I shit a worm

September 16, 2007 9:34 AM

I have worms in my stomach and zero possibilities of seeing a doctor. Tell me what to do! (Graphic Details within)

I am currently in asia in a country where I don't speak the language. After exactly one week, I saw a long thin thing like a glass noodle in my poo. I thought, strange shape. I pressed the flush button and it slowly slid down, shaped like a worm. It was brown and covered in poo, and I did not take a closer look.

That particular specimen was about 3 inches extended out of the tip of the poo (may have been longer within) had a round body like an earthworm, but had a bit of a lower circumfrence than an earth worm. Interestingly, the very tip of it had a small thin pipe like a thread - perhaps 1cm long.

So a few days after this incident, I went out and bought a drug called Zentel (Albendazole) at the pharmacy. I had to employ a translator, and this was a very embarassing process.

I took two tablets (10 Tablets in the pack, each at 0.2g). Over the past days (it has been perhaps 4 days), I've been observing my poo. Though I have not seen any such large worm specimens, I believe I see small thread like things sticking out of the end of some lumps of poo. I've not been able to bring myself to disintegrate the poo to find out if there are more worms.

And this brings me to the question:

1. What type of worm could this be?
2. Is 1 week enough for such a worm to grow so big and be shitted out?
3. If not, then where could I have infected myself with something like this, and how long have they been in me?
4. How do I make ABSOLUTELY sure that whatever worm it is, it's killed and gone?
5. When the worms die, do they get digested?
6. Do I need to warn people to be careful cos I used their toilets?

I've been having a vague tummy ache for quite a while. Also, I suddenly redeveloped chest problems about a year ago (asthma, etc). Over the last 4 months, I've been having a wierd skin allergy that appears whenever my skin gets lightly scratched by anything. My butthole has been itching for a long time. Any relationships to the worms for all that?

Once more: I will not have access to a doctor for the next 6 months. I have to deal with this myself!

Thanks Dr. Mefi!

posted by anonymous to health & fitness (16 comments total)

I am not a doctor, but I do have a copy of "Where There is No Doctor: a village health care handbook", and I provide the information contained therein for entertainment purposes:

Whipworm (Trichuris, Trichocephalus) (Picture of a worm with long thin thread at one end)

3 to 5 cm long. Color: pink or gray.

This worm, like the roundworm, is passed from the feces of one person to the mouth of another person. Usually this worm does little harm, but it may cause diarrhea. In children it cocasionally causes part of the intestines to come out of the anus.

Prevention: Use latrines, wash hands before eating or handling food, protect food from flies, and follow the guidelines of cleanliness described in the first part of this chapter.

Treatment: If the worms cause a problem, give mebendazole. For dosage, see page 374.

I also include:

Pinworm, threaworm, Seatworm (Enterobius)

1 cm. long. Color: white. Very thin and threadlike.

How they are transmitted: These worms lay thousands of eggs just outside the anus (ass hole). This causes itching, especially at night. When a child scratches, the eggs stick under his nails are are carried to food and other objects. In this way they reach his own mouth or the mouths of others, causing new infections of pinworms.

Effect on health: These worms are not dangerous. Itching may disturb the child's sleep.
posted by Comrade_robot at 9:46 AM on September 16, 2007

Here's a place to start to maybe held you determine what kind of a worm it is (includes preventative measures).

Here's info on the medication you are taking, which seems to treat all kind of intesitinal worms.

If you figure out what kind of a worm it is, a good place to find all the info you would need on it (including self-care, causes, prevention etc) is the Mayo Clinic website which has a "Find it Fast" feature to look up any condition that you want to know more about by the first letter.

IANAD etc.
posted by triggerfinger at 10:08 AM on September 16, 2007

You could read through some of the posts at the Parasite forum on Curezone, or post there yourself. Good luck.
posted by iconomy at 10:08 AM on September 16, 2007

The book that Comrade_robot mentioned, "Where There Is No Doctor" and the companion "Where There Is No Dentist" are available for free download (in parts) from the Hesperian Foundation.

A couple of months ago, I combined the parts so that there's a single PDF for each book: (warning, useful self-link)

Where There Is No Doctor.pdf
Where There Is No Dentist.pdf

They're good references to have around.
posted by mrbill at 10:29 AM on September 16, 2007 [56 favorites has favorites]

My wife spent some time in Africa and she told me about pinworms. She made it sound like it was a pretty common thing and other than an itchy butt it didn't seem to cause many problems.

Here is the mayo link for pinworms.
posted by crios at 10:48 AM on September 16, 2007

It's nearly impossible to believe that you have internet access yet there is literally no way you can get to a doctor. Maybe not a Western doctor (though again, I find this hard to believe), but if you can find a translator to buy drugs at the pharmacy (I presume) then surely one can take you to a local doctor. They'll very likely know exactly how to fix this problem.

I know that doesn't answer your specific question, but trust me - there is a hospital near you and as gets said in every medical thread, nobody can diagnose you over the internet. Taking worm-killing drugs you may not actually need probably isn't the best idea.

Your options boil down to this:

a) forget about being embarrassed, go to a local doctor, be sure you're rid of your worms. If you're actually in the backwoods of, say, Laos, take a day or two off to get to the nearest large town.

b) don't go to a doctor and live with your most likely harmless worms for a while.

Stuff like this can be pretty jarring at first, but you'll be okay. I've spent a lot of time in Asia, including some extremely backwater areas, so if you need any advice feel free to email me. It's in my profile.
posted by borkingchikapa at 10:54 AM on September 16, 2007 [1 favorite has favorites]

Shameful personal admission: As a child, I had pinworms. What the OP is saying sounds nothing like my experience. (Oh, except for the whole "I have worms coming out my ass" part. That part's the same.) Pin worms are tiny and you will see many more than just one at a time, IIRC.
posted by thebrokedown at 11:34 AM on September 16, 2007

My money is on Ascaris lumbricoides. It's the largest and most common helminthic infection. It's extremely common outside the US and even within the US.
posted by i_am_a_Jedi at 12:11 PM on September 16, 2007

Any chance that it's not a worm at all? Indigestible fruit skins, for example, sometimes roll up and look sort of wormlike (in my poo, at least). It's not clear how close of a look you got.

If you see a doctor I'd bet they'll want a stool sample anyway, so you might as well nerve yourself up to prodding apart your b.m. and checking for worminess.
posted by hattifattener at 1:49 PM on September 16, 2007

Pinworms are very, very common in the United States, as well as the rest of the world. If you have a child, rest assured that he or she will likely get pinworms (and lice) at least once during the course of pre/elementary school. Don't be ashamed - it happens in most all places and has nothing to do with cleanliness levels. However, pinworms are very hard to see and are generally pretty small, so it doesn't sound like what the poster has.
posted by Addlepated at 4:19 PM on September 16, 2007

IANAD, and this is not medical advice.

Based on the morphology you've described, trichuris sounds more likely.

However, Ascaris is by far more prevalent.

Pinworms are unlikely. They're much smaller, and are more likely to cause itching.

That said albendazole is indeed the standard tx for most nematodes. However, do not take while pregnant / nursing.
posted by NucleophilicAttack at 4:46 PM on September 16, 2007

A friend of mine believes he eliminated (in both senses of the word...) an intestinal parasite he'd been carrying around by drinking comfrey root tea.

I don't know if comfrey root is available where you are, or even if it's safe (my friend survived drinking it), but maybe give it a shot if it's available and regular meds are not.

He got his parasite in Central or South America, and named it "Pepe the Protoplasm."
posted by altcountryman at 7:01 PM on September 16, 2007

Disclaimers aside: they have doctors in Asia. See one of them.
posted by stavrosthewonderchicken at 10:41 PM on September 16, 2007

I had pinworms once. My best advice is do not scratch your bare asshole. If you don't come in contact with the worm eggs, or at least, if you wash your hands very thoroughly after you do, the worm infection will die out on its own.
posted by tehloki at 12:00 AM on September 17, 2007

One more word of advice with albendazole is that it's strongly contraindicated, IIRC, with alcohol. Lay off the booze for a week or two while on it and hopefully you won't have any side effects.
Nthing seeing a doctor and not scratching your anus - that's how some of them spread/re-infect you!
Additionally, while you have the infection, be sure to hydrate well and get extra vitamins and other nutrients (Iron, for example) as sometimes the worms can reduce the amount absorbed from your diet.
(IANAD)
posted by shokod at 2:43 AM on September 17, 2007

I'm really late on this but NO THIS IS NOT A PINWORM. The OP says it was 3 inches long. It's either partially digested fibers or a roundworm.
posted by zek at 11:18 AM on October 26, 2007