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GERD: Symptoms, Causes, and Treatments

Gastroesophageal reflux disease (GERD) is also known as gastro-oesophageal reflux disease (GORD), gastric reflux disease, or simply acid reflux disease. It is caused by the chronic backwash or reflux of stomach acid into the esophagus. Most people experience acid reflux occasionally, but if reflux happens more than twice weekly or disrupts the patient’s daily life, doctors generally diagnose GERD.

Symptoms

The most commonly reported symptom of GERD is heartburn, also termed acid indigestion. Heartburn can range from an uncomfortable warmth to a painful burning sensation in the chest or upper central abdomen. It sometimes spreads all the way up to the throat. Heartburn results when stomach acid and juices flow upward from the stomach into the esophagus, irritating the esophageal lining. A sour taste of stomach acid or bile in the mouth may accompany heartburn. Regurgitation of half-digested stomach contents may occur. Heartburn should not be confused with steady and severe chest pain, which can be a symptom of heart disease or another problem.

Sufferers of GERD may report the sensation of a lump of the throat. This symptom is termed globus pharyngeus. It occurs when the inferior pharyngeal constrictor muscle attached to the esophagus near the voice box tightens in order to prevent stomach from backwashing into the voice box and mouth.

Another symptom of GERD is difficulty swallowing, or dysphagia. The chronic irritation of acid reflux can result in severe esophageal inflammation and injury, creating narrowed sections of esophagus called strictures. These strictures physically interfere with swallowing and may block food on its way to the stomach.

GERD can also cause other injuries to the esophagus, such as ulcers, esophageal cancer, and a condition known as Barrett’s esophagus. In Barrett’s esophagus, the cells at the lower end of the esophageal lining are altered. This cell alteration is associated with a higher risk of esophageal cancer.

Other symptoms are not as commonly associated with GERD, but may still be caused by it. They include sore throat, dry cough, and laryngitis. Asthma, tooth enamel erosion, tooth sensitivity, sinusitis, and damaged teeth may also be related to GERD.

Causes

The lower esophageal muscle (LES) is a round band of muscle between the bottom of the esophagus and entrance to the stomach. It serves as a valve for the stomach. When swallowing occurs, the LES relaxes, allowing food and liquids to enter. Then it tightens, closing the stomach again. When the LES fails to close properly after swallowing, or otherwise weakens and does not hold the stomach properly closed, stomach acid and contents can backwash up into the the esophagus. Chronic malfunction of the LES and subsequent acid reflux results in GERD.

Risk Factors

One direct cause of LES malfunction is a hiatal hernia. In a hiatal hernia, the top portion of the stomach herniates, or protrudes, through the diaphragm muscle and into the upper abdomen. This places additional pressure on the LES and makes it difficult for it to stay fully closed. Obesity, pregnancy, overeating, and chronic coughing may also play excessive pressure on the LES and result in its malfunction.

Smoking is a major risk factor for GERD. Smoking weakens the LES, making it less able to function properly. Smoking also reduces the mouth’s production of saliva, which otherwise helps dissolve stomach acid, thereby decreasing the body’s protection against acid reflux.

Other possible causes of GERD are less understood. A growing number of alternative health practictioners believe that the LES tends to malfunction when there is too little acid present in the stomach. This view is discussed further in the alternative treatments section.

Prevention Tips

There are a number of lifestyle modifications that can help prevent heartburn.

Avoid trigger foods. These are different for every individual. Fried or greasy foods, alcohol, sugary foods, chocolate, peppermint, coffee, garlic, and onions are some foods that may weaken the LES and cause acid reflux. Highly acidic foods such as tomatoes and citrus fruits may not cause reflux, but can worsen any heartburn irritation already present.

If overweight, lose weight. Excess weight puts extra pressure on the abdomen, pushes the stomach upward and can cause acid to reflux into the esophagus.

Do not wear clothing that puts pressure on the abdomen. Clothing that fits tightly on the waist, such as tight belts or waistbands, puts extra pressure on the LES and may contribute to reflux.

Eat at least three hours before lying down. Lying down contributes to pressure on the LES and allows refluxed acid to travel further up the esophagus.

Sleep with the head of the bed elevated. Placing six to nine inch blocks under the head portion of the bed allows gravity to minimize acid reflux. If the bed cannot be raised, it is possible to place a wedge (available from drugstores and medical supply stores) between the mattress and box spring. This raises the body from the waist up.

Don’t overeat. Eating small meals several times a day puts less pressure on the LES and may prevent acid reflux.

Testing and Diagnosis

Many doctors diagnosis GERD based only on symptoms reported by the patient and response to prescribed medication. However, a number of tests can help determine if reflux is actually occurring. Any patient with doubts about their symptoms should request testing from their doctor.

Esophageal pH monitoring

Esophageal pH monitoring is considered the most accurate diagnostic test for GERD. It involves inserting a pH sensor or sensors into the esophagus of a patient and monitoring acid levels for 24 to 48 hours. During this time, the patient carries out his or her daily routine. The test shows if and when acid reflux is occurring.

In older versions of this test, the sensor or sensors were attached to a catheter extending through the throat and out of the nostrils and attached to a small monitor worn outside the body. However, wireless pH monitoring is now possible through use of the Bravo pH capsule. The capsule must be placed on the esophagus during an endoscopy, but it is then completely invisible and generally not felt at all by the patient. The capsule spontaneously detaches and passes harmlessly through the digestive system within several days.

Endoscopy

In endoscopy, a doctor inserts a very thin and flexible tube with a tiny light and camera, called an endoscope, through the mouth and down the esophagus of the patient. The patient’s mouth and throat are generally numbed with a topical anaesthetic beforehand to minimize discomfort. Sedation and general anaesthesia are also options before the procedure. Doctors may observe the state of the esophagus, LES, and stomach, including any signs of acid reflux. A tissue sample may be collected from the esophagus for further analysis.

Endoscopy is useful for revealing signs and damage caused by GERD. However, it cannot observe acid reflux while it is occurring, unlike esophageal pH monitoring.

Esophageal manometry

Esophageal manometry, also known as esophageal impedance or an esophageal motility test, involves inserting a small catheter through the nose, down the esophagus and through the LES into the stomach. The catheter is then slowly pulled back out. The patient will be asked to take deep breaths and swallow several times. On the way out, the catheter records pressure changes and other data which is used to assess the functioning of the esophagus and LES. There is minimal discomfort to the patient during the procedure, which lasts about 45 minutes. This test is useful to help determine if a malfunctioning LES is contributing to acid reflux.

Barium swallow X-ray

This test involves a patient swallowing a liquid solution containing barium sulfate. The barium sulfate covers the surfaces of the digestive tract and acts as a radiocontrast agent, showing up white on X-rays. Doctors can observe the shape of the esophagus, LES, stomach and upper intestine, to see if there is a hiatal hernia or if the LES appears to be functional. They may also assess any visible damage from acid reflux.

Due to its use of radiation and the availability of more accurate tests, a barium swallow X-ray may not be the top choice for diagnosing GERD, but it remains an option.

Treatment options

Pharmaceuticals

There are a number of pharmaceutical options for the treatment of GERD symptoms. They involve either the neutralization of stomach acid or the blocking of stomach acid production. As with any pharmaceutical treatment, unwanted and harmful side effects are possible, particularly with prolonged use of drugs. Also, pharmaceutical treatments for GERD only treat the symptoms of acid reflux. They do not treat the cause of the acid reflux itself, which is malfunction of the LES.

Antacids

Antacids are composed of bases or basic salts which neutralize acid in the stomach. They are usually taken as chewable tablets upon onset of heartburn. When antacids are digested they buffer the acids in the stomach by raising the pH, offering quick relief from reflux discomfort. Some popular brands include Pepto-Bismol, Alka-Seltzer, Maalox, Tums, and Rolaids, all available over the counter and relatively inexpensive.

Antacids provide only symptomatic relief for the pain associated with acid reflux. They do not treat the cause of acid reflux. Overuse of antacids can have adverse side effects, from the mild, such as constipation and diarrhea, to the severe, including milk-alkali syndrome, kidney stones, and kidney failure. Most doctors recommend that antacids only be used for occasional acid reflux. They generally recommend stronger medications for the chronically recurring reflux associated with GERD.

Acid blocking drugs

Acid blocking drugs reduce or block the stomach’s production of acid. They are very commonly prescribed for GERD and fall into two main groups.

H2 receptor antagonists

This acid blocking drug prevents histamine from acting on the acid-secreting cells in the stomach. Normally, histamine stimulates the production of stomach acid. Therefore, H2 receptor antagonists reduce the stomach’s production of acid. Brand names include Tagamet, Pepcid AC, and Zantac. They are available in relatively low over the counter doses and higher prescription doses. They are moderately expensive.

These drugs are recommended by doctors for mild to moderate GERD. They can be taken before a meal to prevent acid indigestion before it occurs, and are effective in reducing acid production for 6-10 hours. However, they do not treat the cause of acid reflux, which is generally a malfunctioning LES. They only minimize the discomfort and damage associated with acid reflux by reducing the acidity of refluxed stomach juices.

H2 receptor antagonists are believed to be well-tolerated by the body in general. They may be taken as often as twice a day. Still, there are possible adverse effects, including hypotension, headache, tiredness, dizziness, confusion, diarrhea, constipation, and rash. There are also possible long term side effects associated with the reduction of stomach acid, such as poor absorption of nutrients and subsequent deficiencies.

Proton pump inhibitors

Proton pump inhibitors are drugs which block the proton pump, an enzyme system, from acting in the acid-secreting cells of the stomach. The normal action of the proton pump is the last step in stomach acid production. Therefore, the blocking of the proton pump effectively shuts down the acid production of a particular cell. Proton pump inhibitors are much more powerful than H2 receptor antagonists, and can block total stomach acid production up to 99%. The prolonged blocking of stomach acid production allows time for esophageal damage from acid reflux to heal.

Due to their much greater strength, proton pump inhibitors have surpassed H2 receptor antagonists in popularity and become some of the most widely prescribed drugs in the world. Brand names include Nexium, Prevacid, and Prilosec. They are available in over the counter and prescription forms and are generally expensive.

Proton pump inhibitors may be taken as often as twice daily and are thought to be well tolerated. However, possible side effects include headache, nausea, diarrhea, abdominal pain, fatigue, and dizziness, rash, itch, flatulence, constipation, anxiety, and depression. In addition, long term suppression of stomach acid can result in nutrient deficiencies and other serious health problems.

Prokinetic agents

These drugs promote quicker emptying of the stomach and can help tighten the LES. They work by increasing the rate of contraction of the small intestine, speeding the process of digestion. They include the drug Reglan. However, they can frequently cause side effects including nausea, diarrhea, fatigue, dizziness, and anxiety. They are sometimes prescribed for GERD in combination with H2 receptor antagonists. This combination of treatments can be expensive. They are rarely prescribed alone and are considered less safe and effective than proton pump inhibitors for the long term treatment of GERD.

Surgery

If lifestyle modifications and medications do not resolve severe GERD, doctors may recommend surgery to tighten the LES.

Nissen fundoplication tightens the LES by wrapping the stomach around the base of the esophagus. Surgery may be open (through a long abdominal incision) or, more frequently, laparoscopic (done by instruments inserted through several tiny abdominal incisions). The surgery has a reported 90% effectiveness rate in eliminating reflux symptoms. However, like any surgery, it has a risk of complications, including gas bloat syndrome, dumping syndrome, trouble swallowing, excessive scarring, and recurrence of symptoms. It can also be expensive and may not be covered by insurance.

Other surgical procedures include the EndoCinch endoluminal gastroplication, which uses stitches in the stomach to create barriers against acid reflux, and the Stretta system, which uses electrode energy to create scar tissue which strengthens the LES. Both procedures are still in experimental stages.

Alternative treatments

Some alternative health practitioners believe that GERD results from too little stomach acid. They propose that a chronic lack of sufficient acid secretion in the stomach may cause the LES to loosen and promote acid reflux. They conclude that conventional pharmaceutical treatments for GERD, which neutralize, reduce, or block stomach acid, actually worsen the root cause of acid reflux and create drug dependence as well as long term health problems.

Some alternative treatments for GERD increase stomach acidity and may keep the LES from opening and allowing reflux to occur.

Apple Cider Vinegar

A spoonful of apple cider vinegar, a highly acidic natural substance, is an inexpensive home remedy for indigestion that increases stomach acidity and may relieve GERD symptoms. Lemon juice may be taken in a similar way.

Digestive Bitters

Digestive bitters include bitter herbs such as gentian root, dandelion, and goldenseal. Bitters have traditionally been used to stimulate the appetite and may increase production of stomach acid and digestive juices. Tinctures of digestive bitters are available in health food stores and are relatively inexpensive. 5-10 drops in a little water–just enough to create a strong taste of bitterness–may be taken 5-10 minutes before eating.

Betaine Hydrochloride (HCl) with Pepsin

Betaine Hydrochloride (HCl), derived from beets, it is a natural substance very similar in content to stomach acid. It usually combined with an enzyme called Pepsin and marketed in health food stores as a digestive aid. It is relatively inexpensive. 1-2 tablets may be taken immediately before a meal to increase stomach acid and may prevent reflux from occurring. They should only be taken just before eating due to the strong increase in stomach acid they create. They should not be taken by anyone using anti-inflammatory medication, including aspirin and ibuprofen. This is due to these drugs’ risk of damaging the stomach lining, which supplemental acid could aggravate.

Other alternative treatments include herbs that may ease GERD symptoms by soothing esophageal irritation, such as slippery elm, chamomile, licorice, and marshmallow. They may be taken in teas and lozenges, or added to foods and drinks as powders.

Acupuncture has been shown to relieve the discomfort of GERD symptoms for some patients. Meditation, relaxation, and reducing stress also reportedly reduce GERD symptoms.

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The thyroid gland, located at the back of the neck below the Adam’s apple, is a gland that produces thyroid hormones. Thyroid hormones regulate our body’s metabolism, as well as helping to regulate energy usage, the use of hormones and vitamins, and the growth and maturation of body tissues. Thyroid disease either creates an overabundance of thyroid hormones, called hyperthyroidism, or too little thyroid hormones, called hypothyroidism. Both of these conditions create unpleasant symptoms, but can be effectively managed after proper diagnosis.

Causes of Thyroid Problems

The “hypothalamus”a part of the brain located just above the brain stem”releases thyrotropin-relasing hormone, or TRH. TRH then travels to the pituitary gland, which is an endocrine gland located at the bottom of the hypothalamus. In response to the presence of TRH, the pituitary gland releases thyroid-stimulating hormone, or TSH, into the blood. The TSH then goes to the thyroid gland, resulting in the thyroid producing two thyroid hormones called L-thyroxine and triiodothyronine. In order to produce these thyroid hormones, dietary iodine must be available to the brain.

The pituitary gland regulates the production of thyroid hormone by sensing how much hormone is in the blood and adjusting the production of hormones as needed. When there is too much thyroid hormone in the blood, the pituitary gland senses this and reduces the amount of TRH and TSH produced until the level of thyroid hormones in the blood returns to normal.

When there is too little thyroid hormone in the blood, the pituitary gland senses this and increases the amount of TRH and TSH produced until the level of thyroid hormones in the blood reaches a normal level. If there is a defect in this thyroid hormone regulatory process, for any reason, hypo- or hyperthyroidism may result.

Causes of Hyperthyroidism

Grave’s Disease: an autoimmune disorder resulting in antibodies stimulating the thyroid and causing too much thyroxine to be released. Antibodies, usually used to protect against viruses, bacteria and foreign substances, attack the thyroid and sometimes the tissues behind the eyes and the skin in the lower legs over the shins. A genetic predisposition appears to be a causal factor of Grave’s Disease.

• Hyper functioning thyroid nodules: the presence noncancerous lumps that form when a part of the thyroid gland walls itself off from the rest of the gland”also called an adenoma”that produce excess thyroxine, thus causing hyperthyroidism. The cause of these adenomas that produce excess thyroxine is unknown.
• Thyroiditis: the inflammation of the thyroid gland, causing excess thyroid hormones to leak into the bloodstream. Some types of thyroiditis cause thyroid gland pain, while others are painless and sometimes occur after pregnancy.
• Autoimmune disease (Hashimoto thyroiditis): an autoimmune disorder resulting in antibodies that attack tissues, affecting the thyroid’s ability to produce hormones.
• Treatment for hyperthyroidism: radioactive iodine or anti-thyroid medications used to treat hyperthyroidism can sometimes result in permanent hypothyroidism.
• Radiation therapy: used to treat cancers of the head and neck, radiation therapy can affect the thyroid gland and lead to hypothyroidism
• Thyroid surgery: the process of removing a large portion or all of the thyroid, resulting in the halting hormone production
• Medications: some, such as lithium, contribute to hypothyroidism
• Congenital disease: birth defect where the thyroid gland did not develop normally in utero
• Pituitary disorder: the failure of the pituitary gland to produce enough TSH, often due to a noncancerous tumor
• Pregnancy: during or after pregnancy some women produce antibodies to their own thyroid gland, resulting in hypothyroidism and putting the pregnancy at risk
• Iodine deficiency: essential for the production of thyroid hormones, the amount of dietary iodine in the body is sometimes too low to assist in the production of thyroid hormones

Symptoms

Many of the symptoms of hyper- and hypothyroidism are uncomfortable and mild. Therefore, thyroid problems are easily overlooked by individuals until they gain in intensity. Symptoms often develop slowly, but as the illness continues untreated the symptoms increase. It is important to know the signs of thyroid problems so medical advice and treatment can be received as soon as possible.

• Sudden weight loss
• Rapid heartbeat (more than 100 beats per minute), irregular heartbeat, or pounding heart
• Increased appetite
• Nervousness, anxiety, irritability
• Tremor, usually in hands and fingers
• Sweating
• Change in menstrual patterns
• Increased sensitivity to heat
• Changes in bowel patterns, especially more frequent occurrence
• Enlarged thyroid gland (goiter), which shows as swelling at the base of the neck
• Fatigue and muscle weakness
• Difficulty sleeping

Additional Symptoms Include:

• Fatigue
• Sluggishness
• Increased sensitivity to cold
• Constipation
• Pale, dry skin
• Puffy face
• Hoarse voice
• Elevated cholesterol level
• Unexplained weight gain
• Muscle aches, tenderness, stiffness
• Pain, stiffness, swelling in joints
• Muscle weakness
• Heavier than normal menstrual periods
• Brittle fingernails and hair
• Depression

Close attention to symptoms common of thyroid problems is essential in diagnosing such problems. While hypothyroidism generally occurs in middle-aged and older women, it is possible for infants and children to develop hypothyroidism as well. The following should be watched for in case of hypothyroidism in infant or children:

• Jaundice: yellowing of the skin and whites of the eyes
• Frequent choking
• Large, protruding tongue
• Puffy face
• Constipation
• Poor muscle tone
• Excessive sleepiness
• Poor growth
• Delayed permanent teeth
• Delayed puberty
• Poor cognitive development

In addition to the various causes of hypothyroidism, there are certain factors that put people at risk of developing the thyroid disorder. These risk factors include:

• A family history of autoimmune disorders
• Having undergone radioactive iodine treatment or taken anti-thyroid medications
• Having undergone radiation treatment to the neck or upper chest
• Having had thyroid surgery

Testing for Thyroid Disease

If concerned about thyroid problems, a medical doctor should be consulted. A comprehensive exam, including a physical exam, medical history, and blood test, can accurately determine if a thyroid disease is present. The blood test is used to determine the level of thyroid hormones in the blood. A low level of thyroxine and a high level of thyroid-stimulating hormone indicates hypothyroidism; while high levels of thyroxine and a low level of thyroid-stimulating hormone indicates hyperthyroidism.

If blood tests indicate hyperthyroidism, the medical doctor may request one of the following additional tests to determine the cause of the overactive thyroid:

Radioactive iodine uptake test: a small oral dose of radioactive iodine is taken, which collects in your thyroid gland, and is checked after 2, 6 or 24 hours to determine how much iodine the thyroid gland has absorbed. If a high amount of radioiodine has been absorbed, the thyroid gland is producing too much thyroxine and the cause of the hyperthyroidism is most likely Graves disease or hyper functioning nodules. If the amount of radioiodine absorbed is low, the cause of the hyperthyroidism is likely thyroiditis.

Thyroid scan: radioactive isotope is injected into the side of the elbow or hand, and a special camera produces an image of the thyroid on a computer screen.

It is extremely important that these additional tests be done in order to determine the cause of the hyperthyroidism, and to ensure the proper treatment of the disease.

Thyroid Disease Treatment

Thyroid disease is a serious medical problem that has no cure or ways to prevent it from occurring. However, the good news is that thyroid disease can be effectively managed with the proper treatment.

Hyperthyroidism Treatment

Radioactive Iodine

Taken orally, radioactive iodine is absorbed by the thyroid gland causing it to shrink and symptoms of hyperthyroidism to subside. Side effects include slowing thyroid activity to the point where medication may be needed every day to replace thyroxine.

Anti-thyroid Medications

Medications that gradually reduce symptoms of hyperthyroidism by preventing thyroid gland from producing excess hormones. Side effects include liver damage.

Beta Blockers

Drugs common for treatment of high blood pressure that do not reduce thyroid levels, and which reduce rapid heart rates and prevent palpitations. May be prescribed until thyroid levels are in the normal range.

Surgery

Removal of most of the thyroid gland. This is used only in rare cases and when anti-thyroid medications cannot be tolerated. Side effects include damage to the vocal cords and parathyroid glands, the need for lifelong treatment to supply body with normal amounts of thyroid hormones, and the need for medication to keep blood-calcium levels normal.

Treatment for hypothyroidism is the prescription of an oral medication that is a synthetic thyroid hormone levothyroxine. This treatment is usually lifelong, though the symptoms of hypothyroidism will begin to alleviate after only a few weeks. This treatment requires a blood test 2 -3 months after beginning oral medication in order to determine TSH levels.

There are virtually no side effects associated with the proper dosage of this medication, though some supplements, medications and foods may interfere with the effectiveness of the medication. The doctor should be made aware of a high soy or fiber diet, as well as medications taken such as iron supplements, Cholestyramine, Aluminum hydroxide (found in antacids), and calcium supplements.

At Home Remedies

There are various at-home remedies believed to assist in the treatment of thyroid disease. However, it is important to note that these herbal and home remedies are not monitored by the FDA and their efficacy cannot be guaranteed. Before choosing these alternatives as treatment, a medical doctor and/or naturopath should be consulted.

• Kelp seaweed: antioxidant containing iodine, which helps in the functioning of the thyroid
• Bladderwack: high in iodine and therefore beneficial for hypothyroidism
• Vitamin B Complex: improves cellular oxygenation and energy, and assists with digestion, immunity and thyroid functioning
• Primrose Oil: essential fatty acid, important for thyroid functioning
• Irish Moss: nourishes the thyroid
• Siberian Ginseng: helps adrenal and thymus glands, which supports thyroid health
• Black walnut: rich in organic iodine and manganese that nourishes and strengthens thyroid function
• Vitamin A rich foods: yellow vegetables, eggs, carrots, and dark green vegetables help in thyroid functioning

In addition to the at-home natural remedies listed above, there are various nutritional supplements available in pill form at organic and naturopathic stores, as well as online. These range in price from $10 – $50 depending on the brand purchased, the store or online retailer purchased from, and the size of the bottle purchased.

As with all issues relating to health, diet and exercise are important factors in the well being of our bodies. Whether pharmaceutical, surgical or at-home remedies are used as treatment for thyroid disorder, a healthy diet and exercise plan can help to increase not only the health of the thyroid, but of the body as whole.

When the sebaceous glands produce too much oil, it can get trapped under the skin, combine with dead skin cells, and clog the pores. When this happens, bacteria can build, and cause inflamed, puss-filled bumps known as pimples, zits, or acne.

Teenagers are prone to pimples because of their overactive hormones during puberty. And women are more likely than men to get pimples because of the hormonal changes that happen during menstruation, and pregnancy. But these unsightly bumps can affect children as young as 10, and adults well into their forties.

There is no single cause for pimples; this skin condition can be the result of many combined factors. Some of these zit-causing reasons include hormones, exposure to oils, stress, using the wrong skincare products, and pressure from wearing helmets or chinstraps. Medications such as those containing lithium, iodides, steroids, and bromides can also contribute to pimples, and worsen existing breakouts.

Pimple breakouts can range in severity, and since everyone’s skin is different there is no one size fits all method for zapping zits. A combination of lifestyle changes, medications, and natural home remedies can be used to clear existing breakouts and prevent new ones from occurring.

Drug Treatments for Pimples

Over the counter creams, cleansers, and gels that contain benzoyl peroxide and salicylic acid are the most commonly used topical medicines for treating mild breakouts. Salicylic acid is a beta hydroxyl acid that promotes rapid shedding of the skin cells. This acne-fighting ingredient also neutralizes bacteria, and constricts pore diameter to reduce pore blockage. Salicylic acid can cause irritation, dryness, peeling, burning, and stinging of the skin. Using other acne-fighting ingredients with salicylic acid can increase burning.

Benzoyl peroxide is an organic compound that acts as a peeling agent to increase skin turnover, clear pores, and reduce bacteria count. The most common side effect of benzoyl peroxide is irritation, and drying of the skin. After a week of using products that contain benzoyl peroxide, the skin builds a tolerance and the drying, and irritation will usually subside.

Less common side effects of benzoyl peroxide include burning, swelling, itching, and peeling. This acne-fighting ingredient can bleach hair, and clothes, so it should be applied with care. Although creams, gels, and cleansers that contain salicylic acid and benzoyl peroxide are available over the counter, pregnant women, and women who are nursing should consult a doctor before using them on their skin.

Simple Breakouts and Antimicrobials

Unfortunately, severe pimple breakouts are not easy to get rid of with over the counter medicines. These types of breakouts usually require the help of a dermatologist. A dermatologist will evaluate the skin, and determine the best way to heal current breakouts, prevent new ones from forming, and reduce the risk of scarring.

Dermatologists commonly prescribe topical antimicrobials, topical retinoids, or oral antibiotics to treat pimples. These medications can be prescribed alone, or in several combinations to improve their effectiveness.

Topical antimicrobials inhibit the population of the p.acnes bacteria, and promote healing of breakouts. Common types of antimicrobials prescribed by dermatologists include:

Azelaic acid

Azelaic acid occurs naturally in the skin and is used to treat both inflammatory and non-inflammatory acne. Side effects of this drug include dryness, and lighting of the skin.

Clindamycin

Clindamycin is a semi-synthetic antibiotic that treats acne. Side effects of this drug include skin dryness, and irritation. Since clindamycin is a topical antibiotic, there is a chance of bacterial resistance if it is not used as directed.

Erythromycin

Topical erythromycin is an antibiotic that is usually combined with benzoyl peroxide to increase effectiveness. Side effects of this drug include drying of the skin, and irritation. Use erythromycin as directed to reduce the risk of bacterial resistance.

Sodium sulfacetamide

Sulfacetamide is usually used to treat inflammatory acne. This drug opens clogged pores, and kills bacteria. The smell, and grittiness of products containing sulfur is strong, and may not appeal to users.

Benzoyl Peroxide

Although benzoyl peroxide can be found in drug stores, dermatologists may find it necessary to prescribe stronger concentrations of this medicine to treat pimples.

Topical retinoids are a derivative of vitamin A. These retinoids work to unclog pores, and prevent pimples from forming. Commonly prescribed topical retinoids include:

Tazarotene

Tazarotene is a synthetic retinoid that should not be used by pregnant women due to the increased risk of birth defects. Side effects of this medication can include skin irritation.

Adapalene

Adapalene is a synthetic retinoid that acts as an anti-inflammatory. Side effects of this drug include skin irritation, and dryness.

Tretinoin

Tretinoin is a natural retinoid that can effectively unclog pores. This drug is very harsh on the skin. Side effects include dryness, irritation, redness, burning, itching, and scaling. Some of these side effects can be minimized by reducing the amount of medication applied to the skin.

Oral Antibiotics

Oral antibiotics are effective at treating persistent acne. When taken orally, antibiotics reduce the p.acnes population, and reduce inflammation to promote healing of pimples. Antibiotics are not typically prescribed for more than six months; if overused, these drugs can cause resistance to bacteria. Commonly prescribed oral antibiotics include:

Erythromycin

When taken internally, erythromycin can cause irritation of the gastrointestinal tract.

Tetracycline, Doxycycline, and Minocycline

These drugs are effective at reducing inflammatory pimples. Tetracycline, and derivative drugs affect the development of bones and teeth, so they should not be used by children under the age of eight, and pregnant or breastfeeding women. Doxycycline is especially effective at treating inflammatory acne. In addition to skeletal damage in children, doxycycline can cause sun sensitivity.

Sometimes pimples can start deep in the skin, and form cystic acne. Cystic acne is the most difficult type of breakouts to treat. If cystic pimples are not treated properly they can become severely inflamed, rupture, and cause permanent scarring of the skin. In cases such as these, dermatologists may need to administer inter-lesional corticosteroid injections to reduce inflammation and promote healing. Skin doctors can also drain, and extract puss from large cysts to speed healing.

Isotretinoin

Isotretinoin is a man-made retinoid used to treat cystic acne that does not respond to other medications. This drug is taken in pill form up to twice a day for 16 to 20 weeks, and the results can last for years. Isotretinoin is used hesitantly due to the long list of serious side effects. One such side effect includes the possibility of severe birth defects in developing fetuses.

Women who use isotretinoin should use two forms of birth control for one month before starting the drug, during the entire treatment, and one month after treatments end. Women should not breastfeed while taking isotretinoin, and they should talk to a doctor to get an all clear before getting pregnant after taking the drug.

Other Side effects of Isotretinoin Include:

• severe chest pain
• severe abdomen pain
• blurred vision
• dizziness
• severe headaches
• bone pain
• joint pain
• nausea and vomiting
• rectal bleeding
• diarrhea
• depression
• skin dryness
• dryness of the eyes
• dryness of the nose
• hair loss

These topical retinoids, topical antimicrobials, and oral antibiotics are approved for use in the United States, and may not be regulated for use on pimples in other countries.

Oral contraceptives regulate hormones, and keep oil glands under control, so they may also be prescribed as a way to reduce breakouts in women. Oral contraceptives may not be appropriate for women over the age of 35, those who have blood clotting disorders, and women who smoke.

Natural Remedies for Pimples

Drug treatments are not the only way to manage pimples; natural treatments can also be used for mild cases. Natural treatments may take longer to work, but they are cheaper than medication, and less likely to cause adverse side effects. Here are some home treatments that can be used to banish pimples from the skin.

Tea tree oil “ tea tree oil has antiseptic properties that can reduce acne-causing bacteria and clear acne blemishes. Tea tree oil should not be used at full strength. Instead, mix 5 percent tea tree oil with 95 percent water. You can also purchase premixed ointments from health food stores, or online vendors.

White vinegar and garlic juice mix “ vinegar regulates PH levels in the skin, and garlic has antibacterial and antimicrobial proprieties that kills infections, and helps repair skin. Use a juicer or cheesecloth to extract the juice from two cloves of garlic, and add two tablespoons of vinegar. Use a cotton ball to apply the mixture to affected areas. Let the vinegar, and garlic sit for 20-minutes, and rinse it off with warm water.

Steam facials “ steaming the face three times a week for 15-minutes per session can unclog pores, and release oil, and dirt form the skin.

Oatmeal facial “ oatmeal tones the skin, soothes irritation, and pulls impurities from the pores. Use a blender to crush oatmeal into a fine powder. Add a little warm water to the oatmeal powder, and mix. Apply the oatmeal to the face, let it dry, and then rinse it off with warm water.

Grapefruit seed extract “ grapefruit seed extract has antiviral and antibacterial properties that can kill bacteria, and heal acne. Mix three drops of grapefruit seed extract with one tablespoon of water. Apply the mixture to pimples with a cotton ball.

Lifestyle Changes to Prevent Pimples:

Although there is no single cause of pimples, lifestyle factors can play a role in breakouts. Here are some things you can do to reduce the likelihood of clogged pores, bacteria, and oil buildup.

Keeping Your Face Clean

Wash your face twice a day with a soft washcloth, and a mild cleanser. Avoid using harsh scrubbing sponges on the face because this can cause irritation, and injury to the skin.

Keep your hands out of your face. Popping or picking at pimples can transfer dirt and bacteria, increase inflammation, and worsen breakouts. On those rare occasions when you have to touch your face with your hands, wash them first.

Washing Pillowcases

Keep pillowcases, and sheets washed regularly to keep dirt, bacteria, and oil from building up, and transferring to your face. Wash hair regularly, and don’t use oily products on the hair.

Exercise

Exercise for at least 30-minutes a day. Regular exercise can decrease breakouts by reducing stress, and regulating hormones. Sweating also slows down the production of oil in the glands, and reduces the likelihood of pimples.

Make Up & Cosmetics

Switch to cosmetic products labeled, Noncomodegenic or Oil-Free. These types of cosmetics reduce the likelihood of allergic reactions, and clogged pores.

Use clean makeup sponges to apply makeup. And wash makeup brushes regularly to prevent the transfer of bacteria.

A face full of pimples can cause you to shy away from social situations. But having zits is not the end of the world. With the wide range of medicines and natural treatments available, embarrassing breakouts can be effectively managed.

Overview

Tuberculosis (TB) is a deadly, highly contagious disease cause by the gram positive bacterium Mycobacterium tuberculosis. The history of tuberculosis and humans has been intertwined since ancient times. There is evidence than Neolithic aged, prehistoric humans had contracted TB as early as 7000 years ago. TB can also infect animals.

Evidence of TB has also been found in bison dating back 18000 years. TB was widespread in antiquity, with evidence of the disease being found in Egyptian mummies, dating back several thousands of years. TB was also known to the ancient Greeks who called the disease phthisis. Until TB was found to be bacterial in origin, the disease was commonly referred to as consumption.

TB has been responsible for millions of deaths throughout history, taking the lives of many famous individuals including the Bronte sisters, Frederic Chopin, George Orwell, Anton Chekhov, John Keats, and Elenore Roosevelt. TB continues to be a threat to this day, even with modern medical advances and treatments.

The German bacteriologist and physicist Robert Koch isolated Mycobacterium tuberculosis, the bacterium that causes TB, in 1882. At the time, despite the efforts of Louis Pasteur and other leading scientists, it was common knowledge that infections happened spontaneously in humans. The idea that bacteria, viruses, or other microscopic organisms could cause disease was incomprehensible for the layman. However, as germ theory gained more proponents, and as medicine has advanced, today that line of thinking has given way to modern theories of infectious disease. Koch was awarded the 1905 Nobel Prize in medicine and physiology.

Alternate Names

Tuberculosis has several alternate names. It’s most common alias is consumption. The term consumption was coined in the 18th and 19th centuries as a way to describe TB’s wasting away effect on the human body. People stricken win the disease were consumed with coughing and fatigue during the disease’s terminal stage, leading to the common name. Tuberculosis infections often leave victims with a pale, ghost-like complexion. Because of this, TB has also been nicknamed the White Plague. In humans, the primary form of TB infection is pulmonary tuberculosis.

Symptoms

In three quarters of the cases of tuberculosis, infection occurs primarily in the lungs. This is called pulmonary tuberculosis. Symptoms include:

• Productive cough lasting over three weeks
• Chest pain
• Coughing up blood or bloody sputum
• Fever
• Chills
• Fatigue
• Weight Loss
• Pale appearance
• Loss of appetite
• Night sweats

Tuberculosis can also infect other areas outside of the lungs including the bones, blood, and central nervous system.

Causes of Tuberculosis and Means of Infection

Tuberculosis is an airborne disease, meaning that it can spread from person to person by inhaling tiny droplets of mucus and sputum. These droplets get into the air for people it inhale when an infected person coughs, spits, sneezes, or even talks. It has been shown that one sneeze or cough can release tens of thousands of microscopic droplets of bacteria-rich sputum into the air. Infection by the TB bacterium can occur by less than ten of the bacteria, so the potential for widespread infection is tremendous. The incubation period for tuberculosis is between 2-12 weeks. This is the time that it takes for a TB test to detect the disease.

Tuberculosis can lie dormant in a person’s bodies for several years. In one out of ten patients, latent TB can develop into an active TB infection. A person is only contagious if he has an active form of TB infection. Latent TB carriers cannot transmit the TB bacterium to other people. Even though infected with the tuberculosis bacterium, nine tenths of those afflicted will have latent tuberculosis. Out of those 90% of people, 10% will develop active TB in their lifetimes.

When a person inhales aerosol droplets of infected mucus, the infection begins when the bacteria reach the alveoli of the lungs. Infection usually occurs between the upper part of the lower lobe or the lower part of the upper lobe of one of the lungs. Once infection has set in, TB can spread throughout the body through the lymphatic system and blood stream.

Bacterium

Tuberculosis bacterium can cause the immune system to produce what is called a granulomatous inflammatory response. Put simply, this is method employed by a person’s immune system in which it attempts to build a wall around pathogens it is unable to destroy. This is done in hopes that isolating the pathogen from the other cells will cause it to die. In the case of tuberculosis, when a TB bacterium is “walled off” it forms a structure called a granuloma. These granulomas can cluster together to form nodules called tubercles or tuberculosis nodules. The TB bacterium can cause necrosis (cell death) in the tubercles, causing tissue damage to the lungs.

Tuberculosis bacteria can also spread through the body via the blood stream and/or the lymphatic system. When it does this, it can produce a systemic infection of the body, including the brain and bones. This is an extremely dangerous form of TB called miliary tuberculosis. Most often, this strikes the immune suppressed, elderly, and children.

Patients with tuberculosis can go through periods where the disease changes in its severity, shifting between good and bad periods for the patient. In this time, tissues can be destroyed and repaired although scarring occurs.

Risk Factors

A condition called silicosis may increase the risk of tuberculosis infection by a factor of 30 in people suffering from the affliction. Silicosis is an occupational hazard disease that is the result of inhaling too much silica. Silica dust is crystalline and rough in texture, which can cause inflammation and scarring in the lungs. Silicosis inhibits the function of white blood cells in the lungs. In a human, when a foreign body is detected by the immune system, specialized white blood cells are released to kill the invading pathogens.

Another risk factor for being infected with tuberculosis is being on dialysis. Because people on dialysis are generally in worse health than the rest of the population and because their immune systems may be compromised due to this weakened state, the risk of developing a TB infection increases by 10-25 times that of the normal population.

Having a low body weight in relation to height may increase the risk of becoming infected by TB by a factor of 2 to 3.

Another group that is at a higher risk of developing TB than the general population is diabetics. Diabetes, especially in patients with poorly controlled glucose and insulin levels can elevate the chances of getting a TB infection by 2-4 times.

Certain drugs may also put a person at increased risk for being infected with TB. Immunosuppressants and some rheumatoid arthritis drugs may increase the chance of infection.

Tests and Diagnosis

When confirming a case of tuberculosis, several steps are taken to develop an accurate diagnosis because many of the symptoms of TB resemble those of less serious diseases.

When a patient first presents with symptoms consistent with a diagnosis of tuberculosis, a physician will take a detailed medical history of the patient. This allows the doctor to gain an overall picture of the person’s health. A patient’s medical history may include known instances of exposure to TB, prior TB infections, and any medical conditions like silicosis that may increase the chances of being infected by tuberculosis.

Although a physician may suspect tuberculosis from the symptoms, it is impossible to make an absolute conclusion without bacterial cultures being taken. Sputum cultures are taken and smeared onto growth medium in Petri dishes. The samples are allowed to incubate for a period of time, during which the bacteria can grow and multiply. After several hours or days, the dishes are examined under a microscope by a pathologist who can determine what bacteria are present in the sample. If tuberculosis bacteria are found, that is a definitive sign that the patient is indeed infected with TB and may have an active form of it.

Chest X-rays

Chest X-rays are often helpful to chart the progression of tuberculosis but not enough on their own to make a definitive diagnosis. When an abnormal chest X-ray is obtained from a patient, a radiologist may look at the film and find indications that suggest an active case of tuberculosis. These include:

1. Patches that may indicate foreign matter

2. Holes without irregular margins

3. Nodules with hazy edges

4. Fluid

5. Enlarged lymph nodes

Evidence of inactive tuberculosis can also be found on a chest X-ray. These signs include:

1. Scar tissue

2. Nodules with distinct edges

Tuberculosis Skin Tests

The Mantoux test is a skin test that is used for screening for tuberculosis. In this test, a patient is injected with a small amount of a protein derived from the TB bacterium called tuberculin. Although the injection of tuberculin into a patient will not cause a tuberculosis infection, the body’s immune system will take action and react to the foreign agent. The test can take 2-3 days before results can be seen. In a negative test, there will be no swelling at the injection site. For a positive result, a small bump ranging in size from 5 to 15 mm will appear at the spot of the injection.

A positive result means that a person has been exposed to TB. The size of the bumps in different groups of people determines a positive result. In immune suppressed persons, a 5 mm bump is enough to be considered a positive result. A 10 mm bump is required for a positive result in person who have been exposed to high risk environments or in those who have chronic diseases that put them at a higher risk of developing TB. Finally, to obtain a positive result in people with no known risk factors for TB, a bump greater or equal to 15 mm is required.

Interferon gamma release assay tests are new blood tests that can detect the presence of TB bacterium. In these tests, a sample of blood is drawn from the patient and mixed with antigens. Antigens are molecules that produce a response from the immune system. The test is based on the fact that white blood cells that are active during the immune response will release a chemical called interferon gamma when exposed to particular antigens — in this case for TB. After a period of 12-16 hours, the amount of interferon gamma is measured to determine whether or not a person is infected.

Treatment Options

Without treatment, tuberculosis has a mortality rate of between 50% and 66%. Treated, the mortality rate for TB drops to 5%. Standard treatment of tuberculosis depends heavily on antibiotic regimens. The TB bacterium is very hardy and poses difficulty for antibiotics to gain entry into its cells. Unlike other bacterial infections, which can take a matter of days to clear with standard antibiotic therapy, tuberculosis treatments require periods of 6-24 months of antibiotic treatment to full rid the body of the bacteria. For active TB, the antibiotics of choice are rifampicin and isoniazid. In latent TB, only isoniazid is required.

The main problem with standard treatment options is the duration of treatment time, over the course of up to 2 years, can lead to patients who become non-compliant. Non-compliant patients are those who do not follow the course of treatment as prescribed and skip doses of antibiotics. A number of reasons may contribute to patient non-compliance including:

• The size of the pills
• The fact that some pills must be taken with food
• Forgetfulness
• Lack of motivation because the treatment lasts so long
• Prematurely assuming they are cured

It is very important to maintain a proper regiment when undergoing antibiotic treatment for tuberculosis because TB may not be fully eradicated or antibiotic resistant strains of TB may develop.

In recent years, drug resistant tuberculosis has become a major health issue. Drug resistant tuberculosis is TB that has mutated in such a way that rifampicin and isoniazid are no longer effective. Drug resistance can develop when patients skip doses of their medications. While the medications may kill off most of the bacteria, there are always some that survive the first doses.

When a person skips doses, these hardier bacteria survive and multiply. The person may restart the treatment, again killing all but the strongest bacteria. They may stop taking the drugs again, and the cycle repeats until eventually, fully drug resistant bacteria are born. These can be very difficult to treat since they have immunity against the most effective TB antibiotics.

To treat drug resistant TB, other, less effective and less efficient antibiotics may be used, however they may not be enough to stem the attack. In these cases, surgery to remove an infected part of the lung may be the only option.

Prevention

Preventing the spread of tuberculosis can be accomplished by treating those who are infected and those who have come in contact with the infected. Also, proper sanitation techniques such and hand washing, not touching one’s face, and wearing masks in high risks areas can help to prevent infection. A TB vaccine is available for children in high risk areas. Vaccinations of children for TB are common in developing nations that have a high rate of TB infection. Although the vaccine prevents TB in up to 80% of children, it is ineffective in protecting adults from pulmonary tuberculosis which is the most common form found in the world today.

Conclusion

Tuberculosis has been with human kind since antiquity and remains a problem to this day. In fact, tuberculosis is the most widespread disease in the world, infecting 1/3 of the world’s population. With the population of the earth nearing 6 billion people, that means that 2 billion are infected with TB. Most of these cases are latent TB, but active TB will develop in 10% of those infected. Without treatment, TB is often fatal, however, with modern antibiotics, the mortality rate of treated TB is less than 5%.

Many efforts are being made in TB research to create a vaccine that can be used universally to prevent TB in all groups. With any luck, in the near future, tuberculosis may finally be a distant memory with advancements in modern biochemistry and medicine. Until then, it is important to get screened for TB and to recognize its symptoms. Treated early and decisively, TB can be tamed, but waiting too long can lead to a less favorable outcome.

Dizziness Overview

Dizziness, often referred to as vertigo or feeling light-headed, is associated with a multitude of conditions. It can be a side effect of a common ailment, or it may indicate the presence of a more serious and even life threatening illness.

Vertigo, while often associated with dizziness, is a little bit different and can be described as the sensation of motion or spinning of either yourself, or objects around you. People diagnosed with multiple sclerosis may present with sudden vertigo due to limited ability to move the eyes.

Dizziness can accompany many health issues including:

• Fainting or near fainting, loss of consciousness.
• Changing your posture too fast, such as standing up quickly, or sudden movement after an extended period of being still. People who have undergone an extended period of bed rest may experience dizziness after getting up.
• Motion sickness that may or may not be associated with a car, plane, boat or other mode of transportation.
• Fatigue due to lack of sleep or illness.
• Flu or severe cold.

Dizziness Symptoms

While the feeling of dizziness is a symptom by itself, it is often accompanied by other symptoms which may include:

• Confusion and disorientation.
• Balance Issues or problems with equilibrium.
• General fatigue due to lack of sleep or illness.
• Feeling light-headed.
• Feeling pale, weak or having the cold sweats.
• Headache or migraine.
• Chest pain.
• Vomiting or nausea.
• Tingling and weakness in the arms and legs.
• Numbness in the face, arms or legs.
• Abnormal pulse, either faster or slower than usual.

Common Causes of Dizziness

The feeling of being light-headed or dizzy can stem from a myriad of causes ranging from less serious to life threatening and may include:

• High or low blood pressure
• Heart irregularities or a weakened heart muscle
• Stroke
• Tumor
• Headaches or migraines, sinus congestion or allergies
• Fainting or near fainting
• Dementia or other age related conditions
• Consumption of drugs or alcohol
• Inner ear issues such as infection
• Medications, or missing a dose of a prescribed medication
• Blood oxygen levels
• Low blood sugar
• Dehydration due to illness, physical activity or heat stroke
• Blood circulation issues
• Hardening of the arteries
• Neuropathy, a side effect of diabetes
• Anemia
• Infection
• Internal bleeding
• Diseases involving the thyroid, adrenal glands or pituitary gland
• Depression and anxiety
• Hyperventilation
• As a side effect of radiation or chemotherapy
• Carbon monoxide toxicity

Dizziness can also be a side effect of the following conditions:

• Ménière’s disease
• Peripheral vestibular disorders
• Central neurological disorders
• Heart Disease
• Cancer
• Down syndrome
• Cervical spondylosis
• Multiple sclerosis
• Addison’s Disease
• Alpine syndrome
• Anorexia Nervosa

If your dizziness is accompanied by one or more of the following issues, you should contact your doctor, call 911, or visit the emergency room:

• A head injury
• Severe dehydration and confusion
• Chest pain
• Loss of consciousness
• High fever

Signs of a stroke, including a change in vision or speech, loss of movement in any part of the body, weakness, shortness of breath.

Tests and Diagnostics

If your dizziness is severe or lasts more than a few days, and is not associated with another ailment or condition such as the flu, cold, or other common illness, you may need to visit your doctor to find out the cause. He will likely ask a series of questions and run one or more tests to check for contributing factors.

Your doctor will ask you to describe the dizziness, when it started and any other factors that may have accompanied the sensation of feeling light-headed. He will also review your medical history to rule out any past illnesses or injuries as the source and may ask for a brief description of your family’s medical history as well.

Common questions your doctor may ask include:

• What are your major symptoms?
• Are you taking any medications?
• Do you have any medical conditions?
• How long have you been experiencing these symptoms?
• Have your sleeping patterns changed. Are you getting more or less sleep than usual?
• Is the feeling of dizziness constant, or does it come and go?
• What were you doing when you first experienced the dizziness?
• Have you noticed anything that seems to make the symptoms better or worse?
• Do certain movements make the symptoms better or worse?
• Do you have any allergies, or have you had an allergic reaction to anything?

In order to answer these questions fully, you may want to keep track of your symptoms in a notebook, and bring it to your doctor appointment. Be sure to include dates, times, durations of symptoms and any food or beverages consumed, and any other circumstances that may have contributed to feeling dizzy. The more information you can give your health care provider, the easier it will be to diagnose and treat the dizziness.

Sometimes, depression or anxiety can manifest in physical symptoms such as pain, fatigue, head and muscle aches. Your doctor may also ask a series of questions relating to your emotional state to determine if the dizziness is perhaps related to a psychological or emotional issue.

• Were you under a lot of stress when you experienced the dizziness?
• Do you worry about things that are out of your control?
• Are you sleeping more or less than usual, or eating more or less than what is considered normal?
• Were you in a crowd or a social situation such as a concert, party or at a mall or sporting event when you felt dizzy?
• Have you been feeling depressed or anxious lately?
• Have you had thoughts of suicide?
• Do you have a history of suffering from panic or anxiety attacks?

Have you experienced any major life changes such as loss of a loved one, the birth of a child, a major career change, a divorce or any event that has led to a significant change in your life? Even happy occasions such as a wedding or moving to a new home or city can spark anxiety.

Additional Tests

• Measurement for low or high blood pressure.
• ECG (Electrocardiogram) which records the heart’s electrical activity.
• ENG (Electronystagmography) which checks for involuntary eye movement.
• MRI (Magnetic Resonance Imaging) which can help doctors look for tumors, spine issues, neurological malformations or any other issues that can otherwise go undetected.
• Neurological tests that measure things such as coordination, balance, recall. He may also ask a series of questions to help determine if you have suffered any memory loss, such as whether or not you can recall the date, year and current United States president.
• Your doctor will also check your reflexes.
• Hearing tests to determine if related to an inner ear problem.

Risks

Dizziness can affect your balance, as well as a multitude of your daily activities such as driving, climbing stairs or lifting heavy objects. To avoid an injury resulting from a fall, you should hold off on any activities that may pose a danger. You should also take a break from exercise as physical activity can cause your symptoms to get worse.

Dizziness is often a symptom of a more serious condition, so if left untreated, it can lead to severe injury. Diseases such as diabetes, cancer, a heart condition and many other problems may advance if they go undetected for too long.

Clinical Treatment for Dizziness

Because the causes of dizziness vary, treatment options are different for each case and may include:

• Emergency care may be administered if due to a heart attack, stroke or other life threatening condition. Many of these conditions may also require surgery, as well as extended aftercare and lifestyle changes to avoid future episodes.
• Whether from physical activity, heat stroke or due to illness, IV fluids may be given if the dizziness is symptom of dehydration.
• If your dizziness is due to a medication you are currently taking, your doctor may prescribe a new medication for you to try.
• Inner ear issues may require treatment using an antihistamine.
• If you have an infection, your doctor may prescribe an antibiotic.

Balance therapy may be required for patients who need to re-learn basic balance skills, such as those dealing with dementia, stroke or the general effects of aging.

Stress management, therapy and antidepressants may all prove beneficial to those suffering from dizziness as a side effect to depression or anxiety. Patients who are experiencing dizziness due to emotional or psychological issues may also benefit from learning how to deal with an anxiety or panic attacks through deep, controlled breathing and other calming techniques, such as meditation and biofeedback.

You may be treated with oxygen. In severe cases, surgery may be required.

Home Treatment Options for Dizziness

If you feel dizzy and like you are about to faint, sit down and squeeze your thighs together. This forces the blood back up from your extremities to the brain, helping to ward off the feeling of light-headedness.

Try sitting down and putting your head down between your knees, this has the same effect as squeezing your leg muscles.

Sometimes lying down is the only way to combat feeling dizzy, especially if it is the result of general fatigue or lack of sleep.

Preventing Dizziness

Stay hydrated during illness, exposure to heat or physical activity by drinking plenty of fluids. If you plan on spending time outdoors in high temperatures, be sure to stay as cool as possible and find shade if necessary. Get early medical care for infections or illness including infections of the inner ear, sinuses and respiratory system.

If you or someone in your household is dealing with dizziness, take some extra precautions to avoid injury, such as using non-skid inserts under rugs and in the shower, or providing a cane to allow for support when moving about the home.

Avoid substances like caffeine, tobacco, alcohol or other drugs that can affect circulation.

If you or someone in your life is dealing with depression and/or anxiety, and often experiences dizziness during social situations, or when under stress, you may need to provide reassurance to that individual or accompany them to a quiet location until the episode has passed. If you are the one experiencing the anxiety, you may benefit from practicing calming exercises and positive self-talk to not only prevent anxiety or panic attacks, but to also learn how to recognize the signs and to stop them before they start.