# Giardia



## LeeMNAZ (Aug 8, 2007)

The results of the stool samples that we submitted last Monday came today, my wife was tested positive for Giardia. This is a common infection which causes diarrhea. She is starting on antibiotics for it. My daughter who is a nurse can't believe that they waited this long to take stool samples.I don't know if this helps anyone else, but it might not hurt to have your GI run stool samples. Here's what they tested for:*Stool Culture for Pathogens; Salmonella, Shigella, Camphylobacter*C.Difficile Toxin x1*Stool for GSA (Giardia)*Ova and Parasites x3*White Blood Cells (WBC), StoolHere's a link to information about Giardia: http://www.medicinenet.com/giardia_lamblia/article.htmI hope this is the cure!!!!


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## Screamer (Aug 16, 2005)

Wow, in Australia the first thing they test/treat anyone who comes in with diarrhea for is Giardia. I hope that it is what is wrong with your wife. At least then she has a chance of getting back to normal.


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## LeeMNAZ (Aug 8, 2007)

Thanks Screamer, I hope that is the problem. The reason that they check for giardia in Australia is 95% of you folks live around and play in water. I was in Sydney and at St. Mary's for 2 weeks in '84 on company business, very much enjoyed it! Even had shrimp on the barbie!


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## Prudy (Jan 21, 2006)

Not true... here in the states they test stools when diarrhea is on going.. I have had it done twice... trying to get a diagnosis... It would be the physician who would have to order it.. not the protocol... because that should be one of the first things to consider with unknown diarrhea..I remember back thirty some odd years ago.. my husband had stomach pains and funky stools... and when they did the stool sample they found the culprit... he went on medication and it resolved.. We were military.. so it is possible he picked it up in his travels.. as he would be in third world countries at times for duty..But we have to remember.. in developed countries.. this can be in the water.. or on food.. heck my vet says we can pick it up on shoes and track it into the house.. it can be anywhere..


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## celestin (May 20, 2004)

Even if one suffers from a (severe) Giardia infection, the stool tests can remain negative...So, for me, the easiest is to treat an IBS/D patient as if he had a Giardia infection. It is so easy ..(metronidazole ne week; nothing 2 weeks, again metronidazole one week).


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## LeeMNAZ (Aug 8, 2007)

celestin said:


> Even if one suffers from a (severe) Giardia infection, the stool tests can remain negative...So, for me, the easiest is to treat an IBS/D patient as if he had a Giardia infection. It is so easy ..(metronidazole ne week; nothing 2 weeks, again metronidazole one week).


My wife on is metronidazole 250mg 4/day for 2 weeks, if not better, then another 2 weeks. The thing that irks me is, she has had diarrhea for over a year but this is the first time that any GI doctor has ordered stool samples.


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## Prudy (Jan 21, 2006)

I would have thought after all that time.. a test of stool... would have been done.. process of elimination.. do least invasive testing first to r/o things..Heck... the third stool sample I had done.. I brought myself into the ER with me.. handed it to them.. and said.. here I brought a sample of my stools with me for you to test... So two were ordered and one self suggested.. It is an expensive test insurance wise.. but then so are invasive ones... who knows.. Hopefully this will be the answer for her.. if not.. at least now you know.. suggest it yourself should you need too again..


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## Lillett (Jun 4, 2006)

Other than constant D, are there other symptoms?


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## LeeMNAZ (Aug 8, 2007)

Lillett said:


> Other than constant D, are there other symptoms?


I would say that they are pretty much the classic symptoms of giardiaiarrhea Gas or flatulence Greasy stools that tend to float Stomach cramps Upset stomachShe has lost 64 lbs. since January, she wanted to lose weight but not quite that fast or this way. It is becoming a very emotional thing for her, she basically is house bound and we were used to going all the time and having a very active life.


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## celestin (May 20, 2004)

LeeMNAZ said:


> The thing that irks me is, she has had diarrhea for over a year but this is the first time that any GI doctor has ordered stool samples.


An anti giardia treatment should have been given, even without performing tests (which are often 'false negative')


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## LeeMNAZ (Aug 8, 2007)

Is there anyone that has taken metronidazole? The doctor warned my wife that she would probably experience D from the med and she has. But on Sunday she was running a fever and chills, so she call the GI doctor office yesterday to advise them as it says you should regarding side effects of the med. Of course, you never talk to the doctor any more, sometimes it's a PA (physician assistant) or now they have a new thing, a "coordinator". Anyway, the doctors coordinator talked to the doc, then told my wife that the fever was caused by the Giardi. Does that mean that the bugs are dying?The more that I read about our digestive system, the more I realize how complex it is and how little the medical profession understands it????I hope that this med helps to get my wife to some point of control and/or remission.Lee


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## LeeMNAZ (Aug 8, 2007)

celestin said:


> Even if one suffers from a (severe) Giardia infection, the stool tests can remain negative...So, for me, the easiest is to treat an IBS/D patient as if he had a Giardia infection. It is so easy ..(metronidazole ne week; nothing 2 weeks, again metronidazole one week).


You know, I am a believer now, maybe the simplest thing is to treat a IBS-D patient as if they have Giardia. I haven't seen the cost yet but I heard that the test for Giardia is expensive. But if your GI doctors won't try metronidazole, I would recommend that you press for a stool sample test.My wife has been on metronidazole for 10 days now and since she had that fever last Sunday, she has been feeling much better. She is down to about 2-3 BM's in the morning and maybe 1 more during the day. In fact, for the the last 3 days she has regained much of her energy and her appetite has even gotten better. I think the GI doctors were treating her for the wrong thing because the colonoscopes showed ulcerative proctitis, mild colitis and she was having some rectal bleeding at the time (I think that was from the D). I hope that this is the cure that we have been praying for!!!!Lee


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## celestin (May 20, 2004)

LeeMNAZ said:


> My wife has been on metronidazole for 10 days now and since she had that fever last Sunday, she has been feeling much better. She is down to about 2-3 BM's in the morning and maybe 1 more during the day. In fact, for the the last 3 days she has regained much of her energy and her appetite has even gotten better. Lee


OK OK...let us hope..but, do not forget the second treatment (4 days of metronidazole are enough)


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## LeeMNAZ (Aug 8, 2007)

Giardia is a nasty little bug that inhibits the colons ability to absorb. I expect that the lack of absorption is what causes D. The symptoms of Giardia and IBS are so similar. I read that Giardia can cause inflammation of the colon, now I am wondering if the GI doctors conclusion of colitis during the colonoscopy could have been inflammation caused by Giardia???? Also, her bouts of rectal bleeding are gone.Only one bad day last week, my wife could almost live with that. The bad day was mostly caused by the urgency and "passing a few marbles" as she calls them. The good days were great! My wife was typically a positive person but this problem has beaten her down to the point where now she is cautiously optimistic.


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## celestin (May 20, 2004)

LeeMNAZ said:


> now I am wondering if the GI doctors conclusion of colitis during the colonoscopy could have been inflammation caused by Giardia????


of course, of course it could..


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## LeeMNAZ (Aug 8, 2007)

Another good week for my wife, she is now done with the antibiotics. She had one flare up 2 days ago and I suspect that it was caused by "DOTS" the candy that you see at movie theaters. #1 son dropped them off for her. Reading the ingredients, they contain largely corn syrup, I think that is bad for people with D.In researching more on Giardia, I found this:"Symptoms of GiardiasisThe most common symptoms of infection include diarrhea greater than 10 days duration, abdominal pain, flatulence, bloating, vomiting, and weight loss (Flanagan 1992). Symptoms vary from person to person, often depending on the inoculum size, duration of infection, and individual host and parasite factors (Wolfe 1992). The diagnosis of giardiasis is based on the detection of cysts or trophozoites in the feces, trophozoite in the small intestine, or by the detection of Giardia antigens in the feces (Flanagan 1992).Giardiasis has been associated with several gastrointestinal disorders such as irritable bowel syndrome, inflammatory bowel disease and biliary tract dysfunction. " http://www.tindamax.com/About_Giardiasis.aspxI would certainly urge anyone with D to be tested for Giardia.


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## LeeMNAZ (Aug 8, 2007)

I wasn't going to post again until the end of this week, but I'm so happy and excited for my wife, I just had to post. Yesterday, she was singing and whistling around the house while she was doing things for the first time in 16-18 months. I would say that she is about 90% back to feeling like she did 5 years ago. While she is still averaging about 4 BM's in the morning and a couple more during the day, they are formed and controlled. She doesn't have the urgency "and can I make it from the kitchen to the bathroom without messing my underwear" any more.2 months ago, she was depressed, distraught, lethargic and having suicidal thoughts. Nothing was helping, diet, calcium, blueberries, Imodium, Asacol, Canasa, Elavil, Citrucel, nothing! There would be a few days of reduced D but then it would return worse than before. On Sept. 17th we received the report that she was diagnosed with Giardia and she went on metronidazole on the 19th for two weeks. What a change!We have been trying to determine when she got giardiasis, I'm guessing that it was during a trip to the western states in '02. She had a colonoscopy in '03 and the GI doctor noted a very small amount of inflammation at that time. I'm guessing that was the start of Giardia as she was having periods of D occasionally. It's not normal, but I have read that a person can have giardia for years. They also estimate that 2-7% of the population has giardia. Even at 2%, that is a lot of people. I definitely urge you to read : http://www.tindamax.com/About_Giardiasis.aspx. I have heard that the test for Giardia is expensive (I haven't seen the cost because Medicare is so slow), probably because it has to be sent to a diagnostic lab. Whatever the cost, it would be worth it if you can regain control again.I would like to thank Celestin, Linda, Prudy and many others for their comments, posts and messages. Thanks for your help and God bless!


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## Prudy (Jan 21, 2006)

I am so glad she is doing so well... God bless her heart.. It must be wonderful to see her like that... I doubt you will know where she picked it up.. My vet tells me it is everywhere..and that people can track it into their homes on their shoes.. So who knows.. where and when.. I can tell you as I have had stools tests done 3 times.. and the test is well over 350.00 to run it..Thank Goodness for insurance that covers most of it..Best wishes to both you and your wife.. and to continued good health.. for both of you..!!


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## LeeMNAZ (Aug 8, 2007)

Yes Prudy, $350 is expensive for the Giardia test. However, that is peanuts compared the thousands of dollars that between the insurance company and my wife have spent on colonoscopy, endoscopy, CT scan, meds, etc over the last 16-18 months. Asacol alone is over $800 for a 3 months supply. Canasa was also over $800 for 3 months. I don't know what the rest cost us. Plus a year and a half of misery. And she was cured with $4.00 of metronidazole!


celestin said:


> Even if one suffers from a (severe) Giardia infection, the stool tests can remain negative...So, for me, the easiest is to treat an IBS/D patient as if he had a Giardia infection. It is so easy ..(metronidazole ne week; nothing 2 weeks, again metronidazole one week).


I don't know if the doctors here in the US would treat a patient like Celestin recommends, but after what my wife has been through, it sure makes sense. I guess if a person has D maybe it wouldn't hurt to ask the doctor his opinion on trying metronidazole.


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## celestin (May 20, 2004)

By the way, a (chronic) Giardia infection can give a low platelet count (slight !, something like 138000 instead of 150000 to 300000).


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## slk2355 (Oct 15, 2007)

LeeMNAZ said:


> I would say that they are pretty much the classic symptoms of giardiaiarrhea Gas or flatulence Greasy stools that tend to float Stomach cramps Upset stomachShe has lost 64 lbs. since January, she wanted to lose weight but not quite that fast or this way. It is becoming a very emotional thing for her, she basically is house bound and we were used to going all the time and having a very active life.


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## slk2355 (Oct 15, 2007)

Harlen, please give Marnie our best for her continued blessed recovery. This has been a severe stress for you both.J & J


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## eric (Jul 8, 1999)

The weight loss should have been a red flag for an IBS diagnoses for one, but it doesn't sound really like thay had labeled her with IBS, unless I missed something.The bleeding, the weight loss, the inflammation they could see with a standard test, all did not point to IBS and we all red flag issues for a better diagnotic evaluation.IBS is not caused by Giardia.It is good to see your wife getting better and feeling herself again.In some people with these kinds of infections, even though the bug is gone, it can still mess up the gut for a while, even up to six months and it sounds like that isn't really happening here which is a very good thing, or that she developed IBS after the infection has resolved, like some people do when they get bacterial gastroenteritist. This shows how getting the right diagnoses and treatment is really important. If its a bug like this then you need that kind of a drug. But in IBS, because of the complexities of it, it usally requires an intergrative approach to treatments and that can be really important.


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## SpAsMaN* (May 11, 2002)

What about people who go like 4-5 times a day and still feel bloated...like constipated by the gas?


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## eric (Jul 8, 1999)

There are some people with IBS that get bloated by other mechanisms, abdomianl wall tension for one, then by gas casuing it, so it is not always gas causes bloating. There is also a difference in bloating and abdominal distension, some people feel bloated inside and actually don't look like it from the outside or have more gas on xrays, this maybe more altered perception problem and some on the other hand you can measure with a tape measure that the gut is distened out. Also in IBS normal amounts of gas can cause pain and discomfort.If your going four or five times a day that is not consitpation. Altered motility, coupled with viceral hypersensivity in IBS and an alternator may feel like you have d and c together or you can have d and the SENSATION of incomplete evacuation which would feel like a type of constipation. Its the colon that makes it feel like its the gas doing it. Altered contractions can back the gas up, until the colon relaxes and then it moves out again.


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## LeeMNAZ (Aug 8, 2007)

eric said:


> The weight loss should have been a red flag for an IBS diagnoses for one, but it doesn't sound really like thay had labeled her with IBS, unless I missed something.The bleeding, the weight loss, the inflammation they could see with a standard test, all did not point to IBS and we all red flag issues for a better diagnotic evaluation.This shows how getting the right diagnoses and treatment is really important. If its a bug like this then you need that kind of a drug. But in IBS, because of the complexities of it, it usally requires an intergrative approach to treatments and that can be really important.


Thanks for the comments Eric, I couldn't agree more. It was very frustrating that the doctors seemed to be just pushing pills and relying on the colonoscopy for their diagnoses. I expect that part of the problem was 3 doctors were involved and perhaps there was a little bit of "your not really my patient" factor involved. The current doctor hasn't said that she has IBS to my wife, but told his nurse/coordinator that he thought that my wife might have IBS. There are a still a few IBS like symptoms, like having a BM soon after a meal and 3-4 BM's in the morning but they are all formed and fairly normal. But overall, she can now go hours without making a bathroom stop.She is starting to introduce food back in her diet that she stopped during all the D. So far, none of them have bothered her. Actually, I'm telling her that she has IBS-O (Old age) as our digestive systems definitely have changed as we have aged.Lee


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## SpAsMaN* (May 11, 2002)

I remember speaking to someone from the FDA.She told me i need 3 stool sample to get a proper diagnosis.I don't remember if it was about Guardia.Well i guess it must be.So,do they test for this in doctor office?


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## LeeMNAZ (Aug 8, 2007)

SpAsMaN* said:


> I remember speaking to someone from the FDA.She told me i need 3 stool sample to get a proper diagnosis.I don't remember if it was about Guardia.Well i guess it must be.So,do they test for this in doctor office?


My wife had to submit 3 samples over 3 consecutive days, one was room temp, one was refrigerated and one was frozen. She goes to a pretty high tech clinic but I don't know if they do the tests in house or if they send them to a diagnostic lab. It took a week to receive the results so I'm guessing that they went to a lab.


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## LeeMNAZ (Aug 8, 2007)

celestin said:


> OK OK...let us hope..but, do not forget the second treatment (4 days of metronidazole are enough)


Celestin, we met with the GI doctor yesterday and he refused to give her a second treatment, he is concerned that it might be too much antibiotic. She has lost another 3 lbs. in the last 6 weeks which concerns him because she is eating pretty normally now. She had 8 BM's yesterday, all formed, non D. She still has the proctitis to deal with, so the doctor recommended that she continue with the 3.6g/day of Asacol for another month. It is possible that the Giardia caused the proctitis.Prudy, you recommend Damon yogurt, is that for the acidophilus? Would the pills do the same thing?I realize that this post isn't about IBS any more, but the symptoms of Giardia and IBS are so similar I feel that it's good information for first timers that have D. If the moderators want to pull this posting, that is fine.


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## LeeMNAZ (Aug 8, 2007)

SpAsMaN* said:


> So,do they test for this in doctor office?


Here's an update on this question, I just received the Medicare summary notice today, the samples went to Laboratory Corporation of America, Burlington, NC. The charge for the test of Giardia was $126, Medicare approved $16.76. The total charge for all tests was $440, Medicare approved $65.84, I hope that helps.


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## lovecolours (Oct 17, 2007)

Could giardia not cause D but the urge to keep wanting to "go" but I constipate. Because I had food poisoning almost a few times yearly in the past with dirrea and vomitting







And all the doctors did was to give me Imodium to slow down the "dirrea".







Anyone knows any replacement for metronidazole(flagyl) because I seem to get side effects from taking it.


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## Prudy (Jan 21, 2006)

I am not sure about the pills.. Yes eating the yogurt is for that.. I have never tried the pills so I can't say how they work.. I know others have.. maybe they can offer some insight on that.. I do know.. when I needed antibotics early this year.. it helped me not to have D through the course of it.... of course I also took them with a full meal as well.. I think you said she was eating Activa.. Maybe switch to regular plain DANNON yogurt and see how that works.. maybe the Activa is keeping her too regular... IYKWIM... I imagine her rectum is emptying because of the irritation... I know how that feels.. maybe once that settles down things will change.. This is my theory on that.. I feel when it is so sensitive from constant going... it doesn't know how to deal with being full ..... the urge to empty happens... In other words it doesn't know how to act any more... hopefully once it calms down she will get down to a managed number.. per day.. Here is hoping and praying she improves more and more each day..


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## LeeMNAZ (Aug 8, 2007)

Thanks for the reply Prudy, your posts are very meaningful to my wife. She is still having a bad day occasionally where she has multiple BM's and mostly good days where she will go for hours with no sense of urgency. There are still times that she has urgency right after eating. She did switch to Dannon yogurt and they had it on sale for 50 cents each recently. I take the pill form of acidophilus which works for me but I don't have IBS. We got copies of my wifes files to take with us to AZ. While the doctor has never directly told my wife that she has IBS, in his medical notes he does suspect that she has IBS. I'm with you on the proctitis, I think that the rectum has been traumatized by the Giardia and will take time to recover.In looking through the notes on the stool sample testing, it was very thorough. I definitely would urge anyone that has D to consider stool sample testing by a GI doctor and a diagnostic lab for analysis if they haven't had it done by now. My wife went through 18 months of hell with Giardia because nothing would stop the D. People keep asking how she contacted Giardia, we have absolutely no idea.So far, so good!


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## eric (Jul 8, 1999)

FYII believe they need to do three stool samples, because of the life cycel of the larve.There are symptoms that discriminate IBS from Giardiasis, although it can mimick some IBS symptoms.Giardiasis(GEE-are-DYE-uh-sis)How do you get giardiasis and how is it spread? The Giardia parasite lives in the intestine of infected humans or animals. Millions of germs can be released in a bowel movement from an infected human or animal. Giardia is found in soil, food, water, or surfaces that have been contaminated with the feces from infected humans or animals. You can become infected after accidentally swallowing the parasite; you cannot become infected through contact with blood. Giardia can be spread by:Accidentally putting something into your mouth or swallowing something that has come into contact with feces of a person or animal infected with Giardia. Swallowing recreational water contaminated with Giardia. Recreational water includes water in swimming pools, hot tubs, jacuzzis, fountains, lakes, rivers, springs, ponds, or streams that can be contaminated with sewage or feces from humans or animals. Eating uncooked food contaminated with Giardia. Accidentally swallowing Giardia picked up from surfaces (such as bathroom fixtures, changing tables, diaper pails, or toys) contaminated with feces from an infected person. What are the symptoms of giardiasis?Giardia infection can cause a variety of intestinal symptoms, which includeDiarrhea Gas or flatulence Greasy stools that tend to float Stomach cramps Upset stomach or nausea. These symptoms may lead to weight loss and dehydration. Some people with giardiasis have no symptoms at all. http://www.cdc.gov/ncidod/dpd/parasites/gi...tm#transmissionA common name for this here is the Northwest is Beaver fever, because many people myself included, have gotten this from drinking water from a stream, downstream of a beavers dam.I got this while working for the forest service and drinking from a stream while fighting wildfires.To me is was somewhat like the flu kindof, watery explosive d, and the feelings of a flu kindof symptoms. It was different feelings then my IBS.


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## LeeMNAZ (Aug 8, 2007)

Here is an excerpt from the Oct. 28th issue of Parade Magazine that is usually with most Sunday newspapers, written by Dr. Rosenfeld:"Infection. In 10% of patients, symptoms occur after a bacterial, viral or parasitic infection of the bowel. "This certainly is the cause of the IBS that my wife has and is experiencing from having Giardia.Here's more from the same article:"Available Treatments Patients with IBS usually are given laxatives for constipation, medications to alleviate diarrhea or smooth-muscle relaxants for pain and bloating, plus dietary advice. Some may obtain relief with anti- depressants, which alter how nerve endings in the digestive tract respond to pain. Two widely used drugs, alosetron and tegaserod, which were withdrawn temporarily from the market due to safety concerns, now are being prescribed with restrictions. A recent trend in the treatment of IBS is to prescribe rifaximin when bacterial overgrowth is suspected. This antibiotic may reduce the number of bacteria in the bowel and help control diarrhea in certain patients. But because of concerns about overprescribing antibiotics, some doctors prefer to perform a breath test first-to document the presence of excessive bacteria-before recommending rifaximin. For some patients, changes in diet and eating habits may be enough to relieve troublesome symptoms. Your doctor will help you decide if additional treatment is necessary."Here is the link if you want to read the full article: http://www.parade.com/articles/editions/20...r_Stomach_Pains


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## Guest (Nov 15, 2007)

Someone was talking about the need for three stool samples to find giardia- is this just to find them microscopically in the ova & parasite test? Because they also have this EIA test specifically for giardia antigens, and I heard it was much more sensitive. But I am wondering what the chances are that one could have some low-lying giardia and yet test negative on the EIA- anyone know this?I was told that I don't have giardia because my EIA from a single stool test was negative and my pronounced symptoms occurred 17 days after the suspect wilderness trip, which the doctor said was "too long." And yet, everything I read online says the giardia incubation period is 1-3 weeks (and I can definitely imagine it being on the long side if I only ingested a small quantity of the parasites- I was very careful with water filtering and definitely did not get large amounts of anything contaminated in me)! So no more stool tests have been prescribed and it's been suggested that I really just have IBS. But I don't quite agree since I don't seem to fit all the criteria..hmmm-AC


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## LeeMNAZ (Aug 8, 2007)

venusflytrap said:


> Someone was talking about the need for three stool samples to find giardia- is this just to find them microscopically in the ova & parasite test? Because they also have this EIA test specifically for giardia antigens, and I heard it was much more sensitive. But I am wondering what the chances are that one could have some low-lying giardia and yet test negative on the EIA- anyone know this?I was told that I don't have giardia because my EIA from a single stool test was negative and my pronounced symptoms occurred 17 days after the suspect wilderness trip, which the doctor said was "too long." And yet, everything I read online says the giardia incubation period is 1-3 weeks (and I can definitely imagine it being on the long side if I only ingested a small quantity of the parasites- I was very careful with water filtering and definitely did not get large amounts of anything contaminated in me)! So no more stool tests have been prescribed and it's been suggested that I really just have IBS. But I don't quite agree since I don't seem to fit all the criteria..hmmm-AC


Yes, in my wife's case, they used 3 stool samples which were sent to an analytical lab for testing which determined that she had giardia. I couldn't find anything that made sense to me about the EIA test. Celestin reported that the giardia testing does report false negatives some times, maybe that is what the EIA test did in your case. Since you were on a wilderness trip, I think that you definitely need to make sure that you don't have giardia because it is a nasty little bug. Our doctor was ready to declare that my wife had IBS-D until the stool sample. You need to be absolutely sure that you don't have giardia, my wife suffered for 14-18 months with it.Lee


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## Guest (Nov 15, 2007)

All right, maybe I will go bug another doctor to give me more stool tests if this minimal IBS diet doesn't work its supposed wonders like the GI doctor said. If anyone has advice on distinguishing IBS from giardia, I'd appreciate hearing them. I know the symptoms can vary greatly from person to person, but perhaps there are some telltale indicators? For me personally, I am curious about any typical weight loss behavior and whether or not people with giardia are relieved after a BM or not (as they are supposed to be with IBS). I'm a 26 yo female under some stress, but no more than usual when my symptoms began 17 days after the wilderness trip. I subsequently lost about 5% of my body weight in 4-6 weeks and am now carrying only about 10% body fat, which is probably about as low as I can go without having other problems! But the GI doctor doesn't seem concerned because I'm not clinically underweight. No matter how hard I try to eat a lot, I can't seem to gain any weight- does this happen to people with IBS too? I know it's a characteristic of giardia. Up until now I was not avoiding any foods in particular or dieting- in fact I was consuming about the same amount as my 165-lb boyfriend, and he was gaining weight! Also, the pain in the abdominal region is fairly constant- I can go have a BM or even D, and I don't feel any different before vs. after. It's just under or around the belly button. I don't know why, but most of the descriptions of giardia say pain is just _above_ the belly button. I wonder if this is significant. Ideas, anyone? Maybe I should go find a giardia messageboard...-AC


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## LeeMNAZ (Aug 8, 2007)

venusflytrap said:


> Also, the pain in the abdominal region is fairly constant- I can go have a BM or even D, and I don't feel any different before vs. after. It's just under or around the belly button. I don't know why, but most of the descriptions of giardia say pain is just _above_ the belly button. I wonder if this is significant. Ideas, anyone? Maybe I should go find a giardia messageboard...-AC


When my wife was dealing with giardia, she had abdominal pain below the belly button. Her stools stunk terrible, she was loosing weight and eventually lost her appetite. She has lost about 70 pounds, which she could stand (gained a lot when she quit smoking). And of course, the D especially in the morning but up to 20 times/day at the worst. Just don't let this drag on for you, find out if you have some kind of parasite.


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## LeeMNAZ (Aug 8, 2007)

This is probably the last time that I will post on this topic as it seems that my wife has recovered from the Giardia. The aftermath of giardia appears to be IBS. She has the typical morning problem of multiple BM’s for about the first 2 hours after arising. After that she has Tenesmus or the urgency to go for pretty much the rest of the day. Since we are retired, we usually don’t have any need to go anywhere on most days, so being in the house isn’t any problem. When we do need to go somewhere, Imodium does seem to take care of her urgency. She does take one calcium and Citrucel daily plus Asacol and Canasa.I want to thank everyone for their help and input. Also, I hope that posting this topic has helped other people that might have some type of intestinal parasite. I urge people to see a GI doctor and have stool tests, don’t let it drag on for 14-16 months like it did for my wife.Happy Holidays to all!Lee


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## 23240 (Mar 25, 2007)

I haven't been on this forum for a long time but I just read this and wanted to put in my two cents. For months the backwoods country GI doctors I saw believed I had IBS and told me to just pop immodium. They did stool tests but any parasitologist or good GI doctor knows that stool tests can be very unreliable for detecting a number of infections that might cause chronic diarrhea, including C.Difficile and various protozoal parasites. Finally I went to a GI doctor in NYC who sent me to a tropical disease lab for a purged stool test. There, they found evidence of a parasite. I've since seen a tropical disease doctor who does his stool test by scraping the bowel. Those 3 day ones are really unreliable. If you have chronic diarrhea and your GI doctor tells you you have IBS, fire him and find a new one. IBS should not be used as an excuse for a doctor's laziness. Also, I found that cutting carbs out of my diet helped the symptoms greatly where nothing else did: calcium, taking probiotics, psyllium husk/metamucil. If these things don't work for you, try cutting out carbs from your diet for a week. If your symptoms improve, you've probably got parasites. They can be cured, but it takes a looooooooong time. Bless you all.


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## LeeMNAZ (Aug 8, 2007)

I can't emphasis hard enough that if you have diarrhea to be tested for parasites. My wife now has IBS from the long term affect of giardia. We believe that she was affected for about 2 years before a new GI doctor finally ordered a stool sample. We don't know at this point if she will heal enough to have near normal BM's.Reading from this webpage is scary: http://www.wddty.com/03363800369655911348/...th-threat.html#Here is an excerpt: "Parasites - The hidden health threatThe most under diagnosed health problem in the West, parasites may be responsible for a multitude of conditions from joint pain and chronic fatigue to many general disorders of the gut and immune systemFew of our doctors in civilised Western nations are trained to recognise the signs of parasitic infestation. Yet parasites do live among us. According to a number of experts, they may be the single most under diagnosed and under appreciated health threat in the West.Parasites, which can be broadly classified as either protozoa (such as Giardia and Cryptosporidium), worms (including roundworms, or nematodes and tapeworms, or cestodes), or flukes (also called trematodes, which attack various body tissues with powerful suckers), have been associated with a wide range of diseases. Eminent doctors, such as WDDTY panellist Dr Leo Galland, have spent many years researching the effects of human parasites on health. Indeed Dr Galland has gone on record suggesting that "every patient with disorders of immune function, including multiple allergies (especially food allergies), and patients with unexplained fatigue or with chronic bowel symptoms, should be evaluated for the presence of intestinal parasites."So please see a GI doctor and better yet, a tropical disease doctor.Happy New Year to all!


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## LeeMNAZ (Aug 8, 2007)

UPDATE - Well, it is back to the GI doctor here in AZ for another stool test for giardia. It has been 6 months since my wife finished with the antibiotic and she is starting to have the same symptoms that she had prior to the previous stool test that identified giardia as her problem. It is possible that she has IBS-D from the extended amount of time that she had the parasite but she needs to make sure. She is still losing weight which is one of the signs of giardia. So we should know in a couple of weeks what is going on.Again, if you have D, get tested for parasites as they can be very nasty bugs!


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## LeeMNAZ (Aug 8, 2007)

UPDATE: I haven't posted for quite awhile and I don't think that this is my most recent, but oh well. My wife was diagnosed last August with ulcerative colitis through her entire colon. She has been on and off of prednisone since then. During the winter, she was on 10mg/day for 5 months. At the doctors orders, she went off of it the first of May. Of course, she had a flare up and had D up to 20 times/day. Back on prednisone, 30mg, tapered to 20mg/day currently. We are still convinced that this all started and is the result of severe giardia back in 2006-2007.The GI doctor has recommended and she has started on Mercaptopurine (6-MP), 50mg 2X/day with the prednisone tapering down over the next 10 weeks. We are nervous that the 6-MP won't be as affective as prednisone, is there anyone that has experience with 6-MP? We know all the dangers of prednisone but it depends on the individual as to how they react to prednisone. We also have a friend that had a kidney replaced in 1964 and has been on prednisone ever since, currently at 5mg/day.Any input would be appreciated!!!!Lee


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## Kathleen M. (Nov 16, 1999)

A lot of the other drugs used for UC are often good at maintaining the remission the prednisone starts it.She may need to be on prednisone to get the control, but once there is some control another medication with less risk can take over during the remission to keep things under control.I go through that cycle every so often with the asthma and allergies. I may not need a lot of prednisone to get things knocked down, but sometimes they feel I'm in a bad enough state I need the "big guns" and I always start the other treatments while on the prednisone then stop the prednisone.5 mgs is a pretty low dose, the lower the dose usually the longer you can risk staying on it continuously. For some things you have to stay on it forever (like so you don't reject a transplanted kidney which would be life threatening) but they always try to find the lowest possible dose and if there is some other thing they can transition you onto to keep things under control once they are under control they will do that.


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## twixcookie (Jun 8, 2009)

celestin said:


> Even if one suffers from a (severe) Giardia infection, the stool tests can remain negative...So, for me, the easiest is to treat an IBS/D patient as if he had a Giardia infection. It is so easy ..(metronidazole ne week; nothing 2 weeks, again metronidazole one week).


This is what I have been talking about on other posts...People keep saying "everyone is different" and I disagree. Even if there were 5 causes of IBS, then there should be at least one consistent treatment for it.It makes no sense that millions of people have the same symptoms, but there are millions of causes, and all of these people have to be treated differently. I have never heard of that and I work in medicine.


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## Kathleen M. (Nov 16, 1999)

There is no one consistent treatment for any other disease (even diabetes can need something other than insulin injections depending on the type and shots alone often aren't enough if you don't watch the diet, etc.)Why should IBS have to have one and only one treatment when cancer, heart disease, Inflammatory Bowel Diseases, every infection everyone has ever had, etc NEVER have one and only one treatment that works for every single person.


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## twixcookie (Jun 8, 2009)

Kathleen M. said:


> There is no one consistent treatment for any other disease (even diabetes can need something other than insulin injections depending on the type and shots alone often aren't enough if you don't watch the diet, etc.)Why should IBS have to have one and only one treatment when cancer, heart disease, Inflammatory Bowel Diseases, every infection everyone has ever had, etc NEVER have one and only one treatment that works for every single person.


But I don't hear of anyone having success with anything. You're right ,they do use various treatments on diseases, but what I am finding out is that most people are resorting to using Imodium. But most other diseases, they KNOW what causes it. Maybe when I die, I will donate my body to science and they can study my bowels for IBS...Diabetes, Type 2, which I have, responds well to eliminating carbs, exercising, and using Metformin. I don't take insulin, but there are some who have Type 2 who do...


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## Kathleen M. (Nov 16, 1999)

Did you read the IBS stories section?Lots of people have lots of success with lots of things.Now on a support board you tend to find the ones that don't find a treatment that works for them easily.The researchers that study it have some good ideas about what causes it. To the point there is a new blood test that can help diagnose IBS in a "yes you have it" way not just a "you have nothing else" way.


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## LeeMNAZ (Aug 8, 2007)

Kathleen M. said:


> The researchers that study it have some good ideas about what causes it. To the point there is a new blood test that can help diagnose IBS in a "yes you have it" way not just a "you have nothing else" way.


That type of test would be nice, I hope that it works. As you know, so many tests have false results. My wife's GI doctor was ready to write her off as having IBS about a year ago but that didn't make sense to me. Her history of D kept getting worse, starting with giardia, then micro colitis with proctitis, etc. The second colonoscopy last August confirmed UC throughout her entire colon. I have been reading this forum for 3 years now, I think more people should pursue with their GI doctors regarding their symptoms and not merely deciding that they have IBS. Granted there are people that truly are afflicted with this terrible symptom.Regarding the 6-MP, we understand what the doctor is doing and is keeping prednisone as a safety valve for when she has flare ups. I'm kind of from the school, if it isn't broken, why fix it? If 10mg or even 5mg prednisone is working for a person of this age, why not continue it so she can have a quality of life? All the research that I've read, the long term effect of less than 7.5mg prednisone is minimal. Interestingly, my wife went for a physical this week and in discussing UC with the GP, she didn't think that 10 or 5mg prednisone is a problem.


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## LeeMNAZ (Aug 8, 2007)

UPDATE: My wife visited the GI doctor on 10/27, she is doing much better, the Mercaptopurine (6-MP), does seem to be helping her ulcerative pan colitis. It did take almost the whole 6 months before it was effective. She tapered down on prednisone in August and had a flare, so back on 20mg of prednisone until recently she reduced to 15 then to 10mg. She is having fatigue and muscle reduction probably from the combination of prednsione and 6-Mp.So, the next step is to reduce prednisone to zero over the next 3 weeks, continue with 50mg of 6-MP twice a day, in about a month, discontinue Asacol which will be nice if that works, as Asacol is very expensive.It is still our belief that giardia from 2006-2007 is what triggered her problem. I keep harping on this, if you have D, be sure to have your stool tested for an intestinal parasite as the long term effects can be a disaster.


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## Lookin'foraLife (Jan 2, 2009)

The only test that came back positive for parasites for me was from Metametrix, and even then it came back "Taxonomy unknown".I've since treated it with the strongest meds out there, lately had a top tropical disease specialist prescribe Nitazoxonide,took it, felt worse after.Now they say: You either had parasites and now suffer from Post Infectuous IBS, or you never had parasites at all to begin with.In any case, if there's any doubt your wife may still have parasites, Nitazoxanide (Alinia) supposedly is the best thing to kill them with.


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## celestin (May 20, 2004)

LeeMNAZ said:


> It did take almost the whole 6 months before it was effective.


6 months??? sôô long..nearly not possible..I think that cortisone and Asacol are effective. You can be nearly sure that THE trigger was the -too long- giardia infection. Good luck...


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## blondeoverblue24 (Oct 20, 2009)

It typically does take an extended amount of time, often 4-6 months for 6MP to work, which is why her doctor gave her prednisone at the same time. Even at low doses, prednisone has effects on the entire body. People on low dose prednisone for extended periods of time still have risks including increased osteoporosis and cataracts, among other things. Most gastroenterologist like to avoid using prednisone long term if at all possible, especially if there is response to other medications.There have been numerous studies regarding the possibility of infections triggering development of inflammatory bowel disease. No direct link has been made, but it may be possible that the disruption of bacteria in the colon may contribute.


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## LeeMNAZ (Aug 8, 2007)

*UPDATE:* Well, the 6MP didn't work, after six months of 6MP, my wife was down to 5MG of prednisone when she started having 15+ BM's per day and bad stomach aches. So for now, she discontinued 6MP and is back up to 20MG of prednisone and is starting to achieve a little normalcy. It takes almost a month to recover from the colitis flares. The flares are so close to IBS, I don't really understand the difference. The doctors keep talking about remission, my wife keeps wondering when she will achieve that.She will taper down to 10MG or maybe 7.5MG of prednisone before we return to MN. We are thinking seriously about going to the Mayo clinic for a second opinon. So far, nothing that she has taken works as good as prednisone. The GI doctor in MN doesn't want her on prednisone long term, so we don't know what the long term answer is going to be. The research that we have read, long term effects of 7.5MG prednisone seem to be minimal.It is still our belief that giardia from 2006-2007 is what triggered her problem. I keep harping on this, if you have D, be sure to have your stool tested for an intestinal parasite as the long term effects can be a disaster.


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## celestin (May 20, 2004)

blondeoverblue24 said:


> It typically does take an extended amount of time, often 4-6 months for 6MP to work, which is why her doctor gave her prednisone at the same time.


really?? (read the update...)6 months was -obviously- too much, why not 1 year, 2 years?


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## celestin (May 20, 2004)

LeeMNAZ said:


> *UPDATE:* The research that we have read, long term effects of 7.5MG prednisone seem to be minimal.It is still our belief that giardia from 2006-2007 is what triggered her problem. I keep harping on this, if you have D, be sure to have your stool tested for an intestinal parasite as the long term effects can be a disaster.


Hello LeeMNAZ!Are you sure (I say:sure) that she is Giardia free? (it is so easy to take again some Metronidazole or equivalent..). Some people are ok with 15/20 mg Prednisone a day, some have problems with 7.5. After +- 2 years of that type of corticotherapy it becomes clear. If you just have had minor side effects it is a good sign.


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## jmc09 (Oct 5, 2009)

Your wife appears to have had the same problems right from the start, are you sure it wasn't UC right from the start or the Giardia is still the problem?I'm just making these observations based on your posts but it seems to me it could have been the same problem all along.


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## LeeMNAZ (Aug 8, 2007)

Thanks for all the replies, yes, she has been retested for giardia and tested for just about anything related to colitis or IBS-D. The GI doctor is frustrated because nothing seems to help and my wife is even more frustrated to the point of giving up on life. I expect if prednisone doesn't work, surgery may be the next step. The GI doctor may want her to go back on 6MP but I'm not sure if she will want to do that. The side effects of 6MP are similar to prednisone except for the bone loss. Her bone density tests last summer were normal.Remicade and Humira are possibilities but the side effects from them can be really bad. It will be 4 years in June that this all started and our lives have been virtually put on hold because of this medical problem. The doctors keep talking about remission, my wife wonders when will that ever happen. The docs keep telling her that diet isn't a problem, yet certain foods are definitely triggers for D. She has been tested twice for celiac with negative results.


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## overitnow (Nov 25, 2001)

Since it sounds as though your wife is reaching the end of her tolerance for these kinds of meds, she might consider trying a couple of the supplements I take. They have helped others with inflammatory problems (UC, Chrons, IBS) and may help her, as well. Certainly, they have given me back my life after 10 years of D-Hell, and have eliminated or so lowered food responses as to make my bowel function now within the normal parameters. Send me a PM if you wish to talk about them in detail.Mark


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## blondeoverblue24 (Oct 20, 2009)

Forgive me if you have said this already (internet problems on my computer), but has your wife ever tried entocort? It's a steroid similar to prednisone, but it has less side effects because it targets the GI tract and doesn't really effect the rest of the body.


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## LeeMNAZ (Aug 8, 2007)

blondeoverblue24 said:


> Forgive me if you have said this already (internet problems on my computer), but has your wife ever tried entocort? It's a steroid similar to prednisone, but it has less side effects because it targets the GI tract and doesn't really effect the rest of the body.


I think that she has tried entocort but I'm not sure as she has taken so many different drugs over the last almost 4 years. It is so hard to decide which direction to go any more.


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## blondeoverblue24 (Oct 20, 2009)

I understand, it's so difficult to remember what has been tried and what hasn't when so many treatments have been thrown your way. And sorry to hear the 6-MP wound up not working. Did she ever have blood testing to see what her metabolites in relation to 6-MP are like? It looks at your genetics to see if you're likely to respond to 6-MP or azathioprine (a similar medication) and if your drug amount can safely be increased. Perhaps they already did this, since they've gone ahead and discontinued her from the medication altogether.Remicade and humira work wonders in some, but a lot of UC patients don't like to risk it, especially when surgery can cure UC. However, that cure comes with its own drawbacks, since it involves removing the colon altogether. If she does stay on the prednisone long term, make sure to ask her doctor about using things like bisphosphonates and calcium supplements to help keep bone loss to a minimum. I wish this road would become easier for you.


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## On Edge (Aug 25, 2009)

It may be that your wife's inflammation and colitis are a reaction to the Flagyl she took for the giardia. I have taken it several times over the years and it always puts me into an inflammatory reaction. It occurs a month or two after the Flagyl treatment.


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## LeeMNAZ (Aug 8, 2007)

Update: As I noted previously, my wife stopped the 6MP and has been solely on prednisone (15mg)/day since January. About a week ago, she started having recital bleeding which really concerned us. She contacted her GI doctor in MN and he recommend that she see our doctor in AZ. So she went to our family doctor in AZ who is an old time doctor. He felt that her proctitis was the problem, he did a DRE and gave her a prescription for Proctozone-HC (hydrocortisone cream USP 2.5%) which she has been on for about a week now. Wow, what a difference! We were almost ready to give up and think that she had IBS. Today, she had some control over her BM's that she hasn't had for years now. We now believe that her major problem is more with the proctitis than with the ulcerative colitis. All of our fingers are crossed, but this may be the cure that she has been seeking. Hope, hope!


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## LeeMNAZ (Aug 8, 2007)

Update: My wife had her 3rd colonoscopy in 4 years last week. The good news, she has had the best 7 days since the colonoscopy in the last 4 years. Normal BM's, 2 or 3 per day, no D, no urgency, no stomachaches. Because of all the problems over the past years, she is so paranoid that it will start up again.The GI doctor found several polyps in the lower colon near the end. 3 were very large, it appeared to him to be noncancerous but we are still waiting for the pathologists report. She had been experiencing rectal bleeding recently, probably from the polyps. The doctor said that the upper colon had improved from her prior pancolitis condition, which was good news. The major problem is the bottom 18" of her colon. Currently, she is on 20MG prednisone, plus Asacol and Canasa to treat colitis.Just a comment on the colonoscopy prep which has been really bad in the past, what they are currently doing isn't as difficult, not as much liquid but it cleans you out pretty well.I still urge people that have D to see a GI doctor, have a stool sample and get checked for intestinal parasites. While my wife might have been prone to colitis, the Giardia over a long length of time certainly made it worse.


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