CT scan also is useful in making the diagnosis and may demonstrate intestinal or biliary obstruction. Treatment is largely symptomatic with appropriate bronchodilators and possibly systemic corticosteroids if marked airway inflammation is present. Administer antihelminthics 1-2 weeks later to clear the infection from the GI tract. Treat patients with intestinal obstruction or hepatobiliary disease with appropriate antihelminthics. If partial intestinal obstruction is suspected on the basis of symptoms of colicky abdominal pain, antihelminthics that cause a flaccid paralysis are preferred to those that cause spastic paralysis, as antihelminthics that cause spastic paralysis may induce complete obstruction.
Surgery is often necessary.
Surgery often is necessary for intestinal and hepatobiliary obstruction, especially with high worm loads, particularly in children. Peppery or spicy foods may induce migration of worms in the intestine and should thus be avoided in suspected cases of partial intestinal obstruction. Mebendazole and pyrantel pamoate are drugs of choice for asymptomatic Ascaris infection. Does not cause paralysis of the worms. Administration over 3 days lessens the risk of worm bolus formation.