Marcelle Pick left for Mexico with visions of herself splashing in the ocean, relaxing on the beach and feasting on local fare. Let’s just say those visions were quickly blurred. “I was on the floor a lot more than I wanted to be because I was in so much discomfort,” says Pick, an OB-GYN nurse practitioner in Yarmouth, Maine.
Expecting her traveler’s diarrhea — aka “Montezuma’s Revenge” — was driven by a parasite, Pick sent a stool sample to a hospital back home, where results came back normal. Unsatisfied, she sent a sample to another lab recommended by a chiropractor. This time, it confirmed her suspicion: She had amoebiasis, a parasitic infection caused by Entamoeba histolytica, or E. histolytica. “I treated it and got much better,” says Pick, who used herbal supplements to kick the bugs.
But Pick’s interest in parasites didn’t stop there. Many of her patients, she realized, have digestive issues that may link back to parasites but are often overlooked by conventional medicine clinicians, who aren’t necessarily well-trained in testing for and identifying the bugs. (In fact, no experts at the American Gastroenterological Association felt comfortable being interviewed for this article.) As a result, some women who are told they have irritable bowel syndrome show up in her office, only to learn they have a parasite. “Most people are not surprised” when they’re diagnosed, Pick says. “It’s like, ‘I knew something was wrong.'”
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“Intestinal parasites” can refer to either helminths (worms with many cells like tapeworms, pinworms and roundworms) or protozoa (single-celled organisms like giardia and cryptosporidium). While the adult worms can’t multiply in the body, protozoa can — and can wreak havoc on the gut as a result.
“What the bacteria are trying to do is they reproduce inside the gastrointestinal tract,” says Terez Shea-Donohue, a professor and researcher at the University of Maryland School of Medicine. “They destroy the cells that line the gastrointestinal tract [and] as a result, you get diarrhea.”
Some people also experience body aches and headaches, fatigue, loss of appetite, weight loss, cramping and other issues often related to diarrhea-induced dehydration, says Chad Larson, a naturopathic doctor in Solana Beach, California, and adviser on the clinical consulting team for Cyrex Laboratories. “The gut is kind of the center of the universe for general health, so if the gut is off, they’re going to be off systemically.”
While people can pick intestinal parasites up during travel since their guts aren’t necessarily equipped to fight off the bacteria in other regions, they can also pick them up in other ways, including by coming into contact with infected feces through food, water or surfaces. (In other words, a parasite-infected person didn’t wash his or her hands thoroughly enough after using the bathroom.) “It’s extremely gross, but it’s fairly common,” Larson says. People with compromised immune systems, such as those taking drugs used to treat autoimmune diseases like rheumatoid arthritis, Crohn’s disease, ulcerative colitis and multiple sclerosis, are particularly vulnerable to infection, Shea-Donohue says.
“If [people] have been told we don’t get parasites [in the U.S.] — that’s not true,” says Pick, who says about 85 percent of her patients have digestive problems and about one-quarter of the stool samples she evaluates turn up parasites. A 2014 report from the Centers for Disease Control and Prevention warned that parasitic infections can affect millions of people. The bugs are increasingly common in the U.S., Pick suspects, as international travel becomes more common and people’s guts become less resistant to infection due to factors like prior antibiotic use, cesarean delivery and a sanitation-obsessed society.
“If you have a newborn and the pacifier falls on the floor, you sterilize it, you do this and that,” Pick says. “In the old days, you’re like, ‘You’re going to be fine.'”
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Fortunately, most people who do get an infection from an intestinal parasite end up being just that — fine. In fact, people with healthy immune systems recover on their own after a few days of discomfort since the body flushes out the bug naturally. In these cases, it’s important to avoid anti-diarrheal medications so you don’t encourage the parasites to stick around.
“If you are taking a probiotic and you don’t have bloating or gas or constipation or diarrhea, you’re fine,” Pick says. “But it’s the people who’ve been on lots of antibiotics as a kid … or had to be on lots of things that really disrupted the flora [that we worry about].”
In those cases, a correct diagnosis is the first step. If you haven’t gotten an answer or effective treatment from a primary care doctor, gastroenterologist or infectious disease specialist, consider someone trained in functional medicine, or a type of care that focuses more on the root cause of diseases rather than the symptoms, Pick suggests. (The Institute for Functional Medicine maintains a searchable database of providers.) Such clinicians are more likely to order and evaluate comprehensive stool samples that can identify parasites.
“By the time we’ve run a stool analysis, they don’t feel well, they want some answer and, at some level, it’s a relief” to discover a parasite, says Larsen, who also runs “sensitivity tests” to help determine which herbs are most likely to kill those specific bugs. Black walnut, wormwood, grapefruit seed extract and oregano can all wage a powerful war against parasites, he finds, although it’s important to make sure such alternative therapies don’t interact with any medications.
Diet, too, is critical in creating an inhospitable environment for parasites to grow. He and others recommend removing sugars, grains, alcohol and other staples of the standard American diet on which parasites thrive. “The grains and the sugars are going to help the bad guys more than the good guys,” he says. If herbs and diet changes don’t eliminate the parasites, antibiotic medications like Flagyl can usually finish them off for good, he says. More conventional providers, meanwhile, may prefer to start with medications, which “can get rid of parasites more quickly and with fewer side effects than most alternative treatments,” according to the University of Maryland Medical Center.
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But before seeking the right treatment for you, the key, Pick says, is receiving an accurate diagnosis if you have unexplainable digestive issues you think could be attributable to parasites. “Don’t be dismayed — we can find out and treat it pretty easily,” Pick says. “You don’t want to have it forever and forever and it never gets better. You don’t have to live that way.”
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