What is balantidiasis?

Balantidiasis is a rare intestinal infection caused by the bacterium Balantidium coli, a single-celled parasite that frequently infects pigs but on occasion (rarely) infects humans.

Some infected people may have no symptoms or only mild diarrhea and abdominal discomfort but others may experience more severe symptoms reminiscent of an acute inflammation of the intestines.

Balantidium infection in humans is rare in countries like the United States. However, balantidiasis is more common among pigs in warmer regions, and in monkeys in the tropical climates, which is why human infections are also more common in these parts of the world.

How common is balantidiasis?

Balantidiasis can affect patients at any age. It can be managed by reducing your risk factors. Please discuss with your doctor for further information.


What are the symptoms of balantidiasis?

Infection with the parasite can result in one of three manifestations:

  • Asymptomatic where the infected person does not exhibit any symptoms but excretes cyst.
  • Acute where there is inflammation of the colon (colitis) with intense symptoms such as bloody diarrhea.
  • Chronic where there are recurrent acute episodes but the patient is almost asymptomatic in between.

The common symptoms of balantidiasis are:

  • Abdominal pain
  • Diarrhea (watery or with blood or mucous)
  • Dysentery
  • Nausea
  • Weight loss
  • Vomiting
  • Headache
  • Low-grade fever
  • Loss of appetite
  • Fluid loss
  • Foul breath
  • Inflammation of the colon (colitis)
  • Presence of ulcers in the intestine
  • Perforation of the intestine (in advanced stages)

Many of these symptoms are non-specific and may be mistaken for other diseases.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.


What causes balantidiasis?

Balantidiasis is caused by Balantidium coli. The host most often acquires the cyst (the parasite stage of Balantidium coli) through ingestion of contaminated food or water. The cysts then go to their next stage: the trophozoites. Following ingestion, excystation occurs in the small intestine, and the trophozoites colonize the large intestine.

Risk factors

What increases my risk for balantidiasis?

There are many risk factors for balantidiasis, such as:

  • Close contact with pigs
  • Handling manure or fertilizer contaminated with pig feces
  • Living in areas with contaminated water supply
  • Poor nutrition
  • Absence of gastric acid (achlorhydria)
  • Alcoholism
  • Poor or weaken immune system

Diagnosis & Treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.


How is balantidiasis diagnosed?

Balantidiasis can be diagnosed with the help of following tests:

  • Lab tests: Stool samples are used to diagnose B. coli infection.
  • Colonoscopy: An endoscopic examination of the colon may be performed to obtain a biopsy sample of ulcers.

How is balantidiasis treated?

Treatment of balantidiasis aims to decrease the severity of the symptoms and to prevent complications. Patients with a weak immune system often require prolonged courses of therapy.

Medication: Antibiotics are given to kill the B. coli protozoa. Tetracycline or other alternatives like metronidazole, puromycin, iodoquinol, and nitazoxanide may be given to the patients with balantidiasis. Tetracycline kills the protozoa by inhibiting protein synthesis in their cells, whereas the synthetic drug metronidazole has efficient anti-protozoal and antibacterial action. Both drugs are frequently given to the patients experiencing diarrhea.

  • Tetracycline tablets are given for 10 days, 4 times a day, an hour before or 2 hours after meals; however, it is not recommended for pregnant women.
  • Metronidazole tablets are given for 5 days, 3 times daily.
  • Alternatively, iodoquinol tablets are given for 20 days, 3 times daily, after meals.
  • Fluid and electrolyte replenishment is recommended for patients with severe diarrhea.

Surgery: Surgery is needed in rare cases, when balantidiasis causes appendicitis. In such patients, appendix is removed in a surgical procedure called appendectomy.

Lifestyle changes & Home remedies

What are some lifestyle changes or home remedies that can help me manage balantidiasis?

The following lifestyles and home remedies might help you cope with balantidiasis:

  • Drinking and using clean water supply.
  • Maintaining hygienic living conditions.
  • Avoiding contact with pigs and fertilizer contaminated with pig feces.
  • Washing hands thoroughly with soap and warm water after using the toilet and before handling food.
  • Washing all fruits and vegetables with clean water.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

msBahasa Malaysia

Review Date: February 26, 2017 | Last Modified: April 29, 2019

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