A Simple Guide to Ulcerative Colitis
----------------------------------------------------
What is Ulcerative Colitis?
---------------------------------------
Ulcerative Colitis is a inflammatory disease of the colon and rectum which causes ulcers in the lining of the colon and rectum.
These ulcers can then bleed, produce pus, and lead to the rapid emptying of the colon and diarrhea.
Who is affected by Ulcerative Colitis?
---------------------------------------------------
Ulcerative Colitis is more common in Jews than non-Jews and in whites than non-whites
Most cases begin at the age range of 15-30 years and occurs less frequently between the age of 50-70 years.
Those above the age of 60 years have more severe symptoms and signs.
It occurs equally in men and women and can be found in families.
What is the Cause of Ulcerative Colitis?
-----------------------------------------------------
The exact cause of Ulcerative Colitis is not known.
It has been suggested that an autoimmune disease is the main cause of Ulcerative Colitis disease.
Psychological problems like stress and anxiety is not a cause of Ulcerative Colitis but has been known to trigger off the disease.
What are the Symptoms and signs of Ulcerative Colitis?
-----------------------------------------------------------
Symptoms:
The symptoms can range from mild to severe.
Mild cases (about 50%)usually have:
1.an insidious onset
2.lower abdominal pain
3.Slight blood stained diarrhea
4.malaise
In the more severe cases, the main symptoms may be:
1.abrupt onset
2.severe diffuse abdominal pain
3.Bloody diarrhea
4.fever
5.shock
6.fatigue
7.weight loss
8.loss of appetite
9.loss of body fluids and nutrients
10.joint pain
Signs:
1.Abdominal distension and tenderness
2.Rectal examination may show blood in the stool
There is also tightness of the anal sphincter
3.pallor due to anemia
4.Wasting of muscles
5.skin lesions
How do you make the Diagnosis of Ulcerative Colitis?
------------------------------------------------------------
1.A history of lower abdominal pain , bloating and bloody diarrhea
2.The physical exam consists of
a.palpation of the abdomen for tenderness
b.digital rectal exam to detect tenesmus or blood.
3.stool may be tested for blood
4.blood tests( HB, WBC, ESR, blood culture) are done for evidence of infection.
5.Xrays of the abdomen and barium enema may be done to show evidence of extent of ulcers in the colon
6.Colonoscopy is also done to confirm evidence of ulcerative colitis and exclude malignant tumors.
What are the complications of Ulcerative Colitis?
---------------------------------------------------
Bowel complications:
1.Strictures of colon
2.Fistula
3.Toxic dilatation(toxic megacolon)
4.Perforation of the colon
5.hemorrhage
6.shock
7.rarely carcinoma(5%)
Non-bowel complications:
1.Bones: arthritis, sacroiliatis
osteoporosis
2.Eyes: uveitis, iritis
3.Skin: eczema
What is the treatment of Ulcerative Colitis?
----------------------------------------------------------------
Mild Cases:
Medications:
1.Antidiarrheal and bulk forming agents
2.Antispasmotic medication for spasm of the colon
3.Sulfasalazine (immunosuppressant) given indefinitely
Other 5-ASA agents, such as olsalazine, mesalamine, and balsalazide, may be used by people who cannot take sulfasalazine.
4.Topical corticosteroids as retention enema or suppositories only where the rectum is involved.
5.Correction of anemia
6.Regular hemoglobin, blood counts and liver function tests
Severe cases:
1.Hospitalisation with bed rest, fluids, electrolyte replacement and blood transfusion if necessary
2.Systemic corticosteroids(intravenous initially, followed by oral medications) These should not be given for long term usage.
3.Sulphasalazine (immuno-suppressant) given indefinitely
4.azathioprine and 6-mercapto-purine (6-MP) can also reduce inflammation by suppressing the immune system
5.Antibiotics in toxic megacolon syndrome
5.surgery if the attacks are severe, do not respond to treatment, toxic megacolon or uncontrollable bleeding.
Surgery is also done for complications such as a fistula or intestinal obstruction.
In more severe cases a total proctocolectomy with ileostomy( a stoma is left in the abdomen for disposal of faeces) is done and is usually curative.
Ileoanal anastomosis in which the ileum is attached to the anus allows the patient to have normal bowel movements because the anus is preserved.
Emergency surgery may be done for perforation, peritonitis, or continued bleeding.
What is the prognosis of Ulcerative Colitis?
-----------------------------------------
The prognosis depends on the severity of the disease
Mortality is o.4% for mild cases, 2.2% for moderate disease and 10-25% for severe disease.
5% will die within the first year.
75% will have recurrence for the rest of their life.
Only 10% will have remissions lasting 15 years.
Showing posts with label bloating. Show all posts
Showing posts with label bloating. Show all posts
Tuesday, July 29, 2008
Saturday, June 21, 2008
A Simple Guide to Diverticulosis
A Simple Guide to Diverticulosis
----------------------------------------------------
What is Diverticulosis?
---------------------------------------
Diverticulosis is a disorder of the colon or large intestine where there are one or more sac-like pouches(called diverticula) in the walls of the colon.
It is more common in the descending and sigmoid colon.
Who is affected by Diverticulosis?
---------------------------------------------------
Diverticulosis becomes more obvious with age.
50% of people over the age 0f 60 years have Diverticulosis.
What is the Cause of Diverticulosis?
-----------------------------------------------------
The exact cause of Diverticulosis is not known.
It has been suggested that a low-fiber diet is the main cause of diverticular disease.
Diverticulosis is common in developed countries where low-fiber diets are common whereas it is rare in Asia and Africa where people eat high-fiber vegetable diets.
Fiber prevents constipation which can make the muscles strain and increase pressure in the colon.
This increased pressure makes the weak spots in the colon lining to bulge out like pouches and become diverticula.
What are the Symptoms of Diverticulosis?
-----------------------------------------------------------
Most cases of Diverticulosis have no or little symptoms.
In the more severe cases, the main symptoms of Diverticulosis are:
1.Abdominal pain or cramps-usually over the left side or over the lower abdomen
2.Bloating
3.constipation
The symptoms can range from mild to severe.
How do you make the Diagnosis of Diverticulosis?
------------------------------------------------------------
1.A history of abdominal pain especially on the left lower abdomen, bloating and constipation
2.The physical exam consists of
a.palpation of the left abdomen for tenderness or masses
b.digital rectal exam to detect tenderness or blood.
3.stool may be tested for blood
4.blood tests(WBC,ESR,bood culture) are done for evidence of infection.
5.Xrays of the abdomen and barium enema may be done to show evidence of pouches in the colon
6.Colonoscopy is also done to confirm evidence of diverticulosis and exclude malignant tumours.
What are the complications of Diverticulosis?
---------------------------------------------------
1.Diverticulitis
Diverticulitis occurs when diverticula become infected with bacteria, viruses or become inflamed.
Bacteria are caught in the pouches and develops into diverticulitis suddenly.
The symptoms and signs of diverticulitis are:
1.abdominal pain usually continuous in the lower left abdomen with tenderness
2.fever due to infection,
3.nausea, vomiting,
4.cramping,
5.constipation
6.rectal tenderness
Diverticulitis can lead to:
1.Bleeding,
rare.
Bleeding can be severe caused by a small blood vessel in a diverticulum that weakens and finally bursts.
Surgery may be needed to stop bleeding if bleeding continues.
2.Abscess, Perforation, and Peritonitis
Often a few days of treatment with antibiotics will cure the diverticulitis.
If the infection gets worse, an abscess which is an infected area with pus may form in the colon.
Small abscesses usually clear up with antibiotics.
More severe abscesses may require drainage of the pus using a catheter.
If pus leaks from perforations in the lining of the colon, then it can cause infection in the abdominal cavity and results in peritonitis.
This is an emergency and requires immediate surgery to clean up the pus in the abdominal cavity and removal of the damaged part of the colon.
3.Intestinal Obstruction
The infection of the diverticula can cause scarring of the lining of the colon resulting in partial or total blockage of the large intestine.
If the obstruction blocks the intestine completely, emergency surgery is required to allow faecal matter to pass through.
A temporary colostomy may be necessary.
4.Fistula
occurs as an abnormal connection between two organs or between an organ and the skin.
It results from the damaged tissues coming together and an opening is left between the two tissues.
Usually the bladder, small intestine, vagina, and skin are the organs involved.
The most common fistula occurs between the bladder and the colon especially in men. This can cause a long-lasting infection of the urinary tract.
Surgery may be necessary to remove the fistula as well as the damaged part of the colon.
5.Urinary tract infections occurs frequently due to the fistula and proximity of the bladder to the infected colon.
6.Discarge of faecal material may occur through a fistula between the colon and vagina in some women.
What is the treatment of Diverticulosis?
-------------------------------------------------
Medication:
1.pain medications will relieve any pain symptoms.
2.Antispasmotic mediacation for spams of the colon
3.Antibiotics may be needed in diverticulitis and complications such as urinary infection and peritonitis.
Diet:
1.high-fiber diet
a.whole grain breads and cereals;
b.fruit like apples and peaches;
c.vegetables like carrots, broccoli, spinach, carrots, cabbage, beans.
2.fiber product such as Metamucil once a day.
3.Avoid nuts, popcorn, pumpkin, and sesame seeds or any food which can cause discomfort in the abdomen
Diverticulitis
1.Antibiotics to treat the infection and inflammation,
2.resting the colon by bed rest, nasogastric suction and a liquid diet
3.hospital stay to prevent complications such as abscess.
4.surgery if the attacks are severe or there are complications.
The surgeon resects the affected part of the colon and then joins the remaining sections.
Surgery is also done for complications such as a fistula or intestinal obstruction.
Emergency surgery may be done for a large abscess, perforation, peritonitis, or continued bleeding.
What is the prognosis of Diverticulosis?
------------------------------------------------------
About 1% develop diverticulitis.
70% of patients with acute attacks of diverticulitis can be treated with medical management and have no further attacks
----------------------------------------------------
What is Diverticulosis?
---------------------------------------
Diverticulosis is a disorder of the colon or large intestine where there are one or more sac-like pouches(called diverticula) in the walls of the colon.
It is more common in the descending and sigmoid colon.
Who is affected by Diverticulosis?
---------------------------------------------------
Diverticulosis becomes more obvious with age.
50% of people over the age 0f 60 years have Diverticulosis.
What is the Cause of Diverticulosis?
-----------------------------------------------------
The exact cause of Diverticulosis is not known.
It has been suggested that a low-fiber diet is the main cause of diverticular disease.
Diverticulosis is common in developed countries where low-fiber diets are common whereas it is rare in Asia and Africa where people eat high-fiber vegetable diets.
Fiber prevents constipation which can make the muscles strain and increase pressure in the colon.
This increased pressure makes the weak spots in the colon lining to bulge out like pouches and become diverticula.
What are the Symptoms of Diverticulosis?
-----------------------------------------------------------
Most cases of Diverticulosis have no or little symptoms.
In the more severe cases, the main symptoms of Diverticulosis are:
1.Abdominal pain or cramps-usually over the left side or over the lower abdomen
2.Bloating
3.constipation
The symptoms can range from mild to severe.
How do you make the Diagnosis of Diverticulosis?
------------------------------------------------------------
1.A history of abdominal pain especially on the left lower abdomen, bloating and constipation
2.The physical exam consists of
a.palpation of the left abdomen for tenderness or masses
b.digital rectal exam to detect tenderness or blood.
3.stool may be tested for blood
4.blood tests(WBC,ESR,bood culture) are done for evidence of infection.
5.Xrays of the abdomen and barium enema may be done to show evidence of pouches in the colon
6.Colonoscopy is also done to confirm evidence of diverticulosis and exclude malignant tumours.
What are the complications of Diverticulosis?
---------------------------------------------------
1.Diverticulitis
Diverticulitis occurs when diverticula become infected with bacteria, viruses or become inflamed.
Bacteria are caught in the pouches and develops into diverticulitis suddenly.
The symptoms and signs of diverticulitis are:
1.abdominal pain usually continuous in the lower left abdomen with tenderness
2.fever due to infection,
3.nausea, vomiting,
4.cramping,
5.constipation
6.rectal tenderness
Diverticulitis can lead to:
1.Bleeding,
rare.
Bleeding can be severe caused by a small blood vessel in a diverticulum that weakens and finally bursts.
Surgery may be needed to stop bleeding if bleeding continues.
2.Abscess, Perforation, and Peritonitis
Often a few days of treatment with antibiotics will cure the diverticulitis.
If the infection gets worse, an abscess which is an infected area with pus may form in the colon.
Small abscesses usually clear up with antibiotics.
More severe abscesses may require drainage of the pus using a catheter.
If pus leaks from perforations in the lining of the colon, then it can cause infection in the abdominal cavity and results in peritonitis.
This is an emergency and requires immediate surgery to clean up the pus in the abdominal cavity and removal of the damaged part of the colon.
3.Intestinal Obstruction
The infection of the diverticula can cause scarring of the lining of the colon resulting in partial or total blockage of the large intestine.
If the obstruction blocks the intestine completely, emergency surgery is required to allow faecal matter to pass through.
A temporary colostomy may be necessary.
4.Fistula
occurs as an abnormal connection between two organs or between an organ and the skin.
It results from the damaged tissues coming together and an opening is left between the two tissues.
Usually the bladder, small intestine, vagina, and skin are the organs involved.
The most common fistula occurs between the bladder and the colon especially in men. This can cause a long-lasting infection of the urinary tract.
Surgery may be necessary to remove the fistula as well as the damaged part of the colon.
5.Urinary tract infections occurs frequently due to the fistula and proximity of the bladder to the infected colon.
6.Discarge of faecal material may occur through a fistula between the colon and vagina in some women.
What is the treatment of Diverticulosis?
-------------------------------------------------
Medication:
1.pain medications will relieve any pain symptoms.
2.Antispasmotic mediacation for spams of the colon
3.Antibiotics may be needed in diverticulitis and complications such as urinary infection and peritonitis.
Diet:
1.high-fiber diet
a.whole grain breads and cereals;
b.fruit like apples and peaches;
c.vegetables like carrots, broccoli, spinach, carrots, cabbage, beans.
2.fiber product such as Metamucil once a day.
3.Avoid nuts, popcorn, pumpkin, and sesame seeds or any food which can cause discomfort in the abdomen
Diverticulitis
1.Antibiotics to treat the infection and inflammation,
2.resting the colon by bed rest, nasogastric suction and a liquid diet
3.hospital stay to prevent complications such as abscess.
4.surgery if the attacks are severe or there are complications.
The surgeon resects the affected part of the colon and then joins the remaining sections.
Surgery is also done for complications such as a fistula or intestinal obstruction.
Emergency surgery may be done for a large abscess, perforation, peritonitis, or continued bleeding.
What is the prognosis of Diverticulosis?
------------------------------------------------------
About 1% develop diverticulitis.
70% of patients with acute attacks of diverticulitis can be treated with medical management and have no further attacks
Monday, September 24, 2007
A Simple Guide to Ovarian Cancer
A Simple Guide to Ovarian Cancer
--------------
What is Ovarian Cancer?
----------------
--------------
What is Ovarian Cancer?
----------------
Ovarian Cancer is a disease which cause abnormal cells in the ovary to proliferate and spread to the rest of the ovary or outside the ovary.
What are the different types of Ovarian Cancer?
-------------------------------------------------
Most experts group ovarian cancers within three major categories, according to the kind of cells from which they were formed:
1.epithelial tumors arise from cells that line or cover the ovaries;
2.germ cell tumors originate from cells that are destined to form eggs within the ovaries; and
3.sex cord-stromal cell tumors begin in the connective cells that hold the ovaries together and produce female hormones.
The most common type, the epithelial carcinoma, that begins from the surface of the ovary is discussed here.
Who is at risk of Ovarian Cancer?
---------------------------------------
The cause of cancer of the ovary is unknown.
However, studies show that certain factors may increase the chance of developing this disease. 1.family history of ovarian cancer.
2.history of cancer of the breast or colon.
3.age over 60 years.
4. Infertility or not having children. The more children you have, the lesser your risk is.
5.Early menstruation before the age of 12
6.late menopause
7.high fat diet
8.Use of fertility drugs, or Hormone Replacement Therapy (HRT).
Attempts are being made to detect early stages of ovarian cancer, especially among women who have an increased risk. A blood test is done to check for a substance called CA 125.
If the sample contains raised amounts of CA 125, an ultrasound scan may be done to see if your ovaries appear abnormal in any way.
What are the Symptoms of Ovarian Cancer?
---------------------------------------------------
Ovarian cancer is the most dangerous of gynaecological cancers because it is often silent and difficult to detect.There is no early detection method, so you must be vigilant and take note of persistent warning signs seriously.
If you are having some of the following symptoms persisting for more than a week or so, see your doctor.
1.Vague gastrointestinal symptoms such as gas, indigestion, nausea and a bloated feeling
2.Swelling in the abdomen, unexplained weight gain
3.Pelvic or abdominal pain or discomfort, and/or feeling of fullness
4.Urinary symptoms e.g. frequency and/or urgency of urination in the absence of an infection
5.Unexplained or changes in bowel habits
6.Loss of appetite/loss of weight
7.backache or pain inthe legs
8.Abnormal vaginal bleeding, although this is rare
If you do have any of the above symptoms you must have them checked by your doctor. Remember, they are non specific and most women with these symptoms will not have cancer.
How do you make the diagnosis of Ovarian Cancer?
-----------------------------------------------------------
If you are at risk of ovarian cancer, see your gynaecologist regularly.
The following may be done:
recto-vaginal bimanual pelvic exam,
recto-vaginal bimanual pelvic exam,
Pap smear,
blood test for CA-125
transvaginal ultrasound
What are the treatment of Ovarian Cancer?
---------------------------------------------------
Treatment depends on a number of factors, including the stage of the disease (the extent of spread of the disease) and the general health of the patient.
Surgery, chemotherapy and various types of radiotherapy may be used alone, or in combination to treat ovarian cancer.
What are the treatment of Ovarian Cancer?
---------------------------------------------------
Treatment depends on a number of factors, including the stage of the disease (the extent of spread of the disease) and the general health of the patient.
Surgery, chemotherapy and various types of radiotherapy may be used alone, or in combination to treat ovarian cancer.
Surgery
Surgery is normally the first choice of treatment for ovarian cancer, and may sometimes also be needed to make the diagnosis. If detected is in the early stages, surgery is all the treatment that may be required. The ovaries, fallopian tubes, uterus and cervix are usually removed. The omentum and lymph nodes in the abdomen are often removed too.
If the surgeon feels the cancer may be difficult to remove, a few cycles of chemotherapy may be applied first and surgery carried out thereafter, in the hope that the tumour would have been reduced.
Chemotherapy
Chemotherapy may be given to destroy any cancerous cells that may remain in the body after surgery, to control cancer growth or to relieve symptoms of the disease. Sometimes a few cycles of chemotherapy may have to be applied before surgery is carried out.
Radiotherapy
Radiotherapy is less commonly used in this cancer but may sometimes be used to treat individual areas of cancer which have recurred after surgery and chemotherapy.
Chemotherapy
Chemotherapy may be given to destroy any cancerous cells that may remain in the body after surgery, to control cancer growth or to relieve symptoms of the disease. Sometimes a few cycles of chemotherapy may have to be applied before surgery is carried out.
Radiotherapy
Radiotherapy is less commonly used in this cancer but may sometimes be used to treat individual areas of cancer which have recurred after surgery and chemotherapy.
There have been many reports of the potential benefits of hormone treatments in patients with ovarian cancer that does not respond to conventional therapy.
Some patients with treatment-resistant (refractory) epithelial cancers have been treated with:
1.progestins - crude forms of the female sex hormone progesterone;
1.progestins - crude forms of the female sex hormone progesterone;
2.estrogens - for example, diethylstilbestrol
3.combination estrogen/progestin therapy;
4.antiestrogens - tamoxifen;
5.androgens - male sex hormones for example, Halotestin
6.gonadotropin-releasing hormone (GnRH) - a hormone of the hypothalamus that stimulates the release of ovary-related hormones from the pituitary gland.
3.combination estrogen/progestin therapy;
4.antiestrogens - tamoxifen;
5.androgens - male sex hormones for example, Halotestin
6.gonadotropin-releasing hormone (GnRH) - a hormone of the hypothalamus that stimulates the release of ovary-related hormones from the pituitary gland.
Gene Therapy
Gene therapy eventually may provide some control over cancer susceptibility and its treatment. Ovarian cancer, like all cancers, is believed to result from a build-up of genetic defects within the cells.Genetic engineers hope to correct such damage by transplanting copies of normal genes into cells with genetic defects. However at the moment gene therapy is still experimental.
Monday, September 17, 2007
A Simple Guide to Gastritis
A Simple Guide to Gastritis
----------------
What is Gastritis?
-------------
----------------
What is Gastritis?
-------------
Gastritis is a disease which is caused by inflammation of the stomach lining.
It may presents as gastritis ,peptic gastric ulcer or if it extends to the duodenum(first part of small intestine) duodenal ulcers.
What are the causes of Gastritis?
--------------------------------------
Two main causes are
1.helicobacter pylori infection - this bacteria damages the protective lining of the stomach making the underlying stomach tissue more vulnerable to the acidic gastric juice.
2.excessive production of acidic gastric juice
Excessive production of acidic gastric juice burns into the protective lining of the stomach and cause inflammation of the underlying stomach tissue.
The causes of excessive production of acidic gastric juice are:
1. Most common is stress and anxiety which automatically increase the production of the acid as a result of sympathetic nervous reaction
2.hereditary- some gastric patient has family history of gastric problem. Blood group O tends to have more gastritis while Blood group A has a tendency towards stomach cancer.
3.irregular meals tend to cause more acidic gastric juice to form at regular meal time.
4.alcohol and smoking has been associated with increased acid formation
5.Drugs: prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen,
6. diseases, such as pernicious anemia, autoimmune disorders, and chronic bile reflux, can cause gastritis as well.
What are the Symptoms of Gastritis?
--------------------------------------------
The most common symptoms are
1.upper abdominal upset or pain.
Other symptoms are
2.belching, abdominal bloating,
3.nausea, and vomiting
4.indigestion or of burning in the upper abdomen or in the chest(heart burn).
5.Blood in your vomit or black stools may be a sign of bleeding in the stomach, which may indicate a serious problem requiring immediate medical attention.
How do you diagnose Gastritis?
------------------------------------
Gastritis is diagnosed through one or more medical tests:
Medical history - past and family history of gastritis
Physical examination- epigastric bloating or tenderness
Upper gastrointestinal endoscopy.
The doctor eases an gastroscope, a thin tube containing a tiny camera, through your mouth and down into your stomach to look at the stomach lining. The doctor will check for inflammation and may remove a tiny sample of tissue for tests(biopsy).
The biopsy will detect how bad is the inflammation or whether there are underlying cancer cells. In additional if any polyps (benign swelling of the lining of the stomach) are detected, they are removed at the same time and sent for biopsy.
Blood test. The doctor may check your blood for any evidence of H.pylori infection and your red blood cell count to see whether you have anemia, which means that you do not have enough red blood cells. Anemia can be caused by bleeding from the stomach.
Urea breath test can also determine whether you have H.pylori infection
Stool test. This test checks for the presence of blood in your stool, a sign of bleeding. Stool test may also be used to detect the presence of H. pylori in the digestive tract.
What is the Treatment of Gastritis?
------------------------------------------
The main treatment is usually
1.reduce stress
2.reorganisation of work in such a way as to be able to handle the pressure of work better as well as to have regular meals
3.Control of diet - avoid hard foods such as peanuts , tough meat, spicy food, cold food, black coffee, strong tea,citrus fruits and their juices,carbonated beverages, deep fried or oily food.
4. Take more frequent and smaller meals.
5. Avoid alcohol and smoking
6. Avoid drugs such as aspirin, painkillers,steroids which may irritate your stomach and cause increase in acid production
Medical treatment:
Treatment usually involves taking drugs
1.Antacids:to reduce stomach acid and thereby help relieve symptoms and promote healing. (Stomach acid irritates the inflamed tissue in the stomach.)
2.H2 Antagonist: to reduce to production of acidic gastric juice.(cimetidine, ranididine,omeprazole, Nexium etc)
3. Antispasmodics: anticholinergic drugs like buscopan, librax reduce the spasm in the stomach and duodenum
4. Antiflatulents - to reduce gas in the abdomen
5.If your gastritis is caused by an infection, that problem may be treated as well. For example, the doctor might prescribe antibiotics to clear up H. pylori infection.
Once the underlying problem disappears, the gastritis usually does too.
Talk to your doctor before stopping any medicine or starting any gastritis treatment on your own.
What are the Complications of untreated Gastritis?
--------------------------------------------------------------
Any untreated gastritis can cause complications such as:
1. peptic ulcers
2. bleeding ulcers
3.perforated stomach and peritonitis
Gastritis or ulcer is not healed overnight. The chances of satisfactory gastric recovery are excellent. However recurrences are always possible so do not stop your medications, good food habits and healthy lifestyle too soon.
It may presents as gastritis ,peptic gastric ulcer or if it extends to the duodenum(first part of small intestine) duodenal ulcers.
What are the causes of Gastritis?
--------------------------------------
Two main causes are
1.helicobacter pylori infection - this bacteria damages the protective lining of the stomach making the underlying stomach tissue more vulnerable to the acidic gastric juice.
2.excessive production of acidic gastric juice
Excessive production of acidic gastric juice burns into the protective lining of the stomach and cause inflammation of the underlying stomach tissue.
The causes of excessive production of acidic gastric juice are:
1. Most common is stress and anxiety which automatically increase the production of the acid as a result of sympathetic nervous reaction
2.hereditary- some gastric patient has family history of gastric problem. Blood group O tends to have more gastritis while Blood group A has a tendency towards stomach cancer.
3.irregular meals tend to cause more acidic gastric juice to form at regular meal time.
4.alcohol and smoking has been associated with increased acid formation
5.Drugs: prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen,
6. diseases, such as pernicious anemia, autoimmune disorders, and chronic bile reflux, can cause gastritis as well.
What are the Symptoms of Gastritis?
--------------------------------------------
The most common symptoms are
1.upper abdominal upset or pain.
Other symptoms are
2.belching, abdominal bloating,
3.nausea, and vomiting
4.indigestion or of burning in the upper abdomen or in the chest(heart burn).
5.Blood in your vomit or black stools may be a sign of bleeding in the stomach, which may indicate a serious problem requiring immediate medical attention.
How do you diagnose Gastritis?
------------------------------------
Gastritis is diagnosed through one or more medical tests:
Medical history - past and family history of gastritis
Physical examination- epigastric bloating or tenderness
Upper gastrointestinal endoscopy.
The doctor eases an gastroscope, a thin tube containing a tiny camera, through your mouth and down into your stomach to look at the stomach lining. The doctor will check for inflammation and may remove a tiny sample of tissue for tests(biopsy).
The biopsy will detect how bad is the inflammation or whether there are underlying cancer cells. In additional if any polyps (benign swelling of the lining of the stomach) are detected, they are removed at the same time and sent for biopsy.
Blood test. The doctor may check your blood for any evidence of H.pylori infection and your red blood cell count to see whether you have anemia, which means that you do not have enough red blood cells. Anemia can be caused by bleeding from the stomach.
Urea breath test can also determine whether you have H.pylori infection
Stool test. This test checks for the presence of blood in your stool, a sign of bleeding. Stool test may also be used to detect the presence of H. pylori in the digestive tract.
What is the Treatment of Gastritis?
------------------------------------------
The main treatment is usually
1.reduce stress
2.reorganisation of work in such a way as to be able to handle the pressure of work better as well as to have regular meals
3.Control of diet - avoid hard foods such as peanuts , tough meat, spicy food, cold food, black coffee, strong tea,citrus fruits and their juices,carbonated beverages, deep fried or oily food.
4. Take more frequent and smaller meals.
5. Avoid alcohol and smoking
6. Avoid drugs such as aspirin, painkillers,steroids which may irritate your stomach and cause increase in acid production
Medical treatment:
Treatment usually involves taking drugs
1.Antacids:to reduce stomach acid and thereby help relieve symptoms and promote healing. (Stomach acid irritates the inflamed tissue in the stomach.)
2.H2 Antagonist: to reduce to production of acidic gastric juice.(cimetidine, ranididine,omeprazole, Nexium etc)
3. Antispasmodics: anticholinergic drugs like buscopan, librax reduce the spasm in the stomach and duodenum
4. Antiflatulents - to reduce gas in the abdomen
5.If your gastritis is caused by an infection, that problem may be treated as well. For example, the doctor might prescribe antibiotics to clear up H. pylori infection.
Once the underlying problem disappears, the gastritis usually does too.
Talk to your doctor before stopping any medicine or starting any gastritis treatment on your own.
What are the Complications of untreated Gastritis?
--------------------------------------------------------------
Any untreated gastritis can cause complications such as:
1. peptic ulcers
2. bleeding ulcers
3.perforated stomach and peritonitis
Gastritis or ulcer is not healed overnight. The chances of satisfactory gastric recovery are excellent. However recurrences are always possible so do not stop your medications, good food habits and healthy lifestyle too soon.
Friday, September 14, 2007
A Simple Guide to Irritable Bowel Syndrome
A Simple Guide to Irritable Bowel Syndrome
----------------------------------------------
What is Irritable Bowel Syndrome?
------------------------------------------
Irritable bowel syndrome (IBS) is a common functional disorder of the gastrointestinal system. It is characterised by abdominal pain/cramps, bloating or gas, diarrhoea and/or constipation. It is also known as spastic colon.
Who is affected by Irritable Bowel Syndrome?
--------------------------------------------
It occurs in one in five persons and usually between the ages of 20-50.
Women outnumber men by two or three to one.
It can become a chronic condition causing much discomfort and inconvenience to the patient. However, it does not progress to cancer.
What is the Cause of Irritable Bowel Syndrome?
--------------------------------------------------------
The exact cause of IBS is not known.
The muscles of the walls of the intestines in the normal person contract and relax in a co-ordinated rhythm known as peristalsis. This action helps to move food along the intestines during which time absorption takes place.
The nerves and muscles in the bowel appear to be extra sensitive in people with IBS. The contractions are stronger and last longer.
Food is pushed along the intestines at a faster rate, giving rise to abdominal pain, gas and diarrhoea. Sometimes, the opposite occurs. The contractions are weaker causing the passage of food to slow down and constipation results.
Other factors that have been shown to play a part are stress, diet and hormones. These are called triggers.
1.Stress
which may be psychological or physical.
Psychological stresses such as family misunderstanding; bereavement; anxiety; meeting deadlines etc.
Physical stresses such as illnesses, infections, exhaustion etc.
2.Diet
certain foods have been known to cause the onset of symptoms. They include fried or oily food; gas-forming foods e.g.broccoli, beans, cabbage; chocolates; coffee.
3.Hormonal changes
some women experience attacks during or around their menstrual periods.
What are the Symptoms of Irritable Bowel Syndrome?
----------------------------------------------------------------
The main symptoms of IBS are:
1.Abdominal pain or cramps-usually over the left side or over the lower abdomen
2.Bloating and/or gas
3.Diarrhoea, constipation or alternating diarrhoea and constipation.
4.whitish mucus in the stool
The symptoms can range from mild to severe.
In many cases the symptoms are bearable and go off after a bowel movement.
Women with IBS often have more symptoms during their menstrual periods.
How do you make the Diagnosis of Irritable Bowel Syndrome?
------------------------------------------------------------------------
Because the cause is unknown and there is a lack of specific physical signs, diagnosis is arrived at through a process of elimination .
A colonoscopy is usually done to rule out colon cancer, diverticulosis, polyps.
What is the Treatment of Irritable Bowel Syndrome?
--------------------------------------------------------------
There is no real cure for Irritable Bowel Syndrome.
Treatment is mainly symptomatic i.e. it is directed towards the relief of symptoms.
Mild symptoms usually go off on their own.
If symptoms are severe, the doctor may prescribe the following:
Anti-spasmodics for the abdominal pain and cramps,
Anti-flatulents to get rid of gas and relief the bloating,
Anti-diarrhoeals to stop diarrhoea,
Antidepressants, even in lower doses than are used for treating depression, can help people with IBS.
Laxatives to relief constipation.
Foods and drinks that may cause or worsen symptoms include:
fatty foods, like french fries
milk products, like cheese or ice cream
chocolate
alcohol
caffeinated drinks, like coffee
carbonated drinks, like soda
Some foods make IBS better.
Fiber may reduce the constipation associated with IBS because it makes stool soft and easier to pass.
However, some people with IBS who have more sensitive nerves may feel a bit more abdominal discomfort after adding more fiber to their diet. Fiber is found in foods such as breads, cereals, beans, fruits, and vegetables.
Too much fiber at once can cause gas, which can trigger symptoms in a person with IBS.
Eat small meals for example eating four or five small meals a day.
Large meals can cause cramping and diarrhea in people with IBS.
Stress doesn’t cause IBS, but it can make your symptoms worse.
Learning to reduce stress can help with IBS. With less stress, you may find you have less cramping and pain. You may also find it easier to manage your symptoms.
Meditation, exercise, hypnosis, and counseling may help.
What can be done to prevent Irritable Bowel Syndrome?
------------------------------------------------------------------
Prevention is an important part in the total management of this condition.
They consist of stress management and life-style changes.
Stress management
Avoid unnecessary stress
Learn to relax
Exercise regularly
Dietary changes
Avoid oily, spicy food
Avoid gas-forming foods e.g. cabbage, broccoli, beans
Avoid coffee, chocolates, and alcohol
Avoid large meals
Take more fibre
----------------------------------------------
What is Irritable Bowel Syndrome?
------------------------------------------
Irritable bowel syndrome (IBS) is a common functional disorder of the gastrointestinal system. It is characterised by abdominal pain/cramps, bloating or gas, diarrhoea and/or constipation. It is also known as spastic colon.
Who is affected by Irritable Bowel Syndrome?
--------------------------------------------
It occurs in one in five persons and usually between the ages of 20-50.
Women outnumber men by two or three to one.
It can become a chronic condition causing much discomfort and inconvenience to the patient. However, it does not progress to cancer.
What is the Cause of Irritable Bowel Syndrome?
--------------------------------------------------------
The exact cause of IBS is not known.
The muscles of the walls of the intestines in the normal person contract and relax in a co-ordinated rhythm known as peristalsis. This action helps to move food along the intestines during which time absorption takes place.
The nerves and muscles in the bowel appear to be extra sensitive in people with IBS. The contractions are stronger and last longer.
Food is pushed along the intestines at a faster rate, giving rise to abdominal pain, gas and diarrhoea. Sometimes, the opposite occurs. The contractions are weaker causing the passage of food to slow down and constipation results.
Other factors that have been shown to play a part are stress, diet and hormones. These are called triggers.
1.Stress
which may be psychological or physical.
Psychological stresses such as family misunderstanding; bereavement; anxiety; meeting deadlines etc.
Physical stresses such as illnesses, infections, exhaustion etc.
2.Diet
certain foods have been known to cause the onset of symptoms. They include fried or oily food; gas-forming foods e.g.broccoli, beans, cabbage; chocolates; coffee.
3.Hormonal changes
some women experience attacks during or around their menstrual periods.
What are the Symptoms of Irritable Bowel Syndrome?
----------------------------------------------------------------
The main symptoms of IBS are:
1.Abdominal pain or cramps-usually over the left side or over the lower abdomen
2.Bloating and/or gas
3.Diarrhoea, constipation or alternating diarrhoea and constipation.
4.whitish mucus in the stool
The symptoms can range from mild to severe.
In many cases the symptoms are bearable and go off after a bowel movement.
Women with IBS often have more symptoms during their menstrual periods.
How do you make the Diagnosis of Irritable Bowel Syndrome?
------------------------------------------------------------------------
Because the cause is unknown and there is a lack of specific physical signs, diagnosis is arrived at through a process of elimination .
A colonoscopy is usually done to rule out colon cancer, diverticulosis, polyps.
What is the Treatment of Irritable Bowel Syndrome?
--------------------------------------------------------------
There is no real cure for Irritable Bowel Syndrome.
Treatment is mainly symptomatic i.e. it is directed towards the relief of symptoms.
Mild symptoms usually go off on their own.
If symptoms are severe, the doctor may prescribe the following:
Anti-spasmodics for the abdominal pain and cramps,
Anti-flatulents to get rid of gas and relief the bloating,
Anti-diarrhoeals to stop diarrhoea,
Antidepressants, even in lower doses than are used for treating depression, can help people with IBS.
Laxatives to relief constipation.
Foods and drinks that may cause or worsen symptoms include:
fatty foods, like french fries
milk products, like cheese or ice cream
chocolate
alcohol
caffeinated drinks, like coffee
carbonated drinks, like soda
Some foods make IBS better.
Fiber may reduce the constipation associated with IBS because it makes stool soft and easier to pass.
However, some people with IBS who have more sensitive nerves may feel a bit more abdominal discomfort after adding more fiber to their diet. Fiber is found in foods such as breads, cereals, beans, fruits, and vegetables.
Too much fiber at once can cause gas, which can trigger symptoms in a person with IBS.
Eat small meals for example eating four or five small meals a day.
Large meals can cause cramping and diarrhea in people with IBS.
Stress doesn’t cause IBS, but it can make your symptoms worse.
Learning to reduce stress can help with IBS. With less stress, you may find you have less cramping and pain. You may also find it easier to manage your symptoms.
Meditation, exercise, hypnosis, and counseling may help.
What can be done to prevent Irritable Bowel Syndrome?
------------------------------------------------------------------
Prevention is an important part in the total management of this condition.
They consist of stress management and life-style changes.
Stress management
Avoid unnecessary stress
Learn to relax
Exercise regularly
Dietary changes
Avoid oily, spicy food
Avoid gas-forming foods e.g. cabbage, broccoli, beans
Avoid coffee, chocolates, and alcohol
Avoid large meals
Take more fibre
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