Trichuriasis

 

Clinical Presentation In Humans

Many people that are infected with T. trichiura are asymptomatic due to light infections. However, in people with heavy infections, whipworm can cause gastrointestinal problems, such as abdominal pain, diarrhea, mucous or bloody stools weight loss, painful urination, and weakness. Rectal prolapse is a hallmark, albeit rare, symptom of a heavy T. trichiura infection that occurs in children more frequently than adults. When rectal prolapse occurs, worms can often be identified on the edematous rectum.
Heavy infections in children display the most severe symptoms, and nutritional deficiencies incurred from the infection can retard growth. Also, some cases of appendicitis are reported in conjunction with a whipworm infection.

Whipworm in the gut

 

Most symptoms associated with whipworm can be attributed to the burrowing of worm heads into the intestinal epithelium. This can result in increased fluid secretion and/or decreased absorption of fluid in the colon. Large increases in luminal fluid content cannot be adequately reabsorbed, and can lead to dehydration, diarrhea, or loss of electrolytes and nutrients. Also, there is some blood loss due to embedded whipworms in the gut.

Rectal prolapse
Rectal prolapse is a condition in which the lower portion of the colon, just inside the anal canal, becomes turned inside out and protrudes outside the body. In a whipworm infection, the rectum loses its internal support because the worms bury their thin heads into the intestinal lining, loosening the elastic epithelium and weakening the surrounding muscles.

Prolapsed Rectum, image courtesy of Dr. Scott Smith