I thought I had persistent threadworms, but…

I thought I had persistent threadworms, but…

I want to share my story, because I think there is a chance other people are suffering from the same problem I had. You can read it in full, or skip to the end for the important bit.

I first got threadworms two years ago from my boyfriend. He woke up one night complaining about an itchy bum, and asked if I'd ever had the same problem. I said I hadn't, but a few weeks later, I also started feeling a tickling in my anus in the evenings. I looked it up online and discovered that threadworms were the most likely explanation. A couple of days later, I found a live wriggling worm in my stool, which confirmed the diagnosis.

I was pretty distressed about it, especially having read some of the horror stories here about people never getting rid of them, so we were extremely thorough in treating it. We each took a dose of mebendazole once a fortnight for 8 weeks. We washed our bedding, nightclothes and underwear every day or two; and showered morning and night. It was tiresome, and I worried, because I would occasionally still feel that tickling sensation, but after a couple of months it seemed to be gone, so we went back to normal.

Then, 7 months later, we went to stay with my boyfriend's parents. I had suspected they might also be infected because my boyfriend was living with them at first, and so I wasn't too surprised when, a few weeks afterwards, I felt the tickly-worm-sensation in my bottom again. So we went through the whole routine. We also told his parents, and they treated themselves. Again, after a few weeks, thankfully it seemed to go away.

Then again, 5 months after that, out of the blue, I felt them again. I couldn't explain how we had been reinfected this time, and what was worse, it didn't seem to get better, no matter what we did, I would keep getting the tickling sensation. At first I could feel it 20 or 30 times throughout the day, later it died down to about 5 times per day, but it would not go away. It did seem odd that I felt them during the day and not at night, but I figured the worms probably aren't really that strict in their behaviour. We took mebendazole once a week for 8 weeks. We showered twice daily, and washed all of our clothes and bedding as often as possible. I read more about threadworms, both scientific papers and other people's experiences, and I settled on the theory that the mebendazole isn't 100% effective, and that some eggs hatch and live on inside of you. I also suspected that we were reinfecting each other during sex, despite how careful we were trying to be with our hygiene. I couldn't see any other explanations for why we weren't getting rid of them.

At the same time, I was confused as to why I couldn't find more conclusive proof of the threadworms themselves. I did the tape test a few times, and on only one occasion did I find something that looked a bit like a worm. I never found them again in my stool, but I was aware that this has a low 'success' rate. I once even got my boyfriend inspect my bum at night when I felt the tickling, because I was sure that he would be able to see the worm crawling out, but he found nothing. In the end, I decided this was just because we were being so thorough in our hygiene - evidently we were keeping the worm population at a low number, too low to find them, yet not managing to eradicate them entirely.

Also, I should mention that my boyfriend didn't feel them as frequently as I did. In fact at first he didn't feel them at all, but he trusted that he would have them because I did. Later he said he might have felt them once or twice. It seemed overall that he just wasn't as sensitive to it as I was.

My mum suggested that it might be a phantom sensation. I was outraged - I had experienced the feeling of worms and I knew what it felt like, and it felt like this. There was no way it was just a regular tickle - I didn't normally get this kind of feeling, not in this place, and it was so distinctly like a worm. I explained to her how much I wished it was phantom, because I was exhausted from all of the constant cleaning and washing, and in despair at the thought of facing this my entire life. But I couldn't stop, because if they were this bad when we were trying so hard to get rid of them, then imagine what would happen if we weren't so careful.

Finally, I went to see a doctor, to see if she had any suggestions: either a better way to treat it, another explanation, maybe it was a different parasite this time. She listened to my story, and she did an inspection of my anus. She couldn't find any evidence of worms, and said that she didn't think it was possible that we still had worms after so many treatments of mebendazole.

She diagnosed it as 'pruritus ani', basically, itchy bottom, or irritated anus. This can be caused by a few things, but in this case she was said it was probably just sensitized skin. She said that this can become a vicious cycle, when you scratch, it damages the sensitive tissue, and causes further itching. I said that I didn't scratch at all. But then she said it can also be caused by washing with soap.

https://patient.info/health/pruritus-ani-itchy-bottom

That was when it all made sense to me. I had been washing my bottom more and more thoroughly, in an attempt to get rid of the eggs that I thought were causing the reinfection. Sometimes I would spend two minutes just washing it. And in fact I'd just been making things worse.

We immediately:

a) stopped taking the mebendazole

b) stopped showering twice a day, and stopped washing all our clothes and bedding as often

c) stopped washing and scrubbing ourselves so thoroughly in the shower

It took a couple of days for the tickling sensation to go away, but it did. It's now 5 months later, and we've had absolutely no further problems.

Looking back, I feel a bit silly that I didn't realise before. The warning signs were:

a) feeling the tickling during the day, not just at night

b) not being able to find definitive evidence of worms with the tape test, nor any other methods

c) the fact that I was feeling the tickling and my boyfriend wasn't, even though we live together. And eventually he did feel it a couple of times - this was brought on by the constant washing, not the other way around.

I don't know how it began, maybe I just washed a bit too thoroughly once, and then it snowballed because the thing we thought was helping the problem was actually making it worse and worse.

I can't say whether other people who think they have worms are in fact suffering from this, but it certainly seems possible. If you have the feeling of worms, but haven't actually been able to find them from the tape test, and have taken regular doses of mebendazole, I definitely recommend going to see a doctor, or consider that this might be the explanation.

If you do have this problem, it would be a good idea to switch to an emollient soap-substitute. These are often used to treat eczema, because they don't irritate the skin as much. You can buy them at the pharmacy counter and I've used one before, but I didn't actually need to this time.

SHORT VERSION: I had threadworms once, and treated them with mebendazole. Got them again, and couldn't get rid of them despite weekly doses of mebendazole and frequent washing. It turned out that the problem was the washing itself! The soap was making my anus extra sensitive, and causing a tickle that felt EXACTLY like the worms. I stopped washing my bottom so thoroughly, and the problem went away very quickly after that.

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