This article will discuss the clinic, diagnosis, treatment of opisthorchiasis. This is a dangerous defeat by parasites - helminths. They affect the liver and biliary tract. Flatulent worms provoke such ailments, which enter the human body mainly when eating fish, in which parasites live. Such a disease can be chronic and undulating: periods of calm alternate with frequent exacerbations.
What causes the disease?
This disease is caused by a parasite of a Siberian fluke (feline). Parasites spread by means of creatures infected by them, when along with feces, the eggs of the pathogen penetrate the water and snails swallow them. Then the larvae spread in them. Early diagnosis of opisthorchiasis is of great importance.
After that, the larvae of cercariae penetrate into the water, which fall into the carp fish. As a result, after eating infected fish, a person becomes infected. It is dangerous to eat dried, raw, slightly salted or insufficiently well-processed fish. Due to the fact that parasites are in the muscles of fish, when they are cut, they can also get on kitchen appliances, which in the future can contribute to the penetration of food.
The disease is most often found in Russia (in Western Siberia), Belarus, Kazakhstan, Ukraine and countries in Southeast Asia (in Vietnam, Thailand, Laos, Cambodia). The largest outbreak in the world is the Tyumen region. Diagnosis of opisthorchiasis should be timely.
Statistics
How common is opisthorchiasis in Russia and Europe?
In Russia, 70-75% of people suffer from this disease, and in the lesions this figure sometimes reaches up to 100% (almost the entire population is infected). Diagnosis of opisthorchiasis in children is often carried out here.
In Belarus, the percentage of infection is 3-5%.
Ukraine and Kazakhstan - about 7-10% each.
The Baltic countries (Latvia, Lithuania, Estonia) and Western Europe (Belgium, Austria and other countries) - according to various sources, from 2 to 5% of the population.
Unfortunately, Russia leads this list. This is due to the peculiar traditions of eating food, which are deeply rooted in some areas: eating fish in raw or poorly processed form (slightly salted, frozen, dried).
However, other residents of other regions also have the opportunity to become infected with opisthorchiasis.
Fish that can be infected are found in the following rivers: Ob, Irtysh, Yenisei, Ural, Kama, Dnieper, Volga, Don, Northern Dvina, Biryusa.
Signs and forms of the disease
Symptoms of opisthorchiasis are determined by the intensity and duration of infection and the individual characteristics of the body. Also, such a disease can be both acute (the period lasts from several days to 8 weeks or more) and chronic (the period of 10 years or lasts a lifetime). Patients with an acute form of the disease usually have complaints of the following symptoms:
- fever;
- hives;
- aches of joints and muscles of the body;
- the liver and gall bladder are enlarged;
- pain under the ribs on the right side;
- vomiting and nausea;
- flatulence;
- loose and frequent stools;
- heartburn;
- loss of appetite.
After fibrogastroscopy, ulcerative lesions of the gastrointestinal tract and erosive gastroduodenitis are detected. Features of the acute form of opisthorchiasis in children can be detected through lung lesions of an allergic nature. In this case, the disease may resemble asthmoid bronchitis. Therefore, a differential must be carried out. diagnosis of opisthorchiasis.
What is the danger of a chronic form?
The chronic form of the disease is followed by gastroduodenitis, pancreatitis, hepatitis and chronic cholecystitis. The patient occasionally has bouts of pain under his right ribs, which are similar to biliary colic, passing to the other side of the chest.
You can observe dyspeptic syndrome and dyskinesia of the gallbladder. This type of parasite affects the nervous system, thereby disrupting its activity. The patient often experiences high fatigue, insomnia, irritability, and his head may also hurt and become dizzy. Sometimes such neurological cases of opisthorchiasis are major. In this case, patients are diagnosed with autonomic neurosis and neurocircular dystonia.
Asthenic syndrome manifests itself in the form of weakness, lethargy, increased physical and mental fatigue. An allergy is manifested, which includes skin itching, hives, arthralgia and food allergies. The chronic form of such a disease is very dangerous, because even after complete deworming, pretty serious consequences can remain, such as gastritis, chronic hepatitis, cholangitis, cholecystitis, damage to the immune system.
Diagnosis of opisthorchiasis by blood is quite informative.
Rehabilitation measures
After successful treatment of the disease, it is necessary to take a series of rehabilitation measures aimed at recovering the liver, gall bladder, and digestive system. The consequences of helminth infections in children can trigger serious allergic reactions.
Diagnosis of opisthorchiasis in this case can be difficult.
Young parasites damage the ducts with spikes, adults with suckers. A large number of bleeding erosions is formed, the regenerative-hyperplastic reaction of the epithelium is not excluded. This process increases the risk of cancer. The concentration in the canals of the hepatopancreatic system of eggs of parasites, epithelium and mucus leads to their clogging, outflow of bile and pancreatic secretion is complicated, their stagnation occurs. Severe complications that relate to the liver - cirrhosis, abscess, cancer. In the biliary system, peritonitis progresses, oncology occurs in the pancreas, acute destructive pancreatitis.
Diagnosis of opisthorchiasis
Diagnosis will require clinical data and urine and blood tests. A coprological examination and fibrogastroduodenoscopy should also be prescribed.
ELISA diagnosis of opisthorchiasis is now very popular.
In the process of laboratory research, a passive hemagglutination reaction (RPHA) and ELISA are performed. This helps to determine the diagnosis in the early stages, even before the eggs are laid by the parasite. In case of a chronic disease, tests are used as diagnostic aids.
In addition, the doctor relies on an epidemiological history: he lived or temporarily visited the outbreak, whether he ate raw or poorly prepared fish, especially cyprinidae.
The choice of the method of laboratory diagnosis of opisthorchiasis will completely depend on this.
The immune system begins to respond first to the presence of foreign agents. And after about two weeks, M-immunoglobulins expressively increase. After another week, G-immunoglobulins begin to be produced. With a prolonged course of this disease (from 10 years), the degree of specific antibodies decreases to a threshold as a result of an immunodeficiency position.
Consider how the diagnosis of opisthorchiasis is carried out by blood, indicators of analyzes.
Biochemical and clinical tests are conducted. The following indicators are revealed by blood:
- A-amylase;
- AST and ALT;
- cholesterol level;
- protein;
- phosphatase (alkaline).
Blood biochemistry analysis
Increased bilirubin in the blood, pancreatic enzyme, transaminase, sublimate and thymol tests indicate that the gall bladder, bile ducts, liver and duodenum do not work well. These indicators are indirect signs of opisthorchiasis, one might say, its only manifestations in the chronic stage.
Pathology is also detected using ultrasound of internal organs. A study of the esophagus, duodenum and stomach through an endoscope. The patient must be assigned a coprogram. The effectiveness of diagnostic methods for opisthorchiasis depends on the degree of the disease.
Treatment
In order to eliminate the disease, it is necessary to perform a number of measures. Usually it consists of several stages.
The first stage is preparation:
- the destruction of inflammatory processes of the biliary tract and gastrointestinal tract, allergic symptoms;
- providing outflow from the channels of the pancreas and biliary tract;
- detoxification of the body;
- improving the quality of liver functions;
- bowel cleansing.
The effectiveness of the upcoming stages of treatment depends on how these measures are carried out. Also, the patient should adhere to a diet that involves limiting fat in the diet. In addition, the doctor may prescribe antihistamines. If there are symptoms of a secondary infection, a course of antibacterial agents with a wide spectrum of action is prescribed.
To correct the outflow, choleretic drugs (cholekinetics, choleretics, mixed) are used. If there is cholestasis, then take "Hepatral", ursodeoxycholic acid. At the treatment stage, digestive enzymes (such as Pancreoflat, Creon, Mezima-Forte), pro and prebiotics, prokinetics (such as Motilium, Motilaka, Metoclopramide) are effective.
Meteospasmil, Baralgin, Drotaverin, Buscopan, Duspatalin, No-Shpu are prescribed as traditional and selective antispasmodics. In the chronic form of the disease, the preparation phase lasts ten days, a maximum of a week with a weakening effect of cholecystitis, cholangitis.
The second stage is to exert an effect on the helminth
The course of treatment of opisthorchiasis in adults and children at this stage involves the use of a special drug - "Biltricida" ("Praziquantel"). This is an anthelmintic drug with a wide spectrum of action, which affects many types of cestodes and trematodes. It enhances the sensitivity of helminths to calcium ions. In the end, parasites have spastic muscle paralysis. After this, the worms separate from the walls and exit with bile.
It is worth noting that Biltricide has a toxic effect. Extremely strong effect on the cells of the pancreas and liver. He is able to provoke allergies, vomiting, nausea, drowsiness, dizziness, diarrhea, cramps, arrhythmias, pains in the right side and many others. So, opisthorchiasis should be treated in special conditions of a medical institution and under the constant supervision of doctors.
Diagnosis and treatment of opisthorchiasis are closely related.
The third stage is rehabilitation
At this stage, the main goal is to eliminate the violations that were triggered by invasion. After using Biltricide, choleretic therapy is of great interest, for example, they turn to tubage with sorbitol, xylitol, drink mineral water and magnesium sulfate.
At the rehabilitation stage, it is extremely important not to forget to cleanse the intestines, laxatives are prescribed according to the instructions. The combination of treatment also includes hepatoprotectors and choleretic herbs.
What can happen if you do not undergo timely treatment?
If you engage in home treatment or be late with it, or, even worse, do not start treatment at all, then a sick person may encounter unpleasant consequences. Incorrect self-medication of the disease or its neglected form can lead to the presence of other health problems. These include:
- jaundice;
- peritonitis;
- Hepatitis B;
- liver failure;
- cirrhosis of the liver;
- acute pancreatitis;
- cancer;
- violation of the functions of the pancreas.
In addition, the patient may experience serious disorders and problems with appetite, he will constantly feel physical and mental fatigue.
Therefore, the differential diagnosis of opisthorchiasis, timely comprehensive treatment, and prevention are so important.
Disease prevention
Prevention of opisthorchiasis is not only compliance with a sufficiently good thermal treatment of fish. She should have such steps:
- look after the quality of frying, cooking and salting fish;
- thoroughly clean appliances that are designed for cutting fish;
- Do not cut the fish in very large pieces, so that you can then heat it well;
- It is strictly forbidden to eat raw fish or give it to pets.
Conclusion
To eliminate parasite eggs in fish, it must be put in the freezer for eight hours, but the temperature should not exceed 40 degrees. If salting of fish is carried out in any solution, then it must be carried out for 40 days. You need to cook the fish for at least a third of an hour (after boiling water, time should be noted). Frying fish is necessarily carried out under the lid, in time it should last at least a third of an hour.
Already knowing what opisthorchiasis is, people can protect themselves and their children from an undesirable problem. Adhering to such simple hygiene measures and preparing river fish, a person will significantly reduce the likelihood of colliding with parasites.
It is not recommended to treat opisthorchiasis alone at home with folk remedies, because this can significantly aggravate the situation. If symptoms of this disease are found, a person should resort to the help of a specialist and undergo further examination. And only after an adult or child is diagnosed, treatment begins.
It is necessary to take drugs with opisthorchiasis for about two weeks. After this, the patient undergoes a rehabilitation course, which will allow him to avoid unwanted parasites in his body.