Ascariasis – Diagnosis and Treatment
Diagnosis
Examining Stool for Worm Signs
Doctors often check for Ascaris lumbricoides by looking at stool samples under a microscope. They look for small, oval eggs or larvae laid by female worms living in the intestines.
These eggs do not appear right away after infection—there is usually a wait of about 40 days before eggs show up in feces. If a person only has male worms or if eggs have not yet been released, the test may come back negative.
A positive test confirms the presence of Ascaris eggs, which helps doctors know the person has active ascariasis.
In cases of heavy infection, people may see whole worms in stool or expel them by coughing or through the mouth or nose.
| Test | What it Looks For | When It’s Useful |
|---|---|---|
| Stool sample | Ascaris eggs/larvae | 40+ days after infection |
| Worms in stool | Adult Ascaris worms | Severe infestations |
Checking Blood for Changes
Blood work may show more eosinophils, a type of white blood cell. This increase, called eosinophilia, can signal that the body is reacting to a parasite.
However, higher eosinophils are not specific to Ascaris—they can occur with different parasites or allergies.
Blood tests may also show other changes depending on how severe the infection is. Doctors use these results along with stool findings and symptoms like abdominal pain, cough, or bronchial problems.
Possible signs in blood tests:
- Eosinophilia
- Changes in other white blood cells
Scans and Imaging of the Body
X-rays, ultrasounds, CT scans, and MRIs can help spot worms that are too big or deep to see in stool samples.
- Abdominal X-rays might show a mass of adult worms.
- Chest X-rays could reveal larvae that have passed to the lungs during the worm’s life cycle and might cause coughing.
- Ultrasound is often used to check for worms in the liver or pancreas.
- CT scans and MRI help find blockages in bile ducts or the pancreas, especially if there are signs like jaundice or severe abdominal discomfort.
Doctors use imaging tests when someone has unusual gastrointestinal symptoms or when stool or blood tests do not provide a clear diagnosis.
Tip: If you see a worm in vomit or saliva, bring it to the clinic for identification to speed up finding the right treatment.
Treatment
Medicines for Managing Ascariasis
Doctors treat ascariasis with anti-parasitic medications that kill adult roundworms in the intestine. These are typically taken over one to three days. Mild side effects such as stomach pain or diarrhea may occur.
For pregnant women, over-the-counter antiparasitic options may be preferred due to safety.
| Medication | Common Use | Possible Side Effects |
|---|---|---|
| Benzimidazole-type antiparasitic | Kills adult worms | Abdominal pain, diarrhea |
| Macrocyclic lactone antiparasitic | Severe infections | Abdominal pain, diarrhea |
| Broad-spectrum antiparasitic agent | General treatment | Abdominal pain, diarrhea |
| Pyrantel pamoate (non-prescription) | Pregnant women | Mild stomach upset |
Surgical Methods to Remove Worms
Doctors may perform surgery for severe cases. This may happen if a person has an intestinal blockage, a hole in the intestine, or problems like a liver abscess caused by the worms.
Surgeons remove the worms and repair damage, such as fixing the intestine or clearing a blocked bile duct. Doctors consider surgery when medicines alone do not work.
Getting Ready for Your Medical Visit
Steps You Can Take Beforehand
- List Symptoms: Write down when symptoms started, such as stomach pain or problems with digestion.
- Note Changes: Record if anything improves or worsens the symptoms, especially after eating certain foods or traveling.
- Check for Worms: Look for signs like worms in stool or vomit, which can be common with infections from contaminated soil.
- Travel History: Mention recent visits to tropical regions or areas with poor sanitation, as these places often have higher rates of soil-transmitted helminths like roundworm, hookworm, or whipworm.
- Medications List: Bring a list of all medicines and supplements, especially if the patient is a child or is experiencing malnutrition.
How the Doctor May Examine and Question You
Doctors may check for pain in the belly by pressing down in different spots. The doctor may request a stool sample to test for parasites, especially in children or those from endemic areas such as China or sub-Saharan Africa.
If the doctor suspects complications like appendicitis or blockage, they may refer the patient to a specialist or surgeon.
