From the Research
Treatment for Dientamoeba fragilis is typically recommended when a positive stool sample is accompanied by symptoms such as persistent diarrhea, abdominal pain, bloating, flatulence, nausea, fatigue, or unexplained weight loss, and the most effective treatment option is paromomycin, as it has been shown to have a higher clearance rate compared to metronidazole, secnidazole, and doxycycline 1. When considering treatment, it's essential to note that asymptomatic infections generally don't require treatment. The symptoms that may indicate the need for treatment include:
- Persistent diarrhea
- Abdominal pain
- Bloating
- Flatulence
- Nausea
- Fatigue
- Unexplained weight loss According to the most recent and highest quality study, paromomycin has been found to be more effective than metronidazole, with a clearance rate of 83% compared to 42% for metronidazole 1. During treatment, patients should:
- Maintain good hydration
- Follow a bland diet if experiencing gastrointestinal symptoms
- Practice strict hand hygiene to prevent reinfection or transmission to others Treatment is justified because D. fragilis can damage the intestinal lining and cause inflammation, leading to persistent symptoms that impact quality of life. Follow-up stool testing may be necessary to confirm clearance of the parasite, especially if symptoms persist after treatment. It's also important to note that the effectiveness of treatment can vary depending on the individual and the presence of other intestinal parasitic coinfections, but paromomycin has been shown to be effective in achieving faecal clearance and clinical cure 1.