Common causes of an itchy bottom
Threadworm infections, although relatively harmless, can be both irritating and distressing - but whilst it's not something we often discuss with family and friends, chances are many of the people you know will have had to deal with this problem at one time or another. Threadworm eggs are easily spread, and infection is more common than you might imagine.
Threadworms are thin, cotton-like worms usually between 2 and 12 mm in length. You may notice them in your or your child's poo after a bowel movement. However, sometimes the only symptom of an infection is itching around the back passage (anus) which occurs more frequently at night. If you suspect you or your child are suffering from threadworms, ask your doctor or pharmacist for advice.
How did I get threadworms?
Threadworm eggs can be picked up from surfaces both in and out of the home, and transferred to the body when eating or touching the mouth. If you or a family member develops threadworms, it isn't necessarily an indication of poor hygiene, and it certainly isn't anyone's fault. Whilst many people are embarrassed about threadworms, chances are that most of us have experienced an outbreak at some point.
Children, in particular, may be embarrassed or even afraid to talk about their symptoms. Reassuring your child that whilst unsightly, threadworm infection isn't harmful and is very common, will put little minds at rest.
How is the infection treated?
Threadworm treatment is fairly straightforward. Your doctor will usually prescribe a medication called mebendazole - available in liquid or tablet form - and a single dose should clear the problem. A second dose is often recommended a fortnight later, to minimise the risk of recurrence as you may reintroduce the problem by ingesting threadworm eggs - which can survive for up to two weeks on bedding, or other household surfaces.
As threadworm infection is very contagious and can easily be passed on to others, your doctor is likely to recommend that the whole household be treated - even if others are displaying no symptoms. However, the medication should not be taken during pregnancy or given to infants under 2 years old, so your doctor may recommend hygiene measures to combat the infection in such cases.
Now the tricky part
Whilst the internal threadworm infection can be easily treated with medication, you also need to ensure that your house is free of threadworm eggs, as these can survive only to be accidentally ingested, starting the whole process again.
This means stripping off and washing all bedding, as well as towels and even the kids' bedtime teddies. Your house will also need a thorough dust and vacuum and surfaces should be cleaned with a damp cloth.
Washing several lots of bedding and deep-cleaning your home all at once may seem like an overwhelming task, but is an important tool in avoiding potential reinfection.
"Changing and washing bedding can help to remove threadworm eggs within the linen," agrees Dr Luke Powles, clinical director at Bupa UK. "However, be careful when removing the sheets as shaking bedding around may cause the eggs to land on other surfaces and spread infection."
Family members also need to ensure they wear underwear during the night for the next two weeks - this stops them scratching in their sleep and collecting eggs under the fingernails, which can then be ingested accidentally. Everyone in the household should wash or shower every morning, paying particular attention to the anal area to remove any eggs.
"Wearing underwear whilst you're sleeping is helpful to contain any further eggs laid by the worms. Change this underwear in the morning and wash it thoroughly," advises Powles.
Other hygiene measures
To reduce risk, attention should also be paid to hand hygiene. "Scratching the affected area can lead to eggs collecting underneath the nail beds and spreading the infection to other surfaces. Keep fingernails short so there's less space for eggs to collect, and make sure everyone's in the habit of regularly and thoroughly washing their hands, especially before eating," explains Powles.
Bedding should be washed regularly, and children should be discouraged from thumb sucking or nail biting, which could potentially return eggs into the body.
If infections recur
Remember, although good hygiene practice may minimise the chance of re-infection, your home and its inhabitants may not be the cause of any recurrence. If you or your child suffer persistent threadworms, whilst it's advisable to practise the good hygiene measures suggested, it's not necessarily a lack of home hygiene that caused the infection in the first place.
Infection can be easily picked up from elsewhere, and may be occurring outside of the home - for example, in your child's school or nursery.
However, if you or your child suffer frequent infections, it's worth speaking with your GP for additional advice.