Giardia lamblia, also known as Giardia duodenalis or Giardia intestinalis, is a flagellated enteric protozoan and a common cause of diarrhea (endemic and epidemic) throughout the world. In the United States, G lamblia has been demonstrated in 4%-7% of stool specimens, making it the most commonly identified intestinal parasite. There is a bimodal distribution, with the illness being reported most frequently in children aged 1-9 years and adults aged 35-45. Disease prevalence is highest during late summer and fall.

The parasite is spread via the feces of an infected person or animal. Acquisition occurs when cysts are ingested via contaminated water or food, or via person-to-person contact. After excystation, trophozoites colonize and multiply in the small bowel and may disrupt epithelial brush border, mucosally invade, or elaborate an enterotoxin. The incubation is usually 7-14 days, with symptoms often lasting more than 2-4 weeks; however, patients may continue to shed cysts for 6 months or longer.

Symptoms:

• Prolonged diarrhea – more than 7-10 days
• Malaise
• Flatulence
• Foul-smelling, greasy stools
• Sulfuric belching
• Abdominal cramps
• Bloating
• Nausea
• Vomiting

Signs:

• Malabsorption
• Weight loss

Risk factors:

• Travel to endemic regions
• Children in daycare
• Men who have sex with men