Asian woman has diarrhea holding her bum, pain in the butt, isolated on white background.
Ascariasis Overview
Ascariasis is a parasitic infection caused by the roundworm Ascaris lumbricoides. It is one of the most common helminthic infections worldwide, particularly in areas with poor sanitation. The infection occurs when people ingest roundworm eggs from contaminated soil, food, or water. The adult worms live in the intestines and can cause various symptoms, depending on the worm burden.
Causes
Ascariasis is caused by the ingestion of the eggs of the roundworm Ascaris lumbricoides. The life cycle begins when:
- Eggs from the feces of an infected person contaminate soil, water, or food.
- These eggs are ingested, hatch into larvae in the small intestine, and then migrate through the bloodstream to the lungs.
- From the lungs, the larvae move up to the throat, are swallowed, and return to the intestines, where they mature into adult worms and lay eggs.
Risk Factors
- Poor sanitation: Areas with inadequate waste disposal systems or no access to clean water are at high risk.
- Living in tropical/subtropical regions: The infection is more common in warmer climates where the eggs thrive in the soil.
- Exposure to contaminated soil: Walking barefoot on contaminated soil or handling soil without proper hygiene increases the risk.
- Children: Younger children, especially those playing outdoors, are more likely to be infected due to frequent hand-to-mouth contact.
- Lack of hygiene: People living in crowded conditions with poor personal hygiene are at increased risk.
Symptoms
Many cases of ascariasis are asymptomatic, especially when the worm burden is low. Symptoms typically appear when the infection is more severe and may include:
- Early stage (lung involvement):
- Coughing
- Shortness of breath
- Wheezing
- Fever (due to the larval migration through the lungs)
- Late stage (intestinal involvement):
- Abdominal pain or discomfort
- Nausea and vomiting
- Diarrhea
- Worms visible in the stool or vomit
- Intestinal blockage (in cases of heavy infection)
- Loss of appetite and weight loss
Diagnosis
- Stool examination: Identifying Ascaris eggs in a stool sample is the most common diagnostic method.
- Imaging tests: In cases of complications, an X-ray, ultrasound, or CT scan may show worms in the intestines or other organs.
- Blood tests: Eosinophilia (an increased number of a type of white blood cell) may be detected, especially during the larval migration stage.
Treatment
- Anthelmintic medications: Ascariasis is treated with antiparasitic medications such as:
- Albendazole
- Mebendazole
- Ivermectin
These drugs are highly effective and usually prescribed for a single dose or a short course. - Surgery: In severe cases where there is intestinal obstruction or other complications, surgical removal of worms may be necessary.
Complications
If untreated, ascariasis can lead to various complications, especially in cases of heavy infection:
- Intestinal blockage: Large numbers of worms can obstruct the intestines, leading to severe pain and vomiting.
- Malnutrition: The worms compete for nutrients, leading to poor growth and weight loss, particularly in children.
- Lung damage: During the larval migration phase, the lungs may be inflamed or damaged, leading to respiratory issues.
- Bile duct or pancreatic duct obstruction: Worms may migrate to and block these ducts, causing intense pain and potential liver or pancreatic issues.
Precautions and Prevention
- Proper sanitation: Ensure access to clean water and proper waste disposal systems.
- Hand hygiene: Wash hands thoroughly with soap and water before eating or preparing food and after using the bathroom.
- Avoid contaminated food and water: Wash vegetables and fruits thoroughly and avoid consuming food or water from unsafe sources.
- Wear footwear: Avoid walking barefoot in areas where soil may be contaminated with human feces.
Self-Care and Management
- Follow prescribed treatment: Complete the course of anthelmintic medication as directed by a healthcare provider.
- Maintain hydration and nutrition: Drink plenty of fluids and maintain a balanced diet to recover from the effects of the infection.
- Monitor symptoms: Watch for signs of complications such as severe abdominal pain, which may indicate intestinal blockage.
Ascariasis can be effectively treated with medication, and the infection is preventable with proper sanitation, hygiene, and safe food and water practices.
