Risky Menus Linked to Liver Fluke Parasite and Cholangiocarcinoma: Symptoms and Prevention

Unveiling risky menus "Liver fluke" parasite linked to "cholangiocarcinoma" Checking symptoms from early, moderate to severe stages along with prevention tips

Following public concern over liver fluke infections, "liver fluke" parasite after the Mahasarakham Provincial Public Health Office reported an outbreak in the area, screening 20,000 people and finding an infection rate of about 11%

Meanwhile, screening of new students entering the 2026 academic year at Mahasarakham University, involving over 12,700 students, found 4,233 infected with liver fluke parasites, accounting for 33%. Screening at Mahasarakham Rajabhat University found 380 infected out of 1,922 students, or 19%, as previously reported.

Liver fluke disease (Opisthorchiasis) is caused by the liver fluke parasite and is a primary cause of cholangiocarcinoma among Thais.

Early-stage symptoms of "liver fluke disease"

• Abdominal fullness and bloating
• Back pain and fatigue
• Weight loss and loss of appetite
• Pain in the upper abdomen beneath the ribs and below the sternum
• Warm sensation on the right side of the abdomen and back
• Indigestion and bloating

Moderate-stage symptoms

• Enlarged liver
• Enlarged gallbladder
• Jaundice, yellowing of skin and eyes

Severe-stage symptoms

• Fever
• Weight loss
• Ascites (abdominal swelling)
• Swollen feet
• Tender and enlarged liver
• Yellowing of skin and eyes
• Pale or gray stools
• Dark urine

Dilation of bile ducts can lead to cholangiocarcinoma, or bacteria entering the bloodstream from bile ducts can cause fatal complications.

Menus to strictly avoid due to risk of cholangiocarcinoma

• Koi pla (raw fish salad)
• Raw fish larb
• Pla som (fermented fish)
• Raw fermented fish (pla ra)
• Pla jom (fermented fish)
• Fish mam (fermented fish sausage)

Prevention methods for liver fluke disease

1. Thoroughly cook freshwater fish dishes made from white-scaled fish using heat.

2. Wash hands with soap and clean water before cooking, before meals, and after defecation.

3. Defecate in toilets and dispose of waste hygienically to prevent parasite egg contamination of the environment.

4. For people aged 40 and above at risk, submit stool samples for parasite egg detection and undergo ultrasound screening for cholangiocarcinoma at nearby hospitals at least once a year.

5. Take medication if diagnosed with liver fluke infection and stop consuming raw or undercooked fish dishes.

Information courtesy of the Department of Disease Control, Ministry of Public Health