It was Christmas Eve. I just assumed I’d eaten too much. It was a mistake to cook that Mexican feast. My brother and his partner enjoyed it and so with some trepidation. I stuffed my tortillas with salsa, onions, squash, chorizo and mashed black beans and enjoyed a generous glass of marguerita. And even though I was full, I forced down a generous slice of Christmas pudding with fresh cream and brandy butter.
I went to bed with it all sitting in my stomach. By morning it was still there and unusual for me, my bowels had seized up. A run in the park is usually guaranteed to make me feel better, but not this time. After no more than 200 yards, I felt spasms of nausea. I couldn’t even face a swim in the river. Berating myself for being a pig, I trotted back home, but couldn’t eat a thing. I just sipped lemon in hot water and fell asleep in the chair while Christmas went on around me.
That night, I lay awake with a very bloated stomach, but I couldn’t be sick. Belching relieved some of the discomfort but the gas tasted and smelt awful. Eggy burps! What did that mean? No gastric acid! Cramps in my stomach flickered like lightning accompanied by dark rumbles of flatulence and spasms of diarrhoea with mushy stools that would not flush away.
I’ve always tended to analyse my own symptoms. These seemed to point to an overgrowth of bacteria in the stomach and small intestine with excessive fermentation and malabsorption. But why should I have bacterial overgrowth? And why now? If it was something, I’d eaten, why did nobody else have the same symptoms?
Boxing Day started bright and cold. I went for a walk. In Millers Dale, a sea of mist tumbled over the ash trees on the slopes and The Salvation Army played carols from the farm opposite. I still had no appetite for food, but picked at the cold turkey and vegetables, which left me bloated again. A tentative glass of wine gave me a headache.
The next day, despite another uncomfortable night, I was a little better. In the evening I enjoyed a small portion of risotto with lemon and smoked salmon. I was still very windy at night, but the eggy burps had gone and with them the nausea, bloating and abdominal cramps, and I could detect the sharp taste of acid.
A few days later, I met Susie in the village and told her I’d had a stomach bug over Christmas. She was in no doubt. ‘Why do you have to swim in the river with all that crap from the farm when you have a lovely clean pool nearby?’ I explained about the invigorating properties of cold water swimming. She was unsympathetic, but she’d got me thinking. I knew that most enteric bacteria will not survive such cold water, but Giardia lamblia is a ubiquitous parasite that can be passed from sheep to man and can survive for months in cold water by encapsulating itself in cysts which break open when swallowed by a new host. Giardia causes malabsorption, diarrhoea and a lot of fermentation. It must also inhibit acid secretion. With no acid, the way is clear for a variety of fermentative organisms, similar to those that occupy the colon, to colonise the stomach and small intestine and generate a lot of bloating and gas.
Giardia was the first animicule that Antonin van Leeuwenhoeck, the inventor of the microscope, spotted in a suspension of his own stool. It can occasionally contaminate water supplies, has been responsible for several large urban outbreaks of gastroenteritis and is still a hazard for trekkers swimming in ponds or rivers and drinking from streams. In America, Giardiasis is know as Beaver Fever as it contaminates beaver pools. Without reinfection, the most severe symptoms can clear within a few days or weeks without antibiotics. I didn’t go for a prescription. I am well, albeit rather loose – no change there, then! I wash my hands a lot, but have not put on the weight I lost at Christmas. Two years later, a routine blood test has revealed I am deficient of vitamin B12.