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Enlarged Spleen: Causes, Symptoms & Treatments

The spleen is an important organ in the immune system. It is a bean shaped structure, located in the left upper portion of the abdominal cavity, under the diaphragm, protected by the 9th through 11th ribs, in the mid-back. The spleen typically weighs 150 grams (5.3 oz) in a typical adult and spans about 11 cm (4.3 inches) vertically in its longest dimension.

The functions of the spleen normally include clearance of invading organisms in the blood (bacteria) from the circulation, production of antibodies for the immune system, and removal of abnormal blood cells.

The spleen can enlarge by performing its normal functions in response to another medical condition. Certain infections, diseases affecting blood cells, increased splenic blood flow, and diseases invading the spleen are some common reasons for the spleen to enlarge. Splenomegaly is not always abnormal, and spleen size may not necessarily say much about its function.

A normal-sized spleen cannot be palpated (felt) during the physical examination of the abdomen, except in slender people. Enlarged spleen (splenomegaly) may be easier to palpate during careful abdominal examination. A small percentage of the normal American population may have a palpable or enlarged spleen.

A spleen weighing up to 500 grams (1.1 pounds) or between 11 to 20 cm (4.3 to 8 inches) in its longest dimension is considered enlarged. Splenomegaly greater than 1000 gm (2 lb 3.3 oz) or longer than 20 cm (8 inches) is considered severe or massive.

Picture of the spleen

Picture of the spleen

Enlarged Spleen Causes:

The causes of splenomegaly vary widely and range from malignancy (cancers), infections, congestion (increased blood flow), infiltration of the spleen from other diseases, inflammatory conditions, and blood cell diseases.

Some of the most common causes of an enlarged spleen include the following:

  • liver disease (cirrhosis due to chronic hepatitis B, chronic hepatitis C, fatty liver, long standing alcohol abuse);
  • blood cancers (lymphoma, leukemia, myelofibrosis);
  • infections (mononucleosis, bacterial endocarditis, malaria, AIDS, mycobacterium, leishmania);
  • abnormal blood flow and congestion (splenic vein thrombosis, portal vein obstruction, congestive heart failure);
  • Gaucher disease (a lipid storage disease);
  • blood cell disorders (sickle cell anemia, thalassemia, spherocytosis);
  • Inflammatory disease (lupus, rheumatoid arthritis);
  • idiopathic thrombocytopenic purpura (ITP); and
  • polycythemia vera.

Enlarged Spleen Symptoms

Splenomegaly does not have any specific symptoms. Vague abdominal painand bloating are the most common, but still nonspecific, symptoms of an enlarged spleen. Some individuals with a very enlarged spleen may complain of early satiety (anorexia) and gastric reflux symptoms because of the stomach displacement and pressure on the stomach as a result of the enlarged spleen.

Otherwise, many symptoms associated with enlarged spleen are related to the underlying cause of the enlargement. These may include:

  • fever,
  • night sweats,
  • paleness (pallor),
  • generalized weakness,
  • fatigue,
  • easy bruising, and
  • weight loss.

When to Seek Medical Care for Splenomegaly

Generally, people with splenomegaly may be cared for by the physician who is managing the underlying cause. For example, hematologists (doctors who specialize in treating blood disorders), oncologists (cancer specialists), and gastroenterologists (liver and digestive tract specialists) all commonly take care of patients who may have enlarged spleen as a response to another condition.

Depending on the cause, individuals with splenomegaly may seek urgent doctor visits if they have evidence of bleeding, infection that is not well controlled at home, or severe abdominal pain.

Enlarged Spleen Medical Treatment

The treatment of splenomegaly essentially depends on the cause of it.

In many conditions, the spleen enlarges a result of performing its normal physiologic function in response to another medical condition, for example, cirrhosis. The main objective is then not necessarily to improve splenomegaly that is a consequence of the disease, but to treat the underlying cause, such as cirrhosis.

In many other situations, such as infections, lymphomas, or leukemias, again the treatment is directed towards the underlying disorder, using antibiotics or chemotherapy.

Surgery for Enlarged Spleen

Occasionally, the indicated treatment is surgical removal of the spleen (splenectomy) in order to control the causative conditions. Some conditions in which splenectomy may be considered are hairy cell leukemia, thalassemia major, splenic vein thrombosis, Gaucher disease, and ITP. A careful consideration of risks versus benefits of surgery is the most prudent approach.

It is important to note the importance of vaccination in cases of splenectomy. People without a spleen (asplenia) are at a high risk for significant infections with Streptococcus pneumoniaeNeisseria meningitidis, and Hemophilus influenzae. Therefore, vaccination against these bacteria (pneumococcal vaccine, meningococcal vaccine, hemophilus vaccine) is strongly recommended in anyone who undergoes splenectomy.

Lung Transplantation: Types of respiratory diseases required treatment

A lung transplant surgery is undertaken to remove diseased lung in an individual and replace the same with a healthy lung, sourced from a deceased donor. A last resort, the surgery is typically undertaken for patients with end-stage lung failure to improve longevity and quality of the life.

A transplant may remove one or both lungs, and in some cases the surgery is combined with a heart transplant as well, in which case it is termed the heart-lung transplant. Lung transplant is carried out to treat certain life-threatening diseases, such as COPD, Pulmonary Hypertension, Cystic fibrosis, Scaring and inflammation of the bronchioles. The Lung Transplantation program at Gleneagles Global Hospitals is one of the best in India. Staffed with the best transplant surgeons and specialized equipment, the facility has pioneered several complicated and innovative transplant surgeries with exceptional success rate.

Model of human anatomy.

A number of respiratory diseases are treated and lung transplantations are offered for various lung disorders. They are:

  • End stage lung disease
  • Cystic fibrosis
  • Pulmonary hypertension
  • Pulmonary hypertension
  • Pulmonary vasodilators
  • Chronic obstructive pulmonary disease (COPD)
  • Interstitial lung disease

Interstitial lung diseases: causes, symptoms & treatments

Interstitial lung disease is a general category that includes many different lung conditions. All interstitial lung diseases affect the interstitium, a part of the lungs’ anatomic structure.

The interstitium is a lace-like network of tissue that extends throughout both lungs. The interstitium provides support to the lungs’ microscopic air sacs (alveoli). Tiny blood vessels travel through the interstitium, allowing gas exchange between blood and the air in the lungs. Normally, the interstitium is so thin it can’t be seen on chest X-rays or CT scans.

Causes of Interstitial Lung Disease

Bacteria, viruses, and fungi are known to cause interstitial pneumonias. Regular exposures to inhaled irritants at work or during hobbies can also cause some interstitial lung disease. These irritants include:

  • Asbestos
  • Silica dust
  • Talc
  • Coal dust, or various other metal dusts from working in mining
  • Grain dust from farming
  • Bird proteins (such as from exotic birds, chickens, or pigeons)
Drugs such as nitrofurantoin, amiodarone, bleomycin, and many others can rarely cause interstitial lung disease.All told, these factors cause a small percentage of interstitial lung disease. The cause of most interstitial lung disease is unknown.Who is at risk from interstitial lung disease? Anyone can develop interstitial lung disease. Men and women of any age can be affected. Interstitial lung disease is more common in people with autoimmune disease, including lupus, rheumatoid arthritis, and scleroderma.

Symptoms of Interstitial Lung Disease

The most common symptom of all forms of interstitial lung disease is shortness of breath. Nearly all people with interstitial lung disease will experience breathlessness, which may get worse over time.

Other symptoms of interstitial lung disease include:

  • Cough, which is usually dry and nonproductive.
  • Weight loss, most often in people with COP or BOOP.
In most forms of interstitial lung disease, the shortness of breath develops slowly (over months). In interstitial pneumonias or acute interstitial pneumonitis, symptoms come on more rapidly (in hours or days).

Diagnosis of Interstitial Lung Disease

People with interstitial lung disease usually come to see a doctor due to concern about shortness of breath or cough. Imaging tests of the lungs are usually done to identify the problem.

Chest X-ray: A simple chest X-ray is the first test in the evaluation of most people with a breathing problem. Chest X-ray films in people with interstitial lung disease may show fine lines in the lungs.

Computed tomography (CT scan): A CT scanner takes multiple X-rays of the chest and a computer creates detailed images of the lungs and surrounding structures. Interstitial lung disease can usually be seen on a CT scan.

High-resolution CT scan: If interstitial lung disease is suspected, using certain CT scanner settings can improve the images of the interstitium. This increases the CT scan’s ability to detect interstitial lung disease.

Pulmonary function testing: A person sits in a sealed plastic booth and breathes through a tube. People with interstitial lung disease may have a reduced total lung capacity. They may also have a decreased ability to transfer oxygen from their lungs into their blood.

Treatments for Interstitial Lung Disease

Treatments for interstitial lung disease vary according to the type of interstitial lung disease and its cause.

Antibiotics . These are effective treatments for most interstitial pneumonias. Azithromycin (Zithromax) and levofloxacin (Levaquin) eliminate the bacteria that cause most interstitial pneumonias. Viral pneumonias usually resolve on their own. Fungal pneumonias are rare, but can be treated with antifungal drugs.

Corticosteroids: In some forms of interstitial lung disease, ongoing inflammation in the lungs causes damage and scarring. Corticosteroids like prednisone and methylprednisolone reduce the activity of the immune system. This reduces the amount of inflammation in the lungs and the rest of the body.

Inhaled oxygen: In people with low oxygen blood levels due to interstitial lung disease, inhaled oxygen may improve symptoms. Regular use of oxygen might also protect the heart from damage caused by low oxygen levels.

Lung transplant : In advanced interstitial lung disease causing severe impairment, a lung transplant may be the best option. Most people undergoing lung transplant for interstitial lung disease make large gains in quality of life and their ability to exercise.

Azathioprine (Imuran): This drug also suppresses the immune system. It has never been proven to improve interstitial lung disease, but some studies suggest it might help.

N-acetylcysteine (Mucomyst): This potent antioxidant may slow the decline of lung function in some forms of interstitial lung disease. It should not be used alone.

Other treatments considered controversial for the treatment of interstitial lung disease include:

  • Cyclophosphamide (Cytoxan)
  • Methotrexate
  • Cyclosporine
  • Pirfenidone (Exbriet)
  • Nintedanib (OFEV)

Schizophrenia: Causes, symptoms & treatments

Schizophrenia is a mental disorder that usually appears in late adolescence or early adulthood. Characterized by delusions, hallucinations, and other cognitive difficulties, schizophrenia can often be a lifelong struggle.

In this article, we will cover the causes, symptoms, and treatment of schizophrenia.

Fast facts on schizophreniaHere are some key points about schizophrenia. More detail and supporting information is in the main article.

  • Schizophrenia affects an estimated 1 percent of the population.
  • Symptoms include delusions, hallucinations, and disorganized thoughts.
  • Diagnosing schizophrenia comes only after other disease have been ruled out.

What is schizophrenia?

Schizophrenia most commonly strikes between the ages of 16 and 30, and males tend to show symptoms at a slightly younger age than females. In many cases, the disorder develops so slowly that the individual does not know that they have had it for many years. However, in other cases, it can strike suddenly and develop quickly.

Schizophrenia affects approximately 1 percent of all adults, globally. Experts say schizophrenia is probably many illnesses masquerading as one.

Symptoms of schizophrenia

Schizophrenia is often a life-long condition.

A sizable proportion of people with schizophrenia have to rely on others because they are unable to hold a job or care for themselves.

Many may also resist treatment, arguing that there is nothing wrong with them.

Some patients may present clear symptoms, but on other occasions, they may seem fine until they start explaining what they are truly thinking.

The effects of schizophrenia reach far beyond the patient – families, friends, and society are affected too.

Symptoms and signs of schizophrenia will vary, depending on the individual.

The symptoms are classified into four categories:

  • Positive symptoms – also known as psychotic symptoms. For example, delusions and hallucinations.
  • Negative symptoms – these refer to elements that are taken away from the individual. For example, absence of facial expressions or lack of motivation.
  • Cognitive symptoms – these affect the person’s thought processes. They may be positive or negative symptoms, for example, poor concentration is a negative symptom.
  • Emotional symptoms – these are usually negative symptoms, such as blunted emotions.

Below is a list of the major symptoms:

  • Delusions – the patient displays false beliefs, which can take many forms, such as delusions of persecution, or delusions of grandeur. They may feel others are attempting to control them remotely. Or, they may think they have extraordinary powers and abilities.
  • Hallucinations – hearing voices is much more common than seeing, feeling, tasting, or smelling things which are not there, however, people with schizophrenia may experience a wide range of hallucinations.
  • Thought disorder – the person may jump from one subject to another for no logical reason. The speaker may be hard to follow or erratic.

Other symptoms may include:

  • Lack of motivation (avolition) – the patient loses their drive. Everyday actions, such as washing and cooking, are neglected.
  • Poor expression of emotions – responses to happy or sad occasions may be lacking, or inappropriate.
  • Social withdrawal – when a patient with schizophrenia withdraws socially, it is often because they believe somebody is going to harm them.
  • Unawareness of illness – as the hallucinations and delusions seem so real for patients, many of them may not believe they are ill. They may refuse to take medication for fear of side effects, or for fear that the medication may be poison, for example.
  • Cognitive difficulties – the patient’s ability to concentrate, recall things, plan ahead, and to organize their life are affected. Communication becomes more difficult.

What are the causes schizophrenia?

Experts believe several factors are generally involved in contributing to the onset of schizophrenia.

Evidence suggests that genetic and environmental factors act together to bring about schizophrenia. The condition has an inherited element, but environmental triggers also significantly influence it.

Below is a list of the factors that are thought to contribute towards the onset of schizophrenia:

Genetic inheritance

If there is no history of schizophrenia in a family, the chances of developing it are less than 1 percent. However, that risk rises to 10 percent if a parent was diagnosed.

Chemical imbalance in the brain

Experts believe that an imbalance of dopamine, a neurotransmitter, is involved in the onset of schizophrenia. Other neurotransmitters, such as serotonin, may also be involved.

Family relationships

There is no evidence to prove or even indicate that family relationships might cause schizophrenia, however, some patients with the illness believe family tension triggers relapses.

Environmental factors

Although there is no definite proof, many suspect trauma before birth and viral infections may contribute to the development of the disease.

Stressful experiences often precede the emergence of schizophrenia. Before any acute symptoms are apparent, people with schizophrenia habitually become bad-tempered, anxious, and unfocused. This can trigger relationship problems, divorce, and unemployment.

These factors are often blamed for the onset of the disease, when really it was the other way round – the disease caused the crisis. Therefore, it is extremely difficult to know whether schizophrenia caused certain stresses or occurred as a result of them.

Drug induced schizophrenia

Marijuana and LSD are known to cause schizophrenia relapses. Additionally, for people with a predisposition to a psychotic illness such as schizophrenia, usage of cannabis may trigger the first episode.

Some researchers believe that certain prescription drugs, such as steroids and stimulants, can cause psychosis.

Treatments for schizophrenia

[Distressed young man]

Ensuring the patient continues with medication is the key to successful treatment.

With proper treatment, patients can lead productive lives.

Treatment can help relieve many of the symptoms of schizophrenia. However, the majority of patients with the disorder have to cope with the symptoms for life.

Psychiatrists say the most effective treatment for schizophrenia patients is usually a combination of:

  • medication
  • psychological counseling
  • self-help resources

Anti-psychosis drugs have transformed schizophrenia treatment. Thanks to them, the majority of patients are able to live in the community, rather than stay in a hospital.

The most common schizophrenia medications are:

  • Risperidone (Risperdal) – less sedating than other atypical antipsychotics. Weight gain and diabetes are possible side effects, but are less likely to happen, compared with Clozapine or Olanzapine.
  • Olanzapine (Zyprexa) – may also improve negative symptoms. However, the risks of serious weight gain and the development of diabetes are significant.
  • Quetiapine (Seroquel) – risk of weight gain and diabetes, however, the risk is lower than Clozapine or Olanzapine.
  • Ziprasidone (Geodon) – the risk of weight gain and diabetes is lower than other atypical antipsychotics. However, it might contribute to cardiac arrhythmia.
  • Clozapine (Clozaril) – effective for patients who have been resistant to treatment. It is known to lower suicidal behaviors in patients with schizophrenia. The risk of weight gain and diabetes is significant.
  • Haloperidol – an antipsychotic used to treat schizophrenia. It has a long-lasting effect (weeks).

The primary schizophrenia treatment is medication. Sadly, compliance (following the medication regimen) is a major problem. People with schizophrenia often come off their medication for long periods during their lives, at huge personal costs to themselves and often to those around them.

The patient must continue taking medication even when symptoms are gone. Otherwise they will come back.

The first time a person experiences schizophrenia symptoms, it can be very unpleasant. They may take a long time to recover, and that recovery can be a lonely experience. It is crucial that a person living with schizophrenia receives the full support of their family, friends, and community services when onset appears for the first time.

polycystic kidney disease: Causes, Symptoms & Treatments

What is polycystic kidney disease?

Polycystic kidney disease (also called PKD) causes numerous cysts to grow in the kidneys. These cysts are filled with fluid. If too many cysts grow or if they get too big, the kidneys can become damaged. PKD cysts can slowly replace much of the kidneys, reducing kidney function and leading to kidney failure.

What other organs besides the kidney are affected by PKD?

PKD can affect other organs besides the kidney. People with PKD may have cysts in their liver, pancreas, spleen, ovaries, and large bowel. Cysts in these organs usually do not cause serious problems, but can in some people. PKD can also affect the brain or heart. If PKD affects the brain, it can cause an aneurysm. An aneurysm is a bulging blood vessel that can burst, resulting in a stroke or even death. If PKD affects the heart, the valves can become floppy, resulting in a heart murmur in some patients.

What are the clues that someone has PKD?

Most people do not develop symptoms until they are 30 to 40 years old. The first noticeable signs and symptoms may include:

  • Back or side pain
  • An increase in the size of the abdomen
  • Blood in the urine
  • Frequent bladder or kidney infections
  • High blood pressureHigh blood pressure is the most common sign of PKD. Occasionally, patients may develop headaches related to high blood pressure or their doctors may detect high blood pressure during a routine physical exam. Because high blood pressure can cause kidney damage, it is very important to treat it. In fact, treatment of high blood pressure can help slow or even prevent kidney failure.
  • Fluttering or pounding in the chestAbout 25% of PKD patients have a so-called floppy valve in the heart, and may experience a fluttering or pounding in the chest as well as chest pain. These symptoms almost always disappear on their own but may be the first hint that someone has PKD.

How is PKD diagnosed?

Ultrasound is the most reliable, inexpensive and non-invasive way to diagnose PKD. If someone at risk for PKD is older than 40 years and has a normal ultrasound of the kidneys, he or she probably does not have PKD. Occasionally, a CT scan (computed tomography scan) and MRI (magnetic resonance imaging) may detect smaller cysts that cannot be found by an ultrasound. MRI is used to measure and monitor volume and growth of kidneys and cysts.

In some situations, genetic testing might also be done. This involves a blood test that checks for abnormal genes that cause the disease.  Genetic testing is not recommended for everyone. The test is costly, and it also fails to detect PKD in about 15% of people who have it. However, genetic testing can be useful when a person:

  • has an uncertain diagnosis based on imaging tests
  • has a family history of PKD and wants to donate a kidney
  • is younger than 30-years old with a family history of PKD and a negative ultrasound, and is planning to start a family

Does everyone with PKD develop kidney failure?

No. About 50 percent of people with PKD will have kidney failure by age 60, and about 60 percent will have kidney failure by age 70. People with kidney failure will need dialysis or a kidney transplant. Certain people have an increased risk of kidney failure including:

  • men
  • patients with high blood pressure
  • patients with protein or blood in their urine
  • women with high blood pressure who have had more than three pregnancies

How is PKD treated?

At present, there is no cure for PKD. However, a lot of research is being done. Recent studies suggest that drinking plain water throughout the day and avoiding caffeine in beverages can slow the growth of cysts. Research is also helping us understand the genetic basis of PKD.

Studies also suggest that some treatments may slow the rate of kidney disease in PKD, but further research is needed before these treatments can be used in patients. In the meantime, many supportive treatments can be done to control symptoms, help slow the growth of cysts, and help prevent or slow down the loss of kidney function in people with PKD.  These include:

  • careful control of blood pressure
  • prompt treatment with antibiotics of a bladder or kidney infection
  • lots of fluid when blood in the urine is first noted
  • medication to control pain (talk to your doctor about which over-the-counter medicines are safe to take if you have kidney disease)
  • a healthy lifestyle with regard to smoking cessation, exercise, weight control and reduced salt intake
  • drinking lots of plain water throughout the day
  • avoiding caffeine in all beverages

Should people with PKD take a special diet?

At present, no specific diet is known to prevent cysts from developing in patients with PKD. Reducing salt intake helps control blood pressure in PKD patients who have high blood pressure. A diet low in fat and moderate in calories is recommended to maintain a healthy weight. Speak to your doctor or a dietitian about other changes to your diet, such as avoiding caffeine.

Is exercise recommended for people with PKD?

Absolutely. However, exercises that are potentially harmful to the kidney, such as contact sports, should be avoided. It is important not to become too dehydrated during any physical activity.

Who is at risk for developing PKD?

PKD runs in families. It is an inherited disorder that is passed from parents to children through genes. Genes are the basic elements of heredity. At conception, children receive a set of genes from each parent. They determine many characteristics such as hair color and eye color. Genes can also determine the likelihood of developing a disease.

A genetic disease can happen if one or both parents pass abnormal genes to a child. This happens through something called dominant inheritance or recessive inheritance.

  • Dominant inheritance

If one parent has the disease and passes an abnormal gene to the child, it is called dominant inheritance. Each child has a 50% chance of getting the disease. The risk is the same for every child, regardless of how many children develop the disease.

  • Recessive inheritance

If both parents carry the abnormal gene, and both parents pass an abnormal gene to the child, it is called recessive inheritance. In this situation, every child has a 25% chance of getting the disease.

Are there different types of PKD?

Yes. The three main types of PKD are:

  • Autosomal Dominant PKD
    (also called PKD or ADPKD)This form of the disease is passed from parent to child by dominant inheritance. In other words, only one copy of the abnormal gene is needed to cause the disease. Symptoms usually begin between the ages of 30 and 40, but they can begin earlier, even in childhood. ADPKD is the most common form of PKD. In fact, about 90 percent of all PKD cases are ADPKD.
  • Infantile or Autosomal Recessive PKD
    (also called ARPKD)This form of the disease is passed from parent to child by recessive inheritance. Symptoms can begin in the earliest months of life, even in the womb. It tends to be very serious, progresses rapidly, and is often fatal in the first few months of life. This form of ARPKD is extremely rare. It occurs in 1 out of 25,000 people.
  • Acquired Cystic Kidney Disease
    (also called ACKD)ACKD can happen in kidneys with long-term damage and severe scarring, so it is often associated with kidney failure and dialysis. About 90 percent of people on dialysis for 5 years develop ACKD. People with ACKD usually seek help because they notice blood in their urine. This is because the cysts bleed into the urinary system, which discolors urine.

Should people with PKD have children?

Individuals with PKD who are concerned about passing the disease to their children may want to consult a genetics counselor to help them with family planning. Many university medical centers have this service.

Should women with PKD get pregnant?

Most of the women with PKD (80 percent) have successful and uneventful pregnancies. However, some women with PKD have an increased risk for serious complications for themselves and their babies. This includes women with PKD who also have:

  • high blood pressure
  • decreased kidney function

Women who have PKD with high blood pressure develop pre-eclampsia (or toxemia) in 40 percent of pregnancies. This is a life-threatening disorder for both the mother and baby, and it can develop suddenly and without warning. Therefore, all women with PKD, particularly those who also have high blood pressure, should be followed closely during their pregnancy by their doctor.

Sacroliac Joint Pain: Causes, Symptoms & Treatments

If you stand up from your chair and feel a pain in your lower back, it could be your SI joint acting up. Don’t let it get the best of you! Take charge with a treatment plan that brings relief.

What Is the SI Joint?

Its full name is the sacroiliac joint. There are two of them in your lower back, and they sit on each side of your spine. Their main job is to carry the weight of your upper body when you stand or walk and shift that load to your legs.

Symptoms:

It could be a dull or sharp. It starts at your SI joint, but it can move to your buttocks, thighs, groin, or upper back.

Sometimes standing up triggers the pain, and a lot of times you feel it only on one side of your lower back. You may notice that it bothers you more in the morning and gets better during the day.

It’s more common than you might think. About 15%-30% of people who hurt like this have a problem with the SI joint.

Causes:

The pain starts when your SI joint gets inflamed. There are several reasons it could happen. You could hurt it when you play sports or if you fall down. You might also get this problem from an activity that gives the area a regular pounding, like jogging.

Do you take uneven strides when you walk because one of your legs is longer than the other? That could be a cause of SI joint pain.

Sometimes you start hurting when the ligaments that hold your SI joint together are damaged, which may make the joint move abnormally.

Arthritis can lead to the problem. A type that affects your spine, called ankylosing spondylitis, can damage the SI joint. You’ll also hurt when the cartilage over the SI joint slowly wears away as you age.

SI joint pain may also start if you’re pregnant. Your body releases hormones that cause your joints to loosen up and move more, which leads to changes in the way the joints move.

Treatments:

You have many choices for treatment. The first step is simply to stop the things that make you hurt. Your doctor will tell you to lay off any sports that inflame your joint. He may also prescribe some pain drugs.

Some other ways to feel better:

Physical therapy. Exercises can improve strength and make you more flexible. You’ll learn to correct any habits you might have picked up when you were trying to avoid pain, like walking with a limp or leaning to one side. Your therapist may try ultrasound, heat and cold treatments, massage, and stretching.

Injections. You may get a shot of cortisone to cut down the inflammation in your joint. If that doesn’t help, your doctor may numb the nerves around your SI joint to give you relief.

Your doctor might also inject a solution of natural ingredients, such as saline, and numbing drugs into your joint. You may hear him call this “prolotherapy.” It’s thought to help tighten loose ligaments, if that’s the cause of your SI joint problem.Chiropractic treatment. Adjustments by a chiropractor can help relieve pain. He’ll use techniques that move your muscles and joints.

Nerve treatment. Your doctor may use a needle to permanently damage the nerve that sends pain signals from your SI joint to your brain. He may also freeze it with an injection, though that technique isn’t used much.

Surgery:

These treatments usually reduce the inflammation and pain in your joint. But in rare cases, if you’re still hurting, your doctor may recommend surgery. In an operation called SI joint fusion, a surgeon uses pins and implants to join the bones near the joint.

Retinitis Pigmentosa: Causes & Symptoms

Retinitis Pigmentosa

Retinitis pigmentosa (RP) is a disease condition that was first identified and named by Dr. Donders in 1857.

Also known as (RP,) this group of genetic disorders that affect the retina’s ability to respond to light. This inherited disease causes a slow loss of vision, beginning with decreased night vision and loss of peripheral (side) vision. This terrible eye disease is a group of related conditions that are progressive and clinically distinctive. These conditions share a similar feature of dystrophy or damage to the photoreceptors of the retina and of the pigment epithelium underneath the photoreceptors. As we have discussed throughout the retina section of this website, the retina is a critical component of the eye responsible for interpreting images and transmitting them onto the brain. Eventually, blindness results from this eye disease. We are sorry to report that unfortunately, there is no cure for retinitis pigmentosa.

Retinitis Pigmentosa (RP) – Causes

Retinitis pigmentosa is an inherited disease that has many different modes of inheritance. It is known to be caused by more than 100 different genetic mutations. Retinitis pigmentosa, with any inheritance pattern, may be either familial (multiple family members affected) or isolated (only one affected person).

Retinitis Pigmentosa (RP)- Symptoms

  • Decreased vision at night or in low light
  • Loss of side (peripheral) vision
  • Loss of central vision (in advanced cases)

Retinitis Pigmentosa (RP) – Treatment:

There are no medications or surgery to treat retinitis pigmentosa. However, researchers continue to seek possible treatments. In 2004, scientists injected stem cells to the back of mouse eyes and stopped retinal degeneration. Scientists are also exploring the possibility of retinal transplantation. Some doctors believe vitamins A and E will slightly slow the progression of the disease in some people. However, large doses of certain vitamins may be toxic and affected individuals should speak to their doctors before taking supplements.

If a person with RP must be exposed to bright sunlight, some doctors recommend wearing dark sunglasses to reduce the effect on the retina. Affected people should talk to their eye doctors about the correct lenses to wear outdoors.

Cervical Lymphadenitis: Causes, Symptoms & Treatments

What Is Cervical Lymphadenitis?

Cervical Lymphadenitis is a medical condition which is characterized by inflammation of the lymph nodes in the neck. This condition is normally caused due to an infection. The functions of the lymph nodes are to produce WBCs which are responsible for fighting infections and keeping the body healthy. Cervical Lymphadenitis usually occurs due to infections in the areas of the mouth, throat, ears, or tonsils. It is very common in children.

What Causes Cervical Lymphadenitis?

As stated, Cervical Lymphadenitis is normally caused due to an infection. Some of the infectious causes of Cervical Lymphadenitis are:

  • Fungal Infections
  • HIV
  • Epstein Barr Virus
  • Staphylococcus Infection
  • Streptococcus Infection
  • Tuberculosis
  • Upper Respiratory Infections.

Some of the noninfectious causes of Cervical Lymphadenitis are:

  • Inflammation due to presence of a foreign body
  • Lymphoma
  • Metastatic cancers spreading from another source.

Cervical Lymphadenitis

What Are The Risk Factors For Cervical Lymphadenitis?

The main risk factor for developing Cervical Lymphadenitis is having a compromised immune system because of which an individual may be prone to frequent infections which can cause Cervical Lymphadenitis.

What Are The Symptoms Of Cervical Lymphadenitis?

Some of the common symptoms of Cervical Lymphadenitis are:

  • Swelling of the lymph nodes in neck
  • Swelling of the lymph nodes under jaw
  • Presence of lumps under skin
  • Swelling in the neck
  • Pain in the neck
  • Facial swelling
  • Fever and chills
  • Persistent sore throat.

Some of the rare symptoms of Cervical Lymphadenitis are:

  • Persistent ear pain
  • Dysphagia
  • Anorexia
  • Persistent fatigue
  • Headaches
  • Generalized body pains
  • Nausea
  • Vomiting
  • Erythema.

How Is Cervical Lymphadenitis Diagnosed?

To diagnose Cervical Lymphadenitis, the physician will first take a detailed history as to when the symptoms started and the duration of the symptoms to find out if the patient has been prone to frequent infections. The physician will then conduct a detailed physical examination of the neck and throat. If the findings reveal an erythematous throat, swelling of the tonsils, discharge from the tonsils, or swelling of the lymph nodes in the neck then the diagnosis of Cervical Lymphadenitis is virtually confirmed. Some other tests may also be required for confirmation of the diagnosis due to bacterial infection which includes a rapid strep test, CBC, monospot, throat culture, which can confirm the diagnosis of Cervical Lymphadenitis.

How Is Cervical Lymphadenitis Treated?

The basic treatment for Cervical Lymphadenitis is dependent on the underlying cause of the condition. If this condition is caused due to a viral infection then common warm compresses and antiinflammatories are good enough to treat the condition. In case if Cervical Lymphadenitis is caused due to bacterial infection then the patient is treated with antibiotics. If Cervical Lymphadenitis is caused due to metastasis then normal procedures for cancer treatment are followed to treat the condition like chemotherapy and radiation. Some of the medications used for treatment for Cervical Lymphadenitis caused due to viral infections are ibuprofen, ketoprofen, naproxen for pain relief. Some of the antibiotics that are used for Cervical Lymphadenitis caused due to bacterial infection are penicillin, amoxicillin, Augmentin, Clarithromycin, Vancomycin, and Rifampin.

Coping Tips For Cervical Lymphadenitis

Some of the ways to cope up with Cervical Lymphadenitis are:

  • Applying warm compresses for about half an hour two to three times a day
  • Drinking plenty of fluids
  • In case of pain and fever using medication like acetaminophen
  • Using NSAIDs like ibuprofen for pain relief
  • Making sure that the medications are taken at the appropriate doses and the medications are not skipped as it affects the efficacy of the medication
  • Make sure to monitor the side effects of any medications that you are taking for treatment of Cervical Lymphadenitis.

Microcytic anemia: types and causes, symptoms & treatments

Microcytic anemia definition

Microcytosis is a term used to describe red blood cells that are smaller than normal. Anemia is when you have low numbers of properly functioning red blood cells in your body. In microcytic anemias, your body has fewer red blood cells than normal. The red blood cells it does have are also too small. Several different types of anemias can be described as microcytic.

Microcytic anemias are caused by conditions that prevent your body from producing enough hemoglobin. Hemoglobin is a component of your blood. It helps transport oxygen to your tissues and gives your red blood cells their red color.

Iron deficiency causes most microcytic anemias. Your body needs iron to produce hemoglobin. But other conditions can cause microcytic anemias, too. To treat a microcytic anemia, your doctor will first diagnose the underlying cause.

Microcytic anemia symptoms

You may not notice any symptoms of microcytic anemia at first. Symptoms often appear at an advanced stage when the lack of normal red blood cells is affecting your tissues.

Common symptoms of microcytic anemias include:

  • fatigue, weakness, and tiredness
  • loss of stamina
  • shortness of breath
  • dizziness
  • pale skin

If you experience any of these symptoms and they don’t resolve within two weeks, make an appointment to see your doctor.

You should make an appointment to see your doctor as soon as possible if you experience severe dizziness or shortness of breath.

Microcytic anemia types and causes

Microcytic anemias can be further described according to the amount of hemoglobin in the red blood cells. They can be either hypochromic, normochromic, or hyperchromic:

1. Hypochromic microcytic anemias

Hypochromic means that the red blood cells have less hemoglobin than normal. Low levels of hemoglobin in your red blood cells leads to appear paler in color. In microcytic hypochromic anemia, your body has low levels of red blood cells that are both smaller and paler than normal.

Most microcytic anemias are hypochromic. Hypochromic microcytic anemias include:

Iron deficiency anemia: The most common cause of microcytic anemia is an iron deficiency in the blood. Iron deficiency anemia can be caused by:

  • inadequate iron intake, usually as a result of your diet
  • being unable to absorb iron due to conditions like celiac disease or Helicobacter pyloriinfection
  • chronic blood loss due to frequent or heavy periods in women or by gastrointestinal (GI) bleeds from upper GI ulcers or irritable bowel syndrome
  • pregnancy

Thalassemia: Thalassemia is a type of anemia that’s caused by an inherited abnormality. It involves mutations in the genes needed for normal hemoglobin production.

Sideroblastic anemia: Sideroblastic anemia can be inherited due to gene mutations (congenital). It can also be caused by a condition acquired later in life that impedes your body’s ability to integrate iron into one of the components needed to make hemoglobin. This results in a buildup of iron in your red blood cells. Congenital sideroblastic anemia is usually microcytic and hypochromic.

2. Normochromic microcytic anemias

Normochromic means that your red blood cells have a normal amount of hemoglobin, and the hue of red is not too pale or deep in color. An example of a normochromic microcytic anemia is:

Anemia of inflammation and chronic disease: Anemia due to these conditions is usually normochromic and normocytic (red blood cells are normal in size). Normochromic microcytic anemia may be seen in people with:

  • infectious diseases, such as tuberculosis, HIV/AIDS, or endocarditis
  • inflammatory diseases, such as rheumatoid arthritis, Crohn’s disease, or diabetes mellitus
  • kidney disease
  • cancer

These conditions can prevent red blood cells from functioning normally. This can lead to decreased iron absorption or utilization.

3. Hyperchromic microcytic anemias

Hyperchromic means that the red blood cells have more hemoglobin than normal. High levels of hemoglobin in your red blood cells makes them a deeper hue of red than normal.

Congenital spherocytic anemia: Hyperchromic microcytic anemias are rare. They may be caused by a genetic condition known as congenital spherocytic anemia. This is also called hereditary spherocytosis. In this disorder, the membrane of your red blood cells doesn’t form correctly. This causes them to be rigid and improperly spherical shaped. They are sent to be broken down and die in the spleen because they don’t travel in the blood cells properly.

4. Other causes of microcytic anemia

Other causes of microcytic anemia include:

  • lead toxicity
  • copper deficiency
  • zinc excess, which causes copper deficiency
  • alcohol use
  • drug use

Microcytic anemias are often first spotted after your doctor has ordered a blood test known as a complete blood count (CBC) for another reason. If your CBC indicates that you have anemia, your doctor will order another test known as a peripheral blood smear. This test can help spot early microcytic or macrocytic changes to your red blood cells. Hypochromia, normochromia, or hyperchromia can also be seen with the peripheral blood smear test.

Your primary care doctor may refer you to a hematologist. A hematologist is a specialist who works with blood disorders. They may be able to best diagnose and treat the specific type of microcytic anemia and identify its underlying cause.

Once a doctor has diagnosed you with microcytic anemia, they will run tests to determine the cause of the condition. They may run blood tests to check for celiac disease. They may test your blood and stool for H. pylori bacterial infection.

Your doctor might ask you about other symptoms you’ve experienced if they suspect that chronic blood loss is the cause of your microcytic anemia. They may refer you to a gastroenterologist if you have stomach or other abdominal pain. A gastroenterologist might run imaging tests to look for different conditions. These tests include:

  • abdominal ultrasound
  • upper GI endoscopy (EGD)
  • CT scan of the abdomen

For women with pelvic pain and heavy periods, a gynecologist may look for uterine fibroids or other conditions that could cause heavier flows.

 Microcytic anemia treatment

Treatment for microcytic anemia focuses on treating the underlying cause of the condition.

Your doctor may recommend that you take iron and vitamin C supplements. The iron will help treat the anemia while the vitamin C will help increase your body’s ability to absorb the iron.

Your doctor will focus on diagnosing and treating the cause of the blood loss if acute or chronic blood loss is causing or contributing to microcytic anemia. Women with iron deficiency from severe periods may be prescribed hormonal therapy, such as birth control pills.

In cases of microcytic anemia so severe that you’re at risk for complications like cardiac failure, you may need to get a blood transfusion of donor red blood cells. This can increase the number of healthy red blood cells that your organs need.

Treatment can be relatively straightforward if simple nutrient deficiencies are the cause of microcytic anemia. As long as the underlying cause of the anemia can be treated, the anemia itself can be treated and even cured.

In very severe cases, untreated microcytic anemia can become dangerous. It can cause tissue hypoxia. This is when the tissue is deprived of oxygen. It can cause complications including:

  • low blood pressure, also called hypotension
  • coronary artery problems
  • pulmonary problems
  • shock

These complications are more common in older adults who already have pulmonary or cardiovascular diseases.

Preventing microcytic anemia with your diet

The best way to prevent microcytic anemia is to get enough iron in your diet. Increasing your vitamin C intake can also help your body absorb more iron. You can also consider taking a daily iron supplement. These are often recommended if you already have anemia. You should always talk to your doctor before you start taking any supplements.

You can also try to get more nutrients through your food.

Foods rich in iron include:

  • red meat like beef
  • poultry
  • dark leafy greens
  • beans
  • dried fruits like raisins and apricots

Foods rich in vitamin C include:

  • citrus fruits, especially oranges and grapefruits
  • kale
  • red peppers
  • Brussels sprouts
  • strawberries
  • broccoli

Uterine Fibroids: Causes, Symptoms & Treatments

Uterine fibroids definition and facts

  • Uterine fibroids are benign tumors that originate in the uterus (womb).
  • It is not known exactly why women develop uterine fibroids.
  • Most women with uterine fibroids have no symptoms. However, fibroids can cause a number of symptoms depending on their size, location within the uterus, and how close they are to adjacent pelvic organs. These are most commonly abnormal bleeding, pain and pressure.
  • Uterine fibroids are diagnosed by pelvic exam and by ultrasound.
  • If treatment for uterine fibroids is necessary, there are several options available that include surgery (hysterectomy, myomectomy, cryosurgery, MRI-guided high-intensity focused ultrasound (MRgFUS or HIFU), and uterine artery embolization (UAE). Medical treatments include medications such as mifepristone (RU-486, danazol (Danocrine), raloxifene (Evista), GnRH analogs (Lupron and others), and low-dose formulations of oral contraceptives.

What are uterine fibroids? What do they look like (Pictures):

Uterine fibroids are benign tumors that originate in the uterus (womb). Although they are composed of the same smooth muscle fibers as the uterine wall (myometrium), they are much denser than normal myometrium. Uterine fibroids are usually round. In most cases, fibroids do not cause pain or other symptoms. However, exceptionally large fibroids may cause pressure on the bladder or other organs, leading to specific symptoms (see: What are the symptoms of uterine fibroids?)

Uterine fibroids are often described based upon their location within the uterus.

  • Subserosal fibroids are located beneath the serosa (the lining membrane on the outside of the uterus). These often appear localized on the outside surface of the uterus or may be attached to the outside surface by a pedicle.
  • Submucosal (submucous) fibroids are located inside the uterine cavity beneath the inner lining of the uterus. Intramural fibroids are located within the muscular wall of the uterus.
  • Intramural fibroids are located within the muscular wall of the uterus.
  • edunculated fibroids grow on a stalk of tissue known as a pedical (like a mushroom), extending either inside the cavity of the uterus or outside the uterus from its outer surface.
Picture of uterine fibroids

What are the symptomsof uterine fibroids? Do they cause pain?

Most of the time, uterine fibroids do not cause symptoms or problems, and a woman with a fibroid is usually unaware of its presence.

However, abnormal uterine bleeding is the most common symptom of a fibroid. If the tumors are near the uterine lining, or interfere with the blood flow to the lining, they can cause heavy periods, painful periods, prolonged periods or spotting between menses. Women with excessive bleeding due to fibroids may develop iron deficiency anemia. Uterine fibroids that are degenerating can sometimes cause severe, localized pain.

Fibroids can also cause a number of symptoms depending on their size, location within the uterus, and how close they are to adjacent pelvic organs. Large fibroids can cause:

  • pressure,
  • pelvic pain, including pain during sex,
  • pressure on the bladder with frequent or even obstructed urination, and
  • pressure on the rectum with painful or difficult defecation.

While fibroids do not interfere with ovulation, some studies suggest that they may impair fertility and lead to poorer pregnancy outcomes. In particular, submucosal fibroids that deform the inner uterine cavity are most strongly associated with decreases in fertility. Occasionally, fibroids are the cause of recurrent miscarriages. If they are not removed in these cases, the woman may not be able to sustain a pregnancy.

What causes uterine fibroids to grow? How big can they get?

We do not know exactly why women develop these tumors. Genetic abnormalities, alterations in growth factor (proteins formed in the body that direct the rate and extent of cell proliferation) expression, abnormalities in the vascular (blood vessel) system, and tissue response to injury have all been suggested to play a role in the development of fibroids.

Family history is a key factor, since there is often a history of fibroids developing in women of the same family. Race also appears to play a role. Women of African descent are two to three times more likely to develop fibroids than women of other races. Women of African ancestry also develop fibroids at a younger age and may have symptoms from fibroids in their 20s, in contrast to Caucasian women with fibroids, in whom symptoms typically occur during the 30s and 40s. Early pregnancy decreases the likelihood that fibroids will develop. Fibroids have not been observed in girls who have not reached puberty, but adolescent girls may rarely develop fibroids. Other factors that researchers have associated with an increased risk of developing fibroids include having the first menstrual period (menarche) prior to age 10, consumption of alcohol (particularly beer), uterine infections, and elevated blood pressure (hypertension).

Estrogen tends to stimulate the growth of fibroids in many cases. During the first trimesterof pregnancy, about a third of fibroids will enlarge and then shrink after the birth. In general, fibroids tend to shrink after menopause, but postmenopausal hormone therapy may cause symptoms to persist.

Overall, these tumors are fairly common and occur in about 70% to 80% of all women by the time they reach age 50.

Uterine fibroids can be as small as a few millimeters (less than an inch) in diameter. They can also be very large (grapefruit-sized or larger).

Can uterine fibroids cause cancer?

For the most part, uterine fibroids that do not cause a problem for the woman can be left untreated. In some cases, even fibroids that are not causing symptoms require removal or at least close observation. Rapid growth is a reason to watch more carefully, since a rare cancerous form of fibroid (referred to as a leiomyosarcoma) can be a fast-growing tumor, and it cannot be differentiated from a benign fibroid by ultrasound, MRI , or other imaging studies. However, this type of tumor occurs in less than 1% of uterine fibroids. It is also important to note that these rare cancerous tumors are not thought to begin in a benign fibroid.

Another risk of leaving these tumors alone is that they sometimes grow to a size that eventually cause significant symptoms, thus requiring removal. If fibroids grow large enough, the surgery to remove them can become more difficult and risky.

 

What tests diagnose uterine fibroids?

Uterine fibroids are diagnosed by pelvic exam and even more commonly by ultrasound. Often, a pelvic mass cannot be determined to be a fibroid on pelvic exam alone, and ultrasound is very helpful in differentiating it from other conditions such as ovarian tumors. MRI and CT scans can also play a role in diagnosing fibroids, but ultrasound is the simplest, cheapest, and best technique for imaging the pelvis. Occasionally, when trying to determine if a fibroid is present in the uterine cavity (endometrial cavity), a hysterosonogram (HSG) is done. In this procedure, an ultrasound exam is done while contrast fluid is injected into the uterus through the cervix. The fluid within the endometrial cavity can help outline any masses that are inside, such as submucosal fibroids.

What is the treatment for uterine fibroids?

There are several options for the treatment of uterine fibroids that include surgery (hysterectomy, myomectomy, cryosurgery, MRI-guided high-intensity focused ultrasound (MRgFUS), and uterine artery embolization (UAE). Medical treatments include medications such as mifepristone (RU-486, danazol (Danocrine), raloxifene (Evista), GnRH analogs (Lupron and others), and low-dose formulations of oral contraceptives.

Surgery for fibroids

 

There are many ways of managing uterine fibroids. Surgical methods are the mainstay of treatment when treatment is necessary. Possible surgical interventions include hysterectomy, or removal of the uterus (and the fibroids with it). Myomectomy is the selective removal of just the fibroids within the uterus. Myomectomy can be done through a hysteroscope, laparoscope or with the standard open incision on the abdominal wall. Some treatments have involved boring holes into the fibroid with laser fibers, freezing probes (cryosurgery), and other destructive techniques that do not actually remove the tissue but try to destroy it in place. Surgery is necessary if there is suspicion of malignancy in any case of a leiomyoma or uterine mass.

Another technique for treating fibroids is known as uterine artery embolization (UAE). This technique uses small beads of a compound called polyvinyl alcohol, which are injected through a catheter into the arteries that feed the fibroid. These beads obstruct the blood supply to the fibroid and starve it of blood and oxygen. While this technique has not been in use long enough to evaluate long-term effects of UAE versus surgery, it is known that women undergoing UAE for fibroids have a shorter hospital stay than those having surgery but a greater risk of complications and readmissions to the hospital. Studies are underway to evaluate the long-term outcomes of UAE as opposed to surgical treatment. Uterine artery occlusion (UAO), which involves clamping the involved uterine arteries as opposed to injecting the polyvinyl alcohol beads, is currently under investigation as a potential alternative to UAE.

High-intensity focused ultrasound (HIFU) is a relatively new treatment for fibroids and other abnormalities. It is also known as MRgFUS (MRI-guided focused ultrasound) and FUS (focused ultrasound surgery). HIFU uses an ultrasound transducer with higher energy than those used for diagnostic examinations. The device focuses the sound waves, generating heat to destroy the fibroid. MRI imaging may be used for planning and monitoring of treatment.

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