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Blastocystis  is a prevalent enteric protozoan that infects a variety of vertebrates. Infection with  Blastocystis  in humans has been associated with abdominal pain, diarrhea, constipation, fatigue, skin rash, and other symptoms. Researchers using different methods and examining different patient groups have reported asymptomatic infection, acute symptomatic infection, and chronic symptomatic infection. The variation in accounts has lead to disagreements concerning the role of  Blastocystis  in human disease, and the importance of treating it. A better understanding of the number of species of  Blastocystis  that can infect humans, along with realization of the limitations of the existing clinical laboratory diagnostic techniques may account for much of the disagreement. The possibility that disagreement was caused by the emergence of particular pathogenic variants of  Blastocystis  is discussed, along with the potential role of  Blastocystis  infection in irritable bowel syndrome (IBS). Findings are discussed concerning the role of protease-activated receptor-2 in enteric disease which may account for the presence of abdominal pain and diffuse symptoms in  Blastocystis  infection, even in the absence of fever and endoscopic findings. The availability of better diagnostic techniques and treatments for  Blastocystis  infection may be of value in understanding chronic gastrointestinal illness of unknown etiology.

Oh my aching gut: irritable bowel syndrome, Blastocystis, and asymptomatic infection