» Internal-Medicine

Cushing’s Syndrome – Could You Be Exercising and Dieting and Still Be Fat? (As Seen On House MD)

Roy — Thu, 29 Jul 2010 08:54:51 +0000

This is part of our House MD Project series.

Click here to read the connection to the episode (spoiler alert!)

Danger level: Medium

What is it?

Cushing’s syndrome is a condition in which there is too much of the hormone cortisol in the body.

Who gets it?

Cushing’s syndrome isn’t very common, and happens to about 13 out of every million people each year.

What causes it?

Cortisol is a steroid hormone produced in our body. It’s released in response to stress or when its level in the blood is low. Its function in our body is to raise blood sugar, suppress the immune system and help with the body’s metabolism.

To understand why Cushing’s syndrome happens, you first have to understand how our body releases and handles cortisol.

The brain makes a hormone called CRH, which tells a gland under the brain, called the pituitary gland, to make another hormone called ACTH. ACTH causes our adrenal glands (which sit above our kidneys) to produce cortisol.

Now what causes cushing’s syndrome?

Taking steroid medicine – These aren’t the steroids you may know that athletes take. Steroids are types of drugs used to suppress our immune system and that are given in diseases such as lupus, asthma, and rheumatoid arthritis. Taking these for a long time is the most common cause of Cushing’s syndrome.
Tumors on the pituitary gland – Like the case on the House episode. This is the second most common cause, and has a slightly different name: Cushing disease. This isn’t cancer and doesn’t spread like cancer does. What this tumor does is produce extra amounts of ACTH which cause the adrenal gland to produce more cortisol than it should.
Tumors on the adrenal gland – These can sometimes be cancer. These tumors produce extra amounts of cortisol themselves.
Tumors elsewhere – These can be lung tumors and others, that simply produce ACTH, causing the adrenal gland to produce extra cortisol.

How does it feel?

The most common symptom is weight gain, especially around the waist, and around the upper back (something called a buffalo hump). It also caused a rounding of the face called moon face.
Fatigue
Muscle weakness
Flushing of the face
Skin changes: The skin bruises easily. You get acne. You get pink or purple stretch marks (called striae) on the belly skin, thighs, breasts, and arms.
Slow healing of wounds and infections
Mood changes, such as depression, anxiety and irritability.
Thicker or more visible body and facial hair.
Irregular or absent periods in women.
Diabetes
High blood pressure
Bone loss, which can lead to fractures

And more…

This video from The National Geographic shows an excellent example and explains it:

www.youtube.com/watch?v=vxSAhLyKVqw

How is it discovered?

There are blood tests that can find out if you have Cushing’s syndrome. Once these are done, a CT scan of your adrenal and an MRI of the pituitary gland are done to find a possible tumor.

Other tests may be possible, which are beyond the scope of this article.

How is it treated?

If the condition is caused by steroid medicine, your doctor will lower your dose or stop them altogether. You should never stop taking steroids on your own, as that can be dangerous to your health.

If a tumor is causing it, it can be removed in surgery, or by other means.

What happens after treatment?

If the surgery removes the tumor completely, people may be cured, although it can sometimes return.

The bottom line – How do I avoid it?

If you take steroids, awareness of the signs of the condition can help you avoid its continuation down the road.

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Leprosy – The Biblical Disease is Still With Us (As Seen On House MD)

Roy — Sat, 10 Jul 2010 08:26:51 +0000

This is part of our House MD Project series.

Click here to read the connection to the episode (spoiler alert!)

Danger level: High

What is it?

Leprosy, also known as Hansen’s disease, is a chronic infectious disease caused by a bacteria. It affect the skin, eyes and nerves.

Who gets it?

That depends on where you’re from. Most cases of leprosy today happen in developing countries, mostly India and Brazil, although with travel it can happen anywhere.

In the US there are about 6,000 people with the disease, and about 95% of them got it abroad. About 200-300 new cases are reported each year, especially in states with large immigrant populations (such as California, New York and Florida).

Around the world about 2-3 million people are estimated to have the disease. About 86% of people with the disease live in one of 11 countries: Bangladesh, Brazil, China, Congo, Ethiopia, India, Indonesia, Nepal, Nigeria, Philippines, and Tanzania.

Leprosy around the world. Pink areas have the greatest amount of leprosy patients, followed by red, orange and yellow. In green areas the disease is rare.

There are a few risk factors – things that can put you at risk of getting infected:

Close contact – If you’re in contact with someone sick with leprosy.
Age – You’re more likely to get it if you’re older (and perhaps also if you’re between the ages 5-15).
Problems with the body’s defense systems – Most people will not develop the disease if they’re exposed to someone ill. Even if they do, they may develop a very mild form of the disease that heals by itself.
Those who do develop the disease do so because a genetic defect in their body’s normal response, which should normally fight the bacteria.

What causes it?

Leprosy is caused by a germ called Mycobacterium leprae. It is spread by sick people through droplets from their nose and mouth, much like the common cold or the flu. Unlike them, though, it is not very contagious.

Mycobacterium leprae under a microscope. The germs are the red stuff scattered all over the picture.

Usually after we get infected with a germ, it takes time for it to grow, multiply and cause a disease. That time can take a few days with a cold. With leprosy, on the other hand, that time can be very long, and takes between 6 months and 40 years (!).

The leprae germ likes cool places in the body, so its best tourism sites are our superficial nerves, skin, the linings of the inside of our upper airways, the eyes, and the testicles. There they cause damage.

How does it feel?

Since, as mentioned above, it takes the bacteria a long time to multiply, the symptoms usually don’t appear before 1 year after infection (usually 5-7 years).

Skin – The disease causes characteristic rashes to appear. They can be a few flat, whitish areas which are numb to touch, in the milder form of the disease (called tuberculoid leprosy). In the more severe form of the disease (called lepromatous leprosy) there are many small bumps or large raised rashes of many sizes and shapes. There are also more areas of numbness and even weak muscles. It can also affect other areas in the body, such as our nose, kidneys, and testicles.

There can also be swellings and lumps on the skin.

Nerves – The sense of touch deteriorates so that the person can’t feel pain and temperature changes. These people may get burns or cuts and don’t notice it. This may lead to loss of toes or fingers. The damage to the nerves can also cause muscle deformation (causing things like clawed fingers).

These are the main symptoms, although there are more.

You can see some visuals of how this affects the body here. Be warned, though, that these aren’t easy pictures to look at.

How is it discovered?

The symptoms (such as the rash) give the doctor a clue. Doing a biopsy of infected skin (which means cutting a small sample and looking at it under a microscope) confirms the suspicion.

How is it treated?

Antibiotics are the treatment for leprosy. They can’t reverse the damage, but can stop any new damage from happening.

The leprosy bacteria are hard to kill and so treatment may continue for a long time – anywhere between 6 months of treatment to many years (and even a lifelong treatment in some cases).

What happens after treatment?

That depends on the type of disease (tuberculoid vs. lepromatous) – the more severe the form of the disease, the less chance there is for a cure. After cure, the disease may (rarely) return, which will require another treatment.

The bottom line – How do I avoid it?

As we said above, leprosy isn’t very contagious. Only the lepromatous form of the disease, if untreated, is contagious (even then, not as much as other infections). Once treatment has begun, the disease is no longer contagious.

To avoid getting infected, avoid contact with bodily fluids and the rash of infected people. Sometimes the vaccine against tuberculosis may protect you against leprosy, but it’s not used very often.

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Cadmium Poisoning – A Health Hazard That Can Hide Under Your Nose (As Seen on House MD)

Roy — Fri, 02 Jul 2010 17:20:32 +0000

This is part of our House MD Project series.

Click here to read the connection to the episode (spoiler alert!)

Danger level: High

What is it?

Cadmium is a chemical element (remember your periodic table of chemical elements? its name there is Cd). It has no function in our body and is toxic, even in low amounts.

Who gets it?

Exposure to cadmium can occur in the workplace or outside of it. In the workplace it can be encountered in battery manufacturing plants, in iron and steel production, and in many other occupations.

Outside the workplace, cadmium can be found in the air, water or soil, especially in industrial areas. It may also be found in certain foods, such as kidneys and livers of adult animals and in certain seafoods, such as mussels, oysters and crabs. And lastly, it can be found in small amounts in tobacco (another reason to quit smoking).

In Japan many people have consumed rice that was grown in cadmium contaminated irrigation water, causing a toxicity they called itai-itai disease (simply translated to “ouch ouch sickness”).

Cadmium can be found in air, water or soil. In fact, on the House episode, the source was the soil in which marijuana the couple consumed grew. Photo by john.duffell

This video is from January this year, when cadmium was found in metal toys, which were eventually pulled off the shelves:

www.youtube.com/watch?v=vvcfTtg1WXY

How does it feel?

One of the symptoms of cadmium exposure is something called osteopenia, or loss of calcium from bones, making them weak and brittle. Osteopenia is a usual phenomenon when we get old. When it happens prematurely, something is wrong…

The osteopenia causes spinal pain and bone pain. The bones get deformed, affecting the way the person walks. Fractures can also happen easily.

Other symptoms include kidney failure, pulmonary problems, loss of the sense of smell, and even cancer.

How is it discovered?

The most useful test for exposure to cadmium (as seen on the House episode) is a urine check, in which cadmium levels will be high. A molecule called β₂-microglobulin will be high in the urine as well. A blood test for cadmium can also discover it.

How is it treated?

There really is no effective treatment. The person exposed to cadmium should stop the exposure before irreversible damage happens to their kidneys.

If the bones are brittle, calcium and vitamin D can be used to try and strengthen them.

The bottom line – How do I avoid it?

There are a number of steps you can take to avoid cadmium poisoning:

Quit smoking!
Identify potential sources of cadmium around your home, at work, and where your children play.
If you have a vegetable garden, use fertilizers tested for cadmium.
Properly store and dispose of cadmium-containing products (such as batteries, metals, fungicides, fertilizers, etc.).
Keep nickel-cadmium batteries out of the reach of small children and dispose of them properly.

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Naphthalene Poisoning – When Mothballs Kill More Than Just Moths (As Seen on House MD)

Roy — Wed, 30 Jun 2010 16:27:40 +0000

This is part of our House MD Project series.

Click here to read the connection to the episode (spoiler alert!)

Photo by Fox

Danger level: High

What is it?

Naphthalene is a type of chemical, best known as the primary ingredient in mothballs. Exposure to large amounts can damage or destroy red blood cells.

Who gets it?

Naphthalene poisoning occurs mostly in children who suck or chew mothballs. Naphthalene poisoning can also happen by inhalation, since mothballs change slowly into gas form.

Skin exposure to naphthalene has also been shown to cause poisoning – it happened to babies that were dressed in clothes stored with naphthalene mothballs.

About a year ago we covered here a condition called G6PD deficiency. People with this condition are more likely to be poisoned by exposure to naphthalene.

Mothballs. Photo by Billie Hara

In the House episode, there was a connection between termites and naphthalene. Researchers have found that termites use naphthalene to protect their nests. So, theoretically, exposure to termites may also lead to naphthalene poisoning.

What causes it?

We’ve covered anemia before on A Disease A Day. It’s a condition in which red blood cells – the cells used to transfer oxygen to body organs – are decreased. There are many reasons for that. The reason in naphthalene poisoning is hemolytic anemia – a condition in which the blood cells get destroyed.

The destruction of blood cells probably causes their precipitation in blood vessels, clogging them, and thus causing blood not to reach its target organs. When an organ doesn’t get enough blood (or, actually, the oxygen the blood delivers) it simply dies, or in medical terms – goes through necrosis.

That’s what happened in the House episode – the boy’s liver started dying.

How does it feel?

The poisoning has symptoms that can occur right after the poisoning and long term effects:

Right after:

Hemolytic anemia
Damage to the liver or kidney
In infants, neurological problems
The poisoning is actually “felt” – people complain of headaches, nausea, vomiting, diarrhea, weakness, confusion, anemia, yellowing of the skin, convulsions and even a coma.
Cataracts can happen in the eye. A cataract is a condition in which the lens of the eye turns yellow and opaque, limiting our ability to see.

Long term effects:

There are many, and we won’t go into detail here. They contain cataracts, lung inflammation and other effects.

How is it discovered?

The doctor can find out if you are poisoned by naphthalene by listening to your story, seeing your symptoms, and taking a blood test, which will show that you have hemolytic anemia (among other things).

How is it treated?

If you think you have been poisoned, seek medical help immediately. The medical care given in cases of a poisoning include flushing the area thoroughly, giving oxygen if needed (or ventilation if the condition is more serious). If naphthalene was ingested, a gastric lavage (“stomach pumping” or “gastric irrigation”) may be performed, in which the contents of the stomach are cleaned out.

Also milk and fatty meals should be avoided for 2-3 hours to avoid further absorption of the naphthalene.

These are just the preliminary measures. Other treatment measures are beyond the scope of this article.

What happens after treatment?

Supportive treatment is needed in case of a naphthalene poisoning. Otherwise, death can occur.

The bottom line – How do I avoid it?

Not ingesting mothballs and avoiding skin contact is an obvious recommendation.

How do you decrease your chances of inhaling it?

You can remove the mothballs and ventilate the house by opening doors and windows.
When you remove them use gloves so that you don’t come in contact with the mothballs.
If you know you have a real problem and someone in your house has symptoms, you may want to leave the house while it ventilates, and even use a fan to increase air circulation during that time.

In any case, if you have any questions, you should contact your local poison control center (in the US the number is 1-800-222-1222).

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Sleeping Sickness – A Fly Bite That Ends in A Coma (As Seen on House MD)

Roy — Fri, 07 May 2010 14:55:12 +0000

This is part of our House MD Project series.

Click here to read the connection to the episode (spoiler alert!)

Danger level: High

What is it?

Sleeping sickness (also called human African trypanosomiasis (HAT)) is a disease caused by a parasite, which causes, among other things, disturbances in the normal sleep cycle.

Who gets it?

The disease, as its name implies, is confined to Africa. From there it’s imported to other countries by travelers. Worldwide, 25,000 new cases are reported to the World Health Organization (WHO) each year.

In sub-Saharan Africa the disease threatens millions of people. In 1986, the WHO estimated that 70 million people live in areas where transmission of the disease is possible.

What causes it?

The disease is caused by a parasite called Trypanosoma brucei. The parasite infects a fly called a tsetse fly. From there there’s a cycle through which a human gets infected:

The fly bites a human, injecting the parasite into their skin. The parasite then travels to the blood stream, from where it can travel to different organs and multiply there.

How does the fly get infected, you may ask? It simply bites an infected human, and then the cycle goes on.

Apart from being bitten by a fly, humans can get infected in other ways:

When a sick mother is pregnant – The parasite can travel through the placenta and on to the fetus.
Blood transfusion – This is rare.
Sexual contact – This is how the woman on the House episode got it. We tried very hard, but couldn’t find a resource (except for Wikipedia…) that claimed this is a possible way of getting infected. So the case on House may have just been pure fiction.

Once the parasite has gotten into the body and multiplied there, its next stop is the central nervous system (the brain), where it causes damage, leading to the symptoms of the disease.

How does it feel?

Sometimes the site of the fly bite can develop into a red sore, called a chancre.

A chancre.

From the skin bitten site, the parasite travels to the lymphatic system, which is responsible for fighting infections in our body. There they multiply, causing our lymph nodes (small organs inside the body not usually seen without an infection) to grow. In this disease, this usually happens in the back of the neck, and is called Winterbottom’s sign.

Sometimes the infected person can also feel headaches, fever (like the woman in the episode had), weakness and joint pain. Other symptoms may follow as well.

The final stage, as mentioned before, is infection of the brain. At that stage the person has headaches, difficulty concentrating, personality changes, psychosis, tremor, seizures, and problems walking. The symptom that gave the disease its name is a change in the sleep cycle – causing the infected person to be sleepy throughout the day. The end of this stage is usually a coma, followed by death.

This somewhat dramatic video shows it graphically:

www.youtube.com/watch?v=4aVUrGO97Zg

How is it discovered?

The doctor takes a sample of blood, chancre, lymph node fluid or of other tissues in the body and examines it under a microscope. Under it, the parasite can be seen.

The parasite (in purple) under a microscope.

Sometimes other blood tests may help discover a response to the parasite, hinting that it exists in the body.

How is it treated?

There are specific drugs that can be given to treat the disease, and they should be given as soon as it’s discovered, to prevent further deterioration. Names of such drugs include suramin, pentamidine, eflornithine and melarsoprol.

What happens after treatment?

Treating the disease on time should cure you. It’s important to note, though, that you can get infected again.

The bottom line – How do I avoid it?

There are some things you can do if you intend to travel to danger areas in Africa and want to protect yourself:

Wear protective clothing: Including long-sleeved shirts and pants. The clothing should be thick, as tsetse flies can bite through thin fabrics. They should also be khaki or olive colored, as tsetse flies are attracted to bright and very dark colors.
Use insect repellants (although they haven’t been proven to work).
Use bed netting when sleeping.
Inspect your vehicle for flies before entering it, and don’t ride in the back of open vehicles.
Avoid bushes, as the flies use them for rest.

Related posts:

Wilson Disease – The Return (As Seen on House MD)

Roy — Sat, 01 May 2010 14:08:41 +0000

Yes, it’s that time of the week – time for another article in the House, M.D. Project. This time it’s episode 6 of season 1, named “The Socratic Method”.

The story in that episode is of Lucille Palmeiro, a woman who supposedly suffers from schizophrenia. At the beginning of the episode she gets something we’ve already discussed – a DVT – meaning deep vein thrombosis, or a blood clot that forms inside the leg veins. The blood clot than travels from her leg to her lungs, causing a pulmonary embolism. To understand what this all means, you can read our article about DVT here.

After the woman vomits blood, the team suspect a bunch of diseases, including vitamin K deficiency, but discovers a tumor in her liver, which is removed.

Finally Dr. House connects all the dots and finds out the woman has Wilson disease, which we covered here in the past – a condition in which there are high levels of copper in the body. Why does it cause her schizophrenia-like condition? You can read about it in our article about Wilson disease here.

Yes, the post today is short Our old time readers already know about DVT and Wilson’s. For those of you who didn’t have the chance yet, you can read our articles above.

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As Seen on Grey’s Anatomy – Acute Porphyria

Roy — Thu, 04 Mar 2010 07:45:30 +0000

On the last episode of Grey’s Anatomy (which, we know, was two weeks ago – sorry for the delay) Dr Bailey recalls a case in her intern year that helped her become the doctor she is today.

The patient presented in the episode had chronic pain and she’s been through many surgeries, including having her ovaries removed, but nothing worked. That led Dr Bailey (then called Mandy) to the diagnosis of porphyria.

Danger level: Medium

What is it?

Porphyria is a group of diseases resulting in the buildup in the body of materials called porphyrins and related materials, leading to abdominal pain, constipation and muscle weakness.

There are 2 types: Acute porphyria and cutaneous porphyria. We will discuss acute porphyria here.

Who gets it?

Acute porphyria is quite rare – it happens to 1-5 people out of 100,000 in the US. Outside the US it can be much higher: in Sweden, for example, it happens to 60-100 people out of 100,000.

It affects women 1.5-2 times more than it affects men. It usually happens around ages 18-40.

What causes it?

Our body produces a substance called heme. It can be found in all of our body, but mostly in red blood cells, our bone marrow and our liver.

Heme is created in our body out of materials called porphyrins. In the body, the machines that are responsible for converting materials from one type to another are called enzymes. In acute porphyria, one of these enzymes is defective, meaning that instead of converting to heme, porphyrins accumulate in the body.

The problem with the enzyme is usually genetic, meaning you inherit it from your parents.

Having the defective enzyme isn’t always enough. People with the defect might not have any symptoms, a condition which is called latent porphyria. Sometimes, though, there are triggers in the environment which call our body to produce more heme – meaning it will need extra-action from the enzyme. In this case, the symptoms may begin.

Examples of such triggers:

Certain drugs – Such as some forms of antibiotics, but even birth control pills.
Surgery
Stress
Smoking
Dieting/fasting
Infections
Alcohol use
Sun exposure
Excess iron in the body

How does it feel?

Acute porphyria mainly affects our nervous system (we mentioned above another type – cutaneous porphyria – this type affects mainly the skin).

What does a person with acute porphyria feel?

Abdominal pain
Constipation
Vomiting
Diarrhea
Pain in the arms, legs or back
Muscle pain, tingling, numbness or paralysis
Seizures
Fever
Confusion
Hallucincations
Disorientation
Paranoia
Red urine
High blood pressure

How is it discovered?

There are several ways to discover when someone has porphyria:

Urine test: In it, the high level of porphyrins in the body will be shown.
Stool test: Sometimes porphyrins can be detected in the feces better than in the blood.

How is it treated?

There are several ways to treat this condition:

Hemin or hematin: This is a form of heme that the doctor injects to your body. This way the body will have enough heme and not try to create more of it (which in this disease will lead to more porphyrins accumulating).
Stopping any triggers: Such as medications that may have led to the condition, or an infection.
Intravenous sugar (glucose) – Can also inhibit the body’s need to produce heme.
A high-carbohydrate diet – Forget Atkins. This is true only for attacks of the disease, not between them.
Pain killers

What happens after treatment?

Porphyria is a life-long disease with symptoms that come and go, more in some people, and less in others. Avoidance of triggers can help reduce the time between attacks.

The bottom line – How do I avoid it?

You can’t prevent having the disease itself (it’s genetic). But if you know you have it, taking the following steps may help avoid attacks:

Avoid medications known as triggers (consult your doctor about this)
Don’t use alcohol or illicit drugs
Avoid fasting or dieting too heavily
Don’t smoke
Minimize sun exposure. When outdoors, wear protective clothing and use sunscreen.
Treat infections promptly.
Reduce stress

Family members of people with porphyria are advised to undergo genetic testing, to discover if they have the defect themselves.

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Irritable Bowel Syndrome (IBS) – How the Intestines Can Affect Your Whole Life

Roy — Sat, 26 Dec 2009 08:53:37 +0000

Danger level: Low

What is it?

Irritable bowel syndrome (IBS) is a chronic condition of the digestive system causing pain and a change in bowel habits.

Who gets it?

It’s estimated that as much as 10-20% of the population in the US suffer from IBS.

Women are 2-3 times more likely to develop IBS than men in Western countries. In the Indian subcontinent, on the other hand, 70-80% of sufferers are men.

The condition starts before age 35 in about 50% of people.

If you have someone in your close family (parents, siblings) with IBS, you may have a higher chance of developing it yourself.

What causes it?

The reason behind IBS isn’t known yet, although there are many theories.

The symptoms of IBS (which we will discuss next) are caused by changes in our bowel habits. Our intestines move the food we eat along the gastrointestinal tract by contraction and relaxation of muscles in the intestines’ walls.

In IBS, these contractions may be stronger and longer, leading to food passing more quickly than normal in the intestines. This can cause gas, bloating and diarrhea. In other people, contractions may be weaker, causing the stools to stay longer in the intestines, making them hard and dry. This may lead to constipation.

The intestines. For some people, they just don’t work the way they’re supposed to. Photo by Curious Expeditions.

People with IBS have a sensitivity to certain triggers which other people don’t respond to. For example -

Foods: Some foods worsen the symptoms in some IBS patients. Examples of such foods include chocolate, milk and alcohol. Also carbonated beverages and some fruits and vegetables may cause discomfort.
Stress: Stressful events may aggravate the symptoms.

How does it feel?

Abdominal pain – The pain is usually crampy and located in the lower left abdomen. Sometimes, as mentioned above, stress and eating may worsen the pain. Going to the toilet may relieve the pain.

Abdominal pain is the most common symptom of IBS. Photo by Peter Gerdes.
Changes in bowel habits – This can include diarrhea, constipation, or an alternation between the two. The diarrhea usually happens during the daytime, most often in the mornings or after meals. People often feel they just have to run to the toilet, and after emptying they often feel not completely emptied. The constipation can last from days to months.
Other symptoms – These can include bloating, gas, belching, heartburn, difficulty swallowing, an early feeling of fullness with eating, and nausea.

How is it discovered?

There are no specific tests which can be done to determine if you have IBS. Instead, there are some criteria, called the Rome 3 diagnostic criteria for IBS, which may help the doctor (and you) determine if you have IBS.

The criteria say that if you have abdominal pain or discomfort that lasts for at least 3 days per month in the last 3 months which are associated with either:

- Improvement with defecation

- It started with a change in bowel frequency

- It started with a change in the appearance of stools

Then you may have IBS.

IBS isn’t a life threatening disorder, but other diseases that may be life threatening may show up with the same symptoms. This is why the doctor may perform tests to rule out other conditions before deciding you have IBS.

How is it treated?

There is really no cure for IBS, so treatment is usually a long term process. Treatment includes:

Monitoring symptoms – This helps to identify which things cause you to feel worse so that you may avoid them. It can be done with a daily diary.
Diet changes – Eliminating foods that may worsen your symptoms is part of the treatment. It shouldn’t be done without a doctor’s consultation, though. This may include lowering your daily intake of dairy products, eating less foods that may cause gas, eating foods which may be easier to digest, and increasing your dietary fiber.
Psychosocial therapy – Since stress and anxiety may worsen the disease for some people, learning to deal with them may ease the disease.
Medications – None of those cure the disease, but may help with the symptoms. Consult your doctor for info about those.

What happens after treatment?

Although IBS can cause substantial physical discomfort and emotional distress, the condition isn’t life threatening. Most people with the condition learn to control their symptoms with time.

The bottom line – How do I avoid it?

There is no known way to prevent IBS, since no one really knows what causes it. If you do have the condition, dealing with stress and eating a proper diet may help to avoid its symptoms.

This video showcases a personal story of IBS, as seen on the Discovery Channel:

Do you suffer from IBS or know someone who does? Share your story in the comments below.

Related posts:

Waldenström’s macroglobulinemia – A Rare Blood Cancer That Can Lead To Strokes

Roy — Wed, 30 Sep 2009 14:54:48 +0000

A few days ago Bob asked the following question in the health forums:

Hi Guys,
My mother, after having a mild stroke, was said to have "Hyperviscosity" of her blood.
The doctors are still not sure, but they say she has "Waeldenstrom’s Macroglobulinemia" or something like that.
Is it common? Never heard of it. BTW she’s 68 YO.
I would really like to know if there’s a cure for it.
Thanks DAD dudes!!
Bob

Read on, Bob, to find out about the disease.

Danger level: High

Health forums category: Cancer

What is it?

Waldesntrom’s macroglobulinemia (WM) is a type of cancer in the blood.

Who gets it?

The disease is quite rare – only about 1,500 cases are diagnosed in the US each year (in the UK, about 10 people out of a million get it each year).

It’s more common in white people (only about 5% of patients are of African origin).

WM is a little more common in men than in women, and it tends to happen around age 65.

What causes it?

Our blood contains many types of cells. One of these types is white blood cells. These cells belong to our immune system and are meant to fight infections.

Like there are many types of cells in the blood, there also several types of white blood cells (five types, actually). One of these types is lymphocytes. To make things even more complicated, lymphocytes themselves are divided into T cells and B cells (and that’s where the complication stops).

Lymphocytes. In WM, this cell goes bad.

WM is a disease of B cell lymphocytes. There are 2 problems these cells cause in this disease:

B cells produce molecules called antibodies. Think of them as the weapons used by these cells to kill the bad guys. There is a type of antibody called IGM, which looks something like this:

In WM B cells create too much of this antibody. The blood is then filled with these IGMs floating about. Because of their large structure, they cause the blood to become less liquid and more sticky, or viscous. The condition is then called hyperviscosity syndrome. This can lead to things such as nosebleed, dizziness, gum bleeding and blurred vision.
In WM, like in other cancers, B cells multiply uncontrollably. They start infiltrating organs in the body.

How does it feel?

Some people don’t feel anything when they have WM. When people do have symptoms, they can include:

a. Weakness

b. Fatigue

c. Bleeding from the nose or gums

d. Weight loss

e. Bruises in the skin

When the condition is more severe (meaning the blood is thicker) other things which may occur include:

a. Blurring or loss of vision

b. Neurological problems – These include headaches, dizziness, and vertigo.

c. Sometimes a stroke or coma may also ensue.

How is it discovered?

A few tests are done to discover WM:

Blood tests: They discover, among other things, the high level of IGM in the blood.
A bone marrow biopsy: A sample of bone from the back of the pelvis is taken using a needle. It is then examined under a microscope.

How is it treated?

There’s no cure for WM. If someone doesn’t have any symptoms, usually no treatment is needed. If symptoms are present, though, usually chemotherapy is used.

In cases of hyperviscosity syndrome, where high levels of IGM are present in the blood, a treatment called plasmapharesis is used. In it blood from the patient is removed and circulated through a machine that separates the plasma (which contains the IGMs) from other parts of the blood (such as red and white blood cells). The blood cells are then returned to the patient, along with a plasma substitute.

What happens after treatment?

With treatment, people may live with the disease for longer than 10 years (this is considered good, since in the past people only survived for about 5 years after the diagnosis).

The bottom line – How do I avoid It?

Unfortunately, there is no known way to prevent WM.

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All You Need To Know About Diabetes

Roy — Sat, 19 Sep 2009 14:39:29 +0000

Diabetes affects about 21 million people in the US, and much more around the world. It raises our risk for other diseases as well. Here you will learn what it is, and how to avoid it altogether.

Danger level: Medium

Health forums category: Diabetes

What is it?

Diabetes, or by its long medical name diabetes mellitus, is a condition in which there is an abnormally high level of sugar in the blood.

Sugar. You blood is rich in it when you have diabetes. Photo by Uwe Hermann.

Who gets it?

That depends. There are 2 types of diabetes:

Type 2 diabetes:
Even though it’s number 2, this is actually the most common type. 90% of people with diabetes have type 2. This is an adult disease, as opposed to type 1 diabetes, although it is seen more and more in children. There are some risk factors which can put you at risk for diabetes type 2 -

Obesity – If you have a high BMI you’re at risk
Inactivity – The less exercise you do and the more sedentary you are, the greater your chances are of getting it
Family history – If someone in your close family has it, you are more likely to get diabetes
Race – People at higher risk include African Americans, Hispanics, American Indians and Asian Americans.
Age – As you get older your risk rises.

As Western society gets more sedentary and more fat, so is the disease spreading more rapidly. That is why more and more children get diabetes type 2.

Type 1 diabetes:

This is a disease which usually starts in childhood. No one knows the reasons behind why it develops, but it possibly runs in families (meaning it’s genetic), which means that if someone in your close family has it, your chances are probably higher than the rest of the population.

What causes it?

It all starts with insulin. This is a hormone produced by our pancreas, which is an organ that sits in our abdomen. When we eat, sugars from the food we ate are broken down into a molecule called glucose. Glucose fuels our body. Glucose gets into our bloodstream and then enters the cells in our body, fueling them. It can’t enter the cells, though, unless insulin is present in the blood.

In diabetes, little or no insulin is produced by the pancreas. This causes glucose to stay in the blood and not enter the cells, causing a high level of glucose in the blood (a situation which in medicine is called hyperglycemia).

This video shows it graphically:

Why it happens differs between the two types of diabetes:

Type 2 diabetes:

There are two things happening here:

The first is called insulin resistance, and it happens early in the disease. In this stage, the pancreas produces insulin, but the body is resistant to its effects, for an unknown reason. The pancreas, in turn, produces more and more insulin, until, with time, it produces less and less of it. This is the later stage of the disease.

Type 1 diabetes

In this type, the body attacks its own pancreas. Antibodies, the molecules the body usually uses to fight infections, are used against the body itself. Diseases in which antibodies attack the body are called autoimmune diseases. We covered several of those in the past, including lupus, celiac, Crohn’s disease, vitiligo and others.

The antibodies lead to the destruction of the pancreas, which can no longer produce insulin.

How does it feel?

There’s a groups of symptoms characteristic of diabetes:

Frequent urination and Increased thirst – In diabetes glucose builds up in the blood, and the kidneys want to get rid of it. To do this, they produce more urine. This is why people with diabetes urinate more, and as a result feel more thirsty.
Extreme hunger – Since sugar doesn’t enter the cells (since there is no insulin to help it do that), the body screams that it needs fuel, causing hunger.
Unexplained weight loss – Again, since sugars don’t get into the cells and are lost in urine, there is no weight gain.
Fatigue

How is it discovered?

Diabetes is discovered by simply taking a blood sample and watching the level of glucose in it. It can be done after fasting or without fasting. In both these circumstances, the level of sugar in the blood will be excessively high.

How is it treated?

That depends on the type and extent of the diabetes:

In type 2 diabetes, drugs are given which work in several ways to increase the amount of insulin produced by the pancreas, or increase the body’s responsiveness to insulin. With time, though, the pancreas may stop producing insulin altogether, which may require the use of artificial insulin, which is injected by the patient.

In type 1 diabetes usually insulin, and not drugs, is given, since early in the disease the pancreas gets destroyed and not enough insulin exists in the body.

What happens after treatment?

Diabetes is a life-long disease. If it is discovered early and treated carefully, people can live with it a normal life.

If, on the other hand, treatment isn’t adequate, complications can develop, including:

Diabetic ketoacidosis – This is a condition that’s more common in type 1 diabetes. It’s a life-threatening condition in which the body breaks down fat since it is starved for energy. It then turns the fat into toxic acids known at ketones, which are dangerous for the body.
Blood vessel problems – Diabetes increases the risk for atherosclerosis, heart attacks and strokes.
Nerve damage – Excess sugar in the blood can damage the small arteries which supply oxygen to our nerves, especially the ones in the legs, causing them to get damaged. This can lead to anything from numbness and tingling, to a complete loss of feeling in the legs, which in turn can lead to dangerous infections. These sometimes necessitate amputation of the legs.
Other nerves which can get damaged include those in our digestive system, which can lead to nausea, vomiting, diarrhea or constipation. In men, the nerves responsible for erection can get damaged as well.
Kidney damage – This can lead to failure of our kidneys, which may necessitate dialysis or a kidney transplant.
Eye damage – The blood vessels in our retina (a part of our eye) can get damaged, leading to blindness.

The bottom line – How do I avoid it?

If you have type 2 diabetes you can help to prevent it (this unfortunately doesn’t apply to type 1 diabetes, which no one knows yet how to prevent).

You can do this by taking the following steps:

Lose weight – If you’re overweight, losing the excess pounds can lower your risk of developing diabetes. You can start by reading our article about using the Internet to lose weight.
Get more physical activity – The American Diabetes Association recommends 30 minutes a day of moderate physical activity. They say that if you combine this with a 5-10% reduction in your body fat, you lower your chances of having diabetes by 60 percent. You can read their recommendations for exercise here.
Eat healthier – This means foods that are lower in fat and calories. You should instead opt for more fruits, vegetables and whole grains. Again, you can read the American Diabetes Association’s recommendations about diet here.

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