Amoebiasis

The parasite is passed in the stool of an infected person as tiny hardy forms called cysts. You become infected by swallowing cysts in food or water contaminated with stool, for example unwashed raw vegetables or fruit, untreated water, or food handled with unwashed hands. It can also spread through close contact with an infected person when hand washing is poor.

The infection is more common in places where sanitation and clean drinking water are limited, and among people who travel to or live in such areas. Many infected people never become ill. Severe disease is much less common than mild or silent infection.

Pilgrims and travellers, and people returning from countries with limited sanitation, should be careful with water and raw foods, and should seek medical advice for diarrhea that is bloody or lasts more than a few days.

Your doctor will ask about travel, water and food exposure. Stool tests look for the parasite or its genetic material or proteins; sometimes several samples are needed because the parasite can be missed. Blood tests can show antibodies, which help especially when a liver abscess is suspected, and ultrasound or CT scan can show a liver abscess. Colonoscopy is not usually needed but may be used if the diagnosis is unclear, and it can look like inflammatory bowel disease, so correct diagnosis matters before starting steroid treatment.

Good hygiene prevents spread and re-infection.

• Wash hands with soap and water after using the toilet and before preparing or eating food.

• Rest and drink plenty of fluids while you have diarrhea.

• Avoid preparing food for others until your doctor confirms you are no longer infectious.

• Do not share towels, and clean toilet surfaces regularly during the illness.

Food does not cure the infection, but it helps you stay hydrated and comfortable.

• Drink safe water, and use oral rehydration solution if you have watery diarrhea.

• Eat small light meals as tolerated; return to a normal diet as you recover.

• Wash raw vegetables and fruit well with safe water, or peel them.

• When travelling to areas with poor sanitation, drink bottled or boiled water and avoid ice of unknown source.

Amoebiasis needs prescription medicines. Do not treat it yourself.

• Your doctor will prescribe an anti-parasitic antibiotic that acts in the tissues, followed by a second medicine that clears parasites from inside the bowel.

• Finish the full course even if you feel better.

• Some of these medicines cause nausea or a metallic taste, and alcohol should be avoided while taking them; ask your doctor or pharmacist.

• Do not take anti-diarrhea medicines such as loperamide unless your doctor says so, as they can make bloody infection worse.

Your doctor decides the medicines and duration. Tell them if you are pregnant or breastfeeding.

Most people do not need a procedure.

• A liver abscess that is large or does not improve with medicines may need to be drained with a needle or small tube guided by ultrasound or CT.

• Surgery is rarely needed and is reserved for severe bowel complications such as perforation.

• Colonoscopy may be used to confirm the diagnosis in unclear cases.

With proper treatment most people recover fully. Treatment usually has two steps: a medicine to kill parasites in the bowel wall and tissues, followed by a second medicine to clear parasites remaining in the bowel. Liver abscess also generally responds well to medicines, sometimes with drainage. Re-infection is possible if exposure continues.

• Which test confirms that I have amoebiasis and not another bowel disease?

• Do I need the second medicine to clear the bowel?

• Should my family members be tested?

• When is it safe to return to work or to prepare food?

• How can I avoid getting it again when I travel?

This guide comes from the Saudi Gastroenterology Association (SGA) patient library, prepared by the Approved for publication by SGA; individual clinician review is ongoing. Last reviewed: 2026-04-24. It is for education and does not replace your doctor's advice.