Pinworms – Causes, Symptoms And Treatment

Pinworms are small worms that infect the intestines. They are common in children and easy to treat.

Causes

Pinworms are the most common worm infection in the United States, primarily affecting school-age children. Pinworm eggs are spread directly from person to person or by touching bedding, food, or other items contaminated with the eggs.
Typically, children are infected by unknowingly touching pinworm eggs and putting their fingers in their mouths. The eggs are swallowed, and eventually hatch in the small intestine. The worms mature in the colon. Female worms then move to the child's anal area, especially at night, and deposit more eggs. This may cause intense itching and the area may even become infected.

Symptoms
Sometimes symptoms are not present. When symptoms are present, the most common symptom is itching around the rectum, disturbed sleep, and irritability. Itching is usually worse at night. Itching is worse at night because the worms are migrating to the area around the rectum to lay their eggs. In some cases, the worms can actually be seen in the area around the rectum or in the stool. The worms look like light-colored threads on the move.

Pinworms don't usually cause serious health problems, and they do not carry disease. But it is possible to get a skin infection from scratching around the anus.
The incubation periodthe time from first contact with eggs until symptoms appearis usually 1 to 2 months or longer. There is no way to find a pinworm infection until symptoms appear.

Diagnosis
Diagnosis is often made by parents discovering live worms (small (1/2 inch size) white thread like worms in a child's stool) in children with typical symptoms. Testing is also available to look for eggs on a pinworm prep or collected with a scotch tape test (which your Pediatrician will look at under a microscope).

Treatment

For symptomatic infections, medication is almost always effective in eliminating the pinworms quickly. Mebendazole (Vermox) may be given as a single 100-mg dose, which is then repeated two weeks later. The same dose is given regardless of age or size of the patient, but use in children under two years of age has not been well studied. Pyrantel pamoate (Antiminth, Pin-Rid) and albendazole (Albenza) are alternative treatment options. Because family members are often also infected, some experts suggest treating the whole family.

Usually, a dose of mebendazole (Vermox) or pyrantel pamoate (Antiminth, Combantrin) is given, followed by a second dose two weeks later. These medicines are very effective in killing worms. Piperazine and pyrvinium are less effective choices. Creams or ointments that relieve anal itching and may contain substances that kill the worms can be prescribed. Careful hygiene is essential to prevent reinfection. Trim the child's fingernails so that he or she will not be harmed by scratching. Soothe the itching and any rectal pain by giving the child a sitz bath and cleaning the anal opening with witch hazel.

Avoid scratching the infected area around the anus, because this contaminates the fingers and everything else that is touched afterwards. Keep hands and fingers away from the nose and mouth unless they are freshly washed. Carry out these measures while family members are treated with medication.