Irritable bowel syndrome and chronic fatigue 3 years after acute giardiasis: historic cohort study

Setting Waterborne outbreak of giardiasis in the city of Bergen, Norway.

Participants 817 patients exposed to Giardia lamblia infection verified by detection of cysts in stool samples and 1128 matched controls.

Main outcome measures IBS and chronic fatigue.

Results The prevalence of IBS in the exposed group was 46.1%, compared with 14.0% in the control group, and the adjusted RR=3.4 (95% CI 2.9 to 3.8). Chronic fatigue was reported by 46.1% of the exposed group and 12.0% of the controls, the adjusted RR was 4.0 (95% CI 3.5 to 4.5). IBS and chronic fatigue were associated and the RR for the exposed group of having a combination of the two outcomes was 6.8 (95% CI 5.3 to 8.5). The RR was also increased for having just one of the two syndromes, 1.8 for IBS (95% CI 1.4 to 2.3) and 2.2 for chronic fatigue (95% CI 1.7 to 2.8).

Conclusions Infection with Giardia lamblia in a non-endemic area was associated with a high prevalence of IBS and chronic fatigue 3 years after acute illness, and the risk was significantly higher than in the control group. This shows that the potential consequences of giardiasis are more serious than previously known. Further studies are needed, especially in areas where giardiasis is endemic.

http://gut.bmj.com/content/early/2011/08/31/gutjnl-2011-300220.abstract

That's interesting since the most painful symptoms I have ever had were bowel cramps which began soon after the birth of my first child.  The diagnosis began with giardia on my newborn son, myself and my Mother who came up to visit (but Mum believes it was the food she ate while traveling home).  Later I was diagnosed with both irritable bowel syndrome and Crohn's disease but I complained about fatigue so much that the physicians were puzzled.  Later on in life there is no sign of active Crohn's via colonoscopy, the irritable bowel and cramps remain but not as severely and the number of prolonged flu-like illnesses increased until they have become continuous.  The malaise and sore glands I now associate with a chronic fatigue syndrome which is better described as myalgic encephalomyelitis.  I wonder if giardia lamblia started it all.  The fibromyalgia pre-dated the giardia.

The Birthday Boy is 32

He was working door-to-door making leads for the sale of solar panels and he had already voiced concerns about working for them but had I known he was going to quit on his birthday, my pre-birthday trip to Maroochydore to see him would have taken place more appropriately on the 19th instead of the 18th.  Un-be-known to me, it had been a Connor weekend but he had been picked up early and I arrived not long after 12.30pm on Sunday 18th armed with a Tiramisu torte bought at the Cheesecake Shop and his birthday card and birthday cash. We decided to lunch at the Maroochy Surf Club because he was a member there however he seemed to have some concern that he should be going to the RSL because he had not been since Remembrance Day.  I am not sure what that was about and I was not really sure what his concerns were about his job (which I guess he had for about a month) but he was not happy working with someone who was toothless among other things.  I could tell it was stressing him.  So I am not surprised that he quit the next day (his birthday) because I more or less told him to do what was best for his peace of mind with the benefit of past experience and hindsight.  He seems very happy with everything else which includes his living arrangements and his studies.  He is on Austudy again so he does not "have to" get a job.  He calls his house a "safe" house because it is blue and yellow and we know how important colours are to this one.

One of them in the house, Pete, owns this huge Home Theatre set up and on the coffee table were the laptops belonging to he and Chris I presume.  It seems to be a house of study with books next to each laptop.  S seems to have claimed the kitchen table for his study spot.

His bedroom

Everything was in pretty good order (better than my place) except for a toilet that smelt like "men".

I waited around while S got spruced up which gave me a chance to reduce my heart rate.  I was going beep, beep just with the effort of getting out of the car and the greetings which meant that I had hit at least 107 bpm.    I try to stay under that, the theory being that it will prevent post-exertion exhaustion (officially called neuroimmune exhaustion) but it was going to be difficult because I deliberately had stopped taking the beta blocker - Metoprolol that day so that I could enjoy my outing beyond Caloundra without feeling like a zombie.  Even some round-abouts set off the heart-rate monitor while I was driving.

Once we got to the surf club and found a place where we were both comfortable (which took a while because I could see S was not entirely happy now we were here) out on the verandah where it was not so packed with people.  We had a beer each.  He had another with lunch and we were both happy to sit and look at the ocean views and all the people.  It was a warm day but it was hazy because of local burning off all around the Coast.  And we didn't win the raffle for a Plasma TV :(

*********************

The Blue Bar

S felt like going for coffee somewhere else.  We ended up at the Blue Bar which was not the place to choose as it turned out so we were not there long.  When we got back to the house, Pete was home and I was introduced before I had even appeared at the door but from the moment I was there until the moment I left again to come home, he did not make eye contact.  He was mumbling about having trouble recording a TV show and did not stop once to say "How do you do?".  So I figured S maybe would not stand out so much in this household.  I did not meet Chris.  I called into pick up my Avon ordered in 2010 from Brenda's place on the way home and ended up staying for a coffee.  I am not impressed that she has not been able to deliver it herself in all those months especially since she has a customer in Pelican Waters.  But she said that she usually has Sharon with her and that they are going shopping.  The colloidal silver I also had ordered then is probably out of date but it is supposed to be a good mouth wash for some problems and I was having that burning mouth going on all that time I could have used it.  Seems I am complaining.  I had no intention of it when I started writing.

Anyway the real birthday was yesterday and it is then that I found out that S was quite keen on repeating the  Mum visiting experience and I felt OK first thing that morning so we were planning an outing to the beach - Sunshine Beach because he likes it there.  It became pretty obvious as I tried to get ready that I was already paying for doing too much on Sunday so I had to cancel for the sake of not sinking too low and having to claw my way back out a bit at a time.  I knew that it would not be until today that I knew the full effect of Sunday's bi-annual outing.  Yes I am not particularly well right now and in a lot more pain but I have not sunk too low to get out of with a few restful days.  Whether I weather the dentist on Thursday as well I cannot say because I will have to wait until Saturday to know.

I have been on the verge of getting better for a while now.  It has been totally spoiled by the fatigue caused by the beta blockers and I have been feeling quite depressed while on them too.  I have been upset by the death of Karla's boy Jamie as well.  I didn't feel well enough to deal with it for Karla's sake and as usual I was too upset to go to a funeral and be on public display crying.  So I could have let Karla down which did not make me like myself much either.  I did keep in touch enough to make sure she had family around her.  We have since had a picnic lunch.  Karla is fine.  Jamie's presence is gone and she is going out every day.