How To Identify and Treat Worms in Your Poop

Intestinal worms are parasites that live in your gut. The worms can cause symptoms like stomach pain, vomiting, and diarrhea. Eventually, the worms can pass through your stool (poop). That means you might be able to see worms or pieces of worms in human poop.

There are many types of worms that might be in your poop, and identification will vary depending on the worm. You should contact your healthcare provider if you believe you might have worms in your stool. This way, you can be treated with medication if necessary.

Proper identification and early treatment are important because while many worm infections cause only mild—if any—symptoms, in rare cases, worms can damage tissues, organs, and nerves. 

What Do Worms Look Like in Human Poop?

If you have an intestinal worm, pieces of it may appear in your poop. The appearance will vary depending on the worm. Many worms resemble earthworms or appear tiny, white, and thread-like. You may even notice the worms moving in your stool. Some worms may also be visible around the anus or on underwear, pajamas, or bedsheets a few hours after a person falls asleep.

Symptoms of Worms in Human Poop

Some people might be able to feel the pieces of worm as they move out of the anus.

Many people with intestinal worms have no symptoms. Others may experience symptoms such as:

• Itching around the anus
• Stomach pain
• Diarrhea
• Nausea
• Vomiting
• Gas or bloating
• Fatigue
• Rash
• Weight loss or loss of appetite
• Dysentery (an infection of the intestines that causes diarrhea with blood or mucus)

Some worms can cause complications such as intestinal obstruction, protein loss, and iron deficiency anemia. People who are immunocompromised may have more severe symptoms and take longer to recover.

Types of Worms in Human Poop

Several types of worms may appear in human poop. Here are some of the most common:

Pinworms

One of the most common types of intestinal worm in the U.S. is pinworm, also known as seatworm or threadworm. Pinworms are small, white roundworms that resemble pieces of thread. Adult males measure 2-5 millimeters (mm), while females are around 8-13 mm with a pointed pin-like tail.

You typically get pinworms from accidentally swallowing the worms' eggs. This can happen if you touch the hands of a person who has pinworms and didn't properly wash their hands after wiping. You can also pick up pinworm eggs through contaminated food and surfaces.

It takes one or two months for pinworms to move through the body and mature into adults. At this point, female pinworms start to exit through the anus and lay eggs.

The most common symptom of pinworm is itching around the anal or vaginal area. Itching can become severe and make it hard to sleep. Some people also experience stomach pain or appendicitis, which is inflammation of the appendix that can cause abdominal pain.

Ascaris

Ascaris lumbricoides (also known simply as Ascaris) is the largest intestinal roundworm that can infect humans. Adults measure 15-35 centimeters long with a diameter of around 6 mm. Females have a straight tail while males have a curved tail.

When you swallow Ascaris eggs, they mature into adults within two months. They may stay in your small intestine for up to two years. Adult females produce up to 200,000 eggs each day, which are passed into your stool. While you wouldn't be able to see the eggs, you might notice a worm that has passed through your stool.

These worms cause an infection called ascariasis. Most people have no symptoms, but others may have symptoms including:

• Bloating
• Breathing problems
• Coughing up bloody mucus
• Diarrhea
• Fever
• Loss of appetite
• Nausea or vomiting
• Poor growth
• Stomach pain

Rarely, worms may come out of the nose or mouth, especially while vomiting or coughing.

Hookworm

Hookworms are roundworms with heads shaped like hooks. They are about half an inch long.

Immature hookworms can penetrate your skin and enter your body when you walk barefoot on contaminated soil. They may cause an itchy rash when they do so.

After entering the body, hookworms make their way to the small intestine. They can stay there for a year or longer before being released into your poop.

People with hookworm may have symptoms like cough, fatigue, fever, and pale skin. They may also have gastrointestinal issues like diarrhea, nausea, loss of appetite, gas, and stomach discomfort. Some people experience protein loss and anemia since hookworms suck blood from the intestinal walls.

Tapeworm

Tapeworms are white flatworms that can survive for years and can grow longer than 12 feet. People get infected from eating the undercooked or raw meat of animals that had been contaminated with immature tapeworms.

Once inside a human intestine, the tapeworm grows into an adult over the span of two months. An adult tapeworm has up to 2,000 segments. Each segment measures up to 1 inch in length and contains up to 100,000 eggs. Segments may detach from the worm and pass into the stool, where you may notice them moving. In your stool, the segments can look like ribbons.

Tapeworm infection symptoms can include nausea, diarrhea, and stomach pain. Rarely, it can have complications like tissue damage, intestinal blockages, and seizures.

Flukes

Intestinal flukes are flatworms that vary in size from several millimeters to a few centimeters. Around 70 different types of flukes are known to infect human intestines.

The largest intestinal fluke to infect humans is Fasciolopsis buski. You can acquire it by drinking water or eating fish, crustaceans, and aquatic plants such as watercress that are contaminated. After you ingest larvae, they attach to your intestinal walls and grow into adult flukes within a few months. Adults live for about a year. Besides adult worms, you might also notice liquids like bile in your stool.

However, Fasciolopsis buski is more common in Asia. There are other types of flukes that are more common in the U.S., though it is less likely you'd be able to see worms in your stool with the naked eye because the types are smaller.

What Causes Worms in Human Poop?

Depending on the type, intestinal worms may be contracted in different ways, such as:

• Having contact with surfaces or objects that have worm eggs (which may happen if someone with worms doesn't wash their hands)
• Touching or walking barefoot on soil containing intestinal worm or worm eggs
• Drinking water or eating food with worm eggs
• Eating raw or undercooked meat of infected animals (especially beef, pork, or fish)
• Having sexual contact (particularly oral-anal contact)

Once the worms or worm eggs enter your body, they travel to your intestines and may pass into your stool.

People with intestinal worms can transmit them to other people—and even reinfect themselves—if they don't wash their hands. This is especially true if they handle food.

Risk Factors

Thanks to modern sewage systems and toilets, many types of intestinal worms are uncommon in the U.S. Living in or visiting an area with less waste control can increase your likelihood of infection. Other risk factors of intestinal worms include:

• Living in or visiting a place with poor sanitation of food and water
  
• Being younger
• Being older
• Having a weakened immune system (especially due to HIV or AIDS)
• Living with school-aged children
• Living in a place with institutional care

How To Diagnose Worms in Human Poop

Reach out to a healthcare provider if you see what you think are worms in your poop or you develop other symptoms of intestinal worms.

Most worms can be diagnosed with a sample of your stool. Your healthcare provider will examine your stool for worms or worm eggs. However, pinworm is usually diagnosed with a tape test. A sticky piece of tape is pressed around the anus and then placed under a microscope to look for eggs.

Depending on the type of worm, your healthcare provider may also perform other tests, such as X-rays and other imaging tests to check for worms, as well as blood tests.

Treatment for Worms in Human Poop

The goal of treatment is to get rid of worms and prevent or treat complications. While most infections aren't serious, some infections can cause significant complications. These include intestinal blockages, seizures, tissue damage, anemia, and allergic reactions.

Some mild infections don't need treatment. Otherwise, infections are typically treated with medications that paralyze or kill the worms. Possible medications vary based on the worm but include albendazole (Albenza), mebendazole (sold under brand names like Vermox and Emverm), and praziquantel (Biltricide). Depending on the worm, like pinworm, the people in your household may also need to take medication.

If you have complications, those should be treated, as well. For example, intestinal blockages are treated with endoscopies to remove worms. Surgery may be necessary in rare cases. Your healthcare provider may recommend eating more protein if you have hookworm and have developed anemia.

Wash your hands regularly before, during, and after treatment to avoid reinfecting yourself or infecting others.

Contact your healthcare provider if symptoms don't improve within a couple of weeks of treatment. Regardless, your healthcare provider may want to check your stool for eggs again after three months to make sure they're gone. If they're not, you may need to be treated again.

How To Prevent Worms in Human Poop

Washing your hands regularly can help you avoid intestinal worms. It's especially important to wash your hands in the following situations:

• Before eating or handling food
• After using the toilet
• After touching soil
• After engaging in outdoor activities
• After playing with animals

Here are some other steps you can take to reduce your risk of intestinal worms:

• Practice food safety.
• Avoid eating raw or undercooked meat (such as pork, beef, or freshwater fish).
• Wash, cook, or peel fruits and vegetables thoroughly.
• Avoid touching objects that may be contaminated with animal feces.
• Avoid contact with soil that may be contaminated with human feces.
• Go to the vet to deworm pets as necessary.
• Dispose of pet feces at least once a week.

When you're in an area with a high risk of parasites, take steps such as the following:

• Use only bottled or boiled water.
• Avoid walking barefoot on soil.
• Stay away from raw fruits and vegetables you didn't peel and wash yourself using safe water.

A Quick Review

Different types of intestinal worms may appear in human poop. These include pinworms, Ascaris lumbricoides, hookworms, tapeworms, and flukes. Sometimes you can see the worms moving in your stool. You might also feel the worm coming out of your anus as you make a bowel movement.

It's important to contact your healthcare provider if you see worms in your poop or notice any other signs or symptoms of intestinal worms. While most infections are mild, treatment can help you avoid complications such as intestinal blockages. Most intestinal worms can be identified with a stool sample and treated with medication.