Würmer im Darm (Wurmeier, Bandwürmer, Madenwürmer): the pathway in the body

Würmer im Darm (Wurmeier, Bandwürmer, Madenwürmer) is part of the pathway “Worms in the gut”. This page shows the whole pathway; the station of Würmer im Darm (Wurmeier, Bandwürmer, Madenwürmer) is highlighted.

Where this laboratory value sits: Hold on the lining — Hooks, suckers, teeth. Hookworms bite onto the small-bowel lining with teeth, whipworms drill their front end into the colonic lining, and tapeworms hold onto the gut wall with suckers and hooks. Source 1, 2, 8

In brief

Worms are multicellular parasites that can live in the human gut. They hold onto the lining or stay in the gut contents, draw their food from there and shed eggs, which leave with the stool.

The pathway step by step

Each station states what the compound does there. Three signs: ↑ supplies — builds up or makes available · ↓ depletes — inhibits, consumes or withholds · ↕ both, depending on amount. Behind it stands what the statement rests on: established physiology, observed in studies, or contested. The signs do not grade; they name the direction.

1. Uptake → Hatching in the gut · Verdauungssäfte In the gut, warmth, acid and digestive juices dissolve the shell of the egg or cyst. The larva hatches and from there follows a different route according to species. Source 1, 8↑ supplies The shell opens only where the larva can live: the signals come together nowhere but along the digestive route. In tapeworms the cyst wall dissolves, and the head of the worm fastens to the small-bowel wall. established physiology Source 1, 8
   ⚖ When the balance tips

   too much — Where many larvae hatch at once, more of them travel on or mature in the gut.

   too little — Where the shells stay closed, the eggs pass through the gut unchanged and appear in the stool.

   established physiology · Source 1, 8

2. Hatching in the gut → Maturing in the gut Pinworms and whipworms mature in the gut itself. Tapeworms form one segment after another behind the head end and grow as long as the gut they live in. Source 1, 4, 8↑ supplies Only the adult worm lays eggs. Weeks pass before that; earlier, microscopy finds no eggs in the stool. established physiology Source 1, 4, 8
   ⚖ When the balance tips

   too much — Where many worms mature, more eggs are formed and shed.

   too little — Where only one worm matures, it still lays eggs; tapeworms do so even as a single animal.

   established physiology · Source 1, 8

3. Hatching in the gut → Migration of larvae Larvae of roundworms and hookworms leave the gut, travel with the blood to the lungs, are coughed up and swallowed again. Only afterwards do they mature in the small intestine. Source 1, 2↓ depletes The migration leads the larva through tissue in which it does not stay: passing through the lung sets up an irritation, and the immune system meets the larva there for the first time. established physiology Source 1, 2, 3
   ⚖ When the balance tips

   too much — Where many larvae migrate at once, the immune system meets them at many places, and many eosinophil cells gather in the tissue.

   too little — Where few migrate, the irritation stays slight, and the migration goes unnoticed.

   established physiology · Source 1, 7

   Field of research — Migration of larvae through tissue is studied in reviews on the type 2 response of the immune system. Source 7

4. Maturing in the gut → Hold on the lining Hookworms bite onto the small-bowel lining with teeth, whipworms drill their front end into the colonic lining, and tapeworms hold onto the gut wall with suckers and hooks. Source 1, 2, 8↓ depletes Where the worm sits, the lining is lost over a small area, and the spot bleeds or weeps. Whipworms lay a furrow into the cell sheet of the colonic wall as they do so. observed in studies Source 1, 2
   ⚖ When the balance tips

   too much — Where many worms hold onto the wall, there are more such spots, and blood and protein pass through them into the gut.

   too little — Where a single worm holds, the spot stays small and closes again once it lets go.

   observed in studies · Source 1, 2

5. Migration of larvae → Hold on the lining Hookworms bite onto the small-bowel lining with teeth, whipworms drill their front end into the colonic lining, and tapeworms hold onto the gut wall with suckers and hooks. Source 1, 2, 8↓ depletes Where the worm sits, the lining is lost over a small area, and the spot bleeds or weeps. Whipworms lay a furrow into the cell sheet of the colonic wall as they do so. observed in studies Source 1, 2
   ⚖ When the balance tips

   too much — Where many worms hold onto the wall, there are more such spots, and blood and protein pass through them into the gut.

   too little — Where a single worm holds, the spot stays small and closes again once it lets go.

   observed in studies · Source 1, 2

6. Hold on the lining → Food of the worm Tapeworms absorb dissolved matter over their whole surface. Roundworms live off the gut contents. Hookworms draw blood at their bite site, and threadworms live within the lining of the small intestine. Source 1, 2, 3↓ depletes What the worm absorbs is no longer at the body’s disposal. In hookworms, blood passes steadily into the gut at the bite site, and iron with it. established physiology Source 1, 2
   ⚖ When the balance tips

   too much — Where many worms live in the gut, they absorb more from the gut contents, and in hookworms more blood passes over.

   too little — Where few live there, the passage stays small, and uptake across the villi covers it.

   established physiology · Source 1, 2

7. Food of the worm → Eggs in the stool Eiablage Adult worms shed eggs, which leave with the stool. In the laboratory their genetic material is sought in it by PCR, or eggs and larvae are sought under the microscope. Pinworms lay their eggs on the skin around the anus. Source 1, 4↑ supplies The eggs carry the worm onwards: they ripen in soil or water, or pass from hand to mouth. What arrives in the stool also settles what the test finds. established physiology Source 1, 4
   ⚖ When the balance tips

   too much — Where many eggs are shed, PCR and microscopy find them more readily.

   too little — Where eggs are shed unevenly or outside the stool, detection may fail in a single sample.

   established physiology · Source 1, 4

8. Cells of the lining → Type 2 response · Interleukin-25 Group 2 innate lymphoid cells and type 2 T helper cells release interleukin-4, -5 and -13. These signalling molecules order the immune answer to multicellular parasites. Source 5, 7↑ supplies The three signalling molecules work together: interleukin-5 multiplies eosinophil cells, interleukin-4 switches B cells to IgE, and interleukin-13 has goblet cells make more mucus. observed in studies Source 5, 7
   ⚖ When the balance tips

   too much — Where the response is vigorous, mucus and gut movement grow, and the worm loses its hold.

   too little — Where it is weak, for instance under medicines that damp the immune system, the worms stay in the gut; with threadworms their number then grows.

   observed in studies · Source 3, 5

9. Type 2 response → Eosinophils and IgE Eosinophil granulocytes move into the gut wall and tissue and settle on the surface of the larvae. IgE binds parts of the larvae and attaches to mast cells. Source 5, 7↓ depletes The settled cells release granules holding proteins that attack the surface of the larva. Bound IgE has mast cells pour out their signalling molecules, whereupon the gut wall releases more fluid. observed in studies Source 5, 7
   ⚖ When the balance tips

   too much — Where many eosinophil cells are in the tissue, the surface of the larvae is attacked at more places.

   too little — Where few are present, the larvae travel on more freely.

   observed in studies · Source 5, 7

   Field of research — The part played by eosinophil cells and IgE with multicellular parasites is studied in reviews. Source 5

10. Type 2 response → Mucus and movement Goblet cells make more mucus, and the muscles of the gut wall work more strongly. Together the two loosen worms from the wall and carry them off with the gut contents. Source 5, 7↓ depletes The thicker mucus denies the worm its hold, and the quicker waves of the gut muscle carry it onwards. In animal models gut worms are shed by this route. observed in studies Source 5, 7
    ⚖ When the balance tips

    too much — Where much mucus is present and the gut works strongly, more worms lose their hold.

    too little — Where little mucus is present, the worms hold onto the wall longer; tapeworms inside the lumen set off this response only weakly in any case.

    observed in studies · Source 5, 9

11. Passage across the wall → Renewal of the cells The gut lining renews itself continuously: new cells grow from cells at the villus base and travel to the tip. Lost places are closed again in this way. Source 5, 6↑ supplies The same signalling molecules that order the immune answer also drive renewal: interleukin-13 brings more goblet and tuft cells into being, and the cell sheet closes over the place. observed in studies Source 5, 6
    ⚖ When the balance tips

    too much — Where renewal runs quickly, the places close promptly, and the lining absorbs nutrients there again.

    too little — Where it runs slowly, for instance when building blocks for new cells are scarce, the places stay open longer.

    observed in studies · Source 5, 10

Further stations

• Uptake — Eggs, larvae, raw meat Worm eggs reach the mouth on hands, vegetables or in water, tapeworm cysts in raw or lightly cooked meat. Larvae of hookworms and threadworms enter through the skin and reach the gut by a detour. Source 1, 2, 8↑ supplies Uptake largely settles the number: most of these worms do not multiply inside a person. How many worms live in the gut depends on how many eggs or larvae were ingested. established physiology Source 1, 2
  ⚖ When the balance tips

  too much — Where many eggs or larvae are ingested, more worms live in the gut, and they share the gut contents between them.

  too little — Where few are ingested, single worms often remain, and they hardly stand out in the gut.

  established physiology · Source 1

• Cells of the lining — Sentries at the surface Single cells of the gut lining, the tuft cells, carry sensory hairs and recognise substances from worms. They then release interleukin-25, a signalling molecule for the immune system. Source 6↑ supplies These cells are the alarm: their signalling molecule sets the type 2 response in motion. The same response brings more tuft cells into being, so the alarm grows louder. observed in studies Source 6, 5
  ⚖ When the balance tips

  too much — Where many tuft cells release interleukin-25, the type 2 response gets under way more strongly.

  too little — Where few release it, the response stays weak, and the worm holds on longer in the gut.

  observed in studies · Source 6, 5

• Passage across the wall — Blood, iron, protein At the places where worms sit, blood and tissue fluid pass into the gut. With hookworms, iron is steadily carried away in this manner, with whipworms protein as well. Source 1, 2↓ depletes What passes across the wall into the gut is not fetched back: iron from the blood and protein from the tissue fluid leave the body with the stool. observed in studies Source 1, 2
  ⚖ When the balance tips

  too much — Where many worms sit, more blood passes over, and the body draws more iron from its stores.

  too little — Where few sit, the passage stays small, and uptake from food covers it.

  observed in studies · Source 1, 2

Cofactors in this pathway

• Iron — Passes with the blood into the gut at the bite sites of hookworms and leaves the body with the stool Source 2In the ORY catalogue as a laboratory value: Eisen
• Ferritin — Storage form of iron; from it the body draws what is given up across the gut wall Source 2In the ORY catalogue as a laboratory value: Ferritin
• Zinc — Building block of enzymes with which the lining forms new cells and closes places again Source 10In the ORY catalogue as a laboratory value: Zink
• Glutamine — Fuel of the gut cells; from it they draw energy for the renewal of the lining Source 13In the ORY catalogue as a laboratory value: Glutamin
• Vitamin A — Retinoic acid arises from it and switches B cells in the gut to the IgA build Source 11
• Vitamin D — Its active form has maturing B cells form the homing receptor with which they find the gut wall Source 12In the ORY catalogue as a laboratory value: Vitamin D

Sources

1. Jourdan PM et al. Soil-transmitted helminth infections. Lancet 2018 · PubMed 28882382
2. Loukas A et al. Hookworm infection. Nat Rev Dis Primers 2016 · PubMed 27929101
3. Gordon CA et al. Strongyloidiasis. Nat Rev Dis Primers 2024 · PubMed 38272922
4. Albasheer O et al. Pinworm (Enterobius vermicularis) in children and adults: a practice-oriented narrative review and household-school algorithm. Front Public Health 2026 · PubMed 42267275
5. Zaiss DMW et al. Cooperation of ILC2s and T(H)2 cells in the expulsion of intestinal helminth parasites. Nat Rev Immunol 2024 · PubMed 37798539
6. Faniyi AA et al. Helminth Sensing at the Intestinal Epithelial Barrier-A Taste of Things to Come. Front Immunol 2020 · PubMed 32849506
7. Zaph C et al. Mucosal immune responses following intestinal nematode infection. Parasite Immunol 2014 · PubMed 25201407
8. Hossain MS et al. Insights into the diagnosis, vaccines, and control of Taenia solium, a zoonotic, neglected parasite. Parasit Vectors 2023 · PubMed 37876008
9. Ito A. Basic and applied immunology in cestode infections: from Hymenolepis to Taenia and Echinococcus. Int J Parasitol 1997 · PubMed 9394191
10. DiGuilio KM et al. Micronutrient Improvement of Epithelial Barrier Function in Various Disease States: A Case for Adjuvant Therapy. Int J Mol Sci 2022 · PubMed 35328419
11. Bos A et al. The role of retinoic acid in the production of immunoglobulin A. Mucosal Immunol 2022 · PubMed 35418672
12. Fakhoury HMA et al. Vitamin D and intestinal homeostasis: Barrier, microbiota, and immune modulation. J Steroid Biochem Mol Biol 2020 · PubMed 32194242
13. Blachier F et al. Metabolism and functions of L-glutamate in the epithelial cells of the small and large intestines. Am J Clin Nutr 2009 · PubMed 19571215

Whole pathway: Worms in the gut

Related pathways

• Bacterial enteric organisms — uptake
• Viral enteric organisms — uptake
• Borrelia — Eisen, Zink
• Clostridioides difficile — Zink, Glutamin
• IgG antibodies to food — Eisen, Zink

As of 2026-10-05. Draft, written by Claude to schema v2; sources checked in PubMed; expert approval pending
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