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Thursday, December 5, 2013
I am a 30 year old female and I have an embarassing problem for the last couple of months. I have a itchy bottom! I have multiple bowel movements especially in the morning. In a day I have about 6 to 7 bowel movements and due to this I am hungry all the time. I wash my hands every time I eat and try not to use any public restrooms so could this be a worm trouble? I am just embarassed to discuss this with my doctor. Recently I have noticed that my 3 year old child keeps itching his back all the time. So I think my son might have got it from me. Can you suggest a medicine for it because I cant find any medicines at the drug store. Does it need a prescription? Also, is there any link between worm trouble and the multiple movements because although my son has the same itching problem as mine he has only 1 bowel movement a day.
You are are a great observer! You are describing the classic presentation of pinworm infection in a mother with a child of exactly the right age who is most likely the person who passed the infection to his mom.
Pinoworm or Enterobius vermicularis infection is the most common intestinal worm infection in the United States. They are white, glistening worms about half an inch long. Pinworms live in the rectum predominantly.
Female pinworms come out of the anus at night and lay eggs on the infected person's perianal region. Unfortunately for females, they may also infect the vagina and cause a discharge as well as the intense perianal itching you are experiencing. Left untreated, they can definitely multiply to the point of causing frequent stooling and even diarrhea.
They are most often acquired by children sitting on and playing in sand or dirt where infected animals have passed stool that has transferred the pinworms to the sand or soil. Unless your son is an unusually conscientious handwasher among 3-year-olds, it is easy for the worms to become lodged under the nails and transferred to the intestines when eating with poorly washed hands.
We mothers contract the worms from our children as we help them with toileting or handle their soiled clothing and bedding because we also don't wash our hands as often and as thoroughly as we really need to to protect ourselves. We often rush from task to task and forget that we intended to wash our hands.
The infection can be diagnosed from stool samples or by applying a piece of transparent tape across your son's anus at bedtime. As the worms come out to lay eggs in the night, some will adhere to the tape. Many pediatric providers diagnose the infection by history, but some will want proof of the problem.
Happily there are several medications available to effectively treat the infection. One of the most common prescription medications is mebendazole, also known as Vermox. Reese's Pinworm Medicine, Pin-X, and Pin-Rid are three possible medications available over the counter. Side effects of all of these medications include dizziness, drowsiness, headache, nausea, vomiting, anorexia, diarrhea, and rash.
The infected child and all family members should be treated. Many providers recommend a second dose 7 days later to assure that any worms hatching from eggs after the first treatment are destroyed. Occasionally a serious infection may require a third round of treatment three weeks later. Most of the available medications are small tablets that are easy to take. A vaginal and strong perianal infection may also require topical treatment.
Hygienic measures to assure successful treatment include daily changing and washing of all underclothing, clothing, bed linens, and towels. Daily toilet cleansing, and frequent handwashing.
I hope this is helpful information.
Mary M Gottesman, PhD, RN, CPNP, FAAN
Professor of Clinical Nursing
College of Nursing
The Ohio State University