Imagine you or someone you love being roused out of a sound sleep – not by a nightmare – but by an uncomfortable, intense itch that you feel compelled to scratch. Once fully awake, you become mortified to discover that the itch is coming from an area that most people don’t care to talk about – the anus. Even more humbling, you soon find that you are infected by a parasitic nightmare called the pinworm.
WHAT IS A PINWORM?
Known also as a threadworm, the pinworm (enterobius vermicularis) is a small, thin white worm that lives in the colon and rectum of humans. Adult worms are about 0.2 to 0.4 inches (5 to 10 millimeters) in length, which is about the size of a staple. If seen, they resemble a small piece of thread or dental floss. Pinworms are parasites, meaning that they use the human body to survive and reproduce. They can live for up to six weeks, making it difficult to get rid of the infection. In fact, a pinworm infection is the most common type of worm infection in the United States, and we humans are its only hosts.
WHO IS AT RISK OF GETTING A PINWORM INFECTION?
A pinworm infection can affect people of all ages and occurs worldwide. However, because of poorer hygiene habits, children under the age of 18 are most likely to become infected. And because it is highly contagious and easily spread, people who take care of, or live in the same household with, infected children are more prone to a pinworm infection.
HOW IS A PINWORM INFECTION SPREAD?
Unfortunately, you can become infected with pinworms very easily and unknowingly, especially if someone around you is infected. A pinworm infection is spread by the fecal-oral route, and you can become infected either directly or indirectly.
There is a cycle to a pinworm infection that can keep repeating if it is not diagnosed and treated properly. The initial infection begins when tiny pinworm eggs are ingested. Once the eggs are ingested, there is an incubation period of one to two months for an adult female pinworm to mature in the small intestines. From there, the adult female pinworm will migrate to the colon and lay her eggs (which may be in the thousands) around the anus, typically at night. The cycle occurs when, because of inadequate hygiene, eggs continue to be ingested causing either new people to become infected or you to become re-infected.
The microscopic pinworm eggs can live for two to three weeks on surfaces. If they are touched, they will be transferred to the hands. If a person doesn’t wash their hands prior to touching their mouth, they are at serious risk of becoming infected.
Common surfaces that pinworms can be found:
- Bed sheets
- Towels and blankets
- Underwear and pajamas
Because pinworm eggs are so small, they can easily be ingested if items such as sheets, towels or blankets are shaken. Shaking items with pinworm eggs can cause them to become airborne and, consequently, cause a person to inhale them.
When the female pinworm lays her eggs, she releases a mucus that triggers an intense itch from her victim. When an infected person scratches, the eggs can transfer to the fingers and underneath the fingernails. From the hands, the eggs can be transferred to anything that is touched, including the person’s own mouth, causing a re-infection.
Common places that a person’s hands can transfer pinworm eggs include:
- Bathroom items – toothbrushes, hairbrushes and combs
- Kitchen utensils
- Kitchen and bathroom surfaces
- Other people’s hands
- Pet fur, such as on dogs and cats
WHAT ARE THE SYMPTOMS OF A PINWORM INFECTION?
Usually, symptoms of a pinworm infection are mild. Sometimes, people have no symptoms.
Symptoms may include:
- Anal itch, which may become intense at night
- Disturbed sleep
- Mild nausea
People with a more severe infection may experience:
- Loss of appetite
- Weight loss
- Severe irritability
- Abdominal pain
- Sleeping difficulties
If one person in a household has a pinworm infection, everyone should be treated, even if there are no symptoms.
HOW IS A PINWORM INFECTION DIAGNOSED?
Itching in the perianal area, especially at night, is a strong indication of a pinworm infection. It can be diagnosed, though, by identifying the worms or eggs. Looking like dental floss or small pieces of white thread, worms can sometimes be seen on the skin near the anus or on underwear, pajamas or sheets. Make sure to inspect these areas late at night when the female worms are outside the anus laying her eggs.
Pinworm eggs cannot be seen by the naked eye, but they can be detected under a microscope. They are typically collected in two ways. One way is a “tape test” performed on a person’s anal area. The test is done by pressing a piece of clear cellophane tape to the skin around the anus. The eggs will stick to the tape and can be viewed under the doctor’s microscope. Bathing and bowel movements can remove the skin, so the test should be performed as soon as the person wakes up in the morning. For young children, it can even be performed after they fall asleep at night. In order to increase the chances of finding pinworm eggs, the “tape test” should be done three consecutive days.
Also, because scratching the anal area is common with a pinworm infection, samples taken from under the fingernails may also contain eggs. Stool and urine samples rarely, if ever, contain pinworm eggs, so they should not be used for diagnosis.
HOW CAN A PINWORM INFECTION BE TREATED?
You should always consult a healthcare provider before treating a pinworm infection, especially if you are pregnant or treating children under the age of two. The infection can be treated with either prescription or over-the-counter medications. Also, it must be remembered that all members of an infected household need to be treated. Treatment should be done in two rounds, with the second round taken two weeks after the first. The second round is taken to prevent re-infection by adult worms that hatch from eggs not killed by the first treatment.
Medications for pinworm infection include:
Mebendazole – It blocks the pinworm’s ability to absorb glucose, which effectively kills it within a few days. The prescription medication can be taken in chewable or liquid form.
Albendazole – The prescription medication also blocks the worm’s ability to absorb glucose. A single 400 milligram dose is taken.
Pyrantel pamoate – It paralyzes the worms in order to kill them. This is available over-the-counter.
It is important to note that neither mebendazole or albendazole should be taken during the first 12 weeks of pregnancy, and pyrantel pamoate should not be taken any time during pregnancy. A doctor should be consulted during the second or third trimester and when breastfeeding if medication is desired.
WHAT CAN BE DONE TO PREVENT RE-INFECTION?
Strict and thorough hygiene measures can remedy pinworm infection and significantly reduce the risk of re-infection. Since the pinworm has a lifespan of about six weeks, good hygiene needs to last at least that long. More importantly, everyone in the same household needs to adhere to these measures in order for the pinworms and their eggs to disappear.
The following strict hygiene measures should be practiced:
- Wash all bed linens, pajamas, underwear and stuffed animals on a daily basis.
- Vacuum all carpets regularly and thoroughly, especially bedrooms.
- Damp-dust surfaces in the bedrooms, kitchen and bathrooms.
- Do not shake any blankets, towels or bed linens.
- Trim everyone’s fingernails as short as possible.
- Refrain from nail biting and finger sucking (which may be difficult with small children).
- Wash hands thoroughly and frequently, scrubbing under the fingernails.
- Change underwear every morning.
- Wear cotton gloves to prevent scratching during sleep.
- Shower regularly, paying close attention to the anal and vaginal areas.
- Replace and/or clean toothbrushes, hairbrushes and combs.
- Do not share bath towels or washcloths.
Even when the pinworm infection is gone, continuing with good hand-washing practices and overall hygiene will help prevent re-infection.
WHAT ARE HOME REMEDIES FOR PINWORM INFECTION?
If a pinworm infection is suspected, a healthcare provider should always be consulted and medication should be considered. There are some popular natural home remedies, but, along with strict hygiene practices, they should be used as complementary treatments to medication. Following is a list of some of the most popular home remedies:
Apple cider vinegar – Consuming apple cider vinegar is a helpful and safe method for eliminating pinworms over time. It will not kill the worms in your intestine right away, but with continued use it can flush them from your system completely. Add two teaspoons to an eight-ounce glass of water twice daily. Drinking this mixture will lower the pH level in your intestine. The lowered pH level will kill off the pinworms. Combine this with other natural home remedies for a faster recovery.
Carrots – Raw carrots are rich in fiber, which can help keep the digestive system healthy and promote regular bowel movements. Carrots may not necessarily fight off pinworms directly, but they may help push the pinworms out of the intestines.
Coconut oil – Coconut oil offers a wide range of household and health uses. It is a popular home remedy for pinworms, as it is believed that applying the oil around the anal area will prevent the female from laying her eggs.
Garlic – It is known for its antibacterial, antiviral and antifungal effects. To use garlic, it can be eaten raw or chopped up and eaten in a variety of dishes. Topically, garlic can be finely minced, added to petroleum jelly and applied directly to the skin around the anus. Be careful not to apply if the skin is irritated or hemorrhoids are present.
Grapefruit seed extract – This can be found in pill or liquid form in many health food stores. It is suggested to take one pill, three times a day for one week. If taking the liquid form, place 10 drops in an eight-ounce glass of water three times a day for one week.
Pumpkin seeds – These seeds contain a compound called cucurbitacin. This compound may make pumpkin seeds effective against internal parasites. Pumpkin seeds may be eaten alone, sprinkled in yogurt or blended with smoothies.
White willow bark – This may be difficult to find, but it is a very popular home remedy for pinworm infection. It contains salicylic acid, the same ingredient found in aspirin. It is a potent agent for fighting off pinworms. Add a teaspoon of white willow bark to tea or warm water and drink twice daily.
Wormwood – Wormwood is an herb that is considered to be an effective treatment for some parasitic infections. It contains santonin, isothujone and thujone, all with antiseptic properties that help to kill worms present in the intestinal tract. Wormwood works by damaging the parasite’s membranes. It can be made into a tea by adding a few drops to a cup of hot water. It can be taken once every two hours for at least five days to see fast results.
Other natural ways to rid your body of pinworms are:
Make Dietary Changes – Besides adopting better hygiene practices, making dietary changes is one of the most natural and easiest ways to help remove pinworms from the body and prevent re-infection. Getting rid of, and not consuming, foods that pinworms feed off of will ensure that your intestines are not a place that the worms will want to live in.
Adjusting your diet by adding more fresh fruits and vegetables and high fiber foods will help to add bulk to the stool and flush pinworms out of your system. Eating probiotics, such as yogurt will help to build the growth of good bacteria in the intestines. The growth and presence of good bacteria in your intestines will become a hostile environment for the pinworms.
Lower pH Levels – Lowering the pH levels in the body helps to kill off pinworms. Besides apple cider vinegar, drinking at least one eight-ounce glass of lemon water daily will also help lower the body’s pH level.
Remove Sugar from Your Diet – Parasites feed off of sugar. Remove items such as, carbohydrates, refined sugars, candy and soda from your diet until the pinworms are gone.
WHAT ARE THE COMPLICATIONS OF A PINWORM INFECTION?
Pinworm infections may be uncomfortable, intensely itchy and humbling, but rarely are there complications that occur. However, if they do, they can include the following:
- Urinary tract infection – This is more common in women. The worm could also migrate to the bladder, causing cystitis.
- Peritoneal cavity infection – In females, the pinworm may move from the anal area to the vagina, uterus, fallopian tubes or around the pelvic organs. This can cause vaginitis or endometriosis.
- Weight loss – If the infection continues for a long time, or is severe, the pinworm may leech essential nutrients from your body, resulting in weight loss.
- Skin infection – Intensely scratching the itch may lead to broken skin. This can raise the risk of infection.
- Appendicitis – In rare cases, pinworms may migrate into the appendix, causing complications.
Pinworms do not cause any serious, life-threatening complications. Medication and natural remedies can help treat the infection effectively. The best way to get rid of a pinworm infection, and prevent the risk of re-infection, is proper hygiene measures. As long as treatment occurs and cleanliness is adhered to, pinworms can be eliminated from your life.
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