Treatment of giardiasis

Before we determine what the treatment for giardiasis is, let us briefly remind you of the general information about this disease.

Giardiasis is a common intestinal infectious disease that can be caused in the human body by a single-celled parasitic microorganism – lamblia. This parasite settles in the cavity of the small intestine and successfully develops, feeding on the resources of the human body.

Children under 5 years of age are most susceptible to the disease – the number of cases during this period reaches 40% of cases. In addition to people, giardiasis also occurs in pets such as dogs, cats, guinea pigs, etc.

Giardiasis can be transmitted through the fecal-oral route, that is, through unwashed hands, objects, water and food, if personal hygiene rules are not followed.

The disease is usually characterized by dyspeptic disorders (diarrhea, nausea, flatulence, pain in the area of the small intestine projection), as well as loss of appetite, weight loss and severe lactose intolerance. In about 26% of cases, the disease may be asymptomatic, and in more than 40% of cases, it is mild, so treatment for giardiasis is prescribed only after reliable data on the pathogen obtained as a result of diagnostics.

What doctor treats giardiasis?

Treatment of giardiasis is a rather complicated and labor-intensive process. This disease cannot be treated independently, but only with the help of a specialist in these pathologies. What kind of doctor treats giardiasis? For children, it is a pediatrician or pediatric gastroenterologist. For adults, it is a gastroenterologist or infectious disease specialist. All of the listed specialists can be found at the nearest clinic, medical center or hospital, where they will provide you with all the necessary assistance.

In addition to the standard, medicinal treatment method, you may need the help of a homeopath and herbalist in the future, who will promote a speedy recovery and strengthen the body.

Where to treat giardiasis?

For treatment of giardiasis, you can contact state and private medical institutions where gastroenterologists and infectious disease specialists receive patients. For children, this may be a children's clinic, a children's infectious disease department, or a pediatric department. Adult patients should contact an adult clinic, a gastroenterology department, infectious disease departments or hospitals, private general clinics, or gastroenterology centers.

In every home or educational institution (school or preschool education), where a person with giardiasis is found, it is necessary to carry out anti-epidemic measures, which are organized by the local representative of the sanitary and epidemiological station (SES).

Modern treatment of giardiasis

Modern treatment of giardiasis consists of a whole complex of medications, procedures and measures. It is difficult to cure this disease, so it is unacceptable to engage in independent treatment methods: the treatment regimen should be determined only by a specialist.

It is more logical and effective to begin therapeutic measures at the moment of exacerbation of the disease, especially with the development of dyspeptic disorders.

Diet correction is an important link for successful treatment of giardiasis. Patients, especially children, should definitely include dishes with a sufficient content of pectin, a natural enterosorbent, in their diet. Such dishes include liquid rice porridge on water, applesauce, and blueberry jelly. After two days, the patient is transferred to a more extensive diet. At first, the exception is foods that create a positive environment in the intestines for the vital activity of giardia. The main part of such products are simple sugars: baked goods, sweets, bakery products, as well as vermicelli, sausage, and whole milk. Rice and buckwheat cooked in water, fermented milk products, compotes, baked apples, berries, vegetables, sunflower oil, and dried fruits are allowed.

An important role in the treatment of giardiasis is played by stabilization of the intestinal microflora, which, as a rule, is disturbed during the disease. In order to eliminate dysbacteriosis, it is recommended to consume fermented milk products, as well as some probiotic preparations: yogurt, lactobacterin, bifinorm, lactofiltrum, probifor, etc.

Drugs for the treatment of giardiasis

At present, a number of drugs have been identified for direct action on the pathogen. When choosing a drug for therapy, it should be taken into account that recently additional parasitic strains have been discovered that are resistant to the effects of standard anti-lambliasis drugs (furazolidone, metronidazole, etc.). In addition, the selected drug should be well tolerated by the patient and not be toxic, as it should be suitable for both adults and children.

• Nifuratel (Macmiror) is a nitrofuran drug that is very popular because it meets all the above requirements. It has an extended range of antimicrobial and antiprotozoal effects. Nifuratel is quickly absorbed, its maximum amount in the blood is observed 2 hours after use. Excretion is carried out through the urinary system. In the treatment of giardiasis, the drug is prescribed:
  • for an adult patient, 0.4 g up to 3 times a day for a week;
  • for a child – 15 mg per kilogram of weight, twice a day for a week.

Nifuratel is less toxic than other nitrofuran drugs. It is not a teratogen or carcinogen, which makes it suitable for therapy in childhood and during pregnancy.

• Metronidazole (Trichopolum) is a selectively toxic drug for anaerobic infections, has mutagenic activity, and also the ability to enhance the effect of radiation therapy in the treatment of oncology. The tablets have a bitter taste, are well absorbed when taken orally. The maximum amount of the drug in the blood is observed 3 hours after administration. Metronidazole enters all tissues and environments of the body, including vaginal secretions, sperm, salivary secretions. It passes through the blood-brain barrier, is excreted during lactation with milk, and overcomes the placental barrier. For these reasons, this drug is not prescribed during pregnancy and breastfeeding. The drug is excreted through the kidneys. Specialists use two main options for taking Metronidazole:
  • 0.4 g three times a day for 5 days;
  • 0.5 g for adults and 5 mg/kg for children three times a day for 10 days.

During the course of treatment, alcohol consumption is contraindicated.

• Niridazole is an antiparasitic agent, used in the amount of 25 mg / kg of weight per day. The duration of treatment is from 5 to 7 days, occasionally the course is extended to 10 days. When taken orally, Niridazole is absorbed in the digestive tract for several hours. Metabolism occurs in the liver, excreted from the body with urine and feces. The drug is not prescribed for severe liver and nervous pathologies, with a tendency to epileptic seizures and mental disorders. Along with Niridazole, antihistamines are required.
• Tiberal (Ornidazole) - similar in characteristics to Metronidazole. Tiberal can be taken simultaneously with alcoholic beverages, in addition, this drug does not have a teratogenic effect. Adult patients take the drug in the amount of 3 tablets at a time at night. The drug is recommended for a child to take at a dose of 40 mg per kilogram of weight at a time. The drug is not used during pregnancy and breastfeeding. Tiberal has some neurotoxicity, so it can cause pain along the muscles, dizziness, dyspeptic disorders.
• Furazolidone is prescribed orally after meals. Adult patients take 0.1 g of the drug 4 times a day, children - 10 mg per kilogram of weight, divided into three doses. Along with Furazolidone, antihistamines and vitamins of the B group are often prescribed to reduce the risk of side effects.

Recently, doctors often use newer medications to treat giardiasis - these are agents that inhibit tubulin of the benzimidazole series: pyrantel, albendazole, etc. Such drugs are safer than the nitroimidazoles listed earlier. However, at the moment, a clear and effective treatment regimen for such drugs has not yet been developed, so therapy with these drugs should be long-term or periodically repeated.

Treatment regimen for giardiasis

The treatment regimen for giardiasis consists of three stages.

Stage I – elimination of internal intoxication and stimulation of the enzymatic function of the intestine, strengthening of the immune system. Conditions: compliance with certain nutritional principles, as well as the prescription of the following drugs:

• choleretic agents – eliminate congestion in the gallbladder (cholekinetic drugs: magnesium sulfate, xylitol, sorbitol, etc.);
• antispasmodics – relieve spasms of the bile ducts;
• sorbent preparations – activated carbon, smecta, polysorb, bilignin, etc.;
• enzyme agents – panzinorm (multienzyme), festal, creon, etc.

Stage II – antiparasitic therapy, using specific antiprotozoal agents:

• Metronidazole (Trichopolum);
• Tinidazole – 2 g per dose;
• Furazolidone;
• Macmiror is a nitrofuran series of drugs;
• Ornidazole;
• Delagil (Chloroquine) 0.25 g three times a day;
• Paromomycin is an aminoglycoside, 25 mg per kilogram, divided into three doses per day.

Stage III – strengthening the immune system and further preventing the development of giardiasis infection in the intestine. The conditions of this stage are proper nutrition with predominant consumption of vegetables, fruits and berries, as well as fermented milk products. It is recommended to drink birch bud tea for a month. To eliminate dysbacteriosis and strengthen the immune system, enzyme preparations and probiotics are prescribed: lactobacterin, mezim, pancreazim, bificol, lacto-mun, etc.

Course of treatment for giardiasis

The course of treatment for giardiasis is usually long.

The first stage usually lasts from 2 weeks to 1 month.

The second stage can last 5-7 days, but in most cases it is repeated a week or 10 days after the end of stage II, in order to confidently avoid relapses of the disease in the future. Sometimes stage II can be prescribed three times, with an interval of 7-10 days. To ensure the maximum effectiveness of such treatment, each course of stage II is recommended to be carried out with different medications.

Stage III does not have a strictly defined duration and can last quite a long time - as long as the body requires. At least one and a half months after the end of treatment, the patient should be observed by the attending physician to remain confident in the complete cure of the disease and the absence of relapses. The prognosis for giardiasis with adequate treatment is positive.

Choleretic for giardiasis

Choleretic drugs for giardiasis can be prescribed along with other necessary drugs. This is done in order to eliminate the inflammatory process in the gallbladder as quickly as possible, as well as to reduce congestion in it. For therapeutic purposes, cholekinetic drugs are mainly prescribed, which expand the bile ducts and facilitate the outflow of bile. Cholekinetics are a number of antispasmodic drugs that relax the valve of the gallbladder and pancreas, which promotes the release of bile into the intestinal cavity. Such cholekinetic drugs include atropine sulfate, papaverine, magnesium sulfate, etc.

By the way, a similar effect can be caused by drinking mineral waters: "Essentuki No. 17 and No. 4", as well as other medicinal waters containing sulfate anions. Such waters are consumed half an hour before meals, 100-150 ml up to 4 times a day.

In addition, in order to tone the bile ducts, cholespasmolytic agents are prescribed, such as drotaverine, platifillin, barberry-based agents, etc. Valerian root also has a similar effect.

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Hofitol for giardiasis

Hofitol is a herbal remedy based on artichoke. This medicine is able to restore damaged liver cells, has a choleretic and diuretic effect. Reduces the level of urea in the bloodstream, stabilizes lipid metabolism and the amount of cholesterol. Can be used with other medicines to reduce toxic damage to the body. Helps remove heavy metal salts, nitrates and other toxins.

Hofitol has direct indications for use in giardiasis, if the patient does not suffer from calculous cholecystitis, acute hepatitis and obstruction of the bile ducts.

Hofitol is used for giardiasis as follows:

• 1-2 tablets three times a day for a month;
• 5 ml of syrup three times a day for 3 weeks;
• 1-2 ampoules of Hofitol intramuscularly, once a day, for 7-14 days.

Hofitol is allowed to be used during pregnancy, but only with the permission and under the supervision of a doctor.

Similar replacements for the drug can be considered Artichoke extract and the medicinal product Holebil.

Allochol for giardiasis

Allochol is a choleretic drug that increases bile production. Allochol, like other choleretic drugs, is actively used for giardiasis. This drug affects liver secretion, stimulates motility and enzymatic activity of the digestive system, and has a slight laxative effect. The drug contains garlic, which reduces fermentation processes in the intestines and relieves bloating.

Allochol for giardiasis is taken orally, 3 times a day, 2 tablets, immediately after meals. In children under 7 years of age, take 1 tablet, then the dosage is the same as for adults. The course of treatment with Allochol lasts for a month, after which a break of 3 months is taken and the therapy is repeated (if necessary).

Allochol is approved for use during pregnancy and breastfeeding. The drug is not prescribed for obstruction of the bile ducts, if stones are found in the gallbladder cavity, or in acute inflammatory processes in the liver and pancreas.

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Antibiotics for giardiasis

Giardiasis is an infectious disease, so many patients rush to start antibiotic treatment on their own. However, we should not forget that this is also a parasitic pathology caused by a pathogen that lives dependently on another organism (human or animal). Giardiasis is one of the forms of protozoan invasion, so drugs for the treatment of this disease should act not just on pathogenic microflora, but specifically on the protozoan infection - giardia.

In case of giardiasis, complex therapy is prescribed. The correct selection of treatment methods guarantees a favorable result, however, violation of the treatment regimen can lead to a more severe, chronic course of the disease.

The exact dosage of medications and the duration of the course of treatment should be determined by the attending physician. Under no circumstances should you attempt to treat giardiasis on your own, as this may require more complex and lengthy treatment in the future.

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