Treatment for elimination of Blastocystis hominis from colon

[bluewaterman]

History: intermittent irritation/slight pain in lower left region, in locality of lower section of decending colon; watery stool, occasional isolated amount of clear/slightly turbid mucus strings with stool.  Annual physical completed 12/26/03, stool test negative for blood, but positive for blastocystis hominis.
While at home in Hawaii, 2.5 years ago the irritation started in same area described above.  While visiting Thailand .5 year later (2 years ago during Song Krong (water festival in April)), felt same irritation, intermittent, then after a couple of days noted bright red blood mixed into clear/turbid mucus string in bowel movement and chronic diarrehea.  Talked with friend that lives in Thailand at that time, said most likely amoebic dissyntery, went to local pharmacy, and did a 5 day course of Flagyl.  Symptoms improved, no indication of blood, dissyntery resolved and felt strong.  About one month later, at home,  intermittent irritation resumed, gas frequently, watery stool, but no blood and strength slightly diminished.  Condition seems to remain at same level.  Recently after 6 months of gruelling work and sleep deprivation, general energy depleted.  Developed joint pain, specifically hip, and occasionally other joints until quit coffee and all sources of caffeine.  Then developed sesitivity to corn chips and corn syrup.  Physically exhauted when engaged in intense athletic activity.  It took me longer than any other period in my career so far to recover from work related sleep deprivation and regain my strength.  Generally feel in good health now but not same level of well being as before 2.5 years ago.  I would like to eliminate the Blastocystis hominis from my large intestine, (colon).  I have researched on the web and found some scientific journals and reports which mention treatments for this normally minor parasite.  Also on a web site www.badbugs.com there is extensive information; but on that site there is reference to failed treatments, especially using Flagyl (or derivative of) alone.  The current treatments mentioned are as follows:  a combination of rifaximin and nitazoxinide; or metrondiazole and septrin (bactrim); or paromomycin and tetracycline; or yodoxin (lodoquinol) and metronidazole; or trimethoprim-sulfamethaxazole; or tmp-smx & metronidazole & pentamidine; or naturopathic: silver & clove by Bioray for 6 weeks.  Where is there up to date information with regard to treatments and subsequent results ?  Do you know or anyone on the board know of the current most successful treatment for the erradication of Blastocystis hominis from one's gut ?  My general physician does not know much about it, and does not have the time to do the research, he asked me to participate in the investigation for the best possible treatment course.  Your assistance and serious consideration in this situation is greatly appreciated.  My general physician is Dr. Donald E. Nicol tel.ph# [phone], his Office assistant is Sharon.

[Kevin Pho, MD]

Blastocystis hominis is an anaerobic protozoan parasite frequently found in the human gastrointestinal tract.  Some refer to it as a pathogen, some as a non-pathogen.  The important point is that eradication of the parasite does not necessarily lead to resolution of symptoms.  In fact, a thorough evaluation should be done first to exclude other causes.  

I would suggest a colonoscopy and/or CT scan to evaluate the symptoms.  If negative, and there continues to be no other pathogen that is identified, then you may want to consider treatment with metronidazole.  Other medications to consider are furazolidone, trimethoprim-sulfamethoxazole (TMP-SMX), quinacrine and pentamidine.  You may want to discuss these options with your personal physician.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

[PAJ]

I have no experience of your particular problem I just looked up the bug on Medline out of interest, I would say that many who host a long term gut infection have duel-infections sometimes with fungi ,If you need any more info on that, post..

PMID: 14702395 [PubMed - as supplied by publisher]
[Blastocystosis: nitazoxanide as a new therapeutic option]

[Article in Portuguese]

Cimerman S, Ladeira MC, Iuliano WA.

3ra. Unidade de Internacao, Instituto de Infectologia Emilio Ribas, Sao Paulo, SP, Brasil. ***@****

We report a case of a patient with AIDS and severe immunosuppression who developed diarrhea due to a vacuolar stage of Blastocystis hominis. The patient was treated with nitazoxanide, a 5-nitrothiazole broad-spectrum antiparasitic agent. We obtained complete remission of symptoms and eradication of the parasite. Nitazoxanide is a new treatment option for blastocystosis in AIDS patients. Further studies to test its efficacy are needed.

Publication Types:
· Case Reports

PMID: 12908045 [PubMed - indexed for MEDLINE]
Microbiology. 2004 Jan;150(Pt 1):33-43. Related Articles, Links

Metronidazole induces programmed cell death in the protozoan parasite Blastocystis hominis.

Nasirudeen AM, Hian YE, Singh M, Tan KS.

Department of Microbiology, Faculty of Medicine, National University of Singapore, 5 Science Drive 2, Singapore 117597.

Previous studies by the authors have shown that the protozoan parasite Blastocystis hominis succumbed to a cytotoxic monoclonal antibody with a number of cellular and biochemical features characteristic of apoptosis in higher eukaryotes. The present study reports that apoptosis-like features are also observed in growing cultures of axenic B. hominis upon exposure to metronidazole, a drug commonly used for the treatment of blastocystosis. Upon treatment with the drug, B. hominis cells displayed key morphological and biochemical features of programmed cell death (PCD), viz. nuclear condensation and nicked DNA in nucleus, reduced cytoplasmic volume, externalization of phosphatidylserine and maintenance of plasma membrane integrity with increasing permeability. This present study also supports the authors' previously postulated novel function for the B. hominis central vacuole in PCD; it acts as a repository where apoptotic bodies are stored before being released into the extracellular space. The implications and possible roles of PCD in B. hominis are discussed.

PMID: 14702395 [PubMed - as supplied by publisher]

[GI.PA]

Please understand that for a wide majority of patients erradication of blastocys.Hom., there is no improvement in sypmtoms.  I am not saying it would not be worth treating (I would simply use the flagyl regimen, saving the big guns for if your stools were positive again after treatment).  One must look at other diagosises (such as non-infections, inflammation, Irritable bowel, colon cancer..etc).  Futher stool tests and a scope to examine the colon (either partially or fully based on your age) may be persued.  If the infection is clear and your symtoms persist, bulking agents to help regulate the consistancy and frequency of the bowel movement may be helpful.

GI.PA

[bluewaterman]

Thank you for the response.  Will follow up with the suggestions to my GP.  I am reluctant to go the Flagyl use due to reports of possible resistance noticed by previous studies ( I assume that in many other countries, such as Thailand, where people can just walk into a pharmacy they treat their bowel/blood in stool symptoms with Flagyl.  Hence the observed resistance to the drug in certain case studies).  I am hoping my GP will go with nitazoxanide, after another broader spectrum stool sample test.  To try and reduce doubt as to the pathogen.

[bluewaterman]

Thanks for the input, Kevin MD, will follow up with my general physician.

[mikulash]

Diagnosed today with Blastocystis hominis,
and apparently there are some natural remedies which might be more successful than the usual antibiotics.
Anybody interested? (bluewaterman?)

[rayls]

l;m new to this,and a little confused about it all.but up on the board l noticed somone said somthing about a naturel way of treatment..if anyone knows of this can they please tell me..Rayls

[stace91]

hi i was just looking for any infomation in relation to natural treatment for blastocystis hominis. My mother who is 42 has recently found out she has this infection. My mum has had this infection for about 2 years and didnt realise it she was just advised it was abug until recently a doctor tock it a bit further, im looking for possible natural treatments and any advise would be greatly apreciated. My mother for the past 2 years has been recieving pains in her legs, she has also been getting dizzy and thinks things are moving when there not. She also finds it difficult to walk up stairs to bed and will sometimes just sleep on the coach. im not really sure what to do but i have been reading about drugs and would like to try a natural remedy. its also very rare in astralia so natural therapists havent heard of it, any advise would be greatly appreciated

[mistyqueen]

Hi all,
  I live in Canada and I was just diagnosed with this little Parasite twice now. Once 2 years ago and Just this last week again. I treated the Blastocystis Hominis With the Help of a Naturalpath Two Years ago but it never really seemed to go away. I am now on 3 Tablets 250 MG of Flaggl for 30 days.The only way I can keep the Flaggl Down is take it with some Olive Oil first after eating some food otherwise I vomit. The Olive oil bit was recommended to me by the pharmacist and it works like a charm.

I have talked to other people in my community who had bad Guts and all were told you have IBS just like myself. All the people i have talked to have talked about Stomach Cramps and feeling like **** from drinking the Tap water here.
Yet I My body leads more to the Constipation side of things. When I  try to add more Fiber to my diet plus Metamucil like all the Doctors Recommend I get Diarrhea where I live in the bathroom. I had a Scope in Dec 2000 and my colon came healthy other than a few Hemorrhoids that were small. I don't have a weakened Immune System because I have had all the tests and they came back negative!I have had problems with Candida before in my bowel because it smells like I'm making Bread its that yeasty!I have been working hard on Cuttng Sugar out of my Diet, I know I'm allergic to Wheat, Wheat Gluten, Chicken Eggs, Dairy, Sugar which I found out from the Naturalpath and when I avoid those I feel somewhat better.

I am not Drinking the Tap water, We get Bottled Water delivered.

Hopefully this can all be resolved for my guts but if not there is some new stuff on the market for IBS at the local health food I may try and I'm going to ask the Doctor if I can have another scope done because since starting the Flaggl 2 days ago I have been having several bowel movements a day and some pink  mucuos after which concerns me.

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