Archives March 2023

Heartburn

Disease_Condition
Daktari 0 Comment

This is a painful burning feeling just below or behind the breastbone. Most of the time, it comes from the esophagus. The pain often rises in your chest from your stomach. It may also spread to your neck or throat.

Causes of Heartburn

Almost everyone has heartburn at some time. If you have heartburn very often, you may have gastroesophageal reflux disease (GERD) or Peptic Ulcer Disease

Normally when food or liquid enters your stomach, a band of muscle at the lower end of your esophagus closes off the esophagus. This band is called the lower esophageal sphincter (LES).

If this band does not close tightly enough, food or stomach acid can back up (reflux) into the esophagus. The stomach contents can irritate the esophagus and cause heartburn and other symptoms.

Heartburn is more likely if you have a hiatal hernia. A hiatal hernia is a condition which occurs when the top part of the stomach pokes into the chest cavity. This weakens the LES so that it is easier for acid to back up from the stomach into the esophagus.

Pregnancy and many medicines can bring on heartburn or make it worse.

Medicines that can cause heartburn include:

Anticholinergics (used for sea sickness)

Beta-blockers for high blood pressure or heart disease

Calcium channel blockers ie nifedipine for high blood pressure

Dopamine-like drugs for Parkinson disease

Progestin for abnormal menstrual bleeding or birth control

Sedatives for anxiety or sleep problems (insomnia)

Theophylline (for asthma or other lung diseases)

Tricyclic antidepressants

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

Home Care for Heartburns

You should treat heartburn because reflux can damage the lining of your esophagus. This can cause serious problems over time. Changing your habits can be helpful in preventing heartburn and other symptoms of GERD.

The following tips will help you avoid heartburn and other GERD symptoms. Talk to your provider if you are still bothered by heartburn after trying these steps.

First, avoid foods and drinks that can trigger reflux, such as:

Alcohol

Caffeine and chocolate

Carbonated drinks

Citrus fruits and juices

Peppermint and spearmint

Spicy or fatty foods, full-fat dairy products

Tomatoes and tomato sauces

Next, try changing your eating habits:

Avoid bending over or exercising just after eating.

Avoid eating within 3 to 4 hours of bedtime. Lying down with a full stomach causes the stomach contents to press harder against the lower esophageal sphincter (LES). This allows reflux to occur.

Eat smaller meals.

Make other lifestyle changes as needed:

Avoid tight-fitting belts or clothes that are snug around the waist. These items can squeeze the stomach, and may force food to reflux.

Lose weight if you are overweight. Obesity increases pressure in the stomach. This pressure can push the stomach contents into the esophagus. In some cases, GERD symptoms go away after an overweight person loses 10 to 15 pounds (4.5 to 6.75 kilograms).

Sleep with your head raised about 6 inches (15 centimeters). Sleeping with the head higher than the stomach helps prevent digested food from backing up into the esophagus. Place books, bricks, or blocks under the legs at the head of your bed. You can also use a wedge-shaped pillow under your mattress. Sleeping on extra pillows does NOT work well for relieving heartburn because you can slip off the pillows during the night.

    Stop smoking or using tobacco. Chemicals in cigarette smoke or tobacco products weaken the LES.
    Reduce stress. Try yoga, tai chi, or meditation to help relax.

If you still do not have full relief, try over-the-counter medicines:

Antacids, like Maalox, Mylanta, or Tums help neutralize stomach acid.

H2 blockers, like Pepcid AC, Tagamet HB, and Axid AR reduce stomach acid production.

Proton pump inhibitors, like Prilosec OTC, Prevacid 24 HR, and Nexium 24 HR stop nearly all stomach acid production.

When to Contact a Medical Professional

Get urgent medical care if:
You vomit material that is bloody or looks like coffee grounds.

Your stools are black (like tar) or maroon.

You have a burning feeling and a squeezing, crushing, or pressure in your chest.

Sometimes people who think they have heartburn are having a heart attack.

Call your provider if:

You have heartburn often or it does not go away after a few weeks of self-care.

You lose weight that you did not want to lose.

You have trouble swallowing (food feels stuck as it goes down).

You have a cough or wheezing that does not go away.

Your symptoms get worse with antacids, H2 blockers, or other treatments.

You think one of your medicines may be causing heartburn. DO NOT change or stop taking your medicine on your own.

What to Expect at Your Hospital Visit

Heartburn is easy to diagnose from your symptoms in most cases. Sometimes, heartburn can be confused with another stomach problem called dyspepsia. If the diagnosis is unclear, you may be sent to a doctor called a gastroenterologist for more testing.
First, your provider will do a physical exam and ask questions about your heartburn, such as:

When did it begin?

How long does each episode last?

Is this the first time you have had heartburn?

What do you usually eat at each meal? Before you feel heartburn, have you eaten a spicy or fatty meal?

Do you drink a lot of coffee, other drinks with caffeine, or alcohol? Do you smoke?

Do you wear clothing that is tight in the chest or belly?

Do you also have pain in the chest, jaw, arm, or somewhere else?

What medicines are you taking?

Have you vomited blood or black material?

Do you have blood in your stools?

Do ,you have black, tarry stools?

Are there other symptoms with your heartburn?

Your provider may suggest one or more of the following tests:

Esophageal motility to measure the pressure of your LES

Esophagogastroduodenoscopy (upper endoscopy) to look at the inside lining of your esophagus and stomach

Upper GI series (most often done for swallowing problems)

If your symptoms do not get better with home care, you may need to take medicine to reduce acid that is stronger than over-the-counter medicines. Any sign of bleeding will need more testing and treatment.

Constipation in Children

Disease_Condition
Daktari 1 Comment

Constipation in infants and children means they have hard stools or have problems passing stools. A child may have pain while passing stools or may be unable to have a bowel movement after straining or pushing.

Considerations

Constipation is common in children. However, normal bowel movements are different for each child.

In the first month, infants tend to have bowel movements about once a day. After that, babies can go a few days or even a week between bowel movements. It’s also difficult to pass stools because their abdominal muscles are weak.

So babies tend to strain, cry, and get red in the face when they have a bowel movement. This does not mean they are constipated. If bowel movements are soft, then there is likely no problem.

Signs of constipation in infants and children

Being very fussy and spitting up more often (infants)

Difficulty passing stools or seeming uncomfortable

Hard, dry stools

Pain when having a bowel movement

Belly pain and bloating

Blood on the stool or on toilet paper

Having less than 3 bowel movements (going for toilet) a week.

Moving their body in different positions or clenching their buttocks

NB: Make sure your infant or child has a problem before treating constipation!

Some children do not have a bowel movement every day.

Also, some healthy children always have very soft stools.

Other children have firm stools, but are able to pass them without problems.

Causes of Constipation

Constipation occurs when the stool remains in the colon for too long. Too much water gets absorbed by the colon, leaving hard, dry stools.

Constipation may be caused by:

Ignoring the urge to use the toilet

Not eating enough fiber

Not drinking enough fluids

Switching to solid foods or from breast milk to formula (infants)

Changes in situation, such as travel, starting school, or stressful events

Medical causes of constipation may include:

Diseases of the bowel, such as those that affect the bowel muscles or nerves

Use of certain medicines and other medical conditions that affect the bowel

Children may ignore the urge to have a bowel movement because:

They are not ready for toilet training

They are learning to control their bowel movements

They have had previous painful bowel movements and want to avoid them

They don’t want to use a school or public toilet

Home Care

Lifestyle changes can help your child avoid constipation. These changes can also be used to treat it.

For infants:

Give your baby extra water or juice during the day in between feedings. Juice can help bring water to the colon.

Over 2 months old: Try 2 to 4 ounces (59 to 118 mL) of fruit juice (grape, pear, apple, cherry, or prune) twice a day.

Over 4 months old: If the baby has started to eat solid foods, try baby foods with high-fiber content such as peas, beans, apricots, prunes, peaches, pears, plums, and spinach twice a day.

For children:

Drink plenty of fluids each day. Your child’s health care provider can tell you how much.

Eat more fruits and vegetables and foods high in fiber, such as whole grains.

Avoid certain foods such as cheese, fast food, prepared and processed foods, meat, and ice cream.

Stop toilet training if your child becomes constipated. Resume after your child is no longer constipated.

Teach older children to use the toilet right after eating a meal.

Stool softeners (such as those containing docusate sodium) may help for older children. Bulk laxatives such as psyllium may help add fluid and bulk to the stool. Suppositories or gentle laxatives may help your child have regular bowel movements. Electrolyte solutions like Miralax can also be effective.

Some children may need enemas or prescription laxatives. These methods should be used only if fiber, fluids, and stool softeners do not provide enough relief.

Do not give laxatives or enemas to children without first asking your child’s provider.

When to Contact a Medical Professional

Contact your child’s provider right away if:

An infant (except those who are only breastfed) goes 3 days without a stool and is vomiting or irritable

An infant younger than 2 months is constipated.

Non-breastfeeding infants go 3 days without having a bowel movement (Contact your child’s provider right away if there is vomiting or irritability.)

A child is holding back bowel movements to resist toilet training.

There is blood in the stools.

What to Expect at Your Hospital Visit

Your child’s provider will perform a physical exam. This may include a rectal exam.

The provider may ask you questions about your child’s diet, symptoms, and bowel habits.

The following tests may help find the cause of constipation:

Blood tests such as a complete blood count (CBC)

X-rays of the abdomen

The provider may recommend the use of stool softeners or laxatives. If stools are impacted, glycerin suppositories or saline enemas may be recommended also.

Rectal Prolapse

Disease_Condition
Daktari 1 Comment

Rectal prolapse occurs when the rectum sags and comes through the anal opening.

Causes

The exact cause of rectal prolapse is unclear. Possible causes may include any of the following:

An enlarged opening due to relaxed muscles in the pelvic floor, which is formed of muscles around the rectum

Loose muscles of the anal sphincter

An abnormally long colon

Downward movement of the abdominal cavity between the rectum and uterus

Prolapse of the small intestine

Constipation

Diarrhea

Chronic coughing and sneezing

A prolapse can be partial or complete:

With a partial prolapse, the inner lining of the rectum bulges partly from the anus.

With a complete prolapse, the entire rectum bulges through the anus.

Rectal prolapse occurs most often in children under age 6.

Health problems that may lead to prolapse:

Cystic fibrosis

Intestinal worm infections

Long-term diarrhea

Other health problems present at birth

In adults, it is usually found with constipation, or with a muscle or nerve problem in the pelvic or genital area.

Symptoms of Rectal Prolapse

The main symptom is a reddish-colored mass that sticks out from the opening of the anus, especially after a bowel movement. This reddish mass is actually the inner lining of the rectum. It may bleed slightly and can be uncomfortable and painful.

Exams and Tests

The health care provider will perform a physical exam, which will include a rectal exam. To check for prolapse, the provider may ask the person to bear down while sitting on a toilet.

Tests that may be done include:

  • Colonoscopy to confirm the diagnosis
  • Blood test to check for anemia if there is bleeding from the rectum

Treatment

Call your provider if a rectal prolapse occurs.

In some cases, the prolapse can be treated at home. Follow your provider’s instructions on how to do this. The rectum must be pushed back inside manually. A soft, warm, wet cloth is used to apply gentle pressure to the mass to push it back through the anal opening.

The person should lie on one side in a knee-chest position before applying pressure. This position allows gravity to help put the rectum back into position.

Immediate surgery is rarely needed. In children, treating the cause often solves the problem.

For example, if the cause is straining because of dry stools, laxatives may help. If the prolapse continues, surgery may be needed.

In adults, the only cure for rectal prolapse is a procedure that repairs the weakened anal sphincter and pelvic muscles.

Copyright © 2023 | Powered by AfyaProds Enterprise Ltd | .ThemeArile