In view of the vegetative form they aremainly in the upper small intestine, and in contact with the colon transformed into cysts (spore form), which stand out from the feces into the environment. In humid conditions, in the shadows, cysts retain their ability to live up to 70 days in soil - up to 9-12 days, and the shortage of water - 4-5 days.
The main source of infection is a person. However found that Giardia parasites in the body of cats, dogs, rodents. From a sick child in the day with stool stands up to 900 million cysts pathogen, while infecting dose is only 10-100 cyst.
Ways of infection giardiasis
There are three main routes of transmission Giardiasis: water, contact-household and food. It dominates the waterway. Infection occurs most often when used poorly purified tap water or water from open reservoirs. In the case of contact-household path of infection through contaminated cysts household items: clothes, toys, kitchen utensils, etc.
In children with bad habits, such asSucking fingers, pencils, pens, nail biting, almost 100% of cases are detected giardia. Infection with the use of infected cysts food.
Proceeding through the mouth, cysts bypass the stomach barrier(Their shells are acid) and fall into the duodenum, where one of the cysts formed two vegetative forms. Giardia attached mucosa into the villae of the proximal small intestine. Here they absorb food digestion products.
The effects of parasitism in the body
Parasitizing lamblia in the small intestine accompanied by a number of pathological effects:
introducing into the mucosa of the small intestine causes the development of inflammation therein, which is a result of cytopathic effects of metabolic products of the parasite;
as a result of inflammation occur subatrophic and atrophic changes in the mucosa of the colon, resulting in damage to the brush border and Development malabsorption, secondary fermentopathy;
violation of binding bile acids is the cause of itching, intestinal motility disorders, biliary dyskinesia;
decrease the synthesis of secretory immunoglobulin A leads to chronic inflammatory processes in the gastrointestinal tract;
as a result of long-term persistence lamblia,impact of their metabolites in the body formed of chronic syndrome of endogenous intoxication, secondary immune deficiency, sensitization.
Most of the patients with giardiasis occurs in subclinical form. When a massive invasion of the disease occurs with severe clinical symptoms and has acute or chronic.
Acute giardiasis is more common in young childrenage and is characterized by diarrhea syndrome in a typical acute intestinal infection, mainly affecting the small intestine. Dehydration lyamblioznoy for acute infection is not typical. The disease occurs on a background of normal or low grade fever. The processing time is no more than 5-7 days.
Chronic giardiasis observed mainly in children of preschool age and has a recurrent character.
Symptoms of chronic giardiasis
For the chronic form of the disease mostcharacterized by the following symptoms: general weakness, fatigue, irritability, decreased appetite, headache, dizziness, poor sleep, the appearance of ticks and hyperkinesis (in the form of bad habits).
Changes in the skin:
pallor, particularly of the skin (normal numbers of hemoglobin) and nose ( "marble" white skin of the nose);
uneven skin color combined with its subikterichnost, brownish-colored ikterichnost neck skin, the lateral surfaces of the abdomen, axillary folds;
follicular point keratosis, dry skin, creating the impression of so-called "goose skin" preferentially localized on the extensor surfaces of the arms and legs, the lateral surfaces of the abdomen;
discoloration and dryness of the skin of palms;
loss portion of the lips (from mild dryness to cheilitis);
- Resistant coated tongue.
- Bloating, flatulence, rumbling in the gut, an unstable chair with alternating diarrhea and constipation.
- Soreness of abdominal palpation in the right upper quadrant and above the navel, at the points of projection gallbladder.
- Increased liver.
- Intestinal dysbiosis.
The general analysis of blood in young children occurs leukocytosis, eosinophilia, monocytosis, anemia, and older children - leukocytosis, hypoeosinophilia, monotsitopeniya, slow sedimentation rate.
Clinical forms of giardiasis
Depending on the predominance of certain symptoms distinguish the following clinical forms of the disease: intestinal, gepatobiliarnuyu, asthenoneurotic, toxic-allergic, anemic and mixed.
When intestinal form The expresseddiarrhea and abdominal syndromes. This is an unstable chair, alternating constipation and diarrhea, steatorrhea, malabsorption, mild abdominal pain, bloating, nausea, weight loss, retarded physical development.
For hepatobiliary forms Giardiasis is characterized bybiliary dyskinesia with spasm or atony sphincter, cholestasis. Often, biliary tract lesion combined with gastritis, gastroduodenitis, pancreatitis.
When asthenoneurotic form giardiasis symptomsfrom the gastrointestinal tract or poorly expressed moderately. In the foreground headaches, irritability, fatigue, sleep disturbance, cardiopsychoneurosis.
Toxic-allergic form of the diseasecharacterized by more frequent acute allergic conditions (urticaria, angioedema). The course of acute giardiasis allergosis with persistent, lingering. It is difficult to drug therapy. Often there is the development of atopic dermatitis, which has continuously relapsing course. In some patients, it may result in the joints.
Methods of diagnosis
The most accessible method of giardiasis laboratory diagnosis in children is scatological study. However, it should be noted that Giardia cysts in feces can be detected not always.
Also feces desirable to carry out a study of duodenal contents (portions A and B).
For serological diagnosis of giardiasisusing ELISA method. Specific antibodies are detected in blood in 2-4 weeks after infection. It should be borne in mind that protivolyamblioznye antibodies can be detected in the blood for a further 4-6 weeks after the readjustment.
Treatment for giardiasis
Initiate therapy with chronic giardiasisuse of antiparasitic drugs impractical because it can lead to severe damage to the reaction with the emergence of toxicological allergic complications and exacerbation of clinical symptoms. Therefore, in such cases, the treatment should be carried out in three stages:
stage I - The elimination of endotoxemia, mechanical removallamblia, improving enzymatic activity of the intestine, correction of immunological protection. Depending on the degree of symptoms of disease stage I is carried out at Lengths 1-2 weeks and includes:
diet, which is aimed at creating conditions that can impair reproduction lamblia (porridge, dried fruits, vegetables, vegetable oil); limiting consumption of carbohydrates;
reception choleretic medication, while priority is given to holekinetiki and holespazmolitikam;
appointment enterosorbents (silicate, aluminosilicate, organomineraly);
fermentoterapii (based on coprogram);
stage II - Antiparasitic therapy. To date, the treatment of giardiasis use of chemotherapy imidazole group, tinidazole, and drugs nitrofuran series.
stage III - Increase the body's defenses and creating conditions that prevent reproduction lamblia in the intestine and gall bladder.
For this assigned diet which improvesperistalsis (cereal porridge, vegetable and fruit puree, baked apples, fresh fruit and vegetables, dairy products). In order to create an environment conducive to the destruction lamblia cysts, recommended broth birch buds for 2-3 weeks, and then 2-week break - reception decoction of seeds bearberry still for 2 weeks.
For correction of the immune response are appointedherbal adaptogens (Echinacea, Siberian ginseng, and so on. p.), multivitamin complexes. To eliminate intestinal dysbiosis, fermentopathy prescribe probiotics, prebiotics, enzyme preparations. The third stage takes about 2-3 weeks.
Prophylaxis of giardiasis
To prevent giardiasis should:
use only filtered tap or boiled water;
conduct in closed children's collectives organized survey of children and staff 2 times per year, and the detection of persons excreting Giardia cysts, sanitizing all family members;
for people who have pets, conduct regular anthelmintic treatment, tablets at least once every half a year, cleaning places and animals;
remember ways of infection and to observe careful hygiene.
A thing to remember is that the parasitic diseasesnot cured with herbs, folk remedies, Badami and "grandmother's methods" (garlic, for example, irritate the intestines and does not cure the disease and aggravates).