14071 Ascariasis

Overview

Ascariasis is an infection of the intestines caused by a type of roundworm called Ascaris lumbricoides. These worms can grow quite large and live inside the digestive tract.

Ascariasis is common in tropical and subtropical areas with poor sanitation, but it is rare in the UK and most other developed countries.

People of all ages can get ascariasis, but it most often affects children living in areas with limited access to clean water and proper sanitation.

Symptoms

Common symptoms

• No symptoms at all in many cases
• Dull belly pain or discomfort
• Bloating or feeling full quickly
• Nausea or diarrhea
• Seeing worms in your stool (poo)

Symptoms in children

• Belly swelling or a pot belly appearance
• Poor weight gain or slow growth
• Worms visible in a nappy or toilet
• Loss of appetite or picking at food

Symptoms in older adults

• Vague abdominal aches or cramps
• Nausea or a feeling of fullness
• Occasional diarrhea or constipation

Causes

Main causes

• Swallowing Ascaris eggs from food or water contaminated with human stool
• Touching contaminated soil and then putting hands to your mouth
• Using untreated human waste as fertilizer in farming

Risk factors

• Living in or traveling to tropical or subtropical regions with poor sanitation
• Practicing open defecation or lacking a proper toilet
• Washing hands infrequently, especially after using the toilet and before eating
• Eating raw vegetables or fruit grown in contaminated soil

When to see a doctor

See a doctor urgently if:

• If you see a worm in your stool or vomit, see a doctor the same day
• If you have persistent belly pain that interferes with daily life, seek urgent care

Book a routine appointment if:

• If you have unexplained digestive symptoms and have traveled to a high-risk area, book a routine appointment
• If you are worried about possible exposure to contaminated soil or water, talk to your doctor

Diagnosis

Your doctor will ask about your symptoms, travel history, and any possible exposure. They will often ask for a stool sample to look for worm eggs or worms.

Tests that may be done

• Stool sample examination to check for eggs or worms
• Blood test to look for antibodies to the parasite (less commonly used)
• Imaging scans, such as an ultrasound or X-ray, if a blockage is suspected

What to expect at your appointment

You will be given a small container and instructions to collect a stool sample at home. The sample is sent to a lab, and results usually come back within a few days. If the test is positive, your doctor will prescribe treatment.

Treatment

Ascariasis is treated with prescription medication that kills the worms living in your intestines. Your doctor will choose the best medicine based on your age and health, and they will explain exactly how to take it.

Self-care at home

• Wash your hands thoroughly with soap and water after using the toilet and before handling food
• Wash and cook fruits and vegetables well if you are in an area with poor sanitation
• Keep your home clean, especially bathrooms and kitchens, to avoid spreading eggs

Medical treatments

Doctors prescribe a type of deworming medicine that paralyzes the worms so they can pass out of the body in your stool. Treatment is usually a single tablet or syrup, sometimes repeated after two weeks. It is safe, well tolerated, and highly effective. Follow your doctor’s instructions and finish any full course of treatment.

When is surgery considered?

Surgery is rarely needed. In very rare cases, a large number of worms can cause a bowel blockage, a blocked bile duct, or appendicitis, and then surgery may be required to remove the worms or fix the problem.

Living with this condition

While you are being treated, continue with your normal routine. Wash your hands often, especially after using the toilet and before meals. You may notice worms in your stool after taking the medicine – this is expected and means the treatment is working.

Lifestyle tips

• Encourage the whole household to wash hands regularly
• Keep fingernails short and clean, and remind children not to put dirty hands in their mouths
• If you live in a high-risk area, use a safe water source and properly dispose of human waste

Diet and exercise

You do not need a special diet while treating ascariasis. Eat balanced meals, drink plenty of fluids, and get regular physical activity as you normally would. If you have diarrhea, drink extra water to stay hydrated.

Mental health and emotional wellbeing

Finding out you have worms can be upsetting or embarrassing, but this is a very common infection in many parts of the world. It is not a sign of poor hygiene or a character flaw. Treatment works, and you can feel confident that you are taking the right step for your health.

Prevention

Yes, ascariasis can be prevented by using clean water, washing hands thoroughly, using proper toilets, and avoiding the use of untreated human waste as fertilizer. Always wash raw fruits and vegetables before eating.

Vaccines

There is no vaccine to prevent ascariasis.

Screening programmes

Routine screening is not needed for most people. If you have traveled to an area where ascariasis is common, your doctor may suggest a stool test if you have symptoms, but screening is not automatic.

Complications

If left untreated

• Intestinal blockage when many worms gather in a mass
• Blockage of the bile ducts, causing jaundice and infection
• Pancreatitis (inflammation of the pancreas)
• Malnutrition in children due to worms taking nutrients from food

Long-term outlook

With treatment, the outlook is excellent. The worms are cleared in nearly all cases, symptoms go away, and most people return to normal health within a couple of weeks. Even children with growth delays usually catch up once the infection is cured. Ascariasis is a treatable problem with a very hopeful future.

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