[Intestinal helminthiasis--general practice problem of the gastroenterologist]

In case of nonspecific, not constantly occurring abdominal symptoms the investigator should be aware of invermination, especially when immigrants or tourists returning from far regions complain about diarrheal tendency, stomach ache, nausea or hepatic and biliary symptoms. Intestinal helminthism is spread all over the world. Some of these diseases are limited to warm regions, but they are more and more often seen in our gastroenterological outpatient departments. Nematodes are found most frequently, with a predominance of Ascaris, Trichuris, and Enterobius. But Ancylostoma and Strongyloides are not seldom, too. Concerning Cestodes, Taenia and Vampirolepis are predominant. Trematodes = Fasciola, Echinostoma, Schistosoma are less frequent. Larva migrans, Acanthocephala and Dipylidium sometimes cause considerable diagnostive problems. Classification of macroscopic and microscopic findings is decisive for the therapeutic strategy. For nematodiasis Mebendazole (Vermox, Surfont), Pyrantelembonate (Helmex), Pyrviniumembonate (Molevac, Pyrcon) are effective. Albendazole (Eskazole) is approved for strongyloidiasis. For cestodiasis Niclosamid (Yomesan) and Praziquantel (Cesol) are suited. Higher doses of Praziquantel (Biltricide) are recommended for trematodiasis. During pregnancy and lactation period absorbable anthelmintics have to be avoided.