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Arthritis

Definition:-
Arthritis means inflammation of the joints. Inflammation generally includes symptoms of redness, heat, swelling, and pain. Many different diseases can result in inflammation of the joints. Arthritis is therefore a general term that describes more than one hundred different diseases of the joints of your body.

There are different forms of arthritis; each has a different cause. The most common form of arthritis, osteoarthritis (degenerative joint disease) is a result of trauma to the joint, infection of the joint, or age. Emerging evidence suggests that abnormal anatomy might contribute to the early development of osteoarthritis. Other arthritis forms are rheumatoid arthritis and psoriatic arthritis, autoimmune diseases in which the body attacks itself. Septic arthritis is caused by joint infection. Gouty arthritis is caused by deposition of uric acid crystals in the joint, causing inflammation. There is also an uncommon form of gout caused by the formation of rhomboid crystals of calcium pyrophosphate. This gout is known as pseudogout.

Click to  see the pictures………...()……………………………………….

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Types of arthritis
Primary forms of arthritis:-

Osteoarthritis
Rheumatoid arthritis
Septic arthritis
Gout and pseudogout
Juvenile idiopathic arthritis
Still’s disease
Ankylosing spondylitis
Secondary to other diseases:

Lupus erythematosus
Henoch-Schönlein purpura
Psoriatic arthritis
Reactive arthritis
Haemochromatosis
Hepatitis
Wegener’s granulomatosis (and many other vasculitis syndromes)
Lyme disease
Familial Mediterranean fever
Hyperimmunoglobulinemia D with recurrent fever
TNF receptor associated periodic syndrome
Inflammatory bowel disease (Including Crohn’s Disease and Ulcerative Colitis)
Diseases that can mimic arthritis include:

Hypertrophic osteoarthropathy
Multiple myeloma
Osteoporosis
Fifth disease

In some types of arthritis, the cause of the disease is known, but in others it is still unknown. Some types of arthritis come on suddenly, and others develop slowly. Any joint can be affected, including your knees, hips, neck, shoulders, and fingers.

Causes:-

Arthritis involves the breakdown of cartilage. Cartilage normally protects the joint, allowing for smooth movement. Cartilage also absorbs shock when pressure is placed on the joint, like when you walk. Without the usual amount of cartilage, the bones rub together, causing pain, swelling (inflammation), and stiffness.

You may have joint inflammation for a variety of reasons, including:

*Broken bone

*Infection (usually caused by bacteria or viruses)

*An autoimmune disease (the body attacks itself because the immune system believes a body part is foreign)

*General “wear and tear” on joints

Often, the inflammation goes away after the injury has healed, the disease is treated, or the infection has been cleared.

With some injuries and diseases, the inflammation does not go away or destruction results in long-term pain and deformity. When this happens, you have chronic arthritis. Osteoarthritis is the most common type and is more likely to occur as you age. You may feel it in any of your joints, but most commonly in your hips, knees or fingers.

Risk factors for osteoarthritis include:-

*Being overweight

*Previously injuring the affected joint

*Using the affected joint in a repetitive action that puts stress on the joint (baseball players, ballet dancers, and construction workers are all at risk)

Arthritis can occur in men and women of all ages. About 37 million people in America have arthritis of some kind, which is almost 1 out of every 7 people.

Other types or cause of arthritis include:

*Rheumatoid arthritis (in adults)

*Juvenile rheumatoid arthritis (in children)

*Systemic lupus erythematosus (SLE)

*Gout

*Scleroderma

*Psoriatic arthritis

*Ankylosing spondylitis

*Reiter’s syndrome (reactive arthritis)

*Adult Still’s disease

*Viral arthritis

*Gonococcal arthritis

*Other bacterial infections (non-gonococcal bacterial arthritis )

*Tertiary Lyme disease (the late stage)

*Tuberculous arthritis

*Fungal infections such as blastomycosis

Symptoms:-

If you have arthritis, you may experience:

*Joint pain

*Joint swelling

*Stiffness, especially in the morning

*Warmth around a joint

*Redness of the skin around a joint

*Reduced ability to move the joint

Diagnosis:-

Exams and Tests :

First, your doctor will take a detailed medical history to see if arthritis or another musculoskeletal problem is the likely cause of your symptoms.

Next, a thorough physical examination may show that fluid is collecting around the joint. (This is called an “effusion.”) The joint may be tender when it is gently pressed, and may be warm and red (especially in infectious arthritis and autoimmune arthritis). It may be painful or difficult to rotate the joints in some directions. This is known as “limited range-of-motion.”

In some autoimmune forms of arthritis, the joints may become deformed if the disease is not treated. Such joint deformities are the hallmarks of severe, untreated rheumatoid arthritis.

Tests vary depending on the suspected cause. They often include blood tests and joint x-rays. To check for infection and other causes of arthritis (like gout caused by crystals), joint fluid is removed from the joint with a needle and examined under a microscope. See the specific types of arthritis for further information.

Treatment:-

Treatment of arthritis depends on the particular cause, which joints are affected, severity, and how the condition affects your daily activities. Your age and occupation will also be taken into consideration when your doctor works with you to create a treatment plan.

If possible, treatment will focus on eliminating the underlying cause of the arthritis. However, the cause is NOT necessarily curable, as with osteoarthritis and rheumatoid arthritis. Treatment, therefore, aims at reducing your pain and discomfort and preventing further disability.

It is possible to greatly improve your symptoms from osteoarthritis and other long-term types of arthritis without medications. In fact, making lifestyle changes without medications is preferable for osteoarthritis and other forms of joint inflammation. If needed, medications should be used in addition to lifestyle changes.

Exercise for arthritis is necessary to maintain healthy joints, relieve stiffness, reduce pain and fatigue, and improve muscle and bone strength. Your exercise program should be tailored to you as an individual. Work with a physical therapist to design an individualized program, which should include:

Range of motion exercises for flexibility
Strength training for muscle tone
Low-impact aerobic activity (also called endurance exercise)
A physical therapist can apply heat and cold treatments as needed and fit you for splints or orthotic (straightening) devices to support and align joints. This may be particularly necessary for rheumatoid arthritis. Your physical therapist may also consider water therapy, ice massage, or transcutaneous nerve stimulation (TENS).

Rest is just as important as exercise. Sleeping 8 to 10 hours per night and taking naps during the day can help you recover from a flare-up more quickly and may even help prevent exacerbations. You should also:

Avoid positions or movements that place extra stress on your affected joints.
Avoid holding one position for too long.
Reduce stress, which can aggravate your symptoms. Try meditation or guided imagery. And talk to your physical therapist about yoga or tai chi.
Modify your home to make activities easier. For example, have grab bars in the shower, the tub, and near the toilet.
Other measures to try include:

Taking glucosamine and chondroitin — these form the building blocks of cartilage, the substance that lines joints. These supplements are available at health food stores or supermarkets. While some studies show such supplements may reduce osteoarthritis symptoms, others show no benefit. However, since these products are regarded as safe, they are reasonable to try and many patients find their symptoms improve.
Eat a diet rich in vitamins and minerals, especially antioxidants like vitamin E. These are found in fruits and vegetables. Get selenium from Brewer’s yeast, wheat germ, garlic, whole grains, sunflower seeds, and Brazil nuts. Get omega-3 fatty acids from cold water fish (like salmon, mackerel, and herring), flaxseed, rapeseed (canola) oil, soybeans, soybean oil, pumpkin seeds, and walnuts.
Apply capsaicin cream (derived from hot chili peppers) to the skin over your painful joints. You may feel improvement after applying the cream for 3-7 days.

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Medications:–

Your doctor will choose from a variety of medications as needed. Generally, the first drugs to try are available without a prescription. These include:

Acetaminophen (Tylenol) — recommended by the American College of Rheumatology and the American Geriatrics Society as first-line treatment for osteoarthritis. Take up to 4 grams a day (2 extra-strength Tylenol every 6 hours). This can provide significant relief of arthritis pain without many of the side effects of prescription drugs. DO NOT exceed the recommended doses of acetaminophen or take the drug in combination with large amounts of alcohol. These actions may damage your liver.
Aspirin, ibuprofen, or naproxen –– these nonsteroidal anti-inflammatory (NSAID) drugs are often effective in combating arthritis pain. However, they have many potential risks, especially if used for a long time. They should not be taken in any amount without consulting your doctor. Potential side effects include heart attack, stroke, stomach ulcers, bleeding from the digestive tract, and kidney damage. In 2005, the U.S. Food and Drug Administration (FDA) asked makers of NSAIDs to include a warning label on their product that alerts users of an increased risk for heart attack, stroke, and gastrointestinal bleeding. If you have kidney or liver disease, or a history of gastrointestinal bleeding, you should not take these medicines unless your doctor specifically recommends them.
Prescription medicines include:

Cyclooxygenase-2 (COX-2) inhibitors — These drugs block an inflammation-promoting enzyme called COX-2. This class of drugs was initially believed to work as well as traditional NSAIDs, but with fewer stomach problems. However, numerous reports of heart attacks and stroke have prompted the FDA to re-evaluate the risks and benefits of the COX-2s. Celecoxib (Celebrex) is still available, but labeled with strong warnings and a recommendation that it be prescribed at the lowest possible dose for the shortest duration possible. Talk to your doctor about whether COX-2s are right for you.
Corticosteroids (“steroids”) — these are medications that suppress the immune system and symptoms of inflammation. They are commonly used in severe cases of osteoarthritis, and they can be given orally or by injection. Steroids are used to treat autoimmune forms of arthritis but should be avoided in infectious arthritis. Steroids have multiple side effects, including upset stomach and gastrointestinal bleeding, high blood pressure, thinning of bones, cataracts, and increased infections. The risks are most pronounced when steroids are taken for long periods of time or at high doses. Close supervision by a physician is essential.
Disease-modifying anti-rheumatic drugs — these have been used traditionally to treat rheumatoid arthritis and other autoimmune causes of arthritis. These drugs include gold salts, penicillamine, sulfasalazine, and hydroxychloroquine. More recently, methotrexate has been shown to slow the progression of rheumatoid arthritis and improve your quality of life. Methotrexate itself can be highly toxic and requires frequent blood tests for patients on the medication.
Biologics– these are the most recent breakthrough for the treatment of rheumatoid arthritis. Such medications, including etanercept (Enbrel), infliximab (Remicade) and adalimumab (Humira), are administered by injection and can dramatically improve your quality of life. Newer biologics include Orencia (abatacept) and Rituxan (rituximab).
Immunosuppressants — these drugs, like azathioprine or cyclophosphamide, are used for serious cases of rheumatoid arthritis when other medications have failed.
It is very important to take your medications as directed by your doctor. If you are having difficulty doing so (for example, due to intolerable side effects), you should talk to your doctor.

Surgery & Other Type of Approach:

In some cases, surgery to rebuild the joint (arthroplasty) or to replace the joint (such as a total knee joint replacement) may help maintain a more normal lifestyle. The decision to perform joint replacement surgery is normally made when other alternatives, such as lifestyle changes and medications, are no longer effective.

Normal joints contain a lubricant called synovial fluid. In joints with arthritis, this fluid is not produced in adequate amounts. In some cases, a doctor may inject the arthritic joint with a manmade version of joint fluid. The synthetic fluid may postpone the need for surgery at least temporarily and improve the quality of life for persons with arthritis.

Prognosis:
A few arthritis-related disorders can be completely cured with treatment. Most are chronic (long-term) conditions, however, and the goal of treatment is to control the pain and minimize joint damage. Chronic arthritis frequently goes in and out of remission.

Possible Complications:

*Chronic pain

*Lifestyle restrictions or disability

Call your doctor if:

*Your joint pain persists beyond 3 days.

*You have severe unexplained joint pain.

*The affected joint is significantly swollen.

*You have a hard time moving the joint.

*Your skin around the joint is red or hot to the touch.

*You have a fever or have lost weight unintentionally.

Prevention :

If arthritis is diagnosed and treated early, you can prevent joint damage. Find out if you have a family history of arthritis and share this information with your doctor, even if you have no joint symptoms.

Osteoarthritis may be more likely to develop if you abuse your joints (injure them many times or over-use them while injured). Take care not to overwork a damaged or sore joint. Similarly, avoid excessive repetitive motions.

Excess weight also increases the risk for developing osteoarthritis in the knees, and possibly in the hips and hands. See the article on body mass index to learn whether your weight is healthy.( Calculate BMI )

Click for Herbal & Alternative Medical help for Arthritis

Treating Arthritis with Acupuncture:

Alternative Arthritis Treatments:->….(1)….(2).…..(3)

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:
http://en.wikipedia.org/wiki/Arthritis
http://www.nlm.nih.gov/medlineplus/ency/article/001243.htm
http://www.eorthopod.com/public/patient_education/6587/arthritis.html

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Behcet’s Disease

Other Nemes: Behçet’s syndrome, Morbus Behçet, Behçet-Adamantiades syndrome, or Silk Road disease.

Definition:
Behcet’s  disease (BD), is a chronic form of vasculitis (inflammation of the blood vessels) involving four primary symptoms: oral and genital ulcers, ocular inflammation, and arthritis.

The inflammation of Behcet’s disease leads to numerous symptoms that may initially seem unrelated. The signs and symptoms of Behcet’s disease — which may include mouth sores, eye inflammation, skin rashes and lesions, and genital sores — vary from person to person and may come and go on their own.

The exact cause of Behcet’s is unknown, but it may be an autoimmune disorder, which means the body’s immune system mistakenly attacks some of its own healthy cells. Both genetic and environmental factors may be responsible for Behcet’s disease.

Description:
Behçet’s disease (BD) was named in 1937 after the Turkish dermatologist Hulusi Behçet, who first described the triple-symptom complex of recurrent oral aphthous ulcers, genital ulcers, and uveitis. As a systemic disease, it can also involve visceral organs such as the gastrointestinal tract, pulmonary, musculoskeletal, cardiovascular and neurological systems. This syndrome can be fatal due to ruptured vascular aneurysms or severe neurological complications.

CLICK & SEE THE PICTURES

In the 1930s Hulusi Behçet observed the three classic symptoms (oral and genital ulcers and eye inflammation) now define this complex condition. BD also has a unique ability to affect all sizes of blood vessels, including arteries and veins. Symptoms related to vasculitis, such as inflammation of joints, gastrointestinal areas, or the central nervous system, are also common.

Symptoms of this disease may have been described by Hippocrates in the 5th century BC, in his 3rd Epidemion-book. Its first modern formal description was published in 1922.

Some sources use the term “Adamandiades  syndrome” or “Adamandiades-Behçet syndrome”, for the work done by Benediktos Adamantiades. However, the current World Health Organization/ICD-10 standard is “Behçet disease”.

In 1991, Saudi Arabian medical researchers discovered “neuro-Behcet’s disease”, a neurological involvement in Behcet’s disease, considered one of the most devastating manifestations of the disease

Demographics:
Incidence of BD is very rare in the United States with approximately five in 100,000 people developing the syndrome. In Middle Eastern and Asian countries between Iran and Japan (known as the “Old Silk Route”), BD is quite prevalent. Incidence in these countries is double that of the United States.

More than twice as many females are diagnosed with BD than males in the United States. However, in Middle Eastern and Asian areas, significantly more men are affected than females.

Causes:
No one knows why the immune system starts to behave this way in Behçet ‘s disease. It is not because of any known infections, it is not hereditary, it does not have to do with ethnic origin, gender, life-style, or age, where someone has lived or where they have been on holiday. It is not associated with cancer, and links with tissue-types (which are under investigation) are not certain. It does not follow the usual pattern for autoimmune diseases.

Behçet disease is normally caused by an autoimmune response that triggers inflammation of the blood vessels. Researchers have discovered a gene, HLA-B51, which predisposes an individual to BD. However, not all individuals with this gene develop the disease. The specific event leading to onset of BD is not known, but there are speculations that it may be related to the following:

*herpes simplex virus infections

*frequent infections of Streptococcus bacteria

*environmental factors

Diagnosis & Symptoms:
Behçet disease is diagnosed based on a set of guidelines established by an international group of physicians. A physician observes clinical signs and symptoms during patient examination. The most recent and accepted guidelines for a positive diagnosis include the presence of recurring oral ulcers (three or more times in one year) and at least two of four secondary symptoms, including recurring genital ulcers, uveitis, skin lesions, a positive pathergy test.

A pathergy test is a skin-prick test to see if a red bump will form at the injection site. If there is a reaction, the test is positive. This test may be given to patients suspected of BD, but it is not an indicator for the disease. Only a small percentage of patients diagnosed with BD actually test positive.

It is diagnosed clinically by specific patterns of symptoms and repeated outbreaks. Other causes for these symptoms have to be ruled out before making the diagnosis. The symptoms do not have to occur together, but can have happened at any time.

CLICK & SEE

There are three levels of certainty for diagnosis:

1.International Study Group diagnostic guidelines (very strict for research purposes)

2.Practical clinical diagnosis (generally agreed pattern but not as strict)

3.’Suspected’ or ‘Possible’ diagnosis (incomplete pattern of symptoms)

International Study Group diagnostic guidelines:
Must have

*oral (aphthous) ulcers (any shape, size or number at least 3 times in any 12 months),
along with 2 out of the next 4 “hallmark” symptoms:

*genital ulcers (including anal ulcers and spots in the genital region and swollen testicles or epididymitis in men),

*skin lesions (papulo-pustules, folliculitis, erythema nodosum, acne in post-adolescents not on corticosteroids),

*eye inflammation (iritis, uveitis, retinal vasculitis, cells in the vitreous),

*pathergy reaction (papule >2 mm dia. 24-48 hrs or more after needle-prick).

Practical clinical diagnosis:

Must have

*mouth ulcers,
along with 1 of the 4 hallmark symptoms above and with 2 of the symptoms below:

*arthritis/arthralgia,

*nervous system symptoms,

*stomach and/or bowel inflammation,

*deep vein thrombosis,

*superficial thrombophlebitis,

*cardio-vascular problems of inflammatory origin,

*inflammatory problems in chest and lungs,

*problems with hearing and/or balance,

*extreme exhaustion,

*changes of personality, psychoses,

*any other members of the family with a diagnosis of Behcet disease

CLICK & SEE THE PICTURES.

Mouth ulcer with Behcet’s Disease.

Aphthous ulcer in a patient with Behcet Disease.

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Aphthous ulcer in a patient with Behcet Disease.

‘Suspected’ or ‘Possible’ diagnosis:

Usually given when someone does not have mouth ulcers or has mouth ulcers but does not have 1 of the 4 hallmark symptoms but has other symptoms and signs of inflammation and other causes for these have been ruled out.

CLICK TO SEE THE TESTS FOR DIAGNOSIS

CLICK  TO SEE THE RISK FACTORS

Treatment:
Current treatment is aimed at easing the symptoms, reducing inflammation, and controlling the immune system. Anti-TNF therapy such as infliximab has shown promise in treating the uveitis associated with the disease. Another Anti-TNF agent, Etanercept, may be useful in patients with mainly skin and mucosal symptoms.

Interferon alfa-2a may also be an effective alternative treatment, particularly for the genital and oral ulcers as well as ocular lesions. Azathioprine, when used in combination with interferon alfa-2b also shows promise, and Colchicine can be useful for treating some genital ulcers, erythema nodosum, and arthritis in women, and arthritis in men.

Thalidomide has also been used due to its immune-modifying effect. Dapsone and rebamipide have been shown, in small studies, to have beneficial results for mucocutaneous lesions.

A different orientation could be explored in Behçet Disease, especially with genetic linkage to HLA-B51 antigen, just like the prevalence of HLA-B27 in ankylosing spondylitis. Ankylosing spondylitis is not due to an ‘oveactive’ immune system; instead it is a true autoimmune disease caused by molecular mimicry of the Osp (outer surface protein) with the Klebsiella pneumoniae germ (2 enzymes produced by this normally non-virulent pathogen), which is always present as a sub-clinical infection, typically at the ileocecal junction. The combination of antibiotics targeted to this specific germ, and dietary controls (elimination or severe restriction of all starches) could therefore potentially provide the most effective treatments, but such treatments have not yet been proven or generally approved. At the current time, a similar infectious origin has not yet been confirmed that leads to Behçet disease, but certain strains of Streptococcus sanguis has been found to have a homologous antigenicity.

Prognosis:
For most patients, the prognosis of Behçet disease is good. Individuals typically experience periods of active symptoms followed by periods of remission in which there are no symptoms. The length of these intervals varies, with ulcerous outbreaks lasting a few weeks and other symptoms occurring for longer durations. With proper treatments and medication, patients can continue to lead active lifestyles in most cases.

Development of vascular or neurological complications often indicates a poorer prognosis. Blindness due to ocular inflammation is also prevalent in patients with BD.

Recovery and rehabilitation:
Unlike most diseases, BD has symptoms that periodically flare up and then disappear for a period of time. As a result, patients may have long intervals with no complications. After treatment for active symptoms, patients usually require rest due to fatigue. Moderate exercise is also recommended to improve circulation and muscle strength.

Click to learn more about:->Behcet’s Disease

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:
http://en.wikipedia.org/wiki/Behcet%27s_disease
http://www.healthline.com/galecontent/behet-disease
http://www.visualsunlimited.com/browse/vu425/vu425957.html
http://vasculitis.med.jhu.edu/typesof/behcets.html
http://www.visualsunlimited.com/browse/vu425/vu425958.html

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Rheumatic Diseases

It’s not widely known, but eye problems, visual impairment and even blindness are not uncommon features of many forms of arthritis and rheumatic disease. Dr Badal Pal and Dr Sathianathan Panthakalam, of Withington Hospital, Manchester, explain.

Common, inflammatory joint disease

The three main problems in rheumatoid arthritis are dry eyes, which affects one quarter of RA patients; keratitis (inflammation of the cornea); and scleritis (inflammation of the sclera, the white outer layer of the eyeball) of which RA is one of the most common causes. Patients may also develop secondary Sjögren’s Syndrome due to salivary gland abnormality which also causes a dry mouth. In scleritis, the sclera can become thin leading to perforation.

Juvenile chronic arthritis:-
Rare form of inflammatory arthritis affecting children from six months upwards

In most cases of JCA, the eyes are unaffected for up to three years, when complications may occur, so it is important for children at risk to have their eyes checked regularly. Up to 18 per cent of youngsters with JCA have a form of uveitis after having JCA for five years. Uveitis is inflammation of the uvea – a layer of tissues made up of the iris and choroid membrane and the middle of the three layers of the eyeball – which causes irritation, reddening of the eye, and blurred or loss of vision. It can be treated by steroid drops and immuno-suppresives. Children at the highest risk are those aged under nine, with a few affected joints. They need screening every three months at the age of two, then regularly until they reach ten. Youngsters with many affected joints, or with systemic onset disease, and all children over the age of nine, are considered low risk.

Systemic lupus erythematosus:-…………[amazon_link asins=’1497477026,0128019174′ template=’ProductCarousel’ store=’finmeacur-20′ marketplace=’US’ link_id=’adf4af8a-f278-11e6-8a3d-ff698e10f0bd’]
Autoimmune disease affecting many organs in the body

Eye damage in patients with lupus vary from minor problems to severe retinopathy (inflammation of the iris or choroid which can lead to visual impairment, even blindness). Five per cent of patients develop scleritis. Retinal vasculitis (inflammation of the arteries) can occur, and patients can develop cotton wool spots at the back of the eyeball, retinal bleeding and swelling of the optic disc. Double vision can also occur,

Systemic sclerosis (scleroderma):-………….[amazon_link asins=’0781737443,0683017403′ template=’ProductCarousel’ store=’finmeacur-20′ marketplace=’US’ link_id=’aa8116ad-f279-11e6-9c2a-057285caa235′]
Rare, serious condition affecting the skin, joints and internal organs

The most common complaint is dryness in the eyes. A minority of patients develop retinopathy with cotton wool spots at the back of the eyeball, retinal haemorrhages and blockage of retinal arteries.

Polymyositis and dermatomyositis:-……………[amazon_link asins=’B01DRY76CA,B00LZXN5R6′ template=’ProductCarousel’ store=’finmeacur-20′ marketplace=’US’ link_id=’fcfef2aa-f279-11e6-855e-f9243fa97110′]
Similar automimmune diseases causing inflammation of the muscles. Dermatomyositis also affects the skin

The typical lilac discolouration (heliotropic) rashes on the eyelids are seen in 40 per cent of patients. Ocular myopathy (muscle wasting) can occur in a small proportion of patients, leading to double vision, and a few people develop retinopathy.

Seronegative arthropathies:-………….
A group of non-rheumatoid inflammatory diseases

Acute uveitis is the most important disease in this group of patients:

Ankylosing spondylitis:-………………..[amazon_link asins=’1502403757,B01LY0BST5′ template=’ProductCarousel’ store=’finmeacur-20′ marketplace=’US’ link_id=’6e0ee2ad-f27a-11e6-867f-ad7e00152c80′]
Rheumatic disease affecting the spine, resulting in stiffness in the back

Uveitis occurs in 20 per cent of patients. Only one eye is usually affected at one time, but both eyes may become affected during the course of the disease.

Reiter’s Syndrome:-…………………….
Also known as reactive arthritis; affects tendons and tissues as well as joints

Conjunctivitis is the most common symptom, seen in 30–60 per cent of patients. Uveitis is less frequent in early disease, but can occur in up to 40 per cent of patients.

Psoriatic spondyloarthropathies:-……………[amazon_link asins=’B002UUTGI0′ template=’ProductCarousel’ store=’finmeacur-20′ marketplace=’US’ link_id=’f91148a4-f27a-11e6-8dd9-ff5db91cb907′]
A form of inflammatory arthritis, similar to RA

Uveitis occurs in up to 15 per cent of patients, and is frequently accompanied by conjunctivitis, dry eyes or keratitis. It can be chronic or acute.

Arthritis associated with inflammatory bowel disease
Arthritis occurs in association with Crohn’s disease, ulcerative colitis and Whipple’s disease.

Uveitis is seen in 10 per cent of these patients. Crohn’s disease seems to be frequently associated with uveitis (less often with ulcerative colitis).

Other eye lesions seen occasionally in this group of patients are episcleritis – inflammation of the superficial vessels of the sclera – or peripheral corneal ulceration. The likelihood of eye lesions increase in those with arthritis, spondylitis and skin symptoms.

Beh§et’s disease:-…………….[amazon_link asins=’0128032677′ template=’ProductCarousel’ store=’finmeacur-20′ marketplace=’US’ link_id=’756e981c-f27b-11e6-9c0a-77a6bebd8a59′]
A rare disorder of oral and genital ulcers, inflammatory eye disease and skin lesions

Eye involvement is the most serious symptom in Beh§et’s patients. It occurs in 70 per cent of patients, and 25 per cent will go blind. Those most at risk are men, particularly those who developed the condition at a young age. Women are less severely affected. Patients develop eye disease within two to three years of developing the condition. Anterior uveitis is fairly easy to treat, but postererior uveitis and retinal vasculitis are more serious. After four years of eye disease, up to 85 per cent of patients have some form of visual impairment.

Wegener’s granulomatosis:-
A form of vasculitis

Eye problems develop in about 50 per cent of patients. The eye socket is infiltrated with granulomatous tissue; the eyes become prominent, and become reddened because of scleritis. Patients sometimes have visual impairment because of the compression of the optic nerve by granulomatous tissue.

Sarcoidosis:-…………………[amazon_link asins=’1478719990,0595321143′ template=’ProductCarousel’ store=’finmeacur-20′ marketplace=’US’ link_id=’97d2c330-f27b-11e6-bc19-0d9411a69a1c’]
Rare skin condition also affecting the lungs, eyes and the musculoskeletal system

Between 30 and 40 per cent of patients will develop eye problems. The most common problem is acute or chronic relapsing uveitis leading to dry eyes. Five per cent of patients develop optic nerve neuropathy (a disease of the peripheral nerves causing weakness or numbness) with a significant loss of sight.

Giant cell arteritis:-
Inflammation of blood vessels commonly in the head

Giant cell arteritis is an emergency condition, and an important cause of preventable blindness in old people. Twenty five per cent of patients develop eye disease and suddenly lose the sight in one eye. Blindness is usually due to loss of blood supply, and subsequent damage to the optic nerve. Treatment is immediate, high dose steroids, to prevent blindness in the other eye, as recovery is unusual.

Ocular side effects of anti-rheumatic therapy:-
Most of these drugs cause no significant side effects, but cortisteroids and antimalarial drugs can have toxic effects.

Antimalarial drugs, hydroxychoroquine and chloroquine, which are used in RA, lupus and other related disorders, can lead to irreversible retinal damage and corneal opacity. Patients on these drugs have their eyes examined once a year.

Corticosteroids can lead to corneal and scleral thinning, and cataracts are common after higher doses of steroids. Raised intra ocular pressure is another common side e

*Sclera…. white outer layer of the eye Retina inner most light-sensitive layer of the eye

*Conjunctiva…. transparent membrane on the front part of the sciera iris pigmented tissue surrounding the pupil – in front of the lens – allowing light to enter the eye.

*Cornia……... front part of the eye overlying the pupil, iris and lens. it is part of the sclera

*Choroid….… middle layer of the eye, alsocalled the uvea. it contains blood vessels and a pigment that absorbs excess light – this prevents blurring

*Optic nerve…… main nerve travelling from the back of the eye carrying signals to the brain for the eye to see

*Vitreous body.… jelly-like substance separating the front part of the eye and the back part where the retina and optic nerve are located.

Click to see also:->
Inflammatory conditions of the eye associated with rheumatic diseases.

EYE INVOLVEMENT IN THE SPONDYLOARTHROPATHIES

Ophthalmologic manifestations of rheumatic diseases

Sources:

http://www.arc.org.uk/news/arthritistoday/106_2.asp

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Collagenous Colitis and Lymphocytic Colitis

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What are collagenous colitis and lymphocytic colitis?

Inflammatory bowel disease is the general name for diseases that cause inflammation in the intestines, most often referring to Crohn’s disease and ulcerative colitis. Collagenous colitis and lymphocytic colitis are two other types of bowel inflammation that affect the colon. The colon is a tube-shaped organ that runs from the first part of the large bowel to the rectum. Solid waste, or stool, moves through the colon to be eliminated. Collagenous colitis and lymphocytic colitis are not related to Crohn’s disease or ulcerative colitis, which are more severe forms of inflammatory bowel disease....CLICK & SEE 

Collagenous colitis and lymphocytic colitis are also called microscopic colitis. Microscopic colitis means there is no sign of inflammation on the surface of the colon when viewed with a colonoscopy or flexible sigmoidoscopy two tests that let a doctor look inside your large intestine. Because the inflammation isn’t visible, a biopsy is necessary to make a diagnosis. A doctor performs a biopsy by removing a small piece of tissue from the lining of the intestine during a colonoscopy or flexible sigmoidoscopy.

What are the symptoms?

The symptoms of collagenous colitis and lymphocytic colitis are the same—chronic, watery, non-bloody diarrhea. Abdominal pain or cramps may also be present. People with collagenous colitis and lymphocytic colitis may suffer from ongoing diarrhea while others have times when they are symptom free.

What causes collagenous colitis and lymphocytic colitis?

Scientists are not sure what causes collagenous colitis or lymphocytic colitis. Bacteria and their toxins, or a virus, may be responsible for causing inflammation and damage to the colon. Some scientists think that collagenous colitis and lymphocytic colitis may result from an autoimmune response, which means that the body’s immune system destroys healthy cells for no known reason.

Who gets collagenous colitis and lymphocytic colitis?

Collagenous colitis is most often diagnosed in people between 60 and 80 years of age. However, some cases have been reported in adults younger than 45 years and in children. Collagenous colitis is diagnosed more often in women than men.

People with lymphocytic colitis are also generally diagnosed between 60 and 80 years of age. Both men and women are equally affected.

How are they diagnosed?

Some scientists think that collagenous colitis and lymphocytic colitis are the same disease in different stages. The only way to determine which form of colitis a person has is by performing a biopsy.

A diagnosis of collagenous colitis or lymphocytic colitis is made after tissue samples taken during a colonoscopy or flexible sigmoidoscopy are examined with a microscope.

Collagenous colitis is characterized by a larger-than-normal band of protein called collagen inside the lining of the colon. The thickness of the band varies; so several tissue samples from different areas of the colon may need to be examined.

With lymphocytic colitis, tissue samples show an increase of white blood cells, known as lymphocytes, between the cells that line the colon. The collagen is not affected.

Treatment

Treatment for collagenous colitis and lymphocytic colitis varies depending on the symptoms and severity of the case. The diseases have been known to resolve on their own, although most people suffer from ongoing or occasional diarrhea.

Lifestyle changes are usually tried first. Recommended changes include reducing the amount of fat in the diet, eliminating foods that contain caffeine and lactose, and avoiding over-the-counter pain relievers such as ibuprofen or aspirin.

If lifestyle changes alone are not enough, medications can be used to help control symptoms.

  • Treatment usually starts with prescription anti-inflammatory medications, such as mesalamine (Rowasa or Canasa) and sulfasalazine (Azulfidine), in order to reduce swelling.
  • Steroids, including budesonide (Entocort) and prednisone are also used to reduce inflammation. Steroids are usually only used to control a sudden attack of diarrhea. Long-term use of steroids is avoided because of side effects such as bone loss and high blood pressure.
  • Anti-diarrheal medications such as bismuth subsalicylate (Pepto Bismol), diphenoxylate atropine (Lomotil), and loperamide (Imodium) offer short-term relief.
  • Immunosuppressive agents such as azathioprine (Imuran) reduce the inflammation but are rarely needed.

For extreme cases of collagenous colitis and lymphocytic colitis that have not responded to medication, surgery to remove all or part of the colon may be necessary. However, surgery is rarely recommended. Collagenous colitis and lymphocytic colitis do not increase a person’s risk of getting colon cancer.

Collagenous colitis and lymphocytic colitis do not increase a person’s risk of getting colon cancer.

Colitis -Natural Cure

Treat Ulcerative Colitis

For More Information

Crohn’s & Colitis Foundation of America Inc.
386 Park Avenue South, 17th floor
New York, NY 10016–8804
Phone: 1–800–932–2423 or 212–685–3440
Fax: 212–779–4098
Email: info@ccfa.org
Internet: www.ccfa.org

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

Source:http://digestive.niddk.nih.gov/ddiseases/pubs/collagenouscolitis/index.htm

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Gas And Flatulence After Meals

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Avoid high-fat meals :
Eating a high-fat meal can generate a large amount of carbon dioxide, some of which is released as gas. That’s because carbon dioxide is produced in the small intestine when bicarbonate is released to neutralise stomach acid and fat during meals.
Eat smaller, more frequent meals instead of three large meals

1. Eat smaller, more frequent meals instead of three large meals.
2. Avoid high-fat meals.
3. Consult your doctor to rule out the possibility of fat malabsorption. Signs of fat malabsorption include loose and light-coloured stools.

Odorous Flatulence and Gas :
Gas that has a strong odour usually results from the metabolism of sulfur-containing proteins and amino acids in the intestines.
1. Chew meat and other protein foods carefully. Avoid excessive protein in your diet.
2. Taking activated charcoal tablets can help to remove the odour.

Eating Foods that Produce Gas:
Certain foods are inherently gas-producing. Gas-producing foods include beans, cabbage, onions, brussels sprouts, cauliflower, broccoli, fluffy wheat products such as bread, apples, peaches, pears, prunes, corn, oats, potatoes, milk, ice cream, and soft cheese.

Foods that produce minimal gas include rice, bananas, citrus, grapes, hard cheese, meat, eggs, peanut butter, non-carbonated beverages, and yogurt made with live bacteria.

When someone has persisting bloating and flatulence, lab tests and x-rays are first conducted to exclude the presence of medical disease. Colorectal cancer often presents with the symptoms of abdomen discomfort and bloating. Celiac disease and inflammatory bowel disease may have similar symptoms.
It’s important to remember that gas and bloating are vague symptoms that can be associated with many medical diseases, so consultation with your primary care provider should always be the first step.

Source: The Times Of India

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