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March 14, 1977

Giardiasis: Manifestations and Diagnosis

JAMA. 1977;237(11):1078. doi:10.1001/jama.1977.03270380022008

To the Editor.—  In response to the case report by Paine and Gluck (236: 2425, 1976) regarding an extensive and expensive evaluation that failed to demonstrate a case of intestinal giardiasis, I would like to wholeheartedly endorse the routine use of the Enterotest string for sampling of duodenal contents in such instances.1 With the contamination of the headwaters of the Salmon River here in Idaho, clinical symptoms of giardiasis have developed in a number of tourists and locals alike who ingested unpurified stream water, and it has become routine in our clinic to use this method of examining duodenal contents on all patients who are seen with abdominal bloating and foul diarrhea. We have uncovered at least 20 cases of giardiasis in the last year that otherwise would have gone undiagnosed had only stool samples been tested. The Enterotest is easily tolerated, we have had no patient failures, and