stomach pain

The gallbladder is tucked up underneath the liver on the right side of the body. Its main function is to store bile – historically called “gall” – which is produced by the liver and carried to the common hepatic duct and the gallbladder through a series of tubules or ducts (bile ducts) embedded in the liver tissue. Normally 3-5 inches long, an inch wide and shaped like a tiny eggplant, the gallbladder can store about 1/4 cup of bile.

A tube called the cystic duct connects the gallbladder to the larger common hepatic duct to form the common bile duct. Not all bile goes to the gallbladder; some of it flows directly from the liver to the common hepatic duct to the common bile duct. The bile that goes to the gallbladder becomes concentrated by removal of fluids. When a meal is eaten, hormonal signals cause the gallbladder to contract and eject its bile.

Just before it connects with the duodenum or the first section of the small intestine, the pancreatic duct joins with common bile duct. A ring of muscle called the Sphincter of Oddi regulates passage of both bile and pancreatic juices into the small intestine. There the bile mixes with food that has come from the stomach and helps to emulsify and digest fats.

Gallbladder Disorders

Gallstones

Conditions that interfere with the flow of bile are the common sources of gallbladder disorders. Chief among these are the occurrence of gallstones (choleliths). Gallstones can be like sand grains or as large as a walnut. There are two main types of gallstones, pigment gallstones, made mostly of bilirubin, which is the breakdown product of red blood cells, and calcium salts and cholesterol gallstones.

Cholesterol gallstones are commonest and are yellowish or greenish in color. Pigment gallstones are dark-colored, either brown ones found in the bile duct or black ones found in the gallbladder. The liver synthesizes about one-quarter of the body’s daily cholesterol requirement, and it is fed into the bile along with other liver products. The liver oxidizes some cholesterol into bile salts, also called bile acids.

Gallstones cause problems when they become large or numerous enough to block bile flow within the liver, the gallbladder or the ducts between the gallbladder and small intestine. People often have gallstones but do not have symptoms (silent gallstones), in which case they are not of medical concern. The presence of gallstones in the gallbladder is called cholelithiasis; if they occur in bile ducts the condition is called choledocholithiasis. Gallstones can also block the pancreatic duct, leading to pancreatitis.

Symptoms

The symptoms of gallstone blockage, usually referred to as a gallstone attack or biliary colic, are pain in the upper right, sometimes central, abdominal region, nausea, vomiting, referred pain between the shoulder blades or below the right shoulder blade. Abdominal pain can be severe and is due to the swelling of the gallbladder and/or ducts as bile builds up due to the blockage or the passage of stones through a duct.

Presence of gas and burping can also occur. Consuming a lot of food at one sitting can trigger an attack. Often attacks occur during the night. Gallstones can move about, and symptoms often abate as they reposition themselves or are excreted and allow a renewed flow of bile.

Symptoms of more advanced gallstones, where the blockage remains in place for longer periods of time or if infection sets in, are chills and fever, jaundice or a yellow tinge to skin and eyes, pain that doesn’t go away, and light-colored stools. It is the presence of bile that gives stools the characteristic brown color. When such symptoms occur, medical help should be sought immediately.

Causes

Gallstone formation is thought to be influenced by inherited factors, by conditions that affect how often and how well the gallbladder empties, and bile imbalances such as excess cholesterol or bilirubin or lower levels of bile salts. For instance, elevated levels of estrogens encourage the liver to increase the amount of cholesterol in bile.

This higher amount of cholesterol in bile, plus possible imbalance in bile salts, which are necessary to keep the cholesterol in a liquid state, makes gallstone formation more likely. Progesterones reduce the movement of the gallbladder so that it doesn’t empty as often or as completely, allowing bile to concentrate further and crystals of cholesterol or precipitates of bilirubin and bile salts to form.

These clump together and harden to form gallstones. If there are narrow places or constrictions along any of the ducts between the gallbladder and the duodenum, blockages can more readily lodge in those areas.

People who have decreased gut motility and hence decreased gallbladder activity due to such causes as being bedridden, limited food intake, or nutrition by IV are also susceptible to gallbladder disorders. These people are likely to produce not gallstones but “sludge” or pseudoliths – small particles of cholesterol, calcium and bile salts which can also produce blockages.

Risk Factors

Risk is elevated in the following categories:

• women
• overweight people.
• people over 40 years old.
• women who have borne multiple children.
• those who have a history of gallstones in their family.
• women who have higher estrogen levels due to pregnancy or medications containing estrogen.
• those who eat foods low in fiber, high in cholesterol and saturated fats.
• people who come from certain ethnic backgrounds: Caucasian, Hispanic, Native American.
• those who take cholesterol-lowering drugs.
• people consuming no-fat or very low-fat diets.
• those who have decreased gallbladder motility due to illness, disease, paralysis, decreased oral intake of food.
• people who have rapid weight loss such as that associated with bariatric surgery or extreme diets.
• people with diabetes.
• those with excess bilirubin in bile due to blood disorders like chronic hemolytic anemia.

Prevention Tips

Estrogen and progestin. Since being female is a risk factor, female hormones estrogen and progestin are implicated in the eventual expression of symptomatic gallbladder disease. The increase of estrogen after pregnancy can be lessened when a woman breast-feeds her child, since milk production keeps her estrogen level low. Considerations should also be given to the amounts of estrogen in birth control formulations and in hormone replacement therapy given around the onset of menopause. The length of use is also important. Hormone replacement therapy has been shown to signficantly increase the number of gallbladder surgeries done.

Maintaining a healthy body weight. Being overweight increases the risk of getting gallbladder disease. In addition, fat tissue produces estrogen, which is a risk factor for developing gallbladder disorders.

Dietary considerations. Eating regular meals of moderate size and foods high in fiber content helps intestinal tract and gallbladder motility, reducing the likelihood of infrequent or partial gallbladder emptying. Reduced intake of foods high in trans-fatty acids and saturated fats is recommended. Conversely, not having enough fat in the diet can also predispose toward gallbladder disease.

Fat in food is the stimulus to produce the hormone cholecystokinin (CCK), which triggers the contraction of the gallbladder to expel its contents. In the absence of fat in foods, gallbladder activity is lessened and gallstones have more of an opportunity to form.

Testing and Diagnosing

When symptoms suggest gallstone disease, detecting their presence or absence is necessary. There are other serious conditions such as appendicitis, ulcers, hiatal hernia, pancreatitis, heart attack, hepatitis which give mid- or right-abdomen pain, and these need to be considered and ruled out since the presence of gallstones alone doesn’t necessarily cause symptoms.

Laboratory studies. These are usually most helpful in diagnosing other conditions that may give abdominal pain. They are not as useful in diagnosis of gallbladder disease except if an infection (cholecystitis) is present. Even then, elevated white blood cell counts are not present in one-third of patients. Some blood tests may indicate the possible location of the problem – if transaminase is high, the liver; if bilirubin and alkalkine phosphatase are high, the common bile duct could be obstructed.

Imaging Techniques

Ultrasound

Gallstones larger than 2 mm can be imaged by ultrasound (sonogram). Noninvasive, with no radiation risk or exposure to contrast dyes, and less expensive than most other options, ultrasound is the diagnostic tool of choice. Images can also reveal if the gallbladder wall has thickened or if the gallbladder is enlarged, both further signs of gallbladder disease.

Classic x-rays

X-rays are used in conjunction with dye tablets swallowed by the patient in doing an oral cholecystogram or OCG. The dye improves the visibility of stones when the gallbladder is x-rayed. Another test, the percutaneous transhepatic colangiogram, uses x-rays in conjunction with an injected contrast dye to image the progress of dye through the biliary system on a fluoroscope.

CT scans (Computerized tomography)

This serves as a secondary tool following sonograms to further image areas of interest. CT scans are used to find stones within the liver’s system of ducts and to delineate the possibility of persistent infections.

Scintigraphy is helpful in imaging blockage of bile ducts within the liver or of the cystic duct. This technique is part of nuclear medicine, where aharmless radioactive isoptope is administered intravenously and its eventual location in the body is mapped by a device which detects radioactivity.

ERCP (Endoscopic Retrograde Cholangiopancreatography)

This outpatient procedure is used to view the inside of the duodenum where the common bile duct enters. It helps evaluate any blockages as well as conditions of the sphincter and ducts. After sedation, a thin tube is put from the mouth into the stomach and then into the small intestine. There is a light and an imaging device – either fiberoptic or video chip – at the end of the tube. Small tools can also be used to take tissue samples and perform other tasks.

Treatment Options

Surgical removal of the gallbladder or cholecystectomy. When gallstones are found present and symptoms occur and recur, treatment of choice is removal of the gallbladder. The biliary system is still able to function without the gallbladder. Bile flows directly from the liver to the small intestine.

Removal can be done laparoscopically or by traditional open surgery involving a 4-7 inch abdominal incision. In laparoscopic sugery, 3-4 small incisions are made at designated points on the abdomen.

Surgical tools and a small lighted camera with are inserted through these. The camera permits the physician to view the abdominal cavity and allows gallbladder removal with minimal destruction to tissues. The patient can usually go home in a day or two and is back to normal routines in about three weeks.

Traditional surgery is needed if complications arise that contraindicate laparoscopic procedures. There is a longer hospital stay and a longer recovery period. Some patients continue to feel gallstone symptoms after the gallbladder is removed (postcholecystectomy syndrome, PCS). It is unknown why this occurs. Complications occur in less than 2% of cases for both types of surgeries; these include damage to bile ducts, bleeding, blood clots, pneumonia, infection.

A possible consequence of cholecystectomy is chronic diarrhea in some patients. Causes are not known, but the laxative effect of the steady stream of bile into the intestine may be responsible. Also, without the bolus of concentrated bile from the gallbladder when eating high-fat foods, fat digestion may not be as effective. Medications can help with these conditions.

Lithotripsy (ESWL or Extracorporeal Shockwave Lithotripsy)

This is the use of shock waves (soundwaves) to break up gallstones. The smaller pieces can then be eliminated. It is used when gallstones are small or when surgery is not indicated. Abdominal pain can occur after this treatment is given.

Medical Treatments

The drugs ursodeoxycholic acid, chenodiol, methyl tert-butyl ether and monoctanoin can be administered to dissolve cholesterol gallstones. They are made from bile salts and take prolonged treatment to be effective, months to years. Ursodeoxycholic acid (Actigall) and chenodiol (Chenix) are taken orally. Actigall is expensive. The latter two drugs are given directly into the bile duct or gallbladder. None of these medications prevent formation of new gallstones once treatment is stopped. They are used primarily in patients who cannot receive surgery.

Alternative Therapies

Acupuncture has been used to treat the pain of attacks and stimulate the flow of bile. Herbal remedies include Milk Thistle (Silybum marianum), Turmeric (Curcuma longa), Globe Artichoke (Cynara scolymus) and green tea. Castor oil packs have been applied to the abdomen to alleviate swelling. Homeopathic remedies include Colocynthis, Chelidonium, and Lycopodium.

Another practice, which is not widely accepted medically, is using gallbladder cleanse, also referred to as liver cleanse or gallbladder flush. It consists of drinking a mixture of olive oil, fruit juice – usually lemon, lime or grapefruit – and sometimes herbs or epsom salt. This preparation supposedly loosens gallstones and helps to expel them in stools.

Inflamed Gallbladder (Cholecystitis)

The leading cause of inflammation is gallstones causing a blockage. When the bile can’t move, inflammatory enzymes are released by the mucus cells lining the gallbladder. The mucus cells become damaged and produce fluid in addition to the trapped bile, resulting in more swelling. Bacteria flourish in such a setting and infection can set in.

Sometimes inflammation occurs when there are no gallstones (acalculous cholecystitis). Causes are stagnant bile, bacterial infections, or reduction in blood flow to the gallbladder. Risk factors include shock, severe trauma or illness, long-term fasting, or a reduced immune system.

Diagnosis and tests are as for gallstones with the addition of antibiotics for infection and pain medications. Treatment is removal of the gallbladder. If infection is present that should be addressed first. Surgery is best performed during earlier stages of inflammation before thickening and toughening of gallbladder walls and scarring and narrowing of ducts (sclerosing cholangitis) can happen. Infection can also spread to the pancreas through the pancreatic duct.

Ongoing untreated choleocystitis can lead to organ damage and malfunction. Gallbladders can become gangrenous or even perforated, allowing the bile to leak to the peritoneal cavity. Death can result.

Gallbladder Cancer

This rare cancer is usually detected when testing for something else. Often there are no symptoms, but the following have been reported: jaundice, abdominal pain similar to that for gallstones, weight loss, diminished appetite, fever and itching.

Women get gallbladder cancer more often than men, and incidence increases with age. If some other gallbladder diseases have been present such as gallstones, cholecystitis, choledochal cysts – which is a bile duct abnormality present at birth – and a condition known as porcelain gallbladder, the person is more at risk.

Diagnosis involves the imaging tests already discussed under gallstones plus the use of MRI (magnetic resonance imaging) to determine the spread and location of the cancer. Exploratory surgery is also used for this. Treatment depends on the stage of the cancer. For cancers contained in the gallbladder (Stage I), cholecystectomy is effective. If the cancer has spread to the adjacent liver (Stage II), it can still be treated surgically. If it has spread to other nearby organs (Stage III) or throughout the body (Stage IV), treatment options are radiation therapy and chemotherapy.

Porcelain Gallbladder (Calcifying cholecystitis)

This uncommon condition is associated with damage from gallstones and recurrent infections. Calcium becomes deposited in the muscles and mucosa of the gallbladder. The walls appear bluish and are brittle. There are no symptoms and most cases of porcelain gallbladder are found when conducting imaging tests for other conditions. Because of the high incidence of gallbladder cancer when porcelain gallbladder is present, gallbladder removal is advised whenever this condition is found. The best way to image it is through CT scans.

Belching Or Eructation

Belching is a perfectly normal human experience and it is common for people to belch about a dozen times in a single day. It is also known as eructation, burping and ructus. Belching releases gas from the digestive system. This gas builds up in the stomach and esophagus, and is then released through the mouth. This is generally accompanied by sound, and often also by odor.

Many people can voluntarily belch, while some suffer from a nervous habit of belching. It can also be a completely involuntary action, however, that is necessary in order to expel air and gases that have been trapped in the stomach and esophagus.

Belching is generally considered impolite in most cultures and many people feel embarrassed when they burp in public. It is usual for people to apologize or ask for pardon after belching in front of other people, particularly on a more formal occasion.

Some cultures may consider belching after a meal to be a sign of satisfaction and enjoyment of the food. This is a common custom among some tribes of Eskimos and in the traditional cultures of the South Sea Islands. Belching several times after finishing a meal is very common, since air is often swallowed along with the food and needs to be released.

Symptoms

Belching is a release of gas from the digestive system through the mouth. The resulting vibration of the upper esophageal sphincter as the gas passes it can create a distinctive belching sound.

Belching is often associated with a number of other symptoms. People who suffer from frequent belching may also experience heartburn, nausea and dyspepsia or indigestion. When it is associated with these additional symptoms, belching may be a sign that the patient is suffering from an ulcer or a hernia. It is advisable to make an appointment with a doctor if these symptoms persist.

Flatulence and bloating may also be more likely to occur in people who frequently suffer from belching, since all three symptoms can be the result of problems in the digestive system and a poor diet. The causes of flatulence can differ from those of belching, however, since the gases that are released in these two forms occur in different parts of the digestive system and can be produced in different ways.

Diagnosis

Normally it is not necessary to visit a doctor because of belching. If belching has been occurring very frequently, or has become painful, or if there are other symptoms associated with the belching, then a visit to the doctor can be helpful.

The doctor will ask about the sorts of symptoms that have been experienced, and will also want to ask about diet and other possible causes of belching and digestive problems. They will also conduct a physical examination. They will probably check the abdomen for swelling and tap it in order to discern whether there is a hollow sound that could indicate that there is trapped gas within it.

If the doctor suspects that there could be an underlying medical condition that is causing excessive belching they will usually run some additional tests in order to check for reasons why there could be a problem with belching.

Causes

Belching often occurs after air has been swallowed while eating and drinking. This air must then be released. The swallowing of air is also known as aerophagia. When belching occurs as a result of air being swallowed, the gases that are expelled in a burp or belch are mainly oxygen and nitrogen, but belching can also be caused by drinking carbonated drinks. This second type of belch is composed of the same carbon dioxide that is used to put bubbles in the drink. The diet can be a significant factor in the frequency of belching.

Burping

Burping is particularly common in babies, and they often need to be burped after feeding. The reason for this is that gases are more likely to enter the digestive system and accumulate when a baby is eating than when an adult eats.

Frequent belching may be the result of a medical condition such as a hernia or stomach ulcer, or a disorder of the gastrointestinal tract such as gastritis (inflammation of the lining of the stomach) and gastroparesis (delayed emptying of the stomach).

Acid Reflux

Acid reflux, which may occur more frequently as the result of gastroesophageal reflux disease, can increase the frequency of belching because repeated swallowing of the stomach acid that rises in the esophagus can result in more air being swallowed that needs to be expelled as belching.

Belching and heartburn are particularly common during pregnancy, but belching is not unusual in any group of people. It is normal for belching to occur in people of all ages and all conditions of health.

Certain medications can also cause belching. The diabetes treatments Byetta and metformin, for example, can lead to belching. In most cases this problem resolves itself after the medication has been taken for a few weeks.

Prevention

It is very rare for a person to belch excessively since it is considered normal for people to burp fairly often. There are cases of abnormally high frequency of belching, but they are very rare. Since burping is usually considered embarrassing and impolite, however, many people prefer to avoid doing it in public. It is often possible to avoid burping when it would be inconvenient, but constantly suppressing belches can lead to the air passing through the digestive system and escaping as flatulence instead, which is often considered more embarrassing than belching.

Avoiding foods and drinks that are likely to cause belching is an easy way of preventing the problem. Certain foods can produce gas when they are being digested in the stomach. Milk and dairy products, and a number of vegetables including beans, lentils, onions, cabbage, sprouts, apricots and prunes can all stimulate belching.

Belching often occurs as the result of drinking carbonated drinks or sodas, champagne or beer, but using chewing gum or sucking on hard candy can also increase the frequency of belching because it results in more air being swallowed. Similarly, inhaling smoke can also cause greater frequency of burping. Wearing dentures that are loose and poorly fitted can also increase the amount of air that is swallowed while eating, and so lead to an increased frequency of belching.

Eat Slowly

In order to avoid swallowing too much air while eating and drinking, it is best to do so slowly and to ensure that everything is chewed properly before it is swallowed. Avoiding overeating can also help to reduce the frequency of belching. It is also sensible to avoid using a straw while drinking.

It is possible to prevent belching by drinking plenty of still fluids and water (although carbonated water should be avoided). Eating a first course of soup at the beginning of a meal can also help to prevent belching. The liquid prepares the stomach for the following courses by stimulating the production of digestive stomach acid.

Since heartburn can increase the frequency of belching, it is possible to reduce belching by ensuring that heartburn is treated before it causes a problem. Mild cases of heartburn can be treated with antacids that are available over the counter, but more serious heartburn that occurs as the result of a gastrointestinal disorder may require prescription medication.

Treatments

Belching is generally harmless and is a natural reaction to trapped gases in the digestive system. It is unusual therefore for ay treatment to be required. There are some options available, however, for anyone who is belching frequently.

Antacid treatments can reduce the frequency of burping that is caused by acid reflux.

Burping a baby after feeding can relieve the discomfort caused by gas that has been swallowed. The baby is usually held against the shoulder and then patted gently on the lower back. This often stimulates the baby to burp, although it can also result in the expulsion of some of the food as vomit.

When there is an underlying medical condition that is causing excessive belching, it will usually be necessary to treat the condition that is causing the problem in order to get rid of the belching.

Traditional Remedies

A variety of home remedies have been used to try and prevent and treat belching. Mint is believed to help to calm the digestion and reduce belching. It can be taken by adding some fresh mint leaves to a meal or mixing some mint essence into a glass of water. Mint tea can also be used to help prevent belching, as can a number of other herbal tea. Raspberry, blackberry and chamomile teas can all be used as digestive aids and will help to reduce the frequency of belching in many people.

A useful home remedy that can provide similar relief to a store bought over the counter antacid can be concocted by mixing half a teaspoon of baking soda into a glass of water. By calming the stomach and neutralizing the stomach acid, this remedy can help to prevent acid reflux and therefore reduce belching.

Asafetida

A remedy that has been used to prevent belching since ancient times is asafetida. This is a pungent herb that is usually considered to have a repulsive odor in its raw from. It can be added to any type of food, however, or mixed with buttermilk, in order to reduce the odor. In cooking, asafetida can be cooked in oil to produce a flavor not unlike sautéed garlic or onion. When it is eaten, asafetida can help to reduce the production of gases in the stomach that can cause belching.

Garlic and Cloves

Garlic and cloves can both be eaten either before or after a meal in order to prevent belching. Since raw garlic is distasteful to most people, it can be added to the food, for example it could be used in a soup starter. Cardamom can also be chewed following a meal in order to prevent belching. Cloves and cardamom have pleasant flavors and therefore do not need to be disguised in food. Ginger can also be an effective remedy for belching. It can be taken as a tea that should be drunk after meals. Ginger tea and other herbal teas that can calm the digestion make good alternatives to an after dinner coffee, since they will be able to have a much better effect on the digestion and to reduce the chances of belching becoming a problem.

Fenugreek

Fenugreek is a plant that is used as both a spice and an herb. It is often used in curry, but the leaves can also be used to produce a drink that can help to prevent belching. In order to obtain the full benefit, it is necessary to soak the leaves in a cup of water for between two and three hours. The solution that is produced should be taken early in the morning, before eating breakfast.

A more complex mixture that can help to prevent belching can also be produced by combining half a teaspoon of baking soda and one tablespoon of freshly squeezed lime juice in a cupful of warm water, and mixing in a small amount of the paste of fresh ginger. As with the fenugreek remedy, this mixture should be drunk on an empty stomach early in the morning. It is usually sufficient to drink it over a period of about ten days. This remedy contains a high concentration of sodium, however, and is therefore not suitable for anyone who suffers from hyperemia.

More Home Remedies

Another recipe for a natural remedy for belching is to mix two teaspoonfuls of lemon juice with a small amount of apple cider vinegar in a cup of water. This mixture should be taken before a meal in order to prevent belching. It can also help to prevent excess acid being produced in the stomach.

Since nervousness and stress can increase the frequency of belching, it may also be possible to cure the problem by finding ways of reducing stress and promoting calmness. Yoga or breathing exercises may be useful, while simply taking a gentle stroll or spending some extra time relaxing can be also be helpful in people whose belching is caused by nervousness. If the problem is causing a great deal of anxiety, then it may be worthwhile seeking therapy or trying to discover the cause of the nervousness. Many people suffer from excessive belching when they are nervous about their work or other issues in their lives and the belching can therefore be cured by finding ways to deal with these stresses.

How Effective Are These Treatments And Remedies?

The success of the treatments and remedies that are available for the prevention of belching can vary between individuals, since the reasons why people suffer from excessive belching can be different. Some people can only cure their belching by making significant changes to their diet, because this is the root cause of their problem. In cases where belching is occurring as a result of heartburn, then some simple antacids or a preparation of baking soda made at home can result in an effective cure. Other people will find that it is sufficient to use an herbal remedy such as mint tea in order to calm their stomach and avoid belching.

Try Different Methods

The best way to find an effective cure for belching is by trial and error. Different methods will work well for different people, so it may take several attempts before finding the one that works. Some people may prefer to use the simpler remedies rather than having to put together one of the more complex herbal remedies. Making changes to the diet and lifestyle can be the best route to curing belching for some people who prefer not to rely on traditional remedies, but others who do not want to change the way that they eat may prefer to try a solution that can calm their stomach without significantly affecting their lifestyle, such as chewing cloves or cardamom after a meal.

When there is an underlying cause behind belching, herbal remedies and lifestyle changes are unlikely to be able to help. The cause needs to be targeted. It may be that a certain medication or disorder of the digestive system has been increasing the frequency of belching. It will then be necessary to seek medical advice and obtain treatment for the disease rather than attempt to find a cure by targeting the belching directly.

Since the remedies and treatments that can be used to prevent and cure belching are all simple and do not involve taking medication or using herbs that are not commonly taken in food, there is no reason to worry about any complications or side effects that could result from using them. They are all very safe. The only exception to this is the baking soda and lime treatment, which could be harmful for people who have hyperemia.

Costs

Treating and preventing belching is very cheap. All of the natural remedies are available at supermarkets and health food stores for under $10. Antacids can also be bought for well under $10, and can be obtained over the counter from many food stores and drug stores.

Many of the treatments that can help to reduce belching are behavioral, requiring changes in lifestyle that affect the way food is eaten, and changes to the diet that usually involve avoiding certain types of food. These treatments are all free, and can in fact end up saving money by cutting out some problematic foods from the diet. Drinking water rather than buying carbonated drinks will create savings, for example, while cutting out a habit such as smoking or chewing gum can also save some money.

The immune system’s primary function is to fight off bacteria, viruses, cancer cells, toxins, and blood or tissue belonging to other humans or species. These intruders are called antigens and white blood cells go into attack mode to protect the body from anything they consider to be intruders by producing antibodies.

However, sometimes white blood cells mistakenly view the body’s healthy organs, cells, or tissue as an invader and will attack its own body tissue just as they would any antigen. The immune system is unable to distinguish between antigens and the body’s own healthy tissue. This results in the destruction of healthy body tissue caused by an autoimmune disease.

For example, when one has an allergic reaction to anything breathed, touched, or eaten, the immune system goes into action immediately to oust the foreign matter from the body. In an autoimmune disease the immune system has the same reaction against its own body tissue.

Symptoms

Approximately 50 million people in the United States suffer from the symptoms of autoimmune diseases. Some symptoms include joint pain, depression, fatigue, heart palpitations, and numbness of the hands and feet.

There are at least 80 known autoimmune diseases. A few of the autoimmune diseases that occur more frequently are listed below.

• Active Chronic Hepatitis
• Addison’s Disease
• Type I Diabetes
• Crohns Disease
• Multiple Sclerosis
• Systemic Lupus Erythematosis
• Celiac Disease
• Cushings Syndrome
• Discoid Lupus
• Fibromyalgia Fibromyositis
• Anti-phospholipid Syndrome
• Dermatomyositis

Studies have shown that one can have more than one autoimmune disease working together.

Autoimmune diseases are grouped by the body systems they affect. These body systems include

• Blood and blood vessels
• Digestive system (including the mouth)
• Eyes
• Glands
• Heart
• Joints
• Kidneys
• Lungs
• Muscles
• Nerves and brain
• Skin

Common Symptoms

Some of the more common symptoms that occur are:

• Fever Fatigue
• Cough Depression
• Wheezing Weight gain
• Diarrhea Sensitivity to cold
• Rash Dry hair
• Joint pain Muscle weakness
• Coughing up blood Constipation

Symptoms are not always present. They may also become worse over time or fade and reappear.

Causes and Risks of Autoimmune Diseases

Scientists have found there are several things that cause autoimmune diseases. Toxins from the environment, viruses, heredity, and certain drugs are considered to be possible causes.

Poor health habits such as stress, lack of exercise, poor food choices, lack of sleep, alcohol abuse, and tobacco all work to leave the immune system weaker and makes it easier to develop an autoimmune disease.

Autoimmune diseases can’t be passed from person to person. They are not spread through touch, sex, or through blood. They can’t spread like a virus or bacteria. The only occurrence of transfer has been from a pregnant mother to her fetus but that happens rarely.

Organ transplants do not transfer autoimmune disease because the white blood cell count in the organ is low and a normal immune system adjusts to handle the new organ. A graft-versus-host disease may occur; however, this is different from an autoimmune disease.

People Who Are Prone To Developing Autoimmune Disease

When autoimmune diseases were first recognized professional health authorities didn’t know what caused an immune system to suddenly not be able to recognize the difference between antigens and healthy body tissue. After careful studies have been conducted it has been noted that anyone can develop an autoimmune disease; however, women who are of childbearing age are more likely to develop the disease.

Some autoimmune diseases frequent families such as multiple sclerosis and lupus. It is also possible for several autoimmune diseases to attack certain family members due to genes. The disease may be triggered with a combination of environment and inherited genes.

The environment has an important part to play in the development of autoimmune diseases. Exposure to solvents, sunlight, bacteria, and viruses can be linked to the development of some autoimmune diseases.

Certain ethnic backgrounds are more likely to develop certain diseases than others. For example Caucasians are more likely to develop Type 1 diabetes while African Americans have a higher incidence of lupus.

Women are more prone to autoimmune diseases than men.

How to Prevent Autoimmune Diseases

Unfortunately, there are no preventative methods for autoimmune diseases. A weak immune system can make the body susceptible to numerous infectious diseases. However, the immune system can be too strong or directed against its own healthy body tissue so strengthening the immune system doesn’t help an autoimmune disease.

Practicing good health habits is your best defense in case you develop an autoimmune disease. Good habits can help relieve some symptoms and keep your body stronger while it’s under attack.

Diagnosis and Tests

Diagnosing an autoimmune disease is a long, tedious process. Many of the autoimmune diseases have the same symptoms and these same symptoms are shared by other diseases. Doctors must eliminate all possibilities of what the symptoms could mean through various tests which takes quite a long time to complete.

Some things you can do to help your doctor diagnose an autoimmune disease are:

• Choose a specialist who treats the general area of your symptoms. For example, if you are experiencing stomach and bowel problems you will need to see a gastroenterologist. Your family doctor can recommend a specialist.
• Write down your family’s health history to include every disease or symptom suffered by any family member including extended family.
• Record all of your symptoms no matter how minor they seem.
• A second or third opinion may make you more comfortable especially if your doctor seems to dismiss your symptoms as being all in your head or he tells you they are due to stress.

Blood tests are given to diagnose autoimmune diseases and to monitor them once diagnosed. Blood tests measure organ function and inflammation. X-rays are also used to monitor diseases. A schedule for the frequency of testing may be several times a day as with diabetes up to every 90 days or so with other diseases.

Diagnosis of an autoimmune disease includes the symptoms, a physical exam conducted by a health professional, and laboratory test results. Early detection is very difficult because symptoms are shared by several diseases. It may be necessary to monitor the symptoms for a long period of time to determine their course and to see if other symptoms develop in order to diagnose an autoimmune disease.

Pharmaceutical Treatment Options

Unfortunately, there is no cure for an autoimmune disease. All treatments are to lessen the frequency and severity of symptoms. The diseases get progressively worse so treatments are used to slow down their progress.

Autoimmune diseases are treated by the symptoms experienced by the body system that is being attacked. For example, inflammation is one symptom that shows up in many of the diseases and is treated with nonsteroidal anti-inflammatory drugs (NSAID) such as aspirin, naproxen sodium (Aleve) and ibuprofen. NSAIDs are purchased over the counter and stronger doses can be prescribed by your doctor.

Medicines are used to replace body substances that can no longer be produced naturally in the body. One notable example is insulin that must be injected into the body to control blood sugar levels. Another example is thyroid hormone that restores proper thyroid hormone levels. Pharmaceutical treatments will vary per person and as time goes on.

The three things rheumatologists, endocrinologists, neurologists, and other professionals do when treating autoimmune disease is relieve symptoms, preserve the organs’ functions, and slow the progress of the disease.

Herbal Remedies

There are natural herbs that can help alleviate the symptoms of autoimmune diseases. It must be understood that any alternative treatments should be shared with your doctor and are not meant to replace any medicine your doctor suggests. A doctor should know what you’re taking in order to avoid negative substance interaction.

Two of the most popular herbs to take in the treatment of autoimmune symptoms are sarsaparilla and yarrow. Both of these herbs work to purify the blood and reduce inflammation in muscles and joints.

A 300 mg dosage of milk thistle or silymarin purifies the blood and increases bile flow to the liver. Yucca reduces stiffness and pain in muscles. Yucca is also good for autoimmune diseases of the skin and is used in shampoos and body soaps.

Other herbs used in the treatment of symptoms generated by autoimmune diseases are:

Chlorella

Chlorella or spirulina is a supplement that is taken daily to treat lupus symptoms. A probiotic and a high-potency vitamin will also help combat the symptoms suffered during a lupus symptom attack.

Plant Sterols

Supplementing with plant sterols and sterolin has proven to be effective in building up a weak immune system and at the time calming down an overactive immune system. One study of sterols and sterolins on 25,000 people has proven them to be safe with no side effects, no negative interaction with drugs, and producing no toxicity. Sterols and sterolin helps reduce stress, pain, and inflammation.

(See www.evenbetternow.com/immune_health_natural_supplement_therapies.php)

These are only two of the hundreds of supplements used by people to find relief from the symptoms of autoimmune diseases. Be very careful of any product that claims complete reversal of any autoimmune disease if their supplements are taken. There are no known cures for autoimmune diseases so you must be careful to continue being monitored by your physician.

Other Possible Treatments

There are other treatments available besides pharmaceutical drugs and herbal remedies.

• Hormone replacement therapy uses hormones to bring relief from the effects of hormone deficiency.
• Enzyme replacement therapy utilizes enzymes to alleviate the effects of enzyme deficiency.
• Corticosteroid treatment uses steroids to regulate inflammation, immune response, and stress.
• Plasmapheresis is used to remove antibodies from the blood to prevent them from attacking body tissue and making more antibodies.
• Immunosuppressants or immunodepressants act to suppress or lessen the immune response.
• Methotrexate is used to slow the progress of certain cells that reproduce quickly such as cancer, skin, and bone marrow cells.
• Cyclophosphamide is used to slow the growth of cancer cells.
• Azathioprine is used in the treatment of rheumatoid arthritis to decrease the effects of certain cells in the immune system.
• Cyclosporin is used in preventing organ rejection and in treating psoriasis and rheumatoid arthritis.
• Intravenous immunoglobulin (IVIG) is a solution of antibodies that are sterile and concentrated. They are taken from healthy people and injected into people who have abnormal production of antibodies.

Even though there is no known cure for autoimmune diseases there are many medical and natural ways to relieve the symptoms, slow down disease progression, and reduce organ deterioration.

How To Live With An Autoimmune Disease

There are several things that can be done to better manage an autoimmune disease.

A healthy diet is essential. Eating a well-balanced diet of vegetables, fruits, low-free or fat-free dairy products, whole grains and lean proteins is the first step in keep your body well by feeding it the right things. You will need to limit the “bad” fats (saturated and trans), salt and sugars. Good foods are the best way to get the nutrients your body needs.

Physical exercise always helps in moderation. Strenuous exercise is probably not the best for you to engage in. Ask your doctor for suggestions or become a student of yoga, tai chi, Pilates, or another gentle exercise.

Reduce stress levels as much as possible. It’s a known fact that stress or anxiety can make the body more susceptible to autoimmune symptoms. Learn a few relaxation techniques such as hypnosis, guided imagery, and meditation and then stick with the one you like the best. There are hundreds of instructions books, dvds, and live teachers who teach the art of relaxation. These techniques can help you relieve pain and cope better mentally with an autoimmune disease. Some people find counseling effective in reducing stress.

Getting enough sleep can also help reduce stress levels. Adequate sleep aids the body in fighting disease. Most people need at least 7 to 9 hours of sleep per night.

Treatment Costs

The first thing to consider in adding up the costs of having an autoimmune disease is that treatment of any kind will be ongoing since there is no cure for an autoimmune disease. Whether you decide to use medicines or natural remedies you will be taking them for the rest of your life.

Some chemical and natural remedies can be expensive to take. Ask your doctor if the drugs you are taking have a generic form to reduce the costs. Sometimes buying medications for several months can reduce the cost. Supplements can be bought the same way.

Some online pharmacies and natural remedy companies offer an affiliate program that you can use to offset your costs. If you find a natural remedy that helps you with your symptoms you may want to spread the word by becoming an affiliate for the company that sells the product.

Some companies pay a commission as high as 50% of the cost. You may even save up to 50% off your own orders for the product. Search the site for a link that reads “affiliates” and read the program they have set up. It won’t be hard to learn how to become a successful affiliate since there is extensive information on the Web on the subject.

Additional Costs

There are other costs, too, such as doctors’ visits and tests you’ll need to take periodically. Adequate health care insurance should help you reduce these costs. There are health care plans you can explore on the Internet.

This report has explained what happens to an immune system that no longer recognizes good tissue from foreign matter in the body. The result develops into an autoimmune disease. Autoimmune diseases can’t be cured. Science has learned to treat symptoms so the patient can reduce pain and slow down deterioration of the body system that is under attack.

Practicing good healthy habits and taking chemical or natural remedies for symptoms are two things that make having an autoimmune disease a little more bearable. It is important to have your disease monitored periodically to remain alert to any new developments.

An eating disorder is a condition that affects one’s eating habits. These disorders can lead one to eat too much or too little. Though eating disorders usually occur in children and young adults, they have also been seen to affect adults later in life, with females being more affected than males. While an eating disorder is a treatable illness, it is usually accompanied by psychiatric disorders like depression or anxiety. Many who suffer an eating disorder may also experience health problems such as kidney or heart failure. Unfortunately, if not treated, this condition can lead to death.

Alternative Names

Eating disorders have many alternative names, as there are many different types of this illness. Some common disorders include anorexia nervosa, bulimia nervosa, and binge eating or compulsive overeating.

Symptoms

The main symptoms include eating too much or too little, usually at extreme amounts.

Anorexia and Bulimia

Anorexia and bulimia both show the same symptoms. While a main sign of an eating disorder is rapid weight loss, it is important to note that a person suffering from this disorder may not appear to be underweight at all. These symptoms can be medical, psychological, and can be seen in one’s day to day living.

Obsession about food is one sign of an eating disorder. This is a situation where the patient goes to extremes worrying about calories and fat intake, weight problems, and has the need to continuously exercise. This may all be kept track of in a food diary. Obsessively reading books and visiting website about losing weight are also common.

Patients usually look for ways to get rid of the food they have eaten or they avoid eating at all. Activities such as running to the bathroom to vomit immediately after meals, binging or purging, and the use of laxatives or diet pills are all signs to be aware of. Some patients restrict the amount of food they eat or avoid eating altogether.

Finding ways to dispose of uneaten food is another alternative to not eating. Moving food around on a plate to make it look as though it is eaten, chewing it then spitting it out into a napkin to throw away or flushed down the toilet, or cutting food into small pieces are all examples. Some patients have secret eating patterns and tend to hide food in places like closets and under the bed in order to eat at a more preferred time.

Medically, the symptoms can be more of a serious threat. Patients tend to experience hair loss and a pale coloring of the skin. They may experience headaches, dizziness, sore throats and swollen glands. Other medical symptoms include low blood pressure, constipation, incontinence, loss of menstrual cycle, bruised knuckles, bloodshot eyes, or bruising under the eyes and on cheeks.

Personally, these patients may have low self-esteem and put themselves down. They may feel the constant need for acceptance from other people, thereby, feeling the need to be a perfectionist. They may also lose sexual desire, suffer mood swings, depression, and fatigue due to insomnia.

Compulsive Overeating

Patients who suffer binge eating often have associated psychological problems with the illness. The sense of fear is one symptom they have to struggle with. They fear not being able to control their eating habits or not being able to stop eating once they get started. They fear eating around others, which in turn, causes them to put themselves in isolation.

These patients feel a need for constant dieting and need to keep up on the most popular diet plans. They assume life will be perfect if they can lose weight because they feel that their failure in society is due to their weight. On the other hand, they may show secretive eating habits and store food in strange places such as in cabinets or in suitcases to eat at a more convenient time.

Medically, patients who overeat are often short of breath after light activity. They experience excessive sweating, high blood pressure, high cholesterol, leg or joint pain, and decreased mobility because of increased weight gain. Because of insomnia, patients usually feel tires, depressed, and experience mood swings and loss of sexual desire.

Causes of Eating Disorders

There is no one cause for someone having an eating disorder. Aside from being a weight problem, it can be associated with family pressures, genetics, cultural pressures, emotional and psychological factors, and personality disorders.

Negative family influences may be a problem with one acquiring an eating disorder. This can result from a mother having a previous eating disorder, a father criticizing a child’s weight, obesity being present in the family, abuse, families with addictions, and those with emotional disorders.

Genetics can play a great role in eating disorders. It is common to learn that many patients have family members suffering from the same problem. There have been specific chromosomes associated with anorexia and bulimia.

Hormonal abnormalities may be partly responsible for one’s susceptibility to the eating disorders. These chemical abnormalities can be found in the thyroid, reproductive areas, and regions of stress and appetite.
Major life changes can cause one to experience an eating disorder. This may result from the feeling of losing control one may feel over the death of a loved one, major illness of someone close to them, or from having to change schools.

There are many other factors that may cause one to become a victim of an eating disorder. Social problems, a traumatic event, psychiatric illnesses such as depression or anxiety, failure at school, work, or athletics can also contribute.

Risk Factors

There are many risk factors\ which can lead one to become susceptible to an eating disorder. The age of the patient is mainly adolescent and young adult, with females being more predominant. It is present in all races and at all socioeconomic levels.

Certain personality disorders can put people at risk for the disorder. Those with Avoidant Personalities tend to be associated with anorexia nervosa. People with avoidant personalities tend to be perfectionists, being perceived as being ‘good’, and being afraid of criticism or humiliation. Other personality disorders that can lead to an eating disorder include Obsessive-Compulsive Personality, Borderline Personalities, and Narcissistic Personalities.

There are emotional disorders that can be the cause of the eating disorder or actually be the result of the disorder. These mainly involve issues with depression and anxiety. Examples include Obsessive-Compulsive Disorder, phobias, panic disorder, and post-traumatic stress disorder.

Serious health problems or death can result from having an eating disorder which has gotten out of control. Patients with bulimia have a better recovery outlook than those with anorexia. While treatment is possible, patients do relapse.

Bulimia Medical Problems

Medical problems associated with bulimia include tooth erosion, cavities, and gum problems. Patients usually experience water retention, swelling, and abdominal bloating, along with acute stomach distress. Females can experience irregular periods. With excessive vomiting or laxative use, there can be fluid loss and low potassium levels. This can lead to weakness, near paralysis, and lethal heart rhythms. Forced vomiting can cause esophagus damage such as rupture and weakened rectal walls.

Self-destructive behavior is also seen in patients with bulimia. This includes smoking, impulsive behaviors, and alcohol and substance abuse.

Anorexia Medical Problems

Anorexia nervosa is an extremely serious disorder which affects the body in many ways. There is no treatment that is 100% effective. Recovery can take years and some patients never recover. Many patients relapse because they retain their desire for perfection and weight loss. It has been researched that anorexia nervosa has the highest death rate of any psychiatric disorder.

A serious effect of anorexia is the hormonal changes. Many hormones are lowered such as the reproductive hormones, thyroid hormones, and growth hormones. Stress hormones tend to rise. For females, this causes changes to the menstrual cycle, infertility, and bone loss.

Suicide is a big concern for patients with anorexia. They tend to be at high risk for anxiety and depression, leading to alcohol and drug abuse.

Heart disease is a common cause of death in patients with anorexia. The disorder can cause dangerous heart rhythms, including brachycardia, which is the slowing of the heartbeat. It can also cause blood flow to be reduced, blood pressure to drop, and the heart muscles to lose size. An electrolyte imbalance can occur due to the reduction of fluids and mineral levels. These minerals, such as potassium and calcium, are essential for the electric currents which keep a normal heartbeat. An electrolyte imbalance can be life-threatening.

Severe anorexia can cause nerve damage to the brain and other parts of the body. Seizures, disordered thinking, and numbness in the hands or feet have been reported. Certain parts of the brain undergo structural changes during anorexia and while most of these changes return to normal after weight gain, some damage is permanent.

Other medical problems which can occur include anemia, gastrointestinal problems, organ failure, and complications for adolescents with diabetes type 1.

Test and Diagnosis Considerations

Admitting that one has an eating disorder is the first step toward a diagnosis. An Eating Disorder Examination (EDE) is a medical interview that may be conducted by the doctor to determine a patient’s eating habits. This may be accompanied with a self-supported Eating Disorders Examination-Questionnaire. The SCOFF questionnaire is another means to help identify young and old patients for anorexia nervosa or bulimia.

Bulimia nervosa can be diagnosed if the patient has two bulimic episodes per week for 3 months. Since bulimia can cause complications with teeth and gums, dentists can also aid in identifying the disorder.

Anorexia nervosa can be diagnosed if the patient refuses to maintain a normal body weight, fears becoming fat while underweight, low self-image, and loss of menstrual function for 3 months.

Once an eating disorder diagnosis has been made, doctors then test for any serious complications that may have resulted. These tests include a complete blood count, testing for electrolyte imbalances, test for protein levels, an EKG and chest x-ray, testing for liver, kidney, and thyroid problems, and a bone density test.

Treatment Options

Medical treatments are available for eating disorders and some patients may need psychological treatment. It is important that each individual patient find a treatment plan that is right for him. Some patients may need constant monitoring and medications, counseling for nutrition, as well as therapy.

Therapy can be made available in an individual, group or family setting. While a professional therapist usually runs the group session, they can also be run by a recovered patient, a loved one of a person with an eating disorder, or a volunteer. While these sessions can take place in an inpatient or outpatient program, a therapist’s office, or with an independent support group, they can also take place in a university, high school, or a private home.

Psychiatrists, psychologist, social workers, and counselors can provide therapy for eating disorders. Most of these professionals have obtained degrees which fall within the fields of psychology, psychotherapy, social work, and counseling. While a therapist may not be a licensed individual, they can still provide support. The only disadvantage is that without a license, they are not permitted to prescribe medications.

Group & Individual Therapy

Group therapy is beneficial because it lets the patients know that they alone do not suffer this disorder. When attending a group therapy session, it is important to know what the goal and objectives are of the group because there are many different methods of treatment when it comes to group therapy. Support groups tend to cover topics such as strategies for coping, family issues, spirituality, and nutrition. Each individual patient needs to know what type of therapy he needs in order to make a good recovery.

Individual therapy is important for a patient in order to learn to be more confident and to learn how to cope with any anger, stress, or depression. There are many different methods to this type of therapy and it is important to know which one is right for the patient. The different types of individual therapy include the Psychoanalytic Therapy, the Nonpsychoanalytic Therapy, Cognitive-Behavior Therapy, and the Eclectic Approach-Combining All Theories. The Eclectic Approach-Combining All Theories is the most commonly used form of therapy because it combines a lot of aspects from the other theories.

Nutritional therapy can be offered from a nutritionist or dietician. The goal of this type of therapy is to help one improve their eating habits and to teach how to incorporate a healthy amount of exercise into the daily routine. The best type of nutritional therapy should be under the supervision of a doctor or therapist.

Every year millions of people see their doctors for symptoms such as constipation, abdominal pain, diarrhea, or excessive gas. These are the most common indicators of gastrointestinal disorders. The diagnoses for digestive disorder range from an upset stomach to the potentially serious and life-threatening colon cancer, or colorectal cancer. The most common diagnoses are Irritable Bowel Syndrome, or IBS, Inflammatory Bowel Disease, also called IBD, and Gastro Esophageal Reflux Disease, GERD. Other possible conclusions that a doctor may come to are that there is an ulcer somewhere in the digestive tract, the esophagus, stomach or large or small intestine. While a family doctor can diagnose and treat these diseases, referral to a gastroenterologist is usually recommended.

Irritable Bowel Syndrome

Also called spastic colon, nervous stomach, irritable colon and spastic colitis, this syndrome is not generally considered to be a serious intestinal disorder. The large intestine, or large bowel, becomes inflamed and irritated. The inflammation is usually not chronic. However, the symptoms and irritation reappear on an irregular basis. IBS does not increase the threat of developing colorectal cancer. Approximately 20 % of adults in the United States are affected by Irritable Bowel Syndrome.

Characteristic symptoms for IBS are bloating, gas, abdominal pain and discomfort, and constipation and/or diarrhea. Excess mucus or frequent urgency in bowel movements, feelings of incomplete evacuation or changes in stool are other symptoms that might be experienced. Nausea, fatigue and vomiting are also associated with IBS.

Specific causes for IBS have not been found. Stress is thought to be a factor in the development of IBS symptoms. Food allergies, excessive alcohol use and use of antibiotics may also play a role in this disorder. Peristalsis, the contraction of the muscles in the colon which moves the waste through, may be involved also. The contractions may stop temporarily or may cause intense periodic spasms.

Testing

Since there is no diagnostic test for IBS, the majority of tests that are performed to will be conducted in an effort to rule out other diseases or disorders. Stool sampling, blood work and abdominal x-rays will probably be performed first. A colonoscopy or sigmoidoscopy will usually be ordered to take a look at the structure of the colon and search for abnormalities. CT scans and lactose intolerance tests are common diagnostic tools that may also be utilized. If the results of this testing is negative, a diagnosis of IBS may follow.

Most doctors use the Rome criteria in addition to the tests mentioned to diagnose this disorder. The Rome criterion states that the following symptoms must be present for at least 3 months out of the past year. The three months of symptoms do not need to be consecutive. First, the patient has had abdominal pain coupled with at least two of the following: it is relieved with a bowel movement, it coincides with a change in frequency of bowel movements, or there is a change in stool consistency.

Treatment methods for irritable bowel syndrome include dietary changes and stress management. Increasing the amount of fiber in your diet or taking fiber supplements will usually decrease constipation. Over-the-counter or prescription anti-diarrheal medicines can be used to control this symptom. Reducing or eliminating salads, raw vegetables and fruits and carbonated beverages will help with bloating and gas symptoms. Antidepressant medications and/or counseling may be prescribed for patients having difficulty managing their stress.

Inflammatory Bowel Disease

There are two related but distinctly different diseases which fall into this category of intestinal disorders. Both of them are associated with chronic pain and swelling of the intestines. Ulcerative colitis, sometimes referred to as chronic ulcerative colitis or CUC, is an inflammation of the lining of the large intestine and rectum. The inflammation from Crohn’s disease can occur in any part of the digestive tract, from the mouth to the rectum. Most commonly it affects the lower part of the small intestine and the large intestine. Unlike colitis, the inflammation occurs in all of the layers of the intestinal wall.

Since both of these inflammatory bowel diseases involve bleeding into the digestive tract, the first symptoms noticed will be diarrhea, blood in the stools, weight loss, fatigue and anemia. Diminished appetite, fever and abdominal cramping are other symptoms common to patients suffering from IBD. Joint pain, skin rashes, and inflammation of the eyes are associated with IBD.

Along with noting the above symptoms, doctors will inquire about family history of IBD, history of cigarette smoking and alcohol intake as well as perform diagnostic tests as part of their examination process. Blood tests will be performed to determine if anemia and a high white blood cell count is present. Stool samples will be checked for the presence of abnormal bacteria, bleeding and infection. A barium enema, or lower GI series, is a procedure that examines the lower part of the small intestine, the entire large intestine and the rectal area.

This will show the presence of obstructions, blockages, or narrowed areas, strictures, in this part of the intestinal tract. A sigmoidoscopy or colonoscopy is usually performed. During this procedure samples of cells or tissue may be removed for a biopsy of the material under a microscope.

Time Period of Treatment

Since inflammatory bowel diseases are chronic they usually require treatment with medications over an extended period of time. Aspirin products, steroids and immune system modifiers are the most common medications used to treat IBD. Antibiotics may also be prescribed to treat or prevent infections. Anemia is treated with Vitamin B and Iron, either in the form of supplements or injections.

Surgery may be indicated for both of these forms of IBD. If the patient’s response to medications is minimal or non-existent or the side effects of the medicine are intolerable surgery will usually be performed. Formation of strictures, blockages or an abscess or changes that indicate a precancerous or cancerous condition are also reasons for surgical intervention. Depending on the severity of the disease, ulcerative colitis patients may have a portion of their large intestine removed, or the entire colon will be taken out. Removing the entire colon is the only cure for colitis patients. If only a part of the colon is removed the remaining sections will be sutured together and normal bowel function will return.

There is a possibility that the colitis will recur, requiring further medication treatment and/or surgery. When the entire large intestine is removed, there are a few options for waste removal. The small intestine can be attached to a stoma, or opening, in the lower abdominal area.

The patient will need to wear an external bag to collect fecal material. This bag is emptied frequently and changed on a regular basis. A procedure known as an ileoanal anastomosis, or pouch procedure, can be quite effective and eliminates the need for a permanent stoma.

The lower part of the small intestine is used to create a reservoir, which is then connected to the anus. Surgery for Crohn’s disease is often required to relieve symptoms and to remove portions of the small intestine that have been damaged by the chronic inflammation.

However, surgery cannot cure the disease. Almost three-fourths of Crohn’s patients require surgery at some time during the course of their treatment. In this surgery the section of intestine that is showing active involvement of the disease is removed and the remaining ends of the intestine are surgically connected. Approximately 75 % of patients will experience a recurrence of Crohn’s disease within 10-15 years following surgery.

Gastroesophageal Reflux Disease

Gastroesophageal reflux disease, or GERD, occurs when gastric juices from the stomach flow upwards into the esophagus. The muscle at the bottom of the esophagus, the lower esophageal sphincter or LES, is thought to be the cause of GERD. A hiatal hernia occurs at this location which causes the sphincter to relax too frequently or for too long a time, allowing gastric acid to reflux into the esophagus.

Other factors may be obesity, overeating, use of alcohol or tobacco, or consuming too much caffeine. Eating fatty, spicy or acidic foods or foods containing peppermint, chocolate or citrus may also cause reflux disease. The disease is chronic, meaning that once it starts patients will suffer from it for their entire life.

Acid indigestion, or heartburn, is the most common symptom of GERD. It is a burning sensation behind the breastbone that seems to move upward toward the neck and throat. Other symptoms may include frequent burping, stomach aches, a persistent cough, gagging or choking, and waking up with a sour taste in your mouth or a soar throat.

Diagnoses

GERD is diagnosed utilizing a number of tests. A chest x-ray will look for signs of aspiration. An upper gastrointestinal series, called an upper GI or barium swallow, will assess the structure of the digestive organs. An endoscopy will often be performed. This involves inserting a small flexible tube containing a light and camera lens into the throat, stomach and the upper portion of the small intestine. In addition to being able to visually examine these areas, the physician is also able to collect tissue samples for biopsy examination.

A pH monitoring device may be inserted in the esophagus just above the LES and attached to an external monitor. Over a period of 24 hours the device records the pH level at the sphincter. The patient records the time and circumstances when an episode occurs, allowing the physician to make a correlation between symptoms and pH levels.

Symptoms

Mild GERD symptoms may be alleviated using antacids. Patients should avoid eating 2 to 3 hours before lying down. Use of tobacco, alcohol, and caffeine should be curtailed or discontinued. Elevating the head of the bed 6 inches is helpful. Cutting back on the amount of food eaten in one sitting is also recommended.

Mild to moderate symptoms will respond to the above lifestyle changes. Foaming agents may be used to cover the contents of the stomach with foam which prevents reflux. H2 blockers are available over the counter but only provide relief in about 50 % of GERD sufferers. These medications only provide short term relief from the symptoms.

Proton pump inhibitors can be obtained over the counter or by prescription. They are more effective than H2 blockers as they not only relieve symptoms but also heal the lining of the esophagus. Prokinetic medications help empty the stomach faster, improve the peristalsis movement in the digestive tract and strengthen the LES. However, the side effects of fatigue, anxiety and depression make physicians cautious in prescribing them. Medications work differently in each individual. They also may have less desirable effects when taken in certain combinations. Patients should always consult their physician before adding new medications or changing dosage.

Ulcers

An ulcer occurs when the lining in part of the digestive tract develops a sore which can cause a hole, or lesion. An ulcer located in the lining of the stomach or the duodenum, the beginning of the small intestine, is called a peptic ulcer. In the stomach, peptic ulcers are classified as gastric ulcers. Peptic ulcers in the duodenum are duodenal ulcers.

In the past physicians felt that ulcers were caused by stress or by eating too much acidic foods. Later they thought that the hydrochloric acid and pepsin released in the stomach during digestion was the cause. It is now known that the bacteria Helicobacter pylori, or H. pylori, and the use of non-steroidal anti-inflammatory drugs, or NSAIDS, are the main factors that cause ulcers.

The H. pylori bacterium produces ammonia, which weakens the protective mucous coating in the stomach, allowing the acids produced during digestion to create sores. NSAIDS are weak acids and cause inflammation of the digestive tract. Smoking, alcohol use, caffeine and physical stress, such as major surgery or severe burns, are also contributory factors in the development of ulcers.

Symptoms

The symptoms of stomach ulcers may go unnoticed for a long time after the ulcer has formed. Duodenal ulcer symptoms present almost immediately after they have formed. A burning pain in the upper middle portion of the abdomen is the most common symptom. This pain may be temporarily relieved by eating or by taking an antacid, but returns with sometimes greater intensity. The pain may cause the patient to awaken suddenly in the middle of the night. Other symptoms may include nausea, frequent belching, blood in the stool, black stool, recurrent vomiting and anemia.

Since there are potentially serious complications from ulcers, it is important to seek medical attention when symptoms present themselves. Persistent bleeding can cause weakness and fatigue as well as anemia. An ulcer may perforate, or eat through, the wall of the stomach or intestine, releasing partially digested food and bacteria into the abdominal cavity.

This could cause peritonitis, an infection requiring prompt medical attention. Ulcers can also cause swelling and scar tissue to form, especially at the end of the stomach where the duodenum is attached. This can cause a narrowing or a complete obstruction at that point which will inhibit or stop the passage of food into the intestinal tract.

Diagnosing

An upper GI series, or barium swallow, is used to diagnose an ulcer. The barium, a chalky liquid, coats the inside of the upper digestive organs which will show the health of those organs on an x-ray. An endoscopic examination will allow the physician to see the extent of the ulcer damage. It also allows for the removal of tissue for biopsy examination. Detecting the H. pylori bacteria is done through blood, breath and stomach tissue tests. It is important for the physician to determine whether this bacterium is present or whether the ulcer has been caused by NSAID drugs as the treatment regimen will be quite different in each case.

People with ulcers should not smoke, as smoking causes delays in the healing process and also causes them to recur. For H. pylori caused ulcers, doctors will prescribe antibiotic medications to kill the bacteria. In addition, antacids, acid blockers, and proton pump inhibitors may be utilized to help reduce the amount of acid produced in the stomach.

Ulcers that do not heal are called refractory ulcers. Many of the reasons that ulcers fail to heal are often related to the choices that patients make. They may continue smoking or consuming alcohol. They may be taking NSAIDS after being told not to take them. They may not be taking their medications according to the directions given them by their doctor.

There are, however, medical reasons that ulcers do not respond favorably to treatment regimens. Some strains of the H. pylori bacteria are resistant to certain antibiotics. It is also possible that another bacterium is present. The patient may have stomach cancer, cirrhosis, or chronic obstructive pulmonary disease which are interfering with the healing process.

Surgery for Ulcers

Infrequently, ulcers that do not heal or respond to conventional treatment may require surgery. There are three types of surgery that may be performed. The first is called a vagotomy. The vagus nerve sends and receives messages from the brain which causes the stomach to produce acid. During a vagotomy, parts of this nerve are severed, interrupting messages sent through it and thus reducing acid production and secretion. A pyloroplasty is often performed along with the vagotomy procedure.

The pylorus is the opening between the stomach and duodenum. During this surgery, the pylorus is enlarged, allowing food from the stomach to pass more freely into the small intestine. An antrectomy is the removal of the lower part of the stomach. This area of the stomach produces a hormone which stimulates secretion of digestive juices. This procedure is also often performed in conjunction with a vagotomy.

Resources

Digestive Disease Myths

WebMd.Com

Auto Immune Disorders

Overview of Morning Sickness

Morning sickness is a condition which occurs during pregnancy that affects approximately more than half of all pregnant women, but it may also be experienced by women using hormonal contraception or hormone replacement therapy. Usually prominent during the early hours of the morning, morning sickness can occur during any part of the day including during the night.

This condition may be experienced only as mild nausea, or it may cause actual vomiting. In only about 1% of all pregnancies, vomiting may become severe enough to cause dehydration, weight loss, alkalosis (a condition in which the pH of the blood is elevated beyond normal and results in hypoventilation as an attempt to balance the pH), and hypokalemia (a condition in which the concentration of potassium (K+) in the blood is low which may result in elevated blood pressure, cardiac arrhythmias, and/or muscle weakness); this severe form of morning sickness is known as hyperemesis gravidarum.

Morning sickness may be one of the earliest signs that a woman may be expecting a child and usually begins around the 6th week of pregnancy, and it seems to cease around the 12th week of pregnancy for most pregnant women which marks the end of the first trimester and the beginning of the second trimester of pregnancy. However, morning sickness may continue throughout the entire pregnancy for some women.

Alternative names of Morning Sickness

• Nausea gravidarum
• Nausea
• Vomiting of pregnancy
• Emesis gravidarum
• NVP
• Pregnancy sickness

Symptoms of Morning Sickness

Nausea during pregnancy which may or may not be accompanied by vomiting.

Causes of Morning Sickness

• Some women are sensitive to the hundredfold increase in the hormone estrogen circulating in their blood.
• Progesterone also increases which relaxes the smooth muscles of the uterus as well as the smooth muscles of the stomach and intestines resulting in excessive amounts of stomach acids which leads to heartburn, or gastrointestinal reflux.
• Hypoglycemia, or low blood sugar, may be to blame for nausea and/or vomiting in pregnancy due to the placenta taking energy from the expectant mother.
• A sudden increase in the pregnancy hormone, HCG (human chorionic gonadotropin), may inevitably cause nausea.
• Increases in the hormone cholecystokinin causes slowed digestion in order for more efficient nutrient absorption to take place both for the mother as well as the growing fetus.
• Perhaps as a built-in defense mechanism against harmful substances, pregnant women tend to experience an increase in sensitivity to odors, which therefore over stimulates the nausea center of the brain.

Risk Factors of Morning Sickness

• A pregnant woman may be at risk for pregnancy-related nausea if she has ever experienced any of the following prior to the current pregnancy: motion sickness, migraines, sensitivity to certain smells or tastes, sensitivity to estrogen in birth control pills, or she has experienced morning sickness during a previous pregnancy
• An expectant woman may also be at risk for morning sickness if she is pregnant with more than one fetus.

Complications of Morning Sickness

Complications that could jeopardize the pregnancy may arise as a result of more severe morning sickness, hyperemesis gravidarum, and include the following:

• Dehydration
• Malnutrition
• Weight loss
• Alkalosis
• Hypokalemia
• Acid reflux
• High blood pressure
• Hypoventilation
• Muscle weakness
• Cardiac arrhythmias

Tips for lessening nausea and avoiding vomiting associated with morning sickness:

• Consume foods that are high in carbs but low in fat.
• Salty foods such as pickles, pretzels, and saltines as well as foods containing ginger can help in lessening and/or preventing morning sickness.
• Avoid greasy, spicy and fatty foods which help create more stomach acid.
• Eat six small meals rather than three large meals per day.
• Have some saltines handy on your nightstand to nibble on 15 minutes before getting out of bed in the morning.
• Avoid an empty stomach which may aggravate nausea.
• Drink water and other liquids 30-45 minutes before or after meals.
• Sip water and/or ginger ale throughout the day to avoid an empty stomach and/or dehydration.
• Sucking on something hard such as candy or ice chips or ice pops may be helpful.
• Avoid known nausea triggers such as foods or smells that seem to aggravate your nausea.
• Expose yourself to as much fresh air as possible versus stale indoor air.
• Take your prenatal vitamins at night with a snack to avoid queasiness brought on by the vitamins.
• Expose yourself to the smell of freshly cut citrus fruits such as lemons.
• Accommodate food cravings (things you want) and aversions (things that aggravate your morning sickness) when possible.
• Pregnant women tend to crave or get nauseated by things typically because their bodies are telling them what they need or what they need to avoid in order to have a healthy pregnancy outcome.
• Consume fruits and vegetables with a high water concentration such as tomatoes, melons, citrus fruits, strawberries, leafy vegetables, and grapes.
• Try the BRATT diet to keep your stomach settled. The BRATT diet is simply made up of bananas, rice, applesauce, toast and tea.
• If the smell of food being cooked aggravates your nausea, have a loved one cook for you, and make sure there is plenty of ventilation such as having a fan on and/or windows open.
• Rest as often as humanly possible!
• Avoid getting overheated which exacerbates pregnancy nausea.
• Try to work in some light exercise such as walking and/or swimming, but don’t over do it.
• Avoid laying down immediately after eating. Try to allow 2-3 hours after eating to avoid stomach upset caused from acid.

Testing and diagnosis for Morning Sickness

There are no specific tests available to diagnosis morning sickness in itself due to the fact that morning sickness is merely a symptom of pregnancy. On that note, a positive pregnancy test may tell a woman the cause of the nausea and/or vomiting she has been experiencing.

However, sever morning sickness known as hyperemesis gravidarum, or HEG, may require further testing in order to rule out other complications in the pregnancy.

Further testing may include the following:

• Amylase
• Blood calcium level
• Serum electrolytes, which can show low potassium or sodium levels in blood. Low levels can mean dehydration or acid-base imbalance.
• Hematocrit, part of a blood count, which may become high due to dehydration
• Liver enzymes and bilirubin
• Urinalysis for ketones and specific gravity. Ketones are a sign of starvation. Specific gravity can show dehydration.
• An ultrasound may also be done to check the condition of the baby and the womb.
• If a woman has abdominal pain or vomits blood, the doctor may do an endoscopy. This is a test where a small tube is passed through a woman’s mouth and throat down to her stomach. The tube has a light at the end, which helps the doctor to look for problems in the stomach.
• Serum for hepatitis testing
• Liver function tests
• Ultrasound to look at gallbladder
• Urinalysis and culture to test for bacteria
• Ultrasound to look for twins or a tumorous growth of the placenta

Treatment Options for Morning Sickness

Herbal & Home Remedies

• Drink a few teaspoons of wheat germ dissolved in warm milk every hour until the nausea subsides.
• Take 1 tablespoon of apple cider vinegar mixed with 1 tablespoon of honey in cold water before bed.
• Suck a piece of peeled ginger root.
• Drink red raspberry leaf tea.
• Drink peppermint or spearmint tea.
• Drink squaw vine tea.
• Drink ginger tea. Make the tea by boiling some ginger root in water then straining it. Finally, add honey to taste.
• Rear motion sickness bands on your wrists where pressure points which control nausea are located.
• Put three drops of lavender essential oil and one of peppermint in a diffuser or humidifier to scent the air.
• Place a cool lavender scented compress on your forehead and a warm lavender compress over your rib cage.
• Have a loved one massage you with a soothing chamomile massage oil.
• Snack on ginger snap cookies made with real ginger.

Pharmaceutical Remedies

Non-prescription morning sickness remedies include the following:

• Emetrol is the only non-prescription nausea medication that’s considered safe during pregnancy.
• For women whose nausea and vomiting is triggered by acid, reflux medications such as Zantac or Pepcid may work.
• According to the FDA, the combination of Doxylamine and vitamin B6 is considered safe and effective for nausea and vomiting associated with pregnancy.
• Doxylamine is available as a sleeping pill under the brand name Unisom Nighttime Sleep-Aid, not Maximum Strength Unisom Sleep Gels which is an entirely different product. Vitamin B6 may be located in the vitamin section of your local grocery store or pharmacy.

Prescription Remedies

Compazine

Possible side effects:

• Abnormal muscle rigidity
• secretion of milk
• sugar in urine
• abnormalities of posture and movement
• agitation
• anemia
• appetite changes
• asthma
• blurred vision
• constipation
• convulsions
• difficulty swallowing
• discolored skin tone
• dizziness
• drooling
• drowsiness
• dry mouth
• exaggerated reflexes
• fever

You should never suddenly stop taking Compazine, due to adverse effects such as a change in appetite, dizziness, nausea, vomiting, and tremors. When discontinuing this drug, it is important to follow your doctor’s instructions closely. Your ability to drive a car or operate heavy machinery may be impaired when taking this drug, so take extreme caution when participating in any activities that require full alertness. Take caution when outdoors due to sunlight sensitivity related to the use of Compazine. Avoid direct sunlight and use sun block and wear protective clothing including sunglasses. Also, beware that Compazine may interfere with your ability to shed extra heat, so take caution in hot weather.

Be sure your doctor is aware of any drug you are taking. Compazine may interact with the following drugs: Anti-seizure drugs such as Dilantin and Tegretol, Anticoagulants such as Coumadin, Guanethidine (Ismelin), Lithium (Lithobid, Eskalith), Narcotic painkillers such as Demerol and Tylenol
with Codeine, Central nervous system depressants such as Xanax, Valium, Seconal, and Halcion Propranolol, and Thiazide diuretics such as Dyazide

Tigan

Possible side effects:

• Hypersensitivity reactions
• Parkinson’s-like symptoms
• blood dyscrasias
• blurred vision
• coma
• convulsions
• depression of mood
• diarrhea
• disorientation
• dizziness
• drowsiness
• headache
• jaundice
• muscle cramps

Tigan is contraindicated and should not be used in patients with known hypersensitivity to trimethobenzamide. Stop using this drug and tell your doctor immediately if any of these serious side effects occur.

Conclusion

Once more, morning sickness may range anywhere from mild nausea to severe vomiting. Before using any remedy, whether it be a herbal/home remedy or a medication, always first consult with your physician. Home remedies should be your first line of defense for morning sickness due to adverse effects related to the use of medications. If all else fails, your doctor can help you decide on the best treatment option for your morning sickness. Remember, the healthier Mom is the healthier the baby will be!

What Is Pneumonia?

Pneumonia, rather than being a specific disease, is something of a catch-all term to describe respiratory distress brought on by a number of different causes, all of which have the same end result. The lungs experience potentially hazardous levels of inflammation, usually brought on by bacterial, viral or fungal infection. In some cases, chemicals or accidentally inhaled fluids may also lead to pneumonia.

No matter what the origin may be, pneumonia is characterized by inflammation of the alveoli. The alveoli are microscopic air sacs within the sponge-like tissue of the lungs. Infections or irritants can cause these sacs to become swollen and blocked with fluid or pus. When this happens, breathing is restricted and the body becomes starved for adequate oxygen. Without treatment, pneumonia can worsen significantly, necessitating hospitalization and even causing death. Of the more than three million people who will contract pneumonia, 150,000 will die. That is why early detection, varied treatment options and ultimately, preventative care are important

Signs and Symptoms

Symptoms of pneumonia can progress from very mild to life threatening. It is often mistaken for the flu until the illness worsens to a serious health threat. Most commonly, you’ll have a persistent, phlegm-producing cough in which blood may be present, and shortness of breath. Many people experience chills, sweats and fever, headaches and muscle pain. In severe cases, you may even feel nausea and diarrhea set in.

Because the term “pneumonia” describes a condition that can have a variety of origins the exact combination of symptoms will vary from one case to the next. Your individual health profile is also a pivotal determining factor in how pneumonia symptoms will present themselves.

Who Gets Pneumonia?

In a given year, over 3 million people will get pneumonia with fifty percent of those infected needing hospitalization. Years ago, more than a third of those who contracted pneumonia would die from it. Thanks to the introduction of modern antibiotics, the mortality rate for pneumonia has gone down to 5%, with many people capable of receiving treatment at home.

Those at greatest risk for getting pneumonia are:

The Elderly

People over the age of 65 are at much greater risk. In the elderly population, pneumonia often exhibits much subtler symptoms than in teens and adults. Therefore, it is extremely important to see a doctor if you notice any sings of infection.

Young children

Young children with still-developing bodies may not yet have acquired the full complement of antibodies their immune systems need to fight infection. Parents should be particularly watchful for early signs if their child has a history of respiratory conditions like as asthma. As with the elderly, symptoms of pneumonia in children tend to be milder, and therefore risk being mistaken for flu.

People whose immune systems have been weakened by illness

If your immune system has been compromised by an illness, whether chronic or acute, opportunistic varieties of pneumonia can be a threat. Sources of immunological distress may include things like a recent illness, chronic obstructive pulmonary disease (C.O.P.D.), cardiovascular disease, emphysema, diabetes, HIV/AIDS, extreme stress, or even prescription medicines. All of these conditions tax the immune system, leaving your immune system too depleted to resist further infection.

Individuals taking immunosuppressant medicines

Immunosuppressive drugs are prescribed for people who have had organ and tissue transplants and those with autoimmune disorders such as psoriasis, ulcerative colitis (Crohn’s disease), arthritis and multiple sclerosis. All of these are characterized by the body’s immune system attacking its own tissues or cells.

Organ transplant recipients

In the case of an organ transplant, the body may mistakenly react to the new organ as though it is a hostile invader. This erroneous response may cause the rejection of the transplanted organ. By blocking these reactions in the immune system, immunosuppressive drugs protect the new organ, greatly reducing the likelihood of rejection and making such preventative treatment essential to the long-term survival of a transplant recipient.

Autoimmune Disease

An autoimmune disorder is a malfunction of the immune system in which the body attacks its own tissues, or hyper-reacts to substances with which you come into contact. Chronic autoimmune disorders like rheumatoid arthritis and multiple sclerosis are usually crippling and can even be fatal. Dulling the activity of the immune system serves to protect the body from dysfunctional internal responses while also reducing the discomfort. Sadly, the almost universal trade off in using such drugs is that they cause increased vulnerability to infections.

People who have recently undergone chemotherapy

Chemotherapy targets cells in the body that multiply rapidly. However, it does so indiscriminately, meaning that non-cancerous cells are also harmed. While this is clearly ideal for halting the growth of fast-growing tumors, it also reduces the number of white blood cells available in the blood stream and lymphatic system. White blood cells, also called leukocytes, serve immunological functions that range from protecting the body from bacteria, fungi and parasites, to limiting inflammation. Since all of these factors commonly precede pneumonia, the additional vulnerability caused by chemotherapy requires vigilance by both patient and physician.

Smoking and Alcohol Abuse

Smoking causes severe damage to the cilia within the nasal cavity and bronchial passages. Cilia are microscopic hairs that act as filters for the airways. They prevent dust particles and other airborne irritants from making their way into the delicate lungs. By beating in a wave-like manner, they gently move natural secretions and irritants out of the airway before they can cause harm. Smoking causes paralysis of these important filtration devices, allowing secretions to build up and block the airways. If these secretions contain bacteria or other infectious agents, they can cause pneumonia.

Alcohol can adversely affect your gag reflex, preventing your body from expelling irritants to the throat, the shared pathway of the digestive and respiratory systems. Alcohol also slows the activity of white blood cells.

Additional Risk Factors

Hospitalization in an Intensive Care Unit

Patients in intensive care units of their hospital are already in a state of acute physical and often, emotional distress that can have a negative effect on their immunity to pathogens. Moreover, should they be placed on artificial ventilation, their risk of getting pneumonia rises significantly. The breathing tube inserted through the mouth bypasses much of the upper respiratory tract where many of the respiratory system’s defense mechanisms reside. It prevents the patient from coughing and can also cause the contents of the stomach to back up and be inhaled accidentally. When these contents contain pathogens or irritate the tissue of the lungs, pneumonia can develop.

Surgery or Traumatic Injury

People who have recently had surgery or any kind of traumatic injury are at increased risk. Their lack of mobility, especially if they have to lie on their back, can make it difficult to cough end expel accumulated mucus from the lungs. Immobility can also impede the proper circulation of lymph through the body. Lymph is the body’s natural cleaning system. It cleans dead cells and pathogens from the bloodstream and tissues. When its circulation is not optimal, your resistance to infection is also reduced.

These issues, as well as the increased presence of antibiotic-resistant pathogens in hospitals may explain why pneumonia acquired during a hospital stay tends to be more severe than other kinds.

Inhaling corticosteriods for more than 24 weeks

Corticosteroids are prescribed as a treatment for chronic obstructive pulmonary disease. However, according to research published by Johns Hopkins in the Journal of the American Medical Association, they increase the risk of pneumonia by as much as 46%. Although the exact reason is not certain, researchers at the university speculate that inhaled corticosteroids suppress the immune system.

Exposure to Chemicals or Environmental Pollutants

Those who work in the industrial, agricultural, military or building industries may be exposed to chemicals which cause inflammation within the lungs, making it hard for your body to keep them clear. Living in areas with high levels of pollution can also increase the risk of getting pneumonia.

Ethnicity

The rate of pneumonia infection is three times higher in African Americans than in Caucasians. In Native American populations, that number jumps up to being 5-10 times that of whites. According to the Center for Disease Control, the mortality rate for Native American infants with pneumonia is double that of the general U.S. population. For this reason, many contemporary allopathic medical practitioners recommend vaccinations for those whose ethnicity places them in a higher risk category.

Causes and Types of Pneumonia

Pathogens

The term pathogen refers to any cause of disease, but most commonly refers to infectious agents. These include bacteria, viruses and fungi. Certain opportunistic infectious organisms can cause severe, even deadly, forms of pneumonia and can affect even healthy people. Examples include the avian flu virus (H1N1 influenza) and SARS (severe acute respiratory syndrome), tuberculosis, anthrax, and plague.

Community-acquired pneumonia

This refers to pneumonia acquired in places people frequent in their everyday lives. Places like your child’s nursery school, your gym, public transportation and your office can be hosts to two types of bacteria which cause pneumonia. The first, streptococcus pneumoniae is the most common cause of pneumonia. The other, mycoplasma pneumoniae causes the mild form of pneumonia which is usually referred to as “walking pneumonia.”

Hospital-acquired pneumonia

Pneumonia contracted during a hospital stay, called nosocomial pneumonia, is usually more serious than other varieties. Hospital-acquired pneumonia is only diagnosed if pneumonia symptoms present themselves at least 48 hours after you are admitted. One subtype within this category is post-operative pneumonia, most common in patients over 70, who have undergone chest or abdominal surgeries. Another subcategory is health-care associated pneumonia, found in people whose health requires them to go to dialysis centers or chronic care clinics where medications are administered by intravenous drip (I.V.).

Medical Tests and Diagnosis

When to Consult a Physician

Pneumonia can be life threatening. If you suspect that you may have it, it is very important to see a qualified physician before your symptoms become severe. If you have a history of respiratory conditions, it is even more essential that you seek out medical expertise right away, since the early stage symptoms can be quite mild, and easily mistaken for a cold or flu. If you are recovering from a cold or flu which suddenly becomes worse, you should see your doctor to rule out pneumonia. If you are experiencing an inexplicable fever over 102ºF, especially if it is accompanied by chills and sweating, and if you have an ongoing cough or shortness of breath, it is time to enlist professional assistance.

Elderly adults, young children, and all those in high risk populations need quick attention since their conditions can progress rapidly from mild to dangerous.

Diagnosis

Diagnosis of pneumonia is made based on several factors. First your physician will consider your health history, particularly whether you have a history of respiratory illnesses. Next, he or she will use a stethoscope to listen to your lungs. Crunchy or bubbly breathing sounds may indicate the presence of fluid accumulation in the lungs. If your doctor detects them, a chest x-ray may be ordered. The x-ray images can confirm with certainty whether you have pneumonia while also allowing your doctor to pinpoint the exact location of the infection. Sometimes, your doctor may also take blood and mucus samples. Analysis of your blood will tell your physician whether your white blood cell count is healthy, while mucus specimens will reveal the exact pathogen behind the infection. Knowing whether the origin of pneumonia was a specific bacterial infection or virus allows your doctor to treat you more quickly and accurately.

How is pneumonia treated?

Treatment of pneumonia is determined by matching the origin of the illness to the proper medication, or other means of healing.

Bacterial

Bacterial infections are treated with antibiotics.

Viral

If a virus caused the infection, your doctor might prescribe antiviral medication. However, it is much more common for no drugs, but plenty of rest and fluids to be the recommended.

Fungal

If your infection was caused by fungi, antifungal medications are available.

It is essential that you take medications exactly the manner your doctor has prescribed. Use the entire prescription to ensure that no remnants of the illness remain in your system.

Side Effects

Side effects from antibiotics, antiviral and antifungal drugs can include stomach upset, anemia, headaches, rashes, kidney damage and liver damage.

Alternative Treatments

Because pneumonia can be life threatening, you should seek the advice of a medical doctor before using alternative care exclusively. Alternative treatments should be complementary to medical care, rather than replacing it completely. In cases when no pharmaceutical prescription is offered, alternative remedies can offer an excellent source of added support and comfort as your body recovers. For individuals who are at a higher risk of getting pneumonia, alternative therapies like herbs and acupuncture are excellent preventative tools.

Acupuncture

Acupuncture uses precise placement of nearly invisible needles to stimulate and balance the flow of bio-electric energy through the body. Its effects bolster immunity, strengthen your lungs and clear excess mucus from your body. Acupuncture practitioners typically have a master’s degree in their art and will do a very detailed exam to determine the best way to assist you. Clinical studies continue to find evidence which supports acupuncture as effective and gentle, and its acceptance in the medical community continues to grow.

Side Effects

Rare. Acupuncture may cause minor, temporary tenderness at the site of needle insertion. Post-treatment, patients may be lightheaded.

Costs

$60-$125 per treatment

Garlic

Garlic is one of the few treatments proven in clinical studies to have an antiviral effect. Since doctors frequently do not prescribe any pharmaceutical medications for pneumonia of viral origin, garlic may be a valuable source of additional support. Herbalists also use garlic to reduce fever and support the cardiovascular system. Garlic supplements should be taken according to a manufacturer’s recommended dosage or the advice of a qualified herbalist. It is useful as a preventative agent as well as a home remedy during an active illness.

Side Effects

Garlic users may notice an odor in the sweat or breath. Garlic may have a very mild blood thinning effect, so excessive intake should be avoided in those who have very low blood pressure or clotting issues.

Cost

$7-$10

Lobelia

Lobelia is a bronchial dilator, meaning it dilates or opens the bronchial passages to ease restricted breathing. It is available in tincture form, with a recommended initial dosage of 10 drops per day.

Side effects

Lobelia is a strong emetic, meaning it can cause nausea in sensitive individuals.

Cost

$10-25

Lungwort

Lungwort is an expectorant, meaning that it clears mucus. In Chinese medicine, it is also considered an emollient, making it a potentially soothing substance. It is known for its gentleness, making it safe even for children. In widely published medical studies, it is praised for potent antibacterial action against strep, staph, and other organisms associated with tuberculosis and pneumonia. When taken in tincture form, 2-4 droppers per day are recommended.

Side effects

None

Cost

$10-25

Preventing Pneumonia

Prevention is the best avenue for avoiding the complications of pneumonia. With more and more treatment resistant strains of bacteria and viruses emerging in recent times, prevention is your most effective line of defense. Any means of strengthening your body’s natural resistance to infection are invaluable. If you have risk factors for pneumonia, like asthma, G.E.R.D., or smoking addiction, resolving those issues will also reduce your vulnerability to infection. For those in high-risk categories, such as the elderly and young children, vaccination may be recommended.

The common cold, also known as upper respiratory tract infection, acute viral rhinopharyngitis, acute coryza, or simply cold, is the one of the most prevalent illnesses in America. It is also the number one reason that people visit their doctors. Depending on the type of virus, symptoms and duration of cold will vary. Some people are more susceptible to colds, and might even contract them several times in a given year.

Unfortunately, there is no known cure for the common cold, only relief for its symptoms. However, colds are generally mild and manageable, and often do go away by itself over a short period of time. There are also a variety of over-the-counter and prescribed medications that can help relieve the symptoms as well.

Symptoms

Colds may exhibit any or all of the following symptoms:

Runny nose

In the beginning, mucous is often clear and thin. Over the course of the cold, mucous might thicken and become yellow and greenish in color.

Sneezing

Sneezing might occur constantly throughout the first few days and lessens over the next few days.

Nasal congestion

This is also known as a “stuffy nose” caused by the build-up of mucous in the nasal passages. Congestion can cause some discomfort in breathing and sleeping at night.

Watery eyes

Watery, itchy and red eyes can all be symptoms of the cold. Beware of excessive rubbing, which might allow bacteria to enter eyes and cause an infection.
Headaches

It is also common to develop headaches or head colds. This might be a result of a natural response in which cytokines are released by your immune system to attack the virus.

Sore Throat

Colds can cause soreness or scratchiness in the throat, making it painful to swallow and talk. Sore throat is one of the early symptoms in the onset of a cold. It could worsen if drainage from the nose or the sinuses irritates the throat, causing an infection.

Low fever

Fevers accompanying colds are usually under 102 degrees and last for a short period of time. A high fever might indicate influenza (flu), which is more severe and lasts for a longer time.

Cough

The excess mucous from the cold often irritates the throat, causing a need to cough. This symptom usually exhibits later on over the course of the cold and can persist for a much longer time, even after all other symptoms disappear.

Mild Muscle Aches

There might be a slight aching sensation throughout the body. The aches should be dull and mild enough to allow for normal body movement.

Fatigue

Fevers often cause a general feeling of tiredness and sleepiness. A person with a cold will feel a great need to rest and stay in bed.

Chills

A feeling of coldness or the need to shiver might present as a symptom. Chills usually accompany fevers and could persist until body temperature returns to normal.

Conjunctivitis

Also known as pink eye, conjunctivitis is the infection of the conjunctiva, the membrane lining the eyelids. The eyelids might look red and swollen and feel itchy and painful. There is often a yellowish discharge that can crust over the eye.

Causes

More than 200 viruses can cause the common cold. Rhinoviruses are the most common, accounting for 10 to 40 percent of all colds. The next most common group of virus is the coronavirus, which accounts for 20% of colds. The respiratory syncytial virus (RSV) causes about 10% of all colds. Colds are mainly spread by direct physical contact.

Sneezing and coughing allow the virus to pass from one person to another. It takes about eight to twelve hours for the virus to replicate after initial contact. For the first cold symptoms to develop, it might take anywhere from ten hours to five days. The duration of a cold is typically a few days to a week. However, a cold can last up to 3 weeks, while symptoms such as coughing can last up to a month.

Risk Factors

Children are highly susceptible to colds. They are constantly in physical contact with other children, making it easier for the virus to spread. Also there is a greater tendency for children to rub their eyes and noses, allowing the virus to enter their bodies. Children are more likely to have more severe symptoms such as persistent coughing and pink eye. They are also at a greater risk for ear infections due to the worsening of cold symptoms.

Some people work in fields that put them at a higher risk for colds, such as teachers and other school personnel that work with children. Working in crowded indoor settings or with large groups of people also increases the risk of contracting the virus.

Parents are also more likely to contract colds from their children. Mothers are twice as likely to catch the cold than fathers.

Although smoking does not cause colds, it increases the risk of contracting a cold. It can also extend the duration of a cold for a few days.

The risk for contracting a cold is highest during the wintertime. One of the reasons is that people tend to be indoors more, allowing for the virus to spread quickly from one person to another. Some studies have also shown that the cold virus lives longer in cold air, making winter a likelier time for the virus to spread.

Prevention Tips

• Wash your hands with soap and water as often as possible. Regular soap works just as well as antibacterial soap. If washing is not possible, the use of hand sanitizers or antibacterial gels can also prevent colds.
• Cover your mouth and nose when you cough and sneeze with a tissue or handkerchief. Do not use your hands. Teach children to cough or sneeze into their elbows if they do not have a tissue on hand.
• Smoke less. Smoking can lower your immune system’s ability to fight off viruses, increasing your chances of contracting a cold.
• Limit alcohol consumption. Just like smoking, alcohol also suppresses your immune system, making you more susceptible to the virus.
• Drink more water. Keep your body healthy by constantly rehydrating and drinking water.
• Sleep more. A lack of sleep might weaken your body’s defenses against viruses. Get plenty of rest and stay relaxed.
• Eat lots of fruits and vegetables. Fruits and vegetables contain the necessary vitamins and minerals that can help boost your immune system.

Test and Diagnosis Considerations

There are no specific tests that indicate whether you have the cold virus. Since colds are quite common and nonthreatening, tests are often done to rule out other possibilities instead.

Influenza or the flu is similar to the cold virus, but exhibits much more severe symptoms. Fever is usually much higher (over 102 degrees) and is accompanied with greater body aches and chills. A person with a cold might feel weaker than usual but can still fulfill simple everyday tasks. However, a person with the flu will feel extreme fatigue that prevents him or her from getting out of bed. A person diagnosed with the flu will need more bed rest and a longer absence from work or school.

A strep test might be administered to determine whether a sore throat is caused by the streptococcal bacteria or the cold virus. Strep throat can have serious long term effects and require antibiotics for treatment. Usually there are clear indications for strep, such as yellow and white patches in the back of the throat. There is usually a high fever of over 101 degrees, as oppose to a low fever for colds.

Allergies can also mimic colds, with excessive sneezing, runny nose or nasal congestion. Although either condition will eventually subside by itself, allergies can be treated with antihistamines for quick relief. Allergies often involve itchiness of the eyes and nose, and are not accompanied by fevers and coughs.

Sinusitis is the inflammation or infection of the sinuses. Although colds do not directly cause sinusitis, their symptoms might. An excessive build-up of fluids in the sinus cavity can lead to infection. Usually there is pain around the eyes, nose and cheekbone area. Antibiotics can be used to treat sinusitis.

Treatment Options

Herbal and Home Remedies

Although there is no cure for the cold virus, there are many herbal and home remedies that can help relieve symptoms and shorten the duration of a cold. Most of them are safe, cost-effective and worth a try.

Water and Hot Fluids

Although water does not flush the cold out of your system like many people believe, it helps keep your body hydrated. This is especially important when you have a cold, since your body might be worn out and dehydrated. Drinking water can also loosen congestion and build-up in your throat. Hot fluids such as tea help relieve symptoms such as sore throat and congestion.

Chicken Soup

Probably the most popular remedy for a cold, chicken soup might possibly have some scientific basis for relieving colds. Some studies have shown that chicken soup actually inhibits the inflammation of cells in the nasal passage, clearing up nasal congestion. Even if its effectiveness is debated, chicken soup is still a tasty and soothing remedy for those experiencing sore throat and a loss of appetite.

Saltwater

Gargling with saltwater often helps relieve soreness in the throat. Some believe that the use of salt reduce the swelling of the throat, thereby relieving the pain.

Echinacea

Echinacea is an herbal plant that was first used by Native Americans for its medicinal properties. It has grown in popularity over the recent years and is used as a remedy to fight the common cold. It is also used as a supplement to prevent the onset of colds. The herb is available in pill or liquid form, and can even be made into a tea.

Research findings seemed to yield mixed results. Side effects are often minimal, though some people have developed allergic reactions from taking the supplement. If you experience shortness or difficulty in breathing, swelling or hives, stop taking it immediately. A person with any types of immunodeficiency or is currently on immunosuppressants should avoid taking echinacea. Echinacea is inexpensive and can be easily purchased at a health store or pharmacy.

Zinc

Zinc helps our bodies maintain a healthy immune system. Some people believe that taking zinc supplements shortens the duration of a cold. The supplement can be taken in as a pill, spray or lozenge. Since different studies yield different data, the results are still inconclusive.

It is advisable to take dosages of zinc as directed on label, since overdosing can be dangerous, interfering with the absorption and metabolism of other minerals in your body. Possible side effects include upset stomach, heartburn and nausea. Although less commonly experienced, some people have also reported fever, mouth sores, fatigue and sore throat. The average cost of the supplement ranges from $3-$25.

Vitamin C

Vitamin C is essential to healthy bones, teeth and gums, and can be found in many types of fruits and vegetables. Some studies have shown that a high dose of vitamin C can reduce the severity and duration of the common cold. Others have shown that any benefits shown from the supplement might be a result of the placebo effect, whereby a person gets better from the mere belief that it is effective.

Again, data has been largely inconclusive from the scientific community. Although not dangerous, side effects of high doses of vitamin C include headache, nausea, vomiting, intestinal cramps, fatigue, insomnia, drowsiness and diarrhea. Risk for any major conditions is very low since vitamin C is water soluble and can easily pass through the body. Supplements can also be purchased at any health store and pharmacy in the price range of $5-25, depending on the brand, dosage and quantity.

Neti Pot

The neti pot is shaped like a kettle and is used for nasal irrigation, a process that existed centuries ago. The pot is filled with saline solution, which is in then poured into the nostril to flush out mucous and other irritants in the nasal cavity.

To use pot, tilt your head to one side and insert spout into nostril. Gently pour saline solution into nostril, which will then exit through the other nostril. The neti pot provides temporary relief and helps with nasal decongestion. They are available for purchase in pharmacies and homeopathic stores and costs between $10- $20.

Pharmaceutical Treatments

Analgesics/Pain Relievers

Analgesics or pain relievers do not kill the cold virus, but target cold symptoms. The most widely used analgesic is acetaminophen, which is the main ingredient of Tylenol. It is effective in reducing fevers, headaches, and muscle soreness. However, there are possible risks of liver or kidney damage in high dosages. Ibuprofen is another common pain reliever available over-the-counter at the pharmacy.

Popular brands containing ibuprofen as the active ingredient include Advil and Motrin. Side effects are rare and include anxiety, constipation, diarrhea, nausea, insomnia, fatigue and upset stomach. Salicylate or aspirin is also widely used for reducing fever and pain. Similarly to the other analgesics, aspirin has few mild side effects including dizziness, heartburn, nausea, nervousness, and upset stomach.

All three types of pain relievers are available at pharmacies. Both brand name and generics are available and generally have the same intended effect. However, generic brands are usually much less expensive than the name brand and can cost less than half the price.

Cough Suppressants (Antitussives)

Cough suppressants or antitussives can provide relief for continuous coughing by reducing the urge to cough. Many people with the cold feel a tickling and itchy sensation in their throats, inducing them to cough. Antitussives are effective for dry coughs only. For wet coughs, expectorants are much more helpful. Cough suppressants are available in syrup form or as lozenges.

The active ingredient commonly used in cough suppressants is dextromethorphan. However, it has shown to be less effective in cough medications for children. Well-known brands containing dextromethorphan include Robitussin, NyQuil, Dimetapp, and Vicks, which can be purchased at any local pharmacy for under $10.

Possible side effects include itching/rashing, nausea, drowsiness, fever, hallucinations, vomiting, blurred vision and dilated pupils. Codeine is another ingredient used in cough suppressants. Since it is a much stronger ingredient, a prescription is required.

Expectorants

Expectorants, on the other hand, thin out the mucus that is blocking the airways to the lungs. This allows the mucous to be expectorated or coughed up and relieves the congestion in the chest cavity. To determine whether cough suppressants or expectorants should be used, figure out whether the cough is wet or dry. For wet coughs, expectorants are much more effective.

The active ingredient in most expectorants is guaifenesin, found in brands including Mucinex, Tussin, and Robitussin Chest Congestion. It is not recommended for women who are pregnant. Side effects include headache, dizziness, upset stomach, diarrhea and vomiting.

Decongestants

Decongestants relieve the swelling in the nasal passages caused by an increase in mucous, clearing up congestion. They are usually available in two forms: pill or nasal spray. Pseudoephedrine is the active ingredient in decongestant medications such as Sudafed, and is also combined with analgesics to create many cold medications.

There are few side effects, including dizziness, restlessness, increased blood pressure and heart rate and irregular heartbeat. Nasal sprays allow for quick delivery of decongestants through the nose by constricting the blood vessels and openings nasal passages for immediate relief. They contain active ingredients such as oxymetazoline hydrocholoride (as in Afrin and Vicks Sinex) and phenylephrine hydrocholoride (as in Neo Synephrine and Dristan). People with high blood pressure, diabetes, heart conditions and thyroid problems should avoid using the sprays.

Side effects, though uncommon, include dizziness, nervousness, and sleeplessness. Most sprays are available over-the-counter for under $10. However, Nasonex requires a doctor’s prescription.

Resources

WebMd.Com
CDC.Gov
EverydayHealth.Com