Brief overview
- Treatment: Especially good hygiene, hand washing, cleaning contaminated items; worming medication for the affected person and household members.
- Symptoms: Nocturnal itching at anus; possibly worms in stool; rarely complications such as intestine or appendicitis; possibly inflammation of vagina if infested
- Cause and risk factors: Infestation with pinworms; fecal-oral transmission through poor hygiene, especially in children; inhalation of eggs, for example, when making the bed; sexual intercourse.
- Diagnosis: Based on symptoms; possibly blood test; microscopic evaluation of an adhesive strip stuck to the anal region in the morning
- Prognosis:Usually harmless, often asymptomatic infection; rarely complications such as inflammation of the bowel or vagina; good chance of treatment; with good hygiene without self-re-infection, cure often by itself
- Prevention: Good hygiene, washing hands after going to the toilet and before preparing food; clean potentially contaminated objects
What is oxyuriasis?
Oxyuriasis is caused by infection with the pinworm. Some doctors refer to the intestinal parasite infection as enterobiosis. The name is based on the Latin name of the worm: Enterobius vermicularis.
How can oxyuriasis be treated?
If an infestation with pinworms has been detected or if an infection is suspected, it is advisable to observe a few points in order to get rid of the parasite infestation as quickly as possible. In order to avoid an immediate reinfection, i.e. a recurring infection, it is important to take some hygiene measures. At the same time, doctors administer medication to kill the worms in the intestine.
Hygienic measures for oxyuriasis (enterobiasis)
In order to avoid further spreading as well as reinfection, affected persons should ideally observe the following instructions, among which cell phone hygiene should be emphasized in particular:
- Thorough hand washing after going to the toilet and before contact with foodstuffs
- Only disinfectants containing chlorhexidine effectively kill the eggs. However, thorough hand washing is usually sufficient.
- Wash underwear, pajamas, and bed linens with boil wash
- Change underwear every night
- Tight underpants during the night prevent unconscious scratching.
- In case of anal itching, apply special cream before going to bed (the doctor will advise)
- Cleaning toys and possible contaminated objects with hot water
- Keep fingernails short
- Detergents containing biguanide and phenol are suitable for cleaning surfaces.
- Household vacuum cleaners only spread the eggs.
Medication for oxyuriasis (enterobiasis).
Treatment of oxyuriasis is very simple. A single tablet is usually sufficient to kill the pinworms in the intestine. Since reinfections are common, therapy should be repeated after 14 days. All infected persons should start drug therapy at the same time to avoid repeated, mutual infection.
Often, close living persons, such as family members in the same household, are also treated as a precaution. There are several medications that successfully kill pinworms. This group of substances is called antihelmintics. The two most commonly used agents are:
- Mebendazole
- Pyrantel
In the case of infestation of the vagina, physicians recommend the worming agent albendazole, which is most likely to be taken as a tablet and also acts systemically throughout the body.
In consultation with the doctor, these drugs can usually also be used during an existing pregnancy.
Home remedies against pinworms
In addition to the effective medications and hygiene measures, some home remedies are described to help quickly get rid of an infestation of pinworms. These include:
- Sauerkraut juice
- Raw sauerkraut
- Raw carrots
- Black cumin oil
- Pineapple
- Papaya
Other home remedies with garlic, thyme or pumpkin seeds, among others, should also help.
Home remedies have their limits. If the symptoms persist over a longer period of time, do not get better or even get worse, you should always consult a doctor.
What are the symptoms?
Pinworms (Enterobius vermicularis) often go unnoticed for a long time, because no symptoms appear. The most common and specific symptom of oxyuriasis is itching of the anus and vagina. Since the female worms usually emerge from the anus at night to spread their eggs in the folds of the surrounding skin, the itching is particularly bothersome at night. Inspection of the stool or underpants sometimes reveals small worms. The patient usually visits the doctor for these two reasons.
In young children, sometimes a behavioral or developmental disorder is noticed. Because of the itching, sometimes there is indirect sleep disturbance.
In girls and women, there is a risk that the worm will infest the vagina and cause an inflammatory reaction there, possibly with discharge.
As a rule, however, enterobiosis or oxyuriasis is a harmless disease, and complications are very rare.
Causes and risk factors
Pinworms occur more frequently in babies and children, but sometimes also in adults. Women are generally more affected than men. Pinworms are small thread-like parasites that belong to the nematodes (threadworms).
As parasites, they belong to the group of living organisms that live in another organism (for example, in humans) and feed at its expense. The pinworm only affects humans. The adult worms live in the large intestine, where they develop from larvae into the adult worm.
The male is about half a millimeter, the female up to 1.5 centimeters. After fertilization, the female migrates to the anus and lays up to 10,000 eggs in the folds of skin directly around the anus, preferably at night. This produces an itching sensation. Due to the partly unconscious scratching during sleep, the eggs thus quickly reach the hands and under the fingernails of the infected person. If the contaminated fingers are put in the mouth, self-infection is possible.
Oxyuriasis is mainly transmitted via hand contact. An important risk factor is therefore poor hygiene and negligent hand washing. Since the infection occurs mainly in young children, the risk of oxyuriasis infection is higher in daycare centers or crèches than at home.
The parasite may also be transmitted during sexual intercourse. Anal-oral practices in particular make infection possible.
Examinations and diagnosis
For the physician, anal itching is often the first sign indicating a possible oxyuriasis infection. The first port of call is usually the family doctor. He or she will first question the patient in detail. He will ask questions such as:
- When does the itching mainly occur?
- Have you observed white worms in the feces or the anus?
A blood test often provides further indications of a pinworm infestation. There is an increase in the number of immune cells that specifically fight against parasites, so-called eosinophils. If their number is increased, this is called eosinophilia.
In some cases, especially with heavy infestation, the small white worms can already be seen on the stool. If the worms reach the outside world, they die quickly. In the excreted stool, however, they can sometimes still be seen in living form. Especially the females stay near the intestinal outlet. They can be recognized by their white, thread-like shape and their whip-like movements.
Course of the disease and prognosis
Oxyuriasis is usually harmless. Only rarely do complications occur. In children, it is common for them to re-infect themselves during the same night. The eggs pass directly from the anus to the mouth through finger/thumb sucking. However, this does not usually pose a major risk to the child’s health.
The therapy is very well tolerated, and side effects occur only in very few cases. Complications are also rare.
In the case of severe infestation, intestinal function may be impaired. Inflammation or perforation are then possible. These potentially life-threatening courses are very rare and are accompanied by stool retention or abdominal/abdominal pain.
If there is no self-re-infection by ingestion of the eggs with appropriately good hygiene, the worms often disappear from the intestine on their own after two to three weeks, when their life cycle has ended.
Prevention
Above all, good hygiene such as washing hands especially after going to the toilet and before preparing food helps prevent infection – or re-infection.
Changing underwear daily, keeping fingernails short, and washing down potentially contaminated toys and objects (especially if other children also handle them) also help.
However, complete prevention is difficult because infection with pinworms happens very easily. In some cases, one already becomes infected, for example, when shaking out the beds by inhaling the eggs. Experts estimate that up to 500 million people worldwide become infected every year and that practically every second person is affected by oxyuriasis at least once in their lifetime.
