Irritable Bowel Syndrome and Chronic Fatigue 6 Years After Giardia Infection: A Controlled Prospective Cohort Study

Abstract

Giardia infection in a nonendemic setting is associated with an increased risk for irritable bowel syndrome and chronic fatigue 6 years later. These conditions should be considered a differential diagnosis in patients with persisting symptoms after eradication of the parasite.

Molecular typing ofGiardia duodenalisin humans in Queensland – first report of Assemblage E

“…Most infections are selflimiting but chronic infections can lead to weight loss and malabsorption (Ryan and Cacciò, 2013) and infections are associated with stunting (low height for age), wasting (low weight for height) and cognitive impairment in children in developing countries (Berkman et al 2002;Feng and Xiao, 2011). Furthermore, acute giardiasis may disable patients for extended periods and can elicit protracted post-infectious syndromes, including irritable bowel syndrome and chronic fatigue (Hanevik et al 2014). In Australia, the overall prevalence is ∼2 to 7%, with a steady increase of reports each year (Asher et al 2016).…”

Irritable bowel syndrome - from etiopathogenesis to therapy

“…15 ). In patients with Giardia lamblia infection the prevalence of IBS was 46.1% as long as 3 years after exposure, compared with 14% in controls 33 . The mechanisms that cause postinfectious IBS are unknown but could include residual inflammation or persistent changes in mucosal immunocytes, enterochromaffin and mast cells, enteric nerves, and the gastrointestinal microbiota 7 .…”

Emerging Issues in Managing Pediatric Parasitic Infections: An Assessment of Clinical and Epidemiological Knowledge of Giardiasis and Cryptosporidiosis

“…Almost all pediatricians would consider a parasite-induced infection after about >1 or >2 weeks (44.9% and 43.3%, respectively), while ~5% cited that they do not usually think about parasitic infection. History and physical Given these findings with respect to the causes and definition of pediatric diarrhea and consideration of parasitic infection in children, it is important to bear in mind recent reports of the potential for long-term complications from parasitic infections [14,15]. Six years after a waterborne Giardia outbreak, [15] the prevalence of irritable bowel syndrome (39.4%) and chronic fatigue (30.8%) were elevated and significantly increased (relative risk approximately 3-fold higher) compared to matched controls.…”

“…History and physical Given these findings with respect to the causes and definition of pediatric diarrhea and consideration of parasitic infection in children, it is important to bear in mind recent reports of the potential for long-term complications from parasitic infections [14,15]. Six years after a waterborne Giardia outbreak, [15] the prevalence of irritable bowel syndrome (39.4%) and chronic fatigue (30.8%) were elevated and significantly increased (relative risk approximately 3-fold higher) compared to matched controls. Compared to results 3 years previously, [14] the prevalence of both conditions decreased over time.…”