Could it be worms?

Although often asymptomatic, parasitic infections can lead to disruptions in mood, behavior and sleep – particularly in children with worms.

The most common worm infection amongst Australian children is threadwork (pinworm, Enterobius vermicularis). With other worms such as roundworms, hookworms and tapeworms being far less common.

It is estimated that 50% of children will experience pinworm infection. Occurring most frequently in school children aged 5-10 years.

What are worms?

Pinworms are tiny, white worms that live in the colon and rectum. Despite our best efforts in schools, childcare centers and kindergartens, worms are passed along easily due to close personal contact between children.

Transfer of infection occurs through parasitic eggs either directly or indirectly by hand contact or through contaminated clothing, bedding or food. The most common culprit is unwashed hands in the bathroom touching door handles. While you may be confident that you have taught your own children effective hygiene practices, we can’t guarantee what their classmates are doing!

Parasitic eggs can survive for up to TWO WEEKS on clothing, bedding, and other objects. This makes persistent re-infection a common occurrence and standard treatment often ineffective.

The larvae hatch in the small intestine before wriggling their way to the rectum. However they have been discovered in surrounding areas. Some examples include: hiding in the appendix and in the female genital tract (due to the proximity between the rectum and vagina leading to cross infection).

What symptoms should I be looking for?

The symptoms of pinworm infection are generally mild and often occur at night, as this is when the female exits the rectum to lay her eggs.

Symptoms include:
  • Abdominal pain (which can mimic appendicitis)
  • Itchy anus
  • Teeth grinding
  • Bed wetting, or frequent urination (enuresis)
  • Insomnia, restless or disturbed sleep
  • Weight loss/difficulty gaining weight
  • Irritability, mood swings and anxiety
  • Persistent cases of urinary tract infections (particularly in girls)

Chronic infections can lead to disturbances to gut bacteria and wreak havoc on the signaling between the gastrointestinal tract and the brain. Altered communication of the gut-brain axis has been linked to behavioral disorders, mood disturbances, depression and anxiety, as well as issues with learning and memory.

As pinworms are nocturnal, their night time activity results in restlessness, itching, irritation and an overall poor sleep quality. Insufficient and unrestful sleep is well known for its negative effects on children’s moods and behavior – significantly attributing to poor cognition, learning and academic performance. Sleep recommendations for school-aged children is between 9-11 hours, with any less than 7 hours contributing to poor mental health, behavior and academic performance.


Stool sample testing is actually largely inaccurate as eggs can only be detected in about 5% of fecal samples. This could explain the prevalence of under-detection and underestimation of parasitic infestations among children.

The most accurate investigation is actually the simplest and cost effective – the scotch-tape test. This involves exactly what you think it does, placing sticky tape over the perianal area immediately upon rising for three consecutive days. Then investigating for the presence of eggs or actual worms.

Naturopathic treatment

We use a particular formulation of medicinal herbs in the treatment of parasitic infections in children and adults. The method of dosing is just as important as the medicines used.

Parasitic infections have a life cycle that can make pharmaceutical treatment ineffective. A single dose worming tablet can kill off the larvae and adult pinworms, which can lead to temporary symptom reduction. However, eventually the infective eggs left behind will hatch and the cycle will continue.

We treat patients with anti-parasitic herbal medicine for 2 weeks to effectively kill off the live parasites. Following this, we have a two week break to give the eggs time to hatch. We then begin a second 2 week round of treatment to kill off the larvae before they mature and begin replicating once again.

All the while co-prescribing probiotic strains to repopulate the gut with the kind of microbes we want living in there. If we have a healthy and robust microbiome full of beneficial bacteria, we reduce the likelihood of reinfection taking place. Repopulating the gut with the good stuff is just as important as weeding out the pathogens!

A final word…

While worms in children are often mild in symptom presentation, they can become chronic if left untreated. This isn’t a glamorous article to write (or read I’m sure!). But it is of significant clinical importance – mostly because these infections are quite often overlooked or disregarded.

At Body Institute, It’s our hope that this article highlights the importance of effectively diagnosing and treating these infections due to the wide variety of issues that can result from this common childhood infection.

If you’re ready to seek treatment, book an appointment with our children’s health Naturopath, Ashlee online here.

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