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Feeling of worms in rectum even after ALBENDAZOLE, MEBENDAZOLE.

Resolved Question:

I would love to hear from a parasite specialist or at least someone with a great deal of experience in parasite diagnosis/treatment.

For about 10 years old patientnow I have felt the sensation of large worms moving inside my rectum that is on and off. They feel much larger than pin worms and are much more active during the night.

Occasionally I see tape like mucus in my stool and sometimes I pass a long stringy tube like mucus stool – usually after eating pumpkin seeds (pumpkin seeds seem to alleviate the symptoms sometimes) .

I have gone to many doctors in several different countries and all have done several stool tests, blood tests – all came back clean and all the doctors said no problems.

However, I am 100% certain there is something moving in my intestines and rectum . I am still feeling them to this day. I have taken pyrantel pamoate and mebendazole and albendazoole to no avail.Some of the medicines ( especially albendazole) work for a day or two and then the symptoms comes back with a vengeance.

I have done two colonoscopies and even one endoscopy – and apart from removal of small polyps – the doctors said everything was fine .

Category: Gastroenterologist, Medical

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Category: Hepatologist
Dr. Ratnakar Kini is online now

Expert:  Dr. Ratnakar Kini replied 4 Days.

Thanks for posting your query at DoctorSpring.com
I am Dr.R.K and I am pleased to assist you.
I would like to know some more information before I can given my opinion.
1. Do you get that sensation in the anal region?
2. Did you see any worm at least once during these 10 years?
3. Does it get worsened during night time?
Get back to me with these information and I would give my opinion.

Patient replied :

Here are the answers to your questions :
1. Do you get that sensation in the anal region?

  • Yes , I get the sensation in the rectum and anal region . Especially at night.It feels like movements and pin sensation like something burrowing or attaching itself to the walls of the rectum.

2. Did you see any worm at least once during these 10 years?
  • Yes , I’ve seen things that I looked like worms . They were string like and white but . Mostly I see transparent film like things – sometimes tape like and sometimes like small round things.

3. Does it get worsened during night time?
  • Absolutely. If I go to bed at 11pm it usually starts around 2/3am. It begins with the sensation I described above then it’s like it moves closer to the anus. Around 30 minutes after this I feel many mites like things moving from the anus to all over my skin – so I get very intense itching because it’s like these micro mites are trying to burrow into the skin. I don’t get much sleep therefore.
  • In the morning , I feel very tired and have severe stiffness on my shoulders – especially the right shoulder . My shoulders look under developed and emaciated. One of the tests I had said about three years old patientago said that my liver was swollen .
  • I do get the symptoms during the day too . Around 1 or 2 hours after the bowels have been evacuated – the sensation of something moving towards the anus restarts again .

Expert:  Dr. Ratnakar Kini replied 3 Days.

Thanks for providing the additional information.

You are having Pruritus Ani. There are many different causes for Pruritus Ani and not just parasitic infestation alone.

You have been examined by multiple doctors and all the tests have been done. Moreover the anti-helminth medications you have taken did not provide any sustained relief.
All these just confirm that the symptoms you have is not due to parasitic infestation and are due to some other cause.
You probably have Idiopathic Pruritus Ani where no underlying cause could be found.
However, make sure the following are done -
1. Look for lesions around the anal opening.
2. Check your blood glucose levels.
3. Avoid coffee, cola, chocolate, milk, beer. The most common culprit is coffee.
4. Avoid rubbing the anal area. Wipe it gently with wet facial/soft tissue.
5. Avoid soap in that area.

These steps will provide relief.

Let me know if I can assist you further.


Patient replied :

Thank you.
Apart from the steps you have outlined above - what medications would effecively treat this condition ?

Expert:  Dr. Ratnakar Kini replied 2 Days.

Thank you for the follow up.

Since all the tests are normal, an antidepressant medication would provide very good relief.
You need to get a psychiatric opinion for that.

Dr. Ratnakar Kini
Category: Hepatologist
Fellowship - DM - TN Dr.MGR Medical UniversityResidency - TN Dr.MGR Medical University Medical School - Stanely Medical College, TN Dr.MGR Medical University
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