Categories
Ailmemts & Remedies

Sjogren’s syndrome

Alternative Names: Mikulicz disease” and “Sicca syndrome

Definition:
Sjögren’s syndrome (SHOW-grins)is a systemic autoimmune disease in which immune cells attack and destroy the exocrine glands  that produce tears and saliva.In some cases, other organs of the body are also affected, including the:
•Kidneys
•Liver
•Pancreas
•Lungs
•Blood vessels
•Brain

CLICK & SEE

It is named after Swedish ophthalmologist Henrik Sjögren (1899–1986), who first described it.

Nine out of ten Sjögren’s patients are women  and the average age of onset is late 40s, although Sjögren’s occurs in all age groups in both women and men. It is estimated to strike as many as 4 million people in the United States alone, making it the second most common autoimmune rheumatic disease.

Sjogren’s syndrome may be classified as primary or secondary. Primary Sjogren’s syndrome occurs alone; secondary Sjogren’s syndrome is seen alongside another disease, such as rheumatoid arthritis and systemic lupus erythematosis (SLE).

CLICK & SEE

The disorder should not be confused with the Sjögren–Larsson syndrome, which was also denoted T. Sjögren syndrome in early studies.

Symptoms:
There are many different symptoms of Sjogren’s. However, not everyone experiences the same ones or to the same degree.
The characteristic dryness of Sjogren’s means the eyes often feel very uncomfortable and may burn, itch or feel gritty. Mouth dryness makes talking, chewing and swallowing difficult.

YOU MAY CLICK & SEE THE PICTURE

Other symptoms include:

•A sore or cracked tongue
•Dry nose and skin
•Digestive problems
•Joint pains
•Fatigue
•Dental problems are more likely (because of the lack of saliva)
As is often the case with any long-term condition, a person’s quality of life may be adversely affected. This may result in depression and make social life, work and relationships more difficult to maintain and enjoy.

Sjogren’s is also associated with an increased risk of miscarriage, Raynauds phenomenom and adverse reactions to medication such as antibiotics.

Causes:
Sjogren’s syndrome is an autoimmune disorder. This means that your immune system mistakenly attacks your body’s own cells and tissues.

Scientists aren’t certain why some people develop Sjogren’s syndrome and others don’t. Certain genes put people at higher risk for the disorder, but it appears that a triggering mechanism — such as infection with a particular virus or strain of bacteria — is also necessary.

In Sjogren’s syndrome, your immune system first targets the moisture-secreting glands of your eyes and mouth. But it can also damage other parts of your body, such as your:

*Joints
*Thyroid
*Kidneys
*Liver
*Lungs
*Skin
*Nerves
Risk Factors:
Although anyone can develop Sjogren’s syndrome, it typically occurs in people with one or more known risk factors. These include:

*Age. Sjogren’s syndrome is usually diagnosed in people older than 40.
*Sex. Women are much more likely to have Sjogren’s syndrome.
*Rheumatic disease. It’s common for people who have Sjogren’s syndrome to also have a rheumatic disease — such as rheumatoid arthritis or lupus.

Complications:
The most common complications of Sjogren’s syndrome involve your eyes and mouth.

*Dental cavities. Because saliva helps protect the teeth from the bacteria that cause cavities, you’re more prone to developing cavities if your mouth is dry.

*Yeast infections. People with Sjogren’s syndrome are much more likely to develop oral thrush, a yeast infection in the mouth.

*Vision problems. Dry eyes can lead to light sensitivity, blurred vision and corneal ulcers.

Less common complications may affect your:

*Lungs, kidneys or liver. Inflammation may cause pneumonia, bronchitis or other problems in your lungs; may lead to problems with kidney function; and may cause hepatitis or cirrhosis in your liver.

*Unborn baby. If you’re a woman with Sjogren’s syndrome and you plan to become pregnant, talk with your doctor about being tested for certain autoantibodies that may be present in your blood. In rare cases, these antibodies have been associated with heart problems in newborns

*Lymph nodes. A small percentage of people with Sjogren’s syndrome develop cancer of the lymph nodes (lymphoma).

*Nerves. You may develop numbness, tingling and burning in your hands and feet (peripheral neuropathy).

Diagnosis:
Diagnosing Sjögren’s syndrome is complicated by the range of symptoms a patient may manifest, and the similarity between symptoms of Sjögren’s syndrome and those of other conditions. Nevertheless, the combination of several tests can lead to a diagnosis of Sjögren’s syndrome.

Blood tests can be done to determine if a patient has high levels of antibodies that are indicative of the condition, such as anti-nuclear antibody (ANA) and rheumatoid factor (because SS frequently occurs secondary to rheumatoid arthritis), which are associated with autoimmune diseases. Typical Sjögren’s syndrome ANA patterns are SSA/Ro and SSB/La, of which SSB/La is far more specific; SSA/Ro is associated with numerous other autoimmune conditions but are often present in Sjögren’s.

Schirmer’s test measures the production of tears: a strip of filter paper is held inside the lower eyelid for five minutes, and its wetness is then measured with a ruler. Producing less than five millimeters of liquid is usually indicative of Sjögren’s syndrome. However, lacrimal function declines with age or may be impaired from other medical conditions. An alternative test is nonstimulated whole saliva flow collection, in which the patient spits into a test tube every minute for 15 minutes. A resultant collection of less than 1.5 mL is considered a positive result. It takes longer to perform than Schirmer’s test, but does not require special equipment.

A slit-lamp examination can reveal dryness on the surface of the eye. Salivary gland function can be tested by collecting saliva and determining the amount produced in a five minute period. A lip biopsy can reveal lymphocytes clustered around salivary glands, and damage to these glands due to inflammation.

Ultrasound examination of the salivary glands is the simplest confirmatory test and has the added advantage of being non-invasive with no complications. The parenchyma of the gland demonstrates multiple, small-2-6 mm hypoechoic lesions which are representations of the lymphocytic infiltrates. Often sialectasis with calculi are demonstrated if the disease is advanced. The sonographic findings have excellent symptom correlation. The other advantage of ultrasound is that complications of the disease such as extra-nodal lymphomas can often be detected as larger 1–4 cm hypoechoic intra-parenchymal masses.

There is also a radiological procedure which is a reliable and accurate test for Sjögren’s syndrome. A contrast agent is injected into the parotid duct, which opens from the cheek into the vestibule of the mouth opposite the neck of the upper second molar tooth. Widespread puddling of the injected contrast scattered throughout the gland indicates Sjögren’s syndrome.

The Revised Classification Criteria for Sjögren’s Syndrome requires the presence of signs, symptoms, and lab findings.

Patient-reported symptoms must include both ocular symptoms, such as daily, persistent, troublesome dry eyes for more than three months, and oral symptoms, such as needing to drink water to swallow food.

Objective evidence of eye involvement relies on Schirmer’s test and the Rose bengal score (or similar). Histopathology studies should show focal lymphocytic sialadenitis. Objective evidence of salivary gland involvement is tested through ultrasound examinations, the level of unstimulated whole salivary flow, a parotid sialography, or salivary scintigraphy. Autoantibodies against Ro (SSA) and/or La (SSB) antigens are also expected.

SS can be excluded from people with past head and neck radiation therapy, hepatitis C infection, Acquired immunodeficiency syndrome (AIDS), pre-existing lymphoma, sarcoidosis, graft-versus-host disease, and use of anticholinergic drugs (since a time shorter than four times the life of the drug).

Treatment:
It’s not possible to prevent Sjogren’s syndrome and there’s no cure, but treatments can help to relieve many of the symptoms. Treatment varies depending on which parts of the body are affected and may include:

•Artificial tears to help with dry eyes
•Saliva stimulants and mouth lubricants for dry mouth
•Anti-inflammatory medication for joint or muscle pain
•Corticosteroids or immunosuppressive drugs for lung, kidney, blood vessel or nervous system problems

Lifestyle and home remedies:

Many symptoms of Sjogren’s syndrome respond well to self-care measures.

To relieve dry eyes:

*Use artificial tears, an eye lubricant or both. Artificial tears (in eyedrop form) and eye lubricants (in eyedrop, gel or ointment form) help relieve the discomfort of dry eyes. Both types of product are available over-the-counter. You don’t have to apply eye lubricants as often as artificial tears. Because of their thicker consistency, though, eye lubricants can blur your vision and collect on your eyelashes. Your doctor may recommend artificial tears without preservatives because the preservatives can be irritating for people with dry eye syndrome.

* Increase humidity. Increasing the indoor humidity and reducing your exposure to blowing air may help keep your eyes from getting uncomfortably dry. For example, avoid sitting in front of a fan or air-conditioning vent, and wear goggles or protective eyewear when you go outdoors.

To help with dry mouth:

*Increase  fluid intake. Drinking lots of fluids, particularly water, helps to reduce dry mouth.

*Stimulate saliva flow. Sugarless gum or hard candies can boost saliva flow. Because Sjogren’s syndrome increases your risk of dental cavities, limit sweets, especially between meals. Lemon juice in water can also help stimulate saliva flow.

*Try artificial saliva. Saliva replacement products often work better than plain water because they contain a lubricant that helps your mouth stay moist longer. These products may come as a spray or lozenge.

*Use nasal saline spray. A nasal saline spray can help moisturize and clear nasal passages so you can breathe freely through your nose. A dry, stuffy nose can increase mouth breathing.

Oral health:

Dry mouth increases your risk of dental cavities and tooth loss. The following precautions may help prevent those types of problems.

*Brush your teeth and floss after every meal.

*Schedule regular dental appointments, at least every six months.

*Use daily topical fluoride treatments and antimicrobial mouthwashes.

Other areas of dryness:

If dry skin is a problem, avoid hot water when you bathe and shower. Pat your skin — don’t rub — with a towel and apply moisturizer when your skin is still damp. Use rubber gloves when doing dishes or housecleaning. Vaginal moisturizers and lubricants help women who experience vaginal dryness.

Prognosis:
Sjögren’s can damage vital organs of the body with symptoms that may plateau or worsen, but the disease does not go into remission as with other autoimmune diseases. Some people may experience only the mild symptoms of dry eyes and mouth, while others have symptoms of severe disease. Many patients are able to treat problems symptomatically. Others are forced to cope with blurred vision, constant eye discomfort, recurrent mouth infections, swollen parotid glands, hoarseness, and difficulty in swallowing and eating. Debilitating fatigue and joint pain can seriously impair quality of life. Some patients can develop renal involvement (autoimmune tubulointerstitial nephritis) leading to proteinuria, urinary concentrating defect and distal renal tubular acidosis.

Patients with Sjögren’s syndrome have a higher rate of non-Hodgkin lymphoma compared to both patients with other autoimmune diseases and healthy people.  About 5% of patients with Sjögren’s syndrome will develop some form of lymphoid malignancy. Patients with severe cases are much more likely to develop lymphomas than patients with mild or moderate cases. The most common lymphomas are salivary extranodal marginal zone B cell lymphomas (MALT lymphomas in the salivary glands)   and diffuse large B-cell lymphoma.

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://halter4sen.org/wp-content/uploads/2011/09/sjogren_syndrome.jpg
http://en.wikipedia.org/wiki/Sj%C3%B6gren’s_syndrome
http://www.mayoclinic.com/health/sjogrens-syndrome/DS00147
http://www.bbc.co.uk/health/physical_health/conditions/sjogrensyndrome1.shtml
http://pubs.acs.org/subscribe/archive/mdd/v05/i04/html/04disease.html

Enhanced by Zemanta
Categories
Ailmemts & Remedies

Episcleritis

Definition:
Episcleritis is irritation and inflammation of the episclera, a thin layer of tissue covering the white part (sclera) of the eye. It occurs without an infection.
click  for  photo
Episcleritis is an inflammatory condition affecting the episcleral tissue between the conjunctiva (the clear mucous membrane lining the inner eyelids and sclera) and the sclera (the white part of the eye) that occurs in the absence of an infection. The red appearance caused by this condition looks similar to conjunctivitis, but there is no discharge. There is no apparent cause, but it can be associated with an underlying systemic inflammatory or rheumatologic condition such as rosacea, lupus or rheumatoid arthritis.

click for photos.>...(001)...…(01)...(1)...(2)……...(3)..

It may also be associated with conditions such as gout and herpes simplex infection, so when episcleritis occurs it’s important to make sure these conditions aren’t a factor.

On rare occasions, it may become apparent that external substances, such as chemicals, are responsible for an attack.

Episcleritis is more likely to affect people in their 30s and 40s, and women are more likely to be affected than men.

Symptoms:
Typical symptoms include generalized or local redness of the eyes that may be accompanied by mild soreness or discomfort but no visual problems.

In general the symptoms are:
•A pink or purple color to the normally white part of the eye
•Eye pain
•Eye tenderness
•Sensitivity to light
•Tearing of the eye

When someone develops episcleritis, their eye (or eyes) appears red and may feel sore, tender and uncomfortable. In this respect, it’s similar to conjunctivitis (inflammation of the conjunctiva, which covers the episclera). But unlike conjunctivitis, episcleritis doesn’t cause a discharge, although watering may occur. Those affected may also find they become sensitive to bright light.

It comes in two forms: simple and nodular.

Simple episcleritis is characterised by intermittent bouts of inflammation that occur every couple of months and last between one and two weeks.

Some people report that these bouts are more likely to affect them in the spring and autumn, and although triggers often remain unidentified, some people find that stress or hormonal changes kick off the process.

Click to see the picture

Nodular episcleritis causes longer bouts of inflammation that are more painful than simple episcleritis. This type is more often associated with underlying medical conditions such as rheumatoid arthritis.

Causes:
Episcleritis is a common condition that is usually mild.

The cause is usually unknown, but it may occur with certain diseases, such as:

*Herpes zoster
*Rheumatoid arthritis
*Gout
*Sjogren syndrome
*Syphilis
*Tuberculosis
*Herpes simplex infection
*Inflammatory bowel disease and Lupus.

Diagnosis:
Diagnosis of episcleritis is made clinically. A work-up may be needed in some cases to uncover a possible underlying medical condition.

Treatment:
The condition usually disappears without treatment in 1 – 2 weeks,  but topical or oral anti-inflammatory agents maybe prescribed to relieve pain or in chronic/recurrent cases. Corticosteroid eye drops may relieve the symptoms faster.
You may Click to see:Alternative Treatment of  Episcleritis

[amazon_link asins=’B00II709G2′ template=’ProductCarousel’ store=’finmeacur-20′ marketplace=’US’ link_id=’82fe620b-f845-11e6-a26a-bffecf13a6bf’]

Prognosis: Episcleritis usually improves without treatment. However, treatment may make symptoms go away sooner.

Possible Completions:
In some cases, the condition may return. Rarely, irritation and inflammation of the white part of the eye may develop. This is called scleritis. Episcleritis, is associated with an underlying disorder about 70% of the time, and Scleritis can produce serious damage to the Eye; Episcleritis never does.

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://www.bbc.co.uk/health/physical_health/conditions/episcleritis1.shtml
http://www.nlm.nih.gov/medlineplus/ency/article/001019.htm
http://www.hopkinsmedicine.org/wilmer/conditions/episcleritis.html
http://lmk23.tripod.com/episcleritis.html

[amazon_link asins=’1441965017,0387940588′ template=’ProductCarousel’ store=’finmeacur-20′ marketplace=’US’ link_id=’88270c80-ef3e-11e6-9dd1-8ba6f43eb035′]

Categories
Ailmemts & Remedies

Xerostomia Or Dry Mouth

Definition:
Xerostomia (pronounced as zeer-o-STO-me-uh)  is the medical term for the subjective complaint of dry mouth due to a lack of saliva. Xerostomia is sometimes colloquially called pasties, cottonmouth, drooth, doughmouth or des (like a desert). Xerostomia is also common in smokers.

Lack of saliva is a common problem that may seem little more than a nuisance, but a dry mouth can affect both your enjoyment of food and the health of your teeth. The medical term for dry mouth is xerostomia (zeer-o-STO-me-uh).
.CLICK & SEE THE PICTURES
Dry mouth can cause problems because saliva helps prevent tooth decay by limiting bacterial growth and washing away food and plaque. Saliva enhances your ability to taste and makes it easier to swallow. In addition, enzymes in saliva aid in digestion.

Xerostomia can cause difficulty in speech and eating. It also leads to halitosis and a dramatic rise in the number of cavities, as the protective effect of saliva’s remineralizing the enamel is no longer present, and can make the mucosa and periodontal tissue of the mouth more vulnerable to infection. Notably, a symptom of heavy methamphetamine use usually called “meth mouth” is largely caused by xerostomia which is worsened by the fact that methamphetamine at recreational doses can cause tight clenching of the jaw, bruxism (compulsive grinding of the teeth), or a repetitive ‘chewing’ movement like the user is chewing without food in the mouth.
Symptoms:
If you’re not producing enough saliva, you may notice the following signs and symptoms:

*Dryness in your mouth
*Saliva that seems thick, stringy
*Sores or split skin at the corners of your mouth
*Cracked lips
*Bad breath
*Difficulty speaking, swallowing
*Sore throat
*An altered sense of taste
*A fungal infection in your mouth
*Increased plaque, tooth decay and gum disease

In women, dry mouth may result in lipstick adhering to the teeth.

Causes:
Dry mouth has numerous causes, including:

*Medications. Hundreds of medications, including some over-the-counter drugs, produce dry mouth as a side effect. Among the more likely types to cause problems are some of the drugs used to treat depression and anxiety, antihistamines, decongestants, high blood pressure medications, anti-diarrheals, muscle relaxants, drugs for urinary incontinence, and Parkinson’s disease medications.

*Aging. Getting older isn’t a risk factor for dry mouth on its own; however, older people are more likely to be taking medications that may cause dry mouth. Also, older people are more likely to have other health conditions that may cause dry mouth.

*Cancer therapy. Chemotherapy drugs can change the nature of saliva and the amount produced. Radiation treatments to your head and neck can damage salivary glands, causing a marked decrease in saliva production.

*Nerve damage. An injury or surgery that causes nerve damage to your head and neck area also can result in xerostomia.

*Other health conditions. Dry mouth can be a consequence of certain health conditions — or their treatments — including the autoimmune disease Sjogren’s syndrome, diabetes, Parkinson’s disease, HIV/AIDS, anxiety disorders and depression. Stroke and Alzheimer’s disease may cause a perception of dry mouth, even though the salivary glands are functioning normally. Snoring and breathing with your mouth open also can contribute to the problem.

*Tobacco use. Smoking or chewing tobacco can increase dry mouth symptoms.

It may be a sign of an underlying disease, such as Sjögren’s syndrome, poorly controlled diabetes, or Lambert-Eaton syndrome, but this is not always the case.

Other causes of insufficient saliva include anxiety,  or the consumption of alcoholic beverages, physical trauma to the salivary glands or their ducts or nerves, dehydration caused by lack of sufficient fluids, excessive breathing through the mouth, previous radiation therapy, and also a natural result of aging, other conditions or factors not mentioned also can have the ability to cause dry mouth. The vast majority of elderly individuals will suffer xerostomia to some degree, although the most common cause is the use of medications. Output from the major salivary glands does not undergo clinically significant decrements in healthy older people and clinicians should not attribute complaints of a dry mouth and findings of salivary hypofunction in an older person to his or her age. The results of one study suggested that, in general, objective and subjective measurements of major salivary gland flow rates are independent of age, gender, and race. Furthermore, signs and symptoms of dry mouth in the elderly regardless of race or gender should not be considered a normal sequela of aging. Playing or exercising a long time outside on a hot day can cause the salivary glands to become dry as the bodily fluids are concentrated elsewhere. Xerostomia is a common side-effect of various drugs such as cannabis, amphetamines, antihistamines, and some antidepressants.

Diagnosis:
To determine if you have dry mouth, your doctor or dentist likely will examine your mouth and review your medical history. Sometimes you’ll need blood tests and imaging scans of your salivary glands to identify the cause.

He or she will do the following:-
Evaluate the patient’s complaint of dry mouth by asking pertinent history questions: When did he first notice the symptom? Was he exercising at the time? Is he currently taking any medications? Is his sensation of dry mouth intermittent or continuous? Is it related to or relieved by a particular activity? Ask about related symptoms, such as burning or itching eyes, or changes sense of smell in or taste.

Next, inspect the patient’s mouth, including the mucous membranes, for any abnormalities. Observe his eyes for conjunctival irritation, matted lids, and corneal epithelial thickening. Perform simple tests of smell and taste to detect impairment of these senses. Check for enlarged parotid and submaxillary glands.  Palpate for tender or enlarged areas along the neck, too.

Treatment:
Treatment involves finding any correctable causes and fixing those if possible. In many cases it is not possible to correct the xerostomia itself, and treatment focuses on relieving the symptoms and preventing cavities. Patients who have endured chemotherapy usually suffer from this post- treatment. Patients with xerostomia should avoid the use of decongestants and antihistamines, and pay careful attention to oral hygiene. Sipping non-carbonated sugarless fluids frequently, chewing xylitol-containing gum,[3] and using a carboxymethyl cellulose saliva substitute as a mouthwash may help. Aquoral or Pilocarpine may be prescribed to treat xerostomia. Non-systemic relief can be found using an oxidized glycerol triesters treatment used to coat the mouth. Drinking water when there is another cause of the xerostomia besides dehydration may bring little to no relief and can even make the dry mouth more uncomfortable. The use of an enzymatic product such as Biotene toothpaste, Biotene mouthwash, and Biotene dry mouth moisturizing liquid has been proven to reduce the rate of recurrence of dental plaque resulting from dry mouth. Of note is that Biotene does not significantly reduce the count of streptococcus mutans.

If your doctor believes medication to be the cause, he or she may adjust your dosage or switch you to another medication that doesn’t cause a dry mouth. Your doctor may also consider prescribing pilocarpine (Salagen) or cevimeline (Evoxac) to stimulate saliva production.

Lifestyle and home remedies:
When the cause of the problem either can’t be determined or can’t be resolved, the following tips may help improve your dry mouth symptoms and keep your teeth healthy:

*Chew sugar-free gum or suck on sugar-free hard candies.
*Limit your caffeine intake. Caffeine can make your mouth drier.
*Avoid sugary or acidic foods and candies because they increase the risk of tooth decay.
*Brush with a fluoride toothpaste. (Ask your dentist if you might benefit from prescription fluoride toothpaste.)
*Use a fluoride rinse or brush-on fluoride gel before bedtime.
*Don’t use a mouthwash that contains alcohol because these can be drying.
*Stop all tobacco use if you smoke or chew tobacco.
*Sip water regularly.
*Try over-the-counter saliva substitutes. Look for ones containing carboxymethylcellulose or hydroxyethyl cellulose, such as Biotene Oralbalance.
*Avoid using over-the-counter antihistamines and decongestants because they can make your symptoms worse.
*Breathe through your nose, not your mouth.
*Add moisture to the air at night with a room humidifier.

Alternative medicine:-
Studies of acupuncture have shown that acupuncture may be helpful for people with dry mouth stemming from various causes. This procedure involves the use of fine needles, lightly placed into various areas of the body, depending on your area of concern. While this treatment looks promising, researchers are still studying exactly how this therapy works for xerostomia. You may click to see:->Acupuncture relieves symptoms of xerostomia


You may click & See also
: Xerosis

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://www.mayoclinic.com/health/dry-mouth/HA00034
http://www.wrongdiagnosis.com/x/xerostomia/tests.htm
http://en.wikipedia.org/wiki/Xerostomia

Enhanced by Zemanta