude that acute Giardia infection may elicit functional gastrointestinal diseases with food and stress related symptoms similar to FGID patients in general.
Hanevik
Kurt
K
Institute of Medicine, University of Bergen, Bergen, Norway. mfakh@ikb.uib.no
Dizdar
Vernesa
V
Langeland
Nina
N
Hausken
Trygve
T
D015746:Abdominal Pain / Q000469:parasitology; D000293:Adolescent; D000328:Adult; D000818:Animals; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D003967:Diarrhea / Q000469:parasitology; D004415:Dyspepsia / Q000469:parasitology; D005260:Female; D005767:Gastrointestinal Diseases / Q000469:parasitology*; D016829:Giardia lamblia; D005873:Giardiasis / Q000150:complications* / Q000188:drug therapy; D006306:Health Surveys; D006801:Humans; D007422:Intestines / Q000469:parasitology; D043183:Irritable Bowel Syndrome / Q000469:parasitology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055815:Young Adult
D000981:Antiprotozoal Agents