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2023 Author: Alfred Shackley | [email protected]. Last modified: 2023-05-21 13:14
Giardiasis is the most common parasitic disease on Earth, due to the peculiarities of the spread of its pathogens, lamblia. Their main place of parasitism is the intestines, and the liver (in particular, the bile ducts and bile ducts) is the most frequent extraintestinal localization of the parasite.
Giardia in the liver: symptoms in adults and children
Giardia is predominantly an intraintestinal parasite.
But sometimes (the reasons for this have not been established), some of them penetrate through the large duodenal papilla into the common bile duct. From where the parasite enters the liver through the bile ducts. And further into the liver, where it lives in the interlobular ducts.
According to the above, the existence of symptoms of hepatic and intestinal giardiasis is impossible.
The latter always prevails, and the former is never possible without it. In addition, a number of signs of hepatic giardiasis can occur with a purely intestinal localization of the parasite.
Therefore, it is appropriate to describe all the symptoms:
- Stomach ache;
- Dyspepsia - nausea, bloating, rumbling;
- Stool disorders - diarrhea alternating with constipation and vice versa;
- Disorders of the biliary tract;
- General intoxication syndrome;
- Atopic dermatitis and general allergization of the body.
The pains are localized in the upper abdomen. Most often this is the epigastric region (epigastric region), the right hypochondrium and near the navel. The occurrence of pain is associated with direct irritation of the intestinal mucosa by the parasite, as well as the epithelium of the biliary tract.
According to the description, abdominal pains are cramping and pulsating in nature. Only with a significant invasion of the liver of the parasite, the pain in the right hypochondrium can be aching or even dull. This is due to the pressure of bile on the ducts due to stagnation due to blockage by parasites.
Dyspeptic phenomena are associated with both intestinal irritation and disruption of its work. It is worth mentioning here that Giardia feeds on the entire surface of the body. They just suck up nutrients. And their greatest concentration is between the intestinal villi.
It is to them that giardia "stick" with their suction cups, as a result of which the work of the villi is disrupted. In addition, lamblia toxins are themselves irritating. And the points of application for them, again, are the villi.
Stool disorders are a direct result of changes in bowel function. Insufficient digestion in the upper regions leads to a whole cascade of reactions from the lower ones. This refers to the small and large intestines, respectively.
This "cascade" means the following:
- changes in transmembrane transport of electrolytes and fluids in the large intestine;
- activation or suppression of the microflora of the large intestine.
If things get worse, diarrhea occurs. In the opposite situation, stool retention develops.
General intoxication syndrome includes symptoms that characterize almost all diseases accompanied by the formation of toxic substances, and disorders of general metabolism.
The syndrome includes several symptoms:
- general weakness;
- dizziness, headache;
- increased irritability;
- decreased appetite;
- sleep disturbance.
The more significant the infection, the higher the intoxication, the more pronounced all these symptoms. For giardiasis, in an adult or children, the dependence of symptoms on the degree of invasion in acute form is characteristic. Chronic giardiasis of the liver may not have symptoms even with a sufficiently large number of parasites.
Increased allergization of the body. This phenomenon denotes the state of the immune system.
With giardiasis, its composition changes towards an increase in active reagin cells.
In other words, immunity acquires the ability to become hypersensitive to any allergen. Therefore, a patient with giardiasis is prone to allergies more than a healthy one.
Atopic dermatitis. For giardiasis, it is the most characteristic allergic disease. The mechanism of its development is simple. General allergization of the body primarily affects the protective integument. And since they are more often than others in contact with allergens, it is with them that the development of immune hypersensitivity reactions (in other words, allergies) begins.
The cause of giardiasis of the liver in adults and children
The causative agent of human disease is the simplest of the same genus, intestinal lamblia. Other members of this genus cause parasitic diseases in many warm-blooded animals.
Giardia is a binucleated protozoan, divided in half by a cytoplasmic membrane. Outside, it is covered with a thin cell membrane, tightly attached to the cytoplasmic membrane. This facilitates nutrition of the protozoan, which occurs through pinocytosis, when the particle is absorbed by the cell by pressing the membrane and its subsequent environment. In this case, there are no protrusions of the cell towards the particle. The particle itself "sticks" to the membrane by means of special receptors.
These descriptions relate to metacercaria - a sexually mature form of Giardia. Only she is capable of feeding. For most of their life, parasites live in the upper intestines, where they feed on digestive products, sucking them up on the entire surface of the body. Occasionally, metacercariae penetrate the bile ducts. Through them, they enter the lobes of the liver. Here, Giardia also feeds on the entire surface of the body.
Reproduction of lamblia occurs by simply dividing their body into two independent cells. In this case, each gets one nucleus and equal parts of the cytoplasm. These are young metacercariae. They are only capable of feeding and moving. These forms cannot reproduce
Part of the young metacercariae continues to remain in the small intestine and liver. Often with feces it moves to the large intestine. Here conditions are unfavorable for them. Therefore, they quickly become covered with a capsule, turning into cysts, which go outside and enter the soil. Here cysts can persist for several months. Only after swallowing them and entering the small intestine does their shell dissolve. At the same time, a young metacercariae emerges from the cyst. The circle is closed.
Treatment of lamblia in the liver in adults and children
A distinctive feature of the treatment of giardiasis in both adults and children is the fact that it should start with a diet (a combination with the elimination of intoxication and the normalization of digestion is recommended). And only after that, protivohelminth treatment is performed.
This state of affairs is simply explained: the massive death of parasites creates an additional burden on the body due to an increase in the amount of toxins in the blood. It does this by absorbing the decomposition products of lamblia.
A special diet promotes the formation of cysts in the small intestine, as well as the transfer of part of the metacercariae to the thick section, as a result of which the parasite population begins to decrease. The remaining amount of lamblia will not be able to significantly worsen the condition of the body, even with a one-time death.
The diet for giardiasis includes foods that help remove parasites:
- Vegetables - red are excluded with the development of atopic dermatitis;
- Some types of unsweetened fruits - green apples, unsweetened pears;
- Fermented milk products - kefir, yoghurts, cottage cheese, cheese;
- Vegetable oil - except for sunflower seed oil and peanuts;
- Low-fat boiled and stewed meats.
The following products are categorically excluded:
- White bread;
- Millet, semolina porridge.
- Animal fats - butter, margarine from animal fats;
- Fatty meats;
- Smoked and fried foods.
Along with the diet, detoxification treatment is prescribed.
It includes the use of sorbents (polyphepan, activated carbon), enzyme preparations (mezim, pancreatitis, etc.). If necessary, infusion treatment can be carried out.
After 3-5 days, during which a daily analysis of feces for worm eggs is done, anthelmintic therapy is started. Treatment is carried out with an ongoing diet. The most commonly used are: tinidazole, ornidazole, delagil, furazolidone.
After a course of treatment with anthelmintic drugs, on the 5-7th day and after a negative analysis of feces, the person continues to follow the diet for 2-4 weeks. And only after 4 weeks, with convincing evidence of the absence of lamblia, you can gradually return to your usual diet.
Prevention of giardiasis of the liver in adults and children
Preventive measures carried out with giardiasis of the liver are not much different from the prevention of other parasitic diseases. Personal hygiene is important, since about 80% of infections occur in cases of cysts getting through the hands. From this, giardiasis is often called "the disease of dirty hands."
The second important aspect of prevention is the identification and treatment of all those infected. They pose the main threat to the spread of the parasite.