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Intestinal parasites result in morbidity and mortality around the world, especially in undeveloped countries. However, even in developed countries, like the United States, intestinal parasites can be a serious medical concern.
What are the Most Common Intestinal Parasites in the United States?
The most common intestinal parasites in the United States are: Enterobius vermicularis, Giardia lamblia, Ancylostoma duodenale, Necator americanus, and Entamoeba histolytica.
Enterobius vermicularis AKA Pinworm or Seatworm
E. vermicularis (otherwise known as pinworm or seatworm) is the most common intestinal parasite in the United States. It is estimated that 209 million people are infected globally. Additionally, more than 30 percent of children, around the world, are infected with pinworm.
Pinworms live in the cecum of the large intestine, primarily. Eggs are spread by fecal-oral contamination. Symptoms include perineal, perianal and vaginal irritation, with constant itching. Although the primary secondary effect is sleep disturbance, due to this irritation, more serious effects can include: weight loss, urinary tract infection and appendicitis.
Giardia lamblia is the most common intestinal parasite in the world, and the second most common in the United States. Like pinworms, giardia is spread through fecal-oral contamination. This means countries with poor sanitation, as well as those with a higher prevalence of oral-anal sexual practices, see a higher incidence rate. Giardia is resistant to chlorine, at levels found in normal tap water, so often becomes water-borne. It also survives well in cold mountain streams, so those who spend a lot of time camping, hunting or backpacking are also susceptible. For this reason, it’s often known as “backpacker’s diarrhea” and “beaver fever.”
Symptoms include: gastrointestinal distress, nausea, vomiting, flatulence, cramping, diarrhea, malaise, steatorrhea, and weight loss. These symptoms last between two to four weeks. Rarely, patients also suffer from reactive arthritis or asymmetric synovitis, typically in the lower extremities.
Ancylostoma duodenale and Necator americanus (AKA Hookworm)
A. duodenale and N. americanus are two forms of hookworm. A. duodenale, “Old World” hookworm is found in Europe, Africa, Japan, China, India, and the Pacific Islands. N. americanus, “New World” hookworm is found in the Americas and the Caribbean, primarily, but has recently been found in Africa, Asia and the Pacific. With the advancements in modern plumbing and footwear, N. americanus infection rates have decreased significantly, since the early 1900s. However, the CDC still reports significant infections in the southeastern part of the US.
The biggest concern from infection of hookworm is blood loss. A hookworm uses an anticoagulant and consumes approximately 0.25 mL of blood per day. This can result in microcytic hypochromic anemia, which can result in hypoproteinemia, edema, pica, and wasting. Hookworm infection in children can result in physical and mental retardation. Thirty to 60 percent of hookworm infected persons will develop eosinophilia.
E. histolytica is typically caused by poor hygiene during food preparation, or fertilizing crops with human waste or oral-anal sex. Crowding and poor sanitation also increase the incidence of spread of this intestinal parasite. It is estimated that 10 percent of the global population is infected; however, 90 percent of those infected people don’t show any symptoms. Of the approximately 50 million cases with symptoms each year, roughly 100,000 are fatal. After malaria, this means E. histolytica is the world’s second leading protozoan cause of death.
The epithelial ulcerations from the parasite can cause bleeding and colitis, typically 2 to 6 weeks after the patient has been first infected. As the infection progresses, this can result in weight loss, malaise, severe abdominal pain, fever, and profuse bloody diarrhea.
What are the Common Signs or Symptoms of Intestinal Parasites?
These are the most common signs or symptoms of intestinal parasites. If you are experiencing any of these, talk to a medical professional.
- Abdominal pain
- Nausea or vomiting
- Gas or bloating
- Dysentery (loose stools containing blood and mucus)
- Rash or itching around the rectum or vulva
- Stomach pain or tenderness
- Feeling tired
- Weight loss
- Passing a worm in your stool
What is the Treatment for Intestinal Parasites?
The treatment for intestinal parasites differs based on which parasite you’re infected with. However, most of the time medication is given to kill the parasite. This medication may be a one-dose type of medication, or it may need to be taken over the course of several weeks.
Nutrition can also help rid your body of intestinal parasites. This includes:
- Avoiding simple carbohydrates, such as those found in refined foods, fruits, juices, dairy products, and all sugars, except honey.
- Eating more raw garlic, pumpkin seeds, pomegranates, beets, and carrots, all of which have been used traditionally to kill parasites. In one study, researchers found that a mixture of honey and papaya seeds cleared stools of parasites in 23 out of 30 subjects. Drink a lot of water to help flush out your system.
- Eat more fiber, which may help get rid of worms.
- Probiotics (Lactobacillus acidophilus, Lactobacilus plantarum, Saccharomyces boulardii, and bifidobacteria) help keep your digestive tract healthy. Probiotics may not be appropriate in some severely immune compromised patients. Talk to your doctor.
- Digestive enzymes will help restore your intestinal tract to its normal state, which makes it inhospitable to parasites. Papain is an enzyme from the papaya plant that may help kill worms when taken 30 minutes before or after meals. Papain may increase bleeding in people with clotting disorders, or in those taking blood-thinning medications, such as warfarin (Coumadin) among others.
- Vitamin C supports the immune system. Lower the dose if diarrhea develops.
- Zinc (20 to 30 mg per day) — Supports the immune system. Zinc may interact with certain medications, particularly some antibiotics, and it may not be appropriate for people with HIV/AIDS. Talk to your doctor.