Opisthorchiasis. Causes, symptoms, diagnosis and treatment of the disease. Signs of opisthorchiasis in adults, symptoms of infection in women and men What organs are affected by opisthorchiasis
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Foci of opisthorchiasis are formed due to the influence of various factors: the presence of water bodies, their pollution with sewage, the dietary habits of the population (eating raw fish). In the modern world, the main part of the range of opisthorchiasis is located on the territory of Russia and Ukraine.
Experts state that over the past ten years, the number of cases of infestation of citizens has noticeably decreased. Nevertheless, the dynamics of the incidence indicates that surveillance should be carried out without fail.
Metacercariae have a very high viability: so, even at a temperature of about -40 ° C, they can last up to six hours. They are less resistant to high temperatures and salt.
If a person has opisthorchiasis, the symptoms of the disease begin to appear between the fifth and forty-second day after infection with the disease. The disease can be mild, moderate or severe. The incubation period is approximately 21 days. As a rule, opistrochiasis begins abruptly, in more rare cases, the disease develops gradually. In this case, the patient complains of severe weakness, periodic sweating, and malaise. The further course of the disease is predominantly subclinical, the symptoms are expressed little. The patient may have a fever, but the rise is usually small - up to 38 ° C. If a person has opisthorchiasis, symptoms may be expressed eosinophilia against the backdrop of moderate leukocytosis .
However, if there is an acute form of the disease, then with moderate opisthorchiasis, the patient has an increase in body temperature, which can reach 39 - 39.5 ° C. These symptoms also complement the catarrhal phenomena of the upper respiratory tract. Eosinophilia and leukocytosis increase, moderate promotion .
Patients with mild to moderate opisthorchiasis note that after one to two weeks their condition improves markedly. In this case, there is a latent phase of the disease, which is continued by the already chronic course of the disease.
If acute opisthorchiasis manifests itself in a severe form (approximately 10-20% of people have just such a course of the disease), then the disease can have a number of variations. Yes, diagnosed typhoid , gastro-enterocolitic hepatocholangitic variants, as well as a variant of the disease in which Airways . In the latter case, opisthorchiasis manifests itself , pneumonia .
At typhoid-like form , which often manifests itself as opisthorchiasis, the symptoms of the disease most clearly reflect the allergic nature of the acute phase of the disease. In this case, the disease begins acutely, the patient suffers from a sharp increase in body temperature, he has chills, rashes on the skin. Quite often noted cardialgia , in which diffuse changes in the myocardium are noticeable on the ECG, there is also intoxication organism. The acute onset of the disease, in addition, already in the first days is accompanied by severe headache, weakness, myalgia, dyspeptic symptoms. At the same time, the person may suffer from cough and other symptoms characteristic of allergies . The acute manifestation of opisthorchiasis usually lasts about two weeks.
For hepatocholangitic form disease is characterized by severe fever, eosinophilia. In addition, there are signs of diffuse liver damage: the patient manifests hepatosplenomegaly , jaundice , the level rises in the blood, protein levels increase. The patient is concerned about pain: sometimes they resemble hepatic colic, in some cases they appear as aching and dull. If the disease takes a severe form, manifestation and dysfunction of the pancreas is possible. In this case, there are dyspeptic manifestations, girdle pains.
If opisthorchiasis manifests itself in gastroenterocolitic variant , then the disease takes the form of erosive catarrhal gastritis , ulcers of the duodenum and stomach , enterocolitis . In this case, as a characteristic symptom, there is pain in the right hypochondrium, epigastrium. A person is very worried about vomiting, nausea, appetite decreases, stool is disturbed. Fibroscopic examination shows erosive hemorrhagic gastroduodenitis , and in some cases - ulcerative niches. Intoxication and fever are more poorly expressed.
Approximately one third of patients suffer from involvement in the disease process respiratory system
, which is manifested by inflammatory processes in the upper respiratory tract, pleurisy, pneumonia, asthmatic bronchitis. A person with this form of opisthorchiasis has an astheno-vegetative syndrome, which is manifested by weakness, sleep disturbances, fatigue, irritability.
Sometimes the acute stage of the disease has a protracted course: in this case, the fever can last about two months or even longer. In this case, the patient does not pass the pulmonary syndrome, and there are signs of liver damage. In the process of reducing the manifestations of the acute stage of the disease, the general condition gradually normalizes, the form of the disease changes, passing into the chronic phase. Very often this manifests itself biliary dyskinesia , chronic pancreatitis , chronic cholangiocholecystitis . Such phenomena, in turn, become a factor contributing to the attachment of a secondary bacterial infection. As a result, the patient may develop a lesion of the hepatobiliary system according to the type of cholangiohepatitis, in which there is a pronounced pain syndrome, jaundice, and an enlarged liver. If the pancreas is affected, a person infected with opisthorchiasis develops pancreatitis.
Due to damage to the gastrointestinal tract, it often occurs chronic gastritis , and duodenitis .
Sometimes patients complain of pain in the region of the heart, uneven pulse. Such phenomena are associated with the presence of dystrophic changes in the myocardium. In the course of the development of the disease, it is inhibited and depleted .
It is expressed, as a rule, in a mild form, while in the acute form the disease manifests itself much less frequently than in adults. In children aged one to three years in the chronic phase of the disease, there is a lag in physical development, signs of biliary dyskinesia, the child does not eat well. When a child grows up, sensitization is more pronounced in him, when he reaches adolescence, the patient already has an organ pathology characteristic of adult patients.
Diagnosis of opisthorchiasis
Also, due to the high concentration of serum specific sometimes serological diagnostic methods are used. The diagnosis is confirmed after about a month if opisthorchia eggs are found.
Treatment of opisthorchiasis
It is important that the treatment of opisthorchiasis, both in the chronic and acute phases, be comprehensive. In this case, methods should be combined etiotropic And pathogenetic therapy.
Treatment of opisthorchiasis takes place in stages: initially, the doctor conducts the necessary preparation for therapy, followed by taking an anthelmintic drug with parallel pathogenetic treatment. The next stage is the patient, after which he must be left at the dispensary and control how effective the treatment was.
Patients who have an acute phase of opisthorchiasis should undergo therapy aimed primarily at eliminating allergic reactions, as well as treating the pathology of the organs associated with them. In this case, drugs with antihistamine action are prescribed ( , , ), as well as sedatives (bromine preparations,). Also, the specialist prescribes the use of anti-inflammatory drugs.
However, even after liberation from invasion, all functions of the hepatobiliary system are not always fully restored. So, there may be disturbances in the work of the gastrointestinal tract, in microcirculation and in the functioning of the immune system. Therefore, it is very important to conduct high-quality rehabilitation therapy. In this case, the doctor prescribes specific drugs and methods of treatment, guided solely by the individual condition of the patient. Particular emphasis should be placed on restorative therapy, you should also undergo a course of treatment for opisthorchiasis with drugs that improve the condition of the biliary system, treatment using physiotherapy procedures. It is also important to follow the diet recommended by your doctor.
For two months after the patient was discharged from the hospital, it is recommended to do tubages with sorbitol using magnesium sulfate once a week.
The duration of medical examination after treatment is determined, guided by how severe the course of the disease was. As a rule, the medical examination period is two to three years, and the patient is examined approximately once every six months.
The doctors
Medications
Prevention of opisthorchiasis
For the implementation of high-quality prevention of the incidence of opisthorchiasis, it is necessary to apply A complex approach. First of all, it is very important to timely detect infested and carry out their deworming with subsequent monitoring of the condition. As a sanitary and epidemiological measure, it is important to prevent contamination of water bodies with faecal contamination and carefully control the processing of fish that will be eaten.
Information on precautionary measures should be disseminated among the population, this is especially important in foci where there is a high level of infection with opisthorchiasis.
Each person must comply with all rules for preparing fish dishes. So, you need to cook fish for at least 20 minutes, fry in a pan - at least 15 minutes. Salted fish can be rendered harmless during hot smoking.
Salt fish should be at a temperature of +16 - +20 ° C for two weeks. In this case, it is necessary to use salt with a consumption of at least 14% by weight of the fish. Canned food and hot-smoked fish cannot contain viable metacercariae.
Complications of opisthorchiasis
If opisthorchiasis is severe, then experts talk about a difficult prognosis and the possibility of complications. So, as complications of this disease can develop, primary liver cancer And pancreas , bile peritonitis .
Serious damage to the nervous system is also possible, as evidenced by the manifestation of headache, insomnia, irritability, and depression.
In addition, infection with opisthorchiasis can aggravate the condition of patients with other diseases, can adversely affect the development , contribute to the formation of typhoid-paratyphoid carriage. If a person is re-infected with opisthorchiasis, then the course of the disease is progressive.
B66.0
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General information
Causes of opisthorchiasis
Opisthorchiasis is caused by two types of fluke helminths: Opisthorchis felineus and Opisthorchis viverrini. On the territory of Russia, the pathogen O. felineus, the Siberian or cat fluke, is common. This is a flat helminth 4–20 mm long, 1–4 mm wide, having a lanceolate body equipped with oral and ventral suckers. Opisthorchiasis caused by O. viverrini is found in Southeast Asia.
The development of opisthorchis occurs with a threefold change of hosts: the first intermediate host is mollusks, the second intermediate is freshwater fish of the carp family (bream, carp, tench, dace, ide, roach, etc.) and the final host is mammals (cat, dog, fox, otter, arctic fox, sable, man), eating fish. The final hosts release eggs with larvae into the environment along with faeces. Once in the reservoir, the eggs are swallowed by freshwater molluscs of the genus Codiella, in whose body they undergo changes: first, miracidium comes out of the egg, which successively turns into a sporocyst, redia and cercaria. The tailed larva (cercariae) emerges from the body of the mollusk and attaches itself to the body of cyprinids in the pond, penetrates into the connective and muscle tissue, where it encysts, turning into metacercariae. Being in the body of fish, after 6 weeks the larvae become invasive, that is, they acquire the ability to cause opisthorchiasis in the final hosts.
The pathogenesis of opisthorchiasis
The nature and severity of pathological processes that characterize the course of opisthorchiasis depend on the massiveness and duration of the invasion, the state of the immune system. Depending on these factors, the course of opisthorchiasis can be erased or manifest; light, medium and heavy. In the pathogenesis of opisthorchiasis, early (acute) and late (chronic) stages are distinguished.
The acute phase of opisthorchiasis manifests itself 2-4 weeks after infection. A mild form of helminthiasis begins with a sudden jump in body temperature up to 38 ° C and the subsequent maintenance of subfebrile condition for 1-2 weeks. At this time, patients experience weakness, abdominal pain, note the unstable nature of the stool. In the peripheral blood with a mild course of opisthorchiasis, moderate leukocytosis and eosinophilia up to 15-20% are detected.
The moderate form of opisthorchiasis occurs with fever (up to 39 ° C and above), which lasts about 3 weeks. Characterized by myalgia and arthralgia, urticarial skin rashes, catarrh of the upper respiratory tract, enlarged liver and spleen, vomiting, diarrhea, asthmatic bronchitis. Increasing leukocytosis, eosinophilia up to 25 - 60%, increased ESR.
Severe forms of acute opisthorchiasis develop in 10-20% of patients and can proceed according to typhoid-like, gastroenterocolitis, hepatocholangitis and respiratory variants. Symptoms of a typhoid-like variant of opisthorchiasis include high fever, chills, lymphadenitis, polymorphic skin rash, and dyspepsia. In clinic the phenomena of intoxication and allergization prevail; possible toxic-allergic damage to the central nervous system or myocardium. With the gastroenterocolitic form of opisthorchiasis, a clinical and pathomorphological picture of gastritis (catarrhal, erosive), gastroduodenitis, stomach and duodenal ulcers, enterocolitis develops. These conditions are accompanied by a decrease in appetite, nausea, pain in the epigastrium and right hypochondrium, diarrhea. During the hepatocholangitic variant of acute opisthorchiasis, jaundice, hepatosplenomegaly, abdominal syndrome of the type of hepatic colic or shingles prevail. Pathological syndromes may include hepatitis, cholangitis, cholecystitis, pancreatitis. With the involvement of the respiratory organs (respiratory variant of opisthorchiasis), tracheitis, asthmatic bronchitis, pneumonia, pleurisy, and fever develop.
Chronic opisthorchiasis most often proceeds according to the type of biliary dyskinesia, cholangiohepatitis, cholangiocholecystitis, cholelithiasis, chronic pancreatitis, gastritis, duodenitis. There are signs of asthenovegetative syndrome: weakness, fatigue, irritability, emotional instability, headache, sleep disturbance, increased sweating. May develop dystrophic changes in the myocardium, manifested by pain behind the sternum, tachycardia, arterial hypotension. The long course of chronic opisthorchiasis can be complicated by cirrhosis of the liver, purulent cholangitis, phlegmon of the gallbladder, bile peritonitis, primary cancer of the liver and pancreas.
Diagnosis of opisthorchiasis
When diagnosing opisthorchiasis, epidemiological information is taken into account, indicating the patient's stay in endemic foci, eating freshly frozen, low-salted, insufficiently thermally processed fish. A change in biochemical samples of the liver and pancreatic enzymes is characteristic - an increase in bilirubin, transaminases, amylase and lipase. Data from instrumental studies (FGDS, ultrasound of the hepatoduodenal zone and pancreas, cholecystography, CT, MRI of the liver and biliary tract) reveal signs of gastroduodenitis, biliary dyskinesia, cholecystitis, cholangitis, hepatitis, pancreatitis.
Treatment of opisthorchiasis is carried out in stages. At the first stage, preparatory therapy is prescribed, including choleretic and antispasmodic drugs, H1-histamine receptor blockers; according to indications - short courses of antibiotics. In addition to drug therapy, physiotherapy is carried out (magnesium sulphate electrophoresis, magnetotherapy, microwave therapy). The purpose of the preparatory stage is the normalization of bile secretion and outflow of bile, the relief of the inflammatory process in the gastrointestinal tract and biliary tract.
Forecast and prevention of opisthorchiasis
In mild and moderate forms of opisthorchiasis, the prognosis is usually favorable, although cases of repeated helminthic invasion are possible. In the event of purulent cholecystitis and peritonitis, the outcome depends on the completeness and speed of surgical care. Prognostically unfavorable is the development of acute liver failure, liver cancer, pancreatic cancer, or cholangiocarcinoma.
Actions to prevent infection with opisthorchiasis include therapeutic and preventive work (identification and deworming of infested), epidemiological measures (protection of water bodies from contamination with human and animal feces, compliance with the technology of processing and cooking fish, extermination of shellfish), sanitary and educational work (informing the population).
Opisthorchiasis, or infection of the body with Siberian flukes, has not without reason earned the notoriety of one of the most dangerous helminthic human invasions. The defeat of the vital glands of the body - the liver and pancreas - coupled with the incredibly high life expectancy of Siberian flukes makes the symptoms of opisthorchiasis extremely multifaceted and numerous, and the helminthiasis itself is difficult to diagnose. In this article, we will try to consider in as much detail as possible the signs of opisthorchiasis in adults and children, as well as the complications that they can go into with a long course of the disease.
Unlike the vast majority of trematodosis (for example, the very common fascioliasis), of which about 40 are known in humans, opisthorchiasis is a deadly disease. At the same time, people die not so much from the defeat of the hepatobiliary system by the worms themselves, but from the degeneration of these lesions into cancerous tumors - hepatocellular carcinoma or cholangiocarcinoma.
It is interesting that residents of highly endemic regions (i.e., places where opisthorchiasis is extremely widespread - for example, Siberia and the countries of Southeast Asia) practically do not suffer from the acute phase of the disease, or it occurs in them in a mild form. In residents of such places, at the end of the incubation period (5–42 days), the disease immediately takes on a chronic, sometimes completely asymptomatic course, and begins to manifest itself already in adulthood or old age.
Residents of moderately endemic (Ukraine and Kazakhstan) and non-endemic regions (when infected during travel) most often suffer from a full-fledged acute phase of opisthorchiasis. After 1–2 weeks, the patient's condition improves, and soon the helminthiasis passes into a chronic phase, which, however, does not cancel potential exacerbations in the future, and Siberian flukes can live inside a person, according to various sources, from 20 to 30 years.
Interestingly, the symptoms of opisthorchiasis in women do not differ at all from the signs of infection in men.
But it is important to know that the symptoms of opisthorchiasis in adults and in a child have a number of differences. A separate article is devoted to the symptoms of acute and chronic opisthorchiasis in children.
So, the symptoms of the acute phase of mild to moderate opisthorchiasis are:
- fever with a gradual increase in temperature to 39 ° C or more;
- increased sweating;
- increased fatigue;
- moderate leukocytosis;
- eosinophilia reaching 25–60%;
- ESR reaching 20–40 mm/hour;
The severe course of the acute phase is a separate conversation, since medicine distinguishes 4 forms of severe acute opisthorchiasis.
Symptoms of the gastroenterocolitic form:
- moderate fever;
- pain in the right hypochondrium and epigastrium (in the diagram below);
- diarrhea or constipation;
- weak appetite;
- nausea, sometimes vomiting;
- stomach and duodenal ulcer;
- catarrhal or erosive gastritis;
- enterocolitis;
- gastroduodenitis in erosive-hemorrhagic form;
- eosinophilia up to 40%.
Symptoms of the hepatocholangitis form:
- severe fever;
- hepatosplenomegaly;
- jaundice;
- high levels of protein and bilirubin in the blood;
- dull aching pain in the right hypochondrium (less often - girdle);
- dyspepsia.
Typhoid-like symptoms:
- severe fever;
- chills;
- severe weakness;
- severe migraines;
- arthralgia;
- myalgia;
- skin allergy;
- cough;
- dyspepsia;
- leukocytosis up to 30 × 10 9 /l;
- eosinophilia up to 90%;
- ESR up to 40 mm/hour;
- lymphadenopathy.
Symptoms of the form with a primary lesion of the respiratory tract:
- irritability;
- weakness and high fatigue;
- pleurisy;
- pneumonia;
- asthmatic bronchitis.
No matter what variant of acute opisthorchiasis a person suffers from, sooner or later (usually within 2.5 weeks), the symptoms will significantly weaken, and helminthiasis will move into its chronic phase.
Symptoms of chronic opisthorchiasis include a number of syndromes:
- biliary dyskinesia;
- cholangiocholecystitis;
- cholangiohepatitis;
- cholangiocarcinoma;
- hepatocellular carcinoma;
- vegetative-vascular dystonia;
- allergic manifestations;
- gastrointestinal manifestations;
- violations of intestinal microbiocenosis;
- pancreatopathy.
In this sense, opisthorchiasis and clonorchiasis are absolutely indistinguishable from each other. The second helminthiasis is also hepatic, but it is already provoked by another helminth from the Opistorchida family - the Chinese fluke, which can be infected in China, Mongolia, Japan, both Koreas and the Russian Far East.
The effect of Siberian flukes on various organs
The above list of syndromes that chronic opisthorchiasis can cause can only be understood by a person with a medical education or who is familiar with these pathologies from personal experience. For people who have not met them before, it is extremely important to consider each syndrome in detail. For convenience, all the symptoms of chronic opisthorchiasis are distributed according to the organ systems that suffer from it.
Hepatobiliary system
The main damage from the vital activity of Siberian flukes is suffered by the hepatobiliary system. Although the vast majority of people do not even know what it is, this medical term hides well-known organs: the liver, intrahepatic and extrahepatic bile ducts and the gallbladder.
Pathological changes in the bile ducts provoke stagnation of bile, and it, in turn, serves as a favorable factor for the reproduction of intestinal bacteria. Sometimes an infection from the intestines is brought literally on its surface by young helminths during re-infection. No matter how bacteria enter the bile ducts, it is their vital activity that leads to cholangitis (inflammation of the bile ducts) or even cholangiohepatitis (inflammation of both the bile ducts and the liver).
So, the full list of symptoms of damage to the hepatobiliary system is as follows.
- Biliary dyskinesia;
- dull and sharp pains in the abdomen, starting after eating or physical activity and radiating to the right shoulder;
- nausea and/or vomiting;
- pain in the Chauffard-Rivet zone (in the figure below the list) and the epigastric region;
- bitterness in the mouth;
- bad breath;
- pain in the gallbladder;
- Cholangiocholecystitis;
- dull, arising after eating (especially fatty or fried) pain in the right hypochondrium;
- nausea;
- bitter eructation;
- heartburn;
- Cholangiohepatitis;
- frequent pain in the liver caused by exercise in an inclined position or food;
- loss of appetite and, as a result, weight loss;
- dyspepsia (early satiety, stomach fullness, bloating in the epigastric region);
- slight yellowness of the palate, less often - sclera;
- enlargement and soreness of the liver;
- subfebrile temperature with periodic increase;
- Cholangiocarcinoma;
- liver dysfunction;
- stomach ache;
- weight loss
- increased body temperature;
- changes in the color of urine and feces;
- Hepatocellular carcinoma;
- aching pain in the upper right quadrant of the abdomen;
- jaundice;
- fever;
- weight loss
- liver enlargement;
- liver failure;
- intra-abdominal bleeding.
Gastrointestinal tract
Opisthorchis of both species do not live in the stomach or intestines, and the damage caused by these helminths to the gastrointestinal tract is a direct consequence of the dysfunction of the hepatobiliary system and the pancreas (which flukes also colonize).
Statistics show that more than 90% of infected people have gastrointestinal manifestations.
Hormonal imbalance in turn leads to a variety of pathological conditions - from dehydration and malnutrition to diabetes.
Symptoms of gastrointestinal dysfunction in opisthorchiasis include:
- Gastritis;
- a feeling of heaviness or fullness in the epigastric region, especially bright after eating;
- unpleasant taste in the mouth;
- heartburn;
- regurgitation;
- nausea;
- weakness;
- Duodenitis;
- nausea and/or vomiting;
- weakness;
- fever;
- pain in the epigastric region (especially on palpation);
- Stomach ulcer;
- pain in the epigastric region;
- sour belching;
- heartburn;
- nausea and/or vomiting;
- weight loss
- Duodenal ulcer;
- pain just above the navel, radiating to the heart and shoulder blade;
- nausea and/or vomiting;
- heartburn;
- belching;
- bloating;
- weight loss
- irritation and insomnia;
- pancreatopathy;
- pain in the navel and left hypochondrium;
- weak appetite;
- unstable chair;
- steatorrhea;
- decreased levels of enzymes in urine and blood;
- moderate enlargement of the pancreas;
- Dyspepsia;
- early saturation;
- full stomach;
- swelling in the epigastric region;
- intestinal dysbacteriosis;
- feeling of discomfort in the abdomen;
- diarrhea (diarrhea);
- constipation;
- flatulence;
- bad breath;
- unpleasant taste in the mouth;
- allergic reactions;
- weakening of the immune system;
- weak appetite;
- increased fatigue;
- deterioration in the condition of nails, hair and bones.
The cardiovascular system
The mechanism of the effect of Siberian flukes on the cardiovascular system is not explained in the scientific literature, but the fact remains that 78% of infested people show signs of vegetative-vascular dystonia.
The main symptoms of damage to the cardiovascular system:
- heartache;
- cardiopalmus;
- diffuse dystrophic changes in the myocardium;
- migraine;
- dizziness;
- orthostatic collapse (dizziness and darkening of the eyes after a sudden change in body position);
- subfebrile temperature;
- feeling of heat in the face;
- cold extremities;
- hand tremor;
- neurotic disorders;
- panic attack;
- respiratory disorders;
- fainting;
- chronic fatigue;
- sleep disorders;
- pain in the joints;
- muscle pain;
- tissue swelling.
Nervous system
As in the case of the cardiovascular system, the mechanism of action of these liver flukes on the autonomic nervous system, as well as the brain and spinal cord, has not been studied. The presence of this effect, however, no one doubts: for example, in 7-9% of patients with opisthorchiasis, sympatho-adrenal crises are recorded, in 3-5% - vagoinsular crises, and in 90% - tremor of the tongue.
Symptoms of damage by opisthorchis of the nervous system:
- Sympatho-adrenal crisis;
- lack of air;
- noise in ears;
- temporary visual impairment;
- chills;
- "goose pimples";
- tremor of the eyelids, lips and hands;
- slight increase in blood pressure;
- slight increase in body temperature;
- heartache;
- cardiopalmus;
- feeling of anxiety;
- Vagoinsular crisis;
- nausea;
- stomach ache;
- flatulence;
- increased intestinal peristalsis;
- decrease in daily urination;
- increased pain sensitivity throughout the body;
- cold and damp palms;
- severe salivation;
- hunger;
- weakness;
- pallor (less often - redness) of the face;
- decrease in blood pressure;
- bradycardia;
- weakening of tendon reflexes;
- pseudo-paralysis or involuntary movements in the limbs;
- Tremor of the tongue.
allergic reactions
Allergic reactions do not affect, as is commonly believed, only the skin. Allergy is a systemic disease of various organs, therefore, unlike the previous sections of the article, allergic manifestations of opisthorchiasis will be considered below, regardless of the organ affected by them.
Opisthorchiasis can cause the following allergic manifestations:
- allergic dermatitis;
- hives;
- eczema;
- psoriasis;
- arthralgia (allergic joint pain);
- bronchial asthma;
- itching on the body;
- food allergy;
- angioedema.
Unproven symptoms of opisthorchiasis
On many online forums, people discuss the clinical manifestations of opisthorchiasis, often supplementing their list with those that are not indicated in any scientific work and are not known to infectious disease specialists with many years of experience.
Such complaints include:
- external hemorrhoids;
- arthritis (not to be confused with arthralgia, which does occur with opisthorchiasis);
- obesity;
- mucus in the throat;
- runny nose;
- stones in the liver or kidneys;
- plaque on the tongue;
- elevated cholesterol levels;
- milkmaid, etc.
When opisthorchiasis is detected, a person has a natural desire to shift the responsibility for all diseases or deviations to helminth invaders, even if these diseases clearly signal that they are caused by lifestyle imperfections: for example, hemorrhoids, obesity and high cholesterol - hypodynamia and overeating. At the same time, it is known that with the development of cholangiohepatitis, pancreatopathy or intestinal dysbacteriosis against the background of opisthorchiasis, people, on the contrary, lose weight, although it is unusual for them to lose weight even with intestinal helminthiases.
In such a situation, one should recall the well-known medical axiom: "After this - does not mean because of this." In other words, the manifestation of any symptom after infection with a cat fluke can have a hundred reasons that are in no way related to helminths.
Treatment methods for opisthorchiasis
In the post-Soviet space, only two drugs are available for the medical treatment of opisthorchiasis: praziquantel and albendazole.
Many infectious disease specialists do not even suspect the possibility of treating this helminthic invasion with albendazole, although albendazole is tolerated incomparably better than praziquantel - for example, in the treatment of echinococcosis, it is taken for 2-3 courses for 28 days.
Treatment of opisthorchiasis with folk remedies is permissible and reasonable in the case when it does not yet threaten the development of cancer. A good anti-opisthorchiasis remedy of traditional medicine, which has successfully passed clinical trials and deserved good reviews, is aspen bark extract, including in the form of preparations "Ecorsol" and "Populin".
With timely detection of opisthorchiasis, the prognosis is almost always favorable.
Conclusion
The symptoms of both acute and chronic opisthorchiasis are extremely diverse, thanks to which this helminthiasis manages to disguise itself as many other diseases. Nevertheless, the main blow in case of opisthorchiasis is taken by the liver, therefore, if any pathologies of this organ appear against the background of living in an endemic region and eating fish, it is necessary to check for opisthorchiasis.
To simplify the writing of the diagnosis in the patient's medical record, there is an international classification of diseases. The ICD information system is reviewed every 10 years. All known names of diseases in the ICD-10 have their own codes, which are written not only in the medical history, but also in disability sheets. Brief formulation of chronic opisthorchiasis according to the ICD: B66.0. For statistics, it is much more convenient if the case history contains such a code.
Chronic opisthorchiasis is classified into phases:
- Primary (no acute form of invasion).
- Secondary (in the anamnesis there is an acute stage).
According to the localization of inflammatory processes, the following variants of the course of the disease are divided:
- cholecystic;
- gastroduodenal;
- pancreatic.
Opisthorchiasis passes into the chronic form for such reasons associated with the long-term pathological influence of helminths as:
Nervous shock, damage, a decrease in the body's defenses, malnutrition become circumstances when a chronic process flows from a remission stage into a period of exacerbation.
How chronic opisthorchiasis invasion manifests itself
The number of opisthorchias in different organs of the biliary system affects what the symptoms of chronic opisthorchiasis will be. There may be pain in the liver, aggravated when the patient is hungry, bloating, intestinal disorders (rarely diarrhea than constipation), nausea, prolonged fatigue, tremor of the limbs.
Symptoms in opisthorchiasis are mainly accompanied by signs of damage to a particular organ.
Cholecystopathic variant
It manifests itself as chronic cholecystitis. With this course of the disease, patients note constant or paroxysmal pain in the hypochondrium on the right, which appears when the diet is not followed. Digestion is difficult, the gallbladder area is painful on palpation, bile excretion is difficult.
Since the gallbladder is associated with intrahepatic ducts, opisthorchiasis hepatitis is observed, which is expressed by nausea, vomiting, belching, jaundice, and skin itching.
Gastroduodenal variant
It is characterized by sharp, aching or stabbing pains in the abdomen, which indicates damage to the stomach. There is a feeling of heaviness in the stomach, even with a small amount of food consumed, nausea. With a disorder of digestion, diarrhea and vomiting are observed. Subsequently, this condition is fraught with chronic gastritis. If the pains appear in the lower abdomen, this is a sign of intestinal damage, then constipation alternates with diarrhea, and there is pressure in the intestine.
pancreatic variant
The appearance of pain in the hypochondrium on the left indicates invasion of the pancreas. Its motor properties are disturbed, bile stagnates, representing a favorable environment for the attachment of secondary infections. Opisthorchiasis pancreatitis is characterized by girdle pain, vomiting, feces with a greasy sheen.
Bronchopulmonary variant
In this case, respiratory diseases are provoked: bronchitis, pneumonia, bronchial asthma.
The clinic in the chronic course of helminthiasis is caused by symptoms of diseases not only from the biliary, but also from the central and autonomic nervous systems. Patients complain of headaches, as well as heart pain, restless sleep, irritability, tearfulness, increased sweating, salivation. An allergic syndrome is possible: skin itching, rash, swelling, food allergy.
In young children, the symptoms of opisthorchiasis are less pronounced than in adults, often they are completely absent. The threat lies in the fact that such an asymptomatic course of the disease provokes a lag in both the mental and physical development of the child. Later, latent chronic opisthorchiasis becomes the reason for the transition of other diseases in children into a latent form.
How to detect chronic opisthorchiasis
It is important to diagnose opisthorchiasis in the early stages, but this is difficult to do due to the lack of specific symptoms of the chronic phase of the disease. Therefore, it is necessary to collect an epidemiological history, after which a cumulative diagnosis is applied, which includes the following laboratory and hardware studies:
- general analysis of blood and urine (the number of leukocytes and eosinophils is much higher than normal);
- blood biochemistry (increased activity of alt and ast transamylases, cholesterol levels);
- ultrasound examination of the abdominal organs;
- x-ray studies.
Treatment Methods
Timely consistent therapy is the key to success in the fight against opisthorchiasis invasion. Chronic opisthorchiasis is recommended to be treated by different methods simultaneously.
Diet
Since the disease affects the organs of the digestive system, therapy begins with therapeutic nutrition. The diet for opisthorchiasis is aimed at maintaining and improving the functions of the liver, gallbladder and pancreas. It is necessary to exclude all fried foods, fatty, salty foods, spicy and pickled. Food should be boiled or steamed, and it is divided into receptions: 5 times a day in small portions.
It is allowed to consume dairy and vegetable soups, low-fat meat, honey and sugar in small quantities, vegetable and butter not more than 50 g per day, vegetables, fruits, low-fat dairy and sour-milk products.
Plentiful fluid intake is necessary for the speedy removal of toxins. These are compotes, fruit drinks, teas and decoctions of herbs.
Drug therapy
Drug treatment of chronic opisthorchiasis is prescribed taking into account all syndromes, the severity of the disease, the individual characteristics of the patient and includes several stages.
- Preparatory stage. This stage includes measures aimed at eliminating allergic reactions (antihistamines), normalizing bile flow (choleretic agents). It is necessary to remove the inflammation of the gallbladder and pancreas (antibiotics, choleretics), stop the pain syndrome (antispasmodics). If indicated, hepatoprotectors and adsorbents are prescribed. The preparation period lasts 2-3 weeks.
- Deworming stage. A course of treatment with praziquantel is prescribed, designed to eliminate helminths from the body. Therapy must be carried out under the supervision of a physician due to the high toxicity of the drug. Praziquantel can cause frequent vomiting, nausea, bloody diarrhea, and severe allergies.
- Recovery. At this stage, there is a partial or complete restoration of the functions of the organs of the biliary system and the gastrointestinal tract. While taking drugs that destroy helminths, dead opisthorchis remain in the bile ducts. Therapy with choleretic drugs helps to bring them out. Vitamins and supplements are prescribed to strengthen the whole body.
Folk methods of treatment
One of the most famous folk remedies for the treatment of chronic opisthorchiasis is birch tar. A few drops of tar are added to 1/4 of a glass of milk. It should be taken 1 time per day before meals. The course lasts 9 days and is repeated three times with a break of 3 weeks.
Another way to take birch tar: mix a drop of tar with a spoonful of carrot or apple puree, take before going to bed with water. Continue taking 2 weeks.
Aspen bark is a traditional medicine widely used in antiopisthorchiasis therapy. 20 g of crushed young bark is poured into two glasses of boiling water, the container is tightly closed and left for 8-10 hours. Take strained infusion 3 times a day before meals for 15-20 days.
Also, chronic opisthorchiasis is treated with herbs. St. John's wort, dandelion, celandine, nettle, pumpkin, coriander seeds are used.
In addition to conservative methods of treating opisthorchiasis invasion, one has to resort to surgical intervention. Indications for surgery are acute pancreatitis, cholangitis, liver abscess.
Prevention measures
To prevent the occurrence of chronic opisthorchiasis, educational work should be carried out among the population about the dangers of eating raw fish. It is also worth explaining that a patient with a chronic form, staying in crowded places (army, kindergartens, schools, catering establishments), does not pose a danger: it is impossible to get opisthorchiasis from a person.
The main precautionary measure is the thorough heat treatment of fish and meat of animals that have eaten fish.
The helminth that causes this disease, the liver fluke is so small in size that its presence in the human body can only be detected by complex tests.
The cause of infection can be eating river fish that is not subject to heat treatment, and humans and carnivores, including domestic animals, are at risk. The treatment is long, and its success depends on the timely visit to the doctor for the correct diagnosis.
Until recently, it was believed that the carriers of opisthorchiasis are mainly representatives of the carp family. However, recent studies have shown that it can be found in other types of fish. Which of them is sick, and which is completely healthy, it is impossible to understand at a glance. Infestation caused by: feline liver fluke.
Opisthorchiasis - symptoms and treatmentAt an early stage (2-3 weeks), weakness, lack of appetite, abdominal pain, diarrhea (constipation), skin rash, fever (39-40 ° C) is possible.
Opisthorchiasis occurs as a result of violations:
- sanitary rules of hygiene;
- eating unwashed fruits, herbs, vegetables;
- eating raw (undercooked) food - meat, fish;
- drinking raw (unpurified, unboiled) water.
Until puberty of the larvae (3-4 months), there is no need for treatment until the worms begin to secrete eggs, infecting the liver, blood, gastrointestinal tract (GIT); inflammation, spleen, gallbladder; possible obstruction of the bile ducts. There is an urgent need for home treatment.
Movement through the body of flukes causes severe damage to organs and tissues. Opisthorchiasis creates favorable conditions for the spread of bacterial infections.
Pathogenesis - what happens in the body
In the human body, opisthorchis cause mechanical damage due to suckers that fix them on the walls of the bile ducts, disrupt blood circulation, and sometimes the integrity of the mucous membranes.
Waste products of helminths can cause intoxication of the human body or the development of allergic reactions. A carcinogenic effect has also been proven: untimely treatment can provoke the development of cholangiocarcinoma associated with a mutation in the cells of the epithelium of the bile ducts.
After 1/3 of the month, the pathogen becomes a fully grown individual capable of laying eggs. The life expectancy of helminths is about 25 years.
Causes of opisthorchiasis - how does infection occur
Infection occurs according to a simple scheme - if the feces of a person or animal sick with opisthorchiasis enter the water (lake, river or even a small pond), along with it a large number of eggs freely spread throughout the reservoir.
Small snails feed on them (an intermediate link between humans and fish), but after a few months the larvae set off for free swimming to penetrate the body of the fish.
Symptoms of opisthorchiasis
For about three weeks, opisthorchis, after entering an adult organism, reaches the gallbladder and bile ducts of the liver. After that, opisthorchiasis reaches an acute form lasting up to 2 months, characterized by:
- malaise;
- rise in temperature;
- rash;
- loss of appetite;
- vomiting;
- diarrhea
- stomach and liver pain;
- pain in joints, muscles;
- pain in the liver and another symptom can cause the disease.
At this stage, an adult without a special study will not establish where the symptom came from and treatment does not begin, since these signs are also characteristic of other diseases.
- heaviness after eating, intolerance to junk food;
- heartburn;
- flatulence;
- belching
- pain syndrome, similar in sensation to colic;
- rapid fatigue, irritability, dizziness, increased sweating, weakness.
Rarely, but it happens that no symptoms appear and treatment is delayed. An adult can accurately determine opisthorchiasis with the help of special examinations: ultrasound, tomography, x-rays, blood tests, and then begin treatment.
The disease has two stages - acute and chronic. They proceed in different ways, but the symptoms of infection of the human body have common features:
- allergic reactions of the body;
- aches all over the body (especially in the muscles);
- prolonged fever;
- severe vomiting;
- dizziness;
- significantly enlarged liver and other organs;
- heavy sweating.
In the absence of attention to the signs, a person will begin to suffer from dizziness, become irritable, and will not sleep well. Then the liver thickens, nervous disorders appear. The patient often has a greatly enlarged gallbladder. For a while, the symptoms will disappear, but the pathology will remain and become chronic.
Some people may develop profuse skin rashes. There are problems with the respiratory tract, shortness of breath or severe coughing spells for no reason - a reason to immediately go to the hospital and report your alarming suspicions to qualified specialists.
The signs manifest themselves especially clearly when a person is engaged in hard and tedious work. At other times, it is almost impossible to determine the disease on your own without a thorough triple laboratory analysis.
A blood test will help determine the danger only at the first stage of the penetration of worms into the human body. It is important to remember that in some cases the disease can lead to severe consequences:
- cirrhosis of the liver;
- oncological diseases;
- pancreatitis.
Treatment here will be almost useless, therefore, if there are the slightest signs of opisthorchiasis, especially if they appeared after eating carp fish, you should seek the help of doctors. Be sure to report suspicions, only then the diagnosis will be most accurate. Immediate treatment in most cases guarantees a positive result.
The disease is divided into early and chronic periods.
- The early phase is acute, associated with the penetration of larvae into the internal organs. The length is both a few days and several months. This stage causes allergic reactions, changes in test results.
- The chronic form can be caused by re-infection of the patient:
- there is an exacerbation of the process of inflammation;
- at the place of the main localization provokes the growth of the connective tissue of the pancreas, the subsequent appearance of cicatricial changes.
May cause liver dystrophy, biliary dyskinesia.
Chronic opisthorchiasis is difficult to treat. It can last for a long time, poisoning the human body with the waste products of helminths.
Opisthorchiasis - diagnostics
Patients go to the doctor when the clinical signs of opisthorchiasis are already manifested acutely or chronically, and when diagnosing the disease, they pay attention to the history data. At risk are children and adults who live in endemic areas, where cases of infection are most frequent, or who consume river fish.
It will be necessary to analyze several stool samples from one patient, since individual samples may have more or less opisthorchia eggs, and the picture, which is important for starting treatment, will be inaccurate.
A clinical blood test reveals eosinophilia (as with most helminthic invasions) and leukocytosis (a sign of inflammation in the body). Biochemical analysis will show an increase in the level of alkaline phosphatase and bilirubin, which indicates the development of pathological processes in the liver and biliary tract.
The main difficulty in treating the disease is diagnosis. Opisthorchiasis is a disease with blurred symptoms, this causes its transition to a chronic form. May appear:
- diseases of the gastrointestinal tract, gastritis, ulcers;
- constantly low blood pressure;
- changes in the cardiovascular system;
- infectious inflammation of the bile ducts;
- hepatitis, cholecystitis, biliary dyskinesia;
- pancreatitis, with an undulating course of remissions, exacerbations;
- fatigue, irritability and other disorders of the central nervous system.
Turning to the chronic form, opisthorchiasis becomes dangerous for the body of a sick person and for the people around him.
You can identify the disease by conducting a series of tests. Along with traditional research methods, new ones are being carried out. One of the methods is a high-tech PCR research method, or polymerase chain reaction.
To identify the form of the disease, ultrasound of the abdominal cavity, the study of bilirubin fractions, the protein composition of plasma, the determination of cholesterol levels, allergological and radiological studies are also performed.
Opisthorchiasis - treatment
After making the final diagnosis, the doctor prescribes treatment individually for each patient, which depends on the form of the disease, the degree of organ damage, as well as sensitivity to the components of drugs.
Treatment of opisthorchiasis in adults takes place in a hospital (except for a mild form). To completely get rid of the disease, you must go through three stages of treatment. This system of treatment is now generally recognized in Europe and the CIS, it shows good results in patients of different ages, sex and stage of the disease.
Treatment of the chronic form of the disease occurs in 3 stages:
Stage 1 - preparatory.
The scheme of the first stage:
- Reduction or removal of allergic reactions.
- Ensuring adequate functioning of the gastrointestinal tract and biliary tract.
- To block the inflammatory processes caused in the biliary tract, treatment is prescribed in the form of a five-day medication.
- A sparing diet with a restriction in the consumption of fats and sugar.
- Take an antihistamine medicine.
The duration of this stage of envy depends on the tolerance of drugs and the severity of the course of the disease. It ranges from 1.5 to 3 weeks, in especially advanced cases, treatment can last about two months.
The main goal of the treatment is to restore the function of the normal outflow of bile. At this stage, it is important to block toxic and allergic reactions and the inflammatory process in the affected organs. For this purpose, antihistamines, antispasmodics are prescribed. In the inflammatory process, a short course of antibiotics may be prescribed.
The use of choleretic drugs in treatment should be differentiated.
In case of opisthorchiasis, drugs are prescribed that stimulate the formation of bile in the liver (Allochol, Oxafenomid, Festal, Cholenzim), including herbal drugs (Galstena, Cholagol), and drugs that promote the excretion of bile ("Tsikvalon", "Theophylline", "Olimetin").
In the process of treating opisthorchiasis, traditional medicines are also used ("Buscopan", "No-Shpa" or "Drotaverin").
At the initial stage, along with the use of drugs, physiotherapy is an effective method of treatment. The course of procedures is prescribed by the attending physician and includes electrophoresis, microwave and magnetic therapy.
Stage 2 - specific drug therapy.
During this period, chemotherapy drugs are used for treatment. The drug is given 3 times a day after 6 hours. If there are age restrictions for the treatment of taking pills or other reasons, then the course dose of the drug is divided into 6 doses per day or the medicine is taken according to a different scheme.
The use of anthelmintic drugs takes place in courses, the independent change of which is unacceptable.
Chemotherapy for opisthorchiasis, treatment and drugs are selected individually for each patient and are taken under the strict supervision of medical professionals. These drugs are very toxic, so they are not suitable for home preventive treatment.
The scheme of treatment at the second stage:
- The doctor selects the necessary medicine for treatment and its quantity.
- Tablets are taken without chewing.
- They eat some food.
- Wash down with a glass of any liquid.
- The rest of the pills for opisthorchiasis are also taken at the time interval indicated by the doctor.
- After the last medication, after 4 hours, a blind probing is performed to remove opisthorchis.
For treatment in modern medical practice, there are a number of drugs, among which the most popular are:
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Treatment with "Chloxil" takes place according to one of 3 schemes, which is prescribed by a doctor. The course of therapy is 2, 3 or 5 days with a total amount of the drug from 15 to 24 g. This is a sufficient dose to cure the disease.
Stage 3 - rehabilitation (recovery).
- The first week of treatment is performed as a daily procedure.
- The next 3 months, 2 times a week.
To restore the body after opisthorchiasis, it is necessary to drink a complex of vitamin preparations.
After 3 months, a complete examination of blood, feces, probing is carried out to determine the results of treatment. A second course of taking medications for opisthorchiasis is possible after 6 months.
However, the complete removal of helminths does not mean recovery. The recovery process in the body and treatment continues for several years. Therefore, in order to avoid infection, it is better to follow simple precautions:
- You can't eat raw fish.
- The fish must undergo a thorough heat treatment.
- For processing fish, you need to have a separate inventory.
- Wash all equipment and hands thoroughly after handling fish.
The prognosis of the disease depends on the timeliness of the start of treatment and the severity of lesions of the internal organs, in most cases favorable. A threat to human life can be purulent diseases of the biliary tract, biliary peritonitis, acute pancreatitis, as well as cancerous tumors.
Treatment of opisthorchiasis at home - folk remedies
Effective remedies from traditional medicine:
The folk home method of treating opisthorchiasis with aspen bark is especially effective. Most medicines contain a healing extract, but you can stock up on valuable raw materials for a long time on your own.
The most valuable is the young fresh bark, which has a high concentration of nutrients.
For one serving of healing potion you will need:
- 25 gr. aspen bark;
- 470 ml. water.
Finely chop fresh aspen bark, turning it into crumbs. Pour boiling water over it (necessarily in a thermos) and leave to cool completely.
Drink the strained liquid throughout the day. In the evening, prepare the next portion, a miraculous elixir will be ready overnight. The course can also be carried out with a decoction, but the mixture of water and bark must be boiled for a quarter of an hour.
For a long time, opisthorchiasis can be completely cured by another miraculous folk remedy - birch tar. Since an artisanal home-made method of preparing a valuable product is impossible, you can buy ready-made tar at a pharmacy.
In its pure form, it is not taken, but mixed with water (mineral) or fresh milk.
An important condition is that the course should follow a simple scheme:
- start with 2 ml;
- the next day, increase by 2 ml;
- again increase by 2 ml.
Continue increasing the dose until 10 ml is reached, then start decreasing in the same order. It is possible to cure opisthorchiasis only for a threefold course, taking breaks of several weeks.
For one serving of folk remedies you will need:
- 180 gr. pumpkin seeds;
- 2 yolks from raw eggs;
- 23-25 gr. fresh honey;
- 15-18 ml. water.
Chop pumpkin seeds or pass through a meat grinder, combine with the rest of the ingredients. Treatment should be carried out before meals, using the entire mixture at a time.
A prerequisite is heating the liver area with a heating pad for an hour. Only after that you can have a full breakfast.
It will take a long time to treat opisthorchiasis with a folk remedy, up to one and a half weeks. Home treatment must be repeated twice, at short intervals.
A folk remedy based on dandelion is also an excellent way to treat opisthorchiasis. It is better to treat with fresh raw materials, but harvested for the future, it does not lose its miraculous abilities.
Preparation of the potion requires:
- 20 gr. dandelion leaves;
- 245 ml. water;
- 15 gr. dandelion root.
Chop the leaves with a knife, and lightly fry the clean chopped root in a dry frying pan, then mix both masses. Boil the bitter mixture with water for about 5 minutes. Several times a day, use a folk remedy without adding sugar or honey.
A folk remedy for opisthorchiasis is a collection of several types of herbs. Home treatment will take place in two stages, two weeks each, with a short (up to 10 days) break. The healing mixture includes:
- buckthorn bark;
- sweet clover;
- tansy;
- wormwood.
Combine medicinal raw materials in equal parts, store in paper bags. 15-18 gr. Pour boiling water over the mixture (a little less than 1 cup). Drink a folk remedy twice a day.
If the treatment takes place at home, be sure to lie down for some time after taking it. The slightest deterioration in health or well-being should be the reason for stopping treatment and turning to another remedy.
Treatment with folk remedies will be especially effective if taken for the disease immediately. You should not treat a serious illness on your own, without the supervision of doctors, because this can bring irreparable harm to the patient. Accurate diagnosis, medical supervision, proven products and regular treatment guarantee excellent results.
Opisthorchiasis in children symptoms and treatment
Symptoms in children in the acute stage:
- A sharp jump in temperature above 38 degrees.
- The temperature, without falling down, can last about 2 weeks.
- One of the symptoms of the disease is diarrhea. It can be exacerbated by nausea and flatulence.
- Loss of appetite, weakness and fatigue.
- Developing, opisthorchiasis causes allergic reactions.
- There are malfunctions in the respiratory system, symptoms of liver and pancreas disease appear.
Symptoms in the chronic form:
- Decreased performance against the background of constant headaches and disturbed sleep.
- The appearance of an allergic rash in a form resembling psoriasis.
- If you do not carry out timely treatment of opisthorchiasis in children, then bronchial asthma may develop.
- With this form, children are characterized by a constant temperature of 37-37.5 degrees.
- There is a decrease in hemoglobin and a decrease in immunity.
- Opisthorchiasis in children causes frequent pain in the right hypochondrium, disorders in the digestive tract.
- Pain in the heart.
If parents notice symptoms similar to opisthorchiasis in children, then it is urgent to consult a doctor.
The pediatrician will prescribe diagnostic tests and, based on their results, treatment will be prescribed, which is carried out in several stages.
- The first preparatory period of treatment includes:
- Transfer of the patient to a diet.
- Reduction of allergens in the body.
- Improving the functioning of the digestive system.
- Taking antibiotics and anti-inflammatory drugs.
After recovery, the patient remains under medical supervision for 3 years. When symptoms similar to the disease appear, new examinations are carried out.
The diet for opisthorchiasis includes products that restore the removal of bile. These products include primarily cereals, in which you can add 50 gr. butter or vegetable oil. A small amount of jam or honey, as well as berries and fruits with a low acid content, will not harm the diet.
In the diet for opisthorchiasis, it is also necessary to include vegetarian soups and broths, that is, dairy, vegetable, fruit. But broths cooked from meat or bones are contraindicated in opisthorchiasis.
It is allowed to eat boiled lean meat, poultry or fish, with a minimum fat content. The diet for opisthorchiasis also allows the use of pickled herring and even dairy sausages.
Dairy products are allowed for any opisthorchiasis. The only restriction on the diet is the fat content of these products. The fat content should not exceed 1%.
It is useful for a patient with opisthorchiasis to drink compotes, jelly, fruit juices squeezed from non-acidic, sweet fruits, rosehip broth, and eat puddings.
What products should be discarded: first of all, it is necessary to abandon all alcoholic beverages, in whatever quantity and quality they are offered. Do not drink strong coffee. Chocolate, cocoa and Coca-Cola are also banned.
For the duration of treatment, you will have to refrain from pickled foods containing vinegar. The diet for opisthorchiasis also imposes a strict taboo on meat, fish and mushroom broths.
The list of forbidden goodies includes all confectionery products containing yeast, sugar and fats. And this means that even bread is on the list of prohibited foods, not to mention cakes and pastries.
Vegetables such as sorrel, spinach, green onions, radish and radish were also included in the list of foods prohibited by the therapeutic diet.
For the gradual rehabilitation of the affected organs, dishes rich in fiber are first introduced into the menu, and berries and fruits, which were previously banned, are gradually added to the diet. But it is not recommended yet to introduce into the menu heavy foods containing fats rich in cholesterol - sausages, smoked meats, bacon.
It is guaranteed to avoid infection by completely refusing to eat raw fish.
During cooking, it is required to cover pots and pans with a lid to maintain the temperature.
In addition to observing the rules for preparing fish dishes, washing equipment and personal hygiene, one must remember the need to:
- regular medical examinations by highly specialized specialists;
- taking tests;
- prophylactic drug use.