Wednesday, 16 August 2017

More than just a nuisance?


Are you missing the signs and symptoms of threadworm infestation?


I don't know if it's coincidence or quite why it happpens but sometimes in clinic I will have patient after patient presenting with the same (or very similar) health problems.

It's great for me as I can really hone a lot of my research time into the one area and the deeper I dig the more (knowledge) I usually find.

This happened recently and inspired this blog-
I 've been seeing a run of  people (usually children ) with recurrent pinworm or enterobiasis infestation.

 

Recurrent worm infection- more than just an itchy bottom?


When I see a patient with recurrent worm infections with short worm free periods in between then I start to concern myself with their;


  • Nutrient status- probably compromised!
  • Immune system- often over burdened and drained.
  • Digestive function- usually disturbed. 


Worm infestation occurs most commonly between the ages of 7-11, more likely in girls at a rate of 3:1 and is very unusual under the age of 2.

Could it be worms?

 

Contrary to popular belief your child could have worms and NOT have an itchy bottom.
Common signs and symptoms of worm infestation include:
  • Appetite change
  • Weight loss
  • Vague abdominal pain
  • Nose picking & thumbsucking
  • Sleep disturbances - nightmares, teeth grinding, resltessness & fatigue
  • Vulval itching, pain & redness- in girls
  • Urinary incontinence

 

How do you tell if you or your child has worms?

 

You can't always rely on the tell tale itchy bum. Many carriers will NOT have an itchy bottom at all.
Aside from the behavioural and gut disturbances listed above we might see elevated eosinophils in a standard blood count and elevated white cells in urine- basically immune cells in wee- this occurs when worms migrate to the vagina, this is fairly common in girls and the standard worming meds do not work outside of the gut.


Female reproductive issues- could it even be worms?

 

Some of the rarer complications of worm infestation are due to migration of worms through the vagina and into the pelvic cavity. There are reports in the literature, albeit rare, of infertility and pelvic inflamatory disease as a result.


 

And the MOST reliable testing method is....

 



Yep, you might have geussed it- the sticky tape method.
This has been scientifically evaluated against culture testing and DNA testing to be the most reliable test when done correctly.
The Sticky tape test involves applying tape to the perianal area on 3 consecutive nights and examining microscopically. More details on how to carry out the test can be found here


 

And the best plan of attack?

 

Of course, the usual strategies such as nail cutting, handwashing, clean bedding and dusting could be applied but beyond that what else can you do?

  • Gut healing- bone broth contains chondroitin sulphate for gut defence and integrity.
  • Immune support- whether with herbs or nutritents, enables a more effective immune response at the gut level.
  • Nurtient repletion- nutrient deficiency can occur due to disturbed digestion and appetite. Often it is our key immune nutrients such as Zinc and vitamin A that become depleted, potentially creating a vicious cycle.
  • Consider screening for diantamoeba fragilis- newer research suggests D.fragilis mayintroduce enterobiasis to the gut.

Threadworm infestation occurs across all strata of society, is more common in girls and may be causal in some instances of appendicitis. In some cases it is more than a nuisance and maybe an indicator that the gut integrity and immune response is lacking.
I would always pay particular attention when it occurs in children under 2 as well as in those with recurrent infections.

Got gut concerns, talk to us at Health expressions, experts in gut health.