Intestinal Parasites

There are two main types of intestinal parasites: helminths and protozoa. Helminths are worms with many cells. Usually helminths cannot multiply in the human body and will eventually clear up without infecting you again. Protozoa have only one cell. They can multiply inside the human body.

Signs and Symptoms

Symptoms include the following.

• Diarrhea
• 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 Causes It?

The following factors put you at higher risk for getting intestinal parasites.

• Living in or visiting an area known to have parasites
• International travel
• Poor sanitation (for both food and water)
• Poor personal cleanliness
• Age—children are more likely to get infected
• Exposure to child and institutional care centers
• Acquired immune deficiency syndrome (AIDS)

What to Expect at Your Provider's Office

Your health care provider will ask if you have traveled overseas recently and whether you have recently lost weight. Your provider will examine you. If he or she thinks you have an intestinal parasite you will probably have one or more of the following tests.

• Fecal testing (examination of your stool) can identify both helminths and protozoa. Stool samples must be collected before antidiarrhea drugs or antibiotics are given or X-rays with barium are taken. Three (five for pinworm) stool samples are needed to find the parasite.
• The string test is used occasionally. For this test you swallow a string that is then pulled back up. Then samples of your stomach contents on the string are tested.
• The "Scotch tape" test identifies pinworm by placing tape around the anus at night.
• Your health care provider may use X-rays with barium to diagnose more serious problems caused by parasites although this is usually not required.

Treatment Options

Treatment Plan

Your health care provider will choose the drug most effective for your intestinal parasite. Drug treatment may be just one dose or may take weeks to complete. Be careful to take the medicine just as it is prescribed or it may not work.

Drug Therapies

Prescription

• Drug therapy for worms selected examples
• Albendazole—for various roundworms tapeworms and pinworms; far fewer side effects than comparable drugs—some diarrhea and abdominal pain
• Mebendazole—for various roundworms and tapeworms; mild side effects (for example diarrhea)
• Pyrantel pamoate—for various roundworms; well-tolerated

• Drug therapy for protozoa selected examples
• Metronidazole (Flagyl)—commonly used for giardia but not FDA approved for this use; avoid all alcohol; side effects—nausea metallic taste dry mouth headache and various rare more serious complications
• Chloroquine—oral therapy for malaria

Over the Counter

• Pyrantel pamoate—available for pinworms in nonprescription strength; well-tolerated

Complementary and Alternative Therapies

While alternative treatments may be helpful in getting rid of intestinal parasites your health care provider must find out what kind of organism is causing your problems before you start treatment. The following nutritional guidelines will help keep organisms from growing. It is important to maintain good bowel habits during treatment.

Nutrition

• Avoid simple carbohydrates such as are found in refined foods fruits juices dairy products and all sugars.
• Eliminate caffeine and alcohol.
• Eat more raw garlic pumpkin seeds pomegranates beets and carrots all of which have antiworm properties. Drink a lot of water and get plenty of dietary fiber to promote good bowel elimination.
• Digestive enzymes will help restore your intestinal tract to its normal state which makes it inhospitable to parasites. Papain taken 30 minutes before or after meals helps kill worms. Acidophilus supplements help normalize bowel bacteria (one capsule with meals).
• Vitamin C (1 000 mg three to four times a day) zinc (20 to 30 mg per day) and beta-carotene (100 000 IU per day) support the immune system.

Herbs

Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy it is important to work with your health care provider on getting your problem diagnosed before you start any treatment. Herbs may be used as dried extracts (capsules powders teas) glycerites (glycerine extracts) or tinctures (alcohol extracts). Many of the herbs used to treat intestinal parasites have toxic side effects. Use them only under the supervision of a qualified practitioner. He or she will treat you with the most gentle herb that is effective for the type of parasite you have.

Homeopathy

Some of the most common remedies used for intestinal parasites are listed below. Usually the dose is 12X to 30C every one to four hours until your symptoms get better.

• Cina is specific for pinworms; with restless agitation and itching rectum
• Rumex crispus for marked itching immediately on undressing
• Spigellia for worm infestations with piercing and sharp pains

Massage

May help stimulate bowel function and elimination.

Following Up

Your health care provider will retest your stool to be sure your parasite is gone and will give you advice to help you avoid reinfection. Follow these instructions carefully. Getting a parasite a second time can cause more serious health problems.

Special Considerations

The seriousness and length of illness varies with the specific intestinal parasite. Complications occur more often in older people and in people who already have serious illnesses such as AIDS.

Intestinal parasites can be more serious if you are pregnant. Your health care provider will tell you which drugs are safe to take during pregnancy. Treatment for intestinal parasites during pregnancy should be closely monitored by a qualified practitioner.

Supporting Research

Fauci AS Braunwald E Isselbacher KJ et al eds. Harrison's Principles of Internal Medicine. 14th ed. New York NY: McGraw-Hill; 1998.

Morrison R. Desktop Guide to Keynotes and Confirmatory Symptoms. Albany Calif: Hahnemann Clinic Publishing; 1993:128 329 353.

Rakel RE ed. Conn's Current Therapy. 50th ed. Philadelphia Pa: WB Saunders; 1998.

Copyright © 2000 Integrative Medicine Communications

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application use or misuse of any of the information contained herein including any injury and/or damage to any person or property as a matter of product liability negligence or otherwise. No warranty expressed or implied is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor pharmacist nurse or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage precautions warnings interactions and contraindications before administering any drug herb or supplement discussed herein.