Chronic schistosomiasis and strongyloidiasis mimicking irritable bowel syndrome over multiple decades: A case report.

Chronic infections caused by Strongyloides stercoralis and Schistosoma spp. can present with longstanding gastrointestinal symptoms that mimic irritable bowel syndrome (IBS). In this case report, we describe a patient who was misdiagnosed with IBS for several decades before receiving a definitive diagnosis of chronic helminthiasis. Treatment with first-line antihelminthics resulted in complete and sustained resolution of symptoms. We review the life cycle, epidemiology, clinical presentations, diagnosis, and management of chronic helminthiases in the context of IBS. We further discuss the impact of misdiagnosis on both the patient and the healthcare system. Given the significant individual and economic burdens of IBS and the diagnostic uncertainty associated with low sensitivity of standard diagnostic tests for helminth infections, healthcare professionals should maintain a low threshold for testing and empiric treatment in patients with relevant travel and medical history.