Medical News Today: What is rhinophyma?

Rhinophyma is a skin disorder that causes the nose to become enlarged and bulbous. The nose may look red, swollen, and distorted.

The condition is a subtype of rosacea, an inflammatory skin disease. Some people with rhinophyma may also experience symptoms of other rosacea subtypes.

Other subtypes of rosacea cause redness and small, pus-filled bumps on the face, commonly on the cheeks, chin, and nose.

Whereas other rosacea symptoms tend to flare up and then subside, people with rhinophyma may find that their nose continues to grow. Researchers believe that rhinophyma can develop over time due to untreated rosacea.

Causes

Rhinophyma <br>Image credit: M. Sand et al, Cutaneous lesions of the nose, 2010</br>
Risk factors for rhinopehyma include a family history of rosacea, being male, and being middle-aged.
Image credit: M. Sand et al, Cutaneous lesions of the nose, 2010

The exact cause of rhinophyma is unknown. In the past, some people believed that alcohol consumption could lead to the condition.

There is no proven link between rhinophyma and alcohol, but alcohol and caffeine can both temporarily dilate blood vessels, and this seems to make rhinophyma worse.

As a result, many people will cut back on drinking alcohol when they have rhinophyma, despite the lack of evidence suggesting that this is necessary.

Other risk factors for rosacea and rhinophyma include:

  • having fair skin
  • being male
  • being middle-aged
  • having a family history of rosacea

Rhinophyma is most common in men between the ages of 50 and 70.


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Symptoms

The primary symptom of rhinophyma is a change in the color and shape of the nose. Over time, the tip of the nose may turn a deep red. It can also grow in odd directions and appear misshapen or bulbous.

Many people experience other symptoms, including:

  • lumps on the nose due to the growth of extra connective tissue
  • red or purplish discoloration
  • enlarged pores
  • thickened skin
  • scarring or pitting
  • dry or oily skin

Rhinophyma tends to occur in people with severe rosacea, so many people experience other rosacea symptoms too. These may include:

  • sensitive skin
  • red patches
  • facial flushing
  • bumps that look like pimples, which may flare up and then subside
  • telangiectasia, or visible blood vessels in the affected skin, including the nose, chin, or cheeks

Diagnosis

Rhinophyma typically begins following a rosacea diagnosis.

When rosacea is in its early stages, people often confuse it with conditions such as acne or eczema. It is easier to diagnose rosacea as the condition progresses.

The characteristic appearance of rhinophyma often makes it easy to diagnose with just a visual examination.

However, doctors may still run tests in some cases if symptoms do not respond to treatment. They may also take a biopsy to check for any worrisome changes or malignancy in the cells.


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Treatment

Rhinophyma of the nose <br>Image credit: James Heilman, MD, 2013</br>
A doctor can treat rhinophyma with medication or surgery.
Image credit: James Heilman, MD, 2013

There are a few different treatments for rhinophyma, depending on the progression of the symptoms.

Doctors typically treat rosacea with antibiotics and retinoids, but rhinophyma may not respond to the same treatments as other subtypes of rosacea.

Medications

Oral isotretinoin is often the first line of treatment. It is more likely to be beneficial if the rhinophyma is at an early stage or if the symptoms are not severe.

The primary aim of medication is to treat the underlying rosacea. Oral or topical antibiotics may reduce redness or inflammation in the area.

Common antibiotics for treating rosacea include:

  • tetracycline
  • metronidazole
  • erythromycin

Azelaic acid and other topical medications, such as cyclosporine, may help to minimize inflammation and redness too.

In some cases, doctors also recommend moisturizers or medications that help prevent the skin from drying out or becoming oily.

Surgery

Surgery is often the best option for long-term treatment of rhinophyma. As the tissues and blood vessels in the area keep growing, it is crucial to perform surgery as early as possible to prevent permanent disfigurement.

There are several surgical treatment options for rhinophyma, including:

  • Dermabrasion, which removes excess layers of skin.
  • Cryosurgery, which freezes and destroys unwanted or abnormal tissues.
  • Sharp excision, where doctors cut away the growth or excess tissue with a scalpel.
  • Carbon dioxide laser resurfacing, which may allow wounds to heal faster than using a scalpel.

Each surgical option has potential risks, so doctors will discuss all of the possible complications with the individual before helping them to decide on a procedure. Doctors may also recommend a combination of two or more techniques.

A person’s choice of surgical treatment can also vary according to the results they want to achieve, which may involve:

  • removing growths or excess layers of skin
  • reshaping a disfigured nose
  • reducing the appearance of tiny, superficial blood vessels in the area
  • improving the overall look of the skin

Lifestyle tips

Some lifestyle changes may help to manage symptoms. These include avoiding the following:

  • spicy foods
  • smoking tobacco
  • alcoholic drinks
  • caffeinated drinks
  • rubbing the face
  • too much sunlight
  • extreme temperatures

Eliminating these factors may help to reduce the appearance of blood vessels or redness for some people.


Outlook

Rhinophyma is a benign condition initially, but proper diagnosis is essential, as there is a small chance that the growth may become malignant.

One study estimated that 3–10 percent of people with rhinophyma have occult basal cell carcinoma, a type of cancer.

Without treatment, severe rhinophyma may lead to deformity, which can cause embarrassment or distress. Successful surgical treatment can help to prevent this.

There is currently no cure for rhinophyma, and the symptoms can return after surgery.

Long-term medication and other treatment options, such as regular dermabrasion, may help.

Treating rhinophyma as early as possible will give the person the best chance of avoiding permanent disfigurement and prolonged symptoms.

Source Article from https://www.medicalnewstoday.com/articles/322166.php

Medical News Today: How to use Epsom salt for constipation relief

Epsom salt is a crystallized form of magnesium sulfate that people use as a traditional remedy for many ailments, including constipation.

The U.S. Food and Drug Administration approve the use of Epsom salt as a laxative. Laxatives can help a person have a bowel movement when they are temporarily constipated.

However, using Epsom salt for constipation can have risks, and there are some groups of people who should not try this home remedy.

In this article, learn how to use Epsom salt for constipation, as well as when to see a doctor.

Use

Epsom salt on wooden spoon.
Epsom salt has a range of therapeutic uses.

People can buy Epsom salt at most drugstores, natural food stores, and online.

A person should read the instructions carefully when using Epsom salt for constipation, as manufacturer’s recommendations can vary.

The Epsom salt must be food-grade quality, meaning people can consume it safely. Manufacturers sell Epsom salt for bathing and even as fertilizer, so it is essential to read the packaging.

Instructions may vary between products, but one company provides the following instructions for safe use:

  • Use the amount of Epsom salt based on a person’s age. Adults and children aged 12 years or older may take 2 to 6 level teaspoons daily. Children ages 6 to 12 years old may take 1 to 2 level teaspoons daily. Children under age 6 years should not use Epsom salt, as a laxative, unless a doctor recommends this treatment.
  • Mix the Epsom salts into an 8-ounce glass of water. A person can also divide the doses across the course of a day but should never exceed the daily limit.
  • Add lemon juice, if desired, to improve the taste. Drink the entire mixture.

After a person uses Epsom salt for constipation, they will usually have a bowel movement in 30 minutes to 6 hours.

Epsom salt attracts more fluid to the bowel. This extra fluid stretches the intestines and helps move stool along.

If a person uses Epsom salt for 2 days in a row without having a bowel movement, they should not continue to use it. They can either try an alternative laxative or talk to their doctor for further treatment recommendations.


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Risks and considerations

People with kidney disease should not use Epsom salt for constipation. Healthy kidneys filter particles such as magnesium. When the kidneys do not work as well, excess magnesium can build up in the body.

Too much magnesium can cause confusion, abnormal heart rhythms, and seizures. If a person is on a low-magnesium diet, they should not use Epsom salt either.

Although rare, severely high magnesium levels can be fatal even in people who do not have kidney problems.

Because of the risk of developing high magnesium levels, a person should not use Epsom salt for a laxative frequently. It is crucial to see a doctor if constipation affects someone for more than a week.

Severe or long-term constipation can indicate an underlying medical condition. This could include a bowel obstruction, which is when stool cannot move past a certain point in the intestines.

A person should not use laxatives at all if they have the following symptoms in addition to constipation:

  • abdominal pain
  • fever
  • nausea
  • vomiting

Instead, they should seek immediate medical attention. People should also go to the emergency room if they experience rectal bleeding.

If a person suspects they have ingested too much Epsom salt, they should call the Poison Control Center at 1-800-222-1222 or their local emergency number.

Symptoms of excess magnesium consumption include:

  • flushing
  • drowsiness
  • fainting
  • slow heart rate

Constipation symptoms

Man with constipation at desk holding his stomach in pain.
Stools that are difficult to pass can be a sign of constipation.

Signs and symptoms of constipation include:

  • having less than three bowel movements a week
  • having stools that are lumpy or dry
  • having stools that are painful or hard to pass
  • straining significantly when having a bowel movement

Having regular bowel movements is essential for eliminating waste and preventing discomfort and stomach fullness.

Many people experience constipation from time to time. If methods such as eating more fiber, exercising, and drinking more water do not relieve constipation, a person may want to consider trying Epsom salt.


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Takeaway

People use Epsom salt as a laxative, as well as for soaking injuries, lawn fertilizer, and more.

When used as a laxative, a person should carefully read instructions and consult their doctor to ensure Epsom salt will not interfere with other medications.

While Epsom salt is a relatively inexpensive laxative, there are other constipation treatments available. A person should consult their doctor if they experience constipation for more than a week.

A range of Epsom salt products are available to purchase online.

Source Article from https://www.medicalnewstoday.com/articles/322160.php

Medical News Today: What are the signs of not eating enough?

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Medical News Today: Could platypus venom help to treat diabetes?

With diabetes currently sweeping the United States, designing more effective treatments is paramount. New research finds a rather surprising source of a potential new drug: platypus venom.
Platypus swimming
As we dig into platypus biology, surprises wait at every turn.

The platypus is arguably Australia’s most iconic and strange animal.

It is classed as a monotreme, which is a group of mammals that includes just five surviving species.

It has fur yet lays eggs and produces milk but has no nipples, and it is one of the few mammals that is venomous.

During breeding season, male platypuses produce venom that can be injected into rival males, predators, or inquisitive humans using a spur on their hind legs.

Although not fatal to humans, the after effects of a platypus sting can be excruciatingly painful.

The platypus genome and diabetes

In 2008, researchers first sequenced the platypus genome. One of the researchers involved in that project — Prof. Frank Grutzner, from the University of Adelaide in Australia — is now looking at novel ways to use this knowledge to help treat diabetes.

People who have diabetes are sometimes prescribed a drug called exenatide. This compound is a modified version of the hormone glucagon-like peptide-1 (GLP-1), which is naturally secreted in the gut and stimulates the release of insulin. This has the effect of lowering the level of potentially damaging glucose in the blood.

GLP-1 is also found in animals, including the platypus. However, the platypus version is significantly modified. As Prof. Grutzner says, “One of the most amazing discoveries of the platypus genome project was the massive loss of genes important for digestion and metabolic control — these animals basically lack a functional stomach.”

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“More recently,” he adds, “we discovered that monotreme GLP-1 has changed radically in these animals, due to its dual function in both the gut and venom.”

One key difference between platypus and human GLP-1 is its resistance to degradation. In other words, it has the potential to hang around in the body, continuing to work for longer than the human version can.

Maybe this iconic Australian animal holds the answer to a more effective and safer management option for metabolic diseases including diabetes.”

Prof. Frank Grutzner

The findings have piqued the interest of the pharmaceutical industry; new diabetes drugs can be lucrative. The researchers involved in this project recently received a significant financial boost from the Central Adelaide Local Health Network, which will help them to continue their work.

While there is a great deal of research and development left to be done, the scientists have high hopes. They believe that platypus GLP-1 might one day offer a longer-lasting drug for use in a disease that already affects well over 400 million people, globally.

Could an egg-laying, venomous mammal provide assistance in this worldwide problem?

Source Article from https://www.medicalnewstoday.com/articles/322156.php

Medical News Today: Why do I wake up depressed?

There are many types of depression. Some, called diurnal variations, involve symptoms getting worse at certain times of the day.

Symptoms of depression can include feelings of helplessness, sadness, and hopelessness, and these may be worse in the morning. The common term for this diurnal variation is morning depression.

Diurnal means that symptoms seem to occur or grow more severe every day at around the same time. For some people, this happens in the afternoon or evening.

Symptoms of morning depression

Morning depression
Symptoms of depression can include diminished or no enjoyment in activities and difficulty sleeping.

A person with morning depression will have the diagnostic symptoms of major depressive disorder. These symptoms will arise or, more often, intensify in the morning.

The symptoms may dissipate or feel less severe as the day goes on.

Doctors diagnose depression according to criteria listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

To receive a diagnosis of depression, a person must experience five or more of the symptoms listed below for 2 weeks or more.

A defining aspect of the condition is a depressed mood or a loss of interest or pleasure in activities once enjoyed.

Other symptoms include:

  • a depressed mood lasting for most of the day, almost every day, though it may be worse at certain times of day
  • diminished or no enjoyment in nearly all activities
  • significant weight loss without effort or a decrease in appetite
  • difficulty sleeping or sleeping too much
  • restlessness throughout most days of the week
  • fatigue or a feeling of no energy throughout most of the week
  • feelings of worthlessness or excessive guilt
  • difficulty concentrating, thinking, or making decisions throughout most of the week
  • recurrent thoughts of death, suicide, or self-harm

In addition, a person with morning depression may notice the following symptoms:

  • difficulty waking up in the morning
  • physical difficulty getting out of bed
  • frequent over-sleeping
  • difficulty thinking clearly, especially in the morning
  • difficulty completing regular morning tasks, such as getting dressed and brushing the teeth

In a person with morning depression, these symptoms will reduce or disappear as the day progresses.


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Causes

Doctors have not identified a specific cause of morning depression, but there are many contributing factors.

Because morning depression occurs at around the same time every day, doctors often connect it to imbalances in a person’s circadian rhythm.

The body’s circadian rhythm is a process that signals the sleep-wake cycle, among other things. Hormonal changes throughout the day can influence the circadian rhythm. One of these hormones is melatonin, which makes a person sleepy.

While people who are not clinically diagnosed with depression often experience changes in mood throughout the day, those with morning depression seem to have more pronounced highs and lows that occur daily or almost every day.

Some research suggests that imbalances in a person’s internal body clock and the amount of sleep and light exposure could lead to mood changes, especially in those with depression.

Beyond changes to the body’s natural rhythms, several other factors may contribute to morning depression and major depressive disorder. These factors include:

  • a family history of depression
  • past or ongoing drug or alcohol addiction
  • medical conditions that can affect a person’s mood, such as sleep disturbances, chronic pain, anxiety, and attention deficit hyperactivity disorder (ADHD)
  • recent changes in life circumstances, such as divorce or loss of a loved one
  • trauma

Diagnosis

Doctors begin to diagnose depression and any diurnal variations, such as morning depression, by asking a person about their symptoms.

They may ask questions about changes in mood, sleep, weight, and appetite. The doctor will attempt to establish how long these symptoms have lasted and whether they are improving or getting worse.

They will also try to rule out other possible causes, such as a medical condition that can cause similar symptoms. Hypothyroidism is one example.

Some medications can also lead to mood changes and symptoms of depression, so a doctor will also ask about any drugs a person is taking.


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Treatment

cbt session
A doctor may recommend psychotherapy to treat depression.

Anyone having suicidal thoughts or thoughts of self-harm should seek emergency medical attention. A doctor can help to provide immediate and continuing care.

Many treatments for depression exist. They include:

  • Psychotherapy: This can help a person to recognize negative thought patterns and learn positive behaviors. Group or family therapy can help to strengthen relationships.
  • Medications: Among those that can help are anti-depressants, mood stabilizers, and antipsychotics. It may take time and some trial-and-error to find the right drug and dosage.
  • Exercise: Getting regular exercise, especially outdoors, can help to reduce mild to moderate depression symptoms. Exercising outside can be especially beneficial for people with morning depression, as it may reduce insomnia and ensure plenty of exposure to natural light.
  • Brain stimulation therapies: While rarely a first-line treatment, brain stimulation therapies, such as electroconvulsive therapy and repetitive transcranial magnetic stimulation, may reduce symptoms of severe depression.

Some people also benefit from alternative therapies, including acupuncture, meditation, and yoga. While these can help people to feel better and maintain good mental health over time, they should not replace medical treatment for major depressive disorder.

Coping

While pursuing medical treatments, a person may wish to adopt habits that can help them to cope with symptoms. Positive changes can include:

  • Improving sleep hygiene. A person can help to promote better-quality sleep by darkening the bedroom, keeping the temperature cool, and eliminating distractions from screens, such as those on cell phones, computers, and televisions.
  • Preparing for the next morning at night. Setting out clothes and items for work or school, and putting together lunches in advance can make mornings easier if a person has little motivation or energy when they wake up.
  • Getting enough rest. Going to sleep and waking up at the same times, and trying to get 8 hours of sleep per night can improve symptoms.
  • Allowing for extra time in the morning. Waking up earlier or adjusting a work schedule to start later, if possible, can relieve pressure and stress in the morning.
  • Using light cues. Light can communicate to the body that it is morning and time to wake up. Opening the curtains right away or timing an overhead light to turn on at the same time every day can help the body to wake up.

A doctor or therapist can make individual recommendations based on a person’s symptoms and needs.


Outlook

According to some research, morning depression is a common form of diurnal depression.

If a person has morning depression, medical treatments and support are available to help.

Source Article from https://www.medicalnewstoday.com/articles/322155.php

Medical News Today: How do you treat a fecal impaction?

Fecal impaction is a severe bowel condition in which a hard, dry mass of stool becomes stuck in the colon or rectum. This immobile mass will block the passage and cause a buildup of waste, which a person will be unable to pass.

Fecal impaction disturbs the normal gastrointestinal process in which digested food passes from the stomach to the intestines and then into the colon and rectum.

Without treatment, fecal impaction can cause severe damage. Therefore, people experiencing any of the symptoms should visit their doctor as soon as possible.

What are the symptoms of fecal impaction?

woman with possible fecal impaction
Fecal impaction can cause stomach pain and abdominal bloating.

Fecal impaction can cause a range of symptoms, which include:

  • liquid stool leaking from the rectum
  • pain or discomfort in the abdomen
  • abdominal bloating
  • nausea or vomiting
  • feeling the need to push
  • a headache
  • unintentional weight loss
  • a feeling of fullness and not wanting to eat

People should seek treatment as quickly as possible if they suspect that they have an impacted bowel. Without treatment, symptoms can become more severe and may include:

  • rapid heart rate
  • feeling confused
  • hyperventilating or feeling breathless
  • fever
  • becoming irritated and agitated
  • incontinence, where a person loses control over urination or bowel movements


Causes

There are several causes of fecal impaction, including:

Untreated constipation

Constipation can occur when stools become hard and dry or when bowel movements become less frequent. Causes of constipation include:

  • a diet low in fiber — a person should consume 30 grams (g) of fiber daily to help soften stools
  • inadequate fluid intake
  • a sedentary lifestyle — regular exercise will help muscles in the bowel wall to stay strong
  • ignoring the urge to defecate
  • certain medications
  • anal fissures or hemorrhoids — the pain these cause can make a person resist the urge to pass stool, resulting in constipation

Overuse of laxatives

Repeated and excessive use of laxatives affects a person’s colon. The body becomes dependent on the laxatives to help with bowel movements. As a result, the colon becomes less able to perform this process naturally.

Other medical conditions

Some medical conditions may cause fecal impaction as a side effect.

These conditions include:

Lack of mobility

A lack of mobility due to injury or aging can weaken the abdominal muscles and reduce colonic mass movements. This impairs the body’s ability to pass stool on its own and could result in fecal impaction.

Certain medications

Some medicines can impair gastrointestinal motility, including:

  • opiate analgesics
  • anticholinergic agents
  • calcium channel blockers
  • antacids
  • iron preparations

Anorectal surgery

Although it is rare, fecal impaction can occur as the result of anorectal surgery.


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Diagnosis

doctor examining female patients stomach
During an examination, the doctor will press down on the stomach to feel for the mass.

It is possible to determine whether or not a person has fecal impaction using several different methods.

Initially, a doctor is likely to ask about the following factors to build up a picture of the individual’s medical history:

  • how often they go to the bathroom and when they last went
  • how often they are constipated
  • how much liquid they drink
  • how much fiber they eat
  • whether they use laxatives
  • what medications they take

The doctor will then perform a physical exam by pressing down on the stomach to feel for the mass. They may also insert a finger into the rectum to try to feel for it or to detect any other problems that could be causing the symptoms.

In some cases, an X-ray may be necessary to check for the mass.

Another option is a sigmoidoscopy, which is a procedure involving the insertion of a thin tube with a light and a lens at its end into the lower colon.


What are the treatment options?

It is vital that a person with fecal impaction receives treatment to remove the mass of stool. Not doing so could cause severe complications, possibly even death.

There are several different treatments for fecal impaction. The most common remedy is a procedure called an enema where a doctor will insert a specific fluid into the rectum that softens the stool and makes it easier to push out.

If an enema fails to work, it may be necessary to break the stool down and remove it by hand. Removing the stool should result in a person’s bowel movements returning to normal, and any side effects should go away.

Other possible treatments for fecal impaction include:

Laxatives

A doctor may recommend oral laxatives. These make the colon produce more water, which softens the mass, allowing the body to pass it through and excrete it. Laxatives are also available to buy over the counter.

Anal suppositories

Following insertion into the rectum, these will draw water into the area to soften the mass of stool.

Water irrigation

During water irrigation, a doctor will insert a small hose into the rectum and flush the area with water, encouraging the stool to soften and break down.

A doctor may massage the rectum after this procedure to help the stool move through, before removing it via another tube.

Are there any home remedies?

People with a fecal impaction should not try to remove the mass by themselves or wait for it to go away on its own. Instead, they must make an appointment with a doctor, who will advise them on the best treatment to cure the issue.

However, a person can adapt their food choices to help keep their bowel movements regular and avoid constipation. A diet high in fiber can aid regular bowel movements, and natural laxatives such as tea, coffee, and prune juice may be beneficial if a person feels constipated.


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Complications

The complications of fecal impaction can range in severity and are more likely to occur if people delay seeking treatment for the condition. Complications typically include:

  • tearing of the colon wall
  • anal tears
  • hemorrhoids
  • anal bleeding

If a person suspects that there is any problem with their colon, digestive health, or bowel movements, they should make an appointment to see their doctor as soon as possible.

Prevention

a selection of fiber rich food
Having a diet rich in fiber can help lessen the risk of fecal impaction.

There are several lifestyle changes that people can make to reduce their risk of fecal impaction. These include:

  • taking regular exercise and staying active
  • eating a diet high in fiber
  • drinking plenty of water
  • avoiding alcohol
  • using the bathroom when the need arises rather than waiting

While it is not always possible to do so, avoiding the use of laxatives and trying to prevent constipation will lower the chance of a person experiencing fecal impaction.

A doctor may also recommend taking stool softeners to help stool pass along more smoothly.


Outlook

Fecal impaction is a common gastrointestinal problem. Prompt and successful treatment will minimize a person’s discomfort and the risk of complications. Not treating fecal impaction is dangerous and can cause serious side effects.

Making diet and lifestyle changes can help people to avoid reoccurrence.

Source Article from https://www.medicalnewstoday.com/articles/322150.php

Medical News Today: What to know about ileus

Ileus is a temporary and often painful lack of movement in the intestines.

An ileus occurs when the intestines do not move food through in the normal way. It often occurs after abdominal surgery.

This is a severe condition because, if left untreated, an ileus can cut off blood supply to the intestines and cause tissue death. This can result in an intestinal tear or life-threatening infection of the abdominal cavity.

Read on to learn more about recognizing and treating an ileus.

Causes

ileus demonstrated by 3D render of intestines.
Abdominal or pelvic surgery may cause ileus.

Typically, muscles in the intestines contract and relax to cause a wave-like motion called peristalsis. This movement helps food to travel through the intestines.

When an ileus occurs, it stops peristalsis and prevents the passage of food particles, gas, and liquids through the digestive tract.

If people continue to eat solid food, it can lead to a backlog of food particles, which may cause full or partial obstruction of the intestines.

An ileus most commonly occurs after abdominal or pelvic surgery. According to some estimates, ileus or other bowel obstruction is the second most common cause for readmission to the hospital within the first month following surgery.

This may be because:

  • normal peristalsis is slow to return after surgery
  • medications prescribed after surgery affect intestinal movement
  • post-surgical scarring can cause a blockage

Some of the medicines that affect muscles and nerves in the digestive tract include:

  • opioid pain-relieving drugs
  • anticholinergics, which are used to treat many conditions including bladder conditions, COPD, and Parkinson’s disease
  • calcium channel blockers, which are often used to treat heart conditions

Other causes of ileus include infections and disorders of the muscles and nerves, such as Parkinson’s disease.

In children, intussusception or ‘telescoping’ often causes ileus. Intussusception is when part of the intestine slides into itself, much like the closing of a telescope.


Risk factors

Some factors that may increase the risk of ileus include:


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Symptoms

Stomach pain in person clutching stomach.
Stomach pain is a characteristic symptom of ileus

Symptoms of ileus include:

  • stomach cramps and pain
  • bloated or swollen stomach
  • nausea
  • vomiting
  • constipation, or passing small amounts of watery stool
  • loss of appetite
  • feeling full
  • inability to pass gas


Ileus versus intestinal obstruction

An ileus and an intestinal obstruction have similarities, but an ileus results from muscle or nerve problems that stop peristalsis while an obstruction is a physical blockage in the digestive tract.

However, a type of ileus known as paralytic ileus can cause a physical block due to a buildup of food in the intestines.

Other causes for obstruction include:

  • areas of fibrous tissue that form after surgery (intestinal adhesions)
  • cancer of the colon
  • diverticulitis, inflamed pouches in the digestive tract
  • a hernia
  • impacted feces
  • inflammatory bowel diseases (IBD)

Diagnosis

To diagnose an ileus, a doctor will first ask about symptoms and take a full medical history. They will ask about:

  • current or past medical conditions
  • medication use
  • surgical history

The doctor will then perform a physical examination to check for swelling or pain in the abdomen. They may use a stethoscope to listen for bowel sounds. Absent or excessive bowel noises suggest an ileus, although imaging tests are usually required to confirm a diagnosis.

Imaging tests

Imaging tests help locate an ileus by highlighting abnormalities in the intestine, such as a buildup of gas or an enlargement of the intestine. Sometimes, there may be a physical blockage. Tests used include:

  • X-ray. An abdominal X-ray may show some obstructions, but they do not always show up an ileus or other intestinal problem.
  • Computerized tomography (CT). A CT scan provides more detail than standard X-ray images. These scans are more likely to highlight an ileus because they show the intestines from different angles. Sometimes, a person swallows a special dye that creates a clearer image.
  • Ultrasound. Doctors often diagnose children with a suspected ileus using an ultrasound scan. Ultrasound scans typically show a coiled area in the intestine when intussusception is present.
  • Air or barium enema. This involves inserting air or liquid barium into the colon through the rectum and then taking X-rays of the abdomen. This procedure can resolve an ileus caused by intussusception in some children.


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Treatment

Treatment options for an ileus include waiting for the ileus to resolve, making dietary changes, or adjusting medication use. Sometimes, surgery is necessary. The treatment will depend on the severity of the ileus and its underlying cause.

Possible treatments for an ileus include:

Hospital care

Man in hospital bed with doctor talking to them.
Some people experiencing ileus may require treatment in the hospital.

Surgery-related ileus often heals within a few days of surgery, and paralytic ileus usually resolves once a person makes changes to their medication. However, individuals may require a stay in the hospital until the issue resolves fully.

Treatment at the hospital can include:

  • intravenous fluids to prevent dehydration
  • nasogastric decompression, which uses a tube to suction out materials that a person might otherwise vomit up
  • pain relief

Dietary changes

Conditions such as Crohn’s disease and diverticulitis can cause a partial intestinal block. Some bowel material can pass through the intestine, but not all of it.

A doctor may recommend that people with this issue follow a low-fiber diet to make it easier to pass stool. This involves cutting down on whole-grain foods, raw vegetables, and nuts.

Medication changes

A paralytic ileus that is caused by medication can often be treated by taking another medicine, such as metoclopramide (Reglan), to stimulate the movement of the intestines.

Another option is to discontinue use of the medication that is causing the ileus. However, only do this with a doctor’s supervision. It is not always advisable to stop antidepressants and some other medications suddenly.

Surgery

If medication or dietary changes do not resolve the ileus, or if the blockage is severe, then a person may need surgery.

Surgical procedures involve removing the blockage, or repairing or removing the damaged portion of the intestine.

Older adults or people with colon cancer may not be suitable candidates for extensive surgery. Instead, they may be fitted with a stent (tube) to keep the intestine open and allow bowel materials to pass through more easily.

In some cases, a person may need to have their entire intestine removed. In this case, the surgeon will perform an ostomy. They will create an opening in the abdomen, called a stoma, allowing stool to pass from the intestine into a pouch.

Although an ostomy requires care, a person can live a healthy life without the intestine.

Complications

An undiagnosed and untreated ileus can cause severe and potentially life-threatening complications, such as:

Necrosis

Necrosis is tissue death. Necrosis occurs when blood cannot reach the intestine. The intestinal tissue dies and becomes weakened. A weak intestinal wall is prone to tearing, which causes bowel contents to leak out.

Infection

Bowel contents are full of bacteria. When they leak into the abdominal cavity, they cause a serious infection called peritonitis. Bacterial peritonitis can lead to sepsis, a widespread infection that can be fatal.


Recovery

After surgery, intestinal function usually returns to normal within 5 days. If it persists for longer than this, it is considered a paralytic ileus.

Recovering from an ileus depends on getting the proper treatment for the underlying cause.

Outlook

Ileus is a relatively common condition that is easy to treat. It is especially prevalent in those who have undergone recent abdominal or pelvic surgery.

An awareness of the symptoms is key to improving the outlook and reducing the risk of complications. It is essential to seek prompt medical treatment as soon as symptoms appear.

Source Article from https://www.medicalnewstoday.com/articles/322149.php

Medical News Today: Parkinson’s: Could this ‘missing link’ be a cause?

Scientists have now identified a faulty cell process that may be common to different forms of Parkinson’s, and they propose a mechanism through which it might lead to the disease.
nurse supporting man with PD
Researchers shed new light on the potential cause of Parkinson’s.

This process involves a group of lipids or fatty molecules called ceramides, which are found in cell membranes and play important roles in their function and structure.

A paper that is now published in the journal Cell Metabolism describes how the team — at Baylor College of Medicine in Houston, TX — made the unexpected discovery in a fruit fly model of a faulty gene condition with Parkinson’s-like symptoms.

Previous studies have identified genes and cell defects linked to Parkinson’s disease and other brain disorders with similar symptoms. The researchers suggest that ceramides are the “missing link” than connects them.

“Numerous genes,” claims senior study author Hugo J. Bellen, a professor of molecular and human genetics and neuroscience at Baylor College of Medicine, “have been associated with Parkinson’s disease or Parkinson-like diseases; nevertheless, there is still little understanding of how these genes cause these conditions.”

Parkinson’s disease and Parkinsonism

Parkinson’s disease affects movement and will get worse over time. Its typical symptoms include tremors, muscle stiffness, and slowness. It can also have nonmotor symptoms, such as sleep disruption, depression, anxiety, and fatigue.

There are around 10 million people worldwide with Parkinson’s, with around 1 million living in the United States.

While the disease mostly strikes after the age of 50, there is a form called early onset Parkinson’s that develops in younger people.

The disease develops because of the destruction of nerve cells, or neurons, in a part of the brain that controls movement. The cells produce a chemical called dopamine that carries messages between the brain and the rest of the body that are important for controlling movement.

Parkinsonism is a general term for conditions that produce symptoms that are similar to those of Parkinson’s, particularly slowness of movement, or bradykinesia, which is the “defining feature.” Parkinson’s disease is the most common cause of Parkinsonism.

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Fruit fly model of Parkinsonism

The study began with research into the human gene PLA2GA6. Mutations of the gene are known to cause Parkinsonism and other disorders involving the loss of brain tissue.

Previous studies have shown that the gene contains instructions for making an enzyme called phospholipase. The enzyme acts on phospholipids, a group of fats known to be important components of the nervous system, but apart from this, not much is known about them.

To study the effects of PLA2GA6 in cells, the researchers used a fruit fly model of Parkinsonism that is made by silencing iPLA2-VIA, which is the fly equivalent of the human gene.

Flies that lacked the gene lived a third as long as normal flies, and their cells displayed similar features as human cells with PLA2G6 mutations.

The researchers also confirmed, in line with previous studies, that youthful mutant flies were healthy but gradually developed neurodegeneration as they aged.

Nervous system deficiencies

They also found that lack of the gene had two other effects in the flies: they took longer to recover from physical impacts, and they also showed progressive problems with visual response. Both effects suggested nervous system deficiencies.

When they examined the neurons in the eyes of the mutant flies with electron microscopes, the scientists found that their membranes contained abnormal “inclusions,” or lumps, that were not present in the normal flies.

They also found several other abnormalities, including malformed mitochondria and abnormally large lysosomes. Mitochondria are compartments inside cells that make energy for the cell. Abnormalities in mitochondria are often found in Parkinson’s disease.

Lysosomes are another type of compartment inside cells that act as recycling centers for worn-out cell materials, including membranes.

When looking at these results all together, they indicate “that the iPLA2-VIA gene is important to maintain proper membrane structure and shape,” notes Prof. Bellen.

The researchers assumed that because the iPLA2-VIA gene provides instructions for making the enzyme that acts on phospholipids, they would find problems with phospholipids in the flies without the gene. This would then explain the results.

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The role of ceramides

However, to their surprise, the researchers did not find what they expected. The phospholipids in the mutant flies behaved normally.

So, they turned their attention to other lipids, and this is when they noticed abnormally high levels of ceramides in the files that lacked the iPLA2-VIA gene.

They then gave some of the mutant flies drugs that block ceramide production. The team found that, compared with untreated mutant flies, the treated mutant flies had not only lower levels of ceramides in their cells, but they also showed reduced symptoms of neurodegeneration and several other nervous system deficiencies. Their cells also had fewer abnormalities in their lysosomes.

Further investigation revealed that the problem lay in the recovery and recycling of lipids in ceramides. Another cell component called a retromer finds and extracts the lipids before they enter lysosomes for recycling and sends them to the membranes. If the lipids are not extracted, they end up being recycled to produce more ceramide.

If the retromer does not work properly, levels of ceramides will increase, causing stiffness of the cell membranes. This sets up a vicious cycle that further disables the retromer, causing a further rise in ceramide levels. Eventually, this causes neurodegeneration.

Other links and alpha-synuclein

In another part of the study, the team confirmed that the mutant flies had lower levels of retromer proteins called VPS35 and VPS26. In normal flies, these attach to iPLA2-VIA protein and help to stabilize retromer function.

Further tests showed that improving retromer function led to reductions in the defects observed in the mutant fruit flies that lacked the iPLA2-VIA gene. “Interestingly,” Prof. Bellen notes, “mutations in the Vps35 gene also cause Parkinson’s disease.”

The researchers replicated the findings using laboratory-grown animal brain cells. They also found that high levels of a protein often found in the brain in Parkinson’s disease, called alpha-synuclein, also causes retromer dysfunction, large lysosomes, and rises in ceramide levels.

The researchers suggest that their findings reveal a new link between previously unconnected features of Parkinson’s disease.

We think that our work is important because it points to a potential mechanism leading to Parkinsonism and perhaps Parkinson’s disease.”

Prof. Hugo J. Bellen

Source Article from https://www.medicalnewstoday.com/articles/322158.php

Medical News Today: How could designer proteins thwart cancer?

Chromosomes, or DNA molecules found in cells carrying genetic material, are “bookended” by telomeres, which will prevent them from “unraveling.” Telomeres are also important in the growth and aging process of cells, but what happens when cancer “hijacks” them, and can this be prevented?
scientist looking through a microscope
Scientists have developed specialized proteins that can interfere with cancer’s growth strategy at a molecular level.

“A normal cell grows for just the right amount of time that is required for us to develop and maintain our bodies,” explains associate professor Oliver Rackham, of the University of Western Australia in Crawley.

Certain molecular mechanisms are in place in cells that “tell” them how much to grow and when it’s time to stop growing.

One such mechanism involves telomeres, which are the “caps” at the ends of chromosomes. Chromosomes carry genetic information.

Telomeres are “attached” to the single strands of DNA that are left “hanging” at the endings, or termini, of chromosomes, securing them, as it were.

“[Cells] control their growth with a molecular counting mechanism that tells the cell how old it is. This occurs on the ends of our chromosomes which have little caps on them,” Rackham says.

“Each time the cell divides,” he goes on, “a little bit at the cap of the chromosome disappears. Once the caps shrink to a certain length the cell knows that it has divided too many times and it will then stop growing or die.”

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How cancer disregulates cell growth

But problems occur when the telomeres don’t shorten incrementally, as they ought to. Throughout a person’s childhood, telomeres are naturally “longer-lived,” as the individual still needs to grow and develop.

However, if, in adulthood, the mechanism that regulates the shortening of telomeres and thus the aging process of cells is disrupted and telomeres do not shorten, the cells keep growing abnormally.

This, research has shown, is what happens in cancer. As Rackham puts it, “[C]ancer cells subvert the counting mechanism that shrinks the ends of our chromosomes so cancer cells keep replicating indefinitely.”

How does cancer “hijack” telomeres? “[B]y producing an enzyme called telomerase which we need when we are babies and growing very fast but which we stop producing when we stop rapidly growing,” explains Rackham.

Approximately 90 percent of all cancer cells contain telomerase, thus disrupting the normal cellular self-regulating mechanism, notes the researcher.

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These artificial proteins are a ‘first’

Rackham and a team of specialists from the University of Western Australia’s Harry Perkins Institute of Medical Research have been working to find an effective way to stop telomerase from facilitating the abnormal growth of cells in cancer.

This enzyme works by “lengthening” the telomeres that at the ends of chromosomes, practically “renewing” their lease of life.

As they reported in an article that is now published in the journal Nature Communications, the University of Western Australia team has developed artificial proteins that wrap around the ends of chromosomes, thus preventing telomerase to “reinforce” the telomeres.

“These proteins,” explains Rackham, “lock down the [single-stranded] DNA [which is secured by telomeres] so telomerase can’t touch it.”

“Our laboratory designed proteins that, for the first time, can actually recognise the single-stranded DNA and bind it. We can basically program these proteins to target them,” he notes.

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In doing this, the team managed to disrupt the molecular mechanism that cancer would “hijack” in order to fuel the uncontrolled, and thus harmful, growth of cells.

The researchers have expressed their excitement at their discovery, arguing that the development of proteins able to bind to single-stranded DNA could, in the future, be used in multiple areas of therapeutic interest.

“In this study we have shown that we have the ability to design proteins that recognise specific [single-stranded DNA] sequences of interest, with many potential applications in biology and biotechnology,” the authors conclude.

Source Article from https://www.medicalnewstoday.com/articles/322148.php

Medical News Today: What does it mean if you have a high C-reactive protein?

C-reactive protein is a substance that the liver makes in response to inflammation. The C-reactive protein test measures the amount of this protein in the blood. The test can help to diagnose acute and chronic conditions that cause inflammation.

A wide variety of inflammatory conditions can cause elevated C-reactive protein (CRP) levels, including the following:

Significantly high CRP levels of more than 350 milligrams per liter (mg/L) are nearly always a sign of a serious underlying medical condition. The most common cause is a severe infection, but a poorly controlled autoimmune disease or severe tissue damage can also lead to high CRP levels.

What does the CRP test involve?

CPR blood test in vial sample in front of document.
The CRP test is a type of blood test.

There is no need to fast or avoid liquids before having a CRP test. However, people having a high-sensitivity CRP (hs-CRP) test are likely to undergo other blood tests at the same time, and these may require fasting for 9–12 hours beforehand.

The hs-CRP test is different from the CRP test. The hs-CRP test detects lower levels of CRP in the bloodstream (0.5–10 mg/L), whereas the CRP test measures levels in a higher range (10–1,000 mg/L). Doctors will use the hs-CRP test to evaluate a person’s risk of developing cardiovascular disease.

Some conditions that may cause an elevated hs-CRP level include:

Obtaining the sample for the test will only take a few minutes and should be relatively painless aside from a small needle prick.


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Symptoms

The symptoms of elevated CRP levels depend entirely on the underlying condition that is causing them.

Many people who have moderate infections or injuries, or conditions that cause chronic inflammation, may experience similar symptoms. These include:

  • unexplained exhaustion
  • pain
  • muscle stiffness, soreness, and weakness
  • low-grade fever
  • chills
  • a headache
  • nausea, loss of appetite, and indigestion
  • difficulty sleeping or insomnia
  • unexplained weight loss

People with very high CRP levels are most likely to have an acute bacterial infection.

Signs of acute infection include:

  • high fever
  • rapid heart rate
  • uncontrollable sweating, chills, or shaking
  • uncontrollable or persistent vomiting, retching, or diarrhea
  • difficulty breathing
  • rash or hives
  • parched lips, mouth, and skin
  • dizziness or lightheadedness
  • a severe headache, body pain, stiffness, or soreness
  • loss of consciousness

What is the normal range?

Doctor with clipboard to patient.
The test results will indicate the risk of certain conditions.

There is currently no set standard for CRP blood levels, and guidelines vary.

However, as a general rule, the following classifications apply to CRP:

  • Levels between 3 mg/L and 10 mg/L are mildly elevated and usually result from chronic conditions such as diabetes, hypertension, or lifestyle factors including tobacco smoking and being sedentary.
  • Levels between 10 mg/L and 100 mg/L are moderately elevated and are usually due to more significant inflammation from an infectious or non-infectious cause.
  • Levels above 100 mg/L are severely elevated and almost always a sign of severe bacterial infection.

The hs-CRP test results indicate a person’s risk of developing cardiovascular disease accordingly:

  • Low risk is less than 1 mg/L.
  • Moderate risk is between 1 mg/L and 3 mg/L.
  • High risk is greater than 3 mg/L.


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Interpreting the results

CRP levels that are mildly or moderately elevated can be hard to interpret.

A huge range of conditions can raise CRP levels slightly, and, as there is no standard reference range set for CRP, there is usually no way to draw any conclusions by looking at CRP levels alone.

The following factors can also make it challenging to interpret CRP levels:

  • Medications: Medications that reduce inflammation in the body, such as some cholesterol-reducing medicines (statins) and specific nonsteroidal anti-inflammatory drugs (NSAIDs), may lower CRP levels.
  • Minor injuries or infection: These conditions may temporarily raise CRP levels and conceal other potential conditions such as diabetes or IBS.
  • Chronic conditions: Conditions that cause persistent inflammation, including autoimmune diseases, may mask other possible causes of elevated CRP such as minor infection.
  • Estrogen levels: Estrogen-based medications such as birth control pills and hormone replacement medications may raise CRP levels.
  • Pregnancy: Pregnancy can elevate CRP levels, especially during the later stages.

A doctor will usually order a CRP test alongside several other tests to get a broad overview of a person’s health. This will allow them to consider a range of medical factors.

A doctor will also often want to repeat the test to see how CRP levels change over time before they make a diagnosis.

However, regardless of any other external factors, CRP levels above 10 mg/L will typically indicate an underlying inflammatory issue.

What is the most likely cause?

Rheumatoid arthritis in hands.
Rheumatoid arthritis can cause high CRP levels.

Usually, moderately elevated CRP levels are due to RA or infectious arthritis, which occurs when a joint is infected.

Significantly elevated CRP levels tend to occur with severe infections, such as bacterial or fungal infections. Infection is responsible for around 80 percent of the cases involving CRP levels greater than 10 mg/L.

Sometimes higher levels also occur due to certain cancers and other conditions that can cause significant inflammation, such as pericarditis.


Takeaway

Doctors use CRP and hs-CRP tests to detect the levels of CRP in the body. Elevated levels of the protein may indicate an underlying condition or a higher risk of cardiovascular disease. The treatment for elevated levels will differ according to the cause.

A range of conditions can cause mildly or moderately raised CRP levels, but very high CRP levels are generally easier to interpret.

Source Article from https://www.medicalnewstoday.com/articles/322138.php