Ascariasis is an infection caused by Ascaris lumbricoides or commonly known as roundworms. These worms can live and reproduce in the human intestine and cause health problems that can cause complications.

Ascariasis occurs when roundworms enter the human body. The worms that cause this disease can infect the lungs or intestines. If left untreated, these worms will continue to multiply and infect other organs, such as the liver and pancreas.

Ascariasis can be found anywhere, but is more common in warmer climates and in areas where faeces are used as fertilizer. Indonesia is a country that has many cases of ascariasis.

Causes of Ascariasis

Roundworm eggs can be found in soil contaminated by human feces. Therefore, a person can get ascariasis due to contact with contaminated soil, for example because:

  • Eating foodstuffs grown on contaminated soil
  • Touching the mouth with unwashed hands after touching the ground

Eggs that enter the body will hatch in the intestines and become larvae. Furthermore, the larvae will enter the lungs through the bloodstream or lymph flow..

After being in the lungs for 10–14 days, the larvae will make their way to the throat. At this stage, the patient will cough so that the larvae come out or they can also be swallowed again and return to the intestine.

Larvae that return to the intestine will grow into male or female worms, then reproduce. Female worms can grow as long as 40 cm with a diameter of 6 mm and can produce 200,000 worm eggs per day.

Some of the worm eggs will come out through the feces and contaminate the soil. Meanwhile, some will hatch and then move to the lungs and become adult worms in the intestines. The entire cycle can take around 2–3 months.

If left untreated, adult worms can survive and reproduce in the human body for 1-2 years. This means that during that time there will be new eggs and new adult worms so that ascariasis can last for a very long time.

Ascariasis Risk Factors

There are a number of factors that can increase a person's risk of contracting this parasite, namely:

  • Live in warm climates
  • Live or work in an environment that uses human feces as fertilizer
  • Age 10 and under, especially if you don't wash your hands regularly
  • Suffering from pica eating disorder that likes to eat soil or sand

Symptoms of Ascariasis

In the majority of cases, ascariasis does not cause any complaints. Usually, symptoms will appear if the worms in the body are increasing.

Symptoms that appear due to ascariasis depend on the organ that is being infected. When roundworm larvae are infecting the lungs, the symptoms experienced by sufferers are similar to those of asthma or pneumonia, including:

  • Fever
  • Cough constantly
  • A lot
  • Hard to breathe

Meanwhile, when the worm larvae infect the intestines, the symptoms that can arise are:

  • Weak
  • Great stomach ache
  • Diarrhea
  • Nausea and vomiting
  • Pass bloody stools
  • Loss of appetite
  • Lost weight
  • There are worms in vomit or feces

When to see a doctor

Check with your doctor if you have persistent stomach pain, diarrhea, and nausea. If left unchecked, roundworms will continue to reproduce and cause dangerous complications.

Diagnosis Ascariasis

The doctor will ask about the symptoms experienced by the patient, along with where you live and possible risk factors that the patient has. If the patient is suspected of having ascariasis, the doctor will examine the stool to find out the presence of worm eggs or larvae in the patient's stool.

Doctors may also run blood tests to see if there are elevated levels of eosinophils , which are a type of white blood cell. However, blood tests cannot confirm ascariasis because elevated eosinophil levels can also be caused by other medical conditions.

In addition to the two tests above, doctors can also perform scans, such as:

  • X-rays, to check the presence of worms in the intestines and see the possibility of larvae in the lungs
  • Ultrasound , to detect the presence of worms in the pancreas or liver
  • CT scan or MRI, to see if worms have blocked the ducts of the liver or pancreas

Ascariasis Treatment

In some cases, ascariasis can heal on its own. However, you are advised to immediately see a doctor if you experience symptoms of ascariasis.

The first treatment for ascariasis is by administering worm medications , such as pirantel pamoat, mebendazole , piperazine, levamisole , or albendazole , which are consumed 1–3 times a day.

In ascariasis that is already severe or causes complications, the doctor will perform a surgical procedure to remove worms from the intestine and repair damage to the patient's intestine.

Complications of Ascariasis

Ascariasis generally causes only mild symptoms and is not dangerous. However, worms in the body can continue to multiply and spread to other organs of the body. As a result, serious complications can occur, such as:

  • Malnutrition and weight loss due to loss of appetite and impaired absorption of food in the intestines
  • Disorders of growth and development in children due to lack of nutrition
  • Blockage of the intestine by a collection of worms which can cause intestinal tears and bleeding
  • Blockage of the appendix which causes inflammation of the appendix
  • Blockage of bile ducts and pancreatic enzymes that can cause severe abdominal pain

Prevention of Ascariasis

Ascariasis can be prevented by always keeping clean. Some simple ways to prevent ascariasis are:

  • Wash your hands with clean water and soap every time before cooking and preparing food, before eating, after defecating, and after touching the ground
  • Wash fruits and vegetables thoroughly before consumption
  • Make sure the food is completely cooked before consumption
  • Consume bottled water that is still sealed when traveling
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