Medical News Today: What to know about macrocephaly

Macrocephaly is the term for an unusually large head. An infant with macrocephaly will have a larger head than most other infants of the same age and sex.

In many cases, this condition is benign or harmless. In other cases, it may indicate an underlying medical condition, such as a genetic syndrome or a brain tumor.

In this article, learn about the causes of macrocephaly and how doctors diagnose and treat the potential underlying medical conditions.

What is macrocephaly?

A child with an unusually large head may have macrocephaly
A child with an unusually large head may have macrocephaly.

Macrocephaly means big head, and it is the name for a condition in which an infant or child has an abnormally large head size.

For a doctor to diagnose macrocephaly, the measurement of the head around its widest part needs to be larger than the 98th percentile.

Macrocephaly may sometimes be a sign of an underlying condition that requires treatment.

In other cases, it may occur due to genetics, including a family history of macrocephaly. If this is the case, the condition will be harmless.

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Genes are responsible for many cases of macrocephaly. When an infant with a large head has a family history of larger-than-average head sizes, doctors will diagnose them with benign familial macrocephaly.

Infants with benign familial macrocephaly will not experience any symptoms other than a large head and will have no additional health concerns.

However, there are several potential causes of macrocephaly that require medical attention, one of which is a fluid buildup on the brain. Extra fluid can put pressure on the brain, increasing the risk of many health complications.

The severity of the condition depends on the amount of fluid present. When there is a significant fluid buildup in the brain, which is called hydrocephalus, the underlying cause is likely to require treatment to prevent further problems.

Other causes of macrocephaly include:

  • bleeding in the brain
  • brain tumors
  • certain metabolic conditions
  • some types of infection
  • Alexander disease
  • Greig cephalopolysyndactyly syndrome
  • Sotos syndrome
  • chronic hematomas and other lesions
  • other genetic syndromes

Signs and symptoms

macrocephaly is often harmless
While macrocephaly is often harmless, it can lead to a buildup of fluid in the brain.

The primary sign of macrocephaly is an unusually large head. In cases of benign familial macrocephaly, this will be the only symptom.

If an infant has an underlying condition that is causing the macrocephaly, they will present with additional symptoms. These may include:

  • delays reaching developmental milestones
  • a fast-growing head
  • comorbidity with other conditions, such as autism
  • mental disorders

A doctor will typically continue to monitor the infant after the diagnosis. The doctor will also ask parents or caregivers to watch for the following signs:

  • excessive sleepiness
  • unusual eye movement
  • poor feeding
  • vomiting
  • a bulging soft spot
  • excessive irritability

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Doctors can usually diagnose macrocephaly during a routine physical examination.

As part of a physical examination for a baby or young child, the doctor will measure the head circumference. They will do this at each checkup, and any time there is a concern. If the doctor notes a rapid increase in head size over time, this can lead to a diagnosis.

If a doctor thinks that an infant has macrocephaly, they will often order imaging tests, such as a CT scan, ultrasound, or MRI.

These tests will help the doctor to determine if there is a fluid buildup in the brain, which could cause pressure and other complications.

Some symptoms of increased pressure on the brain include:

If a child with macrocephaly has additional symptoms, these may help the doctor to diagnose other health conditions. Other symptoms may include:

  • vision problems
  • bulging veins
  • a bulging soft spot on the top of the head


Speech and language therapy can help children with macrocephaly
Speech and language therapy can help children whose macrocephaly stems from a genetic condition.

The treatment for macrocephaly will vary depending on the underlying cause. An infant with benign familial macrocephaly will not usually require any treatment.

Infants whose macrocephaly stems from a genetic condition may require life-long treatment and support, including:

  • occupational therapy
  • behavioral therapy
  • speech and language therapy
  • physical therapy

An infant who has a fluid buildup or bleeding in the brain will often require prompt surgery to reduce the pressure and prevent further complications.

Doctors may use a variety of methods to treat a brain tumor, including:


The outlook largely depends on the underlying condition causing the macrocephaly. Infants with benign familial macrocephaly have a good outlook and will not usually experience any complications.

A child who has macrocephaly as a result of an underlying condition, such as a brain tumor or a genetic syndrome, will require an individualized treatment plan.

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Medical News Today: Alzheimer’s risk 10 times lower with herpes medication

New results could change the face of Alzheimer’s treatment; the herpes simplex virus is found to play a vital role in the condition, and antiherpetic medication is shown to have a dramatic effect on dementia risk.
elderly woman's hands taking medication
Alzheimer’s disease may soon be treated with antiviral medication.

Last month, Medical News Today reported on a study that found “strong evidence” that viruses are involved in Alzheimer’s disease.

The postmortem analyses of brain tissue found that people who lived with this dementia type also had more herpesviruses 6 and 7 than people without Alzheimer’s.

Now, a scientific commentary suggests that the study that MNT covered is not the only one to pinpoint a link between herpes and dementia.

In fact, three more studies have strengthened this link, and the commentary — recently published in the Journal of Alzheimer’s Disease – takes a look at all three.

Ruth Itzhaki, who is a professor of neuroscience and experimental psychology at the University of Manchester in the United Kingdom, alongside Richard Lathe, who is a professor in the Division of Infection and Pathway Medicine at the University of Edinburgh, also in the U.K., authored the commentary.

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‘Remarkable magnitude of antiviral effect’

The studies referenced in the commentary are two articles (Tsai et al., 2017, and Chen et al., 2018) that suggest that acute herpes zoster infection puts people at a higher risk of dementia, and one article that shows that aggressive treatment with antiherpetic medication drastically lowers dementia risk.

The latter study — deemed “most important” by Profs. Itzhaki and Lathe — examined 8,362 people aged 50 and above who received a diagnosis of herpes simplex virus (HSV) infection, as well as a control group of 25,086 age-matched healthy people.

The two groups were followed for almost a decade, between 2001 and 2010. In the herpes group, the risk of dementia was over 2.5 times higher than in the control group.

Significantly, the study also revealed that aggressive antiviral treatment reduced the relative risk of dementia by 10 times.

Prof. Lathe comments on these new findings, saying, “Not only is the magnitude of the antiviral effect remarkable, but also the fact that — despite the relatively brief duration and the timing of treatment — in most patients severely affected by HSV1 it appeared to prevent the long-term damage in [the] brain that results in Alzheimer’s.”

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This article and two others […] provide the first population evidence for a causal link between herpes virus infection and Alzheimer’s disease, a hugely important finding.”

Prof. Ruth Itzhaki

“I believe we are the first to realize the implications of these striking data on this devastating condition which principally affects the elderly,” Prof. Itzhaki adds.

“But,” she says, “we believe that these safe and easily available antivirals may have a strong part to play in combating the disease in these patients.” She also suggests that in the future, it may be possible to prevent the disease “by vaccination against the virus in infancy.”

“Successful treatment by a specific drug, or successful vaccination against the putative microbe, are the only ways to prove that a microbe is the cause of a non-infectious human disease,” says Prof. Itzhaki.

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Medical News Today: Is it true that ‘healthy obesity’ boosts death risk?

Metabolically healthy obesity — also known as “healthy obesity” — describes obesity not accompanied by metabolic health complications, such as diabetes, hypertension, or high cholesterol.
person standing on scales
Is ‘healthy obesity’ tied to a heightened risk of death or not?

There are many debates about how “healthy” metabolically healthy obesity actually is, and whether it renders people more vulnerable to other health problems in the long run.

As recently as last month, Medical News Today reported on a study that suggested that healthy obesity does, in fact, put certain people at a higher risk of cardiovascular disease.

But what about the risk of premature death? This is the question asked by a team of researchers from York University in Toronto, Canada, and the University of South Carolina in Columbia.

The researchers — whose efforts were guided by Jennifer Kuk, an associate professor at the School of Kinesiology and Health Science at York University — found that obesity alone, in the absence of hypertension, dyslipidemia (high cholesterol), and diabetes, is not associated with a heightened mortality risk.

These findings — which are described in a paper published in the journal Clinical Obesity — counter previous assumptions and may pose important questions about current guidelines regarding the care of people diagnosed with obesity.

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Findings ‘in contrast with most literature’

Kuk and team specifically defined “healthy obesity” as obesity that occurs in the absence of any metabolic risk factors. The researchers analyzed health-related data from 54,089 participants — both women and men — who had been involved in five different cohort studies.

They compared the mortality risk of people with obesity but without metabolic diseases with that of people with obesity accompanied by a metabolic problem, and then again with the mortality risk of healthy people, without obesity and without metabolic risk factors.

What they found was that obesity, on its own, did not increase the risk of premature death. This was in contrast with other metabolic risk factors — including diabetes, dyslipidemia, and hypertension — all of which do increase mortality independently.

“This is in contrast with most of the literature and we think this is because most studies have defined metabolic healthy obesity as having up to one metabolic risk factor,” notes Kuk.

This is clearly problematic, as hypertension alone increases your mortality risk and past literature would have called these patients with obesity and hypertension, ‘healthy.’ This is likely why most studies have reported that ‘healthy’ obesity is still related with higher mortality risk.”

Jennifer Kuk

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Benefits of weight loss ‘questionable’

Obesity is diagnosed for individuals with a BMI of 30 or above, and the researchers point out that current recommendations advise that people aim to lose weight if they hit this mark.

However, 1 out of 20 people with obesity do not have any other metabolic problems, Kuk and team found. And if this is the case, they ask, will losing weight actually bring any benefits to people with a BMI of 30 or over?

“We’re showing that individuals with metabolically healthy obesity are actually not at an elevated mortality rate,” says Kuk. “We found that a person of normal weight with no other metabolic risk factors is just as likely to die as the person with obesity and no other risk factors,” she adds.

“This means,” Kuk stresses, “that hundreds of thousands of people in North America alone with metabolically healthy obesity will be told to lose weight when it’s questionable how much benefit they’ll actually receive.”

Below, you can watch Jennifer Kuk explaining the findings of the new study, and their possible implications for existent public health guidelines.

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Medical News Today: What to know about salivary gland infections

People get salivary gland infections when bacteria or viruses get into the salivary glands, which are a group of glands in the head and neck.

Salivary gland infections most commonly develop in the two main glands, which are located in the front of the ear (the parotid gland) and under the chin (the submandibular gland).

A salivary gland infection, also called sialadenitis, can cause a blockage in the saliva ducts due to inflammation. This can lead to pain, tenderness, and swelling.

In this article, we discuss the types, causes, and treatments of salivary gland infections.

Causes of salivary gland infections

Salivary gland infection in sublingual gland
The submandibular gland is susceptible to salivary gland infections.

A salivary gland infection occurs when bacteria or viruses infect a gland that produces saliva.

People can get a salivary gland infection from having:

  • a reduced flow of saliva due to medical conditions, such as dry mouth
  • poor oral hygiene which increases the growth of bacteria, such as Staphylococcus aureus or Haemophilis influenzae
  • a blockage in their salivary glands from a tumor, abscess, or salivary gland stone
  • severe dehydration, which may be due to illness or surgery

Blockages in the salivary glands can cause inflammation, making the glands more vulnerable to infection.

Also, inflamed salivary glands tend to produce less saliva, which flows more slowly than usual. As a result of this, the saliva sometimes pools in the glands, allowing the concentration of bacteria or viruses within the saliva to increase.

Some of the more common causes of salivary gland obstructions include:

  • salivary gland stones
  • kinks in the salivary ducts
  • tumors
  • abnormally formed salivary glands

Bacteria tend to cause more salivary gland infections than viruses do. But some of the more common viruses known to cause of salivary gland infections include:

Types of salivary gland infection

People of all ages, including newborn babies, can develop salivary gland infections. They are especially common in older adults and people with chronic illnesses.

There are three pairs of major salivary glands, with one of each pair located on either side of the face. Any of these six glands can develop an infection. The major salivary glands are the:

  • Parotid glands, which are inside the cheek and extend from the top of the ear into the jaw. These are the largest salivary glands.
  • Submandibular glands, which are behind the lower jawline under the tongue and chin. These are the second largest salivary glands.
  • Sublingual glands, which are on either side of the tongue deep under the floor of the mouth. These are the smallest of the major salivary glands.

The parotid and submandibular glands tend to become infected most often.

Most salivary gland infections are acute or develop suddenly. Infections related to obstructions or narrowed tubes may develop over time.

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Salivary gland infections cause throat pain
People may experience pain and swelling in the neck area.

Most of the symptoms of salivary gland infections only last around a week, though some minor swelling may linger for a few weeks.

Acute salivary gland infections rarely cause additional complications.

The specific symptoms of a salivary gland infection may differ between people and will depend on their location and severity.

The symptoms usually affect parts of the head or neck and may cause:

  • pain
  • skin redness
  • gradual swelling around the area
  • tenderness
  • pus in the mouth
  • a terrible taste in the mouth that does not go away with good dental hygiene
  • trouble or pain opening the mouth, chewing, or swallowing
  • fever
  • chills

For many people, symptoms become worse after eating.

People with tumors that cause obstructions may develop a hard, firm, immobile lump in the affected area.

Seek emergency medical attention if the symptoms:

  • are very severe
  • interfere with eating, drinking, swallowing, or breathing
  • are very painful
  • last longer than two weeks
  • do not get any better with primary care, such as hydration and good oral hygiene


Many salivary gland infections resolve on their own without the use of medications.

The best way to treat salivary gland infections depends on the cause.

People with bacterial infections will usually need to take antibiotics.

There are no specific antiviral medications, but there are medications that can help reduce or manage symptoms of herpes, influenza, and HIV.

When blockages, such as stones or tumors, cause salivary gland infections, a doctor may recommend surgery to resolve the problem.

People may also need surgery to repair or remove kinks or narrowed tubes that affect the flow of saliva.

People with salivary gland infections triggered by underlying medical conditions will require additional specialized treatment.

If a person has an infection caused by a large abscess, a doctor may need to open and drain the abscess.

For people taking medications linked to salivary gland infections, a doctor may need to switch their medication or change the dosage.

Home remedies

Aside from medications, there is a variety of home remedies that may help the body clear salivary gland infections. People can try:

  • boosting fluid intake to treat dehydration
  • massaging the impacted area several times daily if caused by obstruction to encourage the flow of saliva
  • sucking on sugarless lozenges or sour hard candy to encourage the production of saliva
  • consuming sour foods and drinks that promote the production of saliva, such as lemonade, pickles, or sauerkraut
  • applying a warm compress to the affected area for 10 to 15 minutes several times daily
  • using mouth rinses and washes containing carboxymethylcellulose, a saliva substitute

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Ultrasound to check salivary gland infections
An ultrasound may be necessary to look at the blockage in more detail.

To diagnose salivary gland infections, a doctor will often ask a person questions about their symptoms, review their medical history, and perform a physical exam of the area.

Where a tumor or growth has caused the infection, a doctor may also take a sample to send to a lab for testing.

If there is a blockage in the salivary gland, a doctor may also order imaging tests to get a better view of the area, such as a:

  • ultrasound
  • computed tomography (CT) scan
  • magnetic resonance imaging (MRI) scan
  • salivary endoscopy (sialoendoscopy)
  • sialography, involves injecting a dye into the salivary glands that shows up on X-ray scans

Risk factors for salivary gland infections

A wide range of lifestyle factors, medications, and medical conditions can reduce the flow of saliva and trigger salivary gland infections, such as:


In many cases, there are no specific ways to prevent salivary gland infections entirely.

However, a few lifestyle tips may help reduce the risk of infections forming. These include:

  • staying hydrated and sipping on fluids throughout the day
  • brushing the teeth two times daily
  • flossing daily
  • rinsing out the mouth with water after eating or drinking sweetened or carbonated drinks or foods
  • getting a dental cleaning every six months
  • chewing on sugarless gum or suck on sugarless hard candies
  • limiting alcohol intake
  • avoiding tobacco products
  • eating foods in small bites to encourage saliva production

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Overall the outlook for salivary gland infections is excellent in most cases.

A majority of salivary gland infections clear up on their own or with the aid of medications, self-care, and at-home remedies.

People with severe or chronic salivary gland infections will need ongoing medical care, especially if the infection is related to underlying medical conditions.

Always talk with a doctor about head and neck symptoms of any kind that are severe, last for more than two weeks, do not respond to primary care or interfere with the mouth opening and closing.

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Medical News Today: How to get rid of an amoxicillin rash

Amoxicillin is an antibiotic used to treat bacterial infections. The drug comes in many different forms, including capsules, tablets, and liquid. One of the common side effects of amoxicillin is a skin rash.

Amoxicillin comes from penicillin, which is known to cause allergic reactions in some people.

An amoxicillin rash can be mild or severe, depending on how sensitive the individual is to the medication.

It can be red or purple and can spread across the body. Amoxicillin rash may also show up as hives, which are red or white bumps that develop on the skin. Or, it may appear as a maculopapular rash with areas that resemble flat, red patches.

What causes an amoxicillin rash?

amoxicillin rash. Image credit: Skoch3, (2008, February 17)
Amoxicillin may cause a rash in some people.
Image credit: Skoch3, (2008, February 17)

Doctors are not sure why some people develop an amoxicillin rash.

People who break out in hives do so usually because of an allergic reaction.

The development of amoxicillin rash without any additional symptoms may, however, indicate that the person does not have a true allergy.

Amoxicillin rash is more common in children with girls being more likely to develop one than boys.

Children with the condition known as mononucleosis, or mono, who take amoxicillin, are also more likely to develop a rash.

These days, doctors rarely prescribe amoxicillin for children with mono, as it is a viral rather than bacterial condition, and they do not consider amoxicillin to be useful.

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What does it look like?

The type of rash that develops depends on whether the person is experiencing an allergic reaction to amoxicillin or not.

A maculopapular rash will usually appear around 3 to 10 days after a person first takes the medication, although it can occur at any time. The rash will resemble small, flat, pink spots that appear in a symmetrical pattern.

The rash is not contagious and usually begins to fade after 3 days but may take up to 6 days to disappear.

People taking amoxicillin may also develop hives.

Hives appear as raised, red bumps that can come and go and change location and are usually very itchy. If hives develop after a person takes amoxicillin, it may be because of a penicillin allergy.

If someone develops hives after taking amoxicillin, it is vital that they seek medical advice, as soon as possible, as the rash can spread and become more severe.

If breathing difficulties or swelling occur alongside the rash, they should call the emergency services for immediate medical help.


Amoxicillin medication.
An amoxicillin rash may disappear after a person stops taking the medication.

A person who develops amoxicillin rash will usually find that the rash disappears when they stop taking the medication.

If there are no other symptoms besides the rash, it may be that a person does not need any additional treatment and the rash will go away on its own.

Because a rash could be a sign of an allergy, however, it is essential to stop taking the medication and consult a doctor, as soon as possible.

An allergy to amoxicillin could be dangerous, and symptoms could worsen quickly.

If a person experiences an allergic reaction to amoxicillin, they may also experience:

• hives

• itchy skin

• difficulty breathing

• swollen lips or face

Again, if a person experiences swelling or any breathing difficulties, they should call the emergency services.

If the rash is itchy then over-the-counter (OTC) allergy medication, such as Benadryl, can help alleviate symptoms. A doctor may also recommend a steroid cream to help get rid of any itchiness that continues after the rash has gone.

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Children vs. adults

The dosage of amoxicillin for adults and children varies, depending on what condition it is treating. Generally, the dosage for an adult is higher than that prescribed for a child.

People are usually given amoxicillin orally, by injection or by intravenous infusion directly into a vein.

Both adults and children can experience either type of amoxicillin rash.

Other known side effects include:

• dark urine

diarrhea or an upset stomach

• skin blistering or peeling or becoming looser

• feeling fatigued or weak

headache or dizziness

• difficulty sleeping

• seizures

• unusual bleeding or bruising

• yellowing of the eyes or skin

• difficulty passing urine or passing less urine than usual


An oatmeal bath may help to relieve the symptoms of an amoxicillin rash
An oatmeal bath may help to relieve the symptoms of an amoxicillin rash.

Treatment for amoxicillin rash depends on whether the rash is due to an allergic reaction. In mild cases with no additional symptoms, a doctor may not prescribe any treatment, and the rash may disappear a few days after a person stops taking the medication.

If a person develops hives or experiences any of the other symptoms associated with an allergic reaction, they should seek medical advice, and they may need other treatments to help stop the reaction.

Amoxicillin rash may be itchy, in which case a doctor can prescribe medication to stop the itching. This could be in the form of an ointment or topical cream, or a tablet.

Other treatments for amoxicillin rash include an oatmeal bath to relieve itchy skin and drinking plenty of water to flush out any toxins that are causing the reaction.

A person who develops amoxicillin rash should follow any instructions given to them by their doctor. If the rash disappears by itself, a doctor may recommend that the person finish their course of medication anyway.

If symptoms worsen or the rash is very itchy, a doctor will likely recommend the person stops taking amoxicillin and takes a different drug instead.

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Medical News Today: Inflammation: What can deep-diving seals teach us?

As scientists dig deeper into inflammation, its role in health and disease is coming into focus. A new study investigates the lungs of deep-diving seals and provides new insight.
Elephant seal close up
The lungs of elephant seals may help design the anti-inflammatory drugs of the future.

Although inflammation is not inherently bad — it is a way for the body to protect itself from further damage and speed up healing — when it runs off the leash, it can cause more harm than good.

With a role in seemingly unrelated diseases, such as diabetes, schizophrenia, and autoimmune conditions, the race is on for scientists to understand how they might reign in this process.

Although they are slowly unpicking the mechanisms behind inflammation, researchers still have much more work to do.

As part of this search, they are looking in unusual places. For instance, a recent study, published in the Journal of Experimental Biology, takes a long hard look at the lungs of marine mammals.

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Studying deep divers

A team of investigators based at a number of institutions across the United States decided to investigate two particular pinnipeds: the elephant and Weddell seals.

Weddell seals can dive to depths of over 600 meters, and elephant seals have been recorded descending well over 2 kilometers. At those depths, the water pressure around the seal is around 240 times greater than air pressure at sea level.

Among the array of physiological challenges that deep diving presents, the lungs take a significant battering. During a dive, to prevent the absorption of nitrogen, the seal’s lungs collapse, crushing tissues; then, on their return to the surface, blood rushes back in at incredible speeds.

In most mammals, this type of treatment of sensitive tissues causes widespread damage. However, according to the authors of this intriguing study, “There is no evidence that diving damages pulmonary function in these species.”

Led by Allyson Hindle of Harvard Medical School in Boston, MA, and Milton Levin of the University of Connecticut in Storrs, the scientists wanted to understand more about how seals deal with such extreme pulmonary events. Specifically, they wanted to understand whether a reduced inflammatory response might provide protection.

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Challenging seal lungs

To test their theory, they applied a lipopolysaccharide — a bacterial toxin — to seal blood samples; this endotoxin produces a reliable, robust immune response in vertebrates. In most animals, such an affront would cause inflammation; in the seal blood, however, there was barely any response. When the same toxin was added to human blood, the reaction was 50–500 times stronger.

Next, they added seal serum to immune cells taken from mice; the serum significantly reduced the inflammatory response to the toxin. The authors write:

These data suggest that seal serum possesses anti-inflammatory properties, which may protect deep divers from naturally occurring inflammatory challenges, such as dive-induced hypoxia-deoxygenation and lung collapse.”

Researchers hope that this line of investigation might lead to medical interventions beyond the protection of divers’ lungs. For instance, it might one day be used to extend the lifespan of transplanted organs and help treat acute lung injuries.

Much more work will be needed before we understand which components of the serum carry these miraculous anti-inflammatory powers, but the findings are exciting. In the future, once the active ingredients are identified, another piece of the inflammatory puzzle will be added.

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Medical News Today: Even minor distress puts you at risk of chronic disease

Dealing with anxiety, depression, and stress at intense levels for a long time can impact our long-term physical health. But what if we are exposed to low levels of psychological distress? Does it still jeopardize our well-being? According to a new study, the answer is “yes.”
distressed woman
‘Even low levels of distress’ harm our well-being in the long run, warn researchers.

“Although the relationship between significant distress and the onset of arthritis, [chronic pulmonary obstructive disorder], cardiovascular disease, and diabetes is well established,” says Prof. Catharine Gale, from the University of Southampton in the United Kingdom, “there is a significant gap in knowledge regarding the link between lower and moderate levels of distress and the development of chronic conditions.”

Alongside Kyle McLachlan, at the University of Edinburgh in the U.K., Prof Gale conducted a study investigating whether exposure to low and moderate psychological distress — which includes symptoms of anxiety and depression — could increase the risk of developing a chronic disease.

The results, which have now been published in the Journal of Psychosomatic Research, indicate that we do not need to experience a lot of distress in order for our physical health to be endangered. A little distress will suffice, the authors warn.

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Reducing distress may prevent disease onset

In the new study, the researchers analyzed relevant data collected from 16,485 adults for a period of 3 years. Prof. Gale and McLachlan obtain this information using the UK Household Longitudinal Study, which gathers data regarding the health status, well-being, and living conditions — among other things — of U.K. citizens.

They looked specifically for links between psychological distress and the development of four chronic diseases: diabetes, arthritis, lung disease, and cardiovascular disease.

They also investigated whether any such association could be explained by modifiable factors such as eating habits, exercise, or smoking, or by participants’ socioeconomic status.

Prof. Gale and McLachlan’s study found that, despite the fact that they are not considered clinically significant, even low to moderate levels of experienced distress can heighten the risk for a chronic condition later in life.

Our findings show that even low levels of distress, below the level usually considered clinically significant, appear to increase the risk of developing a chronic disease, so intervention to reduce symptoms of anxiety and depression may help to prevent the onset of these illnesses for some people.”

Prof. Catharine Gale

Compared with people who reported no symptoms of psychological distress, those who reported low distress levels were 57 percent more likely to develop arthritis.

Also, those experiencing moderate levels of distress were 72 percent more likely to develop this condition, and individuals reporting high distress levels were 110 percent more likely.

Similar associations were also found for cardiovascular disease and lung disease (specifically, chronic obstructive pulmonary disease [COPD]).

In fact, people with low levels of distress were 46 percent more likely to develop cardiovascular problems, those with moderate levels had a 77 percent higher risk, and those exposed to high levels of distress had a 189 percent higher risk.

For lung disease, the risk did not rise in people reporting low distress levels, but it was heightened by 125 percent in those with moderate distress levels, and by 148 percent in people with high distress levels.

However, the researchers found no significant links between psychological distress and the development of diabetes.

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‘Considerable public health implications’

The researchers note that the new study’s results could change the way in which public health policies consider risk factors for chronic diseases.

“These findings have considerable clinical and public health implications,” explains Prof Gale.

“Screening for distress,” she explains, “may help to identify those at risk of developing arthritis, COPD, and cardiovascular disease, while interventions to improve distress may help to prevent and limit progression of disease, even for people with low levels of distress.”

Distress is a potentially modifiable risk factor, so if the links found by this study are confirmed by further research, it could indicate a new pathway in terms of preventive strategies for chronic diseases.

Prof. Cyrus Cooper, the director of the Lifecourse Epidemiology Unit at the UK Medical Research Council, believes that Prof. Gale and McLachlan’s findings have “the potential to have a major impact on the development and management of chronic diseases.”

Dr. Iain Simpson, former president of the British Cardiovascular Society, states that “cardiovascular disease remains one of the major causes of death and disability,” so “[the] knowledge that distress, even at low levels, is also a risk factor is an important finding which could have significant clinical implications.”

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Medical News Today: What causes a bounding pulse?

A bounding pulse is when a person feels their heart beating harder or more vigorously than usual.

People are often worried that a bounding pulse is a sign of a heart problem. However, anxiety or panic attacks cause many cases and will resolve on their own.

People may notice their heartbeat feels stronger in their chest or when they feel for their pulse in the neck or wrist. They might also notice an irregular heartbeat or heart palpitations.

In this article, we look at the causes and symptoms of a bounding pulse. We also discuss ways that people can treat or prevent it from happening.

Causes of a bounding pulse

Bounding pulse
A person experiencing anxiety will often feel their heartbeat increase.

A range of medical conditions can cause a bounding pulse. If the symptoms do not go away on their own, people should see a doctor to find out what is causing the symptoms.

Some of the most common conditions linked to pulse rate changes include the following:

Anxiety or panic attacks

Anxiety can cause the heart to beat more strongly and more rapidly. Anxiety is a temporary state, and a person’s heartbeat will return to normal when their fear or worry go away.

In cases of extreme anxiety, people might experience a panic attack. Panic attacks usually come on quickly and reach their peak within minutes. In some cases, they can feel like a heart attack, which can add more anxiety.

According to the Anxiety and Depression Association of America (ADAA), the symptoms of a panic attack include:

  • heart palpitations, or an irregular heartbeat
  • a pounding heart
  • a rapid heartbeat
  • chest pain or discomfort
  • shortness of breath
  • fear of losing control or dying

Panic attacks are not a sign of any underlying medical condition. Nevertheless, if a person experiences severe anxiety or panic attacks, they should speak to their doctor.


Dehydration can disrupt the balance of electrolytes in the body. A person’s heart may beat more rapidly to try and correct these imbalances.

A bounding pulse linked to dehydration is more common in people doing intense exercise, experiencing heat-related exhaustion, and those with metabolic disorders that affect their ability to absorb electrolytes.


People may feel their heart beating more quickly or vigorously when they have a fever.

A person’s body heats up when it is trying to fight off an infection, which means the heart has to work harder. This also occurs when people exercise or spend too much time in hot climates.

Some people also become more sensitive to changes in their heart rate when they are sick or have a fever, so they are more likely to notice changes in their heartbeats.


Some drugs and medications can cause the heart to beat faster. Some that may cause this effect include:

  • caffeine and nicotine
  • prescription medications, including Ritalin and other ADHD treatments
  • illicit substances, including cocaine

Hormonal imbalance

Hormones are the body’s chemical messengers. Changes in hormone levels can change the heart rate.

Thyroid diseases, such as hyperthyroidism, which causes the body to produce too much thyroid hormone, are a common cause of hormone imbalances.

People who experience a pounding heart and other symptoms, such as exhaustion or unexplained weight gain or loss, may have a thyroid condition.

Allergic reactions

Mild allergic reactions should not cause changes in people’s heartbeats. However, a severe allergic reaction, such as anaphylactic shock, can produce a rapid, bounding pulse.

Anaphylaxis usually happens within a few minutes of exposure to an allergen.

People experiencing anaphylaxis may have:

  • rapid, pounding heartbeat
  • trouble breathing
  • swollen throat or tongue

Electrical faults in the heart

The heart uses electrical signals to know when to pump and when to relax.

A problem with the heart’s electrical system can cause any of the organ’s four chambers to beat at an irregular rate, or to pump too fast and too hard. This can create the sensation of a bounding pulse.

One of the most common symptoms of an electrical problem is called paroxysmal supraventricular tachycardia (SVT). It often happens during exercise or stress and does not usually mean a person has a serious health problem.

Heart disease

A racing, bounding heart rate may be a sign of heart disease.

Heart disease is more likely in people with cardiovascular risk factors, such as:

  • smoking cigarettes
  • a family history of heart disease
  • being overweight

When the arteries are clogged, the heart has to beat harder to pump blood through the body. This damages the heart and may cause chest pain. It can also cause some people to experience a faster heart rate.

Problems with the heart valves

Aortic insufficiency, sometimes called aortic regurgitation, is where the heart valves do not close properly. This means that the heart cannot pump the blood as well as it should.

Heart disease and some other health problems, such as a bacterial infection, can weaken the heart and cause problems with the heart valves.

Aortic insufficiency can cause:

  • a bounding pulse
  • chest pain
  • weakness
  • swelling
  • fatigue


Shock is a medical condition where the heart does not pump enough oxygen-rich blood around the body. This can happen when a person has one of the following:

  • too little blood in their body
  • a problem with their heart’s pumping mechanism
  • widened blood vessels

Shock can cause the heart to beat faster to compensate. People may go into shock following a severe injury, especially one that causes organ damage or heavy bleeding. A racing heart following an injury is always a medical emergency.


During an episode of bounding pulse, a person may experience the following:

  • sudden increase in pulse rate, such that the heart feels as if it is beating very fast
  • feeling like the heart is beating very hard
  • anxiety about the heart
  • heart palpitations or an irregular heart rate

Some people also experience dizziness or light-headedness. These signs are often due to anxiety.

Anxiety can increase a person’s pulse and make the bounding feeling more intense. This change in pulse can make people feel even more anxious. Finding ways to manage anxiety, such as deep breathing or meditation, may help to break this cycle.

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When to see a doctor

Bounding pulse can be cause for medical treatment
Seek medical help if chest pain is not linked to exercise and does not reduce with rest.

A bounding pulse does not necessarily mean a person has a medical condition, and it usually goes away on its own.

People who frequently experience a bounding pulse should consult a doctor, especially if the symptom is not due to anxiety.

If a person has other symptoms, it is vital to see a doctor quickly, as a bounding pulse associated with other signs may point to a further medical issue.

People should seek emergency medical help if a bounding pulse happens along with:

  • chest pain or pressure not associated with exercise and not improving after rest
  • intense jaw or shoulder pain, especially along with chest pain
  • confusion or changes in consciousness
  • a history of heart disease, stroke, or heart attack
  • starting new medication
  • exposure to a recent allergen, such as a bee sting
  • sweating profusely
  • heavy bleeding or a recent injury
  • spotting during pregnancy
  • a head injury


To find out the cause of a bounding pulse, a doctor will ask about a person’s symptoms and medical history.

The doctor may seek the following information:

  • when the changes in pulse rate began
  • whether a bounding pulse has happened before
  • what triggers the bounding pulse
  • other symptoms, such as an irregular heartbeat or ectopic beats
  • risk factors for heart issues, including family history of heart problems

A doctor may then order tests to measure the speed and regularity of a person’s heartbeat. An electrocardiogram (ECG or EKG) is one of the most common heart tests. It measures heart rhythms over time. Blood testing may also help rule out some causes, such as thyroid disease.


A person with a bounding pulse does not usually require treatment. However, people may need treatment for an underlying medical condition if that is causing their symptoms.

Treatment varies depending on the medical condition involved, but it may include medication, lifestyle changes, and ongoing medical monitoring.

A doctor may recommend regular stress tests to test how the heart responds to physical stress.

When anxiety causes changes in the pulse, people can try various ways to reduce their stress levels. These may include:

  • using deep breathing exercises when anxiety arises
  • learning ways to manage a panic attack
  • practicing meditation or mindfulness

Some people may also benefit from anti-anxiety medication and should speak to a doctor about the best options.

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Regular exercise can reduce risk of bounding pulse
Regular exercise will help to keep the heart healthy.

The best ways to prevent a bounding pulse depend on the cause.

When anxiety causes these symptoms, people can prevent pulse changes by avoiding triggers or developing stress-management techniques.

When chronic health conditions cause a bounding pulse, people should speak to their doctor about the best ways to control their symptoms.

A number of strategies can prevent heart health issues if people are concerned about these or they have a risk of cardiovascular disease.

According to the American Heart Association, people can keep their heart healthy by using the following tips:

  • maintaining a healthy body weight
  • eating a balanced, nutrient-rich diet
  • exercising regularly
  • managing chronic health conditions
  • keeping anxiety and stress under control
  • limiting foods linked to heart health issues, including sodium and red meat
  • eating heart-friendly foods, such as non-fried fish, whole grains, and fruits and vegetables


For most people, a bounding pulse is temporary and will resolve on its own. Anxiety is often the cause.

If a person frequently experiences a pounding heartbeat, they should speak with their doctor to find the causes and triggers.

Heart health issues are usually treatable, and treatment can be more effective when people catch the problems early. People should speak to a doctor about any heart rate changes that persist or cause worry.

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Medical News Today: What are the symptoms of stage 4 breast cancer?

If a person has stage 4 breast cancer, this means that the cancer cells have spread to other organs in their body, such as the lungs, lymph nodes, bones, skin, liver, or brain.

Cancer stages range from 1 to 4 and indicate the extent of the disease. A doctor may also refer to stage 4 as advanced or metastatic breast cancer.

Breast cancer is the second most common cancer in women.

In this article, learn about the symptoms of stage 4 breast cancer, as well as the treatment options.


Breast cancer pink ribbon
Stage 4 breast cancer may cause symptoms throughout the body.

A person with stage 4 breast cancer may experience some symptoms specific to the breast, as well as others that affect the whole body.

Breast-related symptoms include:

  • a lump
  • pitted skin (peau d’orange, or skin that looks like orange peel)
  • nipple changes, such as flattening, inversion, and dimpling
  • redness, swelling, and warmth

Other symptoms that may appear throughout the body include:

  • weakness or numbness
  • a consistent dry cough
  • chest pain
  • loss of appetite
  • bloating
  • constant nausea
  • severe headaches
  • jaundice
  • vision problems
  • seizures and confusion
  • loss of balance

When breast cancer cells move to other areas of the body, they remain as breast cancer cells. For example, breast cancer that has spread to the lungs is still breast cancer, not lung cancer.

In stage 4 breast cancer, cancer spreads to different parts of the body in a process called metastasis. It may cause different symptoms depending on the affected parts of the body:

Bone metastasis

When breast cancer cells move into bone, this is called bone metastasis. It is more common for breast cancer to spread to the bones than to any other body part.

The primary symptom of bone metastasis is intermittent bone pain. At times, the pain may become persistent.

Other symptoms may include:

  • Sudden or sharp pain, which may indicate a fracture.
  • Pain in the back and neck, trouble urinating, and weakness. These symptoms can indicate a compressed spinal cord.
  • Fatigue, nausea, dehydration, and loss of appetite, which may indicate high levels of calcium in the blood due to bone breaking down.

Lung metastasis

Lung metastasis does not always cause symptoms, but a doctor may discover it during a CT scan, as the cells will typically form a tumor.

If symptoms do occur, they may include:

  • shortness of breath
  • wheezing
  • discomfort or pain in the lungs
  • a persistent cough
  • coughing up blood and mucus

Although some of the symptoms may resemble those of a common cold, lung metastasis will require treatment. Therefore, it is vital that anyone with stage 4 breast cancer makes their doctor aware of any new symptoms, even if they do not seem severe.

Brain metastasis

The risk of breast cancer spreading to the brain is generally highest in those with HER2-positive or triple-negative breast cancer, which are more aggressive subtypes of this disease.

About 10–15 percent of women with stage 4 breast cancer will develop brain metastasis.

Symptoms include:

  • a headache
  • memory problems
  • vision problems
  • seizures
  • slurred speech
  • balance problems
  • dizziness
  • stroke

If a doctor suspects that the cancer has moved into the brain, they will order an MRI to confirm the diagnosis.

Liver metastasis

Stage 4 breast cancer showing lymph node and liver tumors in anatomy model.
Stage 4 breast cancer may spread to the liver or lymph nodes.

Breast cancer that spreads to the liver does not always cause symptoms.

A doctor may be able to diagnose liver metastasis with a blood test that measures specific enzymes and proteins in the blood.

If symptoms do occur, they may include:

  • fatigue and weakness
  • discomfort and pain in the upper abdomen
  • weight loss and poor appetite
  • bloating
  • fever
  • swelling in the legs
  • a yellow tint to the skin and eyes, called jaundice

In addition to a blood test, a doctor may use imaging tests, such as an MRI, CT scan, or ultrasound to help them make a diagnosis.

Lymph node metastasis

Lymph nodes are part of a network of tubes and glands that play an important role in the body’s immune system. The lymph system filters waste material and harmful substances from the body. It also helps to fight infections.

When cancer spreads, it can travel through either the bloodstream or the lymph system. If cancer starts to grow inside the lymph nodes, they may begin to feel hard or swollen.

Symptoms of lymph node metastasis can include a lump or swelling in the following areas of the body:

  • under the armpit
  • in the arm or hand
  • in the breastbone or collarbone area

If the lymph nodes are producing uncomfortable symptoms, a doctor can provide treatment.

Other symptoms

In one study, people with stage 4 breast cancer reported feeling frustrated as a result of symptoms restricting their activity. These symptoms included depression, anxiety, sleep problems, fatigue, and sadness.

It is vital to address the mental health issues that a stage 4 breast cancer diagnosis may cause.

To manage these symptoms, people can try yoga, meditation, and other stress-relieving techniques.

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Treatment for stage 4 breast cancer can include surgery, radiation, and chemotherapy.

If doctors believe that stage 4 breast cancer will be terminal, they will focus on trying to alleviate painful or uncomfortable symptoms to help a person have a better quality of life.

If a breast cancer tumor is hormone receptor-positive, the doctor may suggest using hormonal therapy.

Hormonal therapy includes the use of tamoxifen, aromatase inhibitors, and other therapies to reduce estrogen production. This is because estrogen contributes to breast cancer growth.

In some cases, a doctor may also remove a person’s ovaries to reduce the amount of estrogen in their body.

Other targeted therapy treatments identify and attack specific cancer cells. These include:

  • monoclonal antibodies
  • tyrosine kinase inhibitors
  • cyclin-dependent kinase inhibitors
  • PARP inhibitors

Treatment for bone metastasis may include bisphosphonates or denosumab to alleviate pain and reduce the risk of bone disease.

When to see a doctor

A person who suspects they may have breast cancer should see a doctor immediately.
A person who suspects that they may have breast cancer should see a doctor immediately.

If a person is experiencing any symptoms of breast cancer, they should visit a doctor immediately.

Screening is essential for catching and treating breast cancer during the early stages.

Screening involves:

  • self-examination
  • blood tests
  • imaging procedures, such as a mammogram
  • genetic testing for at-risk groups

Regular screening is especially vital if a person has certain genetic mutations or a personal or family history of cancer.

A person with stage 4 breast cancer will usually already have a team of doctors working to treat the disease and reduce symptoms. They should report any new symptoms to a doctor as soon as possible.

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The 5-year relative survival rate for stage 4 breast cancer is 22 percent, which means that 22 percent of people will live for at least 5 years after diagnosis.

However, many factors influence survival rates, including:

  • the subtype of breast cancer
  • how fast the tumor is growing
  • how likely the cancer is to come back
  • the person’s age
  • whether it is a new diagnosis or a recurring cancer
  • estrogen receptor and progesterone receptor levels in the tumor tissue
  • HER2/neu levels in the tumor tissue
  • whether or not the tumor tissue is triple negative

HER2 and triple-negative cancers are more aggressive and may have a lower survival rate.

A doctor that specializes in cancer, called an oncologist, will be able to provide a clear individual prognosis based on a person’s test results and personal medical history.

A person with stage 4 breast cancer can also seek support from family, friends, and support groups for people with a similar diagnosis.

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Medical News Today: Causes and treatment of chronic prostatitis

Chronic prostatitis is inflammation of the prostate that continues for 3 months or longer. It is often painful and can affect sexual function and the ability to urinate. Many health issues, including recurrent bacterial infections and damage to the nerves or muscles in the pelvic area, can cause it.

In this article, we look at the causes and symptoms of chronic prostatitis. We also cover diagnosis, treatment, and home and alternative remedies.

What is chronic prostatitis?

Man discussing Chronic prostatitis with male doctor in office.
Chronic prostatitis is inflammation of the prostate gland.

The prostate is a small gland that forms part of the lower urinary tract in males. It sits under the bladder and surrounds the urethra, which is the tube that carries urine and semen out through the penis.

The prostate is part of the male reproductive system and produces one of the fluids that make up semen. The muscles of this gland also help push semen into the urethra during ejaculation.

Due to its location and function, problems with the prostate can affect urination as well as sexual function.

Prostatitis is an inflammation of the prostate that can often be painful. It can be chronic or acute:

  • Chronic prostatitis develops gradually and can last for months or even years. Doctors consider prostatitis to be chronic if symptoms continue for 3 months or more. It may not respond well to the first treatments a doctor recommends.
  • Acute prostatitis is a temporary condition that occurs suddenly. It may only last a few days or weeks and often responds well to treatment.

Prostatitis is the leading cause of urinary tract issues for men under 50 years of age, and the third most common urinary tract issue for men over 50 years of age.


An accurate diagnosis is key to effective treatment. However, diagnosing the cause of chronic prostatitis can sometimes prove challenging.

The causes of chronic prostatitis fall into two broad categories:

Chronic bacterial prostatitis

A bacterial infection of the prostate causes chronic bacterial prostatitis. In some people, this infection develops following a urinary tract infection or treatment for acute bacterial prostatitis.

The symptoms of chronic bacterial prostatitis are often less severe than those of acute bacterial prostatitis. A person who has previously had an acute infection might notice that their symptoms get better, but do not go away.

Some people with chronic bacterial prostatitis may find that the infection persists. This may be because the bacteria are resistant to antibiotic treatment or the antibiotic treatment course is too short. According to one study, some bacteria that infect the prostate can form biofilms in animals. Biofilms are similar to the plaque that develops on teeth and can make the infection harder to treat.

Chronic non-bacterial pancreatitis, or chronic pelvic pain syndrome

This is a non-bacterial form of prostatitis that can have many causes and is harder to treat. Someone who has had a previous bacterial infection of the prostate may be at risk of developing this type of prostatitis. Other people may develop chronic pain in the prostate after a bacterial infection clears up.

Possible causes of chronic prostatitis include:

  • psychological stress
  • damage to the urinary tract from surgery or a physical injury

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Chronic prostatitis may cause difficulty urinating.
Chronic prostatitis may cause difficulty urinating.

The main symptom of chronic prostatitis is pelvic or genital pain. For some people, the pain feels like a gnawing ache. For others, it is intense and sharp. The pain may come and go or always be present.

Other symptoms of chronic prostatitis include:

  • needing to urinate frequently, including getting up several times at night to use the bathroom
  • pain during urination
  • difficulty urinating
  • a sense of urgency when needing to urinate
  • pain in the perineum, the space between the scrotum and rectum
  • pain in the lower back, rectum, penis, or testicles
  • pain when ejaculating
  • difficulty ejaculating
  • signs of an infection, such as fever, chills, nausea, or vomiting


People with symptoms of prostatitis should see a doctor. Bacterial prostate infections can spread, so anyone with symptoms of an infection should seek medical attention as soon as possible.

To diagnose prostatitis, a doctor will usually begin by taking the person’s medical history. They may also perform a rectal exam.

During a rectal exam, a doctor inserts a finger into the person’s rectum to check the prostate for swelling and inflammation. They may also look for signs of infection, such as discharge from the penis or swollen lymph nodes.

If a doctor suspects the problem is due to a bacterial infection, they may recommend antibiotics. If symptoms do not improve following antibiotic treatment, or there are no signs of an infection, other tests might be necessary, such as:

  • urine, semen, or blood testing to look for signs of infection or other prostate issues
  • a prostate biopsy, where a doctor uses a needle to remove a small sample of tissue from the prostate for analysis
  • an ultrasound of the prostate or urethra
  • a cystoscopy, where a doctor uses a small scope to look inside the bladder or urethra


Treatment for prostatitis depends on the cause. For bacterial prostatitis, a doctor or urologist will usually recommend oral antibiotics. People with chronic prostatitis or recurrent infections may need a long-term course of antibiotics, lasting up to 6 months.

If symptoms do not improve following oral antibiotics, other treatment options include:

  • intravenous antibiotics for severe infections
  • muscle relaxants to relieve spasm of the pelvic muscles
  • non-steroidal anti-inflammatory drugs (NSAIDs) to relieve pain
  • alpha blockers to treat urination difficulties
  • surgery to remove scar tissue in the urethra, which can help urination difficulties
  • therapy to help with psychological stress and anxiety

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Home and alternative remedies

Man cross-legged and meditating
Relaxation techniques, such as meditation, may help to relieve the symptoms of chronic prostatitis.

Kegel exercises, also known as pelvic floor exercises, can help improve urination difficulties in people with chronic prostatitis. The exercises work by strengthening the muscles around the bladder and penis.

To do these exercises, sit in a comfortable position then tighten and relax the pelvic muscles 10 to 15 times in a row. A person can locate their pelvic muscles by pretending to stop urination mid-flow.

Repeat these Kegel exercises several times a day. As a person becomes more comfortable with the exercises, they can increase the length of time they hold the muscle in, as well as the number of repetitions they do. It may take a few months before a person notices the results.

Other home and alternative remedies that may provide symptom relief for people with chronic prostatitis include:

  • acupuncture
  • biofeedback
  • taking daily sitz or hip baths in warm or hot water
  • relaxation exercises
  • using a hot water bottle or heat pad to apply heat to the perineum or rectum


Chronic prostatitis can be painful and can cause difficulties with urination. Anyone with symptoms of prostatitis should see a doctor.

Treatment depends on the cause and symptoms, but a doctor will often prescribe a course of antibiotics. Some people may also find symptom relief from trying Kegel exercises and certain home and alternative remedies.

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