14. The Most Disgusting Thing I Have Seen as a Mom and Pediatrician: Live Pinworms

Though I’m squirming at the thought of discussing pinworms, the subject bears mentioning. Nearly 10 years ago, a young member of my family complained at night that her bottom was itching. For a few nights I checked the area and didn’t see anything usual. Then I had an idea.

“Try bearing down,” I told her. “Push out like you’re going poop on the potty.”

She did, the anal area opened, and what I saw was horrible. A tangle of white worms was wriggling around inside her anus.

“Oh, my,” I breathed.

“What’s wrong?” she asked.

“Nothing,” I said. Then I ran to bathroom, where I leaned over the toilet and nearly vomited.

Never in my life have I seen anything as horrible as pinworms squirming around inside a child (my child!). And I’ve seen a lot of disgusting things!

If you ever have the joy of witnessing pinworms in action, take heart—they are much easier to eradicate than head lice. The key to ridding your family of pinworms is understanding the life cycle. Pinworms are spread from person to person via a fecal-oral route. Kids poop on the potty, don’t wash their hands well, and voila, everyone at preschool has pinworms!

At nighttime, adult worms journey down to the anal area to lay eggs. That’s why kids with pinworms only have itchy bottoms after the sun descends. Children continually reinfect themselves with worms by scratching their behinds, getting eggs caught under their fingernails, and placing their fingers inside their mouths.

As with head lice, OTC pinworm meds treat live critters, but they don’t kill eggs. To interrupt the pinworm lifecycle, start by treating the live worms with medications that can be purchased at the pharmacy (like Reese’s Pinworm Medication, for instance) and repeat in two weeks. At the same time, keep your child’s rear end covered. Children with pinworms should wear either a diaper or underwear all the time, except when they’re in the tub. Once you cut off access to the rear, the worms can’t reproduce. This may be tough in a household where the kids prefer to run around naked, but keeping bottoms covered is critical for banishing pinworms.

When treating children for pinworms, parents should also open the window shades (the eggs don’t like sunlight), file fingernails (so eggs can’t get stuck there), and wipe down bathroom surfaces with cleaning fluid to remove any eggs that may be sitting around. Because the eggs are too small to see, you should assume they’re all over your bathroom. Yuck!

In summary, if your child complains of an itchy bottom at nighttime, talk to your pediatrician about the possibility of pinworms, and cut off access to the rear!

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