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Doctors' Answers to "Frequently Asked Questions" - Parasites

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

[posted 08/25/1999]
Question: I had been diagnosed with an intestinal infection called Amebrasis(Entomeoba Histolyitca), and this was diagnosed approximately last year. I took Metranizodole and that seemed to have cured the diarrhea and stomach problems, but after about 4 months these symptoms began to appear again. This last 6 months, the symptoms have come back. The doctor prescribed me another dosage of Metranizodole, which did not work. He just recently prescribed Iodoquinol to help clear the bug out of my system, since the stool sample was picking up cysts of Entomeoba Histolytica. I still have this stomach problem despite all of this! What could be wrong? The worst part is usually when I wake up in the morning. Just the act of waking up seems to disturb my stomach balance, and I have to go to evacuate my bowels immediately. The morning bowel movement is loose, and a bit watery there is no blood or mucus in the stool. By the end of the day, my final meal is a lot better, and I don't usually have to go to the bathroom after the last meal of the day. However my bowel movements are 3-5 times a day, which is a lot more than before. It feels like I have trapped Gas inside the stomach that just can't leave, and the stool occurs in more frequency with less bulk. Please help me!

Answer: You have not been able to eradicate the infection, I'd see an Infectious Disease Specialist for other options, you've tried the usual.

Treatment of Entamoeba coli and hystolitica [posted 1/12/99]
Question: I have lived in Mexico for several years. A month ago I started having stomach problems and a stool analysis showed "numerous entamoeba hystolitica and entamoeba coli". A friend of mine died of an amoeba last year in South America, so I am very concerned about the disease. My doctor prescribed "Flagenase 400" which contains Metronidazol 400 mg and Dihydroquinolone 200 mg, taking a capsule every 8 hours. He said side effects are very bad, and that therefore most of the patients cannot complete the entire treatment which call for 10 days of taking the drug. However, he said it is OK if I try to take it only for a few days. What is the best treatment against these amoeba? Will the prescribed drug successfully eliminate the amoeba? Is this a safe treatment considering the side effects?

Answer: Elimination of parasites is difficult and requires medications which can be somewhat difficult to take. These would be appropriate medications and most patients can take the metroniadazole fine, it is the dihydroquinolones that give the trouble. Also, there are several types of amoebas and I suspect your friend in South America has the type that affect the liver, which you don't have.

Entamoeba Histolitica [posted 11/24/98]
Question:  Please help me. I really need an article about "entamoeba histolitica". I've been looking all over, but to no avail. I need a recent article about it. Thanks.

Answer: Try Bailey and Scott's Diagnostic Microbiology Ed. 10 pub by Moseby pg. 784. Available in any medical library and many general libraries.

Question: A few weeks ago I saw a television program that advertised a report on parasites stating that many people feel ill all the time because of parasites. I would like to know if this could be true and what can be done about it? Are there over the counter medications for parasites?

Answer: I suspect you are thinking of the news reports of cyclospora from imported Mexican fruit. There are numerous types of parasites. Most are transmitted through contaminated food or water. However, some are transmitted by insect vector (malaria for example). Protecting the food supply is the best way to avoid parasites. General public health policy to wash your food and avoid food from unsanitary environments was good advice in 1920 and is still good advice. It is interesting that we generally avoid fresh fruit in underdeveloped countries to avoid parasites and diarrhea. However, much of the fruit in the United States is now imported from Central and South America. Treatment for any parasitic disease depends on identifying the organism. Some have treatments, but some do not. There are few, if any, over the counter treatments available.

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