Intestinal worms are parasites. In other words, they live in the digestive tract of other organisms, at their expense. We also talk about “intestinal parasites“. The most common worms in France, especially among children, are pinworms. More rarely, tapeworms, roundworms and liver flukes are found. Good hygiene makes it easy to avoid them and limit their spread.
Pinworm, tapeworm, roundworm… What do intestinal worms look like?
- The most encountered worms, but also the most benign, are pinworms. We then speak of pinworms. These small white worms are between 5 and 10 mm long. They are very common in children, and very contagious. Contamination occurs by ingesting eggs while bringing food, objects or soiled hands to the mouth. The eggs hatch in the intestine. The worm reaches its adult size in 3 weeks, during which time it has had time to migrate to the rectum. Each female worm lays about 10,000 eggs in the anal margin, usually at night.
- Another worm, roundworm. It can measure up to 15 cm and colonizes the small intestine, where it feeds on the intestinal contents. We are talking about ascariasis. In France, it is generally imported by travellers.
- the tapewormbetter known as tapeworm, can measure up to 8 meters in length. Widespread, it can be very discreet. Like all worms, it enters the body through the digestive tract. There are two species of tapeworm: that of beef (taenia solium) and that of pork (taenia saginata). Note: the body of tapeworms is made up of a series of rings of about 3mm by 2cm, which detach and fall regularly in the stool. They can also be found in underwear.
- Finally, the liver fluke is a small worm, less than 2 centimeters, in the shape of an amphora, which settles in the liver (as its name suggests).
Other parasites exist, but are rarer, such as theechinococcosis (linked to animal parasitic worms), fox tapeworm (contracted after eating wild berries contaminated with infested urine) or the dog tapeworm (linked to the ingestion of eggs after stroking the coat of an infected dog).
pinworm is often asymptomatic, but can cause:
- abdominal pain,
- anal itching, especially at bedtime and at night
- episodes of diarrhea,
- vulvar irritation, even cystitis in little girls.
Tapeworm may be responsible for abdominal pain, whether or not associated with weight loss. As mentioned before, its presence is noticed thanks to the white segments that can be found in the underwear or in the stool.
Ascaris, it is the cause of various symptoms:
- a persistent cough;
- abdominal pain;
- vomitings ;
- weight loss.
liver fluke usually causes hepatomegaly (enlargement of the liver), accompanied by pain in the right ribs. Jaundice is sometimes observed accompanied by fever.
What complications after an infestation?
The main complications caused by an infestation of intestinal worms are deterioration in general condition, if the problem is not addressed. Liver flukes can lead to more serious complications, particularly in the bile ducts.
How is the diagnosis made?
During the medical consultation, the doctor examines the anal area, looking for lesions and mobile white grubs. The associated symptoms also help guide the diagnosis. If in doubt, a scotch-test may be prescribed, especially in the case of pinworms: it consists of sticking an adhesive tape on the folds of the anus to collect eggs. Said tape is then attached to a microscope slide to be analyzed in the laboratory. When the doctor suspects another intestinal parasitosis, he can prescribe other tests:
- a parasitological examination of the stool, to look for the presence of eggs. For this, a sample of the patient’s stool is collected;
- a blood test ;
- an abdominal ultrasound.
The pinworms. The females come to lay their eggs in the evening, around the anus. By scratching, the victim self-contaminates again when she brings her fingers to her mouth. In the meantime, she lays eggs – which can survive nine days in the open air – on all the objects she touches.
Tapeworms. They cling to the intestinal wall thanks to their head equipped with suction cups and hooks. Small flat segments (or rings) 3 mm wide and 1 to 2 cm long contain eggs. When these segments detach, they fall out with the stool and contaminate various animals, such as freshwater fish, cattle or pigs. The larvae from the eggs then encyst in the muscles of the animals, and pass through the digestive tract of humans when they consume meat that has not been cooked enough.
Roundworms. As for other worms, the females lay eggs, evacuated by the stools, which, for lack of hygiene, can be found on other food and perpetuate the cycle of contamination.
Liver flukes are mainly caught when eating watercress or other wild lettuces. They settle in the liver, but most often infest animals. Man is an accidental guest.
Prevention relies on hygiene
To prevent intestinal worms, nothing beats impeccable hygiene:
- always wash your hands after going to the toilet, before eating or preparing a meal;
- change underwear daily;
- avoid sharing bath linen or underwear;
- regularly wash children’s sheets and toys;
- rinse vegetables and fruits thoroughly before consuming them;
- sufficiently cook meat and fish;
- avoid swallowing water when swimming in the sea, in a swimming pool or elsewhere;
- deworm your pets regularly.
For each parasite, its treatment. But the priority is to avoid the spread around the infected person. For this, hygiene measures must accompany the taking of medication:
- wash hands and nails very regularly;
- change underwear every day;
- sleep in pajamas and wash night clothes regularly;
- Wash sheets at 60°C during and after each treatment.
- clean personal and shared items;
- wash bedroom floors, school tables (in case of school contamination).
The treatment is based on a single dose offlubendazoleor albendazoleto renew three weeks later, when the eggs have hatched. Note: itching in the anus may persist for several days after taking the medication, but this does not mean that the treatment has failed.
To get rid of it, the doctor prescribes two chewable tablets of niclosamide in the morning on an empty stomach to be renewed two hours later. The wearer then expels the worm whole or in pieces.
To eradicate these undesirable worms, the doctor will prescribe a three-day treatment based on flubendazole or treatment withalbendazole
Liver fluke treatment
The treatment of liver fluke is based on the prescription of praziquantel.