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Open Access Highly Accessed Research article

Development of functional gastrointestinal disorders after Giardia lamblia infection

Kurt Hanevik1*, Vernesa Dizdar1, Nina Langeland12 and Trygve Hausken12

Author Affiliations

1 Institute of Medicine, University of Bergen, 5021 Bergen, Norway

2 Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway

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BMC Gastroenterology 2009, 9:27  doi:10.1186/1471-230X-9-27

Published: 21 April 2009

Abstract

Background

Functional gastrointestinal disorders (FGID) may occur following acute gastroenteritis. This long-term complication has previously not been described after infection with the non-invasive protozoan Giardia lamblia. This study aims to characterize persistent abdominal symptoms elicited by Giardia infection according to Rome II criteria and symptoms scores.

Methods

Structured interview and questionnaires 12–30 months after the onset of Giardia infection, and at least 6 months after Giardia eradication, among 82 patients with persisting abdominal symptoms elicited by the Giardia infection. All had been evaluated to exclude other causes.

Results

We found that 66 (80.5%) of the 82 patients had symptoms consistent with irritable bowel syndrome (IBS) and 17 (24.3%) patients had functional dyspepsia (FD) according to Rome II criteria. IBS was sub classified into D-IBS (47.0%), A-IBS (45.5%) and C-IBS (7.6%). Bloating, diarrhoea and abdominal pain were reported to be most severe. Symptoms exacerbation related to specific foods were reported by 45 (57.7%) patients and to physical or mental stress by 34 (44.7%) patients.

Conclusion

In the presence of an IBS-subtype pattern consistent with post-infectious IBS (PI-IBS), and in the absence of any other plausible causes, we conclude that acute Giardia infection may elicit functional gastrointestinal diseases with food and stress related symptoms similar to FGID patients in general.