The study aimed to explore the link between parasitic infections and the severity of ulcerative colitis (UC). 120 UC patients were divided into three groups: those without infection, those with Giardia lamblia infection treated with metronidazole, and those with Giardia infection treated with a combination of metronidazole and E. purpurea. The results revealed that patients with Giardia infections exhibited more severe UC symptoms. All groups experienced improved symptoms following treatment, but the combination therapy group demonstrated the most significant improvement. Remission rates were highest in the group without infection and the group receiving combination therapy. Additionally, the study identified E. purpurea therapy and a substantial reduction in SCCAI score as significant predictors of higher remission rates.

Inclusion Criteria:

• Ulcerative Colitis patients had active disease,
• Patients had parasitic infection by G. lambellia,
• Patients free of parasitic infection,
• Patients free of exclusion criteria..

Exclusion Criteria:

• Patients had Inflammatory Bowel Disease other than Ulcerative Colitis,
• Patients had multiple parasitic infections,
• Patients had infection by parasites other than G. lambellia,
• Patients who were maintained on immunosuppressant therapy,
• Patients who were in remission and patients refused to sign the written consent to participate in the study.