Friday, November 18, 2011

Round Worm (Ascaris lumbricoides) in Stomach after Taking Albendazole

A patient had been prescribed a dose of albendazole, who complained of pain in the sides of upper abdomen followed by a pinching pain in the throat for quite some time. She also gave the history of passing worms. An endoscopy, revealed a live round worm in the next day morning.  

Round worm, Ascaris lumbricoides is a helminth, gains access to human through faeco-oral route in an egg form. After developing to adult worm, usually, resides in the intestine feeding on the nutrients.
It can cause malnutrition, iron deficiency anemia and sometimes intestinal obstruction. Very rarely, it can cause obstructive jaundice gaining access to the biliary channel and gall bladder. It may also cause eosinophilic lung disease.
It is usually treated by 400 mg. of single dose albendazole in adults and children above 2 years of age. Sometimes, it gets irritated by the drug and come up to the stomach. Also, as such, it may come up and gets vomited out or may pass down to get evacuated in stool.
Albendazole paralyses the worm. A little and important advice, many times not passed to the patient is that the drug should be taken in the evening in empty stomach and the night’s meal thereafter. That eases the paralyzed worms to pass out along with the morning evacuation of bowel.
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