Gut worms

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Gut worms are a parasitic disease that infects the stomach, which doubles the host's hunger rate.



  • Increased hunger rate (200% of base)
  • Increased vomit rate (to average once per day)
  • +15-40% Pain (-10 mood)
  • Sick (-5 mood)


Gut Worms do not increase in severity over time, nor are they cured over time. Direct treatment is the primary way to cure it.


Gut Worms will be cured when the treatments performed on it reach a cumulative quality of 300%, thus it is important to maximize the Medical Tend Quality of the Doctor performing the tending and the quality of the medicine used. It takes 48 ingame hours (2 days, or 120,000 ticks (33.33 mins)) between each treatment. For example, the disease can be treated with 3 treatments at 100% quality, or 5 at 60%, or 1 at 130% plus 2 at 85%.

Other Treatments


Frequently when Gut Worms strike a colony, several members will be affected at once. With multiple colonists vomiting, the base can quickly become very dirty. If this happens in the kitchen, the risk of food poisoning increases, risking further vomiting. If vomiting occurs while a pawn is eating a meal, the eating process is cancelled, and the pawn will have to start over after vomiting.

If already malnourished when Gut Worms (or Food Poisoning) strike, this can be a real problem, as things can spiral out of control, and the malnutrition severity can progress, even while seated at the dinner table actively trying to eat a meal. Pemmican is said to be better than meals in this situation, because a pawn may successfully eat a few small pieces of pemmican before the vomiting begins again. In this case, the partial progress toward removing hunger is retained, and malnutrition may not advance.

As with many other things in RimWorld, if Gut Worms are not managed well, minor problems can snowball into mental breaks, downing, death and loss of the entire colony. Preventative installation of a few bionic stomachs, especially in the main cook, is one possible strategy to help prevent future outbreaks of Gut Worms from dominoing out of control.

Version history

Prior to Beta 19, gut worms always required 5 treatments regardless of quality.