Diagnosis can be difficult because it can be easy to overlook the presence of the giardia cysts during a routine inspection of a stool specimen. In the past, the condition has been diagnosed by examining three stool samples for the presence of the parasites. However, because the organism is shed in some stool samples and not others, the infection may not be discovered using this method.
A newer, more accurate method of diagnosing the condition is the enzyme-linked immunosorbent assay (ELISA) that detects cysts and antigen in stool, and is approximately 90% accurate. While slightly more expensive, it only needs to be done once and is therefore less expensive overall than the earlier test.
Acutegiardiasis can usually be allowed to run its natural course and tends to clear up on its own. Antibiotics are helpful, however, in easing symptoms and preventing the spread of infection. Medications include metronidazole, furazolidone and paromomycin. Healthy carriers with no symptoms do not need antibiotic treatment. If treatment should fail, the patient should wait two weeks and repeat the drug course. Anyone with an impaired immune system (immunocompromised), such as a person with AIDS, may need to be treated with a combination of medications.
Giardiasis is rarely fatal, and when treated promptly, antibiotics usually cure the infection. While most people respond quickly to treatment, some have lingering symptoms and suffer with diarrhea and cramps for long peri-
ods, losing weight and not growing well. Those most atrisk for a course like this are the elderly, people with a weakened immune system, malnourished children, and anyone with low stomach acid.
Carol A. Turkington, The Gale Group Inc., Gale, Detroit,