Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
The most common treatment for giardiasis is metronidazole (Flagyl) for 5-10
days. It eradicates the Giardia more than 85% of the time, but it often causes
gastrointestinal side effects such
as nausea and a metallic taste as well as
dizziness and headache. Despite its
effectiveness, metronidazole is not approved by the FDA in the U.S. for treatment of giardiasis.
The only drug approved for treating giardiasis in the U.S.
is furazolidone (Furoxone) for 7-10 days. It is approximately as effective
as metronidazole. Tinidazole is available outside the U.S. and is highly effective
at treating giardiasis(>90%). It also can be given as a single dose and is well tolerated.
Quinacrine is very effective for treating giardiasis but is no longer available
in the U.S. Paromomycin and albendazole are less effective
than other treatments.
Occasionally, treatment fails to eradicate Giardia. In
such cases, the drug may be changed or a longer duration or higher dose may be
used. Combination therapy
also may be effective (e.g., quinacrine and metronidazole).
How can giardiasis be prevented?
Drink only water that has been treated in established
treatment facilities.
If there is any doubt about the adequacy of the
treatment of water, boil the water or
filter it through a filter with a pore size of <1 micrometer, which will
exclude trophozoites and cysts.
Do not drink from fresh water streams or lakes without
boiling or filtering the water.
Do not use ice or drink beverages made from tap water
that may be contaminated.
Do not brush teeth with tap water that may be
contaminated.
Do not eat uncooked or unpeeled fruits or vegetables
grown in conditions in which contamination with Giardia might occur.
Wash hands before eating food, after changing diapers,
using the bathroom, or touching pets.
Abdominal pain is pain in the belly and can be acute or chronic. Causes include inflammation, distention of an organ, and loss of the blood supply to an organ. Abdominal pain can reflect a major problem with one of the organs in the abdomen such as the appendix, gallbladder, large and small intestine, pancreas, liver, colon, duodenum, and spleen.
Diarrhea is a change is the frequency and looseness of bowel movements. Cramping, abdominal pain, and the sensation of rectal urgency are all symptoms of diarrhea. Absorbents and anti-motility medications are used to treat diarrhea.
Nausea is an uneasiness of the stomach that often precedes vomiting. Nausea and vomiting are not diseases, but they are symptoms of many conditions. The causes of vomiting differ according to age, and treatment depends upon the cause of nausea and vomiting.
Travelers' diarrhea is generally contracted by eating contaminated food or drinking contaminated water. Food is the primary source of travelers' diarrhea. Enterotoxigenic E. coli is the cause of up to 70% of all cases of travelers' diarrhea. There are five unique classes of E. coli that causes gastroenteritis. Other bacteria responsible for travelers' diarrhea include
Campylobacter, jejuni, shigella, and salmonella. Viruses such as rotavirus and Norwalk virus (norovirus) and giardia lamblia a parasite may cause travelers' diarrhea. Prevention is careful eating and drinking of water.
Travelers should prepare for their trip by visiting their physician to get the proper vaccinations and obtain the necessary medication if they have a medical condition or chronic disease. Diseases that travelers may pick up from contaminated water or food, insect or animal bites, or from other people include malaria, meningococcal meningitis, yellow fever, hepatitis A, typhoid fever, polio, and cholera.
Children's health is focused on the well-being of children from conception through adolescence. There are many aspects of children's health, including growth and development, illnesses, injuries, behavior, mental illness, family health and community health.
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