It is more common than you think

One of my friends told me that she was having a problem with diarrhea and stomach pain, and she was cutting things out of her diet, changing when she ate, and her whole routine before finally getting a diagnosis from a Gastroenterologist: “giardiasis”.  Giardia is one of those parasites that I always think is always present in third world countries without running water, and could never happen in a place where we eat organic (or at least try to), wash everything in fresh water, and are super freaks about cleanliness, right?  Wrong!  Apparently it is a pretty common cause of diarrhea in the US and other countries.  Yikes!

What is Giardia?
It is a parasite that colonizes and reproduces in the small intestines of humans and other animals causing cramping and diarrhea and can take 1 to 2 weeks from time of first infection until you see symptoms.

How do I get it?
Giardia must be swallowed to cause an infection and you can get it if you ingest food or water which has been contaminated with the parasite.  Also, since it lives in the small intestine, the parasites can also be spread through bowel movements by changing diapers, using toilet paper, etc. So, people who don’t wash their hands after using the bathroom, then smoke, bite their nails, etc. can infect themselves.  Also, if you get the parasite on your hands, you can spread the parasite when preparing foods and spread to other people.  Giardia can be spread quickly in daycare centers with children and in nursing homes, where people require care with bowel movements.  As well, in areas where fresh water is tough to come by, if a water source is infected with any form of raw sewage, it can easily infect others.  It is an infection that requires reporting to the Department of Public Health in your city (in the US) because the risk of spreading is so high.  And it can also be spread through the stool of animals!!

What are the symptoms and how do I know I have it?
The most common symptoms are:
Foul-smelling soft stools
Abdominal cramping
Increased gas
Loss of appetite
Weight loss
If you have these symptoms and they are not going away, you should see your HCP who will order studies on your stool and will test for the parasites or they may do an invasive study (enteroscopy) to look at the small intestine, but mot commonly the stool samples will produce a positive test if you have the infection and you can begin treatment.

How do I treat the parasite?
Some of the infections go away on their own, but most times the infection needs to be treated with with metrodiazole (flagyl) which is an antibiotic and antiprotozoal agent to kill off the parasite and make the area inhabitable for the parasites.  You might also need Intravenous fluids for dehydration and diarrhea, and a lighter diet might be required (like leave out the dairy or heavy foods) while your stomach is cramping and feeling unwell.  Sometimes even with treatment, if you have had the parasite infection for a while, even after the infection is gone, you may still have symptoms for a while.

How do I prevent it?
Prevention is key here, for certain!  If you have a water source that may be contaminated (like if you are hiking or receive a notice from your towns reservoir, etc) you should try to decontaminate water by boiling it, using iodine treatments, or filtration systems before drinking, cooking, or in any way ingesting the water.  As well all healthcare workers and daycare center workers should be vigilant about washing their hands with antibacterial soap after helping with patients/children using the bathroom and with any contact with fecal matter.  Also, after walking your dog, touching any animals, make sure to wash your hands and if you can’t rush to get your hands cleaned off, don’t touch your hands to your face/mouth.

If you have any of the symptoms or are worried that you may have giardia, it is worth a trip to your HCP for a stool test to make sure that you don’t have the parasite, and if you do, getting early treatment will make you feel better faster.  Just be aware that this infection can happen to anyone who lives in developed and undeveloped countries alike!

Yours in Good Health

Nurse Bridgid

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