PINWORMS

General Information

DEFINITION--Infestation with intestinal parasites, a common occurrence in children. Pinworm infestations are more a nuisance than a major health problem.

BODY PARTS INVOLVED--Cecum (pouchlike beginning of the large intestine on the right side to which the appendix is attached); large intestine; anus; skin around the anus.

SEX OR AGE MOST AFFECTED--All ages, but most common in children.

SIGNS & SYMPTOMS

• Skin irritation and painful itching around the anus, especially during sleep.
• Restless sleep.
• Vaginal discharge, itching and discomfort, if pinworms migrate into the vaginal opening.
• Poor appetite and stomach pain (rare).
• Paleness (sometimes).

CAUSES--Infestation of the cecum by a very small worm (oxyuria) that measures only 10mm in its adult form. Pinworms travel from the cecum to the rectum to lay eggs around the anus and buttocks. The tiny eggs are picked up on the fingers by scratching. Eggs are transferred to others on toilet seats or by hand-to-hand or hand-to-mouth contact. They also drift in the air, where they are inhaled or swallowed. Eggs hatch in the small intestine. The larvae travel to the cecum, where they mature, mate and repeat the cycle.

RISK INCREASES WITH

• Groups of children, as in schools or large families.
• Poor personal hygiene.
• Warm climate.

HOW TO PREVENT

• Wash hands carefully after using the toilet and before meals.
• Keep the nails short and clean.
• Wash the anus and genitals at least once a day. Rinse well, preferably under a shower.
• Have children wear snug cotton underpants day and night, and change them daily.
• Don't scratch the anus or put fingers near the nose or mouth.
• Use very hot water to wash dishes.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Microscopic study of the worms or eggs.

APPROPRIATE HEALTH CARE

• Home care after diagnosis.
• Doctor's treatment with medication.

POSSIBLE COMPLICATIONS--No serious complications expected.

PROBABLE OUTCOME--Usually curable in one treatment--two treatments at the most. Treatment should include all family members at once. Recurrence is common. If worms reappear soon after treatment, they usually represent a new infection--not treatment failure.

How To Treat

GENERAL MEASURES--

• The following should be done on the day the family is treated with medicine: Clean the house with extra care. Wash the sheets and clothing with extra bleach or ammonia, or boil them. Scrub washable toys. Sterilize metal toys and similar objects in a hot oven. Cut and clean fingernails. Change towels. Scrub toilet bowls. Take extra-long showers.
• About 2 weeks after treatment, your doctor will probably check to be sure all parasites have been destroyed.

MEDICATION--

• Your doctor may prescribe antiworm medicine. Follow directions carefully. Take the medicine on an empty stomach. The medicine may cause nausea, vomiting and diarrhea. It is not absorbed by the stomach or intestines, so the bowel movement following treatment will probably be the color of the medicine.
• Non-prescription creams or lotions to relieve itching may be helpful.

ACTIVITY--No restrictions.

DIET--No special diet.

Call Your Doctor If

• Anyone in your family has symptoms of pinworms.
• Pinworms reappear after treatment.
• You think medicine is causing side effects that don't disappear quickly.