Intestinal parasite examination

Been abroad? Do the Backpacker Check. Test your stool for parasites!

Fecal test profile V65 consisting of:

• Worm eggs including Schistosoma sp. (Bilharzia)
• Intestinal protozos including dientamoebafragilia
• entamoeba antigen
• Giardia Lamblia antigen

Diarrhea, abdominal pain, nausea. With these symptoms we often quickly think of a stomach virus, allergic reaction or food poisoning. However, intestinal parasites can also cause symptoms. And these are not at all as rare as you might think.

An intestinal parasite usually does little more than absorb food and bacteria from the intestine. This is because a parasite needs a host, human or animal, to survive and thus uses the intestinal contents to live and multiply.

Most people do not notice the presence of the uninvited guest. Thereby, there are also numerous harmless parasites. However, sometimes the parasites bind to the intestinal mucosa and cause inflammatory reactions. Due to irritation and swelling of the mucosa, the abdomen swells and pain and diarrhea occur. In addition to abdominal discomfort and diarrhea, nausea, eczema or skin symptoms and fatigue may also occur.

Infection with a parasite can usually be recognized by the changing structure of the stool. When normal stools alternate with a thinner substance every four to ten days, you may have a parasite in your intestines.

Intestinal parasites that can lead to symptoms

Of the flatworms, the Schistosoma species are the main causative agents of parasitic infections in humans (after malaria parasites). Infection by the parasite is the cause of the disease schistosomiasis.

Bilharzia is a worm disease. In the first weeks or months, fever, diarrhea and skin abnormalities are the known symptoms. After that, an inflammation of the bladder or intestines occurs. Several months to years after infection, symptoms such as diarrhea with blood or blood in the urine can occur. Bilharzia is found in Africa, parts of Latin America, China, Japan, Indonesia and some parts of the Middle East.

Protozoal intestinal infections with diarrhea are not rare. Parasitological fecal examination is worthwhile in explaining misunderstood chronic diarrhea.

Dientamoeba fragilis is a parasite that can occur in the intestine. Parasites need a host (in this case, humans) to survive. Dientamoeba fragilis lives off our intestinal contents and is therefore a parasite. It is a controversial parasite. For years it was thought that this parasite could not cause intestinal problems. However, it turns out that in a number of cases the parasite can still cause symptoms such as abdominal pain and diarrhea (diarrhea). It is certain that some of the people who carry the Dietamoeba fragilis do not have any symptoms. It seems that children in particular can suffer greatly from infection with Dientamoeba fragilis.

Entamoeba histolytica is particularly prevalent in the tropics and subtropics, estimated to affect about half a billion people. One of the main characteristics of Entamoeba histolytica is that it kills red blood cells (erythrocytes). The active feeding state of this entamoeba is also called amoebic trophozoite.

Giardia lamblia is a parasite that occurs worldwide and especially in tropical areas. In the Netherlands an infection with Giardia lamblia occurs frequently and especially in children. An infection with Giardia lamblia is called giardiasis or lambliasis.

With parasitic infections, it is known that outside of a chronic form (where only a portion of people have symptoms) reintroduction can take place via spread of the amoeba by family members. So when you get symptoms again, new / further investigation is needed.

More in-depth research

Since worm eggs are excreted in phases, if there are persistent symptoms, a 3 day schedule of stool samples can be sent in. The costs are equal to 1 sample. However, this is very rarely used and only as an in-depth examination. At least 100 ml (3 x 30 ml) of afternoon urine (send in the dark) and 3 faeces samples (amount the size of a walnut) from 3 different days should be sent. The distance of sample collection should be 1-2 days. To prevent the eggs from developing into larvae, it is recommended that the samples be sent in as soon as possible.

If symptoms persist, refer to a tropical clinic, e.g. Rotterdam, Nijmegen or AMC Amsterdam.