Giardiasis is caused by ingestion of G. lamblia cysts in fecally-contaminated water or food.9-15 The protozoan excysts in the low gastric pH to release the trophozoite. Colonization and multiplication of the trophozoite lead to mucosal invasion, localized edema, and flattening of the villi, resulting in malabsorption states in the host. Achlorhy-dria, hypogammaglobulinemia, or deficiency in secretory immunoglobulin A (IgA) predispose to giardiasis. Individuals with HIV infection and AIDS may have higher carriage rates than the general population. Some patients may develop lactose intolerance after chronic giardiasis.

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