On Nutrition by Ed Blonz


DEAR DR. BLONZ: Thank you for your column on intestinal gas. There is one thing you could add that might be helpful next time the subject comes up: Some parasitic infestations cause chronic cyclical gas episodes.

As a Peace Corps volunteer in the 1960s, I was exposed to many African parasites, and brought at least one of them home. For the next 15 years, I was afflicted with periodic bouts of noxious flatulence, about two days every two weeks. I repeatedly sought medical help (and received lots of ineffective information) before I found a doctor who had experience with tropical ailments. He said, "I don't know what you've got, but Atabrine might clear it up." I took the Atabrine for a week, and it was over. Thus, with one bottle of pills, a 15-year social problem was ended.

Most likely, I learned afterward, the culprit was Giardia lamblia. This organism has become very widespread in the past few decades -- possibly due to folks like me coming home from Africa, then going backpacking in the mountains and woods.

Giardiasis is not particularly debilitating. After a single initial siege of sulfurous burping, the only long-term symptoms seem to be the periodic attacks of stinky gas. I suspect that lots of folks are living with giardia, and occasionally casually asking their doctor about it. Just as I did for a decade and a half, they are receiving suggestions to avoid beans, cabbage or processed meats. Since a bout of gas only lasts a couple of days, the "cure" seems to work, but the trouble will be back in a couple of weeks.

Atabrine, an older quinine drug, probably isn't used much anymore, but there are plenty of newer drugs that will clear giardia up quickly; the trick is finding a doctor who has experience with parasites. Since parasites in general are less common in the U.S. than in Africa, this can take a while. The worst thing that can happen is to get misdiagnosed and mistreated for something else. -- D.R., Orinda, California

DEAR D.R.: Your informative letter speaks to the necessity of seeking assistance from someone with expertise in the area of concern, and of giving your complete background to your health professionals. There is so much information available online, but that places the responsibility on us to be diligent in where and how we search. Stick with academic sites (ending with .edu) or others that rely on evidence-based medicine. I have a list of medical resources at blonz.com/med.htm that can serve as a guide.

Send questions to: "On Nutrition," Ed Blonz, c/o Universal Uclick, 1130 Walnut St., Kansas City, MO, 64106. Send email inquiries to questions@blonz.com. Due to the volume of mail, personal replies cannot be provided.