Absorption studies in patients with parasitic infestation before and after treatment

This investigation has attempted to explore intestinal morphology and function, particularly the absorptive process, in a group of subjects infested with intestinal parasites, and to examine the effects thereon of treatment for the infestation. The study group consisted of 40 adults, 18 male and 22 females, who on admission to hospital showed various intestinal disorders apparently not associated with organic digestive diseases, and in addition, as deduced by various standard methods, intestinal parasitic infestation. All patients were infested with Giardia lamblia; 6 were additionally infested with Strongyloides and 3 with Taenia. Investigations included various blood tests (serum proteins, electrophoresis, blood cell counts), assay of fecal fats, test of iron absorption by whole-body counting, test of vitamin B12 absorption by Schilling test, radiographic examination of stomach and small intestine, and histological examination of biopsy samples of mucosa from duodenum and jejunum. These investigations were performed prior to treatment, and 6 months and again one year later. Only 15 of the patients, including all 9 with Strongyloides or Taenia, showed recognizable morphological abnormalities in the biopsy specimens. Six of these (all with dual infestation) had abnormally low iron absorption, 5 (all with Giardia infestation only) showed abnormally low vitamin B12 absorption, 2 (both with dual infestation) showed moderate steatorrhea, and all showed, by x-ray, dyskinetic disturbances of the intestine. Of the remaining 25 patients, 13 showed dyskinesias of varying intensities but none yielded abnormal results from any of the other tests. At 6 months after treatment the abnormalities were greatly reduced, and at one year all were gone except for 5 cases of minor morphological changes in the biopsy specimens. The investigators concluded that malabsorption in patients with intestinal parasitic infestation is a reality and that it is associated with morphological changes in the mucosa