Gut parasites: common but rarely considered cause of IBS
Part three of How to Fix Your Gut Problems
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It is well known that the gut is inhabited by trillions of bacteria, some good and some not so good. But parasites? They are definitely not so good.
If you have irritable bowel syndrome, you will be familiar with the misery of abdominal pain, gas, bloating, diarrhoea, and/or constipation. It just so happens that these are also common symptoms of a gut parasite infection.
If you have ever thought that your innards appear to have a life of their own, it’s because they have. Down there in that dark, murky area of your being is a parallel universe of microorganisms: microbes, transients, opportunists and freeloaders all merrily coexisting along the tube that runs from mouth to rectum. There they live, breed, feed, ferment, do battle and eventually die or move on out.
Except that some don’t move out. Instead, they take up permanent residency (why wouldn’t they? They’ve found a great place to put down roots), contribute nothing to your wellbeing, and make your life hell.
We tend to think of parasites as hairy, bug-eyed beasts, rather than the invisible microorganisms that they often are. Parasites may be intestinal or blood borne. In the intestines, they are either single-celled microorganisms or helminths — worms, such as roundworm or tapeworm. Worms are generally visible to the naked eye but not so your single-celled parasites, which include the infamous Blastocystis hominis.
B. hominis is the parasite most likely to be found in the intestinal tract and is particularly at home in the human colon. In addition to IBS-type symptoms, B. hominis may also cause fatigue, vomiting, loss of appetite, and skin disorders, including urticaria, or itching.
Blasto what?
Before it was properly understood, B. hominis was considered a normal gut microorganism. That is no longer the case: the US Centers for Disease Control and Prevention now classifies it as a common intestinal parasite.
An infectious pathogen, B. hominis is found across the globe but most commonly in the tropics and in developing countries. However, that situation is changing. Globalisation of our lifestyles has led to globalisation of our diseases, so it is no wonder that this and other infectious agents easily make their way around the world. B. hominis now comes to you.
Transmission is believed to occur via the oral-faecal route. Sorry to be so indelicate, but that usually means poor toilet hygiene on the part of someone involved in food preparation. It can also be spread through untreated water.
“B. hominis is frequently detected in the stool samples of IBS patients.”
The similarity with IBS
“The relative prevalence of symptoms of abdominal pain, diarrhea, and constipation in Blastocystis infection and IBS show a remarkable similarity”
IBS is considered “not a single disease but rather a symptom cluster resulting from diverse pathologies.” In other words, IBS is an umbrella term, covering a myriad of symptoms whose cause is unknown. It is thought to affect around 11% of the global population, though accurate figures are hard to come by because there is no definitive test or “gold standard” diagnostic tool.
Nor is there a specific or standardized therapy. Over-the-counter medications are routinely recommended, and include antidiarrheals, antispasmodics, laxatives, and fibre. However, the effectiveness of these medications is a matter of doubt.
“Most physicians and gastroenterologists acknowledge that the medical treatment for irritable bowel syndrome (IBS) is empirical, not necessarily based on pathophysiological findings and substantially lacking in efficacy.”
So how can you possibly know if the cause of your symptoms is a parasite such as B. hominis?
You can’t, without testing.
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