Worm infestationseitherhelminthiasis– parasitic diseases with primary damage to the digestive organs. Helminths, parasitic worms, can live in many parts of the gastrointestinal tract (gastrointestinal tract), incl. in the large intestine, in the rectum. The diagnosis and treatment of colonic manifestations of helminth infections is carried out jointly by doctors.parasitologistANDcoloproctologist.
Helminthiasis infection is characterized by the following properties:
- chronic course, in which nutrients and defenses are gradually depleted;
- more often the body is invaded by hookworms, roundworms, toxocara, 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 represented by three classes:
- Nematodes (nematodes): roundworms, pinworms (enterobiasis), whipworms (trichocephalosis), eels (strongyloidiasis), hookworms, toxocaras.
- Tapeworms (cestodes): broad tapeworm, bovine and porcine tapeworm.
- Trematodes (trematodes): schistosomes.
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. With raw water, dirty hands, fruits and vegetables contaminated with soil, they enter the human body.
Young children are more susceptiblehelminthiasisdue to the habit of putting one's hands and foreign objects in one's mouth. Animals often carry helminths. Meat, fish and shellfish contain eggs, larvae or fins. These foods, raw or insufficiently heat-treated, also serve as a source of infection.
Parasites cannot exist in the aggressive acidic environment of the stomach. But its 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 bolus, they pass to 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 helminths to live. There is a weak alkaline environment, there is a lot of food residue, and the mucous membrane receives abundant blood. Various adaptation mechanisms (hooks, suction cups, developed muscles) help the worms to stay in the light.gastrointestinal tract, they adhere to the intestinal mucosa and do not come out with the feces.
Its presence in the large intestine leads to local inflammatory processes: typhlitis, colitis, sigmoiditis, proctitis. In the process of life, they are liberated.toxins. Many of them are strong allergens.
Some of the parasites penetrate the pancreatic duct system, bile ducts and liver, causing damage to these organs. In addition, the larvae of various 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 helminthiases.
Depending on the group affiliation, the following types of parasitic infection are distinguished:
- cystodosis – echinococcosis, taeniasis, taeniarynchiasis;
- nematodes – trichocephalosis, ascariasis, necatoriasis;
- Trimatodes: opisthorchiasis, fascioliasis.
Division of parasites according to the method of survival in the environment:
- helminths;
- biohelminths;
- contact with helminths.
Classification according to the method of spread to the host:
- water;
- 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 and gradually spread through the gastrointestinal tract. The permanent habitat is the intestines. These parasites include strongelloidiasis, hookworm, 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.
Extraintestinal forms are considered the most dangerous; cause serious complications.
Symptoms
Helminthiasis can be asymptomatic for a long time. Subsequently, nonspecific symptoms of intestinal disorders appear:
- nausea;
- decreased appetite;
- pain or cramps 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 womanpinwormsShe comes out and lays eggs. This happens mainly at night.
If the course is unfavorable, the intestinal lumen may become clogged with accumulations of worms. In these cases there is a typical clinical picture of mechanical intestinal obstruction with severe abdominal pain, abdominal distension, repeated vomiting, feces and gas retention. Obstruction is complicated by inflammation of the peritoneum with an extremely serious general condition of the patient.
Extraintestinal disorders include:
- headaches;
- weakness, decreased performance;
- changes in the emotional background: depression, irritability, insomnia;
- slimming;
- pale skin, skin rash, paleness and dryness of visible mucous membranes;
- hacking cough;
- frequent colds;
- the occurrence and frequency of bronchial asthma attacks;
- bruxism – cutting teeth during sleep;
- Muscle and joint pain.
These symptoms are caused by organ and tissue damage, poisoning, immunodeficiency, allergies, and vitamin deficiencies. If helminthiasis is not diagnosed, it is associated with other causes.
Diagnosis
Diagnosisdiagnosed on the basis of laboratory analysis of blood and feces. A general blood test reveals a decrease in the level of hemoglobin and red blood cells. The level of eosinophilic leukocytes increases. It must be taken into account thatanemiaand eosinophilia are characteristics of other diseases and therefore only indirectly indicate helminthiasis.
Blood immunodiagnosis aims to detect specific antibodies against the parasite tissues. Be sure to examine the stool for hidden blood and worm eggs. To diagnose enterobiasis, a scraping of the perianal area is performed. To scrape, use a cotton swab or tape. Damage to the intestinal mucosa is diagnosed by 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:
- allergy 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 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 microscopy and histological analysis;
- x-ray or computed tomography 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 - the introduction of a radiotracer that accumulates in the liver and emits 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
HelminthiasisThey are treated with medication. Depending on the type of parasite, a course of treatment is developed usinganthelminticdrugs. Many of them further strengthen the immune system. In addition to 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 necessary.
In severe cases, it is not enough to use medications to treat helminths. It is better to use products with a specific focus against a specific type of parasite:
- anticystic;
- antinematodes;
- antitrematodes;
- Broad spectrum of action against different groups of parasites.
In addition to specific treatment, the prescription of symptomatic medications 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 envelop and eliminate 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 when using anthelmintic and antibacterial drugs to restore the normal state of the intestinal microflora;
- cardiac glycosides for complications of helminthiasis in cardiovascular pathologies;
- non-steroidal anti-inflammatory drugs to suppress the active inflammatory process due to the action of parasites;
- Prescribed glucocorticosteroids for the activation of the immune system and the development of acute allergic reactions.
Surgery is considered the treatment method of last resort. It is prescribed for complications. For example, when parasites move from the intestines to other organs.
Prevention
To prevent the penetration of helminths into the human body, it is recommended to perform 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 anti-helminth drugs, especially if characteristic symptoms appear or the patient is at risk.
Prevention methods reduce the risk of helminth infection, but cannot eliminate it completely. Therefore, doctors recommend periodically donating feces for analysis.
Forecast
The prognosis depends on the following factors:
- type of parasite;
- helminth distribution zone;
- 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, complications will not develop. If it is absent or prescribed incorrectly, pathologies begin to develop that worsen well-being. In severe cases, the 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.