High Altitude Diarrhoea

Giardiasis is a condition caused by a cyst-forming protozoan (one-
celled organism) called Giardia lamblia. This organism is very
common in the mountains and many highlanders have adapted to
harbouring the parasite without any symptoms.

For the rest of us, gatrointestinal symptoms will emerge after an
incubation period of 1 week. Many travellers suffer a watery, greasy
and “explosive”, hydrogen sulphide smelling diarrhoea only after
they have returned home. The frequency of diarrhoea could be as high
as hourly and dehydration rapidly sets in. The victim may feel very
bloated, especially if he has taken Lomotil and other drugs to
control bowel movements. If you suspect that you may have Giardiasis
when you’re back home, go see a doctor immediately. Untreated,
giardiasis may last 1 to 2 weeks.

If you’re in the wilderness, the correct way to treat Giardiasis is
to take 200mg of metronidazole (Flagyl) 3 times a day. Do not take
any Lomotil as this will only cause abdominal distension. With
adequate anti-protozoal therapy, symptoms should clear in a couple
of days.

The problem with Giardia is that it is a spore-forming protozoan,
resistant to most disinfectants. For hands contaminated with giardia
containing soil or faeces, washing with soap and water will not be
sufficient to remove the spores. Only iodine, chlorine and boiling
will destroy the organism. Many travellers swallow giardia when they
rinse their mouths with untreated water after brushing their teeth.
Utensils are also often washed in untreated water. If you trek in
the wilderness often enough, it’s only a matter of time that giardia
finds you. So always carry some Flagyl and oral rehydration salts
with you.

© Chan Joon Yee 2009

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