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Am I Infected with Intestinal Parasites?

1 What is a parasite?
2 What symptoms are caused by harmful single cell parasites (protozoa) in the intestines?
3 How does one diagnose an infection with intestinal parasites?
4 What are the most common intestinal parasites?

5 How does one contract intestinal parasites?
6 I am diagnosed with the Irritable Bowel Syndrome, could I be infected?

1 What is a parasite?
A parasite is a single celled or larger living organism that attaches itself to a plant, animal or human, to use it as nutrition. Parasites live at the expense of the "host". The literal meaning is: “eating along (uninvited)”. Lice, fleas, worms and amoebae are examples of parasitic organisms.
A single cell parasite is called a “protozoa”. Many animals and people carry parasites - worms or protozoa - in the intestine. Worm infections are (except for the little white worms that children often have in the intestines - Enterobius vermicularis) found quite seldom in the Western world. However, protozoa cause major health problems worldwide; more than 25% of the European population is infected with intestinal protozoa.
There are five known types of harmful intestinal protozoa: Dientamoeba fragilis, Blastocystis hominis, Giardia lamblia, intracellular protozoa (such as Cryptosporidium species) and Entamoeba histolytica/dispar. Balantidium coli is another parasite that can be found in the stool but there are no specific tests for identifying it. There are also protozoa which are considered harmless, such as Endolimax nana and Entamoeba coli who, which can be detected by microscope (TFT).

2 What are the symptoms caused by harmful single cell parasites (protozoa) in the intestines?
Abdominal pain or cramps
Flatulence or abdominal distension
Urgent defecation
Diarrhea or sticky stool
Smelly and greasy stool
Constipation (often alternating with diarrhea)
Lack of appetite
Starch intolerance
Itching skin or eczema
Itching of the anus
In children, growth retardation
In combination with intestinal symptoms, the following symptoms may occur: insomnia, depression, muscle weakness, muscle or joint pain, headache, malaise, lack of concentration and sometimes fever.

3 How does one diagnose an infection with intestinal parasites?
The diagnosis is based on the analysis of a stool sample. The laboratory makes use of molecular PCR methods to identify parasitic DNA. This method is the most accurate technique, because the parasite’s DNA can still be found after the parasite has died.

4 What are the most common intestinal parasites?
a. The two most common parasites infecting the large intestine are:
Blastocystis hominis
Dientamoeba fragilis
b. Protozoa infecting the small intestine:
Giardia lamblia
Cryptosporidium species

Note: Entamoeba histolytica/dispar infects the large intestine. Entamoeba histolytica is harmful but seldom seen in the West. Almost all of the Entamoeba histolytica infections are the harmless dispar variety. Parasiet.com does not have a test available for the detection of this parasite.

5 How does one contract intestinal parasites?
An infection with parasites is the result of oral contact with contaminated faeces. This is called the  faecal-oral route. You come into contact with faeces of others more often than you think.
First of all, the doorknob of the toilet contains stool residues from other people - both at public restrooms as well as toilets at home. Stool may contain parasites.
Secondly, you can get infected by eating with unwashed hands.
In the third place by consuming contaminated food. Raw foods such as salads, which are washed with unclean water, or did came in contact with the unwashed hands of the cook, may contain parasites.
A fourth way of contracting an infection is through direct contact with stool, for example changing diapers and sexual contact.
Because of mass tourism and large scale immigration, we frequently come in contact with infected people or contaminated objects. Importation of exotic products also contributes to the spreading of infectious diseases.  The risk of contracting parasites is no longer confined to tropical and subtropical regions. In Europe most people get infected with parasites in their own environment, by their own children, friends, relatives or college’s who are carrying the parasites.
The main cause of infection with intestinal parasites is lack of hygiene. People often eat a meal or take a snack without washing their hands. Many people eat with the bare hands instead of cutlery. Children often get sick at school or in kindergarten. At school children often do not wash their hands before eating their lunch and in some cases there even is no soap in the bathrooms.

An increased chance of infection takes place in certain high risk groups:
1. in certain professions or work environments there is an increased risk of infection:  
in nursing
at daycare centers and kindergarten
in psychiatric institutions
at the airport or seaport
through frequent contact with refugees
in waste management
in the meat industry
2. in children with parents with above professions
3. in small children in kindergarten and daycare centers
4. in families with children with abdominal complaints
5. people originating from or frequently visiting developing countries
6. complaints starting after visiting a (sub)tropical country
7. by frequent contact with animals
8. by male homosexual contact
9. if the partner or family members are (or were) infected

6 I am diagnosed with the Irritable Bowel Syndrome (IBS), should I be tested?
Yes, it is advisable to take a test.
Many people suffer for years from chronic bowel problems without knowing the cause. A large part of these people have received the diagnoses Irritable Bowel Syndrome (IBS). This diagnosis is based on the symptoms defined as the Rome criteria(link). These criteria are not specific, because flatulence, abdominal distension, diarrhea or incontinence can be caused by parasites and diseases such as  bacterial infection, lactose intolerance, celiac disease or food allergies.

Chronic intestinal complaints often cause social restrictions and even loss of work. Numerous scientific publications indicate that IBS symptoms in Europe are caused by intestinal protozoa in 30 - 45% of the cases:
More than 30% of the IBS patients is infected with Dientamoeba fragilis.
More than 45% is infected with Blastocystis hominis.

About 6% is infected with Giardia lamblia and 1% with Cryptosporidium.
In people who are infected, the symptoms disappear in most cases through the use of medication.



Thank you for visiting this website. We hope that we have provided you with sufficient information and have answered your questions regarding intestinal parasites. It is our goal to contribute to the diagnosis of intestinal problems, since one in five people suffer from chronic bowel complaints. Stool exams provide a major contribution in identifying the cause of the symptoms. For many people the diagnosis of Irritable Bowel Syndrome, IBS, and testing is of great value since more than 30% of IBS patients are infected with parasites.

Many doctors do not order parasitic tests, the reason is often the unfamiliarity with the subject. Many doctors assume that most people are infected in (sub) tropical regions, and are not aware that infection with parasites is no longer the specialized field of tropical medicine. Through tourism and immigration we all come into contact with intestinal parasites on a daily basis. Children are often contract a infection in kindergarten or school. The laboratory uses advanced DNA testing techniques and offers the test at the lowest possible price.