Worm infestationorHelminthiasis– 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 gastrointestinal tract. in the colon, in the rectum. Diagnosis and treatment of colonic manifestations of helminthic infections is carried out jointly by doctorsparasitologistAndColoproctologist.
Helminthiasis infection is characterized by the following characteristics:
- chronic course, in which nutrients and defenses are gradually exhausted;
- more often the body is affected by hookworms, roundworms, Toxocara and Trichocephalus;
- Pathology is studied and treated not only in pediatrics and therapy, but also in gastrology, surgery, dermatology, allergology and other areas.
The disease affects a small percentage of the country's population, but tends to spread in areas with poor infrastructure and medical development.
Causes and mechanism
Helminths that parasitize the large intestine are divided into three classes:
- Roundworms (Nematodes): Roundworms, Pinworms (Enterobiasis), Whipworms (Trichocephalosis), Eelworms (Strongyloidiasis), Hookworms, Toxocaras.
- Tapeworms (cestodes): broadband worm, beef and pork tapeworm.
- Flukes (trematodes): schistosomes.
The mostHelminthscomplex development cycle. Between eggs and adults there are intermediate stages: larvae, cystic forms (cysts or fins). Worm eggs are resistant to adverse conditions and can survive in soil and water for a long time. They enter the human body through raw water, unwashed hands, fruit and vegetables contaminated with soil.
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 and shellfish contain eggs, larvae or fins. Such foods, raw or inadequately heat-treated, also serve as a source of infection.
Parasites cannot occur in the aggressive acidic environment of the stomach. However, their shell is resistant to the effects 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 enter the intestine, where the life cycle continues with the formation of adult individuals.
More favorable living conditions for helminths are created in the small and large intestines. There is a slightly alkaline environment, a lot of food residue and the mucous membrane is richly supplied with blood. A number of adaptive mechanisms (hooks, suckers, developed muscles) help the worms to remain in the lumenGastrointestinal tract, stick to the intestinal mucosa and do not come out with the feces.
Their presence in the large intestine leads to local inflammatory processes – typhlitis, colitis, sigmoiditis, proctitis. They are released over the course of lifeToxins. Many of them are strong allergens.
Some of the parasites invade the pancreatic duct system, bile ducts and liver and damage these organs. In addition, the larvae of some helminths are capable of piercing the intestinal wall. With the blood and lymph flow, they reach the muscles, lungs, eyes and brain and damage these organs.
Classification of helminthiasis
Depending on the group affiliation, the following types of parasitic infections are distinguished:
- cystodoses – echinococosis, taeniasis, taeniarinchiasis;
- Nematodes – trichocephalosis, ascariasis, necatoriasis;
- Trimatodes – opisthorchiasis, fascioliasis.
Classification of parasites depending on the type of survival in the environment:
- helminths;
- biohelminths;
- Contact with helminths.
Classification depending on the type of spread into the host:
- Water;
- Eat;
- percutaneously.
Depending on the area of distribution, there are two types of parasites.
- Intestinal shape. They enter the host's body through the oral cavity and gradually spread through the gastrointestinal tract. The permanent habitat is the intestine. These parasites include strongeloidiasis, hookworm disease and tenniosis.
- Extraintestinal forms. Penetration can also occur via 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. Subsequently, non-specific symptoms of intestinal disorders appear:
- nausea;
- decreased appetite;
- aching or cramping pain in the abdomen;
- flatulence;
- Flatulence;
- Diarrhea, constipation, their change.
Distinctive symptomEnterobiasis: Itching, burning in the anus, in the perianal area. This symptom is due to the fact that a sexually mature womanPinwormscomes out and lays eggs. This mainly happens at night.
If the course is unfavorable, the intestinal lumen can become blocked by worm piles. In these cases, the typical clinical picture is a mechanical intestinal obstruction with severe abdominal pain, flatulence, repeated vomiting, stool retention and flatulence. The obstruction is complicated by inflammation of the peritoneum with an extremely serious general condition of the patient.
Extraintestinal diseases include:
- Headache;
- weakness, reduced performance;
- Changes in the emotional background: depression, irritability, insomnia;
- Emaciation;
- pale skin, rash, pallor and dryness of visible mucous membranes;
- dry cough;
- frequent colds;
- the occurrence and frequency of attacks of bronchial asthma;
- Bruxism – cutting teeth while sleeping;
- Muscle and joint pain.
These symptoms are caused by organ and tissue damage, poisoning, immune deficiency, allergies and vitamin deficiencies. If helminthiasis is not diagnosed, other causes are related.
diagnosis
diagnosisDiagnosis is based on laboratory tests of blood and stool. A general blood test shows a decrease in hemoglobin levels and red blood cells. The level of eosinophil leukocytes is increased. That should be taken into accountanemiaand eosinophilia are characteristic of other diseases and therefore only indirectly indicate helminthiasis.
Immunodiagnostics of blood is aimed at detecting specific antibodies against parasite tissue. Be sure to check the stool for hidden blood and worm eggs. To diagnose enterobiasis, curettage from the perianal area is performed. Use a cotton swab or 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 distribution and the extent of damage:
- Allergy skin test with the addition of helminth antigens;
- Ultrasound of the abdominal organs with an assessment of the condition of the intestines, liver, spleen, pancreas;
- Fibrogastroduodenoscopy – visual examination of the upper parts of the digestive tract 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 an endoscopic examination followed by microscopy and histological analysis;
- Radiography or CT of internal organs with the addition of contrast agent to assess the morphological properties of tissues, detect foreign bodies and establish the integrity of the walls;
- Liver scintigraphy – the introduction of a radiotracer that accumulates in the liver and emits radiation displayed on the monitor (morphology, size, location of the organ, presence or absence of defects can be assessed).
Depending on the symptoms that appear and the doctor's suspicion of the degree of spread of helminthiasis, research methods are prescribed.
Treatment
Helminthiasisare treated with medication. Depending on the type of parasite, a specific treatment method is developedanthelminticDrugs. Many of them also strengthen the immune system. In addition to specific treatment, patients take vitamin and mineral complexes and digestive enzymes. Great attention is paid to personal hygiene. In the event of an intestinal obstruction, emergency surgery is necessary.
In severe cases, it is not enough to use medications to treat helminths. It is better to use products specifically aimed at a specific type of parasite:
- anticystadic;
- antinematodes;
- anti-trematodes;
- wide spectrum of action against different groups of parasites.
In addition to specific treatment, the prescription of symptomatic drugs is necessary to eliminate manifestations caused by helminths:
- antibacterial drugs with additional complication of the disease caused by activated pathogenic microflora of the digestive tract;
- sorbents that envelop and remove helminth poisoning products before they are absorbed into the systemic bloodstream;
- Enzymes that improve the digestive process, especially when 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 in complications of helminthiasis with cardiovascular diseases;
- non-steroidal anti-inflammatory drugs to suppress active inflammatory processes due to the action of parasites;
- Glucocorticosteroids, which are prescribed to activate the immune system and develop acute allergic reactions.
Surgery is considered the last resort of treatment. It is prescribed in case of complications. For example, when parasites migrate from the intestines to other organs.
prevention
To prevent helminths from entering the human body, the following measures are recommended:
- frequent hand washing and eating before consumption;
- maintaining basic personal hygiene;
- Use of antiglycemic drugs in animals;
- heat treatment of meat and fish;
- preventive use of drugs against helminths, especially when 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 donating feces for analysis.
forecast
The prognosis depends on the following factors:
- type of parasite;
- Distribution area of helminths;
- degree of intoxication;
- Complications for internal organs and systems.
A timely detected and treated parasitic infection guarantees a positive prognosis. If therapy is carried out in the early stages, complications do not arise. 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 lead to incapacity to work. Possible death due to the development of anaphylactic shock and central nervous system helminthiasis. Therefore, timely diagnosis is important in this case.