Intraepithelial Giardia Intestinalis- how to treat?

[Manisha]

Hello, my 9.5 year old student is suffering from chronic abdominal pain. She had history of diarrhea or pasty stools, neither fever nor vomiting. The feces from her were processed seeking for pathogenic bacteria and the results were negatives. The microscopic examination looking for cysts and ova after the centrifugation-concentration method was negative for cysts and eggs. The lactose hydrogen breath test was positive. The presumptive clinical diagnosis was intraepithelial Giardia Intestinalis. Please suggest some treatment option.

[Athu]

@manisha Giardia intestinalis (also known as G lamblia or G duodenalis) is a successful intestinal parasite that causes waterborne diarrhea in humans and other mammals throughout the world. The WHO has estimated more than 280 million of human infections each year only in Africa, Asia, and America. In Mexico the sero-prevalence is 55.3%. Giardiasis can be asymptomatic or symptomatic characterized by foul smelling diarrhea, with abdominal pain that is exacerbated by eating, flatulence, anorexia, and weight loss. In patients with chronic giardiasis there are periods with constipation or diarrhea with steatorrhea; nutriments malabsorption, and lactase deficiency. The parasite impairs the children's physical and mental development, especially those in developing countries. The giardiasis was included in the “neglected diseases initiative” in 2004. In most cases, giardiasis eventually clears up on its own. Your doctor might prescribe medication if your infection is severe or prolonged. Most doctors will recommend treatment with antiparasitic drugs, rather than leaving it to clear up on its own. Certain antibiotics are commonly used to treat giardiasis: Metronidazole is an antibiotic that needs to be taken for five to seven days. It can cause nausea and leave a metallic taste in your mouth. Tinidazole is as effective as metronidazole, and often treats giardiasis in a single dose. Nitazoxanide is a popular option for children because it’s available in liquid form and only needs to be taken for three days. Paromomycin has a lower chance of causing birth defects than other antibiotics, although pregnant women should wait until after delivery before taking any medication for giardiasis. This medication is given in three doses over the course of 5 to 10 days.