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Home :: Digestive Disorders

Amoebiasis

 

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Amoebiasis is an infection of the large intestine produced by a parasite Entamoeba histolytica. In a country like India almost 75% of the population suffers from this condition in view of the poor hygienic status of the population, flies, open hawking of cooked food. The common mode of spread is the fecal-oral route as also common food borne and water borne transmission. Infection can then spread from the intestines to other organs, e.g. liver, lungs and brain, via the venous system. Under these circumstances the diarrhoea becomes watery and bloody, the abdominal pain becomes more severe, and fever develops.

The E histolytica is present in two forms viz the amoebic motile form and the cyst form. The cyst is commonly spread through the oral route. In the small intestine the cyst wall disintegrateses. Immature amoebae pass into the large intestine where they live in the lumen of the gut feeding on bacteria and debris. Once amoebiasis has been diagnosed then a course of antibiotics can be provided to kill the parasite and to enable the affected person to make a full recovery within a month. Fulinating amoebic colitis is a severe form characterised by the passage of numerous bloody stools, generalised abdominal discomfort, colicky pains preceding evacuation, and rectal tenesmus (often constant and intense), with fever, dehydration and prostration. There may be intestinal haemorrhage or perforation. About 500 million people worldwide are believed to carry E. histolytica in their intestines.

Amoebiasis is infection by a protozoan , typically Entamoeba histolytica . About 9 out of 10 of those who have E. histolytica in their intestines do not develop any symptoms. However, sometimes the amoebas can start eating away at the wall of the intestine, causing diarrhoea and other symptoms. Amoebiasis, a type of gastro, is a cause of diarrhoea among travellers to developing countries. The cysts of Entamoeba Histolytica enter the small intestine and release active amoebic parasites (trophozoites), which invade the epithelial cells of the large intestines, causing flask-shaped ulcers. It is caused by a parasite known as Entamoeba histolytica that infects the bowel.

About 10 percent of the world's population is infected with E.Histolytica. It is usually contracted by ingesting water or food contaminated by amoebic cysts . Gastroenteritis (gastro) can be problem for travellers to countries with poor sanitation. Amoebiasis is common in parts of Africa, Central America, South America, India and Southeast Asia. Amoebiasis can affect people living anywhere in the world, but is most common where living conditions are crowded or there is poor hygiene and sanitation. If the parasite spreads from the bowel then it may go to the liver. Weight loss, dehydration, fever, constipation, headache and drowsiness also occur in some cases. Onset is gradual, lasting one to several weeks. Colonic lesions and perforations and amoeboma (amoebic granuloma), a granulomatous tumour-like mass on the intestinal wall, may develop. About 90 percent of infections are asymptomatic (do not produce any symptoms) and the remaining 1O percent produces a spectrum varying from dysentery to amoebic liver abscess.

Causes of Amoebiasis

The common Causes of Amoebiasis :

  • The infection spreads when infected people do not dispose of their faeces in a sanitary manner or do not wash their hands properly after going to the toilet.
  • This paper describes the unexpected occurrence of the disease in three adult males, two with colitis and the other with an hepatic abscess.
  • Contaminated hands can then spread the parasites to food that may be eaten by other people and surfaces that may be touched by other people.
  • This, to our knowledge, is the first report of amoebiasis in Jamaica for over two decades and serves to underscore the continued need for the inclusion of amoebiasis in the differential diagnosis of unexplained hepato-intestinal disease.
  • Amoebiasis is especially common in parts of the world where human faeces are used as fertiliser and is more likely to affect people who live or have travelled in developing countries, where sanitation and hygiene is poor.
  • If it invades the liver, it causes formation of the typical anchovy paste like pus. Asymptomatic carriers pass cysts in the faeces.

Symptoms of Amoebiasis

Some are common Symptoms of Amoebiasis :

  • Abdominal (stomach) cramps
  • Tenderness in the lower abdominal region
  • Blood-stained stools
  • Tenesmus (painful passage of stools)
  • Severe stomach pain ,
  • Vague gastrointestinal distress,
  • High grade fever, severe abdominal pain and profuse diarrhoea occurs in children and in patients receiving steroids.
  • Severe diarrhoea that contains blood or mucus,
  • Drinking contaminated water
  • Sometimes allergic reactions can occur throughout the body, due to release of toxic substances or dead parasites inside the intestines

Treatment of Amobiasis

Here is the list of the methods for treating Amobiasis :

  • An anti-diarrhoeal medication may also be prescribed. Metronidazole can produce a metallic taste in the mouth and may give rise to nausea. Alcoholic drinks must be avoided while taking metronidazole .
  • Children with amoebiasis should not attend school while they are infected.
  • Large abcesses in the liver may require drainage, using an ultrasound scan to localise the abcess accurately and position the drainage needle.
  • While travelling avoid eating uncooked foods, particularly vegetables and fruit which cannot be peeled before eating in order to prevent Amoebiasis.
  • Metronidazole , or a related drug such a tinidazole , is used to destroy amebae that have invaded tissue.
  • Usually, in Allopathy, a course of anti-protozoal (Metronidazole) is given for eliminating the amoebic trophozites. This will work very temporarily, i.e. till its eggs or cysts get hatched