Review Article of Open Journal of Gastroenterology and Hepatology
Inflammatory bowel disease and amebiasis
Sanyour Joyce1, Nakhoul Mary1, Saniour Philippe2, Abou Rached Antoine1
1Lebanese university, school of medicine, Hadath, Beirut
2Saint Joseph Hospital, Dora, Beirut
Amebiasis affects around 500 million people in the world. Clinical manifestations of intestinal amebiasis can overlap with symptoms of the inflammatory bowel disease (IBD). Many studies evaluated the relationship of IBD patients during exacerbation periods and amoebic colitis as it is important to rule out the infection before starting steroids and/or immunosuppressive treatment.
This mini-review focused on the best strategy to diagnose the infection in this specific population, using classical stool analysis for ova and parasites, serology, investigations by PCR and colonoscopy according to the degree of clinical suspicion.
It also suggested an algorithm for management approach where patients were divided into asymptomatic carriers vs. symptomatic patients under 5 ASA or immunosuppressive therapy having either a vegetative or cystic form of the infection. All these patients were treated accordingly by intraluminal agents, and nitroimidazole was added in the vegetative form. 5-ASA was not a contraindication for treatment, while immunosuppression is forbidden until after eradiation of EH.
Amoebic infection should always be ruled out before starting treatment with steroid or immunosuppressive medications, in order to minimize its deleterious outcomes on IBD patients.
Keywords: Inflammatory bowel disease, amebiasis, review
How to cite this article:
Sanyour Joyce, Nakhoul Mary, Saniour Philippe, Abou Rached Antoine. Inflammatory bowel disease and amebiasis. Open Journal of Gastroenterology and Hepatology, 2019, 2:12. DOI: 10.28933/ojgh-2019-08-0205
1. Babić E, Bevanda M, Mimica M, Karin M, Volarić M, Bogut A, et al. Prevalence of amebiasis in inflammatory bowel disease in University Clinical Hospital Mostar. SpringerPlus [Internet]. 2016 Sep 15 [cited 2018 Aug 20];5(1). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5025403/
2. Begum S, Quach J, Chadee K. Immune Evasion Mechanisms of Entamoeba histolytica: Progression to Disease. Front Microbiol [Internet]. 2015 Dec 15 [cited 2018 Aug 20];6. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4678226/
3. Kalkan IH, Dağli U. What is the most accurate method in the diagnosis of amebic dysentery? Turk J Gastroenterol Off J Turk Soc Gastroenterol. 2010 Mar;21(1):87–90.
4. Vrolijk JM. Amoebic Enterocolitis Mimicking Crohns Disease – Case Report. J Gastrointest Dig Syst. 2016 Apr 29;6(2):1–2.
5. Chaturvedi R, Gupte PA, Joshi AS. Fulminant amoebic colitis: a clinicopathological study of 30 cases. Postgrad Med J. 2015 Apr;91(1074):200–5.
6. Chan KL, Sung JY, Hsu R, Liew CT. The association of the amoebic colitis and chronic ulcerative colitis. Singapore Med J. 1995 Jun;36(3):303–5.
7. Guuml, Akarsu lay A, Karahan ZC, Araz RE, Ccedil, Guuml I, et al. Investigation of Entamoeba histolytica and Mycobacterium spp. in biopsy specimens of patients with inflammatory bowel disease in Turkey. Afr J Microbiol Res. 2011 Apr 18;5(8):888–92.
8. Al-Rwi LIF, Alakori MMH, Abdulghafour KH. Prevalence of Entamoeba Histolytica infection in patients with colitis (Ulcerative and Infective). J Fac Med Baghdad. 2016;6.
9. Ustun S, Dagci H, Aksoy U, Guruz Y, Ersoz G. Prevalence of amebiasis in inflammatory bowel disease in Turkey. World J Gastroenterol WJG. 2003 Aug 15;9(8):1834–5.
10. Colonic perforation due to invasive amebic colitis during anti-TNF therapy for spondyloarthritis [Internet]. [cited 2018 Aug 20]. Available from: http://www.scielo.br/scielo.php?pid=S0482-50042014000600483&script=sci_arttext&tlng=en
11. Genome-Wide Association Study Reveals Genetic Link Between Diarrhea-Associated Entamoeba histolytica Infection And Inflammatory Bowel Disease | bioRxiv [Internet]. [cited 2018 Aug 20]. Available from: https://www.biorxiv.org/content/early/2017/05/12/137448
12. Fotedar R, Stark D, Beebe N, Marriott D, Ellis J, Harkness J. Laboratory Diagnostic Techniques for Entamoeba Species. Clin Microbiol Rev. 2007 Jul 1;20(3):511–32.
13. Addib O, Ziglam H, Conlong P. Invasive amoebiasis complicating iflammatory bowel disease. Libyan J Med. 2007 Dec 1;2(4):214–5.
14. Rectal and colonic mucosal biopsy findings and faeces, sigmoidoscopy, and histopathological correlation in amoebiasis and other colitis. [Internet]. [cited 2018 Aug 20]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1552629/
15. Diagnosis and Management of Amebiasis | Clinical Infectious Diseases | Oxford Academic [Internet]. [cited 2018 Aug 20]. Available from: https://academic.oup.com/cid/article/29/5/1117/337264
16. Ozdoğan M, Küpelioğlu A. Crohn’s colitis perforation due to superimposed invasive amebic colitis: a case report. Turk J Gastroenterol Off J Turk Soc Gastroenterol. 2006 Jun;17(2):130–2.
17. Fulminant Amebic Colitis after Corticosteroid Therapy: A Systematic Review [Internet]. [cited 2018 Aug 20]. Available from: http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0004879
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