Amoebic Colitis

What is Amebic Colitis?

Amebic colitis refers to parasitic infection of the intestines. The condition is caused by the protozoan Entamoeba histolytica, or E. histolytica.

Amebic colitis symptoms

Early-stage amebic colitis symptoms tend to be mild and include:

  • Loose stools
  • Stomach cramping

When the trophozoites breach the walls of the intestines, they can potentially enter the bloodstreams and spread to several internal organs like liver, heart, lungs, brain, etc. on an invasion into an internal organ, the trophozoites can cause:

  • Abscesses
  • Infections
  • Severe illness
  • Death

If the trophozoites overrun the lining of the intestine, they can lead to amebic dysentery which is a dangerous form of amebic colitis and causes frequent watery and bloody stools with severe stomach cramping.When the parasite affects the liver, it can cause amebic liver disease indicated by fever and tenderness in the upper right area of the abdomen.

Who is at risk?

Risk factors that put a person at higher risk of amebic colitis include:

  • People with a travel history of tropical locations where there’s poor sanitation
  • Immigrants from tropical countries with poor sanitation
  • People living in an institution that have poor sanitary conditions, like prisons
  • Men who involve in sex with other men
  • People who have a compromised or weakened immune system

Amebic colitis causes

The major Amebic colitis cause is the protozoan Entamoeba histolytica, or E. histolytica. It is a single-celled protozoan. When a person ingests cysts through food or water is when the protozoan enters the body. Another way the cysts can enter the body is through direct contact with fecal matter.These microscopic cysts are present in fertilizer, soil, or water which has been impaired with infected feces. The transmission can happen through

  • Food handlers while preparing or handling the food
  • Anal sex, oral-anal sex, and colonic irrigation.

On entrance into the body, the cysts lodge themselves in the digestive tract and release an invasive, active form of the parasite which is called a trophozoite. These trophozoites reproduce in the digestive tract and move to the large intestine causing bloody diarrhea, colitis, and tissue destruction.

How is Amebic colitis diagnosed?

A doctor may begin an amebic colitis diagnosis by asking the patient about their recent health history as well as travel history.The doctor may then check the patient for the presence of E. hystolytica. This may include the screening of stool samples for several days for the presence of cysts. Additionally, the doctor may order a test to check the liver function of the patient in order to determine if the parasite has damaged the liver.The parasite may no longer show up in stool samples when they have spread outside the intestine. In such a case, the doctor may order an ultrasound or a CT scan to check for lesions on the liver. On the appearance of lesions, the doctor may have to perform a needle aspiration to check the liver for any abscesses.The doctor may order for another necessary test called a colonoscopy to check the large intestine (colon) for the presence of the parasite.

How is Amebic colitis treated?

In uncomplicated cases, amebic colitis treatment usually consists of a 10-day course of metronidazole (Flagyl) taken orally as a capsule. The doctor may provide additional medications to control nausea if a need arises.In cases where the parasite is present in the intestinal tissues, amebic colitis treatment must address the parasite as well as any damage that has occurred to the infected organs. On the presence of perforations in the colon or peritoneal tissues, surgery may be necessary.Â

How can Amebic colitis be prevented?

Amebic colitis prevention can be done by practicing proper sanitation. It is very important to wash hands thoroughly with soap and water after using bathrooms and before handling any food.When traveling to places where amebic colitis is common, practicing the following steps while preparing and eating food can help keep you safe.

  • Properly and thoroughly washing fruits and vegetables before consuming them.
  • Do not eat fruits and vegetables unless they are washed and peeled by you.
  • Do not eat milk, cheese, or other unpasteurized dairy products.
  • Only use bottled water and soft drinks.
  • Before drinking water from anywhere else, boil it or treat it with iodine.
  • Avoid fountain drinks or ice cubes.
  • Do not eat food sold by street vendors.

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