Parasites and worms in the faeces: symptoms and how to eliminate them with drugs and natural remedies

By Cristiano Antonino On Apr 21, 2023

The finding of worms in the faeces is a rather revolting, but certainly not uncommon occurrence. In fact, it is estimated that helminths (as these parasites are scientifically called) infect about three billion people worldwide

The most common in our latitudes are undoubtedly baby worms (Enterobius vermicularis), also known as pinworms, whose prevalence in paediatric age ranges between 30 and 70%.

Worms in children: prevalence and symptoms

Children are more susceptible to this infestation due to both their immature defence systems and their habit of playing with mud and bringing their hands to their mouths without washing them.

In this infestation, the worms in the faeces appear as very small, threadlike, white, mobile smears.

Females, in fact, measure on average eight to thirteen millimetres (0.8 – 1.3 cm), while males – smaller – do not exceed 5 mm.

Beyond the macroscopic test of faeces, the presence of pinworms can be witnessed by a strong nocturnal itching in the anal and perianal region; the females, in fact, migrate from the intestine to this location to lay their eggs.

The resulting scratching and the habit of bringing the hands to the mouth, as one can easily guess, promote self-infestation.

Recognising worms in faeces

Analysing a person’s faeces, as disgusting as it may sound, can help reveal the presence of intestinal worms.

However, as in the case of pinworms, the parasites are not always large enough to be easily detected with the naked eye.

On the other hand, when the size of the worms becomes important, the scenario becomes even more disgusting.

Helminths, in fact, vary in size and in some cases exceed well over a metre in length.

This is the case of the tapeworm, a segmented flatworm (cestode), which can reach 8-9 metres.

Generally, in this case, one finds in the faeces not so much the whole worm as some of its yellowish-white segments, resembling pieces of noodles and referred to as proglottids.

The associated symptomatology may be absent or limited to nausea, upset bowel movements and abdominal pain.

The main vehicle of transmission is the ingestion of raw or undercooked meat infected by the larvae.

Ascarids

Other large worms, called roundworms (Ascaris lumbricoides), cause the most frequent geohelminthiasis in our country.

In the rest of the world, ascaridiasis is also a ubiquitous and rather widespread infestation.

The term geohelmintiasis explains how these organisms are transmitted; briefly, humans dispose of eggs in the soil, where they become embryonated and acquire the ability to infest other humans.

The eggs, therefore, are not immediately infested like those of pinworms, but must spend some time in the soil to ‘mature’.

The lack of sanitary facilities or the use of sewage to irrigate fields contribute to the spread of the infestation, which is typical – but not exclusive – to rural areas.

The female Ascaris lumbricoides reaches a length of 40 cm and a weight of about 9 grams.

In addition to the visual appearance of these creamy white or pinkish-coloured worms in the faeces, Ascaridiasis can be characterised by symptoms of a respiratory or gastrointestinal nature (depending on the stage of development of the specimens).

The first to appear – as the larvae migrate through the lungs – are respiratory, with a wheezing cough, dyspnoea and traces of blood in the sputum.

In the intestine, on the other hand, symptoms are often specific or limited, characterised by abdominal cramps, nausea and vomiting.

Particularly in developing countries, ascaridiasis can cause potentially serious or even fatal complications.

Other common intestinal parasites

Other rather common intestinal worms are Ancylostoma duodenale and Necator americanus, which are responsible for hookworm disease.

This is still a geohelminthiasis, in which, however, the larvae – instead of being ingested – penetrate through the skin coming into contact with contaminated soil.

These slightly curved nematodes reach a length of 6 – 12 mm (0.6 – 1.2 cm).

Thanks to their special buccal apparatus, they anchor themselves firmly in the duoedeno-digiunal mucosa, absorbing considerable amounts of blood.

The patient may therefore become anaemic, manifesting pallor, weakness, dyspnoea and brittle nails.

In triocephalosis, the parasite (Trichuris trichiura) reaches a length of 3-5 cm and resembles a whip, with the cephalic end thin and cylindrical, and the posterior end squat and pink in colour.

Worms in faeces: repercussions on general health

Finding a worm in the faeces is certainly not a pleasant experience, but the repercussions on the patient’s health are generally mild.

Statistically, I can say that it is much worse to be infected by very small organisms, such as some viruses or bacteria.

Moreover, once the parasite has been detected, it is generally possible to eradicate it relatively easily with a short drug therapy.

Worms in the faeces: drug therapy

Generally, a single dose of specific anti-parasitic drugs (e.g. mebendazole, pyrantel or albendazole) is sufficient to kill the worm (not the eggs!).

The drug dose can possibly be administered again after 14 days.

Asymptomatic forms generally do not require any treatment, as the symptoms recede on their own and the parasite is eliminated through evacuations.

The disease is highly contagious, which is why, as a precautionary measure, it is advisable to extend drug therapy to all members of the affected person’s family.

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Prevention of parasites

Prevention is essentially aimed at observing elementary hygiene rules, such as thorough and frequent hand washing, careful washing of food to be eaten raw and generous cooking of meat (especially minced pork).

Particular caution when travelling to underdeveloped countries (also be careful when walking barefoot and where you bathe).

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