Worm infestations

Worm infestationsorhelminthiasis- parasitic diseases with primary damage to the digestive organs. Helminths, parasitic worms, can live in many parts of the gastrointestinal tract (gastrointestinal tract), incl. in the large intestine, in the rectum. Diagnosis and treatment of colonic manifestations of helminthic infections are carried out jointly by doctorsparasitologistIcoloproctologist.

Helminthiasis infection is characterized by the following features:

• chronic course, in which nutrients and protective forces are gradually depleted;
• the body is more often attacked by hookworm, roundworm, toxocariasis, trichocephalus;
• Pathology is studied and treated not only in pediatrics and therapy, but also in gastrology, surgery, dermatology, allergology and other fields.

The disease affects a small percentage of the country's population, but tends to spread in areas with poor infrastructure and health development.

Causes and mechanism

Helminths that parasitize the large intestine are represented in three classes:

1. Roundworms (nematodes): roundworms, pinworms (enterobiasis), whipworms (trichocephalosis), eelworms (strongyloidiasis), hookworms, toxocaras.
2. Tapeworms (cestodes): broad tapeworm, beef and pork tapeworm.
3. Butterflies (trematodes): schistosomes.

The majorityhelminthscomplex development cycle. Between eggs and adults there are intermediate stages: larvae, cystic forms (cysts or fins). Worm eggs are resistant to adverse conditions and can survive for a long time in soil and water. They enter the human body through raw water, unwashed hands, fruits and vegetables contaminated with soil.

Young children are more susceptiblehelminthiasisdue to the habit of putting hands and foreign objects in the mouth. Animals are often carriers of helminths. Meat, fish, shellfish contain eggs, larvae or fins. Such food, raw or insufficiently thermally processed, also serves as a source of infection.  

Parasites cannot exist in the aggressive acidic environment of the stomach. But their shell is resistant to the action of gastric juices. In addition, the presence of helminths in food in the stomach is short-lived. And then, together with the food bolus, they move to the intestines, where the life cycle continues with the formation of adults.  

More favorable conditions for the life of helminths are created in the small and large intestine. The environment is weakly alkaline, there are a lot of food residues, and the mucous membrane is abundantly supplied with blood. Numerous adaptive mechanisms (hooks, suckers, developed muscles) help the worms to stay in the lumenGastrointestinal tract, they attach to the intestinal mucosa and do not come out with the feces.

Their presence in the large intestine leads to local inflammatory processes - typhlitis, colitis, sigmoiditis, proctitis. In the process of life they are releasedtoxins. Many of them are strong allergens.  

Some of the parasites penetrate the pancreatic duct system, biliary tract and liver, causing damage to these organs. In addition, the larvae of numerous helminths are able to pass through the intestinal wall. With the flow of blood and lymph, they enter the muscles, lungs, eyes and brain and cause damage to these organs.

Classification of helminthiasis

Depending on belonging to the group, the following types of parasitic infection are distinguished:

• cystodoses – echinococcosis, taeniasis, taeniarynchiasis;
• nematodes – trichocephalosis, ascariasis, necatoriasis;
• Trimatodes – opisthorchiasis, fascioliasis.

Division of parasites depending on the way they survive in the environment:

• helminths;
• biohelminths;
• contact helminths.

Classification depending on the way of spread in the host:

• water;
• food;
• percutaneously.

There are 2 types of parasites depending on the area of distribution.

1. Intestinal form. They enter the host's body through the oral cavity, gradually spreading down the gastrointestinal tract. The permanent habitat is the intestines. These parasites include jakeloidiasis, hookworm and taeniasis.
2. Extraintestinal forms. Penetration can also develop through the gastrointestinal tract, but then the parasites migrate through the intestinal walls to other organs. For example, blood vessels, subcutaneous fat, liver, brain. Opisthorchiasis, fascioliasis and trichinosis have this property.

Extraintestinal forms are considered the most dangerous;

Symptoms

Helminthiasis can be asymptomatic for a long time. After that, non-specific symptoms of intestinal disorders appear:

• nausea;
• decreased appetite;
• aching or cramping pain in the abdomen;
• flatulence;
• flatulence;
• diarrhea, constipation, their change.

A recognizable symptomenterobiasis: itching, burning in the anus, in the perianal area. This symptom is due to the fact that she is a sexually mature femalepinwormscomes out and lays eggs. It mostly happens at night.

If the flow is unfavorable, the lumen of the intestine can become clogged with worms. In these cases, a typical clinical picture of mechanical intestinal obstruction occurs with severe abdominal pain, bloating, repeated vomiting, retention of stool and gas. The obstruction is complicated by peritonitis with an extremely severe general condition of the patient.  

Extraintestinal disorders include:

• headaches;
• weakness, reduced performance;
• changes in the emotional background: depression, irritability, insomnia;
• emaciation
• pale skin, skin rash, pallor and dryness of visible mucous membranes;
• dry cough;
• frequent colds;
• occurrence and frequency of bronchial asthma attacks;
• bruxism – teeth grinding during sleep;
• muscle and joint pain.

These symptoms are caused by organ and tissue damage, intoxication, immunodeficiency, allergies and vitamin deficiency. If helminthiasis is not diagnosed, it is associated with other causes.

Diagnostics

Diagnosisit is diagnosed on the basis of laboratory tests of blood and stool. A general blood test reveals a decrease in the level of hemoglobin and red blood cells. The level of eosinophilic leukocytes is elevated. That should be taken into accountanemiaand eosinophilia are characteristic of other diseases, and therefore only indirectly indicate helminthiasis.

Blood immunodiagnosis is aimed at detecting specific antibodies against parasite tissues. Be sure to examine the stool for hidden blood and worm eggs. To diagnose enterobiosis, a scraping is performed from the perianal area. Use a cotton swab or adhesive tape to scrape. Damage to the intestinal mucosa is diagnosed by endoscopic methods - sigmoidoscopy, colonoscopy.

There are additional diagnostic tests that help determine the type of pathogen, the area of its spread and the extent of damage:

• skin allergy test with the addition of helminth antigen;
• Ultrasound of the abdominal organs with assessment of the condition of the intestines, liver, spleen, pancreas;
• fibrogastroduodenoscopy - visual examination of the upper parts of the digestive tract by introducing a certain device through the oral cavity;
• colonoscopy - visual examination of the walls of the large intestine by inserting a probe with a camera;
• endoscopic biopsy – removal of a section of tissue during an endoscopic examination followed by microscopy and histological analysis;
• radiography or CT of internal organs with the addition of contrast to evaluate the morphological properties of the tissue, detect foreign elements and determine the integrity of the walls;
• liver scintigraphy - the introduction of a radiotracer that accumulates in the liver and emits radiation displayed on the monitor (the morphology, size, location of the organ, the presence or absence of defects can be assessed).

Research methods are prescribed depending on the symptoms that appear and the doctor's suspicion of the degree of spread of helminthiasis.

Treatment

Helminthiasisare treated with drugs. Depending on the type of parasite, the course of treatment is developed using specific onesanthelminticdrugs. Many of them additionally strengthen the immune system. Along with specific treatment, patients take vitamin-mineral complexes and digestive enzymes. Maximum attention is paid to personal hygiene. In case of intestinal obstruction, urgent surgery is necessary.

In severe cases, it is not enough to use drugs to treat helminths. It is better to use products with a special focus against a certain type of parasite:

• anticystic;
• antinematodes;
• anti-trematodes;
• a wide spectrum of activity against different groups of parasites.

In addition to specific treatment, it is necessary to prescribe symptomatic drugs to eliminate manifestations caused by helminths:

• antibacterial drugs with an additional complication of the condition activated by the pathogenic microflora of the digestive tract;
• sorbents that envelop and remove the products of helminth intoxication before they are absorbed into the systemic bloodstream;
• enzymes that improve the digestive process, especially if helminthiasis is complicated by diarrhea;
• probiotics - use is mandatory when anthelmintic and antibacterial drugs are used to restore the normal state of the intestinal microflora;
• cardiac glycosides for complications of helminthiasis with cardiovascular pathologies;
• non-steroidal anti-inflammatory drugs to suppress the active inflammatory process caused by parasites;
• glucocorticosteroids prescribed for the activation of the immune system and the development of acute allergic reactions.

Surgery is considered the last method of treatment. It is prescribed for complications. For example, when parasites move from the intestine to other organs.

Prevention

To prevent the penetration of helminths into the human body, it is recommended to take the following actions:

• frequent washing of hands and food before consumption;
• maintenance of basic personal hygiene;
• use of antiglycemic drugs for animals;
• thermal processing of meat and fish;
• preventive use of antihelminth drugs, especially if characteristic symptoms appear or the patient is at risk.

Prevention methods reduce the risk of helminth infection, but cannot completely eliminate it. Therefore, doctors recommend periodically donating feces for analysis.

Forecast

The prognosis depends on the following factors:

• type of parasite;
• helminth distribution area;
• degree of intoxication;
• complications on internal organs and systems.

A timely detected and treated parasitic infection guarantees a positive prognosis. If the therapy is carried out in the early stages, complications will not develop. If it is absent or incorrectly prescribed, pathologies begin to develop that worsen well-being. In more severe cases, the abdominal and thoracic organs are damaged, and the infection can spread all the way to the brain. Such pathologies worsen the quality of life and can cause incapacity for work. Possible death due to the development of anaphylactic shock and helminthiasis of the central nervous system. Therefore, timely diagnosis is important in this case.