recovering from Giardia (or not)

[mgz5005]

Hello Hikers,

So thru hiking has been a dream of mine for as long as I can remember, and I finally made it to Springer Mountain this past spring!

Unfortunately I picked up Giardia pretty early on, still in GA, even though I was treating my water!! First with iodine, then with aquamira... but anyway it's been 5 months since my symptoms started and I'm still not better, and ended up getting off the trail in NY after hiking for four months with terrible terrible abdominal pain and diarrhea.

Has anyone else experienced this? or had success in treating Giardia/IBS symptoms?

I did take Flagyl when it started, but it didn't seem to help at all. I have taken three different brands of probiotics, again with no results. I just finished a round of Rifaximin, which from what I hear is a fairly new treatment for ibs/bacterial imbalances. This has actually helped a little... but I'm definitely not well enough to go backpacking or running, and from what I hear these mild results only last 4-10 weeks.

I've also gone gluten free, dairy free, and almost sugar free, which has reduced abdominal pain, but I'm worried I wouldn't be able to keep that kind of diet on the trail.

Any advice or tips would be great! I never though I'd say this, but I honestly can't wait to be able to put that stupid heavy pack back on!

-Malarkey

[kayak karl]

a doctor might help. the are many types of parasites and a lot of ways of get them other then water source.

[garlic08]

Did you get tested and positively diagnosed with giardia? I hear it's difficult to get a positive test.

[Pedaling Fool]

I don't filter/treat my water and never had those problems and I'm a glutton for gluten as well as all the other "bad" foods; BTW, sugar is brain food.

Maybe you're just one of those that have been screwed by nature, i.e. depriving you of a healthy immune system.

[Colter]

I'm sorry to hear that mgz5005.

When I've had giardia it was extremely unpleasant but I recovered quickly with treatment, but sometimes the effects of giardia can last for many years.

The CDC says Disinfection with iodine or chlorine has a low to moderate effectiveness in killing Giardia; Disinfection with chlorine dioxide has a high effectiveness in killing Giardia Aqua Mira is of course chlorine dioxide. Your iodine treatments might have been ineffective or you might have picked up giardia some other way, or, unless you've had positive lab tests, it might be something else. Lab tests will sometime be negative even if a giardiasis infection is present.

I would highly recommend seeing a (different) competent specialist to confirm exactly what the problem is and to find out the best way to proceed. If it is giardia a second treatment possibly involving a different drug might be in order. See http://www.ncbi.nlm.nih.gov/pmc/articles/PMC88965/ and scroll to "Resistance and relapse."

There is a lot of conflicting information out there. It seems like you are doing your research and I bet you can get it figured out and get back on the trail!

[Slo-go'en]

Hard to belive you got giardia in Georgia. I'm glad I'm immune or very, very lucky. I did not treat or filter water for all of Georgia or NC.

In any event, sounds like what ever you got is serious and if you haven't yet seen a doctor (or two) I'd do that ASAP. If you have seen a doctor, you'd probably not be here asking for advice.

[oldbear]

I had a bad case of Giardiasis in '82 and I too used Flagyl and completely recovered
I really think that you need to see another doctor on this because I have a gut feeling that it might be something else
Good luck

[Dogwood]

STOP! Let's rewind. Let's get onto the same page. Did you consult a doctor about you intestinal symptoms AND AND AND did the doctor 100% confirm through stool samples and laboratory tests you had Giardia? Where did you get the Flagyl? Are you making a self diagnosis? If so MANY false self diagnosis occur. Many symptoms and like medical issues resemble Giardasis and other parasitic infections.

Did you get tested and positively diagnosed with giardia? I hear it's difficult to get a positive test.

http://www.nptrail.org/uploads/GiardiaMyth-Buster.pdf

[Pedaling Fool]

STOP! Let's rewind. Let's get onto the same page. Did you consult a doctor about you intestinal symptoms AND AND AND did the doctor 100% confirm through stool samples and laboratory tests you had Giardia? Where did you get the Flagyl? Are you making a self diagnosis? If so MANY false self diagnosis occur. Many symptoms and like medical issues resemble Giardasis and other parasitic infections.



http://www.nptrail.org/uploads/GiardiaMyth-Buster.pdf

I guess I assumed he had seen a doctor, but then again I think it is possible to get a hold of Flagyl without a prescription, is this correct?


I would rather take a chance on my immune system correcting whatever the op is afflicted with than take a chance on taking medication without a consultation of a doctor.

[Dogwood]

I get how one can assume that he saw a doctor because that's how he obtained Flagyl, which is by prescription. However, some hikers carry Flagyl as a precaution and do offer it to others. I've come across this scenario a number of times. I think it stems from this idea that all water, even in the U.S., is rife with parasites like Giardia. I do understand the blanket recommendation to treat all trail water though. It's aimed at the masses. It's a not an unwise recommendation.

[garlic08]

I had intestinal issues (ahem) after a hike once (was not giardia, though the thought crossed my mind) and a friend offered me her dog's version of giardia meds which is Flagyl. So the stuff can be gotten without a prescription as easily as that.

[Colter]

STOP! Let's rewind. Let's get onto the same page. Did you consult a doctor about you intestinal symptoms AND AND AND did the doctor 100% confirm through stool samples and laboratory tests you had Giardia? Where did you get the Flagyl? Are you making a self diagnosis? If so MANY false self diagnosis occur. Many symptoms and like medical issues resemble Giardasis and other parasitic infections.

http://www.nptrail.org/uploads/GiardiaMyth-Buster.pdf

As usual Dogwood makes a lot of sense.

Many doctors think backpacker giardia is common enough to justify writing a prescription for giardia meds for someone leaving on a thru-hike. People should not assume they have giardia without careful consideration however, because as has been pointed out giardiasis is commonly self-diagnosed incorrectly.

When treatment is justified, people should ask their doctor about Tinidazole (brand name Tindamax) which usually works as well or better than Flagyl with a single dose rather than many pills over several days. It is newly available in the U.S. and many doctors aren't familiar with it yet.

No one should believe the Schlimmer "giardia myth" article linked just above, however. Schlimmer doesn't have a basic understanding of the topic. His paper is the result of data mining, selected anecdotal evidence, distorted facts and extreme bias. He is a personal friend of Dr. TR Welch who is the source of a large part of the giardiasis misinformation widely quoted on the internet. The CDC SPECIFICALLY refutes Welch's claims and has said Although the advice to universally filter and disinfect backcountry drinking water to prevent disease has been debated, the health consequences of ignoring that standard water treatment advice have been documented...

I doubt there is a single competent epidemiologist that would take the Schlimmer "paper" seriously.

And yes, I am on a mission to set the backpacker-giardiasis record straight.

[Slo-go'en]

According to this link Colter provided http://www.ncbi.nlm.nih.gov/pmc/articles/PMC88965/ you need some thing other then a common antibiotic. You might think it helped, but it probably just went away on it's own. I'd drink a pint of Tequila before starting to pop antibiotics.

[Malto]

I get how one can assume that he saw a doctor because that's how he obtained Flagyl, which is by prescription. However, some hikers carry Flagyl as a precaution and do offer it to others. I've come across this scenario a number of times. I think it stems from this idea that all water, even in the U.S., is rife with parasites like Giardia. I do understand the blanket recommendation to treat all trail water though. It's aimed at the masses. It's a not an unwise recommendation.

You can get metronidazole on the web without a prescription. It is a product called Fishzole. I keep a supply of it in my medicine cabinet and I also took it with me on my thru.

To the OP. when I had giardiasis it was brutal but then went away quickly. I wouldn't expect it to come back unless you were reinfected after the initial treatment. Probiotics to my knowledge won't cure giardiasis.

[Blissful]

Sounds like you need a trip to a GI dr (gastrointestinal specialist). It can be anything including full blown colitis which can be very serious. My guess it is not giardia.

[lemon b]

Medical issues are best answered by a Doctor. See one and do what they say. Had it once and the script worked.

[Wise Old Owl]

ah not my words but so relevant..

We here in the United States never consider the consequences of what we are eating or drinking. We assume it is all safe. We are notorious for stuffing our plates and our stomachs, because we have an abundance of food available. Food comes from our own farms and ranches, but it also comes from foreign sources as well. We get fruit from South and Central America, Canada and some things are shipped in from as far away as the Orient and Australia. The global economy has affected not only our Toy market, but our foods as well, but salmonella is not the only danger we have to face. When I lived in the Orient they had something called "honey buckets". These were usually two buckets of human waste carried on a stick between the shoulders of workers going into the produce fields into the fields. Here they were poured on the vegetables and used as fertilizer to help the crops grow. Other countries do not always worry as much about HOW they fertilize their products as we do in the US.
When we were on the other side of the world we knew there was a risk and took extra caution with what we bought. It was thoroughly washed/cleaned before we consumed it. In Mexico there used to be signed that people laughed at because they said, "Don't drink the water, drink the Cerveza." because the water is considered dangerous and full of bacteria that people who are not from their country might catch. I've heard this referred to as "Montezuma's revenge" and if you fail to heed the warnings, you soon would know what that term meant.
I had not been in Mexico or any other foreign country for some time when I made the serious mistake of eating a grape in the grocery check out line. The grape looked luscious and indeed it was. However I will NEVER do that again. This seems like an innocent thing, but I learned the hard way as it almost cost me my life. We all need to be more careful with our food and what we put in our mouths, including our hands.
I thought at first it was some kind of virus, but as it got worse and worse. Soon I was going to the bathroom 35 times a day and all my body fluids depleted quickly. As I got weaker and weaker, I could not even hold down a glass of water. A friend of mine who was a nurse came to see me and immediately recognized the symptoms. She rushed me to the hospital where after several test, it was confirmed.
I had Guardia Lamblia.
My first question was,"What in the dickens is it?"
The doctor explained, "It is a protozoan parasite that gets inside your small intestines and if not treated with antibiotic can very quickly kill you."
I knew what a protozoa and a parasite were because I had studied them in college; so my next question was, "Where in the world did I get it?"
They started to track it down by asking me questions. Had I been on a camping trip, drank any well water; been in the mountains anywhere;. had I been in a swimming pool, a hot tub? None of these things rang a bell. I hadn't been anywhere or done any of theses things. Did we have a dog or a cat? At that time we didn't, so we could eliminate that too. Then they asked me if I had eaten any uncooked food, fresh fruit, or vegetable without washing them? The checkout line at the grocery store immediately popped into my head, as I never done anything like that before. Suddenly it dawned on me ... The grape! We had tracked down the cause. Apparently that grape was contaminated.
It is easier to get this terrible disease than one might imagine. It can be picked up on a bathroom fixtures, your hot tub, in a lake, on a diaper pail, through your pets or from something you ate that was not properly cleaned.. You can get it through contact with infected blood or by accidentally swallowing it in the water you drink at the swimming pool. It is in our soil, our food and sometime in our water. It is the most common cause of waterborne diseases in humans in the US in the last twenty years according to the Center for Disease Control in Atlanta. How many of you reading this, are aware that this little one cell terror lurks in your own back yard?
It can be found in every part of the US.
Your mother probably told you to wash you hand as a kid. Well, it is time we listened, but it is not enough!
We need to make people aware of the terrible tiny one cell protozoa that can certainly kill you, if you are not aware of it. It is as dangerous as the contaminated lettuce and spinach episode we had recently, the only difference is it works more slowly and no one is talking about it.
Spread the word. The life you save could be your or that of someone you love.

all that being said... go upwards a few posts.. how the hell a person on antibiotics is supposed to avoid a protozoa? Help me out..

[Trailweaver]

As WOO mostly covered everything, and accurately, I won't repeat it, but will add to it a bit. He's right about washing everything - assume every piece of fruit/vegetable is contaminated (if not bacteria, then think pesticides) and wash it thoroughly. Then repeat after me: I will not bathe in the creeks on trails because this creates a potential hazard for people collecting drinking water after I have been there. I will treat all water as if it is contaminated because I cannot tell from looking at it whether it is or isn't.

Those people who tell the tale of never treating their drinking water are simply playing Russian roulette with their gut. Giardiasis can be in the creek on say June 3rd and not on June 19th. It can be at point X and not 20 yards away at point Z. (It depends on the point of contamination by the animal and when.). As another point, you can get food bourne illness from the potato salad on the salad bar by serving yourself from the side of the bowl that became contaminated when the whole bowl is not (yet) contaminated, which is why everyone who eats potato salad that night might not get sick. It also would depend on how much a person ate (two bites or a whole, large portion).

One other thing: one reason this is so difficult to treat is that this little bugger has a whole different approach to the Darwin theory (survival). This parasite has the ability to encase its eggs in a "cyst" that is resistant to the body's natural efforts to kill it, and somewhat resistant to some antibiotics, I believe. It can (does) often survive years in this manner, and just when you think you are cured, you aren't. Tests for it are difficult because it may show up in a stool specimen one day, but not again for several weeks, which is why you think you're cured and may not be. Given all this information, why in this world would you choose to gamble with whether to treat your water?

i took parasitology from a prof in college who had worked more than 30 years for the CDC traveling the world studying and trying to prevent food/water illnesses. I learned more from him in 3 months than I learned from some other profs in a whole year. He was amazing.

If you have any thought that you may have picked up this little nasty, get to someone who can treat it, even if that means going to a larger city with an infectious disease specialist. GI docs can often treat it, but some can't because they don't see it often enough to recognize it. An infectious disease specialist would. It's common among travelers to foreign countries.

Sorry to have rambled on. . . I just do think this issue is important, and I get livid when I roll into a campsite and see people bathing in my drinking water! I can forgive the deer, raccoons, etc., but not the hikers. ;-)

[Sailing_Faith]

I hope you are able to find relief and get back on the trail soon. For what it is worth, your thread has once again reaffirmed my decision to use my filter... Thanks.

[OutnBack]

See a good GI & follow their recommendations to the letter.