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All About Dientamoeba fragilis

D fragilis is an enigma. It has been classified as an “unflagellated” flagellate (not a typo) protozoan parasite that, strangley, shows a higher prevalence in developed countries.

 

Symptoms have been reliably mapped throughout the last century noting diarrhea, nausea and abdominal pain as common presentations amongst other GI complaints.

How do I know I have Dientamoeba fragilis?

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  • Diarrhea

  • Abdominal Pain

  • Appetite loss

  • Weight loss

  • Nausea

  • Fatigue

  • Intermittent diarrhea

  • Intermittent vomiting

  • Abdominal paid

  • Nausea

  • Anorexia

  • Malaise

  • Fatigue

  • Poor weight gain,

  • Eosinophilia

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What is Dientamoeba fragilis?

 

Dientamoeba fragilis is in itself a conundrum. It has been stated that we know less about this organism than any other potentially pathogenic protozoa that infects humans. The jury is still out as to whether it is a pathogen or not due to its presence in people that are asymptomatic. Nevertheless enough clinical evidence exists to paint a picture of this organism that is not flattering.

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Symptoms have been reliably mapped throughout the last century noting diarrhea, nausea and abdominal pain as common presentations amongst other GI complaints.

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It’s hard not to draw a parallel between the GI-related symptoms of IBS and those of this parasite, and researchers have verified the disappearance of IBS-like symptoms when eradicating D fragilis.  Nevertheless  research out of Northern Europe repeatedly finding higher incidence of this organism in healthy control groups rather than symptomatic patients.

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How did I get infected?

 

While science has some good indicators, the official answer is that no one knows for sure. Almost always diagnosed simmulateously with Blastocystis hominis, D fragilis has also a strong affinity with a completely different type of parasite.

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Throughout the early 1970’s experiments were done to investigate the association of D fragilis with Enterobious vermicularis (pinworm). These studies were done to determine the vector of D fragilis as up until then no cyst stage had been identified for this protozoa. Researchers were able to infect themselves with D fragilis by ingesting the ova of pinworms. Further research has discarded this helminth vector hypothesis as the cyst stage of D fragilis was in fact described in studies published in 2013-14.

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This does not discount an association between these two parasites, though.​

Is there a silent link between D. fragilis and Irritable Bowel Syndrome?

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Is Dientamoeba fragilis infestation dangerous?

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Debilitating but rarely, if ever, life-threatening, this protozoan parasite may play a role in an unconnected way to another prevalent health condition. The following has been established about D fragilis:

 

1.   It causes IBS-like symptoms

2.   It cross-infects with other parasitic organisms

3.   Eradicating it has shown IBS-type symptoms resolve

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A lack of scientific follow-up on this potential link is both intriguing and alarming with one paper suggesting that just because the parasite is detected then that should not lead to efforts to eradicate it. One would easily challenge the common sense of such a view.

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Nevertheless, there are broad-acting herbal preparations drawn from traditionss around the wold that safely eradicate protozoan parasites like Dientamoeba fragilis. Would using them to eradicate this parasite also lead to relief or cessation of symptoms of irritable bowel syndrome?

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Yes or no, using them as prescribed is unlikely to cause any adverse implications to health, even if no parasitic influence is present.

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Research:

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  1. Canavan C, West J, Card T. The epidemiology of irritable bowel syndrome. Clin Epidemiol. 2014;6:71-80. Published 2014 Feb 4. doi:10.2147/CLEP.S40245

  2. HealthDirect  Irritable bowel syndrome (IBS)  (Sept 2020)  www.healthdirect.gov.au/irritable-bowel-syndrome-ibs

  3. Rouse, R. Is it irritable bowel? Rule our parasites first  (Oct 11, 2002) Medical Observer

  4. Stark D, Barratt J, Chan D, Ellis JT. Dientamoeba fragilis, the Neglected Trichomonad of the Human Bowel. Clin Microbiol Rev. 2016;29(3):553-580. doi:10.1128/CMR.00076-15

  5. Krogsgaard LR, Engsbro AL, Stensvold CR, Nielsen HV, Bytzer P. The prevalence of intestinal parasites is not greater among individuals with irritable bowel syndrome: a population-based case-control study. Clin Gastroenterol Hepatol. 2015 Mar;13(3):507-513.e2. doi: 10.1016/j. cgh.2014.07.065. Epub 2014 Sep 16. PMID: 25229421.

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This page is for information only and is not meant to be used for self-diagnosis or as a substitute for consultation with a health care professional. If you have any questions about the disease described above or think that you may have a parasitic infection, consult a health care professional.

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