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Clin Gastroenterol Hepatol. 2015 Mar;13(3):507-513.e2. doi: 10.1016/j.cgh.2014.07.065. Epub 2014 Sep 16.

The prevalence of intestinal parasites is not greater among individuals with irritable bowel syndrome: a population-based case-control study.

Author information

  • 1Department of Medical Gastroenterology, Køge University Hospital, Køge, Denmark. Electronic address: lrk@dadlnet.dk.
  • 2Department of Medical Gastroenterology, Køge University Hospital, Køge, Denmark; Department of Clinical Microbiology, Hvidovre University Hospital, Hvidovre, Denmark.
  • 3Department of Microbiology and Infection Control, Statens Serum Institut, Copenhagen S, Denmark.
  • 4Department of Medical Gastroenterology, Køge University Hospital, Køge, Denmark.

Abstract

BACKGROUND & AIMS:

The parasites Dientamoeba fragilis and Blastocystis have been detected in feces from patients with irritable bowel syndrome (IBS), therefore these parasites may be involved in IBS pathogenesis. We proposed that a higher prevalence of the parasites in IBS subjects compared with asymptomatic controls would support such a mechanism. We aimed to determine the prevalence of these parasites in IBS subjects (cases) and controls and to identify risk factors associated with parasite carriage.

METHODS:

We performed a population-based, case-control study of an adult population from an internet-based research institute in Denmark. In January 2010, subjects completed a questionnaire based on the Rome III criteria for IBS and answered questions on factors associated with parasite carriage. Respondents (n = 483) were asked to submit fecal samples for parasite testing; samples were analyzed from 124 cases and 204 controls.

RESULTS:

A greater proportion of controls than cases carried the parasites (50% vs 36%; P = .01). D fragilis was detected in a greater proportion of fecal samples from controls than cases (35% vs 23%; P = .03), as was Blastocystis (22% of controls vs 15% of cases; P = .09), and a greater percentage of controls carried more than 1 species of parasite (16% of controls vs 8% of cases; P = .05). D fragilis infection was associated with having children 5 to 18 years old in the household and Blastocystis infection was associated with high income (≥600,000 Danish Kroner/y, approximately $100,000 US dollars/y), no animals in the household, and drinking bottled water.

CONCLUSIONS:

D fragilis and Blastocystis were detected in a greater proportion of fecal samples from the asymptomatic background population in Denmark than from subjects with IBS symptoms. These findings indicate that these parasites are not likely to have a direct role in the pathogenesis of IBS. Longitudinal studies are required to understand their role in gastrointestinal health.

KEYWORDS:

Blastocystis; Dientamoeba fragilis; Microbiota; Risk Factors

PMID:
25229421
DOI:
10.1016/j.cgh.2014.07.065
[PubMed - indexed for MEDLINE]
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