Which clinical history findings suggest giardiasis?

Updated: Oct 01, 2018
  • Author: Hisham Nazer, MBBCh, FRCP, DTM&H; Chief Editor: Burt Cagir, MD, FACS  more...
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Answer

A small number of persons develop abrupt onset of explosive, watery diarrhea, abdominal cramps, foul flatus, vomiting, fever, and malaise; these symptoms last 3-4 days before transition into the more common subacute syndrome. Most patients experience a more insidious onset of symptoms, which are recurrent or resistant.

Stools become malodorous, mushy, and greasy. Watery diarrhea may alternate with soft stools or even constipation. Upper GI symptoms, often exacerbated by eating, accompany stool changes or may be present in the absence of soft stools. These include upper and midabdominal cramping, nausea, early satiety, bloating, substernal burning, and acid indigestion.

Constitutional symptoms

Anorexia, fatigue, malaise, and weight loss are common. Weight loss occurs in more than 50% of patients and averages 10 pounds.

Chronic illness may occur. Adults may present with long-standing malabsorption syndrome and children, with failure to thrive.


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