Giardia, Entamoeba, Cryptosporidium and Shigella
(Shigella is a bacterium and the others are protozoa)
 The vast majority of enteric infections are passed through
contaminated water and food via fecal-oral contact (poor hand
washing, river water, etc.).
 Sexually transmitted enteric infections are passed through
contact with the anus (feces) through oral-anal sex or
“rimming”. The microscopic organism must be ingested in
order to infect.
 Often asymptomatic, but symptoms can include: diarrhea,
abdominal cramps, bloating, fatigue, and weight loss.
 Infection is usually self-limiting unless the person is HIV coinfected
– then the infection is more serious and prolonged.
 Curable with specific medications.
V. Douching
 Several recent studies reveal that women who douche get more PID
than women who do not douche.
 Women who douche also are more likely to get Bacterial Vaginosis
(BV), a common sexually associated vaginal infection.
 Experts in women’s health recommend that women do not douche.
 Although more research needs to be done on the effects, anal
douching, enemas, or colonics are not recommended.
 People who receive anal sex and want to douche anally, using only
water is one form of risk reduction.