The carriers of hepatic trematodes causing opisthorchiasis in areas of primary distribution are about half of the total population. This is due to the fact that opisthorchions enter the human body even in childhood and after a pronounced or erased acute phase, the invasion passes into a chronic stage. The chronic phase of the disease, which can last for decades, causes a malfunction in the functioning of the immune defense system and the body becomes vulnerable to attacks of pathogenic viruses and bacteria, the risk of producing malignant tumors in parasite-affected internal organs or bile peritonitis increases.
Pathological changes in the internal organs of chronic opisthorchiasis occur for various reasons, including:
- Mechanical damage by suckers and tweezers of parasites when they are in the gallbladder mucosa, the passage of pancreatic and bile ducts.
- The accumulation of opisthorchias and parasitic eggs, which cause stagnation of bile.
With the constant action of these factors, the mucous membranes are consolidated, leading to the formation of scars on them. At the same time, by narrowing the common bile and pancreatic ducts, an imbalance of digestion occurs, which provokes the development of various diseases.
Symptoms and treatment of chronic opisthorchiasis
The main signs of chronic opisthorchiasis are a manifestation of inflammation of the gallbladder and pancreas, and of course gastroduodenitis. Most often( more than 2/3) there is a cholecystopathic variant of the development of helminthiasis. Dyspeptic syndrome and dyskinesia of the gallbladder are noted in 85% of people affected by helminthic invasion. For 2/3 patients, signs of chronic opisthorchiasis are pathological reflexes of biliary-pancreatic and character.
Among the systemic symptoms of chronic opisthorchiasis can be called:
- asthenovegetative syndrome;
- allergic syndrome;
- disorders of the autonomic nervous system and CNS.
One of the first signs of the presence of chronic opisthorchiasis is a symptom similar to that of gallbladder diseases:
- rejection of fatty foods;
- attacks of nausea;
- pain in right side;
- dry mouth.
The manifestations of the chronic stage of the opisthorchiasis, which are visible by skin condition, are:
- urticaria;
- itching rashes;
- Quincke edema;
- is an allergy to food.
Symptoms of chronic opisthorchiasis with the development of complications caused by the action of parasites become more pronounced and change. Blockage of the bile ducts causes pain in the right upper quadrant, abdominal tenderness, vomiting. Jaundice, darkened urine, profuse sweating, fever testify to narrowing of the large duodenal papilla of the duodenum. Against the backdrop of opisthorchiasis develops pancreatitis, purulent cholangitis, purulent inflammation of the peritoneum, perforation, abscesses of the liver.
Modern methods for the treatment of chronic opisthorchias require two stages directed directly at treatment, and in the third stage, rehabilitation measures are carried out aimed at restoring the functions of the biliary system in normal mode, eliminating symptoms of intoxication, inflammatory and allergic processes. At the second stage, deworming is carried out, using antihistamines and antibiotics of a wide range of effects. Normalization of outflow of bile is carried out using a complex of physiotherapy( magnetotherapy, electrophoresis, microwave therapy).
The most effective drug for pathogenetic therapy is Ursofalk. Biltricide is considered the most effective antihistamine drug. Of great importance is a special diet, which is observed for the duration of treatment. The diet provides for the exclusion of fatty foods, sweet, plentiful drink and food intake in frequent small portions.
Diagnosis of chronic opisthorchiasis
The administration of drugs to eliminate the effects of helminthic invasion is based on the differential diagnosis of chronic opisthorchiasis. The diagnosis of the disease complicates the polymorphism of clinical manifestations, the similarity of symptoms of helminthic invasion with concomitant diseases. In addition to collecting data of anamnesis and a thorough examination, the doctor prescribes instrumental and laboratory studies.
The list of these studies includes:
- blood tests;
- general urinalysis;
- microscopic and bacteriological examination of bile;
- stool analysis;
- ultrasound examination of the peritoneum and other instrumental methods.
If necessary, the doctor also prescribes other methods of investigation that are required to establish the parasitic nature of the disease.