Why do Blastocystis patients kill themselves?

Last year, someone relayed an account to me about several Blastocystis patients who had committed suicide after a lengthy illness, and multiple attempts to treat it. Many patients find the severe fatigue, diarrhea, pain, and other symptoms too much to deal with.

If you're a US physician reading this, I'm sure you're thinking that Blastocystis infection can't get that severe, and the patients must had some other disease. That's what has been taught in some US medical schools. But that information doesn't match what's reported in peer reviewed medical literature. In fact, most of what is taught in the US appears to be based on 3 or 4 studies performed in the US in the 1980's and early 1990's by health care workers with no background in infectious diseases or parasitology. In the mid-1990's, the field started attracting higher quality researchers, the observational and anecdotal studies disappeared, and have been replaced by studies which resemble those performed to assess the impact of other infectious diseases.

But US medical schools don't want to hear that, so we're stuck with a 1993 view of the world, which means many doctors have no idea of what they are dealing with, and even if they do, they are getting little support in how to manage the infection clinically. These people had seen some of the best gastrointestinal specialists in the world -- Blastocystis infection was their only problem.

In the US, most of the country's medical research spending goes into research for AIDS and cancer. People with these diseases want to live. In fact, when cancer patients "beat cancer", they now go onto write books, appear on talk shows, producing standing ovations in the crowd when they recount their personal struggle. According to doctors, Blastocystis patients just have a little diarrhea. And many of them don't even have that. So why are they killing themselves?

Theory #1: Nobody wants to have permanent diarrhea Many Blastocystis patients wind up with severe diarrhea - as frequently as 20 times per day. In this state, it is difficult to hold down a job, or do anything productive. Others also have severe fatigue on top of that. So even if the diarrhea is controllable, the fatigue can make it difficult to participate in any meaningful human activity.

Based on the most recent studies from multiple sites, most people with what Western doctors called "irritable bowel syndrome" (IBS) are infected with Blastocystis. And researchers have been following the suicidal habits of IBS patients for some time. IBS patients report a lowering in their quality of life that is similar to that reported by patients with congestive heart failure. And they contemplate suicide, and engage in suicidal acts three times more often than their healthy counterparts. So one possibility is simply that Blastocystis infection lowers the quality of life of patients to the point that they do not want to keep on living.


Theory #2: Societal attitudes toward illness. Scientists studying Blastocystis infection have trouble understanding why the medical community is making such a big deal about treating it. From the viewpoint of a lab, the organism is no different from a half-dozen other intestinal protozoa that we treat all the time, like Giardia, E. hisolytica, and D. fragilis. The major difference appears to be that Blastocystis is more difficult to treat, so doctors would have to use different drugs, or prescribe them for a longer period of time.

Faced with this situation, many doctors in the 1990's simply stated that Blastocystis patients have irritable bowel syndrome (IBS). IBS represents the only case where an infectious disease was first treated by doctors, and then redefined as a "syndrome." As Blastocystis spread, and more patients developed IBS, researchers sought an explanation for why so many individuals would show up at the doctor's office with a syndrome.

Their answer is called "learned illness behavior." The current theory, fully supported by research grants from the NIH, states that people who have Blastocystis infection are not really sick. Rather, they are perfectly healthy, and they choose to have diarrhea, severe fatigue, and other symptoms because (and I am not making this up) they like going to the doctor.

It isn't unusual for society to attack individuals with an infectious disease. In the Middle Ages, infectious diseases were considered a judgment from God. If you got sick with a disease, it was a punishment for wrongdoing. Other primitive societies considered sick people to be bad omens. One would have hoped that with the development of the microbial theory of disease, these attitudes would have faded, but they haven't. In fact, the NIH has done more to stigmatize patients with Blastocystis infection than any other organization in the world.

According to microbial research, if an individual in a family develops diarrhea and other symptoms, others may develop the same symptom due to "contagion." The new NIH indicates that microbes don't really cause these symptoms, but they are rather the personal choice of the sick individual, who choose to be sick because they get benefits from this. If you watch Oprah, you will see how similar this is to New Age thought, in the form of the book called the "Secret", which teaches that people who do positive things live positive lives, while negative things happen due to people's negative attitudes. So how does the NIH explain contagion in a family? Their research called this "Learned Illness Behavior." That is, children develop diarrhea and other symptoms after their parents, because they see their parents being sick, and decide this is such a great thing, they should be sick too (really, I'm not making this up).

As such, you see that cancer patients have a different reception from Blastocystis patients, and this may explain the difference in suicide rates. Cancer patients get support from the community, their families, and physicians. Blastocystis patients are told they are making up the symptoms to avoid work or get some kind of benefit. That is, they are weak, despicable people, and their disease is their own fault. So many of them kill themselves.

Theory #3: Organic Causes. Blastocystis and other gastrointestinal protozoal infections are different from viral and bacterial infections, in that they don't usually cause symptoms by "attacking" the host. Chronic illness is produced when these organisms turn off specific host immune responses. One of the side effects of turning off certain immune responses is that others kick in, and some of these can cause substantial organic changes to a patient's physiology. And these changes can produce neurological and psychiatric symptoms. As such, a third reason that Blastocystis patients kill themselves may be because they develop psychiatric disease as a result of their infection.

Because Blastocystis infection rates have increases in some states substantially over the last 15 years, we can look to see if suicide rates have risen along with that. In Oregon, this has certainly been the case. In the early 1990's, the Blastocystis infection rate measured in West Coast labs was less than 2.5%. It rose to over 20% by 2000, and now is in the 10-20% range, as measured from Oregon's Public Health Laboratory. Oregon's suicide rate kept pace with this change, and is now among the highest in the nation.

So why do Blastocystis patients kill themselves? There may be several reasons, or a combination of reasons. Societies can be judged by how they treat their most vulnerable citizens, and what the medical community in the US is doing to Blastocystis patients today is unforgivable.

References:

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