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Opisthorchiasis

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Opisthorchiasis Opisthorchiasis is a parasitic disease caused by a flatworm with the scientific name “Siberian or Feline Fluke (Opisthorchis felineus)”. The carrier of the parasite can be both humans and pets (cats, dogs). When opisthorchiasis affects such organs as:

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



Ways of infection

Eating salted, undercooked (underdone), if not raw fish contaminated with opisthorchosis larvae leads to infection. And fish are contaminated due to contamination of the reservoir with fecal masses of a person or animal having opisthorchiasis.

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

Form of development

The larvae of opisthorchiasis are in the capsule, which, when released into the stomach, dissolves. Then, already in the duodenum, the larva itself breaks the hyaline membrane and penetrates the duodenum, as well as the gallbladder and its ducts.

In all invasive (infected) people, opistorchis (opisthorchiasis larvae) are located in the biliary and intrahepatic passages. Sixty out of a hundred sick parasites are detected in the gallbladder. Thirty-six out of a hundred suffer from pancreatic injury.

Stages of development of parasites in a living organism

Once in the human or animal body, after a month of metacercariae (the larvae in the infested stage, the habitat of which was the organism of an additional host - fish, crab), they mature and acquire the ability to lay eggs. Thus, we can conclude that for the full development cycle 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) with opistorchis eggs begins. However, in this case, the final owner, becoming a carrier of parasites, can not get sick. More precisely, it happens more often. And only in the case when re-infection with opistorhis occurs, signs begin to grow, indicating that the person is infected with parasites of animal origin.

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

Symptoms of opisthorchiasis

The clinic of opisthorchiasis is not static. Two patients infected with opistorhis may have completely different symptoms. It all depends on how susceptible the host organism is to the products of the parasite's vital activity, and also on how long and with what intensity the infection occurred.

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

Signs of the acute form of opisthorchiasis:

  • The patient is in a fever.
  • The body is covered with urticaria.
  • There is aching muscles and joints.
  • In the right hypochondrium there are pains of paroxysmal character, having signs of hepatic colic, radiating to the right side of the chest.
  • The liver and gallbladder protrude beyond the lower edge of the ribs.
  • In the epigastric region pain and sensation of heaviness.
  • The patient is sick, and sometimes vomits.
  • A person suffers from heartburn, his stool is fluid and frequent, as well as constant flatulence.
  • Appetite reduced.
  • Sometimes there is a lung lesion, which is allergic in nature and gives symptoms of asthmoid bronchitis.

Fibrogastroscopy conducted 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,
  • biliary dyskinesia.

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

  • excessive sweating;
  • uncontrollable tremor of the eyelids, fingers and tongue.

Sometimes it happens that the disorders of the digestive tract are not very significant, and neurological problems come to the fore. With such a course of the disease, the diagnosis is complicated, and the person diagnosed with opisthorchiasis is mistakenly diagnosed, for example, “vegetative neurosis” or “neurocircular dystonia”.

Allergic syndrome occurs in all patients and it manifests itself:

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

Even after deworming (removal of the parasite from the patient's body) opistorhoz does not pass without a trace. A person suffers all his life 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 immediately after the patient gets rid of the parasite, to begin health therapy of the entire digestive system.

Complications

One of the most dangerous complications of opisthorchiasis is an allergy caused by the fact that an invasive organism is constantly poisoned by decomposition products and the metabolism of opistorchis and necrosis of the epithelial cells of the bile ducts. Necrosis of the epithelium is caused by spikes of young helminths, traumatic duct walls (biliary and pancreatic). Then, in the process of migration of mature worms that cling to the walls of the canals with suckers, the epithelial cells break off, leaving bleeding erosion on the mucosa. Just the same, these erosions subsequently cause oncological diseases. In addition, the accumulation of necrotic epithelium, mucus, opistorchis eggs, as well as young and mature individuals of the parasite creates a stagnation of bile and pancreatic secretions.

Severe complications of opisthorchiasis:

  1. Gall peritonitis.
  2. Liver abscess.
  3. Cirrhosis of the liver .
  4. Primary liver cancer.
  5. Acute destructive peritonitis.
  6. Pancreas cancer.

Diagnosis of opisthorchiasis

Opisthorchosis is diagnosed as follows:

  1. Anamnesis is collected, during which it becomes clear whether the patient lived in a place where opisthorchiasis is often diagnosed, and if there were episodes of eating poorly processed thermal fish of carp.
  2. The next stage is a laboratory study of blood, urine and feces.
  3. Also performed fibrogastroduodenoscopy.
  4. Mandatory comprehensive diagnostics, which is carried out on 3 specific markers - IgM, IgG, CIC, which make it possible to accurately diagnose.
  5. Since the immune system is the first to react, it contacts the antigens of opisthorchiasis and begins to produce specific M immunoglobulins (IgM). The maximum value of the synthesis of these substances occurs within a fortnight, and after two months the production of immunoglobulins of class G (IgG) begins. These immunoglobulins reach the greatest concentration in two or three months, and these indicators keep for quite a long time. But, if the disease is not treated for 10 years, the level of specific antibodies goes below the permissible values. Having identified this reduction, you can diagnose opisthorchiasis. Such studies have not previously been conducted, and only recently scientists have developed methods by which it has become possible to determine a 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 preparatory. During this period, the doctor will try:

  • stop the allergic syndrome and relieve inflammation of the biliary tract or the entire gastrointestinal tract;
  • to ensure the flow of mucus from the biliary tract and ducts located in the pancreas;
  • improve the functioning of the liver tissue.

Also, it will be mandatory to have detoxification therapy, bowel cleansing and a special diet prescribed to limit fat.

Drug therapy involves the appointment of antihistamines and sorbents. If there are indications, for example, the accession of a secondary infection, a five-day course of broad-spectrum antibiotics is prescribed. To improve the drainage of the bile ducts, given the type by which dyskinesia of the bile ducts, choleretic drugs are used.

Symptomatic treatment is carried out by 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.

The effectiveness of the subsequent treatment depends on how this stage will be carried out.

The second stage is characterized by the use of a specific drug biltricid (praziquivel).

Biltricid is an effective anthelmintic drug that has a wide spectrum of action and adversely affects 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 that are part of biltricid. And this effect causes spastic paralysis of the helminth muscles, as a result of which they detach 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 the liver cells and pancreas.

Side effects when using biltricid:

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

Because of these serious side effects, deworming is carried out only under the supervision of a doctor in a hospital.

The third stage (rehabilitation) is intended to restore the violations that occurred in the body as a result of invasion. In addition, it is taken into account that the person was treated with biltricid, which means that there is every reason to use choleretic therapy through various kinds of tubages, taking decoctions of herbs with choleretic effect and hepatoprotectors. Also during the entire rehabilitation period, the intestines should be cleaned with enemas or laxatives.

Prevention of opisthorchiasis

Preventing opisthorchiasis is much easier than diagnosing and treating it. To do this, you do not need to make any expensive vaccinations - you just need to follow simple, common rules of hygienic behavior, namely:

  1. Under no circumstances should you use raw water, be it water from streams, wells, or running water. At the same time, in order to know for sure that all the parasites that are in polluted water have died, it is better to boil it for at least ten minutes.
  2. Hands should be washed frequently. This is the simplest, but effective way by which a person effortlessly protects himself from the vast majority of infectious diseases.

When washing your hands is necessary:

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

Explain to the children that while swimming in water, whether it is a pool, sea or river, the mouth should be kept tightly closed. This will allow not to 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 a lifetime.

Products such as vegetables and fruits should be washed very carefully. Just doused with water from the tap is not enough. Fruits and especially vegetables are washed with a special brush, and then, for a while, left under running water.

Particular attention should be paid to the preparation of fish. Even infected fish pieces become harmless if they are fried or boiled for twenty minutes.


| 4 December 2014 | | 1 865 | Uncategorized
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