"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."
"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."
"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."