Giardia in children: symptoms, treatment, photos, how to treat giardiasis in children

What are Giardia?

The name Giardia is an unofficial name. So people named them in honor of the Czech anatomist Lamblius Vilem Dusan, who discovered them in 1859. Giardia or giardia is the name adopted in medicine.

They belong to a very common order of protozoa - diplomonods. Giardia is quite small in microscopic size and cannot be seen without a microscope. Under the device we will be able to see small teardrop-shaped creatures. They have four pairs of tourniquets, with a suction disk, with the help of which they are attached to the intestines. These are not worms, because they are single-celled. In fact, it is between bacteria and multicellular organisms.

Anthony van Leeuwenhoek, the scientist who first tested the microscope, discovered Giardia, and further research was continued in the 19th century. Soviet pediatricians paid close attention to these tiny parasites; they considered them the main culprits of most intestinal disorders in children.

Symptoms of giardiasis

Giardiasis is a disease that is predominantly associated with dysfunction of the gastrointestinal tract. Due to constant parasitism in the lumen of the small and large intestine, the functional state of the mucous membrane is disrupted and the nonspecific clinical picture progresses. The most common symptoms of giardiasis:

• abdominal pain, which is often paroxysmal. The intensity of the symptom depends on the characteristics of each clinical case. Sometimes the pain is so severe that the disease requires differentiation from acute surgical pathology;
• bowel dysfunction such as diarrhea or constipation;
• foamy stool;
• loss of appetite, weight loss;
• deterioration in the quality of nails, hair, skin (due to disruption of the absorption of microelements in the intestines);
• belching, sometimes vomiting.

In addition to signs of gastrointestinal dysfunction, Giardia provokes an inadequate immune response to the presence of these microorganisms.
This is manifested by allergic reactions - rash, itchy skin. In some cases, the pathology occurs as an asymptomatic carriage type. The child does not experience any discomfort due to the vital activity of Giardia, but actively excretes them in the feces, being a source of infection.

Due to nonspecific symptoms, giardiasis in the early stages of the disease requires differentiation from other gastrointestinal pathologies. Because of this, the prescription of adequate drug therapy is delayed. If the above clinical signs are identified, you should immediately seek help to find out the root cause of intestinal dysfunction.

Distinctive signs of giardiasis in children

It is necessary to note that this disease has many symptoms that make its diagnosis difficult, but there are the most common signs:

1. Diarrhea is one of the symptoms of this disease. Soft feces, liquid and unformed, there is mucus, blood with a foul odor and frequent. Giardia is characterized by recurrence of diarrhea and constipation, which lasts for quite some time.
2. Nausea, heartburn, vomiting. A typical symptom, particularly in children, is vomiting.
3. Intestinal dysfunction. Very often with this disease there are various deviations - gas formation is more than normal, bloating and various noises from it, and the like.
4. Rashes on the skin. Allergic rashes often occur with acute lamblia in children. They may remind us of bile disease, measles or diathesis. This is due to the development of the disease.
5. Pain. Children most often notice aching, sometimes sharp pain in the upper abdomen, that is, in the perigastric region and also near the navel.
6. Fever. In the acute form of Giardia, the temperature rises to 37, rarely higher. This is one of the features of general intoxication.
7. Appetite changes. Sometimes patients complain of food intolerance, poor appetite, and in some patients it does not even change.
8. Malabsorption. This is poor absorption of nutrients, which is typical for these types of diseases. And practice shows that the child eats as usual, but loses weight.
9. Dizziness and pain. These symptoms are also associated with insufficient intake of nutrients. In addition to these signs, there is also nervousness, very rapid fatigue, general malaise, emotional instability and retardation of physical development.
10. The appearance of the skin changes. A marbled nose, discoloration of the skin - these are signs characteristic of a long and complex course of this disease.
11. Dry skin. Children with lamblia sometimes experience peeling, the skin of the feet becomes rough, cracks, snags and pimples appear, and the hair becomes thinner than usual.

As we showed in this publication, there are many symptoms of giardiasis in children They occur in the digestive system and in others. To accurately determine the cause, it is necessary to carry out a number of diagnostics. No one can say with full guarantee that we can cure this disease with one medicine.

treatment of lamblia in children

Treatment of giardiasis is a long and thorough process. Without a combination of drugs that affect sexually mature individuals and intractable forms of Giardia: cysts and spores, it is impossible to completely cure this disease. It is worth considering that the drugs used in the treatment of lamblia have side effects on the body. To do this, it is very important to accurately determine that the child has chronic giardiasis in order to treat this disease, and it is also important to examine all members of the child’s family and his environment. And if we do not take this circumstance into account, we may have a re-infection.

About the disease

Giardiasis is a common pathology that affects not only children, but also adults and even pets (cats, dogs).
Pathogenic microorganisms can exist in two forms - vegetative and cystic (spore). In the first case, Giardia parasitizes in the upper parts of the small intestine and remains very sensitive to negative environmental factors. The spores live in the large intestine and are excreted from the body along with feces. In the cyst form, parasites can maintain their vital activity for up to 3 months. It is worth noting that giardiasis has not yet been fully studied. There is an opinion of some experts who claim that in the absence of a clinical picture, the disease does not require special treatment. However, the danger of pathology lies in the constant spread of the pathogen with possible infection of healthy people.

Symptoms

Giardiasis often has mild symptoms and occurs without pronounced clinical manifestations.
In the typical form of the disease, the first symptoms begin to appear after the end of the incubation period, which lasts from 1 to 3 weeks, and during this time the disease has no manifestations. The intestinal form of the acute stage is characterized by:

1. Pain in the right hypochondrium, in the navel area and rarely in the lower abdomen.
2. Belching.
3. Feeling of heaviness in the left side of the abdomen.
4. Decreased appetite.
5. Frequent bowel movements up to 3-5 times a day, which can give way to constipation.
6. Nausea.
7. Constant feeling of heaviness in the stomach.
8. Flatulence.

In young children, mushy stools are observed.
The duration of the acute phase of the disease is 5-7 days, after which either recovery occurs or the infection transitions to a subacute chronic course. The hepatobiliary variant of giardiasis in women and men is manifested by pain in the liver area and indigestion.

Skin manifestations can be very different and include pallor, the appearance of a icteric tint, dryness and flaking, and a small allergic rash. Stomatitis may develop in the mouth, and jams or cracks may appear in the corners of the mouth.

The intoxication syndrome during giardiasis depends on how many cysts enter the body, as well as on the duration and severity of the disease. Patients may complain of headaches, dizziness, sleep disturbances, decreased performance, irritability, and emotional lability. Children may experience tics, hyperkinesis, and fainting.

Recommendations for the prevention of giardiasis

Because giardia is most often spread through contaminated water and food or contact with an infected person or animal, you should avoid using untreated water sources and wash your hands with soap and water after handling potentially contaminated fecal material or contact with an infected person or animal. Alcohol-based gels are ineffective against Giardia cysts and should not be used as a substitute for hand washing when there is a risk of Giardia infection.

In the hospital, standard precautions include wearing gloves and washing hands after removing gloves.

Before traveling to areas where water may be contaminated or the safety of drinking water is questionable, travelers, tourists, and vacationers should be informed of methods to make the water safe to drink.
These measures include using bottled water, disinfecting the water by heating it to a boil for 1 minute, or using a filter that has been tested and certified to NSF Standard 53 or Standard 58 to reduce cysts and oocysts. Outbreaks of waterborne giardiasis can be prevented by a combination of proper filtration of water sources, chlorination, and maintenance of water distribution systems. Travelers should also be advised of the possibility of transmission of giardiasis through the use of contaminated water for recreational purposes (eg, lakes, rivers, inadequately treated swimming pools). Call a doctor at home Make an appointment with a doctor or call +7 (812) 331-17-74

Preventing relapses of giardiasis

There are no known pharmacological agents that effectively prevent relapse of giardiasis. Reinfection often occurs in endemic areas or in situations where hygiene levels are poor or contaminated water (such as private wells) is not properly treated. Re-infection can be prevented by consistent hand hygiene, especially after bowel movements and handling soiled diapers. You should also practice hand hygiene before preparing and eating food. To reduce the risk of disease transmission, children with diarrhea should be removed from childcare settings until the diarrhea stops. Children with giardiasis should not go to recreational water facilities for 2 weeks after the symptoms disappear.

Diagnosis of giardiasis

The specialists of the SM-Doctor clinic are aware of all the features of the course of the disease and the difficulties of identifying the pathogen.
Thanks to our own laboratory and the availability of modern diagnostic procedures, our doctors quickly determine the root cause of dyspeptic disorders and prescribe the correct treatment. Even at the initial appointment, a specialist may suspect giardiasis in a child. Characteristic complaints, medical history, and clinical examination of the baby are taken into account. If there are dogs or cats in the house, the likelihood of the parasitic nature of the disease increases. To verify the final diagnosis, doctors use:

• detection of Giardia cysts by direct microscopy of stool;
• coprogram (undigested fats are found in stool);
• enzyme-linked immunosorbent assay (ELISA) to identify specific immunoglobulins for Giardia;
• polymerase chain reaction (PCR) is a highly informative diagnostic method that allows you to detect even a minimal number of microorganisms using DNA or RNA fragments that are present in the biological environment of a sick child;
• a set of standard laboratory tests to assess the general health of the child (blood and urine tests, blood “biochemistry”).

If it is necessary to assess the functional state of other organs and systems, the patient is referred for consultation to related specialists - gastroenterologist, cardiologist, neurologist.

Classification

Signs of giardiasis may not be noticeable in a quarter of all cases.
This condition is called asymptomatic carriage. In this case, the person himself is not sick, but he becomes a source of infection for others. In half of all patients with giardiasis, the disease is subclinical. They also have no symptoms and do not consider themselves infected. Only diagnostics can help identify the disease.

And only in the remaining percentage of patients the disease has pronounced symptoms, which can be acute, subacute or chronic.

Causes of giardiasis

The key reason for the development of giardiasis is the penetration of cysts of the unicellular flagellar microorganism Lamblia intestinalis into the gastrointestinal tract of a child.
In the form of cysts, the pathogen, together with contaminated water, food or personal hygiene products, and toys, enters the stomach and intestines of a small patient, where it turns into a vegetative form. Factors that contribute to infection are:

• living with a sick person in the same house;
• ignoring basic rules of personal hygiene;
• presence of dogs and cats in the house;
• frequent exchange of toys between children in kindergarten or other common places.

The patient is infected through the fecal-oral route by consuming unwashed vegetables, fruits, and water. The pathogen is easily transmitted through toys that children at an early age like to lick. Newborns can become infected through the blood of an infected mother during birth.

Treatment of giardiasis

Treatment of giardiasis has 2 main goals – eliminating the pathogen and correcting the patient’s well-being.
To implement them, a diet is prescribed that includes avoiding eating fried and smoked foods and reducing the size of portions. Drugs prescribed for the treatment of giardiasis:

• enterosorbents – substances for binding free toxins and waste products of microorganisms;
• probiotics and prebiotics - these drugs restore normal microflora and stimulate its independent growth in the intestines;
• antimicrobial agents from the group of nitroimidazoles and nitrofuran derivatives.

In case of dysfunction of the pancreas and/or gall bladder, enzymes or cholekinetics may be additionally prescribed.
Prevention of giardiasis involves simultaneous treatment of all contacted people (parents, brothers and sisters), strict adherence to personal hygiene rules, washing vegetables and fruits before eating and avoiding drinking raw water.

“SM-Doctor” is an advanced medical institution that offers young patients a full range of diagnostic and treatment services. Thanks to extensive experience working with children, our specialists will help get rid of giardiasis in the shortest possible time and return the child to a full life. Contact professionals for qualified help!

Treatment

Giardiasis requires complex treatment.
Therapy for uncomplicated forms is carried out on an outpatient basis. When the diagnosis is confirmed, one of the antigiardiasis drugs is prescribed, which must be combined with the use of choleretic drugs, as well as drugs that improve intestinal microflora. The chronic course requires long-term complex treatment, which will include not only medication, but also a diet for giardiasis, which limits the intake of carbohydrates into the body. Etiotropic drugs help to cope with protozoa, and immunotherapy helps to increase a person’s natural defenses. Choleretic agents and probiotics must be prescribed to restore intestinal microflora.

Modern medicine in the treatment of giardiasis offers some clinical recommendations. At the first stage, diet therapy and fasting days are prescribed, as well as taking choleretic and, if necessary, antihistamines.

At the second stage, the patient takes special antiprotozoal drugs prescribed by the doctor. To get rid of Giardia, not one, but two courses are often prescribed.

At the third stage, multivitamins, enterosorbents, enzyme preparations, immunostimulants, and herbal medicine are used.

Prevention

After recovery, the risk of re-infection does not decrease, and relapses occur frequently.
To completely get rid of parasites, repeated doses of medication are often required. Dispensary observation is carried out for 3-6 months with mandatory examination for parasites. To prevent infection with giardiasis, you should not drink raw water, even from the tap, follow all sanitary and hygienic rules, be sure to wash your hands before eating and after using the toilet, and do not eat unwashed vegetables, fruits, and berries.

It is important to consult a doctor at the first suspicion of a disease and undergo all the necessary tests to refute or confirm the diagnosis with further mandatory treatment.

Author:

Pugonina Tatyana Alekseevna, Therapist