Anisakis duodenitis syndrome

　　Hookworm enteritis syndrome is a multi-causal disease caused by hookworm infection, which leads to hookworm enteritis. Stimulatory foods, drugs such as aspirin, alcohol, and radiation therapy for duodenitis can all exacerbate this disease. Hookworm enteritis syndrome is a group of duodenitis caused by specific etiologies, including hemorrhagic duodenitis caused by hookworm infection, portal hypertension, heart failure, and other diseases such as hepatitis, pancreatitis, and biliary tract diseases. Due to local compression or spread, duodenal ischemia may occur.

　　Patients with hookworm enteritis syndrome may have complications such as dermatitis, anemia, atypical food cravings, infant hookworm disease, and eosinophilia.

　　1. Dermatitis and eczema are often used as synonyms to refer to a type of skin inflammation, representing the allergic reaction of the skin to various substances such as chemical agents, proteins, bacteria, and fungi.

　　2. Anemia is defined as having a red blood cell count, hemoglobin content, and red blood cell hematocrit all below the normal standard in a certain volume of circulating blood. Among them, hemoglobin is the most important. Adult males with hemoglobin below 120g/L (12.0g/dl) and adult females with hemoglobin below 110g/L (11.0/dl) are generally considered to have anemia.

　　3. Hookworm disease is a disease caused by the寄生 of the human small intestine by the duodenal hookworm or the American hookworm, which is one of the parasitic diseases that seriously harm the health of the Chinese people, especially farmers. Clinically, it is mainly manifested as anemia, malnutrition, edema, abdominal pain, and gastrointestinal dysfunction. In the high-incidence areas, it is known as 'yellow fat disease'.

　　Eosinophilia refers to the absolute value of eosinophils in peripheral blood greater than (0.4～0.45)×109/L (400～450/mm3), which is often associated with various diseases in clinical practice, especially parasitic infections, allergic diseases, connective tissue diseases, and non-specific reactions to tumors.

　　Hookworm enteritis syndrome presents with increased appetite and weight loss, discomfort and hidden pain in the upper abdomen, bloating after meals, decreased appetite in the later stage, and may include nausea, vomiting, constipation, or diarrhea. There is a tendency for atypical food cravings, and some patients may have symptoms similar to peptic ulcer disease, leading to 10% of patients being misdiagnosed as such in clinical practice. However, the pain is not rhythmic, and antacids are ineffective.

　　Treating patients with hookworm enteritis syndrome is an important link in preventing this disease, playing a role in controlling the source of infection and blocking transmission. Patients should avoid acid and spicy刺激性 food and cold, hard-to-digest food. Chew slowly while eating to allow food to mix well with saliva, which is conducive to digestion and reduces stomach irritation. The diet should be regular and abundant in nutrition, rich in vitamins A, B, and C. Avoid drinking strong tea and strong coffee and other stimulating beverages. It is also necessary to maintain a cheerful spirit in daily life. Depression or excessive tension and fatigue are easy to worsen the symptoms of hookworm enteritis syndrome.

　　Patients with hookworm enteritis syndrome should undergo stool parasite examination, gastric basic acid output (BAO) determination, gastric barium meal, gastric ultrasound examination, and stool routine examination, etc., which can be seen:

　　1. Decreased or absent gastric acid.

　　2. Typical iron deficiency anemia.

　　3. Fecal occult blood positive, blood eggs can be found.

　　4. X-ray shows deformation of the duodenal bulb, but no ulcer crater shadow.

　　Patients with hookworm enteritis syndrome should eat easily digestible foods such as congee, noodles, steamed buns, flower rolls, dumplings, soft cakes, soft rice, etc., chew slowly, which is conducive to full digestion and absorption. Eat less legumes, onions, potatoes, sweet potatoes, etc., which are easy to produce acid and gas, and avoid cold, greasy, spicy, and drinking alcohol to avoid stimulation of the ulcer by adverse factors.

　　The treatment of hookworm enteritis syndrome in children mainly includes deworming treatment, correcting anemia, and symptomatic treatment. Common deworming drugs include mebendazole, albendazole, and thiabendazole, etc., which not only have the effect of killing and expelling worms but also have the effect of inhibiting the development or killing of eggs and larvae. A 15% ointment prepared with thiabendazole can be applied locally to treat hookworm dermatitis. If combined with hyperthermia therapy, the effect is even better. Immersing the infected area in 53℃ hot water for 20-30 minutes may kill the larvae migrating under the skin.