Threadworms & giardia

Right after waking, before washing and before opening the bowels, press a strip of clear tape briefly to the skin and stick it on a slide. A single test misses half of them.

The modern test finds considerably more than microscopy alone, and shedding varies from day to day — hence three samples on different days.

For threadworms everyone in the household is treated at the same time and again after two weeks, because the eggs survive that long.

Shower in the morning, nails short, underwear and bedding at sixty degrees, do not shake them out, a separate towel each. This is what decides whether it comes back.

With giardia, recheck the stool if symptoms persist — relapse and reinfection within the same household are common.

After giardia a temporary lactose intolerance often remains for weeks to months. That is not a relapse.

In an adult with a single persistent spot the worm picture no longer fits — then it is worth looking at the skin itself.

Six level teaspoons of sugar and half a teaspoon of salt in a litre of boiled water — sipped through the day.

Cook oat flakes long in water, eat lukewarm; grate an apple, let it brown, then eat.

Pinworm eggs lie at the anus, not in the stool. The strip is applied before getting up and before washing, on three different mornings — a single stool sample misses them almost always.

The organism is shed in waves. Three samples on different days or an antigen test find it far more often than a single microscopy.

Against threadworms a single tablet works; it kills the worms, not the eggs — which is why it is repeated after two weeks, when the new worms have hatched. Without laundry and hand hygiene at the same time it comes back, because the eggs survive for days.

Female threadworms lay up to ten thousand eggs on the skin around the anus at night; the eggs are infectious after about six hours and survive two to three weeks on surfaces. Treatment is repeated after fourteen days, because it does not reach the eggs. Giardia has an incubation of one to three weeks; the diarrhoea is typically fatty and foul-smelling and can last weeks. Stool is examined on three different days, because shedding varies.

The cardinal sign of threadworms, because egg laying happens in the evening and at night.

Often read as restlessness or a concentration problem, when it is simply the itch waking the child.

The worms can travel forwards and cause itching and discharge there — often taken for a bladder infection.

With bloating, burping and belly pain after eating, often in waves over weeks. Blood in the stool does not belong to it.

Giardia: mountain streams, wells, travel, swimming pools, nursery. Threadworms: simply other children.

An important sign with giardia over weeks — it is not part of threadworms.

Usually entirely normal with threadworms and giardia — neither migrates through tissue. A normal value does not argue against them.

Falls with longer-standing giardia, because less is taken up in the small bowel.

Affects the same stretch of absorption as iron and explains part of the tiredness.

Usually stays normal here. It rules out inflammatory bowel disease but does not rule these two out.

Taken up right at the end of the small bowel and needing a helper from the stomach. If either place is affected a deficiency arises — often only after years, because the liver holds a store.

Fever, sweating and faster breathing clearly raise the need. Drinking enough keeps the mucus thin and the circulation steady — in children and older people it is the most important point of all.

Taken up in the upper small bowel and needing stomach acid. Acid blockers, an inflamed lining and silent blood losses often come together here.

With low levels airway infections occur somewhat more often; correcting a deficiency makes sense, a high single dose during the infection does not act on it.

Needed by the defence cells. For lozenges at the start of a cold there are hints of a slightly shortened duration; at a high dose over months zinc lowers copper.

Traditionally used against worms; the human studies are small and mostly concern tapeworms. With threadworms something else decides: the second dose after 2 weeks and treating the whole household at the same time.

For giardia it has been studied alongside the antibiotic and showed higher success rates in small trials. As a treatment on its own it is not tested.

After a longer infestation with diarrhoea zinc belongs to the refilling — in children that is the internationally recommended accompaniment, 10–20 mg a day over 10–14 days.

Clearly worthwhile and well supported when deficient — vegan, older adults, certain drugs. No energy boost without a deficiency.

Clearly effective with proven deficiency, useless without. Take only with a documented deficiency — excess is harmful.

Clearly worthwhile and well studied when deficient; fewer data for the wider uses. Fat-soluble — check blood levels at high doses.

A longer-standing giardia infestation disturbs uptake in the small intestine — in children growth can fall behind because of it. The growth curve then says more than any stool sample.

Threadworms travel to the anus at night — hence the itch that comes exactly then, and hence the sticky tape in the morning before washing. A rhythm, not a coincidence.

Threadworms pass on via the hands. Treatment is with a medicine, usually twice two weeks apart — no food replaces that. With giardia diarrhoea and fatty stools often last weeks, and then fluid replacement counts.

Traditionally used against worms. Proof of effect in humans is missing; threadworms are treated with a medicine, usually twice two weeks apart, otherwise the eggs hatch again.