Ascariasis – Symptoms and Causes

About Roundworm Infection

Roundworms (Ascaris) are parasites that use human bodies to grow from eggs into adult worms. These pinkish-white worms have pointed ends and can grow quite large.

Female worms may reach more than 15 inches (40 centimeters) in length and be about 6 millimeters wide. Males are typically smaller.

These parasites are among the most common worm infections worldwide, though they rarely appear in the United States. Many people with roundworms have mild cases without symptoms, but heavy infections can cause serious health problems.

Children living in tropical and subtropical regions face the highest risk, especially in places with poor sanitation.

Treatment typically involves:

• Anti-parasitic medications
• Follow-up testing
• Preventive education

Most patients recover completely when treated promptly.

Signs and Symptoms

When someone has ascariasis, they may have different symptoms based on where the worms are in their body. Many people with mild infections don’t have any symptoms at all.

Lung Symptoms

After swallowing ascariasis eggs, they hatch in the small intestine. The larvae then move through the blood or lymph system to the lungs. During this stage, a person might experience:

• Constant cough
• Trouble breathing
• Wheezing sounds when breathing

These symptoms can look similar to asthma or pneumonia. After spending about 10-14 days in the lungs, the larvae travel to the throat. There, a person coughs them up and then swallows them again.

Intestinal Symptoms

Once in the small intestine, the larvae grow into adult worms. In mild or moderate cases, symptoms may include:

• Unclear stomach pain
• Feeling sick and throwing up
• Loose or bloody bowel movements

With heavy worm infestations, more serious symptoms can develop:

• Severe stomach pain
• Feeling very tired
• Regular vomiting
• Losing weight or not getting enough nutrients
• Seeing an actual worm in vomit or stool

The adult worms typically stay in the intestines until they die naturally.

When to Call a Medical Professional

Get in touch with your doctor if you feel stomach pain that doesn’t go away, have loose stools, or feel sick to your stomach often. These symptoms might point to a health problem that needs attention.

Why Worm Infections Happen

Worm infections don’t pass directly between people. Instead, they spread when someone touches soil mixed with infected human or pig waste containing worm eggs.

In some countries with poor sanitation, human waste may contaminate yards, fields, or water sources. People can also get infected from eating uncooked infected pig or chicken liver.

Young children face higher risks because they often play in dirt and put their hands in their mouths. Eating unwashed fruits or vegetables grown in contaminated soil is another common way infections spread.

The worm life cycle involves several important stages:

1. Swallowing the eggs – Tiny worm eggs in soil enter the body when someone accidentally swallows contaminated dirt or eats unwashed produce grown in infected soil.

2. Movement through the body – After being swallowed, larvae hatch in the small intestine and travel through the intestinal wall. They move to the heart and lungs through blood vessels or the lymph system.

3. Growth phase – The larvae develop in the lungs for about 10-14 days. Then they break into the airways, get coughed up, and are swallowed again.

4. Becoming adult worms – Back in the intestines, the worms grow to full size. Female worms can grow more than 15 inches long, while males are usually smaller.

5. Making more eggs – Female worms can produce up to 200,000 eggs daily when male worms are present. These eggs leave the body in feces and must spend 2-4 weeks in soil before they can infect someone else.

The complete cycle from first infection to producing new eggs takes about 2-3 months. These worms can live inside a person’s body for 1-2 years if not treated.

Risk Factors

Certain factors may raise your chance of getting ascariasis:

• Age: Children under 10 face a higher risk, mostly because they often play in soil.
• Climate: Warmer regions have more cases, including the southeastern United States, while developing countries with year-round warm weather see even more infections.
• Poor Sanitation: Countries where human waste mixes with soil have widespread infection rates.

These conditions create ideal environments for the parasite eggs to develop and spread through communities.

Complications

Most people with mild ascariasis infections do not experience serious problems. However, heavy worm infestations can lead to several complications:

Growth delays in children may occur due to poor appetite and reduced nutrient absorption. Children might not get enough nutrition, affecting their normal development.

Intestinal blockage can happen when large numbers of worms cluster together, causing severe stomach pain and vomiting. In serious cases, these worms might create holes in the intestinal wall or appendix, leading to:

• Internal bleeding
• Appendicitis
• Severe infection

Blocked ducts can develop when worms migrate to the liver or pancreas, blocking the narrow passages. This causes intense pain and potential damage to these organs.

Prevention

Good hygiene is the best way to protect yourself from ascariasis. There are simple steps you can take to lower your risk of infection.

Wash your hands with soap and water before handling food. Always clean fresh fruits and vegetables thoroughly before eating them.

When traveling, drink only bottled water. Be careful with raw vegetables in areas where ascariasis is common. If you can’t peel or properly wash vegetables, it’s safer to avoid them.

• Always wash hands after using the bathroom
• Clean cooking surfaces regularly
• Teach children proper handwashing habits
• Avoid eating food prepared in unsanitary conditions