Enterobiosis, what is it? Symptoms, causes and treatment

Enterobiosis is the most common type of helminthiosis, implying the defeat of the human body with pinworms.The disease has a pronounced clinical picture and is capable of being transmitted from an infected person to a healthy person, regardless of gender and age.

Infection with pinworms are affected by people living in countries with absolutely different climatic conditions. The life cycle of this type of parasite is not affected by weather conditions or air temperature. Also from enterobiosis, even those people who live in countries with high social and economic indicators are not insured.

You can get infected with pinworms even if you take periodic anthelmintic drugs for preventive purposes. That is why it is so important to regularly undergo a survey for the detection of this species of helminths, their larvae or eggs in the body.

How is enterobiosis transmitted?

Enterobiosis can be infected by contact with a sick person. Pinworms can lay eggs not only on the epithelium of the internal organs, but also on the surface of the epidermis. After 4-6 hours they mature and begin to pose a threat to healthy people.

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Infection with eggs of helminths of this variety occurs mainly through a contact-household way - through bedding, hygiene items, children's toys, furniture, clothing, etc. The parasites of the parasites are flies in most cases. By infection with pinworms can become:

raw or undercooked meat or fish;
poorly washed fruits and vegetables;
tap water;
food products of doubtful origin.

Eggs of helminths can enter the body and air, for example, when a person inhales contaminated or dusty air.

With the development of enterobiasis, an infected person does not always complain only of discomfort in the abdomen. The symptomatology of pathology is quite diverse, so it can manifest itself in different parts of the body. But in most cases, the culprit of this is the carrier of the disease itself. Combing itching places, it thereby promotes the spread of pinworms, which, in turn, causes them to re-enter the intestine.

Causes and epidemiology of enterobiasis

The causative agent of the pathology is the round worm Enterobius vermicularis, which has a milky white color and a round-oblong shape. The ends of his body are pointed, due to which he got his name (pinworm). Males can reach 3-5 mm in length, females - 9-12 mm.

Parasites are affected, as a rule, the lower part of the thin and upper - the large intestine. After the fertilization process, the male immediately dies, and the female, because of the increase in the uterus and accompanying changes in the body, becomes unable to attach to the walls of the large intestine. Consequently, in the process of its reduction, female pinworms move into the rectum.

When the eggs of the worms ripen, and the stage of formation of the tadpole-shaped larva occurs, the female leaves rectum through the anus to lay eggs in the area of the skin of the perineum. After that, the female dies (dries). As a rule, the pinworm creeps out at night, during the sleep of its carrier. Eggs laid by the female ripen within 4-6 hours and begin to spread during the waking of the invaded person. They are carried on clothes very easily - you just have to touch the zone around the anus. First, eggs fall under the nail plates of the patient, after that - on everyday objects and mucous membranes of the mouth and nose.

Adult individuals of pinworms live in the body for 3-4 weeks, then die if a person complies with the rules of hygiene. If this is neglected, in 99% of cases, repeated infection with pinworms occurs and, as a consequence, a new outbreak of enterobiosis.

Eggs of oysters ripen at a temperature of 35-37 ° C, but sometimes the optimal conditions for them can be temperature regimes, fluctuating in the range 23-40 ° C. The impact of higher temperatures (55 degrees and above) and solar radiation has a detrimental effect on the eggs of the worms, which leads to their death.

What happens when you get infected?

When ingested in the human intestine, the helminths tightly attach to its mucous membranes, which leads to mechanical damage to their integrity. As a result of this, inflammatory processes develop on the locations of pinworms, which are accompanied by a pronounced edema of the epithelium. On its surface erosions, hyperemic areas and bruising are formed.

Throughout the life cycle, pinworms release into the thicknesses of the intestinal epithelium the products of their vital activity, which leads to intoxication of the organism of the infected person. In addition, as the absorption of these products into the blood begins to occur the process of sensitization of the body, resulting in an allergic reaction. It can appear, both on the skin and on the mucous membranes.

In addition, pinworms that creep through the anus can penetrate the genitals. This is fraught with serious problems, because helminths are able to tolerate intestinal bacteria that provoke various diseases of the genitourinary system.

Symptoms of enterobiasis

After infection with pinworms, people do not immediately begin to experience malaise. The incubation period can last from 3 to 6 weeks. The very first alarming symptom, indicating a helminthic invasion (in particular, enterobiosis), is the itching in the region of the anus. It can be insignificant or quite intense - depending on the individual characteristics of the human body and the number of parasites that live in the rectum.

If the disease proceeds in mild form, then within a few days it manifests itself through the appearance of a slight itch which passes by itself. As a rule, it appears only at night. But in case of its constant manifestation during 2-3 weeks, it can be about auto- or re-invasion.

If the number of pinworms in the human intestine is too large, the itching becomes quite intense, painful and unbearable. An infected person is forced to constantly comb the perianal zone, which often leads to injuries. Due to damage to the skin, wounds, cracks and abrasions are formed. Such anomalies lead to the attachment of secondary infection and the development of contact dermatitis, which only complicate the situation and aggravate the state of health of the infected person.

Some patients complain of the appearance of intestinal disorders, accompanied by:

meteorisms;
rumbling in the abdomen;
nausea;
vomiting (rarely);
a violation of the stool.

It is the last symptom observed in patients suffering from enterobiosis and other types of helminthiosis. Cal can become liquid, contain mucus or blood inclusions (rarely). Sometimes it is possible the appearance of constipation, due to which feces can acquire a dark color.

Absence of treatment in severe enterobiasis, or with its repeated development, can lead to serious complications, so if the above symptoms were seen, it is not worth while to hesitate - it is necessary to immediately consult a doctor for further instructions.

Complications of enterobiasis

When there are skin manifestations of enterobiosis (itching and irritation of the epidermis) a person often has an unbearable desire to scratch the sore spots. But this should be avoided, because when combing the itching zones, wounds are formed, in which pathogenic microflora penetrates, which often results in dermatitis and eczema. But among all the complications of this disease, these are the easiest.

If enterobiosis occurs in severe form, or if secondary infection with pinworms occurs, the situation may become more complicated:

irritation of the peritoneum;
development of pyoderma;
paraproctitis;
sphincteritis;
enterobiosis endometritis (develops in women after ingress of female pinworms into the cervical canal).

In rare cases, when the pinworm penetrates deeply into the layers of the intestinal epithelium, it is possible to form a granuloma around it. Too deep immersion of the worm into the intestine may lead to its further ingression into the abdominal cavity, which is fraught with an extremely serious complication, the development of peritonitis.

As a result of irritation with the parasites of the intestinal wall, there is a significant disturbance of peristalsis, which may result in gastroduodenitis or enteritis. In addition, pinworms cause disruption of normal intestinal microflora, which causes the development of dysbacteriosis.

In women, the result of untreated enterobiasis can be infectious diseases of the urinary system. Among the most common complications are cystitis and vulvovaginitis.

On a note. Enterobiosis is a favorable condition for the development and transmission of such parasitic diseases as giardiasis and hymenolepiasis.

Enterobiosis in pregnant women often leads to the development of toxicosis, and also significantly aggravate its course.

Pinworms negatively affect the functioning of the human immune system, so people suffering from enterobiasis are most susceptible to infectious diseases.

It is important! This pathology leads to the development of immune supression in children. This pathological condition is especially acute after antidiphtheria vaccinations, which may result in a significant reduction in the effect of the vaccine.

Diagnostics

It is very important to have a doctor's examination in time for pinpointing pinworms in adults and small patients. You can apply to both the family doctor (or the therapist) and the pediatrician (if the child suffers from helminthiasis). In addition to collecting an anamnesis, the doctor should send a person infected with pinworms to the following examinations.

Koprologic analysis is the study of feces for eggs or larvae of pinworms. However, with enterobiasis, such a diagnostic procedure is ineffective, so it is used as an additional method.
Scraping of a sample of skin in the region of the perianal zone. This technique gives much more information for the reasons described above (a female pinworm lays eggs in this part of the body). To conduct such a procedure is recommended at least 3 times with an interval of 7 days. This is necessary to obtain the most reliable results, since the first scraping can occur during the period of low activity of the female pinworm.
Graham's method is an analysis based on the use of a special adhesive tape that is placed in the perianal zone of the patient. On the surface of the tape remains a mold, which is subsequently subjected to a thorough laboratory examination. Perform manipulation in the morning before going to the toilet and conducting hygiene procedures. Fence material occurs at intervals of 7-10 days. This is one of the most informative methods of research on enterobiasis in adults and children.

How to treat enterobiasis?

Preparations for the treatment of this pathology are the same for all categories of patients - adults and children. Differ only dosage of the medicine, non-observance of which can have serious consequences for the health of a person infected with pinworms. For the same reason, you should not self-medicate.

The most effective anthelmintic medications today are:

Decaris. The active substance is levamisole. In addition to the destruction of helminths, this drug positively affects the human immune system.
Pirentel or Helmintox. The active ingredient is pyrantel pamoate.
Vermox, Wormil, Mebex - anthelmintic preparations based on mebendazole.

One of the most potent antihelminthic drugs is Nemosol. But its use is only in extreme cases, as a systematic use of it can lead to blood cancer. In addition, the drug has a huge number of side effects, and therefore give it to children under 6 years to treat enterobiasis is strictly prohibited. Even after reaching this age, it is better to replace Nemosol with another, safer, medication that has an antiparasitic effect. Its use is justified only if there is a mixed helminthic invasion.

If a pregnant woman or a nursing mother suffers from enterobiasis, in this case prescribe the drug Piperazine. However, it has low efficiency, so there is no guarantee that it will help get rid of all worms.

Rules for taking antihelminthic drugs

Before taking anthelmintic medications, you need to prepare the body. For this, it is necessary to exclude from the diet all the "fastening" foodstuffs a day before the first dose. Before going to bed, you can eat only light food, giving up fried foods. Such a diet should be observed throughout the treatment period.

The drug prescribed by the doctor must be taken on an empty stomach - this increases its absorption into the blood, and therefore the effect of its use will be higher. In the evening you need to drink a laxative to completely clear the intestines from helminths, their larvae and eggs. To achieve maximum results from therapy, after 2 weeks, you should re-take the same drug from worms.

Auxiliary preparations

If a person infected with pinworms is tormented by allergy symptoms, it is necessary to take an antihistamine. For adults, such drugs are released in the form of tablets, for children who have reached six months of age - in the form of syrup. The most effective antiallergic drugs are:

Cetrin.
Fenkarol.
Loratadin.
L-Cet.
Claritin.
Eden and others.

In addition to stopping allergic reactions caused by the breakdown of the products of vital activity of pinworms, these drugs will help prevent a sharp reaction of the body to taking anthelmintic means.

With an intolerable itch in the area of the anus, you can put a cleansing enema. For its preparation, mix 10 soda with 1 liter of boiled water. Apply the whole mixture for 1 time.

Five rules for successful treatment of enterobiasis

To therapy with antihelminthic drugs when infected with pinworms gave the result, it is necessary:

Wash hands with soap after each hike to the street and visit the restroom. Performing a hygienic procedure is also necessary before eating.
Keep the nails clean and always cut them short.
Throughout the treatment period, you need to regularly change your underwear (2 times a day). Before you put on, it should be ironed well with a hot iron.
Use disinfectants to wash the toilet.
Daily do wet cleaning in the house.

If one of these rules is violated, the effect of treatment of enterobiasis will be under great threat. In addition to the fact that a person undergoes repeated development of enterobiosis, he will become a source of infection and for the people around him.