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added more information about symptoms - paper from South Africa (it's not a review paper but do find me a better one) |
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=== Tissue damage and infections ===
Heavy infections directly damage tissues as the parasites can block internal organs or exert immense pressure in the gut. Infections are predominantly found in [[alimentary tract]] and sometimes in [[circulatory system]], as the parasites inhabit these organs. General symptoms are [[stomachache]], [[fever]], [[vomiting]], [[diarrhoea]], [[anorexia (symptom)|loss of appetite]], [[anemia|loss of blood]], [[fatigue (medical)|fatigue]], and [[Fatigue (medical)|listlessness]].
Antimesenteric splitting of the outer layers of the bowel wall can occur due to large amount of helminths, such as ascaris: The bowel can be so tightly packed with ascaris that it becomes semi-rigid and inflexible and the outer layers of the bowel wall, the muscle layers, hsplit under the tension.
Abdominal distension and abdominal pain might be the symptoms together with vomiting, sometimes vomiting of worms.<ref name=":9">{{Cite journal|url = http://www.ncbi.nlm.nih.gov/pubmed?term=%28Hadley%20GP%5bAuthor%5d%29%20AND%20Surgical%20management%20of%20worm%20volvulus%5bTitle|title = Surgical management of worm volvulus|last = Madiba TE, Hadley GP.|first = |date = 1996|journal = S Afr J Surg|doi = |pmid = 8629187|access-date = 14 March 2015}}</ref> Patients might present with peritonitis or a gangrenous bowel.<ref name=":9" /> This often requires emergency surgery. Volvulus complicating ascariasis still carries a high mortality and morbidity rate.<ref name=":9" /> Early detection and early operative intervention is very important<ref name=":9" />.
=== Morbidity ===
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=== Medications ===
Broad-spectrum [[benzimidazoles]] (such as [[albendazole]] and [[mebendazole]]) are recommended for treatment of intestinal [[nematoda|roundworm]] and [[cestoda|tapeworm]] infections; while macrocyclic lactones (such as [[ivermectin]]) are effective against adult and migrating larval stages of nematode; and [[praziquantel]] is the drug of choice for schistosomiasis, taeniasis, and most types of food-borne trematodiases. [[Oxamniquine]] is also widely used in mass deworming programmes. [[Pyrantel]] is commonly used for veterinary nematodiasis.<ref>{{cite web|title=Anthelmintics|url=http://www.drugs.com/drug-class/anthelmintics.html|website=Drugs.com|accessdate=17 November 2014}}</ref><ref>{{cite web|title=Overview of Anthelmintics|url=http://www.merckmanuals.com/vet/pharmacology/anthelmintics/overview_of_anthelmintics.html|work=The Merck Veterinary Manual|publisher=Merck Sharp & Dohme Corp.|accessdate=17 November 2014}}</ref> [[Artemisinins]] and derivatives are proving to be candidates as drugs of choice for trematodiasis.<ref>{{cite journal|last1=Pérez del Villar|first1=Luis|last2=Burguillo|first2=Francisco J.|last3=López-Abán|first3=Julio|last4=Muro|first4=Antonio|last5=Keiser|first5=Jennifer|title=Systematic Review and Meta-Analysis of Artemisinin Based Therapies for the Treatment and Prevention of Schistosomiasis|journal=PLoS ONE|date=2012|volume=7|issue=9|pages=e45867|doi=10.1371/journal.pone.0045867|pmid=23029285|pmc=3448694}}</ref>
=== Surgery ===
Surgery might be required to remove parts of the intestine if the worm infestation has reached such a high number of worms that the worms block that piece of intestines.
=== Mass deworming ===
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