Sunday, July 27, 2014

Epigastric Pain

Epigastric Pain Epigastrium is medically described as central part of the abdomen and is found between the lower portion of the thorax and sub coastal plane. Epigastric pain is felt due to infection or any other diseases on epigastrium. Pain occurs suddenly and sharply in the abdominal region. It might cause continuous pain when this portion becomes defective. This pain can cause compulsive breath exhalation by the affected person. Ulcer or pancreatitis can cause epigastric pain commonly. This pain can be managed by taking proper medication based on the cause of pain. As such epigastric pain is not a disease and is a warning signal of underlying medical condition.


Causes :


Though there are number of causes that produce epigastric pain still some of the common causes are discussed below. It can occur due to indigestion in elderly people and due to infection in healthy adults. Esophagus disease can cause sudden epigastric pain. The patient will feel like vomiting along with heartburn or discomfort in the chest region. It can also cause sore throat and change in voice if the throat region develops inflammation.


Gastric ulcer or peptic ulcer is a chronic problem that can irritate the soft lining of the duodenum. Any problem in the gall bladder can cause pain in the duodenum area. Inflammation of pancreas (pancreatitis) can cause epigastric pain. In addition chronic heart problems or cardiac diseases can affect the esophageal region causing pain on the epigastrium. Infections like cystitis (urinary bladder infection) and urethritis can cause abdominal pain. Inflammatory disease on the pelvic region, proteus mirabilis bacterial infection and diverticulitis (inflammation of diverticulum) can also cause epigastric pain. In some people exact cause of epigastric pain is unknown which is called as idiopathic epigastric pain.


Symptoms :


Epigastrium is the region found on the stomach and hence epigastric pain causes mild to severe abdominal pain, bloated feeling, vomiting/nausea and constipation. Symptoms vary in accordance with the causative factor. If epigastric pain occurs due to pelvic floor infection it can cause fever, vaginal bleeding and intense pain during intercourse.


Diagnosis :


Range of tests is available for detecting the underlying cause of epigastric pain. Endoscopy is the best way to analyze the inner areas of abdomen and intestine. Esophageal cancer and dysplasia can be evaluated by endoscopic procedure. For healthy adults below 45 years endoscopy is the ideal method for detecting epigastric pain. Biopsy of the tissue sample can also be taken during endoscopy to detect tumors or ulcers.


Imaging tests like X-ray will be done for diagnosing problems in liver, kidney and urinary bladder. In addition your doctor may request for blood test, urine analysis, and ultrasound scan to check the functionalities of internal organs. Cardiac test will be done if epigastric pain originates from heart problems.


Treatment :


The method of treatment varies from one person to the other depending on the root cause of epigastric pain. In case of severe pain the treatment would be complicated and extended for long time. Pain killers like Ibuprofen or other drugs of NSAID’s can be taken for managing pain and fever. Prescription drugs include cimetidine (given for symptoms of peptic ulcer) and antacids (given for managing stomach acidity and heartburn).


Histamines H2 receptor agents like ranitidine is given to control stomach acidity and also for peptic ulcer. With right doses of medications, mild to moderate epigastric pain can be easily managed. Only in severe complications like chest pain, fever, breathlessness and choking, you need to seek immediate medical advice. For patients with H pylori infection H2 blocking agents are given.


Lifestyle Changes :


You can easily manage mild epigastric pain by making small changes in your life. Take frequent small meals several times a day to help easy digestion. Avoid taking spicy and hot foods and include only limited portion of oily foods. Do not skip breakfast which can increase stomach acidity. You are not going to lose any pounds by skipping breakfast.


Instead you can always plan the calories consumed daily to fit your weight regimen. Try to manage stressful events and control your emotions since it can affect your stomach and intestine causing intense pain. Be relaxed and practice yoga or meditation each day. Manage your weight by doing aerobic exercises.


Cold Sores

Cold Sores Cold sores occur commonly in the form of blisters or lesions on the oral cavity. These bumps are red and swollen and are also found on the lips. The blisters contain a clear fluid which may break open after few days. Cold sores do not require any treatment since it would heal on its own within few days. Though body’s immune system will generate antibodies for killing viruses still it is not eliminated in full. For this reason the symptoms may recur after some time. Cold sores are a viral infection caused by HSV herpes simplex virus. The same virus would also cause painful sores on the genitals.


How cold sores occur?


It is the virus herpes simplex that causes cold sores. It will gain entry into the body through small cut or injury on the skin. The disease is also contagious and can easily spread to another person when he touches the infected fluid accidentally. It can spread when a person kisses the affected person, shares razor with him, or through any other fluid connection. The infected mother will easily spread the virus to the children in this manner.


Symptoms :


Some of the common signs of cold sores are swelling of mouth, sore throat, pain on the affected lips, and swollen lymph nodes on the neck or other parts. Many adults would have fever with body pain. The affected person will develop red colored small lesions on the oral cavity which will eventually discharge pus or fluid once it break opens. This is the time when the virus spreads easily to others when they touch the fluid. It would also spread to other parts of the body and the same person would develop painful sores on the hands/legs. Cold sores can be painful for some people but not for all. There are people who may not show any symptoms even if they develop cold sores.


Causes :


It is the HSV virus that causes cold sores. Two types of herpes simplex are known to cause cold sores. Often Type 1 virus is the root cause of cold sores. Any person can get infected with the virus when he kisses or shares person items with the infected person. The infection can easily contracted if the person coughs through which saliva is passed to others. When a person has oral sex with someone who has been infected with herpes simplex virus he can easily get infected.


The virus becomes highly contagious when the blisters break open to discharge yellowish fluid. After few days the lesions are crusted over and eventually disappear within few days. It is interesting to note that you can get HSV from others even when he does not have any symptoms. There are many cases in which the person would not develop painful sores but may still have the virus.


Once the virus gains entry into your body it reaches the nerve cells and move up to ganglion. It is the safe place for the virus to stay for months together and even for years without causing any symptoms. This is called the latent period of the virus where it stays inactive. When the situations become favorable or if the immune system is weakened the virus would become active causing lesions on the lips or oral cavity.


Tests :


Your doctor will examine your body for the above symptoms to find out if you have been infected with virus. He would look for the painful sores on the mouth or on the lips or even other body parts. He would also examine if the blisters are oozing out fluid. No special test is needed for diagnosing cold sores.


Treatment :


Very often cold sores need no treatment since the symptoms will heal in few days. You can consult your doctor if you have painful sores that cause discomfort. Depending on the intensity of cold sores your doctor would prescribe topical ointments or creams. For some people he would give oral pills for getting quick relief from the symptoms. Once you have the initial symptoms of cold sores you need not wait to go to the clinic. You can apply antiviral creams on the mouth/lips or infected area to get relief from the symptoms.


Sometimes cold sores will give burning sensation or tingling feeling on the mouth. You need to apply skin ointment liberally inside the oral cavity several times a day. Alternatively you can also use cold sore patches available over the counter. Apply this patch over the painful blister for quick healing process. In rare cases cold sores can lead to dehydration if the person develops cold sores on his throat. He may not be able to drink anything causing dehydration.


Risk Factors :


Cold sores can develop on any one irrespective of the age and gender. Even children or older adults can have cold sores. But certain factors like weakened immunity, exposure to UV rays of the sun, change in hormones, stressful events and trauma or injury to the skin can trigger the virus to become active causing painful blisters on the skin. Fever or common cold is the topmost factors that can cause cold sores. Once the person gets infected with cold sores the virus would stay in his body for many years.


Pictures of Cold Sores :


Images, Pics, Pictures and Photos of Cold Sores


Cold Sores Cold Sores Cold Sores Cold Sores Cold Sores Cold Sores


Prevention :


You can avoid sharing towels, utensils or cups with someone who is suspected to have cold sores. Do not kiss or make direct skin contact with the person who has developed cold sores. Flaring of cold sores occur if you are exposed to harsh sunlight. Hence use sunscreen lotion liberally or avoid going out in hot summer.


The same person can spread the virus to other parts of the body. Hence it is advised not to touch the cold sores anytime once you are infected. It can easily spread to other body parts when you touch your eyes or genitals after touching the painful sores. Wash your fingers consistently before eating food.


Bells Palsy

Bells Palsy Bell’s palsy is a strange condition that causes weakness in the muscles of the face. Weakening of muscles of the face is sudden reaction that may change the appearance of the face. When the affected person smiles it will not be complete smile. One side of his face begins to droop and his eyes would resist closing as he continues to smile. Since the facial muscles are affected due to this problem Bell’s palsy is also known as facial palsy.


This condition can occur at any age with the sudden onset of symptoms. For most of the people the symptoms will automatically be resolved without any treatment. For few others with continued Bell’s palsy medications are prescribed to manage the inflammation of facial muscles. Surgery is also done to correct the compression of the nerve endings on the face. If you have sudden signs of weakness of your face and symptoms of Bell’s palsy you need to consult your doctor immediately since it can be due to more serious causes like stroke or ischemic attack.


Symptoms :


Bell’s palsy is characterized by the sudden appearance of symptoms. It has the peculiar sign of face drooping on one side. It can cause partial or total paralysis of the nerves of your face and development can take place within hours. It becomes difficult for the person to smile and there may be trouble in closing the eyes on one side.


This can cause mild to moderate pain in the jaws and also on the ear of the affected side. Again all these symptoms appear on only one side of the face and not on both sides. In some cases it would cause numbness on the affected side. The affected side of the face becomes sensitive to sound and any movement. Some people will have problems in tasting the food and it can cause reduced secretion of saliva and tears. It can cause eye problems like reduced tears (dryness) or excess of tears on the eye.


Causes :


What exactly triggers the problem of Bell’s palsy is not fully understood. It is believed to be caused by nerve weakness on the face or due to inflammation of facial muscles. Experts believe that Bell’s palsy occurs due to viral infection. Group of viruses that cause herpes simplex, herpes zoster, adenovirus, Epstein Barr virus, rubella virus and influenza virus can cause Bell’s palsy when the nerve endings of the facial muscles are affected. Actually the nerve endings become swollen affecting the normal movement of the facial muscles.


Who are at risk?


Bell’s palsy can develop on any individual irrespective of age and gender. People who have recently developed infections like flu or common cold affecting the upper respiratory tract are more prone to get Bell’s palsy than others. Pregnant women (III trimester stage) and women who have recently given birth are prone to develop Bell’s palsy.


Complications :


In rare cases Bell’s palsy can cause permanent damage to the facial muscles. In extreme cases this disease can cause partial vision loss when the eyes become overly dry tearing the protective layer.


Diagnosis :


No lab test is available to diagnose Bell’s palsy. But the doctor can easily detect this problem by observing the symptoms and looking at your face. He may ask you to close your eyes or smile or lift your eyebrow to check for normal movements of the facial muscles.


Treatment :


Very often Bell’s palsy symptoms will get cured on its own within few days. However in some cases if the facial muscles become compressed medications can be given for correcting it. Anti-inflammatory drugs like prednisone are prescribed to reduce inflammation of face muscles. The muscles will have to sit properly on the narrow bony path to prevent the partial paralysis of the nerves. These drugs will give the desired effect and cure the symptoms. If the doctor suspect viral infection is the cause of Bell’s palsy he would prescribe antiviral medications like acyclovir or valacyclovir.


Physiotherapy is the next best alternative for treating compressed facial muscles. The therapist will gently massage the muscles on your face to get relief from compression. It would also prevent further shrinkage of the muscles. Surgery is the last choice for treating Bell’s palsy and is done only on severe cases. The surgeon would open the bony corridor on the face on which the nerve passes. He would gently relieve the pressure from the nerve endings on the face. However this type of surgery carries some risk. For some people this can cause deafness and permanent injury on the face.


Pictures of Bells Palsy :


Images, Pics, Pictures and Photos of Bells Palsy


Bells Palsy Bells Palsy Bells Palsy Bells Palsy


Home Remedies :


In case the compressed face muscle has affected your eye you can use eye-drops for getting relief from dryness. This would keep your eyes moist and will also help in secretion of tears. To get temporary relief from pain beneath the ears due to Bell’s palsy you can take pain killers like Ibuprofen or aspirin. (Children should not be given aspirin without consulting the doctor)


Alternatively you can use hot and cold therapy on the affected eye to get relief from pain and dryness. Apply warm cloth over the affected eye and leave it for some minutes. Repeat this process using soft cloth dipped in ice water. This can be applied on the face also which helps in reducing the inflammation.


Geographic Tongue

Geographic Tongue Normally the tongue has an extra layer of covering with fine hair like structures called papillae. But people with geographic tongue will not have these papillae thus exposing the patches on the tongue. These patches will sometime look like small islands with clear defined border resembling a country’s map. For this reason it is called as geographical tongue. In medical terms it is called as erythema migrans or migratory glossitis.


These irregular patches on the tongue will not remain on the same place. It would heal within weeks just to reappear on the other surface of the tongue. Hence for this reason they are called migratory glossitis. As such geographic tongue do not possess any problem and are benign (harmless) in nature.


Symptoms :


Geographic tongue is not the same for all people since the symptoms differ from one person to the other. The size and shape of the patches vary widely. For some people it would appear on one corner of the tongue which would disappear to re-appear on the other area. The map like appearance on the tongue will have defined border which is white in color. It would create red patches on the tongue with defined borders.


The map like shape on the tongue will disappear within days or weeks for some people but for others it would not go even for months or years. For some people it would cause mild pain and discomfort while eating hot and spicy foods. Smoking can aggravate the pain if an individual is having geographic tongue. It affects about 1-3% of people and it develops on elderly people often. Geographic tongue is harmless and does not require any treatment and in case of any pain it can be managed by over the counter pain killers.


Causes :


The main cause for geographic tongue is the missing layers of papillae on the tongue. They are small bumps found in several layers on the tongue and some people may lack papillae giving rise to geographic tongue. But what exactly accounts for missing layers is not known. It is believed that geographic tongue runs in families. Again this problem is more likely to occur for people with psoriasis and other skin infection. An individual with fissured tongue is more prone to develop geographic tongue than others.


Diagnosis :


Geographic tongue can be easily diagnosed by simple examination of the tongue. Your dentist/doctor will use a small lighted torch to illuminate your oral cavity and identify small patches on the tongue. He would ask you to move the tongue in sideways to assess for more number of patches.


Pictures of Geographic Tongue :


Images, Pics, Pictures and Photos of Geographic Tongue


Geographic Tongue Geographic Tongue Geographic Tongue Geographic Tongue


Treatment :


As such geographical tongue needs no treatment if the person has no discomfort. The symptoms will often subside within few weeks but for some it may appear on other surface of the tongue. To get relief from pain/discomfort you can take over the counter pain killers. Your dentist would recommend an anesthetic mouth wash to prevent any infection on the tongue. In case of any inflammation antihistamines can be taken.


In severe cases topical creams that contain corticosteroid is prescribed. You can manage the discomfort by avoiding hot and spicy foods if you have geographic tongue. Quit smoking or taking tobacco in any form. Do not change your toothpaste often and avoid toothpaste with heavy flavor since it may worsen the problem.


Papilledema

Papilledema Papilledema is the medical term denoting swelling of optic disc. It can develop due to intracranial pressure, infections, or inflammation developed on the optical disc. One should not confuse papilledema with disc atrophy (that occurs due to loss of nerve fiber on the optical nerve). This condition can produce symptoms like headache, nausea and vomiting also apart from affecting the normal vision. Papilledema can cause blurred vision or flickering vision.


Symptoms :


The prominent symptom of papilledema is optical swelling due to intracranial pressure. In addition, it can cause headache (more when the person wakes up in the morning), nausea and vomiting and rarely loss of consciousness. Some people would have blurred vision, flickering vision and decreased perception of color due to this problem. In some cases diplopia is seen if the sixth nerve palsy is affected.


The symptoms are not found in all the cases. For many people papilledema is found only on routine eye examination. Some of the early signs of papilledema are disc hyperemia, swelling of nerve fiber layer, and small hemorrhages in the nerve fiber layer. Spontaneous pulsation will be missing in many individuals if the intracranial pressure is above 200mm of water. As the disease continues to progress, it can cause swelling of nerve fiber layer with venous congestion.


Causes :


Papilledema develops due to intracranial pressure on the optical disc. Presence of any tumor or lesions on the CNS and cerebral edema can cause this problem. Infectious diseases like meningitis, venous sinus thrombosis and hemorrhage in subarachnoid membrane can cause papilledema. Intake of strong medications like tetracycline, lithium, and corticosteroids can also cause this problem.


Diagnosis :


Neuroimaging tests are highly effective in detecting papilledema. The degree of swelling of optical disc will be assessed using several ophthalmologic tests. Optical coherence tomography will be done to keep track of the changes in the optical disc. If papilledema occurs due to other causes like ischemic optical neuropathy or optic neuritis or retinal vein occlusion then complete ophthalmologic evaluation is to be done. MRI scan will be done to rule out any other clinical causes like venous sinus thrombosis or lesions on the central nervous system.


Stages :


Some experts use staging system to categorize papilledema.


Early Stage : In this stage, the retinal veins will be distended and disc capillaries will be dilated.


Acute Stage : There will be internal hemorrhage looking like small red spots inside. In addition the retinal vessels will be hidden due to swelling.


Chronic Stage : Papilledema will be progressing gradually without any acute signs. In the later stage the optical disc will become pale with prominent swelling.


Treatment :


The aim of treatment to papilledema is to reduce the intracranial pressure and inflammation developed on the optical disc. Depending on the intensity of the disorder and the urgency of underlying medical condition, either medical therapy or surgical procedure is initiated. Several factors like age, health condition of the patient is considered before proceeding for surgery. Diuretic drugs like acetazolamide or anhydrase inhibitor medications are prescribed to reduce intracranial pressure in case the underlying cause of papilledema is not known.


For optical disc swelling due to venous sinus thrombosis hematologist is to be consulted. In case the individual has developed intracranial pressure due to increased weight then the doctor may consider bariatric surgery for weight reduction. In most of the cases other weight loss methods like restricted diet and exercise are recommended. For people who have developed inflammatory disorders corticosteroids like prednisone are prescribed in low doses.


Surgery is the last option for papilledema when no other therapeutic methods are effective. Tumors or mass lesions on the eyes are removed surgically. For people with intracranial hypertension lumboperitoneal shunt is provided by surgery. In case no other treatments can improve the ocular symptoms optical nerve sheath decompression surgery is to be done. In most of the surgical cases the patient should also consult a neurologist in addition to an ophthalmologist.


Pyoderma Gangrenosum

Pyoderma Gangrenosum Pyoderma gangrenosum is a condition that causes large bumps or ulcers on the legs. The painful sores can develop anywhere on the skin but it largely occurs on the legs. It is believed to be caused by abnormal immune system where the body’s own immunity will destroy and damage the skin surface causing blisters. People with preexisting chronic disorders like rheumatoid arthritis or inflammatory bowel disease are more likely to develop this disorder. Painful ulcers can be controlled using powerful medications and by using anti-suppressing agents. However it is a rare disorder affecting only few people.


Symptoms :


Pyoderma gangrenosum is marked by the formation of painful sores or blisters on the skin. The bumps are red in color with the shape of spider bite. Within few days the bumps will grow in size forming large blisters. Very often it develops on the legs. For some people several small ulcers will unite to form large blister causing chronic pain.


Causes :


Exact cause of pyoderma gangrenosum is not known. It can be an autoimmune disorder in which the body’s own immune system will produce antibodies for attacking the skin causing blisters.


Who are at risk?


Adults of age group 40-50 years are likely to develop this skin problem. A person having chronic disorders like rheumatoid arthritis, myeloid blood dyscrasias, ulcerative colitis and Chrohn’s disease is likely to develop this disorder later.


Diagnosis :


Your doctor will look into the bumps on the legs to identify pyoderma gangrenosum. He would request for blood sample to rule out any infectious diseases on the liver or kidney. He would do a biopsy to remove a small tissue from the bumps to test it on the lab.


Pictures of Pyoderma Gangrenosum :


Images, Pics, Pictures and Photos of Pyoderma Gangrenosum


Pyoderma Gangrenosum Pyoderma Gangrenosum Pyoderma Gangrenosum Pyoderma Gangrenosum Pyoderma Gangrenosum Pyoderma Gangrenosum


Treatment :


Often it takes time for the lesions to heal completely. Two possibilities are there for managing the symptoms. One is to suppress the immune system and the second is to heal the blister directly through medications. Corticosteroid like prednisone is given for managing chronic pain from lesions. It can cause adverse effect and hence you should follow the instructions of your doctor in dosage. After few months your doctor would give cyclosporine or any other relevant drug to reduce the corticosteroid dosage.


Topical creams that contain sulfadiazine can improve healing process. Anti-inflammatory drugs like dapsone give quick relief. For some people compression bandage is done on the legs to reduce the pain. Immuno-suppressant drugs like tacrolimus cream are prescribed to control the immune system if that are the culprit causing blisters and bumps on the skin. Surgery will be done for treating chronic pain arising from large ulcerous blisters. Skin grafting is another method in which piece of artificial skin is grafted to the affected area after completely removing the ulcers.


Prevention :


You can do nothing to prevent pyoderma gangrenosum since exact cause of this skin disease is not known. Avoid cuts, injury on the skin since it can trigger formation of new ulcers.


Thursday, July 17, 2014

Vasculitis

Vasculitis The walls of the blood vessels can become weak and narrow causing inflammation. This condition is known as vasculitis. The blood vessels may become narrow or thick not allowing enough blood passing through it. This can seriously affect the organs that receive blood supply causing tissue damage. Vasculitis can occur for short term or for long period. It can be treated by proper medications. Vasculitis can develop in any organ but is common in the blood vessels of eye, skin and brain.


Causes :


What factor triggers narrowing of blood vessels is not known till now, but repeated infections can cause inflammation of blood vessels. Virus infection and certain kinds of allergic reaction can cause vasculitis. Certain factors can trigger the immune system of your body causing damage to your blood vessels. The immune system will mistake your own cells of blood vessels as foreign substances to attack and destroy them. When the blood vessels become narrow it will not allow required amount of blood flow thereby causing depletion of oxygen and nutrients to the organs. Having autoimmune disorder for extended period can cause vasculitis.


Complications :


Vasculitis can become life threatening in some cases when the walls of the blood vessels become fragile and ruptures and start bleeding inside. It can bulge overly causing aneurysm and death of tissues. Blood supply to the concerned organ may get totally depleted causing tissue death and organ failure.


Symptoms :


Depending on the organ that is affected by vasculitis, symptoms vary. It can cause skin rash if the underlying blood vessels of the skin gets affected. Vasculitis can affect the nervous system and also the underlying blood vessels of the brain leading to stroke or heart attack. Some of the general symptoms of vasculitis are fever, loss of weight, fatigue, severe muscle/joint pain and loss of appetite. In rare cases, the nerves of the organ can get affected causing numbness of particular organ.


Vasculitis can also cause Behcet’s syndrome (eye inflammation, acne and genital ulcers), Buerger’s disease (inflammation of extremities and ulcers on fingers/toes), Churg Strauss syndrome (inflammation of lungs) and condition called cryoglobulinemia (affecting hands/toes causing nerve damage). For some people vasculitis can cause Kawasaki disease (rash with high fever), Henoch Scholein purpura (affecting joints and skin), polyarteritis nodosa (affecting blood vessels of kidneys or heart), Takayasu’s arteritis and Wegener’s granulomatosis (affecting blood vessels of throat, nose, lungs and kidneys).


Diagnosis :


Your doctor will collect information about your general health condition and look for the above symptoms. He may order for blood test (to check the rate of erythrocyte sedimentation), urine analysis, and imaging tests like X-rays, CT/MRI scanning. Angiogram is done for checking the heart condition. In case he suspects any organ death he would do biopsy by cutting a small tissue of the affected organ and testing it on the laboratory.


Treatment :


Depending on the intensity of vasculitis and the organ it has affected, treatment methods may vary. Corticosteroids like prednisone are prescribed to manage swelling of blood vessels. It can cause side effects if you are taking it for long term. In case vasculitis is caused by weakened immunity medications like cytotoxic drugs are given to control the immune system. This medication is effective in treating vasculitis caused by granulomatosis.


Pictures of Vasculitis :


Images, Pics, Pictures and Photos of Vasculitis


Vasculitis Vasculitis Vasculitis Vasculitis


Lifestyle Changes :


Once you are diagnosed with vasculitis you need to accept the condition. Before taking any medication you can get second opinion to confirm the diagnoses. You should understand about the side effects of the medicine you are prescribed fully so that you can tell your doctor if there are any changes. Eat a well balanced diet with plenty of fresh vegetables and fruits. You can take calcium supplement or Vitamin D supplement after consulting your doctor. Practice exercise regularly to prevent thinning of bones and to improve blood circulation.


What Is Osteoporosis

What Is Osteoporosis Osteoporosis is a bone disorder affecting the bones making it weak and vulnerable. Very often, the bones in the wrist or hip or spine area gets affected and become brittle and weak. In this condition even a small cough or mild stress can cause fracture. Normally, the bones are constantly replaced after the death of old bone tissue. But during osteoporosis the new bone may not develop properly after the death of old bone. People who are above 45 years can develop osteoporosis. This condition can be corrected by medications and healthy diet.


Symptoms :


Osteoporosis does not show any signs initially. Once the bone become very weak and vulnerable to fracture it can cause some symptoms like severe back pain, difficulty in walking and standing and sudden fracture. Due to mild fracture the vertebral column can get collapsed which can subsequently cause loss of height. The affected person can stand in a stooped posture. Women who in the period of post-menopause, can consult the doctor if they have any of the above symptoms.


Causes :


The process of building of new bones happens in our body constantly. New bones are made as and when old ones become weak and break. As one grows old, this process becomes slow and hence elderly people are at high risk of developing osteoporosis. During the developmental stage, there will be peak bone mass. Hence the higher the bone mass the lower the risk of developing osteoporosis in old age.


Who are at risk?


Women have increased risk of developing osteoporosis than men (post menopause). Old age people, and people of certain race (Asian and white people) are at high risk for getting osteoporosis. Individual with family history of osteoporosis are vulnerable to develop fractures and people with short structure (small body frame) are at high risk for getting osteoporosis. Hormones play a role in osteoporosis. The bones become weak if the levels of sex hormones decreases. Women may not have sufficient estrogen after menopause and hence at high risk. Similarly aged men will have lower level of testosterone are at risk. Increased production of thyroid hormone makes one vulnerable for getting osteoporosis.


Low intake of calcium in your diet will put you in high risk for developing osteoporosis. People with eating disorders like anorexia may not eat well leading to decreased calcium levels. Prolonged intake of corticosteroids can reduce bone density causing osteoporosis. Bad habits like sedentary lifestyle, drinking excess of alcohol and using tobacco makes one prone to develop this condition. Osteoporosis can cause complications like sudden hip fracture or spinal fracture. The bones become very weak and fragile that even a small fall may cause a fracture.


Diagnosis :


After listing to the symptoms of back pain or wrist pain your doctor may check the bones on your hip and lower back by sending low level of X-rays through it. It helps in finding the exact proportion of mineral in the bones.


Treatment :


Bisphosphonates are prescribed for osteoporosis. Drugs like Alendronate, risedronate or zoledronic acid are given. These medications can cause some adverse effects like abdominal cramps and inflammation of esophagus. Drugs are either injected on the vein or given in the form of pills. For some people it can affect the jawbones.


For some women, estrogen therapy is given to maintain bone density. But it makes them prone to breast cancer and endometrial cancer. In men testosterone therapy is recommended for increasing bone density. In rare cases medications like teriparatide or denosumab are prescribed for increasing bone density.


Lifestyle Changes :


You can easily maintain good eating habits to avoid osteoporosis. Quit smoking and drinking. Alcohol can reduce the absorption of calcium by the bones thereby decreasing bone density. Avoid falls by choosing the right pair of shoes and avoid high-heeled shoes.


Prevention :


You can prevent osteoporosis by taking sufficient calcium and vitamin D in your daily diet. An adult requires about 1000 milligrams of calcium each day and as you grow old your requirement of calcium increases. Hence you can include calcium rich diet like dairy products, green vegetables, soy foods and orange in your diet. Vitamin D is freely available in sunlight and also in many food products. Practice regular exercise so that your bones become strong with increased bone mass.


Pinguecula

Pinguecula Pinguecula is the development of extra growth on the eyes causing yellowish patch inside the eyes. Unlike pterygium that grows on the cornea, pinguecula grows in the conjunctiva of the eyes with deposits of fat and protein. It can occur due to eye irritation or over-exposure to sunlight. It is benign (harmless) tumor growth on the eyes forming thin tissue of yellow layer. The growth is projected as slightly raised one from the sclera (white surface) of the eyes. This condition is often seen on elderly people and requires no treatment.


Shape of pinguecula :


A small tumor like growth of pinguecula is mostly triangular in shape. It appears as raised patch growing close to the cornea and lies clearly above the pupil and iris of the eyes. It develops commonly on the corner of the eyes that is close to the nose and rarely on the other corner. The size of pinguecula is small but rarely it can grow big and the growth rate is very slow.


Causes :


Exact cause of pinguecula formation is not known but it is believed to be caused by over exposure to sunlight or dust. As one grows older, there is high risk of development of pinguecula. It is formed due to changes in the tissue of conjunctiva creating a small bump. These patches or bumps are added with fat particles and protein molecules. People working in welding industries are at high risk for developing pinguecula since more of dust particles enter into their eyes. Farmers have increased risk of getting pinguecula because they are prone to dust particles.


Symptoms :


Pinguecula can cause eye irritation and dryness. Sometimes you feel that something has fallen into your eyes giving a gritty feeling. For some people, this can cause inflammation of the eyes and itching. The symptoms of pinguecula vary from one person to the other considerably. For some people, the signs are mild and for others it can be severe. The symptoms depend on the size of bump and its location.


Diagnosis :


Mere examination of the eyes is enough to diagnose pinguecula.


Treatment :


Often, pinguecula does not require any treatment. No pinguecula will become too big affecting the normal vision. Treatment is done only if there is swelling or itching or gritty feeling inside the eyes. Eye ointments/drops are prescribed for getting relief from irritation and dryness. Surgery is the last option for treating pinguecula and it can leave a scar inside your eyes. It is done only if it bothers you very much, it causes great discomfort while wearing contact lenses and it develops severe inflammation even when treated.


Prevention :


One cannot fully prevent development of pinguecula but can avoid the risk factors by following simple rules. Wear sunglasses when you are going out in the sunlight to block UV rays. They are helpful in protecting your eyes from dust and wind. Applying mild steroid eye drops on the eyes is enough to clear any debris built inside. In case you have dryness of eyes you can use artificial tears for keeping it moisturized.


Enlarged Thyroid

Enlarged Thyroid Thyroid gland is found at the base of your neck having butterfly like shape. It is placed below the Adam’s apple in front of the neck. Goiter is the name given for enlarged thyroid. A goiter is normally harmless but sometimes if the size of thyroid gland becomes too big it can cause breathing problems and difficulty in swallowing/drinking.


Enlarged thyroid can be mild or severe and accordingly treatment is done. Iodine insufficiency is the major cause of enlarged thyroid. For some people thyroid gland gets swollen and even small lumps can develop inside it. Two types of hormone T3 and T4 are secreted from the thyroid glands which are needed for body metabolism and right function.


Enlargement of thyroid gland can occur in two ways :



  • In the first type (diffused goiter) the entire thyroid gland becomes big in size.

  • In the second time (nodular goiter) small lumps are formed in the gland.


Causes :


Even when the thyroid gland gets enlarged still it can carry out its normal activities namely secretion of hormones. But sometime it will produce too much of hormones (hyperthyroidism) or very little hormone (hypothyroidism).


Thyroid gland gets enlarged due to many factors given below:-


Deficiency of Iodine : Iodine is richly found in seawater/salt. In some countries people are still getting enlarged thyroid due to iodine deficiency. Nowadays iodine is added in table salt so that the body can get good supply of iodine easily.


Grave’s Disease : Enlargement of gland occurs due to autoimmune disorder in which the body’s own immune system will attack thyroid gland. This in turn will produce too much of thyroid hormone leading to swelling of gland.


Hashimoto Disease : Here the thyroid gland becomes underactive producing less or almost no hormone.


Enlargement of thyroid gland occurs due to multi nodular goiter, solitary nodule, thyroid cancer and inflammation of glands.


Symptoms :


Enlarged thyroid can produce some of the symptoms like visible swelling in the neck portion, stiffness in the throat region, coughing, difficulty in eating/drinking and hoarseness in your voice.


Who are at risk?


Enlarged thyroid can occur to all people irrespective of their age. Individuals who are not taking enough iodine, aged persons, pregnant women, women in the menopause, intake of certain medications like antiretroviral and exposure to radiation are prone to develop enlarged thyroid gland. In general, women are more prone to get goiter than men. Most of the time, enlarged thyroid will not cause any problem. But in rare cases, it can lead to fatigue, weight gain and insomnia.


Diagnosis :


Physical examination is enough for detecting enlarged thyroid. But your doctor may order for hormone test T3 and T4 for checking its level. Ultrasonogram test and thyroid scan test is done for getting clear picture of the gland. In rare cases biopsy is done for checking the tissue sample of the gland.


Treatment :


The method of treatment varies with the size of enlargement and on the intensity of the symptoms. For small sized goiter no treatment is required. Medications like levothyroxine are given for hypothyroidism. This will eventually reduce the size of the gland producing right amounts of hormone.


Surgery is done if the person has large sized lump in the gland which causes difficulty in eating and breathing. To remove cancerous growth from thyroid gland surgery is the only option. The patient will have to continue using levothyroxine even after surgery to control the secretions. Radioactive iodine is given orally to manage the size of thyroid gland. It will subsequently reduce the size of goiter and sometimes it can reduce the production of hormone also.


Lifestyle Changes :


In case you have developed enlarged thyroid due to deficiency of iodine, you can take iodized salt in your daily diet. Include seafood like sushi and shrimp regularly.


Emphysema

Emphysema Emphysema belongs to group of diseases of chronic obstructive pulmonary disease. Smoking is the major cause of emphysema and most of the time the damages done to the lungs are irreversible. Emphysema cannot be cured and only some of the symptoms are treated. Medications and oxygen supplements are effective methods of treating emphysema. Emphysema is a chronic disorder affecting the quality of life for long-term.


How it happens?


As a person smokes, nicotine in the cigar reaches the lungs to cause damage to the air sacs or alveoli. As more and more of nicotine damages the air sacs the soft tissues are destroyed forming big spaces inside. Now air gets trapped in this space leading to enlargement of lungs building more pressure inside (pulmonary hypertension). The air sacs called alveoli are continuously damaged in the lungs leading to shortness of breath. Inner walls of these sacs are weakened and subsequently they will rupture forming a big space inside the lungs.


This will reduce the total area of the lungs which would have a direct effect on oxygen consumption. The lungs may not be able to breathe properly since it cannot get oxygenated air as before. To compensate the loss of oxygen the body automatically increases the breathing rate. After some days or weeks, increased rate of breathing is not enough to maintain the required oxygen consumption. Subsequently the lungs get narrowed leading to pulmonary hypertension.


Symptoms :


There are lots of people who may not have any symptoms for years together but still the process of emphysema is slowly happening inside the lungs. It causes shortness of breath and choking. But even at this stage the person will avoid doing certain activities that require more of oxygen and hence he may ignore the symptom. The problem will get noticed when the affected person have difficulty in managing daily tasks. For some people due to loss of oxygenated blood, fingernails will become blue in color. Even their mental stability will get diminished.


Causes :


Smoking is the main cause of emphysema. In addition, air pollution, long time exposure to tobacco smoke (passive smoking) and workplace related smoke like fumes can also cause emphysema. In rare cases emphysema is inherited due to protein deficiency.


Risk Factors :


Smoking of any kind, old age, over exposure to any kind of smoke and workplace related fumes are the major risk factors for emphysema. In severe case, emphysema can collapse the lungs leading to life threatening situations. It can also cause heart problems.


Tests :


After collecting the medical history the doctor would ask for the symptoms of shortness of breath and choking. He would request for imaging test like chest X-ray to check how far the disease has advanced. Blood test is done for checking the capacity of lungs to transfer the oxygen into the body. Special lung function test can also be done to measure the functionality of the lungs.


Treatment :


The damage caused by emphysema is irreversible. Some of the symptoms can be managed by effective medications and therapy. Bronchodilators and corticosteroid drugs are largely used for managing shortness of breath. To treat bacterial infection on the lungs, antibiotics are prescribed.


Therapies like pulmonary rehabilitation are helpful in learning various breathing exercises. In addition the affected person will be asked to take nutritious food to manage the right weight. For some people supplementary oxygen is needed at home and workplace. Surgery is done only if the symptoms are severe. Lung transplantation is done only if there is no other option. For some people, small volumes of the lungs that are badly damaged are removed by surgery.


Lifestyle Changes :


To begin with the person has to quit smoking to prevent further damage. Avoid working in allergy prone environment like fumes and automobile smoke. Stay away from strong perfumes and incense sticks. Do your exercise regularly which helps in getting rid of breathing problems. Keep your home clean and pollution free. Take precautions during winter by wearing scarf to protect your lungs from cold air. Use face mask when you need to mingle with people since you may get infection from them.


Pictures of Emphysema :


Images, Pics, Pictures and Photos of Emphysema


Emphysema Emphysema Emphysema


Coping :


Even the daily routine activities can become tiresome for you, if you cannot breathe properly. You can no longer take place in long time entertainment. Accept this change and join a support group to express your feelings.


Prevention :


Avoid smoking completely and do not get involved even with passive smoking. This can only prevent you from emphysema.


Menieres Disease

Menieres Disease Meniere’s disease affects the inner ear causing ear fullness, ringing and loss of hearing. There will be constant spinning motion inside the ears and pressure on the inner ear. The flow of fluids will not be at normal rate for the person affected with Meniere’s disease. Very often, it affects only one ear. Though this disease can develop on people of any age, it occurs largely on adults of 40-50 years. Medications are available for controlling the symptoms and many times diet and little changes in lifestyle can help you to overcome the symptoms. In rare cases, surgery is the option.


Symptoms :


Vertigo Episodes :


There will be a sensation of spinning movement inside the ears. It is very much like the feeling you get when you stop suddenly after spinning for several times. It causes loss of balance and it occurs almost suddenly without any warning. This episode may last for few minutes or even hours. It can cause vomiting/nausea.


Hearing loss :


Loss of hearing is not certain in all the people affected with Meniere’s disease and it depends on the intensity of the disease. It can cause certain degree of hearing loss and for some it can be permanent.


Tinnitus :


It is a feeling of constant ringing sound in the ear and many people complain this as roaring sound or whistling sound inside the ears. In addition, there will be fullness feeling in the ear due to increased pressure caused by flow of fluids. First it starts with fullness feeling followed by tinnitus followed by vertigo. The entire episode may occur for 20-30 minutes or even more. Since there is variation in the duration of the episodes, it can cause mild to severe disturbance in hearing.


Causes :


Exact cause of Meniere’s disease is not known. It is believed to develop due to excess flow of fluids in the inner ear. If you look into the inner ear, you can see a group of cavities and passages. The outer part of inner ear is made of bony labyrinth and inner portion is called as membrane labyrinth. This membrane portion contains endolymph (a special fluid) and has a lining of hairy structures which respond to fluid movements. For these sensors of hairy structures to function properly, the fluid should maintain constant volume and pressure. However if there is excess of fluid pressure it can lead to Meniere’s disease. Certain factors like migraine, abnormal immunity, improper fluid drainage and viral infection can affect the fluid quantity and pressure.


Diagnosis :


Based on the symptoms your doctor will refer the case to ENT specialist who will do hearing assessment. Audiometry test will be done for checking the functionality of the ears and how far you can hear different pitches. Quality of hearing can be assessed by this test and your doctor will also able to tell you if the problem is due to nerve of the inner ear or due to Meniere’s disease.


For testing the balance function, VNG videostagmography test is done during which warm/cool water or cool air is sent into the inner ear and subsequently your eye movements are recorded using special goggles. Any abnormality in this test is a clear sign of problem in the inner ear. Alternatively rotary chair test or VEMP test or posturography test is done for checking the inner ear function. Sometimes you will be asked to undergo various imaging tests like MRI or CT scan to rule out other problems in the brain.


Treatment :


There is no cure for Meniere’s disease but there are solutions for managing the symptoms. The condition of vertigo episodes can be controlled by medications like meclizine which would reduce the rotating sensation inside the inner ear. Drugs like promethazine are given to control nausea/vomiting sensation due to vertigo. Fluid retention is managed by several effective medications like Dyazide or Maxzide. It helps in reducing the body fluid which in turn would control the flow of fluid inside the ears. These drugs are effective diuretic. But you need to check for fluid balance regularly since it may cause depletion of some important minerals due to frequent urination.


Some kinds of non-invasive therapies like rehab therapy and hearing aid are effective in managing Meniere’s disease. Vestibular rehab therapy is ideal to attain the right balance easily. Your brain and body will effectively regain the balancing ability by practicing certain exercises. Hearing aid is recommended for restoring the loss of hearing. For some people, meniett device is used to apply pressure on the middle ear which can improve fluid transfer.


An injection like gentamicin is injected into the middle ear and for some people steroids like dexamethasone is given to reduce the vertigo episodes and to attain balance. Surgery is the last option for this disease and is done only if the symptoms are severe and other therapies are ineffective. Endolymphatic procedure or vestibular nerve procedure is done for decreasing the vertigo and for retaining fluid balance. For some people labryinthectomy is done during which the affected portion of the ear is removed and is done only if the patient has lost his hearing in that particular ear.


Lifestyle Changes :


You cannot solve the symptoms by home remedies but you can reduce its impact very well. If you are feeling dizzy due to vertigo episode you should sit down calmly when you get the first sign. Avoid seeing bright lights or watching television during that time. Take some rest after you have got an episode to restore your balance. Illuminate your house properly so that you may not fell down when you get up during nights. People having frequent vertigo should avoid driving motorcycle or car to prevent any accidental injury.


Adjust your eating pattern such that you are getting enough food/drinks throughout the day. You can opt for 5-6 small meals instead of 3 hefty meals. Reduce the salt intake to prevent fluid retention. You need to avoid taking coffee since it can make the ringing sound worse. Quit smoking and drinking and reduce your stress by joining yoga class. You can avoid allergy causing agents and stay away from them since it can aggravate the symptoms. The only worst part of Meniere’s disease is sudden episodes of vertigo and tinnutis. Under such circumstances the person should take break from his workplace to lie down quietly. He cannot have entertainment during such episodes. Some people can get depressed or feel anxious because of this episode and cannot take part in leisure activities.


Gaucher Disease

Gaucher Disease Gaucher disease is characterized by the accumulation of fat particles in excess in the vital organs like liver, lungs, spleen and bone marrows. This collection of harmful fatty molecules can cause intense bone pain and organ swelling. This condition occurs due to the shortage of enzyme glucocerebrosidase and hence this disease is also called as glucocerebrosidase deficiency. Gaucher disease can develop in all age groups and often seen in Jewish people of Central Europe and Eastern European countries.


Symptoms :


Symptoms of Gaucher disease vary as per the age, health condition and type of the disease. It is possible that even identical twins can have different range of symptoms.


There are 3 types of Gaucher’s disease as given below :


Type 1 :


Type 1 is the mildest form of this disease and is the most common variety. This type largely occurs in adults. Some of the signs of Type 1 disease are thinning of bones, intense pain on the bones, liver enlargement (hepatomegaly) or enlargement of spleen, reduced production of red blood cells (anemic condition), extreme tiredness, reduced blood platelets (causing bruises often), delay in puberty and yellow patches on the eyes. Often, this type does not affect the brain.


Type 2 :


This type is very rare and is severe when compared with the other two types. Initial symptoms begin as early as 3 months of age and the babies will have intense brain damage as the disease progresses. The symptoms are very severe like that of first type and in addition the affected baby can develop seizures, brain problems and stiffness. Often, the baby is diagnosed for mental retardation.


Type 3 :


Type 3 is also very rare and occurs in childhood. This type is chronic and slow progressing in nature. It also affects the brain as the Type 2 but the damage is milder than type 2. Apart from the symptoms mentioned in Type 1, the affected child may develop brain problems (in slower rate), lack of muscle coordination and may show abnormal eye movements.


Causes :


Gaucher disease is caused by deficiency of glucocerebrosidase enzyme. This enzyme is essential for breaking up of fatty particles and due to shortage of enzyme fatty substances get accumulated in various organs and brain and even on the bone marrow. It can be inherited on the basis of autosomal recessive pattern. For a child to inherit this disease, both the father and the mother should be carriers of mutated gene. Even then the child can develop this disease only on chances. There is 25% chance for inheriting the carrier genes, 25% chance for developing Gaucher disease and 50% chance for not inheriting the carrier genes/and not this disease.


Who are at risk?


People belonging to Ashkenazi Jewish race of Central Europe or Eastern Europe have increased risk of getting this disease. In rare cases, this disease can cause complications like severe bone pain, fractures, internal bleeding, and multiple myeloma (a type of cancer). Developing seizures are common if the child gets Type 2 disease and some children having Type 3 can develop heart problems due to calcification of valves.


Diagnosis :


Diagnosis can be made right before the child-birth if the parents are carriers of mutated gene. The doctor will measure the levels of enzyme glucocerebrosidase and very low level indicates the presence of disease and intermediate level can be a sign of carrier. Genetic mutation test is done to identify the type of Gaucher disease.


It is necessary to monitor the disease once your child is diagnosed with this disease. On such cases, MRI scanning and dual energy X-ray tests are done as per the symptoms. Prenatal screening is done for the pregnant women if she belongs to Ashkenazi race. Genetic counseling is the best solution to avoid pregnancy among both carrier genes.


Treatment :


People with Type 1 symptoms may not require any treatment if they do not have any discomfort. No treatment is available for Type 2 and 3. Only the symptoms are managed by therapies. Enzyme replacement is done to improve the deficiency of glucocerebrosidase. High dosage of enzyme is injected intravenously for every 2 weeks until the symptoms disappear. This approach can certainly prevent enlargement of spleen/liver. It can also improve bone density preventing fractures. In severe cases transplantation of bone marrow can be done but it carries certain risk. Medications like miglustat are prescribed for adults with Gaucher disease. But this drug can cause diarrhea and weight loss.


Prognosis :


If the disease develops in adulthood it may not cause severe complications and the affected person can lead normal life. But infants and children having this disease cannot survive more than 2 years. An individual developing this disease on his teens have chances of survival like other adults. It is a very rare disease affecting only a few people of specific race.


Unexplained Weight Loss

Unexplained Weight Loss Losing weight without making effort can be described as unexplained weight loss. This can be warning signal of underlying medical issue. Your body weight is largely based on what you eat and how your lifestyle is. Amount of calorie intake is the main factor to decide your weight. Under normal health conditions, a person’s weight will remain stable after he reaches adulthood. It is common to add/lose few pounds which are not a concern medically.


A person is said to have unexplained weight loss if he loses 10 pounds in a month or even more without making any effort. This problem can be due to various medical issues like depression, diabetes, cancer, thyroid problem or other infectious diseases. Treatment can be given only if the underlying medical problem is identified.


Causes :


Any problem in thyroid gland secretion can alter your weight. It can occur due to hyperthyroidism, celiac disease, Addison’s disease, mal-absorption, heart failure, infectious diseases like TB, or due to peptic ulcer. Heart disease, kidney problems and liver infection can cause loss of weight in due course. Chronic arthritis and lung infection can cause weight loss.


During adolescence, some people will develop eating disorders which will lead to unexplained weight loss. They are constantly under the obsession of maintaining their physique and refuse to eat or drink anything on the fear of losing their image. For some people, significant weight loss occurs after stressful event like loss of loved ones, and sudden loss of job etc. On that case, it has to be dealt by psychologist. Counseling will be helpful to overcome the loss and feel happy again. Subsequently the person will regain his normal weight once he comes out of depressive thoughts.


Symptoms :


There is no specific symptom of unexplained weight loss except the loss of weight. The person may not have the regular appetite and he will become weak and tired gradually. Loss of appetite can be due to eating disorder like anorexia nervosa or due to other medical conditions.


Diagnosis :


Your doctor will collect all necessary medical information from you and your family. He will refer your case to psychiatrist to check if there is any mental disorder like anxiety/depression. He would request for various procedures like blood test, urine analysis, renal function test, thyroid function test, liver function test, and various other tests for checking absorption of nutrition. He would rule out other possible disorders like eating disorders.


Treatment :


Doctor will first diagnose the root cause of unexplained weight loss and accordingly give medications and treatment. In case the patient has eating disorder the doctor will give treatment accordingly.


Trichotillomania

Trichotillomania Trichotillomania can be simply described as “hair pulling disorder” where one gets the urge to remove the hair from the scalp or eyebrows on compulsion. Pulling of hair can leave bald spots on the scalp which may reduce the personality of the concerned person. People affected with this disorder will do anything to conceal the hair-loss. The range of disorder can be mild to very severe which can cause discomfort and stress for the concerned person. The reaction of pulling out hair is irresistible and can be overwhelming. This disorder can be treated with psychotherapy and medications.


Symptoms :


The affected person will repeatedly pull his hair from the scalp or eyebrows or other parts of his body. It would cause increased tension for the person if the pulling action is stopped. He or she will be at comfort only after certain hair is pulled out. A sense of pleasure/relief will be achieved after pulling.


The concerned person will have thin hair or short hair on the scalp and other areas and for some the eyebrows would be totally missing. They will also bite/chew or eat the pulled out hair. Some people will retain the hair and engage in playing with it. Most of them will also constantly bite their nails and chew their lips resulting in bleeding. This action of “pulling hair” will be done in privacy and not in public.


For some people the action of pulling hair can be focused (pulling out right hair from exact place) or it can be automatic (without their realization) which can be involuntary. Trichotillomania is a chronic disorder and should be treated failing which the symptoms can become severe. And most of them will hide their problem and wear wigs or hats to cover the baldness.


Causes :


Exact reason for “hair pulling” action is not yet identified. It can be due to hormonal imbalance, abnormal nerve signals that control emotions or habits. For some people depression can be the reason for trichotillomania. This disorder runs in families (genetic) or can be acquired due to environmental factors.


Who are at risk?


People who are born to parents with trichotillomania are at high risk of developing it. People of teenage group can develop this problem due to hormonal imbalance. For many people this action is related with negative emotions and they involve in hair pulling when they are stressed or under high emotion. Often, people with this disorder will get relief and comfort only if they pull out hair and thus it can become positive reinforcement as they continue to do the same action.


People with other mental disorders like depression/anxiety and obsessive compulsive disorder are more likely to develop trichotillomania. There is no complication physically for the affected person but it can affect their image in the society. They often feel embarrassed to mingle with strangers which can largely affect their performance at workplace. Many people affected with this disorder will avoid social situations or gathering to hide their problem. In due course, it can cause total hair loss and lead to infection.


Tests :


No specific methods are available for diagnosing trichotillomania. Often, the person will not accept it and they may visit the doctor out of compulsion. The patient will be referred to a psychiatrist who can evaluate this problem by asking series of questions. He would try to find out if the person is affected with impulsive disorder by checking the hair loss in several areas of his body.


The person should have at least some of the following signs to be diagnosed with trichotillomania:-



  •  Pulling out hair from the scalp or eyebrows would result in frequent hair loss

  •  The person will make all possible efforts to stop this action but he may not control it

  •  Constant pulling of hair would cause significant problems at job, school or other places

  •  Loss of hair is not due to any other medical condition other than voluntary pulling.


Treatment :


Since this disorder is the result of habit formation due to positive reinforcement it has to dealt on psychological basis. Your doctor will refer to any psychiatrist who would assist you with psychotherapy methods.


Cognitive behavior therapy based on habit reversal method is employed for stopping this action. The person will be helped to identify his/her problem and will be taught other methods of controlling their anxiety or stress. Through relaxation techniques therapist will ease out his tension and gradually change his behavior. It is the unwanted thought that urges the person to pull out hair repeatedly.


The person will be trained on acceptance/commitment therapy to gradually control his urge. He/she will be asked to clench his fists for few minutes whenever he has an irresistible urge to pull out his hair. Medications of antidepressant agents are prescribed to control and manage intense urges. Drugs like SSRI group like clomipramine and mood stabilizing drugs like zyprexa can be prescribed. People affected with trichotillomania will feel desperate and alone due to hair pulling experience. They can find relief by joining a support group.


Polyps in Uterus

Polyps in Uterus Polyps are extra growths on the uterus and they often get attached to the wall of the uterus. In medical terms they are called endometrial polyps since they are caused by the endometrium which is the lining of the uterus. The polyps are not cancer causing often and only in rare cases the polyps turn into cancerous cells.


Polyps differ in size and growth ranging from just a millimeter to few centimeters or even more. Some of them grow bigger than a golf ball causing complications. The polyps stick on to the wall of the uterus through a thin stalk. Generally they are found well inside the uterus but in some cases they move down to reach the cervix region. Polyps are largely seen in women who are in menopause period.


Symptoms :


Some of the signs of presence of polyps (in uterus) are irregular periods (lasting for several days or having no menstrual periods for several months), bleeding between the periods, excess of bleeding and bleeding after menopause time. Bleeding can be heavy and unpredictable. But for some women there may not be any symptoms and if at all they have, there would be light spotting.


Causes :


It is not certain what causes growth of uterine polyps in women. It is believed to be caused by hormonal imbalance. The secretion of estrogen can directly influence the growth of polyps, the more the secretion the more the polyps’ growth will be and vice versa. Chronic inflammation of the uterus can cause polyps. Polyps can occur if there is any problem in the blood vessels of the cervix region.


Who are at risk?


Women in the postmenopausal period, women who are obese, women with hypertension and women who are taking tamoxifen are more prone to develop polyps than others. In rare cases, the growth of polyps can cause infertility. It also increases the risk of miscarriage in pregnant women and this is more specific in women who are taking IVF (in vitro fertilization) therapy. Complete removal of polyps can certainly increase the chance of getting pregnant.


Diagnosis :


The doctor would look for the above symptoms after collecting information from the concerned women and may order for few tests to diagnose polyps. She can do hysteroscopy or vaginal ultrasound or curettage procedure to examine the presence of polyps. In ultra-sonogram a long wand like instrument is placed inside the vagina that will send specific frequency of sound waves which in turn would give clear picture of the uterus. In some cases the doctor would use saline water for getting clear picture of the polyps.


During hysteroscopy the doctor would insert a thin tube that contains mini telescope into the vagina to study the inside of uterus region. In curettage the doctor would gently scrape the inner lining of the uterus to check the sample on the laboratory for the presence of polyps.


Treatment :


If you don’t have any problem like irregular periods or heavy bleeding even if you have polyps in uterus, then you don’t need any treatment. Very often, the polyps are non-cancerous or benign. However your doctor will send the sample tissue collected from the uterus to check for presence of cancerous cells. Hysteroscopy is the best method for treating polyps. During this procedure, your doctor will use a special device to get the maximum clear view of the uterus portion and gently remove the polyps from inside.


This is a small surgical procedure where local anesthesia is given and you can get back home on the same day. However you should avoid having sex for at least a week after undergoing hysteroscopy. Some women might have mild cramps or slight bleeding from the vagina. Taking certain hormonal drugs like gonadotropin producing hormone agonists can give you temporary relief from polyps but it can recur again.


Fertility and polyps :


Presence of polyps in the uterus can affect the way you become pregnant normally. If a woman is not able to conceive even after a year of trying it is possible that she has polyps in her uterus. Polyps can prevent the fertilized egg to get implanted in the wall of the uterus thus acting as an intra uterine device. Similarly polyps can cause miscarriage or abortion for some women.


Swollen Tongue

Swollen Tongue Tongue is an essential part of your body which is largely used in digestion of food particles. Tongue is a muscular organ that helps one to speak properly. Any swelling on the tongue can affect the way you eat or speak. Number of factors can affect the tongue causing inflammation and swelling. Tongue inflammation is medically described as smooth tongue or glassodynia. The tongue changes its normal color and become red and swollen. Swollen tongue can be caused due to vitamin B12 deficiency, side effect of medications and due to acromegaly or gigantism. It can be treated if the underlying causes are known.


Causes :


Various factors can cause tongue inflammation or swollen tongue. ACE inhibitors drugs given for hypertension can cause swollen tongue. These medications are given for inhibiting the angiotensin enzyme and this can cause inflammation of the tongue called angioneurotic edema. People taking ACE inhibitors will develop swelling on their face and tongue due to adverse reaction. However not all the people taking this drug would develop inflammation but only some people are affected.


Angioneurotic edema can also occur as allergic reaction of other medications causing swollen tongue. Eating too hot and spicy foods can also affect the soft lining of the tongue causing inflammation. Deficiency of vitamin B12 can cause inflammation of the tongue. Candida infection can cause fever and thrush leading to swollen tongue. Certain conditions like dehydration can cause dry mouth which may lead to tongue inflammation.


Certain illness like hypothyroidism (less secretion of thyroid hormone) can cause swollen tongue. Anemia, Kawasaki disease and strep infection can also affect your tongue. Sometimes people can develop swollen tongue due to allergic reaction caused by wearing dentures, dental procedures, mouthwash, and medications. Any abnormality in the functions of salivary gland can affect the tongue causing inflammation.


Swollen tongue can also be formed as a result of injury or infection inside the oral cavity. Certain skin problems like syphilis, oral lichen planus and bullous pemphigoid can affect the tongue causing swelling. Eating hot and spicy foods and consumption of alcohol can also cause tongue irritation leading to swollen tongue.


Symptoms :


Some of the common signs of tongue inflammation are ulcerous growth on the tongue, change in normal color, tender tongue, and swelling of tongue, burning pain on the tongue and loss of taste and problems in eating/swallowing and even speaking. In severe cases inflammation of tongue can affect the normal breathing pattern.


Diagnosis :


Mere physical examination of the tongue is enough to detect swollen tongue. Your doctor will check the condition of the tongue looking for sores and change in color. For some people there can be small papules or lesions on the tongue indicating ulcers. He would collect complete medical history of the patient including the list of medications and habits etc. In case he suspects vitamin deficiency he would order for blood test. For confirming skin infection, your doctor may do a biopsy on the tongue by collecting small tissue sample from your tongue and testing it on the laboratory.


Treatment :


The plan of treatment varies according to the root cause of tongue inflammation. The main objective of the treatment is to reduce swelling and give relief from the symptoms. Anti-inflammatory drugs like histamines and pain killers like ibuprofen are given for first hand relief. In case of fungal/yeast infections, antimicrobial drugs are prescribed. He would also advise you to take vitamin B12 supplements.


Lifestyle Changes :


You need to quit smoking and drinking if you develop swollen tongue. Inflammation of the tongue can be a sign to tell that something is wrong inside. Practicing good oral hygiene is necessary. Brushing your teeth after every meal can help in reducing the infection largely. Go for routine dental checkups.


Cholelithiasis

Cholelithiasis Gallbladder stones are known as cholelithiasis in medical terms. During the process of digestion several chemical reactions takes place and enzymes are secreted to break down the food particles. Sometime these digestive fluids get hardened to form stones that get accumulated in the gallbladder. Gallbladder is a small organ found on the right upper portion of the stomach just below the liver. It also secretes an enzyme (bile) that helps in digestion and gets discharged into the small intestine.


Gallstones are formed if the bile (digestive enzyme) contains high cholesterol or it contains high content of bilirubin. These stones vary in size and shape. For some people there can be only one stone and for others number of stones can be formed. Choleolithiasis can be effectively treated by removing gallbladder surgically (for severe cases) or by taking medications to destroy gallstones.


Types :


There are 2 common types of cholelithiasis :



  • If gallstones are formed due to excess of cholesterol in the enzyme bile it is known as cholesterol stone.

  • If gallstones are formed due to excess of bilirubin (breaking up of RBC causes this waste product) it is known as pigment stone.


  • Symptoms :


    Choleolithiasis do not produce any symptoms most of the time. It causes sudden pain in the abdomen only if the gallstone strikes with a duct causing a blockage. There can be sharp and sudden pain in the upper right portion of the stomach, or in the center of the abdomen beneath the breastbone. It can also cause intense pain in the right shoulder or shoulder blades.


    For some people it can cause fever, chills, nausea, vomiting, tenderness in the abdomen, black colored stools and change in skin color (yellowish skin). For serious cases it can cause high fever, intense abdominal pain, bloated sensation and abdominal swelling. In that case emergency medical help is to be taken.


    Causes :


    The main cause of cholelithiasis is excess of cholesterol formation in the gallbladder. These particles get hard to form stone like substance that gets accumulated in various sizes and shapes. Choleolithiasis is caused when the bile contains excess of bilirubin in the gallbladder. Gallstones are formed due to blood disorders, and biliary tract infections. Sometimes gallbladder may not function properly to eliminate the substances inside. Gradually bile gets piled up and becomes hard to form gallstones.


    Who are at risk?


    Women are more prone to develop cholelithiasis than males (for reasons unknown). Old age, having high cholesterol in daily diet, fat diet, being obese and belonging to certain ethnic race like American Indian, Mexican American also makes one prone to gallstone formation. Pregnancy also increases the risk of developing gallstones since gallbladder is pushed inside and it may not be able to empty the contents properly. Having a history of cholelithiasis, having diabetes, taking cholesterol reducing drugs for extended period and taking estrogen supplement poses risk for developing choleolithiasis.


    Complications :


    Gallstones can cause serious complications if the stone gets clogged in the gallbladder neck. Sometimes many stones can block the tubes such that no liquids can flow freely from the gallbladder into the intestine. For some people gallstones can enter into the pancreatic duct blocking its flow causing inflammation of pancreas which requires urgent medical care. In rare cases gallstones can lead to gallbladder cancer causing life threatening problem.


    Diagnosis :


    Ultrasound of the abdomen is done to detect the presence of gallstones. It would give exactly the number of gallstones and its position in the gallbladder. Your doctor can also use dye test for checking the bile ducts if any stone is blocking its way. Imaging tests like CT, MRI scanning may also be done for getting a clear picture. In addition he may request for blood test to rule out any infection or jaundice in the liver.


    Treatment :


    Gallstones that do not cause any pain or discomfort require no treatment. For people with moderate or severe symptoms of abdominal pain treatment is given based on the intensity of pain and the patient’s age and health condition. Cholecystectomy is done for removing gallbladder if there are many gallstones. During this surgery, the surgeon will remove the entire gallbladder (a small pouch found on the upper part of the stomach) so that the bile would flow directly into the small intestine.


    Removal of gallbladder does not cause any serious problem in life since it is not needed for the process of digestion. For mild symptoms the patient will be given oral medications to dissolve gallstones. However only mild symptoms can be managed by this option and the person has to take drugs for years together for getting the stones dissolved.


    Prevention :


    You cannot do anything to prevent cholelithiasis but you can take precautionary steps to reduce the risk of developing it. If you are obese take steps to reduce your weight. Do not skip breakfast or meals which can actually make conditions worse. Take steps to maintain healthy weight. Do not consume high cholesterol diet.


    Duodenitis

    Duodenitis Duodenum is part that lies in the upper portion of small intestine that connects stomach with the intestine. Any inflammation on the duodenum is medically known as duodenitis. It can cause severe abdominal pain and bleeding of intestine. The symptoms of this disease can vary from mild to severe. The major cause of duodenitis is a type of bacteria by name H Pylori. If left untreated bacterial infection can lead to ulcer formation. Some other causes are side effects of certain medications and over consumption of alcohol. Duodenitis can be treated with antibiotics if H pylori bacterium is the cause of infection.


    Symptoms :


    Signs of duodenitis vary from one person to another depending on the intensity of infection. Some of the common symptoms include stomach pain, bloating sensation (fullness), gas formation, loss of appetite, indigestion, nausea and vomiting. In rare cases there can be bloody discharge in the stool (black colored stool) with sharp abdominal pain. In that case emergency intervention is needed.


    Causes :


    H pylori bacterium is the common cause of duodenitis. Hepatitis infection and gastritis can also cause inflammation f the duodenum. Some people who are taking non-steroids for extended period of time can develop inflammation on the duodenum. Sometimes, Crohn’s disease and undergoing radiation therapy for stomach cancer can cause infection of the duodenum.


    Since the duodenum lies very close to the stomach some of the digested food particles and gastric juices can enter into it causing irritation and inflammation. Being very close to stomach, all the food that you eat would pass into the small intestine through duodenum. This makes it more prone to irritation and infection.


    Who are at risk?


    People who are taking NSAID’s for prolonged period, people with Crohn’s disease, people who are consuming excess of alcohol, people who are taking radiation therapy, people who are overly stressed and people who use tobacco in many forms are prone to develop duodenitis. In severe cases, duodenal ulcer can cause internal bleeding leading to life threatening complication.


    Diagnosis :


    Your doctor will look for the above symptoms of abdominal pain. He can order for imaging tests of CT scan of the stomach, ultrasound scan and if required he may do a biopsy by cutting small tissue sample from the stomach portion and testing it for infection. In addition, he would ask for blood test, urine analysis and stool analysis.


    Treatment :


    If duodenitis is caused by H pylori your doctor would prescribe antibiotics for two weeks or even more. Some of the common antibiotics given are clarithromycin, amoxicillin, metronidazole and tetracycline. For some patients, he may prescribe proton pump inhibitors like omeprazole, lanzoprazole, pantoprazole and rabeprazole. Histamine H2 antagonists like tagamet, pepcid and zantac are also given. To control excess of vomiting/nausea you can use electrolyte available over the counter. In case the symptoms occur due to prolonged use of medications, your doctor would reduce the dosage or prescribe alternate drugs for other illnesses.