Giardia lamblia and chronic gastritis.

One hundred and two patients suffering from giardiasis and/or chronic gastritis were subjected for upper gastrointestinal endoscopy. Purified immune rabbit's serum against Giardia lamblia was used in ELISA and immunoperoxidase (IIP) techniques for detection of Giardia antigen in the stomach. Results showed that out of 70 cases with intestinal giardiasis, 8 (11.4%) by ELISA and 6 (8.6%) by IIP showed gastric giardiasis. Higher percentage of gastric giardiasis (14%) was encountered in cases with both giardiasis and chronic gastritis (50) than in cases with giardiasis alone (5%) but with statistically insignificant difference (P > 0.05). None of the cases with chronic gastritis alone (without giardiasis) was positive for gastric giardiasis. Dyspepsia was the main presenting symptom in cases with gastric giardiasis (P < 0.05) with significant (P < 0.05) association. Helicobacter pylori was encountered in 6 out of 8 cases (75%) with gastric giardiasis (P < 0.05) with significant (P < 0.05) association. Duodenogastric reflux was detected in 4 out of 8 cases (50%). Histopathological changes in antral mucosa were detected in all cases of gastric giardiasis. This study indicates that under abnormal circumstances most probably with decreased gastric acidity, gastric giardiasis can occur in concomitance with intestinal giardiasis. So, one has to search for Giardia in gastric biopsies, particularly those showing chronic atrophic gastritis and H. pylori. Also, one has to be aware of gastric giardiasis as a possible cause of upper gastrointestinal symptoms.