Worm attack

Worm attackorhelminthiasis– a parasitic disease with primary damage to the digestive organs. Helminths, parasitic worms, can live in many parts of the gastrointestinal tract (gastrointestinal tract), includingin the large intestine, in the rectum. Diagnosis and treatment of colonic manifestations of helminth infection are carried out together by doctorsparasite expertAndcoloproctologist.

Infection with helminthiasis is characterized by the following features:

• chronic course, in which nutrients and protective forces are gradually exhausted;
• more often the body is attacked by hookworms, roundworms, toxocara, trichocephalus;
• pathology is studied and treated not only in pediatrics and therapy, but also in gastrology, surgery, dermatology, allergy and other areas.

The disease affects a small percentage of the country's population, but it tends to spread in areas with poor medical infrastructure and development.

Causes and mechanisms

Large intestinal parasitic helminths are represented by three classes:

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

Most of themhelminthscomplex development cycle. Between egg and adult there is an intermediate stage: larva, cyst form (cyst or fin). Worm eggs are resistant to adverse conditions and can live 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 vulnerablehelminthiasisdue 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 fins. Such food, raw or insufficiently heat treated, also serves as a source of infection.  

Parasites cannot exist in the aggressively acidic environment of the stomach. But their shells are resistant to the action of gastric juices. In addition, the presence of helminths in food in the stomach is short-term. And then, together with the food bolus, they enter the intestine, where the life cycle continues with the formation of an adult individual.  

Better conditions for helminths to live are created in the small and large intestines. There is a weak alkaline environment, there is a lot of food waste, and the mucous membrane is supplied with a lot of blood. A number of adaptive mechanisms (hooks, suckers, developed muscles) help the worm to remain in the lumenGastrointestinal tract, adhere to the intestinal mucosa, and do not come out with feces.

Their presence in the large intestine leads to local inflammatory processes - typhlitis, colitis, sigmoiditis, proctitis. In the process of life, they are liberatedtoxins. Many of them are strong allergens.  

Some parasites penetrate the pancreatic duct system, bile ducts, and liver, causing damage to these organs. In addition, the larvae of some helminths are able to bore 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 the combination of groups, the following types of parasitic infections are distinguished:

• cystodoses - echinococcosis, taeniasis, taeniarinchiasis;
• nematodes - trichocephalosis, ascariasis, necatoriasis;
• Trimatoda - opisthorchiasis, fascioliasis.

The distribution of parasites depends on the way they live in the environment:

• helminths;
• biohelminths;
• contact helminths.

Classification depends on the method of spread into the host:

• water;
• food;
• percutaneous.

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

1. Bowel shape. They enter the host's body through the oral cavity, gradually spreading to the gastrointestinal tract. The permanent habitat is the intestine. These parasites include strongelodiasis, hookworm disease, and tenniosis.
2. The outer shape of the intestine. Penetration can also develop through the gastrointestinal tract, but then the parasite migrates through the intestinal wall to other organs. For example, blood vessels, subcutaneous fat, liver, brain. Opisthorchiasis, fascioliasis and trichinosis have this characteristic.

The external form of the intestine is considered the most dangerous; it causes severe complications.

symptoms

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

• nausea;
• decreased appetite;
• pain or cramping in the stomach;
• flatulence;
• flatulence;
• diarrhea, constipation, alternating.

Distinct symptomsenterobiasis: itching, burning in the anus, in the perianal area. This symptom is caused by the fact that a sexually mature womanpinwormscome out and spawn. This happens especially at night.

If the journey is not favorable, the lumen of the intestine may become blocked with a cluster of worms. In this case, there is a typical clinical picture of mechanical intestinal obstruction with severe abdominal pain, flatulence, repeated vomiting, stool retention and gas. Obstruction is complicated by inflammation of the peritoneum with a very serious general condition of the patient.  

Extraintestinal disorders include:

• headache;
• weakness, decreased performance;
• changes in the emotional background: depression, irritability, insomnia;
• emaciated;
• pale skin, skin rash, pallor and visible dryness of mucous membranes;
• dry cough;
• frequent colds;
• appearance and frequency of bronchial asthma attacks;
• bruxism - grinding teeth while sleeping;
• muscle and joint pain.

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

Diagnostics

Diagnosisdiagnosed based on blood and stool laboratory tests. A general blood test reveals a decrease in hemoglobin and red blood cell levels. The level of eosinophilic leukocytes is increased. It should be taken into account thatanemiaand eosinophilia is characteristic of other diseases, and therefore only indirectly indicates helminthiases.

Blood immunodiagnosis aims to detect specific antibodies to parasitic tissue. Be sure to check the stool for hidden blood and worm eggs. To diagnose enterobiasis, scraping is done from the perianal area. To scrape, 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, its spread area and the extent of damage:

• allergic skin test with the addition of helminth antigen;
• Ultrasound of the abdominal organs with assessment of the condition of the intestines, liver, spleen, pancreas;
• fibrogastroduodenoscopy - visual examination of the upper part of the digestive tract using the introduction of a certain device through the oral cavity;
• colonoscopy - visual examination of the wall 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 or CT of internal organs with the addition of contrast to evaluate the morphological properties of tissues, detect foreign elements, and identify the integrity of the wall;
• liver scintigraphy - identification of radiotracers that accumulate in the liver and emit radiation that is displayed on the monitor (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 of the degree of spread of helminthiasis.

Treatment

Helminthiasistreated with medicine. Depending on the type of parasite, a course of treatment is developed using specificworm medicinedrugs. Many of them strengthen the immune system. Along with specific treatment, patients take vitamin and mineral complexes and digestive enzymes. Maximum attention is paid to personal hygiene. If there is an intestinal obstruction, emergency surgery is required.

In severe cases, it is not enough to use drugs to treat helminths. It is better to use products with a specific focus on certain types of parasites:

• 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 complications of the condition by activated pathogenic microflora of the digestive tract;
• a sorbent that envelops and removes helminth intoxication products before they are absorbed into the systemic bloodstream;
• enzymes that improve the digestive process, especially if helminthiasis is complicated by diarrhea;
• probiotics - use is mandatory when using anthelmintic and antibacterial drugs 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 are prescribed for the activation of the immune system and the development of acute allergic reactions.

Surgery is considered a last resort. It is prescribed for complications. For example, when the parasite moves from the intestine to other organs.

Prevention

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

• frequently wash hands and food before eating;
• maintain basic personal hygiene;
• the use of antiglycemic drugs for animals;
• heat 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 stool for analysis.

Forecast

Predictions depend on the following factors:

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

Parasitic infections that are identified and treated in time guarantee a positive prognosis. If the therapy is carried out at an early stage, no complications will occur. If it is not present or is set incorrectly, pathology begins to develop that worsens well-being. In severe cases, abdominal and thoracic organs are damaged, and the infection can spread to the brain. Such pathology worsens the quality of life and can cause the inability 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.