Worm infestationsORhelminthiasis– parasitic diseases with primary damage to the digestive organs. Helminths, parasitic worms, are able to live in many parts of the gastrointestinal tract (gastrointestinal tract), incl. in the large intestine, in the rectum. Diagnosis and treatment of colon manifestations of helminth infections are carried out jointly by doctorsparasitologistANDcoloproctologist.
Helminthiasis infection is characterized by the following properties:
- chronic course, in which nutrients and protective forces are gradually depleted;
- more often the body is invaded by hookworms, roundworms, toxocara, whipworms;
- 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 to areas with poor medical infrastructure and development.
Causes and mechanism
Helminths that parasitize the large intestine are represented by three classes:
- Roundworms (roundworms): roundworms, pinworms (enterobiasis), whipworms (whipworms), eels (strongyloidosis), hookworms, toxocara.
- Tapeworms (tapeworms): broad tapeworm, bovine and porcine tapeworm.
- Trematodes (trematodes): Schistosomes.
Mosthelminthscomplex development cycle. Between eggs and adults, intermediate stages are distinguished: larvae, cystic forms (cysts or finna). Worm eggs are resistant to adverse conditions and can survive for a long time in soil and water. With raw water, unwashed hands, soil contaminated fruits and vegetables 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 fins. Such food, raw or insufficiently heat-treated, 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 intestine, more favorable conditions are created for the life of helminths. There is a weak alkaline environment, there are many food residues, and the mucosa is abundantly supplied with blood. A series of adaptive mechanisms (hooks, suckers, developed muscles) help the worms stay in the lumenGastrointestinal tract, they 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. In the process of life, they are releasedtoxins. Many of them are strong allergens.
Some parasites enter the pancreatic ductal system, the biliary tract and the liver, causing damage to these organs. Furthermore, the larvae of numerous helminths are capable of piercing 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 group membership, the following types of parasitic infection are distinguished:
- cystodosis – echinococosis, taeniasis, taenyarrhiasis;
- roundworms – whipworm, ascariasis, necatoriasis;
- Trimatodes – opisthorchiasis, fascioliasis.
Division of parasites according to the method of survival in the environment:
- helminths;
- biohelminths;
- contact helminths.
Classification based on the method of spread in the host:
- waterfall;
- food;
- percutaneous.
There are 2 types of parasites depending on the distribution area.
- Intestinal form. They enter the host's body through the oral cavity, gradually spreading into the gastrointestinal tract. The permanent habitat is the intestine. These parasites include strongeloidiasis, hookworm disease, and tenniosis.
- Extraintestinal forms. Penetration can also develop 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.
The extraintestinal forms are considered the most dangerous; cause serious complications.
Symptoms
Helminthiasis can remain asymptomatic for a long time. Subsequently, nonspecific symptoms of intestinal disorders appear:
- nausea;
- decreased appetite;
- aching or cramping pain in the abdomen;
- swelling;
- flatulence;
- 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 femalepinwormsshe comes out and lays eggs. This happens especially at night.
If the course is unfavorable, the intestinal lumen can become blocked with clusters of worms. In these cases, a typical clinical picture of mechanical intestinal obstruction presents with severe abdominal pain, bloating, repeated vomiting, retention of feces and gas. Obstruction is complicated by inflammation of the peritoneum with extremely serious general condition of the patient.
Extraintestinal disorders include:
- heachache;
- weakness, decreased performance;
- changes in the emotional background: depression, irritability, insomnia;
- emaciation;
- pale skin, rash, paleness and visible dryness of the mucous membranes;
- dry cough;
- frequent colds;
- the occurrence and frequency of bronchial asthma attacks;
- bruxism – cutting teeth while sleeping;
- muscle and joint pain.
These symptoms are caused by organ and tissue damage, intoxication, immunodeficiency, allergies and vitamin deficiencies. If helminthiasis is not diagnosed, it is associated with other causes.
Diagnostics
Diagnosisdiagnosed on the basis of laboratory tests on blood and feces. A general blood test reveals a decrease in the level of hemoglobins and red blood cells. The level of eosinophilic leukocytes is increased. This should be taken into accountanemiaand eosinophilia are characteristic of other diseases and therefore only indirectly indicate helminthiasis.
Blood immunodiagnostics aim to detect specific antibodies against parasitic tissues. Be sure to examine the feces for hidden blood and worm eggs. To diagnose enterobiasis, curettage of the perianal area is performed. To scrape, use a cotton ball or 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 extent of damage:
- skin allergy test with addition of helminth antigens;
- Ultrasound of the abdominal organs with evaluation of the condition of the intestine, 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 to evaluate the morphological properties of tissues, detect foreign elements and identify the integrity of the walls;
- liver scintigraphy - introduction of a radiotracer that accumulates in the liver and emits radiation displayed on the monitor (it is possible to evaluate the morphology, size, location of the organ, the presence or absence of defects).
Research methods are prescribed based on the symptoms that appear and the doctor's suspicion of the degree of spread of helminthiasis.
Treatment
Helminthiasisare treated with drugs. 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 take vitamin and mineral complexes and digestive enzymes. Maximum attention is paid to personal hygiene. In case of intestinal obstruction, emergency surgery is required.
In severe cases, it is not enough to use drugs to treat helminths. It is best to use products targeted against a specific type of parasite:
- anti-cyst;
- antinematodes;
- antitrematodes;
- broad spectrum of action against different groups of parasites.
In addition to specific treatment, the prescription of symptomatic drugs is necessary to eliminate the manifestations caused by helminths:
- antibacterial drugs with further complication of the condition due to activated pathogenic microflora of the digestive tract;
- sorbents that envelop and remove 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 the intestinal microflora;
- cardiac glycosides for complications of helminthiasis with cardiovascular pathologies;
- nonsteroidal 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 resort for treatment. It is prescribed for complications. For example, when parasites move from the intestine to other organs.
Prevention
To prevent the penetration of helminths into the human body, it is recommended to carry out the following actions:
- frequent washing of hands and food before consumption;
- maintain basic personal hygiene;
- 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 feces for analysis.
Forecast
The forecast depends on the following factors:
- type of parasite;
- helminth distribution area;
- degree of intoxication;
- complications for internal organs and systems.
Parasitic infection identified and treated promptly guarantees a positive prognosis. If therapy is carried out in the early stages, no complications will develop. If it is absent or prescribed incorrectly, pathologies begin to develop that worsen well-being. In severe cases, abdominal and thoracic organs are damaged and the infection can spread to the brain. These pathologies worsen the quality of life and can cause 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.