Management Team

Amoebic colitis

Overview

Amoebic colitis is an intestinal infection caused by the parasite Entamoeba histolytica. It is a type of amoebiasis, a disease primarily affecting the colon, although it can also affect other parts of the body, such as the liver, lungs, and brain.

The infection is transmitted via the faecal-oral route, typically through the consumption of food or water contaminated with Entamoeba histolytica cysts. It is common in areas with poor sanitation, particularly in parts of the developing world.

  • Pathogenesis:
    • Ingestion of cysts: The cysts are ingested through contaminated food or water. Once they reach the intestines, they release trophozoites, which are the active form of the parasite.
    • Invasion of the colonic mucosa: The trophozoites invade the mucosal lining of the colon, causing inflammation and ulceration. They can also spread to other organs, especially the liver, leading to abscess formation.
    • Tissue damage: The parasite produces enzymes and other factors that cause tissue destruction, leading to the symptoms of amoebic colitis.

  • Diarrhoea (which may be bloody and mucousy)
  • Abdominal pain (cramping or constant)
  • Fever
  • Nausea and vomiting
  • Weight loss
  • Fatigue
  • In severe cases, the condition can lead to colonic perforation and sepsis.

  • Stool examination: Identification of Entamoeba histolytica cysts or trophozoites in stool samples.
  • Serological tests: Detection of antibodies or antigens related to the parasite.
  • Endoscopy or colonoscopy: Visual examination of the colon can reveal characteristic ulcers or lesions.
  • Imaging: In cases where there is suspicion of extra-intestinal involvement (like liver abscess), imaging studies (e.g., ultrasound, CT scan) may be used.

  • Antiprotozoal medications:
    • Metronidazole or Tinidazole: These are the first-line treatments for amoebic colitis, as they effectively kill the trophozoites.
    • Luminal agents (e.g., Paromomycin or Iodoquinol): These are used to treat any remaining cysts in the intestines after the systemic infection has been controlled.
  • Supportive care: Fluid and electrolyte management to prevent dehydration, especially in severe cases with diarrhoea.
  • Surgical intervention: In rare cases where there is perforation, abscess formation, or severe complications, surgery may be required.

  • Improved sanitation: Access to clean water and proper sanitation can significantly reduce the risk of infection.
  • Handwashing: Regular handwashing, especially after using the bathroom and before handling food.
  • Food and water safety: Avoiding potentially contaminated food or drinking water, especially in areas with poor hygiene.
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