Why She Is Constantly Infected With Threadworms?

Question:

My 11- year-old daughter suffers repeatedly with threadworms. Each time she has them I treat her with Vermox, with I get on prescription. I am worried that this medicine is harmful, especially as I am using it every two to three months. She is very clean, keeps her nails short and washes her hands; no other members of the family have them. Any suggestions?

Answer:

Threadworms (also known as pinworms) are more common in temperate countries such as Britain than in the tropics. The adult Enterobius vermicularis worms are about 1cm long and dwell in the bowels. The female worms sneak out of the anal region at night and lay up to 10,000 eggs at the entrance to the rectum. This leads to terrible itching which may cause inflammation as the eggs develop and the resulting young worms wriggle back into the bowels.

When the area is scratched, eggs get lodged under the nails. Even if you wash thoroughly, these eggs invariably get transferred to the mouth within a few hours and from there to the intestines, where they hatch, grow into adult worms and live  happily in the bowel where the life cycle starts again. From egg to adult worm takes about a month and the worms survive another month or so before laying eggs and dying. Because of the vast number of eggs and worms, the process is continuous and, without treatment, the bowls are permanently infected.

The transfer of eggs is literally hand-to-mouth, so entire families can get infected (although not in your case). One of the common symptoms is itching, particularly at night. Children often grind their teeth at night because the itching causes restlessness, which leads to irritability and tiredness during the day. Severe infection can cause weight gain and even abdominal pain. On rare occasions, the threadworms can invade the vaginal area and cause irritation, which may spread to nearby areas.

The worms absorb nutrients, so infection may result in malnutrition and mineral deficiency. They absorb iron in abundance so an infected person may be anaemic (iron-deficient). People with worms commonly look Pale and undernourished even though their appetite increases. Eating a lot doesn't help, however, because the worms absorb nutrients, leaving the person still hungry.

The common test for threadworms is to analyse the faeces, but this is useless because the eggs are not released in the bowels. An accurate diagnosis is arrived at by applying clear Sellotape to the peri-anal region, then examining it under a microscope to see whether there are any eggs.

Threadworms are effectively treated with one of the group of anthelmintic drugs, such as Vermox. A couple of weeks after the first course, a second is advised. The whole family should be  treated to eliminate any hidden source of infection. However, the manufacturer's information lists possible side effects, including, ‘severe swelling of lips, face or tounge' itchy rash, abdominal pain and diarrhoea'. It emphasises that anyone who suffers an allergy should stop taking the drug immediately.

If you would prefer a natural route, I suggest the following

*Sugar feeds the worms, so avoid it, along with yeast-containing products such as bread, pizza, beer and wine, and fungal foods such as blue cheese, mushrooms and vinegar.

* Worms don't like hard stools, as they make it difficult for them to lay eggs outside the bowel, so in this case constipation can be helpful. For two weeks avoid fibre-rich foods such as fruit vegetables, cereal and wholegrain bread. Instead, offer your  laughter red meat, chicken, boiled eggs, mashed potatoes, rice, pasta with olive oil, grilled fish, porridge and carrots. These will clog up her bowels. Once the infection is eliminated, however, you must put the child back on a regime that will get her bowels moving again. This should include lots of water, Papaya, bananas and vegetables such as spinach, broccoli, asparagus and cabbage.

* I usually advise adults to chew betel leaf with kattha a herbal paste, which both have de-worming properties.

However, betel stains the tongue and lips and doesn't taste that good. Your daughter should take a Pinch of kattha with water for seven days. Kattha is available from Indian grocers and the  Integrated Medical Centre shop.

* Take kadu and kariatu combined. Put two twigs of kadu and ½ teaspoon kariatu in a cup of hot water, soak overnight strain and drink in the mornings for one month. It is bitter, but the whole family should take it in your case.