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Does Entamoeba histolytica cause irritable bowel syndrome?
P Sinha1, U C Ghoshal, G Choudhuri
1Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow.
Summary
Irritable bowel syndrome (IBS) symptoms are not caused by Entamoeba histolytica infection. Non-dysenteric amebic colitis is an inappropriate term for IBS patients with nonpathogenic ameba, preventing unnecessary anti-amebic drug treatment.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Parasitology
Background:
- Irritable bowel syndrome (IBS) symptoms often resemble non-dysenteric amebic colitis.
- Differentiating between IBS and amebic infections is clinically significant.
Purpose of the Study:
- To investigate the clinical relevance of Entamoeba histolytica presence and types in IBS patients' stools.
- To determine if E. histolytica infection contributes to IBS symptoms.
Main Methods:
- IBS diagnosis utilized Manning's criteria.
- Stool examinations for E. histolytica were conducted over 48 weeks.
- Polyacrylamide-gel electrophoresis (PAGE) with hexokinase (HK) isoenzyme distinguished pathogenic E. histolytica from nonpathogenic Entamoeba dispar.
Main Results:
- E. histolytica identified in four IBS patients showed a nonpathogenic isoenzyme pattern (slow-moving HK band).
- These patients spontaneously cleared the infection without symptom improvement.
- Serology for antiamebic antibodies was negative, and sigmoidoscopy revealed normal rectal mucosa.
Conclusions:
- Bowel symptoms in IBS patients are unrelated to E. histolytica infection.
- The term 'non-dysenteric amebic colitis' is inappropriate for IBS patients with nonpathogenic ameba.
- Misdiagnosis can lead to unnecessary treatment with anti-amebic drugs.