Liver Fluke: Causes, Symptoms, Treatment

What is Liver Fluke?

Liver Fluke is a parasitic infection that causes inflammation in the bile ducts. This parasite enters the body through ingestion of fluke contaminated fresh water raw fish. Clonorchis sinensis, Opisthorchis viverrini and Opisthorchis felineus are some of the species that are known to cause Liver Fluke Disease. Once in the body, these flukes settle in the intrahepatic bile ducts where they stay dormant for as long as 20 years.[1, 2, 3]

These flukes then cause inflammation of the bile ducts and cause conditions like epithelial hyperplasia, periductal fibrosis, and bile duct dilatation. In majority of the cases, Liver Fluke disease is asymptomatic but in severe cases the patient may complain of abdominal symptoms.[1, 2, 3]

Liver Fluke can at times also lead to complications to include stones and cholangiocarcinoma. It has been estimated that there are approximately more than 35 million cases of Liver Fluke across the globe and there are many regions around the world where Liver Fluke causes cholangiocarcinoma.[1, 2, 3]

What Causes Liver Fluke?

The medical term for Liver Fluke is Fascioliasis. As stated, it is a parasitic infection that is caused by a parasite found in fresh water raw fish or plants that have been infested by the fluke. Once a person eats the contaminated food, the larvae of the parasite move from the small intestines into the abdominal cavity. There they gradually grow and become immature worms and then reach the liver.[3]

In the liver they feed on liver tissues for a period of approximately a month or more and finally they settle down in the bile ducts where they eventually cause inflammation and the diseases that have been mentioned above. Liver Fluke can be easily killed by thoroughly washing and cooking the foods that are known to contain these parasites.[3]

What are the Symptoms of Liver Fluke?

Liver Fluke occurs in three phases namely acute, chronic, and latent. The acute phase of liver fluke starts about four days after the infection. It generally lasts for a period of about three to four months. During this time, the person will have pain in the abdomen, fever, and other problems with the GI system. Some people also tend to develop hives. There is also palpable tenderness around the liver. In some cases bronchial asthma is also seen in people with acute Liver Fluke infection.[3]

The latent phase begins when the parasite is matured and settles down in the bile ducts. It may last for several months. In majority of the cases, the patient remains asymptomatic. The chronic phase of Liver Fluke lasts for several years and the patient complains of pain around the abdomen and stomach, intolerance to certain foods, jaundice, nausea, abdominal tenderness and in some cases itching.[3]

How is Liver Fluke Treated?

It is important that Liver Fluke be diagnosed and treated early as any delay in treatment can cause complications that have been described above. The frontline medication used to treat Liver Fluke is named Triclabendazole. It is given as a single dose and should be taken after food. However, in severe cases the physician may recommend two doses of this medication 12 hours apart. This medication is beneficial in killing both mature and immature worms.[3]

The medications that were used previously had to be given for a period of five days for it to be effective, so Triclabendazole is believed to be far better than others with regard to treatment of Liver Fluke. Researchers feel that close inspection of high risk animals like fresh water fishes can be a good step forward in containing this infection especially in areas where people are most vulnerable to Liver Fluke.[3]

References: