Causes and risk factors
Threadworm infection is caused due to Enterobius vermicularis parasite. This parasite harbours into the human body. A person infected with threadworm passes eggs in the feces. Open defecation causes contamination of the soil with the eggs of the parasite.Accidentaly contamination with food or raw vegetables causes the entry of parasite into the human body. The eggs are hatched into the larva in the small intestine. They moult twice and becomes into adults. The male and the female threadworm undergo the sexual cycle in the ileum after which the male worm dies. The died worm is passed through the stools. The females worm remains attached to the intestine and feeds on the colonic content. The female worm lays egg around the anus and vagina. Some of these eggs are again passed through the feces out and thus the cycle continues. Contamination of the infected soil with food or working in soil or infected dirt areas causes transmission of the organism. Itching of at anus can lead to transmission of the eggs from the anus to the mouth through contaminated fingers. An immune compromised people, old people and children whose immunity is yet to build up completely are at high risk for developing the infection. The infection is more prevalent in areas where there is poor sanitation and in warm climate areas. Use of bedlinen, clothing and towels can also spread the infection.
Clinical presentation
Itching around the anus particularly at night along with restlessness during sleep is the cardinal symptom. In females itching at the vaginal along with abnormal discharges are also commonly seen. Ingestion of contaminated food causes pain in abdomen, nausea, vomiting, and diarrhea. The patient experience cramps while passing stools. The stool is watery and bloody. Fever, loss of appetite, and weakness are the other symptoms seen. It leads to protein and iron deficiency and hampers the overall nutrition status of the individual. Recurrent infection in children hampers the physical and mental development of the child due to lack of important nutrition. Weightloss occurs. Accumulation of large number of worms in the intestine can lead to intestinal blockage.
Investigations
Diagnosis is confirmed on the basis of the symptoms narrated by the patient and on the basis of physical examination carried out by the doctor. Itching and sensation as if something is crawling around the anus, narrated by the patient itself helps in confirming the worm infestation. Stool examination is a diagnostic tool. Adhesive tape test for detection of eggs is simple and useful test. Diagnosis can also be confirmed with the help of abdominal X-rays or endoscopy. Certain other routine investigations like complete blood count; urine test etc can also be advised.
Treatment
Administration of oral medications is the only line of treatment.Antihelmintics is prescribed. Iron supplements can also be advised. Ointments for soothing the itch complaints are advised. In severe cases like obstruction of the intestine the person is hospitalized and appropriate treatment is given. Along with this certain preventive measures needs to be implemented. It comprises of maintaining personal hygiene, the clothing must be changed daily. Avoiding open defecation, avoid sharing clothing and Lenin. One should avoid walking barefoot in soil or infected prone areas, all the vegetables and meat should be properly washed and cooked.
Other modes of treatment:
Certain other modes of treatment can also be helpful in coping up the symptom. Taking into consideration the symptoms in holistic way, homoeopathy can offer a good aid for the relief of the symptoms. The Ayurvedic system of medicine which uses herbs and synthetic derivates can also be beneficial in combating the complaints.
