Sunday, October 25, 2009

Parasites: Little Bugs, Big Trouble

Parasites: Little Bugs, Big Trouble

posted by Megan, selected from Experience Life Oct 24, 2009 3:04 pm

By Catherine Guthrie, Experience Life

Two weeks after kayaking on the Tennessee River, Kathryn Gage doubled over with a sharp, stabbing sensation in her gut. When the pain morphed into severe diarrhea and nausea, she saw a gastroenterologist.

The 40-year-old Knoxville resident told him she’d downed some river water while rolling her kayak, and she suspected her illness was related. Her intuition was fed by a friend who’d suffered from a parasite she’d picked up overseas and whose symptoms were strikingly similar. But after learning that Gage hadn’t been globetrotting, the specialist dismissed her theory and ordered upper and lower endoscopies instead. Both tests came back normal.

Meanwhile, Gage’s health deteriorated. Usually bubbling over with energy, the entrepreneur and mother of two refused to leave the house for fear she’d have a bathroom emergency. “When I did go out, everyone told me how green I was,” she recalls. Within a month, she dropped 20 pounds, leaving just 115 pounds on her 5-foot, 10-inch frame. Weak and dehydrated, she revisited the doctor, begging him again to test her for parasites. Her fears were unfounded, he said, and he ordered a colonoscopy.

The test didn’t find anything amiss, but during the procedure, the doctor removed a benign polyp and didn’t seal the wound completely. Several days later, Gage’s husband rushed her to the emergency room with life-threatening bleeding. Her physician finally agreed to check her for parasites, and sure enough, she tested positive for Giardia, one of the most common waterborne parasites in the United States. “One quick round of antibiotics and I was completely cured,” she says. “I couldn’t believe it, after all I’d gone through.”

The complications that ensued from Gage’s illness were unusual, but her doctor’s refusal to ponder parasites was not. “Most doctors think parasites only infect people who live in or travel to the tropics,” says Omar Amin, PhD, professor of parasitology and founder of Parasitology Center, a research and testing facility in Tempe, Ariz. “People with this mindset are up for a rude awakening.”

The Bug Boom

The Centers for Disease Control and Prevention (CDC) estimates that millions of Americans are sickened by parasites each year and admits the problem is vastly under-reported. “Since many of the conditions are not reportable, we don’t have an accurate estimate of all the cases,” says Monica Parise, MD, chief of the CDC’s Division of Parasitic Diseases.

Amin and other experts believe as many as one in three Americans is hosting parasites. As evidence, he points to his 2002 study published in the American Journal of Tropical Medicine and Hygiene. Of the 2,896 patients who submitted stools for testing, 32 percent tested positive for parasitic infections. And the infection rate, Amin notes, is actually underestimated, since many patients don’t get tested for parasites.

Parasites are a big reason why one in four Americans has digestive trouble, Amin says, and many alternative practitioners agree. They note that the diagnosis and treatment of many GI troubles like gallstones are routine, while conditions like irritable bowel syndrome, and inflammatory bowel disease, which includes Crohn’s disease and ulcerative colitis, are tough to explain. The symptoms of these more mysterious ailments - stomach upset, gas, bloating, bleeding and diarrhea - mimic those of a GI parasitic infection.

Just coincidence? Skye Weintraub, ND, doesn’t think so. A naturopathic physician in Eugene, Ore., and author of The Parasite Menace: A Complete Guide to the Prevention, Treatment and Elimination of Parasitic Infection (Woodland Publishing, 1998), Weintraub finds underlying parasitic infections in roughly half of her patients who suffer from chronic GI troubles. “People come to me after they’ve been labeled as having irritable bowel syndrome, Crohn’s disease or ulcerative colitis,” she says. “Their doctors tell them they may need drugs for the rest of their lives, but I can often get rid of a parasite, and in a month or two, their symptoms are gone.”

Clinical nutritionist Ann Louise Gittleman, PhD, CNS, author of Guess What Came to Dinner? Parasites and Your Health (Avery, 1993), sees a similar trend. “Parasites are an unsuspected cause of many people’s health problems,” she says. “You can only find what you know how to look for, and most conventionally trained doctors don’t know how to look for parasites.”

Both Weintraub and Gittleman admit their specialized knowledge attracts patients with hard-to-treat parasitic infections, which skews their perspectives. But the question they pose is a valid one: Are parasites bugging us more than we think?

Parasites 101

A parasite is simply an organism that leeches nutrients from another, and humans can host hundreds of them. They range in size from the invisible, single-celled pests, like protozoa, to the more biologically complex worms, which are ingested as larvae and can grow to several feet in length.

Crossing paths with a parasite is easy. Contaminated water, undercooked meat, and poorly washed fruits and vegetables are all common pathways not to mention picking them up from animals and other people. (See “Seven Ways to Avoid Parasites at Home,” below.)

Parasites are linked to foreign travel for good reason. Of the 50-million-plus people who travel to the developing world each year, 22 to 64 percent report a travel-related health problem, and up to 8 percent seek medical care during or after their trip, according to a 2006 study published in the New England Journal of Medicine. Many of these illnesses can be linked to parasites. The three buggiest travel destinations? Central America, South America and South Central Asia.

But staying home won’t necessarily keep you pest-free. Gage, after all, was nearly undone by a parasite without ever leaving Tennessee. And, 40 percent of Amin’s patients get their parasites without pulling out their passports. “With all the foreign travel, parasites move easily from continent to continent,” he says. “There are no barriers anymore.”

So how does a tourist in Bolivia bring a pest back to Boise? Most bugs hopscotch around the world by fecal-oral transmission. Yes, that’s about as disgusting as it sounds, but it happens all the time.

To infect hundreds of people, it takes just one person to get infected abroad, come home and get careless with his personal hygiene, says John Christie, PhD, MD, a medical professor at the Brody School of Medicine at East Carolina University in Greenville, N.C.

Christie, who studies and teaches parasitology, notes that with global tourism, immigration and even military deployment on the rise, we should expect increases in parasitic infections.

NEXT: How to prevent getting sick at work

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