Worms: what you need to know

By: Dr Neil Forrest

Osler Health: Star Vista
Posted on: 1 Jun 2021


Intestinal worms are a common issue worldwide, and we frequently see children with them in Singapore. The good news is that they are very unlikely to be harmful and normally easy to deal with once we have diagnosed the problem. Here I’ll outline how we find out if your child has worms and what we can do to get rid of them!

Types of worms

There are actually many different types of intestinal worms but for the purpose of this article I will focus on the most common type, which accounts for almost all the cases I see in my patients: threadworms (also known as pinworms).

Threadworms look like tiny white threads around one centimetre long. They live in the intestines and come out at night to lay their eggs on the skin between the buttocks and sometimes in the vagina in girls. They are most commonly seen in the poo after going to the bathroom, or around the anus at night. Often, they will still be wriggling which helps confirm the diagnosis!


By far the most common symptom is itching around the buttocks (and vagina in girls). This occurs more frequently at night and can disturb sleep so some kids can become more irritable and tired. Occasionally there can be loss of appetite. Sometimes I see a rash around the buttocks caused by the child scratching. Generally speaking, threadworms do not cause significant abdominal pain or weight loss.

How are they spread?

Scratching causes the eggs to collect between the fingernails which are then spread to food, surfaces and other kids. Each female worms lays 10,000 or more eggs and they can survive for two weeks outside the body in our warm humid climate! Humans don’t catch threadworms from family pets

How do we treat them?

We need to stop them spreading, and kill the worms. Stopping spread is achieved by discouraging scratching, keeping fingernails trimmed short and washing hands frequently. Washing bedsheets in hot water kills the eggs, and floors and mattresses can be vacuumed to remove any that have escaped.

To kill the worms which are already inside the body we use a medication called albendazole. This is available in tablet and liquid form and I recommend treating the whole household at the same time, even those without symptoms. The medication is generally harmless and easy to take. In some instances, I give a repeat dose two weeks later.

It’s important to note that repeat infections are common and it is worth notifying your child’s class teacher so that other parents can be on the lookout for worms. If your child is experiencing other symptoms like abdominal pain or if you have seen a much larger worm in the poo, then we would investigate further as the problem probably isn’t threadworms.

If you are unsure – please see your doctor and we can help!

Dr Neil Forrest is a UK trained GP based at Osler – Star Vista. T: 6339 2727
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