Problems in distinguishing between the two conditions:
(1) both may present with similar clinical findings
(2) both may look similar on endoscopy
(3) serum antibody to Entamoeba has limited use for diagnosis of a patient living in a country where the disease is endemic
Ozin et al found that almost one third of patients with ulcerative colitis in Turkey were coinfected with Entamoeba histolytica.
Recommendations:
(1) Testing should include antigen testing in addition to stool for ova and parasites. Multiple specimens taken on different days should be evaluated.
(2) A patient presenting for the first time with apparent ulcerative colitis should be tested for Entamoeba histolytica if the person has lived in or recently traveled to a region where amebiasis is endemic.
(3) A patient with ulcerative colitis should be tested for Entamoeba histolytica if there is an apparent increase in disease activity.
(4) Aggressive therapy with corticosteroids in a patient with ulcerative colitis should be avoided until amebiasis has been excluded.
