Opisthorchiasis: diagnosis in adults and children, causes and treatment

In this article, we will discuss clinical features, diagnosis, treatment of opisthorchiasis. This is a dangerous defeat parasites - helminths. They affect the liver and biliary tract. Similar ailments provoke flatworms-flukes that enter the human body mainly by eating fish in which live parasites. This disease may be chronic and the wave: periods of calm interspersed with frequent exacerbations.

What causes the disease?

The disease is caused by a parasite Fluke Siberian (cat). The parasites spread by using contaminated creatures when along with the feces the eggs of the pathogen to penetrate into the water, and swallow them snails. Then comes the spread of larvae. Early diagnosis of opisthorchiasis is of great importance.

After that, the water penetrating larvae-cercaria, which penetrate into carp fish. As a result, after eating contaminated fish in the food and infected people. Dangerous eating cured, raw, salted or not well treated fish. Due to the fact that the parasites are in the muscles of fish, when they are cutting they can also get kitchen appliances that may further contribute to the penetration into the food.

The Disease is most often found on the territory of Russia (Western Siberia), Belarus, Kazakhstan, Ukraine and countries in Southeast Asia (Vietnam, Thailand, Laos, Cambodia). The largest outbreak of the disease in the world — the Tyumen region. Diagnosis of opisthorchiasis should be timely.

Statistics

As distributed opisthorchiasis in Russia and Europe?

In Russia from this disease suffers 70-75% of people, and in the lesions, the figure sometimes reaches 100% (almost all the population is infected). It is often carried out diagnostics of opisthorchiasis in children.

In Belarus, the percentage of infection is 3-5%.

Ukraine and Kazakhstan — about 7-10%.

The Baltic countries (Latvia, Lithuania, Estonia) and Western Europe (Belgium, Austria and other countries) — according to different sources, from 2 to 5% of the population.

The Leader of Russia, unfortunately, in this list. This is due to the peculiar traditions of food use, which are deeply rooted in some areas: eating fish raw or poorly processed form (salted, frozen, dried).

However, other residents of other regions can also be infected with opisthorchiasis.

The Fish which might be infected, is found in such a rivers: Ob, Irtysh, Yenisei, Ural, Kama, Dnieper, Volga, don and Northern Dvina river, Biryusa.

Features and forms of the disease

Symptoms of opisthorchiasis are dictated by the intensity and duration of infection and individual characteristics of the organism. Also this disease can be acute (lasts from several days to 8 weeks) or chronic (a period of 10 years or last a lifetime). Patients with the acute form of the disease usually have complaints of the following symptoms:

• Fever;
• Hives;
• Aching joints and muscles;
• Liver and gall bladder increased in size;
• Pain under ribs on right side;
• Nausea and vomiting;
• Flatulence;
• Liquid and frequent stools;
• Indigestion;
• Loss of appetite.

After conducting a gastrofibroscopy revealed ulcerative lesions of the gastrointestinal tract and erosive gastroduodenitis. Features of acute opisthorchiasis in children can be detected through lung lesions of allergic nature. In this case, the disease may resemble asthmatic bronchitis. So must be deaf. diagnosis of opisthorchiasis.

How dangerous chronic form?

For the chronic form of the disease should gastroduodenitis, pancreatitis, hepatitis and chronic cholecystitis. The patient from time to time there are attacks of pain under the right ribs, which are similar to biliary colic, passing on the other side of the chest.

Can be observed dyspeptic syndrome and dyskinesia of the gallbladder. This parasite affects the nervous system, thereby disrupting its activities. The patient often experiences high fatigue, insomnia, irritability, also it can hurt and feel dizzy. Sometimes these neurological cases of opisthorchiasis are the main. In this case, patients are diagnosed with vegetative neurosis and soldier's heart dystonia.

Manifested asthenic syndrome in the form of weakness, lethargy, increased physical and mental fatigue. Allergies, which includes pruritus, urticaria, arthralgia and food allergies. The chronic form of this disease is very dangerous, because even after a complete de-worming can be very serious consequences such as gastritis, chronic hepatitis, cholangitis, cholecystitis, damage to the immune system.

Diagnosis of opisthorchiasis by blood rather informative.

Rehabilitation measures

After successful treatment of the disease should take a number of rehabilitation measures aimed at recovery of the liver, gallbladder, digestive system. The consequences of helminth infection in children canto run serious allergic reactions.

Diagnosis of opisthorchiasis in this case can be difficult.

The Young parasites damage the ducts spikes, adults – suction cups. A large amount of bleeding erosions, are not excluded regenerative-hyperplastic response of the epithelium. This process increases the risk of developing cancer. Concentration in channels hepatopancreatitis system of egg parasites of the epithelium and mucus leads to their clogging, complicated flow of bile and pancreatic secretions, is their stagnation. Severe complications that affect the liver-cirrhosis, abscess, cancer. In the biliary tract peritonitis progresses, there is cancer in the pancreas, acute destructive pancreatitis.

Diagnosis of opisthorchiasis

The diagnosis will require clinical data and the results of urine and blood. You must also assign a scatological study and fibrogastroduodenoscopy.

ELISA test for diagnosis of opisthorchiasis is now very popular.

In laboratory studies is the reaction of passive hemagglutination (PHA) and ELISA. This helps to determine the diagnosis in the early stages, even before the parasite eggs will be postponed. Disease in the chronic form tests are used as auxiliary diagnostic tools.

In addition, the doctor relies on epidemiological history: lived or temporarily visited the hotbed of the epidemic, I tried whether the food is raw or poorly cooked fish, especially the carp family.

This will completely depend on the choice of the method of laboratory diagnostic of opisthorchiasis.

The First starts to react the immune system to the presence of foreign agents. And after about two weeks expressive increase of M-immunoglobulins. After one week begins to produce G-immunoglobulins. Prolonged course of the disease (10 years) degree of specific antibodies is reduced to the threshold result in immunodeficiency status.

Consider what are the diagnostic methods of opisthorchiasis in the blood, performance tests.

Carried out the biochemical and clinical tests. In the blood revealed the following characteristics:

• A-amylase;
• AST & ALT;
• Cholesterol level;
• Protein;
• Fosfatazu (alkaline).

Analysis of blood chemistry

Increased blood bilirubin, pancreatic enzyme, transaminase, sublimate and thymol samples indicate that the bad gallbladder, bile duct, liver and duodenum. These indicators are indirect signs of opisthorchiasis, it is possible to tell, only its manifestations in the chronic stage.

The Pathology is also detected using ultrasound of internal organs. Conducting a study of the esophagus, duodenum and stomach through the endoscope. The patient is obligatorily coprogram. The effectiveness of diagnostic methods of opisthorchiasis depend on the severity of the disease.

Treatment

In order to resolve the disease, you need to perform a number of actions. It usually consists of several stages.

The First phase – training:

• Destruction of the inflammatory processes of the biliary tract and of the gastrointestinal tract, allergic symptoms;
• Providing outflow from the channels of the pancreas and biliary tract;
• Detoxification of the body;
• Improving the quality of the liver;
• Colon cleansing.

How carried out these activities largely depends on the efficiency of future stages of treatment. Also, the patient should stick to a diet that involves limiting fat in the diet. In addition, the doctor may prescribe antihistamines. If you have symptoms of a secondary infection, prescribed a course of antibiotics with a broad spectrum of action.

To correct the outflow use of choleretic drugs (holekinetiki, haereticum, mixed). If there is cholestasis, then take “Heptral”, ursodezoksiholeva acid. At the stage of treatment is effective digestive enzymes (such as “Pancreatite”, “CREON”, “Mezim-Forte"), Pro - and prebiotics, prokinetics (such as “the Motylium”, “Motieka”, “Metoclopramide”).

As a traditional and selective antispasmodics prescribed “Meteospasmyl”, “Baralgin”, “Drotaverine”, “Buscopan”, “Duspatalin”, “But, Silos”. In the chronic form of the disease the stage of training lasts ten days, a week at the weakening effects of cholecystitis, cholangitis.

The Second phase – to provide the effect on helminth

Treatment of opisthorchiasis in children and adults at this stage involves the use of special medication – “Biltricid" ("Praziquantel"). It is anthelmintic medicine with broad spectrum of action that affects many species of cestodes and trematodes. It enhances the sensitivity of worms to calcium ions. Eventually the parasites can sometimes be spastic paralysis of the muscles. Then the worms are separated from the walls and out of the bile.

It is Worth noting that “Biltricid” there is a toxic effect. Exclusively much he affects the cells of the pancreas and liver. He is abletrigger allergies, vomiting, nausea, drowsiness, dizziness, diarrhea, convulsions, arrhythmia, pain in the right side and many others. So to treat opisthorchiasis should be in a special medical environment and under constant supervision of doctors.

Diagnosis and treatment of opisthorchiasis are closely linked.

Third step – rehabilitation

At this stage the main aim is to eliminate violations, which were provoked by the invasion. After the use of “Biltricid” great attention to have choleretic therapy, for example, appeal to the tyubazh with sorbitol, xylitol, mineral water, and magnesium sulfate.

On the stage of rehabilitation, it is important not to forget to clean the intestines, according to the instructions prescribed laxatives. The combination treatment also included hepatoprotectors and choleretic herbs.

What can happen if you do not undergo timely treatment?

If you do home treatment or to be late with it or, worse, do not start treatment at all, a sick person may face unpleasant consequences. Incorrect self-treatment of illness or her running form may lead to other health problems. These include:

• Jaundice;
• Peritonitis;
• Hepatitis b;
• Liver failure;
• Cirrhosis of the liver;
• Acute pancreatitis;
• Cancer;
• Impairment of the function of the pancreas.

In Addition, the patient may experience serious violations and problems with appetite, he will continue to feel physical and mental fatigue.

Therefore, it is important differential diagnosis of opisthorchiasis, a timely and comprehensive treatment, and prevention.

Prevention

Prevention of opisthorchiasis is not only in compliance with good enough thermal treatment of fish. She must have these steps:

• To look after as frying, boiling and salting fish;
• Thoroughly clean the appliances, which are designed for cutting fish;
• Cut the fish in very large pieces, in order to then it is well thermally processed;
• Strictly forbidden to eat raw fish, or give it a pet.

Conclusion

To eliminate the eggs of parasites in fish, it must be put in the freezer for eight hours, but the temperature should not exceed 40 degrees. If you are salting fish in any solution, it must be held for 40 days. Cooking fish need at least a third of an hour (after boiling water to time). Frying fish is necessarily performed under cover, in time it should last at least a third hour.

Knowing what opisthorchiasis, people can protect themselves and their children from unwanted problems. Adhering to these simple measures for hygiene and the preparation of river fish, the person will greatly reduce the chance of encountering parasites.

To Treat opisthorchiasis independently at home folk remedies is not recommended because it can significantly aggravate the situation. Upon detection of symptoms of this disease the person should enlist the help of a specialist and undergo further tests. And only after an adult or child is diagnosed, treatment begins.

To Take drugs in opisthorchiasis should be about two weeks. After this the patient passes a course of rehabilitation that will allow him to avoid the unwanted results of life in his body of the parasites.