"Many of the clinical symptoms associated
with IBS are non-specific and have also been
reported in patients infected with D. fragilis
and B. hominis. Irritable bowel syndrome is
usually diagnosed clinically according to the Rome II criteria.24 Many laboratories in the
UK would not be able to exclude D. fragilis
and B. hominis, therefore it is possible that
some patients infected with these parasites
could be misdiagnosed as having IBS.
Anecdotal evidence suggests that many
patients infected with these parasites are
indeed being misdiagnosed as having IBS" D. fragilis and B. hominis:
neglected human protozoa. J. J. Windsor. The Biomedical Scientist. July 2007. Pages 524-27.
The clinical consequences of B. hominis infection are mainly diarrhea or abdominal pain with nonspecific gastrointestinal symptoms such as nausea, anorexia, vomiting, weight loss, lassitude, dizziness, and flatulence. Irritable Bowel Syndrome: In search of an etiology: role of B. hominis.Javed Yakoob et al
Am. J. Trop. Med. Hyg., 70(4), 2004, pp. 383-385
Most recent literature accepts that D. fragilis is an important enteric pathogen with an estimated incidence of symptomatic infection of between 4 and 91%. Symptoms include abdominal pain, bloating, and diarrhea. Peek et al, 2004, American Society for Microbiology
"The clinical consequences of B. hominis infection are mainly diarrhea and abdominal pain as well as nonspecific gastrointestinal symptoms such as nausea, anorexia, vomiting, weight loss, lassitude, dizziness, and flatulence. Case reports and series have suggested a pathogenic role of B. hominis in causing intestinal inflammation. Also some studies have suggested that inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) are associated with B. hominis infection. The investigators indicate that the stools of all patients presenting with IBD or IBS should be examined, and culture methods for B. hominis carried out. Invasion and mucosal inflammation of the intestine with B. hominis have been observed in studies of gnotobiotic guinea pigs." Blastocystis hominis and bowel diseases.Turkiye Parazitol Derg. 2006;30(1):72-76
The search for Blastocystis hominis should be a parasitological routine analysis since it is the cause of frequent intestinal disorders. Ponce de Leon P, Svetaz MJ, Zdero M. Rev Latinoam Microbiol.
The pathogenicity of D.fragilis continues to be questioned; however, the circumstantial evidence incriminating this organism as a pathogen is overwhelming. D.fragilis: the unflagellated human flagellate. JJ Windsor & EH Johnson, Br.J.Biomed Sci 1999 Dientamoeba fragilis — a protozoal infection which may cause severe bowel distress. Norberg A, Nord CE, Evengard B.
Clin Microbiol Infect. 2003 Jan;9(1):65-8.
Blastocystis hominis may be the most common parasitic infection of humans. This organism is often missed on stool examination but grows luxuriantly in all the media used to cultivate xenic Entamoeba. Establishing Cultures of Entamoeba in vitro London School of Hygiene & Tropical Medicine 2000
The clinician should however be aware of this parasite as a possible cause of gastroenteritis, particularly when no other pathogen can be identified. Nguyen XM, Krech T
Blastocystis hominis, a parasitic cause of diarrhea.
Schweiz Med Wochenschr.
1989 Apr 15;119(15):457-60.
"Research is to see what everybody else has seen, and to think what nobody else has thought." Albert Szent-Gyoergi,
winner of the Nobel Prize in medicine for his discovery of Vitamin C.
"I found your site last year when I was so overwhelmed with illness,
and it was a beacon of sense and professionalism blended with first-hand accounts."Similar comments here.
Badbugs explains about the two most commonly underdiagnosed gut parasites:
Dientamoeba fragilis and Blastocystis hominis.
My name is Jackie and in 1998, four years after becoming infected with D. fragilis and B. hominis, I established Badbugs.
Two years earlier I had been diagnosed with Dientamoeba fragilis by the specialist lab Great Smokies Laboratories (now called Genova).
The first of three stool samples was negative. The second sample contained a "few" D.fragilis parasites, and the third "many" parasites.
Each sample was collected in fixative, which is essential to prevent the parasite from disintegrating and becoming unrecognisable. Without fixative, D.fragilis is rarely diagnosed.
Stool samples sent to local labs were not fixed so it was not suprising that eighteen months passed before I discovered why I had lost twenty-five percent of my bodyweight and felt so unwell.
Getting diagnosed was the easy part. Finding a doctor who would take D.fragilis into consideration when assessing my symptoms was much harder.
The long-standing and widely-held medical opinion that D.fragilis was harmless delayed my recovery for another six years. Doctors were relucant to sanction either specialised treatments or specialised stool collection and testing methods, recommended in decades of published medical literature. Such measures, they advised, were unnecessary to diagnose or treat a harmless parasite. Because of their intractable views it was another six years before I discovered I had both Blastocystis hominis and Dientamoeba fragilis.
I was diagnosed with Irritable Bowel Syndrome and the best treatment offered by modern medicine for this incurable set of symptoms was Metamucil (a bulk-producing laxative and fibre supplement containing psyllium seed husks) and peppermint oil capsules. When these failed to help, I was encouraged to seek psychiatric advice.
In 1997 I began researching Dientamoeba fragilis at the medical libraries of Sydney University. I found mamy studies from the past few decades which confirmed that D.fragilis causes the symptoms my doctors had disagnosed as Irritable Bowel Syndrome.
With this research, I felt very hopeful I could convince a specialist to consider the possibility that the parasite was causing my symptoms. I couldn't have been more wrong. The studies were dismissed as irrelevant. Until irrefutable proof that D.fragilis was a pathogen, my chronic condition — which drove me almost to the brink of suicide — was to remain misdiagnosed as an "irritable bowel".
I decided to publish the literature on a website in the hope that it might help others under the care of more open-minded doctors. In 1998 very few sites existed about D.fragilis, and they reflected the views of Sydney health professionals.
"I wish there had have been a site like yours up this past summer, I couldn't find much information on D. fragilis when I needed it."(USA. 1998)
Soon after launching badbugs it became clear that the opinions of Sydney health professionals were far from unique. People from the US and Canada, the UK and continental Europe, New Zealand and other parts of Australia wrote of their despair at ever overcoming their infection. Many had been sick for years, some for decades before being diagnosed. Most had been misdiagnosed with IBS.
In early 2001, I finally located a specialist who, after initial doubts, agreed that my research had merit. He arranged for me to submit three fixed samples to a Sydney parasitologist. B.hominis and D.fragilis were diagnosed.
I revisited Sydney University medical library to research Blasto.
I found many parallels with D.fragilis regarding Blasto's pathogenicity, misdiagnosis, underdiagnosis and inadequate or inappropraite treatments. I this latest research to my website.
This site documents the tremendous impact the centry-long unsettled pathogenicity debate has had on people with these infections. A few examples follow. More can be found on the Medical Mismanagement pages of Dientamoeba fragilis and Blastocystis hominis.
Some of the specialists I consulted have since changed their minds about the pathogenicity of these two parasites which brings to mind Haldane's profound thought:
"Theories have four stages of acceptance:
this is worthless nonsense;
this is an interesting, but perverse, point of view.
this is true but quite unimportant.
I always said so."
J.B.S. Haldane, 1963
The full account of my battle to find medical help ishere. _____________________________________________
The experience of a Canadian diagnosed with Dientamoeba fragilis is typical of the thousands of emails received over the past decade:
"I have been living with several severe symptoms for 12 years now - chronic fatigue, abdominal pain, weight loss, etc. I have seen many specialists but nobody seems to be able to help me. Last year, I did a parasitology test and received the results but nobody wants to treat it. I cried for an hour just reading your web site and all these stories. For the first time in my 12 years I found people that live with the same kind of problems as I do. Almost incredible to me!" (January 05)
A UK student struggled to cope with his D.fragilis infection for four years. Despite losing a quarter of his body weight and suffering typical D.fragilis symptoms, he was advised to to ignore his infection:
"Every single aspect of life is a struggle at the moment for me. I cannot plan anything and even if I have a night out with my friends I find it hard to eat the next day even though I have only been drinking water on the night out. The nausea comes all the way from my stomach to my mouth, it is so overwhelming at times that it is painful to be conscious. "( July 2005)
Mary-Anne from the UK, infected with Dientamoeba fragilis, wrote:
"Once again I wanted to say how totally grateful I am to you for putting your informational website together...if you hadn't done it myself & so many others would not have the necessary details to get the proper treatment in order to beat this stubborn parasite! Your website also made me feel very supported and not alone in how I was feeling...at some points I thought that my symptoms were all in my head & that I was going crazy! " read Mary-Anne's full story here
For 22 years N. suffered with bloating, gas, constipation, dizziness and lethargy before being diagnosed with Dientamoeba fragilis. His infection had a huge impact on his quality of life...cont.
S., from the UK, suffered debilitating symptoms for eight years before being diagnosed with D.fragilis. Her debilitating symptoms had been by her GP as Irritable Bowel Syndrome (IBS). When she was offered Prozac she felt it was time to change doctors: "I was not depressed - I wanted answers.". After going on a specialised treatment she made a complete recovery. Details here.
C, from the UK, overcame her GP's scepticism about the importance of specialised testing by enlisting the aid of her vet ....cont.
The account of an expat UK man living in the US of trying to find a doctor to treat his D. fragilis and B. hominis infection would be amusing if his infection had not impacted quite as severely on his quality of life. Details here.
Comprehensive information about the importance of specalised testing necessary to diagnose D.fragilis and B.hominis. Details here.
Flagyl continues to be the most commonly prescribed drug to treat parasitic infections, yet of the thousands of people who have contacted this site over the past decade less than a handful have achieved clearance of Blasto. or D.fragilis from stool samples and resolution of symptoms.
Flagyl is often prescribed in case of undetected Giardia, as in this case:
"I just found out I have blasto hominis and found your site. I mentioned to the Dr. that your site doesn't recommend Flagyl, but that is what he prescribed. It is kind of spooky how your site predicted the Dr.'s comments even down to telling me the this (parasite) doesn't cause symptoms but they will treat it because I might have something else." (Nov 2005).
A Sydney gastroenterology clinic have come up with a combination of three drugs which cures more than 80% of Blastocystis hominis infections. It is also very effective against Dientamoeba fragilis. The outcome is determined by three fixed samples tested four weeks post treatment. More here.