Q. What is the best course of action for IBS-D with high blastocystis hominis?

Answered by
Dr. A V Hussain Shihaz
and medically reviewed by Dr. Vinodhini. J
Published on Jan 13, 2020

Hello doctor,

I was diagnosed with IBS-D five years ago. This month tests have identified high levels of blastocystis hominis in my stool as well as yeast and imbalance in gut flora. I am traveling away and I am wondering what the best course of action for me is?

I have done comprehensive stool analysis and recent full blood test.

Dr. A V Hussain Shihaz

Medical Gastroenterology
#

Hi,

Welcome to icliniq.com.

Blastocystis hominis does not usually require treatment unless there is a co-pathogen (they were none found in your stool study) or if the individual is immunosuppressed.

The other issue is your SCFA (short-chain fatty acid) and but the rate are a bit on the lower side. How was your IBS-D (irritable bowel syndrome with diarrhea) diagnosed? Was it after a colonoscopy, and checking celiac disease antigen as well as stool calprotectin level?


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Thank you doctor,

Yes, I understand that however, within the literature there are heavy links of blastocystis with IBS, so I would like to try and irradicate the parasite to see if symptoms improve if possible. I never had a colonoscopy but multiple fecal calprotectin and celiac tests returned normal. I was told I have post-infectious IBS that would clear up in time, it has not for five years. The people who ran the test told me SFCAs are probably low due to the lack of Lactobacillus present. Is it true? How would I go about returning my gut flora species to normal? Do probiotics do this?

Dr. A V Hussain Shihaz

Medical Gastroenterology
#

Hi,

Welcome back to icliniq.com.

The link between blastocystis hominis, though linked with IBS the evidence is not strong and has been conflicting with the equal number of studies coming up with no association. In view of the above, there is no clear consensus to treat.

I would not advise treatment, also due to the fact that a course of antibiotics could worsen your gut bacterial flora. I would suggest you increase on yogurt in your daily diet and also have a course of probiotics, preferably VSL3 capsules twice a day after food for two weeks.


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Thank you doctor,

Yes, I was looking to avoid antibiotics and go with Oregano oil which has been shown to be effective. Would this be suitable alongside the probiotics you recommend?

I have been suffering for five years and have intermittently tried probiotics. Sorry if I seem dismissive I am just desperate to improve my condition. I have heard good things about VSL3 so I will try to get hold of some.

Dr. A V Hussain Shihaz

Medical Gastroenterology
#

Hi,

Welcome back to icliniq.com.

Yes, antibiotics would not be a great idea right now. There are no known adverse interactions between Oregano oil and VSL3, so you can go ahead with it.


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