How is opisthorchiasis treated? Opisthorchiasis and its treatment with folk remedies

Opisthorchiasis is long and difficult to tolerate and treat, difficult to diagnose, has many nonspecific symptoms. He is dangerous with serious complications. The longer the opisthorchis worms are in the body, the stronger their damaging effect on internal organs and systems.

Infection of animals, humans, who ate the invaded fish, occurs due to the ingress of metacercariae into his digestive system.

The highest incidence is observed in the age group of patients from 15 to 50 years old. In men, opisthorchiasis occurs more often, which is associated with the peculiarities of their lifestyle (professions and hobbies for fishing, food habits and addictions).

How and why does the disease occur

Sources of infection are sick wild and domestic animals, people, whose feces, getting into rivers, brings helminth eggs into them.

Having been freed from the membranes by the action of the juice in the stomach, the metacercariae enter the liver, the cavity of the gallbladder, and the pancreas. There the larvae mature and then begin to lay eggs. The pathological effect of opisthorchis worms on the human body is both mechanical and toxic.

Mechanical impact

During life, helminths have a damaging effect on the walls of the gallbladder, pancreatic and bile ducts, causing:

In the process of life of opisthorchis worms, the following occurs:

Symptoms of opisthorchiasis

The first signs of the disease appear 2-4 weeks after the entry of metacercariae into the human body. The number of days in their incubation period depends on the concentration of larvae trapped in the gastrointestinal tract, their activity, as well as on the state of the human immune system.

Usually, the disease in its development goes through two stages: acute and chronic. But in regions with an unfavorable situation regarding the incidence of opisthorchiasis, in adults and children, the disease often immediately acquires a chronic form, bypassing the acute stage. This is due to the presence of innate partial immunity in the inhabitants of these regions due to constant infections.

Acute phase of the disease

Symptoms of opisthorchiasis in the acute phase are non-specific and characteristic of many other diseases. The manifestation of the acute phase, depending on the severity of the symptoms, is mild, moderate and severe.

Light current

The disease is manifested by the following symptoms:

• fever, temperature above 39 degrees;
• headache;
• general malaise, weakness.

This condition lasts for one to two weeks.

Moderate course

In this condition, the above symptoms are joined by:

• rash on the skin of an allergic nature, such as urticaria;
• muscle and joint pain, sometimes muscles are tense to cramps;
• dyspeptic symptoms - nausea, vomiting, diarrhea.

The duration of the course is 15-20 days.

Symptoms of severe acute phase

In this condition, in addition to fever, high fever and allergic reactions, signs of damage to internal organs and the nervous system appear:

• increased agitation or lethargy, insomnia;
• pain in the right hypochondrium;
• enlargement of the liver, yellowness of the sclera and skin;
• cough, shortness of breath, shortness of breath, swollen lymph nodes;
• Quincke's edema;
• malfunctions of the gastrointestinal tract

Gradually, the symptoms of acute manifestation subside, and the disease becomes chronic.

Symptoms of chronic opisthorchiasis

With opisthorchiasis, which has turned into a chronic form, the clinical picture is different. In endemic areas where the inhabitants have developed partial immunity, the disease is long and asymptomatic. The longer the illness lasts, the more negative the effect on the entire body. The manifestations are:

Allergy often accompanies helminthic invasions. A person with opisthorchiasis has pronounced skin rashes. Urticaria, Quincke's edema and other symptoms typical of allergic diseases are often shown.

In women, disorders in the work of the reproductive system are expressed, the menstrual cycle is disrupted, and menstruation is accompanied by severe pain.

Diagnostics and treatment

What does the diagnosis include?

The diagnosis begins with the collection of anamnesis. An epidemiological history indicates the likelihood of the patient having opisthorchiasis.

If opisthorchiasis is suspected, laboratory and instrumental studies are carried out in order to confirm the diagnosis.

What research is needed:

Timely diagnosis helps to start treatment of opisthorchiasis on time and prevent dangerous complications.

How to properly treat opisthorchiasis

The treatment regimen consists of several stages.

Preparatory stage

At this stage, preparation for deworming is taking place. The symptoms that characterize the acute period of the disease are immediately eliminated. Drug treatment is carried out with the aim of:

• body detoxification - sorbents, hepatoprotectors;
• elimination of pain syndrome - antispasmodics;
• removal of allergic phenomena - antihistamines, corticosteroids;
• restoration of digestive processes - enzymes, prokinetics;
• ensuring the outflow of bile - choleretic drugs, cholespasmolytics;
• elimination of inflammatory processes - antibiotics.

The duration of this stage is two to three weeks. Acute severe opisthorchiasis is treated in a hospital setting.

The causative agent of opisthorchiasis is Siberian or feline fluke (opisthorchiasis felineus), which is a hepatic trematode. Helminth is a lanceolate worm ranging in size from 9 × 1.1 mm to 19 × 2 mm. In the phases of development of helminths, 2 intermediate hosts are involved - gastropods and fish (mainly cyprinids). The role of final owners is played by animals and humans.

The invasion of bitiniid mollusks (the first intermediate hosts) is carried out in small or dry freshwater bodies of water located in the floodplains of rivers. Infection of gastropods is carried out by swallowing the eggs of worms that enter the reservoir with animal or human excrement. In the body of the mollusk, the worm develops for 7 to 8 weeks until the stage of the larva (cercaria), after which it leaves and enters the body of the fish, the second intermediate host.

In what fish can the causative agent of opisthorchiasis be found? Potentially dangerous fish species in terms of the likelihood of human infection with the disease are roach, tench, bleach, gudgeon, ide, rudd, sabrefish, minnow, spike, chub, bream, dace, blue bream, asp, verkhovka, white-eye. Many people are interested in whether there is opisthorchiasis in pike? Recent studies indicate that opisthorchiasis also occurs periodically in pike, but much less frequently than in carp species.

The invasion of humans and carnivores is carried out as a result of the consumption of sick fish, not subjected to appropriate heat treatment. In addition, opisthorchiasis is transmitted from person to person. In the upper parts of the digestive tract, metacercariae are released from the cocoons and through the bile ducts freely penetrate into the gallbladder and liver. Often, helminths are localized in the pancreas.

Metabolic products of helminths can cause sensitization and allergic processes in the body of an infected person. In the absence of adequate treatment for opisthorchiasis, the development of cholangiocarcinoma is not excluded. In people with blood group I, the occurrence of erosive-ulcerative gastroduodenitis is possible, and in people with group III - diffuse liver damage.

Symptoms of opisthorchiasis

The emergence and further development of symptoms of opisthorchiasis in adults and children directly depends on the time interval that has passed since the moment of infection, the level of invasive intensity, as well as on the individual characteristics of a person. There are 2 types of ailment - acute and chronic opisthorchiasis. The acute phase usually lasts no more than 2 months. The duration of the chronic form can be several decades, while the disease is often asymptomatic.

Signs of acute opisthorchiasis:

• feeling of pain in the right hypochondrium;
• hyperthermia;
• aching joints and muscles;
• an increase in the size of the liver or gallbladder;
• nausea accompanied by vomiting;
• recurring heartburn;
• pain in the epigastric zone;
• flatulence;
• decreased or complete loss of appetite;
• diarrhea.

Symptoms of opisthorchiasis also appear on the skin in the form of skin rashes that look like hives.

At the time of the fibrogastroscopic examination, erosive gastroduodenitis is revealed. Ulceration of the mucous membranes of the upper gastrointestinal tract (stomach, duodenum) is often diagnosed. Sometimes the symptoms of opisthorchiasis are similar to the signs of acquired pulmonary pathology of allergic etiology (for example, asthmatic bronchitis).

Chronic opisthorchiasis symptomatically resembles hepatitis, chronic cholecystitis, gastroduodenitis or pancreatitis. In such a situation, the following symptoms of opisthorchiasis arise:

• intense paroxysmal pain arising in the right hypochondrium;
• transfer of pain to the chest area;
• dyskinesia of the gallbladder;
• pain in the gallbladder area at the time of palpation;
• dyspepsia;
• intolerance to foods high in fat.

Over time, opisthorchiasis affects the intestines, which disrupts its proper functioning.

Opisthorchiasis is also manifested by disorders of the central nervous system:

• regular dizziness;
• low level of performance;
• irritability;
• headache;
• insomnia;
• depression;
• tremor of the eyelids, fingers, tongue;
• rapid fatigue (physical, mental).

Often, disorders of the nervous system are the main signs of opisthorchiasis. In this case, autonomic neurosis or neurocirculatory dystonia can be diagnosed.

Chronic opisthorchiasis, occurring against the background of allergization of the body, is often accompanied by the following symptoms:

• urticaria, accompanied by itchy skin;
• Quincke's edema;
• arthralgia;
• food allergies.

A specific feature of the disease is the development of irreversible pathologies in the internal organs. Opisthorchiasis is often accompanied by chronic forms of hepatitis and gastritis, cholangitis or cholecystitis. Almost always, there is a violation of the functions of the immune system. Chronic opisthorchiasis is sometimes accompanied by liver cirrhosis or hepatocellular carcinoma.

Symptoms of opisthorchiasis and its treatment in such patients involves carrying out procedures during the recovery period that help to improve the functions of the gastrointestinal tract, liver, and gallbladder.

Complications

With prolonged manifestation of symptoms of opisthorchiasis and the absence of treatment in adults and children, serious intoxication of the body occurs, caused by the waste products of flukes and tissue necrosis of the person himself.

Opisthorchiasis can cause complications:

• acute destructive pancreatitis;
• cessation of the outflow of pancreatic juice, bile;
• pancreas cancer;
• abscess;
• bilious peritonitis;
• cholangitis;
• cholecystitis;
• cirrhosis of the liver;
• the formation of sand and stones in the gallbladder;

There are known cases of diabetes mellitus in patients with opisthorchiasis.

Diagnostics

Diagnosis of opisthorchiasis is based on the study of symptoms and epidemiological data of the region. There are risk factors that increase the likelihood of developing the disease:

• eating potentially contaminated fish (without prior thermal cooking);
• residence (temporary or permanent) in an endemic region;
• belonging to some ethnic groups (peoples of the North).

To establish a diagnosis, it is necessary to conduct studies of feces or duodenal juice for the presence of helminth eggs in them. An analysis for opisthorchiasis is collected no earlier than a month after a possible invasion. Samples are taken multiple times to confirm the reliability of the data obtained. The detection of less than 100 eggs in 1 g of feces indicates the presence of a mild form of the disease, more than 30,000 eggs - of an extremely severe one.

Adults can be identified by endoscopy or by endoscopic retrograde cholangiopancreatography. It is possible to examine the liver, as well as the bile ducts by means of ultrasound, CT, MRI and radiography, which makes it possible to establish indirect symptoms of the disease (structural changes in the liver, gallbladder, as well as an increase in their size, inflammation and fibrosis of the bile ducts).

Detection in a blood test for opisthorchiasis also indicates a possible helminthic invasion. Opisthorchiasis is often accompanied by high levels of bilirubin, serum transaminase and alkaline phosphatase with a simultaneous low level of serum albumin.

In recent years, new types of diagnostics have begun to be used - molecular and immunological. The immunological method is based on the detection of specific antibodies produced by the human body in the presence of antigenic determinants of the worm. The most effective way is to take an enzyme-linked immunosorbent assay, which allows you to determine the stage of development of the disease.

Molecular diagnostics makes it possible to establish in the analysis of feces the presence of fragments of helminth DNA by means of a polymerase chain reaction. This method is effective in the case of massive helminthic invasion.

Opisthorchiasis treatment

Most people do not know how to treat opisthorchiasis correctly. Treatment of all forms of the disease involves an integrated approach that includes 3 consecutive stages:

1. preparatory stage;
2. specific anthelmintic chemotherapy;
3. rehabilitation.

The preparatory stage is necessary to get rid of the patient from allergization of the body and relieve inflammatory processes in the digestive and hepatobiliary systems. At this stage, the normal movement of secretion is established, symptomatic and detoxification therapy is carried out. The correctness of this stage significantly affects the effectiveness of the treatment of opisthorchiasis.

In addition to adhering to a diet for opisthorchiasis, patients are prescribed drug therapy:

• detoxification - involves the use of a 5% glucose solution, saline solutions or hemodesis for intravenous administration;
• desensitizing - the use of antiallergic medications;
• drainage of the biliary system - choleretic synthetic drugs (choleretic or cholekinetic) are used;
• antibiotics of a wide range of action - are prescribed when signs of a secondary infection are detected (the minimum period of admission is 5 days).

Treatment of opisthorchiasis in adults and children involves taking pro- and prebiotics, antispasmodic drugs (drotaverine, no-shpa, baralgin, buscopan, duspatalin, meteospazmil). Also used are prokinetics (motilium, motilac) and preparations based on digestive enzymes (mezim forte, creon, penzital).

The dosage of drugs in the treatment of opisthorchiasis, as well as the time it takes to complete the preparatory stage, depend on factors such as the intensity of the invasion and its phase, the general clinical picture, the presence of complications, and others.

In case of chronic asymptomatic opisthorchiasis, occurring against the background of a remission form of cholangitis or cholecystitis, the patient's preparation period lasts no more than 2 weeks. In the presence of hepatitis or pancreatitis, its duration is 3 weeks.

Specific anthelmintic chemotherapy. At this stage, the acquired allergization of the body and the formed organ pathologies are eliminated. For these purposes, antihistamines (suprastin, diphenhydramine), calcium chloride, and sedatives (bromine, valerian) are used.

Usually, to prevent possible vasculitis, various anti-inflammatory drugs are prescribed - butadion, ascorutin, and salicylates.

To cure opisthorchiasis, modern pharmaceuticals offer the following drugs:

• albendazole;
• praziquantel (biltricide);
• chloxyl.

Albendazole- causes dysfunctions of the digestive system of causative agents of opisthorchiasis at the cellular level, which radically changes the course of biochemical reactions in their body. As a result of this effect, the helminth dies.

Opisthorchiasis in children (2 years of age and older) and adults with albendazole is treated as follows: the drug is taken twice a day. A single dose is 400 mg. The duration of therapy is 3 days. In the event of leukopenia, drug treatment is discontinued. To achieve the maximum effect, the drug must be taken by the whole family to prevent re-infection.

Albendazole has a number of contraindications:

• individual intolerance to the drug;
• retinal lesions;
• reduced productive capacity of the hematopoietic system;
• liver disease;
• pregnancy;
• lactation period;
• children's age (up to 2 years).

It is possible to take structural analogs of albendazole - mebendazole, vormin, medamin and vermox.

Praziquantel (biltricide)... It causes paralysis of the muscle tissue of the causative agents of opisthorchiasis and their subsequent death.

Biltricid is taken twice or three times a day, taking into account the maximum possible daily dosage of 40 mg / kg. In severe cases, the dose may be increased to 75 mg / kg. The interval between doses should be within 4 - 6 hours. The duration of therapy is 1 day. In some cases, the treatment regimen can be adjusted.

Treatment with the drug, as a rule, is carried out in a hospital setting, which is associated with the frequent manifestation of side effects:

• diarrhea;
• stomach ache;
• nausea, often vomiting;
• traces of blood in feces;
• allergization of the body;
• headache;
• lethargy;
• disorientation in time and space;
• hyperthermia;
• inhibition of reactions;
• excessive sweating;
• dizziness.

Side effects are most pronounced in cases of mass helminthic invasion. Patients often have high levels of liver enzymes.

The medicine is prohibited for use by patients suffering from liver pathologies, as well as pregnant and lactating women. Opisthorchiasis in children under 4 years of age is not allowed to be treated with baltricide.

In the absence of biltricide, the use of its structural analogs is allowed: antimonyl sodium tartrate, cystricide, ditrazine citrate, droncite, piquiton, cesol, cestox, azinox, biltrid.

Chloxil... There are 3 drug regimens: two-, three- and five-day. The individual dosage is 0.3 g / kg. The total amount taken for the entire course of the drug should be within 15 - 24 g. To calculate the daily dose, this amount is divided by the number of days of the selected treatment regimen.

Chloxil is drunk 3 or 4 times a day with milk. Its reception is usually carried out in combination with duodenal intubations.

The medicine is forbidden to be taken by pregnant women, hypertensive patients, in acute viral hepatitis, in the presence of liver diseases, as well as in case of individual intolerance to the drug.

Side effects are possible: feelings of intoxication and drowsiness, enlargement of the liver, the appearance of discomfort in the right hypochondrium, allergic reactions. Sometimes proteinuria, cardialgia, arrhythmia, heart pains are recorded.

Rehabilitation. An important role is played by probeless duodenal intubation. During the first week it is carried out daily, for the next 3 months - twice a week. A prerequisite for the recovery period is daily bowel movements. With physical retention of feces, laxatives are prescribed.

In the recovery period, a treatment course is carried out with hepatoprotective drugs (Heparsil, Legalon, Essentiale N, Darsil, etc.), as well as choleretic agents (Allochol, Hofitol, Holosas). The use of herbal decoctions with a choleretic effect is recommended. Sometimes anti-cholestatic drugs, antispasmodics, symptomatic drugs are prescribed.

Anti-inflammatory and restorative therapy is carried out. A special diet is prescribed for opisthorchiasis, excluding the use of foods high in fats, purines and cholesterol.

Monitoring the effectiveness of treatment

The collection of tests to determine the effectiveness of treatment is carried out 3 months after passing all stages of treatment. Duodenal intubation is performed 1 time, coproovoscopy - three times. Obtaining negative results in all cases indicates recovery. If positive results are obtained, the treatment is repeated six months later.

The complete elimination of flukes from the body does not always indicate a complete restoration of the normal functioning of the hepatobiliary, immune and digestive systems.

Disease prevention

Prevention of opisthorchiasis consists in maintaining control over the heat treatment of consumed fish. You can eat only high-quality boiled, smoked, fried or salted fish products.

The fish should be cooked in portions for 25 minutes, frying - at least 15 minutes (large pieces - 20 minutes). The fish pies should be baked for at least an hour.

In order to disinfect potentially dangerous fish, a freezing method is recommended for use: at -40 ° C the fish is kept for at least 7 hours, at -35 ° C - 14 hours, at -28 ° C - 32 hours. Low temperatures should evenly affect all parts of the fish to exclude the possibility of survival of the fluke larvae. In an ordinary refrigerator, helminths can survive for a month.

For salting fish, which ensures its disinfection, use a strong saline solution. The duration of the salting depends on the type of fish:

• bleak, verkhovka, gudgeon, minnow - 10 days;
• dace, chub, roach, rudd, podust, blue bream, spike, white-eyed, sabrefish, asp, small individuals (less than 25 cm) bream, tench, ide - 21 days;
• large (more than 25 cm) tench, bream, ide - 40 days.

In the process of cold drying, you should also adhere to the recommended schemes:

• 2-week preliminary salting (1 kg of salt per 5 kg of fish), soaking, drying;
• 3-day pre-salting (1 kg of salt per 5 kg of fish), drying for 3 weeks.

The temperature regime for hot smoking should be +70 - + 80 ° С, the processing time should be at least 2.5 hours.

Opisthorchiasis is widespread in Russia, Ukraine, Kazakhstan, Southeast Asia and practically does not occur in Europe and America. The disease is caused by two types of worm - Opisthorchusfelineus, or cat fluke (common in fresh rivers of Ukraine, Russia and Kazakhstan) and Opisthorchusviverrini (common in Asia).

Life cycle of a worm

The causative agent of opisthorchiasis is the worm Opisthorchusfelineus

The intermediate hosts of the causative agent of opisthorchiasis are freshwater molluscs and freshwater fish (more often the Carp family). Molluscs swallow the eggs of the pathogen that are in the silt of freshwater reservoirs. The pathogen lives in the body of the mollusk for about two months, turning during this time into a larva with a tail (cercarium). After maturation, the cercariae emerge from the body of the mollusk into the water and literally "drill" into the body of the fish, penetrating through the scales.

What happens in the body after infection with opisthorchiasis?

After entering the body, the worm sticks to the biliary tract.

The waste products of the worm sensitize the body and contribute to the development of allergic reactions. Described the carcinogenic effect of causative agents of opisthorchiasis - the products of their vital activity contribute to the proliferation of the epithelium of the biliary tract, the emergence of epithelial mutations, and, as a consequence, the emergence of malignant tumors of the hepatobiliary system.

In addition, causative agents of opisthorchiasis can cause damage to the liver parenchyma and the development of erosive gastroduodenitis.

The first signs are fever, vomiting, allergic reactions

The first signs of opisthorchiasis appear two, and sometimes four weeks after infection. The disease can occur in both acute and chronic forms. The first signs of opisthorchiasis in the acute course of helminthiasis are nonspecific symptoms: an increase in temperature to febrile numbers (38 degrees and above), arthralgia, myalgia, nausea and vomiting, sleep disorders, headaches, skin rashes, an increase in peripheral lymph nodes can be observed. Then, against this background, more specific symptoms of opisthorchiasis appear - pain in the right hypochondrium, jaundice of varying intensity, bloating, bitterness in the mouth.

As a rule, these symptoms persist for up to two weeks, after which the patient's condition improves somewhat and opisthorchiasis passes into its chronic stage.

Symptoms of the chronic stage of opisthorchiasis are: a constant feeling of heaviness in the right hypochondrium, frequent nausea, occasional vomiting, especially after eating fatty foods, an increase in the size of the liver, jaundice of varying intensity. The manifestation of the chronic form of opisthorchiasis can be symptoms of pancreatic lesions (girdle pain in the abdomen, unstable stool), symptoms of erosive duodenitis (pain in the epigastric region, "hungry" and night pains, heartburn), as well as - manifestations of asthenic syndrome - increased fatigue, irritability , sleep disorders, mood swings.

Opisthorchiasis in children may appear already at one year of age and immediately in a chronic form

In children living in areas endemic for opisthorchiasis, the disease can be recorded as early as one year of age. A feature of opisthorchiasis in children, in contrast to adults, is the course of helminthiasis immediately in a chronic form.

Often, the disease in children proceeds in a latent form and its only manifestations can be prolonged subfebrile condition, allergic reactions and an increase in peripheral lymph nodes. In this case, detailed clinical manifestations in the form of damage to the organs of the hepatobiliary system can occur already in adulthood.

Diagnostics of the opisthorchiasis

To diagnose the disease, laboratory tests of infected fish and feces of infected

Diagnosis of opisthorchiasis is based on the study of the epidemiological history (consumption of raw or poorly salted fish) and the clinical picture of the disease. To confirm the diagnosis of opisthorchiasis, serum samples are used - the reaction of indirect hemagglutination, which in 80% of cases allows detecting opisthorchiasis. To diagnose the chronic form of opisthorchiasis, a study of the duodenal contents or feces is used to detect the eggs of the pathogen. The collection of duodenal contents in opisthorchiasis is carried out using duodenal intubation. An important condition for the diagnosis of opisthorchiasis is the collection and examination of three portions of the duodenal contents.

The analysis of feces for opisthorchiasis is recommended to be carried out three times, with an interval of several days. This is due to the fact that it is not always possible to immediately detect the eggs of the pathogen. A more modern diagnostic study used to diagnose opisthorchiasis is the detection of worm DNA using a polymerase chain reaction. The method can be used in both children and adults.

Feces and duodenal contents serve as the material for the study. In chronic forms of opisthorchiasis, the complex of diagnostic studies includes ultrasound examination of the hepatobiliary system, computed tomography of the liver, X-ray examination of the biliary tract.

In the general analysis of blood with opisthorchiasis, even before the onset of its clinical manifestations, an increased content of eosinophils is often found, and with the addition of an inflammatory process, leukocytosis can be observed.

How to treat opisthorchiasis?

Treatment of opisthorchiasis is performed with anthelmintic drugs and diet

They use a diet that is gentle on the digestive organs and excludes the use of fatty, fried, smoked foods and products that stimulate the secretion of the pancreas and stomach - meat and fish broths, spices, sauces.

The diet is selected by a doctor and includes light vegetable soups without frying, crumbly cereals, boiled meat and fish, low-fat dairy products. Drug treatment should include the use of anthelmintic drugs, restoration of impaired functions of the gastrointestinal tract, symptomatic treatment. In the acute period of opisthorchiasis, treatment begins with the elimination of intoxication and manifestations of allergies. In order to relieve the manifestations of intoxication, infusion solutions are used in treatment, enterosorbents are used. For the treatment of allergic manifestations, antihistamines are used.

Of the anthelmintic drugs in the treatment of opisthorchiasis, albendazole (Zentel, Vormil), Chloxil, Praziquantel (Biltricid, Azinox) are used. Praziquantel is a toxic drug with many side effects, therefore it is used mainly for the treatment of opisthorchiasis in adults.

Anthelmintic drugs for the treatment of opisthorchiasis, their doses and duration of administration are selected by the doctor. To improve the outflow of bile, choleretic drugs are prescribed. Treatment of mild forms of opisthorchiasis in adults, as a rule, is carried out at home under the constant supervision of a doctor. In the acute form of opisthorchiasis, in the case of opisthorchiasis in children, as well as in the presence of severe disorders of the liver and pancreas, home treatment is contraindicated. In this case, hospitalization of patients in a hospital is indicated.

Treatment of opisthorchiasis with folk remedies

The use of folk remedies for opisthorchiasis is an auxiliary, and not the main method of its treatment. It is possible to treat opisthorchiasis using decoctions of choleretic herbs (corn stigmas, immortelle, arnica). A good effect is obtained by using at home raw pumpkin seeds, which have a natural antihelminthic effect.

Complications with opisthorchiasis

The most common complications of opisthorchiasis are:

• Cholecystitis
• Cholangitis
• Pancreatitis
• Erosive gastroduodenitis
• Liver abscesses
• Ruptures of the biliary tract with the development of biliary peritonitis

Prevention of opisthorchiasis

Proper fish handling is the best prevention

Prevention of opisthorchiasis is as follows:

1. Monitoring the sanitary state of water bodies and preventing the ingress of feces there
2. Sanitary and educational work among adults aimed at maintaining hygiene when working with raw fish (separate cutting boards and knives used only for cutting fish and not used for cutting other products)
3. Avoiding the use of uncooked river fish

Their manifestation directly depends on the time that has passed since the person was infected, the state of his health, the immune system and the intensity of the course of the disease.

Taking all this into account, two types of opisthorchiasis are distinguished, the first takes an acute form, and the second chronic, which can be asymptomatic for several decades.

Symptoms of acute opisthorchiasis are:

Most often, all of the listed symptoms are complemented by skin rashes, in appearance they may resemble hives.

With certain examinations, ulcerative formations on the mucous membranes of the duodenum or stomach are revealed. Sometimes the signs of acute opisthorchiasis resemble allergic manifestations, in particular, they are similar to asthmatic bronchitis.

The chronic form of the disease in question in its symptoms resembles pancreatitis, hepatitis, cholecystitis or gastroduodenitis, so it is quite possible to confuse them, in order to avoid this, you should undergo all the necessary examinations.

The main signs of the chronic form are:

In addition to all the listed symptoms, a person can observe deviations in the work of the central nervous system, namely:

Sometimes the primary signs of opisthorchiasis are malfunctions in the nervous system, they can be diagnosed as neurocirculatory dystonia or autonomic neurosis.

If chronic opisthorchiasis proceeds in parallel with the allergic manifestations of the body, then this can result in:

With opisthorchiasis, irreversible pathologies often occur in the internal organs, in some cases everything can end with cirrhosis of the liver.

Diagnostics

In order for the doctor to understand how to treat the patient, he is assigned a series of examinations that are aimed at identifying, confirming or obtaining a negative result about the disease.

The following techniques can be used to confirm the diagnosis:

• X-ray methods;
• CT scan;
• ultrasonography.

Accurately confirming the diagnosis is possible only a month after infection, it is during this time that the opisthorchis have time to lay their eggs in the feces that are in the excretory intestines of a person.

All methods of treatment of opisthorchiasis

In adults, therapy takes place in three stages:

Drug treatment

In the first described stage, antihistamine tablets are used, if necessary, antibiotics can be prescribed, which are administered intravenously for high efficiency; among the known drugs, Hemomycin and Cefazolin are most often recommended.

The pains that often accompany the disease are relieved by drugs such as: Drotaverin, No-shpa, Baralgin and others.

To protect the liver, be sure to drink Urolesan or Silymarin. They will be able to protect the liver from the toxic effects of prescribed drugs, in addition, they will facilitate the outflow of bile. And food enzymes in the form of Pangrol and Pancreatin will help improve the work of the digestive tract.

After this stage, it is time for chemotherapy. At this stage, choleretic agents are used: Holosas and Holiver. One of them is optionally used by the course in order to accelerate the outflow of bile; in case of cholelithiasis, they can be used only with the permission of a doctor. This is a difficult stage, and it is better to get treatment in a hospital, especially if the patient is a child.

These two drugs speed up kidney function and metabolism. A huge advantage of such funds is that they can be safely used for children who have reached 2 years of age, as well as expectant and lactating mothers.

The last third stage, along with the intake of vitamins, provides for the control of the patient's stool, according to the analyzes of which it is possible to determine the amount of magnesium and sorbents.

During rehabilitation, it is imperative to consume as much mineral water as possible.

Acceptance of choleretic agents and hepatoprotectors continues throughout this period until the patient's final recovery. It is also worth drinking medications to improve the functioning of the digestive system in order to restore the patient's appetite and restore weight, which is often reduced during illness.

Treatment with home recipes

With a serious approach, adults will be able to cure this disease on their own at home with affordable products. This therapy can be used in parallel with the main treatment at each stage. And at the very beginning of the disease, you can completely restore health only with home remedies.

Aspen bark

It is one of the components of medicines used to treat opisthorchiasis, such as Eksol or Populin, and you can also make homemade tincture from it. For these purposes, it is necessary to collect the young bark of a tree, separate 20 grams from the total mass, grind and pour 2 cups of boiling water, pour the mass into a thermos and leave to infuse overnight. Some boil the bark for 15 minutes instead.

Then the prepared infusion is filtered and taken half an hour before meals 4 times a day. The aspen treatment course is 2-3 weeks.

Birch tar

This remedy is in special demand for opisthorchiasis, its substance can be purchased at a pharmacy and added a few drops to milk. The tar in milk should be drunk one hour before meals.

There is a whole scheme of treatment with birch tar. A certain amount of medicine will need to be added to a quarter of a glass of milk: on the first day it will be two drops, then in all subsequent days, their amount increases by exactly two drops until the limit of 10 drops is reached, then it is necessary to reduce the dosage of the medicine gradually, also by two drops. everyday.

Another treatment option is the joint reception of tar with grated carrots or apples. Drop birch tar into a teaspoon of fruit puree and stir. Take the medicine before bedtime, for better absorption, with water. So it is necessary to be treated for 10 days.

St. John's wort

According to the recipe, you need to use dry grass, so it is harvested in advance. One teaspoon of St. John's wort is poured with 1 tbsp. boiling water, leave for half an hour, and then filter. The prepared infusion is taken in 1 tbsp. l. 4-6 times a day.

Diet treatment

The meat must be replaced for a while with fresh vegetables and herbs, cottage cheese, natural juices and fruits. You should drink abundantly and consume honey and vegetable oil within reasonable limits. Bread is allowed to be eaten only in dried form.

Judging by the fact that you are now reading these lines, the victory in the fight against liver diseases is not yet on your side ...

Have you already thought about surgery? This is understandable, because the liver is a very important organ, and its proper functioning is the key to health and well-being. Nausea and vomiting, a yellowish skin tone, bitterness in the mouth and an unpleasant odor, dark urine and diarrhea ... All these symptoms are familiar to you firsthand.

But perhaps it is more correct to treat not the effect, but the cause? We recommend reading the story of Olga Krichevskaya, how she cured the liver ...

The population living in the basins of large rivers (Ural, Volga, Irtysh and others) is often diagnosed with a special type of helminthiasis - opisthorchiasis. However, you can become the owner of a helminth on a trip to Thailand, Ukraine, Kazakhstan. This is because the source of the infection is in freshwater fish.

The damaging effect of fluke worms on the human body:

Opisthorchiasis gives polymorphic symptoms, detection of helminth often occurs already at the chronic stage of the disease. Without appropriate therapy, flatworms can live in humans for up to 25 years. Even effective treatment of opisthorchiasis does not completely eliminate the damage done to the body.

Mass infection is recorded among cyprinids: roach, bream, rudd, minnow, verkhovka, gudgeon, sabrefish, ide, white-eyed and others.

However, cases of infection with opisthorchiasis from pike, ruff, burbot, perch and other predatory fish that have the same habitat with the cyprinid family are recorded.

It is absolutely impossible to get infected with opisthorchiasis when swimming in a reservoir infected with opisthorchiasis larvae. Having penetrated the skin, the larvae quickly die and can only cause itching and a short-term rise in temperature.

opisthorchiasis photo

• Mild course - lasts 1-2 weeks, the patient complains of fever up to 38 ° C, weakness, fatigue, headache.
• Moderate course - the infected person develops an itchy urticaria rash like urticaria (toxic effect on the vascular bed), muscle and joint pain, vomiting, diarrhea, temperature up to 39 ° C. Decreased appetite, possibly weight loss. Symptoms last 2-3 weeks.
• Severe course - against the background of an extremely serious condition of the patient due to severe intoxication, lethargy or psychomotor agitation, signs of damage to certain parts of the gastrointestinal tract, insomnia are observed. Possible development of acute epidermal necrosis (Lyell's syndrome), acute myocarditis, Steven-Johnson syndrome, Quincke's edema.

Forms of acute opisthorchiasis:

• Hepatocholangitis - associated with extensive damage to the gallbladder and liver. The patient complains of spastic pain localized in the right hypochondrium and mimicking hepatic colic. Signs of bile stagnation are recorded: yellowness of the skin and sclera.
• Pancreatic - signs of pancreatitis are often associated with damage to the bile ducts. There are girdle pains, flatulence, dyspepsia.
• Gastroenterocolitic - in the symptomatology of opisthorchiasis, signs of inflammatory and ulcerative lesions of the duodenum and, often, the stomach prevail. In this case, intoxication is most often weakly expressed.
• Typhoid - skin rashes, hyperthermia, and sometimes a cough come to the fore in the symptomatic picture.

In residents of districts of Western Siberia, unfavorable in terms of the epidemiology of opisthorchiasis, the disease often proceeds in a latent form, without giving vivid symptoms.

symptoms in an adult

Gradually, pronounced symptoms of opisthorchiasis subside, and the disease turns into a chronic stage: against the background of normalization of temperature, symptoms of biliary dyskinesia, cholecystitis, hepatitis, pancreatitis periodically appear.

Often, patients are diagnosed with gastroduodenitis or stomach ulcers. And only the data of laboratory and instrumental studies can reveal.

Chronic opisthorchiasis is also characterized by toxic damage to other organs:

• central nervous system - constant headaches, twitching of the eyelids, hand tremors, irritability and depression;
• hearts - heart pain, arrhythmia, signs of myocardial dystrophy appear on the ECG;
• depletion of the adrenal glands - astheno-vegetative syndrome.

Lack of treatment is fraught with the development of cirrhosis or liver cancer, pancreatic cancer, peritonitis.

Analyzes and diagnostics of opisthorchiasis

The diagnosis of "opisthorchiasis" at an early stage of the development of the disease is rather difficult: helminth eggs in feces and bile are found in 4-6 weeks. after infection. Diagnostic methods for detecting the presence of flatworms in the body:

• A blood test with the definition of a leukocyte formula - eosinophillosis (indicates the presence of any helminths and the development of sensitization to a foreign protein);
• - an increase in liver enzymes (ALT, AST), a change in protein indicators;
• Feces for worm eggs - carried out repeatedly (eggs are released sporadically), up to 100 eggs per 1 g - mild, over 30 thousand - massive invasion;
• Immunological analysis - blood for opisthorchiasis reveals antibodies to the opisthorchis protein;
• - detection of helminth DNA in feces;
• Instrumental studies confirming opisthorchiasis;
• Abdominal ultrasound, CT, MRI - detection of damage to the liver and biliary tract;
• Duodenal intubation - detection of opisthorchis eggs in the collected bile;
• Retrograde pancreatocholangiography and percutaneous cholangiography - endoscopic techniques can detect accumulations of helminths.

Treatment of opisthorchiasis in adults, drugs

Preparatory Course

With the beginning of the treatment of opisthorchiasis, the symptoms are eliminated in the first place, as well as the developing pathological processes:

• Ensuring the outflow of bile - choleretic (Cholenzym, Holosas, Tsikvalon, Galstena), traditional antispasmodics (No-shpa, Buscopan, the best is Duspatalin), cholespasmolytics (Platifillin, Atropine);
• Digestion restoration - enzymes (Mezim forte, Pancreatin, Creon), prokinetics (Motilium, Motilak);
• Elimination of cholestasis - Geptral, Ursofalk, Urososan;
• Elimination of sensitization - antiallergic drugs (Tavegil, Suprastin), with severe allergic manifestations, corticosteroids (Dexamethasone) are advisable;
• Detoxification of the body - sorbents (activated carbon, Prolisorb, Enterosgel, Lactofiltrum), hepatoprotectors (Karsil), infusion therapy;
• Leveling of inflammation - antibiotics (Amoxicillin, Ampicillin), Metronidazole, course - no more than 10-14 days.

The course of drug preparation takes 10-20 days.

Dehelmentization

The destruction of flatworms is carried out by the course of taking toxic anthelminthic drugs: Albendazole, Chloxila, Praziquantel (the best). The treatment regimen for opisthorchiasis in adults - the dosage of drugs, the frequency of administration per day, and the duration of the course - are determined individually.

With caution, anthelminthic chemotherapy drugs are prescribed for the elderly and patients with severe heart, kidney and liver damage. These medicines are contraindicated in pregnant women (1 trimester), nursing mothers and children under 4 years of age.

Against the background of deworming, pain occurs in the right hypochondrium, headache, nausea, weakness and dyspepsia increase. Sometimes in the first 2-3 weeks of taking anthelmintic drugs, there is a deterioration in liver function tests, and a skin rash may appear.

On the 2nd day of deworming, blind duodenal intubation with xylitol or mineral water is performed to remove the decay products of worms into the intestines. Strengthening the outflow of bile is achieved by using electrical stimulation and a pulsed magnetic field.

The use of home remedies (popular - garlic with celandine) at the stage of deworming and the replacement of anthelmintic drugs prescribed by a doctor is unacceptable!

Rehabilitation stage

Drug therapy restores the normal functioning of the damaged parts of the gastrointestinal tract. For 3-4 months, antispasmodics, hepatoprotectors, choleretic drugs are used.

It is at this stage that the treatment of opisthorchiasis with folk remedies is permissible: decoctions of St. John's wort, plantain, calendula, elecampane.

• A successful cure for opisthorchiasis is stated with negative studies of feces and duodenal contents after 1, 3 and 6 months after the end of the treatment course. In each of the indicated terms, the study is carried out three times.

Prevention of opisthorchiasis

To avoid infection with opisthorchiasis, the following recommendations for the preparation and use of freshwater fish should be strictly observed:

• It is strictly forbidden to eat poorly processed fish, and, moreover, to taste the raw product.
• Refuse lightly salted freshwater fish, stroganin.
• Thorough washing of dishes (cutting board, knife) in contact with raw fish.
• Effective freezing: -28 ° C - 32 hours, -35 ° C - 14 hours, -40 ° C - 7 hours.
• Cooking fish: in chunks - 20 minutes, fish semi-finished products (dumplings) - 5 minutes. From the beginning of the boil.
• Frying: whole small fish - 15-20 minutes, large pieces and minced fish cutlets - 20 minutes, fish pies - in the oven for 1 hour.
• Salting in a strong saline solution: large - 40 days, fish up to 25 cm in size - 21 days, small fish - 10 days.
• Ambassador before drying (10 kg of product requires 2 kg of salt): 2 weeks. salting and drying at will, 3 days of salting and drying 3 weeks.
• Smoking: hot + 70-80 ° C - 2-2.5 hours, cold smoking - salting for 2 weeks or freezing.

Due to possible contamination from animals, contact with wildlife (foxes, arctic foxes) should be avoided. Pets (cats, dogs) should only be fed well-boiled fish.