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Parasitic infestation: Ascariasis

Constipation in children

Ascaris lumbricoides infection


One of the most common parasitic infestations in the gastrointestinal tract is ascariasis. Heavy ascaris infections are most popular in children, and prevalence is alarming in areas where there is poor sanitation practices and hygiene. The highly durable ascaris eggs are the key for its survival in every part of the globe. Children are the most likely to get the infection, especially those who love playing with sand and soil.

The causative organism of ascariasis, which is Ascaris lumbricoides, is also known as the giant roundworm in humans. These common roundworms are frequently found in the small intestine, with larvae typically located in the lungs of infected individuals. Ascariasis is common worldwide. Infection follows after ingestion of viable eggs through contaminated food. The usual path followed by the roundworms after ingestion is that at first the larvae hatch in the small intestine, infiltrate their way into the bloodstream which will then allow them to have access to the lungs. It is in the lungs where they molt, and after a week they are being carried to the bronchioles, bronchi, trachea, and even to the mouth! These are then swallowed back by the host unknowingly, then afterwards the roundworms gain their way back into the gastrointestinal tract. It is in the digestive tract where they stay to grow into adult worms, growing up to 40 cm in length and persisting for approximately one to two years. The developing larva contained within eggs, which are covered with a highly protective shell that can withstand tremendous amounts of heat and cold, are then excreted in the feces. No wonder why A. lumbricoides is the most common and most known parasite infecting the gastrointestinal tract.

Alike most parasitic infestations, individuals with ascariasis are most often asymptomatic, especially those with light intestinal infection. At times, during migration of worms in the body especially to the lungs, a few systemic but non-specific symptoms develop such as cough, fever, difficulty in breathing, and chest pain can be present. Sometimes, larvae can be lodged at sites such as the eye, brain, spinal cord, and kidney and this will consequently result to localized symptoms.

For those who are heavily infected, abdominal pain or discomfort is most prominent. It is in these cases wherein worms get coughed out or vomited out, due to infection of the lungs. These worms can also emerge via the anus or go as high as the nose, and can also migrate to other sites such as the common bile duct, the neighboring pancreatic duct, and even the appendix. Massive amounts of worms can obstruct the small and large intestines, thus interfering with food passage and can cause abnormalities in defecation. As a result, there is commonly malnutrition in infected children, not to mention a significant decrease food intake and even in appetite.

There are a number of treatment regimens available nowadays, even as over-the-counter medications. But in cases of heavy infection, as manifested when adult worms begin emerging out from the mouth and other sites, complications need to be ruled out through imaging modalities, as requested by the physician. Obstruction by the worms in the intestines does not generally require surgery and can be alleviated through intake of an antihelminthic. However, pancreatitis, appendicitis, intussusception (or the prolapse of a part of the intestine into the lumen of an adjacent part), and even death, can ensue in highly massive infections. Thus, ascariasis should not be taken lightly!

Due to its very high in prevalence, intake of an antihelminthic is advised every six months for both adults and children. Sticking to this advice will help you loosen up and protect you and your children, whether at work or at play!


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