Intestinal parasitosis is usually considered a benign disorder mainly pediatric and therefore is often excluded by default in adults.
Among the most common intestinal worms we will mention the commonly called tapeworm, but pinworms are also very frequent.
These small round white worms (Enterobius vermicularis) of a few millimeters are found in the soil and in green spaces. They often colonize young children who, while playing outdoors, come into contact with the eggs (found under their fingernails or on their hands) and put them in their mouths. This is how the worms can enter the digestive tract where they will settle. More precisely, after ingestion, the eggs hatch in the stomach under the effect of digestive juices. The larva then develops into an adult worm and migrates through the intestine.
The symptoms associated with this type of parasitosis are relatively discreet since, in young children, they involve digestive disorders (episodic and unexplained diarrhea), abdominal pain, irritability and anal itching. For this reason, colonization of the digestive tract by pinworms can go unnoticed for long periods.
This infection also has the characteristic of being highly contagious. In fact, it is not uncommon to find that the entire family has the infection during a parasitic infection in a child.
Pinworm-associated parasitosis rarely presents with serious complications, but must be absolutely managed because it does not resolve spontaneously even under perfect immunological conditions.
Relationship with cystitis
In case of parasitosis, the presence of worms in the intestine (small one and colon) alters the balance of the microbiota. This invasion of a balanced environment by pathogens leads to intestinal dysbiosis and, subsequently, to the inflammation of the enterocyte wall. These two changes in intestinal functionality, associated with transit disorders and anal hitching, constitute a series of risk factors for bacterial and abacterial cystitis for several reasons:
-> the gut microbiota is responsible for 80% of an individual’s immune competence. Therefore, intestinal dysbiosis due to parasites inevitably leads to a reduction in physiological immunity which, for example, in the presence of bladder biofilms, can be the cause of an acute episode of bacterial cystitis.
-> intestinal dysbiosis also tends to favor the appearance of more aggressive bacterial strains and, in particular, of uropathogenic bacteria. This overgrowth of bacteria can have a significant impact in terms of a resurgence of urinary tract infections
-> inflammation of the intestinal mucosa is also a risk factor for both infection (bacterial migration to the bladder due to the formation of intestinal porosity phenomena) and inflammation (inflammatory processes, initially intestinal, that progressively lead to pelvic inflammation that finally reflected at the urological level
-> transit disorders also favor a massive passage of potentially uropathogenic germs to the perineum with a greater risk of contamination of the urinary tract by ascent (this is particularly true in case of diarrhea)
-> anal itching is also the cause of germs rising from the anus to the urinary meatus
-> in some cases, the symptomatology of the parasitosis (for example, abdominal cramps) can be the starting point of muscular dysfunctions in the pelvic floor that affect the bladder and its functionality (urination, bladder capacity, etc.)
-> if the parasitosis is prolonged over time or is repeated, the wall of the enterocyte may present damage that causes a hyperpermeability syndrome that allows the passage of “toxins” to the mucosa itself or even to the circulation. This excessive porosity is the cause of allergic-type inflammatory responses: production of antibodies and inflammatory mediators (histamine in particular) that can successively give rise to autoimmune, inflammatory or neuropathic extraintestinal pathologies (we will cite here a case of IC/PBS).
For all these reasons, when cystitis (bacterial or abacterial) is chronic and unexplained, searching for a parasite may be a good idea to rule out a possible cause that is often overlooked.
What to do
Here the question if to treat or not parasitosis does not even arise. Obviously, this infection needs to be taken care of, as soon as possible and effectively.
At the same time, it will certainly be useful to act:
– if necessary, to help regulate intestinal transit
– recolonization and support of the digestive microbiota for a return to balance
– an intervention to address inflammatory and allergic processes
– if the cystitis is bacterial, an action against pathogenic biofilms (which usually form mainly when urinary infection is caused by bacterial migration) is also desirable
– if the cystitis is abacterial, it will be necessary to support the re-epithelialization of the bladder urothelium