Giardiasis other diagnostic studies

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Yazan Daaboul, M.D.; Serge Korjian M.D.

Overview

No other tests are required for the diagnosis of giardiasis. Other diagnostic studies may include the entero-test (string test), D-xylose absorption test for patients with giardiasis-related vitamin B12 deficiency, and esophagogastroduodenoscopy with small bowel biopsy for patients who are suspected to have giardiasis despite negative lab findings or patients who remain symptomatic after adequate therapy.

Other Diagnostic Studies

No other tests are required for the diagnosis of giardiasis. Other diagnostic studies may include the following:

Entero-test (string test)

• The string test may detect parasites (Giardia and other parasaites) in the duodenum.
• The patient remains NPO (nothing per os) for at least 12 hours, then swallows a gelatin capsule that contains a nylon spring and a weight.
• The end of the string is taped to the patient's cheek or the back of the neck.
• Four to six hours later, the string is retrieved. Strings with bilious staining suggest successful passage of the capsule into the duodenum.
• Once the string is retrieved, it is examined within one hour for the detection of parasites.

D-xylose Absorption Test

• The test may be used among patients with vitamin B12 deficiency due to giardiasis.

Esophagogastroduodenoscopy (EGD) and Small Bowel Tissue Biopsy

• Reserved for patients with high suspicion of giardiasis who were undiagnosed by other methods and for patients who remain symptomatic despite therapy.
• Biopsy may be remarkable for the presence of lymphocytic infiltration, villous atrophy and shortening, and detection of the organism (parasitic trophozoites).