Ascariasis In Adults - What Are The Symptoms And Treatment? What To Do?

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Ascariasis in adults: symptoms and treatment

What is Ascariasis?

Ascariasis is a type of helminthiasis caused by roundworms belonging to the nematode class, the Ascarididae family (roundworms). They parasitize in the intestines of humans and animals. According to the US Centers for Disease Control and Prevention (CDC), 807-1.2 billion people worldwide suffer from ascariasis ^[1].

There are several types of these parasites that infect various vertebrates: cats, dogs, birds, pigs. Basically, they are selective about the choice of the main host, preferring only a certain species and not affecting other animals. The species Ascaris lumbricoides (human roundworm) parasitizes only in the human body, where it can live from one to two years.

The main place of life of ascaris is the small intestine. At the same time, the worms do not have any scolex-type devices that allow them to attach to the intestinal walls. In order to stay in the intestines, the adult roundworm has to constantly make movements in the direction opposite to the movement of the food bolus. This helminth cannot be found alive in the feces. Only dead individuals or eggs laid by female roundworms get there. Reproduction begins only when sexually mature females and males are present in the intestines. Individuals of the same sex are not capable of reproduction, most often they exist in the human body until the natural end of their life. Such cases are rare, since with a mass invasion there is no shortage of both sexes.

In countries with high sanitary and hygienic standards and an excellent level of development of medicine, the incidence of ascariasis is significantly lower than in developed countries, where even clean water and quality food are lacking. Most often, children from 3 to 7 years old are infected with this parasitic infection. This age group is not characterized by a sufficiently careful adherence to hygiene requirements, children wash their hands from time to time, often eat poorly washed fruits and vegetables, and play with animals.

The manifestations of ascariasis most often disturb patients during the migration of larvae and adults throughout the body. The existing symptoms depend on the stage of parasitic invasion and the location of the helminths. Most often, the invasion manifests itself in the form of disturbances in the normal functioning of the digestive system (due to the vital activity of adults), and the respiratory system (where the larvae migrate).

Ascariasis in most cases does not lead to deaths, although disorders in the human body can result in dangerous complications. Most often, this development of events threatens children and adults with weakened immunity.

Read more: structural features of the roundworm / diagram of the development of the life cycle of the roundworm

Content:

• Who is Ascaris?
• Ascariasis symptoms
• Complications of ascariasis
• Causes of infection with ascariasis
• Diagnosis of ascariasis
• Treatment of ascariasis
• What doctor treats ascariasis?
• Treatment of ascariasis during pregnancy
• Prevention of ascariasis

Who is Ascaris?

Ascaris is a worm, Ascaris Lumbricoides, which belongs to the roundworm group. The length of females can reach 40 cm, and the length of males is 25 cm, the width of individuals ranges from 4 to 6 cm. The tail of the males has a characteristic bend towards the abdomen. Ascaris color is white-pink or yellow-pink, spindle-shaped. Ascaris eggs can be found in soil, in water, on plant products. The method of transmission of parasites is oral-fecal (through water, soil or food seeded with worm eggs).

Ascaris larvae enter the human body if the rules of personal hygiene are not followed. The disease manifests itself in an increase in body temperature to high levels, in general malaise, in a persistent dry cough, in disruption of the gastrointestinal tract, in allergic reactions. To identify parasitic infestation, feces must be taken for eggs of worms, auxiliary methods are a general blood test, serological samples. Adult roundworms are often detected by taking x-rays of the lungs and intestines.

How many roundworms live in the human body?

Ascaris live in the human small intestine. They are held in it due to constant movement in the direction opposite to the movement of food. Together with feces, ascaris eggs and dead individuals are excreted outside. The parasite lives in the human body from one to two years, then it dies from old age. Individuals of both sexes most often grow in the intestines during infection.

What do Ascaris eggs look like in feces?

Ascaris eggs in the feces are difficult to see with the naked eye, since their size does not exceed 0.05-0.07 mm. They can be round or oval. If the helminth egg is not fertilized, then its shape will be incorrect. The egg has a dense shell of even layers. Eggs can only be viewed under a microscope. In the feces, they will appear after about 2-3 months from parasite infestation.

How many eggs do Ascaris lay daily?

Every day, mature ascaris lays more than 200,000 non-invasive eggs in the human intestine. They, together with feces, are released into the external environment. After entering the soil, under favorable conditions, the eggs acquire the ability to cause disease two weeks later.

Ascariasis symptoms

Ascariasis in an adult who does not have severe chronic pathologies can be asymptomatic for a long time. Such signs of ascariasis, such as belching, heartburn, indigestion, pain in the intestines ^[2], can be attributed by patients to violations of the usual diet or diet. The reason for this carelessness lies in the fact that ascariasis does not have specific symptoms inherent only in this disease. In most cases, it has to be differentiated from other disorders of the digestive system.

The manifestations of the symptoms of ascariasis depend on the stage of the disease and concomitant pathologies. Distinguish between the early stage of helminthiasis (migratory), and late (intestinal). The migratory phase lasts for 2-3 weeks, while the larvae migrate with blood flow through the liver and lungs. The intestinal phase lasts a year or more, as long as the roundworms are in the patient's small intestine.

In which organs do the symptoms of ascariasis occur?

Most of all, the small intestine suffers from ascariasis, where sexually mature individuals feed and reproduce. However, the complex developmental cycle of this parasite forces them to penetrate both the respiratory and circulatory systems. Ascaris larvae are here for a short time compared to the intestinal phase of the disease.

Organs that roundworms can get into during massive invasion:

• The intestine throughout its entire length, including the cecum and appendix;
• Pancreatic ducts;
• Stomach and esophagus (briefly)
• Gallbladder and common bile duct (bile ducts);
• Lungs;
• Liver;
• A heart.

In other organs, finding roundworms is not typical for this type of helminths. In such cases, they form cavities like abscesses. Such formations do not grow and cannot be destroyed on their own. They are not dangerous, since in them the roundworm larvae cannot develop into an adult.

Symptoms of ascariasis in the migration phase

Symptoms of ascariasis are most often manifested in the gastrointestinal tract and respiratory system. Helminths damage the tissues of the lungs and intestines, and also cause allergic manifestations. The time of manifestation of symptoms depends on the concentration of ascaris in the human body. Invasion with a small number of roundworms causes blurred, mild symptoms (fatigue, weakness, decreased performance) or does not provoke any manifestations at all.

Symptoms of ascariasis with massive invasion:

• Cough - can be dry and moist, have different intensity, contain mucous sputum in the discharge, sometimes streaks of blood. It appears due to damage to lung tissue when larvae move from the pulmonary capillaries to the alveoli.
• Pain in the chest of moderate intensity - caused by the movement of larvae, as well as the temporary disconnection of the lung lobe from the respiratory process.
• Shortness of breath during exertion - manifests itself with a severe allergic reaction, as well as with a history of bronchial asthma.
• Low-grade fever (37-37.9) with chills, pain in muscles and joints, increased sweating, abdominal pain.
• Tachycardia is a rapid heartbeat with a frequency of 80 beats / min or more.
• Jumps in blood pressure - more often in the direction of hypotension with a decrease in pressure to 90/60 mm Hg. Art. and less.

The addition of allergy symptoms in adult patients occurs infrequently and is fully manifested only with increased sensitivity of the body. Most often, allergic symptoms appear during the molting period of ascaris larvae and can be expressed by edema, itching, and a rash. The factor that triggers biochemical reactions in the body is the circulation of the IgE class immunoglobulin. The consequence of this is urticaria, enlarged lymph nodes, allergic hepatitis and myocarditis. The most severe complication of an allergy to ascaris waste products is anaphylactic shock, which can be fatal from suffocation.

At a late stage of development of ascariasis and during its transition to a chronic form, most of the symptoms are associated with the activity of sexually mature ascaris in the small intestine.

Symptoms of ascariasis in the intestinal phase

After roundworms enter the small intestine for the second time, they begin to grow there.

This leads to the following symptoms:

• Instability of stool, in which constipation is replaced by diarrhea.
• Bloating, dysentery symptoms.
• Abdominal pain, vomiting and nausea. The pains are localized mainly in the right iliac region and in the navel area. The nature of the pain is cramping.
• Itching in the anus and redness of the skin of the anus.
• Decreased appetite, sudden weight loss. The patient looks emaciated and exhausted.
• Neurological symptoms are expressed in hysterical seizures, in disturbances of normal night rest (patients often have nightmares), night cries are characteristic. The appearance of seizures is possible. Headaches, dizziness occur periodically. Patients with ascariasis get tired very quickly.
• From the side of the visual organs, disturbances are observed quite rarely, however, a pathological reaction to bright light, anisocoria and amblyopia is not excluded.
• Blood pressure in patients with ascariasis is most often lowered.
• Blood tests in the intestinal phase: the level of eosinophils returns to normal, and the level of hemoglobin falls.
• Against the background of a decrease in immunity, the skin and mucous membranes begin to suffer first. Suppuration and inflammation are often observed. The patient becomes more vulnerable to various infectious diseases.
• If roundworms perforate the intestines, then they can enter the cecum and provoke the development of acute appendicitis.
• Massive invasions often lead to blockage of the bile ducts with the development of cholecystitis, obstructive jaundice, liver abscess, peritonitis, granulomatous hepatitis. With a massive accumulation of worms in the intestine, symptoms of intestinal obstruction develop.

Clinical medicine describes cases of ascaris asphyxiation, when the worms crawl into the airways, throat and sinuses. In addition, parasites can be found in the lungs, in the right ventricle of the heart, in the human brain.

Ascariasis is extremely dangerous for pregnant women, since the process of bearing a fetus is complicated by severe toxicosis, which contributes to intrauterine growth retardation and violations of labor.

Complications of ascariasis

This type of helminthiasis does not pose a great danger to human life or health. Some of the infected patients live safely with roundworms, unaware of their existence. However, in certain categories of patients (pregnant women, persons with a history of chronic pathologies), roundworms can cause complications. The immunity of such people is significantly weakened, and the parasitic invasion spreads faster.

The most common complications of ascariasis:

• Intestinal obstruction, its cause is blockage of the lumen of the small intestine with a ball of helminths. Another reason for this complication is intestinal spasm due to damage to the neuromuscular regulation of its walls. Nerve endings in this case are irritated by ascaris secretions. Symptoms are abdominal pain, prolonged absence of bowel movements, severe swelling of the abdominal wall. Food cannot move through the intestines, rupture of its wall and peritonitis are possible. Untimely medical care increases the risk of intoxication, vomiting with the smell of feces appears.
• Acute pancreatitis - provoked by the ingress of helminths into the ducts of the pancreas. As a result, the secretion of digestive enzymes, which normally go to the duodenum, is disrupted. As a result, enzymes are retained and activated in the pancreas, thereby destroying its structure. Symptoms are girdle pain in the back, dagger pain in the upper abdomen, vomiting. The process may end with pancreatic necrosis.
• Obstructive jaundice - occurs due to the penetration of helminths from the duodenum 12 into the common bile duct (bile ducts). Helminths completely clog the narrow ducts, bile is deprived of the possibility of a natural outflow. Stagnation of bile leads to an increase in the level of bilirubin, the skin and sclera of the eyes acquire a yellow tint. The absorption of fats from food is impaired, headaches and drowsiness appear, heaviness in the right hypochondrium. The higher the bilirubin level, the more intense the symptoms.
• Peritonitis is not a specific symptom, it occurs due to bacterial infection of the peritoneum as a result of intestinal rupture, as a complication of appendicitis, with pancreatic necrosis. Untimely diagnosis of peritonitis and lack of assistance is fatal.



• Appendicitis - in patients with ascariasis, this complication often appears, which may be associated with the penetration of ascaris into the cecum. Symptoms - pain in the lower right abdomen, radiating to the navel, hyperthermia, vomiting. The condition is life-threatening, requires immediate medical attention, delay with it is fraught with death.
• Hepatic abscess - occurs due to ascaris entering the liver through the portal vein system along with the blood stream, as well as through the bile ducts. Helminths damage the mucous membrane of the organ, pyogenic bacteria enter the liver tissue through damage, and an abscess occurs.
• Purulent cholangitis - develops due to helminth damage to the mucous membrane of the biliary tract and the addition of bacteria to the process that cause tissue inflammation. Symptoms are significant hyperthermia (up to 39 ° C), chills, severe pain in the right hypochondrium.
• Pneumonia - appears during the pulmonary stage of ascariasis. The bacteria that cause pneumonia build up in damaged capillaries and respiratory alveoli. The symptoms of bacterial pneumonia are manifested by rapid breathing, fever, wheezing when listening to the lungs. The short-term stay of the larvae in the respiratory system does not allow the attending physician to establish a connection between pneumonia and ascariasis.
• Atypical localization of ascaris - manifests itself as a result of the ingestion of helminth larvae or adults with blood flow into the sinuses, middle ear, lacrimal canal, into the organs of the genitourinary system. There they do not cause tissue destruction, over time they die and are discovered quite by accident.
• Asphyxiation as a result of blockage of the airways - occurs as a result of reflex spasm of smooth muscles, as a result of which the airways are blocked, breathing stops. The cause of the spasm is irritation of the pharyngeal mucosa by the larvae of the parasite. Asphyxia may be preceded by a severe painful cough.

The appearance of complications is most often provoked by excessive motor activity of ascaris. It increases when exposed to drugs, intestinal infections, hyperthermia. Sexually mature individuals begin active movements along the digestive system, provoking complications. Their risk increases with re-infection, which is explained by the peculiarities of the development of the parasite.

Causes of infection with ascariasis

The source of infection and the owner of ascaris is only a person. Together with the feces of a sick person, the eggs of the worms fall into the soil. There they can exist for many years, although they turn into larvae ready for invasion after two weeks. But larvae cannot develop outside the human body. Favorable conditions for the ripening of eggs are the air temperature +24 degrees, moisture-saturated air and soil. Ascaris eggs enter the human body with water or food contaminated with soil. First of all, these are unwashed berries and vegetables. Failure to comply with personal hygiene rules and negligent hand washing are two dangerous factors that increase the risk of infection.

Ascariasis is very often recorded in preschool children. After all, they are not able to fully comply with the rules of personal hygiene and very often come into contact with the soil (with sand). The risk group also includes rural residents, gardeners, summer residents, people living in adverse conditions. The peak of infection with ascariasis occurs in the fall and summer months, when contact with soil and water occurs much more often. In addition, there is an increased risk of eating seeded fruits and vegetables, as well as unboiled water.

Infection occurs through the fecal-oral mechanism, by the alimentary route. That is, the eggs released into the external environment must again enter the intestines. They are brought there through the mouth through the gastrointestinal tract. Subsequently, the larvae migrate through the body with final settling in the intestine.

Often there are cases of self-infection with ascaris eggs produced by adults in the patient's own intestines. This route of infection is found in children. They do not wash their hands, on which the helminth eggs are located, carrying them to food and toys, household items. Re-ingestion of eggs leads to the beginning of a new reproduction cycle of the parasite.

Even if the larvae got into the circulatory system for some time, it is impossible to become infected with roundworms through the blood. The parasite migrates through the small circle of blood circulation: from the digestive tract to the liver and lungs of a person. From there, the ascaris enters the pharynx and into the oral cavity. When kissing, coughing and sneezing, in contact with saliva, it is impossible to become infected with roundworms, since such a migration occurs only during sleep.

To protect yourself as much as possible from possible infection, you must adhere to the following rules:

• Gloves must be worn when working with the ground.
• All herbal products should be washed thoroughly.
• Nails should be cut short, this is especially true for farmers, gardeners, gardeners.
• Hands should be washed with soap and water before cooking or eating.
• Children should be taught from an early age to keep their hands clean.

Find out more: what is the transmission of ascaris eggs to humans?

Diagnosis of ascariasis

Detection of ascariasis can be difficult because each stage of helminth development has characteristic changes. For an accurate assessment, the doctor may need several weeks (at least 2-3), during which it is possible to verify the presence of ascaris in the body. This time is usually enough to identify complications caused by the invasion of helminths.

Methods for diagnosing ascariasis used in adults at various stages of the disease:

• General and biochemical blood tests;
• A blood test for antibodies;
• Sputum analysis;
• Analysis of feces for ascaris eggs;
• Analysis of urine;
• X-ray of the lungs;
• Ultrasound.

Blood test for ascariasis In most cases, these methods do not show the specific changes that occur in the body with ascariasis. An increase in the level of leukocytes is noted during the movement of larvae into the lungs from the digestive tract. Thus, the immune system responds to the body's contact with the worm. A high level of leukocytes is due to an increase in the fraction of eosinophils - blood cells that react earlier to parasite invasions. This reaction is short-lived, it manifests itself within a few days. The same symptom can be observed with allergies of a completely different origin.

Analysis for antibodies to roundworm Serological diagnostic method accurately determines the presence of invasion. It is based on the determination of antibodies to ascaris in the patient's blood serum. They form immediately after the larvae of the helminth have entered the body. The peculiar defense cannot withstand the parasite protected by the cuticle. The formation of antibodies briefly delays its development in the initial stage.

Serological research methods for antibodies to ascaris Ring precipitation reaction; Indirect hemagglutination reaction; Agglutination reaction with carmine; Accelerated sedimentation of erythrocytes in the presence of ascaris antigen in the sample; Immunofluorescence analysis; Precipitation reaction; Complement binding reaction; Bentonite flocculation reaction. The method for determining antibodies to ascaris is informative at the larval stage of helminth development. The intestinal phase of the disease is most accurately diagnosed when analyzing feces for eggs of worms.

Sputum analysis for ascariasis The method is informative in the pulmonary phase of the development of ascariasis. A microscopic examination of the sputum released when the patient coughs reveals ascaris larvae in it. This symptom is accompanied by an increased content of eosinophils in the blood. In the absence of discharge, lavage is examined - a washout of bronchial secretions obtained during bronchoscopy. Such a study is rarely carried out, since it is quite laborious and associated with unpleasant sensations for the patient. It is performed as the only diagnostic tool for ascariasis in a seriously ill patient.

Stool analysis for ascariasis The most common method for diagnosing this disease. It is based on such a feature of the development of roundworms as the laying of a large number of fertilized eggs by a sexually mature female. A yellow-brown elliptical helminth egg with a diameter of 30 to 60 microns is perfectly differentiated when analyzing feces under a microscope. Research methods: According to Krasilnikova; By Kalantaryan; According to Fullenborn. The absence of helminth eggs in the patient's feces cannot be a guarantee that the disease is absent. At the larval stage, the parasite does not lay eggs; it will be able to produce them only a few months after entering the body. Therefore, stool analysis must be repeated. If several individuals of the female genus enter the body, the presence of unfertilized eggs in the feces is permissible. They are small in size, differ in color and are difficult to distinguish under microscopic examination. Male helminths do not lay eggs at all, although they cause significant damage to the body.

Urine analysis for ascariasis A specific biochemical analysis of urine for the presence of volatile fatty acids will help confirm the presence of ascariasis. Such acids are secreted by both adults and helminth larvae in the process of carbohydrate metabolism. The method allows you to determine the presence of the parasite at the earliest stage of the disease, before puberty and the period of oviposition. The method can lead to erroneous conclusions, since the same violation occurs with other pathologies.

Radiography for ascariasis The method is used to determine changes in the lungs and intestines. It is an affordable and inexpensive diagnostic method, used immediately at the first suspicion of ascariasis. X-ray changes: X-ray of the abdominal cavity - the accumulation of feces and air is diagnosed with intestinal obstruction, it can be performed in order to distinguish ascariasis from other pathologies of the gastrointestinal tract. Roundworms are not directly detected on the x-ray. Chest X-ray - characteristic changes in tissues are detected during the pulmonary stage of ascariasis (within 10 days). A volatile Leffler infiltrate is diagnosed, which changes its location after a few days. The differences between ascariasis and pneumonia, as well as neoplasms in the lungs, become apparent on repeated imaging, when the accumulations of parasites move to another site. Pneumonia can be diagnosed in immunocompromised patients as a secondary complication of the disease.

Ultrasound examination for ascariasis The peculiarity of this method is the different reflection of sound waves from the tissues of the body. Ultrasound is not able to detect the localization of ascaris, but this study effectively diagnoses diseases of the digestive system that are similar in symptoms (stomach and intestinal ulcers, colitis, Crohn's disease). In case of complications, ultrasound reveals organ damage caused by roundworms (cholangitis, pancreatitis, intestinal obstruction). The most accurate method for diagnosing ascariasis of all of the above is a serological antibody test. The rest of the research methods are used only for differentiation, since the results obtained with their help may indicate pathologies that are completely far from helminthiasis.

Treatment of ascariasis

For the treatment of ascariasis, the doctor selects a drug taking into account the patient's age and the characteristics of the organism, the severity and massiveness of the invasion. Modern antiparasitic agents guarantee a cure of the disease by 80-100%.

Anthelmintic therapy of ascariasis is not difficult, but must be carried out under the guidance of the attending physician. In his arsenal there is a large number of modern highly effective agents that can completely destroy the parasite in a single dose. Unlike bacteria, helminths are unable to develop resistance to certain drugs. However, most of these drugs are highly toxic, and an overdose can harm the human body. A properly calculated dose and dividing it into several doses helps to reduce the risk of toxic effects.

Directions of complex treatment of ascariasis:

1. Destruction of ascaris - carried out with the help of highly effective means that allow you to completely remove parasites from the body.
2. Treatment of the symptoms of ascariasis is carried out after the destruction of parasites, symptoms such as cough, stool disorders, abdominal pain, etc. are stopped.
3. Prevention of reinvasion is the destruction of sources of re-infection that remained in the household environment of patients. A complex of sanitary measures is carried out to eliminate the outbreaks.
4. Adequate nutrition - used to restore the health of children who are lagging behind in growth. A special diet is not required for the treatment of ascariasis.
5. Carrying out a course of vitamin preparations - used to replenish the supply depleted by helminths during the invasion.
6. Treatment of complications of ascariasis - the use of additional methods, the use of surgical intervention for appendicitis or intussusception of the small intestine.
7. Additional supportive therapy is used as directed by the attending physician, who prescribes enzymes and probiotics to restore full digestion, and other medicines.
8. Treatment of concomitant chronic diseases - is carried out with the aggravation of the course of intestinal infections and exacerbation of other pathologies.

Treatment of ascariasis begins immediately after the diagnosis is clarified. In regions with a high incidence of invasion, preventive treatment of all residents is carried out with a single dose of the drug.

Be sure to treat ascariasis before surgery on the intestines or lungs. The addition of complications caused by ascariasis can provoke death during surgery or in the postoperative period.

Find out more: medicines for ascaris.

Medicinal treatment of ascariasis

To eliminate ascariasis, antiparasitic drugs are used, which are used taking into account the localization of ascaris and the form of the disease. Ascariasis can be diagnosed both in the acute and in the chronic stages of the development of the invasion. The doctor takes into account the individual characteristics of the patient and possible contraindications to the use of highly toxic drugs.

Drug name	A photo	Reception mode	Contraindications
Decaris (Levamisole)		It is used for massive invasions. Adults once 120 - 150 mg, children - 2.5 mg per 1 kg of body weight.	Not prescribed for pregnant and lactating women and children under 14 years of age.
Mebendazole (Vermox)		It is the drug of choice for simultaneous ascariasis and trichocephalosis. It is taken at 100 mg 2 times a day for 3 to 4 days.	Contraindicated in ulcerative colitis, Crohn's disease, liver failure. Not prescribed for children under 2 years old, pregnant and lactating women.
Mintezol (Thiabendazole)		50 mg / kg body weight twice a day for a week. The drug is effective in the early stages of the disease.	Contraindicated in children under 2 years of age, pregnant women, nursing mothers.
Albendazole		For adults, a dose of 100 mg is divided into 2 times a day. Take three days. For children, the dose is 25-50 mg / day (age from 2 to 10 years).	Contraindicated in children under 2 years of age, pregnant women, nursing mothers.
Piperazine citrate		A highly effective agent for the treatment of ascariasis and enterobiasis, used in the form of tablets or solution. The chemical compound (Piperazine adipate) is not hygroscopic and takes a crystalline form. Dosage - 3 times a day one hour after meals, the course of treatment is 3 days.	Parallel administration of chlorpromazine is prohibited.
Pirantel		10 mg / kg once orally after meals.	Can be used during pregnancy under the strict supervision of doctors. It is forbidden for renal failure and for children under the age of six months.

When ascariasis is in the migration phase, drugs for nematodes of universal action are used to treat infestation in children and adults:

• Mebendazole - Vormin, Mebex, Vermox (from 90 to 130 rubles), Termox, Vero-Mebendazole, Vermakar;
• Levamisole - Decaris (from 70 to 90 rubles);
• Tiabendazole - Mintezol, Mertect, Arbotekt, Tresaderm, Mintezol, Tecto.

Additionally, bronchodilators are prescribed for obstructive bronchitis and pneumonia, as well as corticosteroids.

The intestinal stage of ascariasis is stopped by the following drugs:

• Pirantela pamoat - Helmintox (from 90 to 120 rubles), Pirantel (from 30 to 50 rubles), Kombantrin, Nemocid, all drugs are designed for single use;
• Decaris - taken in accordance with the instructions, focusing on the age and weight of the patient.
• Mebendazole - Vormin, Mebex, Vermox, Termox, Vero-Mebendazole, Vermacar.

Universal drugs for the specific therapy of ascariasis:

• Santonin - taken for 2 days, the dosage of the drug is adjusted depending on age. Preparation for Santonin Treatment in Adults - Colon cleansing with a laxative. The dosage of the drug is 3 rubles / day, one hour before meals. At night, a laxative must be taken, easily digestible food is used. A second course of treatment - a month later. Contraindications for use - gastroenteritis, nephrosonephritis.
• Sankafen is a highly effective drug that acts similarly to Nemozol. Before treatment with Sankafen, the patient is given a cleansing enema the day before, he takes a laxative. The dosage is 2 times a day, the course of treatment is 2 days. The drug is taken the next day after a light breakfast, in 2 doses with an hour interval of the entire daily dose. After 2-2.5 hours, food is allowed, a mild laxative is prescribed in the evening. The second day of treatment for ascariasis is similar, with the difference that a saline laxative is taken in the evening. A diet during treatment is prescribed with restriction of fat and spicy foods.

Self-treatment of ascariasis is prohibited, since an incorrectly calculated dose may result in serious intoxication of the body. The short-term side effects from the use of drugs are so varied that they can lead to negative consequences for the patient.

In addition to the oral route of administration of drugs, oral methods can also be used. With massive invasion, it is allowed to administer the drug using a nasogastric tube - directly from the nose into the stomach, bypassing the oral cavity and contact with saliva.

Laxatives are not used in the treatment of acute ascariasis, especially in the case of constipation. It can be caused by intestinal obstruction, and additional stimulation of the intestinal muscles will lead to rupture of the intestinal wall and the development of peritonitis. It is possible to use laxatives after deworming for the speedy removal of dead or paralyzed ascaris from the body.

If a bacterial infection is suspected, a course of antibiotic treatment may be required. In general, the treatment of ascariasis, not complicated by concomitant pathologies, is rather short-lived.

Other treatments for ascariasis

The use of oxygen is a modern method of treating ascariasis, developed by N. Kravets. The method consists in injecting oxygen into the stomach under low pressure using a thin probe or catheter (when treating children from one to three years old). The probe is inserted through the nose, the device is connected to an oxygen cushion, a pneumothorax apparatus, or a Richardson balloon. No preliminary bowel cleansing is required. The procedure is carried out in the supine position, on an empty stomach, in minimal doses. The course of treatment is 2 days for 2 hours. A couple of hours after the procedure, you can eat as usual, limiting only fatty and spicy dishes. Lack of stool throughout the day is a reason for taking a laxative. Contraindications to the use of the method - exacerbation of stomach and duodenal ulcers, the danger of peritonitis, inflammatory diseases of the gastrointestinal tract.

Heptylresorcinol - the drug is produced in the form of tablets. They should not be chewed to avoid irritation of the oral mucosa, pharynx and esophagus. Before treatment, you need to check whether the patient is able to swallow the drug without chewing it. Preliminary preparation - 12-hour fasting, taken before bedtime on the eve of a laxative (saline). In the morning, the patient takes the full dose of the drug with an interval of 5 minutes between the use of tablets, washed down with water. During the day, the patient adheres to bed rest, at night or the next morning, a saline laxative is taken. Possible side effects (abdominal pain, vomiting) are controlled with a warm heating pad or enema. The diet throughout the treatment is similar to that of the Santonin treatment. Contraindications for use - peptic ulcer, gastrointestinal inflammation, general weakening of the body. Repeated course - within 20 days.

Henopodium oil - has a pungent taste, has a light yellow color. The dose of the drug is measured with a graduated pipette, mixed with a laxative (castor oil), taken simultaneously. Preparation for treatment - bowel cleansing with an enema the night before. The next day in the morning, 2 hours after a light breakfast, a solution of the drug is taken. The next meal is after 3 hours. For constipation, a laxative is prescribed or an enema is given. Contraindications to the use of henopodium oil - kidney pathology, infancy, acute gastrointestinal tract diseases, CNS pathology, general weakness. A second course of treatment is carried out in 2 months under laboratory supervision. Enterosorbents to restore bowel function (Polyphepan, Polysorb, activated carbon) complete the treatment of ascariasis. Monitoring the effectiveness of anthelmintic therapy is carried out a month after the course.

Find out more: how to get rid of ascaris from the body?

What doctor treats ascariasis?

Diagnosis and treatment of ascariasis is carried out by a parasitologist. Such a doctor of narrow specialization is not available in all medical institutions, more often an infectious disease doctor deals with parasitic invasions. It performs the same functions of diagnosing and treating ascariasis as a parasitologist. Since the first symptoms that the patient pays attention to are disorders of the digestive or respiratory system, it is possible to contact a therapist or family doctor. To clarify the diagnosis or stop the consequences and complications of ascariasis, narrow specialists of related profiles are involved.

Consulting doctors in the treatment of ascariasis:

• Immunologist - in case of allergy manifestations;
• Surgeon - for examination and surgical treatment of complications;
• Gastroenterologist - in the presence of chronic pathologies of the digestive system;
• Microbiologist - to conduct an in-depth examination and make an accurate diagnosis.

Do I need to go to the hospital for ascariasis? After the diagnosis and initial examination, the doctor prescribes treatment. Since in most cases it is a single dose of anti-worming medicine, home treatment is sufficient. Hospitalization is not required to fulfill the recommendations of the infectious disease specialist;

You can confirm recovery after laboratory tests (feces analysis, etc.). Only a repeated negative result can be a guarantee that the patient got rid of the worms.

Treatment in a hospital is carried out only in the presence of serious complications. Such life-threatening conditions as appendicitis, intestinal obstruction, pancreatitis require special attention. Joining ascariasis processes provoked by pathogenic bacteria can significantly worsen the patient's condition. Doctor's supervision is required for patients with diabetes mellitus, heart or respiratory failure, since ascariasis can provoke a sharp deterioration in their well-being.

Treatment of ascariasis during pregnancy

If ascariasis in the average patient is considered a dangerous disease, then during pregnancy this danger increases several times. The placental barrier cannot serve as an obstacle to the penetration of the larvae of this helminth into the fetus. The toxins released during the life of roundworms have a negative effect on the body of a woman who is expecting a baby. Abdominal pains appear, nausea increases, and vomiting may occur.

If the roundworm larvae have penetrated the lungs of an unborn child, he will probably suffer from chronic bronchitis or pneumonia after birth, inflammation of the respiratory tract, and manifestations of allergies. These diseases are extremely difficult to treat. Roundworms that enter the liver of a newborn baby cause inflammation (hepatitis) and chronic jaundice.

When choosing an anthelmintic agent for the treatment of ascariasis in a pregnant woman, the doctor prefers the least toxic medicine. The most commonly used drugs are Piperazine and Heptylresorcinol.

Prevention of ascariasis

Prevention of ascariasis is of great importance for the complete cure of this disease. Even after the parasites were expelled from the body, ascaris eggs could remain in the patient's environment. This factor can lead to reinfection. Preventive measures will help to avoid new infection as a result of the ingestion of eggs and larvae of the parasite. Ignoring preventive measures increases the recurrence of ascariasis.

Measures for the prevention of ascariasis:

• Early screening of the disease. If you suspect infection with ascaris, you should undergo the necessary diagnostic research: analysis of feces for helminth eggs, a blood test to detect antibodies to ascaris and other studies. If the result is positive, treatment is carried out, and an explanatory conversation on the observance of hygiene rules. Infection of at least 10% of the population prescribes in some countries a mandatory check once a year for all residents of the region. At 40% infection, it is recommended to carry out general preventive treatment with anthelmintic drugs.
• Thorough hygienic hand washing. Since the earth is the most likely habitat for the distribution of roundworms, the development of their larvae from eggs, then everyone who has contact with the soil should pay special attention to careful hand washing.
• Washing products that are not heat treated before eating. Fruits, vegetables, poultry eggs can be in contact with soil containing roundworm larvae. Since these products can be used for food without being cooked, they should be rinsed with particular care. Short-term heating at a temperature of about + 50 ° C will completely eliminate the risk of contamination from food.
• Briefing by SES staff. Categories of the population at increased risk of contracting ascariasis should have complete information about this disease and precautions. These are employees of public catering, preschool institutions, agricultural workers and sewer workers. Such instruction must be carried out by the sanitary and epidemiological services of the region. Particular attention should be paid to educating children of the skills of observing hygiene standards by their parents and kindergarten teachers.
• Protecting the soil from faecal contamination. Sanitary soil protection includes the following measures: analysis of soil composition before starting construction of facilities and allocation of farmland, mandatory cementing of cesspools, creation of an appropriate legal framework.
• Monitoring the condition of water supply and sewerage networks. A worn-out sewage system, due to its defects, contaminates the soil with feces. Through damage in water pipes, ascaris eggs enter the water for drinking and cooking.
• Disease vector control. Ascaris eggs can be transferred to food by flies and cockroaches when they come into contact with feces and contaminated soil. That is why the fight against them in catering enterprises is of such great importance.

High-quality protection against infection with ascariasis is created by the joint efforts of SES doctors, epidemiologists and infectious disease specialists, as well as by the regional administration. But their efforts will be in vain if the patient becomes infected due to non-observance of basic hygiene rules.

Author of the article: Danilova Tatyana Vyacheslavovna | Infectionist

Education: in 2008 received a diploma in General Medicine (General Medicine) at the Pirogov Russian Research Medical University. Immediately passed an internship and received a diploma of a therapist