Pinworm Infection

The most common type of intestinal worm infection worldwide is the pinworm infection. Pinworms are also called enterobius vermicularis or oxyuriasis.

Pinworms are white and thin, measuring about ¼ to ½ inch (roughly 5 to 13 millimeters) in length.

Female pinworms lay thousands of eggs in the folds of the skin surrounding the anus while a person sleeps. In some cases, people with pinworm infection have no symptoms except for anal itching and restless sleep.

It occurs mostly in school-age children, as the microscopic eggs spread easily from one child to another.

Oral drugs that kill pinworms are one form of treatment for the infection, as well as washing underwear, bed linens, and bedclothes.

Pinworm infection can create serious complications if not treated in a timely manner. It is quite common for a pinworm infection to spread among family members, as it mostly favors crowded places. Animals do not contract this infection, however, only humans.

Pinworm symptoms can at times be easily detected, but in some cases, the person may not experience any.

Signs and symptoms of pinworm infection are:

• Itching of the anal or vaginal area
• Intermittent abdominal pain
• Nausea
• Irritability and restlessness
• Insomnia
• Stools showing the presence of pinworms
• Pain around the anal area
• Discomfort while sleeping
• In women, urinary tract infection
• Lack of sleep due to pinworm movement causing irritation
• Bleeding due to constant scratching

Visit your doctor if you have severe anal itching or any of the above symptoms.

If you breathe or swallow a pinworm egg, it can cause an infection. The eggs can be carried into your mouth through contaminated food or drinks and through your fingers.

The eggs hatch in your intestines and grow into mature worms after a few weeks.

The female pinworms then move to your anus to lay eggs, which can lead to itching and, after you scratch it, the eggs get onto your fingertips and are transferred to surfaces such as bed linens, tables, or toys. They can also be transferred from contaminated fingertips to drinks, food, and other people.

The eggs can survive for two to three weeks on a surface.

Pinworm is a highly contagious illness that spreads easily when one unintentionally inhales or ingests the pinworm eggs deposited on an object touched by an infected person. Once the eggs have been ingested, the cycle of infection begins. Eggs can only be seen under a microscope.

The eggs remain in the human body until they hatch and mature. Once they are adults, the female pinworms enter the colon and then exit the body through the anus. Before exiting the body, they lay eggs around the anus in the folds of the skin. Hence, the person infected with pinworms is usually seen scratching the anal area due to the presence of the eggs.

Scratching the affected area also becomes the medium of transmitting this disease, as the pinworm eggs are transferred onto the person’s fingers. They can then survive for several hours, during which time they can be transferred onto objects such as toys, household objects, a toilet seat, or clothing. Once the eggs latch onto these objects, they can survive for around two to three weeks.

Since children have lower immunity as well as a habit of touching things unknowingly, they easily carry eggs and become infected. Children tend to put any object or toy in their mouth, hence, the eggs enter their body easily. It is also possible for adults to inhale the eggs while shaking clothing or bedding, however, this is quite uncommon. 

Consult your doctor if you suspect you have a pinworm infection. They might then suggest a tape test to make a diagnosis. In a tape test, your doctor will place a transparent tape on the skin around the anus.  The eggs, if present, will stick on the tape, and your doctor will put this tape under a microscope to check for eggs or pinworms.

Some of the questions you can ask your doctor include:

• What are the possible causes of my symptoms if I do not have a pinworm infection?
• If I have a pinworm infection, does my family need treatment, too?
• How can I get rid of pinworms?
• How do I prevent this from happening again?

Your doctor will also ask you questions such as:

• What are your symptoms?
• When did they start?
• Do they occur mostly when you sleep?
• What makes them better?
• What makes them worse?
• Does anyone in your family have the same symptoms?
• Do you know if you had contact with someone who has a pinworm infection?
• Have you found any dead worms anywhere in your house?

While waiting for your appointment, avoid scratching your anus. Identifying the eggs or worms is how your doctor will confirm the presence of infection.

You can also perform the tape test at home. If you are the one who has pinworms, ask for help from a family member, or if you suspect someone of having pinworms, do the tape test when they wake up and before they use the toilet or get dressed.

You can also perform the tape test three days in a row for better results and bring it to your doctor to examine under a microscope.

To treat a pinworm infection, your doctor may suggest over-the-counter pamoate (Reese’s Pinworm medication, Pin-X) for you and your family to avoid infection and reinfection.

Some of the anti-parasite medications include Albendazole (Albenza) and Mebendazole.

Mild gastrointestinal problems are a possible side effect, and you might need two or more doses to completely remove the infection.

Some of the methods to prevent the spread of pinworm eggs or to prevent reinfection include:

• Washing your anal area in the morning to reduce the number of eggs and showering to avoid possible bath water contamination
• Wash your clothes in hot water, especially your towels and bed sheets, and then dry on high heat to help kill the eggs
• Change underwear and bedding daily
• Wash your hands so the infection will not spread, especially after having a bowel movement and before eating
• Do not scratch the anal area, cut your fingernails to avoid eggs getting on your fingertips, and avoid nail biting

Pinworm eggs can attach to surfaces such as:

• Tables
• Toys
• Toilet seats
• Chairs or beddings

Medications are always the first line of defense when it comes to treating a pinworm infection. However, there are certain home remedies that can help reduce the itching and irritation at the anal region and the infection, to a certain extent. One should note that what works for one person may not work as well for another; it all depends on the body type. Home remedies include:

• Garlic: Garlic is considered one of the most effective remedies when it comes to killing pinworms. It is loaded with vitamins, like vitamin A, vitamin C, vitamin D, vitamin B6, iron, and magnesium.  Garlic has been mostly called a medicinal herb, used to treat many health conditions such as blood pressure, heart disease, cholesterol, and heart attack. Garlic prevents female pinworms from laying eggs and also kills the existing eggs laid at the skin folds of the anal region. One can ingest garlic in small doses by dicing up a clove and mixing it in pasta or bread. Garlic can also be eaten raw. Apart from ingesting, you can also apply garlic topically, like a salve. The method to create the salve is to first chop off a few garlic cloves and make it into a fine paste. Mix this paste with a small amount of petroleum jelly or any other oil. Then, take a clean cotton swab and dip it in the mixture, and apply it to the anal region. This will kill the eggs. Even though garlic is considered good, it can also cause certain side effects in some people, such as burning sensation in the mouth or stomach. Too much raw garlic ingested can cause vomiting, nausea, and diarrhea. Too much garlic applied topically can damage the skin as well.

• Dietary changes: Diet plays an important role when it comes to building up the immune system. A healthy immune system helps the body fight against many infections and diseases. On the other hand, a body with a poor immune system is not able to fight against any infection, causing many other health issues. When it comes to a pinworm infection, one should avoid the intake of sugary foods and foods rich in carbohydrates since it acts as nutrients for the pinworm. Sugary beverages and high-caloric food should also be avoided. These type of foods help the pinworm grow and lay more eggs, and it makes the environment more favourable for them. Instead, one should include foods rich in fiber, such as whole wheat and raisins, which help flush the pinworms out of the system. Apart from fiber and vitamins, one can also opt for probiotics, which help keep the urinary tract healthy. Probiotics also increase the good bacteria in the body, which helps fight against the bad bacteria, thus making the intestines not so favourable for pinworms. Yogurt is one such probiotic food, but avoid added sugar in yogurt.

• Coconut Oil: Loaded with antibacterial, antifungal, and antiviral properties, coconut oil helps clear pinworm infections if applied on a regular basis, at least three or four times a day. You can also swallow a teaspoon of pure coconut oil first thing in the morning, otherwise, you can apply small amounts of coconut oil to the affected area. This should be done regularly until the infection goes away.

• Fresh carrots: Fresh carrots during the right season can also be used as a treatment for pinworm infection. Carrots are known to be good for your overall health, so the inclusion of carrots in your diet will provide great benefits. Rich in beta carotene, carrots help boost vision. Intake of carrots on a daily basis also helps the body fight against viral, bacterial, and fungal infections. They are also a low-caloric food with plenty of nutrients, such as vitamin A, vitamin K, vitamin C, vitamin B6, vitamin B3 and B12, potassium, and magnesium. You can shred the carrots and have them at least three times a day on a regular basis. Carrots can be eaten raw, but if you do not like raw items, try adding a little honey to improve the taste. Carrots can be mixed with other raw veggies and eaten in salads as well.

• Pumpkin seeds: Pumpkin seeds are used to treat many intestinal parasites, as they help flush them out. But it should be noted that pumpkin seeds do not actually kill the worms, only paralyze them, due to their high levels of compounds called cucurbitins. Blend a cup of pumpkin seeds with plain yogurt. You can also use milk or coconut water instead of yogurt. Continue adding the yogurt or coconut water until it becomes a fine paste. You can eat this mixture directly as a porridge, and you can also add honey, which contains antifungal and antibacterial properties. Sugar should not be added to this mixture.

• Flaxseed and clove: Crush clove and mix it with flaxseeds. Both of these ingredients have worm-fighting capabilities. You can add this mixture to any food, and be sure to consume it once every three days to get rid of the worms.

• Onions: Onions contain sulfur, which helps the body fight against pinworms. Slice a medium onion and soak it in water overnight or for a couple of hours. You can drink this liquid three times a day to remove the pinworms from the intestine.

Other homeopathic remedies for pinworm infection include:

• Caladium (Calad): Useful when worms are in the vagina,
• Teucrium (Teucr): When there is anal irritation
• Sinapis nigra
• Spigelia (Spig): For nausea
• Ignatia (Ign): For the anus
• Calcarea (Calc): To eradicate the worms

These alternative remedies are to be done after seeking professional advice.

Some effective lifestyle tips you can follow include:

• Wash hands often, especially after waking up in the morning, before eating, and after going to the bathroom
• Avoid nail biting and eye rubbing
• Cut your nails short to avoid eggs clinging to your fingernails
• Wash your bed sheets, clothes, and towels in hot water
• Take a bath everyday with hot water
• Mix a teaspoon of vinegar in water and drink it everyday
• Cut an onion and soak it in a pitcher of water overnight, then drink it three times a day to remove the pinworms from your intestines
• Consume bitter gourd, which is an effective way to flush out pinworms and eggs
• Grind a few gloves of garlic and mix with Vaseline, then apply to the anal area to relieve itching and kill pinworms

The person infected with pinworm infection should avoid scratching the anal area, and instead apply some ointment to the affected area to provide some relief from irritation.

Bathing together, especially when it comes to children, should be avoided, as it can easily spread the infection

All areas of the house should be vacuumed and cleaned thoroughly; all surfaces should be cleaned with disinfectant; household items should be washed before using; toys should be washed thoroughly before giving them to kids; and floors, carpets, and toilet seats should also be cleaned properly.

Wash your hands before and after using the toilet and after changing your baby’s diapers. Keep an eye out for the presence of worms in the diaper, and check bowel movements for them as well.

The infection is most likely to affect children younger than 18, because it can be easily spread in school and child care centers. People who are living in crowded places, such as institutions, are also at a higher risk.

Pinworms do not usually cause any serious conditions, but sometimes heavy infestations can cause an infection of the female genitals. It can cause problems such as inflammation of the vagina (vaginitis) or the inner lining of the uterus (endometritis), because the parasite can travel from the anus up to the vagina, then to the uterus, pelvis, and fallopian tubes.