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Suggest treatment for enterobius vermicularis infection

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Posted on Sat, 16 May 2015
Question: I have had severe anal itching for about 7 years now, it doesn't seem to get better, tried pinworm medicine, anti fungal cremes, steroidal creams, washing with hypoallergenic soaps, baby wipes, soaking, it itches around the anus and between the testicles and anus area. Please see photo from this morning. I have had hemmhoroid surgery about 10 years ago as well.
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Answered by Dr. Noble Zachariah (40 minutes later)
Brief Answer:
Suggestions follow.

Detailed Answer:
Hello,

Welcome and thanks for your query.
I can imagine how annoying it has been to you.
The two likely diagnoses for the itching would be enterobius vermicularis ( pin worm) and candidiasis. Did you have a stool examination? Sometimes it shows up in that. you should also check if it is related to any food you eat as food allergies are a common cause of anal itching.
The treatment I would recommend is Albendazole 400 mg as a single dose at bed time. The dose will have to be repeated once a week for two weeks.
You can also take an antihistamine like Zyrtec at night till the itching stops.
If this does not work then you should treat for the next probable cause, the candidiasis. This would be with Flucanazole 150 mg once a week for 3 weeks.
Try these and I hope you would be rid of the problem. If not you would have to have some blood tests for rare causes of itching.
Hope you would be better soon.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Noble Zachariah (13 minutes later)
I did not have a stool examination but about about 8 years ago I had a colon hydrotherapy cleansing treatment and the woman administering the treatment mentioned that she saw worms in the clear tube as the feces were being removed. I bought some over-the-counter pinworm medication but it didn't seem to help so I discounted that as not being the problem but I'll try again. I used something called "Pin-X (Pyrantel Pamoate - Pyrantel base 50mg/mL) but not Albendazole. From there I will move on to the other options. Thank you.
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Answered by Dr. Noble Zachariah (1 minute later)
Brief Answer:
Welcome

Detailed Answer:
Thanks for the feed back.
Do get back to me after you have had the medicines suggested or if you have further queries.
Wish you good health and a great day.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Noble Zachariah

Internal Medicine Specialist

Practicing since :1974

Answered : 2320 Questions

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Suggest treatment for enterobius vermicularis infection

Brief Answer: Suggestions follow. Detailed Answer: Hello, Welcome and thanks for your query. I can imagine how annoying it has been to you. The two likely diagnoses for the itching would be enterobius vermicularis ( pin worm) and candidiasis. Did you have a stool examination? Sometimes it shows up in that. you should also check if it is related to any food you eat as food allergies are a common cause of anal itching. The treatment I would recommend is Albendazole 400 mg as a single dose at bed time. The dose will have to be repeated once a week for two weeks. You can also take an antihistamine like Zyrtec at night till the itching stops. If this does not work then you should treat for the next probable cause, the candidiasis. This would be with Flucanazole 150 mg once a week for 3 weeks. Try these and I hope you would be rid of the problem. If not you would have to have some blood tests for rare causes of itching. Hope you would be better soon.