the gastrointestinal screen and comprehensive digestive ... · •gastrointestinal screen...

The Gastrointestinal Screen and Comprehensive Digestive Stool Analysis in Digestive System

Assessment with Emphasis on Common Parasitic Infections

Copyright© 2017, Educational Resource Association. This material may not be reprinted, distributed or used without permission.

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• Gastrointestinal Screen with/without H. pylori (#401 & #401-H):• From BioHealth Laboratory

• Comprehensive Digestive Stool Analysis w/Parasitology• Great Plains Laboratory & Doctors Data

• How to interpret each test & clinical correlation

• Parasite detection:• Blastocystis hominis

• Cryptosporidium parvum

• Giardia lamblia

• Entamoeba histolytica

• Others – Iodamoeba butschlii, Endolimax nana, etc.

• Natural and antibiotic treatment options and protocols

Lecture Overview

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Support Documents for Module #2

• Pathogenic Organism Chart (pdf)

• Interpreting the #401 and #401-H (article)

• Ketotifen (handout)

• Mucosal Barrier Remedies (handout)

• Botanical Parasite Treatments (handout)

• Antibiotic Parasite Treatments (handout)

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• Overview of Intestinal Permeability Testing (pdf)

• Lecture Slides (pdf)

• Lecture Slides – note taking (pdf)

• Addendum Lecture Slides – mucosal barrier remedies (pdf)

• Addendum Lecture Slides – note-taking (pdf)

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Support Documents for Module #2

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Prioritization of Gut Treatment

1. Eliminating immune reactive and toxic foods.

2. Identifying and treating gut pathogens

3. Actively utilizing treatments to promote healing.

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Stool Testing

GI Screen (#401-H)Comprehensive Digestive

Stool Analysis

• Specific test for GI Pathogens

• High parasite yield with 3 stool sample collection + antigen analysis.

• C. difficile – analyzed separately via #417 assessment.

• H. pylori antigen detection

• Is NOT a comprehensive digestive stool analysis.

• Does NOT evaluate function

• Provides analysis of gut flora + culture/sensitivity.

• Parasite detection yield often not as high as #401-H.

• May or may not give specifics to C. difficile A & B.

• H. pylori often not reported• Provides information

regarding digestion and inflammation.

• IS a functional digestive analysis.

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Gastrointestinal Screen (#401 and 401-H)

Understanding The Role Of Pathogen Testing from BioHealth Laboratory and

Interpretation of Findings

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GI Screen – BioHealth Laboratory (BioHealthLab.com)

• Ova & Parasites X 3• Trichrome stain

• Giardia & cryptosporidium antigen (H. pylori antigen too with #401-H).

• Culture: bacteria, yeast, fungi

• Occult blood

• C. Difficile – assessed separately via #417 test

NOTE: parasite detection looks specifically for protozoa, flatworms and roundworms too.

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Clostridia difficile: Colitis Toxins

Common to not detect clostridia enterotoxins, but the OAT can show

high HPHPA and/or 4-cresol

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Culture Section

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Document Section for Module #2

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The Human Microbiota

• The human microbiota consists of bacteria, fungi, and archaea (single cell organisms with no cell nucleus or membrane bound organelles).

• Microbiota = collection of microorganisms that live on the surface and deeper layers of the skin, oral mucosa, vagina, conjunctiva and digestive system.

• Normal flora = organisms that in normal situations do not cause disease.

• Biota = total collection of microorganisms in a particular environment.

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Human Microbiome Project

• In 2012, a consortium of over 200 researchers from 80 research institutes catalogued the 1000’s of microorganisms in the digestive tract of humans.

• Used advanced DNA sequencing for organism identification.

• Primarily studied the carbohydrate enzyme function from various microorganism populations.

• Healthy humans have thousands of types of microorganisms, more so in the mouth and intestinal tract, than other areas of the body, e.g. vagina, skin.

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An Abundance of Bacteria

• Conservative estimate: 10X the number of bacteria in/on the human body versus number of human body cells.

• Mass of these organisms is considered to make-up approximately 1% to 3% of total body mass.

• Many of the ‘gut flora’ help to breakdown certain carbohydrates not easily digestible in humans.

• Most are anaerobes and considered ‘commensal’ -defined as organism benefitting another organism without affecting it.

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Too Much Of A Good Thing

• Normal flora can be ‘opportunistic’ in the presence of lowered immunity:• Mouth bacteria (e.g. Actinomyces viscosus) leading to

plaque build-up on teeth.

• Vaginal microflora (consisting mostly of lactobacillus species) when disturbed can lead to bacterial vaginosis or candidiasis.

• Other oral bacteria leading to systemic health problems such as heart valve damage.

• Small Intestine Bacterial Overgrowth (SIBO)

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• Various organisms can trigger dysfunction in the digestive system, particularly in the junction between the large and small intestine (aka. ileocecal valve region).

• Certain toxins produced by intestinal pathogens alter the levels of normal intestinal cells which are normally responsible for moving bowel debris and opportunistic bacteria from the small intestine into the large bowel.

How Does SIBO Occur?

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How Does SIBO Occur?

• This situation creates an avenue for either overgrowth of opportunistic intestinal bacteria in the small intestine and/or migration of normal large bowel flora into the small bowel contributing to bacterial carbohydrate fermentation.

• Giardia lamblia is a known trigger, as well as campylobacter (specifically C. jejuni), salmonella, shigella, and various viruses.

SIBO To Be Discussed During Module #618

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Bacteria commonly found in the human colon*

Bacterium: Incidence (%):

Bacteroides fragilis 100

Bacteroides melaninogenicus 100

Bacteroides oralis 100

Enterococcus faecalis 100

Escherichia coli 100

Enterobacter sp. 40-80

Klebsiella sp 40-80

Bifidobacterium bifidum 30-70

Staphylococcus aureus 30-50

Lactobacillus 20-60

Clostridium perfringens 25-35

Proteus mirabilis 5-55

Clostridium tetani 1-35

Clostridium septicum 5-25

Pseudomonas aeruginosa 3-11

Salmonella enteritidis 3-7

*"The Normal Bacterial Flora of Humans“ (textbookofbacteriology.net)

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Stool Culture Section

• Organisms listed as Light (+1, +2), Moderate (+3) or Abundant (+4).

• NG = No Growth

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Ova & Parasite Section

• Ova & Parasite – visual examination under microscope looking for presence of protozoa cysts and trophozoites, larvae, eggs and adult helminths.

• Trichrome Stain – rapid staining procedure to differentiate internal structure of various parasites, as well as differentiate these structures from background material and debris.

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Stool Antigen Section

• Routine ova & parasite analysis has very poor sensitivity for Giardia (approx. between 65% to 80%) and Cryptosporidium (less than 5%).

• Immunoassay Antigen – greatly increases yield of these two protozoans.

BioHealth Laboratory #401 and #401-H GI Screens evaluatefor Cryptosporidium parvum, Entamoeba histolytica and Giardia lamblia antigens.

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Parasite Definitions

• Protozoa – single cell organism capable of movement, e.g. paramecium:• Amoeba, ciliate, flagellate, sporozoan

• Amoeba – ability to alter its shape; pseudopods

• Ciliate – move by small hair-like structures

• Flagellate – move by one or more whip-like organelles. Ex: Giardia lamblia.

• Sporozoan – produce infective spores. Ex: Cryptosporidium parvum, malaria.

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Parasite Definitions

• Helminth – parasitic worms. Large multicellular organisms:• All produce eggs

• Larvae hatch from these eggs

• Roundworms, whipworms, tapeworms, flukes, etc.

• Ova - egg

• Trophozoite – the active, motile feeding stage of a sporozoan parasite, e.g. cryptosporidium, malaria.

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Additional Sections

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Occult Blood (clinical considerations):• Anal fissure• Angiodysplasia – fragile, abnormal blood vessels• Diverticular disease• Esophageal problems• Hemorrhoids • Peptic ulcers – r/o H. pylori, NSAID use• Polyps/cancer

NOTE: Black, tarry colored stools indicates bleeding higher up in the digestive tract, whereas bright red or maroon colored stools is more indicative of blood lower in the digestive tract.

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Other Types of Testing

• Salivary IgA – reported to have 80%+ sensitivity to various pathogens: Toxoplasma, E. histolytica, Ascaris, Tapeworm, and Trichinella. • Diagnos-Techs – Gastrointestinal Health Panel

(Diagnostechs.com)

• Fecal Polymerase Chain Reaction (PCR) analysis –DNA analysis reported to have high sensitivity (upwards of 100%) for pathogenic bacteria and protozoans compared to stool culture. • DRG Laboratory – GI Pathogen Profile (Drglab.com)

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Comprehensive Digestive Stool Analysis (CDSA)

Incorporating Dysbiosis, Digestive Function and Inflammation Markers for a Deeper

Clinical Analysis

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Dysbiosis Profile From CDSA

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Overview of Probiotics To Be Discussed During Module #5

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Yeast Culture From CDSA

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Arabinose

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3 year old ASD child

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Stool Testing

• Toxigenic stool culture – sensitive test for C. difficile, takes 2 to 3 days, but is still considered the gold standard.

• Polymerase Chain Reaction (PCR) analysis is good option too, e.g. DRG Laboratory.

• Virtually, all the research on C. difficile is focused on the intestinal damaging strains.

• Toxin-negative strains of C. difficile are considered non-pathogenic for intestinal disease.

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Stool Testing

• C. difficile is the only clostridia bacteria, out of nearly 100 known species, to be tested in the stool from nearly all hospital laboratories around the world.

• The bacteria is not commonly cultured, but is detected via the presence of Toxin A and Toxin B.

• The problem with stool testing is that high numbers of cultures are negative.

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Clostridia Bacteria Toxicity To Be Discussed in Module #5

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Digestive Function Assessment

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Pancreatic Function

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Support Digestion

BioMatrixOne.com 2 capsules with meals

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DiZorb (Betaine HCL & Pepsin)

nbnus.com 1 to 2 capsules with meals

• Betaine HCL

• Pepsin

• Does not contain Ox Bile

• Helps with protein digestion, proper stomach acidity.

• Be cautious in children – DO NOT chew.

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Zyme-Prime

nbnus.com

• Protease, lipase, amylase, etc.

• Aids in protein, carb, and fat digestion.

• 1 to 2 capsules with meals

• 2 to 4 chewable tablets with meals

• Rule of thumb = 1 capsule per 2 chewable tablets.

• Use with caution in inflammatory bowel disease.

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Bowel Inflammation

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Lactoferrin and Calprotectin more specific for inflammatory bowel disease (IBD)compared to Lysozyme which can be elevated in irritable bowel syndrome (IBS).

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Common CDSA Markers

• Calprotectin – marker of intestinal inflammation secreted predominately by neutrophils in the gut. Can be elevated in IBD and infections.

• Lysozyme – indicates intestinal inflammation via immune activation on the mucosal lining. Can be triggered by infection, food allergy or sensitivity, chemical injury, etc. Sometimes elevated in Inflammatory Bowel Disease (IBD), but more commonly associated with Irritable Bowel Syndrome (IBS).

• Lactoferrin – GI specific marker for inflammation used to differentiate IBD from Irritable Bowel Syndrome (IBS).

• WBC & mucus – correlates with WBC infiltration and prolonged mucus production in the digestive system.

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Curcumin 250

1 capsule+ twice daily with food

nbnus.com

• Turmeric Phytosome(Curcuma longa) root,

dried extract, min. 18% curcuminoids & phosphatidylcholine complex

• 250mg/capsule

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• Check bacteria, yeast, and parasites• Food sensitivities

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• Check bacteria, yeast, and parasites• Check inflammatory markers

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Short Chain Fatty Acid (SCFA) – end products of dietary fiber fermentation by intestinal flora. Lactobacillus and Bifidobacterium bacteria produce large

amounts of SCFA. Helps to improve pH which prevents against yeast and bacterial overgrowth. SCFA’s also stimulate healing and decrease

inflammation.

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• Butyrate – byproduct of bacterial fermentation on dietary fiber. Also, found in raw milk and butter, as well as Ghee (clarified butter).

• Beneficial in clearing high ammonia produced in the gut

• Supports against gut problems, e.g. diarrhea

• Supports the health of intestinal cells by decreasing inflammation – particularly the large intestine.

• Calcium/Magnesium, Potassium Butyrate available –600mg to 1200mg with food twice daily. Typical capsule amount is 600mg.

Butyric Acid (butyrate)

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New Beginnings Nutritionals –nbnus.com

2 to 6 capsules daily with food

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Secretory IgA and Mucosal Barrier Function

Addendum Lecture for Module #2 -During Question and Answer Session #1

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Parasites

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Blastocystis hominis

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Blastocystis hominis – What Is It?

• It has been previously considered as a yeast, fungi, or ameboid, flagellated or sporozoan protozoa.

• Based on molecular studies and RNA sequencing, B. hominis has been placed within an informal group called the stramenopiles.• Stramenopiles are defined, based on molecular

phylogenies, as a heterogeneous evolutionary assemblage of unicellular and multicellular protistsincluding brown algae, diatoms, chrysophytes, water molds, slime nets, etc.

Source: DPDx – Centers for Disease Control ‘Division of Parasitic Diseases’

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• Distribution: worldwide

• Clinical presentation – debatable because it is widely seen in both symptomatic and asymptomatic individuals.• Diarrhea

• Abdominal pain

• Perianal pruritus

• Excessive flatulence

• Transmitted: fecal-oral, contaminated water

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Cryptosporidium parvum

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Cryptosporidiosis

• Many species of cryptosporidium can infect humans, but the most common form is Cryptosporidium parvum.

• Is considered a protozoan, more specifically a sporozoan, because of its spore formation which is a stage of high infectivity.

• Invasion of the enterocytes occurs from sporozoitesof Cryptosporidium that leads to its disease pathology.

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Cryptosporidium

• Distribution: worldwide• Outbreaks do occur regionally

• The most pronounced, and well documented outbreak in the United States occurred in Milwaukee, WI. in 1993 with over 400,000 people being affected.

• Can be highly resistant to chlorine making it an important water borne pathogen in developed countries.

• Clinical presentation – asymptomatic to severe life-threatening illness:• Watery diarrhea is the most frequent symptom which

can be seen with dehydration, abdominal pain, fever, nausea and vomiting.

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Cryptosporidium

• In an immunocompetent individual, symptoms may only last 1 to 2 weeks (self-limiting?). Can be longer and more severe in immunocompromised people.

• Small intestine is more common site affected:• Other sites seen - other GI organs, lungs, and

conjunctiva.

• Is considered an invasive parasite. Can migrate in and out of cells (usually on a 7 to 10 day cycle).

• Very destructive for the mucosal barrier

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Giardia lamblia

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Giardia lamblia Stool Detection

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Giardiasis

• Giardiasis - Giardia lamblia, Giardia intestinalis, and Giardia duodenalis.

• Most frequently diagnosed parasitic infection in the United States.

• Found in soil, food, and water

• Giardia is protected by an outer shell that makes it tolerant to chlorine and allows it to survive outside the body for quite some time.

• Fecal-oral and water contamination are most common exposure sources.

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Giardiasis• Clinical presentation – can be asymptomatic or

symptomatic:• Diarrhea

• Excessive gas

• Nausea/vomiting

• Stomach and abdominal cramping

• Greasy stools that tend to float

• Less common symptoms: itchy skin, hives, eye and joint swelling. Overtime, weight loss, along with vitamin A and B12 deficiency can be seen.

• Poor growth in children with chronic giardia

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Giardia

• Giardia infection results in topographical changes in

the gut including:

a.Villous atrophy

b.Blunting of brush border

c.Reduction of surface area for absorption

• Damage to finger tips of villi cause:

a.() lactase enzyme → lactose intolerance

b.() sucrase enzyme → sucrose intolerance

c.Damage to lacteals → inability to absorb fats & oils

• Results in crypt hyperplasia & crypt deepening

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Giardia• Maldigestion, malabsorption & malnutrition involving:

a. Fatty acid, carbohydrate, amino acid, and mineral

imbalances.

• Promotes cyst infiltration of the gall bladder, common

bile duct and pancreatic duct:

a. Cysts can live under the fingernails for up to 6 months

b. Cysts are highly infectious – ALL household members are

vulnerable.

c. The length of cyst incubation is 7-21 days

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Pets – An Exposure Source for Giardia Too

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Entamoeba histolytica

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Amebiasis• Entamoeba histolytica – well recognized as a

pathogenic amoeba that is associated with intestinal and extra-intestinal infections. The other species of Entamoeba are important because they may be confused with E. histolytica in diagnostic investigations, e.g. E. dispar.

• Distribution: worldwide• High incidence in developing countries

• In developed countries, high risk amongst homosexual men, travelers, and institutionalized individuals.

• Clinical presentations – from asymptomatic to invasive intestinal amebiasis and extra-intestinal amebiasis.

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Brain AbscessHematogenous

Lung AbscessHematogenous

Liver AbscessHematogenous

Splenic AbscessHematogenous

Portal Veins

Lung Abscess

Extension

Subdiaphragmatic Abscess

Elevation of Diaphragm

Amebiasis CutisExtension

Large Intestine Abscess

Primary

Appendix InfectionPerianal Infection of Skin, Fistula

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• Can be a very serious and life-threatening infection.

• Can inhabit the entire large bowel 5-7 weeks after exposure – known to trigger appendicitis and IBD.

• Invades the enteroplexus nerve supply of the large bowel damaging both the nerve and muscle tissue.

• Can invade the liver and become systemic creating abscesses throughout the body.

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Death can occur with liver abscess biopsy:If E. histolytica is present, it can be released into the

general circulation via biopsy causing death from antigen overload.

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Other Parasites Commonly Seen On Stool Tests

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Non-Pathogenic Intestinal Protozoa

• “Nonpathogenic intestinal protozoa are single-celled parasites commonly found in the intestinal tract, but never associated with illness. They do not harm the body, even in people with weak immune systems.”

• “Symptomatic people who are found to have these protozoa in their stool should be examined for other causes of their symptoms.”

Non-pathogenic intestinal protozoa include:

• Chilomastix mesnili• Endolimax nana• Entamoeba coli• Entamoeba dispar• Entamoeba hartmanni• Entamoeba polecki• Iodamoeba buetschlii

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Statements by the Centers for Disease Control

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Dientamoeba fragilis

• Protozoan parasite

• Lives primarily in the large intestine

• People may be asymptomatic or symptomatic:• Bloating and gas

• Loose stools

• Abdominal cramping

• Treatment – similar to other protozoan parasites (Metronidazole, Tinidazole, Nitazoxanide), or botanicals.

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Parasite TreatmentsBotanical and Other Natural Remedies

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Wormwood (Artemesia)

• Two types:• Artemesia Absinthium

• Artemesia Annua

• Properties:• Anti-inflammatory, anti-pyretic, anti-pathogen (bacteria,

yeast, parasites and worms).

• Active ingredient: • Artemesinin

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Wormwood

• Traditional uses:• Vermifuge – destroys and expels worms

• Tonifies the liver and gallbladder

• Increases bile production

• Decreases gas and bloating

• Increases stomach acid production for improved digestion.

• Dosage:• Capsule – 1 to 3 grams in divided doses

• Tincture – 10 to 30 drops in water or dilute juice 3x/day

• Artemesinin (100mg capsules) – 2 capsules 1 to 2x/day

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Black Walnut Hulls (Juglans nigra)

• Properties:• Laxative, hepatostimulant, astringent, anti-pathogen

(bacteria, yeast, parasites, worms).

• Active Ingredient:• Juglans, tannins

• Traditional uses:• Vermifuge, anti-parasitic, anti-candida

• Mild laxative

• Aids digestion

• Treats skin fungus when used topically

• Heals canker sores

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Black Walnut Hulls

• Dosage:• Capsules – 200mg to 400mg daily in divided

doses.

• Tincture – 10 to 30 drops in water or dilute juice 3x/day.

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Berberine

• Alkaloid found in several herbs:• Goldenseal, Oregon Grape, Barberry, Golden Thread,

Tree Tumeric.

• Properties:• Anti-pathogen (bacteria, yeast, parasite, viral, worms)

• Traditional uses:• Colds and flus

• Various infections (bacteria, yeast, etc.)

• Blood sugar control

• High lipids

• Positive effect specifically against E. histolytica and Giardia.

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Berberine

• Dosage:• Capsules – 200mg 2 to 4x/day

• Dosage may vary in different combination botanical formulas.

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Garlic (Allium sativum)

• Properties:• Decrease platelet aggregation and fibrinolytic activity

• Anti-pathogen (bacteria, yeast, parasite, virus)

• Active ingredient:• Allicin

• Traditional uses:• Infections – bacterial, fungal, parasitic, viral

• Cardiovascular – decrease blood pressure, decrease cholesterol and glucose.

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Garlic

• Dosage:• Cloves – 1 to 3 daily

• Allicin – 500mg to 1000mg/day

• Garlic oil capsules – 5000mg 1 to 2x/day

• Garlic extract – 500mg to 1000mg 1 to 2x/day

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Clove (Syzygium aromaticum)

• Properties:• Antiseptic

• Topical anesthetic

• Anti-pathogen (bacteria, yeast, viral, parasites and worms).

• Active ingredient:• Eugenol

• Tannins

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Clove

• Traditional uses:• Kills parasite ova and worm eggs by stopping life cycle

when used in conjunction with Black Walnut and Wormwood.

• Decreases nausea, vomiting and gas

• Stimulates digestion

• Topical use on oral lesions and dental infections

• Dosage:• Capsule – 100mg to 200mg 2x/day

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Additional Herbs Found In Many Anti-Parasitic Formulas

• Thyme oil – decreases growth rate of parasites

• Oregano oil – resets microbial environment

• Cayenne – does not directly kill parasites, but helps to create an environment not conducive for their survival. Also, increases effectiveness of other herbal remedies.

• Pumpkin seeds – mostly an antihelmintic. Active ingredient is Curcubitin which paralyzes the worms so they can’t hold onto the intestinal wall.

• Grapefruit seed extract

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Paracid Forte

BioMatrixOne.com

• 1 capsule 2x/day –beginning.

• 1 capsule 3x/day –moderate infections.

• 2 capsules 3x/day –significant infections. 10

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GI-Micro-X

DesignsForHealth.com

Supplement Facts

Serving Size: 1 capsule

Amount Per Serving

% Daily Value

Tribulus Extract (Tribulus terrestris) (aerial) [standardized to contain 40% steroidal saponins]

200 mg *

Sweet Wormwood Extract (Artemisia annua) (leaf) [standardized to contain 10% artemisinin]

150 mg *

Magnesium Caprylate (yielding 100 mg caprylicacid; 10 mg magnesium)

150 mg *

Berberine Sulfate (from Berberis aristata) (root) 100 mg *

Grapefruit Extract (Citrus paradisi) (seed) 100 mg *

Barberry Extract (Berberis vulgaris) (bark) [standardized to contain 6% berberine]

50 mg *

Bearberry Extract (Arctostaphylos uva ursi) (leaf) [standardized to contain 20% arbutin]

50 mg *

Black Walnut Extract (Juglans nigra) (hull) 50 mg *

Dose similar as Biocidin or Paracid Forte

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USP Effectiveness Testing of Biocidin®

Demonstrates inhibitory activity of against both gram positive and gram negative bacteria, yeast and fungus.

Bilberry extract, Grape Seed extract, Milk Thistle, Echinacea, Goldenseal, Shiitake, White Willow, Garlic, Black Walnut (hull and leaf), Raspberry, Fumitory, Gentian, Noni, Tea Tree oil, Galbanum oil, Lavender oil, Oregano oil

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Biocidin

Biocidin.com

• 1 to 2 capsules two to three times daily:• 1 capsule 2x/day – beginning

• 1 capsule 3x/day – moderate infections.

• 2 capsules 3x/day –significant infections.

• Ideally, use until symptoms clear.

• Typical duration is 4 to 6 weeks.

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BioBotanicalResearch.com – found withinDocument Section for Module #2

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Suggested Botanical Treatment Options

• Giardia – 1 to 2 capsules – two to three times daily for 4 to 6 weeks.

• Cryptosporidium - 1 to 2 capsules – two to three times daily for 4 to 6 weeks.

• Blastocystis hominis – 1 to 2 capsules – two to three times daily for 4 to 6 weeks.

• Dientamoeba fragilis – 1 to 2 capsules – two times daily for 2 to 4 weeks.

• Entamoeba histolytica – refer to infectious disease specialist or initiate appropriate antibiotic regimen.

• Non-pathogenic Parasites – 1 capsule – two times daily for 2 weeks.

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Dietary Considerations

• Avoid: sugar, processed foods, artificial ingredients, excess dairy and meat.

• Include:

• High fiber foods

• Gentian, ginger and garlic

• Cayenne

• Blackberries, pineapple and papaya

• Raw cabbage and pumpkin seeds

• Coconut oil

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Bowel Detoxification

• Option – to initiate after treatment course for parasitic infection.

• Maintenance frequency – at least twice yearly

• Need to use herbs to stimulate peristalsis, e.g. Senna, Cascara sagrada.

• Need to use herbs and fiber to bind toxins:• Diatomaceous earth

• Bentonite or pyrophyllite clay

• Activated charcoal

• Fiber

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BioBotanical Research – Comprehensive Cleansing Program – Biocidin.com

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HerbDoc.com

Bowel, Liver and Kidney Detoxification Packages

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Parasite TreatmentsPrescription Antibiotics

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• According to the CDC, the clinical significance of B. hominis is controversial so treatment needs to be correlated clinically with the patient.

• Antibiotic options include:• Metronidazole (Flagyl) – 250mg to 750mg 3x/day for 7

to 10 days.

• Metronidazole (Flagyl) – 1500mg orally once daily for 7 to 10 days.

• Trimethoprim (TMP)/sulfamethoxazole (SMX), also known as Bactrim:• 6 mg/kg TMP, 30 mg/kg SMX once daily for 7 days

• 320mg TMP, 1600 mg SMX once daily for 7 days

• 160 mg TMP, 800 mg SMX twice daily for 7 days

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• Nitazoxanide (Alinia):• Adults (and children 12 years and older), 500 mg

nitazoxanide orally twice daily for 3 days.

• Children (4 years to 11 years), 200mg orally twice daily for 3 days.

• Children (1 year to 3 years), 100mg orally twice daily for 3 days.

• Alina oral suspension comes in 100mg/5ml

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• Metronidazole (Flagyl) - 250mg to 750mg 3x/day for 5 to 7 days.• Pediatric – 15mg/kg/day – divided dosages daily for 5 to 7

days.

• Tinidazole (Tindamax) - 250mg to 500mg 3x/day for 7 to 10 days.• Acute: Flagyl or Tindamax – 2000mg as a single dose

(adults). Use 500mg single dose for 2 years to 14 years old.

Giardiasis

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Giardiasis






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Cryptosporidiosis






• Paramomycin – 30mg/kg/day in 3 divided dosages for 10 days.

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•Metronidazole (Flagyl) - 250mg to 750mg 3x/day for 10 days, OR

• Tinidazole (Tinidamax) - 250mg to 500mg 3x/day for 10 days

Followed by:

• Paromomycin - 30mg/kg/day in 3 divided dosages for 10 days.

Be cautious about just treating with herbs or other supplements alone for this particular parasite. This is one

particular parasite that should likely be treated with antibiotics.

Amebiasis (E. histolytica)

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Others (Iodoamoeba, Endolimax, etc.)

• There are no established protocols specifically for these “other” non-pathogenic parasites.

• If going to use antibiotics than Metronidazole (Flagyl) or Nitazoxanide (Alinia) in their standard dosing similar to Giardia lamblia or Blastocystis hominis is most often sufficient.

• Dientamoeba fragilis – antibiotic dosing same as Giardia or Blastocystis hominis usually sufficient.

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Final Suggestions

• It is suggested to follow prescription antibiotics and botanical treatment with probiotic supplementation, at least 20 to 40 billion organisms twice daily for 4 weeks.

• Repeat testing of stool pathogen screen should be done 2 weeks after completion of antibiotic prescription or botanical course of treatment.

• Stopping other supplements such as diatomaceous earth, bentonite or pyrophyllite clay, and activated charcoal is important too so as not to interfere with stool specimen analysis.

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Gain access to comprehensive testing including Organic Acid, Comprehensive Digestive Stool Analysis, Adrenal Hormone, Hair,

Amino Acid, etc.

• All tests kits sent to your home or office• No doctor visit needed for ordering• Each lab reviewed personally by integrative medicine doctor• Written lab review provided with recommended action steps based on lab test markers• Access to professional line supplements

www.labtestsplus.com for a complete list of lab tests available

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Topic• The Organic Acids Test and Evaluation for Candida

Metabolic Toxicity:• In-depth analysis of candida toxicity and why a

practitioner cannot solely rely on stool or blood testing for the detection of chronic candida.

• Correlating findings on the Organic Acids Test to those on a stool pathogen screen and/or comprehensive digestive stool analysis.

• Treatment options and protocols using prescription antifungals and natural remedies, including treatment approaches for mild, moderate and severe candida overgrowth.

Module #3

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Thank YouKurt N. Woeller, D.O. & Tracy Tranchitella, N.D.

GIMasteryCourse.com

[email protected]

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