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Liver Fluke

Liver disease is serious and requires treatment and regular monitoring by a liver specialist.

A liver specialist is known as a hepatologist and you need to be referred by your family doctor or general practitioner. Over nearly 40 years of practicing medicine I have seen many patients develop severe liver disease, which sadly could have been prevented by early detection and early referral to a hepatologist. There needs to be more awareness of liver disease so that patients can be treated early so that we can prevent cirrhosis, liver failure and liver cancer. Make sure you have your liver function checked annually with a blood test.

I have presented my ideas on how to help those with liver diseases using nutritional medicine, which I have been using for many years with good success rates. However my recommendations do not replace the care of your own doctor and you should remain under the care of your own doctor whilst using nutritional therapies.

If you have any questions you may contact my naturopaths on 623 3343232 or email us at contact@liverdoctor.com

Liver Fluke

Liver fluke disease is a chronic parasitic disease of the bile ducts. Infection with this parasite occurs through eating fluke-infested, fresh-water raw or undercooked fish.liver fluke

The most common types of liver flukes are Clonorchis sinensis, Opisthorchis viverrini and Opisthorchis felineus.

Approximately 35 million people are infected with liver flukes throughout the world and the very high incidence of cancer of the bile ducts (cholangiocarcinoma) in some countries is associated with a high prevalence of liver fluke infection. It is most common in South-East Asia, South Korea, Taiwan, Northern Vietnam, Laos and Northeast Thailand, Eastern Europe Eastern Russia, Manchuria, Northern Siberia and China. In China 15 million people carry liver fluke.

People living along rivers are prone to infection by flukes because they have a habit of eating raw or undercooked fresh-water fish. This food-borne malady is an important public health issue and liver fluke infection does not receive the awareness it deserves.

The control of liver fluke and any food borne infections requires collaboration between the sectors of public health, the food industry and the media. Consumer education is crucial to make people aware of the need to stop eating raw fish. Because of increasing immigration and travel more doctors should know about the high prevalence of liver fluke infection among healthy looking people and the long term severe complications of the infection.

Liver fluke is not common in the Western world. In North American countries and Australia where many Asian immigrants are now living, people may carry liver fluke caught in their country of origin and because it is not previously commonly seen, the diagnosis is often missed until severe liver damage has resulted.

The flukes get into the small bile ducts inside the liver and the gallbladder where they live for 20-30 years. The flukes cause chronic inflammation of the bile ducts causing scarring (fibrosis) of the bile ducts and bile duct dilatation. A liver fluke is a type of flat worm. One adult fluke lays 2000-4000 eggs each day and the eggs are excreted through the bile ducts and feces of the infected person. The cycle re-circulates via eating of raw fresh-water fish.

Most people infected with this parasite have no symptoms; however patients with severe infection suffer from fatigue and abdominal discomfort. Long standing infection may cause stone formation in the bile ducts and the gallbladder, recurrent bacterial secondary infections in the bile ducts and cancer of the bile ducts.

Severe infection can cause an enlarged liver (hepatomegaly) and complaints such as abdominal pain, anorexia, nausea, vomiting and indigestion. Jaundice is due to the mechanical obstruction in the bile ducts caused by a multitude of flukes, or it is due to bile duct obstruction caused by stones, or bile duct cancer (cholangiocarcinoma) as a late complication of chronic infection.

clonorchiasis diagram

Testing Patients for Liver Fluke Infection

In endemic areas, it is recommended to do screening tests such as a stool ova test and a liver ultrasound scan. The high risk groups for liver fluke infection are those who have a history of eating raw, freshwater fish in endemic areas. An ultrasound scan or CAT scan images may show dilatation of the bile ducts. If tests are positive then anthelminthic (anti-worm) drugs should be prescribed.

People should be told to have regular periodic stool tests to check for the presence of eggs in the stool. Also anyone who has travelled to these parts of the world and eaten raw or under cooked fresh water fish should be tested.

The typical appearance of past/healed liver fluke infection is widespread dilatation of the bile ducts inside the liver without evidence of an obstructing cause (dilatation without obstruction); this is seen on ultrasound, CAT or MRI scans of the liver. This picture is frequently found in healthy looking but infected people in endemic areas.

Important Point

If liver fluke is left undetected for years, this can become a very serious disease and cause destruction of the liver. Most people with liver fluke infection are completely unaware because they experience no symptoms at all. A small percentage of patients experience fatigue and non-specific abdominal discomfort, which easily gets mistaken for indigestion or irritable bowel syndrome. So it is important to have a high awareness of this insidious and destructive liver disease.

Medical Treatment of Liver Fluke

Tablets are prescribed to kill the worms and these drugs are known as antihelmintic medications. If the disease is detected too late, sometimes the damage caused by the flukes is so extensive that a badly damaged part of the liver must be surgically removed. The sooner the infection is detected and eradicated, the less harm it is able to do to the bile ducts and the liver.

An experimental drug called tribendimidine could help cure millions of people infected with liver fluke. In a study published in The Lancet medical journal, researchers found that tribendimidine is as safe as and more effective than the standard treatment for liver fluke. The standard treatment is a generic drug called praziquantel, which has a cure rate of 70 percent. The cure rates for tribendimidine were much better than praziquantel, although this needs to be confirmed in larger clinical trials.

In contrast to the new drug, older drugs such as artemether, artesunate and mefloquine are not very effective and should not be recommended for treating liver fluke.

Highest cure rates of over 70 percent can be achieved in patients treated with tribendimidine, followed by 56 percent for those treated with praziquantel. Cure rates are much less from taking combined mefloquine and artesunate.

There are many types of parasitic worms and they cause disease in more than a billion people around the world. Over time these parasites have become increasingly resistant to available drugs; this brings an urgent need to find new drugs to fight them.

Flukes are very hard to eradicate. It can be done but often takes a long time depending on the amount of flukes in the liver. If you look at forums on the Internet, people taking antihelmintic drugs have found that when clearing flukes they passed several hundred flukes every day in their stools.

There are many Internet blogs (such as parasite drug forum) about liver fluke where people share their experiences of taking multiple antihelmintic drugs and rotating them until they clear all the flukes.

Brand names of drugs used include:

  • Egaten (Triclabendazole)
  • Praziquantel
  • Albendazole also Valbazen, which is the animal liquid form and is much cheaper
  • Vermox (mebendazole)
  • Yomesan (niclosamide)

For more information on how to obtain these drugs email victoriat@cabothealth.com.au

  • Shyama Patil

    Is it possible to get infested by liver fluke by drinking unprocessed river water ?

  • kbpg24

    I am a Chinese student living in California. I
    ate an under-cooked steamed fresh-water fish. I was not aware of the
    serious consequences about eating an under-cooked fresh-water fish.
    After that, I looked up on the internet and found that it can cause Clonorchis sinensis, a kind of liver fluke. After reading the article talking about Clonorchis in your website, I am so worried about being infected with Clonorchis.
    Do the Chinese fresh-water fishes in United States contain this kind of
    liver fluke, or it only exists in area in Asia? Also, where can I go to
    if I want to check for the parasite?

    am so worried and panic but I don’t know where to seek help. People
    around me may think this is a joke only because few people are aware of

    • http://www.sandracabot.com Dr Cabot Team

      The chance of getting an infection in the USA is low, but it would be good to see your doctor for a stool test and blood test to be sure.

      • Leah

        I have liver flukes and 8 other known parasites. I have been treated for 2 months and have seen nothing for 3 weeks until today. I saw a few flukes today. I do live in the USA.

        • kim

          i have been trying to get help for 5 years now and been tested and all negative but I know this is what i have i see this in every time i go to restroom but i have a blockage so its all been horrible and gotten worse, How did how did you get someone to listen and get diagnosed they look at me like im totally nuts

          • Leah

            I was seeing a naturalpath Dr a d he tested for presence of parasites and it tested high. I showed him pictures of what I was seeing and that was enough for him. Because liver flukes seem to be not common in the U.S. at first he wasn’t sure what he was looking at. But he researched and talked to other Drs and they all confirmed. Now ice been pushed out to western medicine due to his growing concern for my general health, to test my liver enzymes and other organ function.

          • kim

            I can not get any doctor to take me serious much less get them to even look at pictures I had that look like all the ones online there finally doing a test for parasites but I’ve read that it is actually hard to detect!! Everything regarding all my health problems all point to liver fluke I have had 1 blood transfusion already and close to needing another. Do u have any suggestions?

          • Leah

            I discovered mine only from having diarrhea for 16 hours and seeing them come out sometimes 50 a day. It is true that it’s hard to detect them through stool samples because eggs may not be present when they check. My Dr just looked and verified without giving me issues. If you are pretty certain, maybe get another opinion from another Dr?

          • kim

            When you only have managed Medicaid plan your so limited to services I’m finding! I need 3 specialists for 3 different issues and none take the plan in goin in circles gettin no where! I took specimens. 1 which I just put what I am calling flukes and they didn’t test it only the full stool which I didn’t think had any signs of parasites go figure! I’ve been so sick so anemic now I can’t get rid of bronchitis I’ve had 3 times past 3 months and can’t get rid of it either!! It’s so frustrating!

          • Lisa Elliott

            Check out Humaworm.com. Last week I did a liver flush (directions on site under Q & A, at bottom) & released many liver/gallbladder stones & dead flukes. More dead flukes came out the next day during a salt water enema. I started their parasite cleanse six days ago. There’s a facebook page. I had no luck with doctors, they all want me on antidepressants for “psychological” problems. I sent out an online stool test from drjockers.com but haven’t gotten the results back. Just as well the docs aren’t listening to you because they’d give you numerous antibiotics that wouldnt work & would make you sicker. Regardless, check out Humaworm or other parasite cleanses, Hulda Clark, etc. It’s not so bad, though if you’re very infested (as am I) be prepared for dieoff.

      • kim

        Every stool test has tested negative and the one tube I took that was only what I have been calling flukes they didn’t test go figure!! That’s how my luck has been! All my blood wirh is abnormal and or critical low what blood tests are there for testing flukes!
        Thank you

  • Trevor

    interesting article. I farm in a liver fluke prone area of Victoria. is it the same fluke as infest cattle and sheep? can the disease jump species by means other than via the snail? thanks, Trevor

    • Margaret

      There are many different species of flukes.

    • Lisa Elliott

      We can get liver flukes from cattle, etc., it’s a matter of the proper environment for them to reproduce.

      Google alcohol fluke. Stay away from sopropyl alcohol.

  • http://www.facebook.com/100002616880398 Y.t. Whitemansson

    So, blood tests can or can’t detect liver flukes?

    • victoriah

      Blood tests are available but their usefulness is limited due to cross reactivity with other worm species that may be causing the infestation

      Direct microscopy is a far more reliable method because the parasites and eggs are easily recognised.

  • Joey

    I believe that I passed HUNDREDS of flukes at one time in my life when i was living in a flood zone with slugs climbing up on everyone’s soda/beer cans etc. I didn’t know what a liver fluke was at that time. Is there any blood test that can tell IF ONE HAS HAD FLUKES IN THE PAST?
    thank you

  • Paris

    I have got early stage liver dsease my scor is f 1. 6.8

    • Kylie

      Do you mean cirrhosis Paris? If so, daily supplementation of Vitamin E and Selenomune will assist. Also- Liva tone Plus and NAC i would also recommend. Raw Juices daily and the eating protocol out lined on the liver doctor web site. Look under the “liver” tab, scroll down to Liver problems- scroll further for “Cirrhosis”

    • Kylie

      If you mean Simply fatty liver- as Cirrhosis is end stage liver disease, then please follow the protocol in Dr Cabots book Fatty Liver you can reverse it.

  • Laura Poffenroth

    I have h.pyloria. I have taken the one round of antibiotics. They did not work. I have also chronic yeast problems,(for years). How, can I get rid of H.pyloria naturally? I don’t want to take antibiotics if there is something else available.

    Laura Poffenroth

    • Jase

      Mastic Gum, Probiotics and Peppermint Oil

      • Kylie

        Ulcerative Colitis?

        • Rachael

          You should try taking MSM (organic sulfur) for your colitis and DMSO for flukes. There are many reports of people curing colitis with DMSO also. Look up: sulfur deficiency and the West Coast Organic Sulfur Study.

          God bless