Opisthorchiasis is a disease from the group of trematodoses that causes parasitic flatworms, known as opisthorchis felineus (cat fluke). This is the name of the trematode parasite that infects the liver of mammals. Unfortunately, the person is also at risk.
What causes the infection? What symptoms indicate the presence of this disease? How and with what should it be treated? This and much more will now be discussed.
Infection
Before proceeding to the consideration of the symptoms of opisthorchiasis, it should be noted that this is a very common ailment. According to statistics, approximately 75% of diseases of the group of helminthiases are attributable to it.
How does this hepatic trematode get into the human body? Very simple. The source of this parasite is raw, slightly salted and insufficiently processed river fish of the carp family. Every person who eats such food has a risk of contracting infection.
First, parasites that live on the bottom, in the silt, enter the body of mollusks, for which they are food. In them, flukes develop for about two months and lay cercariae - larvae. They leave the body of the mollusk and are actively introduced into the body of cyprinids and develop.
Then flukes enter the body of a person or mammals if they have eaten infected fish. This becomes their "end" station.
Developed larvae (metacercariae) discard their shell and spread throughout the body through ducts, passages and blood vessels. In the gallbladder and liver, they reach puberty (it takes 10-12 days), and then they begin to lay eggs.
In the human body, the parasite can live 10-20 years. That is why, having noticed the symptoms of opisthorchiasis (especially if there is a love for river fish), you need to urgently consult a parasitologist. And to monitor what is eaten, of course.
Symptoms of opisthorchiasis
They begin to manifest themselves approximately 2-4 weeks after the infection occurred. Here's what happens to a person:
- Suddenly the temperature rises. It can jump to 38-39 ° C and last 1-2 weeks.
- Unreasonable weakness appears.
- The chair becomes unstable.
- My stomach hurts constantly.
A detailed examination also reveals eosinophilia and leukocytosis up to 15-20%. If you ignore these manifestations, they will last about two weeks. Then the condition worsens. The following changes will occur:
- The temperature will not fall below 39 ° C.
- Arthralgia will appear, manifested by pain in the joints of a volatile nature in the absence of symptoms of their defeat.
- There is a possibility of the formation of myalgia. This is a pain in the muscle area that occurs due to hypertonicity of muscle cells. Moreover, it is observed both in a calm state and under stress.
- Uctaric skin rashes will appear. Visually similar to hives. Accompanied by a non-passing court.
- Often there is a catarrh of the upper respiratory tract. Symptoms as with severe colds.
- The spleen and liver increase.
- Cases of diarrhea and vomiting are becoming more frequent.
The appearance of asthmatic bronchitis is also possible. At this stage, leukocytosis and eosinophilia increase. Indicators range from 25% to 60%. The erythrocyte sedimentation rate also increases.
This stage lasts about three weeks. If you ignore the listed symptoms of opisthorchiasis, a person will have big health problems. Because a month and a half after infection, the disease becomes severe, and it becomes very difficult to cure.
What happens next?
In approximately 10-20% of those infected, the disease becomes severe. And everyone has a different course. There are several scenarios. Four, to be more precise, and each one is worth telling.
Typhoid-like course. What's happening:
- High fever. The temperature becomes abnormally high, cramps are possible.
- Persistent chills.
- Lymphadenitis This is the name of an inflammatory purulent disease of the lymph nodes.
- Polymorphic skin rash. Everyone manifests itself in different ways, but usually it is small and bright red, as if burned by a long exposure to the sun.
- Violation of the normal activity of the stomach (dyspepsia).
- Manifestations similar to allergies and intoxication.
- Perhaps toxic-allergic damage to the myocardium or central nervous system.
Gastroenterocolitic course. What's happening:
- Symptoms indicate the presence of erosive or catarrhal gastritis.
- There is inflammation of the gastric mucosa (gastroduodenitis).
- An ulcer of the duodenum and stomach develops.
- Digestion is disturbed (enterocolitis).
- Appetite disappears.
- Nausea and diarrhea appear.
- Pain in the right hypochondrium and epigastrium (the area under the xiphoid process) is becoming more common.
Hepatocholangitic course. What's happening:
- Jaundice appears.
- The spleen and liver simultaneously increase in size (hepatosplenomegaly).
- Increasingly, pain is encircled by herpes zoster.
- Symptoms of hepatic colic appear.
- Perhaps the development of cholangitis, hepatitis, pancreatitis and cholecystitis.
Respiratory course. In such cases, a person develops signs of the following diseases:
- Pneumonia.
- Pleurisy.
- Asthmoid bronchitis.
- Tracheitis.
In any case, no matter what type of disease develops, it is necessary to consult a doctor at the very first symptoms of opisthorchiasis. After infection, a person's immunity drops dramatically, and it becomes harder and harder for the body to fight the disease. Therefore, it is strongly discouraged to bring to the extreme stage.
Chronic form
Having passed into this stage, opisthorchiasis in most cases proceeds as one of the following diseases:
- Biliary dyskinesia. It is manifested in violation of the motility of the gallbladder.
- Cholangiocholecystitis. Inflammation of the intrahepatic and extrahepatic bile ducts.
- Cholangiohepatitis. Damage to the liver.
- Cholelithiasis. The formation of gallstones.
- Chronic pancreatitis. It is accompanied by exocrine and endocrine insufficiency.
- Duodenitis. Inflammation of the duodenum.
- Gastritis. Inflammation of the inner lining of the stomach.
Along with this, the following symptoms of opisthorchiasis in adults are manifested:
- Fatigue and weakness.
- Frequent mood changes, emotional instability.
- Sleep disturbance.
- Increased sweating.
- Causeless irritability.
In addition to the above, often the patient shows changes in the myocardium of a dystrophic nature, severe pain behind the chest, arterial hypotension (constantly low blood pressure) and tachycardia.
Effects
Much has been said above about the signs and symptoms of opisthorchiasis in humans. Of course, the long course of such a serious disease cannot but entail consequences. And this is what the opisthorchiasis is fraught with:
- Cirrhosis of the liver. Extensive organ disease due to which parenchymal tissue degenerates into fibrous. If it is not cured in time, then a liver transplant is required.
- Purulent cholangitis. Inflammation of the biliary tract, usually purulent in nature. This is a serious pathology. Many people with cholangitis end in death. In addition, other diseases develop against its background - DIC, biliary sepsis, multiple organ failure and endotoxic shock.
- Phlegmon of the gallbladder, purulent inflammation. It is treated only surgically.
- Biliary peritonitis. It is fraught with the penetration of bile acids into the bloodstream, resulting in cholemia. In the advanced case, an infectious toxic shock and sepsis may occur.
- Cancer of the liver and pancreas.
The body is not able to get rid of opisthorchiasis at the expense of its own protective reserves. From the listed consequences - too.
If treatment is neglected, then helminth infections are aggravated. In addition to these diseases, there will be constant intoxication of the whole organism, the cause of which will be the products of the vital activity of helminths. At best, a person will simply be allergic to a variety of foods for their whole life. At worst, it will be fatal from the consequences.
Diagnostics
Having noticed the first symptoms of opisthorchiasis on the skin and in your body, you need to go to a gastroenterologist. After conducting an initial examination and questioning of the patient, the doctor will prescribe tests that will help diagnose the disease. Due to the cyclical development of the infection, some of them will then have to be repeated at certain time intervals determined by the doctor.
It is difficult to diagnose the disease at an early stage. This is due to the fact that traces of the presence of parasites are detected in bile and feces only a few weeks after infection. So at the beginning of the disease, the guideline can only be on external manifestations.
A blood test is also performed. The results obtained in this way are not as accurate as they do not show the presence of eggs of hepatic flukes. But, if the patient is infected, antibodies can be detected in the blood. As a rule, they use the RNGA or REMA method - their accuracy is 85% and 92%, respectively.
But the most reliable way is ELISA, enzyme-linked immunosorbent assay. With its help, you can detect the presence of parasitic invasion at any stage. It is ELISA that helps determine the type of parasite and how badly the body is affected.
It must be remembered that the study of biomaterials submitted for analysis takes a certain time, therefore, it is necessary to consult a doctor at the very first signs and symptoms of opisthorchiasis.
Drugs for treatment
What medications a person will take to eliminate the disease is determined only by the doctor. Self-medication is fraught with serious consequences. Moreover, most drugs have contraindications. But usually the same drugs are prescribed, which are briefly described.
Praziquantel. Designed to combat various parasites. This medicine increases the degree of permeability of the membranes of the flukes cells, as a result of which its active substances penetrate their cells. The result is an intense contraction of muscle dragging parasites. As a result, the body of the helminth is paralyzed, and it dies.
Drink the drug for 2-3 tablets with an interval of 4-6 hours. The duration of treatment is one day. But the doctor, depending on the case, can make adjustments, depending on the severity of the disease. The treatment of the symptoms of opisthorchiasis in humans and the disease itself with these pills is carried out under inpatient conditions.
The drug is serious, has a number of contraindications and side effects, so medical supervision is necessary. Often after taking it, diarrhea, nausea, vomiting, headaches and stomachaches, drowsiness and fatigue, sweating, lethargy, and dizziness occur. The patient may even feel lost in space and time.
Albendazole Another drug that helps treat the symptoms of opisthorchiasis in children and adults. Its active substances disrupt the digestive system of parasites, which triggers a number of irreversible biochemical reactions that lead to their death.
Indicated for use by patients older than two years. It is drunk twice a day at 400 milligrams at a time. The treatment course lasts three days. There are analogues, which include Vermox, Vormin, Mebendazole and Medamine.
Chloxyl. This drug also helps to eliminate the symptoms of opisthorchiasis, the photo of the causative agent of which is presented above. Its active substances disrupt carbohydrate metabolism in the body of parasites, which also leads to their death.
For the entire course you need to take from 15 to 24 grams of the drug. The dosage, as well as the duration of treatment, is determined by the doctor. The course can be 2, 3 and 5 days. It is highly recommended that tablets be washed down with milk, as its components enhance their effect.
Auxiliary drugs
Based on the previously listed symptoms of opisthorchiasis in humans, photos of which are definitely not for impressionable people, one could understand that the disease brings a lot of unpleasant sensations.
Therefore, in addition to the main drugs, you have to drink other medications that help cope with pain and other manifestations of the disease. Such drugs are usually prescribed:
- Suprastin. Effective blocker of histamine H1 receptors. It has an antiemetic, peripheral, antispasmodic and anticholinergic effect.
- 'Diphenhydramine'. Produces a moderate ganglion-blocking effect, also acts as an anesthetic, sleeping pill, sedative, antiallergen and antispasmodic.
- Tavegil. It acts against itching, prevents the development of vasodilation, reduces the permeability of capillaries and blood vessels, inhibits the formation and exudation of edema. It also has an m-anticholinergic effect.
- Valerian and bromine. These are effective sedatives in this case, which calm, without causing muscle relaxation and ataxia.
- Butadion. Reduces fever, eliminates inflammation and has an analgesic effect. In addition, it reduces the synthesis of prostaglandins and inhibits the activity of COX.
- Ascorutin. Helps to restore deficiency of vitamin P and C. It has an antioxidant effect, strengthens the vascular wall, reduces fragility and permeability of capillaries.
- Sodium salicylate. Effectively quenches pain and lowers fever.
What exactly to use with the symptoms of opisthorchiasis in children and adults, the attending physician will say. It is very important to correctly select auxiliary preparations so that their active components do not aggravate the effect of the main medicines aimed at the destruction of parasites.
Rehabilitation
Recovery is a very important stage that occurs after the treatment of symptoms of opisthorchiasis is completed. The photo above shows how parasites that flourish in the body of an infected person look like. So, so that they do not appear again, it is necessary to undergo rehabilitation.
The main procedure is duodenal probeless sounding. It is done daily for a week. Then, in the next three months, no more than twice every 7 days.
Also, every day you need to empty. When stool is delayed, laxatives may be prescribed.
Doctors often prescribe antispasmodic, anticholestatic, and other symptomatic medications. Cholagogue can also be prescribed, which include "Holagogum", "Hofitol", "Allohol", "Holosas".
It will also require taking medications aimed at restoring normal liver function. These include Darsil, Heparsil, Carsil, Legalon, Essential, Silegon.
In addition, over the next 3-4 months, a person will need to take decoctions made from choleretic herbs. In pharmacies, ready-made fees are sold. They include immortelle flowers, a three-leaf watch, coriander fruits, mint, chamomile, tansy and calendula.
Diet
It is also worth briefly telling about it at the end of the topic regarding the symptoms of opisthorchiasis in adults. The photo above shows parasites for which food is not only human biological fluids, but also what he eats.
It is strictly forbidden to eat fatty, smoked, sweet, spicy and fried. We must abandon tomatoes, poultry, chocolate, ice cream, energy and soda, mushrooms, canned foods, meat and fish, bakery products, eggs, pickles and seasonings.
The following products are allowed:
- Cereals with a small addition of sunflower or butter.
- Fresh fruits.
- Berries
- Dried fruits.
- A small amount of honey and jam.
- Low-fat boiled meat, better turkey.
- Dairy and vegetable soups.
- Natural juices.
- Compotes, fruit drinks, jelly.
- Weak tea.
- A decoction of rosehip berries.
- Any dairy product, but low in fat.
These products will help prevent the reappearance of symptoms of opisthorchiasis and adults and rid the body of toxic substances. Such a diet is aimed at restoring immunity, the work of the biliary tract and normalizing body functions.
All food consumed should be steamed, or by cooking / baking. You will have to switch to fractional nutrition (eat 5-6 times a day in small portions) and drink plenty of clean water (2 l).
It must be remembered - it is important to comply with all medical recommendations for the treatment of such a serious disease, including nutrition.