Deworming helps prevent and treat intestinal worm infections, particularly in children and people in high-risk areas. But who needs it, how often should it be taken, which medicines are used, and is one dose enough?
Six leading doctors explain when deworming is recommended, how to use common medicines safely, possible side effects, key precautions, and whether home remedies can replace proven treatment.
- Dr Krishna Prasad — Consultant – Paediatrician, Motherhood Hospitals, Electronic City, Bengaluru
- Dr. Basavaraj S Kumbar — Senior Consultant – Internal Medicine, Aster Whitefield Hospital, Bengaluru
- Dr Shehla Kazi — Consultant Paediatrics & Neonatology, Jaslok Hospital and Research Centre, Mumbai
- Dr. Kushagra Gupta — Consultant – Paediatrics, Fortis Hospital Greater Noida
- Dr Jatin Ahuja — Consultant, Infectious Disease, Indraprastha Apollo Hospital, Delhi
- Dr. Zahid Ali — Sr. Consultant – Pediatrics & Neonatology, Pacific One Health, Delhi
Q. Who is most at risk of intestinal worm infections, and can adults get worms too?
Children aged 1–14 are most commonly affected because of frequent outdoor play, contact with contaminated surfaces, hand-to-mouth behaviour and poor hygiene.
“Intestinal worms are most commonly found in children, especially those aged 1 year to 14 years, since they meet soil and are not always able to maintain proper hygiene standards,” Dr. Basavaraj said.
Adults can also get roundworms, hookworms and whipworms. Risk depends more on sanitation and exposure than age. People exposed to poor sanitation, unsafe water, contaminated soil or food, agricultural work, barefoot walking or an infected household member are at higher risk. Pregnant women and immunocompromised people may face greater risks or complications.
“People who live in places where sanitation is not proper, sewage is not properly handled, or where getting safe drinking water is hard are at higher risk too. On top of that, pregnant women, agricultural workers, and anyone who shares a home with an infected person tend to have an increased chance of catching and spreading these parasites,” Dr Krishna said.
Q. What are the common signs and symptoms? How do worm infections affect children?
Many infections are asymptomatic. Symptoms may include abdominal pain or cramps, bloating, diarrhoea or alternating diarrhoea and constipation, unexplained weight loss, fatigue, weakness, anal itching, nausea, vomiting and worms in the stool.
“Fatigue and weakness can also occur, often caused by iron-deficiency anemia, especially with hookworms, which feed on blood. Anal itching is another common symptom, particularly with pinworms, and is typically worse at night. Some people may also experience nausea or vomiting, which can cause occasional digestive upset,” Dr. Zahid said.
Worms can irritate the intestine, reduce appetite and interfere with nutrient absorption. Hookworms can cause chronic blood loss and iron-deficiency anaemia. In children, repeated or untreated infections can cause malnutrition, poor weight gain, stunted growth, reduced concentration and, in severe cases, impaired cognitive development.
Dr. Kushagra said parasites deprive the body of essential nutrients.
“They also cause appetite loss, vomiting, and digestion issues, resulting in weight loss, diarrhea, and even anemia. In children, chronic parasitism leads to delayed growth and cognitive development. The good news is that with appropriate anti-parasitic treatment, all these complications can be prevented.”
Q. How do intestinal worm infections spread, and can raw or unwashed vegetables increase the risk?
Worms spread through contaminated soil, food or water, poor hygiene and the faecal-oral route. Eggs from infected human or animal faeces can contaminate food, water and soil and enter the body through contaminated hands or surfaces.
“Worm eggs can contaminate soil, water, and food. Eating raw or inadequately washed vegetables, drinking unsafe water, consuming undercooked meat, or poor hand hygiene after using the toilet can increase the risk. Proper washing of produce, safe cooking practices, regular handwashing, and sanitation are key preventive measures,” Dr. Jatin said.
Leafy greens, lettuce and root vegetables can be risky when grown in contaminated soil or irrigated with contaminated water. Hookworm larvae can also penetrate skin, particularly when walking barefoot. Dr. Kushagra stressed good hygiene and thoroughly washing fruits and vegetables.
Q. Do pets increase the risk of worm infections?
Dogs and cats can carry zoonotic parasites including Toxocara canis and Toxocara cati. “Humans, especially children, can get infected by accidentally ingesting eggs from contaminated soil or surfaces where infected pet feces were present. This can lead to conditions like visceral larva migrans,” Dr. Shehla said.
Regular veterinary deworming, prompt disposal of pet faeces, keeping pets away from children’s play areas and handwashing after handling them can reduce risk. Avoid letting pets lick faces or sharing food with them.
With proper veterinary care and hygiene, pets pose little risk, and the benefits of pet ownership outweigh these risks.
Q. Can eating sweets or sugar cause intestinal worms?
No. Infection occurs when worm eggs or larvae are ingested through contaminated food, water or soil, or through poor hand hygiene.
“The confusion arises because children with worm infestations often have increased appetite and sugar cravings. This happens because worms compete for nutrients in the gut, and the body’s response can alter appetite,” Dr. Shehla said.
High sugar intake may slightly affect immune function and gut microbiota, but sugar itself does not cause worms. Good hygiene, safe food and water and a balanced diet help prevent infection.
Q. When and how often should children and adults be dewormed?
There is no universal need for periodic deworming. Dr. Kushagra said treatment depends on symptoms, patient category and regional prevalence.
Children in high-risk areas may be dewormed periodically through public health programmes.
“Deworming recommendations depend on age, symptoms, and the risk of exposure. In high-risk environments, children are often dewormed periodically under public health programmes. The choice of medicine and whether a repeat dose is needed depends on the type of worm and severity of infection,” Dr. Jatin said.
Dr. Zahid said WHO recommends preventive chemotherapy for preschool- and school-age children, women of reproductive age and adults in high-risk occupations such as farming or mining in endemic areas, generally once or twice a year.
Routine preventive deworming is generally unnecessary for adults without risk factors in non-endemic areas; treatment is usually given when infection is suspected or diagnosed.
Q. Which medicines are used, what is the dosage, and is one dose enough?
Albendazole and mebendazole are the most commonly used medicines. Albendazole is usually given as a single 400 mg dose to adults and children over 2; lower dosing may be used in children under 2. Mebendazole may be given as 100 mg twice daily for three days or a single 500 mg dose, depending on the infection.
One dose is often enough for roundworms and hookworms. Pinworm, whipworm and infections with high reinfection rates may require a repeat dose, often after two weeks, as advised by a doctor.
Q. Can people safely take over-the-counter deworming medicines?
Albendazole and mebendazole are generally safe when used correctly, but medical advice is preferable because the drug and dose depend on the parasite, age, weight and health status.
Dr. Krishna said consultation helps identify the parasite and prevent inappropriate use. Dr. Basavaraj stressed considering age, pregnancy and existing health conditions before taking these medicines.
Medical advice is especially important for children under 2, pregnant or breastfeeding women and people with liver or kidney disorders or other serious illnesses.
Dr. Zahid said preventive use once or twice a year is common in high-risk regions, but unnecessary or frequent use without risk factors may cause side effects or delay diagnosis of other conditions.
Albendazole and mebendazole should generally be avoided during the first trimester of pregnancy unless prescribed by a doctor.
Q. What are the side effects of deworming medicines?
Most side effects are mild and temporary. “These side effects commonly experienced include mild stomach ache, nausea, temporary diarrhoea, feeling full, loss of appetite, or headaches, all of which are caused by natural removal of the parasites in the body. Severe side effects such as allergy and liver damage rarely occur and can be attributed to excess dosage,” Dr. Krishna said.
Some people may pass worms in their stool after treatment. Allergic reactions and liver-related effects are rare and more likely with continuous or excessive use. Follow the recommended dose and avoid unnecessary repeat treatment.
Q. Can home remedies such as garlic or papaya seeds treat worms?
Dr. Kushagra said, “The gold standard in the treatment of parasitic infections remains antiparasitic drugs”.
“This is especially important for children, since the chronic form of the disease significantly delays their development and leads to anemia. Therefore, it is not recommended to rely only on traditional medicine and folk healing methods.”
Dr. Jatin said home remedies may provide temporary relief but cannot reliably clear an infection because different worms require different medicines. Delaying treatment can allow infection to persist or cause complications.
Garlic, pumpkin seeds, papaya seeds and coconut oil may have mild antiparasitic properties, Dr. Zahid said, but have not been scientifically proven to cure infections.
“Relying solely on home remedies for a heavy infection can lead to prolonged illness, malnutrition, and complications. They can be used as dietary supplements, but medical treatment remains essential for clearing an infection.”
Disclaimer: This article is for informational purposes only and is not a substitute for professional medical advice.