Archive for 'General health'
PREVENTION AND HEALTH: ULCERS
Posted on April 23, 2009, under General health.
What are they?
An ulcer is any naturally occurring break in a lining surface of the body. Ulcers can, for example, occur in the mouth, on the skin, in the vagina and in the gastro-intestinal system. Peptic ulcers get their name from the digestive enzyme called pepsin which is found in the stomach. A combination of pepsin and gastric acid erodes the lining of the stomach or duodenum (the part of the intestine immediately after the stomach) to produce an ulcer. In hiatus hernia and gastro-oesophageal reflux these substances produce an ulceration of the lower end of the oesophagus (gullet) where food enters the stomach.
We all have acid in our stomach and some have more than others. There is a general tendency for those who produce more acid (whether this is inherited or in response to life’s stresses) to be more likely to have ulcers.
About one in ten westerners will have peptic ulcers at some time in their lives-usually during middle age. Duodenal ulcers are about four times as common as gastric (stomach) ulcers and men are affected more than women. For some unknown reason duodenal ulcers are becoming much less common than they were twenty or thirty years go. A high proportion of duodenal ulcer patients are of blood group Î and close relatives of these patients are more likely to have an ulcer than are others.
The most common symptom of duodenal ulcer is a gnawing pain, usually in the middle to upper abdomen. The pains come on 1-3 hours after a meal and some sufferers wake every night at about 2 or 3 a.m. with their pain.
Most ulcers heal themselves but treatment with simple antacids, newer gastric-acid blocking medications or even surgery may be needed.
Gastric ulcers are less well-defined in their symptoms.
What causes them?
• Heredity definitely plays a part (see above).
• Men are more likely than women to get a duodenal ulcer. This difference is becoming less marked as more women smoke and so raise their gastric-acid secretion.
• Stress produces more acid in the stomach and so makes duodenal ulcers more likely.
• The heavy use of coffee, tea and cola drinks increases gastric acid production.
• Aspirin in large doses (especially as non-soluble tablets) can produce gastric ulceration.
• Milk actually raises the production of gastric acid in some people though it has for years been erroneously used as a treatment and preventive for duodenal ulcers.
• Refined foods are harmful too (see below).
• Alcohol produces dramatic rises in gastric-acid production and should be avoided.
Peptic ulcers are always more common in smokers than in non-smokers and a recent study found that smokers who continued even when taking the latest anti-ulcer medications (H2-antagonists) had higher relapse rates than non-smokers.
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PREVENTIVE MEDECINE: BAD BREATH (HALITOSIS)
Posted on April 22, 2009, under General health.
What is it?
Foul-smelling breath produced by one or more of several causes.
What causes it?
• Infective conditions within the mouth, the commonest of which by far is dental decay and associated gum disease.
• Infections in the nose or sinuses.
• Infections in the throat. The average child with a sore throat has very unpleasant, smelly breath.
• Infections with pus in the lungs.
• Smoking.
• Dirty dentures.
• Eating smelly foods such as garlic, onions, alcohol or certain volatile substances that are excreted by the lungs or in the saliva.
• Severe toxic conditions including peritonitis.
• Fasting. This produces a smell of pear drops on the breath, caused by the body breaking down fat to produce energy in the absence of food.
• Certain drugs.
Prevention
The prevention of any of the above causes of bad breath starts with finding out which of the causes are active in any particular case. This may need the help of a doctor. By far the commonest causes are the dietary ones (in which case the cause is usually fairly obvious) and tooth decay or gum disease. Given that about nine out of 10 adults in the West suffer from some degree of gum disease, bad breath is understandably very common. If your gums bleed when you brush them they are inflamed and you should see a dentist for further advice.
• Sucking lozenges and peppermints simply masks the smell. Mouth washes reduce bacterial counts but not for long-soon there are even more bacteria in the mouth than before. Gargling too is not advisable because the tissues of the back of the throat can be damaged and become inflamed-leading to further bad breath. Heavy users of mouth washes have been found to have a higher risk of head and neck cancers. In one study of eleven people with these cancers who had never used alcohol or tobacco (the two main risk factors for this type of cancer) ten had been heavy users of mouth washes.
• Apart from preventing the preventable causes listed above a useful preventive and curative procedure is tongue brushing.
Tongue brushing is an ancient pursuit: Mohammed told his followers ‘you shall clean your mouth including the tongue’; the Romans used iron tongue scrapers and other cultures made them from ivory, whalebone and wood.
A study was conducted in Vancouver to find the most effective way of reducing bad breath. Eight volunteers used one of three methods to freshen their breath in the morning: brushing the teeth; brushing their tongue; and a combination of the two. The results showed that tooth brushing reduced mouth odour by 25 per cent but brushing the tongue reduced it by 75 per cent. When the two were combined odour was reduced by 85 per cent. Even those who had never brushed their tongue before soon got into the habit.
• Diet provides another preventive method. Bad breath can be caused by processes involved in the digestion of caffeine, refined sugar, white flour and cows’ milk. According to researchers in the US these foods produce either the fermentation of carbohydrates or the putrefaction of proteins in the digestive tract. In both cases noxious chemicals enter the bloodstream and are excreted in the lungs to produce bad breath.
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LEGS, SWOLLEN, WITH PROMINENT VEINS, USUALLY NOT PAINFUL: DESCRIPTION AND POSSIBLE MEDICAL PROBLEMS
Posted on April 9, 2009, under General health.
Out of all the changes the aging process incurs on the body, the one many women fear most is the appearance of varicose veins: prominent, enlarged veins that appear in the legs. Though people in their 20s can have varicose veins, the condition is more common among midlife and older adults, particularly women. In addition, people who spend a lot of hours on their feet are more prone to developing varicose veins.
Varicose veins are the result of faulty valves in the veins in the legs. The valves typically help to send blood back to the heart from the legs. However, when the valves become strained or stretched or damaged in some way, the blood flows back down into the vein, where it collects and builds up pressure. The vein, in turn, becomes distended and twisted, making it visible through the skin.
Since varicose veins are more of a cosmetic annoyance than a real health problem, many people learn to live with them. Usually, varicose veins are painless. Sometimes, however, an ulcer will form in the vein near the ankle or on the skin because of the great decrease in circulation. This results in an undernourished vein or patch of skin where an ulcer can form.
They may also swell up. The vein itself may become painful, the skin on the ankle near the valve may begin to itch, and your entire leg may become swollen. Most women with varicose veins find they experience these severe symptoms a few days before their periods; the rest of the time, they’re not particularly bothered by their varicose veins.
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URINARY INCONTINENCE IN WOMEN OVER 50: THE CAUSE
Posted on April 9, 2009, under General health.
Sometimes, however, the cause can’t be found on the DIAPPERS list. For instance, if you have a chronic cough because you’re a heavy smoker, the smoking can be directly responsible for your urinary incontinence. If you stop smoking, your cough will gradually disappear along with your urinary incontinence.
In addition to your doctor’s treatments, Kegel exercises can be helpful for treating incontinence. These exercises involve contracting and releasing the pelvic muscles in the same way as you control the flow of urine. Try to do these exercises several times a day, starting at holding for 10 seconds and working up to as long as possible.
If you have urge incontinence or mixed incontinence, retraining your bladder can be helpful. Try to hold your urine for at least an hour before urinating; or, if you tend to wait too long before urinating, try to urinate every hour, which will help to reduce accidents.
For women with urge or mixed incontinence, certain medications, such as antidepressants and bladder antispasmodics, can be helpful in preventing incontinence.
Every woman has to become educated about incontinence and stop being ashamed so that the proper treatment can be found—or at least the proper way to cope and live well with the problem. Here’s how one woman did it.
One of my patients is an active 60-year-old woman who stopped going to church and to places like Atlantic City because she was embarrassed that she might become incontinent. She began wearing a diaper, but she remained self-conscious.
Whenever she saw me for her yearly checkup, she never mentioned the incontinence even when I asked her. One time, she was waiting in the examination room for me. As I came in, she darted past me to the bathroom down the hall. When she reached the bathroom, she accidentally urinated on the floor and herself. She started to cry and told me and my nurse how ashamed she felt. She even offered to clean the bathroom.
My examination revealed that she had a urinary tract infection. She was also taking a diuretic every day to reduce swelling in her ankles, and she had had six children, which had left her pelvic floor quite weak. I referred her to a urologist, and together we decided that taking a different diuretic medication, getting her urinary tract infection treated, doing regular Kegel exercises, and keeping a urination diary was all she needed to do.
Two weeks later she returned to my office and told me that she wasn’t having any more accidents, that I was the best doctor in the world and that—by the way—she had hit the jackpot on the slot machines in Atlantic City.
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HOW THE DIGESTIVE SYSTEM AGES: EXAMINATION
Posted on April 9, 2009, under General health.
A routine yearly exam will include a physical examination as well as your personal health history. Some of the tests your physician may run include a blood test, a sigmoidoscopy, a colonoscopy, and a stool occult blood card. During this exam, many kinds of undetected cancers—or precancerous masses in the form of benign polyps—can be detected and removed. Colon cancer is the third most common form of cancer in this country, and since early detection is essential to the successful treatment, an annual exam is essential.
If you notice that your digestive system isn’t working as smoothly as it usually does, you should ask yourself the following questions and relay the answers to your doctor. This will help you to articulate your Body Signals and your doctor to make an accurate diagnosis and treatment.
1. How long have I had the discomfort? Hours, days, weeks, years?
2. How would I describe the pain very specifically? Does it move or rumble? Is it sharp or dull?
3. If my stomach hurts, exactly where do I feel the pain the most? Point to the area.
4. Does the pain prevent me from sleeping or wake me up in the middle of the night?
5. Do I have other symptoms, such as fever, diarrhea, or constipation?
6. Have I noticed that a particular food makes the pain better or worse?
7. Do I have friends or family members with complaints that are similar to mine?
8. Have I recently changed my diet or medications?
9. Have I increased the time I spent traveling? Have I recently been to an area I haven’t visited before?
10. Do I have a family history of gastrointestinal disease?
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CHEST PAIN UPON BREATHING
Posted on April 9, 2009, under General health.
Description and Possible Medical Problems
If you feel a pain in your chest that’s either located in one spot or spread out throughout your chest whenever you take a breath, I have two pieces of good news for you. The first is that it probably doesn’t involve your heart. The second is that this kind of chest pain is easy to treat.
As with any type of chest pain, you should note if you’ve recently been injured, had an infection of some kind, or experienced any change in the state of your health.
It’s possible that you may have fractured a rib or strained the muscles of the rib cage by lifting, pushing, or pulling a heavy object. The lining of one of your lungs may have become inflamed due to fluid in the lung; the pain in your chest may be sharp and occur at a rib or across the back part of the lung. If you’re under 50, this is usually due to a respiratory infection like pneumonia. In an older person who is frail, the cause can be due to heart failure, a malignant tumor, or liver or kidney failure.
Treatment
Your doctor will determine the exact cause and treatment based on your medical history and whether you’ve experienced any recent or past lung infection or trauma. She will also conduct a physical exam with a stethoscope and the “tapping” test on the chest that is known as percussion. She will also probably take a chest X ray or an X ray of the ribs.
As mentioned earlier, having a pain in your chest on breathing is easy to treat. In most cases, all you need is time—about two weeks—and an analgesic such as Advil, Tylenol, or Naprosyn to relieve the pain. If, however, the pain is caused by fluid in the lung, the fluid will need to be removed with a small needle in a hospital. Your doctor will send the fluid to a lab for testing and will perform a complete medical work-up to determine the underlying cause of the chest pain.
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LESION, BROWN, WITH IRREGULAR BORDER
Posted on April 9, 2009, under General health.
Description and Possible Medical Problems
We have all noticed minute changes in our skin, whether a new mole that has suddenly appeared or a scar that appears to be invisible—until we get a sunburn or a tan.
If you notice that a small patch of skin on your face or body has turned dark brown and has an irregular border, you may have malignant melanoma, which is the most dangerous type of skin cancer to have.
Basal cell carcinoma the other types of skin cancer, are easy to treat because they don’t spread, or metastasize, to other pans of the body. Malignant melanoma, however, can quickly spread throughout the lymphatic system.
Melanoma develops as a lesion on the skin or inside moles or other skin growths; it starts in the cells that provide pigment to the skin. While some benign tumors later become malignant, malignant melanoma starts out as cancerous cells and does not develop from a previously benign growth.
As with basal and squamous cell carcinomas, malignant melanoma tends to occur in people who have had a significant amount of exposure to the sun, such as sailors, farmers, and construction workers.
Treatment
The moment you notice any change in a mole or in a dark brown, irregularly shaped patch of skin on your face or body, see your doctor. It’s important to treat malignant melanoma before it has a chance to spread, because it does metastasize so rapidly.
Your doctor will take a biopsy of your skin to determine if the growth is benign or malignant. If it is malignant, she will remove the tumor under local anesthesia, usually on an outpatient basis. If the growth has appeared near a lymph gland in your neck, your doctor will probably remove the gland as well, to guard against further spread. If your doctor believes the melanoma has spread into the muscle or bone, he may also order chemotherapy or radiation treatment.
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NITROGLYCERIN AND HEART ATTACKS
Posted on April 2, 2009, under General health.
Nitroglycerin, held under the tongue or rubbed on the skin, is an established drug for angina pectoris, the chest pain that afflicts people with narrowed coronary arteries. Angina occurs whenever too little blood reaches the myocardium (heart muscle) to meet its demands in response to exercise or emotion. Nitroglycerin relaxes arteries generally, thereby removing any coronary spasm contributing to angina. Nitroglycerin’s drawback is that it also lowers the blood pressure (BP), and since the BP falls during heart attacks anyway, lowering it still further could be dangerous. This is why doctors used to stop the drug during heart attacks.
Nowadays, according to the American Journal of Cardiology (49:842), doctors are beginning to use nitroglycerin to improve myocardial blood flow during heart attacks. They manage to do this safely by keeping their patients lying down with their legs elevated while nitroglycerin is employed. This prevents blood from flowing away from the heart and into the legs by gravity. Patients whose symptoms suddenly worsen (possibly owing to a heart attack) after they have taken nitroglycerin should therefore lie down and put their legs up. About the worst thing they could do would be to drive themselves to the hospital. Rather, they should go by ambulance, or lie down in the back of the car, and let somebody else do the driving.
Here’s another warning: A doctor writing in the New England Journal of Medicine (308:782) reports that a heart patient who urgently needed an NTG tablet died while struggling to get one out of a previously unopened bottle. Fatal delay occurred while the patient tried to pull the cotton stuffing out of the bottle. To avoid this danger, all patients who rely upon sublingual NTG are advised to open their new bottles of this medicine while a few tablets still remain instantly available in another container.
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COMMONLY USED ANTIBIOTIC SOMETIMES CAUSES BRAIN SWELLING
Posted on April 2, 2009, under General health.
Tetracycline, the antibiotic taken by thousands of teenagers for acne, is a rare but well-known cause of brain swelling in infants, making the soft, non-bony parts of their heads (the fontanelles) bulge outward. This side effect usually disappears within a day or two if the tetracycline is discontinued right away.
For about 25 years, tetracycline-associated brain swelling was regarded as a problem peculiar to infancy, but now, according to the British Medical Journal (262:19), it has also been discovered in adults. Since, unlike babies, adults have no soft parts in the skull, there is no tell-tale bulging of the head to help diagnose this condition after infancy. Adults, do, however, have headache, blurred vision, nausea, and vomiting.
Alarming, but not serious, this swelling subsides just as promptly in adults as it does in babies after tetracycline is discontinued. To date, there has been no suggestion of tetra-cycline-associated brain damage, but, just to make sure, stop taking the drug, and consult your physician right away for an alternative antibiotic if you develop a headache while on tetracycline.
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DRINKING WATER — A NEW CAUSE OF CANCER?
Posted on April 2, 2009, under General health.
A study carried out by the President’s Council of Environmental Quality and reported in Science (211:694) suggests an association between three common types of cancer (rectum, colon, and bladder) and chlorinated water. This carcinogenic effect is not thought to be caused by chlorine itself but, rather, by cancer-producing chemicals formed by the action of chlorine on organic substances naturally present in surface water. Well water, unlike surface water, lacks these substances and, according to Science, is therefore not associated with an increased incidence of cancer, even if chlorinated.
How can we avoid cancer if even water is not safe? We should not be too alarmed, Science suggests, because chlorinated water probably does not even double the “normal” rate of cancer and risks less than two-fold are generally subject to doubt. Regardless of this comforting thought, federal regulations require that chlorine compounds in our water be kept below one part per 10 million. Meanwhile, remember that the chlorine in our water kills bacteria, thereby protecting us from dangerous epidemics, a benefit which clearly outweighs this newly-defined potential and marginal risk of cancer.
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