How is a tapeworm infection managed in diabetic patients?
Patient's Query
Hello doctor,
I am a type 1 diabetic, and I have suffered from chronic diarrhea for the past 10 years. Finally, the doctor found tape worms and eggs in the stool. I had several rounds of praziquantel (antihelmintics), the last round was 2 weeks ago, with 650 mg per day, with a break in between. I took supplements of all kinds, and now colonics. I am still passing worms. I have improvements in health, pain, and girth around my stomach, also improved but I am frustrated. I cannot seem to get rid of it.
Please help.
Thank you.
Hello,
Welcome to icliniq.com.
I suppose you must give a brief history of the nature of your diarrhea.
- Like, mostly it is oily and malodorous, watery, or gassy?
- Does it have any relation to meals?
- Do you feel any abdominal pain, fever, or itching in the anal area?
- Do you ever have a low Hb (hemoglobin)?
- Any loss of weight?
- What type of worms did you notice on the stool R/E (routine examination) report?
- And most importantly, is your diabetes controlled?
Please help.
Thank you.
Patient's Query
Hi doctor,
Thank you for your answer.
I have been diabetic for 30 years. My HbA1c (glycated hemoglobin) is always around 6, but elevated in the past year with digestion changes now that I am absorbing more food. I take a low-carb and low-sugar diet, organic, and whole food-based. I cook and eat Mediterranean dishes. I am aware of diabetic diarrhea. I know I have gastroparesis, and it is making tapeworm infection worse. My stool is watery, malodorous, and gassy, and it happens 3-10 times a day. Sometimes I have bloating and water retention, and I eat low FODMAP. What I eat at dinner is clearly out by noon the next day. My stomach is always achy and painful. Some anal itching usually occurs at night or after diarrhea. My iron levels are up after much work. The type of tapeworm is Dipylidium (a type of tapeworm in animals), though I never had pets. We eat a lot of fresh fish out of the ocean, but not sure of the source.
Thank you.
Hello,
Welcome back to icliniq.com.
You have a history of tape worms, and you have already tried Praziquantel (antihelmintics). According to your history, I must suggest Albendazole 400 mg per day for three days. You also have some symptoms related to your diabetes (small intestinal bacterial overgrowth,) so it is better to add another drug known as Rifaximine.
Investigations to be done
Differential diagnosis
Treatment plan
Preventive measures
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