My understanding is that Nanavira Thera committed suicide in 1965 (aged 45 years) due to having having painful amoebiasis and a nervous disorder. If this is incorrect in any way, please correct.
Amoebiasis is an infection of the large intestines caused by Entamoeba histolytica, a single-celled parasite.
What is going on in the body?
The large intestine, or colon, is infected after cysts are eaten. The parasite can then invade the colon, causing it to become inflamed.
What are the signs and symptoms of the infection?
The illness may produce no symptoms at all, or may produce only very mild ones. The symptoms may be so vague, they are not noticed, and may include:
episodes of diarrhoea and constipation
flatulence, or excess gas
abdominal distress, which may include cramping abdominal pain
mucous and blood in the stool
What are the causes and risks of the infection?
Direct transmission of amoebiasis occurs through contact with infected stool. The infection is also a sexually transmitted disease, particularly among male homosexuals. Fruits and vegetables can be contaminated when they are grown in soil fertilised by human stool, washed in polluted water, or prepared by someone who is infected.
Amoebiasis is more common and more severe in subtropical and tropical areas. It occurs more often when living conditions are crowded, sanitation is poor, and nutrition is inadequate.
What can be done to prevent the infection?
A person should eat only food that is unlikely to be contaminated, especially when traveling to tropical regions. This means keeping to food that is well cooked and water that is bottled. Practicing safer sex will also help prevent the spread of amoebiasis.
How is the infection diagnosed?
Amoebiasis is usually identified by examining the stool. Several samples may need to be tested. Antibody titre blood tests may also be ordered.
What are the long-term effects of the infection?
A very severe amoebiasis infection can lead to perforation or rupture of the colon. Rarely, the infection involves other organs in the body, such as the liver, brain, or lung.
What are the risks to others?
Someone who excretes cysts into his or her stool puts others at risk for amoebiasis. Careful hand-washing and good sanitation help prevent the spread of this infection.
What are the treatments for the infection?
Medications such as ioloquinol, paromomycin, and diloxanide are used to kill the parasites in the intestines. Other medications, such as metronidazole, may be used to kill the organisms that have invaded the tissue. Surgery may be needed for complications like perforation of the bowel.
What are the side effects of the treatments?
Side effects depend on the medication used. Metronidazole often causes nausea, vomiting, and diarrhoea. Surgery carries a risk of bleeding, infection, and allergic reaction to anaesthesia.
What happens after treatment for the infection?
Amoebiasis is usually cured with medication, and the person can go back to normal activities.
How is the infection monitored?
Stool samples are examined 1, 3, and 6 months after treatment to be sure the person is free of the parasite. Any new or worsening symptoms should be reported to the doctor.
Author: Danielle Zerr, MD
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
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