Abstract
BackgroundBlastocystosis is a frequent bowel disease. We planned to to evaluate the prevalence of Blastocystis spp. in patients who applied to the same internal medicine-gastroenterology clinic with or without gastrointestinal complaints to reveal the association of this parasite with diagnosed IBS and IBD.MethodsA total of 2334 patients with gastrointestinal symptoms composed the study group, which included 335 patients with diagnosed inflammatory bowel disease and 877 with irritable bowel syndrome. Patients without any gastrointestinal symptoms or disease (n = 192) composed the control group. Parasite presence was investigated by applying native-Lugol and formol ethyl acetate concentration to stool specimens, and trichrome staining method in suspicious cases.ResultsBlastocystis spp. was detected in 134 patients (5.74%) in the study group and 6 (3.12%) in the control group (p = 0.128). In the study group, Blastocystis spp. was detected at frequencies of 8.7% in ulcerative colitis (24/276), 6.78% in Crohn’s disease (4/59), 5.82% in irritable bowel syndrome (51/877), and 4.9% in the remaining patients with gastrointestinal symptoms (55/1122). Blastocystis spp. was detected at a statistically significant ratio in the inflammatory bowel disease (odds ratio [OR] = 2.824; 95% confidence interval [CI]: 1.149-6.944; p = 0.019) and ulcerative colitis (OR = 2.952; 95% CI: 1.183-7.367; p = 0.016) patients within this group compared to controls. There were no statistically significant differences between the control group and Crohn’s disease or irritable bowel syndrome patients in terms Blastocystis spp. frequency (p = 0.251, p = 0.133).ConclusionsBlastocystosis was more frequent in patients with inflammatory bowel disease, especially those with ulcerative colitis. Although symptomatic irritable bowel syndrome and Crohn’s disease patients had higher rates of Blastocystis spp. infection, the differences were not significant when compared to controls.
Highlights
Frequency of Blastocystis spp. infections in the study vs. control group Overall, Blastocystis spp. was found in 134 cases (5.74%) out of 2334 patients in the study group who applied to the gastroenterology clinic with gastrointestinal complaints while in 6 patients (3.12%) in the control group (n = 192) who applied to the same clinic without gastrointestinal complaints [Table 1]
Consideration of Blastocystis spp., frequency in the study group with respect to diagnosis revealed the identification of Blastocystis spp. in significantly higher number of patients with inflammatory bowel disease (IBD) (28 of 335, 8.35%) patients when compared to control group (OR = 2.824; 95% CI: 1.149–6.944; p = 0.019)
In a study by Mylonaki et al emphasizing the importance of routine microscopic stool analysis in IBD exacerbation, Blastocystis spp. was amongst the detected enteric infectious agents [29]. These results suggested the correlation of Blastocystis spp. with IBD and strengthened the hypothesis that the parasite may have a role in the exacerbation of diseases [28]
Summary
We planned to to evaluate the prevalence of Blastocystis spp. in patients who applied to the same internal medicine-gastroenterology clinic with or without gastrointestinal complaints to reveal the association of this parasite with diagnosed IBS and IBD. Blastocystis spp. is a unicellular protozoan found in the large intestine in humans. The pathogenic potential of Blastocystis spp. is still a debated issue due to the fact it is the most frequently encountered protozoan in healthy individuals as well as patients with gastrointestinal symptoms [1,4]. It was reported that the parasite can be encountered together with serious cases such as rectal bleeding, weight loss, anemia, and eosinophilia [2]. Blastocystis spp.-induced superficial intestinal invasion and mucosal inflammation was demonstrated in animal studies [9] while the pathogenic role of Blastocystis spp. in bowel inflammation has been investigated in many clinical trials
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