Giardia and Flagyl (metronidazole)

The correct name for the disease would be giardiasis, no? Just dropping the name here to make it searchable on it, really.

I've never felt this out of it in my life.

I've been having problems with what seems to be Giardia for over 2 months now after my vacation. I've done a couple of stool samples (ova and parasite test) and they came back negative. That being said, one doctor was kind enough to prescribe me with Flagyl based on my symptoms, although I haven't taken it yet. (I started with diarrhea, malaise, fatigue, nausea, lost weight, burping, lack of appetite, trouble sleeping, and later had constipation)

At this moment my symptoms are: bloating, stomach cramping, mild-nausea, strange loose looking stools, and getting tired fairly easily.

My fear is that I don't know if I still have giardia or if my symptoms are just the post-infection after effects of it.

For those of you who got over Giardia, did all your symptoms go away when you were cured? Or did it linger on afterwards?

Also I've been diagnosed with 1.5g per day of Flagyl for about a week. Are side effects common?

Thanks for all your help

Hi breakaway, welcome to Indiamike. I wish you were joining the site in happier circumstances!

First off I have NO medical knowledge, but I have had giardia and can share my own experience. However I have friends who've also had giardia and had comppletely different experiences.

So, my experience. My symptoms (nausea, loss of appetite, churning stomach, explosive bowel movements, weakness) came back after taking one course of flagyl, so I had to take a second course.

I felt absolutely terrible when taking the flagyl. I suspect that this was the side-effects of the Flagyl.

After I'd taken that second course I no longer had the stomach cramps or strange bowel movements. But the weakness and weight loss went on for probably six months. I had various medical tests to find out was it something else causing the weight loss and lack of energy but everything else was fine: so it was entirely because of the giardia / side-effects of flagyl.

If you do decide to take flagyl - and my own personal view (I repeat I'm not a medic) is that it's the only way to actually KILL the giardia rather than just suppressing the symptoms - my advice is to cut out all dairy produce. Apparently flagyl can make you temporarily lactose-intolerant.

(I also cut out meat, fish, eggs, wheat, sugar, caffeine, alcohol. I wanted to just be very gentle on my digestive system while it was recovering)

I wish you well, you certainly have my sympathy. I know how horrible giardia can be


Edited later to add: I've just read back through what I wrote earlier on this thread last year. I noticed I said in April that I thought I was over it. Well I obviously thought I was, but in hindsight I can say that I actually wasn't, in fact that happened several times, I was impatient to be well again, but I wasn't actually completely fit again till about 6 months after I came back from India.

Really feel for you guys! If I spend six months in India, I generally expect to get pretty ill at least twice.

I spent one year in India in six month segments. Towards the end of my first trip, after some usual travelers bowel issues, I experienced something particular nasty!

It started off with normal diarrhea but quickly became explosive! After around two weeks in the jungle (I was in the far east and a long way from medical help) I made it back to Delhi. I had ended up with a bowel, lung and blood infection!

Fast forward to my second trip. I arrived at Pushkar on my birthday and the same symptoms came back - man, I was out for a good week. A few months later, symptoms came back when I was in Orissa (ate some fish which, in retrospect, was a stupid idea).

The symptom that linked all these together was these god awful 'nutty' burps! This made me believe it could have been Giardia but tests in Delhi showed nothing of the sort.

It can persist for quite some time, sometimes indeed months. It's also possible that the stool tests came back negative, they only detect the parasite when it's in one specific phase of its cycle.

That's a relatively high dose, I assume your doc knows what he's doing and is following you during treatment. The higher the dose, the more side effects, mostly it'll be a metallic taste in your mouth, nausea and diarrhea (sorry). Stay away from booze while taking it. But if you have questions, you should talk to your dr or pharmacist, not to anonymous people on a travel forum.

I had giardia again (this time more acute, with vomiting, not just diarrhea) after coming back from India last year - treated with Flagyl/Norfloxacin for 5 days (iirc). Even though I was on my feet again after 2 days of treatment the meds were making me feel weak and vaguely queasy. I started taking probiotics as a friend suggested and felt better the next day. I am going to Nepal soon and have started taking probiotics(Culturelle) - I have heard it can prevent the more common traveler's diarrhea(caused by E. Coli) though I am unsure if it would prevent giardia infection. At least I will know what to do if I need to go on antibiotics again.

Incidentally, I think I may have gotten sick from the fruit on the Air India flight coming home - remind me not to listen to my husband next time - he said 'it must be OK to eat, don't worry'

Very nasty. Sorry to hear that.
But, after vomiting and diarrhoea, you're going to feel week for some time: is it fair to blame the meds? On the other hand, these are heavy-weight meds for a heavy-weight problem, so some side effects may be inevitable.
Isn't E. coli a heavy food-poisoner? I think that traveller's diarrhoea is caused by trivial things, sometimes even a change in diet without any infection.
Air Lanka did that to me. I'd survived India without a stomach upset (for the first time!) and was dreadfully ill as soon as I got back home!

Hello,
I've been fighting since late August with Giardia Lamblia I cought in Rajasthan and have already had Metronidazol, Tinidazol (4 times in weekly cycles), Paromomycine (3 x 500mg x 5 days) and (currently) Albendazol (2 x 400mg x 10 days). I still don't feel any better and I'm just wondering if someone treated Giardia with some other medicines successfully ?

Regards,
Artur

I assume stool tests have been taken after each drug regimen and confirmed the presence of the parasite? Asking the question because sometimes people become temporarily lactose-intolerant after giardia infection and this produces the same gastrointestinal symptoms.

Looks like your dr is doing what's usually done (drugs of different classes to try to get around resistance). If this doesn't work, ask about treatment with quinacrine, that also targets the cysts. But it's harsh. Listen to your dr.

Seconded dillichaat. Your doc might try quinacrine.

Get well soon!

Yes, 3-feaces tests confirmed cysts after 1 week following each treatment (when I started having symptomps again too). Unfortunately quinacrine is not available in Holland but fortunately I still have 2 doses of Tinidazol so I'll take it next day after I finish Albendazol. Question is whether to repeat it next day or better wait 1 week ?

Thank you so much for your post, much appreciated. We have two daughters adopted from Bangalore, we live in California. The first daughter came home with giardia and the second one we treated with Tinidazole before we even left Bangalore! Since Indian doctors don't commonly test - just treat children every 6 months for parasites we didn't even know if she also had it. Our first daughter was treated with several different kinds of meds. when she came home and battled chronic giardia for 5 months, she was only 2 years old! She came home 2 1/2 years ago now and about 1 1/2 years after she returned home she appeared to have the symptoms back but tested negative. Then the symptoms went away and she experienced unprecedented growth. The second daughter came home in Feb. and doesn't appear to have any symptoms, but a funny thing happened. Yesterday our veterinarian called to say that our indoor cat tested positive for giardia! Now we are thinking we better have all of us tested again (inculding our dog) so we are off to the doctors/vet tomorrow morning! Do humans commonly give giardia to animals and vice versa? BTW when our first daughter was treated my husband and I also had mild sypmtoms, even though our one off stool samples were negative. We were both given flagel anyway. My husband had no side affects but I must be a light weight as I took one dose and had such a chemical headache I was almost immediately bed ridden and had nausea. He had to come home from work to take care of our daughter, I was that bad. I am guessing the dosage was too high. Doctors here do not seem to know what they are doing when it comes to giardia. We ended up at Stanford Hospital Infectious Disease with our first daughter (but only in the fifth month as our pediatrician finally gave up) and we are running our stool samples through them again tomorrow. I am thinking of having a friend deliver us some Tinidazzole from India if any one of us test positive, since that seems to be a better more effective option than flagel.

.



Possible and it can easily happen. Transmission of giardia is fecal-to-mouth. Pets drink form toilet and additionally they lick rear ends. . .

I have treated this many times in the field.
I don't need a disclaimer, as I am qualified to comment.
Whilst most of the pharmacology has been covered, this is only the KILLING phase of the treatment.
If you are feeling really ill, this has a lot to do with your vitamins not being absorbed. We all know that by eating food we get vitamins and minerals from that food. Body absorbtion is a cascade effect. Ie some vitamins can only be absorbed providing you have other vitamins to allow that absorption. I wont go into it here and in any case, I am not a nutritionist. I am a front-line paramedic.
Back to my point. I have treated people who have been bedridden for a month to getting them up and going well within a few days.
The trick is intramuscular B12. Not tablets as you must bypass your "gut" One of the side effects of Giardia is preventing the body from getting b12. Without B12, you can't absorb other vitamins etc. Only a processional should do this for you. B12 (A quality brand such a neo) IM Injection into the side of your leg. 1Ml is a good start. See how the patient goes, then another 1Ml two days later. This has worked many times for me. Like I said, get a Doc or medic to do it, don't do it yourself. GP's in western countries wouldnt have a clue other than off the shelf treatments which kill the bug but don't help Pt recovery.

just a quick note for anyone fighting with giardia - after 4 months (when I tried Metronidazol, Tinidazol, Albendazol and Humatin alone) I've finally got rid of it (already confirmed with 4 tests by starting with Humatin (Paromomycine) for 10 days and including Tiberal (Ornidazol) after 5 days for the remaining 5 days - it's been advised by specialists both in Holland and Poland.
Good luck to all still suffering.