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.