What are the symptoms of intestinal helminthiasis (worms) in stool?

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From the Guidelines

Symptoms of worms in your poop include visible worms or worm segments in stool, abdominal pain, diarrhea, nausea, unexplained weight loss, and fatigue, and the most common symptom is pruritus ani, especially with threadworms. These symptoms can vary depending on the type of worm infection, with some infections being asymptomatic [ 1 ]. Some key points to consider are:

  • Visible worms or worm segments in stool, which may appear as small white or cream-colored threads (pinworms), flat white segments (tapeworms), or thin spaghetti-like strands (roundworms) [ 1 ]
  • Itching around the anus (especially at night with pinworms) [ 1 ]
  • Abdominal pain, diarrhea, nausea, unexplained weight loss, and fatigue [ 1 ]
  • Pruritus ani, especially with threadworms [ 1 ] If you notice these symptoms, consult a healthcare provider who will likely request a stool sample for testing [ 1 ].

Treatment and Prevention

Treatment typically involves antiparasitic medications such as albendazole, mebendazole, or ivermectin, with specific dosing depending on the type of worm identified [ 1 ]. Some examples of treatment regimens include:

  • Albendazole PO 400 mg as a single dose for ascariasis [ 1 ]
  • Albendazole PO 400 mg twice daily for 21 days for threadworms [ 1 ]
  • Albendazole PO 400 mg daily for 3 days for hookworm [ 1 ] For household prevention and to avoid reinfection, practice good hygiene including thorough handwashing, proper food preparation, and washing bedding and underwear in hot water [ 1 ]. Family members may need treatment simultaneously as intestinal worms can spread easily within households [ 1 ].

From the Research

Symptoms of Worms in Stool

The presence of worms in stool can be indicative of an intestinal parasite infection. According to 2, some common symptoms of intestinal parasite infections include:

  • Nausea and vomiting
  • Diarrhea
  • Weight loss
  • Malabsorption
  • Irritation and sleep disturbances (specific to Enterobius vermicularis or pinworm infection)
  • Blood loss, anemia, pica, and wasting (specific to hookworm infections caused by Ancylostoma duodenale and Necator americanus)
  • Intestinal ulcerations, bloody diarrhea, fever, gastrointestinal obstruction, and peritonitis (specific to Entamoeba histolytica infection)

Diagnostic Methods

Diagnosis of intestinal parasite infections can be made using various methods, including:

  • Stool ova and parasite studies
  • The "cellophane tape test" (specific to Enterobius vermicularis or pinworm infection)
  • Finding eggs in the feces (specific to hookworm infections)
  • Stool and serologic assays, biopsy, barium studies, and liver imaging (specific to Entamoeba histolytica infection)

Treatment and Prevention

Treatment of intestinal parasite infections depends on the type of parasite and may include:

  • Mebendazole and household sanitation (for Enterobius vermicularis or pinworm infection)
  • Metronidazole (for Giardia infection)
  • Albendazole, mebendazole, pyrantel pamoate, iron supplementation, and blood transfusion (for hookworm infections)
  • Luminal and tissue amebicides, metronidazole, chloroquine, and aspiration (for Entamoeba histolytica infection) Preventive measures include proper handwashing, consumption of bottled water, wearing shoes, and treating sewage 2.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Common intestinal parasites.

American family physician, 2004

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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