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blastocystis treatment

What is the best treatment for blastocystis homini for a 13 year old.  I am concerned to treat with Flagyl because I hear so moany time that this is effective for a short period of time and then the blastocystis comes back.


This discussion is related to Diarrhea, gallbladder sludge, diverticulitus, parasites....I'm confused.
15 Responses
Avatar universal
For the most part, the majority of reports on the effect of antimicrobial therapy for B. hominis infection are either case reports or small, noncontrolled studies. There are a few small studies that suggest that metronidazole 800 mg three times daily for 5–10 days is effective in some, but the reports seems to indicate that it's difficult to have an accurate prediction as to whether or not it will work - percentages vary. Some studies suggest co-trimoxazole (sulfamethoxazole 800 mg and trimethoprim 160 mg, twice daily for 7 days) may eradicate the organism in about 90% of infected, symptomatic individuals - but no treatment seems to be foolproof. Even a newer drug, nitazoxanide, shows variable results: nitazoxanide (500 mg twice daily for 3 days) showed a 'cure-rate' of about 85 percent (small study, I believe).
Avatar universal
Thanks so much for your response. A recent test on her gallbladder showed it functioning at 23%. I am told that it should be at about 35%.  
I have two questions.  
Can you treat blastocystis without taking out the gallbladder?  
Do you know of a good gastroenterologist? We are seeing a pediatric gastroenterologist and are in the midst of a bunch of tests on much of her entilre body but I want to make sure she gets the best treatment initially once a treatment process is started. I would be happy to travel to the best one or have my present doctor consult with one on the cutting edge of knowledge about this blastocystis and how it affects the digestive system and the body.
Avatar universal
It can be treated w/o removing the GB. That ejection fraction is just a bit low. Most docs these days would not suggest removing the GB unless there was a presence of stones or sludge. There are unfortunately too many who suffer from some rather severe side-effects when the GB is removed with 'only' a low EF and no other sign of disease or dysfunction.

I'm sorry, I can't recommend a doc. I would suggest you ask those that you know and trust for a recommendation.
Avatar universal
Ok, CalGal.  It sounds like you know a little bit about this and I am a concerned Mom trying to find the best medical care for my daughter. So, if you treat this with the drugs you mentioned above, then there is some hope it will be eliminated from the gallbladder, is that right?  My daughter had an ultrasound done on the gallbladder and nothing showed up on the ultrasound.  After she had the hidascan done of the gallbladder showing a 23%, she has also had a test done to see how fast the food goes through her stomach.  I think the score shoud run at about a 60. Her score, I am told is in the range of what is acceptable, but in the high end of acceptability. She scored a 90 on this test. I find it interesting that both have a ratio of two thirds.  How do I find out if this parasite is in her gallbladder?  We are doing a stool test. One done previously, about 2 to 3 weeks ago found a few blastocystis homini in her stool. It did note or find any other bacteria or parasites in the report. She gets a feeling of nausea after every meal, the bigger the meal the more nauseous she says she feels.
Avatar universal
I reread your last posting. I guess I got so excited that I did not comprehend what you so clearly stated. You are suggesting to treat the blastocystis and not remove the gallbladder. You state too many people suffer severe side effects when removing the gaalbadder when not having another disease or dysfunction. I am trusting what you say. You are giving me hope. How do you know all of this. Are you a doctor? Help me to understand this further and to convince my doctors that the above mentioned drugs are the best treatment.How can I find a doctor I trust completely and one that will use a course of treatment or a combination of drugs that are not widely known to be used for blastocystis. I am not sure, but I think most doctors prescribe Flagyl which seems to have a poor success rate and you seem to think others have a better success rate.. Are these drugs you mentioned previously safe for someone who will be 13 in April, 2009. Her body weight is between 125 and 128. What are the side effects of these drugs?  What is it does not leave her body with these suggested drugs, what then?
Avatar universal
I am not saying that the GB should not be removed. If it is diseased, or nearly non-functional then it will have to come out. But there should be clear indications that the problem is truly due to the GB. Both a GB ultrasound and HIDA scan with CCK injection should indicate the presence of stones, or sludge, or an enlarged/thickened wall, and a lowered ejection fraction. Many people with only a slightly low ejection fraction - and no other indication of other problems - have undergone GB removal and continue to have problems after the surgery. When the problems continue, those individuals are then told - after other tests come back negative - that the surgery 'uncovered' an underlying problem that was probably present and was causing the symptoms in the first place - spasms of the common bile duct or sphincter of Oddi. The condition is called sphincter of Oddi dysfunction (SOD) and it is extremely difficult to resolve - there's no easy way to do it. Many people unfortunately have the problem, and it's starting to force the surgeons to rethink what should be done with people present with GB symptoms, but the tests don't show 'true' GB issues.

As far as the drugs go, if you reread my post you'll note that I said that no drugs are foolproof. Some drugs may be slightly better than others for one individual, but there's no way of knowing which drugs are going to work unless they're tried. It's like using meds to suppress acid production - nexium works for one person and not for another.

I believe you're assuming that B. hominis may be causing the lowered ejection fraction, and that may not be the case. The two issues may be entirely unconnected. You also need to keep in mind that B. hominis is, in many cases, considered a commensal organism in the GI tract and unless a person is immunocompromised or is otherwise having medical issues, the organism is not considered to be a cause of problems.

I can't tell you which drugs are safe or not, it's something you're going to have to discuss with your doc. Only he/she knows your daughter and knows the in's and out's of what's going on with her system. All I can do is provide you with info on the subject. Most docs probably will start with something like flagyl and if that fails they'll move on to other drugs. Flagyl is a 'known' entity for most docs and that would be considered 'safer' and a way to start.

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