Parasites are micro or macro organisms which live or depend on other living organisms for their survival or food or both. Amoebiasis is an intestinal parasitic illness which is caused by a single-celled microscopic parasite called Entamoeba histolytica. It is the simplest organism of the animal kingdom which belongs to the class of Rhizopoda, order of Amoebida, genus of Entamoeba and species of E.Histolytica.
Gastroenteritis (diarrhoea or dysentery with abdominal pain and exhaustion) is the main symptom of amoebiasis. In day-to-day life, amoeba is often misunderstood as a worm, but it is not so. Amoeba is a protozoa which is a primitive unicellular organism which usually multiplies by binary fission i.e. asexual mode of reproduction. It consists of cytoplasm and nucleus only. But Helminths (worms) are multicellular intestinal parasites which have mouth, digestive tract and anus and they multiply sexually.
Lifecycle of amoeba:
The lifecycle of Entamoeba histolytica involves active trophozoites, inactive cysts and carrier(s). When trophozoites or cysts are swallowed with contaminated foods or drinks, they reach the stomach first. There, trophozoites usually die due to the acidic nature of gastric juices. But cysts are resistant to these acids or any chemical reaction. So, they thrive and reach the large intestine, where they usually live.
The enzyme trypsin in the small intestine helps the excystation process (hatching of cyst to become active trophozoites). After excystation, four amoebulae (young trophozoites) emerge from each cyst and divide once to form eight amoebulae. These trophozoites destroy or burrow the lining tissues of the large intestines and make flask-shaped cavities which contain mucous, cell debris and organisms. This process will induce irritability of the intestines and diarrhoea to clean up the intestines. In this process it often spreads to another person or places. Trophozoites are often carried in faeces with mucous and Rbcs (red blood cells). The cysts passed in faeces can stick on to soil, grass, vegetables and fruits, which then get contaminated. They either enter the human intestine directly with the contaminated food or indirectly through ingesting animal food or intestines.
Cysts can also get into the blood vessels and spread to other organs of the body while they burrow the intestinal wall. While spreading to other organs in the human body like liver, lungs, brain or spleen, they will not reproduce or cause any more spread since the cysts cannot get excystation due to lack of trypsin. So, in these cases, they reach a dead-end in their lifecycle.
- Taking food contaminated with cysts causes more risk than foods contaminated with trophozoites since cysts are resistant to gastric acid juices.
- Being close to the sufferer or to asymptomatic cyst passers carries more risk due to constant infection or re-infection.
Incidences: Depending upon the amount of sanitation and cleanliness, anyone can be infected or affected with amoebiasis. But incidences are more common in youngsters than old people or children. The occurrence of amoebiasis is also more common in tropical, poor countries where there is no proper sanitation. The possibility or probability of it spreading inside the body as amoebic liver abscess is about 5-10 per cent, as amoebic lung abscess is 1-2 per cent and as amoebic brain abscess is less than 1 per cent.
Causes: Even though there is constant spread of infection, (within a family or in a hotel) some people are resistant to amoebiasis. Even if infected, some are only carriers and do not suffer from it. This shows that the ultimate cause of suffering is hidden than the exposed causative factor i.e. amoeba.
Amoeba infects in two ways.
- Taking contaminated food or drinks
- Taking vegetables and fruits which have been contaminated by the soil
- Taking non-veg foods (meat and intestines of animals – goat, pig, beef, etc.)
As with trophozoites,
- From pets
- From human carriers directly to others thro’ food contamination, sharing towels, etc.
- Unhygienic conditions and poor sanitation – especially after using the toilet
Most of the cases may not have any symptoms at all and function only as carriers and also function as spreaders, polluting the areas wherever they go. The disease symptoms usually start after a period of 7-15 days of infection which is called the incubation period. The symptoms are in two forms:
1. By burrowing the intestines and making ulcers, which bleed and cause anaemia or other diseases due to added infection
2. Absorbing the food from the host or letting out toxic substances in the intestines
- Usually symptoms start with diarrhoea (watery stools) and abdominal pain (mostly in right hypochondrium)
- Poor appetite or fear of food due to abdominal pain and loose stools
- Later, with increased intensity of the infection, fever, nausea and bloody stools i.e. characteristic amoebic dysentery with slimy mucous occurs and complicate the condition
- In due course, the patient loses weight and stamina
- Sometimes allergic reactions can occur throughout the body, due to release of toxic substances or dead parasites inside the intestines
- Complications usually develop after the trophozoites enter the blood stream to infect other organs. They especially invade the liver, which purifies blood
- Anaemia due to blood loss in stools
- Septicaemia due to abscesses in intestines, liver, lung, brain, spleen, etc.
- Perforation of intestines and peritonitis which lead to shock or septicaemia
- Jaundice due to spread in liver (with liver abscess)
- Constant infection leads to appendicitis or stricture of intestines
- Constant foul smelling stools due to infected ulcers caused by amoeba
- Intestinal damage or scarring which restrict normal absorption of nutrients
- Fits or epilepsy due to spread in brain as brain abscess or cysts in brain
- Practice good sanitary conditions
- Make servers or chefs wear gloves while preparing or serving food to avoid food contamination
- Take care of drinking water – either opt for mineral water or water boiled for 20 minutes
- Wash hands before food and after using the toilet
- Cut and keep your nails clean
- Wash vegetables and fruits well in flowing water before intake or cooking
- Avoid sharing towels with infected persons
- Avoid alcohol for preventing intestinal complications while having amoebiasis
Stool examination – Microscopic examination for identifying demonstrable E.H cysts or trophozoites in stool samples is the most confirmative method for diagnosis. Trophozoites survive only for a few hours, so the diagnosis mostly goes with the presence of cysts. But fresh warm faeces always show trophozoites. The cysts are identified by their spherical nature with chromatin bars and nucleus. They are noticed as brownish eggs when stained with iodine.
Biopsy also can point out E.H cysts or trophozoites.
Culture of the stool also can guide us for diagnosis.
Blood tests may suggest infection which may be indicated as leucocytosis (increased level of white blood cells), also it can indicate whether any damage to the liver has occurred or not.
Ultrasound scan – it should be performed when a liver abscess is suspected
General treatment: Usually, in Allopathy, a course of anti-protozoal (Metronidazole) is given for eliminating the amoebic trophozites. This will work very temporarily, i.e. till its eggs or cysts get hatched. So, again and again the course of medicines may be required. Sometimes, side-effects of the medicines, such as nausea, dizziness, vomiting, constipation, headache, rashes, poor appetite, abdominal pain, etc., do not allow the patient to take them continuously, for a course of time. This shows that research is still in its infancy since the effort to kill the trophozoites and cysts in the large intestines of the sufferer or carrier is still a challenge.
Homeopathic approach to amoebiasis: Amoebiasis usually starts as an acute problem and becomes persistent as a chronic complaint. Some persons take bitter leaves like neem, or vegetables like bitter gourd or any other self-medication to ‘kill’ the amoeba, but an overdose of these things only hinders the digestive process.
Also, many of the patients keep going from doctor to doctor to find a cure. A lot of persons constantly suffer from ameobiasis or its recurrence, even while undergoing treatment. This means the attempt to kill protozoa or destroy the eggs is not effective. In Homeopathy, we treat symptoms of patients rather than the disease or its effects. Homoeopathy not only relieves the condition but also cures the condition without any persistent usage of drugs or dependency or habit-forming or any side-effects.
Homeopathic medicines commonly used in cases of amoebiasis are Aloes, Ars alb, Baptisia, Chinchona, Colocynth, Ipecac, Kali Bich, Lycopodium, Mer cor, Nux vom, Podophyllum, Pulsatilla, Rhus tox, Sulphur, Thrombidium, Thuja, etc. These Medicines should be taken under the advice and diagnosis of a qualified Homeopath.
Dr. S. Chidambaranathan, BHMS, MD
24 E. New Mahalipatti Road
Tel: +91-452-233-8833 | +91-984-319-1011
www.drcheena.com / www.drcheena.in
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(Disclaimer: The contents of this column are for informational purpose only. The content is not intended to be a substitute for professional healthcare advice, diagnosis, or treatment. Always seek the advice of healthcare professional for any health problem or medical condition.)