Threadworms (enterobius vermicularis)

There are types of worm that can live and thrive inside our bodies causing health problems. The commonest such worm is the threadworm – sometimes known as the pinworm.

Threadworms are very, very much smaller than the garden earthworm but are visible to the naked eye they appear as thin white strands up to a centimetre long, looking like desiccated coconut or threads of white cotton around the anal margin or actually coating the stool.

They can live inside our gut. But come out, usually at night, to lay eggs on the skin around the anus. The eggs attach by a sticky substance that causes itching. To complete their life cycle the eggs must reach the mouth of another person and be swallowed back into the gut.

This sounds unlikely but is in fact common. Itching leads to scratching and some people dont wash their hands after toileting.
As a result they may unwittingly have the invisible eggs on their hands or under their fingernails. They can reinfect themselves or pass on the infection when touching others. The cycle is completed fingers touch the mouth and eggs are swallowed.

Threadworm infection is commoner in young children for this reason. They are more likely to have poor hand hygiene and more likely to put their fingers in their mouths.

Threadworms cause itching which is usually around the ano- rectal region and more noticeable at night. Infection can result in:
– marked soreness
– discomfort when urinating
- bedwetting
- sleep deprivation
- irritability.

A story of perianal itching, worse at night with the characteristic white threads noted on the stool is enough to confirm infection. Lab tests are usually not necessary.

Thankfully, treatment is simple and usually involves a one off dose of medication such as mebendazole or piperazine. There is little in the way of side effects and both medicines come in a liquid or tablet form.
All family members must be treated as some people do not show any symptoms of infection
Specific advice should be sought from a doctor or pharmacist if you are pregnant or your child is under 2 years of age.

After treatment infection may take up to two weeks to clear
During this time simple measures will help to prevent re- infection and further spread
-ensure hand washing after using the toilet
-use a nail brush
-keep fingernails trimmed
-bath after waking
-avoid hand to mouth contact
-avoid finger feeding (use cutlery)
-wear nightclothes or pants in bed
-wash nightclothes and bed linen daily

Remember, threadworm infection is rarely serious and the real key to preventing this and other infections is washing hands properly after using the toilet.
Keep clean, keep well.

If you are unsure in anyway about your health then get checked out. Seek advice from your family doctor, nurse or clinic.

Builth and Llanwrtyd Medical Practice has made every effort to ensure that the information in these episodes is accurate, up to date, and as helpful as possible. However we will not be responsible for any inaccuracies or omissions.
In particular if you are unwell, it is important that you do not rely on information from the Internet – you should seek professional medical advice from your Doctor. If your condition is getting worse, or if you are seriously ill, you should call or visit your Surgery.

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