Ascariasis medical therapy


 * Associate Editor-In-Chief: Imtiaz Ahmed Wani, M.B.B.S

Treatment
Pharmaceutical treatments include:
 * Mebendazole (Vermox) (C16H13N3O2). Causes slow immobilization and death of the worms by selectively and irreversibly blocking uptake of glucose and other nutrients in susceptible adult intestine where helminths dwell.  Oral dosage is 100 mg 12 hourly for 3 days.
 * Piperazine (C4H10N2.C6H10O4). A flaccid paralyzing agent that causes a blocking response of ascaris muscle to acetylcholine.  The narcotizing effect immobilizes the worm, which prevents migration when treatment is accomplished with weak drugs such as thiabendazole.  If used by itself it causes the worm to be passed out in the feces.  Dosage is 75 mg/kg (max 3.5 g) as a single oral dose.
 * Pyrantel pamoate (Antiminth, Pin-Rid, Pin-X) (C11H14N2S.C23H16O6) Depolarizes ganglionic block of nicotinic neuromuscular transmission, resulting in spastic paralysis of the worm. Spastic (tetanic) paralyzing agents, in particular pyrantel pamoate, may induce complete intestinal obstruction in a heavy worm load.  Dosage is 11 mg/kg  not to exceed 1 g as a single dose.
 * Albendazole (C12H15N3O2S) A broad-spectrum antihelminthic agent that decreases ATP production in the worm, causing energy depletion, immobilization, and finally death.  Dosage is 400 mg given as single oral dose (contraindicated during pregnancy and children under 2 years).
 * Thiabendazole. This may cause migration of the worm into the esophagus, so it is usually combined with piperazine.
 * Hexylresorcinol effective in single dose, mentioned in : Holt, Jr Emmett L, McIntosh Rustin: Holt's Diseases of Infancy and Childhood: A Textbook for the Use of Students and Practitioners. Appleton and Co, New York,11th edition
 * Santonin, more toxic than hexylresorcinol, mentioned in : Holt, Jr Emmett L, McIntosh Rustin: Holt's Diseases of Infancy and Childhood: A Textbook for the Use of Students and Practitioners. Appleton and Co, New York,, 11th edition
 * Oil of Chenopodium, more toxic than hexylresorcinol, mentioned in : Holt, Jr Emmett L, McIntosh Rustin: Holt's Diseases of Infancy and Childhood: A Textbook for the Use of Students and Practitioners. Appleton and Co, New York, 11th edition

Also, corticosteroids can treat some of the symptoms, such as inflammation.

Native Americans have traditionally used epazote (Chenopodium ambrisioides) for treatment, which was not as powerful as pharmaceutical compounds, but spontaneous passage of Ascarids provided some proof of efficacy.

Some recent studies exist in the medical literature suggesting that sun-dried papaya and watermelon seeds may reduce infections by a large factor. The adult dosage is one tablespoon of the seed powder in a glass of sugar water once a week for two weeks. The sugar makes the bitter taste palatable and acts as a laxative.