The Opisthorchiasis
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Opisthorchiasis

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Opisthorchiasis Opisthorchiasis is a parasitic disease caused by a flat worm that has the scientific name "Siberian fluke or felineus" (Opisthorchis felineus). The carrier of the parasite can be both man and domestic animals (cats, dogs). With opisthorchiasis, organs such as:

  • gallbladder;
  • ducts of the pancreas;
  • bile ducts of the liver.



Ways of infection

The use of malosal, undercooked (undercooked), and even completely raw fish contaminated with opisthorchiasis larvae, results in infection. And the infection of fish is due to contamination of the reservoir by the calves of a patient with an opisthorchiasis of a human or animal.

A person can swallow a parasite or its larvae without even eating the infected fish, but simply by using a knife, a cutting board or a plate on which this fish lay.

Form of development

Larvae of opisthorchiasis are in a capsule, which, upon ingestion into the stomach, dissolves. Then, already in the duodenum, the larva itself tears the hyaline membrane and penetrates the duodenum, as well as the gallbladder and its ducts.

In all infected (infected) people opisthorchis (opisthorchiasis larvae) are found in the biliary and intrahepatic passages. Sixty out of a hundred patients have parasites in the gallbladder. Thirty-six out of a hundred suffer from pancreatic injury.

Stages of development of parasites in the living body

Once in the body of a person or an animal, within a month of metacercaria (larvae in the invasive stage, the habitat of which was the body of an additional host - fish, crabs) ripen and acquire the ability to lay eggs. Thus, it can be concluded that for a full cycle of development the parasite needs four to four and a half months. After this period of time, the insemination of the organism of the final host (man, animal) begins with the eggs of the opisthorchis. However, in this case, the final host, becoming a carrier of parasites, can not get sick. More precisely, it happens most often. And only in the case when there is a re-infection of opisthorchis, signs begin to increase, indicating that a person is infected with parasites of animal origin.

Opisthorchis are "long-livers" among parasites. In a living organism, they can exist up to twenty-five years.

Symptoms of opisthorchiasis

The opisthorchiasis clinic is not static. In two patients infected with opisthorchis, completely different symptoms can be observed. Everything depends on how receptive the host organism is to the products of the life of the parasite, and also on how long and how intense the infection was.

At the initial stage develops an acute form of opisthorchiasis. Usually this condition lasts from one to two months. Then there is a transition of the acute form into a chronic one, the duration of which is from twenty-five years and longer.

Signs of acute form of opisthorchiasis:

  • The patient is in a fever.
  • The body is covered with hives.
  • There is an aching in the muscles and joints.
  • In the right hypochondrium pain of paroxysmal character is noted, with signs of hepatic colic, with irradiation to the right side of the thorax.
  • The liver and gallbladder protrude beyond the lower edge of the ribs.
  • In the epigastric region, pain and a feeling of heaviness.
  • The patient vomits, and sometimes tears.
  • A person suffers from heartburn, his stool is thin and frequent, and also constant meteorisms.
  • The appetite is reduced.
  • Sometimes there is lung damage, which is allergic and gives symptoms of asthmatic bronchitis.

Fibrogastroscopy performed at this time indicates the presence of:

  • erosive gastroduodenitis;
  • stomach ulcers;
  • ulcers in the duodenum.

Chronic opisthorchiasis can manifest itself as a separate disease of the digestive tract, for example:

  • chronic cholecystitis,
  • gastroduodenitis,
  • pancreatitis ,
  • hepatitis,
  • dyskinesia of the biliary tract.

Following the disruption of the digestive tract begins to suffer nervous system of the patient. The person becomes irritable, quickly gets tired, does not sleep at night, complains of dizziness and headache. To this are added:

  • increased sweating;
  • uncontrolled trembling of the eyelids, fingers and tongue.

Sometimes it happens that violations of the digestive tract are not very significant, and neurological problems come to the fore. With such a course of the disease, the diagnosis becomes more complicated, and a patient with an opisthorchiasis is diagnosed with an erroneous diagnosis, for example, "vegetative neurosis" or "neurocircular dystonia".

Allergic syndrome happens in all patients and it manifests itself:

  • skin itching,
  • hives,
  • edema Quincke,
  • arthralgia,
  • food allergy.

Even after dehelminthization (removal of the parasite from the patient's body), opisthorchiasis does not pass without a trace. A person all his life suffers from an imbalance in the immune system, he is diagnosed with hepatitis, cholecystitis , gastritis and other painful changes in the digestive system. Therefore, it is important that once a patient gets rid of a parasite, he begins a wellness therapy for the entire digestive system.

Complications

One of the most dangerous complications of opisthorchiasis is an allergy arising from the fact that the invaded organism is constantly poisoned by the products of decay and metabolism of opisthorchias and necrotic cells of the bile duct epithelium. Necrosis of the epithelium is caused by the spines of young helminths, traumatizing the walls of the ducts (bile and pancreatic ducts). Then, during the migration of mature specimens of helminths, which cling to the walls of the ducts with suckers, the epic cells break away, leaving bleeding erosions on the mucous membrane. Just the same, these erosions subsequently cause cancer. In addition, the accumulation of necrotic epithelium, mucus, eggs of opisthorchis, as well as young and mature individuals of the parasite, creates stagnation of bile and pancreatic secretions.

Severe complications of opisthorchiasis:

  1. Bile peritonitis.
  2. Abscess of the liver.
  3. Cirrhosis of the liver .
  4. Primary liver cancer.
  5. Acute destructive peritonitis.
  6. Pancreas cancer.

Diagnosis of opisthorchiasis

Opisthorchiasis is diagnosed as follows:

  1. An anamnesis is collected, during which it is determined whether the patient lived in a place where opisthorchiasis is often diagnosed, and whether there were episodes of eating badly processed carp breed fish.
  2. The next stage is a laboratory study of blood, urine and feces.
  3. Fibrogastroduodenoscopy is also performed.
  4. Mandatory comprehensive diagnosis, which is carried out on 3 specific markers - IgM, IgG, CEC, which make it possible to accurately diagnose.
  5. Since the immune system is the first one to react, it begins to develop specific immunoglobulins of class M (IgM), when contacting antigens of opisthorchises. The maximum value of the synthesis of these substances occurs in half a month, and in two months the development of immunoglobulins of class G (IgG) begins. The greatest concentration of immunoglobulin data is achieved in two or three months, and these indicators last for quite some time. But, if the disease is not treated within 10 years, the level of specific antibodies descends below the acceptable values. Having identified this decrease, opisthorchiasis can be diagnosed. Such studies have not been conducted before, and only recently scientists have developed methods by which it became possible to determine the reduced level of specific antibodies.

Treatment of opisthorchiasis

Treatment of opisthorchiasis can be successful if it is complex and is carried out in three stages.

The first stage is called the preparatory phase . During this period the doctor will try:

  • to stop allergic syndrome and to remove inflammation of the bile ducts or the entire gastrointestinal tract;
  • Ensure the outflow of mucus from the bile duct and from the ducts located in the pancreas;
  • improve the functioning of the liver tissue.

Also, mandatory detoxification therapy, cleansing of the intestine and a special diet for limiting fat.

Drug therapy involves the appointment of antihistamines and sorbents. If there is evidence, for example, the attachment of a secondary infection, a five-day course of broad-spectrum antibiotics is prescribed. To improve the drainage of the bile ducts, taking into account the type through which dyskinesia of the bile ducts passes, cholagogue preparations are used.

Symptomatic treatment is carried out with prokinetics, antispasmodics, food enzymes, pre- and probiotics.

If the patient has a remission of cholecystitis or cholangitis, the preparatory stage lasts up to two weeks, with pancreatitis and hepatitis - up to three weeks.

On how this stage will be carried out, the effectiveness of subsequent treatment depends to a large extent.

The second stage is characterized by the use of a specific biltricid preparation (prazikventel).

Biltricide is an effective anthelmintic preparation with a wide spectrum of action and detrimental to almost all trematodes and cestodes. The mechanism of action of this drug is as follows. The membrane of parasites has a high permeability for calcium ions, which are part of the biltricide. And this effect causes spastic paralysis of the helminth muscles, as a result of which they are detached from the walls of the bile ducts and are evacuated with bile.

But this dosage form should be used with great caution, since the drug is toxic and can cause damage to liver and pancreas cells.

Side effects when using biltricid:

  • allergy,
  • nausea and vomiting,
  • pain concentrating in the right hypochondrium,
  • diarrhea with an admixture of blood,
  • dizziness,
  • constant drowsiness,
  • myalgia,
  • arrhythmia,
  • convulsions ,
  • violation of blood composition.

Because of such serious side effects, de-worming is done only under the supervision of a doctor, in a hospital.

The third stage (rehabilitation) - is designed to restore the violations that have occurred in the body due to infestation. In addition, it is taken into account that a person was treated with biltricide, which means that there is every reason to use cholagogue therapy through various kinds of tjubazh, reception of decoctions of herbs with choleretic effect and hepatoprotectors. Also during the entire rehabilitation period, the bowels should be cleaned with enemas or laxatives.

Prevention of opisthorchiasis

To prevent opisthorchiasis is much easier than to diagnose and treat it. To do this, you do not need to do any costly vaccinations - you just have to carry out simple, generally accepted rules of hygiene behavior, namely:

  1. Under no circumstances should you consume raw water, be it water from streams, wells or water pipes. At the same time, to know for sure that all parasites that can be found in contaminated water have died, boil it for at least ten minutes.
  2. Hands should be washed often. This is the simplest, but effective way, through which a person without special efforts protects himself from the vast majority of infectious diseases.

When to wash hands necessarily:

  • before and after a visit to the toilet;
  • after working with the land;
  • after the game or contact with any, even domestic, animals;
  • after changing diapers;
  • coming home from the street;
  • before you start to cook or sit down at the table;

Explain to children that when swimming in pools, be it swimming pool, sea or river, keep your mouth tightly closed. This will not swallow any "dirty trick", from which, if it is still swallowed, it will be very difficult to get rid of for many years or even for life.

Such products as vegetables and fruits, should be washed very carefully. Just to fill them with water from the tap is not enough. Fruits and especially vegetables, washed with a special brush, and then, for a while, left under running water.

Particular attention should be paid to cooking fish. Even infected fish pieces become harmless if they are fried or cooked for twenty minutes.


| 4 December 2014 | | 1 865 | Uncategorized
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