Worm infestationsorhelminthiasis– parasitic diseases accompanied by primary damage to the digestive organs. Helminths, parasitic worms, can live in many parts of the gastrointestinal tract (gastrointestinal tract). in the colon, rectum. Diagnosis and treatment of colon manifestations of helminth infections are carried out jointly by doctors.
Infection with helminthosis is characterized by the following features:
- a chronic course in which food and protective forces are gradually exhausted;
- more 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 part of the country's population, but tends to spread in areas with poor infrastructure and medical development.
Causes and mechanism
Helminths parasitizing the large intestine are represented by three classes:
- Roundworms (nematodes): roundworms, pinworms (enterobiasis), whipworms (trichocephalosis), snail worms (strongyloidiasis), hookworms, toxocaras.
- Tapeworms (cestodes): broad tape, beef and pork worms.
- Flukes (trematodes): schistosomes.
The mosthelminthscomplex development cycle. There are intermediate stages between eggs and adults: larvae, cystic forms (cysts or fins). Worm eggs are resistant to adverse conditions and can live in soil and water for a long time. They enter the human body with raw water, unwashed hands, fruits and vegetables contaminated with soil.
Young children are more vulnerablehelminthiasisbecause of 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. Raw or undercooked food also serves as a source of infection.
Parasites cannot exist in the aggressive acid 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-term. And then, together with the food bolus, they pass to the intestine, where the life cycle continues with the formation of adults.
More favorable conditions are created for helminths to live in the small and large intestines. There is a weakly alkaline environment, there are many food residues, and the mucous membrane is abundantly supplied with blood. A number of adaptive mechanisms (hooks, suckers, developed muscles) help worms stay in the lumen.Gastrointestinal tract, stick to the intestinal mucosa and do not come out with feces.
Their presence in the colon causes local inflammatory processes - typhoid, colitis, sigmoiditis, proctitis. In the process of life, they are releasedtoxins. Many of them are strong allergens.
Some of the parasites penetrate the duct system of the pancreas, bile ducts and liver, causing damage to these organs. In addition, the larvae of a number of helminths are able to bore through the intestinal wall. They enter the muscles, lungs, eyes, brain through blood and lymph flow and damage these organs.
Classification of helminths
Depending on group affiliation, the following types of parasitic infection are distinguished:
- cystodoses - echinococcosis, taeniasis, taeniarynchiasis;
- nematodes - trichocephalosis, ascariasis, necatoriasis;
- Trimatodes – opisthorchosis, fascioliasis.
Division of parasites depending on the way they live in the environment:
- helminths;
- biohelminths;
- contact helminths.
Classification depending on the method of spread to the host:
- water;
- food;
- percutaneously.
Depending on the distribution area, there are 2 types of parasites.
- Intestinal form. They enter the host's body through the oral cavity, gradually spreading to the gastrointestinal tract. The permanent residence is the intestines. These parasites include strongelloidosis, ankylosing spondylitis, and tenniosis.
- Extraintestinal forms. Penetration can also develop from the gastrointestinal tract, but then the parasites move through the intestinal walls to other organs. For example, blood vessels, subcutaneous fat, liver, brain. Opisthorchosis, fascioliasis and trichinosis have this feature.
Extraintestinal forms are considered the most dangerous, causing severe complications;
Symptoms
Helminthiasis can be asymptomatic for a long time. Later, non-specific symptoms of intestinal disorders appear:
- nausea;
- decreased appetite;
- aching or cramping pain in the abdomen;
- swelling;
- flatulence;
- diarrhea, constipation, their turn.
A different symptomenterobiosis: itching, burning in the anus, perianal area. This symptom is related to being a sexually mature womanpinwormsemerges and lays eggs. This happens mostly at night.
If the course is unfavorable, the intestinal lumen may be clogged with groups of worms. In these cases, there is a typical clinical picture of mechanical intestinal obstruction with severe abdominal pain, bloating, repeated vomiting, retention of feces and gases. Obstruction is complicated by inflammation of the peritoneum with an extremely serious general condition of the patient.
Extraintestinal diseases include:
- headaches;
- weakness, decreased performance;
- changes in the emotional background: depression, irritability, insomnia;
- emaciation;
- pale skin, skin rash, pallor and dryness of visible mucous membranes;
- dry cough;
- frequent colds;
- appearance and frequency of attacks of bronchial asthma;
- bruxism - teeth grinding during sleep;
- muscle and joint pain.
These symptoms are caused by organ and tissue damage, intoxication, immune deficiency, allergy, vitamin deficiency. If helminthosis is not diagnosed, they are associated with other causes.
Diagnostics
Diagnosisit is diagnosed on the basis of laboratory tests of blood and feces. A general blood test shows a decrease in the level of hemoglobin and red blood cells. The level of eosinophilic leukocytes increases. It should be noted thatanemiaand eosinophilia are characteristic of other diseases and therefore indicate helminthosis only indirectly.
Blood immunodiagnosis is aimed at detecting specific antibodies to parasite tissues. Be sure to check the feces for hidden blood and worm eggs. For the diagnosis of enterobiosis, a scraping is performed from the perianal area. Use a cotton swab or adhesive tape to tighten. 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 spread and the degree of damage:
- allergy skin test with the addition of helminth antigens;
- Abdominal ultrasound with assessment of the condition of intestines, liver, spleen, pancreas;
- fibrogastroduodenoscopy - visual examination of the upper parts of the digestive system using a special device from 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 CT of internal organs with the addition of contrast to evaluate the morphological characteristics of tissues, detect foreign elements and determine the integrity of the walls;
- liver scintigraphy - application of a radiotracer that collects in the liver and emits radiation shown on the monitor (organ's morphology, size, location, presence of defects can be evaluated).
Research methods are prescribed depending on the emerging symptoms and the doctor's suspicion of the prevalence of helminthosis.
Treatment
Helminthosestreated with drugs. Depending on the type of parasite, a course of treatment is prepared using specific
In severe cases, it is not enough to use drugs to treat helminths. It is better to use products with special attention against a certain type of parasite:
- antichristian;
- antinematodes;
- anti-trematodes;
- broad spectrum of activity against various groups of parasites.
In addition to special treatment, it is necessary to prescribe symptomatic drugs to eliminate the manifestations caused by helminths:
- antibacterial preparations with additional aggravation of the situation with the activated pathogenic microflora of the digestive system;
- sorbents that cover and remove the products of helminth intoxication before they are absorbed into the systemic blood;
- enzymes that improve the digestive process, especially if helminthosis is complicated by diarrhea;
- probiotics - to restore the normal state of the intestinal microflora, use is mandatory when using anthelmintic and antibacterial drugs;
- cardiac glycosides for complications of helminthosis with cardiovascular pathologies;
- non-steroidal anti-inflammatory drugs to suppress the active inflammatory process under the influence of parasites;
- glucocorticosteroids prescribed for the activation of the immune system and the development of acute allergic reactions.
Surgery is the last resort. It is prescribed for complications. For example, when parasites move from the intestines to other organs.
Prevention
To prevent helminths from entering the human body, it is recommended to take the following actions:
- frequent washing of hands and food before eating;
- observe basic personal hygiene rules;
- use of antiglycemic drugs for animals;
- heat treatment of meat and fish;
- prophylactic 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. That's why doctors recommend periodically giving 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 parasitic infection detected and treated in time guarantees a positive prognosis. If the therapy is carried out in the early stages, no complications will develop. If it is absent or incorrectly determined, pathologies that impair well-being begin to develop. 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 loss of work ability. Possible death due to the development of anaphylactic shock and helminthosis of the central nervous system. Therefore, timely diagnosis is important in this case.