Worm infections

Worm infectionsorhelminthiasis– parasitic diseases with primary damage to the digestive organs. Helminths, parasitic worms, can live in many parts of the gastrointestinal tract (gastrointestinal tract), including the intestinal tract. in the colon and rectum. Doctors jointly diagnose and treat colonic manifestations of intestinal worm infectionsparasitologistAndcoloproctologist.

Helminthiasis infection is characterized by the following features:

• a chronic course in which nutrients and protective forces are gradually depleted;
• hookworm, roundworm, toxocara, trichocephalus attack the body more often;
• Pathology is examined 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 it usually spreads in areas with poor infrastructure and medical development.

Causes and mechanism

Helminths parasitizing the colon can be divided into three classes:

1. Roundworms (nematodes): roundworms, needleworms (enterobiasis), whipworms (trichocephalosis), eelworms (strongyloidiasis), hookworms, toxocara.
2. Tapeworms (cestodes): broad tapeworm, cattle and pig tapeworm.
3. Flukes (trematodes): schistosomes.

Mosthelminthscomplex development cycle. Between eggs and adults there are intermediate stages: larvae, cystic forms (cysts or fins). Eggs of worms are resistant to adverse conditions and can survive for long periods in soil and water. They enter the human body with raw water, unwashed hands, and 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 worms. Meat, fish, shellfish contain eggs, larvae or fins. Such raw or improperly heat-treated food also serves as a source of infection.  

Parasites cannot exist in the aggressive acidic environment of the stomach. But their shell resists the effects of gastric juice. In addition, the presence of helminths in food in the stomach is short-lived. Then, together with the bolus from the food, they enter the intestine, where the life cycle continues with the development of adult individuals.  

More favorable conditions for the life of helminths are created in the small and large intestine. There is a weakly alkaline environment, there is a lot of food residue, and the mucous membrane is abundantly supplied with blood. Several adaptive mechanisms (hooks, suckers, developed muscles) help worms stay in the lumenGastrointestinal tract, sticks to the intestinal mucosa and does not come out with stool.

Their presence in the large intestine leads to local inflammatory processes - typhlitis, colitis, sigmoiditis, proctitis. They are released in the course of lifetoxins. Many of them are strong allergens.  

Some of the parasites penetrate the duct system of the pancreas, the bile ducts and the liver and damage these organs. In addition, the larvae of many helminths can bore through the intestinal wall. Through the flow of blood and lymph, they enter the muscles, lungs, eyes and brain and damage these organs.

Classification of helminthiasis

Depending on the affiliation of the group, the following types of parasitic infections are distinguished:

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

The distribution of parasites depending on how they survive in the environment:

• helminths;
• biohelminths;
• contact helminths.

Classification depending on the mode of spread into the host:

• water;
• food;
• percutaneously.

Depending on the distribution area, there are 2 types of parasites.

1. Intestine form. They enter the host through the oral cavity, gradually spreading in the gastrointestinal tract. The permanent habitat is the intestines. These parasites include strongeloidiasis, hookworm disease and taeniosis.
2. Extraintestinal forms. The penetration can also occur through the gastrointestinal tract, but then the parasites migrate through the intestinal wall to other organs. For example, blood vessels, subcutaneous fat, liver, brain. Opisthorchiasis, fascioliasis and trichinosis have this feature.

Extraintestinal forms are considered the most dangerous, causing serious complications.

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;
• bloating;
• bloating;
• diarrhea, constipation, alternation of these.

Distinctive symptomenterobiasis: itching, burning sensation in the anus, in the perianal area. This symptom is due to the fact that she is a sexually mature womanpinwormscomes out and lays eggs. This happens mainly at night.

In the event of an unfavorable course, the intestinal cavity can become clogged with groups of worms. In these cases, the characteristic clinical picture of mechanical intestinal obstruction is associated with severe abdominal pain, bloating, repeated vomiting, stool and gas retention. The obstruction is complicated by inflammation of the peritoneum, with an extremely serious general condition of the patient.  

Extraintestinal disorders include:

• headache;
• 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;
• appearance and frequency of bronchial asthma attacks;
• bruxism - teeth grinding during sleep;
• muscle and joint pain.

These symptoms are caused by damage to organs and tissues, poisoning, immune deficiency, allergies and vitamin deficiency. If helminthiasis is not diagnosed, they are associated with other causes.

Diagnostics

Diagnosisit is diagnosed based on laboratory blood and stool tests. A general blood test shows a decrease in the level of hemoglobin and red blood cells. The level of eosinophilic leukocytes increases. This should be taken into accountanemiaand eosinophilia are characteristic of other diseases, so they only indirectly indicate helminthiasis.

Blood immunodiagnosis is aimed at detecting specific antibodies against parasitic tissues. Be sure to check the stool for hidden blood and worm eggs. To diagnose enterobiasis, a scraping is performed from the perianal area. Use a cotton ball or duct tape to scrape. Damage to the intestinal mucosa is diagnosed using endoscopic methods - sigmoidoscopy, colonoscopy.

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

• allergic skin test with the addition of helminthigens;
• Ultrasound of the abdominal organs by assessing the condition of the intestines, liver, spleen, and pancreas;
• fibrogastroduodenoscopy - visual examination of the upper part of the digestive system by introducing a specific 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 tissue sections during endoscopic examination, followed by microscopic and histological analysis;
• radiography of internal organs or CT with the addition of contrast to assess the morphological properties of tissues, detect foreign elements and identify 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 organ's morphology, size, location, presence or absence of defects can be assessed).

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

Treatment

Helminthiasistreated with medication. Depending on the type of parasite, specific treatment is usedanthelminticmedicines. Many of them further strengthen the immune system. In addition to special treatment, patients take vitamin and mineral complexes and digestive enzymes. Maximum attention is paid to personal hygiene. Intestinal obstruction requires emergency surgery.

In severe cases, it is not enough to use drugs to treat helminths. It is better to use products that focus on a specific type of parasite:

• anticystic;
• antinematodes;
• anti-trematodes;
• broad spectrum of action against different groups of parasites.

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

• antibacterial drugs with additional complications of the condition with activated pathogenic microflora of the digestive system;
• sorbents that encapsulate and remove helminth poisoning products before they are absorbed into the systemic bloodstream;
• enzymes that improve the digestive process, especially if helminthiasis is complicated by diarrhea;
• probiotics - their use is mandatory if 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 due to the effect of parasites;
• glucocorticosteroids prescribed for the activation of the immune system and the development of acute allergic reactions.

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

Prevention

In order to prevent the penetration of helminths into the human body, it is recommended to perform the following actions:

• frequent hand washing and before eating;
• compliance with basic personal hygiene;
• use of antiglycemic drugs for animals;
• heat treatment of meat and fish;
• preventive use of anti-helminthic 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 regularly giving stool for analysis.

Forecast

The forecast depends on the following factors:

• the type of parasite;
• area of distribution of helminths;
• degree of poisoning;
• complications in internal organs and systems.

A parasite infection recognized and treated in time guarantees a positive prognosis. If the therapy is carried out in the early stages, complications do not develop. If it is missing or incorrectly prescribed, pathologies develop that impair well-being. In severe cases, the abdominal and chest organs are damaged, and the infection can spread all the way to the brain. Such pathologies impair 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.