Irritable bowel syndrome (IBS) caused by Blastocystis hominis parasite?

[Hip]

The common protozoan parasite Blastocystis hominis that lives in the gut has been associated with irritable bowel syndrome (ref: 1), and it may be that Blastocystis hominis will turn out to be the cause of IBS in many patients. Better understanding of the biology and pathogenicity of Blastocystis hominis has only emerged quite recently (in the last 10 years).

The Blastocystis hominis parasite can be hard to test for, and hard to treat (but not impossible); nevertheless for many people with IBS, exploring whether their IBS (and its attendant mental and emotional symptoms) may be caused by Blastocystis hominis is definitely a path worth pursuing. There is every possibility that you may be able to cure yourself of IBS, simply by taking some anti-protozoan drugs that will kill off the Blastocystis hominis parasite in your gut.

There is also the possibility that those with both IBS and chronic fatigue syndrome will experience improvement in their CFS symptoms, if you manage to fix your IBS.

This is because there is a lot of symptom overlap between IBS and CFS, so having IBS might exacerbate your CFS symptoms (and vice versa).

It's quite possible that CFS is generally underpinned by more than one infection/condition, and so the severity of your CFS symptoms may be reduced if you manage to eliminate at least one of your underlying infections.

The fact that irritable bowel syndrome and chronic fatigue syndrome frequently occur together supports this view: that in many patients, their CFS may be the sum total of the various overlapping symptoms produced by a number of co-existing infections/conditions in your body.

Other conditions that frequently occur together with CFS include interstitial cystitis, which, like IBS, may well be due to some hard-to-detect infection.

Note that SIBO (small intestine bacterial overgrowth) and IBS have almost identical symptoms, and one is often misdiagnosed as the other.


Blastocystis hominis mental symptoms

Blastocystis hominis can cause major physical and mental symptoms.

The dire mental symptoms that this Blastocystis hominis protozoan can produce are listed on the Budbugs website that extensively covers this protozoan. These symptoms include:

Nervous and sensory disorders including inability to concentrate, depression, panic attacks, brain fog, sleep disturbances, depression and feelings of doom.


Testing for Blastocystis hominis

Blastocystis hominis infection is hard to detect, and a single stool analysis will often completely miss this organism. This is because people infected with Blastocystis hominis may only intermittently shed protozoa in their stool - so the parasite is not always found in their stool samples.

Also, many strains of Blastocystis hominis are in fact benign, so a positive stool test result on its own (without symptoms) does not mean much (as regular lab stool testing does not normally distinguish which strain you have). But since there are strains of Blastocystis hominis that are very pathogenic, if you have symptoms, plus are positive for Blastocystis, this suggests that a pathogenic Blastocystis strain may be causing your symptoms. The pathogenic strains are thought to have come from the Middle East.

Genova diagnostics also test for Blastocystis via their Comprehensive Digestive Stool Analysis 2.0 + Parasitology

Genova diagnostics UK is here.

One research diagnostic parasitology laboratory facility in the UK that has special interests in Blastocystis hominis is here.


Treating Blastocystis hominis

Blastocystis hominis is hard to treat, as the parasite can exist in four different lifeforms: vacuolar form, granular form, amoeboid form, and cyst form. The cyst form is the toughest to kill. If you don’t eliminate all the forms in your gut, the Blastocystis infection will reestablish itself.

There is no single anti-protozoal drug that can kill all the different forms in the life cycle of Blastocystis hominis, so to have a reasonable chance of eliminating this infection, you need to take several anti-protozoal drugs simultaneously, that between them will target all forms of the Blastocystis organism.

Metronidazole (Flagyl) is the standard medical treatment for Blastocystis hominis, but apparently this rarely works. Blastocystis hominis has developed resistance to metronidazole.

Jackie of the Badbugs website recommends a 10-day triple anti-protozoal drug cocktail, which apparently cures more than 80% of Blastocystis hominis infections.


Herbal treatments for Blastocystis hominis:

Herbs are not thought to be that effective. They can reduce symptoms while you take them, but rarely, if ever, eliminate the infection. I cannot find much reliable information, but apparently useful are: grapefruit seed extract, curcumin, black walnut, wormwood, berberine, and oregano oil for 6 weeks.


Dietary treatments for Blastocystis hominis:

Some say Blastocystis hominis feeds off carbohydrates, particularly grains, so cutting out carbs and consuming a high protein diet is useful.

Saccharomyces boulardii, a probiotic yeast, can be useful. This is because Blastocystis hominis is immunosuppressive: Blasto lowers the levels of secretory IgA antibodies (sIgA) in your gut mucous membranes. Saccharomyces boulardii probiotic is known to raise sIgA.


More information about Blastocystis hominis and IBS:


Badbugs
The Causes of IBS
Bowel parasites
Life Cycle of Blastocystis Hominis
Blasto Cure (Blog): My battle against Blastocystis hominis
Blastocystis hominis. Is It Really A Problem?
Infectious Causes of Irritable Bowel Syndrome

 

[Mark]

Thanks for this Hip, sounds quite promising; I've added it to my list of things to suggest to my GP next time I see him.

 

[leaves]

Ive had this, got rid of it (which was not easy) but did not improve my symptoms in any way.

 

[Mark]

Hi Leaves, are you saying it didn't improve your IBS symptoms, or that it didn't improve the rest of your symptoms?

 

[leaves]

It didnt improve any of my symptoms including ibs

 

[Crappy]

Ain't that the sh*ts!

I have been reading about this too. Hoping fixing it would restore everything. There goes another "silver bullet".

 

[Hip]

It didnt improve any of my symptoms including ibs

I understand that this outcome quite often happens: the Blastocystis is eliminated, but irritable bowel syndrome symptoms do not improve.

One difficulty with this whole Blastocystis hominis situation is that only a few strains of Blastocystis are pathogenic, and the tests do not distinguish pathogenic from non-pathogenic Blastocystis strains. So you may test positive for Blastocystis, you then get rid of it through anti-protozoal drugs, but perhaps it was a benign strain, so it may not have been the cause of your IBS anyway (if you follow the logic).

Pathogenic Blastocystis is a sort of emerging pathogen, so there is only scant research on it at present.

Also, another thing: testing is for Blastocystis hominis is a hit and miss affair. Sometimes you can get a stool analysis done (usually comprising a batch of three stool samples taken over several days), and Blastocystis hominis will not appear in these samples. But then if you get other stool analysis done say the following week, you may find that Blastocystis hominis IS detected in that batch of samples.

The problem is that Blastocystis hominis seems to have and irregular pattern of shedding in stool, so apparently you can often not find this parasite if it is not shedding when you do your stool analysis.

I just mention this, leaves, because you said "I got rid of it", but I wonder how much verification you had from your doctors that it was in fact truly eliminated. From what I have read, it is quite difficult to be sure that it tis gone, unless you take several batches of stool analyses over a period of time, and they are all negative.

In terms of precise figures, apparently, provided fixative is used immediately on taking the stool samples, a the normal batch of three stool samples taken over severals days has around an 80% chance of detecting this parasite in someone who has Blastocystis. Put another way: 1 time out of 5, a three-sample stool analysis will show a false negative in someone who has Blastocystis.

From the Badbugs website information page on lab testing:
Even under ideal circumstances, a single stool specimen is diagnostic only 50% to 60% of the time; three samples increases the sensitivity to 80% and six samples to 95%. Vol. 18, No. 4 The John Hopkins Microbiology Newsletter. Monday, January 25, 1999..

I really wish that there could be some major advance in pathogen detection; it seems this is always a very tricky area.

 

[anne_likes_red]

I've had sooooo many antiprotozoals...

I became sick with ME in 1984 immediately after 2 weeks in hospital being treated for congenital toxoplasmosis in the brain and optic nerves. It was a relatively rare form of a common protozoal infection. I was treated, that time over 6 weeks with a cocktail - including pyremethamine and sulfonamides. Then I was treated approx every 18 months for the following 11 years, in three different countries with a number of different combinations of antiprotozal drugs. I usually had more than one drug at a time as each time the infection flared I was in danger of losing my eyesight permanently and the doctors always seemed to want to throw everything at it!

There may be different antiprotozaols these days, but I've had quite a few, and I still have ME, including gut issues, 26 years later.

PS, thanks for the info. Protozans are fascinating....a bit scary too, some of them Anne.

 

[Hip]

I became sick with ME in 1984 immediately after 2 weeks in hospital being treated for congenital toxoplasmosis in the brain and optic nerves. It was a relatively rare form of a common protozoal infection. I was treated, that time over 6 weeks with a cocktail - including pyremethamine and sulfonamides. Then I was treated approx every 18 months for the following 11 years, in three different countries with a number of different combinations of antiprotozal drugs. I usually had more than one drug at a time as each time the infection flared I was in danger of losing my eyesight permanently and the doctors always seemed to want to throw everything at it!

There may be different antiprotozaols these days, but I've had quite a few, and I still have ME, including gut issues, 26 years later.

PS, thanks for the info. Protozans are fascinating....a bit scary too, some of them Anne.

Did any of your doctors speculate that your ME might be due to Toxoplasma gondii? Toxoplasma gondii is one of the known causes of CFS/ME symptoms (other known and proven causes include the bacteria Chlamydia pneumoniae and Coxiella burnetii).

Interestingly, Wikipedia says that France, Germany, Holland and Brazil have high levels of Toxoplasma gondii carried in the general population, with France being the highest: around 88% of the population of France are carry Toxoplasma gondii.

The US has around 11%, Britain about 22%, and South Korea the lowest at 4.3%.

 

[anne_likes_red]

No they didn't suggest it was the cause of it, more that the flare-up of it (I had it before I was born) during adolescence might have been an initiating event on top of genetic susceptibilty for ME.
The flu-like Toxoplasmosis (not the form of infection I have...or had), often passed from cats or poorly cooked meat probably is similar to ME in some ways. The people I've known who had this form mostly bounced back in a month or two. They had swollen glands and needed rest but did not end up bedbound or anything. One forum member here didn't bounce back and he ended up with ME/CFS.

Anne.