الفهرس 
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Abstract
Chronic or recurrent abdominal pain is the commonest gastroenterological complaint the physician is confronted with in his outpatient clinic.
Intestinal symptoms with parasitic infections are frequent and include abdominal pain. The common intestinal parasites that may give rise to chronic digestive disorders as persistent diarrhea, chronic abdominal pain and/or blood in the stool are protozoa as Balantidium coli, Blastocystis hominis, Cryptosporidium spp., Cyclospora cayetanensis, Dientamoeba fragilis, Entamoeba histolytica, Giardia intestinalis (syn.: G. lamblia and G. duodenalis) and Isospora belli, or helminthes as Ascaris lumbricoides, Capillaria philippinensis, Diphyllobothrium spp., Hymenolepis spp., hookworm (Ancylostoma duodenale and Necator americanus), Taenia spp., Trichuris trichiura, intestinal flukes.
Our study aims to detect the presence of intestinal parasite infection in both healthy normal subjects and patients with chronic abdominal pain.
This study was conducted on 150 subjects, their ages ranged between 12 to 90 years. After signing a written consent, all subjects were subjected to clinical assessment, stool analysis for the presence or absence of intestinal parasite infection, blood sample and abdominal ultrasound.
Subjects in this study were categorized into 2 groups:
• Group1: 130 patients with chronic abdominal pain (80 males and 50 females).
• Group2: 20 healthy controls (13 males and 7 females).
Intestinal parasites were detected in 76% of patients with chronic abdominal pain and 60% of controls. The results of the present study revealed that the prevalence of intestinal parasite in patients with chronic abdominal pain was higher in the rural areas (67.69%) than in urban areas (8.46%). Neither of the studied special habits nor sex were risk factors for intestinal parasite infection.
Intestinal parasites are associated with other gastrointestinal symptoms as anorexia (36.92%), flatulence (31.54%) and diarrhea (30.77%).
In our study 10.66% of patients were diabetic and 81.25% of them had positive stool findings. The most common parasites were Entamoeba histolytica in 69.23% patients, followed by Giardia lamblia in 15.38% patients and H.nana in 15.38% patients.
Anemia and eosinophilia are major laboratory findings in patients with positive stool analysis for intestinal parasites.
The most common intestinal parasite associated with anemia were Giardia lamblia followed by Entamoeba histolytica while the most common intestinal parasite associated with eosinophilia were Entamoeba coli and Taenia saginata followed by Enterobius vermicularis and Ancylostoma duodenale.
In conclusion:
Intestinal parasites are common both in patients with chronic abdominal pain and in apparently healthy controls. The most common parasites are Entamoeba histolytica cyst followed by H. nana. Diabetes mellitus is commonly associated with intestinal parasites mostly Entamoeba histolytica and Giardia lamblia. Anemia and eosinophilia are common in these patients and if found in asymptomatic person should direct the physician towards repeated stool examination and upper gastrointestinal endoscopy if needed.
Recommendation
• We recommend:
1. Improving personal and environmental hygienic measures.
2. Regular screening and treatment for parasitic infections.
3. More studies on larger number of patients in rural and urban areas of Egypt.
4. If anemia and/or oesinophilia were accidentally discovered in asymptomatic person we should do repeated stool examination and may even ask for upper gastrointestinal endoscopy looking for Ancylostoma duodenale or Giardia Lamblia.