Editing Trichuriasis (section)

==Signs and symptoms==
Light infestations (<100 worms) frequently have no symptoms. Heavier infestations, especially in small children, can present gastrointestinal problems including abdominal pain and distension, bloody or mucus-filled diarrhea, and tenesmus (feeling of incomplete defecation, generally accompanied by involuntary straining). Mechanical damage to the intestinal mucosa, and toxic, or inflammatory damage to the host's intestines may occur. While appendicitis may be brought on by damage and edema of the adjacent tissue, if there are large numbers of worms or larvae present, it has been suggested that the embedding of the worms into the ileocecal region may also make the host susceptible to bacterial infection. A severe infection with high numbers of embedded worms in the rectum leads to edema, which can cause [[rectal prolapse]], although this is typically only seen in small children. The prolapsed, inflamed, and edematous rectal tissue may even show visible worms.{{citation needed|date=July 2020}}

[[Failure to thrive|Physical growth delay]], [[weight loss]], [[nutritional deficiencies]], and [[anemia]] (due to long-standing blood loss) are also characteristic of infection, and these symptoms are more prevalent and severe in children. It can cause [[eosinophilia]] but it is not common.<ref>{{cite journal
| last1 = Abdullah
| first1 = Nasturah
| last2 = Baharudin
| first2 = Noorhida
| last3 = Mohd Rustam
| first3 = Farah Roslinda
| last4 = Khalid
| first4 = Zalizah
| title = Significant Leukocytosis with Hypereosinophilia Secondary to Trichuris trichiura in Adult: A Case Report
| journal = Clinics and Practice
| volume = 11
| issue = 4
| pages = 785–790
| date = 2021-11-26
| language = English
| doi = 10.3390/clinpract11040094
 | pmid = 34842643
| pmc = 8628709
| doi-access = free
}}</ref>

[[Coinfection]] of ''T. trichiura'' with other parasites is common and with larger worm burdens can cause both exacerbations of dangerous trichuriasis symptoms such as massive gastrointestinal bleeding (shown to be especially dramatic with coinfection with ''[[Salmonella typhi]]'') and exacerbation of symptoms and pathogenesis of the other [[parasitic infection]] (as is typical with coinfection with ''[[Schistosoma mansoni]]'', in which higher worm burden and liver egg burden is common).  Parasitic coinfection with HIV/AIDS, tuberculosis, and malaria is also common, especially in [[sub-Saharan Africa]], and helminth coinfection adversely affects the natural history and progression of HIV/AIDS, tuberculosis, and malaria and can increase clinical malaria severity.  In a study performed in Senegal, infections of [[soil-transmitted helminth]]s like ''T. trichiura'' (as well as schistosome infections independently) showed enhanced risk and increased the incidence of malaria.<ref>{{cite journal
| last1 = Le Hesran
| first1 = J.Y.
| last2 = Akiana
| first2 = J.
| last3 = Ndiaye
| first3 = el H.M.
| last4 = Dia
| first4 = M.
| last5 = Senghor
| first5 = P.
| last6 = Konate
| first6 = L.
| title = Severe malaria attach is associated with high prevalence of Ascaris lumbricoides infection among children in rural Senegal.
| journal = Transactions of the Royal Society of Tropical Medicine and Hygiene
| volume = 98
| issue = 7
| pages = 397–9
| date = Jul 2004
| language = English
| doi = 10.1016/j.trstmh.2003.10.009
| pmid = 15138075
}}</ref>

Heavy infestations may have bloody [[diarrhea]]. Long-standing [[blood loss]] may lead to [[iron-deficiency anemia]].<ref>{{cite journal|author1=Gyorkos TW|author2=Gilbert NL|author3=Larocque R |author4=Casapía M|journal=Trop Med Int Health|year=2011|volume=16|issue=4|pages=531–7|title=Trichuris and hookworm infections associated with anaemia during pregnancy|doi=10.1111/j.1365-3156.2011.02727.x|pmid=21281406|s2cid=205391965|doi-access=}}</ref> [[Vitamin A]] deficiency may also result due to infection.<ref name="Medterms.com">{{cite web |url=http://www.medterms.com/script/main/art.asp?articlekey=12961 |title=Trichuris trichiura definition - Medical Dictionary definitions of popular medical terms easily defined on MedTerms |publisher=Medterms.com |date=2000-04-15 |access-date=2009-05-19 |url-status=live |archive-url=https://web.archive.org/web/20110606011050/http://www.medterms.com/script/main/art.asp?articlekey=12961 |archive-date=2011-06-06 }}</ref>