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Entamoeba Histolytic, stomach cramps, diarrhea, gas troubles. Treatment options ?

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Internal Medicine Specialist
Practicing since : 2007
Answered : 362 Questions
Entamoeba histolytic question:
Hi there, I am a man, 41 years old weight: 80 kg. I am pretty sure I´ve got Entamoeba histolytic as I have discovered the same symptoms as I had 10 years ago, when I last had this infection. When I first discovered it, I felt incidents of cramps in the stomach that really hurt – some for like 1-2 minutes, diarrhea (with no fresh blood present). Now – one month later, I don’t feel too much pain, but my stomach is “blown up” and “gassy”.

I went to the doctor – who wanted me to take feces tests – as well as taking blood tests. The problem was that the test glasses for the feces I got, did not contain Formalin (so the feces tests got old and useless).

No my doctor is on holiday. And I am going to Portugal myself for three weeks. I do have a recipe for Metronidazole (500 mg x 30 pills) which was for treating another infection I had, but I never used it. I understand that this antibiotic is the most common drug used to treat this disease.

Just to prevent the possible disease from progressing – and to be on the secure side – I would like to take a cure of these tablets. I see people going to tropical areas can bring their own Metronidazole for self-treatment – if they suffer from stomach pains and so on.

But being surfing the web – I find that the treatment differs a little:
Some sites (here In Norway – recommend 2 g a day – single doze – for three days). Some sites advices on a less intense treatment – sharing the doses in smaller amount several times a day – and often for a longer period.

As I am going to holiday, next Friday, I would like to finish the cure BEFORE going, as I would like to enjoy some glasses of wine and so on (I know there could be trouble mixing alcohol with the drug)

What would you suggest - a single dose of 2g for three days? Or spreading it out on the day? I really want to stop further progress of the disease – and make a try to see if the gas problems disappear. But – on the other side – will this ruin further treatment – if this is not the disease I have – or I need a more intense treatment? I think, myself, that if you are advised to bring these tablets to tropic area – it wouldn’t hurt to give it a try? What is your opinion? Thank you in advance,

Posted Wed, 11 Apr 2012 in Digestion and Bowels
Answered by Dr. Kiran Kumar 1 hour later

Thanks for the query,

I really appreciate your patience for an elaborate explanation of your situation. I understand your concerns.

Based on your symptoms even I feel its more likely related to Amoebiasis (Entamoeba Histolytica).

The treatment of choice for Amoebiasis is Metronidazole and its group of medications (Secnidazole, Tinidazole etc)

Metronidazole is usually given thrice a day.
Its Tinidazole which recommended as 2 gms once a day for 3 days (As you have mentioned in your question).

Its advisable that you consider taking Metronidazole for a full course of 5 days as its the preferred medication. There is no dosage recommendation of taking 2 gms of Metronidazole.

Taking the medication now will not hamper your chances of treatment in future if required as some times multiple courses might be required in situations of reinfection.

You are right that in tropics, Metronidazole can be taken over the counter for presumed amoebiasis.
So there is no harm.

Take Metronidazole spread out three times a day for 5 days. Avoid Alcohol till 48 hours of finishing the course.

Hope this answers your query. Do get back if you need any further information

Dr Kiran.
Above answer was peer-reviewed by
Follow-up: Entamoeba Histolytic, stomach cramps, diarrhea, gas troubles. Treatment options ? 4 hours later
“how many mg a day of Metronidazole should I use?”. It is really urgent to get this answer, as I am going on holiday, and will start my medication-regime tomorrow.
Answered by Dr. Kiran Kumar 1 hour later
Hi and thanks again,

Here in the tropics, I would treat my patients who are diagnosed as amoebiasis clinically and by stool test positive with a course of metronidazole.

Metronidazole usually comes in 400 mgs tablet formulation. I treat my patients with this dosage in majority of cases. The frequency and duration of treatment depend on the general body weight of the patient, response to the treatment and the side effects reported. I have treated most of my patients with three times a day pills for 5 to 10 days.

The same applies to amoebiasis as well.

I encourage you to take the antibiotics under the guidance of a local physician.

Hope this answer is informative and adequate

Wish you speedy recovery.

Above answer was peer-reviewed by
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