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Generally, do not treat asymptomatic persons who excrete the organism, except to prevent household transmission (eg, from toddlers to pregnant women or to patients with hypogammaglobulinemia or cystic fibrosis) and to permit adequate treatment in individuals with possible Severely dehydrated or malnourished patients should be admitted for further care. A significant portion of patients have symptoms of lactose intolerance (cramping, bloating, diarrhea), and maintenance on a lactose-free diet for several months may be helpful. Acquired lactose intolerance occurs in as many as 20-40% of cases. If possible, treatment should be avoided during the first trimester. Mildly symptomatic women should have treatment delayed until after delivery. If treatment is necessary, paromomycin can be used as systemic absorption is poor. is found in the patient, a careful history should indicate whether this is a reinfection or a treatment failure. 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