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Abdominal Diseases
Symptoms, Causes and Treatment
...

First printng 2017
All rights reserved
...
Published in the United Republic of
Tanzania
...
Their partcipaton in
meetngs and workshops, and their input in the
development of content for this book have been
invaluable
...


AMEOBIASIS
Amebiasis is a disease caused by a one-celled parasite
called Entamoeba histolytica
...
It also is found in people
who have traveled to developing countries and in people
who live in institutions that have poor sanitary
conditions
...

How can I become infected with E
...

histolytica
...
histolytica
...
histolytica
...
histolytica becomes sick from the infection
...
Amebic
dysentery is a severe form of amebiasis associated with
stomach pain, bloody stools, and fever
...

histolytica invades the liver and forms an abscess
...


If swallowed E
...


What should I do if I think I have amebiasis?
See your health care provider
...
Because E
...

Diagnosis of amebiasis can be very difcult
...
histolytica when seen under a microscope
...
histolytica even though they are not
...
Unlike infection with E
...
dispar never makes people sick and
therefore does not need to be treated
...
histolytica but you are

feeling fne, you might be infected with E
...

Unfortunately, most laboratories do not yet have the
tests that can tell whether a person is infected with E
...
dispar
...
histolytica
...
However, the test is
recommended only when your health care provider
thinks that your infection has invaded the wall of the
intestine (gut) or some other organ of your body, such as
the liver
...

How is amebiasis treated?
Several Antprotozoa like Metronidazole,Tinidazole or
secnidazole are available to treat amebiasis
...
You will be treated
with only one antibiotic if your E
...
You probably will be treated with
two antibiotics (frst one and then the other) if your
infection has made you sick
...
What should I eat and drink there so I will
NOT become infected with E
...
Do not
drink fountain drinks or any drinks with ice cubes
...

Absolute 1 micron flters can be found in
camping/outdoor supply stores
...

 Do not eat or drink milk, cheese, or dairy products
that may not have been pasteurized
...

Should I be concerned about spreading infection
to the rest of my household?
Yes
...
This includes thorough hands
washing with soap and water after using the toilet, after
changing diapers, and before handling food
...
& Fauci, A
...
(2008)
...

Oxford: McGraw Hill
...
(2006)
...
Churchill: Livingstone
...
J
...
(2006)
...
Churchill: Livingstone
• MOHSW (2005)
...

Dar es Salaam, Tanzania: Ministry of Health and
Social Welfare
...
& Glynn, M
...
Hutchison’s
Clinical Methods (22nd ed
...
It
can also be caused by Salmonella, a related bacterium
that usually causes a less severe illness
...

The incidence of typhoid fever in the United States has
markedly decreased since the early 1900s, when tens of
thousands of cases were reported in the U
...
Today, less
than 400 cases are reported annually in the United
States, mostly in people who have recently traveled to
Mexico and South America
...
India, Pakistan,
and Egypt are also known as high-risk areas for
developing this disease
...

How Do People Get Typhoid Fever?
Typhoid fever is contracted by drinking or eating the
bacteria in contaminated food or water
...
Contamination of the
water supply can, in turn, taint the food supply
...

About 3%-5% of people become carriers of the bacteria
after the acute illness
...
These people may become longterm carriers of the bacteria -- even though they have no
symptoms -- and be the source of new outbreaks of
typhoid fever for many years
...
The bacteria are
carried by white blood cells in the liver,spleen and bone
marrow, where they multiply and enter the bloodstream
...

Bacteria invade the gallbladder, biliary system, and the
lymphatic tissue of the bowel
...
The bacteria pass into the intestinal tract and
can be identifed in stool samples
...

What Are the Symptoms of Typhoid Fever?
The incubation period is usually 1-2 weeks, and the
duration of the illness is about 3-4 weeks
...
The
fever becomes constant
...

About 10% of people have recurrent symptoms after
feeling better for one to two weeks
...


How Is Typhoid Fever Treated?
Typhoid fever is treated with antibiotics which kill
the Salmonella bacteria
...
Death occurred from
overwhelming infection, pneumonia, intestinal bleeding,
or intestinal perforation
...
With
appropriate antibiotic therapy, there is usually
improvement within one to two days and recovery within
seven to 10 days
...
Chloramphenicol was the original drug of
choice for many years
...
The choice of antibiotics is guided
by identifying the geographic region where the infection
was contracted (certain strains from South America show
a signifcant resistance to some antibiotics
...

Those who become chronically ill (about 3%-5% of those
infected), can be treated with prolonged antibiotics
...

For those traveling to high-risk areas, vaccines are now
available
...

 Typhoid fever is contracted by the ingestion of
contaminated food or water
...

 Typhoid fever is treated with antibiotics
...

 Approximately 3%-5% of patients become carriers of
the bacteria after the acute illness
...
& Fauci, A
...
(2008)
...

Oxford: McGraw Hill
...
(2006)
...
Churchill: Livingstone
...
J
...
(2006)
...
Churchill: Livingstone
• MOHSW (2005)
...

Dar es Salaam, Tanzania: Ministry of Health and
Social Welfare
...
& Glynn, M
...
Hutchison’s
Clinical Methods (22nd ed
...


OESOPHAGITIS
common forms of esophagitis include reflux esophagitis,
infectious esophagitis, pill esophagitis, eosinophilic esophagitis,
and radiation and chemoradiation
esophagitis
...
The prognosis is
good with rapid diagnosis and proper treatment; ultimately, it
depends on the underlying disease
...

Infectious esophagitis
...
Double-contrast
esophagram shows linear lesions in the esophagus, with
normal intervening mucosa
...
Symptoms of reflux esophagitis
(the most common type) may include the following:
 Heartburn, or dyspepsia (the most common symptom)
 Water brash
 Regurgitation

Other common symptoms include upper abdominal
discomfort, nausea, bloating, and fullness
 Less common symptoms are dysphagia, odynophagia,
cough, hoarseness, wheezing, and hematemesis
 Chest pain indistinguishable from that of coronary artery
disease (CAD)
Patients with infectious esophagitis (eg,
from Candida, cytomegalovirus [CMV], herpes simplex virus
[HSV], or human immunodeficiency virus [HIV]) may be
asymptomatic, but typical symptoms include the following:
 Onset of difficult or painful swallowing (ie, dysphagia or
odynophagia)
 Heartburn
 Retrosternal discomfort or pain
 Nausea and vomiting
 Fever and sepsis
 Abdominal pain
 Epigastric pain
 Hematemesis (occasionally)
 Anorexia and weight loss
 Cough
Physical examination usually does not help confirm
uncomplicated esophagitis but may reveal other potential
sources of pain
...



Diagnosis
Laboratory tests are usually unhelpful unless complications are
present (eg, upper gastrointestinal [GI] hemorrhage)
...
Considerations for the use of diagnostic procedures
include the following:
 Double-contrast esophageal barium studies are
recommended as the initial imaging study for dysphagia,
though a case can be made for initial upper gastrointestinal
(GI) endoscopy (esophagogastroduodenoscopy [EGD])
 Barium studies are not recommended for patients with
absolute dysphagia or odynophagia; upper GI endoscopy is
recommended under these circumstances
 Barium studies and upper GI endoscopy are
complementary rather than competing
 Diagnosis of metastatic cancer is best made by means of
barium contrast radiography and computed tomography
(CT)
Other studies that may be helpful include the following:
 Blind brush cytology (now, with the availability of EGD,
less commonly used)
 Electrocardiography (ECG)
 Troponin or other cardiac markers (if acute coronary
syndrome is being considered)
Management
Treatment includes the following components:
 Hemodynamic stabilization (eg, in cases of bleeding or
perforation)
 Pain management – Because chest pain of esophageal
origin cannot be accurately differentiated from chest pain

associated with CAD protocols for the latter should be
followed
 Specific therapy, depending on the cause of the
esophagitis and any complications
Treatment of reflux esophagitis may include the following:
 Histamine-2 receptor antagonists (H2RAs)
 Proton pump inhibitors (PPIs)
 Cisapride (a gastroprokinetic agent)
 Sucralfate (a coating agent)
Treatment of infectious esophagitis is directed at the underlying
cause, as follows:
 Fungal esophagitis – Topical, oral,
 HSV esophagitis – Acyclovir, (for acyclovir-resistant
cases), or famciclovir
 CMV esophagitis – Ganciclovir
 HIV esophagitis – Oral corticosteroids in conjunction with
anti viral therapy
 Varicella-zoster virus (VZV) esophagitis – Acyclovir,
famciclovir (for acyclovir-resistant cases)
 Epstein-Barr virus (EBV) esophagitis – Acyclovir
 Human papillomavirus (HPV) esophagitis – No treatment,
in most cases; systemic interferon alfa, bleomycin
 Tuberculous esophagitis – Standard antituberculous
therapy
 Bacterial esophagitis – Broad-spectrum beta-lactam
antibiotics, usually with an aminoglycoside, adjusted as
appropriate
Treatment of noninfectious esophagitis depends on the
underlying condition, as follows:
 Behçet disease esophagitis – Corticosteroids;
chlorambucil or azathioprine (long-term therapy)
 Graft-versus-host disease esophagitis – prednisone,
cyclosporine, azathioprine, and thalidomide
 Inflammatory bowel disease esophagitis – Corticosteroids;
dilation; occasionally surgery
 Eosinophilic esophagitis – Diet modification,
corticosteroids



Metastatic cancer esophagitis – Radiation therapy;
palliative

Background
The most common cause of esophagitis is gastroesophageal
reflux disease (GERD)
...

Corrosive esophagitis
...
The patient had a fish bone in her throat
...

Eosinophilic esophagitis has also emerged as an important
cause of esophagitis in both children and adults
...
(See
Etiology
...
Ultimately, the prognosis depends on the underlying
disease process
...
)
The history findings vary based on the type of esophagitis (eg,
reflux or infectious)
...
However, the examination may reveal other
potential sources of chest or abdominal pain
...
)
Laboratory tests are usually unhelpful unless complications are
present (eg, upper gastrointestinal [GI] hemorrhage)
...
Doublecontrast esophageal barium studies and upper endoscopy are

the recommended initial imaging studies; these tests should be
viewed as complementary rather than competing in the
evaluation of patients with dysphagia
...
)
Treatment begins with hemodynamic stabilization and pain
management
...
(See
Treatment and Medication
...


PEPTIC ULCER DISEASE
Key points






Causes
Symptoms
How Serious Are They?
Diagnosis

 Treatment
Peptic ulcer disease forms painful sores or ulcers in the
lining of your stomach or frst part of your small
intestine, which your doctor may call the duodenum
...
We do
know they come from an imbalance between digestive
fuids in the stomach and duodenum
...

pylori)
...
These include over-the-counter
like aspirin, ibuprofen, and naproxen, as well as
others you can get by prescription
...
If you do, they may include:
 A gnawing or burning pain in your stomach between
meals or at night
 Bloating
 Heartburn
 Nausea or vomiting
 Loss of appetite
In severe cases, symptoms can include:





Dark or black stool
Vomitng blood or material that can look like cofee grounds
Weight loss
Severe pain in your belly

How Serious Are They?
Though ulcers often heal on their own, you shouldn't ignore their
warning signs
...
The risk is
especially concerning for the elderly and those with a history of peptic
ulcer disease
...

But to make sure, to order tests of your blood ,breath, and stool
...
to see if symptoms get better
...
A small,
lighted tube (called an endoscope) is put in down your esophagus and
into your stomach to look around
...

Treatment
There are several ways to treat ulcers, including:
Lifestyle changes: If you smoke or drink alcohol, stop
...

Medications: These can include:
 Proton pump inhibitors (PPIs) that ease acid levels and let the
ulcer heal
...

Bismuth an ingredient in many medicines and cosmetics, is also part
of some treatment regimens
...

You'll need an operation if your ulcer created a hole in the wall of your
stomach, or if there's serious bleeding that can't be controlled with
an endoscopy
...


HEPATITIS
What is hepatitis?
Hepatitis refers to an inflammatory condition of the liver
...
These include autoimmune hepatitis and hepatitis

that occurs as a secondary result of medications, drugs, toxins, and
alcohol
...

Your liver is located in the right upper area of your abdomen
...
4 million Americans are currently living with chronic
hepatitis B and C
...

Treatment options vary depending on which type of hepatitis you
have
...


5 types of viral hepatitis
Viral infections of the liver that are classified as hepatitis include
hepatitis A, B, C, D, and E
...


Hepatitis A is always an acute, short-term disease, while hepatitis B,
C, and D are most likely to become ongoing and chronic
...

Hepatitis A
Hepatitis A is caused by an infection with the hepatitis A virus
(HAV)
...

Hepatitis B
Hepatitis B is transmitted through contact with infectious body fluids,
such as blood, vaginal secretions, or semen, containing the hepatitis B
virus (HBV)
...

It’s estimated by the CDC that 1
...

Hepatitis C
Hepatitis C comes from the hepatitis C virus (HCV)
...
HCV is among the
most common viral infections in the United States
...
7
to 3
...


Hepatitis D
Also called delta hepatitis, hepatitis D is a serious liver disease caused
by the hepatitis D virus (HDV)
...
Hepatitis D is a rare form of hepatitis that
only occurs in conjunction with hepatitis B infection
...
It’s very
uncommon in the United States
...
Hepatitis E is mainly found in areas with poor sanitation and
typically results from ingesting fecal matter that contaminates the
water supply
...

However, cases of hepatitis E have been reported in the Middle East,
Asia, Central America, and Africa, according to the CDC
...
This is sometimes referred to as alcoholic hepatitis
...
Over time, it can
cause permanent damage and lead to liver failure and cirrhosis a
thickening and scarring of the liver
...


Autoimmune system response
In some cases, the immune system mistakes the liver as a harmful
object and begins to attack it
...
It’s three
times more common in women than in men
...
Symptoms
may not occur until the damage affects liver function
...
They include:









fatgue
fludlike symptoms
dark urine
pale stool
abdominal pain
loss of appette
unexplained weight loss
yellow skin and eyes, which may be signs of jaundice

Chronic hepatitis develops slowly, so these signs and symptoms may
be too subtle to notice
...


During a physical examination, your doctor may press down gently on
your abdomen to see if there’s pain or tenderness
...
If your skin or eyes are
yellow, your doctor will note this during the exam
...
Abnormal results of these tests may be the first
indication that there is a problem, especially if you don’t show any
signs on a physical exam of liver disease
...

Other blood tests
If your liver function tests are abnormal, your doctor will likely order
other blood test to detect the source of the problem
...
They can also be used to
check for antibodies that are common in conditions like autoimmune
hepatitis
...
This test allows your doctor to take
a close at your liver and nearby organs
...
This
can be a useful test in determining the cause of your abnormal liver
function
...
It can be done through your
skin with a needle and doesn’t require surgery
...

This test allows your doctor to determine how infection or
inflammation has affected your liver
...


How hepatitis is treated
Treatment options are determined by which type of hepatitis you have
and whether the infection is acute or chronic
...
Bed rest may be recommended if symptoms cause a great deal
of discomfort
...

The hepatitis A vaccine is available to prevent this infection
...
It’s a
series of two vaccines
...


Hepatitis B
Acute hepatitis B doesn’t require specific treatment
...
This form of
treatment can be costly because it must be continued for several
months or years
...

Hepatitis B can be prevented with vaccination
...
The series of three vaccines
is typically completed over the first six months of childhood
...

Hepatitis C
Antiviral medications are used to treat both acute and chronic forms
of hepatitis C
...
They may also
need further testing to determine the best form of treatment
...

Currently, there is no vaccination for hepatitis C
...
According to a 2013 study ,a drug called alpha interferon can be
used to treat hepatitis D, but it only shows improvement in about 25
to 30 percent of people
...

Hepatitis E
Currently, no specific medical therapies are available to treat hepatitis
E
...
People with this type of infection are often advised to get
adequate rest, drink plenty of fluids, get enough nutrients, and avoid
alcohol
...

Autoimmune hepatitis
Corticosteroids, like prednisone or budesonide, are extremely
important in the early treatment of autoimmune hepatitis
...

Azothioprine (Imuran), a drug that suppresses the immune system, is
often included in treatment
...

Other immune suppressing drugs like (CellCept), (Prograf) and
cyclosporine (Neoral) can also be used as alternatives to azathioprine
for treatment
...
If you’re traveling to a developing country, you should
avoid:






local water
ice
raw or undercooked shellfish and oysters
raw fruit and vegetables

Hepatitis B, C, and D contracted through contaminated blood can be
prevented by:





not sharing drug needles
not sharing razors
not using someone else’s toothbrush
not touching spilled blood

Hepatitis B and C can also be contracted through sexual intercourse
and intimate sexual contact
...

Vaccines
The use of vaccines is an important key to preventing
hepatitis
...
Experts are currently developing vaccines against
hepatitis C
...


Complications of hepatitis
Chronic hepatitis B or C can often lead to more serious health
problems
...

Complications of liver failure include:
 bleeding disorders
 a buildup of fluid in your abdomen, known as ascites
 increased blood pressure in portal veins that enter your liver,
known as portal hypertension
 kidney failure
 failure which can involve fatgue, memory loss, and diminished
mental abilites due to the buildup of toxins, like ammonia, that
afect brain functon
 Liver carcinoma, which is a form of liver cancer
 death
People with chronic hepatitis B and C are encouraged to avoid alcohol
because it can accelerate liver disease and failure
...
If you
have chronic hepatitis B or C, check with your doctor before taking
any new medications
...
The scar tissue prevents the liver working
properly
...

But it usually takes years for the condition to reach this stage
and treatment can help slow its progression
...
As your liver becomes more damaged, you may:
 feel very tired and weak
 feel nauseous
 lose your appetite
 lose your sex drive
As the condition gets worse, further symptoms can include:
 yellowing of the skin and whites of the eyes (jaundice)
 vomiting blood
 itchy skin
 dark, tarry-looking poo
 a tendency to bleed or bruise more easily
 swollen legs (oedema) or tummy (ascites) from a build-up
of fluid
See your GP if you think you may have cirrhosis
...


Diagnosing cirrhosis
If your GP suspects cirrhosis, they'll check your medical history
and carry out a physical examination to look for signs of longterm liver disease
...
Tests include:
 Blood Test
 scans – an ultrasound scan, CT scan, or MRI scan
 liver biopsy– a fine needle is used to remove a sample of
liver cells so they can be examined under a microscope
 Endoscopy– a thin, flexible tube with a light and camera
at the end (an endoscope) is passed down your throat and
into your stomach; images of your oesophagus and
stomach can show swollen veins (varices), which are a
sign of cirrhosis
Treating cirrhosis
There's currently no cure for cirrhosis
...

Treating the underlying cause, such as using anti-viral
medication to treat a hepatitis C infection, can also stop
cirrhosis getting worse
...
A wide range of alcohol
support services are available
...
In this
case, a liver transplant is the only treatment option
...

What causes cirrhosis?
In the UK, the most common causes of cirrhosis are:
 drinking too much alcohol over many years

 being infected with hepatitis for a long time,
particularly hepatitis C

 non-alcoholic steatohepatitis – a more severe form of nonalcoholic fatty liver disease ,where the liver becomes
inflamed as the result of a build-up of excess fat
Alcohol consumption
Drinking too much alcohol can damage the liver's cells
...

Women who drink heavily are more likely to get liver damage
than men, partly because of their different size and build
...
Alcohol speeds up the rate at which
cirrhosis progresses, regardless of the cause
...

Read more about alcohol units and alcohol misuse
...

Using a condom during sex and not injecting drugs will reduce
your risk of getting hepatitis B and C
...

Aim for a healthy weight
To reduce your risk of developing non-alcoholic fatty liver
disease, which can lead to cirrhosis, try to maintain a healthy
weight by having a healthy, balanced diet and exercising
regularly
...

For example, it:
 stores glycogen, a carbohydrate that produces short-term
energy
 makes bile, which helps digest fats
 makes substances that clot the blood
 processes and removes alcohol, toxins or drugs
Your liver is very tough
...


LIVER CANCER

Primary liver cancer is an uncommon but serious type of
cancer that begins in the liver
...

Read about secondary liver cancer on Macmillan Cancer
Support
...
They can include:
 unintentional weight loss
 loss of appetite
 feeling very full after eating, even if the meal was small
 feeling sick and vomiting
 pain or swelling in your abdomen (tummy)
 jaundice (yellowing of your skin and the whites of your
eyes)
 itchy skin
 feeling very tired and weak
Visit your GP if you notice any of the symptoms listed above
...

You should also contact your GP if you've previously been
diagnosed with a condition known to affect the liver, such
as cirrhosis or a hepatitis C infection, and your health suddenly
deteriorates
...

Cirrhosis can have a number of different causes, including:
 drinking excessive amounts of alcohol over many years –
read more about alcohol misuse
 having a long-term hepatitis B or hepatitis C viral infection
 haemochromatosis-an inherited disorder in which iron
levels in the body slowly build up over many years
 primary biliary cirrhosis– a long-term liver disease in which
the bile ducts in the liver become damaged
It's also believed obesity and an unhealthy diet can increase
the risk of liver cancer because this can lead to non-alcoholic
fatty liver disease
...


Over the past few decades, rates of liver cancer in the UK have
risen considerably, possibly as a result of increased levels of

alcohol consumption and obesity
...

However, regular check-ups for liver cancer (known as
surveillance) are often recommended for people known to have
a high risk of developing the condition, such as those with
cirrhosis
...
The earlier liver cancer is diagnosed, the more
effective treatment is likely to be
...

Treating liver cancer
Treatment for liver cancer depends on the stage the condition
is at
...

Treatment options in the early stages of liver cancer include:
 surgical resection – surgery to remove a section of liver
 liver transplant – where the liver is replaced with a donor
liver
 microwave or radiofrequency ablation – where
microwaves or radio waves are used to destroy the
cancerous cells
However, only a small proportion of liver cancers are diagnosed
at a stage where these treatments are suitable
...


In these cases, treatments such as transplanty are used to slow
down the spread of the cancer and relieve symptoms such as
pain and discomfort
...

Liver failure is a life-threatening condition that demands urgent
medical care
...
However, a more rare condition known as acute liver failure
occurs rapidly (in as little as 48 hours) and can be dificult to detect
initially
...
These include:

 Acetaminophen overdose
 Viruses including hepatitis A, B, and C (especially in children)
 Reactions to certain prescription and herbal medications

 Ingestion of poisonous wild mushrooms
Are the Symptoms of Liver Failure?

The initial symptoms of liver failure are ofen ones that can be due to
any number or conditions
...
Early symptoms include:






Nausea
Loss of appetite
Fatigue
Nause

However, as liver failure progresses, the symptoms become more
serious, requiring urgent care
...

Likewise, if a virus causes liver failure, supportive care can be given at
a hospital to treat the symptoms until the virus runs its course
...


For liver failure that is the result of long-term deterioration, the initial
treatment goal may be to save whatever part of the liver is still
functioning
...

Fortunately, liver transplant is a common procedure that is ofen
successful
...
Here are some tips to help prevent
these conditions:

 Get a hepatitis vaccine to prevent hepatitis A or B
...

 Drink alcohol in moderation
...

 Practice proper hygiene
...
Also, wash your hands before you touch any food
...

 Don't share any personal toiletry items, including toothbrushes
and razors
...

 Be sure to use protection (condoms) when having sex
...


WORMS INFECTION

What are parasitic worms?
Key points

1
...

2
...

3
...

Parasites are organisms that live in and feed off a living host
...
Among
them are flatworms, flukes, and roundworms
...

TYPES OF WORMS

What worms commonly cause infection?

When it comes to parasitic infection, flatworms and roundworms are the
likely culprits
...


Tapeworm

You can get a tapeworm by drinking water contaminated with tapeworm
eggs or larvae
...

Tapeworms embed their heads into the intestinal wall and remain there
...


A tapeworm looks like a long, white ribbon
...

Flukes

Flukes are a type of flatworm
...
Raw watercress and other fresh water plants
are the main sources of flukes in humans
...

They make their home in your intestines, blood, or tissues
...

Hookworms

Hookworms are transmitted through feces and infected soil
...


Hookworms live in the small intestine, where they attach themselves to the
intestinal wall with a “hook
...

(Threadworms)

are tiny, fairly harmless worms, but they’re quite common in children
...
The female lays eggs
around the anus, usually during the night
...
People get
infected when they touch the eggs and end up putting them in their mouths
...
They’re easily passed among children and caregivers or in
institutions
...
The most common
way humans get trichinosis is by eating undercooked meat that contains
the larvae
...
As they reproduce, those
larvae can travel outside the intestines into muscle and tissue
...
You may not have any symptoms, or they may
be quite mild
...
These may include:


fever



fatigue

Additional symptoms of hookworms include:


itchy rash



anemia



fatigue

As trichinosis worms travel through the bloodstream and enter other
tissue or muscles, they can cause:


fever



swelling of the face



muscle pain and tenderness



headache



light sensitivity



conjunctivitis

DIAGNOSIS
If you’re experiencing any unusual symptoms, especially if you’re returning
from a trip to another country, you should consult your doctor
...

Diagnostic tests will be necessary to identify the culprit:



A fecal test involves checking a stool sample for parasites, larvae, or
eggs
...
They may also help eliminate other
causes for your symptoms
...




Imaging tests like MRI, CT scan, or X-rays can be used to detect
parasites
...
The tape
can be examined under a microscope for the presence of pinworm
eggs
...


TREATMENT

How is parasitic infection treated?

The main treatment is prescription antiparasitic medication
...
In most
cases, you’ll have to take the medication for several weeks
...

In very severe cases in which parasites have invaded other parts of the
body, additional treatments like surgery may be necessary
...
And follow up with your doctor as advised
...

A full recovery can be expected in most cases
...

PREVENTION

How to prevent parasitic infection

The following tips can often help prevent parasitic worm infection:


Never eat raw or undercooked meat or poultry
...




Disinfect all cutting boards, utensils that touched raw meat
...





Don’t walk barefoot in places where soil may be contaminated by
feces
...


You should also give your hands a good scrubbing with soap and water:


before eating



before food prep



after touching raw meat



after using the toilet



after changing a diaper or caring for someone who is sick



after touching an animal or animal waste
...
& Clark, M
...
Clinical Medicine: Edinburgh:
Elsevier Saunders
...
D
...
Davidson’s
Principles and Practice of Medicine: Oxford • MOHSW (2008)
...
Dar es
Salaam, Tanzania: Ministry of Health and Social Welfare
...
& Fauci, A
...
(2008)
...
Oxford: McGraw Hill
...
(2006)
...
Churchill: Livingstone
...
J
...
(2006)
...
Livingstone
...
& Glynn, M
...
Hutchison’s Clinical Methods
(22nd ed
...




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