How to remove threadworms?

Threadworms commonly infect the intestines, especially in children. Although this sounds alarming, worms are nothing to be afraid of. They are easily treated with medication and strict hygiene measures. Without treatment, threadwoods usually do not go away because the infection continues as long as the adult worms remain in the intestine.

Let’s take a look at how we can remove threadworms and how to stay worm-free, read on.

🐛 Different types of worms

Parasitic worms that lurk in a person’s intestinal tract are called Helminths, they can not multiply within a human body and pass through a person’s stool. Here are some different types:

Threadworms

Threadworms (species Enterobius vermicularis) also known as pinworms, are tiny worms inside the large intestine that cause intense itching. They are often visible in poo which is one of the first signs of an active pinworm infection. They’re tiny and often described as being about the size of a staple.

Threadworms in faeces are the most common in pre-schoolers and older children, but babies and adults can also catch them. It is thought that around two in five children will get threadworm infections at some point.

Hookworms

Hookworms (species Necator americanus) commonly enter the human digestive tract when ingesting contaminated water, fruit, and vegetables. This worm infection can also enter the body if a human walks barefoot on contaminated soil, with faeces penetrating the skin.

Tapeworm

A tapeworm infection occurs when a person eats undercooked or raw fish that’s contaminated with tapeworm larvae, most commonly in places where people eat raw or undercooked fish from lakes and rivers.

📝 Ways in which you can get threadworm

By mouth

The most common way people get threadworms is by swallowing the worm’s eggs by getting worm eggs on your hands and putting your hands in your mouth. Also contaminated food, kitchen and bathroom surfaces and toothbrushes

From the anus

Threadworms leave your gut at night and lay eggs on the skin around your anus (bottom). The eggs can get onto your hands or beneath fingernails by scratching the itchy area or because of poor handwashing after using the toilet

The air

Threadworm eggs can also get onto carpets, bed linen, towels, soft toys, and flannels and into household dust. By shaking these items they are passed by inhaling the eggs in the air

🧪 Symptoms of threadworm

The most common symptoms people with threadworms have, include:

• An intense itchy bottom, particularly at night. This is when the female worms come out to lay eggs. These pinworm eggs have a pin-like tail, which is where the name comes from
• Hard to sleep at night. As anal itching is most prominent at night, sleeping is impaired, leading to fatigue and lack of focus during the day
• Vaginal itching. In females, this can occur if eggs spread to that area
• Threadworms may be visible on your bedsheets or clothes, or you may notice them in your stools as thin pieces of white thread. Often parents will check their child’s bottom to check for signs

🦠 Diagnosis of threadworm

The tape test

After taking a history of symptoms or signs, any previous episodes of threadworm, treatment already received and which other members of the household, if any, are displaying similar symptoms a healthcare professional can give medical advice.

You may also be asked to do a simple test that involves applying a transparent piece of tape around the anus and catching any worms that come out to lay eggs. The tape can then be examined and used to support diagnosis.

💊 What is the best medication to eliminate threadworms?

Mebendazole, albendazole and pyrantel pamoate are over-the-counter treatments for threadworms for people aged over 2 years. It is available as a chewable tablet or liquid that you swallow. If you’re using an OTC medication, your symptoms will likely subside within three days of your first dose. A second dose may be required in 2 weeks, if re-infection occurs.

Mebendazole, albendazole and pyrantel pamoate belong to a group of drugs called anthelmintics. Anthelmintics paralyse the parasite by binding to its nerve and muscle cells, which disrupts glucose transport by cells. These sugars are essential to their survival, therefore this disruption stops the worms from staying alive. Within a few days, this leads to the death of the worms. Once dead, the worms are removed from the body by passing through the gut into the stools. Threadworm symptoms may still be experienced for a couple of days until the worms begin to die.

Piperazine is an alternative medicine and can be used in children under 2 years (but over 3 months) taken in 2 doses, 14 days apart.

Treatment of threadworms only kills the adult worms and not their eggs, so it’s important to treat all family members. It is important to maintain strict hygiene standards during or after treatment to avoid any new eggs that can cause a new infection.

Side effects

Before using anthelmintic drugs speak to your doctor if you’re pregnant or your child is younger than 2 years old. Side effects include:

• Diarrhoea
• Nausea
• Belly pain
• Upset stomach
• Weight loss

🌿 What home remedies are effective for eliminating threadworms?

Some home remedies have been suggested for getting rid of threadworms, but they have no scientific backing:

• Coconut oil – some people think applying coconut oil on and around the anal area (before bedtime) could stop eggs from laying there
• Raw garlic – it is thought that eating raw garlic can destroy eggs and prevent female pinworms from producing more
• Carrots – due to the high fibre content of carrots it may encourage a bowel movement and excrete threadworms out
• Papaya seeds – it has been shown in a study on rats that papaya seeds may have anthelmintic activity similar to mebendazole

Home remedies should not replace proven treatments. Pinworms are contagious, and delaying treatment can put those around you at risk.

❗ How to prevent threadworm re-infection

The NHS suggest some of the following good hygiene measures to minimise re-infection.

Good personal hygiene

• Wash hands and scrub under fingernails – particularly before eating, after using the toilet or changing nappies
• Encourage your children to wash their hands regularly
• Wash every morning
• Rinse toothbrushes before using them and cover the bristles with a cap
• Keep fingernails short
• Encourage family members in the household to wear underwear at night and change it in the morning

Good home/kitchen hygiene

• Thoroughly wash garden-grown fruit and vegetables
• Wash sleepwear, sheets, towels and soft toys on a high-temperature setting
• Vacuum and dust with a damp cloth
• Disinfect kitchen and bathroom surfaces regularly with hot water

🤔 Can I treat threadworm if I am pregnant?

Mebendazole should be avoided in the first trimester of pregnancy and during breastfeeding. Treatment in pregnancy should be discussed with a healthcare provider before starting treatment.

📝 Conclusion

Medication and attention to strict hygiene measures are the most effective ways to remove threadworms. Caution needs to be taken when treating pregnant women and children under 2 years old.

Preventing reinfection is the biggest challenge when trying to remove threadworms. It requires a lot of effort to clean surfaces continuously, laundry bedding and clothing as much as needed to destroy all the eggs, but you’ll get through it. Take the time to teach your child about proper handwashing and good hygiene, both at home and at school, to prevent more threadworm episodes.

Sources

• Anthelmintic activity of papaya seeds on Hymenolepis diminuta infections in rats – PubMed
• Pinworms (Threadworms): Symptoms, How You Get Them & Treatment
• Threadworms-June-2014.pdf
• Threadworms – NHS
• Threadworms: Advice for Referrers