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The pathogenesis of irritable bowel syndrome (IBS) is not yet clear. Our study suggested parasitic infection and other plausible risk factors among Egyptian IBS patients. We studied 40 IBS patients diagnosed according to Rome III criteria (Group I), 40 with other gastrointestinal symptoms (Group II) and 40 healthy controls (Group III). Stool samples were examined using direct wet smear, sedimentation technique, trichrome stain and immune-chromatographic tests for Cryptosporidium parvum. IBS patients displayed a significantly greater percentage of Blastocystis hominis infection (45%) than non-IBS patients (20%) and healthy controls (10%). Dientamoeba fragilis was identified in two IBS patients. Detection of B. hominis was independent of demographic characters, IBS subtype, Helicobacter pylori infection or medications, but with a positive association with a history of antibiotic intake with IBS.

Background: Giardia is a diarrheagenic eukaryotic parasite that consists of at least eight morphologically identical but genetically distinct genotypes. Human giardiasis is caused mainly by A and B assemblages. Aim and objectives: The study aimed to compare the performance of gdh polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and tpi assemblage-specific primers in genotyping of G. intestinalis . Materials and Methods: Stool samples of 315 children were microscopically screened for G. intestinalis . Positive samples were genotyped using tpi assemblage-specific primers and gdh semi-nested PCR-RFLP techniques. Results: The prevalence of Giardia was 18.1%. The detected genotypes using tpi and gdh approaches were assemblage A (15.8% vs. 12.7%) and assemblage B (36.8% vs. 74.5%) as single infections and mixed assemblages A and B (47.4% vs. 12.7%). The two approaches showed a moderate agreement (kappa index = 0.413, P < 0.001). PCR-RFLP of gdh gene revealed that sub-assemblages BIII and BIV were equally detected (30.9% each). The remaining samples were equally divided between sub-assemblage AII, mixed BIII and BIV, and mixed AII and BIII (12.7% each). A significant association was detected between the retrieved sub-assemblages and the presence of symptoms. Conclusions: Although both approaches confirmed the predominance of assemblage B, the use of assemblage-specific primers is more effective in elucidating the true picture of mixed assemblage infection.