2023 Author: Josephine Shorter | [email protected]. Last modified: 2023-05-24 11:52
Treatment of opisthorchiasis
Opisthorchiasis is a parasitic disease provoked by flatworms from the fluke class. The invasion is accompanied by damage to the hepatopancreatobiliary system with an increase in body temperature, skin rashes, abdominal pain and jaundice.
Opisthorchiasis is a very relevant disease for Russia. There are endemic areas in the country where this helminthiasis occurs very often. Opisthorchiasis is widespread among the population living near the basins of the Volga, Irtysh, Ob and Kama rivers. There opisthorchiasis is the most common helminthiasis in the general structure of parasitic invasions. Although there are about 30 species of opisthorchis in nature, only three types of parasites can live in the human body, including: Opisthorchis felineus, Opisthorchis viverrini and Opisthorchis felineus arvicola.
Opisthorchiasis is a natural focal disease, in natural conditions, infection is maintained by the circulation of parasites among wild animals that feed on fish.
The worm has two intermediate hosts: freshwater mollusks of the bitiniida family (first host) and fish (second host).
The final owner of opisthorchs can be a person, a cat, a dog, a pig, a fox, an otter and other wild fur animals.
Helminths are small in size, no more than 2 mm in width and no more than 10 mm in length. Therefore, they can inhabit the intrahepatic and extrahepatic bile ducts, as well as in the pancreatic ducts. A person becomes infected after eating raw, dried, salted, smoked or poorly processed fish. A month after the invasion, the helminth turns into a sexually mature individual and begins to reproduce eggs.
The more parasites in the human body, the more pronounced the symptoms of the disease will be. The age of the patient and the state of his immunity also have an effect.
The main signs of opisthorchiasis are:
- Intoxication of the body.
- Allergic manifestations.
- Disorders of the digestive system such as hepatitis, cholecystitis, pancreatitis and cholangitis.
- Neurological symptoms.
The nonspecific symptoms of opisthorchiasis include:
- Increase in body temperature to high values. Subfebrile body temperature is rarely kept.
- Loss of appetite, pain in muscles and joints.
- The appearance of a small rash like papules or dots. Localized rashes on the chest, back and arms. After 10 days, the rash disappears without any treatment.
- The occurrence of severe allergic reactions is possible, the development of asthmatic bronchitis, Quincke's edema, Lyell's syndrome, acute myocarditis, etc.
Since the parasites live in the ducts of the liver and gallbladder, the following symptoms will be observed from the hepatobiliary system:
- Pain in the liver and gallbladder.
- Pain can be given to the right scapula and to the clavicle.
- The appearance of nausea and a feeling of bitterness in the mouth, belching and vomiting.
- The development of jaundice with an increase in the level of bilirubin in the blood more than threefold.
- Enlargement of the liver in size.
- Itchy skin.
In children, symptoms of enterocolitis and gastritis often join. If there is no treatment, opisthorchiasis becomes chronic. At the same time, it becomes more difficult to suspect a disease by any symptoms.
Signs of the chronic form of the disease are:
- Chronic aching pains of moderate intensity. Pains are localized in the gallbladder, in the epigastric zone. If the pancreas is affected, the pains become shingles.
- Often a person is worried about dyspeptic disorders with flatulence, heartburn and nausea.
- The skin and whites of the eyes turn slightly yellow, or acquire an earthy tint.
- The liver increases in size.
- A person loses weight, his fatigue increases, and an aversion to food appears.
A long course of opisthorchiasis is dangerous because the patient may develop cancer of the liver and pancreas. Therefore, the disease requires timely detection and quality treatment.
- Basic principles of treatment of opisthorchiasis
- List of pills for opisthorchiasis
- Diet in the treatment of opisthorchiasis
- Treatment of opisthorchiasis with folk remedies at home
- Prevention of opisthorchiasis
- Answers to questions on the topic "opisthorchiasis"
Basic principles of treatment of opisthorchiasis
The approach to the treatment of patients with opisthorchiasis should be complex. Medical correction is reduced to the appointment of the drug Praziquantel, which has a wide spectrum of anthelmintic activity. After taking the drug orally, the muscles of the worms are affected, as a result of which they lose their mobility. Absorption into the systemic circulation occurs quickly, traces of Praziquantel are present in breast milk. Against the background of kidney pathologies, the excretion of Praziquantel from the body slows down.
The daily dose is 40-75 mg / kg, it is divided into two or three doses. After completing the course of treatment, it is mandatory to monitor its effectiveness. For this, after 3-6 months, feces and the contents of the duodenum are taken from the patient for the detection of opisthorchus eggs.
Praziquantel is not prescribed for people with eye diseases, since blindness may develop after the death of worms. If therapy was started in the acute period of the disease, then after taking Praziquantel, severe allergic reactions may develop, which are associated with massive death of parasites. Sometimes the manifestations of allergization of the body are so pronounced that patients are prescribed the administration of hormonal drugs.
Praziquantel is not used to treat women in the first trimester of pregnancy. As needed, it can be prescribed to get rid of opisthorchiasis in nursing mothers. However, it will not be possible to apply to the child's breast for 2 days after taking the therapeutic dose of the drug.
Since after taking the drug, a person may develop dizziness, he should refuse to drive vehicles while taking Praziquantel and for another day after completion of treatment. Particular care should be taken by those people whose work requires increased concentration of attention.
The drug is not used to treat children under the age of 2 years. After taking Praziquantel, it is possible to develop side effects such as: headaches and dizziness, muscle weakness, fever and hives. Most often, adverse events are of mild or moderate intensity, therefore, no specific therapy is needed.
It is equally important during treatment and for six months after its completion to adhere to a dietary diet. To do this, you must follow diet number five. Patients are prohibited from eating spicy, pickled, salty foods, as well as baked goods. All foods must be boiled, baked or steamed.
Stages of treatment of opisthorchiasis:
Preparation stage. Before you start taking anthelmintic drugs, you need to prepare the body. For this, the patient is prescribed choleretic drugs. In parallel, the administration of antispasmodics, adsorbents and hepatoprotectors is shown. The duration of the preparatory stage is 10-20 days.
- Deworming stage. At this time, the patient takes medications prescribed by the doctor. Self-treatment is unacceptable. Also, you should not interrupt the started course without the doctor's permission, or change the therapeutic scheme.
- Recovery phase. Since a large number of dead worms accumulate in the ducts, choleretic agents are prescribed to patients. This will allow you to quickly remove them and the body. To protect the liver, patients are advised to take hepatoprotectors. Dietary supplements and vitamin and mineral complexes. They allow you to quickly restore the body after the invasion.
The results are monitored six months later, since it is impossible to evaluate the effectiveness of treatment earlier. It is during this time that the eggs of the parasites will leave the body and the digestive organs will restore their work.
List of pills for opisthorchiasis
Cysticide is a praziquantel-based drug. It belongs to the group of broad-spectrum anthelmintic drugs. Cysticide comes in tablet form.
Cysticide leads to persistent paralysis of helminths with their subsequent death.
Do not use the drug in the first trimester of pregnancy, as well as for the treatment of children under 4 years of age. Taking Cysticide is also contraindicated for lactating women. Care should be taken to treat patients with hepatic failure and hepatosplenic schistosomiasis with the drug.
For the treatment of opisthorchiasis, a one-day intake of Cysticide is required, at the rate of 75 mg / kg. The daily dose is divided into 3 doses.
The development of side effects such as vomiting, nausea, diarrhea, abdominal pain, drowsiness, dizziness and headaches is possible. Development of allergic reactions, increased sweating is not excluded.
Biltricid is an anthelmintic drug produced in tablets. The main active ingredient is praziquantel.
Do not prescribe Biltricid to the following patient groups:
- patients with cysticercosis of the eyes;
- children under 4 years old;
- patients undergoing treatment with Rifampicin;
- women in the 1st trimester of pregnancy;
- women during lactation (with a short course of treatment, you need to stop breastfeeding for two days);
- in the presence of hypersensitivity to the components of the drug.
It is recommended to take Biltricid with caution against the background of hepatic failure, with heart rhythm disturbances and with hepatolienal schistosomiasis.
For the treatment of opisthorchiasis, the drug is prescribed at the rate of 25 mg / kg of body weight, 3 times a day. The course of treatment can last from one to three days.
The following adverse reactions may develop:
- Drowsiness, headaches, dizziness, convulsions;
- Increased body temperature, asthenia;
- Muscle pain;
- Urticaria, polyserositis.
Cesol is a praziquantel-based anthelmintic drug. Cesol is produced in the form of tablets for oral administration.
Contraindications: pregnancy, hypersensitivity to the components of the drug, age under 4 years, ocular cysticercosis.
The tablets are taken whole, without chewing and with water. For the treatment of opisthorchiasis, the daily dose is 75 mg / kg. It must be divided into three steps.
Undesirable reactions from the nervous system are possible in the form of dizziness, headaches, seizures, increased drowsiness. Also, allergic reactions are not excluded, which can be triggered by the intake of Cesol or the death of helminths.
The drug should be taken with caution in patients with hepatic insufficiency, as well as with schistosomiasis.
Azinox is an anthelmintic drug derived from pyrazinisoquinoline (praziquantel). The drug has a wide spectrum of action against helminths.
Do not prescribe Azinox in case of increased sensitivity of patients to praziquantel, in the first trimester of pregnancy, children under 4 years of age. You should not use the drug for the treatment of patients with cysticercosis of the eyes and liver, as well as against the background of liver failure.
A single dose is 10-50 mg / kg of body weight. The more accurate dosage and duration of treatment is determined by the doctor.
After taking the drug, headache, dizziness, and increased drowsiness may develop. Sometimes there are pains in the muscles and in the abdomen. Nausea, vomiting and allergic reactions may also join. An increase in body temperature is possible.
Bithionol is an anthelmintic drug produced in the form of a powder, packaged in plastic bags. The drug has a paralytic effect on the neuromuscular system of worms.
A single dose for adults is 30-50 mg / kg. The drug is taken orally, after a meal. The duration of treatment and a more accurate dosage is determined by the doctor.
The following side effects may develop: fever, leukopenia, insomnia, diarrhea, abdominal pain, headaches, dizziness, nausea, anorexia, skin rash.
Bithionol is not prescribed for children under the age of 8 years, as well as for people with any diseases in the decompensated stage.
It should be noted that modern parasitologists do not use Bithionol to treat people, since this drug provokes the development of pronounced side effects. It is used to treat helminthiasis in veterinary medicine.
Chloxil is an anthelmintic drug produced in powder form. A suspension is made from the powder and taken orally. Chloxyl is a xylene derivative.
Chloxil is not prescribed for liver disease (not provoked by helminths), with myocardial damage. It is not used to treat pregnant women, as well as against the background of increased sensitivity to the components that make up the drug.
The daily dose is 0.1-0.15 g / kg. The course of treatment leaves 2 days, during which time the patient can take from 10 to 20 g of the drug, depending on the doctor's instructions.
If a 5-day course of treatment is expected, then the daily dose is reduced to 0.04-0.06 g / kg and given in 2-3 doses. Re-treatment is possible after 4-6 months.
Side effects: hepatomegaly, proteinuria, arrhythmia, eosinophilia, allergic reactions. You can not combine the drug with alcohol, with fatty foods.
Learn more: Broad Spectrum Parasite Medicines
Diet in the treatment of opisthorchiasis
The diet in the treatment of opisthorchiasis should be gentle for the digestive system, but at the same time stimulating the secretory function of the pancreas and stomach. The amount of proteins, fats and carbohydrates should completely cover the physiological need of a person. It is important to give up the use of fried foods, remove from the menu all products containing refractory fats. Should not be on the table of a person undergoing treatment for helminthiasis, products containing cholesterol and purines.
Fruits and vegetables help to remove excess cholesterol and increase intestinal peristalsis. The daily amount of kilocalories must be at least 2200 kcal, but not more than 2500 kcal, of which:
- Carbohydrates - 300-350 g.
- Proteins and fats - 80-90 g.
Do not eat hot and cold meals, the number of meals per day is from 5 to 6. Products can either be boiled or baked.
It is possible to include the following products in the menu:
- Juices based on fruits and non-acidic berries;
- Kissel, compote;
- Unsalted tomato juice;
- Weak tea and coffee with milk;
- Rosehip decoction;
- Yesterday's bread, rye, doctor's and wheat bread;
- Mild cheeses, milk, cottage cheese, sour cream with a reduced percentage of fat;
- Vegetable, dairy, fruit soups;
- Butter (no more than 50 g per day);
- Unleavened biscuits;
- Steam omelet (1 egg per day);
- Honey, sugar, jam;
- Loose porridge;
- Lean meat, fish, poultry, milk sausages;
- Fruits and non-acidic berries;
- Pressed caviar, soaked herring.
During the treatment of opisthorchiasis, you should stop eating the following foods:
- Butter bakery products, fresh bread;
- Lard, fats;
- Meat, fish, mushroom soup;
- Fatty meat, fish and poultry;
- Fried and boiled eggs;
- Smoked and canned foods;
- Marinades and pickles;
- Sorrel, radish, spinach, radish, green onion;
- Hot spices (horseradish, pepper, mustard);
- Ice cream and any other chilled desserts;
- Confectionery with fat cream;
- Strong coffee, chocolate, cocoa;
- Sour fruits and berries;
- Alcoholic drinks.
It is imperative to check with your doctor about possible prohibitions during treatment for opisthorchiasis. Despite the abundance of foods that should not be consumed, it is important that all the physiological needs of the body are covered.
Treatment of opisthorchiasis with folk remedies at home
Treatment of opisthorchiasis with folk remedies at home is possible, however, you should definitely consult your doctor.
The following folk recipes are popular:
- You will need 1 drop of birch tar, which is dissolved in a tablespoon of boiled water. On the first day you need to drink 1 spoonful of the product, on the second day 2 drops of tar are dissolved in a spoon, on the third day - 6 drops of tar, on the fourth day - 8 drops, and on the fifth day - 10 drops. As a rule, a five-day course is enough to get rid of opisthorchiasis.
- If the disease is in an acute stage, when the patient has vomiting and fever, then burdock juice can come to the rescue. Fresh leaves are crushed with a meat grinder, then juice is squeezed out of them and taken 3 times a day half an hour before meals. The amount of juice per dose is 30 ml. The course of treatment is from a week to 10 days. You can repeat the course several times a year, if necessary.
- Pumpkin seeds are another effective remedy for opisthorchiasis. To do this, grind a glass of grains in a meat grinder, add 2 egg yolks, a spoonful of honey and a glass of water (200 ml) to it. This mixture should be eaten in the morning on an empty stomach. Then the person goes to bed and applies heat to the right side (a heating pad with hot water). It is necessary to stay in bed for several hours. By the evening, the body temperature should return to normal, and the pain will decrease, as the parasites will die. This treatment must be repeated twice with an interval of 10 days.
Find out more: Herbs for parasites in the human body
Prevention of opisthorchiasis
Prevention of opisthorchiasis is reduced to compliance with the following measures:
- You should refuse to eat raw fish, subject any fish to high-quality heat treatment.
- Fry fish or cutlets from it for at least a quarter of an hour in boiling oil.
- Cook lumpy fish for at least 15 minutes after boiling.
- It is good to salt the fish in warm saline solution for 14 days. You need at least 270 g of salt per kilogram of fish.
- It is possible to get rid of fish from parasites using low temperatures. Helminths will die in 7 hours at -40 ° C, in 14 hours at -35 ° C, in 32 hours at -28 ° C.
- It is good to wash your hands after any contact with fresh fish and carefully handle the items that were used to cut it.
Observing these rules, you can protect yourself from a disease such as opisthorchiasis.
Answers to questions on the topic "opisthorchiasis"
- How to treat opisthorchiasis and which doctor should I contact? Opisthorchiasis is a contagious disease, the methods of transmission of the invasion are the use of fish that has not undergone high-quality heat treatment. Infectionists and parasitologists are engaged in the treatment of opisthorchiasis.
- Is it necessary to treat opisthorchiasis in a hospital? There are symptoms such as: subfebrile body temperature, headaches, increased fatigue. Was treated by an infectious disease doctor, but at home. It was not possible to get rid of the disease. When can I get a second test? Treatment of opisthorchiasis is carried out on an outpatient basis. The repeated timing of the test for opisthorchiasis is determined by which diagnostic method is used for this purpose, as well as by what course of treatment the patient received.
- The child is 6 years old. CIK-opisthorchiasis 1:10 was found in the blood. Antibodies to opisthorchiasis have not been identified. How is it treated and what does it mean? If the CEC is found in the blood, then this indicates an "old" helminthiasis. Therefore, it is necessary to conduct probing with a bile sampling for further research. If the diagnosis is confirmed, it is imperative to be treated, since opisthorchiasis can provoke serious complications.
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