Worms in your stomach? Is this about Ascariasis? Let's find out!

Hello! How are you? Today we are going to talk about a health problem that is a bit unpleasant, but can affect many people. That is the intestinal worm disease called Ascariasis. The name may sound a bit strange, but to put it simply, this is an infection caused by a special type of worm that grows inside our intestines. Don't worry, let's talk about this in detail and simply.

What exactly is Ascariasis?

Simply put, ascariasis is an infection of your intestines caused by a roundworm called Ascaris lumbricoides. Like other parasites, these worms use our bodies to complete their life cycle, that is, to grow to the point where they lay eggs. If these worms grow well inside our bodies, they can harm us. A. lumbricoides is a soil- transmitted helminth (STH). Imagine, the eggs of these worms are passed out with the feces of a person with this worm infection. If such a person defecates in a place where there are no toilet facilities, the eggs become infectious within a few weeks. So if you come into contact with such soil, that is, if you touch dirty soil, you can unknowingly infect this A. lumbricoides` eggs can enter the body and cause a new infection. Also, you can get sick if you drink food and water that contains these eggs. Because these eggs are too small to be seen with the naked eye. However, in urban areas, these eggs do not come through the tap water system, because there are treatment systems. In countries like the United States, this ascariasis infection is very rare. However, in some parts of the world, especially where sanitation is poor (for example, where toilets are not easily accessible to everyone), it is very common. In such areas, people are more likely to come into contact with this dirty soil, food, drink, and water.

What are the main types of Ascariasis?

Ascariasis is most often caused by the roundworm A. lumbricoides, which is found in humans. However, humans can also be infected by the roundworm Ascaris suum, which is found in pigs. If you raise pigs or use pig manure, you are at increased risk of developing this infection.

How common is Ascariasis?

In fact, ascariasis is one of the most common parasitic infections in humans worldwide. It affects more than a billion people. It is the most common intestinal worm disease. It is most commonly found in children living in tropical and subtropical regions with poor sanitation.

What are the symptoms of Ascariasis?

If you only have a few worms in your body, you may not have any symptoms.. Or, you may feel like you have a stomach ache that comes and goes. Sometimes the first sign of this infection is that you pass a live worm when you vomit or have a bowel movement. These `A. lumbricoides` worms are like the worms we see. They are between 6 and 13 inches long and about the thickness of a pencil. Whether you have symptoms depends on where the worms are in your body. They are in different places at different stages of their life cycle.

An infection in your lungs

The larvae, or worms, can infect your lungs. This is the early stage of the infection. During this time, you may experience symptoms similar to those of pneumonia. These include:

• Wheezing is a whistling sound when breathing.
• Cough.
• Shortness of breath .
• Fever.
• Although rare, skin rashes (Hives) may occur.

It is difficult to accurately diagnose the disease at this point, as the symptoms are similar to many other diseases.

Infection in your intestines

The adult worms are in your intestines. At this point, the stomach discomfort you feel may be mild or severe. It depends on how many eggs you have ingested and where the adult worms are located. Symptoms include:

• Severe stomach ache .
• Filling the stomach .
• Nausea and vomiting .
• Sometimes diarrhea .
• Food is tasteless .
• Weight loss without reason.
• Restlessness.
• Insomnia.

As the number of worms in your body increases, the symptoms become more severe .

What causes Ascariasis?

You can get ascariasis if you ingest the eggs of the human roundworm, A. lumbricoides. These worms use your body as a favorable environment to complete their life cycle, which means they grow, mate, and lay more eggs. This species of worm depends on the human body to complete its life cycle.

How is Ascariasis transmitted?

Ascariasis is transmitted by hand-to-mouth contact.`(hand-to-mouth contact)`. That is, if a person touches something that has fertilized eggs of these `A. lumbricoides` worms and touches them with their mouth, those eggs can be ingested. Imagine, in places where sanitation facilities are not good, people with ascariasis infection can defecate in the open. In some areas, people even use human feces as fertilizer. So, dirty feces containing `A. lumbricoides` eggs can be found in fields, roads, and gardens without anyone knowing. People can get these tiny eggs that are too small to see with the naked eye without realizing it in these ways:

• If you touch dirty soil and then put your hand in your mouth or an area around your mouth without washing your hands.
• If you eat fruits and vegetables grown in dirty soil without washing them with clean water, peeling them, or cooking them,
• If you drink dirty water that contains parasite eggs.

What is the life cycle of the worm `A. lumbricoides`?

Once you ingest these eggs, they go into your intestines. There, they develop into larvae and begin to travel throughout your body: 1. These larvae travel through your bloodstream or lymphatic system and eventually to your lungs. They stay there for about two weeks. 2. Then, they travel through the air sacs in your lungs and into your throat. You then swallow them again. 3. The swallowed larvae travel to your small intestine , where they grow into larger worms, mate, and begin to lay eggs. A single female can lay over 200,000 eggs a day! 4. These eggs are passed out of your body in your feces. This entire life cycle can take about two to three months. Once they are passed out of your body in your feces, it takes several weeks for these eggs to become infective to another person. These eggs can survive even the harshest weather conditions and can remain infectious for up to 17 months. If a new person ingests one of these eggs during this time, the cycle begins again in that person's body.

Who is at higher risk of developing Ascariasis?

People who live in or travel to these areas are at higher risk of developing ascariasis:

• Places with limited sanitation and health facilities, such as toilets and clean water for washing hands.
• Places where human feces (or pig feces containing `A. suum`) are used as fertilizer .
• The warm and humid tropical and subtropical regions of Asia, sub-Saharan Africa, and the Americas are ideal for these eggs to survive and become infective.

Age is also a risk factor. Children aged 8 years and younger are more likely to develop this infection. This may be because it is common for children to play in the dirt outside and put their hands in their mouths without washing them.

What are the possible complications of Ascariasis?

Severe infections, especially in children, can lead to complications if left untreated. Some can even be life-threatening if left untreated, but this is very rare.

• Bowel obstruction or blockage of your ducts: If the worms get too large, they can partially or completely block the passageways through your digestive system that allow food and waste to pass through. You may need emergency treatment to remove this blockage.
• Severe inflammation : These blockages can cause severe, sometimes life-threatening inflammatory conditions, such as pancreatitis, cholecystitis, and cholangitis.
• Malnutrition : Infection can prevent you from getting the nutrients you need. If children are infected for a long time, nutritional deficiencies can cause growth problems.

Remember, these complications caused by ascariasis can be prevented if the disease is diagnosed and treated in a timely manner .

How is Ascariasis diagnosed?

Once the worms have entered your intestines, a doctor can test you for the infection by taking a stool sample . They will look for eggs or worms in your stool. Ascariasis can be difficult to diagnose unless the infection has spread beyond your lungs. If your doctor suspects an infection, they may order a chest X -ray to look for worms in your lungs. Other imaging tests – such as ultrasound , computed tomography (CT) scans , and magnetic resonance imaging (MRI) scans – can produce clear images of the worms in places like your ducts. They can also tell how severe your infection is.

How is Ascariasis treated?

Antiparasitic medications can treat this infection. They kill the adult worms. You will need to take this medication for one to three days, and all the large worms will die. Most people will start to feel better and their symptoms will improve quickly after taking this medication, even before all the worms are dead. It is normal for the dead worms to pass out in the stool after treatment, which can be a bit uncomfortable. There are several types of medications that are used for treatment:

• Albendazole (Albendazole - Albenza®)
• Ivermectin (Ivermectin - Stromectol®)
• Pyrantel pamoate (Pin-X®) – This may be more appropriate if you are pregnant.

These medications kill the adult worms the most . Larvae do not die so easily. Therefore, you may need to take another round of this medication in about a month or three to give the larvae time to develop into adults and kill them too.

Does Ascariasis require surgery?

Although this is very rare, if you have a complication such as a bowel obstruction, you may need surgery. Your doctor may need to remove the worms or repair damaged tissue. Most often, doctors do these repairs using a minimally invasive procedure called endoscopic retrograde cholangiopancreatography (ERCP). This involves smaller incisions and a shorter recovery time than traditional open surgery.

Can Ascariasis be prevented?

Yes, you definitely can. If you live in or travel to an area with high infection rates, be aware of these things:

• Do not touch soil that may be contaminated with bare hands , especially soil used as fertilizer for crops.
• Wash your hands thoroughly with soap before preparing food and before eating.
• Teach your children to wash their hands regularly .
• Wash, peel, and/or cook vegetables and fruits that are eaten raw (especially those grown in fertilized soil).
• Do not defecate in the open in areas where there are no proper waste disposal facilities.

What is the outlook for people with ascariasis?

Ascariasis is a very treatable disease . If you take your anti-parasitic medication correctly, you won't have any long-term problems. Take your medication as directed by your doctor. Follow the steps to prevent reinfection.

What happens if Ascariasis is not treated?

The worms can live for about two years. When they die, they pass out when you poop. Unless you ingest the eggs again and start the cycle over, the infection is over once the worms are gone. However, it is not a good idea to "just sit there" with an ascariasis infection because it can cause complications. Also, if you live in an area where the infection is common, you can easily get reinfected. If you or your child have symptoms of an infection, or if you see a worm, such as an `A. lumbricoides` worm, in your stool, see a doctor right away .

What questions should I ask my doctor?

You can ask the doctor questions like:

• Do I need to be tested to determine if I have an infection?
• What kind of treatment do I need?
• How long do I need to take the medicine?
• Will ascariasis cause me long-term health problems?
• What can I do to avoid getting infected again?

Ascariasis is a common roundworm infection that is found all over the world. It can be prevented if the community has adequate sanitation. If you live or travel to an area where the infection is common, help protect yourself by washing your hands often. Wash fruits and vegetables thoroughly, peel them, cook them, and prepare other foods properly. If you have symptoms of ascariasis, such as severe stomach pain, see a doctor. Antiparasitic medications can kill the worms and cure the infection.

Take-Home Message

• Ascariasis is a soil-borne worm disease . The eggs enter the body through dirty hands, food, and water.
• This is commonly seen among children.
• Symptoms may disappear, or you may experience stomach upset, cough, or fever.
• This can be cured very well with simple medicines .
• The most important thing is to stay clean and follow good hygiene practices . Handwashing, proper food preparation, and safe defecation practices are essential.

If you have any further questions about this, don't hesitate to talk to a doctor. Stay healthy!