Treatment of giardiasis: a scheme for the use of medications, the use of alternative methods. The program of staged treatment of giardiasis The first stage (preparatory) Characteristics of the stage What is the dosage of magnesia sulfur in giardiasis

Intestinal Giardia can have two forms. The body moves from one to the other. The second is giardia trophozoite. This form is considered active and viable. Trophozoites actively develop and grow, multiply in the intestinal region - they usually occupy a place in the duodenum. If unfavorable conditions are created for them, then they turn into a cyst form. Under a microscope, trophozoites look like pear-shaped microorganisms. On one of the surfaces you can see a disk. It is this structure that allows you to firmly fix on inner wall intestines.

The first signs will be noticeable 1-3 weeks after Giardia has entered the human body. At this stage, the patient complains of the following:

1. 1. Diarrhea, that is, frequent liquid feces. They have a pronounced pungent odor. A characteristic difference diarrhea due to Giardia cysts is that the stool does not contain blood clots or mucus (this is usually characteristic of this infectious disease digestive system like dysentery).
2. 2. Pain in the abdomen. Almost always they appear with diarrhea. The intensity of pain ranges from mild to aching character to strong contractions. Pain is usually felt in the projection of the intestine on the front side of the abdomen. As a rule, discomfort is felt in the upper part of this zone.
3. 3. Flatulence. The development of such a disease is characterized by a violation digestive processes. Moreover, the normal intestinal microflora also changes, which leads to the intensive formation of gases. Flatulence with giardiasis is not the only symptom, but manifests itself along with diarrhea and other unpleasant sensations.

As for the general symptoms, they will be as follows:

1. 1. Feeling of weakness, weakness, lethargy.
2. 2. Sleep problems, constant drowsiness.
3. 3. A person gets tired quickly and cannot fully relax.
4. 4. Violations of the neuropsychic type. For example, this applies to dizziness, headaches. Attention and memory deteriorate.

Due to the fact that there are problems with the absorption of useful trace elements, the following complications arise:

1. 1. Anemia - the number of red blood cells decreases. This is due to a lack of B vitamins in the body, which are actively involved in metabolic processes and in the formation of blood cells.
2. 2. Weight loss. A person quickly begins to lose weight.
3. 3. Immunity weakens, the body's ability to resist negative effects worsens environment. In the future, the risk of developing various diseases, especially infectious ones, increases.

Additional features

Concerning allergic manifestations, then they will be as follows:

1. 1. Rash on the skin in the form of small dots. Usually with giardiasis, urticaria appears. It is represented by bubbles of small sizes with transparent contents. Strofulus can also develop - this is a separate type of urticaria, when the bubbles transform into brownish nodules. There is a risk of developing eczema and neurodermatitis.
2. 2. Feeling of itching on the skin, in the nose and on the anus.
3. 3. Bronchial asthma, rhinitis and other respiratory problems.
4. 4. Conjunctivitis - inflammatory processes in the mucous layer of the eyes.

Diagnostic measures

To determine giardiasis, several methods are used. The main one is the detection of cysts in feces, in duodenal contents or on biopsy thin department intestines.

Immunological diagnostics is also used. This method is based on the fact that antibodies appear in the patient's blood that help the human body fight pathogens. If a patient has IgM class antibodies, this indicates that the disease is now in acute phase. If antibodies of the IgG type are detected, this indicates that the pathological processes have become chronic. If both antibodies are detected, then this indicates that the patient is now in a period of exacerbation chronic disease. But this method does not always give accurate results, since antibodies can remain in the blood. long time.

In addition, the effectiveness of therapy depends on a number of measures that the patient must comply with. It is necessary not only drug treatment but also adherence to a diet, the implementation of hygiene standards. This will prevent re-infection (which is often observed in patients), and also improve the condition of the digestive tract.

1. 1. Drug treatment of giardiasis in adults. Are used various drugs. Trichopolum is usually appointed. It is also known as Metronidazole. The action of this medication is associated with the inhibition of the vital activity of not only Giardia, but also any microorganisms from the class of protozoa. In addition, the drug affects some pathogenic bacteria, which often cause concomitant inflammation with giardiasis. The tool has anti-inflammatory properties, improves the patient's condition and speeds up the healing process. The course lasts approximately 1-1.5 weeks. Giardiasis can be treated with Ornidazole (known as Tiberal) and Tinidazole (Fazizhin). You need to take such funds only 1 time. In addition, Furazolidone is prescribed. It has antimicrobial and antiseptic properties. All these drugs should be used only under the supervision of a doctor, as they cause severe complications. As for children, some drugs are not recommended for use, as they have side effects that will harm the growing body. On the second day of therapy, the child's condition may deteriorate sharply. This is due to the fact that Giardia die in large numbers. Sometimes there is a parallel infection with a fungal infection or bacteria. In this case, additional antimycotic or antibacterial therapy is required. After the end of treatment, the child develops immunity against Giardia, but it is unstable, so secondary infection is not excluded. As for pregnant women who have become infected with Giardia, treatment will have to be refrained from during the gestation period. But a medication has been developed that can be used no matter what the gestational age of a woman is Enterofuril. The negative effect of this drug on the child has not been revealed. Such a drug is not absorbed through the walls of the digestive organs, so that the likelihood of an allergic reaction is minimized. In addition, the normal intestinal microflora is not disturbed.
2. 2. Hygiene. Treatment of giardiasis in adults and children in without fail required to follow the rules of hygiene. Always wash your hands after going outside, after going to the toilet, and especially before eating. Water must be boiled and disinfected. Periodically, wet cleaning is required in the room. Bed linen and towels need to be changed more often. Vegetables and fruits should always be washed.

Effective Diet

Required for giardiasis proper nutrition. It is recommended to switch to foods that are considered easily digestible. For example, from dairy products, cottage cheese, kefir, yogurt, sour cream are suitable. Vegetable food is very useful, as it contains many minerals and vitamins. For example, you need to eat more cabbage, potatoes, onions, beets, tomatoes. From fruits, citrus fruits, apples, berries, pears, etc. are perfect.

It is necessary to limit the use of foods that are hard and long to digest. For example, this applies to fatty and fried, overly spicy, salty and spicy dishes, especially if they are made from meat. You need to give up fat and fatty pork.

When a diet is prescribed for giardiasis, disorders in the functioning of the digestive tract are taken into account.

In the acute course of the disease, it is recommended to use foods that are crushed, it is best to grind them. It is allowed to increase the volume of dishes. If the course of the disease is chronic, then the prescriptions will be the same, but it is also allowed to add meat and other foods with a large amount of proteins (cheese, eggs) to the diet.

Medical therapy

Treatment of giardiasis with medicines includes several main stages.

1. 1. Enterosorbents. Suitable Laktrofiltrum, Enterosgel, Smekta. They do not affect Giardia themselves in any way, but create poor conditions for their reproduction. They remove bacteria, toxic substances, cholesterol, allergens, bilirubin and other compounds. Some drugs create good conditions to multiply beneficial bacteria, are lacto- and bifidobacteria.
2. 2. Medicines with lactulose. For example, Duphalac is suitable. It is usually used for constipation.
3. 3. Means that affect the process of bile production. For spasms, No-shpa, Gimekromon, Mebeverin are usually used. Domperidone and magnesium sulfate solution are used to reduce the activity of the gallbladder.
4. 4. Medicines from the enzymatic group. Used when necessary. Usually prescribed Creon, Pancreatin.
5. 5. Hepatoprotectors. Also sometimes used. Suitable Silymarin, Ursosan. They improve the functioning of the liver and protect the body from the action of toxins.

The choice of a drug with anti-giardia properties depends on the age of the patient and the course itself. Usually Tinidazole or Ornidazole is used in the first course. For the second course, Albendazole or Macmirror are used.

In addition to drugs with anti-giardia properties, those that can reduce the manifestation of an allergic reaction are also used. For example, Zirtek and Telfast are suitable. To improve the tolerability of therapy, Wobenzym is prescribed - this is a remedy with immunostimulating properties. It also has an enzymatic, anti-edematous, anti-inflammatory effect.

The third phase is the final one. At this time, the following medications are prescribed:

1. 1. To restore normal intestinal microflora. For example, Probifor, Lactobacterin, Enterol, etc.
2. 2. To replenish the reserves of useful trace elements and vitamin compounds. Usually complex drugs are used. For example, Vitrum, Alphabet, Stimbifid, etc.
3. 3. To strengthen the immune system. As a rule, agents with immunostimulating properties are used. Suitable Likopid, Polyoxidonium, etc. Be sure to establish proper nutrition.

Prevention measures

Giardia is very dangerous for the human body, as their presence leads to the development of pathologies. Must be taken preventive measures to prevent infection. Prevention is as follows:

If you do not follow these rules, then the probability of infection is very high. By the way, this figure is much higher in children than in adults. In the future, various complications develop.

Suffer first the immune system, since the body does not receive enough vitamins and minerals, which leads to its weakening. Because of this, a person can become infected with a viral or bacterial infection.

Another complication is allergic diseases. For example, this concerns bronchial asthma. It is very common among people with giardiasis. But even when it is possible to cure such an ailment, allergic disease quite often preserved, although it clinical picture will be less pronounced.

Traditional medicine recipes

At home, you can also get rid of Giardia. Medicines do not always guarantee 100% effectiveness. To achieve good results in therapy, it is required A complex approach. Besides, medicines can cause various complications, as they have high toxicity for kidneys and liver. As an auxiliary treatment, traditional medicine can be used.

This article will introduce how to take Ursosan, which has established itself as one of the most modern hepatoprotective medications.

(URSOSAN) - medicinal preparation prescribed to normalize liver function, metabolic processes the whole organism. The country in which Ursosan is produced is the Czech Republic.

Dosage form, composition, packaging

The product is produced in the form of elongated dense white opaque gelatin capsules, inside the contents resemble a powder in structure, sometimes with pieces of white mass.

Each capsule consists of an active ingredient - ursodeoxycholic acid and inactive ingredients:

• corn starch;
• stearic acid;
• titanium dioxide;
• gelatin;
• colloidal silica.

Ursosan capsules are produced in two dosages - 250 and 500 mg, the company produces Ursosan in a carton box of 10, 50 and 100 capsules in aluminum base blisters, 10 pieces per one.

Pharmacological properties

The mechanism of action of Ursosan is based on the function included in its composition, ursodeoxycholic acid.

With a disease of the hepatobiliary region, damage to the membranes of the liver cells occurs. and their mitochondria, followed by a violation of their metabolic function, a decrease in their regenerative properties, and inhibition of enzymatic activity.

Ursodeoxycholic acid binds to phospholipids, forming complex molecules, and becomes a structural part of the cell membrane of the liver, intestines, bile ducts, increasing cytoprotective protection from bile acids, which are toxic, and harmful factors.

This increases the antitoxic role of the liver in the body, controls the process of differentiation, division and renewal of cells, reducing the degree of growth of fibrous inactive tissue in the liver.

Ursodeoxycholic acid in Ursosan forms single crystalline particles with bile acids, reducing their aggressive toxic effect on hepatocytes, on the mucous membrane of the stomach and esophagus, intestines with reflux disease.

If Ursosan is taken, it inhibits the absorption of bile acids through the mucosa of the digestive tract, thereby increasing the secretion and excretion of bile, which leads to a weakening of the lithogenic properties of bile and a decrease in pressure in the biliary ducts.

Ursosan inhibits the synthesis of its own cholesterol by hepatocytes and, as a result, reduces the level of lipids in the blood. It dissolves cholesterol and reduces bilirubin in bile, normalizes bile secretion, which is important in the prevention of bile sludge and calculosis.

Ursosan increases the secretion of pancreatic enzymes, thereby improving the digestion process, lowering glucose levels.

Ursosan affects immune function due to:

• reducing the antigenic load on the cells of the liver and bile ducts;
• activation and formation of cytokines - interleukin-2 and T-lymphocytes;
• decrease in eosinophilic activity;
• suppression of immunoglobulins.

Pharmacokinetics

If Ursosan is taken orally, it is easily absorbed through the mucosa of the digestive tract, about 90%.

The degree of connection with plasma proteins in Ursosan is high (96-99%), this should be taken into account when prescribing other drugs.

After oral administration of Ursosan, peak blood concentration is determined after 1-3 hours.

In the liver, Ursosan is metabolized to the formation of taurine and glycine conjugates, which are excreted into the bile.

Output Excretion: about 50-70% with bile, the rest of the total dose of the drug is broken down by microflora in the thick gastrointestinal tract to form lithocholic acid, which is transported through the lymphatic system to the liver, where it undergoes sulfation and is then excreted with bile.

Indications for use

Ursosan is a medication that improves basic functions hepatic tissue and intensity of metabolism in the body in the following clinical situations:

Contraindications to the use of Ursosan

Reception Ursosan is contraindicated in the following indications:

Instructions for use

Ursosan capsules are intended for oral administration, do not break, during meals or immediately after meals, drink clean water. The duration of therapy with Ursosan depends on the type of disease.

Instructions and the correct method of taking:

Correspondence table of daily doses to the number of capsules per day

Body mass human	Daily dose in capsules
	10 mg/kg	12 mg/kg	15 mg/kg	20 mg/kg	30 mg/kg
19–25 kg	1	1	2	2	3
26–30 kg	1	1	2	2	4
31–35 kg	1	2	2	3	4
36–40 kg	2	2	2	3	5
41–45 kg	2	2	3	4	5
46–50 kg	2	2	3	4	6
51–55 kg	2	3	3	4	7
56–60 kg	2	3	4	5	7
61–65 kg	3	3	4	5	8
66–70 kg	3	3	4	6	8
71–75 kg	3	4	5	6	9
76–80 kg	3	4	5	6	10
81–85 kg	3	4	5	7	10
86–90 kg	4	4	5	7	11
91–95 kg	4	5	6	8	11
96–100 kg	4	5	6	8	12
101–105 kg	4	5	6	8	13
106–110 kg	4	5	7	9	13

Reception Ursosan with hepatitis C

Hepatitis C- is chronic viral disease, it is called the “gentle killer”, since the disease is asymptomatic for a long time, and as a result, liver fibrosis and progression of cirrhosis occur.

Given the ability of Ursosan to slow down the growth process connective fibrous tissue and improve the function of the liver tissue, its intake is necessary for people with this disease in order to prolong the life of the patient.

It must be understood that hepatoprotective drugs do not cure viral hepatitis, for this purpose, specific antiviral agents are prescribed.

Side effects

On adverse events, if you take Ursosan, patients rarely complain.

Of the symptoms sometimes present while taking Ursosan:

As a rule, they disappear after a decrease in the number of Ursosan capsules. Also, taking Ursosan may be accompanied by the appearance of itching, alopecia, pain syndrome in the back area.

If these symptoms appear, you should immediately see a doctor.

Overdose

In the literature, there were no signs of an overdose of Ursosan, since with an increase in dosage, its absorption worsens in parallel and excretion with feces increases.

In case of development of prolonged profuse diarrhea, you must stop taking Ursosan and immediately contact a medical professional (paramedic, doctor) or call for emergency medical care.

Ursosan during pregnancy and lactation

Given the lack of data on the ability of Ursosan to be transported through the hemato-lactation barrier, then take Ursosan at the stage of feeding breast milk not necessary.

When planning pregnancy, women should stop taking Ursosan because of the negative impact on the conception process. At the beginning of pregnancy, treatment with Ursosan is contraindicated.

Ursosan crosses the placenta. During childbearing, Ursosan is approved for use only in the second and third trimesters to reduce itching of pregnant women, which develops due to compression of the bile ducts by the growing uterus, and only on the recommendation of a doctor, with an assessment of the intended benefits and potential harm.

Use in children

Ursosan is not recommended for children under two years of age.

If there is a problem with swallowing the capsule, you can pour its contents into water and take after dissolution.

With jaundice. Newborn babies with prolonged or severe physiological jaundice who have not yet fully adjusted liver function and there is a risk of damage to the central nervous system, Ursosan is prescribed ¼ capsules per day for 2-4 weeks under the control of bilirubin.

Interaction with other medicines

What is the effect of some drugs on the action of Ursosan, consider below:

It is advisable during the period when you are prescribed to take Ursosan to limit the intake of alcohol-containing liquids in order to effectively treat.

which implies a limitation fatty foods, coffee, any canned food, smoked meats.

Reception with insufficient function of the liver and kidneys

The main purpose of taking Ursosan is to protect hepatocyte membranes, restore detoxification function, improve metabolism and energy metabolism of the body.

Therefore, any liver pathology in the patient's history will not affect the dosage of Ursosan, with the exception of severe liver failure.

At kidney failure (at chronic illness kidney stage 4-5) Ursosan is contraindicated.

Ursosan in the elderly

In patients of the age category, the rate of metabolism and excretion of the drug Ursosan slows down, like other drugs. There is no information on dose adjustment for these individuals, except in cases of chronic kidney disease and severe liver failure.

The benefits and harms of Ursosan

Useful therapeutic effects of Ursosan:

Harm from Ursosan can only be expected as a result long-term use and not in all patients, since UDCA does not have cytotoxicity:

• unwanted allergic reactions;
• calcination of stones, which will become an absolute indication for surgical treatment;
• harm can be done if you yourself without examination started taking drugs in the presence of a large stone (more than 15 mm), with obstruction of the biliary tract, with acute inflammation gall, pancreas, with a large number of stones in the bladder.

special instructions

There is no information in the reference books that if Ursosan is taken, the driving technique may decrease, therefore it is allowed for drivers and people working with moving mechanisms with increased attention.

Ursosan has the property of reducing lipids by reducing the secretion of cholesterol in the liver, stops the growth of cholesterol plaques in the vessels.

Ursosan stimulates secretion gastric juice and pancreatic enzymes, which improves the digestion of fatty foods, especially lowers blood sugar.

After starting Ursosan, after 4 weeks, control of ALT, AST, alkaline phosphatase, GGTP, bilirubin, and lipid profile is necessary. Further control is enough to carry out 1 time in 3 months. There may be transient increases in ALT and AST.

Ultrasound monitoring of the state of the biliary system is also necessary after 6 months from the start of treatment to determine the effectiveness of the dissolution of stones and decide on further tactics.

It is necessary to take Ursosan to dissolve stones only after consulting a qualified doctor and undergoing an examination to confirm the conditions that are necessary for cholelitholytic success in treatment:

• X-ray negative stones (not calcified);
• passable choledoch and cystic duct, stone diameter up to 15 mm;
• fullness of the gallbladder with stones no more than 50%.

After successful dissolution of the stones, Ursosan is continued for three months to prevent recurrent stone formation.

According to the results of many studies, the role of Ursosan in the prevention of colorectal cancer has been proven, due to its ability to reduce the toxic effect of bile acids - cytoprotection.

Terms of dispensing from pharmacies

Ursosan is a prescription medication. The pharmacist will ask prescription form from a doctor.

Storage conditions and shelf life

Ursosan capsules are stored in places with a temperature regime of 15 0 C to 250 C. Necessarily in a dry and dark place where there is no access for children.

The shelf life is indicated on the packaging - 4 years.

Price

The average price of the drug Ursosan in Russian pharmacies varies from 160 (for 10 capsules) to 1500 (for 100 capsules) rubles.

Analogues

Arriving at the pharmacy, you can see a wide variety of analogues of the drug Ursosan, both Russian and foreign production:

1. - This is a remedy that has milk thistle in its composition. Him less list indications for admission. Its main purpose is to cleanse the body. Does not affect the process of fibrosis in the liver. Country of manufacture Bulgaria, price range 330-400 rubles.
2. . differs in composition auxiliary components and some patients tolerate it better. It has the form of release in the form of a suspension. Manufacturer Germany, cost 200-2000 rubles.
3. Levodex this drug is also based on ursodeoxycholic acid, but is available in the form of tablets containing active substance 150 and 300 mg each and has other additional components. Less evidence base. Manufacturer - India. Price varies from 200 to 700 rubles.
4. is a hepatoprotective drug containing ademetionine. The mechanism of action is different. Price range 1500-2500 rubles. It is more recommended for advanced stages of liver pathology (hepatic encephalopathy), as it has an antidepressant property. Manufacturer - Italy.
5. - This is an enzymatic medicine containing the main enzymes that are normally produced by the pancreas. Creon is used for disturbed digestive processes, insufficient excretory function of the pancreas. It is prescribed in the complex treatment of hepatobiliary pathology. Country of origin France. Price 500 - 1500 rubles.
6. This is a drug to enhance the choleretic properties based on dry bile, garlic, nettle, activated charcoal. And, therefore, the indication for its appointment is a violation of biliary excretion from biliary tract hypokinetic type. Cost approx. 50 rubles. Producer Russia.
7. consists of phosphatidylcholine and glycyrrhizic acid, due to which the mechanism of action differs from Ursosan, has contraindications for admission and a longer list of adverse events. Price 500-1300 rubles. Producer Russia.
8. are phospholipids that are embedded in damaged membranes. Manufacturer Germany, price 600-2000 rubles depending on the volume of the package.
9. identical to Essentiale forte, but differs in a lower concentration of phosphatidylcholine and, accordingly, less efficiency. average price 350-400 rubles.
10. in addition to phosphatidylcholine, it also contains phosphoglycerides, thereby differing in its mechanism of action from Ursosan. Country of origin Germany. Price 1400 rubles.
11. Urolesan is a preparation from plants with similar therapeutic effects, only a diuretic and antispasmodic based on oregano, hops, mint, carrot seeds. Producer Russia, price 300-400 rubles.
12. – herbal preparation with hepatoprotective and choleretic action based on the roots of capers, chicory, yarrow. Manufacturer India, cost 400 rubles.
13. Ursodez- this is the Russian analogue, the cost 700-1000 rubles. Has less evidence base.
14. - a non-chemical preparation based on milk thistle and silymarin. Manufacturer Germany, price 300 rubles.
15. This natural preparation from dry bile, dried pancreas of cattle. Producer Belarus. Price 150 rubles.
16. Exhol this is the Russian analogue of Ursosan, the cost 150-1200 rubles.
17. consists of ornithine and aspartate, has a hypoammonemic property. Price 2500 rubles. Manufacturer Germany.
18. it's a biosupplement. It is prescribed for functional pathology of the biliary tract. Price 150-200 rubles.
19. - plant substance based on artichoke. It is prescribed to normalize the tone of the biliary tract. Price 350 rubles.

Allochol

Ursofalk Essliver Forte

Exhol Phosphogliv

Hepa-Merz Ursodez

Ursosan or Ursofalk what to choose?

Ursofalk differs in the composition of auxiliary components - there are more of them. It has the form of release in the form of a suspension and capsules. Manufacturer Germany, the cost is higher than that of Ursosan.

Ursosan or Ursoliv?

Both drugs are identical in composition and pharmacological action. It differs by the country of origin: the Czech Republic and Russia, respectively. There is evidence of different tolerability of both drugs.

Therefore, one should take into account individual characteristics, as well as a low evidence base for Ursoliv. The cost of the latter varies from 200 - 800 rubles.

Ursosan or Urdoksa - which is better?

Urdoksa is a Russian generic, it differs in price, which is lower. And the evidence base, which Ursosan is quite extensive.

Conclusion

From this list, we can conclude that there are a large number of hepatoprotective drugs. All of them differ in pharmacological action.

When choosing a drug for the treatment of hepatic pathology, it is necessary:

• consult a doctor
• assess the main markers of blood biochemistry
• functional state of the liver and biliary tract using diagnostic examination(fibrogastroduodenoscopy, ultrasound examination, ERCP, duodenal sounding, magnetic resonance imaging).

It should be borne in mind that Ursosan has a large evidence base. Assess the list of contraindications according to the annotation for admission.

And also, it is important that during monotherapy with Ursosan alone, several body functions are immediately restored:

1. improve lipid (reduces total cholesterol and low-density lipids) and carbohydrate metabolism (reduces glucose);
2. the manifestations of the intoxication-inflammatory process decrease and protect the liver during chronic alcohol use, constant medication;
3. slow down the progression of diseases of the organs of the hepatobiliary region;
4. stimulate partial or total dissolution of small cholesterol-type stones;
5. reduces antigenic expression on hepatocyte membranes, which is important in autoimmune pathologies;
6. reduce the manifestation of itching in cholestatic cirrhosis (PBC, PSC).

There are several ways of getting giardiasis:

• drinking untreated water;
• household - infection through household items;
• through food: often the cause of infection is insufficient heat treatment of food.

Treatment is prescribed taking into account the symptoms manifested. Severe diarrhea occurs, body temperature rises, additional symptoms may develop:

• vomiting, nausea;
• skin rashes;
• complete lack of appetite;
• sharp pain in the abdomen;
• headache, irritability;
• emotional instability;
• pallor of the skin.

To confirm the diagnosis, laboratory research. The material for research is feces (cysts, trophozoites, antigens are found), duodenal contents (giardia trophozoites, vegetative forms can be found).

Therapy Methods

Therapy for giardiasis in infected older patients has not been fully approved due to some difficulties:

• it is impossible to find the only correct way of therapy;
• frequent side effects;
• the presence of mutating forms of Giardia resistant to traditional substances (metronidazole, furazolidone);
• high risk of re-invasion due to lack of immunity;
• the presence of comorbidities.

Infectionists carry out phased treatment:

Preparation is an important step in the treatment regimen for giardiasis in an adult patient. Its duration depends on the degree of intoxication and the severity of disorders of the gastrointestinal tract. The period can be from 3 days to 1 month. On the this stage important diet, the basic principles of which:

• reduce the intake of carbohydrates (sucrose, lactose). It is carbohydrates that are the nutrient medium for the growth of Giardia;
• increased protein intake - protein stops the growth, development of Giardia;
• increase the consumption of fermented milk products, sour fruits, berries;
• frequent, fractional nutrition promotes the release of bile, which destroys Giardia, you should eat 5-6 times a day, with an interval of no more than 4 hours;
• add bran to the diet to increase the amount of dietary fiber.

Such patients are prescribed 5 dietary table. The diet should be dominated by:

• cereals;
• lean meat and fish;
• lean soups;
• bran bread, whole grain;
• dairy products;
• vegetables, fruits, berries;
• honey, marshmallow, marmalade.

It is necessary to completely exclude:

• pork fat, margarine;
• fatty meat and fish;
• rich broths;
• all varieties of legumes (beans, peas);
• more than one egg per day;
• all sweets, soda;
• spicy, smoked;
• mushrooms.

Medical therapy

Preparation of the patient for therapy includes the use medical preparations for the normalization of the digestive tract. The patient is prescribed:

1. Smektu (Dioctit, Diosmectin) is a remedy that cleanses the body of toxins and bacteria well, while normalizing the intestinal microflora. Smecta is not absorbed in the intestines, therefore it is prescribed to patients of any age.
2. Lactulose (Duphalac, Normaze) - these drugs are prescribed for constipation. Their advantage is that they are allowed to be taken by pregnant, lactating mothers.
3. Enterosgel is a liquid sorbent. In the intestines, it absorbs toxins, bacteria, neutralizing and removing them from the intestines without harm to health.

The presence of a reduced work of the gallbladder requires a special diet with a sufficient amount of vegetable fats. To reduce discomfort and pain, prokinetics (Domperidone), cholecystokinetics (Magnesium sulfate, Sorbitol, Xylitol) are prescribed.

In the presence of a spasm of the sphincter of Oddi, a diet with a small amount of fat (up to 40 g per day) is recommended, and the amount of choleretic is limited. It is recommended to treat this condition with antispasmodics (Gimecromon, Odeston) or non-selective muscle relaxants (Duspatalin, Drotaverin, Trimedat).

Depending on the patient's condition, the doctor may prescribe:

• enzymes (Pancreatin, Festal);
• hepatoprotectors (Gepabene, Legalon).

Second phase

At the second stage of treatment, it is aimed at getting rid of Giardia. For this, 3 main groups of drugs are used:

1. Nitroimidazoles (Ornidazole, Tinidazole). Usually, this is a single dose of medication. Such drugs should not be used during pregnancy, breastfeeding, as well as children under 12 years of age. Among the side effects, dizziness, drowsiness, headache, nausea, vomiting, allergies and hypersensitivity to the drug are most often noted. Metronidazole belongs to this group of drugs. But it is rarely used in the treatment of giardiasis (due to the immunity of giardia).
2. Nitrofurans (Nifuratel, Macmirror) - drugs of this group are considered the best for the treatment of giardiasis. They are excreted by the kidneys, so they have a minimum side effects(may cause nausea, bitter taste in the mouth, itching and skin rashes). These are tropic drugs that act only on intestinal infections. The course of treatment with Nifuratel is up to 7 days. It is not recommended to take during pregnancy and lactation. Furazolidone is another representative of this group of drugs. But it is not used to treat giardiasis due to the immunity of giardia to it.
3. Benzimidazoles (Albendazole) - have universal anthelmintic properties. Albendazole effectively acts on all stages of helminth development. It should not be used during pregnancy, lactation, children under 6 years of age. The duration of treatment is from 3 to 7 days. The main side effects of the drug: impaired hematopoiesis, allergies and hypersensitivity reactions, kidney failure.
4. As complex treatment may prescribe Enterol. It has an anti-giardia effect. This is a probiotic that is used to combat dysbacteriosis. It is well tolerated. The course of admission is 5-7 days.

If giardiasis is diagnosed, the treatment regimen for an adult consists of 2 courses of different drugs, a break between which is 1 week.

Hypersensitivity reactions can be reduced using Cetirizine, Telfast or Zyrtec.

At the third stage, restorative therapy is carried out. The patient is prescribed Stimbifid or Bion 3. Prevention of the disease consists in proper nutrition, hygiene.

Worms can live asymptomatically in your body for years and their waste products will interfere with your body and cause other diseases, the course of which often becomes chronic.

You are familiar with the following symptoms firsthand:

• nausea;
• gas and bloating;
• frequent colds;
• bad dream;
• weight problems;
• excessive nervousness;
• fatigue;
• skin problems?

The basis of the treatment of giardiasis is drug therapy.

How to understand that it is giardiasis

Adults after infection with Giardia do not always start treatment on time. The problem of this category of patients is constant employment and the hope that unpleasant symptoms will go away on their own.

Unfortunately, giardiasis can masquerade as other diseases. The infection has several syndromes, which are a collection of symptoms indicative of diseases different systems. These include:

Medicines at the first stage of treatment of giardiasis

In the treatment of giardiasis, a complex of drugs is prescribed to combat concomitant diseases.

On the initial stage the list of drugs for giardiasis in adults may include about 5-7 drugs. Their list is approved by the attending physician based on the symptoms and contraindications present.

Preparation for gastroenterocolic syndrome

It is recommended to start treating Giardia in adults with gastroenterocolic syndrome with dietary adjustments, which will avoid fermentation processes in the intestines and reduce gas formation. This can be achieved by taking the following groups of drugs:

Drug group	Drug names	What symptoms are prescribed
Enzymes	Pancreatin; Wobenzym; Creon; Mezim-forte; Festal; Enzistal.	With bloating, colic in the intestines, belching that occurs due to insufficiently good breakdown of food in the intestines. The drugs help to establish peristalsis, improve the condition of the intestine as a whole.
Antispasmodics	No-Shpa; Drotaverin.	With colic, abdominal pain, severe discomfort before and after eating.
Enterosorbents	Reban; Smecta; Polysorb.	With belching, swelling, systematic change in stool, signs of intoxication of the body in the form of weakness and dizziness.
Antiemetics	Domperidone.	With bouts of vomiting on days of exacerbations and with constantly present nausea.
Antidiarrheals	Herbal preparations: teas with astringent fees.	Assign with prolonged diarrhea, lasting longer than a day. You need to drink them no longer than 2-3 days, but if the stool is normal, the reception is stopped earlier.
Cholagogue	Mannitol; Xylitol; Sorbitol; Magnesium sulfate in solution.	Used for heaviness in the hypochondrium, stool disorders, belching and swelling.

The dosage and scheme of how to take the drug of each group is selected by the doctor. It is important to remember that each remedy will have to be taken for a long time, since preparatory Course therapy lasts at least 4 weeks.

Preparation for hepatobiliary syndrome

With hepatobiliary syndrome, patients are shown a diet with low content fats to reduce the load on the liver. In addition, preparatory treatment involves taking drugs that normalize the outflow of bile, reduce inflammation in the affected organs.

Reception of antispasmodics is necessary for hepatobiliary syndrome

The following medications are used:

• Antispasmodics - No-Shpa, Drotaverin, Odeston or Duspatalin;
• Hepatoprotectors - Essentiale Forte, Karsil;
• Enterosorbents - Smecta, Enterosgel;
• Antidiarrheal and antiemetic drugs (if there are such problems).

If you have gallbladder problems, take choleretic drugs It is strictly forbidden, since patients have a spasm of the bile ducts. The use of such funds may end acute cholecystitis requiring surgical intervention.

Hepatoprotectors are also prescribed

To reduce the activity of Giardia, probiotic preparations (Bion-3) are used, as well as drugs that help restore immunity - Polyoxidonium, for example.

Preparatory treatment for astheno-neurotic syndrome

Since astheno-neurotic syndrome is a consequence of the negative effect of lamblia on the absorption of certain substances, the doctor first of all tries to restore bowel function. In this case, the previously mentioned means are used:

• choleretic;
• antispasmodics;
• enterosorbents;
• probiotics;
• enzymes and others.

Tanaxol will help eliminate additional symptoms

In addition, therapy is supplemented with drugs that help eliminate symptoms such as headaches, fatigue, insomnia and irritability. In most cases, complexes are used in the form of syrups, capsules and herbal balms with a sedative effect. One of them is Tanaxol, which contains herbs that improve bile secretion, enzymatic activity, and protect liver cells.

Preparatory therapy for toxic-allergic syndrome

When allergic syndrome against the background of general intoxication of the body, experts recommend that the patient reduce the intake of red and yellow vegetables and fruits (they contain many allergens). The list of drugs at the same time contains mainly means for cleansing the body of toxins: enterosorbents, probiotics, as well as antiallergic drugs, including external ones.

With toxic-allergic syndrome resort to taking enterosorbents

Only at the end of preparatory therapy, when the patient's condition becomes stable, the doctor can prescribe a drug that fights directly against the pathogenic microflora.

Preparations at the second stage of treatment of giardiasis

At this stage of therapy, the doctor selects what exactly the causative agent of giardiasis will be destroyed. At the same time, it is important to choose highly effective Giardia pills that will be safe for the patient. This takes into account concomitant infections, diseases and other conditions.

Preparations at the third stage of the treatment of giardiasis

• Preparations with intestinal bacteria - Bifikol, Colibacterin, Lactobacterin, Acidophilus or others. The choice of means is carried out after a coprogram, which reveals a shortage of individual bacteria.

The presented drugs are prescribed at the final stage of the treatment of giardiasis

• Enzyme means - Enzistal, Festal, Pancreatin or Mezim. They help to reduce the load on the digestive organs and restore the process of assimilation of nutrients.
• Enterosorbents - Polysorb, Smecta. These drugs help to remove residual toxins from the digestive tract.

In parallel, the patient is shown a sparing diet. The diet is enriched with vegetables and fruits, dairy products. To prevent re-infection with Giardia, it is recommended to drink bottled or boiled water. Periodically, it is recommended to be examined for Giardia in order to identify the infection in time and repeat the course of treatment.

You can learn about giardiasis from the video:

Treatment of giardiasis is a rather complicated and time-consuming process. Such a disease cannot be cured on its own, but only with the help of a specialist in these pathologies. Which doctor treats giardiasis? In children, it is the pediatrician or pediatric gastroenterologist. In adults, a gastroenterologist or infectious disease specialist. All of these specialists can be found at the nearest clinic, medical center or hospital, where they will provide you with all the care you need.

In addition to the standard medical method treatment, in the future, you may need the help of a homeopath and a phytotherapeutist, who will help speedy recovery and strengthen the body.

Where to treat giardiasis?

Regarding the treatment of giardiasis, you can contact public and private medical institutions, where gastroenterologists and infectious disease specialists are treated. For children, this can be a children's clinic, a children's infectious diseases department, a pediatrics department. Adult patients should go to the adult polyclinic, gastroenterology department, infectious diseases departments or hospitals, private clinics general profile or centers of gastroenterology.

in every house or educational institution(school or preschool education), where a sick giardiasis is found, an anti-epidemic measure is required, which is organized by the local representative office of the sanitary and epidemiological station (SES).

Modern treatment of giardiasis

Modern treatment of giardiasis consists of a whole range of medicines, procedures and activities. It is difficult to cure this disease, so it is unacceptable to engage in independent medical methods: the treatment regimen should be determined only by a specialist.

It is more logical and effective to start therapeutic measures at the time of an exacerbation of the disease, especially with the development of dyspeptic disorders.

For successful treatment giardiasis an important link is the correction of the diet. Patients, especially in childhood, it is necessary to include dishes with a sufficient content of pectin, a natural enterosorbent, in the diet. Such dishes are considered liquid rice porridge on the water, applesauce, blueberry jelly. After two days, the patient is transferred to a more advanced diet. At first, the exception is products that create a positive environment in the intestines for the life of Giardia. The main part of such products is simple sugars: muffins, sweets, bakery products, as well as vermicelli, sausage, whole milk. Rice and buckwheat boiled in water, sour-milk products, compotes, baked apples, berries, vegetables are allowed. sunflower oil, dried fruits.

An important role in the treatment of giardiasis is played by the stabilization of the microflora in the intestine, which, as a rule, is disturbed during the disease. In order to eliminate dysbacteriosis, it is recommended to use fermented milk products, as well as some probiotic preparations: yogurt, lactobacterin, bifinorm, lactofiltrum, probifor, etc.

Preparations for the treatment of giardiasis

• Nifuratel (Macmiror) is a nitrofuran drug that is very successful, as it absolutely meets all of the above requirements. It has an extended range of antimicrobial and antiprotozoal effects. Nifuratel is quickly absorbed, its maximum amount in the blood is observed 2 hours after consumption. Excretion is carried out through the urinary system. In the treatment of giardia lesions, the medication is prescribed:
  • for an adult patient, 0.4 g up to 3 times a day for a week;
  • child - 15 mg per kilogram of body weight, twice a day for a week.

Nifuratel is less toxic than other drugs of the nitrofuran series. It is not a teratogen and a carcinogen, which is quite suitable for therapy in childhood and during pregnancy.

• Metronidazole (trichopol) is a selectively toxic drug for anaerobic infections, has mutagenic activity, as well as the ability to enhance the effect of radiation therapy in the treatment of oncology. Tablets have a bitter taste, are perfectly absorbed when taken orally. The maximum amount of the drug in the blood is observed 3 hours after ingestion. Metronidazole enters all tissues and environments of the body, including vaginal secretions, semen, and salivary secretions. Passes through the blood-brain barrier, is excreted during lactation with milk, overcomes the placental barrier. For these reasons this drug not prescribed during pregnancy and breastfeeding. The drug is excreted through the kidneys. Specialists use two main options for taking Metronidazole:
  • 0.4 g three times a day for 5 days;
  • 0.5 g for adults and 5 mg/kg for children three times a day for 10 days.

During the course of treatment, alcohol is contraindicated.

AT recent times doctors often use newer medications to treat giardiasis - these are drugs that inhibit tubulin of the benzimidazole series: pyrantel, albendazole, etc. Such drugs are safer than the previously listed nitroimidazoles. However, at the moment, a clear and effective treatment regimen with such drugs has not yet been developed, so therapy with these drugs should be long-term or periodically repeated.

The scheme of treatment of giardiasis

The treatment regimen for giardiasis consists of three stages.

Stage I - elimination of internal intoxication and stimulation of the enzymatic function of the intestine, strengthening the immune system. Conditions: compliance with certain nutritional principles, as well as the appointment of the following drugs:

• choleretic agents - eliminate congestion in gallbladder(cholekinetic drugs: magnesium sulfate, xylitol, sorbitol, etc.);
• antispasmodics - relieve spasms of the bile ducts;
• sorbent preparations - activated carbon, smectite, polysorb, bilignin, etc.;
• enzymatic agents - panzinorm (multienzyme), festal, creon, etc.

• Metronidazole (Trichopolum);
• Tinidazole - 2 g at a time;
• Furazolidone;
• Macmirror - nitrofuran series of drugs;
• Ornidazole;
• Delagil (Chloroquine) 0.25 g three times a day;
• Paromomycin is an aminoglycoside, 25 mg per kilogram, divided into three doses per day.

Stage III - strengthening immune protection and further prevention of the development of giardiasis infection in the intestine. The conditions for this stage are proper nutrition with the predominant consumption of vegetables, fruits and berries, as well as fermented milk products. It is recommended to drink tea based on birch buds for a month. To eliminate dysbacteriosis and strengthen immunity, prescribe enzyme preparations and probiotics: lactobacterin, mezim, pancreasim, bifikol, lacto-mun, etc.

The course of treatment for giardiasis

The course of treatment for giardiasis is usually long.

The first stage usually lasts from 2 weeks to 1 month.

The second stage can last 5-7 days, but in most cases, a week or 10 days after the end of stage II, it is repeated again in order to confidently avoid relapses of the disease in the future. Sometimes it is possible to assign stage II three times, with an interval of 7-10 days. To maximize the effectiveness of such treatment, each course of the second stage is recommended to be carried out with various medications.

Stage III does not have a strictly defined duration and can last quite a long time - as long as the body requires. At least one and a half months after the end of treatment, the patient should be observed by the attending doctor in order to remain confident in complete cure disease and no recurrence of the disease. The prognosis of giardiasis with adequate treatment is positive.

Cholagogue with giardiasis

Cholagogue with giardiasis can be prescribed along with others necessary drugs. This is done in order to eliminate the inflammatory process in the gallbladder as quickly as possible, as well as reduce congestion in it. AT medicinal purposes predominantly prescribe cholekinetic drugs that dilate the bile ducts and facilitate the flow of bile. Cholekinetics are a series of antispasmodic drugs that relax the valve of the gallbladder and pancreas, which promotes the release of bile into the intestinal cavity. Such cholekinetic drugs include atropine sulfate, papaverine, magnesia sulfate, etc.

By the way, a similar effect can also be caused by using mineral waters: "Essentuki No. 17 and No. 4", as well as others medicinal waters containing sulfate anions. Such water is consumed half an hour before a meal, 100-150 ml up to 4 times a day.

In addition, in order to tone up the biliary tract, cholespasmolytic drugs are prescribed, such as drotaverine, platifillin, barberry-based products, etc. Valerian root also has a similar effect.

Hofitol with giardiasis

Hofitol is a herbal remedy based on artichoke. This medication is able to restore damaged liver cells, has a choleretic and diuretic effect. Reduces the level of urea in the bloodstream, stabilizes lipid metabolism and the amount of cholesterol. Can be used with other medications to reduce toxic damage to the body. Helps remove salt heavy metals, nitrates and other toxins.

Hofitol has direct indications for prescribing for giardiasis, if the patient does not suffer calculous cholecystitis, acute hepatitis and lack of patency of the biliary tract.

Hofitol with giardiasis is used as follows:

• 1-2 tab. three times a day, for a month;
• 5 ml of syrup three times a day, for 3 weeks;
• 1-2 ampoules of Hofitol intramuscularly, once a day, for 7-14 days.

Hofitol is allowed to be used during pregnancy, but only with the permission and under the supervision of a doctor.

Artichoke extract and drug Cholebil can be considered similar replacements for the medication.

Allochol with giardiasis

Allochol is a choleretic drug that enhances bile production. Allochol, like other choleretic drugs, is actively used for giardiasis. This medication affects the secretion of the liver, stimulates the motility and enzymatic activity of the digestive system, and has a slight laxative effect. The composition of the medication includes garlic, which reduces fermentation processes in the intestines and stops bloating.

Allochol with giardiasis is taken orally, 3 times a day, 2 tablets, immediately after meals. In children under 7 years old, take 1 tablet, then the dosage corresponds to that in adults. The course of treatment with Allochol lasts for a month, after which they take a break of 3 months and repeat the therapy (if necessary).

Allochol is approved for use during pregnancy and lactation. Do not prescribe the drug for obstruction of the bile ducts, when stones are found in the cavity of the gallbladder, with an acute inflammatory process in the liver and pancreas.

Antibiotics for giardiasis

In giardiasis, it is prescribed complex therapy. The correct selection of treatment methods guarantees a favorable result, meanwhile, a violation of the treatment regimen can lead the disease to a more severe, chronic course.