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The association of the amoebic colitis and chronic ulcerative colitis
1Department of Medicine, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, Hong Kong.
Abstract:
Three patients with idiopathic ulcerative colitis and infection of Entamoeba histolytica were reviewed. They represented three different relationships between the two conditions, vis asymptomatic carrier, coexisting infection and superinfection causing exacerbation of colitis. A two-way relationship between amoebic colitis and ulcerative colitis has been discussed and the possible mechanisms in the literature have been reviewed. In patients with a short history of diarrhoea and in tropical countries where amoebic infection is endemic, it is important to role out amoebic colitis before commencing steroid therapy for inflammatory disease.
Insights
Idiopathic ulcerative colitis (UC) and Entamoeba histolytica infection can coexist. Ruling out amoebic colitis is crucial before steroid treatment, especially with short diarrhea history in endemic areas.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Colorectal Surgery
Background:
- Idiopathic ulcerative colitis (UC) is a chronic inflammatory bowel disease.
- Entamoeba histolytica (E. histolytica) is an intestinal parasite causing amoebiasis.
- The interplay between UC and amoebic colitis requires careful consideration.
Observation:
- Reviewed three patients with UC and E. histolytica infection.
- Observed varied relationships: asymptomatic carrier, coexisting infection, and superinfection exacerbating UC.
- Documented a two-way relationship between amoebic colitis and UC.
Findings:
- E. histolytica infection can present in multiple ways in UC patients.
- Superinfection with E. histolytica can trigger or worsen UC flares.
- A bidirectional influence between amoebic colitis and UC is suggested.
Implications:
- Diagnosing amoebic colitis is vital before initiating steroid therapy for UC.
- Consider amoebic infection in UC patients with recent diarrhea, particularly in endemic regions.
- Early diagnosis and treatment of amoebiasis can prevent UC exacerbations.