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Query: UMLS:C0017536 (giardiasis)
1,714 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Giardia lamblia specific secretory immunoglobulin A (sIgA) levels in the duodenal fluid of adult giardiasis cases are reported for the first time. The sIgA levels in the study group were found to be significantly higher (p less than 0.01) than in the 20 age- and sex-matched controls comprising cases classified as non-ulcerative dyspepsia who did nor reveal any G. lamblia in their stools and the duodenal fluid. An inverse relationship between the clinical severity of giardiasis and the level of sIgA in the duodenal fluid was noted. Cases with a higher trophozoite load in duodenal aspirate tended to be associated with envanescent G. lamblia-specific antibodies.
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PMID:Human giardiasis: correlation of specific secretory IgA levels in duodenal fluid to the severity of disease and infestation by Giardia lamblia. 152 Sep 60

In 1987 and 1988, 340 consecutive patients attended the endoscopy centre of Cochin hospital, Paris, and underwent oesophago-gastroduodenal endoscopy in a search for Giardia lamblia parasitology and histology. Two-hundred and eight of these patients presented with non-ulcer dyspepsia and entered a prospective study aimed at determining the advisability of a systematic search for Giardia lamblia in this population. Six biopsies were positive for giardiasis, including 3 in patients with acquired immunodeficiency, 1 in a case of chronic diarrhoea with atrophic villi and 2 in dyspeptic patients. Giardiasis, therefore, cannot be regarded as a cause of non-ulcer dyspepsia, and a systematic search for the parasite is of little interest in such cases. However, giardiasis remains a cosmopolitan parasitic disease with a non-negligible prevalence in France among subjects at risk, such as communities, children, travellers, homosexuals and immunodeficient patients.
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PMID:[Role of giardiasis in non-ulcer dyspepsia]. 182 98

To determine the frequency of giardiasis in patients undergoing upper G.I. endoscopy for dyspepsia and other upper G.I. disorders, duodenal aspirates were collected in 200 patients and simultaneous duodenal biopsies in 163 patients. Nine percent aspirates and 1.8% duodenal biopsies showed Giardia lamblia trophozoites. Giardia as a cause of dyspepsia should be considered in patients with negative endoscopy and in those who remain symptomatic inspite of adequate treatment for known upper G.I. disorders.
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PMID:Giardia lamblia in patients undergoing upper G.I. endoscopy. 186 41

Multiple biopsies from the lower duodenum were obtained during endoscopy of 171 patients with dyspepsia, diarrhoea and/or suspected malabsorption. Histological evidence of lambliasis was obtained in six (3.5%). Antibiotic treatment with metronidazole, 250 mg two or three times daily for seven to 11 days (which had to be repeated in two cases), improved symptoms in four. In most of the patients "functional upper-abdominal symptoms" had been diagnosed after extensive examinations. In case of unclear upper-abdominal symptoms, chronic or chronic-recurrent diarrhoea and/or malabsorption lambliasis should be considered and histological examination of the duodenal mucosa undertaken.
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PMID:[Lambliasis: a cause of malabsorption and diarrhea?]. 272 87

Direct microscopy and an ELISA technique were used to determine the prevalence of Giardia lamblia and its antigen in stool samples from patients with Crohn's disease, ulcerative colitis, acute-onset diarrhoea, or dyspepsia. Cysts of Giardia lamblia were observed by microscopy of faeces from two of the patients with acute-onset diarrhoea and one with dyspepsia. Giardia antigen was detected in the faeces of five patients, including all three in whom cysts had been identified by microscopy. No evidence of giardiasis was found in any patient with Crohn's disease or ulcerative colitis. It is concluded that the ELISA can reliably distinguish giardiasis from a range of other gastrointestinal disorders.
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PMID:A microscopic and immunodiagnostic search for giardiasis in patients with gastrointestinal disorders. 336 92

Previous studies have suggested that Giardia lamblia may cause nonulcer dyspepsia as the sole manifestation of infection. To explore this premise, duodenal aspirates from patients undergoing upper endoscopy were examined for Giardia and results were correlated with endoscopic findings and symptoms. Of 155 patients, 15.5% had Giardia. Patients with dyspepsia, with or without obvious lesions at endoscopy, had a similar prevalence. Patients with vomiting and diarrhea had an increased prevalence (38.5%) (p less than 0.05). The prevalence of Giardia lamblia in this patient population is surprisingly high. This study suggests that Giardia lamblia infection is not a major cause of nonulcer dyspepsia.
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PMID:Giardia lamblia in patients undergoing endoscopy: lack of evidence for a role in nonulcer dyspepsia. 341 Feb 37

One hundred and two patients suffering from giardiasis and/or chronic gastritis were subjected for upper gastrointestinal endoscopy. Purified immune rabbit's serum against Giardia lamblia was used in ELISA and immunoperoxidase (IIP) techniques for detection of Giardia antigen in the stomach. Results showed that out of 70 cases with intestinal giardiasis, 8 (11.4%) by ELISA and 6 (8.6%) by IIP showed gastric giardiasis. Higher percentage of gastric giardiasis (14%) was encountered in cases with both giardiasis and chronic gastritis (50) than in cases with giardiasis alone (5%) but with statistically insignificant difference (P > 0.05). None of the cases with chronic gastritis alone (without giardiasis) was positive for gastric giardiasis. Dyspepsia was the main presenting symptom in cases with gastric giardiasis (P < 0.05) with significant (P < 0.05) association. Helicobacter pylori was encountered in 6 out of 8 cases (75%) with gastric giardiasis (P < 0.05) with significant (P < 0.05) association. Duodenogastric reflux was detected in 4 out of 8 cases (50%). Histopathological changes in antral mucosa were detected in all cases of gastric giardiasis. This study indicates that under abnormal circumstances most probably with decreased gastric acidity, gastric giardiasis can occur in concomitance with intestinal giardiasis. So, one has to search for Giardia in gastric biopsies, particularly those showing chronic atrophic gastritis and H. pylori. Also, one has to be aware of gastric giardiasis as a possible cause of upper gastrointestinal symptoms.
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PMID:Giardia lamblia and chronic gastritis. 875 56

Clinical studies of children with Giardia lamblia infection have indicated that its clinical symptoms are largely nonspecific and characterized by pain, dyspepsia, asthenic neurosis and allergic dermatosis. Dyspepsia is the leading clinical syndrome of giardiasis that was detected in 81.5% of the examinees. Pain was noted in 76.9% of such children, asthenic neurotic and allergic reactions were found in 64.8 and 15.7%, respectively. Among concurrent parasitic diseases, enterobiosis is more common (26.9%). On physical examination, three fourths of the children with giardiasis had pain on palpation of areas of the epigastrium, pyloroduodenum, right hypochondrium, as well as a splashing sound and rumbling along the thick bowel. Laboratory studies showed that a third of the patients with giardiasis had elevated eosinophil levels and moderate dysproteinemia, which is indicative of the body's sensitization and an inflammatory process in the biliary system. The clinical manifestations of Giardia lamblia infection were analyzed in children of different age groups. It was found that dyspeptic and allergic dermatological syndromes were prevalent in children aged 2-3 years, dyspepsia in those aged 4-7 years, dyspepsia and pain in those aged 13-15 years, and pain in those aged 13-15 years. Thus, changes in the clinical symptoms of giardiasis were followed up. There were poorer clinical symptoms in old age groups and organic digestive pathology developed in the patients.
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PMID:[Clinical symptoms of giardia infection in children]. 1229 63

In an outbreak of waterborne giardiasis where 1300 subjects were diagnosed, with Giardia lamblia, 139 continued to have abdominal symptoms of whom two of three had negative stool culture and microscopy. These were considered to have a postinfectious functional gastrointestinal disorder. We investigated visceral hypersensitivity in patients with persisting abdominal symptoms after Giardia infection and assessed the effect of 5HT(3)-antagonist ondansetron. Twenty-two patients with Giardia negative stools and 19 controls were included. A subset of patients (n = 15) had both irritable bowel syndrome (IBS) and functional dyspepsia (FD). All subjects underwent a satiety test with a soup combined with three-dimensional ultrasound. Fifteen of 22 patients underwent double-blind, randomized, placebo-controlled study with the 5-HT(3) antagonist ondansetron given orally. Drinking capacity was lower in patients than in controls (P < 0.01) and gastric emptying was reduced (P < 0.05). Patients had more symptoms both fasting and postprandially (P < 0.001) compared to controls. Ondansetron had no effect on these parameters except from less nausea postprandially (P < 0.05). In conclusion, patients with Giardia-induced gastrointestinal symptoms developed both IBS and FD. They exhibited gastric hypersensitivity with lower drinking capacity and delayed gastric emptying. The 5-HT(3) antagonist ondansetron did not improve drinking capacity, gastric emptying or symptoms except nausea.
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PMID:Increased visceral sensitivity in Giardia-induced postinfectious irritable bowel syndrome and functional dyspepsia. Effect of the 5HT3-antagonist ondansetron. 1797 37

Chronic abdominal pain (CAP) continues to be a diagnostic and therapeutic challenge. It affects about 10% of school-going children and adolescents. Few Indian studies have reported an organic cause in 30%-40% of children with recurrent abdominal pain. In developing countries, parasitic infestations such as giardiasis and ascariasis are an important cause, of recurrent abdominal pain but their frequency has decreased over time. There is a paucity of data from India on the aetiology, epidemiology and management strategies for CAP, and there is no consensus on the clinical approach to this problem. We present a practical approach to CAP in children. The first step is to elicit a detailed history and do a thorough physical examination so as to categorize CAP according to the site of pain (epigastric, periumbilical or left lower quadrant), the predominant symptom associated with pain (dyspepsia, isolated pain or altered bowel habits) and to differentiate the pain as organic or functional based on the characteristics of pain and presence or absence of alarm signs. The second step is to do appropriate investigations, restricted to simple tests when functional pain is suspected (Level I) and more investigations (Level Ia) if there are alarm signs and pain appears to be organic in nature. Invasive investigations such as gastrointestinal endoscopy (Level II) may be reserved for those with possible organic pain. Level III investigations need to be done in a small percentage of children and include EEG, workup for food allergy and porphyria. The third step is management of organic CAP according to the aetiology, while for functional CAP the pharmacological and, rarely, psychological intervention is more difficult but should be done discreetly and tailored to the needs of the child.
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PMID:Chronic abdominal pain in children. 2092 8


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