Infectious disease specialist
Sinitsyn
Olga Valentinovna
33 years of experience
Highest qualification category of infectious disease doctor
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The most common type of helminthiasis in the world is enterobiasis. This disease is caused by intestinal parasites - pinworms, which settle in the small intestine of a person, provoking a variety of intestinal and toxic-allergic disorders. In Russia, it accounts for up to 70% of all cases of human helminthiasis. A characteristic feature of this type of helminthiasis is the passage of the full cycle of development of the parasite in the host’s body.
Where do helminths come from?
Parasites can enter our body in different ways: through poorly washed vegetables or fruits from the garden, and through interaction with animals (and then with unwashed hands at the table). Most parasites that enter the human body are helminths. They usually settle in the intestines, less often in other parts of the body. This is not only unpleasant, but also dangerous to health, because worms can cause allergies and digestive problems. It is dangerous if parasites penetrate the brain, lungs, eyeballs or muscles.
Unfortunately, it is not always possible to avoid helminth infection. Helminthiasis varies according to the type of pathogen, and treatment requires special anti-worm medications.
Parasites living in the human body are divided into three groups:
- round helminths (class of nematodes);
- flatworms (class trematodes);
- tape parasites (class of cestodes).
The most important thing when treating helminthiasis is to determine what type of parasite a person is infected with. It is also necessary to determine the stage of development of the parasite (larvae or mature individuals). After all, there are medicines that destroy only larvae, and there are those that act on the parasite at any stage.
How to recognize helminthic infestation?
About two weeks pass from the moment of infection, after which the first signs of enterobiasis appear. The skin around the anus becomes red and irritated, the patient feels itching in this area, which intensifies at night, when female pinworms crawl out to lay eggs. And due to constant scratching, abrasions and small wounds can form on the skin, often with suppuration and pyoderma. If the disease lasts for a long time and hygiene rules are not observed, abscesses or granulomas can form in the anus, the contents of which contain eggs or adult female pinworms.
Due to constant irritating itching, the patient develops astheno-neurotic syndrome: decreased performance, headaches, irritability, increased fatigue, and night sleep disturbances.
The vital activity of pinworms in the intestines leads to the development of abdominal manifestations of the disease - abdominal pain localized in the navel, increased frequency of bowel movements, and bloating. The consistency of stool changes: it softens and resembles a paste in consistency, and mucus appears. Some patients experience occasional nausea.
Almost the only symptom of enterobiasis in children is itching in the anal area, which causes sleep disturbances. It persists for a long time after getting rid of the parasites, since a stable focus of excitation is formed in the brain. In girls, the disease is more severe than in boys, since pinworms can penetrate the genitals, causing the development of vulvitis and endometritis, as well as inflammation of the urinary tract.
Due to repeated repeated infections, the disease lasts a long time. Parasites change the intestinal biocenosis, due to which the protective function of the microflora decreases, and the number of lactone-negative microorganisms in the intestine increases. The secretion of digestive enzymes deteriorates, which leads to a decrease in the digestive function of the intestine. Lack of nutrients leads to weight loss and delayed physical development of the child.
The disease can occur in mild, moderate or severe form, which is reflected in the symptoms. The severe form is most common in children. Adults, as a rule, are ill asymptomatically or with minor manifestations, which are expressed in decreased performance and disturbances in night sleep. We can talk about the chronic course of the disease starting from the second month of infection.
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Pirantel
This anti-worm drug is available in the form of a suspension and tablets. The active substance is pyrantel. The medicine acts on flat and roundworms, quickly and effectively. The course of treatment is 1-3 days, and after 2-3 weeks you need to repeat the dose in order to destroy those parasites that could hatch from eggs after the first use of Pirantel.
The medicine for worms is well tolerated and has almost no side effects from the gastrointestinal tract. When taking Pirantel, laxatives and enemas are not needed; children are prescribed it from 3 years of age. The dosage of "Pitrantel" is calculated based on the patient's weight. You cannot take any other anti-worm medications in parallel with Pirantel - this increases toxicity to the body.
Pirantel
Ozon LLC, Russia
The main indications for use are ascariasis, hookworm disease, necatoriasis and enterobiasis.
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How to avoid infection
The main measures to prevent enterobiasis are to comply with hygiene requirements:
- mandatory hand washing after visiting the toilet, walking, visiting public places, contacting animals, etc.;
- nail care, getting rid of the habit of biting nails;
- frequent replacement of bed linen, towels, hygiene items;
- washing underwear and bed linen in hot water, followed by ironing and steaming;
- wet cleaning with disinfectants every two to three days.
Nemozol
This deworming medicine is available in the form of regular tablets, chewable tablets, and suspension. The active substance of the drug is albendazole. Effectively destroys round and tape parasites. Depending on the identified parasite, the course of treatment can last from 3 days to 1 month. If it is enterobiasis or ascariasis, it is enough to take the medicine once. During treatment with Nemozol, you do not need a special diet or heavy drinking.
The second dose of the drug is taken after 2 weeks - to destroy those parasites that could hatch after the initial treatment. Nemozol has a pleasant taste, no side effects, but it cannot be taken on an empty stomach.
Those who have liver problems should take Nemozol with caution. Be sure to carefully calculate the dose of the medicine; pregnant women and children under 6 years of age are prohibited from taking Nemozol.
Nemozol
Ipca Laboratories, India
— nematodes (ascariasis, enterobiasis, hookworm disease, necatoriasis, trichocephalosis);
- mixed helminthic infestations; — strongyloidiasis; — neurocysticercosis caused by the larval form of Taenia solium; - echinococcosis of the liver, lungs, peritoneum, caused by the larval form of Echinococcus granulosus; - giardiasis; - toxocariasis; - as an adjuvant in the surgical treatment of echinococcal cysts. from 39
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Nutrition
To increase the anthelmintic effect of medications and folk remedies, it is recommended to reduce the load on the digestive system as much as possible. To do this, follow a light diet. It is recommended to exclude sweet and flour products, fried and fatty foods from the diet. You can eat dairy products and drink freshly squeezed juices.
It is allowed to eat porridge and light soups with a small amount of potatoes. It should be remembered that following a diet during treatment for pinworms enhances therapy and improves the general well-being of the patient.
Piperazine
The active ingredient in these anti-helminth tablets is piperazine adipate. The drug is effective against roundworms (pinworms and roundworms). The medicine does not affect parasite eggs, only adults. The drug is prescribed to adults and children.
The course of treatment with Piperazine is 2 days. To enhance the positive effect of treatment, it is advisable to take a laxative or do an enema at this time. After 2 weeks, it is recommended to repeat the course of treatment.
There are almost no side effects when treating with this drug; it is prescribed to adults and children over 3 years of age. To prevent re-infection, you must follow hygiene rules.
Piperazine
Pharmstandard JSC, Russia
Piperazine is an anthelmintic drug that is effective against ascariasis and enterobiasis.
It has a paralyzing effect on nematodes: by disrupting the function of their neuromuscular system, it causes muscle paralysis. from 11
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Bottom line
Enterobiasis cannot be classified as a severe helminthic infestation. Parasites are relatively small in size, and the intoxication of the body as a result of their vital activity is average. But we cannot take this problem lightly.
Advanced forms of enterobiasis are severe and cause complications (intestinal bleeding, bacterial inflammation of the tissues of the perianal area, indigestion and dysbacteriosis). The biggest problem is the rapid spread of the disease and the difficulties of laboratory diagnosis. The appearance of even slight itching in the anus, which intensifies at night, requires immediate consultation with a doctor to rule out pinworm infection.
Vermox
This anti-worm medicine is available in tablets, and the active ingredient is mebendazole. “Vermox” is excreted in feces (and 10% by the kidneys) and is not absorbed through the intestinal wall. The drug against parasites is indicated for children from 3 years of age and adults. Acts on roundworms and nematodes, cestodes. It has no effect on parasite eggs, but suppresses larvae and adult worms.
Depending on your body weight, you need to take 2-4 tablets at once. The treatment lasts 3 days (so you will need to buy several packages of Vermox). During treatment, you should avoid fatty foods, alcohol and laxatives.
Vermox
Gedeon Richter, Hungary
— enterobiasis;
- ascariasis; — hookworm disease; — strongyloidiasis; - trichocephalosis; - trichinosis; - taeniasis; — echinococcosis (if surgical treatment is not possible); - mixed helminthiases. from 86
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Dekaris
Decaris - paralyzes the nervous system of pinworms.
Another name for Decaris is Levomisole. This drug was initially used as an immunomodulator, but as an anthelmintic it began to be used much less frequently.
The mechanism of action of Dekaris: the medicine paralyzes the nervous system of pinworms, which are excreted from the intestines within 24 hours. This medicine can be taken with caution during pregnancy, but it is completely unacceptable when breastfeeding a child, and when treating enterobiasis in children under 3 years of age.
The recommended dose is from 25 mg (1 tablet) in children to 50 mg (2 tablets) in older schoolchildren and adults. The tablets are taken in the evening, after dinner. They need to be washed down with a small amount of water.
In addition to the above contraindications, the drug should not be taken by patients with agranulocytosis; persons with renal or hepatic insufficiency should be used with caution. In case of overdose (600 mg and above), the following symptoms may appear:
- vomiting and nausea,
- headache,
- confusion,
- dizziness,
- convulsions.
Gastric lavage immediately after an overdose relieves most of the symptoms of poisoning.
It is highly not recommended to combine treatment of enterobiasis with Dekaris with alcohol intake.
Manifestations of ascariasis
The development cycle of these worms is about 3 months. This period is the incubation period of the disease. Clinical symptoms of ascariasis are varied. They include:
- the appearance of a rash;
- skin itching;
- slight increase in body temperature;
- decreased appetite;
- nausea;
- flatulence;
- abdominal pain;
- hypersalivation;
- drowsiness;
- weakness;
- irritability.
In severe cases of ascariasis, signs of intestinal obstruction are possible: pain, bloating, constipation. In some cases, adult helminths can be excreted in the feces. Less commonly, ascariasis affects other organs. If roundworms are localized in the eye, oculomotor disorders and hemorrhages are formed. With pulmonary localization, suffocation may occur.
Diagnosis of pinworms
To confirm the presence of enterobiasis, the child must undergo certain diagnostics.
Since pinworm eggs are localized in the folds of the anus, the main method of studying the disease is perianal scraping, which is subsequently subjected to careful analysis under a microscope. It should be noted that to obtain a reliable diagnosis, the study must be carried out several times with an interval of 3-5 days. The sticky tape method is also practiced. During the examination, a special tape is applied to the perianal area, after which the tape is examined under optical magnification. There are other methods for studying helminthic infestation:
- General blood analysis. Elevated levels of eosinophils may indicate the presence of pinworms in the body.
- Coprological analysis - examination of stool can help identify worms and determine their type, however, this method is not always reliable (pinworms are not in a fixed position, but move freely through the intestines, which complicates the diagnostic process).
Causes of pinworms
The main reason for the occurrence of enterobiasis is the widespread prevalence of pinworm larvae and eggs in the child’s environment and non-compliance with the rules of individual hygiene.
The parasitic infection is transmitted by the fecal-oral route. Children injure itchy areas, in the process of which worm eggs end up on their hands and under their nails. In the absence of subsequent hygienic measures, all objects with which the patient comes into contact are exposed to infection. At the same time, pinworm eggs are very small and practically invisible to the naked eye, which allows them to disperse and settle on toys, clothing, bedding and other everyday items. Children with enterobiasis are prone to self-infection. The situation occurs when scratching the itchy skin around the anus. This is how the infection gets on the skin of the hands and re-enters through the mouth into the intestines.
There are factors that increase the risk of enterobiasis:
- visiting crowded places (infection often occurs in kindergartens, schools, playgrounds, etc.);
- failure to comply with personal hygiene rules;
- the presence of habits of biting nails with teeth or sucking fingers;
- lack of cleanliness in the home and children's institutions;
- eating unwashed vegetables and fruits.
