This article is written to reveal something of the relationship between Dientamoeba fragilis and blastocystis and development of disease. The focus is not on the parasites Giardia lamblia and Entamoeba histolytica, as these parasites have a much more well-known disease progression and therapy. Blastocystis hominis and dientamoeba fragilis are often much harder to eliminate requiring a comprehensive understanding of various treatment methods to eliminate the parasite.
Dientamoeba fragilis and blastocystis hominis are parasites that can sometimes infect the human digestive track. Many of those who are infected are asymmptomatiske carriers, that is, they apparently have no symptoms. People who are infected can develop a wide range of symptoms such as diarrhea, constipation, mucoid stools, abdominal pain, flatulence and bloating. Other symptoms may include nausea and vomiting, headache, dizziness, weight loss, chronic fatigue, depression, low grade fever, rash and hives, bloody stools and anal itching. Many patients may have problems for years before they find out this, and they are often misdiagnosed with irritable bowel syndrome.
D. fragilis is a pathogenic protozoan parasite that exists in the world. It lives in the colon of humans. Although it was first described as an amoeba, has recently been classified as a flagellate. Unlike amoebas form D. fragilis not resistant cyst, and it therefore can not live long outside the human host. Infection can occur by fecal-oral transmission. It is seen that there is often a coinfection with intestinal worms. One theory that has not been confirmed is that D. fragilis survive inside this worm outside the human host, which therefore helps to protect and spread the parasite. D. fragilis infection can be acute or chronic, and has been reported in both children and adults. The infected host may be asymptomatic or symptomatic. Most common symptoms are abdominal pain, diarrhea, loss of appetite, weight loss and gas pains. Other symptoms are eosinophilia, urticaria and pruritus.
The complete life cycle of this parasite has not yet been determined, but assumptions were made based on clinical data. To date, the cyst stage has not been identified in D. fragilis life cycle, and the trophozoite is the only stage found in stools of infected individuals . D. fragilisis probably transmitted by fecal-oral route and transmission via helminth eggs (e.g.,Ascaris, Enterobius spp.) has been postulated . Trophozoites of D. fragilis have characteristically one or two nuclei (, ), and it is found in children complaining of intestinal (e.g., intermittent diarrhea, abdominal pain) and other symptoms (e.g., nausea, anorexia, fatigue, malaise, poor weight gain).
Life cycle image and information courtesy of DPDx.
Image: Binucleate (left) and uninucleate (right) trophozoites of D. fragilis, stained with trichrome.
Blastocystis hominis is a parasite classified as heterokontid kromista. B. hominis lives in the intestines of humans and primates, mammals and birds. Several studies have shown the relationship between B. hominis and irritable bowel syndrome. This can be related to poor hygiene, more close contact with the animals, the intake of contaminated food and water.
It is also possible with coinfection with other parasites like Giardia lamblia, Entamoeba histolytica and D. fragilis. In some studies blastocystis the most common parasite found in human avførlingsprøver. The infected by fecal-oral transmission
Knowledge of the life cycle and transmission is still under investigation, therefore this is a proposed life cycle for B. hominis. The classic form found in human stools is the cyst, which varies tremendously in size from 6 to 40 μm . The thick-walled cyst present in the stools is believed to be responsible for external transmission, possibly by the fecal-oral route through ingestion of contaminated water or food . The cysts infect epithelial cells of the digestive tract and multiply asexually (, ). Vacuolar forms of the parasite give origin to multi vacuolar and ameboid forms. The multi-vacuolar develops into a pre-cyst that gives origin to a thin-walled cyst , thought to be responsible for autoinfection. The ameboid form gives origin to a pre-cyst , which develops into thick-walled cyst by schizogony . The thick-walled cyst is excreted in feces .
Life cycle image and information courtesy of DPDx.
There have been conducted many studies to try to uncover the connection between blastocystis hominis and disease. There is little to suggest that blastocystis is invasive in the intestines, so the harmful effect is therefore linked to an immune activation in the intestine. Recently, a 29-kDa parasite protein and a parasite assosert protease has been revealed as a potential cause of developing disease.
The infected host may be asymptomatic or symptomatic. Symptoms can vary widely from patient to patient and include acute and chronic diarrhea, abdominal pain, nausea, anorexia, gas and bloating. Other non-intestinal related symptoms include allergic reactions such as urticaria and pruritus. Patients with blastocystis is often incorrectly diagnosed with irritable bowel syndrome. Studies suggest that a low-grade inflammation due to ongoing immune activation caused by infection with blastocystis with ongoing antigen exposure can play a major role in the development of irritable bowel syndrome.
There has been some discussion in gastroenterological environments on blastocystis infection be treated, because there is still a big debate about whether blastocystis leads to disease.
Image: B. spp. cyst-like forms in wet mounts under differential interference contrast (DIC) microscopy.
The premier gastroenterological hospital in this area called the Centre for Digestive Diseases http://www.cdd.com.au/ Located in Sydney, Australia. Doctors here have dealt with complex tarmdysbioser decades. B. hominis and D. fragilis is recognized as an important factor for various chronic diseases. Doctors there have long treated patients with these parasites, and often observe a good symptomatic effect of it. Treatment includes a combination therapy with several anti-parasitic agents. In addition, it is necessary with enema just starting to make a good irrigation of parasites and toxins associated with it. After the cure is so important to build a good tarmfunskjon by providing supply of probiotics, prebiotics and nutrients to optimize a normal tarmbiota. During Treatment of parasites has led to resistant forms. Simple therapy treatment with medications such as metronidazole (Flagyl) can cause not all parasites are completely eliminated, which may lead to a recurring problem, as well as the development of resistance. To avoid this, it developed combination therapy of several anti-parasitic agents.
There are also patients who do not notice improvement of their symptoms after a parasittkur. That’s when several factors to consider:
Is it developed resistance to anti-parasitic agents
Are there others in the family who is infected with the parasite, and the patient has been reinfected.
The patient will need further treatment to clean up a complex tarmfloradysbiose with dysbiosebakterier and mushrooms.
It is therefore important to consider all the underlying factors and a holistic perspective on why the patient experiences their various ailments. This can be achieved by performing a thorough analysis of both history and various functional medical tests are designed to detect various biological and biochemical imbalances.