Worm profile – stool test for worm DNA and microsporidia (PCR)

The roundworm (Ascaris lumbricoides) belongs to the so-called soil-transmitted helminths. Its eggs reach the mouth via contaminated soil, vegetables or hands; the larvae migrate through the liver and lungs before the adult worms live in the small intestine. Worldwide, more than a quarter of the population is at risk of such worms, mainly in tropical regions with basic sanitation (PubMed 28882382, review in the Lancet).

Positive means: the laboratory found roundworm genetic material in the sample. The review describes that infected people can present with very different conditions and that doctors should consider these worms in people living in or returning from endemic regions (well established). Many infected people have no complaints.

Limits: the report does not show how many worms are present. Whether and how to treat is decided by the doctor.

Pinworms (Enterobius vermicularis) are the most common human worms in Europe. According to a paediatric review, around 30% of children worldwide are affected, most often at the age of 5 to 14; about 30 to 40% of those affected have no complaints. The most common sign is itching around the anus at night (PubMed 38288810).

The females lay their eggs on the skin around the anus, not in the gut. That is why worms and eggs usually do not end up in the stool. The review names the adhesive tape test ("sellotape test") as the best examination: a single test detects about half of cases, three tests on three mornings about 90%. Stool examination is explicitly not recommended for pinworms (well established).

What this means for you: a positive result for pinworm DNA is an indication; a negative result does not rule out pinworms. For anal itching – especially in children – the tape test at the paediatrician or GP is the usual route.

These three roundworms occur mainly in tropical and subtropical regions. Hookworms (Ancylostoma duodenale, Necator americanus) and the threadworm (Strongyloides stercoralis) enter the body as larvae through the skin, for example when walking barefoot; the whipworm (Trichuris trichiura) via eggs from soil or food (PubMed 28882382).

The threadworm has a special feature: its larvae can develop further in the gut and re-infect the body (autoinfection). Many infected people have no or non-specific gastrointestinal, respiratory or skin complaints. With weakened immunity – for example under cortisone or other immunosuppressive drugs – this can lead to a severe, often life-threatening course (well established, PubMed 38272922).

Positive means: genetic material of the respective worm was found. This result belongs in a doctor's hands, for threadworm especially when immunosuppressive treatment is planned or ongoing.

The test covers tapeworms of the genus Taenia (beef and pork tapeworm) and, according to the sample report, the dwarf tapeworm (Hymenolepis nana). Taenia tapeworms are acquired via raw or undercooked beef or pork and live in the small intestine; single segments are passed with the stool. With the pork tapeworm (Taenia solium), the larvae can also invade tissue (cysticercosis), with courses ranging from symptom-free to severe (PubMed 26824681). The dwarf tapeworm is transmitted from person to person and is considered a neglected worm infection found worldwide (PubMed 25743998).

Positive means: tapeworm genetic material was found. The doctor clarifies which species it is and whether further examinations are needed.

Not covered: the fox tapeworm and dog tapeworm (Echinococcus) are not among the measured species. In humans they do not live in the gut but form cysts in organs; a stool test is not suitable for them.

Microsporidia are not worms but spore-forming single-celled organisms that live in cells of the gut lining (including Enterocytozoon bieneusi, Encephalitozoon intestinalis). They were first described mainly in people with severely weakened immunity (PubMed 9675442).

A study of 21 travellers with normal immunity and persistent diarrhoea after trips to the tropics found microsporidia in the stool; the diarrhoea resolved in almost all, even though the microsporidia sometimes remained detectable in the stool. The authors see only a transient link between detection and complaints (observed in studies, small study, PubMed 16103591).

What this means for you: a positive result alone says little about its significance. It is assessed by a doctor, especially with weakened immunity.

PCR specifically amplifies short sections of genetic material and assigns them to a species via a target sequence. The result is qualitative: positive (found) or negative (not found). There is no quantity or "severity".

Negative means: no genetic material of the measured species was found in this one sample. However, worms do not release their genetic material evenly but intermittently into the stool. A negative result therefore does not reliably rule out an infection – and certainly not for pinworms (see above).

Positive means: genetic material was found. This is an indication that is confirmed and interpreted by a doctor. Whether there is an infection that needs treatment is determined by the doctor, not by the report alone.

Worms living in the human gut can roughly be divided into two groups: roundworms (pinworm, roundworm, whipworm, hookworms, threadworm) and tapeworms. The routes of infection differ:

• Hand to mouth: pinworm eggs are passed on via fingers, laundry or objects, often within families and nursery groups (PubMed 38288810).
• Soil and food: roundworm and whipworm eggs mature in soil and are ingested with contaminated vegetables, water or via the hands (PubMed 28882382).
• Through the skin: hookworm and threadworm larvae penetrate on contact with contaminated soil (PubMed 28882382).
• Meat: beef and pork tapeworm via raw or undercooked meat.

Apart from the pinworm, the measured worms are rare in Germany and occur mainly after stays in tropical or subtropical countries.

Worm eggs cannot be seen with the naked eye; at most, whole worms or tapeworm segments are visible. There are several ways to examine:

• Microscopy of a stool sample for eggs and larvae – the classic method in practices and laboratories (PubMed 28882382).
• PCR for the genetic material of worms, as in this test. Several species are checked in one run.
• Adhesive tape test at the anus for pinworms, ideally on three mornings (PubMed 38288810).
• Blood test: a rise in certain white blood cells (eosinophils) can indicate worms in returning travellers; British guidelines describe how doctors then investigate further (PubMed 39537036).

If you have seen a worm or a worm segment in your stool, take it – for example in a closed container – to the doctor's practice. It can be identified there directly.

None of the worms measured in this profile, and no microsporidia, are on the national German list of notifiable pathogens under § 7 IfSG of the Infection Protection Act (checked October 2026). Notifiable there are, for example, the fox and dog tapeworm (Echinococcus) and Trichinella – neither is measured by this stool test.

Regardless of the pathogen: in Germany, children under six with infectious diarrhoea may temporarily not attend community facilities such as nurseries (§ 34 IfSG), and people working with food are subject to special rules if they have infectious diarrhoea (§ 42 IfSG). What applies in an individual case is clarified by the doctor.

Many people with worms have no complaints. Where complaints do occur, research describes different patterns depending on the worm:

• Itching around the anus, especially at night: the most common sign with pinworms; 30 to 40% of those affected have no complaints (PubMed 38288810, well established).
• Abdominal pain, diarrhoea, bloating: non-specific gut complaints are described with soil-transmitted worms and threadworm (PubMed 28882382, PubMed 38272922, well established but not specific).
• Anaemia and malnutrition: with heavy hookworm or whipworm infection, especially in children in endemic regions (PubMed 28882382, well established).
• Cough, skin rash: respiratory and skin complaints are described with threadworm (PubMed 38272922, observed in studies).
• Persistent diarrhoea after travel: observed with microsporidia, usually transient (PubMed 16103591, small study).
• Raised eosinophils in the blood: a laboratory sign in returning travellers, not a noticeable complaint (PubMed 39537036, guideline).

Important: these associations come from studies of groups of people. They do not show what causes complaints in an individual. The test does not explain complaints and does not make a diagnosis. Please have persistent or new complaints assessed by a doctor first.

With these signs, a medical examination is the first step, not a home test – and waiting is not a good idea:

• Blood in the stool or black, tarry stool
• Fever, especially together with diarrhoea or after travel
• Severe or increasing abdominal pain, vomiting
• Diarrhoea after travel to tropical or subtropical countries, especially if it lasts more than a few days
• Unintended weight loss, severe tiredness or paleness
• Signs of dehydration, especially in young children, older people and during pregnancy
• Weakened immunity, for example due to cortisone, chemotherapy or other immunosuppressive drugs
• A visible worm or worm segment in the stool – ideally take it with you
• Children with anal itching: paediatrician or GP, where the tape test is usual

In Germany, stool examinations ordered by a doctor because of complaints are usually covered by statutory health insurance.

A positive result is an indication that is assessed by a doctor. Take the report to your GP or paediatrician, and if you have returned from travel, to a tropical medicine clinic. There it is decided whether the result should be confirmed, whether further examinations are needed and whether and how to treat.

With pinworms, the doctor also decides whether other household members are examined or treated as well; the review describes that re-infection within households is common (PubMed 38288810).

The free results consultation with the ORY expert team or with your doctor or naturopath, for example from the ORY expert network helps you understand the report and prepare for the medical appointment. It does not replace medical assessment.

This page does not recommend any products – neither deworming medicines from the pharmacy nor home remedies or herbal "parasite cleanses". Which treatment is appropriate depends on the worm species, age, pregnancy and other conditions. This is decided by the doctor after the result.

For prevention, the pinworm review mentions general hygiene: frequent handwashing, especially after using the toilet and before meals, short fingernails and no scratching in the anal area (PubMed 38288810). This is not a treatment.

A follow-up test after treatment only makes sense if the doctor considers it necessary.

Collecting the sample takes a few minutes. Important points:

• No contact with toilet water: collect the stool with the water-soluble stool catcher. Cleaning agents and disinfectants can distort the PCR result.
• Only open the yellow cap: insert the sampling stick into the stool in at least four places, close the tube and swirl it, do not shake. Do not open the white cap.
• Label the tube and complete the request form, including the collection date.
• Send quickly: the sample must reach the laboratory within 72 hours. Do not send on Fridays, at weekends or before public holidays. Cooling is not needed.

If you take medication or have recently been treated for worms, mention this in the results consultation.

The kit is dispatched the next working day. The report is usually available 7–21 days after the sample arrives at the laboratory, not from the date of order. As soon as it is ready, we will inform you and you can book the free results consultation.

If you have acute complaints, do not wait for the result – see a doctor.

The worm profile costs €125.00 including VAT, shipping, return shipping and results consultation.

Statutory health insurance in Germany usually does not cover this self-test. If a doctor orders a stool examination or tape test because of complaints, insurance usually covers it. Private health insurance reimburses laboratory analyses fully, partly or not at all, depending on the contract – the section below describes the process.

Different examinations suit different questions:

• Worm profile (this page, €125.00): stool PCR for DNA of several worm species and microsporidia.
• Parasite PCR profile (€150.50): stool PCR for DNA of six intestinal single-celled organisms (protozoa) instead of worms, including Blastocystis and Dientamoeba.
• Basic gut profile (€285.00): broader stool profile on microbiome, leaky gut markers and histamine, without worm testing.
• Pinworms: here the tape test at the paediatrician or GP is the usual examination, not a stool test.

With complaints, a medical examination is the first step. Which analysis makes sense beyond that is something to discuss in the free initial consultation with the ORY expert team or with your doctor or naturopath, for example from the ORY expert network.