‘I’m a Gastroenterologist—Please Don’t Diagnose Yourself With Stomach Worms’ 

TikTok is full of recommendations—some great and some not-so-much. By all means, turn to TikTok for fun, catchy dances that spark joy into movement. But you might want to be more careful following random nutrition or health advice. Case in point: the new TikTok trend to eat papaya seeds or buy over-the-counter deworming pills in a (likely imaginary) fight against stomach worms.

People all over TikTok have been diagnosing themselves with stomach worms, taking ParaGuard or other supplements or eating papaya seeds, and then claiming that they feel better and can see little worms inside their poop. People who have dewormed themselves also claim that they experience less bloating, fewer sugar cravings, and less digestive issues. The impression these TikTokers are giving is that just about everyone has parasitic worms squiggling around in their stomachs. But that’s far from the truth.

“Stomach worms are not unheard of in the U.S.,” says Christine Lee, MD, a gastroenterologist at the Cleveland Clinic. However, getting stomach worms in the U.S. is pretty rare, she says. Estimates claim that roundworms—a term that encompasses several types of parasitic worms—affect between 20 and 42 million people in the United States. That sounds like a lot, but it’s actually only between 6 and 12 percent of the population, and most parasitic worms in the U.S. are found in children, according to the Cleveland Clinic.

So it’s very unlikely that all the TikTokers claiming to see worms in their poop actually are.

How do you even know if you have stomach worms

In many of the TikTok videos, it’s unclear why people think they might have stomach worms. While it’s true that some people with stomach worms can be asymptomatic for years, meaning they feel no symptoms and have no reason to suspect something is off, intestinal parasites do cause symptoms similar to other gastrointestinal illnesses. If you have stomach worms, you might experience abdominal pain, diarrhea, nausea or vomiting, gas and bloating, bloody diarrhea, rash or itching around the rectum, stomach pain, fatigue, and unexplained weight loss. Seeing a worm in your poop is also a big sign, according to Mount Sinai Health System. So people who have stomach worms really might see worms in the toilet.

If you think you might have stomach worms, Dr. Lee urges you to head to a provider instead of buying papaya seeds or supplements. All a doctor needs is a poop sample to confirm that you do indeed have parasites in your stomach, Dr. Lee says. The worms will show traces in your poop.

Worms might also hang out around your anus, so doctors can do what’s called the “Scotch tape” test, according to Mount Sinai Health System. A doctor will touch tape to your anus several times and then look at the tape under a microscope to see if there are worms. Finally, according to Mount Sinai Health System, a doctor might suggest you do an x-ray to look for worms, though this step is usually not needed.

How do you get stomach worms—and how do you avoid them

Stomach worms are contagious. Those little parasites like living inside humans or animals and they’ll take the chance to spread if they can. So, you can get stomach worms if someone else who is infected goes to the bathroom, doesn’t wash their hands, and then either touches you or touches a surface that you also touch and then touch your mouth without washing your hands. Gastroenterologists call this “fecal-oral transmission,” says Carolyn Newberry, MD, a gastroenterologist at Weill Cornell Medicine.

Fecal-oral transmission can also happen when you’re in places that don’t have adequate sanitation systems, she says. If you go swimming in a lake where animals poop or where a sewer system has overflown and washed human poop into the water, you might end up with stomach worms if you accidentally swallow some water. In developing countries with rudimentary sanitation systems, you can also get parasites from water used to cook food or to wash fruits and vegetables, even if you avoid drinking tap water while there.

Even in the U.S., you should be careful about washing produce, Dr. Lee says. “People think if their fruits and vegetables are labeled organic, it’s just good to eat,” she says. “Organic just means there are no pesticides. It doesn’t mean natural fertilizer wasn’t used—natural fertilizer being manure.”

Your first line of defense against stomach worms is hygiene, Dr. Lee says. Wash your hands. Wash your fruit and vegetables. Make sure the meat you eat is thoroughly cooked, especially pork. Make sure you have access to clean water when traveling or hiking in a rural area. And know how to sanitize your water if you can’t guarantee clean water otherwise.

Okay, what’s with the papaya seeds

As random as they seem, the idea that papaya seeds can treat stomach worms didn’t come out of thin air. But, they aren’t a scientifically robust treatment for stomach worms, either. The evidence comes from two sources, Dr. Lee says. Farmers have been using papaya seeds in livestock feed to fend off parasites for several years. According to the University of Delaware’s Animal Science program, evidence suggests that ground-up papaya seeds could be an effective treatment for parasites in goats.

“Now, does that translate to humans?” Dr. Lee says. “There’s really little to no data.” There is one human study—which is being cited on TikTok. In this study, published in 2007, 60 Nigerian children who were asymptomatic but had evidence of parasites in their poop, were given either a spoonful of honey or a spoonful of honey with four grams of ground papaya seeds mixed in. The study claimed that 71 percent of the kids who got the papaya seeds had stool cleared of parasites following the treatment.  Still, there’s too little scientific evidence to warrant papaya seeds’ use, especially for people who have not confirmed a stomach worm diagnosis with their doctors and in a country where other, FDA-approved medications are easy to access, Dr. Lee says.

More concerning, she says, is that the 2007 study didn’t follow up with the kids who ate papaya seeds to check on side effects or toxicities. “We do know there are trace amounts of cyanide on papaya seeds,” she says. “So obviously, when you start concentrating four grams of dried seeds we are a little bit concerned for human safety.”

How should stomach worms be treated

If you actually did have stomach worms, a doctor wouldn’t suggest papaya seeds or unregulated supplements like ParaGuard as a main defense. Amazon actually doesn’t make any claims about ParaGuard’s ability to get rid of parasites, instead claiming that it helps “keep a healthy balance of intestinal microflora.” ParaGuard is a combination of herbs and natural foods like walnut hull, wormwood, pumpkin seeds, and garlic. Some herbs actually can be used to treat certain parasites, according to Mount Sinai. But some herbs can be toxic or can interfere with certain medications, so you should always work with your doctor to find a treatment plan.

Instead, your doctor will probably prescribe a drug called albendazole, Dr. Lee says. “Albendazole is monitored by the CDC,” she says. “And that’s how they can get the most updated percentage of people affected in the U.S. because you can trace how much it’s been prescribed.” Albendazole is a pill taken by mouth for anywhere between eight and 30 days to rid your body of parasites.

The biggest reason you shouldn’t diagnose yourself

So it’s unlikely that all the TikTokers posting about stomach worms actually have them. But if you’re concerned about stomach worms because you have frequent diarrhea or an upset stomach, there are many other GI illnesses that could explain your symptoms, Dr. Lee says.

You could have celiac disease — an autoimmune disorder that makes your body attack itself when you eat gluten — or irritable bowel syndrome — a GI disorder that responds to triggers with diarrhea, stomach pain, or constipation. You could also have inflammatory bowel disease, which is characterized by inflammation in your gut. It could also be viral gastroenteritis, Dr. Lee says, which is inflammation, swelling, and irritation inside the lining of your GI tract.

So the biggest risk in diagnosing and treating yourself for stomach worms is opening yourself to side effects of concentrated papaya seeds or the herbs in unregulated supplements, Dr. Lee says. But a close second is thinking you’ve cured yourself when you may actually have another illness that needs treatment. The same symptoms can point to many different disorders, which is why it’s so important to check in with your doctor.

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