A California man’s daily sushi habit ended in a trip to hospital with a stomach-churning item to show doctors: a 1.6-metre tapeworm that “wiggled” out of his body. Fresno emergency department doctor Kenny Banh said he was sceptical when the man walked in to his hospital, asking for treatment for a worm. But when the patient opened a plastic bag, the “giant” parasite was inside, wrapped around a toilet roll. “Apparently it was still wriggling when he put it in the bag but it had died in transit,” Banh said. The patient, whose identity has not been revealed, told the doctor that during a bout of bloody diarrhoea he looked down and thought a piece of his intestine was hanging from his behind. When the man pulled on it and it kept coming out, he realised it was moving and must be a worm. This was marginally better, Banh said, than “if you think you’re dying because your entrails are shooting out of your bottom”. The incident happened last August but came to light last week because Banh spoke about it on a medical podcast called ‘This Won’t Hurt a Bit’. It’s not eating your pizza, it’s eating you Dr Kenny Banh He unravelled the worm, he said, and laid it on paper towel on the floor of the trauma room at the Community Regional Medical Centre in Fresno. It was 1.6 metres long. The patient was given a de-worming pill which, Bahn explained, was no different from the kind generally given to pets. “He said he’d felt like something was moving around in his guts and he thought it was just gas,” Banh said of the patient. “He’d been in discomfort for a few months.” The man said he ate raw fish, especially salmon sashimi, almost every day. Last January, the US Centres for Disease Control and Prevention (CDC) put out a warning of an elevated risk of parasitic larvae that can grow into tapeworms being found in Pacific Ocean salmon, including Alaskan wild salmon that is popular in the US and elsewhere. Cooking kills the tiny larva; sushi is supposed to be flash-frozen to kill such parasites too. Larva may survive in poorly prepared raw salmon, then take up residence in a human digestive tract. Most people, Banh said, think tapeworms survive on food in intestines. In fact, a worm attaches its head to the wall of the small bowel, just below the stomach, allowing it to suck its host’s blood “like a leech”. “It’s not eating your pizza, it’s eating you,” Banh said. Many human hosts experience no symptoms. Worms often die and are passed at the end of their lifecycle. They can also slip out alive, as in the case in Fresno.