While it may seem strange, it is possible for worms to live inside the human body and even be expelled through the mouth, nose, or other orifices. This condition is known as intestinal parasitism and is often caused by roundworm, pinworm, tapeworm, or other parasitic worms that take up residence in the gut. When worms emerge from the body, their appearance can range from resemble rice, sesame seeds, or thin spaghetti noodles. Understanding what worms look like when passed helps identify the type of parasite and guide treatment.
What Causes Worms in Humans?
Worm infections are spread through ingesting microscopic eggs or larvae. Sources include:
- Contaminated food or water
- Poor hygiene and sanitation
- Contact with infected surfaces or soil
- Some worms can penetrate skin
Once inside the body, worms travel to the intestines where they can live, feed, grow, and reproduce. Over time, a population of adult worms develops and causes symptoms. In some cases, worms migrate to other organs like the liver. Worms produce eggs that are then passed in the feces to continue the lifecycle. Larvae and eggs can reinfect the original host through the fecal-oral route.
Common Intestinal Worms in Humans
Roundworms
Roundworms are long, tubular worms that look like stretched out spaghetti, measuring from 1 to 12 inches long. Species that infect humans include:
- Ascaris lumbricoides
- Strongyloides stercoralis
- Trichuris trichiura
Roundworm eggs and larvae live in soil. Infection occurs from ingesting eggs through contaminated produce, water, or surfaces. The worms travel to the intestines where they can grow over 12 inches long. Heavy roundworm infections can cause intestinal blockages.
Pinworms
Pinworms are tiny thread-like worms less than 1 inch long. Despite their small size, they are the most common intestinal parasite in the United States.
Pinworm eggs are easily spread through contaminated surfaces, food, or improper hand washing. After ingestion, the eggs hatch in the intestines. Mature female pinworms migrate out of the anus and deposit eggs on the surrounding skin which can cause intense itching.
Tapeworms
There are several tapeworm species that can infect humans. They live in the intestines and can grow over 30 feet long. Tapeworms have flat, segmented bodies. Each segment contains eggs and breaks off to pass out of the body through feces.
People get tapeworms from eating contaminated pork, beef, or fish. The worms attach to the intestinal lining using hook-like mouthparts and absorb nutrients. Tapeworm segments passed in stool may be visible crawling or moving independently.
Whipworms
Whipworms are named for their whip-like shape. They are between 1 to 2 inches long and live in the cecum and colon.
Whipworm eggs are passed through feces into soil. Humans can become infected through exposure to contaminated soil or food. After ingesting eggs, larvae hatch and travel to the intestines to mature. Female worms use blood to produce eggs.
Signs and Symptoms of Worm Infections
Light worm infections may not cause symptoms. Heavier infestations can cause:
- Abdominal pain
- Diarrhea
- Gas and bloating
- Fatigue and weakness
- Weight loss
- Itching around the anus (pinworms)
In some cases, worms may be visible in the stool, vomit, or emerging from the nose or mouth. Coughing up worms can indicate a heavily infected lung. Some worms get expelled while crawling out of the anus or detaching from intestinal lining. Let’s look at what different worms look like when passed.
Appearance of Worms Passed Through Feces or Vomit
Roundworms
Roundworms are long, tubular parasites reminiscent of earthworms, measuring from 1 to 12 inches. They have a smooth, tan color and rounded ends. Roundworms passed in stool may appear:
- Coiled or folded over
- Moving or crawling
- Twisting and flailing around
Sometimes only roundworm eggs are passed. They cannot be seen without a microscope. Under magnification, roundworm eggs have a distinctive football shape with a lumpy outside shell.
Pinworms
Pinworms look like tiny, white or transparent threads about 1 inch or less in stool. They may be:
- Coiled up
- Moving or wiggling
- Crawling on the surface of feces
Pinworm eggs need a microscope to be seen. They have an asymmetrical oval shape and grow over time after being laid.
Tapeworms
Tapeworm segments passed in feces look like small pieces of white rice, seeds, or grains of rice. They may be motionless or seen crawling or moving independently.
Sometimes an entire coiled up tapeworm is passed measuring several feet. It has a flat body wider than a roundworm. Under a microscope, tapeworm eggs have a round shape with a thick radial wall.
Whipworms
Whipworms passed in feces look like tiny (1-2 inch), yellowish-white threads that are thinner than roundworms. Their delicate whip-like ends may be visible.
Whipworm eggs cannot be seen without magnification. They have an oval shape with a transparent shell and identifiable larvae inside.
Worms Passed Through Coughing, Gagging, Nose
In rare cases, worms may be coughed up or emerge from the nose or mouth. This can occur with:
- Roundworms migrating through the respiratory system
- Coughing fits that expel intestinal worms upwards
Worms detaching from intestinal lining
Coughed up worms appear long, wet, and may be moving. Worms exiting the nasal cavity look stringy. Gagging can force intestinal worms upwards and out of the mouth.
Worms Emerging From the Skin
While most worms live in the intestines, some can burrow out through the skin. This is more common with parasitic larvae.
Signs include:
- Small, raised red bumps
- Itchy rash or hives
- Pinpoint wounds that leak pus
- Visible worms emerging from skin
Worms coming out of skin look like tiny, white or red threads. They may be coming partially out of a puncture wound. The surrounding skin is red, inflamed, and itchy.
Worms Crawling Out of Anus
Some worms make their way out of the intestines through the anus. This is most common with:
- Pinworms
- Tapeworms
- Roundworms
Signs of worms exiting the anus include:
- Itching, redness, and irritation around the anus
- Worms visible crawling on toilet paper or underwear
- Worms emerging from the anus
Pinworms look like tiny white threads wiggling out of the anus. Roundworms appear as long tan worms actively twisting and moving. Tapeworms look like smaller segmented worms or pieces detaching.
How to Collect and Identify Worms Passed
If you suspect worms emerging from your body, try to collect a sample to identify the type of parasite. Steps include:
- Inspect underwear, toilet paper, or bedding for any worms.
- Loosely wrap any worms passed in toilet paper or seal in a plastic bag.
- Place worm samples in a sealed container.
- Note the location worms were passed from.
- Bring samples to your doctor for analysis under a microscope.
Knowing what worms look like and where they come from helps identify the parasite. This guides appropriate treatment to eliminate the worm infestation.
Treatment for Worm Infections
Most worm infections are easily treated with oral medication prescribed by a doctor. Common anti-worm medications include:
- Albendazole
- Mebendazole
- Ivermectin
- Pyrantel pamoate
These drugs paralyze and kill worms so they detach from the intestines and exit the body through feces. Most people see improvements after a single dose, but multiple treatments may be needed.
For severe cases, surgery may be required to remove masses of worms blocking intestines. Getting rid of an intestinal worm infection requires diligent hygiene to prevent reinfection and spread to others.
Prevention of Worm Infections
Preventing worm infections involves interrupting the lifecycle between humans and soil. Tips include:
- Wash hands before eating or preparing food
- Wash all fruits and vegetables thoroughly
- Only drink clean water from sealed bottles or treated sources
- Avoid walking barefoot where there may be worm eggs in soil
- Cook meat thoroughly to kill any worm larvae
- De-worm household pets regularly
Practicing good hygiene, especially around food and eating, can help avoid ingesting worm eggs or larvae. Taking preventative worm medication can protect those at high risk like children or those visiting tropical areas.
Conclusion
Worms that infect humans come in many shapes and sizes. But most look like some form of thread or noodle when passed in stool, through coughing/gagging, from the skin, or exiting the anus. The exact appearance of worms expelled can indicate the parasite type, such as roundworms, tapeworms, or pinworms. This helps guide appropriate treatment to fully eliminate the worms. Practicing careful hygiene and sanitation is key to preventing worm infections in the first place.