Category Archives: Ailmemts & Remedies

Crepitus

Other Name:Crepitation

Description:
Crepitus is a medical term to describe the grating, crackling or popping sounds and sensations experienced under the skin and joints or a crackling sensation due to the presence of air in the subcutaneous tissue.

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Various types of crepitus that can be heard in joint pathologies are:

*Bone crepitus: This can be heard when two fragments of a fracture are moved against each other.

*Joint crepitus: This can be obtained when the affected joint is passively moved with one hand, while the other hand is placed on the joint to feel the crepitus.

*Crepitus of bursitis: This is heard when the fluid in the bursa contains small, loose fibrinous particles.
Crepitus of tenosynovitis. In most cases, crepitus is harmless if it occurs in normal people. But if crepitus is associated with an injury, or, if there is knee pain or swelling, then further investigations are required.

Symptoms:
Crepitus, or joint sounds, can be a normal part of movement. Many people experience popping joints, especially as they get older. You may notice:

*Popping or cracking when you bend your knee or elbow
*Crunching sounds in your knee when you go up or down stairs or kneel
*Crackling or grinding sounds or a crunching sensation when you move your shoulder
*Occasional or continual swelling around the joint

How to protect the nee:
Orthopedic surgeons say that the best way to protect the knee is to warm up prior to exercise. By strengthening the quadriceps, one can decrease the load on the patellofemoral joint and also reduce the risk of eroding the cartilage. Other means of protecting the knee include stretching and wearing suitable shoes. It is also important to maintain a healthy weight to decrease stress on the knee joint.

If crepitus occurs during exercise, one should:
* Not stop but modify the exercise
* Avoid running on hills or inclines
* When cycling, maintain tension on the pedals
* If you are using quadriceps to lift weights, use lightweights and increase the frequency
Finally during an exercise listen to your body, if you develop pain, stop the activity.

Causes:
The sound can be created when two rough surfaces in an organism’s body come into contact—for example, in osteoarthritis or rheumatoid arthritis when the cartilage around joints erodes and the surfaces in the joint grind against one another, or when the fractured surfaces of two broken bones rub together. Crepitus is a common sign of bone fracture.

Crepitus can easily be created and observed by exerting a small amount of force on a joint, thus ‘cracking it’. This is caused by bubbles of nitrogen forming in the synovial fluid bursting. Almost every joint in the body can be ‘cracked’ in this way, but the joints which require the least amount of effort include the hallux, knuckles and neck joints.

In soft tissues, crepitus can be produced when gas is introduced into an area where it is normally not present.

The term can also be used when describing the sounds produced by lung conditions such as interstitial lung disease—these are also referred to as “rales”. Crepitus is often loud enough to be heard by the human ear, although a stethoscope may be needed to detect instances caused by respiratory diseases.

In times of poor surgical practice, post-surgical complications involved anaerobic infection by Clostridium perfringens strains, which can cause gas gangrene in tissues, also giving rise to crepitus.

Subcutaneous crepitus (or surgical emphysema) is a crackling sound resulting from subcutaneous emphysema, or air trapped in the subcutaneous tissues.

Treatment:
Treating Crepitus in the Knee, Shoulder or Other Joints:
Many causes of joint popping and cracking improve with home remedies, like taking anti-inflammatory medications or using the RICE method (rest, ice, compression and elevation). Other causes might require a doctor’s help.

Noninvasive Treatments for Crepitus:
Your doctor will talk with you about possible treatments, including:

*Bracing or splinting: Sometimes, a brace or splint can help align the joint so an injury can heal.
Physical therapy: Our physical therapy teams tailor treatment plans to your condition, activities and goals. Get more information about physical therapy.

*Custom orthotics: Orthotics – special shoe inserts that stabilize the foot and knee – can relieve pain and help you stay active. Learn more about custom foot orthotics.

*Pain relief: We take pain management very seriously. Handled correctly, pain relief methods can eliminate discomfort and inflammation and may let you get back to your favorite activities safely. Read more about orthopedic pain we treat.

Surgical Options to Eliminate Pain-Causing Crepitus:
Some causes of crepitus might require surgical treatment. We’ll advise you on the least invasive treatment to relieve joint pain and minimize future damage. You might consider:

*Arthroscopic surgery: Arthroscopy is a minimally invasive surgery that uses small instruments inserted through tiny incisions to access the joint. For PFS, your surgeon can remove bits of damaged tissue or reposition tendons to provide more knee movement. Learn more about treatments for knee pain.

*Debridement: Some types of PFS and arthritis improve with debridement. In this minimally invasive surgery, the surgeon can smooth damaged cartilage to reduce rubbing.

*Joint replacement: When arthritis or joint damage is advanced, you might consider joint replacement. Joint replacement surgery implants an artificial joint in place of a damaged joint. Find out more about orthopedic medicine and orthopedic surgery.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
https://en.wikipedia.org/wiki/Crepitus

Crepitus of the Knee: When is it Serious?


https://www.aurorahealthcare.org/services/orthopedics/conditions/crepitus#Treatment

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Bradycardia

Description:
Bradycardia is an abnormally slow heart rate of less than 60 beats per minute. Each time the heart beats, oxygen-rich blood is pumped through the body. When an individual has an extremely low resting heart rate, his or her organs may not receive enough oxygen to operate properly.

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Bradycardia typically does not cause symptoms until the rate drops below 50 BPM. When symptomatic, it may cause fatigue, weakness, dizziness, sweating, and at very low rates, fainting.

During sleep, a slow heartbeat with rates around 40–50 BPM is common, and is considered normal. Highly trained athletes may also have athletic heart syndrome, a very slow resting heart rate that occurs as a sport adaptation and helps prevent tachycardia during training.

The term relative bradycardia is used in explaining a heart rate that, although not actually below 60 BPM, is still considered too slow for the individual’s current medical condition.

Clasification:
Atrial bradycardias are divided into three types. The first, respiratory sinus arrhythmia, is usually found in young and healthy adults. Heart rate increases during inhalation and decreases during exhalation. This is thought to be caused by changes in the vagal tone during respiration.[3] If the decrease during exhalation drops the heart rate below 60 bpm on each breath, this type of bradycardia is usually deemed benign and a sign of good autonomic tone.

The second, sinus bradycardia, is a sinus rhythm of less than 60 BPM. It is a common condition found in both healthy individuals and those considered well-conditioned athletes. Studies have found that 50–85% of conditioned athletes have benign sinus bradycardia, as compared to 23% of the general population studied.[4] The heart muscle of athletes has become conditioned to have a higher stroke volume, so requires fewer contractions to circulate the same volume of blood.

The third, sick sinus syndrome, covers conditions that include severe sinus bradycardia, sinoatrial block, sinus arrest, and bradycardia-tachycardia syndrome (atrial fibrillation, flutter, and paroxysmal supraventricular tachycardia).

Atrioventricular nodal:
An atrioventricular nodal bradycardia or AV junction rhythm is usually caused by the absence of the electrical impulse from the sinus node. This usually appears on an EKG with a normal QRS complex accompanied with an inverted P wave either before, during, or after the QRS complex.

An AV junctional escape is a delayed heartbeat originating from an ectopic focus somewhere in the AV junction. It occurs when the rate of depolarization of the SA node falls below the rate of the AV node.[3] This dysrhythmia also may occur when the electrical impulses from the SA node fail to reach the AV node because of SA or AV block.[5] This is a protective mechanism for the heart, to compensate for an SA node that is no longer handling the pacemaking activity, and is one of a series of backup sites that can take over pacemaker function when the SA node fails to do so. This would present with a longer PR interval. A junctional escape complex is a normal response that may result from excessive vagal tone on the SA node. Pathological causes include sinus bradycardia, sinus arrest, sinus exit block, or AV block.

Ventricular:
A ventricular bradycardia, also known as ventricular escape rhythm or idioventricular rhythm, is a heart rate of less than 50 BPM. This is a safety mechanism when a lack of electrical impulse or stimuli from the atrium occurs. Impulses originating within or below the bundle of His in the atrioventricular node will produce a wide QRS complex with heart rates between 20 and 40 BPM. Those above the bundle of His, also known as junctional, will typically range between 40 and 60 BPM with a narrow QRS complex. In a third-degree heart block, about 61% take place at the bundle branch-Purkinje system, 21% at the AV node, and 15% at the bundle of His. AV block may be ruled out with an EKG indicating “a 1:1 relationship between P waves and QRS complexes.” Ventricular bradycardias occurs with sinus bradycardia, sinus arrest, and AV block. Treatment often consists of the administration of atropine and cardiac pacing.

Infantile:
For infants, bradycardia is defined as a heart rate less than 100 BPM (normal is around 120–160). Premature babies are more likely than full-term babies to have apnea and bradycardia spells; their cause is not clearly understood. The spells may be related to centers inside the brain that regulate breathing which may not be fully developed. Touching the baby gently or rocking the incubator slightly will almost always get the baby to start breathing again, which increases the heart rate. Medications (theophylline or caffeine) can be used to treat these spells in babies if necessary. Neonatal intensive-care unit (NICU) standard practice is to electronically monitor the heart and lungs for this reason.

Symptoms:
If one has bradycardia, his or her brain and other organs might not get enough oxygen, possibly causing these symptoms:

*Near-fainting or fainting (syncope)

*Dizziness or lightheadedness

*Fatigue

*Shortness of breath

*Chest pains

*Confusion or memory problems

*Easily tiring during physical activity

Causes:
This cardiac arrhythmia can be underlain by several causes, which are best divided into cardiac and noncardiac causes. Noncardiac causes are usually secondary, and can involve recreational drug use or abuse; metabolic or endocrine issues, especially in the thyroid; an electrolyte imbalance; neurologic factors; autonomic reflexes; situational factors such as prolonged bed rest; and autoimmunity. Cardiac causes include acute or chronic ischemic heart disease, vascular heart disease, valvular heart disease, or degenerative primary electrical disease. Ultimately, the causes act by three mechanisms: depressed automaticity of the heart, conduction block, or escape pacemakers and rhythms.

In general, two types of problems result in bradycardias: disorders of the sinoatrial node (SA node), and disorders of the atrioventricular node (AV node).

With sinus node dysfunction (sometimes called sick sinus syndrome), there may be disordered automaticity or impaired conduction of the impulse from the sinus node into the surrounding atrial tissue (an “exit block”). Second-degree sinoatrial blocks can be detected only by use of a 12-lead EKG.[8] It is difficult and sometimes impossible to assign a mechanism to any particular bradycardia, but the underlying mechanism is not clinically relevant to treatment, which is the same in both cases of sick sinus syndrome: a permanent pacemaker.

Atrioventricular conduction disturbances (AV block; primary AV block, secondary type I AV block, secondary type II AV block, tertiary AV block) may result from impaired conduction in the AV node, or anywhere below it, such as in the bundle of His. The clinical relevance pertaining to AV blocks is greater than that of sinoatrial blocks.

Patients with bradycardia have likely acquired it, as opposed to having it congenitally. Bradycardia is more common in older patients.

Beta-blocker medicines also can slow the heart rate and decrease how forcefully the heart contracts. Beta blockers may slow the heart rate to a dangerous level if prescribed with calcium channel blocker-type medications.

Bradycardia is also part of the mammalian diving reflex.

Diagnosis:

Your physician may hear an abnormally slow heart rate when listening to your heart with a stethoscope during a physical exam. He or she also may detect normal or low blood pressure. Tests used to help in the diagnosis include the following:

Electrocardiogram (ECG or EKG):

An electrocardiogram, also called an ECG or EKG, is a primary tool for evaluating bradycardia. Using small sensors (electrodes) attached to your chest and arms, it records electrical signals as they travel through your heart.

Because an ECG can’t record bradycardia unless it happens during the test, your doctor might have you use a portable ECG device at home. These devices include:

Holter monitor. Carried in your pocket or worn on a belt or shoulder strap, this device records your heart’s activity for 24 to 48 hours.

Your doctor will likely ask you to keep a diary during the same 24 hours. You’ll describe any symptoms you experience and record the time they occur.

Event recorder. This device monitors your heart activity over a few weeks. You push a button to activate it when you feel symptoms so that it records your heart’s activity during that time.
Your doctor might use an ECG monitor while performing other tests to understand the impact of bradycardia. These tests include:

Tilt table test. This test helps your doctor better understand how your bradycardia contributes to fainting spells. You lie flat on a special table, and then the table is tilted as if you were standing up to see if the change in position causes you to faint.
Exercise test. Your doctor might monitor your heart rate while you walk on a treadmill or ride a stationary bike to see whether your heart rate increases appropriately in response to physical activity.

Laboratory and other tests:

Your doctor will order blood tests to screen for conditions that might be contributing to bradycardia, such as an infection, hypothyroidism or an electrolyte imbalance.

If sleep apnea is suspected of contributing to bradycardia, you might undergo tests to monitor your sleep.

Treatment:
The treatment of bradycardia is dependent on whether or not the person is stable or unstable. If oxygen saturations are low, supplemental oxygen should be provided.

Stable:
Emergency treatment is not needed if the person is asymptomatic or minimally symptomatic.

Unstable:
If a person is unstable, the initial recommended treatment is intravenous atropine. Doses less than 0.5 mg should not be used, as this may further decrease the rate. If this is not effective, intravenous inotrope infusion (dopamine, epinephrine) or transcutaneous pacing should be used.[10] Transvenous pacing may be required if the cause of the bradycardia is not rapidly reversible.

Regular walking for 30 minutes, Yoga & meditation is the best way to get releve from Bradycardia.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
https://en.wikipedia.org/wiki/Bradycardia
https://www.mayoclinic.org/diseases-conditions/bradycardia/diagnosis-treatment/drc-20355480

Proctitis

Description:
Proctitis is an inflammation of the anus and the lining of the rectum, affecting only the last 6 inches of the rectum. Proctitis may be acute or chronic. Anal sex, inflammatory bowel disease, or radiation therapy to your pelvic area or abdomen may cause proctitis. If not treated, proctitis may have complications.

Proctitis can cause rectal pain, diarrhea, bleeding and discharge, as well as the continuous feeling that you need to have a bowel movement. Proctitis symptoms can be short-lived, or they can become chronic.

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Proctitis is common in people who have inflammatory bowel disease (Crohn’s disease or ulcerative colitis).

Symptoms:
A common symptom is a continual urge to have a bowel movement—the rectum could feel full or have constipation. Another is tenderness and mild irritation in the rectum and anal region. A serious symptom is pus and blood in the discharge, accompanied by cramps and pain during the bowel movement. If there is severe bleeding, anemia can result, showing symptoms such as pale skin, irritability, weakness, dizziness, brittle nails, and shortness of breath.

Symptoms are ineffectual straining to empty the bowels, diarrhea, rectal bleeding and possible discharge, a feeling of not having adequately emptied the bowels, involuntary spasms and cramping during bowel movements, left-sided abdominal pain, passage of mucus through the rectum, and anorectal pain.

Causes:
Proctitis has many possible causes. It may occur idiopathically (idiopathic proctitis, that is, arising spontaneously or from an unknown cause). Other causes include damage by irradiation (for example in radiation therapy for cervical cancer and prostate cancer) or as a sexually transmitted infection, as in lymphogranuloma venereum and herpes proctitis. Studies suggest a celiac disease-associated “proctitis” can result from an intolerance to gluten.

A common cause is engaging in anal sex with partner(s) infected with sexual transmitted diseases in men who have sex with men. Shared enema usage has been shown to facilitate the spread of Lymphogranuloma venereum proctitis.
Sexually transmitted infections are another frequent cause. Proctitis also can be a side effect of radiation therapy for certain cancers.

Diagnosis:
Doctors can diagnose proctitis by looking inside the rectum with a proctoscope or a sigmoidoscope. A biopsy is taken, in which the doctor scrapes a tiny piece of tissue from the rectum, and this tissue is then examined by microscopy. The physician may also take a stool sample to test for infections or bacteria. If the physician suspects that the patient has Crohn’s disease or ulcerative colitis, colonoscopy or barium enema X-rays are used to examine areas of the intestine.

Risk factors:

Risk factors for proctitis  are:

* Unsafe sex. Practices that increase your risk of a sexually transmitted infection (STI) can increase your risk of proctitis. Your risk of contracting an STI increases if you have multiple sex partners, don’t use condoms and have sex with a partner who has an STI.

* Inflammatory bowel diseases. Having an inflammatory bowel disease (Crohn’s disease or ulcerative colitis ) increases your risk of proctitis.

* Radiation therapy for cancer. Radiation therapy directed at or near your rectum (such as for rectal, ovarian or prostate cancer) increases your risk of proctitis.

Complications:

Proctitis that isn’t treated or that doesn’t respond to treatment may lead to complications, including:

* Anemia. Chronic bleeding from your rectum can cause anemia. With anemia, you don’t have enough red blood cells to carry adequate oxygen to your tissues. Anemia causes you to feel tired, and you may also experience dizziness, shortness of breath, headache, pale skin and irritability.

* Ulcers. Chronic inflammation in the rectum can lead to open sores (ulcers) on the inside lining of the rectum.

* Fistulas. Sometimes ulcers extend completely through the intestinal wall, creating a fistula, an abnormal connection that can occur between different parts of your intestine, between your intestine and skin, or between your intestine and other organs, such as the bladder and vagina.

Treatment:

Treatment of proctitis depends on its cause and the severity of your symptoms and often includes medicines. Some causes of proctitis, such as infection or rectal injury, can be prevented. Doctors treat complications of proctitis with medical procedures.

For example, the physician may prescribe antibiotics for proctitis caused by bacterial infection. If the proctitis is caused by Crohn’s disease or ulcerative colitis, the physician may prescribe the drug 5-aminosalicyclic acid (5ASA) or corticosteroids applied directly to the area in enema or suppository form, or taken orally in pill form. Enema and suppository applications are usually more effective, but some patients may require a combination of oral and rectal applications.

Another treatment available is that of fiber supplements such as Metamucil or psyllium husk. Taken daily these may restore regularity and reduce pain associated with proctitis.

Prevention:

To reduce your risk of proctitis, take steps to protect yourself from sexually transmitted infections (STIs). The surest way to prevent an STI is to abstain from sex, especially anal sex. If you choose to have sex, reduce your risk of an STI by:

* Limiting your number of sex partners

* Using a latex condom during each sexual contact

*Not having sex with anyone who has any unusual sores or discharge in the genital area

If you’re diagnosed with a sexually transmitted infection, stop having sex until after you’ve completed treatment. Ask your doctor when it’s safe to have sex again.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
https://www.niddk.nih.gov/health-information/digestive-diseases/proctitis
https://www.mayoclinic.org/diseases-conditions/proctitis/symptoms-causes/syc-20376933
https://en.wikipedia.org/wiki/Proctitis

Ménétrier’s Disease

 

Other Name: Hypoproteinemic Hypertrophic Gastropathy

Description:
Ménétrier’s disease causes the ridges along the inside of the stomach wall—called rugae—to enlarge, forming giant folds in the stomach lining. The rugae enlarge because of an overgrowth of mucous cells in the stomach wall.

It is a rare, acquired, premalignant disease of the stomach characterized by massive gastric folds, excessive mucous production with resultant protein loss, and little or no acid production. The disorder is associated with excessive secretion of transforming growth factor alpha (TGF-?)

In a normal stomach, mucous cells in the rugae release protein-containing mucus. The mucous cells in enlarged rugae release too much mucus, causing proteins to leak from the blood into the stomach. This shortage of protein in the blood is known as hypoproteinemia. Ménétrier’s disease also reduces the number of acid-producing cells in the stomach, which decreases stomach acid.

The average age of onset is 40 to 60 years, and men are affected more often than women. Adults with Ménétrier disease have a higher risk of developing gastric adenocarcinoma.

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Symptoms:
Individuals with the disease present with upper abdominal pain (epigastric), at times accompanied by nausea, vomiting, loss of appetite, edema, weakness, and weight loss. A small amount of gastrointestinal bleeding may occur, which is typically due to superficial mucosal erosions; large volume bleeding is rare. 20% to 100% of patients, depending on time of presentation, develop a protein-losing gastropathy accompanied by low blood albumin and edema.

Symptoms and pathological features of Ménétrier disease in children are similar to those in adults, but disease in children is usually self-limited and often follows respiratory infection.

Causes:
Scientists are unsure about what causes Ménétrier’s disease; however, researchers think that most people acquire, rather than inherit, the disease. In extremely rare cases, siblings have developed Ménétrier’s disease as children, suggesting a genetic link.

Studies suggest that people with Ménétrier’s disease have stomachs that make abnormally high amounts of a protein called transforming growth factor-alpha (TGF-?).

TGF-? binds to and activates a receptor called epidermal growth factor receptor. Growth factors are proteins in the body that tell cells what to do, such as grow larger, change shape, or divide to make more cells. Researchers have not yet found a cause for the overproduction of TGF-?.

Some studies have found cases of people with Ménétrier’s disease who also had Helicobacter pylori (H. pylori) infection. H. pylori is a bacterium that is a cause of peptic ulcers, or sores on the lining of the stomach or the duodenum, the first part of the small intestine. In these cases, treatment for H. pylori reversed and improved the symptoms of Ménétrier’s disease.1

Researchers have linked some cases of Ménétrier’s disease in children to infection with cytomegalovirus (CMV). CMV is one of the herpes viruses. This group of viruses includes the herpes simplex viruses, which cause chickenpox, shingles, and infectious mononucleosis, also known as mono. Most healthy children and adults infected with CMV have no symptoms and may not even know they have an infection. However, in people with a weakened immune system, CMV can cause serious disease, such as retinitis, which can lead to blindness.

Researchers are not sure how H. pylori and CMV infections contribute to the development of Ménétrier’s disease.

Diagnosis:
The large folds of the stomach, as seen in Ménétrier disease, are easily detected by x-ray imaging following a barium meal or by endoscopic methods. Endoscopy with deep mucosal biopsy (and cytology) is required to establish the diagnosis and exclude other entities that may present similarly. A non-diagnostic biopsy may lead to a surgically obtained full-thickness biopsy to exclude malignancy. CMV and helicobacter pylori serology should be a part of the evaluation.

Twenty-four-hour pH monitoring reveals hypochlorhydria or achlorhydria, and a chromium-labelled albumin test reveals increased GI protein loss.[5] Serum gastrin levels will be within normal limits.

Other possible causes (eg differential diagnosis) of large folds within the stomach include: Zollinger-Ellison syndrome, cancer, infection (cytomegalovirus/CMV, histoplasmosis, syphilis), and infiltrative disorders such as sarcoidosis.

Treatment:
Cetuximab is the first-line therapy for Ménétrier disease. Cetuximab is a monoclonal antibody against epidermal growth factor receptor (EGFR), and has been shown to be effective in treating Ménétrier disease.

Several medications have been used in the treatment of the condition, with variable efficacy. Such medications include: anticholinergic agents, prostaglandins, proton pump inhibitors, prednisone, and H2 receptor antagonists. Anticholinergics decrease protein loss. A high-protein diet should be recommended to replace protein loss in patients with low levels of albumin in the blood (hypoalbuminemia). Any ulcers discovered during the evaluation should be treated in standard fashion.

Severe disease with persistent and substantial protein loss despite cetuximab may require total removal of the stomach. Subtotal gastrectomy is performed by some; it may be associated with higher morbidity and mortality secondary to the difficulty in obtaining a patent and long-lasting anastomosis between normal and hyperplastic tissue. In adults, there is no FDA approved treatment other than gastrectomy and a high-protein diet. Cetuximab is approved for compassionate use in the treatment of the disease.

Pediatric cases are normally treated for symptoms with the disease clearing up in weeks to months.

Intravenous Protein and Blood Transfusions:
A health care provider may recommend an IV treatment of protein and a blood transfusion to a person who is malnourished or anemic because of Ménétrier’s disease. In most cases of children with Ménétrier’s disease who also have had CMV infection, treatment with protein and a blood transfusion led to a full recovery.

Surgery:
If a person has severe Ménétrier’s disease with significant protein loss, a surgeon may need to remove part or all of the stomach in a surgery called gastrectomy.

Surgeons perform gastrectomy in a hospital. The patient will require general anesthesia. Some surgeons perform a gastrectomy through laparoscopic surgery rather than through a wide incision in the abdomen. In laparoscopic surgery, the surgeon uses several smaller incisions and feeds special surgical tools through the incisions to remove the diseased part of the stomach. After gastrectomy, the surgeon may reconstruct the changed portions of the GI tract so that it may continue to function. Usually the surgeon attaches the small intestine to any remaining portion of the stomach or to the esophagus if he or she removed the entire stomach.

Eating, Diet, and Nutrition:
Researchers have not found that eating, diet, and nutrition play a role in causing or preventing Ménétrier’s disease. In some cases, a health care provider may prescribe a high-protein diet to offset the loss of protein due to Ménétrier’s disease. Some people with severe malnutrition may require IV nutrition, which is called total parenteral nutrition (TPN). TPN is a method of providing an IV liquid food mixture through a special tube in the chest.

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Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
https://en.wikipedia.org/wiki/M%C3%A9n%C3%A9trier%27s_disease
https://www.niddk.nih.gov/health-information/digestive-diseases/menetriers-disease

Fecal Incontinence


Other Names:Bowel Control Problems, Bowel Incontinence

Description:
Fecal Incontience is the inability to control bowel movements. It’s a common problem, especially among older adults.

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Accidental bowel leakage is usually not a serious medical problem. But it can seriously interfere with daily life. People with bowel incontinence may avoid social activities for fear of embarrassment.

Symptoms:
The symptoms of fecal incontinence include a strong urge for a bowel movement and not being able to control it, and passing solid or liquid stool without knowing it.

Causes:
Fecal incontinence has many causes, including digestive tract disorders and chronic diseases. The most common cause is damage to the muscles around the anus (anal sphincters). Vaginal childbirth can damage the anal sphincters or their nerves. That’s why women are affected by accidental bowel leakage about twice as often as men.

Anal surgery can also damage the anal sphincters or nerves, leading to bowel incontinence.

There are many other potential causes of bowel incontinence, including:

*Diarrhea (often due to an infection or irritable bowel syndrome)

*Impacted stool (due to severe constipation, often in older adults)

*Inflammatory bowel disease (Crohn’s disease or ulcerative colitis)

*Nerve damage (due to diabetes, spinal cord injury, multiple sclerosis, or other conditions)

*Radiation damage to the rectum (such as after treatment for prostate cancer)

*Cognitive (thinking) impairment (such as after a stroke or advanced Alzheimer’s disease)

More than one cause for fecal incontinence is frequently present. It’s also not unusual for bowel incontinence to occur without a clear cause.

Diagnosis:
Discussing fecal incontinence may be embarrassing, but it can provide clues for a doctor to help make the diagnosis. During a physical examination, a doctor may check the strength of the anal sphincter muscle using a gloved finger inserted into the rectum.

Doctors use your medical history, a physical exam, and tests to diagnose fecal incontinence and its causes. Your doctor will ask specific questions about your symptoms. Play an active role in your diagnosis by talking openly and honestly with your doctor.

Other tests may be helpful in identifying the cause of bowel incontinence, such as:

Stool testing. If diarrhea is present, stool testing may identify an infection or other cause.

Anorectal manometry: A pressure monitor is inserted into the anus and rectum. This allows measurement of the strength of the sphincter muscles.

Endosonography: An ultrasound probe is inserted into the anus. This produces images that can help identify problems in the anal and rectal walls.

Nerve tests: These tests measure the responsiveness of the nerves controlling the sphincter muscles. They can detect nerve damage that can cause bowel incontinence.

MRI defecography: Magnetic resonance imaging of the pelvis can be performed, potentially while a person moves her bowels on a special commode. This can provide information about the muscles and supporting structures in the anus, rectum, and pelvis.

Complications:
Complications of fecal incontinence may include:

Emotional distress: The loss of dignity associated with losing control over one’s bodily functions can lead to embarrassment, shame, frustration, anger and depression. It’s common for people with fecal incontinence to try to hide the problem or to avoid social engagements.

Skin irritation: The skin around the anus is delicate and sensitive. Repeated contact with stool can lead to pain and itching, and potentially to sores (ulcers) that require medical treatment.

Treatment:
Many effective treatments can help people with bowel incontinence. These include:

*Medicine

*Surgery

*Minimally invasive procedures

Talking to your doctor is the first step toward freedom from fecal incontinence.

Dietary changes:
What you eat and drink affects the consistency of your stools. If constipation is causing fecal incontinence, your doctor may recommend drinking plenty of fluids and eating fiber-rich foods. If diarrhea is contributing to the problem, high-fiber foods can also add bulk to your stools and make them less watery.

Exercise and other therapies:
If muscle damage is causing fecal incontinence, your doctor may recommend a program of exercise and other therapies to restore muscle strength. These treatments can improve anal sphincter control and the awareness of the urge to defecate. Options include:

Biofeedback: Specially trained physical therapists teach simple exercises that can increase anal muscle strength. People learn how to strengthen pelvic floor muscles, sense when stool is ready to be released and contract the muscles if having a bowel movement at a certain time is inconvenient. Sometimes the training is done with the help of anal manometry and a rectal balloon.

Bowel training: Your doctor may recommend making a conscious effort to have a bowel movement at a specific time of day: for example, after eating. Establishing when you need to use the toilet can help you gain greater control.

Sacral nerve stimulation (SNS): The sacral nerves run from your spinal cord to muscles in your pelvis. These nerves regulate the sensation and strength of your rectal and anal sphincter muscles. Implanting a device that sends small electrical impulses continuously to the nerves can strengthen muscles in the bowel. This treatment is usually done only after other treatments are tried.

Posterior tibial nerve stimulation (PTNS/TENS): This minimally invasive treatment may be helpful for some people with fecal incontinence, but more studies are needed.

Vaginal balloon (Eclipse System): This is a pump-type device inserted in the vagina. The inflated balloon results in pressure on the rectal area, leading to a decrease in the number of episodes of fecal incontinence. Results for women have been promising, but more data are needed.

Doing regularly Yoga & Meditation under a trained person totally cures the  fecal incontinence.

Prevention:
Depending on the cause, it may be possible to prevent fecal incontinence. These actions may help:

*Reduce constipation:  Increase your exercise, eat more high-fiber foods and drink plenty of fluids.

*Control diarrhea:  Treating or eliminating the cause of the diarrhea, such as an intestinal infection, may help you avoid fecal incontinence.

*Avoid straining: Straining during bowel movements can eventually weaken anal sphincter muscles or damage nerves, possibly leading to fecal incontinence.

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Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
https://www.webmd.com/digestive-disorders/bowel-incontinence#2
https://www.niddk.nih.gov/health-information/digestive-diseases/bowel-control-problems-fecal-incontinence
https://www.mayoclinic.org/diseases-conditions/fecal-incontinence/diagnosis-treatment/drc-20351403