Biliary ascariasis

Prunus mume (Sieb.) Sieb. et Zucc. Wu Mai (Black plum) (fruit) Prudomenin, malic acid, succinic acid, citric acid, tartaric acid, amygdalin.33-53 Treat biliary ascariasis and hookworm. 

Indications Shao yin disease, four counterflows patterns (i.e., cold extremities due to the liver failing to course and discharge heat). Gastritis, peptic ulcer, cholecystitis, gallstones, hepatitis, intercostal neuralgia, biliary ascariasis, hernia, acute appendicitis, pancreatitis, intestinal obstruction, allergic colitis, neurotic diarrhea, pleurisy, rhinitis, tubercular peritonitis, neurosis, epilepsy, mastitis, and fibrocystic breasts... 

For biliary ascariasis, add Fructus Pruni Mume (WuMei) and Semen Arecae Catechu (Bing Lang). 

Indications Roundworm inversion patterns. Ascariasis, biliary ascariasis, chronic dysentery, chronic gastritis, gastric ulcer, post-gastrectomy syndrome, neurosis, insomnia, and menstrual, premenstrual, and menopausal complaints associated with candidiasis and a combination of hot and cold, vacuity and repletion signs and symptoms, including endometriosis... 

The following drugs also are indicated in Ascariasis. Piperazine citrate (if intestinal or biliary obstruction) thiabendazole. 

Piperazine is an appropriate alternative to mebendazole for the treatment of ascariasis, especially in the presence of intestinal or biliary obstruction. Cure rates of more than 80% are obtained following a 2-day regimen. 

Ferreyra, N.R, Cerri, G.G. Ascariasis of the alimentary tract, liver, pancreas and biliary system its diagnosis by ultrasonography. Hepa-togastroenterol. 1998 45 932-937... 

Ascariasis. Hyperphosphatasemia is not a consistent finding in ascariasis. When present, it tends to be associated with a greater immunological response, as judged by the severity of asthma and eosino-philia (P14). Adult forms of Ascaris lumbticoides may find their way into the biliary system and the rise in serum alkaline phosphatase associated with this invasion may be marked. Pfefferman et al. (P13) described a patient whose serum alkaline phosphatase was 10 timra the upper reference limit in the presence of a normal serum bilirubin. 

Mebendazole, albendazole, and pyrantel pamoate (antiminth, others) are preferred drugs all infected persons should be treated. Mebendazole and albendazole are preferred for therapy of asymptomatic-to-moderate ascariasis. Both compounds should be used with caution to treat heavy Ascaris infections, alone or with hookworms. Rarely, hyperactive ascarids may migrate to cause complications such as appendicitis, biliary or intestinal obstruction, and intestinal perforation— sometimes requiring surgery. Pyrantel is safe for use in pregnancy, whereas BZAs should be avoided during the first trimester (see below). 

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