How to Diagnose Pinworms
Pinworms are 0.2 to 0.4 inches long (5 to 10 mm). After their eggs are orally ingested, they grow in the intestine and then descend to the rectum to lay eggs. They are not dangerous and are highly treatable, but they are itchy. Strangely, they come out of the rectum at night to lay eggs. This is when people really notice the sensation of something crawling. Nausea, insomnia and vaginal itching are other symptoms. An itchy rectum at night can have other causes though.
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Instructions
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Have a doctor administer what is called a "tape test." The strategy is to find the telltale eggs. The method consists of applying regular cellophane tape to the anus. While the worms don't come out in the day, the eggs are left behind on the exterior. The doctor then examines the tape under microscope. Several "tapings" may be necessary before they are found. You may be able to bring samples in to the doctor yourself, a larger sample size than the doctor can get on his own. Use clear Scotch tape, and do it in the morning before a bowel movement or bathing. Doing it yourself can produce more tape samples over time.
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Look for the adult worm yourself, possibly in your underwear or in the toilet after defecating. It looks like a little white piece of thread. Therefore, wearing dark underwear for easier identification may help.
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Insert a lubricated finger into the rectum, scraping along the interior wall. The worms may get stuck on the lubricant and be visible. Another possibility is to use a lard like Crisco to attract them. Unfortunately, their narrow white bodies don't show up well against Crisco. Nighttime is the best time of application, since the adults stay away from the anus during daytime. Therefore, you may have a better opportunity to find them than your doctor.
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Get tested for yeast and Candida, as a possible alternative diagnosis. Consider the possibility of hemorrhoids, as well. The crawling sensation may be from your own pulse, since an external hemorrhoid is, essentially, a pinched vein. A growth such as a cyst may cause muscle or nerve reaction that feels like crawling, though it wouldn't tend to be confined to nighttime, as in the case of inchworms.
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Apply hydrogen peroxide for a few days. If this makes the crawling sensation go away, the pest may have been mites instead of inchworms.
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Speak to your healthcare provider about other options should you and he fail to find evidence for pinworms.
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