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Ask Dr. D. Love Your Own Question

Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 17651
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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Im from Birmingham,England and have been working in Saudi

Customer Question

Hi Im from Birmingham,England and have been working in Saudi for 4 months now. I am suffering from roundworms. I have seen them in my stools more then twice now. today was the latest. this has been a ongoing issue since the start of september. I have taken albendazole twice ( the first really seemed to clear me up alot) however the second time there wasn't much difference. I knew something still wasn't correct due to the way my body is feeling and my bloated stomach ( I usually carry very little fat on my body and my stomach is completely flat) I have been feeling tired and itchy all over. I have been changing my bedsheets every day since September and have been showering and changing my clothes as much as possible. Yesterday I went to the local pharmacy here in riyad and them advised me to buy NEGAZOLE (metronidazole) and fennel peppermint capsules for the bloating. This seems to have already started working as I clearly saw worms in my stools today. I would like to know what else can I do to cure myself and what foods to eat. unfortunatly I am a smoker and I am trying to quit or atleast cut down. my health is extremely important to me as im 28 years old single male and hope to eventually go back to the Birmingham and get married (without having to tell my girlfriend there is a 3rd party in the relationship.) please please please help me. Thank You very much in advance. You are all the real superhero's. M Saleem
Submitted: 3 months ago.
Category: Medical
Customer: replied 3 months ago.
I would also like to mention i forced my self to go to the gym yesterday and trained my back ( I used to gym all the time however haven't since the start of September) I weigh around 175 pounds and am 6 ft in height. Slim/ athletic build. I felt a lump yesterday on my back, felt like a really big spot which is what scared me and I went to the pharmacy. I believe from my own research that I have a form of roundworm even though im not sure with type. they are white in colour. The very 1st worm stool I saw contained some blood around the head/foot of the worm. not much but i thought I would ad it in for clarity.
Expert:  Dr. D. Love replied 3 months ago.

Hello from JustAnswer. This is Dr. Love and I will be glad to assist you with your questions today.

The albendazole is one of the usual first-line medicines for treatment of a roundworm infection and it is usually very effective. However, no medicine works 100% of the time. When the albendazole has not been effective, then there are a few options. There is a similar medicine, mebendazole. However, if the albendazole has had little effect on the second treatment, I would prefer to use a medicine in a different chemical class, such as ivermectin or pyrantel pamoate. I am not able to determine which of these medicines are readily available in Saudi, but you can ask at the local Pharmacy. If all of them are available, then I would prefer the pyrantel pamoate as the next step.

The diet that is recommended to prevent roundworm infection is to assure a reliable water source, and if uncertain to primarily drink bottled water. Fresh fruits and vegetables also may be an issue, since they also may have contacted unreliable water, so limiting food intake to cooked and hot food would be safer.

If I can provide any additional information, please let me know.

Customer: replied 3 months ago.
I only drink bottled water and have done so since I have been in Saudi. when you say how food doctor, the main source of food here is fast food Mcdonalds, kfc etc.. which I know is a disaster. I have ate subway a few times ( however that contains fresh salad) Im not sure what to eat ? and will the metronidazole continue killing the worms? what are the worms life span?
Expert:  Dr. D. Love replied 3 months ago.

It would be better to avoid any uncooked vegetables, even tomatoes, lettuce, or onions at fast food restaurants.

The metronidazole may help, but the other medicines that I noted above are better at treating a roundworm infection.

The life cycle is 2-3 months from initial infestation to becoming adult worms. The life span of an adult worm without treatment is about 1-2 years.

Customer: replied 3 months ago.
How can I know how many worms are inside me? can they kill me? Is the drug you suggested pyrantel pamonate safe for humans, Ive had a look online and its suggested use is for domesticated animals? can I eat bread? Ive also got very dry skin. Is round worm curable even after re-infection? how will I know when im clear?
Expert:  Dr. D. Love replied 3 months ago.

It is impossible to know how many worms are inside you. Even if diagnostic tests are done to prove that roundworms are present, the test would not say how many are present, only whether some are present or not.

Yes, the pyrantel pamoate is safe for humans.

Yes, it would be OK to eat bread.

Yes, roundworm is curable, even in someone that has been re-infected multiple times.

The only way to know that you are clear would be to perform stool tests to look for worms or eggs (the medical term for the test is a stool test for ova and parasites, and is abbreviated O&P).

Customer: replied 3 months ago.
I was in Birmingham on the 10th of this month and had a O&P done, My personal Dr then called me to inform me everything was normal and wrote NA on the stool samples. however today Ive seen worms, is there any other way apart from a O&P to clarify. Also I would like to know if I pay in Saudi is there any operation to completely remove the round worms?
Expert:  Dr. D. Love replied 3 months ago.

Imaging tests may show worms, but will typically only detect large amounts of worms and is very inaccurate at detecting low level infections. When someone has a low level infection, it may require an O&P on three days to detect the worms.

There is a surgery that can remove significant clumps of worms. However, it is typically only done when there is a clump of worms that is causing an obstruction of the gut. Surgery is typically not effective at removing every worm that is causing an infection.

Customer: replied 3 months ago.
once I give a rating can I still ask further questions?
Expert:  Dr. D. Love replied 3 months ago.

Yes, even after giving a rating, you can ask additional follow-up questions.

Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 17651
Experience: Family Physician for 10 years; Hospital Medical Director for 10 years.
Dr. D. Love and 4 other Medical Specialists are ready to help you
Customer: replied 2 months ago.
Good afternoon Dr Love
I have been to the Pharmacy and they don't have Pyrantel Pamoate. I believe I have Ascariasis ( from my own research), I have been having more diarrhea since our last conversation and I'm not sure if this is a good thing or a bad thing. I have become unsure of what to eat to prevent reinfection, should I not eat potato/chips/crisps? Is it good to go to gym while I still have this problem? is it safe to take protein shakes? I have taken a course of mebendazole which is available from the pharmacy. Im still feeling bloated and slept almost 14 hours yesterday, usually I sleep around 5-7 hours. I have been boiling eggs and eating them. and having peppermint tea. my skin still is dry ( especially around my backside). Is there anything I else I can do to weaken the infection or cure myself ?
Expert:  Dr. D. Love replied 2 months ago.

If they do not have pyrantel pamoate, then the othe rmedicine to consider would be the ivermectin that I noted above. The mebendazole is a fine drug, but is chemically similar to the albendazole, so when the albendazole has not worked, I usually try a drug in a different chemical class, which is why I mentioned the pyrantel pamoate and ivermectin.

The only dietary intervention is what I noted above. Within that recommendation, potatoes that are cooked are fine, including chips and crisps. Protein shakes would only be a problem if they had any water or ice added tot he shake of dubious origin. It does not work to alter the diet to try to weaken the infection. If you deprive the worms of nutrients, then you also deprive yourself of nutrients. And if you deprive yourself of nutrients, then your immune system weakens, and you need a good immune system to get rid of works, even when taking medicines.

It will not promote or hurt the worms to go to the gym. The only issue with going to the gym is whether your energy level would support it.

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