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