Thursday, October 26

About Hammer Toe

A Hammer Toe
A Hammer Toe
Hammer toe is a deformity of the toe where the end of the toe is bent downward.

Causes of Hammer Toe

Hammer toe most often affects the second toe. However, it may also affect the other toes. The toe moves into a claw-like position.

The most common cause of hammer toe is wearing short, narrow shoes that are too tight. The toe is forced into a bent position. Muscles and tendons in the toe tighten and become shorter.

Hammer toe is more likely to occur in:

• Women who wear shoes that DO NOT fit well or often wear shoes with high heels
• Children who wear shoes they have outgrown

The condition may be present at birth (congenital) or develop over time.

In rare cases, all of the toes are affected. This may be caused by a problem with the nerves or spinal cord.

Symptoms of Hammer Toe

The middle joint of the toe is bent. The end part of the toe bends down into a claw-like deformity. At first, you may be able to move and straighten the toe. Over time, you will no longer be able to move the toe. It will be painful.

A corn often forms on the top of the toe. A callus is found on the sole of the foot.

Walking or wearing shoes can be painful.

Exams and Tests

A physical exam of the foot confirms that you have hammer toe. The health care provider may find decreased and painful movement in the toes.

Treatment of Hammer Toe

Mild hammer toe in children can be treated by manipulating and splinting the affected toe.

The following changes in footwear may help relieve symptoms:

• To avoid making the hammer toe worse, wear the right size shoes or shoes with a wide toe box for comfort
• Avoid high heels as much as possible.
Wear shoes with soft insoles to relieve pressure on the toe.
• Protect the joint that is sticking out with corn pads or felt pads.

A foot doctor can make foot devices called hammer toe regulators or straighteners for you. You can also buy them at the store.

Exercises may be helpful. You can try gentle stretching exercises if the toe is not already in a fixed position. Picking up a towel with your toes can help stretch and straighten the small muscles in the foot.
Hammer Toes Before and After Surgery

For severe hammer toe, you will need an operation to straighten the joint.

• The surgery often involves cutting or moving tendons and ligaments.
• Sometimes, the bones on each side of the joint need to be connected (fused) together.

Most of the time, you will go home on the same day as the surgery. You may be able to put weight on your heel to walk around during the recovery period. The toe may still be stiff after surgery, and it may be shorter.

Outlook (Prognosis)

If the condition is treated early, you can often avoid surgery. Treatment will reduce pain and walking problems.

When to Contact a Medical Professional

If you have hammer toe, call your provider:

• If you develop thick blisters or corns on your toes
• If your pain gets worse
• If you have difficulty walking or fitting into shoes comfortably

Prevention of Hammer Toes
Hammer Toes

Avoid wearing shoes that are too short or narrow. Check children's shoe sizes often, especially during periods of fast growth.
Read More »

Wednesday, October 25

Bedwetting or Nocturnal Enuresis

Bedwetting or Nocturnal Enuresis

Bedwetting, or nocturnal enuresis, is when a child wets the bed at night, more than twice a month, after age 5 or 6.

Causes of Bedwetting

The last stage of toilet training is staying dry at night. To stay dry at night, your child's brain and bladder must work together so your child wakes up to go to the bathroom. Some children develop this ability later than others.

Bedwetting is very common. Millions of children in the U.S. wet the bed at night. Some children still wet the bed at age 7, or even older. Although the problem usually goes away over time, many children, and even a small number of adults, continue to have bedwetting episodes.

Bedwetting also runs in families. Parents who wet the bed as children are more likely to have children who wet the bed.

There are 2 types of bedwetting;

• Primary enuresis. Children who have never been consistently dry at night. This most often occurs when the body makes more urine overnight than the bladder can hold, and the child does not wake up when the bladder is full. The child's brain has not learned to respond to the signal that the bladder is full. It is not the child's or the parent's fault. This is the most common reason for bedwetting.

• Secondary enuresis. Children who were dry for at least 6 months, but start bedwetting again. There are many reasons that children wet the bed after being fully toilet trained. It might be physical, emotional, or just a change in sleep. This is less common, but still not the fault of the child or parent.

While less common, physical causes of bedwetting may include:

• Lower spinal cord lesions
• Birth defects of the genitourinary tract
• Urinary tract infections
• Diabetes

Self-care at Home

Remember that your child has no control over bedwetting. So try to be patient. Your child also may feel embarrassed and ashamed about it, so tell your child that many children wet the bed. Let your child know you want to help. Above all, do not punish your child or ignore the problem. Neither approach will help.

Take these steps to help your child overcome bedwetting.

• Help your child understand not to hold urine for a long time.
• Make sure your child goes to the bathroom at normal times during the day and evening.
• Be sure your child goes to the bathroom before going to sleep.
• It is OK to reduce the amount of fluid your child drinks a few hours before bedtime. Just do not overdo it.
• Reward your child for dry nights.
Bedwetting Alarm
Bedwetting Alarm
You might also try using a bedwetting alarm. These alarms are small and easy to buy without a prescription. The alarms work by waking children when they start to urinate. Then they can get up and use the bathroom.

• Bedwetting alarms work best if you use them every night.
• Alarm training can take several months to work properly.
• Once your child is dry for 3 weeks, continue using the alarm for another 2 weeks. Then stop.
• You may need to train your child more than once.

You may also want to use a chart or keep a diary that your children can mark each morning they wake up dry. This is especially helpful for children, ages 5 to 8 years old. Diaries allow you to see patterns in your child's habits that may help. You can also show this diary to your child's doctor. Write down:

• When your child urinates normally during the day
• Any wetting episodes
• What your child eats and drinks during the day (including time of meals)
• When your child naps, goes to sleep at night, and gets up in the morning

When to Call Your Doctor

Always notify your child's health care provider of any bedwetting episodes. A child should have a physical exam and a urine test to rule out urinary tract infection or other causes.

Contact your child's health care provider right away if your child is having pain with urination, fever, or blood in the urine. These may be signs of an infection that will need treatment.

You should also call your child's provider:

• If your child was dry for 6 months, then started bedwetting again. The provider will look for the cause of the bedwetting before recommending treatment.
• If you have tried self-care at home and your child is still wetting the bed.

Your child's doctor may prescribe a medication called DDAVP (desmopressin) to treat bedwetting. It will decrease the amount of urine produced at night. It can be prescribed short-term for sleepovers, or used long-term for months. Some parents find that bedwetting alarms combined with medicine work best. Your child's provider will work with you to find the right solution for you and your child.
Read More »

Monday, October 16

Knock Knees or Genu Valgum

Knock Knees or Genu valgum
Knock Knees or Genu valgum
Knock knee is a condition in which the knees touch, but the ankles do not touch. The medical term for knock knee is genu valgum, it causes the knees to turn inward and touch either while standing straight. The legs turn inward.

Genu valgum is common among small children around the ages of 2 to 4 and will sometimes last up until the child is 8 years old where he or she will have grown out of it.

Causes of Knock Knees

Infants start out with bowlegs because of their folded position while in their mother's womb. The legs begin to straighten once the child starts to walk (at about 12 to 18 months). By age 3, the child becomes knock-kneed. When the child stands, the knees touch but the ankles are apart.

By puberty, the legs straighten out and most children can stand with the knees and ankles touching (without forcing the position).

However, if this condition doesn't develop until the child reaches 6 years old or older, or if the child still has knock knees during their adulthood then it may be a sign of a more serious problem and knock knee correction should be mandatory.

People who enter their adolescents/adulthood with knock knees will want to correct the problem even if they don't feel any pain because they feel awkward when they stand or walk.
Genu valgum or Knock Knees
Genu valgum or Knock Knees
They will have an unnatural gait due to their knees rubbing against one another, which can have a negative impact on their self-esteem/confidence in social settings.

Other than an embarrassing gait, knock kneed adults are much more injury prone than those who are not. As you can imagine playing sports and participating in certain activities would put a person who has knock knees at great risk of injuring themselves.

Some of the signs to look out for that could indicate a more serious underlying problem include:

• Extreme curvature
• Just one side is affected
• The problem doesn't go away after age 8.
• Your child is unusually short for his or her age.

Knock knees can develop as a result of a medical problem or disease, such as:

• Injury of the shinbone (only one leg will be knock-kneed)
• Osteomyelitis (bone infection)
• Overweight or obesity
• Rickets (a disease caused by a lack of vitamin D, phosphate, and calcium)
• Osteoarthritis - Different types of arthritis can affect a person's knee joint and lead to the development of knock knees.
• Blount's Disease - Blount's disease is a condition that causes abnormal growth in the lower leg bone called the tibia or shin bone.
• Scurvy - Scurvy is another condition that can cause knock knees. This condition is the result of vitamin C deficiency.
Knock Knees or Genu valgum on Xray
Knock Knees or Genu valgum on Xray
Exams and Tests

A health care provider will examine your child. Tests will be done if there are signs that knock knees are not a part of normal development.

Treatment of Knock Knees

Knock knees are not treated in most cases.

If the problem continues after age 7, the child may use a night brace. This brace is attached to a shoe.

Surgery may be considered for knock knees that are severe and continue beyond late childhood.

Outlook (Prognosis) for Knock Knees

Children normally outgrow knock knees without treatment, unless it is caused by a disease.

If surgery is needed, the results are most often good.

Possible Complications of Knock Knees

Complications may include:

• Difficulty walking (very rare)
• Self-esteem changes related to cosmetic appearance of knock knees
• If left untreated, knock knees can lead to early arthritis of the knee
• When to Contact a Medical Professional
• Call your provider if you think your child has knock knees.

Prevention of Knock Knees

There is no known prevention for normal knock knees.
Read More »

Sunday, October 8

A Guide to Cataracts

Eye With Cataracts
Eye With Cataracts
What Are Cataracts?

A cataract is a progressive, painless clouding of the natural, internal lens of the eye. Cataracts block light, making it difficult to see clearly. Over an extended period of time, cataracts can cause blindness. They're often related to growing older, but sometimes they can develop in younger people

How Cataracts Affect Your Vision

In a normal eye, light enters and passes through the lens. The lens focuses that light into a sharp image on the retina, which relays messages through the optic nerve to the brain. If the lens is cloudy from a cataract, the image you see will be blurry. Other eye conditions, such as myopia, cause blurry vision, too, but cataracts produce some distinctive signs and symptoms.
Blurred Vision Seen With Cataracts
Blurred Vision Seen With Cataracts
Cataract Symptoms

Blurry Vision

Blurry vision at any distance is the most common symptom of cataracts. Your view may look foggy, filmy, or cloudy. Over time, as the cataracts get worse, less light reaches the retina. People with cataracts may have an especially hard time seeing and driving at night.

Glare

Another early symptom of cataracts is glare, or sensitivity to light. You may have trouble seeing in bright sunlight. Indoor lights that once didn’t bother you now may seem too bright or have halos. Driving at night may become a problem because of the glare caused by street lights and oncoming headlights.

Double Vision

Sometimes, cataracts can cause double vision (also known as diplopia) when you look with one eye. This is different from the double vision that comes from the eyes not lining up properly. With cataracts, images appear double even with one eye open.
Color Changes Due To Cataracts
Color Changes Due To Cataracts
Color Changes

Cataracts can affect your color vision, making some hues look faded. Your vision may gradually take on a brownish or yellowish tinge. At first, you may not notice this discoloration. But over time, it may make it harder to distinguish blues and purples.

Second Sight

Sometimes, a cataract may temporarily improve a person’s ability to see close-up, because the cataract acts as a stronger lens. This phenomenon is called second sight, because people who may have once needed reading glasses find that they don’t need them anymore. As the cataract worsens however, this goes away and vision worsens again.

New Prescription

Frequent changes to your eyeglass or contact lens prescription can be a sign of cataracts. This is because cataracts are usually progressive, meaning they get worse over time.

Who Gets Cataracts?

The majority of cataracts are related to aging. More than half of Americans over 65 have cataracts. Babies are sometimes born with cataracts, also called congenital cataracts, or children may develop them as a result of injury or illness. Exposure to Ultraviolet (UV) light can also increase the risk of cataract and other eye conditions.
Illustration Of Cataract
Illustration Of Cataract
What Causes Cataracts?

The exact cause of cataracts is unknown. While the risk grows as you get older, these factors may also contribute:

• Diabetes
• Smoking
• Excess alcohol use
• Eye Injury
• Prolonged use of corticosteroids
• Prolonged exposure to sunlight or radiation
• Cataract On Eye Seen From Side

How Are Cataracts Diagnosed?

Most cataracts can be diagnosed with an eye exam. Your eye doctor will test your vision and examine your eyes with a slit lamp microscope to look for problems with the lens and other parts of the eye. The pupils are dilated to better examine the back of the eye, where the retina and optic nerve lie.

Surgery for Cataracts

If you have vision loss caused by cataracts that can’t be corrected with glasses or contact lenses, you may need surgery to remove the cataracts. In cataract surgery, the cloudy lens is removed and replaced with an artificial lens. The surgery, which is done on an outpatient basis, is safe and extremely effective at improving vision. If cataracts are present in both eyes, surgery will be done on one eye at a time.

Types of Cataract Surgery

There are two types of cataract surgery. In the more common type, called phacoemulsification (phaco), the doctor makes a tiny incision in the eye and breaks up the lens using ultrasound waves. The lens is removed, and an intraocular lens (IOL) is put in its place. In most modern cataract surgeries the IOL eliminates the need for thick glasses or a contact lens after surgery.

Cataract Surgery Innovations

Recent developments in cataract surgery can correct both near and distance vision. They minimize or eliminate the need for reading glasses after surgery. Conventional "monofocal" lenses only correct for distance vision, meaning reading glasses are still needed after surgery. Multifocal IOLs (Intraocular Lens) can be an option in some patients to help improve both distance and near vision. "Toric" implants are available to correct astigmatism. A lens for better color vision is in development (shown here next to a dime).

What to Expect After Surgery

For a few days, your eye may be itchy and sensitive to light. You may be prescribed drops to aid healing and asked to wear an eye shield or glasses for protection. It'll take about eight weeks for your eye to heal completely, though your vision should begin to improve soon after surgery. You may still need glasses, at least occasionally, for distance or reading -- as well as a new prescription after healing is complete.
Preparing For Cataract Eye Surgery
Preparing For Cataract Eye Surgery
Cataract Surgery Risks

Complications from cataract surgery are rare. The most common risks are bleeding, infection, and changes in eye pressure, which are all treatable when caught early. Surgery slightly raises the risk of retinal detachment, which requires emergency treatment. Sometimes, lens tissue left after surgery and used to support the IOL can become cloudy, even years after surgery. This "after-cataract" is easily and permanently corrected with a laser.

Should You Have Cataract Surgery?

Whether or not to have cataract surgery is up to you and your doctor. Rarely cataracts need to be removed right away, but this isn’t usually the case. Cataracts affect vision slowly over time, so many people wait to have surgery until glasses or contacts no longer improve their vision enough. If you don’t feel that your cataracts are causing problems in your day-to-day life, you may choose to wait.

Tips to Prevent Cataracts

Things you can do that may lower your risk of developing cataracts:

• Don't smoke.
• Always wear a hat or sunglasses in the sun.
• Keep diabetes well controlled.
• Limit alcohol consumption.
Read More »

Saturday, October 7

About Nosebleed or Epistaxis

About Nosebleed or Epistaxis

A nosebleed is loss of blood from the tissue lining the nose. Bleeding most often occurs in one nostril only.

Nosebleeds are very common. Most nosebleeds occur because of minor irritations or colds.

The nose contains many small blood vessels that bleed easily. Air moving through the nose can dry and irritate the membranes lining the inside of the nose. Crusts can form that bleed when irritated. Nosebleeds occur more often in the winter, when cold viruses are common and indoor air tends to be drier.
The nose contains many small blood vessels that bleed easily
The nose contains many small blood vessels that bleed easily
Most nosebleeds occur on the front of the nasal septum. This is the piece of the tissue that separates the 2 sides of the nose. This type of nosebleed can be easy stopped by a trained professional. Less commonly, nosebleeds may occur higher on the septum or deeper in the nose. Such nosebleeds may be harder to control. However, nosebleeds are rarely life threatening.

Causes of Nosebleed

Nosebleed can be caused by:

• Irritation due to allergies, colds
• sneezing or sinus problems
• Very cold or dry air
• Blowing the nose very hard, or picking the nose
• Injury to nose, including a broken nose, or an object stuck in the nose
• Deviated septum
• Chemical irritants
• Overuse of decongestant nasal sprays

Repeated nosebleeds may be a symptom of another disease such as high blood pressure, a bleeding disorder, or a tumor of the nose or sinuses. Blood thinners, such as warfarin (Coumadin),  clopidogrel (Plavix) or aspirin, may cause or worsen nosebleeds.

Home Care for Nosebleed

How to stop a nosebleed:
How to stop a nosebleed
How to stop a nosebleed
• Sit down and gently squeeze the soft portion of the nose between your thumb and finger (so that the nostrils are closed) for a full 10 minutes.
• Lean forward to avoid swallowing the blood and breathe through your mouth.
• Wait at least 10 minutes before checking if the bleeding has stopped. Be sure to allow enough time for the bleeding to stop.

It may help to apply cold compresses or ice across the bridge of the nose. Do not pack the inside of the nose with gauze.

Lying down with a nosebleed is not recommended. You should avoid sniffing or blowing your nose for several hours after a nosebleed. If bleeding persists, a nasal spray decongestant (Afrin, Neo-Synephrine) can sometimes be used to close off small vessels and control bleeding.

Things you can do to prevent frequent nosebleeds include:

• Keep the home cool and use a vaporizer to add moisture to the inside air.
• Use nasal saline spray and water-soluble jelly (such as Ayr gel) to prevent nasal linings from drying out in the winter.

When to Contact a Medical Professional

Get emergency care if:

• Bleeding does not stop after 20 minutes.
• Nose bleeding occurs after a head injury. This may suggest a skull fracture, and x-rays should be taken.
• Your nose may be broken (for example, it looks crooked after a hit to the nose or other injury).

Call your health care provider if:

• You or your child has frequent nosebleeds
• Nosebleeds are not associated with a cold or other minor irritation

What to Expect at Your Office Visit

The provider will perform a physical exam. In some cases, you may be watched for signs and symptoms of low blood pressure from losing blood, also called hypovolemic shock.

You may have the following tests:

• Complete blood count
• Nasal endoscopy (examination of the nose using a camera)
• Partial thromboplastin time measurements
• Prothrombin time (PT)
• CT scan of the nose and sinuses

The type of treatment used will be based on the cause of the nosebleed. Treatment may include:

• Controlling blood pressure
• Closing the blood vessel using heat, electric current, or silver nitrate sticks
• Nasal packing
• Reducing a broken nose or removing a foreign body
• Reducing the amount of blood thinner medicine or stopping aspirin
• Treating problems that keeps your blood from clotting normally

You may need to see an ear, nose, and throat (ENT) specialist for further tests and treatment.
Read More »

Saturday, September 30

About Sickle Cell Disease, SCD

Normal Red Blood Cells and Sickled Red Blood Cell Seen In Sickle Cell Disease
Normal Red Blood Cells and Sickled Red Blood Cell Seen In Sickle Cell Disease
Sickle Cell Disease, SCD is a group of inherited red blood cell disorders. Healthy red blood cells are round and they move through small blood vessels to carry oxygen to all parts of the body. In someone who has Sickle Cell Disease, the red blood cells become hard and sticky and look like a C-shaped farm tool called a "sickle". The sickle cells die early, which causes a constant shortage of red blood cells. Also, when they travel through small blood vessels, they get stuck and clog the blood flow. This can cause pain and other serious problems such infection, acute chest syndrome and stroke.

Types of Sickle Cell Disease

Following are the most common types of SCD:

• HbSS

People who have this form of SCD inherit two sickle cell genes ("S"), one from each parent. This is commonly called sickle cell anemia and is usually the most severe form of the disease.

• HbSC

People who have this form of SCD inherit a sickle cell gene ("S") from one parent and from the other parent a gene for an abnormal hemoglobin called "C". Hemoglobin is a protein that allows red blood cells to carry oxygen to all parts of the body. This is usually a milder form of SCD.

• HbS beta thalassemia

People who have this form of SCD inherit one sickle cell gene ("S") from one parent and one gene for beta thalassemia, another type of anemia, from the other parent. There are two types of beta thalassemia: "0" and "+". Those with HbS beta 0-thalassemia usually have a severe form of SCD. People with HbS beta +-thalassemia tend to have a milder form of SCD.

There also are a few rare types of SCD:

• HbSD, HbSE and HbSO

People who have these forms of SCD inherit one sickle cell gene ("S") and one gene from an abnormal type of hemoglobin ("D", "E", or "O"). Hemoglobin is a protein that allows red blood cells to carry oxygen to all parts of the body. The severity of these rarer types of SCD varies.
About Sickle Cell Disease, SCD

Sickle Cell Trait (SCT)

• HbAS

People who have SCT inherit one sickle cell gene ("S") from one parent and one normal gene ("A") from the other parent. This is called sickle cell trait (SCT). People with SCT usually do not have any of the signs of the disease and live a normal life, but they can pass the trait on to their children. Additionally, there are a few, uncommon health problems that may potentially be related to sickle cell trait.

Cause of Sickle Cell Disease

SCD is a genetic condition that is present at birth. It is inherited when a child receives two sickle cell genes - one from each parent.

Diagnosis of Sickle Cell Disease

SCD is diagnosed with a simple blood test. It most often is found at birth during routine newborn screening tests at the hospital. In addition, SCD can be diagnosed before birth.

Because children with SCD are at an increased risk of infection and other health problems, early diagnosis and treatment are important.

You can call your local sickle cell organization to find out how to get tested.
About Sickle Cell Disease, SCD

Complications and Treatments

People with SCD start to have signs of the disease during the first year of life, usually around 5 months of age. Symptoms and complications of SCD are different for each person and can range from mild to severe.

The reason that infants don’t show symptoms at birth is because baby or fetal hemoglobin protects the red blood cells from sickling. When the infant is around 4 to 5 months of age, the baby or fetal hemoglobin is replaced by sickle hemoglobin and the cells begin to sickle.

SCD is a disease that worsens over time. Treatments are available that can prevent complications and lengthen the lives of those who have this condition. These treatment options can be different for each person depending on the symptoms and severity.

There is no single best treatment for all people with SCD. Treatment options are different for each person depending on the symptoms.

Hydroxyurea is a medicine that has been shown to decrease several complications of SCD. This treatment is very safe when given by medical specialists experienced in caring for patients with sickle cell disease. However, the side effects of taking hydroxyurea during pregnancy or for a long time are not completely known.

Cure of Sickle Cell Disease

The only cure for SCD is bone marrow or stem cell transplant.

Bone marrow is a soft, fatty tissue inside the center of the bones where blood cells are made. A bone marrow or stem cell transplant is a procedure that takes healthy cells that form blood from one person - the donor - and puts them into someone whose bone marrow is not working properly.

Bone marrow or stem cell transplants are very risky, and can have serious side effects, including death. For the transplant to work, the bone marrow must be a close match. Usually, the best donor is a brother or sister. Bone marrow or stem cell transplants are used only in cases of severe SCD for children who have minimal organ damage from the disease.
Read More »

Tuesday, September 26

About Haemorrhoids

Haemorrhoids

Haemorrhoids are swollen veins in the anus or lower part of the rectum.

Causes of Haemorrhoids

Haemorrhoids are very common. They result from increased pressure on the anus. This can occur during pregnancy, childbirth, and due to constipation. The pressure causes the normal anal veins and tissue to swell. This tissue can bleed, often during bowel movements.

Haemorrhoids may be caused by:

• Straining during bowel movements
• Constipation
• Sitting for long periods of time, especially on the toilet
• Certain diseases, such as liver cirrhosis

Haemorrhoids may be inside or outside the body.

• Internal haemorrhoids occur just inside the anus, at the beginning of the rectum. When they are large they may fall outside (prolapse). The most common problem with internal haemorrhoids is bleeding during bowel movements.
• External haemorrhoids occur outside the anus. They can result in difficulty cleaning the area after a bowel movement. If a blood clot forms in an external hemorrhoid, it can be very painful (thrombosed external haemorrhoid).
4 Grades of Internal Hemorrhoids
4 Grades of Internal Hemorrhoids
Symptoms of Haemorrhoids

Haemorrhoids are most often not painful, but if a blood clot forms, they can be very painful.

Common symptoms include:

• Painless bright red blood from the rectum
• Anal itching
• Anal ache or pain, especially while sitting
• Pain during bowel movements
• One or more hard tender lumps near the anus

Exams and Tests

Most of the time, a health care provider can often diagnose haemorrhoids simply looking at the rectal area. External haemorrhoids can often be detected this way.

Tests that may help diagnose the problem include:

• Rectal exam
• Sigmoidoscopy
• Anoscopy

Treatment of Haemorrhoids
Haemorrhoids: Surgical Methods of Treatment
Haemorrhoids: Surgical Methods of Treatment
Treatments for haemorrhoids include:

• Over-the-counter corticosteroid (for example, cortisone) creams to help reduce pain and swelling
• Haemorrhoid creams with lidocaine to help reduce pain
• Stool softeners help reduce straining and constipation

Things you can do to reduce itching include:

• Apply witch hazel to the area with a cotton swab.
• Wear cotton underwear.
• Avoid toilet tissue with perfumes or colors. Use baby wipes instead.
• Try not to scratch the area.

Sitz baths can help you to feel better. Sit in warm water for 10 to 15 minutes.

If your haemorrhoids do not get better with home treatments, you may need some type of office treatment to shrink the haemorrhoids.
Haemorrhoid Banding
Haemorrhoid Banding
If office treatment is not enough, some type of surgery may be necessary, such as removal of the haemorrhoids (haemorrhoidectomy). These procedures are generally used for people with severe bleeding or prolapse who have not responded to other therapy.

Possible Complications

The blood in the haemorrhoid may form clots. This can cause tissue around it to die. Surgery is sometimes needed to remove haemorrhoids with clots.

Rarely, severe bleeding may also occur. Iron deficiency anemia can result from long-term blood loss.

When to Contact a Medical Professional

Call for your health care provider if:

• Haemorrhoid symptoms do not improve with home treatment.
• You have rectal bleeding. Your provider may want to check for other, more serious causes of the bleeding.
Understanding Haemorrhoids
Understanding Haemorrhoids
Get medical help right away if:

• You lose a lot of blood
• You are bleeding and feel dizzy, lightheaded, or faint

Prevention of Haemorrhoids

Constipation, straining during bowel movements, and sitting on the toilet too long raise your risk for haemorrhoids. To prevent constipation and haemorrhoids, you should:

• Drink plenty of fluids.
• Eat a high-fiber diet of fruits, vegetables, and whole grains.
• Consider using fiber supplements.
• Use stool softeners to prevent straining.
Read More »

Friday, September 22

Gastroesophageal Reflux Disease

Gastroesophageal Reflux Disease
Gastroesophageal Reflux Disease
Gastroesophageal reflux disease (GERD) is a condition in which the stomach contents leak backwards from the stomach into the esophagus (the tube from the mouth to the stomach). This can irritate the esophagus and cause heartburn and other symptoms.

Causes Of Gastroesophageal Reflux Disease

When you eat, food passes from the throat to the stomach through the esophagus. A ring of muscle fibers in the lower esophagus prevents swallowed food from moving back up. These muscle fibers are called the lower esophageal sphincter (LES).

When this ring of muscle does not close all the way, stomach contents can leak back into the esophagus. This is called reflux or gastroesophageal reflux. Reflux may cause symptoms. Harsh stomach acids can also damage the lining of the esophagus.

The risk factors for reflux include:

• Use of alcohol (possibly)
• Hiatal hernia (a condition in which part of the stomach moves above the diaphragm, which is the muscle that separates the chest and abdominal cavities)
• Obesity
• Pregnancy
• Scleroderma
• Smoking

Heartburn and gastroesophageal reflux can be brought on or made worse by pregnancy. Symptoms can also be caused by certain medicines, such as:

• Anticholinergics (for example, seasickness medicine)
• Bronchodilators for asthma
• Calcium channel blockers for high blood pressure
• Dopamine-active drugs for Parkinson disease
• Progestin for abnormal menstrual bleeding or birth control
• Sedatives for insomnia or anxiety
• Tricyclic antidepressants

Talk to your health care provider if you think one of your medicines may be causing heartburn. Never change or stop taking a medicine without first talking to your provider.

Symptoms of  Gastroesophageal Reflux Disease

Common symptoms of GERD include:

• Feeling that food is stuck behind the breastbone
• Heartburn or a burning pain in the chest
• Nausea after eating

Less common symptoms are:

• Bringing food back up (regurgitation)
• Cough or wheezing
• Difficulty swallowing
• Hiccups
• Hoarseness or change in voice
• Sore throat

Symptoms may get worse when you bend over or lie down, or after you eat. Symptoms may also be worse at night.

Exams and Tests

You may not need any tests if your symptoms are mild.

If your symptoms are severe or they come back after you have been treated, your doctor may perform a test called an upper endoscopy (EGD).

• This is a test to examine the lining of the esophagus (the tube that connects your throat to your stomach), stomach, and first part of the small intestine.
• It is done with a small camera (flexible endoscope) that is inserted down the throat.

You may also need 1 or more of the following tests:

• A test that measures how often stomach acid enters the tube that leads from the mouth to the stomach (called the esophagus)
• A test to measure the pressure inside the lower part of the esophagus (esophageal manometry)

A positive stool occult blood test may diagnose bleeding that is coming from the irritation in the esophagus, stomach, or intestines.

Treatment

You can make many lifestyle changes to help treat your symptoms.

Other tips include:

• If you are overweight or obese, in many cases, losing weight can help.
• Avoid drugs such as aspirin, ibuprofen (Advil, Motrin), or naproxen (Aleve, Naprosyn). Take acetaminophen (Tylenol) to relieve pain.
• Take all of your medicines with plenty of water. When your doctor gives you a new medicine, ask whether it will make your heartburn worse.

You may use over-the-counter antacids after meals and at bedtime, although the relief may not last very long. Common side effects of antacids include diarrhea or constipation.

Other over-the-counter and prescription drugs can treat GERD. They work more slowly than antacids, but give you longer relief. Your pharmacist, doctor, or nurse can tell you how to take these drugs.

• Proton pump inhibitors (PPIs) decrease the amount of acid produced in your stomach
• H2 blockers also lower the amount of acid released in the stomach

Anti-reflux surgery may be an option for people whose symptoms do not go away with lifestyle changes and medicines. Heartburn and other symptoms should improve after surgery. But you may still need to take drugs for your heartburn.

There are also new therapies for reflux that can be performed through an endoscope (a flexible tube passed through the mouth into the stomach).

Outlook (Prognosis)

Most people respond to lifestyle changes and medicines. However, many people need to continue taking medicines to control their symptoms.
Gastroesophageal Reflux Disease
Gastroesophageal Reflux Disease
Possible Complications

Complications may include:

• Worsening of asthma
• A change in the lining of the esophagus that can increase the risk of cancer (Barrett esophagus)
• Bronchospasm (irritation and spasm of the airways due to acid)
• Chronic cough or hoarseness
• Dental problems
• Ulcer in the esophagus
• Stricture (a narrowing of the esophagus due to scarring)

When to Contact a Medical Professional

Call your health care provider if symptoms do not improve with lifestyle changes or medicine.

Also call if you have:

• Bleeding
• Choking (coughing, shortness of breath)
• Feeling filled up quickly when eating
• Frequent vomiting
• Hoarseness
• Loss of appetite
• Trouble swallowing (dysphagia) or pain with swallowing (odynophagia)
• Weight loss

Prevention

Following heartburn prevention techniques may help prevent symptoms. Obesity is linked to GERD, so maintaining a healthy body weight may help prevent the condition.
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Thursday, September 21

Influenza And Your Baby

Influenza And Your Baby

Influenza (or Flu) is an easily spread infectious disease. Children under age 2 have a higher risk of developing complications if they get the flu.

The information in this article has been put together to help you protect children under age 2 from the flu. This is not a substitute for medical advice from your health care provider. If you think your baby may have the flu, you should contact a health care provider right away.

Flu Symptoms In Infants And Toddlers

Influenza or the flu is an infection of the nose, throat, and (sometimes) lungs. Call your baby's health care provider if you notice any of the following signs:

• Acting tired and cranky much of the time and not feeding well
• Cough
• Diarrhea and vomiting
• Has a fever or feels feverish (if no thermometer available)
• Runny nose

How is the flu treated in Babies?

Children younger than 2 years old will often need to be treated with medicine that fights off the flu virus. This is called antiviral medicine. The medicine works best if started within 48 hours after symptoms begin, if possible.

Oseltamivir (Tamiflu) in liquid form will likely be used. Although this drug is not approved for use in children younger than 1 year of age, serious side effects are quite rare. After talking about the risk of side effects against the possible complications of the flu in your baby, you and your health care provider may decide to use this medicine to treat the flu.

Paracetamol, Ibuprofen or Acetaminophen (Tylenol) help lower fever in children. Sometimes, your health care provider will tell you to use both types of medicine.

Always check with your health care provider before giving any cold medicines to your infant or toddler.

Should My Baby Get The Flu Vaccine?

All infants 6 months or older should get the flu vaccine, even if they have had a flu-like illness. The flu vaccine is not approved for children under 6 months old.

• Your child will need a second flu vaccine around 4 weeks after receiving the vaccine for the first time.
• There are two types of flu vaccine. One is given as a shot, and the other is sprayed into your child's nose.
A Baby Receiving The Flu Shot
A Baby Receiving The Flu Shot
The flu shot contains killed (inactive) viruses. It is not possible to get the flu from this type of vaccine. The flu shot is approved for people age 6 months and older.

A nasal spray-type flu vaccine uses a live, weakened virus instead of a dead one like the flu shot. It is approved for healthy children over 2 years.

Anyone who lives with or has close contact with a child younger than 6 months old should also have a flu shot.

Will The Vaccine Harm My Baby?

You or your baby cannot get flu from vaccine. Some children may get a low-grade fever for a day or two after the shot. If more severe symptoms develop or they last for more than 2 days, you should call your health care provider.

Some parents are afraid the vaccine could hurt their baby. But children under 2 years of age are more likely to get a severe case of the flu. It is hard to predict how ill your child may get from flu because children often have a mild illness at first. They may become sick very fast.

A small amount of mercury (called thimerosal) is a common preservative in multidose vaccines. Despite concerns, thimerosal-containing vaccines have NOT been shown to cause autism, ADHD, or any other medical problems.

However, all of the routine vaccines are also available without added thimerosal. Ask your health care provider if they offer this type of vaccine.

How Can I Prevent My Baby From Getting The Flu?

Anyone who has flu symptoms should not care for a newborn or infant, including feeding. If a person with symptoms must care for the child, the caretaker should use a face mask and wash their hands well. Everyone who comes in close contact with your baby should do the following:

• Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue away after using it.
• Wash your hands often with soap and water for 15 to 20 seconds, especially after you cough or sneeze. You may also use alcohol-based hand cleaners.

If your baby is younger than 6 months old and has close contact with someone with the flu, inform your health care provider.

If I Have Flu Symptoms, Can I Breastfeed My Baby?

If a mother is not ill with the flu, breastfeeding is encouraged.

If you are sick, you may need to express your milk for use in bottle feedings given by a healthy person. It is unlikely a newborn can catch flu from drinking your breast milk when you are sick. Breast milk is considered safe if you are taking antivirals.

When Should I Call The Doctor?

Talk to your child's health care provider or go to the emergency room if:

• Your child does not act alert or more comfortable when the fever goes down.
• Fever and flu symptoms come back after they have gone away.
• The child does not have tears when crying.
• The child's diapers are not wet, or the child has not urinated for the last 8 hours.
Read More »