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Amoebiasis (Zaheer-e-Sadique): Integrating Classical Unani Descriptions with Modern Insights on Epidemiology, Pathogenesis, Diagnosis, and Management – A Comprehensive Review


Authors : Dr. Syeda Ameena Tasleem; Dr. Syed Osman Pasha; Dr. Mohammed Maqbool Hussain; Dr. Juveriya Ifath; Dr. Fouzia Anjum

Volume/Issue : Volume 11 - 2026, Issue 4 - April

Google Scholar : https://tinyurl.com/bdem47nu

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DOI : https://doi.org/10.38124/ijisrt/26apr2106

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Abstract : Amoebiasis, caused by the protozoan Entamoeba histolytica, remains a significant global health burden, responsible for an estimated 50 million infections and 55,000 deaths annually, with 2.2 million disability-adjusted life-years (DALYs) lost each year. The infection is transmitted via the faecal-oral route and predominantly affects populations in low-income countries with poor sanitation, though cases are increasingly identified in high-income countries due to international travel, migration, and sexual transmission among men who have sex with men (MSM). Clinically, amoebic colitis presents with a gradual onset of bloody diarrhoea, abdominal pain, and tenesmus, closely mimicking inflammatory bowel disease (IBD). Extraintestinal manifestations, of which amoebic liver abscess (ALA) is most common, represent a significant cause of morbidity and mortality. In classical Unani medicine, this condition was described under the heading of Zaheer-e-Sadique, with descriptions by Hippocrates, Ibn-e-Sina (Avicenna), Zakariyya Razi, and Ali ibn Abbas Majusi bearing remarkable concordance with the modern clinical picture. Diagnosis relies primarily on stool Entamoeba histolytica PCR, which must be specifically requested, alongside serology, antigen detection, and, where appropriate, colonoscopy with histopathology. Misdiagnosis as IBD with inadvertent immunosuppression can result in fulminant colitis and death. Treatment requires both a tissue amoebicide (metronidazole) and a luminal amoebicide (paromomycin) to eliminate intestinal carriage and prevent recurrence. This review comprehensively addresses the microbiology, epidemiology, pathogenesis, Unani classical perspective, clinical features, diagnosis, and treatment of amoebiasis to guide contemporary clinical practice.

Keywords : Amoebiasis, Entamoeba Histolytica, Amoebic Colitis, Amoebic Liver Abscess (ALA), Zaheer-e-Sadique, Unani Medicine, Inflammatory Bowel Disease (IBD), Faecal-Oral Transmission.

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Amoebiasis, caused by the protozoan Entamoeba histolytica, remains a significant global health burden, responsible for an estimated 50 million infections and 55,000 deaths annually, with 2.2 million disability-adjusted life-years (DALYs) lost each year. The infection is transmitted via the faecal-oral route and predominantly affects populations in low-income countries with poor sanitation, though cases are increasingly identified in high-income countries due to international travel, migration, and sexual transmission among men who have sex with men (MSM). Clinically, amoebic colitis presents with a gradual onset of bloody diarrhoea, abdominal pain, and tenesmus, closely mimicking inflammatory bowel disease (IBD). Extraintestinal manifestations, of which amoebic liver abscess (ALA) is most common, represent a significant cause of morbidity and mortality. In classical Unani medicine, this condition was described under the heading of Zaheer-e-Sadique, with descriptions by Hippocrates, Ibn-e-Sina (Avicenna), Zakariyya Razi, and Ali ibn Abbas Majusi bearing remarkable concordance with the modern clinical picture. Diagnosis relies primarily on stool Entamoeba histolytica PCR, which must be specifically requested, alongside serology, antigen detection, and, where appropriate, colonoscopy with histopathology. Misdiagnosis as IBD with inadvertent immunosuppression can result in fulminant colitis and death. Treatment requires both a tissue amoebicide (metronidazole) and a luminal amoebicide (paromomycin) to eliminate intestinal carriage and prevent recurrence. This review comprehensively addresses the microbiology, epidemiology, pathogenesis, Unani classical perspective, clinical features, diagnosis, and treatment of amoebiasis to guide contemporary clinical practice.

Keywords : Amoebiasis, Entamoeba Histolytica, Amoebic Colitis, Amoebic Liver Abscess (ALA), Zaheer-e-Sadique, Unani Medicine, Inflammatory Bowel Disease (IBD), Faecal-Oral Transmission.

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31 - May - 2026

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