What is Ascariasis? Symptoms, Causes, & Treatment

Ascariasis is an infection caused by roundworms called Ascaris lumbricoides that live in your intestines. These parasitic worms are surprisingly common worldwide, affecting over 800 million people, though they're less frequent in developed countries with good sanitation.

The good news is that ascariasis is completely treatable with medication. Most people recover fully without any lasting problems when they get proper care.

What is Ascariasis?

Ascariasis happens when roundworm eggs enter your body through contaminated food, water, or soil. Once inside, these eggs hatch in your small intestine and grow into adult worms that can live there for 1-2 years.

Adult roundworms look like large earthworms and can grow up to 14 inches long. They live in your small intestine, where they feed on the food you eat and reproduce by laying thousands of eggs daily.

These eggs then pass out of your body through bowel movements. In areas with poor sanitation, the eggs can contaminate soil and water sources, continuing the cycle of infection.

What are the Symptoms of Ascariasis?

Many people with ascariasis don't experience any symptoms at all, especially in the early stages. When symptoms do appear, they typically develop in two phases as the worms move through your body.

During the first phase, when larvae travel through your lungs, you might notice:

• Dry cough or wheezing
• Shortness of breath
• Chest discomfort
• Low-grade fever
• Fatigue or feeling unwell

These lung symptoms usually last 1-2 weeks and can feel similar to a mild respiratory infection. You might not even realize they're connected to worms at this point.

The second phase occurs when adult worms settle in your intestines. Common intestinal symptoms include:

• Abdominal pain or cramping
• Nausea and occasional vomiting
• Diarrhea or loose stools
• Loss of appetite
• Unexplained weight loss
• Feeling bloated or gassy

In some cases, you might actually see worms in your stool or vomit. While this can be alarming, it's actually helpful for diagnosis and confirms that treatment is needed.

Children with ascariasis may experience additional symptoms like restless sleep, irritability, or difficulty concentrating. These effects happen because the infection can interfere with proper nutrition absorption.

What Causes Ascariasis?

Ascariasis is caused by swallowing microscopic roundworm eggs from contaminated sources. The infection spreads through what doctors call the "fecal-oral route," meaning the eggs travel from infected feces to your mouth.

The most common ways people get infected include:

• Eating unwashed fruits and vegetables grown in contaminated soil
• Drinking water contaminated with sewage or infected feces
• Touching contaminated soil and then touching your mouth
• Eating food prepared by someone with poor hand hygiene
• Playing in contaminated sandbox or playground areas

Young children are especially at risk because they often put their hands in their mouths after playing in dirt or sand. The eggs are incredibly hardy and can survive in soil for months or even years.

It's important to understand that you can't catch ascariasis directly from another person or from pets. The eggs need time in soil to become infectious, usually 2-4 weeks in warm, moist conditions.

When to See a Doctor for Ascariasis?

You should contact your healthcare provider if you notice persistent digestive symptoms, especially if you've recently traveled to areas where ascariasis is common. Early treatment prevents complications and helps you feel better faster.

Seek medical attention if you experience:

• Ongoing abdominal pain or cramping
• Persistent nausea or vomiting
• Unexplained weight loss
• Visible worms in stool or vomit
• Chronic cough with no clear cause

Call your doctor immediately if you develop severe symptoms like intense abdominal pain, high fever, or difficulty breathing. These could indicate complications that need urgent care.

For children, watch for signs like poor growth, difficulty concentrating, or behavioral changes. Kids may not be able to describe their symptoms clearly, so trust your instincts if something seems off.

What are the Risk Factors for Ascariasis?

Certain factors increase your chances of developing ascariasis, though anyone can get infected under the right circumstances. Understanding these risk factors helps you take appropriate precautions.

Geographic and environmental factors play the biggest role:

• Living in or traveling to tropical and subtropical regions
• Areas with poor sanitation and sewage systems
• Rural communities where human waste may be used as fertilizer
• Regions with warm, humid climates year-round
• Places where access to clean water is limited

Personal and lifestyle factors that increase risk include:

• Being a child between ages 2-10 years
• Working with soil or in agriculture
• Having poor hand hygiene habits
• Eating raw or undercooked vegetables
• Living in crowded conditions
• Having a weakened immune system

Children face higher risk because they're more likely to play in dirt, put objects in their mouths, and may not wash their hands consistently. However, adults who work outdoors or travel frequently are also at increased risk.

What are the Possible Complications of Ascariasis?

Most people with ascariasis recover completely with treatment and don't experience any complications. However, problems can develop if the infection goes untreated or becomes severe.

The most common complications occur when worms multiply extensively or migrate to unusual locations:

• Intestinal blockage from a large mass of worms
• Bile duct obstruction causing jaundice
• Appendicitis if worms enter the appendix
• Pancreatic duct blockage leading to pancreatitis
• Malnutrition from poor nutrient absorption

In children, heavy infections can cause more serious developmental issues:

• Stunted growth and development
• Cognitive impairment or learning difficulties
• Severe malnutrition
• Increased susceptibility to other infections

Rare but serious complications can include bowel perforation or worms migrating to the lungs, liver, or other organs. These situations require immediate medical intervention.

Pregnant women with ascariasis may face additional risks, including complications during delivery if worms cause intestinal obstruction. However, with proper medical care, these complications are preventable.

How Can Ascariasis be Prevented?

Preventing ascariasis focuses on breaking the transmission cycle through good hygiene and sanitation practices. The key is avoiding contact with contaminated soil and practicing safe food and water habits.

Essential prevention strategies include:

• Washing hands thoroughly with soap and water before eating
• Washing hands after using the bathroom or handling soil
• Washing all fruits and vegetables before eating
• Drinking only bottled or properly treated water
• Avoiding raw or undercooked vegetables in high-risk areas
• Teaching children proper hand hygiene

When traveling to areas where ascariasis is common, take extra precautions:

• Eat only hot, freshly cooked foods
• Avoid street vendor food and salads
• Use bottled water for drinking and brushing teeth
• Avoid ice cubes in drinks
• Keep hands away from your mouth

At home, maintain good sanitation by disposing of human and pet waste properly, keeping play areas clean, and washing hands after gardening or yard work.

How is Ascariasis Diagnosed?

Diagnosing ascariasis usually involves examining stool samples to look for roundworm eggs under a microscope. This is the most common and reliable method for confirming the infection.

Your doctor will likely request a stool sample and may ask you to collect samples over several days. Sometimes eggs aren't present in every bowel movement, so multiple samples increase the chances of detection.

Additional diagnostic methods may include:

• Blood tests to check for signs of infection or malnutrition
• Imaging studies like X-rays or ultrasounds if complications are suspected
• Examination of any visible worms you may have passed
• Complete blood count to check for anemia

In some cases, worms may be discovered during other medical procedures like endoscopy or surgery. Adult worms are large enough to be visible on imaging studies if they're present in large numbers.

Your doctor will also ask about your travel history, symptoms, and potential exposure to contaminated soil or water. This information helps confirm the diagnosis and guides treatment decisions.

What is the Treatment for Ascariasis?

Ascariasis is treated with anti-parasitic medications that are highly effective at eliminating the worms. Most people feel significantly better within days of starting treatment.

The most commonly prescribed medications include:

• Mebendazole: Usually taken for 3 days
• Albendazole: Often given as a single dose
• Ivermectin: Typically a single dose treatment
• Pyrantel pamoate: May be used as an alternative

Your doctor will choose the best medication based on your age, weight, and overall health. These medications work by paralyzing the worms, making them unable to hold onto your intestinal wall.

Most people don't experience significant side effects from treatment. Some may notice mild nausea, stomach upset, or dizziness, but these symptoms are usually temporary and mild.

After treatment, you may continue to pass dead worms for several days or weeks. This is normal and actually indicates that the medication is working effectively.

Your doctor may recommend follow-up stool tests 1-3 months after treatment to ensure the infection has been completely eliminated. If eggs are still present, you may need another course of medication.

How to Take Home Treatment During Ascariasis?

While medication is the primary treatment for ascariasis, supportive care at home can help you feel more comfortable during recovery. Focus on rest, proper nutrition, and staying hydrated.

Supportive care measures include:

• Drinking plenty of fluids to prevent dehydration
• Eating bland, easy-to-digest foods if you have nausea
• Getting adequate rest to help your body recover
• Taking over-the-counter pain relievers for abdominal discomfort
• Avoiding alcohol and spicy foods that might irritate your digestive system

Maintain strict hygiene during treatment to prevent reinfection and protect family members:

• Wash hands frequently with soap and warm water
• Keep fingernails short and clean
• Wash bed linens and underwear in hot water
• Avoid preparing food for others during treatment
• Clean bathroom surfaces regularly

Don't be alarmed if you pass visible worms during treatment. This is actually a good sign that the medication is working. However, contact your doctor if you develop severe abdominal pain or high fever.

How Should You Prepare for Your Doctor Appointment?

Preparing for your appointment helps ensure you get the most accurate diagnosis and appropriate treatment. Gather relevant information about your symptoms and potential exposure beforehand.

Before your visit, write down:

• When your symptoms started and how they've changed
• Any recent travel, especially to tropical regions
• Whether you've seen worms in your stool or vomit
• All medications and supplements you're currently taking
• Questions you want to ask your doctor

If possible, collect a stool sample according to your doctor's instructions. They may provide you with a collection kit or specific guidelines for proper sampling.

Consider bringing a family member or friend for support, especially if you're feeling unwell or anxious about the appointment. They can help you remember important information and questions.

Be prepared to discuss your living situation, work environment, and eating habits. This information helps your doctor assess your risk factors and determine the best treatment approach.

What's the Key Takeaway About Ascariasis?

Ascariasis is a treatable parasitic infection that affects millions of people worldwide, but it responds excellently to proper medical care. The key is recognizing symptoms early and getting appropriate treatment.

Remember that this infection is completely curable with the right medication. Most people recover fully without any lasting effects when they receive timely treatment.

Prevention remains your best defense against ascariasis. Good hygiene practices, safe food handling, and clean water sources dramatically reduce your risk of infection.

If you suspect you might have ascariasis, don't hesitate to contact your healthcare provider. Early diagnosis and treatment prevent complications and help you return to full health quickly.