Giardiasis in childhood and its effects on the small intestine.

The effects of Giardia lamblia on small bowel function were studied. Thirty-three asymptomatic children were studied before and after treatment with metronidazole (Nimorazol). Patients had a small intestinal biopsy, bile salt determinations, and the following absorptive tests: D-xylose, triglyceride, and lactose and sucrose tolerance tests. Before treatment, 87% had unconjugated bile salts in duodenal fluid but afterwards only 60% did. Small bowel biopsy changes did not correlate with the pre- and posttreatment periods. Triglyceride absorption showed significant differences between patients at different periods of the study; D-Xylose absorption did not reveal differences between the periods of the study but was significantly impaired when compared with controls. Lactose malabsorption was detected in 56% and sucrose in 7% of the patients. G. lamblia may have some pathogenic role, although nonspecific to intestinal function. It probably acts more in a synergistic way with other pathogenic agents that inhabit the intestinal lumen of children living under unfavorable conditions producing the picture of tropical enteropathy.