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Giardia species (most commonly G. lamblia) are protozoal microorganisms found in water and can cause watery and foul smelling diarrhea. In addition to diarrhea, abdominal pain with abdominal fullness with flatulence is common. Giardia produces a physical barrier to absorption of luminal contents by coating the small bowel lumen. The histologic findings are of mild to moderate villous blunting and increased inflammatory cells in the lamina propria. Sometimes, the binucleate trophozoite forms of the organisms can be seen near the luminal surface.

This patient also had Helicobacter pylori gastritis, see Related Content.

Helicobacter pylori is a gram-negative microorganism that affects 50% of the world population. H. pylori gastritis is an infection of the stomach that can lead to multiple consequences including increased risk of gastric and peptic ulcers, gastric adenocarcinoma and gastric lymphoma. The stomach is an acidic environment and H. pylori attempts to counter this harsh environment by producing ammonia through the activity of urease enzyme. Moreover, H. pylori also burrow into stomach mucous and preferentially colonize the stomach antrum in order to avoid stomach acid and the acid producing parietal cells. In this patient, the medications have reduced the gastric acidity, thus H. pylori readily colonizes the acid producing oxyntic mucosa of the stomach.

The histologic features of both acute and chronic gastritis can be seen. The H. pylori organisms can also be seen on both H&E sections, and using special stains.

This is an H&E stain; see Related content for Warthin-Starry stain. This patient also had duodenal giardiasis (see slide in Related Content).

Helicobacter pylori is a gram-negative microorganism that affects 50% of the world population. H. pylori gastritis is an infection of the stomach that can lead to multiple consequences including increased risk of gastric and peptic ulcers, gastric adenocarcinoma and gastric lymphoma. The stomach is an acidic environment and H. pylori attempts to counter this harsh environment by producing ammonia through the activity of urease enzyme. Moreover, H. pylori also burrow into stomach mucous and preferentially colonize the stomach antrum in order to avoid stomach acid and the acid producing parietal cells. In this patient, the medications have reduced the gastric acidity, thus H. pylori readily colonizes the acid producing oxyntic mucosa of the stomach.

The histologic features of both acute and chronic gastritis can be seen. The H. pylori organisms can also be seen on both H&E sections, and using special stains.

This is an Warthin-Starry stain; see Related content for H&E stain. This patient also had duodenal giardiasis (see slide in Related Content).