The defeat of the human body by the hepatic trematode from the genus of opisthorchus provokes the development of serious complications, up to the cancer of the liver and pancreas. The untimely detection of opisthorchiasis, which causes parasitic worms, leads to a weakening of the body's defenses and the development of diseases of almost all organs and especially of the liver and pancreas.
Diagnosis of opisthorchiasis in adults is complicated by the fact that the symptoms of infection are similar in their manifestations to those that cause other helminths. In addition, helminthic invasion provokes an increase in existing chronic diseases, and complications are manifested in the form of diseases of the digestive tract, bronchopulmonary system, central nervous system and autonomic nervous system, eyes, and also the major glands. Symptomatic of these diseases comes to the fore and masks the destructive activity of parasites. At the same time, starting treatment of the corresponding diseases, favorable conditions for the further vital activity of parasites are created. Given that in the human body, they can be for decades and their number may increase, the lack of struggle with them can lead to sad consequences. Therefore, the timely establishment of a diagnosis of opisthorchiasis is so important.
How to identify opisthorchiasis in an adult?
The choice of diagnostic methods for opisthorchiasis depends on the stage of helminthic invasion( acute or chronic) and the variant of the disease in the chronic stage. For the diagnosis of opisthorchiasis in the acute phase, the following symptoms should be present:
- gastrointestinal tract disorder;
- decline of vitality;
- lack of appetite, non-acceptance of fatty foods;
- pain under the right hypochondrium;
- allergic manifestations on the skin.
The presence of these signs requires further examination for opisthorchiasis. Moreover, in the acute phase of the disease, clinical signs can be vaguely expressed, quickly pass, and in some cases not at all. How to identify opisthorchiasis in humans there is a rich choice of methods that allow you to correctly establish a diagnosis and begin effective treatment.
Methods for detecting helminthic invasion in an adult include:
- laboratory diagnostics;
- instrumental studies of opisthorchiasis;
- analysis of complaints and the nature of the course of the disease during the examination;
- computer and magnetic resonance imaging;
- duodenal sounding.
A physician can detect opisthorchiasis only after collecting all the data. The simplest and most affordable way to test for opisthorchiasis is to diagnose by laboratory methods.
Laboratory diagnostics of opisthorchiasis
Under laboratory conditions, a study is being conducted:
- feces for the presence of parasite eggs;
- samples of bile under a microscope and bacteriological study;
- general and biochemical blood test;
- chromatic duodenal sounding.
Opisthorch eggs found in feces or bile on examination can accurately determine the diagnosis. With already existing complications in the work of organs, duodenal clogging of the liver is an effective way to diagnose this disease. Such an analysis is carried out during the period of the greatest activity of parasites. However, it is not possible to establish this period precisely, so it is done daily for quite a long time.
The probability of identifying eggs is increased if appropriate training is provided. This may be the appointment of cholagogue, antispasmodics, a special diet before the examination. Difficulties of differential diagnosis are determined by the absence of specificity and polysyndromicity of clinical manifestations of the disease.
In the initial acute phase of helminthic invasion, it must be distinguished from infectious diseases with an acute febrile syndrome, such as ARI, abdominal or viral hepatitis. According to statistics, in almost 80% of patients with opisthorchiasis, other infectious diseases are first diagnosed. The expressed muscular pains, arthralgias at helminthic invasion are very similar to the signs characteristic for acute respiratory diseases also complicate.
Detect opisthorchiasis in adults by differentiating it from other infections. How to check the helminthic invasion in icteric form, so as not to confuse with hepatitis, helps the presence of pain syndrome on the right side of the abdomen, with sharp pain during palpation. To differentiate acute dysentery from acute opisthorchias by the type of gastroenterocolitic indicative is the absence of false desires, tenesms, veins of blood in feces, and at palpation the sigmoid colon is not spasmodic.
It is difficult to properly diagnose the presence of symptoms characteristic of blood diseases. Diagnosis by blood is essential in determining opisthorchiasis. A general analysis indicating an increased content of eosinophils and leukocytes may indicate helminthiasis. To clarify the diagnosis appoint a biochemical analysis. When detecting a disease by blood, the indicators indirectly indicate the presence of opisthorchia.
Immunoassay analysis among other diagnostic methods can detect the disease at the earliest stages, even before egg production begins. However, when going to the chronic stage, this method is inefficient and can only be used as an auxiliary one. The use of an enzyme-linked immunosorbent assay is based on the fact that antibodies to opisthorchiasis are absent in the blood serum. In the acute stage, the worms cause a strong allergic reaction, which causes an increase in the rates of eosinophils. However, it should be borne in mind that in people suffering from toxoplasmosis false positive results on ELISA are 5.6-7.3%.Much higher false-positive result is observed in patients with echinococcosis( 15.4%), trichinosis( 20%) and in almost 30% of patients with fascioliasis.
The sensitivity of serological reactions in helminthic invasion is higher in visitors than in those who permanently live in the foci of parasite spread and this is due to the fact that when people permanently residing in the epidemiological region adapt to these conditions of existence. Molecular diagnostics can detect opisthorchiasis with the help of a specialized chain reaction. With its help, it is possible to identify parasites in the stool. Detecting sexually mature specimens of helminths allows a retrograde pancreaticolangographic retrograde method in which the endoscopic method examines the bile ducts.
Changes in the gallbladder, liver or pancreas are detected during computer and magnetic resonance imaging. Very often to clarify the diagnosis of ultrasound. The advantage of ultrasound investigation is the ability to determine in real time how much the thickness of the walls of the ducts and gallbladder has changed, and in addition to seeing traces of the stratification of the walls inside the liver. Often, together with ultrasound for opisthorchiasis, bile analysis is made, which makes it possible to establish the presence of pathogenic flora.