How do you know if you have parasites? When I have a client that eats a healthy diet compatible with their doshas but still has many digestive problems, I start to consider parasites and then look for signs.

Passing a worm in your stool is a definitive sign that you have parasites.

Other important signs include excessive food cravings and/or weight loss, despite eating large portions of food. Indigestion, frequent gas, abdominal pain, and food poisoning all hint at the possibility of parasites. If your elimination consists of chronically soft stool or acute watery stool and diarrhea, you may be harboring unwelcome visitors. Many parasites cause anal itching. If you experience bloody stools, constipation, or IBS, consider getting tested to determine whether parasites are ravaging your GI tract.

Next, consider your tongue. Is it coated? Does it have depapillated regions - places where it looks irritated, as if a piece of it was scraped off? Is your tongue swollen with teeth marks around the edges? Do you have a bitter or metallic taste in the mouth? All of these can indicate changes in the digestive tract caused by parasites. However, these signs may be present in individuals without parasite infection as well.

• Parasites destroy ojas so may see signs of dryness or low ojas on tongue. This may include cracks as well as bare patches on the tongue (a peeled tongue).
• Parasites create inflammation so you may see rawness or heat signs on the tongue such as a yellow coating, red dots (inflamed papillae), or rawness due to toxic mucus. Your tongue may be swollen (with scalloped edges) due to inflammation and low agni.
• Parasites create ama so you may see a thick coating on the tongue.

Parasites can make you feel jittery and prevent you from sleeping soundly. Their waste products contain toxins that can make you a bit cuckoo, a condition called "verminous intoxication." These toxins can also cause joint pain, reactive arthritis, and skin irritation. They may wake you up throughout the night to pee. They can cause you to grind your teeth. Parasites can make you feel weak and fatigued. These little vampires can lead to anemia as they rob your body of nutrients.

Parasites frequently secrete specific hormones and chemicals to make your body a more hospitable host. For example, blastocystis secretes chemicals that shut down your immune system, making you more vulnerable overall to infection. If you experience frequent urinary tract infections or vaginal yeast infections but your diet is otherwise clean, think about getting tested. Also consider getting tested if you frequently get sick for no apparent reason.

Parasites often have cyclical flare ups that coincide with the moon or a particular time of year. Every parasite has a different life cycle. Some will cause pain in the upper GI, others will cause pain in the lower GI. You may find one of these invaders passed in your stool, which is why it's always a good idea to check out your poop before you flush. Traveling increases your risk for contracting a parasite because you have no natural immunity in a foreign territory.

Beware! Parasites are often stealthy and keep their presence under the radar by causing no signs or symptoms at all. That's why an antibody or DNA stool test is your best bet to ensuring you are parasite free.

Once you find out that you do have parasites, many wonder - "how did this happen?!" Parasites are endemic to every country, including developed industrialized nations. Pinworms are especially common in the United States, affecting up to 40% of all children. Hookworms, tapeworms, and ascaris are also common worldwide. H pylori and blastocystis hominus are some of the most infectious agents, affecting anywhere from 20%-60% of the population worldwide. Most digestive parasites infect via the fecal-oral route, for example, by restaurant employees who fail to wash their hands after going to the bathroom or children who scratch their butts then touch a doorknob. Contaminated food or water may contain parasites. Undercooked meat and untreated water are two of the most common pathways to pathogenesis. Many parasites enter the skin through your bare feet. You can pick them up from handling animals, shaking hands with someone who has poor hygiene, or by working or walking in contaminated soil.

As with almost any illness, weak digestion increases susceptibility. In particular, gooey food such as wheat or dairy coats parasites in mucus, protecting them from stomach acids. As mentioned, travelers are at an increased risk because they lack natural immunity to parasites in non-native lands. When traveling, digestion may be weak due to different routine, foods, and jet lag, leaving your gut more susceptible to infection. It's especially important to avoid gooey and difficult to digest food when traveling, tempting as they may be. Avoid undercooked meat. Boil water when traveling. Dishes, cups, and silverware may even become contaminated during the rinse cycle of washing.

Parasites flourish when the weather is warm and moist. That makes autumn an ideal time to get tested and to cleanse your body of summer parasites.

Joyful Belly recommends DiagnosTechs Full GI Panel, or Genova's GI Effects Stool Test which gives you both an assessment of parasites and the function of your entire digestive tract. Traditional visual exam under microscope for ova and parasites is insufficient on its own. There are frequent false negatives because parasites must be alive and active once they get to the lab for them to be detected with this test. Tests should include a visual ova test as well as a test for specific presence of antibodies in saliva and stool. A DNA test or antibody test is more accurate in detecting their undercover presence than visual inspection alone. This level of testing ensures you will have the most accurate picture of what's going on in your gut. Even if parasites are ruled out, the GI function test will still give you a clue as to what might be causing any digestive distress you experience.

Ultimately, the diagnosis of parasites must be made by a Western medical doctor. Your doctor should recommend a treatment that is specific to the parasite rather than broad spectrum. Herbs will often reduce or eliminate symptoms but may fail to kill the infection entirely, unless accompanied by an appropriate diet and cleanse. Since pharmaceuticals inevitably disturb your gut biome, be sure to ask your doctor to recommend a probiotic that specifically contains beneficial organisms killed by the pharmaceutical. Note that treatment is often far less expensive than the test itself.

Some parasites are classified as both good and bad bacteria, depending on who you talk to. In that case, some discernment may be required before taking a pharmaceutical. Otherwise, parasites should be killed as quickly as possible, before they have a chance to adapt to your gut or cause permanent damage. Once parasites adapt, they are more difficult to get rid of.

Esssential oils, herbs from the mint and carrot family, and berberine herbs have strong antimicrobial action. Here are some common Ayurveda herbs used for parasites. See the complete list further down.

Herbs:	Vidanga, Neem, Bilva
Spices:	Cloves, turmeric, oregano, cumin

Pesky parasites are trouble! At Joyful Belly, we specialize in digestive health and wellness. Students on our Mastering Ayurvedic Digestion & Nutrition program learn all about how to fight parasites using herbs, diet, and lifestyle. Don't fall victim to an invasion. Get tested to be sure all of the guests in your gut support your well being.