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Congestive Heart Failure (CHF)

Introduction | Anatomy | Causes | Symptoms | Diagnosis | Treatment | Prevention | Am I at Risk | Complications | Advancements Introduction Congestive heart failure (CHF) develops when the heart cannot pump enough blood for the body.  The most common causes of CHF are high blood pressure and coronary artery disease.  CHF is usually a progressive long-term condition.  Many forms of CHF can be controlled with lifestyle changes, medications, and treatment of underlying medical conditions.  Select people with severe CHF may require implanted devices, such as a pacemaker, or a heart transplant. Anatomy The heart is the core of the cardiovascular system.  Your heart is located to the left of the center of your chest.  It is about the size of your fist.  The heart is a muscle that pumps blood throughout your body.  The blood carries oxygen-rich blood that your body cells require. Your heart contains four chambers.  The chambers are separated by the septum, a thick muscle wall.  There are two chambers on each side of your heart.  The top chambers, the atria, receive blood.  The bottom chambers, the ventricles, send blood. Your heart contains a right and left pumping system.  Your left atrium receives oxygenated blood from the lungs, and your left ventricle sends it out to your body.  Your right atrium receives deoxygenated blood from your body, and your right ventricle sends it to your lungs. Four heart valves prevent the blood from back flowing as the blood moves forward through the heart chambers.  The mitral valve and the tricuspid valve regulate blood flow from the atria to the ventricles.  The aortic valve and the pulmonary valve control blood as it leaves the heart.  The first sound of your heartbeat is from the mitral valve and the tricuspid valve closing.  The second sound in your heartbeat occurs when the aortic valve and the pulmonary valve close after the blood leaves your heart. Arteries are blood vessels that carry oxygenated blood away from your heart.  The aorta is the largest blood vessel in your body.  The aortic valve separates the left ventricle from the aorta.  The coronary arteries branch off the aorta and supply the heart with oxygen rich blood and nutrients to keep it healthy.  The pulmonary artery carries deoxygenated blood from the right ventricle to the lungs. Veins are vessels that carry blood from your body and lungs back to your heart.  Your two largest veins are the superior and inferior vena cavae.  They are located above and below your heart. The large arteries and veins surrounding the heart branch out and become smaller throughout your body.  Small capillaries connect the arteries and veins.  Capillaries deliver oxygen and nutrients to all of the cells in your body.  They also remove waste products, such as carbon dioxide. Causes CHF develops when the heart cannot pump enough blood to supply the body.  Instead of being pumped forward, blood may back up and accumulate in other areas of the body, such as the lungs, gastrointestinal tract, arms, and legs.  Vital organs may not receive enough blood to function.  CHF is usually a chronic long-term condition that can affect both or either side of the heart.  In some cases, it may develop suddenly. The most common causes of CHF are high blood pressure and coronary artery disease.  CHF can be caused by lung disease, heart tumors, arrhythmia, and structural abnormalities associated with heart valve disease, congenital heart disease, and dilated cardiomyopathy. Symptoms CHF can lead to weight gain and swelling in the arms, legs, and abdomen.  Your arms and legs may feel cool at rest.  Neck veins may protrude.  You may experience shortness of breath after activities or lying flat.  You may have indigestion, nausea, vomiting, and loss of appetite.  You may feel weak, faint, or very tired.  You may feel the beat of your heart (palpitations) and have an irregular or fast pulse.  You may have difficulty sleeping, remaining alert, concentrating, and remembering things.  You may sweat a lot.  You may cough or suddenly gasp for breath, especially at night.  You may produce smaller amounts of urine than usual and may need to urinate more frequently at night.Some people with CHF may not have symptoms.  They may experience symptoms if they develop infections with a high fever, anemia, arrhythmias, hyperthyroidism, and kidney disease.  Infants may sweat while feeding or during other exertion. Diagnosis Your doctor can diagnose CHF by reviewing your medical history and examining you.  You should tell your doctor about your symptoms.  Your doctor will listen to your heart and lungs for any abnormal sounds or heart rhythms.  The veins in your neck will be examined and your liver will be checked for enlargement.  Lab tests on your blood and urine will provide your doctor with information about how your heart, liver, kidneys, and circulatory system are functioning.A series of tests may be ordered to evaluate your heart.  Common tests include electrocardiogram (ECG), echocardiogram, coronary angiography, and nuclear ventriculography (MUGA or RNV).  An ECG records the heart’s electrical activity.  An ECG may be repeated over several hours.  An echocardiogram uses sound waves to produce an image of the heart on a monitor.  Coronary angiography involves inserting a long narrow tube through a blood vessel and injecting dye into the heart to see how the heart and coronary arteries are working.  A nuclear ventriculography involves using a safe radioisotope injection to produce an image of the heart with special scanners.  The heart structures may also be viewed with computed tomography (CT) scans and magnetic resonance imaging (MRI) scans.  Treatment Your doctor will classify the type of CHF that you have.  Many forms of CHF can be controlled with lifestyle changes, medications, and treatment of underlying medical conditions.  Treatment for CHF is focused on relieving symptoms and preventing progression of the disease.  Your doctor will treat reversible causes of CHF such as anemia, infection, or high blood pressure.You should make lifestyle changes to keep your heart healthy.  This may include maintaining a healthy weight, not smoking, avoiding excessive amounts of alcohol, eating healthy foods, and regular aerobic exercise.  Your doctor may advise…

High Cholesterol – Dyslipidemia

Introduction | Anatomy | Causes | Symptoms | Diagnosis | Treatment | Prevention | Am I at Risk | Complications  Introduction High cholesterol occurs when there is too much or an unhealthy balance of cholesterol in the blood.  Your body needs some cholesterol for healthy functioning but too much is dangerous to your health.  High cholesterol has no symptoms.  The only way to find out if you have high cholesterol is to get tested with a simple blood test.  High cholesterol is treated with lifestyle changes, dietary changes, and medications.  Untreated high cholesterol increases the risk for heart and blood vessel disease, including heart attack and stroke. Anatomy Cholesterol is a fat-like substance that is essential to your health.  You obtain cholesterol from the foods that you eat, but the majority of cholesterol is produced by your liver.  Cholesterol is a component in your blood, cells, and body tissues.  Your brain, nerves, muscles, skin, liver, intestines, and heart use it to function.  Your body uses cholesterol to produce hormones, vitamin D, and bile that helps to digest fat.  Cholesterol helps your nerves and brain send messages.  Cholesterol is also a component of body fat.  Your body needs cholesterol to be healthy; however, too much cholesterol is dangerous to your health. A total cholesterol test shows the total amount of cholesterol in your blood.  A more detailed test, a lipid profile, includes lipoprotein measurements that are more useful and reflective of your health.  Cholesterol travels out from your liver and into your bloodstream on fat and protein carriers called lipoproteins.  The two main types are low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol.  Most cholesterol is LDL.  LDLs transport cholesterol away from the liver and into the bloodstream.  LDLs contain more fat than protein.  LDLs are more likely to collect on the walls of blood vessels, which can contribute to heart disease, including heart attack and stroke.  LDLs are the “bad” cholesterol.  To help people remember, the “L” in LDL is commonly referred to as “lousy.”  You want your LDL numbers to be low. HDL cholesterol contains more protein than fat.  HDLs carry cholesterol away from your arteries and out of your body. High HDL levels can reduce the risk of heart attack.  HDLs are the “good” cholesterol.  The “H” in HDL is commonly referred to as “healthy.”  You want your HDL levels to be high. Causes High cholesterol occurs when there is too much or an unhealthy balance of cholesterol in the blood.  High cholesterol can lead to narrowed and clogged arteries and contribute to heart disease, including heart attack and stroke.  Eating high-fat or high-cholesterol foods and inherited factors are believed to be the primary causes of high cholesterol. Your genes control how fast LDL is produced and removed from your body.  This is a factor for high cholesterol that you have no control over.  Some people have familial hypercholesterolemia, a specific form of high cholesterol that is inherited. Certain medical conditions, such as liver disease, diabetes, Cushing’s syndrome, kidney disease, or an underactive thyroid, can contribute to high cholesterol.  Certain medications including birth control pills, estrogen, corticosteroids, some diuretics, and beta-blockers can increase your cholesterol levels.  Lifestyle factors, such as smoking, excessive alcohol consumption, and lack of exercise, are associated with high cholesterol.  Your weight is another factor.  Excess weight can increase your LDL level.  Both children and adults can have high cholesterol.  Cholesterol levels tend to increase with age.  For women, cholesterol typically increases around menopause. Symptoms High cholesterol has no symptoms.  The only way to find out if you have high cholesterol is to have your cholesterol tested.  Regular cholesterol testing should begin at age twenty, unless otherwise specified by your doctor. Diagnosis Your total cholesterol level can be identified with a blood test.  If your test reveals high cholesterol, another blood test called a lipid panel is used to determine your LDL, HDL, and triglyceride levels.  Triglycerides are fats that are used to build cholesterol.  High levels of triglycerides can contribute to heart disease.A total cholesterol of 200 mg/dL or lower is desirable and puts you at a lower risk for heart disease.  The higher your total cholesterol, the greater your risk for heart disease.  A total cholesterol of 200-239 mg/dL is considered borderline high.  High total cholesterol readings are 240 mg/dL and greater.  Optimally, you want your LDL results to be low, your HDL rates to be high, and your triglyceride rates to be low to reduce your risk for heart disease.  The following table is from the American Heart Association.  Total Cholesterol (mg/dL) Status Less than 200 Desirable 200-239  Borderline High Greater than 240 High  LDL Cholesterol (mg/dL)     Less than 100 Optimal  100-129 Near Optimal/Above Optimal 130-159 Borderline High 160-189  High Greater than 190 Very High HDL Cholesterol (mg/dL)    Less than 40 for men, Less than 50 for women Low  Greater than 60  High/Desirable Triglycerides (mg/dL)    Less than 150  Normal 150-199 Borderline High 200-499 High 500 or Higher  Very High Treatment The goal of treatment for high cholesterol is to lower cholesterol levels into the healthy ranges to reduce the risk of heart disease.  High cholesterol is treated with lifestyle changes, special diets, and medications.  Your doctor will make specific recommendations for you based on the results of your lipid profile. You should make lifestyle changes to reduce the risk factors that you can control.  This includes not smoking, losing weight, maintaining a healthy weight, and exercising regularly.  Exercise can help raise HDL and lower LDL.  You should eat a low fat, low cholesterol, high fiber diet.  The National Cholesterol Education Program, a division of the National Heart, Lung, and Blood Institute, has eating guidelines for people with high cholesterol.  The American Heart Association’s Cholesterol Low Down is another good resource for eating and exercise guidelines.  Your doctor may make specific recommendations or refer you to a nutritionist for healthy meal planning. If lifestyle and dietary changes alone do not lower your cholesterol into healthy ranges, your doctor will prescribe cholesterol lowering medications.  There are several types of…

Hypothyroidism

Introduction | Anatomy | Causes | Symptoms | Diagnosis | Treatment | Prevention | Am I at Risk | Complications  Introduction Hypothyroidism is a condition that most often occurs when the thyroid gland does not produce enough thyroid hormone.  Your thyroid gland is located at the front of your neck.  Thyroid hormones regulate your body metabolism.  Metabolism refers to all of the chemical processes that take place in your body.  This includes the production of energy and hormones, tissue growth, elimination of waste products, and the distribution of nutrients in the blood. Hypothyroidism can affect all of your body functions.  It generally causes the body’s normal rate of functioning to slow down.  This can result in physical, emotional, and behavioral changes.  Most types of hypothyroidism cannot be prevented, but can be treated.  Untreated hypothyroidism can lead to serious medical problems. Anatomy Your thyroid gland is located in the front lower part of your neck, in front of your windpipe.  Your thyroid primarily produces the thyroid hormone Thyroxine (T4).  This then is converted to the biologically active form called triiodothyronine (T3).  The thyroid hormones are secreted into your blood circulation and travel throughout your body.  These help to regulate the function of practically every cell and tissue in your body.  T4 and T3 are necessary for good health and control of your metabolism and energy levels. The hypothalamus and pituitary gland in your brain regulate T4 and T3 production in the thyroid gland.  When T4 and T3 levels are low, the hypothalamus produces thyrotropin-releasing hormone (TRH) to signal the pituitary gland to produce thyroid-stimulating hormone (TSH).  The TSH travels in the bloodstream and signals the thyroid gland to produce more T4 and T3.  When T4 and T3 levels are high, the pituitary gland stops producing TSH. Causes Your thyroid primarily produces the thyroid hormone Thyroxine (T4). This then is converted to the biologically active form called triiodothyronine (T3).  Hypothyroidism usually develops because of an underactive thyroid gland.  Hypothyroidism most commonly results from problems with the thyroid gland.  Hashimoto’s Thyroiditis is the most common cause of hypothyroidism in the United States.  Hashimoto’s Thyroiditis is an autoimmune disorder.  It occurs when abnormal blood antibodies and white blood cells attack and damage the thyroid cells.  This leaves a low amount of thyroid cells, which are unable to produce adequate amounts of thyroid hormones. In other parts of the world, a lack of iodine is the most common cause of hypothyroidism.  This is rarely seen in the United States.  In the United States, iodine is added to salt, food, and water. Surgery, radioactive iodine therapy, or radiation treatments that affect part or all of the thyroid gland can also cause hypothyroidism.  The thyroid gland may be surgically removed for the treatment of certain thyroid conditions or cancer.  Radioactive iodine therapy, a treatment for hyperthyroidism, can destroy the thyroid gland.  Radiation treatment, such as external beam radiation used to treat cancer, can also damage the thyroid gland.  Additionally, some women develop hypothyroidism during pregnancy. Less common causes of hypothyroidism include infections, certain medications, such as lithium, and excessive iodine intake.  Some infants are born without a functioning thyroid gland.  All infants in the United States are tested for hypothyroidism at birth. In rare cases, hypothyroidism can occur with a normal thyroid gland.  This often occurs when there is a problem with the hypothalamus or the pituitary gland.  The pituitary gland does not produce enough TSH.  In turn, the thyroid gland cannot produce T4 and T3 without the signal from TSH to do so. Symptoms The symptoms of hypothyroidism usually develop slowly over months or years.  Hypothyroidism causes your metabolic rate to slow down.  You may have a slow pulse and feel tired, sluggish, or weak.  You may want to sleep all of the time.  You may develop high cholesterol.  Your blood pressure may be too high or too low.  In rare severe cases, the heart muscle may weaken, leading to heart failure. You may feel unusually cold or have cold skin.  You may feel more comfortable in hot weather; however, you may not sweat.  This happens as your body works to conserve heat by redirecting blood away from your skin.  This will also cause you to look pale.  Your skin may develop a yellow color because of a buildup of carotene.  Carotene is normally converted to Vitamin A, but the conversion process is slowed by hypothyroidism. Your skin may also become dry and flaky.  Skin cracks may develop on your knees and elbows.  Your fingernails may become very brittle and develop lines and grooves.  You may also develop red itchy hives on your skin. Your hair may become thin, coarse, and brittle.  It is common to lose hair, even to the point of balding.  You may also lose your body hair, including hair from your eyebrows, arms, legs, and pubic area. You may notice some changes in your digestive system because your body has slowed down.  Food may not move through your stomach and intestines as fast as it did before.  This can cause constipation, hard stools, bloating, and heartburn.  Additionally, some people gain weight when their metabolism slows down. Females may experience irregular menstrual periods that are heavier and last longer.  In some women, the ovaries stop producing eggs, which can cause infertility.  You may also overproduce prolactin.  Prolactin is the hormone responsible for milk production.  Your breasts may produce discharge, even if you are not currently breastfeeding.  Too much prolactin can also interfere with menstruation and ovulation. You may experience muscle aches and cramps.  The pain may be severe enough to wake you up at night.  You may lose your coordination and feel clumsy.  You may feel a “pins and needles” sensation and develop carpal tunnel syndrome. Hypothyroidism can cause memory problems, poor concentration, and depression.  Depression is a real medical condition that can be treated.  Symptoms of depression include continually feeling sad, irritable, tired, and uninterested in activities that used to be enjoyable.  Other common symptoms of depression include changes in appetite, sleep…

Sleep Apnea

Introduction | Anatomy | Causes | Symptoms | Diagnosis | Treatment | Prevention | Am I at Risk | Complications | Advancements Introduction Sleep apnea is a common and under-diagnosed sleep disorder.  It causes repeated episodes of stopped breathing (apneic episodes) and startling or gasping for air during sleep.  People with sleep apnea frequently do not realize that they have it.  The consequences of untreated sleep apnea can be severe or life threatening therefore early diagnosis and treatment is essential.  Sleep apnea may be treated or managed with lifestyle changes, use of a breathing assist device at night, or surgery. Anatomy Sleep is vital for life, just like eating and breathing.  Sleep allows your body to rest.  It is believed that during sleep your brain performs important functions, such as storing memory and processing brain chemicals. In a way, your body goes on “auto-pilot” while you sleep.  Your brain regulates automatic functions for you, such as breathing, heart rate, and blood pressure.  Although sleep is a complex process that is not fully understood, it is known that a good night’s sleep is important for optimal health and functioning. Causes Sleep apnea occurs when breathing stops in repeated episodes during sleep.  Apnea means lack of breathing.  The majority of sleep apnea cases are caused by obstructions in the nose or throat that block a person’s breathing airway.  During sleep, the airway muscles relax and the airway closes or is blocked.Central sleep apnea is less common.  It is caused by a low blood carbon dioxide level.  Carbon dioxide is a powerful breathing signal and if it is too low, the brain fails to signal the lungs to breathe. Symptoms People may have sleep apnea and not be aware of it.  People with sleep apnea may stop breathing numerous times during the night and not fully awaken to realize it.  In many cases, a household member is the first to notice that a person snores loudly, stops breathing for periods of time, and gasps or snorts during sleep.  Daytime drowsiness, headache upon awakening, weight gain, depression, irritability, leg swelling, sexual dysfunction, and difficulty thinking or remembering may be signs of sleep apnea.  Sleep apnea can contribute to high blood pressure, and researchers suspect that up to half of all people with sleep apnea have high blood pressure.  Sleep apnea can contribute to stroke, heart attack, or death. Diagnosis You should contact your doctor if you suspect that you have sleep apnea.  Your doctor will examine your nose and throat for structural abnormalities.  Your doctor may recommend a sleep study to help diagnose sleep apnea and determine its severity. A sleep study may be performed at a sleep disorders clinic or in some cases, in-home equipment may be used.  Polysomnography testing is used to record a variety of body functions while you sleep.  During this test measurements of your brain activity, blood oxygen levels, airflow, heart rate, breathing, eye movements, and muscle movements will occur.  A multiple sleep latency test may be used to determine how quickly you fall asleep.  A multiple sleep latency test is helpful for identifying the extent of daytime sleepiness. Treatment Treatment for sleep apnea depends on the cause and extent of the condition.  Treatment may include lifestyle changes, use of an air device, dental appliance, and surgery.  Some people may use more than one type of treatment. Lifestyle changes may treat mild cases of sleep apnea and help reduce the number of apneic episodes for others.  Achieving and maintaining a healthy weight can help.  Even small weight loss amounts can reduce the amount of apneic episodes.  You should avoid using alcohol, tobacco, sedatives, or sleeping pills.  Additionally, it may be helpful to sleep on your side instead of your back. Continuous positive airway pressure (CPAP) is the most common treatment for sleep apnea.  CPAP entails wearing a device over the nose during sleep.  The nasal device is connected to a small machine that creates airflow and gentle air pressure to keep the airway open.  CPAP is an effective way to treat sleep apnea. Dental devices are another method of treatment.  Dental appliances are used to position the lower jaw and tongue during sleep.  Such devices may be appropriate for people with mild to moderate sleep apnea. In some cases, surgery may be used to increase the size of the airway.  Common surgeries include removal of the tonsils, adenoids, and excess throat or palate tissue.  Nasal surgery may be used to remove obstructions, such as polyps.  Children appear to benefit more from surgery for sleep apnea than adults do. Prevention You may be able to prevent sleep apnea by reducing the risk factors that you can control, such as maintaining a healthy weight and avoiding smoking, alcohol, and sedatives.  Early diagnosis and treatment may help reduce the serious consequences that may result from sleep apnea. Am I at Risk Sleep apnea most frequently occurs in people over the age of 40, although individuals of all ages, including children, may experience it.  In adults younger than 65, sleep apnea is more common in African Americans than Caucasians.  Sleep apnea is more common in the elderly and obese populations. Risk factors for sleep apnea include: Being overweight, especially with a large collar (neck) size, is a risk factor for sleep apnea. However, many people who are not overweight also have sleep apnea. Consuming alcohol increases the risk of sleep apnea. People with blocked nasal passages, a large tongue, narrow throat, or other structural problems have an increased risk of sleep apnea. High blood pressure and other medical conditions are associated with sleep apnea. Sleep apnea appears to run in families, and researchers are studying a possible genetic pattern of inheritance. People who snore loudly are more likely to have sleep apnea than those who do not snore. Complications It is very important to treat sleep apnea.  Sleep apnea has recently been identified as a contributor to high blood pressure and other medical conditions.  Sleep deprivation from sleep apnea can cause personality changes, hallucinations, and confusion.  Sleep apnea can contribute…

Strep Throat

Introduction | Anatomy | Causes | Symptoms | Diagnosis | Treatment | Prevention | Am I at Risk | Complications Introduction Strep throat is a common type of sore throat.  The germ that causes strep throat is spread from person to person in saliva and nasal secretions.  Strep throat is treated with antibiotics.  You can help prevent the spread of strep throat with regular hand washing and by covering your mouth and nose whenever you cough or sneeze. Anatomy Two tonsils are located in the back of the throat.  Two adenoids are positioned in your upper throat in the area behind your nose.  The tonsils and adenoids are glands that filter germs that enter through your nose and mouth to help keep you healthy. Causes Strep throat is caused by bacteria (Group A Streptococcus).  It is contagious; meaning it can be spread in saliva or nasal secretions from one person to another. Symptoms The symptoms of strep throat develop 2-5 days after the germ is contracted.  The sore throat can range from mild to severe.  Your throat may feel swollen and have whitish yellow spots on it.  You may also experience fever, headache, stomachache, nausea, chills, or rash. Diagnosis A doctor can diagnose strep throat by  examining you and conducting some tests.  A rapid strep test can give results in just one hour.  A throat culture and blood tests may also be used. Treatment Confirmed cases of strep throat are treated with prescription antibiotics.  You should stay home from work or school for 24-48 hours after starting antibiotics to prevent spreading strep to other people.Drinking liquids or sucking on popsicles can help ease symptoms.  Sucking on throat lozenges or hard candy can help increase saliva to ease symptoms.  Gargling with a solution made of ½ teaspoon of salt in 1 cup of water several times a day is a popular home remedy.  A vaporizer or humidifier can increase the humidity in a room and make breathing easier. Prevention You should wash your hands with soap and water regularly.  Cover your mouth when you cough or sneeze. Am I at Risk Children between the ages of 5 and 15 most frequently experience strep throat, although people of all ages can develop the condition. Complications Although it is rare, complications from strep throat include arthritis and rheumatic fever.  Treatment with antibiotics helps to reduce such complications.

Ulcers

Introduction | Anatomy | Causes | Symptoms | Diagnosis | Treatment | Prevention | Am I at Risk | Complications Introduction A Peptic Ulcer is a sore in the lining of the stomach or the first part of the small intestine.  An ulcer is caused by an imbalance between the acids and enzymes that break down food in the upper gastrointestinal tract.  The imbalance of digestive fluids leads to inflammation, deterioration of the protective mucus lining, and ulcer formation.  A Gastric Ulcer refers to an ulcer that is located in the stomach.  A Duodenal Ulcer is located in the first section of the small intestine.Some ulcers may not cause symptoms.  Others may cause pain and bleeding.  Ulcers are rarely life threatening.  Treatments for ulcers include lifestyle changes, medications, and surgery.  Anatomy When you eat, your tongue moves chewed food to the back of your throat.  When you swallow, the food moves into the opening of the esophagus.  Your esophagus is a tube that moves food from your throat to your stomach.  Muscles in your esophagus wall slowly squeeze the food toward your stomach. A ring of muscles located at the bottom of the esophagus is called the lower esophageal sphincter (LES).  The LES opens to allow food to enter the stomach.  The LES closes tightly after the food enters.  This prevents stomach contents and acids from backing up into the esophagus. Your stomach produces acids to break down food for digestion.  Your stomach secretes mucus to protect its lining from the acids.  Your stomach processes the food you eat into a liquid form.  The processed liquid travels from your stomach to your small intestine. The small intestine is a tube that is about 20-22 feet long and 1 ½ to 2 inches around.  The duodenum is the first part of the small intestine.  It is a short C-shaped structure that extends off of the stomach.  The jejunum and the ileum are the middle and final sections of the small intestine.Your small intestine breaks down the liquid even further so that your body can absorb the nutrients from the food you ate.  Your small intestine also has protection from irritating digestive acids.  The remaining waste products from the small intestine travel to the large intestine. Your large intestine, also called the large bowel, is a tube that is about 5 feet long and 3 or 4 inches around.  The first part of the large intestine, the colon, absorbs water and nutrients from the waste products that come from the small intestine.  As water is absorbed, the product becomes more solid and forms a stool.  The stool moves through the large intestine and passes out of your body when you have a bowel movement.  Causes Peptic Ulcer Disease is caused by an imbalance between acid and pepsin enzyme in the stomach and duodenum.  The imbalance of digestive fluids causes inflammation, breakdown of the protective mucus lining, and leads to ulcer formation.  A Gastric Ulcer is located in the stomach.  A Duodenal Ulcer is located in the duodenum. Most ulcers occur in the first layer of the stomach or intestinal lining.  Some ulcers can penetrate through the intestine, creating a hole.  This condition is called a Perforated Ulcer or Perforation of the Intestinal Lining. Peptic Ulcer Disease occurs for several reasons.  A bacterial infection from Helicobacter pylori (H. pylori) can cause ulcers.  They can be caused by the use of non-steroidal anti-inflammatory medications (NSAIDS) including aspirin, ibuprofen, naproxen, and other prescription medications.  Tumors produced by Zollinger-Ellison Syndrome can increase acid output and cause ulcers.  People that breathe with a mechanical respirator have a risk for ulcers.  Additionally, smoking, consuming alcohol, chronic gastritis, and increasing age contribute to ulcer formation. Symptoms Some ulcers may cause no symptoms at all.  Symptoms can differ from person to person.  You may experience a gnawing or burning pain in your stomach or upper abdomen.  The pain may occur more frequently between meals or at night.  The pain may even waken you at night.  Your pain may get better or worse after eating a meal. Ulcers can cause nausea, bloating, and heartburn.  In severe cases, you may vomit blood or have blood in your stools from intestinal bleeding.  Your stools may appear very dark or black if they contain blood.  You may lose weight and feel tired all of the time. Diagnosis Your doctor can diagnose peptic ulcer disease after reviewing your medical history and by conducting a physical examination. You should tell your doctor about your symptoms and risk factors. Your doctor may order blood tests, stool tests, and a test for H. pylori bacteria. Your doctor may also order tests, including a Barium Swallow or an Upper Gastrointestinal Intestinal (GI) Endoscopy, to help confirm the diagnosis. An Upper Gastrointestinal (GI) Series or Barium Swallow provides a set of X-rays showing the esophagus, stomach, and small intestine. Before the X-rays are taken, barium, a chalky substance, is swallowed. The barium provides a picture of the upper gastrointestinal structures on the X-ray images. A barium swallow is commonly used to determine the cause of pain, swallowing problems, blood stained vomit, and unexplained weight loss. A barium swallow is an outpatient procedure that does not require sedation or anesthesia. An Upper Gastrointestinal Intestinal (GI) Endoscopy is a procedure that uses an endoscope to view the esophagus, stomach, and upper duodenum, the first part of the small intestine. This test is also called an esophagogastroduodenoscopy (EGD) or a gastroscopy. An endoscope is a long thin tube with a light and a viewing instrument that sends images to monitor. The endoscope allows a doctor to examine the inside of the upper gastrointestinal tract for ulcers, bleeding, tumors, polyps, diseases, and other abnormal conditions. A tissue sample or biopsy can be taken with the endoscope. This is frequently done to test for H. pylori bacteria. An endoscope is also used to treat bleeding. An upper GI endoscopy is an outpatient procedure. You will receive medication to relax you prior to the test. Treatment Some ulcers may go away without formal treatment. …

Urinary Tract Infection – Bladder Infection

Introduction | Anatomy | Causes | Symptoms | Diagnosis | Treatment | Prevention | Am I at Risk | Complications Introduction Urinary Tract Infections (UTIs) are a common condition.  Most UTIs result from infection caused by bacteria that enters the urinary tract system.  UTIs can be quite uncomfortable and lead to problems with urination.  Fortunately, most UTIs respond well to prescription medication in a short amount of time. Anatomy Your urinary tract system consists of your kidneys, ureters, bladder, and urethra.  Your kidneys are a pair of bean shaped organs located around your lower back.  They filter waste products and extra fluids from your blood and turn them into urine.  Urine is composed of mainly water and metabolic waste products.  The urine travels through two tubes, called ureters, to your bladder.  Your bladder holds and collects the urine from your kidneys.  When a certain level of urine has accumulated in your bladder, your body signals you to urinate.  Your urethra is the tube that carries the urine from your bladder to outside of your body.  The female urethra is shorter than the male urethra. Causes Bacteria that enter the urethra cause the majority of UTIs.  Bacteria normally live in your colon or bowels.  They are also in your stools or bowel movements.  The bacteria can move from your anal area to the opening of your urethra.  This can occur because of poor hygiene and sexual intercourse. Usually, if bacteria enter the urethra, they are flushed away and removed during urination.  However, if there are too many bacterium, they may not be removed, but instead remain and grow.  The bacteria may cause an infection and travel throughout the urinary tract system.An infection in the urethra or bladder is termed a “lower urinary tract infection.”  An infection in the urethra is called “urethritis.”  An infection in the bladder is called “cystitis.”  The infection may spread through the urinary tract to the ureters and kidneys.  An infection in this area is termed an “upper urinary tract infection.”  An infection of the kidneys is called “pyelonephritis.”  In general, the higher the location of the infection, such as the kidneys, the more serious it is. UTIs are categorized as simple infections or complicated infections.  Simple infections can be treated with medications.  They do not spread to other parts of the body.  They may be caused by an abnormality in the urinary tract system.  Complicated infections may spread to other parts of the body.  They can be difficult to treat.  The infection may be resistant to some medications. Symptoms UTIs can cause pain and difficulty with urination.  You may feel pressure or aching over your bladder in your lower pelvic area.  You may have low back and flank pain.  It may hurt, sting, or burn when you urinate.  Your urine may appear cloudy or have blood in it.  Your urine may smell bad or have a strong urine odor.  You may feel like you need to urinate very frequently; however, you may only pass small amounts of urine at a time.  You may urinate several times during the night. Diagnosis Your doctor can diagnose a UTI after reviewing your medical history and your symptoms.  Your doctor will also conduct a physical examination and some tests.  In some cases, doctors may order additional tests to rule out other conditions that may cause symptoms similar to a UTI, such as sexually transmitted diseases, an enlarged prostate gland, or a kidney stone. Your urine will be examined for the presence of blood, abnormal cells, and bacteria.  This procedure is called a urinalysis.  The test is simple to conduct.  You will provide your doctor with a urine sample.  Your urine will be tested, and your doctor will interpret the results.  In some cases, the urine may be cultured.  This additional test can specify the type of bacteria that is causing the infection and help determine the best medication to treat it. Treatment Most UTIs are treated with antibiotics.  There are several types of antibiotics.  The type of medication you receive depends on the severity, type, and location of your infection.  Medication type and duration may also be dependent on your other health conditions, such as diabetes or pregnancy.  In addition to treating the infection, your doctor can prescribe medication to relieve bladder pain and pain associated with urination.  It is helpful to drink plenty of water.  Most simple UTIs respond well to prescription medication in a short amount of time. Prevention There are several ways you can prevent UTIs.  You should keep your genital area clean and wear clean, dry cotton underwear.  You should wipe from front to back after urinating or a bowel movement.  You should drink plenty of fluids.  Drinking cranberry juice may be helpful. Women prone to UTIs should avoid using birth control methods such as a contraceptive diaphragm and spermicidal jelly.  Women should not douche or using similar feminine hygiene products.  Women and girls should avoid bubble bath products.  Bubble baths do not cause a UTI, but they can irritate the urinary tract. You should urinate after sexual intercourse.  Some women consistently develop UTIs after sexual intercourse.  In these cases, doctors can prescribe an antibiotic that is taken after sexual intercourse as a preventive measure. Am I at Risk Certain people appear more likely to get UTIs than others.  Females are more susceptible to UTIs than males because their urethra is shorter and located near their anal area.  UTIs are especially common in women between the ages of 20 and 50 years old.  Sedentary or immobile people, such as people in a nursing home or some people of older age are at higher risk for developing UTIs.  Some children develop UTIs.  Girls tend to get UTIs around age three, during the toilet training period. Risk factors may increase your likelihood of developing a UTI.  People with all of the risk factors may never develop a UTI; however, the chance of developing a UTI increases with the more risk factors you have.  You should tell your doctor about your risk factors and…

High Blood Pressure – Hypertension (HTN)

Introduction | Anatomy | Causes | Symptoms | Diagnosis | Treatment | Prevention | Am I at Risk | Complications | Advancements Introduction High blood pressure, or hypertension (HTN), is a common condition in the United States.  High blood pressure is termed a “silent killer” because it usually does not have symptoms but can cause significant cardiovascular and organ damage.  The only way to know if you have high blood pressure is to get tested.  High blood pressure can be controlled with lifestyle changes and medications.  Uncontrolled high blood pressure can lead to life threatening medical conditions. Anatomy Your heart pumps blood throughout your body.  Your blood pressure is a measure of how hard your heart works to force the flow of blood.  Your blood pressure measurement reflects systolic and diastolic pressure.  Your systolic pressure is the amount of force that occurs when your heart contracts to pump blood out of your heart.  Your diastolic pressure is the minimum pressure between heartbeats when the heart is relaxed. Your blood pressure is recorded as two numbers.  Your systolic blood pressure is recorded as the top number and your diastolic blood pressure is the bottom number.  For example, a blood pressure that is 120/80 mm Hg is stated as “120 over 80.”  In this instance, the systolic blood pressure is 120 and the diastolic blood pressure is 80. Causes In about 10% of people, high blood pressure is caused by another medical condition.  This is termed secondary hypertension.  Conditions that can cause high blood pressure include kidney disease, adrenal gland tumors, coarctation of the aorta (being born with a narrowed aorta), pregnancy, using birth control pills, alcohol abuse, and thyroid dysfunction.  In most cases, if the source of secondary hypertension is treated, blood pressure can return to normal. In about 90% of people, the cause of high blood pressure is not known.  This is termed primary hypertension.  Many risk factors are associated with primary hypertension. Symptoms High blood pressure usually does not have symptoms.  High blood pressure has been termed a “silent killer” because although people may not have symptoms, progressive damage can occur to the heart, blood vessels, and other organs.  People can have high blood pressure for years and not know it.  The only way to find out if you have high blood pressure is to have your blood pressure checked. Severe high blood pressure and malignant high blood pressure can cause headaches, vision problems, lightheadedness, nausea, and vomiting.  Malignant high blood pressure, a hypertensive crisis, is high blood pressure that rises rapidly.  The diastolic blood pressure often exceeds 140 mmHg.  You should go to a hospital emergency department if your diastolic pressure is greater than 100 mm Hg.  You should call an ambulance if you experience the symptoms of a stroke or heart attack, which may include severe headache, dizziness, fainting, blurred vision, loss of vision, chest pain, shortness of breath at rest, and weakness. Diagnosis The only way to find out if you have high blood pressure is to have it measured with a blood pressure cuff.  Having your blood pressure checked is quick and painless.  A blood pressure cuff is placed around your arm and inflated.  As air in the cuff is released, a person listens to your pulse.  Blood pressure is classified as normal, prehypertension, or high.  Classification Systolic (Top Number)  Diastolic (Bottom Number) Normal Less than 120  Less than 80 Prehypertension 120-130 80-89 High Blood Pressure- Stage 1 140-159 90-99 High Blood Pressure- Stage 2 160 or Higher 100 or Higher  If you have high blood pressure, your doctor may order tests to check your organs for damage.  Such tests may include blood tests, urine tests, an eye exam, or imaging tests.  Specific tests may be used to detect heart or blood vessel damage. Treatment The goal of treatment is to keep blood pressure below 140/90 mmHg.  The goal is lower, 125-130/80 mmHg, for people with diabetes, chronic kidney disease, or a prior heart attack or stroke.  You doctor can tell you what your specific goal should be.  Treatment of secondary conditions can return blood pressure to normal.  Treatment for high blood pressure usually consists of lifestyle changes, medications, or both. Some people can lower their blood pressure with lifestyle changes including weight loss, exercise, and dietary changes.  You should work towards achieving and maintaining your ideal weight.  Even a small weight loss is beneficial.  It is helpful to eat low fat, low calorie, low cholesterol, high fiber, and low salt foods.  You should eliminate using table salt.  The Dietary Approaches to Stop Hypertension (DASH) diet is a guide for people with high blood pressure.  You should quit smoking and avoid alcohol.  If making lifestyle changes are difficult for you, your doctor can refer you to resources for assistance and support. Medications to treat high blood pressure may also be used along with lifestyle changes.  There are many prescription medications that work in different ways to treat high blood pressure.  Your medication or dose may need to be changed over time. It is very important that you take your medications according to your doctor’s instructions.  You should take your medication as directed, even if you feel better.  It is also important to monitor your blood pressure per your doctor’s instructions.  You should make and keep all of your doctor appointments.The prognosis is usually good for high blood pressure that is controlled.  You may need to take medication for the rest of your life, unless you can lower your blood pressure with significant lifestyle changes.  Uncontrolled high blood pressure can lead to life threatening medical complications. Prevention It is helpful to reverse the risk factors for high blood pressure that you can control.  Some people can control or prevent high blood pressure with healthy lifestyle choices.  It is helpful to lose excess weight and maintain a healthy weight.  Regular exercise is important.  You should quit smoking and not use alcohol or illegal drugs.  It is helpful to eat low fat, low calorie, low cholesterol, high fiber, and low salt foods.  You should eliminate…

Electrocardiogram – ECG

Introduction Introduction An electrocardiogram (ECG or EKG) is useful for identifying if the heart is beating normally.  It may be used for people with chest pain, heart palpitations, or suspected heart disease.  An ECG measures the electrical activity of the heart.  It provides information about the size and position of the heart chambers, heart damage, and the effect of a pacemaker or heart regulating medication. Test Procedure  Prior to your ECG procedure a technician will apply several discs to your skin.  The discs are attached to electrodes that transmit information to a recording machine.During the test, you will be asked to remain motionless or hold your breath at times.  An ECG is a painless procedure.  The recording machine will print your results.  Your doctor will review your results with you.