Opisthorchiasis in adults: symptoms and treatment, consequences of the disease

Allergic reactions. Skin rashes appear, characterized by severe itching. Swelling is less common.
Disturbances in the functioning of the gastrointestinal tract. Possible: abdominal pain, digestive disorders, nausea, vomiting, etc.
Asthenovegetative syndrome.
Changes in the size of the liver and other organs.
Periodic pain in joints and muscles.
Problems with the bronchi and lungs, characterized by severe coughing attacks, shortness of breath and mucous discharge from the nose, are also symptoms of opisthorchiasis.

Pathogens of the disease opisthorchiasis

The disease gets its name from the class of flatworms that cause its appearance. Opisthorchiasis is caused by worms of the class of flukes, which in the scientific literature is called opisthorchiasis.

In the human body, flatworms can live for about 20 years. The feces of an infected person can contaminate soil and water bodies, where the process of ontogenesis will begin anew.

Some of the most common types of parasites found in patients are called Siberian fluke and cat fluke. These worms are characterized by their small size, from 8 to 18 centimeters, as well as a narrow and pointed body shape.

In order to enter the human body, the parasite needs to go through two intermediate forms:

damage to freshwater mollusks: parasites penetrate these underwater organisms through the entry of infected feces of the previous intermediate host into the reservoir. Feces contain worm eggs, which are transformed in the mollusk's body into fluke larvae - cercariae. In total, the transformation process takes about 2 months;
It is in the form of cercariae that parasites penetrate the body of freshwater fish, localizing in muscle tissue and subcutaneous tissue. In this organism, the worms undergo a second stage of transformation, turning into metacircoria. After a month and a half, the larva that enters the fish’s body becomes capable of infecting the human body. Until this time, the fluke will not be able to take root in the aggressive environment of the final host;
If all necessary conditions are met, the larvae of the worm infect a person, localizing in the small intestine, and then entering the gallbladder and liver cavity. After 10–12 days, the parasite reaches the age of an adult capable of reproduction.

What is opisthorchiasis

Opisthorchiasis (lat. opisthorchiasis) is a disease from the group of trematodes caused by parasitic flatworms of the genus Opisthorchiasis.

The main causative agent of opisthorchiasis in humans is the squirrel fluke (or Opisthorchis viverrini).

Opisthorchiasis was first discovered in 1875 . In 1884, the parasite was first discovered in cat livers in Northern Italy and named Opisthorchis felineus (or cat fluke ). Russian scientist and pathologist Konstantin Nikolaevich Vinogradov discovered this parasite in humans in 1891 and called it " accidental Siberian fever ." This disease is also called " Southeast Asian liver disease ".

The helminth affects the liver and pancreas, which entails serious consequences, including death.

Statistics clearly indicate that two thirds are affected by this disease worldwide.

The disease occurs in both adults and children due to insufficient heat treatment of fish in which the parasites live, subsequently the parasite enters the body.

Diagnosis of opisthorchiasis

In the first stages of opisthorchiasis development in adults or children, diagnosis is a difficult task. It is noteworthy that trematode eggs can be detected in a patient’s stool no earlier than 4-5 weeks after infection.

That is why the acute form of the disease can be diagnosed taking into account the clinical picture and epidemiological history. The doctor will definitely ask the patient about his diet, especially whether his diet included raw or lightly salted fish.

Differential diagnosis of opisthorchiasis

If opisthorchiasis is suspected, diagnosis should be carried out as soon as possible and only under the strict supervision of competent specialists. When examining the patient, it is necessary to exclude pneumonia, tuberculosis and echinococcosis.

The theory of a tumor process, which may also be accompanied by a similar clinical picture, is also considered. When opisthorchiasis is suspected, differential diagnosis always plays one of the most important roles.

Laboratory diagnostics: tests for opisthorchiasis

Laboratory testing is important in identifying opisthorchiasis and confirming the final diagnosis.

A doctor may not prescribe all of the listed tests to a patient suspected of opisthorchiasis, but feces and blood are necessarily examined for opisthorchiasis. Stool examination is carried out several times, as this makes it possible to obtain the most accurate result.

Diagnosing the disease using laboratory methods includes the following basic tests:

examination of stool for the presence of pathogen eggs;
blood composition analysis (biochemical, general);
PCR diagnostics; urine test.

Blood for opisthorchiasis

Today, a screening blood test for opisthorchiasis is considered the most informative. The study is carried out using an enzyme immunoassay test (ELISA method) and makes it possible to simultaneously detect several types of helminths, if any are present in the body.

ELISA analysis for opisthorchiasis allows you to detect not only this disease, but also detect echinococcosis, toxocariasis and trichinosis. If a blood test for opisthorchiasis gives a positive result, a clarifying study is carried out for antibodies to a specific parasite. For this analysis, blood serum is taken.

Opisthorchiasis - symptoms. After the analysis for opisthorchiasis has been carried out, its result must be deciphered. If a person is healthy, he does not have antibodies to the pathogen. If infection occurs, they appear during the first 2 weeks. The longer the helminth remains in the body, the lower the antibody titer will be. If there is an obvious suspicion of opisthorchiasis, including on the basis of symptoms, a repeat blood test is prescribed.

Features of donating blood for opisthorchiasis are as follows:

the patient takes the test in the morning, always on an empty stomach;
Eating before the procedure is prohibited; only plain water is allowed to drink. It is necessary that at least 8 hours pass from the last meal to the time of blood donation;
You cannot eat smoked meats, fried and fatty foods, drink alcohol, or smoke;
Before the analysis, it is advisable to avoid medications as much as possible. If it is impossible to completely eliminate medications, you need to tell your doctor what medications you are taking and for how long;
you need to limit physical activity, avoid emotional tension and stress.

Diagnostics

Opisthorchiasis is diagnosed as follows:

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 poorly thermally processed carp fish.
The next stage is laboratory testing of blood, urine and feces.
Fibrogastroduodenoscopy is also performed.
A comprehensive diagnosis is required, which is carried out using 3 specific markers - IgM, IgG, CEC, which make it possible to accurately make a diagnosis.

Since the immune system is the first to react, it, in contact with opisthorchiasis antigens, begins the production of specific immunoglobulins of the M class (IgM). The maximum value of the synthesis of these substances occurs after half a month, and after two months the production of immunoglobulins of class G (IgG) begins.

These immunoglobulins reach their highest concentration after two or three months, and these indicators last for quite a long time. But, if the disease is not treated for 10 years, the level of specific antibodies drops below acceptable levels. Having identified this decrease, opisthorchiasis can be diagnosed. Such studies have not been carried out before, and only recently have scientists developed methods that make it possible to determine reduced levels of specific antibodies.

Opisthorchiasis - symptoms in adults

Opisthorchiasis - symptoms. The disease begins 5-42 days after infection. The average incubation period is 21 days. The acute onset of the disease predominates, less often - a gradual onset with the manifestation of malaise, weakness, sweating, and low-grade fever.

In the future, opisthorchiasis can occur subclinically, asymptomatically, accompanied by a short-term rise in temperature to 38 ° C, eosinophilia up to 15 - 20% against the background of moderate leukocytosis.

In severe cases of acute opisthorchiasis (10 - 20% of patients), typhus-like, hepatocholangitic, gastroenterocolitic variants and a variant with predominant damage to the respiratory tract in the form of asthmatic bronchitis and pneumonia are distinguished.

Opisthorchiasis - symptoms. Acute opisthorchiasis of moderate severity (40 - 50% of patients) is characterized by high fever with a gradual increase in temperature to 39 - 39.5 ° C, catarrhal symptoms of the upper respiratory tract. Eosinophilia reaches 25 - 60%, leukocytosis increases, ESR moderately increases to 20 - 40 mm/hour.

In patients with mild to moderate severity, after 1 - 2 weeks there is an improvement, a latent period of the disease, which later becomes chronic. In severe cases of acute opisthorchiasis (10 - 20% of patients), typhus-like, hepatocholangitic, gastroenterocolitic variants and a variant with predominant damage to the respiratory tract in the form of asthmatic bronchitis and pneumonia are distinguished.

The typhus-like variant, which most clearly reflects the allergic nature of the acute phase, is characterized by an acute onset, high fever with chills, lymphadenopathy, and skin rashes. Cardialgia, with diffuse changes in the myocardium on the ECG, and intoxication phenomena are often noted.

Opisthorchiasis - symptoms. From the first days of the disease, severe weakness, severe headaches, myalgia and arthralgia, dyspeptic symptoms, cough and other allergy symptoms are observed. Eosinophilia reaches 80 - 90% with leukocytosis up to 20 - 30 -109/l, increased ESR up to 30 - 40 mm/hour. Acute phenomena last 2 - 2.5 weeks.

The hepatocholangitic variant occurs with high fever, eosinophilia and symptoms of diffuse liver damage: jaundice, hepatosplenomegaly, functional disorders - increased bilirubin content in the blood serum in a direct reaction, increased protein levels due to a2 - y-globulins, changes in sediment samples (sulemic, thymol and etc).

The gastroenterocolitic variant manifests itself clinically in the form of catarrhal, erosive gastritis, enterocolitis, gastric and duodenal ulcers.

The most striking symptoms of the disease are pain in the epigastrium, right hypochondrium, loss of appetite, nausea, less often vomiting, and stool disturbances. Fibroscopy reveals erosive-hemorrhagic gastroduodenitis, sometimes ulcerative niches. Fever and intoxication are less pronounced, eosinophilia is up to 30 - 40%.

Opisthorchiasis - symptoms include abdominal pain syndrome: dull, aching, pressing pain, sometimes like hepatic colic. In more severe cases, the symptoms of hepatobiliary pathology are aggravated by manifestations of pancreatitis with impaired pancreatic function. Patients complain of girdle pain in the right and left hypochondrium and dyspeptic symptoms.

In one third of patients, the respiratory system is involved in the process in the form of inflammation of the upper respiratory tract, asthmatic bronchitis, pneumonia, and pleurisy. As a rule, astheno-vegetative syndrome occurs in the form of weakness, fatigue, irritability, and sleep disturbances.

In some cases, a protracted course of the acute stage is noted. The fever lasts for up to two months or more, signs of liver damage and pulmonary syndrome persist. As the manifestations of the acute stage subside, the patient’s condition improves, and the disease enters the chronic phase.

How can you get infected?

The Siberian fluke is characterized by a complex development cycle. Humans, as well as piscivorous mammals (cats, dogs and foxes) are its definitive hosts. They are parasitized by an adult worm that lays up to 4 thousand eggs daily.

The life cycle of the fluke begins in a fresh water body, where helminth eggs fall along with the feces of the final host. The eggs are swallowed by bitinidia mollusks, inside which tailed larvae (cercariae) develop. After 2 months, they leave the mollusk and penetrate into the muscles of fish of the carp family. A metacercaria is formed in them - a larva covered with a double protective shell. A person becomes ill in one single way - by eating fish infected with metacercariae. In the human stomach, the larva emerges from the membranes, penetrates the biliary system and begins laying eggs. The eggs are then hatched, released into the river, and the cycle repeats.

Attention! From the above it follows that opisthorchiasis is not transmitted from person to person.

Symptoms of opisthorchiasis in adults

Opisthorchiasis - symptoms. It is worth noting that abdominal pain does not have a clearly defined location. Liver damage leads to liver enlargement, icteric syndrome and gland dysfunction. In patients who have chronic opisthorchiasis, the following diseases can be diagnosed: cholelithiasis, hepatitis (threatening cirrhosis), gastritis, pancreatitis, cholecystitis, ulcers of the stomach and duodenum, enteritis.

With opisthorchiasis, the functioning of the immune system is disrupted, therefore both adults and young patients are more susceptible to infections of various natures than others, and in addition, there is a high probability of the appearance of neoplasms. Opisthorchiasis, “adjacent” to diabetes mellitus and pancreatitis, significantly complicates the course of chronic illnesses. Helminths also have an adverse effect on the course of pregnancy.

Opisthorchiasis - symptoms in the chronic stage are manifested by the following signs:

increased body temperature at 37-37.5˚C;
indigestion;
increased fatigue, insomnia, weakness, dizziness, tremors of the limbs;
allergic rashes in the form of urticaria. The face and skin in the joint area are affected. In addition, the skin cracks and the patient suffers from painful itching;
sudden weight loss (due to impaired absorption in the intestine);
problems in the cardiac system (pain, arrhythmia);
aching pain in joints and muscles.

Symptoms of the disease

After the fluke enters the body, it can take from 5 to 40 days; on average, the first symptom appears on the twenty-first day. But a person may not feel the onset of the disease, mistaking weakness and malaise as a consequence of work or overwork. The body then reacts by raising the temperature and sweating.

The main signs of opisthorchiasis in adults:

aching feeling in the joints,
temperature rise to 40 degrees,
discomfort on the right side of the hypochondrium,
upset stomach, vomiting,
skin rashes,
decreased appetite,
heartburn,
enlargement of the liver and biliary organs,
jaundice,
excessive gas formation,
hives.

Those who have been treating a cold may confuse the first symptoms with a banal acute respiratory viral infection or poisoning. This is a slight increase in body temperature that a person may not notice. It is variable in nature, appearing from time to time. There is a slight fever.

A pronounced clinical picture of opisthorchiasis is accompanied by damage to the respiratory system, cough, chills, inflammation of the lymph nodes, development of asthma, and pneumonia may appear . As a result of the penetration of parasites, their waste products can spread through the blood, to which the body reacts with an allergic reaction, a rash and itching. The nervous system also reacts:

irritability,
insomnia,
nervousness.

Symptoms of opisthorchiasis in women are additionally manifested by increased pain during menstruation and cycle disruption. Symptoms of opisthorchiasis in men do not have any distinctive features.

Symptoms in the chronic stage

Chronic opisthorchiasis appears during prolonged infection, when helminths with their suckers, spines, and other things have caused significant harm to the body. The symptoms pass and return with renewed vigor. By this time, the mucous membrane of the gallbladder is inflamed, the cells die. Problems appear in the intestines, gall bladder, and motor function of the stomach.

The mucous membrane of the gallbladder becomes scarred, as do the ducts. As a result, the ducts narrow and cease to perform their functions in full. In digestion, problems arise with the absorption of food, as a result of which a person quickly loses weight.

Most often, the chronic stage occurs in conjunction with cholecystitis (inflammation of the gallbladder wall), symptoms of hepatitis appear, in particular pain in the right hypochondrium.

Other symptoms of opisthorchiasis in adults:

Murphy's symptom, Kera - pain on palpation of the gallbladder during inspiration, as a sign of cholecystitis,
Ortner's symptom - pain when tapping the right costal arch, as a sign of chronic inflammation of the gallbladder,
severe diarrhea,
shaking hands, eyes (tremor),
active fever.

The addition of an additional infection or disease to opisthorchiasis is a common phenomenon in the chronic form. If you previously had problems with the stomach, intestines, liver or biliary organs, then in the chronic stage of opisthorchiasis they progress very quickly. At the first signs, you should urgently consult a doctor so that he can immediately diagnose and treat the infection.

Treatment regimen for opisthorchiasis in adults

Opisthorchiasis - symptoms. If the patient feels normal and, in the opinion of the doctor, does not need outpatient treatment, then therapy can be carried out at home. However, with a high temperature and poor health, the patient will require hospital treatment.

Treatment of opisthorchiasis infestation must be carried out necessarily, since infection with the liver fluke can cause serious consequences for the body and will require long-term treatment. When prescribing a treatment regimen, the specialist examines the obtained tests, takes into account the severity of the disease, and concomitant diseases. The individual characteristics of the body, the patient’s age and other factors must be taken into account. Therapy for opisthorchiasis is divided into three stages, each of which plays its own role in successful healing. Patients need to understand that they should not deviate from the prescribed treatment regimen, as there is a risk of ineffective treatment. How and with what to treat opisthorchiasis in adults is determined only by the attending physician, after the conclusion of such specialists as an infectious disease specialist, an allergist, a gastroenterologist and a hepatologist.

Preparatory stage of treatment of opisthorchiasis in adults

These measures are aimed at preparing the patient’s body for subsequent treatment, as well as eliminating inflammatory and other pathological processes caused by the disease. The first stage is preparatory and lasts from one to three weeks.

The preparatory stage includes:

a diet excluding fried, spicy and salty foods;
use of antihistamines;
taking sorbents; hepatoprotectors;
choleretic drugs;
digestive sorbents;
analgesic drugs; antibiotics.

Choleretic drugs that help stimulate liver function and bile excretion: Herbal preparations with minimal side effects: Holosas, Galstena, Flamin, Holaflux. Combined: Allohol, Cholenzym. Hydrocholeretics – help to “wash” stagnant bile from the bladder and ducts. Synthetic drugs: Cyclalone, Oxafenamide. Cholespasmolytics that weaken the tone of the bile ducts: Atropine sulfate, Theophylline. how and with what to treat opisthorchiasis in adults.

Stage: medicinal

The next phase of treatment can be carried out inpatiently or at home, depending on the severity of the disease. To destroy weakened parasites and restore the functioning of the body, the following anthelmintic drugs can be prescribed:

Biltricide - effectively copes with opisthorchiasis, and is prescribed to adults and children from 4 years of age. To understand how to get rid of opisthorchiasis quickly, you must adhere to the indicated dosage of the drug. The course of treatment does not exceed three days.
Ecorsol is a natural complex that can not only destroy parasites, but also protect the liver from toxins. The natural composition has no severe side effects and is well tolerated by patients. The course of treatment is 5-7 days.
Populin is a natural preparation containing beneficial acids and aspen bark. Prescribed for adults and children over 4 years of age. Duration of treatment – 7 days.
Nemozol is a broad-spectrum complex that can destroy not only opisthorchiasis, but also other parasites. The medication is toxic, so it should only be taken under the supervision of a physician. The duration of therapy is no more than three days.

Prescription of specific drugs that can fight opisthorchiasis

The second stage is a direct impact on the parasite, which is carried out using anthelmintics. It is important during this period to prevent an overdose of these drugs, since the massive death of larvae provokes a deterioration in the patient’s condition.

At the second stage, it is strictly forbidden to use traditional medicine, which is due to the increased load on the liver. Medicines prescribed against worms are quite toxic to the human body. For this reason, doctors recommend this stage of opisthorchiasis treatment be carried out in a hospital under the supervision of medical personnel.

Rehabilitation stage of treatment of opisthorchiasis in adults

The third stage involves the implementation of techniques aimed at restoring the body after a course of fairly strong drugs, as well as restoring the normal functioning of the gastrointestinal tract. The patient may also be offered physiotherapeutic methods to restore the functions of the liver, gallbladder and ducts.

Treatment of opisthorchiasis lasts quite a long time, but any of the stages cannot be neglected: all of them are extremely important for the elimination of parasites and consequences from life in the human body.

Opisthorchiasis - symptoms. For these purposes, the attending physician may prescribe:

choleretic drugs; vitamin complexes;
hepatoprotectors; enzyme and laxative drugs.

Treatment

First of all, you need to find out which doctor treats worms. Here you can contact a parasitologist; if not, then an infectious disease specialist. A therapist can also help and guide you. When treating opisthorchiasis, removing the parasites is not enough. It is necessary to take measures to eliminate any traces of flukes and their offspring, and to combat the consequences of harm caused to the body. Reviews from doctors say that this should only be done with medication; there will be no benefit from lemon infusion, aspen bark, or lemon seeds.

Treatment of opisthorchiasis in adults is prescribed at home. Initiation of treatment in a hospital is required in extreme advanced cases, with a severe course of the disease.

Unfortunately, the answer to the question “can opisthorchiasis be cured forever” is negative. Once contracted, the disease makes a person a potential carrier for life. The treatment regimen for opisthorchiasis in adults has three stages.

Sequence of treatment

The preparatory stage is aimed at eliminating symptoms and alleviating the patient’s condition. It can last from a week to three, depending on the degree of the disease, and includes the following activities and appointments:

diet is necessary to relieve damaged organs,
elimination of allergy reactions, prescribe antihistamines that relieve rash and itching (suprastin, tavegil, loratadine),
prescribing cholekinetics or choleretics to facilitate the excretion of bile,
broad-spectrum antibiotics are taken to treat inflammatory processes,
sorbents to cleanse the intestines (Polysorb),
liver protection products,
painkillers that relieve spasms (no-spa),
enzymes to improve the functioning of the gastrointestinal tract (Oraza, pancreatin).

The second stage takes about a week, it is aimed at eliminating the cause of the disease, namely the destruction of parasites inside the body. This usually requires observation, since the drugs can cause intoxication, so the patient is treated in a hospital. This could be Chloxyl, Praziquantel, Albendazole. Flukes are poisoned with toxic drugs, so you cannot self-medicate here.

The third stage of recovery can take six months, it is aimed at eliminating the consequences, normalizing the functioning of damaged organs and blood vessels, and is carried out not in a hospital, but on an outpatient basis:

means that enhance the excretion of bile, it is with it that dead creatures can come out,
choleretic herbal decoctions,
in some cases a laxative is required,
vitamin complexes,
continuation of taking enzyme preparations,
drugs that improve liver function.

Treatment of opisthorchiasis in adults using folk methods

Opisthorchiasis - symptoms. It is important to remember that traditional methods of therapy can both help the patient get rid of parasites and aggravate his condition. Therefore, before treating opisthorchiasis with unconventional methods, consultation and approval of a parasitologist is mandatory.

Treatment with folk remedies is possible only in the absence of contraindications from a doctor who treats opisthorchiasis in adults with symptoms and whose treatment does not contradict the use of traditional methods.

The following alternative medicines help with opisthorchiasis:

tar: birch tar is dissolved in purified water in the proportion of a drop per tablespoon. The drug is taken for five days, gradually increasing the dose by two drops per day. On the fifth day, the amount of tar in a tablespoon of water should be 10 drops. Five days should be enough to eliminate the parasites;
pumpkin seeds: this remedy is also effective against opisthorchiasis. To prepare the medicine, you need to grind a glass of pumpkin seeds, then mix the resulting mass with a glass of water, a spoonful of honey and two egg yolks. This mixture should be consumed in the morning on an empty stomach, and then a heating pad should be applied to the right side for several hours. This method allows you to gradually eliminate the worms, which will lead to a decrease in pain and fever. It is recommended to use this method for 10 days;
burdock: this remedy is used in the presence of symptoms of opisthorchiasis such as vomiting and fever, which are observed during the acute stage of the disease. Freshly picked leaves of the plant are ground in a blender or meat grinder, and then the juice is squeezed out. You can also use a juicer to make it. The product is taken in an amount of 30 ml 30 minutes before meals three times a day. The duration of treatment can be from 7 to 10 days until the disturbing symptoms go away.

Prevention of opisthorchiasis

Prevention of opisthorchiasis should be carried out comprehensively. You can only eat well-cooked, fried and salted fish. It is necessary to remember the cleanliness of cutting utensils, knives and boards, cut the fish into pieces no more than 5 cm thick for high-quality heat treatment. It is forbidden to try raw fish or minced meat or feed it to domestic animals. Veterinarians recommend regularly (once every six months) deworming courses for pets. It is important to follow the technology for preparing fish dishes.

Methods for eliminating parasites in fish:

freezing for 7-8 hours (at -40 degrees);
pickling in a salt solution for up to 40 days (depending on weight);
cook the fish (at least 20 minutes after boiling);
fry the fish (at least 20 minutes covered).

Complications and consequences of opisthorchiasis in adults

Since it is not always possible to immediately determine opisthorchiasis invasion, the disease becomes chronic and contributes to the development of a sluggish inflammatory process in the bile ducts. The danger lies in the fact that this, in turn, leads to the development of various kinds of pathologies.

Complications and consequences of opisthorchiasis:

peritonitis: (inflammation of the peritoneum);
liver abscess: (formation of an abscess in the liver);
liver failure: (inability of the liver to adequately cope with its functions);
chronic hepatitis: (liver inflammation);
Liver cirrhosis: (replacement of normal liver tissue with rough connective tissue);
acute destructive pancreatitis: (severe inflammation of the pancreas);
cholecystopancreatitis: (inflammation of the pancreas and gallbladder);
cancer: (malignant tumor) of the liver and pancreas.

Why is opisthorchiasis dangerous?

The cause of infection with this helminth is a small flatworm (cat or Siberian fluke), which parasitizes the ducts (bile and pancreas). Less commonly, it can be found in the tissues of the liver and gall bladder. Opisthorchiasis is dangerous, because once it enters the internal organs of a person, it reaches puberty within a month and begins reproduction (lays eggs), causing a painful condition. Helminths of this species are also called flukes.

Pathogenesis of the disease opisthorchiasis:

allergic reaction (poisoning by metabolic products of parasites);
mechanical impact (damage to organ tissue by suction cups and thorns, a large number of worms can block the ducts);
neuro-reflex problems (irritation of nerve endings on tissues, which leads to pathological impulses of organs);
the disease creates conditions for the occurrence and overlap of infections.

Signs of opisthorchiasis

The disease has two stages - acute and chronic. They occur in different ways, but the symptoms of infection of the human body have common features:

allergic reactions of the body;
aches throughout the body (especially in the muscles);
prolonged fever;
severe vomiting;
dizziness;
significantly enlarged liver and other organs;
heavy sweating.

If you do not pay attention to the signs, the person will begin to suffer from dizziness, become irritable, and have difficulty sleeping. Then the liver becomes denser, and nervous disorders appear. The patient's gallbladder is often greatly enlarged. The symptoms will disappear for a while, but the pathology will remain and become chronic.

Some people may experience severe skin rashes. Problems also occur with the respiratory tract, shortness of breath or severe coughing attacks for no reason - a reason to immediately go to the hospital and report your alarming suspicions to qualified specialists.

The signs manifest themselves especially clearly when a person is engaged in hard and tedious work. At other times, it is almost impossible to determine the disease on your own without a thorough three-fold laboratory analysis.

A blood test will help determine the danger only at the first stage of penetration of worms into the human body. It is important to remember that in some cases the disease can lead to severe consequences:

liver cirrhosis;
oncological diseases;
pancreatitis.

Treatment here will be almost useless, so if you have the slightest signs of opisthorchiasis, especially if they appeared after eating carp fish, you should seek medical help. You should definitely report any suspicions, only then will the diagnosis be most accurate. Immediate treatment in most cases guarantees a positive result.

External signs and laboratory diagnosis of the disease

Examination by a specialist

It is impossible to determine opisthorchiasis by external signs. However, with acute opisthorchiasis, the patient looks like he has a cold, he is worried about:

low-grade fever;
runny nose;
cough.

Allergic rashes, abdominal pain and enlarged lymph nodes may also occur.

With chronic opisthorchiasis, various diseases of internal organs can be observed: pancreatitis, gastritis, stomach ulcers, liver tumors and others. The patient looks tired. Complaints of fluctuations in body temperature, skin rash, abdominal pain, weight loss. So, the patient is worried about:

yellowish skin color;
swollen eyelids, sometimes with a small rash on them;
cracks in the tongue;
enlarged liver;
allergies;
stomach ache.

Suspecting a helminthic infestation, the doctor sends the patient to a parasitology laboratory for tests.

Analysis for opisthorchiasis

To identify opisthorchiasis, the following is carried out:

Complete blood count - shows a high content of eosinophils (indicates an allergic reaction) and leukocytes (indicates reduced immunity).
Blood chemistry. Direct and indirect bilirubin, liver transaminases, sublimate and thymol tests are increased. This means that the internal organs are affected.

In rare cases, the patient undergoes duodenal intubation to collect bile for analysis, however, this diagnostic method, in this case, is ineffective.

Blood for opisthorchiasis

To identify a parasitic disease, specific blood tests are used:

In acute opisthorchiasis, you can notice IgM antibodies - this is a protein that is produced by the immune system when foreign bodies enter the body. During the chronic phase, their levels first decrease and then disappear. In chronic opisthorchiasis, IgG is increased - this is a protein that signifies the response of the immune system.
Since this diagnostic method often gives false-positive and false-negative results, it is necessary to repeat the analysis after a month, if IgM is detected, and IgG - immediately.

The influence of Siberian flukes on various organs

The above list of syndromes that can cause chronic opisthorchiasis can only be understood by a person with a medical education or who is familiar with these pathologies from personal experience. For people who have not encountered them before, it is extremely important to consider each syndrome in detail. For convenience, all the symptoms of chronic opisthorchiasis are distributed according to the organ systems that suffer from it.

Hepatobiliary system

The hepatobiliary system suffers the main damage from the vital activity of Siberian flukes. Although the vast majority of people do not even know what it is, this medical term hides well-known organs: the liver, intrahepatic and extrahepatic bile ducts and the gallbladder.

When moving and fastening with the help of suction cups, the parasites damage the walls of the bile ducts. A fragment of the mucous membrane of the wall, drawn in by the suction cup of the helminth, becomes pinched, which provokes a cessation of blood circulation or even injury to the mucous membrane. In addition, the front part of the body of young flukes is equipped with cuticular spines, which cause additional damage.

In attempts to recover, the mucous membrane of the ducts grows unnaturally, which leads to a narrowing of their lumen and, consequently, a deterioration in the flow of bile. The current worsens even more with severe infestation (the presence of many helminths) or with old opisthorchiasis. It is hampered by both accumulations of the parasites themselves and lumps of epithelium exfoliated from the walls of the ducts.

Pathological changes in the bile ducts provoke stagnation of bile, which in turn serves as a favorable factor for the proliferation of intestinal bacteria. Sometimes infection from the intestines is brought literally on their surface by young helminths during re-infection. No matter how bacteria penetrate the bile ducts, it is their activity that leads to cholangitis (inflammation of the bile ducts) or even cholangiohepatitis (inflammation of both the bile ducts and the liver).

The most dangerous complication of opisthorchiasis and clonorchiasis is not hepatitis, but cancer of the liver and/or bile ducts caused by flukes. Malignant tumors develop due to proliferation (abnormal growth) of oval cells of the liver or epithelial cells of the bile ducts. The ability of these parasites to cause cancer led the International Agency for Research on Cancer to list Siberian flukes as a Category 1 carcinogen (i.e., those scientifically proven to be carcinogenic) in 1994. Squirrel flukes and Chinese flukes were added to the same category in 2012.

So, the complete list of symptoms of damage to the hepatobiliary system is as follows.

Biliary dyskinesia;

dull and sharp pain in the abdomen, starting after eating or physical activity and radiating to the right shoulder;
nausea and/or vomiting;
pain in the Choffard-Rivet area (in the figure below the list) and epigastric region;
bitterness in the mouth;
bad breath;
soreness in the gallbladder area;

Cholangiocholecystitis;

dull pain in the right hypochondrium that occurs after eating (especially fatty or fried food);
nausea;
bitter belching;
heartburn;

Cholangiohepatitis;

frequent pain in the liver area caused by physical activity in an inclined position or eating;
loss of appetite and, as a result, weight loss;
dyspepsia (early satiety, stomach fullness, bloating in the epigastric region);
slight yellowness of the palate, less often of the sclera;
enlarged and painful liver;
low-grade fever with periodic increases;

Cholangiocarcinoma;

liver dysfunction;
stomach ache;
weight loss;
increased body temperature;
changes in the color of urine and feces;

Hepatocellular carcinoma;

aching pain in the upper right quadrant of the abdomen;
jaundice;
fever;
weight loss;
liver enlargement;
liver failure;
intra-abdominal bleeding.

Gastrointestinal tract

Opisthorchis of both species does not live in the stomach or intestines, and the damage these helminths cause to the gastrointestinal tract is a direct consequence of dysfunction of the hepatobiliary system and pancreas (which is also colonized by flukes).

Statistics show that more than 90% of infected people experience gastrointestinal symptoms.

For example, the neuro-reflex factor is of great importance: although parasites irritate the nerve receptors of the biliary tract, the pain caused by chronic opisthorchiasis disrupts the motility and secretion of the intestines and stomach, leading to the development of dysbacteriosis. In addition, there is a disruption in the production of peptide hormones in the liver and pancreas: glucose-lowering insulin, thirst-inducing angiotensin, hunger-inducing ghrelin, regulating the secretion of other hormones somatostatin, etc.

Hormonal imbalance, in turn, leads to a variety of pathological conditions - from dehydration and malnutrition to diabetes.

Symptoms of gastrointestinal dysfunction in opisthorchiasis include:

Gastritis;

a feeling of heaviness or fullness in the epigastric region, especially bright after eating;
unpleasant taste in the mouth;
heartburn;
regurgitation;
nausea;
weakness;

Duodenitis;

nausea and/or vomiting;
weakness;
fever;
pain in the epigastric region (especially upon palpation);

Stomach ulcer;

pain in the epigastric region;
sour belching;
heartburn;
nausea and/or vomiting;
weight loss;

Duodenal ulcer;

pain just above the navel, radiating to the heart and shoulder blade;
nausea and/or vomiting;
heartburn;
belching;
bloating;
weight loss;
irritation and insomnia;

Pancreatopathy;

pain in the navel and left hypochondrium;
weak appetite;
unstable stool;
steatorrhea;
decreased levels of enzymes in urine and blood;
moderate enlargement of the pancreas;

Dyspepsia;

early saturation;
fullness of the stomach;
swelling in the epigastric region;

Intestinal dysbiosis;

feeling of discomfort in the abdomen;
diarrhea (diarrhea);
constipation;
flatulence;
bad breath;
unpleasant taste in the mouth;
allergic reactions;
weakened immunity;
weak appetite;
increased fatigue;
deterioration of the condition of nails, hair and bones.

The cardiovascular system

The mechanism of the effect of Siberian flukes on the cardiovascular system is not explained in the scientific literature, but the fact remains: 78% of infested people show signs of vegetative-vascular dystonia.

The main symptoms of damage to the cardiovascular system:

heartache;
cardiopalmus;
diffuse dystrophic changes in the myocardium;
migraine;
dizziness;
orthostatic collapse (dizziness and darkening of the eyes after a sudden change in body position);
low-grade fever;
feeling of heat in the face;
cold extremities;
hand tremors;
neurotic disorders;
panic attack;
respiratory disorders;
fainting;
chronic fatigue;
sleep disorders;
joint pain;
muscle pain;
swelling of tissues.

Nervous system

As is the case with the cardiovascular system, the mechanism of action of these liver flukes on the autonomic nervous system, as well as the brain and spinal cord, is not understood. The presence of this effect, however, is beyond doubt: for example, sympathoadrenal crises are recorded in 7–9% of patients with opisthorchiasis, vagoinsular crises in 3–5%, and tongue tremor in 90%.

Symptoms of opisthorchiasis damage to the nervous system:

Sympatho-adrenal crisis;

lack of air;
noise in ears;
temporary visual impairment;
chills;
"goose pimples";
tremor of eyelids, lips and hands;
slight increase in blood pressure;
slight increase in body temperature;
heartache;
cardiopalmus;
feeling of anxiety;

Vagoinsular crisis;

nausea;
stomach ache;
flatulence;
increased intestinal motility;
decreased daily urination;
increased pain sensitivity throughout the body;
cold and damp palms;
severe drooling;
hunger;
weakness;
pallor (less often - redness) of the face;
decrease in blood pressure;
bradycardia;
weakening of tendon reflexes;
pseudoparalysis or involuntary movements in the limbs;

Tremor of the tongue.

Allergic reactions

Allergic reactions do not, as is commonly believed, affect exclusively the skin. Allergy is a systemic disease of various organs, therefore, unlike the previous sections of the article, allergic manifestations of opisthorchiasis will be discussed below, regardless of the organ affected by them.

The development of allergies itself does not occur due to the destructive effects of Siberian/squirrel flukes on the bile ducts, but due to the reaction of the immune system to the antigens (proteins or polysaccharides) of these parasites. It is interesting that most cases of allergies due to helminth infections are caused by an inadequate and senseless immune response to completely harmless antigens, and not at all to dangerous toxins.

Opisthorchiasis can cause the following allergic manifestations:

allergic dermatitis;
hives;
eczema;
psoriasis;
arthralgia (allergic joint pain);
bronchial asthma;
itching on the body;
food allergies;
Quincke's edema.

Recovery stage

After previous treatment methods, a study is carried out, and doctors evaluate the result. Next, the patient must adhere to a diet for 6 months. The patient should also undergo tubing using mineral water. They are performed 3 times for 7 days for 1.5 months. After this, their number is reduced to 1 time per week. Tubages still need to be made for about 3-6 months.

To correct dysbiosis, probiotics are taken.

Important! All drugs for opisthorchiasis do not help get rid of complications. Therefore, if they develop during the period of illness, it is necessary to undergo additional treatment. It takes a long time for the body to fully recover.

Prevention

Undoubtedly, prevention will help reduce the risk of disease and especially complications, often very serious.

It consists of a few simple steps related to hygiene and eating raw foods.

Never use a common cutting board for prepared foods or those that need to be cooked. The first particles containing parasites will inevitably lead to illness.
Process food before eating it - this applies not only to fish, but also to meat, because... Some mammals may also be the definitive host. Heat treatment is the most reliable; smoking and salting can reduce the risk, but not completely.
Heat treatment can involve either heat or cold. The most profitable option is to freeze food for 7 hours at -40 ºC.
Do not drink raw, unboiled water. Parasites are often found there, and not only in natural bodies of water - in wells as well. You need to boil the water for at least 10 minutes to be sure to get rid of the larvae.
Frequent hand washing is a sure way to get rid of parasites acquired through contact with an infected person.
After swimming in bodies of water, thoroughly cleanse your body and do not eat food without washing your hands. This applies specifically to freshwater, because... This parasite is not found in the sea in its pure form.

Prevention can also mean strengthening the immune system, because a person is able to cope with the disease in rare cases and without the help of a doctor (only in the initial stages).

The use of vitamins and other ways to increase it will help not only cope with the disease in the case of a small number of parasites that have entered the body, but also then make it easier to endure the course of the disease.

If you follow these rules of prevention, there is a huge chance of forever protecting yourself from infection with opisthorchiasis, the consequences of which no one wants to experience.

Diet during treatment

Table No. 5 according to Pevzner is an important condition for the effectiveness of antiparasitic therapy; it ensures restoration of the functions of a weakened organism. Sweets, fatty, spicy, fried foods are excluded from the diet. To improve intestinal motor functions and bile discharge at the end of the treatment course, gradually include foods high in fiber, including:

plums;
pears;
blueberry;
peaches;
bananas;
apricots;
apples.

It is recommended to increase the amount of water you drink, consume vegetables, cereals, cottage cheese, boiled or baked meat.

Specific treatment

Doctors often prescribe Praziquantel. This is an effective anti-helminthic drug that is used to treat opisthorchiasis. It is necessary to adhere to a certain pattern of drug use. A couple of hours will pass from the moment of taking the drug, after which the helminths will be discharged.

Important! The pattern of drug use is related to the patient’s body weight. This is how the dosage is calculated, which is divided into 3 doses per day.

To facilitate the removal of parasites from the body, probing with mineral water is used. This procedure is prescribed after a person has completed the course of taking the medicine.

When taking the drug, intoxication may increase. In this case, it is necessary to use antihistamines, sorbents, and carry out internal injections. Any medications for opisthorchiasis should be taken only after approval by the doctor.

Disease in animals

In carnivorous predators, infection occurs when eating fish infested with metacercariae. After an incubation period lasting from 5 to 21 days, the animals’ temperature rises, general weakness appears, and eosinophilia occurs. In severe cases of the disease, animals may experience fever, jaundice, and hepatosplenomegaly. The liver becomes lumpy to the touch. Vomiting, diarrhea, constipation, hair loss, and ascites may also occur. After some time, the animal’s condition improves, the disease passes from the acute stage to the chronic stage and is manifested by biliary dyskinesia, chronic cholangiocholecystitis, and chronic pancreatitis[28].

Metabolic products of opisthorchis can sensitize the host's body with the subsequent development of allergies.[29]

The diagnosis is made based on the detection of opisthorchid eggs in feces. Praziquantel is used for treatment. Hexachloroparaxylene, hexichol and polytreme can be classified as obsolete drugs[28].

Since domestic animals (cats, dogs) play an important role in the spread of the disease, for the purpose of prevention in foci of opisthorchiasis it is necessary to feed them only thoroughly cooked fish[9].

It has been established that animals and humans can be carriers of the parasite for several years and release helminth eggs into the environment with feces. Therefore, accurate and timely diagnosis, identification of carriers, adequate high-quality treatment of patients, as well as protection and disinfection of water bodies are important preventive measures against opisthorchiasis. However, the main importance in preventing infection with opisthorchiasis is the exclusion of raw, insufficiently salted or insufficiently heat-treated fish from the diet. In farms, nurseries, clubs located in areas unfavorable for opisthorchiasis, measures are taken to prevent infection of animals: sanitary-epidemiological, treatment-and-prophylactic and sanitary-educational work. Fish from reservoirs unfavorable for opisthorchiasis is fed to animals only in pieces weighing no more than 100 g, boiled for 30 minutes after boiling water or frozen at a temperature of −10 ºС for four weeks, at −20 ºС - 72 hours, −28 ºС - 32, − 35 ºС - 14, −40 ºС - 7 hours. When salting fish, the temperature of the brine should be 16-20 °C, and the fish should be in it for at least 14 days. To salt 10 kg of fish, you should use 2.7-2.9 kg of table salt. These measures should be observed especially carefully in Western Siberia in the basin of the Ob, Irtysh rivers and their tributaries. In these areas, it is necessary to completely exclude non-neutralized freshwater fish from the diet of carnivores. Preventive deworming of adult foxes and arctic foxes is carried out 1 month before the rut and after the litter is deposited, puppies - from 3 months of age; therapeutic deworming - if indicated. Pregnant females are dewormed no later than 1 month before whelping. Starting from the age of one month, carnivores are accustomed to specially prepared ready-made rations for small animals (dry, wet), and adult animals should also be transferred to ready-made rations. It is necessary to organize the disposal of carnivore carcasses, periodically conduct diagnostic studies of fur-bearing animals, dogs, cats and, if necessary, deworm them.[30]

Diagnosis of the disease

Symptoms that appear with opisthorchiasis may signal another disease. Therefore, before treatment, it is recommended to carry out the correct diagnosis in order to clarify the diagnosis.

Important! When visiting a doctor, it is worth telling about the consumption of river fish if the patient has eaten it recently. This is an important fact that can prompt a doctor to diagnose opisthorchiasis.

After examining the patient, the doctor begins diagnostics. It can consist of the following methods:

General blood analysis. The level of red blood cells, hemoglobin and other factors that may indicate the presence of the disease are examined.
Blood chemistry. The increase in ALT, AST, bilirubin is studied;
Fecal analysis. It can show the presence of parasite eggs and symptoms that confirm a malfunction of the pancreas.

Other studies are also carried out, but the tests cannot always accurately determine the exact diagnosis. For this reason, doctors resort to other methods. They take x-rays of the chest and abdomen. Ultrasound examination, MRI, CT are also performed. After this, the doctor will be able to accurately confirm or refute the development of opisthorchiasis. If the patient is found to have this disease, it is worth starting treatment.

Symptoms

Opisthorchiasis manifests itself differently in different people, sometimes a person may not even suspect that he is infected. Common symptoms look like this:

deterioration of general condition, characterized by weakness, increased fatigue, poor health;
an allergic reaction to substances secreted by opisthorchiasis, often manifests itself on the face in the “T zone”;
fever;
increased sweating;
inflammatory processes in the upper respiratory tract;
diarrhea;
vomit;
flatulence;
stomach pain;
lack of appetite[20].

Note: Sometimes there may be no symptoms at all. A person may not suspect the presence of opisthorchiasis for months or even several years without experiencing any discomfort. Typically, an allergic reaction in the form of dermatitis can be a sign that a person has parasitosis.

Pathogenesis - what happens in the body

In the human body, opisthorchids cause mechanical damage due to suction cups, which fix them on the walls of the bile ducts, disrupt blood circulation, and sometimes the integrity of the mucous membranes.

A large number of parasites can accumulate in the bile ducts and provoke stagnation of bile, which is a favorable factor for the development of purulent infections (purulent cholangitis).

The waste products of helminths can cause intoxication of the human body or the development of allergic reactions. A carcinogenic effect has also been proven: untimely treatment can provoke the development of cholangiocarcinoma associated with a mutation of bile duct epithelial cells.

After 1/3 of a month, the pathogen becomes a fully adult individual capable of laying eggs. The lifespan of helminths is about 25 years.

Spreading

The mollusk is the first intermediate host of Opisthorchis
Opisthorchiasis, caused by the trematode Opisthorchis viverrini

(English) Russian, distributed in Southeast Asia in countries such as Thailand, Laos, Vietnam and Cambodia[7]. Rare cases of the disease associated with the importation of contaminated fish have been reported in Europe and North America[8].

Opisthorchiasis caused by the trematode Opisthorchis felineus

, distributed throughout Russia, Ukraine, and Kazakhstan. Its foci are confined to the river basins: Ob, Irtysh, Ural, Volga, Kama, Don, Dnieper, Northern Dvina[9], Biryusa[10]. The maximum level of affected population is recorded in the middle and lower reaches of the Ob and Irtysh[9].

In the structure of biohelminthiasis (see helminthiasis) on the territory of the Russian Federation, opisthorchiasis accounts for 74.4% of the incidence. The most disadvantaged are the Khanty-Mansi and Yamalo-Nenets Autonomous Okrugs, Tyumen, Tomsk, Omsk, Novosibirsk regions, and the Altai Republic. In 2010, 33,657 cases of opisthorchiasis were registered among the adult population, and 4,571 cases among children under 17 years of age[11].

In Western Siberia, a significant part of trematodes is caused by a mixed invasion of Opisthorchis felineus

and metorchis (
Metorchis bilis") [12].
In 2019, the disease was discovered in the Shatura district of the Moscow region.[13]

The influx of labor migrants has worsened the sanitary and hygienic situation in the Russian Federation, including the incidence of opisthorchiasis.

Notes

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Ilyinskikh E. N. “Current issues in studying the problem of opisthorchiasis in Siberia” // “Bulletin of Siberian Medicine”. - 2002. - Issue. 1. - pp. 63-70
Bocharova T. A. “The causative agent of opisthorchiasis and other muscle parasites of carp fish of the lower Tom basin” / Tomsk: Tomsk State University Publishing House, 2007. - 66 p.
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V. V. Podyapolskaya, V. F. Kapustin. "Human helminthic diseases." — M.: “Medgiz”. 1958. - 663 p.
Beer S. A. “Biology of the causative agent of opisthorchiasis.” - M.: “Association of Scientific Publications KMK”, 2005. 336 p.
Young ND, Campbell BE, Hall RS, Jex AR, Cantacessi C, et al. (2010) Unlocking the Transcriptomes of Two Carcinogenic Parasites, Clonorchis sinensis and Opisthorchis viverrini. PLoS Negl Trop Dis 4(6): e719. doi:10.1371/journal.pntd.0000719
King S, Scholz T. Trematodes of the family Opisthorchiidae: a minireview // The Korean journal of parasitology. - 2001. - Vol. 39. - No. 3. - P. 209-221
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SanPin 3.2.569-96 “Prevention of parasitic diseases on the territory of the Russian Federation” (approved by Resolution of the State Committee for Sanitary and Epidemiological Supervision of Russia dated October 31, 1996 No. 43)
(unspecified)
(inaccessible link). Retrieved July 19, 2012. Archived December 25, 2012.
Rusinek O. T., Kondratistov Yu. L. Study of infestation of trematode metacercariae in the focus of opisthorchiasis (Taishetsky district, Irkutsk region, Russia) // News of Irkutsk State University. Earth Science Series. - 2010. - T.3 - No. 1. - P. 132-142
On the sanitary and epidemiological situation in the Russian Federation in 2010: State report. M.: Federal Center for Hygiene and Epidemiology of Rospotrebnadzor, 2011. - 431 p.
Ilinskikh et al, 2007.
Residents of the Moscow region suffered from fish infected with opisthorchiasis / Moskovsky Komsomolets. February 24, 2019.
↑ 12
Vasilkov G.V. Parasitic diseases of fish and sanitary assessment of fish products. - M.: Publishing house VNIRO, 1999. - 191 p.
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Ichthyopathy / N. A. Golovina, Yu. A. Strelkov, P. P. Golovin, etc. - M.: Mir, 2007. - 448 p.
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Vozianova Zh. I. Infectious and parasitic diseases. T.1. Kyiv: Health, 2001. 904 p.
Chemich N. D., Ilyina, N. I., Zakhlebaeva V. V. et al. Opisthorchiasis in Ukraine: epidemiological and clinical features // Journal of Infectology - 2011. - T. 2, no. 2. - pp. 56-62
Martynova N. A., Odintsova I. N. Liver cancer in the region of Siberia and the Far East // Siberian Journal of Oncology - 2003. - Issue. 2. - pp. 77-78.
IARC Monographs - Classifications - Group1
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↑ 1 2 Bronshtein A. M., Luchshev V. I.
Liver trematodes: opisthorchiasis, clonorchiasis // Russian Medical Journal. - 1998. - T. 6, issue. 3. Archived November 10, 2012.
↑ 1 2 Edited by Eli Schwartz.
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Lippincott's Guide to Infectious Disease. - Lippincott William & Wilkins, 2011. - P. 222-223. — ISBN 978-1-60547-975-0.
K. Darwin Murrell, Bernard Fried.
Chapter 1. Liver Flukes // Food-Borne Parasitic Zoonoses. - Springer Science + Business Media, LLC, 2007. - P. 34-37. — ISBN 978-0-387-71357-1.
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Pustovalova V. Ya., Stepanova T. F., Shonin A. L. Opisthorchiasis Tyumen: Publishing House TGMA, 1999. 10 p.
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How does infection occur?

Initially, worm eggs with animal excrement end up in a pond, river or lake, and only then the fish swallows them along with food. As soon as the parasites find themselves in human organs, they begin to multiply rapidly, gradually affecting the internal organs, and only after a few months signs of opisthorchiasis appear. Snails can be an intermediate carrier. Men who are fond of fishing or live in close proximity to bodies of water are at risk. Almost all fishermen eat dried, lightly salted and raw fish, which significantly increases the chances of contracting opisthorchiasis and resulting in cirrhosis or even liver cancer.

If a woman is infected, the first signs may appear during menstruation (they become painful), and the cycle may also be disrupted. During pregnancy, the fetus can suffer from opisthorchiasis and be born with congenital pathologies of internal organs.

Inhabitants of water bodies become infected with helminth larvae for a number of reasons:

pollution of water bodies, lack of cleaning, poor condition of the water in them;
the influence of external factors (climatic or natural) on the state of water;
consumption of fish by humans or animals without the necessary heat treatment.

First stage

Initially, it is necessary to begin to fight allergies, inflammation, and also normalize the functioning of the biliary system. The patient must follow a certain diet at this stage of treatment. Doctors prescribe anti-allergy medications, for example, Loratadine, Cetirizine. The patient is also prescribed antispasmodics, for example, Mebeverine or Drotaverine. If bile stagnates, then ursodeoxycholic acid is prescribed.

Chronic opisthorchiasis

If the first signs of opisthorchiasis are left unattended, complications will begin in the form of various pathologies of internal organs, and the disease may become chronic. This is due to the protective functions of the body, which begin to fight toxins and the symptoms become less pronounced. Often, doctors do not recognize the damage to the body by helminths and diagnose stomach diseases.

In the chronic form, additional signs may be present, which together should alert you:

frequent headaches;
tremor of hands and feet;
heart pain;
depression or constant irritation;
nervous tic of the eyelid.

During ultrasound diagnostics, exhausted adrenal glands and myocardial dystrophy are clearly visible.

Treatment of the disease

If no complications of the disease were found, then treatment at home is allowed. To get rid of opisthorchiasis, it is necessary to carry out complex therapy. This means that the patient should take the pills prescribed by the doctor and stick to a diet. You can also use traditional methods of combating the disease.

Treatment of the disease consists of several stages:

elementary;
specific;
restorative.

Each stage has its own characteristics.