Irritable Bowel Syndrome Message Boards

Irritable Bowel Syndrome

"Parasitic infection should be considered in patients with vague gastrointestinal symptoms".
Millet, V. et al. Dig Dis Sci 1983 Apr;28(4):335-9

"Blastocystis hominis was frequently demonstrated in the stool samples of IBS patients"
Am J Trop Med Hyg. 2004 Apr;70(4):383-5.

Irritable Bowel Syndrome (IBS) affects almost one quarter of the population in developed countries. Despite the similarity of its symptoms to those of D.fragilis and B.hominis infections, diagnosis is usually made independently of the specialised stool collection and testing methods recommended for detection of the two parasites.

The advice for IBS is often to learn to live with symptoms, as the following message posted on an IBS message board, shows:

"I went to see my doctor about diarrhia, and pain and bloating. And she said, "You have ibs. There's nothing that can be done". About a year later, it was getting so bad I didn't even want to leave the house, I was getting so depressed, so I went back to her and said I wanted a second opinion, she sent me to a gastroenterologist. He listened to my complaints, and said to me "Well I have good news and I have bad news, the good news is I don't think you have cancer, the bad news is I think you have ibs and there is nothing I can do for you". So I went home more depressed than when I started out. (2002).

Over the years many theories have been proposed as a cause for IBS � the psychological need of sufferers to pass a large stool, (Achord, JL. 1979); psychological disturbance (Lea & Whorwell, 2003); abuse in childhood (Talley et al, 1998); chemicals in water (A.K. Susheela, et al. 1992), etc.

Parasites on the other hand, rarely rate a mention in IBS literature. An example is the Gastroenterology Society of Australia's IBS patient handbook, and the Australian IBS support group IBIS website. Neither mention the possibility of parasites. Curious really, considering that a number Blastocystis hominis and Dientamoeba fragilis studies show these parasites are common in patients with IBS. Neither do these sites mention anything about the specialised stool testing necessary to diagnose them. The Gastroenterology Society's Patient Handbook even advises that testing is unnecessary(!) if symptoms are typical of IBS.

This man was told his symptoms were due to IBS, but specialised stool testing revealed an infection with both Dientamoeba fragilis and Blastocystis hominis:

"I first became ill around 18 months ago. My symptoms included stomach pains loose bowel movements and nausea. The GP gave me pills to reduce stomach acid and told me I might have IBS and not to worry as the symptoms would go away given time.

I explained my symptoms to a naturopath who told me straight up "You have a parasite" She gave me some herbal medicine that initially helped but soon after I ceased taking the herbs the symptoms returned. I changed GPs and a stool test found that I had (high levels of) D.fragilis. Three courses of Flagyl later I not only still had D.flagilis I also now had the blastocystis appear in my stool test." (October 2005)

Since the site began in 2001 the majority of people diagnosed with a parasite were incorrectly diagnosed with IBS, as I was (see My Story).

Decades of published research shows that both Blastocystis hominis and Dientamoeba fragilis are more common than the parasite Giardia, and accurate diagnosis is dependent on specialised stool collection and testing methods (see side bar). This type of specialised testing is not routinely used when patients present with symptoms of an irritable bowel.

The London School of Tropical Hygiene & Medicine tested chronic IBS patients for parasites using specialised stool collection and staining methods. Forty percent were infected with B.hominis (April 2002. Biomedical Scientist).

In another UK study researchers tested 1,000 IBS patients and again using the same specialsed stool collection and testing methods as above found that 25% were infected with D.fragilis and more than 40% had B.hominis (unpublished data 2000).

The London School of Hygiene & Tropical Medicine consider Blastocystis hominis "may be the most common parasite known to infect humans." (Establishing Cultures of Entamoeba in vitro - on line)

Despite the fact that these parasites are commonly found in those diagnosed with IBS, the majority are not tested for these parasites. This is especially true if the treating physician mistakenly believes parasites are rare in western countries, or that D.fragilis and B.hominis are benign parasites not capable of causing illness.

Two-hundred and twenty-one people diagnosed with IBS responded to a survey on this site.
The question was: "Have you ever been tested for parasitic infection":

57%

(127 votes)

Never been requested to submit a stool sample to test for infection

25%

(56 votes)

One stool sample tested

17%

(38 votes)

Requested to submit three stool samples, collected over consecutive days.

On site survey (2001)

Not all cases of IBS are due to a parasitic infection, but there is enough anecdotal and published evidence to warrant a uniform method of testing of all IBS patients. Until this is adopted many people suffering from a parasitic infection, misdiagnosed as IBS, will continue to suffer needless ill-health.

COMPARISON OF SYMPTOMS BETWEEN IBS & A PARASITIC INFECTION

Diagnoses of IBS is often based on the symptoms alone. Note the similarity of symptoms between a parasitic infection and IBS:

SYMPTOMS IRRITABLE BOWEL SYNDROME:

Abdominal pain which is relieved after going to the the toilet; abdominal bloating and discomfort; constipation; periods of diarrhoea; altered stool form (lumpy, hard , loose, or watery); alternating constipation and diarrhoea; need to go to the toilet frequently to defecate or feeling of incomplete emptying of the bowel; frequent passage of mucus; altered stool passage (straining, urgency, incomplete evacuation.

DIENTAMOEBA FRAGILIS SYMPTOMS in order of the most frequently reported:

Diarrhoea; abdominal pain; abnormal stool (blood with mucus, loose); flatulence, fatigue or weakness; alternating diarrhoea and constipation, constipation, belching; tenesmus (form of constipation); anorexia or malaise.
D.Fragilis: A Review with Notes. Yang & Scholten (1976)

TESTING FOR PARASITES

Comprehensive information can be found on the Lab Testing page.

DIET & IBS:

Many people with IBS experience a worsening of their symptoms after certain foods are eaten. Wheat and dairy are high on the list of offending foods. Restriction of these foods can bring some relief to the symptoms.

For 20 years a 31 year old woman's digestive symptoms had been attributed to IBS. Specialised testing detected the presence of B.hominis in her stool samples:

"carbohydrates definitely makes my problems worse and when eaten I become totally mentally/emotionally unstable." (2003)

This case is not unusual: Site feedback shows that the majority infected with parasites are diagnosed with IBS.

The Specific Carbohydrate Diet has given many relief from the symptoms of IBS. The following research is of interest:

Foods rich in carbohydrates, as well as fatty food, coffee, alcohol and hot spices were most frequently reported to cause symptoms. The food score was higher in patients than in controls (p < 0.0001). In the IBS group higher scores were observed in patients with anxiety (p = 0.005), and females (p < 0.001), but the results were unrelated to IBS subgroup, referral status or BMI. The BMI did not differ between groups. Conclusion: A majority of IBS patients consider their symptoms to be related to meals. Especially foods rich in carbohydrates and fat cause problems.
Food-related gastrointestinal symptoms in the irritable bowel syndrome.
Simren M; Mansson A; Langkilde AM; Svedlund J; Abrahamsson H; Bengtsson U; Bjornsson ES
Digestion 2001;63(2):108-15

For an explanation of why dietary restrictions can help read the Diet page of this site.

Examples of misdiagnoses:

"I am from Ontario, Canada. I am overjoyed to have come across your site. I have just recently found out that I have D. Fragilis. Ten years ago I was diagnosed with Irritable Bowel Syndrome , but just recently found out that I have D.fragilis. This bug has screwed up my life and living for 10 long years. "
Canada. July 2004

"After more than 10 years of chronic low-grade fever, fatigue (diagnosed as) IBS , I was diagnosed with D. fragilis last October. I believe I picked up the organism in Western Turkey in 1990."
May 03

Most people diagnosed with D.fragilis and B.hominis are misdiagnosed as suffering from an Irritable Bowel. examples in Medical Mismanagement D.fragilis and Medical Mismanagement B.hominis pages.

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IBC-C SINCE FEB '07
"I'M GOING TO FIND THE CURE

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