November 12, 2010 9:34 PM   Subscribe

ParasiteFilter: Could I have tapeworms hiding in my body 10 years later? Grossish details inside.

When I was 11 or thereabouts, I definitely had some kind of tapeworm infestation in my gut as I had small white wiggling worms in my stool. This occurred on and off for around six months to a year and hasn't been seen since. Around the same time, but not directly co-resident, I had various bouts of intense nighttime rectal itching that sounds rather like Pinworm. This also went away on its own after a while. I never saw a doctor or took medication for either problem.

At the time, I was an 11 year old boy with rather poor hygiene habits. I remember examining the worms in my stool, was a pretty big nail biter, and wasn't particularly big on handwashing. In short, it would not surprise me if I managed to ingest some of the parasites 10 years ago.

Fast forward to today, I've had ongoing issues with depression, for which I am being treated, but especially with fatigue and oversleeping (12+ hours several days in a row). My doctor has done some blood work and ruled out sleep apnea with a trip to the sleep lab, and we're currently working with the idea that my fatigue is psychiatric in origin, even though it doesn't seem to vary with my mood or activity.

That's all well and good, and very well could be the case, but I have a lingering feeling that perhaps some of this is coming from a parasitic infection left over from a decade ago. I'm certainly open to talking this over with my doctor next time I see her, but I'd rather not sound completely neurotic if this is, in fact, impossible, so I'm hoping the hivemind can help me untangle:

- Is it normal for tapeworms and/or pinworms to just go away on their own without infecting myself in a more insidious way?

- Could I have some kind of parasitic infestation lurking inside me from these episodes 10 years ago?

- Depending on the answers to the above, what kind of tests can we do to find out whether this is actually happening?
posted by anonymous to Health & Fitness (9 answers total)
I can't speak to tapeworms, but I had pinworms on and off as a child and eventually outgrew it to no ill effect. And while I won't go into detail, there were instances where I touched the pinworms. And I was hardly an obsessive hand-washer.

I would doubt that childhood pinworm encounters would have anything to do with this.

I would also assume that, if you have pinworms today, you would know it.
posted by Sara C. at 9:49 PM on November 12, 2010 [1 favorite]

I doubt that you have had tapeworms for 10 years without knowing it, but I guess it falls within the realm of unlikely-while-technically-still-possible. Have your doctor run a stool sample and CBC (parasitic infestations will often show disturbances here). They will probably be negative and you can stop worrying. If by some chance anything turns up positive you can get treated fairly easily, and, once again, stop worrying. Win-Win situation.
posted by troublewithwolves at 9:54 PM on November 12, 2010

- Depending on the answers to the above, what kind of tests can we do to find out whether this is actually happening?

Getting tested is no big deal (unless you are the poor sap who has to do the stool analysis). Your doctor fills out a form (or you no doubt can order the test yourself online), you put some of your poop in a container, and you drop it off at the lab while feeling slightly embarrassed about carrying your poop around with you.

But because the deworming drugs are pretty benign (mostly they just give you the shits), doctors will often just prescribe them preventively rather than waiting on stool tests. Talk to your doctor, explain your history, and go from there. If the doctor blows you off rather than listens and responds to your concerns, find a new doctor.
posted by Forktine at 10:04 PM on November 12, 2010

If you're so concerned, go to the chemist, by some worming tablets, and take em. They are cheap and effective.

But - and trust me I know how totally, totally frustrating it is when you have vague symptoms that nothing seems to clear up; you start hunting for the most abstruse causes and feel like you're descending into little better than augury with chicken entrails, and you get very paranoid about what might be causing your malaise or "setting you off" etc - but if you had enough worms to leave you malnutritioned, and fatigued on that level, you would definitely know about it.

Infection on that scale is relatively rare these days in all but the most poverty-stricken areas of the developing world. You would have to be eating a shockingly bad diet, _and_ you would probably be seeing other symptoms like gastritis, haemorrhage, some amount of rectal bleeding, cramping, and arse that feels like it's been dusted with a mixture of draino, cayenne pepper and uranium, and possibly more for that to be the case. I mean, a worm or two ain't gonna do the trick in this kind of situation my friend. They're not very big; you eat a lot of food. You would need to be riddled with worms. Your intestine would look like either a terry-towelling washcloth or an infinite corridor of sausage casings. You would need to have a fucking worm the size of a moray eel inside of you.

So, nope, I don't think it's worms. But if it is, go to a pharmacist, and buy some worm tablets. They're like six bucks, and they will nuke your eyeless tummy snakes from orbit. It certainly won't hurt and will help put your mind at ease. :)
posted by smoke at 4:58 AM on November 13, 2010 [3 favorites]

If it was never treated, it's very possible that you still have tapeworms. If that's the case, just get it treated so you can cross that off the list. Contrary to what smoke says, the wikipedia article on beef tapeworms says that they can often be asymptomatic.
posted by smokingmonkey at 5:53 AM on November 13, 2010

Tapeworm segments passed in stool don't generally look like you describe, more like grains of rice (the tapeworm is made of segments in a long string that are attached to a head, and it sheds the segments, so it generally doesn't look like a "worm" in the traditional sense), what you are describing sounds more like pinworms (threadworms).
posted by biscotti at 6:22 AM on November 13, 2010

Where There Is No Doctor (buy the book, or download the free pdfs and make a donation because they are doing amazing work) has a really good section on parasites, including worms, as well as treatment options.

but if you had enough worms to leave you malnutritioned, and fatigued on that level, you would definitely know about it.

Anecdotally, I don't think this is true. I've had several friends in the US end up with severe worm infestations, and I have of course seen it often overseas. People don't always have obvious clues (like having tons of worms in their stools or the other symptoms you describe), and doctors in the US and Europe are not usually very experienced with worms and don't tend to think to look for them. So while I agree that there are probably other explanations for the symptoms the OP describes, I don't think that worms can be ruled out, particularly because of the previous infestation.
posted by Forktine at 6:29 AM on November 13, 2010

Here's a story a friend told me. He had stomach problems for some time. Tried various treatments, then a medicine to expell worms. Worms, they were expelled. He'd been a vegan for 14 years, and was convinced he'd been carrying worms since his last bite of sushi. That's what my friend said, so in my expert and professional opinion you should ask your doctor if nowormium snright for you.
posted by eccnineten at 6:55 AM on November 13, 2010

Small, white wiggling worms in your stool were likely pinworm (enterobius) which is very common in the US and the UK. The itching anus was likely caused by these same, visible female pinworms when they came out of the anus at night to lay their eggs.

Pinworms don't live very long - several weeks. Reinfection is common because there is no intermediate host: a kid with bad hand washing practices can easily get the eggs under his fingernails and accidentally ingest them, thereby getting a new infection. However, the infection can go away on its own as the worms die, assuming there is some improvement in hygiene.

It is unlikely you had a tapeworm. They are not common in the developed world, infection with tapeworms generally requires the consumption of under-cooked meat (the intermediate host), and they present as small, flat "segments" in the stool (segments of the much longer entire worm that is inside the intestine) or sometimes only eggs.

A pinworm infection is surely long gone by now. Had you had a tapeworm, it's also unlikely you'd still have it. I guess certain tapeworms from fish can live as long as 10 years. I don't think the pork borne kind live that long. There is a "dwarf tapeworm" (Hymenolepis nana) that does occur in the US, but only the eggs are visible in feces, so you wouldn't have seen crawling worms. And I don't think they survive for decades.

I'm sorry to hear about the depression. Sleepiness is weird. SOmetimes I'll have periods where I need 10 hours of sleep every night. I think it's mostly stress related and seasonal for me. Good luck.
posted by serazin at 10:37 PM on January 7, 2011

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