Intestinal amoebiasis is a disease common in countries with low sanitation. It is caused by the simplest parasitic organisms - amoeba. Who has the highest chance of contracting amoebiasis? How is the intestinal form of this disease manifested, and how is its treatment carried out? This information may be useful for people traveling on a long trip.
Some statistics
The greatest likelihood of contracting intestinal amebiasis prevails in regions where there is a high level of unsanitary conditions, since infection occurs through the oral-fecal route. Countries in tropical and subtropical humid climates are at risk. Most often, travelers bring intestinal amoebiasis from India and Mexico. In these countries, a very high level of disease among the local population. Also a large percentage of the incidence in Africa and South Asia. In some territories, illnesses affect 50 to 80% of the population. So, going to distant lands, it will be useful to find out everything about amoebiasis - what it is and how not to catch this infection in the first place.
You can get intestinal amoebiasis not only in exotic countries. Not everything is smooth and in the post-Soviet space. The spread of amoebiasis, of course, is not so strong there. It is observed in Armenia, Georgia, Kyrgyzstan and Turkmenistan.
Oddly enough, men suffer from intestinal amoebiasis more often than women. It has been established that the natural susceptibility of the human body to amoebic invasion is quite high. According to statistics, intestinal amoebiasis is detected in one out of ten patients who have caught this parasite. Data published by the World Health Organization show that more than 480 million people in the world are carriers of amoeba. Up to 50 million cases of intestinal and other forms of amoebiasis are officially recorded annually. Of these, 2% of cases become fatal.
Amoeba - causative agent of intestinal amoebiasis
As already understood, the cause of the disease is dysenteric amoeba. In Latin, the name of this parasitic protozoan sounds like Entamoeba histolytica. The dysenteric subspecies of the amoeba is smaller than ordinary amoeba (Amoeba proteus). They are more mobile, their pseudopods (pseudopodia) are smaller in size, but wider. The outer cell layer of the cytoplasm is delimited from the inner endoplasm.
The life cycle of a dysenteric amoeba involves 3 forms: tissue, luminal, and cysts. The tissue form is detected only in patients with amoebiasis. It parasitizes in the mucous and submucous layers of the walls of the colon. Translucent form and cysts are detected both in carriers and in patients. The habitat of these vegetative forms of dysenteric amoeba is the upper part of the large intestine. They are the main stage in the life cycle of a dysenteric amoeba.
How is the infection transmitted?
Intestinal amoebiasis is transmitted from person to person. The distributor of the infection has already been ill, and is currently considered clinically healthy, but remains a carrier of cysts. Doctors consider intestinal amebiasis and giardiasis, like other intestinal infections, a disease of dirty hands.
The transfer is as follows:
- A carrier of cysts, which neglects the rules of personal hygiene, releases them into wastewater, into the soil or into open water (excretion occurs with feces). Water enters the gardens and infects vegetables and fruits. A healthy person eats cysts with unwashed vegetables and fruits.
- The cyst carrier does not wash hands with soap after the toilet. Cysts can be transported to any items, including food, which were touched with dirty hands. A healthy person, without washing his hands before eating, swallows cysts, and they spread through the intestines.
As already mentioned, this pathway is called oral-fecal.
How does the disease develop?
A swallowed cyst reaches the large intestine and passes into the active phase of development. But this does not mean that a person fell ill with intestinal amoebiasis. Dysenteric amoeba can live quietly in the colon, feeding on its contents. In this case, the person will be an asymptomatic carrier. The amoeba does not harm his condition, but he secretes cysts out.
If a person has an imbalance in the intestinal microflora or a weakened immunity, then the active form of the parasite behaves aggressively. Amoeba is attached to the intestinal wall and goes into the category of tissue parasites. Under the influence of dysenteric amoeba, the intestinal wall gradually deteriorates. The pores that develop into ulcers become noticeable. The size of ulcers on the walls is more than 10 mm. Through ulcers, the products of the vital activity of amoebae enter the patient's blood. Constant stress, an unbalanced diet (starvation) and the accompanying overwork can also cause aggressive behavior of a dysenteric amoeba.
Complications of intestinal amebiasis
Ulcers can be quite deep. In some cases, they "eat" through the wall of the intestine. This is called perforation, or perforation of an ulcer. This condition causes complications of intestinal amebiasis, as the contents of the intestines flow into the abdominal cavity, causing peritonitis.
Other complications may occur if an ulcer forms at the site of passage of a large blood vessel. It can provoke profuse intestinal bleeding. And in this case, the way opens for the spread of the active amoebic form throughout the body with a blood stream.
Blood transports the simplest parasite to the liver, brain, and other departments (bronchi, lungs, and so on). Next, the maturation of amoebic abscesses in the form of large ulcers begins. Most likely, such abscesses occur in the right lobe of the liver. These complications can lead to the death of the patient.
Complications accompanying intestinal amoebiasis can cause an intestinal tumor, the so-called amoeba, or colon gangrene. These conditions are also life-threatening and require urgent treatment.
Symptoms of the disease
Signs of amoebiasis (intestinal) are manifested as follows:
- The patient has frequent stools. In the initial stage of infection, up to 6 times a day, then up to 10 times. In the feces, mucous and blood impurities become noticeable. In a neglected form, the stool turns into a mucous-bloody mass.
- At the beginning of the disease, body temperature is kept within normal limits, then it rises sharply.
- The patient has pain in the lower abdomen. The nature of the pain is aching, cramping. During bowel movements, the intensity of pain increases.
- False bowel movements (tenesmus) are observed.
Symptoms of a moderate course of intestinal amebiasis suggest joining the above signs of vomiting, nausea and loss of appetite.
The acute form of intestinal amoebiasis lasts up to 6 weeks. When treatment is prescribed in a timely manner, then full recovery occurs. If treatment for amebiasis has not been prescribed or has been impaired (interrupted), then the symptoms disappear, but recovery does not occur. The patient enters a period of remission, which is delayed from two weeks to several months. Then there is a resumption of amoebiasis with a transition to a chronic form. To prevent this, intestinal amoebiasis in adults and children must be treated in a timely manner.
Chronic form of intestinal amoebiasis
The chronic form of this disease can last for years. But with insufficient treatment or in its absence, the outcome is difficult to predict. Symptoms of a chronic form are as follows:
- A person feels an unpleasant taste and a burning sensation of his tongue, his appetite falls. Sometimes it disappears completely, which causes exhaustion.
- The patient quickly gets tired, experiences general weakness. Cannot do the simplest job.
- A significant increase in the liver is observed.
- Anemia develops, hemoglobin levels can be very low. The skin becomes pale.
- Pain "under the pit of the stomach" appears.
- The heartbeat is quickening, an irregular pulse is being felt, which are signs of cardiovascular lesions.
The chronic form often leads to complications that can be life threatening.
Diagnostics. Fecal Analysis
When contacting a doctor, the patient describes the symptoms, and the doctor examines and palpates the abdomen. During this manipulation, the doctor feels a slight bloating, detects pain points in the area of the colon, probes an increase in the right lobe of the liver (with a liver abscess), and detects a bulging from above the abdomen (in case of amoebic hepatitis).
If the patient has intestinal amoebiasis, diagnosis involves the appointment of laboratory tests. First of all, this is a study of feces, from which smears are prepared using one of two methods:
- Native smears, that is, the application to a glass slide of a small piece of feces (a few drops of liquid stool). Adding the necessary reagents, get a transparent smear, which is examined under a microscope. So you can consider the living forms of amoebas (luminal and tissue) and their cysts. To identify living forms, the material must be fresh, collected 30 minutes before the study. Otherwise, the amoeba will die, and the smear will be false negative.
- Lugol painting method. In this case, a native smear is prepared and an aqueous solution of iodine is added. Iodine is able to stain transparent cyst cells.
Fecal analysis can not only identify various forms of dysenteric amoeba, but also establish the stage of infection.
Instrumental research
To determine intestinal amoebiasis, the following methods of instrumental studies are used:
- sigmoidoscopy;
- Ultrasound
- computed tomography.
Amoebic dysentery
Amoebas were first discovered in the feces of a patient in 1875. This was done by the Russian scientist F. A. Lesh. And in 1883, the scientist R. Koch isolated this pathogen from intestinal ulcers and ulcers. In 1891, a new disease, amoebiasis was included in the category of independent diseases. But then he was given the name "amoebic dysentery."
It must be distinguished that ordinary dysentery (shigellosis) and amoebiasis are different diseases. In the first case, the distal colon is affected. In the second case, the proximal sections. In addition, pain with dysentery is localized in the left side of the abdomen, and with intestinal amoebiasis - in the right side. Amoebic dysentery and shigillosis have different pathogens. Common dysentery is caused by Shigella bacteria.
Treatment of adult patients. Traditional approach
Traditional medicine prefers the treatment of mild forms of amoebiasis at home. The severe course of the disease requires referral to the infectious ward of the hospital. The main treatment for amoebiasis is medication. The most effective drugs are Metronidozole, Trichopolum and Fazizhin. These are antiprotozoal and antimicrobial agents. In addition to them, drugs from other groups are often prescribed:
- the luminal form of the amoeba is effectively affected by: "Interoseptol", "Mexform", "Intestopan";
- the tissue form of amoeba is best affected by Ambilgar, Dihydroemethine and other drugs;
- tetracycline preparations affect both living forms of dysenteric amoeba.
Intestinal amoebiasis does not tolerate self-medication. Any medications and their dosage can be prescribed only by a doctor. The form of the disease and the severity affect the choice of the drug.
With a complication of amoebiasis in the form of internal abscesses, the patient may require surgical intervention.
Treatment of amoebiasis in children
Intestinal amoebiasis in children is treated in a hospital. Children are prescribed Trichopolum, Fazizhin and (or) Oleandomycin. With abscesses, surgery is rare.
The child’s body loses fluid faster, so it must be replenished to prevent dehydration. In addition to replenishing the fluid level, it is necessary to control the level of hemoglobin.
Children are more likely to tolerate intestinal amoebiasis, as their intoxication proceeds in a more severe form. In addition, childhood amebiasis causes a higher body temperature.
Treatment. ethnoscience
In their right mind, no one will treat intestinal amoebiasis with herbs and plants. But using folk remedies, as an addition to traditional treatment, is very effective.
Most often used garlic tincture. To obtain it, 100 g of garlic are finely chopped in 100 ml of high-quality vodka. Tincture stands in the dark for 14 days, and then taken with kefir 15 drops 3 times a day.
Another good recipe is hawthorn infusion. For this, dried hawthorn fruits, about 100 g, and 2 cups of boiling water are needed. When the infusion has cooled, it is filtered and drunk throughout the day. By the same principle, the fruits of sea buckthorn are steamed.
Forms of Amebiasis
Everyone who wondered: “Amoebiasis: what is it and how to treat it?” Now knows the answer. We add that, in addition to the intestinal form of amoebiasis, there is an extraintestinal and skin form. Any organ of a person can suffer from an extra-intestinal form, but most often the liver is affected. From the skin form, ulcers form on the buttocks, in the anal area, in the perineum or on the hands.