Not your average diarrhoea
- 40 year old male
- Progressive watery diarrhoea, 8-10 episodes per day for 6 months
- No associated symptoms
- No mucus or blood in stool
- No weight loss
- No history of travel
- Strong alcohol history (Stopped 3 years ago)
- No past medical or surgical history
- No previous chronic diarrhoea
- No other family members affected
- FBC, LFT, Alb, TFT, CRP normal
- HIV negative
- Faecal elastase normal
- Stool MCS normal
- Colonoscopy normal – random biopsies taken
- Histology revealed spirochetosis
- Flagyl 400mg three times daily for 14 days
- Excellent response with normalisation of stool frequency within 7 days
Spirochetosis: An overview
- Borrelia eurygyrata, Brachyspira aalborgi, or Serpulina pilosicoli.
- Genetically unrelated to nonintestinal spirochetes, such as Treponema pallidum.
- Patients may be asymptomatic or present with watery diarrhoea, weight loss, abdominal pain and rectal bleeding.
- Treatment is with Flagyl 400mg tds x14 days