Giardia lamblia and Helicobater pylori Coinfection

Background: Giardia lamblia and Helicobacter pylori are two flagellate microorganisms that grow in duodenum and stomach. The aim of this study was to evaluate the prevalence of them in patients with dyspepsia and other GI disorders. Methods: In this cross-sectional study, co-infection of above-mentioned agents was investigated in a group of 130 patients [median age of 40 yr (range=11-79) including 76 males (58.8%)] with dyspepsia using three methods of duodenal aspiration sample, duodenal biopsy samples and evaluation of stool samples. Results: : From 105 patients (59 males, 46 females, median age 40 years, range 11-79) entering this study from 3 hospitals, 4 patients (3.8%) had G. lamblia and 61 patients (58%) had H. pylori. All 4 patients infected by Giardia had also H. pylori infection. Tenesmus (3 out of 4 patients) was the most common symptom in patients with H. pylori infection (48 out of 61 patients) was reflux. Other symptoms in patients infected with both organisms (4 patients) included diarrhea (2 cases), weight loss (2 cases), and loss of appetite (1 case) but no report of vomiting. Conclusion: In patients co-infected with Giardia, H.pylori differentiation by physical examination is not possible. So in those patients with positive Rapid Urease Test (RUT), stool examination for Giardia detection is recommended. In addition, metronidazole (broad spectrum, anti-protozoal drug) can be useful in H. pylori infection.