Fecal-Oral Infections: Parasites and Pathogenic Bacteria

Fecal-oral transmission of parasites or pathogenic bacteria?

Hello Dr.
Lin, I previously inquired about chronic diarrhea and suspect that it may be due to a parasitic or pathogenic bacterial infection from an incident over three years ago when I accidentally ingested toilet water.
I would like to ask you: 1.
Does Taipei Hospital offer stool screening? 2.
Additionally, could you inform me about the possible parasites or bacteria that may be present in toilet water? If I were to undergo stool screening, what specific tests would be conducted (would it check for the presence of parasites, eggs, or pathogens in the stool)? 3.
Lastly, I would like to ask you if it is possible for parasites or bacteria to remain in the intestines or even proliferate in the body after more than three years.
You mentioned previously that the most likely cause of chronic diarrhea is due to psychiatric medication, and I am still taking these medications daily.
I apologize for the numerous questions as I am feeling quite anxious.
Thank you very much for taking the time to assist me with my inquiries.
Thank you.

Ms. Chen, 20~29 year old female. Ask Date: 2024/05/14

Dr. Lin Wufu reply Internal Medicine

1.
There are many bacteria, predominantly Escherichia coli.
2.
Parasites are typically present in individuals who have been recently infected; thus, the water in the toilet may contain parasites only if someone with a parasitic infection has used it (parasites cannot survive long in toilet water).
Our feces naturally contain bacteria, and if you are truly concerned, you can test for parasite eggs in the stool for confirmation.
3.
The vast majority of parasites cannot reproduce on their own within the human body, so even if one becomes infected, the parasites will eventually die off.
A few parasites that can reproduce may be reintroduced into the mouth through one's hands, but if proper hygiene practices are followed, the likelihood of this occurring is very low.

Reply Date: 2024/05/14

More Info

Understanding fecal-oral infections, particularly those caused by parasites and pathogenic bacteria, is crucial for maintaining gastrointestinal health. Your concerns about potential infections from accidentally ingesting contaminated water, such as toilet water, are valid and warrant a thorough understanding.

1. Fecal Testing Availability: Most hospitals, including Taipei Hospital, typically offer stool testing services. These tests can help identify the presence of parasites, bacteria, and other pathogens that may be causing gastrointestinal symptoms such as chronic diarrhea. It's advisable to contact the hospital directly or visit their website to confirm the specific tests they provide and how to arrange for a stool sample collection.

2. Potential Contaminants in Toilet Water: Toilet water can be a reservoir for various pathogens, including bacteria like Escherichia coli (E. coli), Salmonella, and Shigella, as well as parasites such as Giardia lamblia and Entamoeba histolytica. These organisms can cause gastrointestinal infections leading to symptoms like diarrhea, abdominal pain, and nausea. The risk of infection largely depends on the hygiene practices in the area and the presence of these pathogens in the environment.

3. Stool Testing Parameters: When undergoing stool testing, the laboratory typically checks for the presence of parasites (including eggs), pathogenic bacteria, and sometimes viruses. Common tests include:
- Ova and Parasite Examination: This checks for the presence of parasites and their eggs.

- Bacterial Culture: This identifies pathogenic bacteria that may be present in the stool.

- Stool Antigen Tests: These tests can detect specific pathogens like Giardia or Cryptosporidium.

- Fecal Occult Blood Test: This checks for hidden blood in the stool, which can indicate various gastrointestinal issues.

4. Persistence of Pathogens: Regarding your concern about whether parasites or bacteria could still be present in your intestines after three years, it is possible but not common. Most acute infections resolve within weeks to months, especially with proper treatment. However, some parasites, like Giardia, can persist if not adequately treated. Chronic infections can lead to ongoing gastrointestinal symptoms. If you suspect a lingering infection, it is essential to consult a healthcare provider for appropriate testing and treatment.

5. Impact of Psychiatric Medications: You mentioned that you are currently taking psychiatric medications, which can sometimes affect gastrointestinal motility and function. Medications such as antidepressants and antipsychotics can lead to side effects like constipation or diarrhea, which may complicate the clinical picture. It’s crucial to discuss these symptoms with your prescribing physician, as they may need to adjust your medication or provide additional support for your gastrointestinal health.

In summary, if you suspect a fecal-oral infection due to past exposure, it is advisable to pursue stool testing to identify any potential pathogens. Understanding the risks associated with contaminated water and the specific organisms that may be present can help you take preventive measures in the future. Additionally, maintaining open communication with your healthcare provider about your ongoing symptoms and medication can lead to better management of your overall health.

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