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Amoebic Dysentery / Amoebiasis

Written by Dr. Vivekanand, MBBS | Medically Reviewed by Dr. Ramya Ananthakrishnan, MD on Nov 01, 2022
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Amoebic Dysentery - Overview

It is also known as Amoebiasis or Traveller's Diarrhoea(1 Trusted Source
Amebiasis.

Go to source
).

  • It is the infection of the large intestine, sometimes involving the liver. It causes diarrhoea among other symptoms.
  • Frequently affects people whose hygiene is poor.
  • Travellers to countries with poor sanitation are at greater risk of contracting the disease (hence known as traveller's diarrhoea).
  • It can affect any one young or old of either sex.
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About 10% of the world's population is infected with amoebas, particularly people who live in

  • Mexico
  • India
  • Central America
  • South America
  • Africa
  • Tropical areas of Asia.

In industrialized countries, amoebiasis is very common among recent immigrants and travellers who visit countries where amoebas are prevalent.

Amoebic Dysentery - Causes And Spread

The infection is caused by a parasite called "Entamoeba histolytica." (EH)

These are microscopic one-celled parasites commonly known as amoebas. Entamoeba histolytica exists as two forms in contaminated food and drink(2 Trusted Source
Parasites - Amebiasis - Entamoeba histolytica Infection

Go to source
)

  • As free amoebae (known as "trophozoites")
  • As infective cysts, which are a group of amoebae surrounded by a protective wall, which have been passed in the faeces of the carrier (human or animal).

As these parasites live in the large intestine, they travel in the feces of infected people, and can contaminate water supplies in places where sanitation is poor.

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The parasite spreads by:

  • The contamination of fruits and vegetables grown in areas where human feces are used as fertilizer.
  • Dirty hands of infected people especially after bowel movement when they don't wash their hands properly.

Once amoebas enter the mouth, they travel through the digestive system and settle in the large intestine. A harmless strain of the parasite (Entamoeba dispar) can live in the intestine without causing damage.

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E. Histolytica can also sometimes live in the intestine without causing symptoms, but it can cause severe disease-

  • These amoebas may invade the wall of the intestine and can cause small ulcers and inflammations leading to amoebic dysentery.
  • These amoebas also may pass into the bloodstream and sometimes travel to the liver and rarely, to the brain, where they can form pockets of infection leading to abscesses(3 Trusted Source
    Entamoeba Histolytica.

    Go to source
    ).

Amoebic Dysentery - Symptoms

The symptoms of amoebic dysentery's can be mild to severe depending on the location of infection. The infection can get to be life threatening in an immunocompromised individual (eg AIDS/HIV suffers) or a post transplant patient.

Mild early symptoms

  • Weight loss
  • Anaemia
  • Indigestion
  • Intermittent diarrhoea with foul-smelling stool that may be preceded by constipation.
  • Dehydration
  • Blood and mucus in the stool.
  • Gas and Abdominal Bloating
  • Abdominal cramps and tenderness
  • Fever
  • Fatigue
  • Chills

The disease can sometimes become complicated if the amoebae break through the intestinal wall and the lining called peritoneum. This causes perforation and leads to

  • Peritonitis, meaning the inflammation of the peritoneum.

The amoebae may be then carried in the blood to the liver resulting in the formation of an abscess that presents the following symptoms

  • Fever
  • Chills
  • Pain in the upper right portion of the abdomen
  • Nausea
  • Vomiting
  • Weight loss
  • Enlarged liver

Amoebic Dysentery - Diagnosis

The best diagnosis is by demonstrating cysts or trophozoites in a stool sample.

1. Stool tests

  • Three stool samples should be done in the laboratory to confirm the presence of E. histolytica(4 Trusted Source
    Laboratory diagnosis of amebiasis.

    Go to source
    ).

2. Blood tests

  • There are many blood tests that can be done for diagnosis having a high degree of accuracy(4 Trusted Source
    Laboratory diagnosis of amebiasis.

    Go to source
    ).

3. Proctosigmoidoscopy or Colonoscopy

  • These are special procedures done when the diagnosis is not clear after stool and blood tests.
  • This involves the use of a thin, lighted instrument inserted into the rectum and colon to view them directly and tissue samples are taken for laboratory examination(4 Trusted Source
    Laboratory diagnosis of amebiasis.

    Go to source
    ).

4. Ultrasound

  • If there are complications and involvement of the abdominal organs, then further investigations, such as ultrasound, may be necessary to confirm the diagnosis(4 Trusted Source
    Laboratory diagnosis of amebiasis.

    Go to source
    ).

Amoebic Dysentery - Treatment

  • Involves taking antibiotic drugs to kill the parasites, the commonly used antibiotics are-
  1. Metranidizole(5 Trusted Source
    Antiamoebic drugs for treating amoebic colitis.

    Go to source
    ).
  2. Tinidazole(6 Trusted Source
    Tinidazole and metronidazole in the treatment of intestinal amoebiasis.

    Go to source
    )
  • Bed rest and drinking a solution (containing salt and glucose) to replace losses from the diarrhoea and for rehydration may also be necessary.
  • Painkillers and muscle relaxants are given to treat stomach or abdominal pain.
  • Complicated cases may require hospitalisation.
  • If dehydration is severe, intravenous fluids may be required.
  • It is very important not to consume alcohol during treatment.
  • After treatment, regular stool tests will be taken to ensure that the parasite is completely eradicated, as amoebiasis has a tendency to recur at intervals.

Preventions and Precautions

There is no immunization to protect against gastrointestinal amoebiasis.

  • Always wash hands with soap after going to the toilet as well as before preparing and eating food.
  • The best way to avoid infection with amoebic cysts is to ensure that everything eaten or drunk has been washed or sterilised properly and cooked thoroughly.
  • While travelling avoid foods like-
  1. Salads
  2. Peeled fruit
  3. Ice cream
  • Ice cubes may be made of contaminated water, hence it is best to try and avoid having drinks that contain ice in roadside hotels especially in tropical countries
  • Consumption of clean and sterile drinking water.
  • Water can be made safe by, by boiling it for 10 to 15 minutes, and then cooling it rapidly and keeping it covered. It is important to remember that the chemical methods of sterilisation are not a guaranteed method to completely destroy all possible harmful organisms.
  1. Amebiasis. - (https://www.ncbi.nlm.nih.gov/books/NBK519535/)
  2. Parasites - Amebiasis - Entamoeba histolytica Infection. - (https://www.cdc.gov/parasites/amebiasis/index.html)
  3. Entamoeba Histolytica. - (https://www.ncbi.nlm.nih.gov/books/NBK557718/)
  4. Laboratory diagnosis of amebiasis. - (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC207118/)
  5. Antiamoebic drugs for treating amoebic colitis. - (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6326239/)
  6. Tinidazole and metronidazole in the treatment of intestinal amoebiasis. - (https://pubmed.ncbi.nlm.nih.gov/340131/)

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Post a Comment

Comments should be on the topic and should not be abusive. The editorial team reserves the right to review and moderate the comments posted on the site.

Comments

gurmit22

kurchi Q is the best medicine for any type of intestinal parasites [dysentry] problem , 5 to 10 drops two times daily for 30 days .

Ted70

I believe that I have had intestinal parasites for over two years but my doctors say no as the stool tests always come back negative. One particular test I submitted a vial with two cysts and no mention of this in the lab report. My wife confirmed that she saw me put the cysts in the test vial. [The cysts, which I am passing almost daily are about 1/2" diameter, round or oblong, prickly rough exterior, soft sticky or mushy interior. On the exterior there are two "eyes"-usually one or both still intact-and two teeth like objects projecting beneath the "eyes".] The doctor had me bring one of these cysts in to her-later that same day as luck would have it-and she took it to the lab. Late that same afternoon I received a phone call informing me that I had a bacterial infection. I took metronidazole 500mg 3xday for 10 days. She said the cysts were "unprocessed food". I gradually felt better then about 5 days later the cysts in my stool returned. Very easy to spot as they would always float on the water in the toilet. Then I passed several that were still attached to the stool. That's when I really got serious about careful observance of each and every bowel movement. I also noticed the shape and identifying similarities of each piece of stool (worms?). A head with two "eyes" and yes a mouth partially open on some of them. In may I passed a large worm with a cyst still attached by membrane to its mouth. I have photos taken by me with my cheap camera....some three hundred such photos on my computer. Nobody wants to see them. I'm told that I have IBS and a vivid imagination! I am about ready to give up and put myself in God's hands. The pain and suffering is more than I can handle although it is said that God never gives us more than we can handle.

Advancells

Amoebic Dysentery is a curse on mankind. I had suffered with it two years back and I can still recall those terrible days and I was almost dead and tired. Finally, I recovered after taking some Ayurvedic medicines which my aunt suggested. I lost about 15 kilos in 10 days of this ailment. Thank God, I finally recovered. I still believe that Ayurvedic medicines are the best.

jo1957

my son has rheumatoid arthritis and had arthrotomy of the hips. he had amoebiasis on his 3rd day of stay in the hospital. he was treated with metronidazole 500 mg 3x/day for a week. then the dysentery recurred anout 5 days after getting out of the hosp, and this time gave him fevers and fatigue. he had to be confined again and he was back to metronidazole along with rifaximin for another week. this gave him so many side effects, he could not sleep, headaches, cramps, joint pains all over - he was in distress! he was well for a week, though. yesterday, he had abdominal cramps again and he passed stool around 3 times. it was not watery and i suspected his low fat milk was the culprit. today he passed stool and to my aghast, there was mucus [again!]i dont know what to do. why is this? we complete his medication, wash our hands, he drinks distilled water etc. he is 18 years old around 110 lbs 5'7". last year in february, he had the 1st bout of amoebiasis and it recurred only this year. why is this so? i am afraid metronidazole will worsen again his arthritis. he can hardly walk so its really hard for him to have bouts of dysentery like this. please help. please please

raviv

my name is himanshu i am suffring from amoboisis last 5 month my age is 27 please help

Rupendra16

Hello respected, Sir... I'm Rupendra, Age-26, Hight-6 feet, Weight-55, suffring from dysentary from last 25 days. My symptoms are smell in passing stool, mucus without blood, chills and fatigue. Weight loss-2kg in 1 month. After treatment it was controlled little but not complete relief. Please suggest me for suitable homeopathy medicine or any other , further treatment.

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