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Probing after biltricide. Modern problems of science and education. It's worth reading

Today, practitioners offer the treatment of opisthorchiasis with Biltricid - this method is recognized as the most effective for combating helminths. Consider what the drug is, what features of therapy the patient should be aware of.

Principles of treatment of opisthorchiasis

The disease can occur in acute or chronic form and be accompanied by:

allergic manifestations.
Violations of the liver, gallbladder, intestines, etc.
Pathological changes in the heart, nervous system.

Experts prefer therapy that includes three stages:

preparatory;
basic;
final (rehabilitation).

The initial stage involves the appointment of anti-inflammatory drugs, hepatoprotectors and antispasmodics, as well as symptomatic drugs according to indications (antipyretics, or antipyretics for fever). The main stage is understood as a course of deworming (for example, Biltricid), and rehabilitation includes the use of medications, methods, physiotherapy and detoxification. If surgical complications of opisthorchiasis develop (a cyst or abscess of the liver, stricture of the cystic duct, etc.), it is necessary to use surgical techniques.

Instructions for use Biltricid in opisthorchiasis

Composition, form of release and dosage

The medicine contains 600 mg of the active ingredient, as well as a number of auxiliary ingredients:

starch;
cellulose;
povidone;
titanium dioxide, etc.

Biltricid is available in the form of white tablets with an orange tint, having stripes for dividing into parts - this allows you not to make a mistake when choosing a single dose, which can differ significantly from the total content of Praziquantel in the amount of 600 mg.

The action of the drug

On the muscular system of opisthorchs, provoking convulsions. This is achieved by influencing the processes of transport of calcium ions.
On the carbohydrate metabolism of the body of helminths.

The scheme of treatment of opisthorchiasis with Biltricid

general (which will be taken for the entire course);
one-time.

The dosage of Biltricide for opisthorchiasis should be within the volume indicated in the table. To drink the right amount of medicine, use the divisions on the tablet. A sparing option is prescribed for people with a high risk of allergies, intoxication.

Contraindications and side effects

Praziquantel-based medicines should not be used for:

It is also worth refusing to take it in the first three months of gestation (carrying a child) and, if necessary, simultaneous use with a pharmacological agent such as Rifampicin.

Biltricide is not prescribed for children under 4 years of age.

There are no guarantees of safety for health, and the risk-benefit ratio is dominated by the likelihood of severe complications.

The drug is prescribed with caution, correction of the standard dosage for:

functional insufficiency of the liver of severe degree;
concomitant damage to this organ and the spleen by helminths-schistosomes;
the presence of disorders of the heart, accompanied by arrhythmia;
exhaustion, severe forms of chronic pathologies.

With the correct selection of the dose, adverse reactions are absent or disappear quickly; among them are the following:

nausea;
weakness;
dizziness;
unsteadiness of gait;
tremor of fingers;
heaviness and pain in the abdomen, under the rib on the right;
skin rash (urticaria).

Features of therapy during pregnancy and in old age

The purpose of this stage of therapy is to improve the outflow of bile, reduce the activity of the inflammatory process, desensitization (elimination of signs of allergy). It is also important to reduce the load on the liver and pancreas.

Diet correction

alcohol;
sweet fresh pastries;
carbonated drinks;
juices in packages;
canned food;
sausages;
citrus;
mushrooms;
peanut.

It is necessary to eat cereals, sour-milk products, as well as vegetables, steamed, boiled or baked in the oven. For the first soups are served without rich meat or fish broths, lean. You can not add spicy seasonings. Bread is allowed yesterday, fruits - sweet varieties (for example, apples, pears). Butter given to the patient in limited quantities, the same goes for sugar. It is necessary to drink plenty of fluids (mineral water without gas, compote, weak tea), as this reduces the effects of intoxication.

Medical therapy

Such drugs are prescribed as:

Histamine H1 receptor blockers (Cetrin, Erius, Loratadin).
Antispasmodics (No-Shpa, Duspatalin, Mebeverin).
Cholagogue, hepatoprotectors (Holenzim, Galstena, Essentiale, Ursofalk, magnesium sulfate).
Prokinetics (Motilium, Domrid).
Enzymes (Panzinorm, Creon).
Probiotics (Linex, Bifinorm).

Antipyretics (Ibuprofen, Paracetamol) can also be used - once to stop the fever. Some patients require infusion therapy (intravenous infusion of drugs) using solutions of sodium chloride, glucose, the appointment of broad-spectrum antibacterial drugs in a short course (for 5 days). The following methods are also used:

electrophoresis;
microwave and magnetic therapy.

The preparatory phase continues for several weeks.

Histamine H1 receptor blockers can also be used during the period of specific chemotherapy. Biltricid is prescribed no earlier than 21 days from the start of the pathological process. The level of eosinophils in the blood should not be higher than 20%.

The patient is required to undergo an examination in advance, including laboratory and instrumental methods; they are also used after the end of medication to monitor the effectiveness of therapy. In acute or severe form of helminthic invasion, hospitalization is required.

Alternative Treatments

It is worth starting with the fact that pharmacological agents based on Praziquantel are by far the best drugs of choice; they are present in all protocols for the treatment of opisthorchiasis approved by the Ministry of Health, since they allow achieving satisfactory results of deworming with a short course of administration. As an alternative, only traditional medicine recipes are offered:

Aspen bark.
Tar.
Pumpkin seeds.
Cleaner, etc.

Their effectiveness may be different, but in all cases they cannot be compared with specific chemotherapy. Completely cure opisthorchiasis folk remedies can not. But medicines based on herbs and other herbal ingredients are widely used as a supplement to pharmacy medicines. At the same time, an important condition is the absence of allergies, as well as the refusal to use alcohol, garlic, kerosene and other components hazardous to health.

What to add to therapy?

To improve the results of deworming, elimination of toxins and recovery (rehabilitation), it is recommended:

antispasmodics, hepatoprotectors;
histamine H1 receptor blockers;
enzymes, prokinetics;
probiotics, solutions for infusions;
sorbents (White coal, Enterosgel).

From herbal preparations, infusions of corn stigmas, calendula flowers, birch leaves are useful.

It also requires blind probing, or tubage with xylitol, magnesium sulfate or mineral water. To do this, the patient needs to take an antispasmodic in the evening and drink the desired solution in the morning on an empty stomach after emptying the intestines; then the position is taken lying on the right side on the roller for 40 minutes with legs bent at the knees.

Tubage cannot be performed with a mechanical obstruction to the flow of bile (presence of calculi, or stones in the bladder, etc.).

This procedure is carried out on the 2nd day after the end of the deworming course, in the first 7 days it is repeated twice or thrice, then once a week up to 3 months inclusive. Relaxation and / or increase in the volume of stool is a sign of the effectiveness of tubage.

Hello. About two years ago, my son and I were infected with opisthorchiasis. I have symptoms: mostly only allergies - itching, urticaria, my son has allergies, gastric problems, temperature. They diagnosed him by feces at the MCC NSMU. We underwent a course of treatment with biltricide in the 1st infectious diseases hospital in Novosibirsk, with preparation. Duodenal sounding after biltricide was not prescribed, but a course of 3 months was prescribed. with cholagogues and tubes of mineral water and sorbitol, all appointments were fulfilled, the symptoms disappeared. Three months later, a blood test was performed there at the MCC NSMU (on their advice), opisthorchiasis was not found. probing - opisthorchia was not detected, the symptoms were significantly weakened. I got itching mainly on the hands and feet, but less pronounced than 2 years ago. The main question is which method is the most reliable for confirming or denying opisthorchiasis: duodenal sounding or blood test for opisthorchiasis IgM / IgG / CEC, or both.? Thanks in advance.

For this, special preparations are used, for example, those included in the Gelmostop course, as well as some food products. That is why, at the first stage of treatment, the menu should include easily digestible products, which, on the one hand, do not require extra energy from the body to digest food, and on the other hand, allow the gallbladder to be activated, thereby forcing the body to use its own resources.

At the second stage, medications are used, the action of which is aimed at eliminating the helminths directly.

To one of the most effective drugs, allowing you to get rid of the liver fluke and other helminth trematodes, is "Biltricid". With "Biltricid" some folk remedies are also used that stimulate the gallbladder (if the main sources of damage are the cardiovascular system or the respiratory tract). The menu in this case should also include easily digestible foods that do not require titanic efforts from an already weakened body to digest food.

At the third stage, during which the body goes through a recovery period, additional vitamins and nutrients are needed. This is due to several reasons.

Firstly, during the disease, helminths create extremely unfavorable conditions in the digestive system, releasing special enzymes. The latter interfere with the normal digestion of products, which is why they rot and roam. At the same time, the human body suffers from high intoxication, because, on the one hand, the products in the digestive tract rot and roam, on the other hand, the helminths themselves multiply and grow, which is accompanied by the excretion of their own metabolic product (they do not go anywhere, but remain there). , in the human digestive tract). And, on the third hand, trematode helminths actively consume the nutrients that a person needs for normal life. It turns out that the patient's body suffers from both high intoxication and a lack of nutrients.

As trematode helminths develop and multiply in the human digestive system, the latter experiences discomfort due to the gradual accumulation of metabolic products secreted by helminths, as well as a lack of nutrients, most of which are consumed by flukes. Compliance with the diet is one of the main aspects of successful treatment and recovery after the treatment of opisthorchiasis, especially if the treatment was carried out with Biltricid.

What is?

The diet for opisthorchiasis involves the consumption of a small amount of food, the total calorie content of which per day should not exceed kilocalories. Of these, the focus should be on the use of carbohydrates (about 350 grams per day), a small amount of vegetable fats (up to 90 grams per day) and proteins. The main attention should be paid to the use of carbohydrates, since the body spends much less energy on their absorption than on the digestion of protein foods.

The main emphasis after the treatment of helminthiasis-opisthorchiasis should be placed on the use of easily digestible food rich in carbohydrates and fiber. On the one hand, it will saturate the body with all micro and macro elements, and on the other hand, it will require little energy for digestion.

So, after the treatment of opisthorchiasis, the main components of the menu should be fruits and vegetables. From drinks, preference should be given:

homemade compotes from seasonal fruits, as well as berries. They can also be used during the main course of treatment);
jelly. They perfectly “envelop” the walls of the stomach and intestines, and this is important, because after the activity of helminths, many cracks and ruptures form in the mucosa;
juices. When it comes to packaged juices, be careful because they contain a lot of sugar. With fresh juices - even more so, since a high acid content is contraindicated if there is a suspicion of an ulcer or gastritis. So juices should be diluted with water before drinking;
tea and coffee can be consumed no more than once a day (tea can be twice, only weak). Natural coffee should not be consumed, it is better to add milk or low-fat cream to it.

Dairy products, by and large, show everything, but do not abuse the percentage of fat. After the treatment of opisthorchiasis, the body needs strength, and the digestion of fats takes too much time and effort.

Main dishes. Among the main dishes, preference should be given to soups, and preferably broths with a low fat content. Puree soups are also perfect, which are quite easily digested and have a “enveloping” effect, which is so necessary for the body to facilitate digestion.

Among protein foods, the focus should be on lean meat. Perfect option - chicken fillet and fish. Naturally, they should be consumed steamed, stewed or baked, but in no case fried.

A good way to restore the digestive system after the treatment of helminth infections are cereals. It is advisable to cook them in water or add milk and water in equal proportions, and with a little sugar.

During the first week after the completion of the main course of treatment, you should refuse to add dried fruits to cereals, since the stomach and intestines need time to restore normal motility.

Summary. The main requirements for the menu after the treatment of helminthiasis are the absence of animal fats and "chemicals". All foods should be natural, easily digestible and high in nutrients.

It's worth reading

At this stage, special attention is paid to choleretic therapy. The main goal is the normalization of the work of organs whose functions have been impaired by helminthic invasion. After persecution of opisthorchis, procedures of probeless duodenal sounding are carried out. Thanks to them, the gallbladder contracts more actively and the infected bile is removed from the liver and biliary tract.

The procedure is performed as follows: the patient in the morning on an empty stomach after emptying slowly drinks warm mineral water for 20 minutes, which the doctor prescribes, and then lies on his right side and puts a heating pad on the liver area for about an hour. Tubazhi with opisthorchiasis are first prescribed daily for 7 days, and then this procedure can be performed 2 times a week for 3 months.

During these procedures, the chair should be daily, it is very important to control this, if there are any problems, the doctor can prescribe laxatives. Tubage after treatment of opisthorchiasis is an important stage of treatment, but this procedure should be prescribed by a doctor, because the patient may have contraindications.

In addition, during the rehabilitation period it is very important to take various choleretic herbs, as well as hepatoprotectors, if necessary, antispasmodics and other drugs are prescribed that improve the functions of organs affected during helminthic invasion.

Is it possible to finally get rid of opisthorchia after treatment?

Some patients complain that after the treatment of opisthorchiasis, the right side hurts, this happens because this disease negatively affects the liver and other organs. In some cases, the functions of these organs are not fully restored. That is why all patients who have had this disease should be examined for six months, so possible complications can be prevented.

Opisthorchiasis is a disease caused by flatworms. This disease causes various liver damage.

Usually, the treatment of enterobiasis is not difficult. Modern pharmacological preparations effectively destroy pinworms.

A very unpleasant topic in the medical field that every person would like to avoid.

PANCREATITIS

TYPES OF PANCREATITIS

WHO HAPPENS?

TREATMENT

NUTRITION BASICS

CONSULT YOUR PHYSICIAN!

Opisthorchiasis treatment - drugs and course of treatment according to the scheme

1 Features of opisthorchiasis and its treatment

The cat or Siberian fluke is localized in the bile ducts. It affects the liver and can live in it for up to 20 years. The only way to get to the fluke and poison it is through blood. At the same time, the person himself suffers. Part of the intoxication is given by drugs for opisthorchiasis - a kind of chemotherapy. Then the dying helminths decompose in the ducts and poison the blood and liver.

2 Scheme for the treatment of opistarchosis

Experts have developed the treatment of opisthorchiasis with Biltricid, the scheme includes 3 stages.

With opisthorchiasis, if left untreated, a high percentage of deaths. Often, malignant tumors and cirrhosis of the liver are formed in organs damaged by helminths.

3 Preparatory stage

During preparatory phase the liver and gallbladder, which are destroyed by flukes, are restored as much as possible. It is necessary to prepare the way for the elimination of toxins and minimize intoxication. The preparatory stage is carried out taking into account all the pathologies of the body and includes courses:

low fat diet;
antiallergic course of drugs and dietary supplements;
5-day course of broad-spectrum antibiotics;
detoxification of the body with intravenous infusions of glucose and hemodez;
choleretic preparations for cleaning the ducts.

To strengthen the immune system and the whole body, vitamin-mineral complexes are prescribed.

With a decrease in the amount of bile entering the stomach - cholestasis, drugs containing ursodeoxycholic acid are prescribed:

With severe pain, the patient is given antispasmodics: No-shpu, Meteospasmil, Baralgin or Drotaverin.

The duration of stage 1 is 10-20 days, depending on the severity of the disease, the presence of other pathologies and drug tolerance.

4 Biltricid - pills for opisthorchiasis

There are several chemicals that destroy the fluke. They are used as a substitute if the medicine for opisthorchiasis - Biltricid cannot be used due to intolerance to its constituent substances.

The main active substance of Biltricid, praziquantel, kills flatworms regardless of their location. Depending on the severity of the invasion, the course dose is calculated in the range of 40-75 mg per kg of body weight. It is divided into 6 doses per day with the calculation of taking 1 or 2 days (6 and 12 servings, respectively). Biltricid is taken 6 times every 4 hours. Experts recommend that adults take pills at night, starting at 22:00.

Stage 5 Chemotherapy

For convenient selection of the prescribed dosage, there are risks on the surface of the tablets. It is impossible to grind and chew the drug, it must enter the stomach in the shell and the main component dissolve in the intestines.

The anthelmintic drug is a potent, has a large number of side effects:

nausea;
rash;
dizziness;
bitterness in the mouth;
a state of dejection, depression;
intoxication;
pain in the right hypochondrium;
temperature increase;
vomit;
insomnia;
weakness;
lack of coordination;
spasms in the intestines;
temperature increase.

In the presence of vomiting, it is necessary to remember the time of taking the tablets and the urge to vomit, report them to the doctor to adjust the amount of Biltricidol taken.

Intoxication of the body, its increase, are associated with the production of additional antigens, which the immune system directs to fight alien proteins and bacteria. Additionally, sorbents are prescribed for purification from slags created by antibodies - decomposition products of flukes. Anti-allergic drugs relieve itching and reduce irritation from exposure to antigens.

After taking the last portion of Biltricide, probing is prescribed approximately 4 hours later:

blind with the use of mineral water;
duodenal.

The purpose of probing is to remove the remains of the bodies of flukes from the biliary tract, their evacuation from the body. At this time, adverse reactions to anthelmintic chemotherapy may increase.

6 Recovery after Biltricide - Stage 3

Dubazhi are made according to the scheme. Daily for the first week. Then once every 7 days for a long time, up to 90 days. Treatment is carried out on an outpatient basis, the patient comes to the hospital for examination and procedures.

The rehabilitation course also includes drug therapy. The patient is prescribed:

hepatoprotectors;
choleretic agents;
anticholestatic substances;
pathogenic preparations.

Additionally, folk remedies can be used to enhance the effect of a medical recovery course. Herbal decoctions:

There are many choleretic plants, and the doctor will recommend the most suitable in a particular case. Cholagogue herbs are brewed separately and fees are prepared from them. To exclude addiction, every 3-4 weeks the composition of the decoctions must be changed. Folk remedies are also used after the completion of drug therapy and a course of probing. Usually herbs drink 4 - 6 months.

3 months after the course of treatment with Biltricid - 2 stages, a 3-fold coprooscopy is done, a stool analysis is performed to determine the number of eggs and worms.

With re-infection, treatment of opisthorchiasis according to the scheme is possible only six months after the completion of the recovery stage.

Recovery after biltricide

I am 22 years old, weight 53 kg, height 165 cm.

I was treated with biltricid 4 days ago (6 tablets).

When I was discharged, I was told to do tubazhi, and take cholagogue for 2 weeks a month for 3 months. They said you can drink weed or pills Allohol, Alfit, Odeston. And then they also advised the dietary supplement "Ecorsol", which includes aspen bark and hill hodgepodge, which have, as it were, an "anti-opisthorchiasis effect." I was told that these substances are able to fight opisthorchs to some extent. Well, if suddenly they remained after biltricide, which could be, because when probing opisthorchs, they found bile in three samplings, and they said that it was a lot.

Should I buy Ecosol? If I buy regular wasp bark, will I get the same effect? And does aspen bark really have such an effect?

Probing took place BEFORE treatment, 2 months ago. In the clinic, the infectious disease doctor said that there were eggs in three bile samplings, and this is too much, so she said that treatment with biltricide may not be 100% successful.

During this week in the hospital, I gave general analysis urine, feces, complete blood count, biochemical analysis blood. I didn’t see the results in my eyes, but the doctor told me that the results are good, without any complaints, there’s even nothing to discuss :). On the last day before discharge, she passed the feces, everything is fine.

I have not heard anything about the level of liver enzymes. What kind of analysis checks this?

By the way, I was lying in the ward of the city infectious diseases hospital in Novosibirsk, about 55 steps from Tolokonskaya's office 😉 But this is so, by the way 🙂

Thank you, Elena Evgenevna, for the clarifications and recommendations!

Almost a year ago I was treated with biltricide. But. like a real Russian person, I didn’t find time to bring everything to the end * with a guilty look, I throw up my hands * 🙂

As a result, not a single control probing after treatment, not a single visit to the therapist / infectious disease specialist. By the way, now there is no infectious disease specialist in our clinic at all 🙁

A month ago, a rare rash again went, red seals, itchy. Nothing else worries.

There is no doubt that it is necessary to check again by sounding.

My question is this: control soundings after the treatment of opisthorchiasis are needed to torment a person, but to reassure the doctor that the treatment has helped; Or does it have a healing effect?

Treatment

Opisthorchiasis does not go away by itself, it needs to be treated. Ignoring the disease can result in serious damage to the liver and digestive organs. It can affect both adults and children, as well as animals that eat fish.

Comprehensive treatment involves taking a number of medications, aimed not only at the destruction of helminths, but also at supporting the body of the infected. In addition to deworming drugs, the doctor prescribes choleretic, enzymatic and intestinal motility drugs. Antihistamines are often needed. The scheme of therapy and doses depend on the patient's condition and the degree of damage to his body by helminths.

Diet

In addition to taking medication, therapy includes a diet that plays an important role in treatment - it increases its effectiveness, reduces the recovery time. The main settings of the diet are frequent meals in small portions, the exclusion of fatty, fried and spicy foods and alcohol. Drinking plenty of water is shown, which helps to remove toxins from the body. The diet is included in the preparatory stage.

Preparatory phase

Diet, which has already been mentioned above.
Taking antihistamines. They are necessary to fight allergies, since infection often causes an allergic reaction in the body.
Cleansing the intestines from toxins with the help of sorbents.
Reception of enzyme and choleretic agents to improve the digestion of food. Drugs are taken according to a certain scheme, depending on the type of JVP.
Painkillers (antispasmodics). They relieve pain, which is a frequent companion of the disease.
Broad-spectrum antibiotics to fight inflammation in organs affected by helminths.

Treatment regimen

The method of therapy involves stages, and it begins with the preparation of the body. The need for a preparatory phase is explained by the fact that some anthelmintic drugs are toxic to the human body. It mainly concerns the digestive system.

One of the activities of the preparatory phase is the diet. In addition to her, the doctor prescribes a number of medications to support the body, which is experiencing a serious load during deworming. These are the following drugs:

Edem, Cetrin and Diazolin - have an anti-allergic effect.
Hemodez solution or 5% glucose - for detoxification.
Choleretics and cholekinetics - as choleretic drugs.
Antibiotics with a wide spectrum of action - to combat inflammation.
Enterosgel or activated charcoal - remove toxins from the intestines.
Biological products and enzymatic substances - to maintain a healthy intestinal microflora and improve digestion.

A feature of the preparatory stage is that it is carried out in a hospital under the supervision of a doctor.

main stage

There are many types of anthelmintics available. All of them have their own characteristics regarding the dose and regimen. Most often, the following medications are prescribed for deworming.

Find out how to get rid of opisthorchiasis at home here.

Biltricide

Biltricide is taken before or during meals. Tablets are washed down clean water. The time between doses should be in the range of 4-6 hours. The duration of the reception is short - only 1-3 days - and it is determined by how successfully the recovery is going.

One tablet of biltricide contains 600 mg of the active substance. The dose is determined at the rate of 25 mg per kg of the patient's weight. The maximum daily dose is 1800 mg (3 tablets).

Biltricide may have the following side effects:

malaise and weakness;
lack of coordination;
headache;
a feeling similar to alcohol intoxication;
bitterness in the mouth;
numbing of the senses.

Ecorsol

Ecorsol is a natural antihelminthic drug that effectively destroys opisthorchis. It has a complex effect - deworming and hepatoprotective. The latter is especially important, since in the treatment of helminths the human liver sometimes suffers.

The drug can be taken by people over 12 years of age. It is taken 3 times a day for 3 tsp. within half an hour after eating. Reception should last from 3 days to a week. The vast majority of patients tolerate Ecorsol easily, without any complications.

What pills for worms better find out here.

Populin

The raw material for the production of populin is aspen bark, rich in salicin, tannins and acids. Due to its naturalness, populin is absolutely harmless and can be prescribed to children from a very early age.

Adults should take the medicine one teaspoon diluted in 100 ml of water. For children over 4, half a teaspoon is enough. If necessary, the doctor can adjust the dose. The medicine is taken after meals three times a day. The course of therapy is a week.

Nemozol

Nemozol has an extended spectrum of action against helminths. It can be taken by adults and children from 3 years of age. Moreover, the dose does not vary depending on age, all patients should take 400 mg of the drug at a time (20 mg of concentrated suspension). Nemozol is taken once a day for 3 days.

Praziquantel

Praziquantel - often prescribed for deworming with opisthorchiasis. If the patient has undergone a massive infection and is admitted to the hospital, then his treatment will most likely be carried out with the help of praziquantel. The drug easily penetrates the body of helminths and causes paralysis of their muscles, as a result of which opisthorchis die.

Praziquantel should be taken two to three times a day. Usually one day of admission is enough to destroy the helminths. But if necessary, the doctor can extend the course. The dosage is determined individually, taking into account the weight of the patient.

Treatment after biltricide

Biltricide is used as one of the main means of deworming. It can be prescribed to adults and children from 4 years. There is no information on the safety of biltricide for babies under 4 years of age, so you should refrain from using it. Women who are in the first months of pregnancy are also not prescribed it - in order to avoid negative consequences for the fetus.

With regard to helminths, biltricid acts quickly and effectively, but has a number of side effects that make treatment quite uncomfortable for them. In particular, those taking biltricide may experience these side effects of taking the medication.

Vertigo with headache.
Nausea and vomiting.
Pain in the intestines.
Diarrhea stained with blood.
Heaviness in the hypochondrium.
Sweating.
Symptoms of meningism (irritation of the meninges with dizziness, headache and other manifestations).
Increased intracranial pressure.
Inconsistency of thinking.
Allergy.

Exceeding the dosage of biltricide can lead to destructive changes in the liver, which appear after 12 hours from the moment of administration. The disadvantages of the drug include the manifestation of symptoms of damage to the gastrointestinal tract, liver, biliary tract. Therefore, treatment is aimed at restoring the functions of the digestive system.

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Conclusion

Opisthorchiasis in adults can be in the chronic or acute stage. With the right treatment regimen, it is completely curable. In the case of a massive infection, with severe symptoms, the neutralization of the disease should be carried out in a hospital. The time for the final cure of the invasion depends on the degree of infection and the condition of the patient.

Opisthorchiasis is a systemic disease in which many organs are affected. In the chronic course of helminthiasis, deep, sometimes irreversible morphological changes in organs and tissues are formed. Treatment of opisthorchiasis should be comprehensive and affect all parts of the pathological process. With its successful implementation, the clinical manifestations of the disease are stopped or reduced, the functioning of vital organs is improved and often completely restored.

Most patients are treated on an outpatient basis. In severe cases, the patient is hospitalized. When prescribing drugs for the treatment of opisthorchiasis, the patient's age, comorbidity, severity and clinical features of the disease are taken into account.

Treatment of opisthorchiasis is phased. First, a proper outflow of bile and pancreatic juices is ensured, anti-inflammatory, detoxification and antiallergic treatment is carried out. Next, deworming is carried out, after which - rehabilitation (recovery stage).

Rice. 1. In the photo of opisthorchia.

Rice. 2. In the photo there is an opisthorch sucker located at the head end. Sucker with cuticular spines (left photo). In the photo in the middle of the suction cup and pharynx. View of the sucker in a scanning microscope (photo on the right).

Diet for opisthorchiasis

The diet involves the exclusion from the diet of fatty foods, as well as spicy, fried and smoked foods.

Recommended eat low-fat varieties of fish and meat, yesterday's bread, crackers, vegetable soups, low-fat cottage cheese and dairy products, soft-boiled eggs and omelettes, a small amount of creamy and vegetable oil, cereals, fruits and vegetables, weak coffee, tea and juices.

Forbidden spicy, salty, sour and fried foods, fresh pastries, legumes, sweets.

Culinary processing when cooking: it is recommended to steam, bake or boil food.

Meal frequency: food is fractional, in small portions, 6 times a day.

Rice. 3. Diet for opisthorchiasis is an integral part of pathogenetic treatment

Treatment of opisthorchiasis at the preparatory stage

The task of therapy of the first preparatory stage is to restore the proper outflow of bile and pancreatic juices, relieve allergic manifestations and inflammation, combat intoxication, improve the functioning of the liver, stomach and intestines. The duration of the preparatory stage is from 15 to 20 days.

Elimination of symptoms of biliary dyskinesia

If the patient has pain in the right hypochondrium, it is necessary to establish the type of biliary dyskinesia and select the correct treatment. With congestion (hypokinetic dyskinesia), biliary stimulants are prescribed - cholekinetics and carrying out procedures of blind probing (tubage). To stimulate bile formation, reception is indicated choleretics. The course of treatment for opisthorchiasis with choleretic and antispasmodic drugs ranges from 1 to 3 months.

Bile stimulants (choleretics)

Stimulate bile formation drugs containing bile acids, synthetic drugs, drugs plant origin and hydrocholeritics.

Bile acid products include: Hologon,Decholin, Allohol, Festal, Cholenzim, Digestol, Meksaz, Liobil.
Synthetic choleretics include: Nicodin, Tsikvalon, Oxafenamide, Holonerton.
Herbal preparations include: Kurenar, Galstena, Flamin,Holagogum, Fumeterre, Holagol, Holaflux, Holosas. Plants: immortelle flowers, Corn silk, Flamin, Peppermint, Holosas, Cholagol, Parsley, Holaflux, Tanaflon, Polyphytochol, Kurepar, Fumeterre.
Hydrocholeretics include mineral waters: "Essentuki" №17(highly and slightly mineralized), Izhevskaya, Jermuk, Naftusya, Smirnovskaya, Arzni and "Slavyanovskaya".

Bile secretion stimulants - ( cholekinetics)

Cholekinetics promote contraction of the gallbladder and relax the sphincter of Oddi. These include: Xylitol, Sorbitol, Magnesium sulfate, Carlsbad salt, Berberine, Alcohol tincture of barberry leaves, Decoction of tansy and Sunflower oil.

Antispasmodics

Preparations containing drotaverine: Drotaverine and No-shpa.
Expands blood vessels and relieves spasm of smooth muscles of the gallbladder, bile and pancreatic ducts, stomach, intestines, kidneys and bronchi Platifillin.
As an antispasmodic, preference should be given to selective preparations containing mebeverine: Mebeverine, Mebeverine hydrochloride, Mebespalin retard, Dutan, Duspatalin, Talinda retard, Spareks, Niaspam. They selectively act on the smooth muscles of the gastrointestinal tract - they reduce the tone and reduce their contractile activity, do not cause side effects, and actively affect the sphincter of Oddi.

Rice. 5. The photo shows a mass of eggs in the uterus of opisthorchs, located in the bile ducts.

Hepatoprotectors

Rice. 6. Liver damage in opisthorchiasis.

Enzyme preparations

Enterosorbents effectively bind and remove toxic substances from the body. Thus, the clinical manifestations of food poisoning and diarrheal syndrome are weakened. Their use helps to restore the functions of the gastrointestinal tract and the immune system.

For digestive disorders, enzyme preparations are prescribed: Pancreatin, Mezim forte, Digestal, Digestal forte, Festal, Panzinorm forte, Creon, Penzital, Pangrol and etc.

Allergosis treatment

The waste products of opisthorchis (toxins) in the host organism cause sensitization (hypersensitivity) and the development of an allergic reaction. It is allergosis that comes to the fore in the pathogenesis of the development of the acute stage of opisthorchiasis. It is manifested by granulomatous hepatitis, pancreatitis, antigenic pneumonitis and eosinophilic infiltrates in a number of other organs and tissues.

Enterosorbents effectively bind and remove toxic substances from the body. With opisthorchiasis, enterosorbents of different groups are used: Activated carbon, Polysorb, Smecta, Neosmectin Enterodez, Enterosgel, Enterosorb, Multisorb and etc.
Of the antiallergic drugs, antihistamines of the 2nd and 3rd generations are used: Lomilan, Claridon, Claritin, LoraGeksal, Zirtek, Rupafin, Telfast, Trexil. The drugs of this group are used in the acute phase of the disease and, according to indications, in the chronic phase and the rehabilitation period.

Rice. 7. Rash with damage to the digestive organs.

Anti-inflammatory therapy

With the help of oral suckers and cuticular spines, opisthorchis are fixed on the mucous membrane of the gallbladder, bile ducts and pancreatic ducts, which leads to mechanical damage and disruption of their blood supply. The walls of the ducts become inflamed, multiple bleeding erosions appear on them. Groups of penicillins, cephalosporins or macrolides are used as anti-inflammatory drugs for opisthorchiasis.

Rice. 8. In severe cases of opisthorchiasis, the work of the liver is disturbed, yellowness of the sclera and skin appears.

Treatment of opisthorchiasis at the stage of deworming

After the preparatory period, the patient is prescribed anthelmintic drugs. The effectiveness of specific chemotherapy depends on the quality of the preparatory stage.

Tablets from opisthorchiasis

For the treatment of opisthorchiasis, drugs such as Praziquantel, Chloxil and Albendazole. The most effective of them are preparations containing praziquantel - Praziquantel and Biltricid. Analog Praziquantela domestic drug Azinox proved high efficiency and in last years also began to be used in the treatment of trematodosis.

Praziquantel and Biltricid in the treatment of opisthorchiasis

Conditions for prescribing drugs:

Before proceeding with the treatment of opisthorchiasis, it is necessary to check the functional state of the kidneys and liver. With insufficient work of these organs, the dose of drugs is halved.
Praziquantel and its analogues are prescribed no earlier than 3 weeks from the onset of the disease and the level of eosinophilia in the blood is not more than 20%.

Treatment of opisthorchiasis is best done in a hospital.

Pharmacological action of the drug

Death of opisthorchis upon exposure Praziquantela and biltricida associated with the development of spastic paralysis in them, which occurs as a result of an increase in the permeability of cell membranes for calcium ions, which in turn leads to a reduction in the muscles of helminths.

Doses and methods of application

Biltricid and Praziquantel are used at a dose of 50 to 75 mg per 1 kg of body weight per day for 1 to 3 days. With a single dose, the tablet is taken in the evening. With repeated (sparing technique) - during the day with an interval of 4 to 6 hours. Tablets are taken orally before or during meals, not chewed, washed down with water. On the second day after taking the drugs, duodenal or blind probing is prescribed. This will allow to evacuate the products of decay and vital activity of opisthorchis. Blind probing in children should be carried out with caution.

Interaction with other drugs

When taken concurrently with Dexamethasone there is a decrease in the concentration of anthelmintic drugs in the blood plasma.

Side effect

Appointment Biltricide or Praziquantel may occur side effects: fever, headache, dizziness, nausea and vomiting, pain in the abdomen and right hypochondrium, diarrhea, pruritus, urticaria, rarely - lethargy and disorientation in space.

Adverse reactions are usually short-lived and disappear quickly. The most pronounced and prolonged adverse reactions with massive helminthic invasion.

Contraindications

The first trimester of pregnancy, children under 4 years of age, hypersensitivity to the drug and ocular cysticercosis are the main contraindications when taking Biltricide or Praziquantel. The drugs are contraindicated in persons with severe neuropsychiatric pathology. During the period of treatment should be abandoned breastfeeding and from work involving rapid concentration. With caution, drugs should be prescribed to people with kidney, liver and heart diseases, as well as to elderly and senile people.

Due to the high toxicity, anthelmintic drugs are used only as directed and under medical supervision. Do not self-medicate!

Rice. 9. Biltricid and Praziquantel are anthelmintic drugs.

Treatment of opisthorchiasis during the recovery period

Rice. 10. In the photo of opisthorchia. The adult cat fluke has a lanceolate body - flat and elongated. Its length is 8 - 18 mm, width - 1.2 - 3.5 mm.

Monitoring the effectiveness of treatment (deworming)

Monitoring the effectiveness of deworming is carried out using a microscopic method for examining feces or duodenal contents 1, 3 and 6 months after treatment, three times in each of the indicated periods.

Rice. 11. Opisthorch eggs in feces.

Forecast of epistorchiasis

In most cases, the prognosis of the disease is favorable. The prognosis worsens with the development of serious complications from the bile ducts and pancreas - bile peritonitis, acute pancreatitis and development of primary liver cancer.

Features of the treatment of chronic opisthorchiasis

In chronic opisthorchiasis, deep morphological changes are formed in the organs. Patients with a chronic course of opisthorchiasis are shown to carry out complex therapy, the purpose of which is sufficient restoration of the affected organs and preparation of the patient for anthelmintic treatment. The completion of the treatment process is the implementation of rehabilitation (restorative) activities.

Preparatory stage

In chronic opisthorchiasis, the course of preparatory therapy lasts 2-3 weeks. Therapeutic measures are aimed at improving the functioning of the liver and pancreas, stomach and intestines, eliminating the symptoms of biliary dyskinesia, allergic reactions and toxicosis.

Rehabilitation therapy

Rice. 12. In the photo, opisthorchis grown in laboratory conditions (photo on the left) and opisthorchis and tailed larvae (photo on the right).

Prevention of opisthorchiasis

Prevention of opisthorchiasis is multifaceted. It includes activities aimed at protecting water bodies from fecal pollution, observing the technology of fish preparation, health education and health promotion.

Sanitary and preventive measures:

Protection of freshwater reservoirs from pollution by fecal masses of people and animals. Do not allow sewerage, household waste, fish production waste and waste from water transport latrines to enter them.

Carrying out activities for the destruction of mollusks.

Compliance with sanitary and technical rules in production.
Compliance with the sanitary and anti-epidemic regime in organized groups.

Therapeutic and preventive measures:

Identification of persons infested with opisthorchs.
Carrying out a complex of therapeutic measures.
Monitoring the effectiveness of treatment.

Particular attention should be paid to water transport workers, fishermen and residents of coastal zones.

Health education and health promotion

Health education of the population is carried out using memos, lectures, individual conversations, radio and television appearances.

Personal prevention:

do not drink water from stagnant reservoirs;
do not eat unwashed greens, especially if it is watered from stagnant water sources;
do not eat raw and half-cooked fish, do not taste minced fish or other fish product;
After working with fish, thoroughly wash the knife and cutting board.

Do not feed raw fish to pets.

Rice. 13. Raw and semi-raw fish can be a source of opisthorchiasis.

What types of fish are affected by opisthorchiasis

Infection of carp fish is different. In some cases, this figure reaches 100%. The maximum of infected fish is recorded in water bodies located near settlements, in commercial lakes and dried up riverbeds (oxbow lakes).

The cyprinid genus includes dace, carp, bream, roach, ide, roach, carp, blue bream, crucian carp, tench, bleak, spike, rudd, chebak, ram, minnow and others.

Sometimes there are whitefish fish infected with larvae of opisthorchis - vendace, muksun, cheese and cheeks. Cases of carriage of helminthiasis in fish living in the same reservoir with fish of cyprinids - perches, pikes, burbots, smelt and pike perches are revealed.

Carp fish are the most important object of fishing in our inland waters.

How is infection detected in fish?

To identify fish affected by opisthorchiasis metacercariae, it is necessary to make an incision along the dorsal fin with a scalpel, cut off the skin flap and make a thin section of muscle tissue. Metacercariae are clearly visible under a magnifying glass with a magnification of 10-20 times.

Rice. 14. Opisthorchis enter the human body and carnivorous animals in the form of metacercariae located in the muscle tissue and fat layer. The metacercariae is located in a rounded cyst - a capsule in the form of a mobile larva.

Rules for processing freshwater fish at home

Freezing

The duration of freezing fish at a temperature of - 28 º C is 32 hours, at a temperature of - 35 º C - 14 hours, at a temperature of - 40 º C - 7 hours.

Fish cooking

Cook fish in a piece for at least 20 minutes, dumplings with minced fish - at least 5 minutes from the moment of boiling.

Fish frying

Whole small fish and fish cakes are fried for 15 - 20 minutes. Large pieces weighing up to 100 grams are fried for 20 minutes.

Rice. 16. There are no opisthorchis in well-fried fish.

Pastry with fish and minced fish

Culinary products with fish and minced fish are baked in the oven for at least 50-60 minutes.

Rice. 17. Fish pies should be baked for at least 50 - 60 minutes.

Salting fish

The fish is salted in a strong saline solution (the amount of salt should be at least 15 - 20% of the weight of the fish) for 14 days. Large fish are salted for at least 40 days, fish up to 25 cm long are salted for 21 days, small fish for at least 10 days.

Drying fish

Drying fish can be done in two ways:

Method 1: salting (for 10 kg of fish 2 kg of salt) for 2 weeks, then soaking and drying (to taste).

Method 2: salting (for 10 kg of fish 2 kg of salt) for 3 days, then drying for 3 weeks.

Small species of carp fish (dace, roach) are salted for 2-3 days, followed by drying for 3 weeks.

Rice. 19. Drying fish.

Fish smoking

Hot type of smoking is carried out for 2 - 2.5 hours at a temperature of + 70 - 80 ° C.

The cold type of smoking is carried out after strong salting (for 10 kg of fish 2 kg of salt) for 2 weeks or freezing for 2 days at a temperature of -28 ° C or 10 hours at a temperature of - 35 ° C.

Rice. 20. Smoking bream (photo on the left). Ready-made cold-smoked bream (photo on the right).

The absence of low-temperature chambers at fish processing plants is one of the factors in the spread of infection.

Increased eosinophilic cationic protein after taking three courses of nemozole, biltricide There were frequent recurrences of genital herpes (every month) during the year. The treatment prescribed by the venereologist did not help in any way (acyclovir 800 mg three times a day). After changing the venereologist and the hospital, an immunogram was prescribed, which showed an increased ECP value (I am attaching a photo of the analysis, the ECP analysis showed 80 ng / ml), which was in February of this year. After administration of Nemozole, the value rose to 91 ng/ml, and after subsequent courses of Nemosol and biltricide, the value gradually decreased to 36 ng/ml and remained unchanged after another course of biltricide and triad. The relapses of HH decreased (this year there were 4 times), since acyclovir was drunk for half a year. Before the first tests for ECP, anti-allergic drugs were taken, and I never observed allergies in myself, except for the fact that a runny nose begins in the cold. A few years ago I did allergy tests for the main allergens, the result was negative. What other tests need to be done to exclude or confirm the helminthic cause of an increase in ECP? You just don’t feel like drinking anthelmintic drugs, because the gastrointestinal tract is in poor condition after the courses that have already taken place.