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Bloating/Fatigue Issue from Last Spring: Apparently Infection After All (Dientamoeba)

I’m publishing this with the goal of perhaps helping someone else who runs into a similarly unsettling and baffling issue.

I had a terrible time starting several weeks after March 22 Solvang Spring Double; something hit me hard with bloating and fatigue, and the effects went on for at least 5 months, slowing getting better but not quite resolving.

Now it looks like the answer might be at hand: Dientamoebe Fragilis and possibly endolimax nana.

Dientamoeba fragilis is a single-celled parasite found in the gastrointestinal tract of some humans, pigs and gorillas. It causes gastrointestinal upset in some people, but not in others.[1] It is an important cause of travellers diarrhoea, chronic diarrhoea, fatigue and, in children, failure to thrive.

Endolimax is a genus of amoebozoa[1] that are found in the intestines of various animals, including the species E. nana found in humans. Originally thought to be non-pathogenic, studies suggest it can cause intermittent or chronic diarrhea.[2][3] Additionally, it is very significant in medicine because it can provide false positives for other tests, notably the similar species Entamoeba histolytica, the pathogen responsible for amoebic dysentery, and because its presence indicates the host has consumed fecal material.

DientAmeobe Fragilis is transmitted by stool (feces), according to the doctor. But aparently the transmission vectors are not well understood. Personally I suspect contamination of water during the Solvang Spring Double event, but that might be completely erroneous—no way to say.

Either way, I’m quite annoyed that the vector must have involved someone not washing their hands after pooping who prepared food or drink that I consumed. Bad luck, as I rarely (very rarely) eat out, though I did so once in Solvang after the double century. And I ate and drank at the rest stops with some dubious water supply pipes and hoses. And the onset of symptoms (~2 weeks after) is consistent with the timing of the Solvang trip.

The cure

Oh joy, a 2-week course of an antibiotic that gives 30-40% of patients nausea: metronidazole. Its chemical structure is similar to a drug for alcoholics, to make them vomit if even a little alcohol is consumed. So no wine for two weeks.

Metronidazole is an antibiotic. It fights bacteria in your body.

Metronidazole is used to treat bacterial infections of the vagina, stomach, skin, joints, and respiratory tract. This medication will not treat a vaginal yeast infection.

Do not drink alcohol while you are taking metronidazole and for at least 3 days after you stop taking it. You may have unpleasant side effects such as fast heartbeats, warmth or redness under your skin, tingly feeling, nausea, and vomiting.

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