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2 year old with stomach ache and itching in the anus. Medication?

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Pediatrician, Infectious Diseases
Practicing since : 2005
Answered : 1528 Questions
hi, my daughter is 2 years old, and lately she has been complaining of some stomach ache at times.Also feels itchi in the rectum area.
Please advise
Posted Sun, 29 Apr 2012 in Child Health
Answered by Dr. Hema Yadav 7 hours later
Thanks for posting your query.
Itchiness in anal region along with pain in abdomen are most likely indicative of worm infestations in children.
Though there are many types of worm infections the most probable in this case could be thread worm or pinworm .
Threadworms are common but are not usually serious. Threadworms infect the gut and lay eggs around your anus which causes itch. Treatment usually includes medication plus hygiene measures. Medication kills the worms, but not their eggs, which can survive for two weeks. Therefore, you also need strict hygiene measures for two weeks after taking medication to prevent you from swallowing eggs which may cause a new infection. All household members should be treated at the same time, preferably
The treatment like most other worm infestations , is deworming with agents like albendazole , mebendazole or piperazineor ivermectin.
The dose would be as directed by her pediatrician according to age and weight and after the first dose a repeat course after an interval of two weeks may be preferred.
Medication will kill the worms in the gut, but not the eggs that have been laid around the anus. These can survive for up to two weeks outside the body on underwear, bedding, in the dust, etc
So, hygiene measures aim to clear any eggs from the body and the home, and to prevent any
eggs from being swallowed. This will then break the cycle of re-infection.
So first of all , I would advise you to consult her pediatrician and get a stool routine test or alternative tape test to confirm the diagnosis and start apropriate treatment.
Along with this you should follow the following hygiene measures to prevent reinfection
1. Make the child bath early in the morning( ideally straightaway after getting up from bed )& wash the anus to get rid of eggs laid overnight.
2.wash all her sleepwear, bed linen, undergarments with normal washing soap and water & rinse well .
3.Prevent her from scratching her anus and cut her nails .Practise frequent hand washing and prevent finger sucking.biting nails etc
4.Clean bedroom, bathroom thoroughly to get rid of any eggs.
However, it may not be your home which is a main source of threadworm eggs. Your children may come into contact with eggs in schools or nurseries, particularly in the toilets if they are not cleaned properly. so good personal hygiene will help but cannot guarantee protection.
Please do not worry as this is not a harmful infestation.There are no major complications but the worms if untreated for long may cause anal itching and sores, abdominal pain, urethral and vaginal infections in female child .Once treated appropriately and with good hygiene it may soon resolve .
Hope I have answered your query.

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