eMedicine Specialties > Gastroenterology > Intestine

Giardiasis: Follow-up

Author: Sandeep Mukherjee, MB, BCh, MPH, FRCPC, Associate Professor, Department of Internal Medicine, Section of Gastroenterology and Hepatology, University of Nebraska Medical Center; Consulting Staff, Section of Gastroenterology and Hepatology, Veteran Affairs Medical Center
Coauthor(s): Mark H Johnston, MD, Associate Professor of Medicine, Uniformed Services University of Health Sciences; Consulting Staff, Lancaster Gastroenterology Inc
Contributor Information and Disclosures

Updated: Nov 18, 2009

Follow-up

Further Inpatient Care

  • The patient should be admitted if evidence of severe dehydration or a malnourished state is present.

Further Outpatient Care

  • Carefully monitor the patient's response to medications, and note any adverse effects.

Complications

  • Weight loss, disaccharidase deficiency, malabsorption, and growth retardation are possible complications.20,21
  • Hanevik et al investigated whether functional gastrointestinal disorders can occur in association with giardiasis, after a patient's Giardia infection has been eradicated.22 The authors used structured interviews and questionnaires to obtain information from 82 patients, at least 6 months after Giardia had been eliminated from their system. All of the patients had persistent abdominal symptoms, and each individual was evaluated to exclude symptom causes other than the previous Giardia infection.
  • Using Rome II criteria, Hanevik and colleagues determined that 76 of the study's patients had symptoms consistent with irritable bowel syndrome (IBS) and/or functional dyspepsia, while the rest of the patients could be placed in other Rome II categories.

Prognosis

  • Giardiasis usually is responsive to therapy, although reinfection is possible and some resistance has been observed.22

Patient Education

  • Patients and at-risk individuals should be instructed regarding appropriate hygiene methods and signs/symptoms of infection. Travelers, in particular, should be educated.
  • For excellent patient education resources, visit eMedicine's Esophagus, Stomach, and Intestine Center. Also, see eMedicine's patient education article, Giardiasis.

Miscellaneous

Medicolegal Pitfalls

  • Failure to recognize other enteric infections such as amoebiasis or cryptosporidiosis

Special Concerns

  • This is a common cause of chronic diarrhea and growth retardation in children in developing countries.
  • Antimicrobial resistance has been reported.
  • Furazolidone is the antibiotic of choice in pregnant women. No clinical reports have indicated teratogenicity in the fetus or newborn infant.
 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous author, Brooks D Cash, MD, FACP, to the development and writing of this article.



More on Giardiasis

Overview: Giardiasis
Differential Diagnoses & Workup: Giardiasis
Treatment & Medication: Giardiasis
Follow-up: Giardiasis
Multimedia: Giardiasis
References
Further Reading
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References

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Further Reading

Clinical guidelines
WGO practice guideline: acute diarrhea.
World Gastroenterology Organisation - Medical Specialty Society. 2008 Mar. 28 pages. NGC:006567

Parasitic infections. In: Guidelines for prevention and treatment of opportunistic infections among HIV-exposed and HIV-infected children.
Centers for Disease Control and Prevention - Federal Government Agency [U.S.]. 2004 Dec 3 (revised 2008 Jun 20). 17 pages. NGC:007350

Clinical trials

Efficacy of BIO-K+ CL1285® Prophylaxis in the Prevention of Traveler's Diarrhea in Adults

Parasitic Infections of the Gastrointestinal Tract


Related eMedicine topics

 Giardiasis (Emergency Medicine)

Giardiasis (Pediatrics: General Medicine)

Intestinal Protozoal Diseases

Malabsorption

Malabsorption Syndromes

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Keywords

giardiasis, lambliasis, , , , intestinal parasite, , treatment, giardiasis symptoms, giardiasis treatment, protozoan parasites, endemic diarrheal illness, epidemic diarrheal illness, intestinal parasites, gut parasites, protozoal infection

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Contributor Information and Disclosures

Author

Sandeep Mukherjee, MB, BCh, MPH, FRCPC, Associate Professor, Department of Internal Medicine, Section of Gastroenterology and Hepatology, University of Nebraska Medical Center; Consulting Staff, Section of Gastroenterology and Hepatology, Veteran Affairs Medical Center
Sandeep Mukherjee, MB, BCh, MPH, FRCPC is a member of the following medical societies: Royal College of Physicians and Surgeons of Canada
Disclosure: Nothing to disclose.

Coauthor(s)

Mark H Johnston, MD, Associate Professor of Medicine, Uniformed Services University of Health Sciences; Consulting Staff, Lancaster Gastroenterology Inc
Mark H Johnston, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, and Christian Medical & Dental Society
Disclosure: Nothing to disclose.

Medical Editor

Manoop S Bhutani, MD, FACG, FACP, Professor, Department of Medicine, Division of Gastroenterology, Director, Center for Endoscopic Ultrasound, Co-Director, Center for Endoscopic Research, Training and Innovation, University of Texas Medical Branch at Galveston
Manoop S Bhutani, MD, FACG, FACP is a member of the following medical societies: American Association for the Advancement of Science, American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, American Institute of Ultrasound in Medicine, and American Society for Gastrointestinal Endoscopy
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Oscar S Brann, MD, FACP, Associate Clinical Professor, Department of Medicine, University of California at San Diego; Consulting Staff, Mecklenburg Medical Group
Oscar S Brann, MD, FACP is a member of the following medical societies: American Gastroenterological Association
Disclosure: Nothing to disclose.

CME Editor

Alex J Mechaber, MD, FACP, Associate Dean for Undergraduate Medical Education, Associate Professor of Medicine, University of Miami Miller School of Medicine
Alex J Mechaber, MD, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, and Society of General Internal Medicine
Disclosure: Nothing to disclose.

Chief Editor

Julian Katz, MD, Clinical Professor of Medicine, Drexel University College of Medicine; Consulting Staff, Department of Medicine, Section of Gastroenterology and Hepatology, Hospital of the Medical College of Pennsylvania
Julian Katz, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, American Geriatrics Society, American Medical Association, American Society for Gastrointestinal Endoscopy, American Society of Law Medicine and Ethics, American Trauma Society, Association of American Medical Colleges, and Physicians for Social Responsibility
Disclosure: Nothing to disclose.

 
 
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