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HomeAnswersInfectious Diseasespinworm infectionI have abdominal pain, bloating, etc. What is the reason?

Does vaginal pinworm infection cause chronic abdominal pain, vaginal discharge, and anal itching?

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

iCliniq medical review team

Published At January 11, 2023
Reviewed AtOctober 10, 2023

Patient's Query

Hello doctor,

I believe I have vaginal pinworms and or multi-parasitic infection. I have chronic abdominal pain, bloating, vaginal discharge, anal itching at night and in the morning, extreme weight loss, loss of appetite, and terrible weird feelings in my anus. I have constipation and or diarrhea but mostly constipation. I am taking the tablet Subutex, Celexa, a stool softener, and a plethora of herbs. I am attaching the pictures for your reference.Kindly suggest.

Hello,

Welcome to icliniq.com.

Pinworm infection is caused by the parasite Enterobius vermicularis, a slender white worm with a pointed tail. In humans, they reside in the large intestine and appendix. Female pinworms are 8 to 13 mm long, and males are 2 to 5 mm long. Pinworm infection is primarily seen in children, and parents may be typically affected through their children. Thus, do you have children in your house who has been affected by worm infestation or are being treated? Transmission may also happen via direct contact with contaminated furniture, bedclothes, bedding, towels, toilets, doorknobs, or other objects. The parasite can also be transmitted during sexual contact. Do you have anyone else living with you in your house who may have been diagnosed with pinworm or any other worm infestation? Pinworm infection generally does not produce symptoms; asymptomatic carriers are common. However, there may be symptoms, including itching and pain around the anus, lack of sleep, or an initial sign of loose stools or diarrhea. The complications may include appendicitis, perianal eczema, or a bacterial infection around the rectum due to scratching the itchy area. In girls, pinworm infection can spread to the vagina and cause a vaginal discharge. As per your description, you seem to have anal itching and occasional diarrhea, which might suggest a worm infestation. You also complained of vaginal itch and discharge, listed as a complication. Abdominal bloating is nonspecific and can be caused by multiple reasons, including worm infestation but other causes, such as gastritis, GERD (gastroesophageal reflux disease), and irritable bowel syndrome, among other ailments, due to the side effect of current medications. You mentioned the loss of appetite and weight loss, which again may be caused by worms or other ailments due to the side effects of drugs currently being taken by you. Pinworm is diagnosed by detecting worm eggs and female worms.

The pale-colored female pinworm (about 10 mm) may be seen around the anus with the naked eye. The worm's appearance may be confused with bits of cotton thread. Eggs (30 μm X 50 to 60 μm) are usually not seen without a microscope. A specimen is best obtained by dabbing the stretched, unwashed perianal folds in the early morning with cellophane tape and affixing the specimen onto a slide. A negative test for five consecutive mornings effectively rules out the diagnosis. I hope your doctor has undertaken such tests. The pictures that you attached (attachment removed to protect the patient's identity) may not be those of worms. However, a microbiologist is the best person to confirm the same. The pictures may be those of mucus-like specimens. Also, the stool tests have suggested negative tests. However, this does not mean there may not be worms in the past (which may have spontaneously been expelled) or may not be in the future. Antihelminths or anti-worm medications should be taken to rule out any possible future or current infestation. Kindly do not discontinue the current medications.

Thank you.

Investigations to be done

1. Cellophane test for pinworm detection. 2. Stool test. 3. Blood- CBC.(complete blood count), ESR (erythrocyte sedimentation rate), and liver function tests (LFTs). 4. USG (ultrasound) of the abdomen and pelvis.

Treatment plan

1. Tablet Albendazole 400 mg one tablet once daily for three days. 2. Tablet Pantoprazole 40 mg one tablet once daily for four weeks. Consult your specialist doctor, discuss with them and take medications with their consent.

Preventive measures

1. Hygiene of your hands and your family members.

Regarding follow up

After test reports or after two weeks.

Patient's Query

Hello doctor,

I have four children, and my daughter also had similar stools as I had about two weeks ago. It looked like her stool had thread in it. I am a server at a restaurant where I am around countless people, and I have also conducted the tape test. I do have a little white string on them. The still test that I took came back negative. However, I did not test for pinworms. I am sure that it is a pinworm infection.

Hello,

Welcome back to icliniq.com.

You should not worry too much about what you see on the stool. Instead, let the microbiologist be opinionated in the stool report and doctors' clinical interpretations and diagnoses. Intestinal and extraintestinal helminthiases are common ailments affecting humans. It needs both prevention and treatment, both of which are simple. For treatment, both therapeutic and prophylactic antiparasitic and anthelminthic medications are recommended periodically to prevent a recurrence. For prevention, appropriate hand and general hygiene care in diet and lifestyle are mandatory, besides using prophylactic medications to avoid infestations. As described above, direct contact with contaminated items or persons can cause transmission infestation for pinworm infection. Please take the antiworm medicines, as advised earlier, without discontinuing your current medications. Revert with the test results as advised earlier, and we can take it further from there to understand and treat better.

Thank you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Shubadeep Debabrata Sinha
Dr. Shubadeep Debabrata Sinha

Infectious Diseases

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