Worm infections

Worm infectionsORhelminthiasis– parasitic disease with primary damage to the digestive organs. Helminths, parasitic worms, are able to live in many parts of the gastrointestinal tract (gastrointestinal tract), including. in the large intestine, in the rectum. Diagnosis and treatment of colonic manifestations of helminth infections are carried out together by doctorsparasitologistANDcoloproctologist.

Infection with helminthiasis is characterized by the following properties:

• chronic course, in which nutrients and protective forces are gradually depleted;
• most often the body is invaded by hookworm, roundworm, toxocara, 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 medical infrastructure and development.

Causes and mechanism

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

1. Roundworms (nematodes): roundworms, pinworms (enterobiasis), whipworms (trichocephalosis), eelworms (strongyloidiasis), hookworms, toxocariasis.
2. Tapeworms (cestodes): broad tapeworm, bovine and porcine tapeworm.
3. Flukes (trematodes): schistosomes.

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

Young children are more sensitivehelminthiasisdue 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 feathers. Such food, raw or insufficiently treated with heat, 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 juice. In addition, the presence of helminths in food in the stomach is short-lived. And then, together with the food bolus, they pass into the intestine, where the life cycle continues with the formation of adult individuals.  

In the small and large intestines, more favorable conditions are created for helminths to live. It has a weak alkaline environment, there is a lot of food waste and the mucosa is abundantly supplied with blood. A number of adaptive mechanisms (hooks, suckers, developed muscles) help worms stay in the lumenGastrointestinal tract, adhere to the intestinal mucosa, and do not come out with feces.

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

Some of the parasites penetrate the ductal system of the pancreas, the biliary tract and the liver, causing damage to these organs. In addition, the larvae of a number of helminths are capable of boring 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 group affiliation, the following types of parasitic infection are distinguished:

• cystodosis – echinococcosis, taenia, taeniarinchiasis;
• nematodes – trichocephalosis, ascariasis, nekatoriasis;
• Trimatodes – opisthorchiasis, fascioliasis.

Division of parasites depending on the way of survival in the environment:

• helminths;
• biohelminths;
• contact poisons.

Classification depending on the mode of propagation in the host:

• water;
• food;
• percutaneous.

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

1. The shape of the intestines. They enter the host's body through the oral cavity, gradually spreading to the gastrointestinal tract. The permanent habitat is the intestines. These parasites include fortelloidiasis, pinworm disease and taeniosis.
2. Extraintestinal forms. Penetration can also take place 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, they cause serious complications.

Symptoms

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

• nausea;
• decreased appetite;
• painful pains or cramps in the abdomen;
• bloating;
• bloating;
• diarrhea, constipation, their alternation.

Distinctive symptomenterobiasis: itching, burning in the anus, in the perianal area. This symptom is due to the fact that a sexually mature femalebreast wormsemerges and lays eggs. This happens mostly at night.

If the course is unfavorable, the intestinal lumen can be blocked with groups of worms. In these cases there is a typical clinical picture of mechanical intestinal obstruction with severe abdominal pain, bloating, repeated vomiting, stool and gas retention. Obstruction is complicated by inflammation of the peritoneum with an extremely severe general condition of the patient.  

Extraintestinal disorders include:

• headache;
• weakness, decreased performance;
• changes in the emotional background: depression, nervousness, insomnia;
• weakening;
• pale skin, redness of the skin, paleness 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, lack of immunity, allergies and vitamin deficiency. If helminthiasis is not diagnosed, they are associated with other causes.

Diagnosing

diagnosticdiagnosed on the basis of laboratory analyzes of blood and stool. A general blood test reveals a decrease in the level of hemoglobin and red blood cells. The level of eosinophil leukocytes is increased. It should be noted thatanemiaand eosinophilia are characteristic of other diseases, and therefore only indirectly indicate helminthiases.

Blood immunodiagnosis aims to detect specific antibodies against parasite tissues. Be sure to examine the stool for hidden blood and worm eggs. To diagnose enterobiasis, scraping is performed from the perianal area. For scratching, use a cotton swab or adhesive tape. 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 helminth antigens;
• Ultrasound of the abdominal organs with assessment of the state of the intestines, liver, spleen, pancreas;
• fibrogastroduodenoscopy - visual examination of the upper parts of the digestive tract using the introduction of 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 an endoscopic examination followed by microscopy and histological analysis;
• x-ray or CT of internal organs with the addition of contrast to evaluate the morphological properties of tissues, to detect foreign elements and to 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 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 about the extent of the spread of helminthiasis.

Treatment

Helminthiasisare treated with medications. Depending on the type of parasite, a course of treatment is developed using specificanthelminticdrugs. Many of them further strengthen the immune system. Along with specific treatment, patients receive vitamin and mineral complexes and digestive enzymes. Maximum attention is paid to personal hygiene. In case of intestinal obstruction, emergency surgery is necessary.

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

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

In addition to specific treatment, the prescription of symptomatic drugs is required to eliminate the manifestations caused by helminths:

• antibacterial drugs with additional complication of the condition by activated pathogenic microflora of the digestive tract;
• sorbents that wrap and remove the products of poisoning from helminths before they are absorbed into the systemic circulation;
• 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 intestinal microflora;
• cardiac glycosides for complications of helminthiasis with cardiovascular pathology;
• non-steroidal anti-inflammatory drugs to suppress the active inflammatory process due to the action of 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 intestines to other organs.

Preventing

To prevent the penetration of helminths into the human body, the following actions are recommended:

• frequent washing of hands and food before consumption;
• maintaining basic personal hygiene;
• use of antiglycemic drugs for animals;
• thermal treatment of meat and fish;
• preventive use of drugs against helminths, 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.

PREDICTION

The forecast depends on the following factors:

• type of parasite;
• distribution area of helminths;
• degree of intoxication;
• complications for internal organs and systems.

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