Fulya G. DEMİRÇEKEN, İrfan SOYKAN, Zafire KULOĞLU, Hülya ÇETİNKAYA, Ali ÖZDEN

Dispepsili hastalarda Giardiazis sıklığı

Giriş ve Amaç: Fonksiyonel veya ülser dışı nedenlere bağlı dispepsi etyolojisi tam olarak bilinmemekte ve birçok faktör suçlanmaktadı r. Giardia lamblia sindirim kanalından en fazla izole edilen protozoan olup, kronik giardiasis dispepsi nedenlerindendir. Bu çalışmada amacımız, dispepsi nedeniyle üst gastrointestinal endoskopi yapı lan hastalarda giardiazis sıklığını belirlemek ve sonuçları eş zamanlı yapılan mikroskopik dışkı incelemeleri ile karşılaştırmaktı. Gereç ve Yöntem: Yüz dört dispeptik hasta (63 K, 41 E, 17-80 yaş) çalışmaya alındı. Giardia lamblia araştırılması için bütün hastalardan duodenal aspiratlar toplandı ve eş zamanlı mikroskobik dışkı incelemeleri de yapıldı. Bulgular: Geğirme dispeptik hastalarda en fazla yakı nılan semptomdu (%52,9). Giardia pozitifliği duodenal aspiratta %8,7 (1 trofozoit, 8 kist) iken eş zamanlı dışkı incelemelerinde %3,8 bulundu. Erkeklerde daha fazlaydı (%12?ye karşı %6). Bütün giardiazisli hastalarda epigastrik ağrı veya karında rahatsızlık hissi vardı. Uygun antiparaziter tedaviyi takiben giardia pozitif tüm hastalardaki dispeptik yakınmalar kayboldu. Sonuç: İki yöntem arasında istatistiksel olarak anlamlı bir fark yoktu. Bu çalışma giardiazis tanısı için eğer tanı değeri yüksek yeni tekniklerle dışkı incelemesi yapılabiliyorsa duodenal aspirat almanın gereksiz olabileceğini düşündürdü. Ancak tanıdan kuvvetle şüphelenildiği halde tekrarlanan dışkı incelemeleri negatif sonuç veriyorsa biyopsi ve duodenal aspiratları n alınabildiği üst gastrointestinal endoskopi tanıda dikkate değer bir seçenektir.

Anahtar Kelimeler:

Giardiazis, dispepsi, endoskopi, duodenal aspirat

Giardiasis in dyspeptic patients

Background and Aims: The etiology of functional (nonulcer) dyspepsia is unknown and many factors are suspected. Giardia lamblia is the most common protozoan isolated from the gastrointestinal tract, and chronic giardiasis is considered as a cause of dyspepsia. Our aim was to determine the frequency of giardiasis in patients undergoing upper gastrointestinal endoscopy for dyspepsia and to compare with results of stool examination by microscopy. Materials and Methods: One hundred and four dyspeptic patients (63 F, 41 M, aged 17-80 years) were included in the study. Duodenal aspirates were collected in all and simultaneous stool examinations for Giardia lamblia were done. Results: Belching was the most prominent symptom in patients with dyspepsia (52.9%). Giardia positivity was 8.7% in duodenal aspirates (1 trophozoite, 8 cysts) and 3.8% in stool examination simultaneously. There was a male predominance (12% vs 6%). All patients with giardiasis had epigastric pain or abdominal discomfort. Following the appropriate antiparasite treatment, dyspeptic complaints were improved in all Giardia-positive patients. Conclusions: There was no significant difference between the two methods statistically. This study suggests that duodenal aspirates for giardiasis may be unnecessary if stool examination with new techniques is used for diagnosis. If repeated stool examination results in negative findings, but the diagnosis is still suspected, upper gastrointestinal endoscopy with biopsies and duodenal aspirate is a reasonable alternative for diagnosis.

Keywords:

Key words: Giardiasis, dyspepsia, endoscopy, duodenal aspirate,

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