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Insulin is a hormone produced by the pancreas to control blood sugar. Diabetes can be caused by too little insulin, resistance to insulin, or both. To understand diabetes, it is important to first understand the normal process by which food is broken down and used by the body for energy. Several things happen when food is digested: - A sugar called glucose enters the bloodstream. Glucose is a source of fuel for the body. - An organ called the pancreas makes insulin. The role of insulin is to move glucose from the bloodstream into muscle, fat, and liver cells, where it can be stored or used as fuel. People with diabetes have high blood sugar because their body cannot move sugar from the blood into muscle and fat cells to be burned or stored for energy, and/or because their liver makes too much glucose and releases it into the blood. This is because either: - Their pancreas does not make enough insulin - Their cells do not respond to insulin normally - Both of the above There are two major types of diabetes. The causes and risk factors are different for each type: - Type 1 diabetes can occur at any age, but it is most often diagnosed in children, teens, or young adults. In this disease, the body makes little or no insulin. This is because the pancreas cells that make insulin stop working. Daily injections of insulin are needed. The exact cause is unknown. - Type 2 diabetes is much more common. It most often occurs in adulthood, but because of high obesity rates, children and teens are now being diagnosed with this disease. Some people with type 2 diabetes do not know they have it. With type 2 diabetes, the body is resistant to insulin and doesn't use insulin as well as it should. - There are other causes of diabetes, and some people cannot be classified as type 1 or type 2. Gestational diabetes is high blood sugar that develops at any time during pregnancy in a woman who does not have diabetes. If your parent, brother, or sister has diabetes, you may be more likely to develop the disease.

Diabetes Diabetes - type 1 Diabetes - type 2 Diabetes - gestational Type 1 diabetes Type 2 diabetes Gestational diabetes Diabetes mellitus Summary Diabetes is a long-term (chronic) disease in which the body cannot regulate the amount of sugar in the blood. Causes Insulin is a hormone produced by the pancreas to control blood sugar. Diabetes can be caused by too little insulin, resistance to insulin, or both. To understand diabetes, it is important to first understand the normal process by which food is broken down and used by the body for energy. Several things happen when food is digested and absorbed: A sugar called glucose enters the bloodstream. Glucose is a source of fuel for the body. An organ called the pancreas makes insulin. The role of insulin is to move glucose from the bloodstream into muscle, fat, and other cells, where it can be stored or used as fuel. People with diabetes have high blood sugar because their body cannot move sugar from the blood into muscle and fat cells to be burned or stored for energy, and/or because their liver makes too much glucose and releases it into the blood. This is because either: Their pancreas does not make enough insulin Their cells do not respond to insulin normally Both of the above There are two major types of diabetes. The causes and risk factors are different for each type: Type 1 diabetes is less common. It can occur at any age, but it is most often diagnosed in children, teens, or young adults. In this disease, the body makes little or no insulin. This is because the pancreas cells that make insulin stop working. Daily injections of insulin are needed. The exact cause of the failure to make enough insulin is unknown. Type 2 diabetes is more common. It most often occurs in adulthood, but because of high obesity rates, children and teens are now being diagnosed with this disease. Some people with type 2 diabetes do not know they have it. With type 2 diabetes, the body is resistant to insulin and doesn't use insulin as well as it should. Not all people with type 2 diabetes are overweight or obese. There are other causes of diabetes, and some people cannot be classified as type 1 or type 2. Gestational diabetes is high blood sugar that develops at any time during pregnancy in a woman who does not have diabetes. If your parent, brother, or sister has diabetes, you may be more likely to develop the disease. Symptoms A high blood sugar level can cause several symptoms, including: Blurry vision Excess thirst Fatigue Frequent urination Hunger Weight loss Because type 2 diabetes develops slowly, some people with high blood sugar have no symptoms. Symptoms of type 1 diabetes develop over a short period. People may be very sick by the time they are diagnosed. After many years, diabetes can lead to other serious problems. These problems are known as diabetes complications, and include: Eye problems, including trouble seeing (especially at night), light sensitivity, and blindness Sores and infections of the leg or foot, which if untreated, can lead to amputation of the leg or foot Damage to nerves in the body, causing pain, tingling, a loss of feeling, problems digesting food, and erectile dysfunction Kidney problems, which can lead to kidney failure Weakened immune system, which can lead to more frequent infections Increased chance of having a heart attack or stroke Exams and Tests A urine analysis may show high blood sugar. But a urine test alone does not diagnose diabetes. Your health care provider may suspect that you have diabetes if your blood sugar level is higher than 200 mg/dL (11.1 mmol/L). To confirm the diagnosis, one or more of the following tests must be done. Blood tests: Fasting blood glucose level. Diabetes is diagnosed if the fasting glucose level is higher than 126 mg/dL (7.0 mmol/L) on two different tests. Levels between 100 and 126 mg/dL (5.5 and 7.0 mmol/L) are called impaired fasting glucose or prediabetes. These levels are risk factors for type 2 diabetes. Hemoglobin A1c (A1C) test. Normal is less than 5.7%; prediabetes is 5.7% to 6.4%; and diabetes is 6.5% or higher. Oral glucose tolerance test. Diabetes is diagnosed if the glucose level is higher than 200 mg/dL (11.1 mmol/L) 2 hours after drinking a sugar drink (this test is used more often for type 2 diabetes). Screening for type 2 diabetes in people who have no symptoms is recommended for: Overweight children who have other risk factors for diabetes, starting at age 10 and repeated every 3 years. Overweight adults (BMI of 25 or higher) who have other risk factors such as having high blood pressure, or having a mother, father, sister or brother with diabetes. Adults over age 45, repeated every 3 years. Treatment Type 2 diabetes can sometimes be reversed with lifestyle changes, especially losing weight with exercise and by eating healthier foods. Some cases of type 2 diabetes can also be improved with weight loss surgery. There is no cure for type 1 diabetes (except for a pancreas or islet cell transplant). Treating either type 1 diabetes or type 2 diabetes involves nutrition, activity and medicines to control blood sugar level. Everyone with diabetes should receive proper education and support about the best ways to manage their diabetes. Ask your provider about seeing a certified diabetes educator (CDE). Getting better control over your blood sugar, cholesterol, and blood pressure levels helps reduce the risk for kidney disease, eye disease, nervous system disease, heart attack, and stroke. To prevent diabetes complications, visit your provider at least 2 to 4 times a year. Talk about any problems you are having. Follow your provider's instructions on managing your diabetes. Support Groups Many resources can help you understand more about diabetes. If you have diabetes, you can also learn ways to manage your condition and prevent diabetes complications. Outlook (Prognosis) Diabetes is a lifelong disease for most people who have it. Tight control of blood glucose can prevent or delay diabetes complications. But these problems can occur, even in people with good diabetes control. Possible Complications After many years, diabetes can lead to serious health problems: You could have eye problems, including trouble seeing (especially at night), and light sensitivity. You could become blind. Your feet and skin can develop sores and infections. After a long time, your foot or leg may need to be amputated. Infection can also cause pain and itching in other parts of the body. Diabetes may make it harder to control your blood pressure and cholesterol. This can lead to a heart attack, stroke, and other problems. It can become harder for blood to flow to your legs and feet. Nerves in your body can get damaged, causing pain, tingling, and numbness. Because of nerve damage, you could have problems digesting the food you eat. You could feel weakness or have trouble going to the bathroom. Nerve damage can make it harder for men to have an erection. High blood sugar and other problems can lead to kidney damage. Your kidneys may not work as well as they used to. They may even stop working so that you need dialysis or a kidney transplant. Your immune system can weaken, which can lead to frequent infections. Prevention Keeping an ideal body weight and an active lifestyle may prevent or delay the start of type 2 diabetes. If you're overweight, losing just 5% of your body weight can reduce your risk. Some medicines can also be used to delay or prevent the start of type 2 diabetes. At this time, type 1 diabetes cannot be prevented. But there is promising research that shows type 1 diabetes may be delayed in some high risk people. Review Date 2/22/2018 Updated by: Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology & Nutrition, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how do people get diabetes

how do people get diabetes

Treatment of burns depends on the type and extent of the injuries. Most minor burns can be treated at home using over-the-counter products or aloe. They usually heal within a few weeks. For serious burns, after appropriate first aid care and wound assessment, your treatment may involve medications, wound dressings, therapy and surgery. The goals of treatment are to control pain, remove dead tissue, prevent infection, reduce scarring, regain function and address emotional needs. You may need months of additional treatments and therapy.

Burns Overview Burns can be minor medical problems or life-threatening emergencies. Many people die each year from fire-related burn injuries. Electricity and chemicals also cause severe burns. Scalding liquids are the most common cause of burns in children. Treatment of burns depends on the location and severity of the injury. Sunburns and small scalds can usually be treated at home. Deep or widespread burns need immediate medical attention. People with severe burns often require treatment at specialized burn centers. They may need skin grafts to cover large wounds or to minimize scarring with deep wounds. And they may need emotional support and months of follow-up care, such as physical therapy. Symptoms Burns don't affect the skin uniformly, so a single injury can reach varying depths. Distinguishing a minor burn from a more serious burn involves determining the extent of tissue damage. The following are three classifications of burns: - First-degree burn. This minor burn affects only the outer layer of the skin (epidermis). It may cause redness, swelling and pain. It usually heals with first-aid measures within several days to a week. Sunburn is a classic example. - Second-degree burn. This type of burn affects both the epidermis and the second layer of skin (dermis). It may cause red, white or splotchy skin, pain, and swelling. And the wound often looks wet or moist. Blisters may develop, and pain can be severe. Deep second-degree burns can cause scarring. - Third-degree burn. This burn reaches into the fat layer beneath the skin. Burned areas may be charred black or white. The skin may look waxy or leathery. Third-degree burns can destroy nerves, causing numbness. A person with this type of burn may also have difficulty breathing or experience smoke inhalation or carbon monoxide poisoning. When to see a doctor Seek emergency medical assistance for: - Burns that cover the hands, feet, face, groin, buttocks, a major joint or a large area of the body - Deep burns, which means burns affecting all layers of the skin and even other tissues - Burns caused by chemicals or electricity - Difficulty breathing or burns to the airway Minor burns can be cared for at home, but call your doctor if you experience: - Large blisters - Signs of infection, such as oozing from the wound, increased pain, redness and swelling - A burn or blister that doesn't heal in several weeks - New, unexplained symptoms - Significant scarring Causes Many things can cause burns, including: - Fire - Hot liquid or steam - Hot metal, glass or other objects - Electrical currents - Radiation from X-rays or radiation therapy to treat cancer - Sunlight or ultraviolet light from a sunlamp or tanning bed - Chemicals such as strong acids, lye, paint thinner or gasoline - Abuse Complications Deep or widespread burns can lead to many complications, including: - Infection. Burns can leave skin vulnerable to bacterial infection and increase your risk of sepsis. Sepsis is a life-threatening infection that travels through the bloodstream and affects your whole body. It progresses rapidly and can cause shock and organ failure. - Low blood volume. Burns can damage blood vessels and cause fluid loss. This may result in low blood volume (hypovolemia). Severe blood and fluid loss prevents the heart from pumping enough blood to the body. - Dangerously low body temperature. The skin helps control the body's temperature, so when a large portion of the skin is injured, you lose body heat. This increases your risk of a dangerously low body temperature (hypothermia). Hypothermia is a condition in which the body loses heat faster than it can produce heat. - Breathing problems. Breathing hot air or smoke can burn airways and cause breathing (respiratory) difficulties. Smoke inhalation damages the lungs and can cause respiratory failure. - Scarring. Burns can cause scars and ridged areas caused by an overgrowth of scar tissue (keloids). - Bone and joint problems. Deep burns can limit movement of the bones and joints. Scar tissue can form and cause shortening and tightening of skin, muscles or tendons (contractures). This condition may permanently pull joints out of position. Diagnosis During the physical exam, your doctor will examine your burned skin and determine what percentage of your total body surface area is involved. In general, an area of skin roughly equal to the size of your palm equals 1 percent of your total body surface area. For people ages 10 to 40, the American Burn Association defines a severe burn as one that involves 25 percent total body surface area or any burn involving the eyes, ears, face, hands, feet or groin. You'll also be examined for other injuries and to determine whether the burn has affected the rest of your body. You may need lab tests, X-rays or other diagnostic procedures. Treatment Treatment of burns depends on the type and extent of the injuries. Most minor burns can be treated at home using over-the-counter products or aloe. They usually heal within a few weeks. For serious burns, after appropriate first aid care and wound assessment, your treatment may involve medications, wound dressings, therapy and surgery. The goals of treatment are to control pain, remove dead tissue, prevent infection, reduce scarring, regain function and address emotional needs. You may need months of additional treatments and therapy. This may be done during a hospital stay, on an outpatient basis or at home. Factors affecting this choice include your wishes, other conditions and abilities, such as whether you're able to change bandages. Medications and wound healing products For major burns, various medications and products are used to encourage healing. - Water-based treatments. Your care team may use techniques such as ultrasound mist therapy to clean and stimulate the wound tissue. - Fluids to prevent dehydration. You may need intravenous (IV) fluids to prevent dehydration and organ failure. - Pain and anxiety medications. Healing burns can be incredibly painful. You may need morphine and anti-anxiety medications - particularly for dressing changes. - Burn creams and ointments. Your care team can select from a variety of topical products for wound healing. These help keep the wound moist, reduce pain, prevent infection and speed healing. - Dressings. Your care team may also use various specialty wound dressings. These create a moist environment that fights infection and helps the burn heal. - Drugs that fight infection. If you develop an infection, you may need IV antibiotics. - Tetanus shot. Your doctor might recommend a tetanus shot after a burn injury. Physical and occupational therapy If the burned area is large, especially if it covers any joints, you may need physical therapy exercises. These can help stretch the skin so the joints can remain flexible. Other types of exercises can improve muscle strength and coordination. And occupational therapy may help if you have difficulty doing your normal daily activities. Surgical and other procedures You may need one or more of the following procedures: - Breathing assistance. If you've been burned on the face or neck, your throat may swell shut. If that appears likely, your doctor may insert a tube down your windpipe (trachea) to keep oxygen supplied to your lungs. - Tube feeding. Your metabolism goes into overdrive when your body starts trying to heal your burns. To provide adequate nutrition for this task, you doctor may thread a feeding tube through your nose to your stomach. - Easing blood flow around the wound. If a burn scab (eschar) goes completely around a limb, it can tighten and cut off the blood circulation. A scab (eschar) that goes completely around the chest can make it difficult to breathe. Your doctor may cut the eschar in several places to relieve this pressure. This procedure is called decompression. - Skin grafts. A skin graft is a surgical procedure in which sections of your own healthy skin are used to replace the scar tissue caused by deep burns. Donor skin from cadavers or pigs can be used as a temporary solution. - Plastic surgery. Plastic surgery (reconstruction) can improve the appearance of burn scars and increase the flexibility of joints affected by scarring. Lifestyle and home remedies To treat minor burns, follow these steps: - Cool the burn. Run cool (not cold) tap water over the burn for 10 to 15 minutes or until the pain eases. Or apply a clean towel dampened with cool tap water. Don't use ice. Putting ice directly on a burn can cause further damage to the tissue. - Remove rings or other tight items from the burned area. Try to do this quickly and gently, before the area swells. - Don't break small blisters (no bigger than your little fingernail). If blisters break, gently clean the area with mild soap and water, apply an antibiotic ointment, and cover it with a nonstick gauze bandage. - Apply moisturizer or aloe vera lotion or gel. This may soothe the area and prevent dryness as the wound heals. - If needed, take an over-the-counter pain reliever. Nonprescription products include ibuprofen (Advil, Motrin IB, others), naproxen (Aleve) and acetaminophen (Tylenol, others). - Consider a tetanus shot. Make sure that your tetanus booster is up to date. Doctors recommend people get a tetanus shot at least every 10 years. Whether your burn was minor or serious, use sunscreen and moisturizer regularly once the wound is healed. how do we treat the burns caused by radiation?

how do we treat the burns caused by radiation?

REPORT EXPOSURE TO EMERGENCY OFFICIALS. If symptoms occur during or after medical radiation treatments: - Tell the provider or seek medical treatment. - Handle affected areas gently. - Treat symptoms or illnesses as recommended by the provider.

Radiation sickness Radiation poisoning Radiation injury Rad poisoning Summary Radiation sickness is illness and symptoms resulting from excessive exposure to ionizing radiation. There are two main types of radiation: nonionizing and ionizing. Nonionizing radiation comes in the form of light, radio waves, microwaves and radar. These forms usually don't cause tissue damage. Ionizing radiation causes immediate effects on human tissue. X-rays, gamma rays, and particle bombardment (neutron beam, electron beam, protons, mesons, and others) give off ionizing radiation. This type of radiation is used for medical testing and treatment. It is also used in industrial and manufacturing purposes, weapons and weapons development, and more. Considerations Radiation sickness results when humans (or other animals) are exposed to very large doses of ionizing radiation. Radiation exposure can occur as a single large exposure (acute). Or it can occur as a series of small exposures spread over time (chronic). Exposure may be accidental or intentional (as in radiation therapy). Radiation sickness is generally associated with acute exposure and has a characteristic set of symptoms that appear in an orderly fashion. Chronic exposure is usually associated with delayed medical problems such as cancer and premature aging, which may happen over a long period of time. The risk of cancer depends on the dose and begins to build up, even with very low doses. There is no "minimum threshold." Exposure from x-rays or gamma rays is measured in units of roentgens. For example: Total body exposure of 100 roentgens/rad or 1 Gray unit (Gy) causes radiation sickness. Total body exposure of 400 roentgens/rad (or 4 Gy) causes radiation sickness and death in half of the individuals who are exposed. Without medical treatment, nearly everyone who receives more than this amount of radiation will die within 30 days. 100,000 roentgens/rad (1,000 Gy) causes almost immediate unconsciousness and death within an hour. The severity of symptoms and illness (acute radiation sickness) depends on the type and amount of radiation, how long you were exposed, and which part of the body was exposed. Symptoms of radiation sickness may occur right after exposure, or over the next few days, weeks, or months. Bone marrow and the gastrointestinal tract are especially sensitive to radiation injury. Children and babies still in the womb are more likely to be severely injured by radiation. Because it is difficult to determine the amount of radiation exposure from nuclear accidents, the best signs of the severity of the exposure are: the length of time between the exposure and the onset of symptoms, the severity of symptoms, and severity of changes in white blood cells. If a person vomits less than an hour after being exposed, that usually means the radiation dose received is very high and death may be expected. Children who receive radiation treatments or who are accidentally exposed to radiation will be treated based on their symptoms and their blood cell counts. Frequent blood studies are necessary and require a small puncture through the skin into a vein to obtain blood samples. Causes Causes include: Accidental exposure to high doses of radiation, such as radiation from a nuclear power plant accident. Exposure to excessive radiation for medical treatments. Symptoms Symptoms of radiation sickness may include: Weakness, fatigue, fainting, confusion Bleeding from the nose, mouth, gums, and rectum Bruising, skin burns, open sores on the skin, sloughing of skin Dehydration Diarrhea, bloody stool Fever Hair loss Inflammation of exposed areas (redness, tenderness, swelling, bleeding) Nausea and vomiting, including vomiting of blood Ulcers (sores) in the mouth, esophagus (food pipe), stomach or intestines Your health care provider will advise you how best to treat these symptoms. Medicines may be prescribed to help reduce nausea, vomiting, and pain. Blood transfusions may be given for anemia (low counts of healthy red blood cells). Antibiotics are used to prevent or fight infections. First Aid Giving first aid to radiation victims may expose rescue personnel to radiation unless they are properly protected. Victims must be decontaminated so that they do not cause radiation injury to others. Check the person's breathing and pulse. Start CPR, if necessary. Remove the person's clothing and place the items in a sealed container. This stops ongoing contamination. Vigorously wash the victim with soap and water. Dry the victim and wrap with a soft, clean blanket. Call for emergency medical help or take the person to nearest emergency medical facility if you can do so safely. Report the exposure to emergency officials. If symptoms occur during or after medical radiation treatments: Tell the provider or seek medical treatment right away. Handle affected areas gently. Treat symptoms or illnesses as recommended by the provider. DO NOT DO NOT remain in the area where exposure occurred. DO NOT apply ointments to burned areas. DO NOT remain in contaminated clothing. DO NOT hesitate to seek emergency medical treatment. Prevention Preventive measures include: Avoid unnecessary exposure to radiation, including unnecessary CT scans and x-rays. People working in radiation hazard areas should wear badges to measure their exposure level. Protective shields should always be placed over the parts of the body not being treated or studied during x-ray imaging tests or radiation therapy. Review Date 7/2/2017 Updated by: Jesse Borke, MD, FACEP, FAAEM, Attending Physician at FDR Medical Services/Millard Fillmore Suburban Hospital, Buffalo, NY. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how do we treat the burns caused by radiation?

how do we treat the burns caused by radiation?

DO NOT apply ointments to burned areas. DO NOT hesitate to seek emergency medical treatment.

Radiation sickness Radiation poisoning Radiation injury Rad poisoning Summary Radiation sickness is illness and symptoms resulting from excessive exposure to ionizing radiation. There are two main types of radiation: nonionizing and ionizing. Nonionizing radiation comes in the form of light, radio waves, microwaves and radar. These forms usually don't cause tissue damage. Ionizing radiation causes immediate effects on human tissue. X-rays, gamma rays, and particle bombardment (neutron beam, electron beam, protons, mesons, and others) give off ionizing radiation. This type of radiation is used for medical testing and treatment. It is also used in industrial and manufacturing purposes, weapons and weapons development, and more. Considerations Radiation sickness results when humans (or other animals) are exposed to very large doses of ionizing radiation. Radiation exposure can occur as a single large exposure (acute). Or it can occur as a series of small exposures spread over time (chronic). Exposure may be accidental or intentional (as in radiation therapy). Radiation sickness is generally associated with acute exposure and has a characteristic set of symptoms that appear in an orderly fashion. Chronic exposure is usually associated with delayed medical problems such as cancer and premature aging, which may happen over a long period of time. The risk of cancer depends on the dose and begins to build up, even with very low doses. There is no "minimum threshold." Exposure from x-rays or gamma rays is measured in units of roentgens. For example: Total body exposure of 100 roentgens/rad or 1 Gray unit (Gy) causes radiation sickness. Total body exposure of 400 roentgens/rad (or 4 Gy) causes radiation sickness and death in half of the individuals who are exposed. Without medical treatment, nearly everyone who receives more than this amount of radiation will die within 30 days. 100,000 roentgens/rad (1,000 Gy) causes almost immediate unconsciousness and death within an hour. The severity of symptoms and illness (acute radiation sickness) depends on the type and amount of radiation, how long you were exposed, and which part of the body was exposed. Symptoms of radiation sickness may occur right after exposure, or over the next few days, weeks, or months. Bone marrow and the gastrointestinal tract are especially sensitive to radiation injury. Children and babies still in the womb are more likely to be severely injured by radiation. Because it is difficult to determine the amount of radiation exposure from nuclear accidents, the best signs of the severity of the exposure are: the length of time between the exposure and the onset of symptoms, the severity of symptoms, and severity of changes in white blood cells. If a person vomits less than an hour after being exposed, that usually means the radiation dose received is very high and death may be expected. Children who receive radiation treatments or who are accidentally exposed to radiation will be treated based on their symptoms and their blood cell counts. Frequent blood studies are necessary and require a small puncture through the skin into a vein to obtain blood samples. Causes Causes include: Accidental exposure to high doses of radiation, such as radiation from a nuclear power plant accident. Exposure to excessive radiation for medical treatments. Symptoms Symptoms of radiation sickness may include: Weakness, fatigue, fainting, confusion Bleeding from the nose, mouth, gums, and rectum Bruising, skin burns, open sores on the skin, sloughing of skin Dehydration Diarrhea, bloody stool Fever Hair loss Inflammation of exposed areas (redness, tenderness, swelling, bleeding) Nausea and vomiting, including vomiting of blood Ulcers (sores) in the mouth, esophagus (food pipe), stomach or intestines Your health care provider will advise you how best to treat these symptoms. Medicines may be prescribed to help reduce nausea, vomiting, and pain. Blood transfusions may be given for anemia (low counts of healthy red blood cells). Antibiotics are used to prevent or fight infections. First Aid Giving first aid to radiation victims may expose rescue personnel to radiation unless they are properly protected. Victims must be decontaminated so that they do not cause radiation injury to others. Check the person's breathing and pulse. Start CPR, if necessary. Remove the person's clothing and place the items in a sealed container. This stops ongoing contamination. Vigorously wash the victim with soap and water. Dry the victim and wrap with a soft, clean blanket. Call for emergency medical help or take the person to nearest emergency medical facility if you can do so safely. Report the exposure to emergency officials. If symptoms occur during or after medical radiation treatments: Tell the provider or seek medical treatment right away. Handle affected areas gently. Treat symptoms or illnesses as recommended by the provider. DO NOT DO NOT remain in the area where exposure occurred. DO NOT apply ointments to burned areas. DO NOT remain in contaminated clothing. DO NOT hesitate to seek emergency medical treatment. Prevention Preventive measures include: Avoid unnecessary exposure to radiation, including unnecessary CT scans and x-rays. People working in radiation hazard areas should wear badges to measure their exposure level. Protective shields should always be placed over the parts of the body not being treated or studied during x-ray imaging tests or radiation therapy. Review Date 7/2/2017 Updated by: Jesse Borke, MD, FACEP, FAAEM, Attending Physician at FDR Medical Services/Millard Fillmore Suburban Hospital, Buffalo, NY. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how do we treat the burns caused by radiation?

how do we treat the burns caused by radiation?

Lanreotide comes as a long-acting solution (liquid) to be injected subcutaneously (under the skin) into the upper outer area of your buttock by a doctor or nurse. Lanreotide long-acting injection is usually injected once every 4 weeks. Ask your doctor or pharmacist to explain any part you do not understand.

Lanreotide Injection Why is this medication prescribed? Lanreotide injection is used to treat people with acromegaly (condition in which the body produces too much growth hormone, causing enlargement of the hands, feet, and facial features; joint pain; and other symptoms) who have not successfully, or cannot be treated with surgery or radiation. Lanreotide injection is also used to treat people with neuroendocrine tumors in the gastrointestinal (GI) tract or the pancreas (GEP-NETs) that have spread or cannot be removed by surgery. Lanreotide injection is in a class of medications called somatostatin agonists. It works by decreasing the amounts of certain natural substances produced by the body. How should this medicine be used? Lanreotide comes as a long-acting solution (liquid) to be injected subcutaneously (under the skin) into the upper outer area of your buttock by a doctor or nurse. Lanreotide long-acting injection is usually injected once every 4 weeks. Ask your doctor or pharmacist to explain any part you do not understand. Your doctor will probably adjust your dose or the length of time between doses depending on your lab results. Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient. Other uses for this medicine This medication may be prescribed for other uses; ask your doctor or pharmacist for more information. What special precautions should I follow? <h3>Before receiving lanreotide injection,</h3> /h3> tell your doctor and pharmacist if you are allergic to lanreotide injection, any other medications, or any of the ingredients in lanreotide injection. Ask your pharmacist for a list of the ingredients. tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: beta blockers such as atenolol (Tenormin, in Tenoretic), labetalol (Trandate), metoprolol (Lopressor, Toprol XL, in Dutoprol), nadolol (Corgard, in Corzide), and propranolol (Hemangeol, Inderal, InnoPran); bromocriptine (Cycloset, Parlodel); cyclosporine (Gengraf, Neoral, Sandimmune); insulin and oral medications for diabetes; quinidine (in Nuedexta), or terfenadine (no longer available in the U.S.). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. tell your doctor if you have or have ever had diabetes, or gallbladder, heart, kidney, thyroid, or liver disease. tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while receiving lanreotide injection, call your doctor. you should know that lanreotide injection may make you drowsy or dizzy. Do not drive a car or operate machinery until you know how this medication affects you. What special dietary instructions should I follow? Unless your doctor tells you otherwise, continue your normal diet. What side effects can this medication cause? This medication may cause changes in your blood sugar. You should know the symptoms of high and low blood sugar and what to do if you have these symptoms. <h3>Lanreotide injection may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: </h3> /h3> diarrhea loose stools constipation gas vomiting weight loss headache redness, pain, itching, or a lump at the injection site depression <h3>Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately or get emergency medical treatment: </h3> /h3> pain in the upper right part of the stomach, center of the stomach, back, or shoulder muscle pain or discomfort yellowing of the skin and eyes fever with chills nausea swelling of the face, throat, tongue, lips, or eyes tightness in the throat difficulty breathing and swallowing wheezing hoarseness rash itching hives shortness of breath slowed or irregular heartbeat Lanreotide injection may cause other side effects. Call your doctor if you have any unusual problems while receiving this medication. If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088). What should I know about storage and disposal of this medication? If you are storing the prefilled syringes in your home until it is time for it to be injected by your doctor or nurse, you should always store it in original carton in the refrigerator and protect it from light. Throw away any medication that is outdated or no longer needed. Talk to your healthcare provider about the proper disposal of your medication. In case of emergency/overdose In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911. What other information should I know? Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your body's response to lanreotide injection. Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies. Brand names Somatuline Depot how do you administer lanreotide

how do you administer lanreotide

Lanreotide comes as a long-acting solution (liquid) to be injected subcutaneously (under the skin) into the upper outer area of your buttock by a doctor or nurse. Lanreotide long-acting injection is usually injected once every 4 weeks. Ask your doctor or pharmacist to explain any part you do not understand. Your doctor will probably adjust your dose or the length of time between doses depending on your lab results.

Lanreotide Injection Why is this medication prescribed? Lanreotide injection is used to treat people with acromegaly (condition in which the body produces too much growth hormone, causing enlargement of the hands, feet, and facial features; joint pain; and other symptoms) who have not successfully, or cannot be treated with surgery or radiation. Lanreotide injection is also used to treat people with neuroendocrine tumors in the gastrointestinal (GI) tract or the pancreas (GEP-NETs) that have spread or cannot be removed by surgery. Lanreotide injection is in a class of medications called somatostatin agonists. It works by decreasing the amounts of certain natural substances produced by the body. How should this medicine be used? Lanreotide comes as a long-acting solution (liquid) to be injected subcutaneously (under the skin) into the upper outer area of your buttock by a doctor or nurse. Lanreotide long-acting injection is usually injected once every 4 weeks. Ask your doctor or pharmacist to explain any part you do not understand. Your doctor will probably adjust your dose or the length of time between doses depending on your lab results. Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient. Other uses for this medicine This medication may be prescribed for other uses; ask your doctor or pharmacist for more information. What special precautions should I follow? <h3>Before receiving lanreotide injection,</h3> /h3> tell your doctor and pharmacist if you are allergic to lanreotide injection, any other medications, or any of the ingredients in lanreotide injection. Ask your pharmacist for a list of the ingredients. tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: beta blockers such as atenolol (Tenormin, in Tenoretic), labetalol (Trandate), metoprolol (Lopressor, Toprol XL, in Dutoprol), nadolol (Corgard, in Corzide), and propranolol (Hemangeol, Inderal, InnoPran); bromocriptine (Cycloset, Parlodel); cyclosporine (Gengraf, Neoral, Sandimmune); insulin and oral medications for diabetes; quinidine (in Nuedexta), or terfenadine (no longer available in the U.S.). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. tell your doctor if you have or have ever had diabetes, or gallbladder, heart, kidney, thyroid, or liver disease. tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while receiving lanreotide injection, call your doctor. you should know that lanreotide injection may make you drowsy or dizzy. Do not drive a car or operate machinery until you know how this medication affects you. What special dietary instructions should I follow? Unless your doctor tells you otherwise, continue your normal diet. What side effects can this medication cause? This medication may cause changes in your blood sugar. You should know the symptoms of high and low blood sugar and what to do if you have these symptoms. <h3>Lanreotide injection may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: </h3> /h3> diarrhea loose stools constipation gas vomiting weight loss headache redness, pain, itching, or a lump at the injection site depression <h3>Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately or get emergency medical treatment: </h3> /h3> pain in the upper right part of the stomach, center of the stomach, back, or shoulder muscle pain or discomfort yellowing of the skin and eyes fever with chills nausea swelling of the face, throat, tongue, lips, or eyes tightness in the throat difficulty breathing and swallowing wheezing hoarseness rash itching hives shortness of breath slowed or irregular heartbeat Lanreotide injection may cause other side effects. Call your doctor if you have any unusual problems while receiving this medication. If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088). What should I know about storage and disposal of this medication? If you are storing the prefilled syringes in your home until it is time for it to be injected by your doctor or nurse, you should always store it in original carton in the refrigerator and protect it from light. Throw away any medication that is outdated or no longer needed. Talk to your healthcare provider about the proper disposal of your medication. In case of emergency/overdose In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911. What other information should I know? Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your body's response to lanreotide injection. Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies. Brand names Somatuline Depot how do you administer lanreotide

how do you administer lanreotide

hepatitis C, is caused by the hepatitis C virus (HCV). It usually spreads through contact with infected blood. It can also spread through sex with an infected person and from mother to baby during childbirth.

Hepatitis C HCV Summary Your liver is the largest organ inside your body. It helps your body digest food, store energy, and remove poisons. Hepatitis is an inflammation of the liver. One type, hepatitis C, is caused by the hepatitis C virus (HCV). It usually spreads through contact with infected blood. It can also spread through sex with an infected person and from mother to baby during childbirth. Most people who are infected with hepatitis C don't have any symptoms for years. If you do get symptoms, you may feel as if you have the flu. You may also have jaundice, a yellowing of skin and eyes, dark-colored urine, and pale bowel movements. A blood test can tell if you have it. Usually, hepatitis C does not get better by itself. The infection can last a lifetime and may lead to scarring of the liver or liver cancer. Medicines sometimes help, but side effects can be a problem. Serious cases may need a liver transplant. There is no vaccine for HCV. NIH: National Institute of Diabetes and Digestive and Kidney Diseases how do you catch hepatitis c

how do you catch hepatitis c

The hepatitis C virus spreads through contact with an infected person's blood

Hepatitis C What is hepatitis C? Hepatitis C is a viral infection that causes liver inflammation and damage. Inflammation is swelling that occurs when tissues of the body become injured or infected. Inflammation can damage organs.Viruses invade normal cells in your body. Many viruses cause infections that can be spread from person to person. The hepatitis C virus spreads through contact with an infected person's blood.Hepatitis C can cause an acute or chronic infection.Although no vaccine for hepatitis C is available, you can take steps to protect yourself from hepatitis C. If you have hepatitis C, talk with your doctor about treatment. Medicines can cure most cases of hepatitis C.Acute hepatitis CAcute hepatitis C is a short-term infection. Symptoms can last up to 6 months. Sometimes your body is able to fight off the infection and the virus goes away.Chronic hepatitis CChronic hepatitis C is a long-lasting infection. Chronic hepatitis C occurs when your body isn't able to fight off the virus. About 75 to 85 percent of people with acute hepatitis C will develop chronic hepatitis C.13Early diagnosis and treatment of chronic hepatitis C can prevent liver damage. Without treatment, chronic hepatitis C can cause chronic liver disease, cirrhosis, liver failure, or liver cancer. How common is hepatitis C in the United States? In the United States, hepatitis C is the most common chronic viral infection found in blood and spread through contact with blood.14Researchers estimate that about 2.7 million to 3.9 million people in the United States have chronic hepatitis C.13 Many people who have hepatitis C don't have symptoms and don't know they have this infection. About 75 percent of U.S. adults who have hepatitis C are baby boomers, born between 1945 and 1965.14Since 2006, the number of new hepatitis C infections has been rising, especially among people younger than age 30 who inject heroin or misuse prescription opioids and inject them.15,16New screening efforts and more effective hepatitis C treatments are helping doctors identify and cure more people with the disease. With more screening and treatment, hepatitis C may become less common in the future. Researchers estimate that hepatitis C could be a rare disease in the United States by 2036.17 Who is more likely to get hepatitis C? People more likely to get hepatitis C are those whohave injected drugs had a blood transfusion or organ transplant before July 1992 have hemophilia and received clotting factor before 1987 have been on kidney dialysis have been in contact with blood or infected needles at work have had tattoos or body piercings have worked or lived in a prison were born to a mother with hepatitis C are infected with HIV have had more than one sex partner in the last 6 months or have a history of sexually transmitted disease are men who have or had sex with menIn the United States, injecting drugs is the most common way that people get hepatitis C.13 Should I be screened for hepatitis C? Your doctor may recommend screening for hepatitis C if youhave a high chance of being infected were born between 1945 and 1965Screening is testing for a disease in people who have no symptoms. Doctors use blood tests to screen for hepatitis C. Many people who have hepatitis C don't have symptoms and don't know they have hepatitis C. Screening tests can help doctors diagnose and treat hepatitis C before it causes serious health problems.Your doctor may recommend screening you for hepatitis C if you were born between 1945 and 1965. What are the complications of hepatitis C? Without treatment, hepatitis C may lead to cirrhosis, liver failure, and liver cancer. Early diagnosis and treatment of hepatitis C can prevent these complications.CirrhosisCirrhosis is a condition in which the liver slowly breaks down and is unable to function normally. Scar tissue replaces healthy liver tissue and partially blocks the flow of blood through the liver. In the early stages of cirrhosis, the liver continues to function. However, as cirrhosis gets worse, the liver begins to fail.Liver failureAlso called end-stage liver disease, liver failure progresses over months, years, or even decades. With end-stage liver disease, the liver can no longer perform important functions or replace damaged cells.Liver cancerHaving chronic hepatitis C increases your chance of developing liver cancer. If chronic hepatitis C causes severe liver damage or cirrhosis before you receive hepatitis C treatment, you will continue to have an increased chance of liver cancer even after treatment. Your doctor may order an ultrasound test to check for liver cancer. Finding cancer at an early stage improves the chance of curing the cancer. What are the symptoms of hepatitis C? Most people infected with hepatitis C have no symptoms. Some people with an acute hepatitis C infection may have symptoms within 1 to 3 months after they are exposed to the virus. These symptoms may includedark yellow urine feeling tired fever gray- or clay-colored stools joint pain loss of appetite nausea pain in your abdomen vomiting yellowish eyes and skin, called jaundiceIf you have chronic hepatitis C, you most likely will have no symptoms until complications develop, which could be decades after you were infected. For this reason, hepatitis C screening is important, even if you have no symptoms. What causes hepatitis C? The hepatitis C virus causes hepatitis C. The hepatitis C virus spreads through contact with an infected person's blood. Contact can occur bysharing drug needles or other drug materials with an infected person getting an accidental stick with a needle that was used on an infected person being tattooed or pierced with tools or inks that were not kept sterile-free from all viruses and other microorganisms-and were used on an infected person before they were used on you having contact with the blood or open sores of an infected person using an infected person's razor, toothbrush, or nail clippers being born to a mother with hepatitis C having unprotected sex with an infected personYou can't get hepatitis C frombeing coughed or sneezed on by an infected person drinking water or eating food hugging an infected person shaking hands or holding hands with an infected person sharing spoons, forks, and other eating utensils sitting next to an infected personA baby can't get hepatitis C from breast milk.18 How do doctors diagnose hepatitis C? Doctors diagnose hepatitis C based on your medical history, a physical exam, and blood tests. If you have hepatitis C, your doctor may perform additional tests to check your liver.Medical historyYour doctor will ask about your symptoms and whether you have any history of blood transfusions or injected drug use.Physical examDuring a physical exam, your doctor will typically examine your body to check for signs of liver damage such aschanges in skin color swelling in your lower legs, feet, or ankles tenderness or swelling in your abdomen What tests do doctors use to diagnose hepatitis C? Doctors use blood tests to diagnose hepatitis C. Your doctor may order additional tests to check for liver damage, find out how much liver damage you have, or rule out other causes of liver disease.Blood testsYour doctor may order one or more blood tests to diagnose hepatitis C. A health care professional will take a blood sample from you and send the sample to a lab.Blood tests for hepatitis C include the following:Screening test for antibodies to the hepatitis C virus. A screening blood test will show whether you have developed antibodies to the hepatitis C virus. A positive antibody test means you were exposed to the hepatitis C virus at some point. However, the virus may no longer be present in your blood if your body fought off the infection on its own or if you received treatment that cured the infection. Hepatitis C RNA test. If your antibody test is positive, your doctor will use a hepatitis C RNA test to detect RNA-a type of genetic material-from the hepatitis C virus. The hepatitis C RNA test can show whether you still have the hepatitis C virus and how much virus is in your blood. This information can help your doctor treat the infection. To see if you are responding to treatment, your doctor may order this test while you are undergoing treatment to find out if the amount of virus in your blood is changing. Genotype test. Your doctor can use this test to find out what strain, or form, of hepatitis C virus you have. At least six specific strains-called genotypes-of hepatitis C exist. Genotype 1 is the most common hepatitis C genotype in the United States.1 Your doctor will recommend treatment based on which hepatitis C genotype you have.Your doctor may order one or more blood tests to diagnose hepatitis C.Additional testsIf you've had chronic hepatitis C for a long time, you could have liver damage. Your doctor may recommend additional tests to find out whether you have liver damage, how much liver damage you have, or to rule out other causes of liver disease. These tests may includeblood tests transient elastography, a special ultrasound of your liver liver biopsy, in which a doctor uses a needle to take a small piece of tissue from your liverDoctors typically use liver biopsy only if other tests don't provide enough information about a person's liver damage or disease. Talk with your doctor about which tests are best for you. How do doctors treat hepatitis C? Doctors treat hepatitis C with antiviral medicines that attack the virus and can cure the disease in most cases.Several newer medicines, called direct-acting antiviral medicines, have been approved to treat hepatitis C since 2013. Studies show that these medicines can cure chronic hepatitis C in most people with this disease. These medicines can also cure acute hepatitis C. In some cases, doctors recommend waiting to see if an acute infection becomes chronic before starting treatment.Your doctor may prescribe one or more of these newer, direct-acting antiviral medicines to treat hepatitis C:daclatasvir (Daklinza) elbasvir/grazoprevir (Zepatier) ledipasvir/sofosbuvir (Harvoni) ombitasvir/paritaprevir/ritonavir (Technivie) ombitasvir/paritaprevir/ritonavir/dasabuvir (Viekira Pak, Viekira XR) simeprevir (Olysio) sofosbuvir (Sovaldi) sofosbuvir/velpatasvir (Epclusa) sofosbuvir/velpatasvir/voxilaprevir (Vosevi)Newer medicines are sometimes used along with these older hepatitis C medicines:ribavirin peginterferon alfa-2a (Pegasys) or peginterferon alfa-2b (PEG-Intron)Doctors treat hepatitis C with antiviral medicines that attack the virus.You may need to take medicines for 12 to 24 weeks to cure hepatitis C. Your doctor will prescribe medicines and recommend a length of treatment based onwhich hepatitis C genotype you have how much liver damage you have whether you have been treated for hepatitis C in the pastYour doctor may order blood tests during and after your treatment. Blood tests can show whether the treatment is working. Hepatitis C medicines cure the infection in most people who complete treatment.Hepatitis C medicines may cause side effects. Talk with your doctor about the side effects of treatment. Check with your doctor before taking any other prescription or over-the-counter medicines.For safety reasons, talk with your doctor before using dietary supplements, such as vitamins, or any complementary or alternative medicines or medical practices.Cost of hepatitis C medicinesThe newer direct-acting antiviral medicines for hepatitis C can be costly. Most government and private health insurance prescription drug plans provide some coverage for these medicines. Talk with your doctor about your health insurance coverage for hepatitis C medicines.Drug companies, nonprofit organizations, and some states offer programs that can help pay for hepatitis C medicines. If you need help paying for medicines, talk with your doctor. Learn more about financial help for hepatitis C medicines. How do doctors treat the complications of hepatitis C? If hepatitis C leads to cirrhosis, you should see a doctor who specializes in liver diseases. Doctors can treat the health problems related to cirrhosis with medicines, surgery, and other medical procedures. If you have cirrhosis, you have an increased chance of liver cancer. Your doctor may order an ultrasound test to check for liver cancer.If hepatitis C leads to liver failure or liver cancer, you may need a liver transplant. How can I protect myself from hepatitis C infection? If you don't have hepatitis C, you can help protect yourself from hepatitis C infection bynot sharing drug needles or other drug materials wearing gloves if you have to touch another person's blood or open sores making sure your tattoo artist or body piercer uses sterile tools and unopened ink not sharing personal items such toothbrushes, razors, or nail clippersHepatitis C can spread from person to person during sex, but the chances are low. People who have multiple sex partners, have HIV or other sexually transmitted diseases, or who engage in rough or anal sex have a higher chance of getting hepatitis C. Talk with your doctor about your risk of getting hepatitis C through sex and about safe sex practices, such as using a latex or polyurethane condom to help prevent the spread of hepatitis C. Do not share drug needles or other drug materials.If you had hepatitis C in the past and your body fought off the infection or medicines cured the infection, you can get hepatitis C again. Follow the steps above, and talk with your doctor about how to protect yourself from another hepatitis C infection. If you think you may have been exposed to the hepatitis C virus, see your doctor as soon as possible. Early diagnosis and treatment can help prevent liver damage. How can I prevent spreading hepatitis C to others? If you have hepatitis C, follow the steps above to avoid spreading the infection. Tell your sex partner you have hepatitis C, and talk with your doctor about safe sex practices. In addition, you can protect others from infection by telling your doctor, dentist, and other health care providers that you have hepatitis C. Don't donate blood or blood products, semen, organs, or tissue. Is a hepatitis C vaccine available? Researchers are still working on a vaccine for hepatitis C. If you have hepatitis C, talk with your doctor about vaccines for hepatitis A and hepatitis B. These vaccines can protect you from hepatitis A and hepatitis B infections, which could further damage your liver. What should I eat and drink if I have hepatitis C? If you have hepatitis C, you should eat a balanced, healthy diet. Talk with your doctor about healthy eating. You should also avoid alcohol because it can cause more liver damage. Hepatitis C [13] Hepatitis C FAQs for health professionals. Centers for Disease Control and Prevention, Division of Viral Hepatitis website. www.cdc.gov/hepatitis/HCV/HCVfaq.htm. Updated July 21, 2016. Accessed October 19, 2016. [14] U.S. Preventive Services Task Force. Final recommendation statement: hepatitis C: screening. www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/hepatitis-c-screening. Current as of June 2013. Accessed October 19, 2016. [15] Suryaprasad AG, White JZ, Xu F, et al. Emerging epidemic of hepatitis C virus infections among young nonurban persons who inject drugs in the United States, 2006-2012. Clinical Infectious Diseases. 2014;59(10):1411-1419. [16] Viral hepatitis and young persons who inject prescription opioids and heroin. Centers for Disease Control and Prevention website. www.cdc.gov/hepatitis/featuredtopics/youngpwid.htm. Updated March 30, 2016. Accessed October 19, 2016. [17] Kabiri M, Jazwinski AB, Roberts MS, Schaefer AJ, Chhatwal J. The changing burden of hepatitis C virus infection in the United States: model-based predictions. Annals of Internal Medicine. 2014;161(3):170-180. [18] Hepatitis B and C infections. Centers for Disease Control and Prevention, Division of Nutrition, Physical Activity, and Obesity website. www.cdc.gov/breastfeeding/disease/hepatitis.htm. Updated June 17, 2015. Accessed October 19, 2016. how do you catch hepatitis c

how do you catch hepatitis c

There is no single test to diagnose systemic lupus erythematosus (lupus). It may take months or years for your doctor to diagnose the disease. Your doctor may use many tools to make a diagnosis: - Medical history. - Complete physical exam. - Samples from the blood, skin, or kidneys for laboratory tests.

Systemic Lupus Erythematosus (Lupus) What is it? Points To Remember About Systemic Lupus Erythematosus (Lupus) What is systemic lupus erythematosus (lupus)? Lupus can affect many body parts, including the joints, skin, kidneys, heart, lungs, blood vessels, or brain.You will have periods of illness (flares) and wellness.Anyone can get lupus, but it most often affects women. Lupus is also more common among African American, Hispanic, Asian, and Native American women.Genes play an important role in lupus, but other factors are also involved.Most people will see a rheumatologist for their lupus treatment. Treatment generally consists of a team approach.Learning to recognize the warning signs of a flare can help with reducing or preventing the flares.Systemic lupus erythematosus (lupus) happens when the body's defense system attacks healthy cells and tissues, instead of viruses and bacteria. This can damage many parts of the body such as the: Joints.Skin.Kidneys.Heart.Lungs.Blood vessels.Brain.You can't catch lupus from another person. If you have lupus you will have periods of illness (flares) and wellness. Lupus can affect many body parts, including the joints, skin, kidneys, heart, lungs, blood vessels, or brain.You will have periods of illness (flares) and wellness.Anyone can get lupus, but it most often affects women. Lupus is also more common among African American, Hispanic, Asian, and Native American women.Genes play an important role in lupus, but other factors are also involved.Most people will see a rheumatologist for their lupus treatment. Treatment generally consists of a team approach.Learning to recognize the warning signs of a flare can help with reducing or preventing the flares. Lupus can affect many body parts, including the joints, skin, kidneys, heart, lungs, blood vessels, or brain.You will have periods of illness (flares) and wellness.Anyone can get lupus, but it most often affects women. Lupus is also more common among African American, Hispanic, Asian, and Native American women.Genes play an important role in lupus, but other factors are also involved.Most people will see a rheumatologist for their lupus treatment. Treatment generally consists of a team approach.Learning to recognize the warning signs of a flare can help with reducing or preventing the flares.Systemic lupus erythematosus (lupus) happens when the body's defense system attacks healthy cells and tissues, instead of viruses and bacteria. This can damage many parts of the body such as the: Joints.Skin.Kidneys.Heart.Lungs.Blood vessels.Brain.You can't catch lupus from another person. If you have lupus you will have periods of illness (flares) and wellness. Who gets it? Who gets systemic lupus erythematosus (lupus)? Anyone can get systemic lupus erythematosus (lupus), but it most often affects women. Lupus is also more common in African American, Hispanic, Asian, and Native American women than in white women.Anyone can get systemic lupus erythematosus (lupus), but it most often affects women. Lupus is also more common in African American, Hispanic, Asian, and Native American women than in white women. What causes it? What causes systemic lupus erythematosus (lupus)? No one knows what causes systemic lupus erythematosus (lupus). Research suggests that genes play an important role, but genes alone do not determine who gets lupus. It is likely that many factors trigger the disease.No one knows what causes systemic lupus erythematosus (lupus). Research suggests that genes play an important role, but genes alone do not determine who gets lupus. It is likely that many factors trigger the disease.No one knows what causes systemic lupus erythematosus (lupus). Research suggests that genes play an important role, but genes alone do not determine who gets lupus. It is likely that many factors trigger the disease. Is there a test for it? Is there a test for systemic lupus erythematosus (lupus)? There is no single test to diagnose systemic lupus erythematosus (lupus). It may take months or years for your doctor to diagnose the disease. Your doctor may use many tools to make a diagnosis: Medical history.Complete physical exam.Samples from the blood, skin, or kidneys for laboratory tests.There is no single test to diagnose systemic lupus erythematosus (lupus). It may take months or years for your doctor to diagnose the disease. Your doctor may use many tools to make a diagnosis: Medical history.Complete physical exam.Samples from the blood, skin, or kidneys for laboratory tests.There is no single test to diagnose systemic lupus erythematosus (lupus). It may take months or years for your doctor to diagnose the disease. Your doctor may use many tools to make a diagnosis: Medical history.Complete physical exam.Samples from the blood, skin, or kidneys for laboratory tests. How is it treated? How is systemic lupus erythematosus (lupus) treated? Your doctor will develop a treatment plan to fit your needs. You and your doctor should review the plan often to be sure it's working. You should report new symptoms to your doctor right away so that treatment can be changed if needed.Treatments may include: <strong>Medicines</strong> to: <ul> Reduce swelling and pain.Prevent or reduce flares.Help the immune system.Reduce or prevent damage to joints.Balance the hormones.Treat problems related to lupus, such as high cholesterol, high blood pressure, or infection. <li><strong>Alternative treatments</strong> may improve symptoms. No research shows that this kind of treatment works for people with lupus. You should talk to your doctor about alternative treatments.</li> </ul> Your doctor will develop a treatment plan to fit your needs. You and your doctor should review the plan often to be sure it's working. You should report new symptoms to your doctor right away so that treatment can be changed if needed.Treatments may include: <strong>Medicines</strong> to: <ul> Reduce swelling and pain.Prevent or reduce flares.Help the immune system.Reduce or prevent damage to joints.Balance the hormones.Treat problems related to lupus, such as high cholesterol, high blood pressure, or infection. <li><strong>Alternative treatments</strong> may improve symptoms. No research shows that this kind of treatment works for people with lupus. You should talk to your doctor about alternative treatments.</li> </ul> Your doctor will develop a treatment plan to fit your needs. You and your doctor should review the plan often to be sure it's working. You should report new symptoms to your doctor right away so that treatment can be changed if needed.Treatments may include: <strong>Medicines</strong> to: <ul> Reduce swelling and pain.Prevent or reduce flares.Help the immune system.Reduce or prevent damage to joints.Balance the hormones.Treat problems related to lupus, such as high cholesterol, high blood pressure, or infection. <li><strong>Alternative treatments</strong> may improve symptoms. No research shows that this kind of treatment works for people with lupus. You should talk to your doctor about alternative treatments.</li> </ul> Who treats it? Who treats systemic lupus erythematosus (lupus)? Most people will see a rheumatologist for their systemic lupus erythematosus (lupus) treatment. Treatment generally consists of a team approach and may include: Family doctors, who can work with your other doctors to coordinate your care.Clinical immunologists, who treat problems with the immune system.Nephrologists, who treat kidney disease.Hematologists, who treat blood disorders.Dermatologists, who treat skin problems.Neurologists, who treat problems of the brain and spinal cord.Cardiologists, who treat problems with your heart and blood vessels.Endocrinologists, who treat problems related to the glands and hormones.Nurses.Psychologists.Social workers.Most people will see a rheumatologist for their systemic lupus erythematosus (lupus) treatment. Treatment generally consists of a team approach and may include: Family doctors, who can work with your other doctors to coordinate your care.Clinical immunologists, who treat problems with the immune system.Nephrologists, who treat kidney disease.Hematologists, who treat blood disorders.Dermatologists, who treat skin problems.Neurologists, who treat problems of the brain and spinal cord.Cardiologists, who treat problems with your heart and blood vessels.Endocrinologists, who treat problems related to the glands and hormones.Nurses.Psychologists.Social workers.Most people will see a rheumatologist for their systemic lupus erythematosus (lupus) treatment. Treatment generally consists of a team approach and may include: Family doctors, who can work with your other doctors to coordinate your care.Clinical immunologists, who treat problems with the immune system.Nephrologists, who treat kidney disease.Hematologists, who treat blood disorders.Dermatologists, who treat skin problems.Neurologists, who treat problems of the brain and spinal cord.Cardiologists, who treat problems with your heart and blood vessels.Endocrinologists, who treat problems related to the glands and hormones.Nurses.Psychologists.Social workers. Living With It Living with systemic lupus erythematosus (lupus) Dealing with a long-lasting disease like systemic lupus erythematosus (lupus) can be hard on the emotions. You might think that your friends, family, and coworkers do not understand how you feel. Sadness and anger are common reactions.Besides working with your doctor to determine a treatment plan, there are a few things you can do to help you live with lupus: Learn to recognize the warning signs of a flare so that you and your doctor might reduce or prevent them. These warning signs include: <ul> Feeling more tired.Pain.Rash.Fever.Stomachache.Headache.Dizziness. <li>Eat a proper diet, exercise, and learn relaxation techniques to help cope with stress. A healthy lifestyle, as well as quitting smoking, will also reduce your risk for heart disease associated with lupus. Talk to your doctor before starting an exercise program.</li> <li>Develop and maintain a good support system of family, friends, medical professionals, community organizations, and support groups.</li> </ul> <h3>Pregnancy and Contraception for Women With Lupus</h3> Pregnancy in women with lupus is considered high risk, but most women with lupus carry their babies safely. There are a few things to keep in mind: Talk to your doctor if you plan to become pregnant.See your doctor often once you are pregnant.Good nutrition during pregnancy is important.Lupus can flare during pregnancy.Recent studies have shown that birth control pills are safe for women with lupus.Dealing with a long-lasting disease like systemic lupus erythematosus (lupus) can be hard on the emotions. You might think that your friends, family, and coworkers do not understand how you feel. Sadness and anger are common reactions.Besides working with your doctor to determine a treatment plan, there are a few things you can do to help you live with lupus: Learn to recognize the warning signs of a flare so that you and your doctor might reduce or prevent them. These warning signs include: <ul> Feeling more tired.Pain.Rash.Fever.Stomachache.Headache.Dizziness. <li>Eat a proper diet, exercise, and learn relaxation techniques to help cope with stress. A healthy lifestyle, as well as quitting smoking, will also reduce your risk for heart disease associated with lupus. Talk to your doctor before starting an exercise program.</li> <li>Develop and maintain a good support system of family, friends, medical professionals, community organizations, and support groups.</li> </ul> <h3>Pregnancy and Contraception for Women With Lupus</h3> Pregnancy in women with lupus is considered high risk, but most women with lupus carry their babies safely. There are a few things to keep in mind: Talk to your doctor if you plan to become pregnant.See your doctor often once you are pregnant.Good nutrition during pregnancy is important.Lupus can flare during pregnancy.Recent studies have shown that birth control pills are safe for women with lupus. how do you check for lupus?

how do you check for lupus?

There is no one test to diagnose lupus, and it may take months or years to make the diagnosis.

Lupus Discoid lupus SLE Subacute cutaneous lupus Systemic lupus erythematosus Summary If you have lupus, your immune system attacks healthy cells and tissues by mistake. This can damage your joints, skin, blood vessels and organs. There are many kinds of lupus. The most common type, systemic lupus erythematosus, affects many parts of the body. Discoid lupus causes a rash that doesn't go away. Subacute cutaneous lupus causes sores after being out in the sun. Another type can be caused by medication. Neonatal lupus, which is rare, affects newborns. Anyone can get lupus, but women are most at risk. Lupus is also more common in African American, Hispanic, Asian and Native American women. The cause of lupus is not known. Lupus has many symptoms. Some common ones are - Joint pain or swelling - Muscle pain - Fever with no known cause - Fatigue - Red rashes, often on the face (also called the "butterfly rash") There is no one test to diagnose lupus, and it may take months or years to make the diagnosis. There is no cure for lupus, but medicines and lifestyle changes can help control it. NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases how do you check for lupus?

how do you check for lupus?

Tests that may be done include: - ANA titer - BUN and creatinine - Complement levels - Urinalysis - Urine protein - Kidney biopsy, to determine appropriate treatment

Lupus nephritis Nephritis - lupus Lupus glomerular disease Summary Lupus nephritis, which is a kidney disorder, is a complication of systemic lupus erythematosus. Causes Systemic lupus erythematosus (SLE, or lupus) is an autoimmune disease. This means there is a problem with the body's immune system. Normally, the immune system helps protect the body from infection or harmful substances. But in people with an autoimmune disease, the immune system cannot tell the difference between harmful substances and healthy ones. As a result, the immune system attacks otherwise healthy cells and tissues. SLE may damage different parts of the kidney. This can lead to disorders such as interstitial nephritis, nephrotic syndrome, and membranous glomerulonephritis. Over time, kidney failure can result. Symptoms Symptoms of lupus nephritis include: Blood in the urine Foamy appearance to urine Swelling (edema) of any area of the body High blood pressure Exams and Tests The health care provider will perform a physical exam and ask about your symptoms. Abnormal sounds may be heard when the provider listens to your heart and lungs. Tests that may be done include: ANA titer BUN and creatinine Complement levels Urinalysis Urine protein Kidney biopsy, to determine appropriate treatment Treatment The goal of treatment is to improve kidney function and to delay kidney failure. Medicines may include drugs that suppress the immune system, such as corticosteroids, cyclophosphamide, mycophenolate mofetil, or azathioprine. You may need dialysis to control symptoms of kidney failure, sometimes for only a while. A kidney transplant may be recommended. People with active lupus should not have a transplant because the condition can occur in the transplanted kidney. Outlook (Prognosis) How well you do, depends on the specific form of lupus nephritis. You may have flareups, and then times when you do not have any symptoms. Some people with this condition develop chronic kidney failure. Although lupus nephritis may return in a transplanted kidney, it rarely leads to end-stage kidney disease. Possible Complications Complications that may result from lupus nephritis include: Acute renal failure Chronic renal failure When to Contact a Medical Professional Call your provider if you have blood in your urine or swelling of your body. If you have lupus nephritis, call your provider if you notice decreased urine output. Prevention Treating lupus may help prevent or delay onset of lupus nephritis. Review Date 8/1/2017 Updated by: Walead Latif, MD, Nephrologist and Clinical Associate Professor, Rutgers Medical School, Newark, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how do you check for lupus?

how do you check for lupus?

Signs and symptoms of lupus may vary over time and overlap with those of many other disorders. No one test can diagnose lupus. The combination of blood and urine tests, signs and symptoms, and physical examination findings leads to the diagnosis. Laboratory tests Blood and urine tests may include: - Complete blood count. This test measures the number of red blood cells, white blood cells and platelets as well as the amount of hemoglobin, a protein in red blood cells. Results may indicate you have anemia, which commonly occurs in lupus. A low white blood cell or platelet count may occur in lupus as well. - Erythrocyte sedimentation rate. This blood test determines the rate at which red blood cells settle to the bottom of a tube in an hour. A faster than normal rate may indicate a systemic disease, such as lupus. The sedimentation rate isn't specific for any one disease. It may be elevated if you have lupus, an infection, another inflammatory condition or cancer. - Kidney and liver assessment. Blood tests can assess how well your kidneys and liver are functioning. Lupus can affect these organs. - Urinalysis. An examination of a sample of your urine may show an increased protein level or red blood cells in the urine, which may occur if lupus has affected your kidneys. - Antinuclear antibody (ANA) test. A positive test for the presence of these antibodies - produced by your immune system - indicates a stimulated immune system. While most people with lupus have a positive ANA test, most people with a positive ANA do not have lupus. If you test positive for ANA, your doctor may advise more-specific antibody testing. Imaging tests If your doctor suspects that lupus is affecting your lungs or heart, he or she may suggest: - Chest X-ray. An image of your chest may reveal abnormal shadows that suggest fluid or inflammation in your lungs. - Echocardiogram. This test uses sound waves to produce real-time images of your beating heart. It can check for problems with your valves and other portions of your heart. Biopsy Lupus can harm your kidneys in many different ways, and treatments can vary, depending on the type of damage that occurs. In some cases, it's necessary to test a small sample of kidney tissue to determine what the best treatment might be. The sample can be obtained with a needle or through a small incision. Skin biopsy is sometimes performed to confirm a diagnosis of lupus affecting the skin.

Lupus Overview Lupus is a systemic autoimmune disease that occurs when your body's immune system attacks your own tissues and organs. Inflammation caused by lupus can affect many different body systems - including your joints, skin, kidneys, blood cells, brain, heart and lungs. Lupus can be difficult to diagnose because its signs and symptoms often mimic those of other ailments. The most distinctive sign of lupus - a facial rash that resembles the wings of a butterfly unfolding across both cheeks - occurs in many but not all cases of lupus. Some people are born with a tendency toward developing lupus, which may be triggered by infections, certain drugs or even sunlight. While there's no cure for lupus, treatments can help control symptoms. Symptoms No two cases of lupus are exactly alike. Signs and symptoms may come on suddenly or develop slowly, may be mild or severe, and may be temporary or permanent. Most people with lupus have mild disease characterized by episodes - called flares - when signs and symptoms get worse for a while, then improve or even disappear completely for a time. The signs and symptoms of lupus that you experience will depend on which body systems are affected by the disease. The most common signs and symptoms include: - Fatigue - Fever - Joint pain, stiffness and swelling - Butterfly-shaped rash on the face that covers the cheeks and bridge of the nose or rashes elsewhere on the body - Skin lesions that appear or worsen with sun exposure (photosensitivity) - Fingers and toes that turn white or blue when exposed to cold or during stressful periods (Raynaud's phenomenon) - Shortness of breath - Chest pain - Dry eyes - Headaches, confusion and memory loss When to see a doctor See your doctor if you develop an unexplained rash, ongoing fever, persistent aching or fatigue. Causes Lupus occurs when your immune system attacks healthy tissue in your body (autoimmune disease). It's likely that lupus results from a combination of your genetics and your environment. It appears that people with an inherited predisposition for lupus may develop the disease when they come into contact with something in the environment that can trigger lupus. The cause of lupus in most cases, however, is unknown. Some potential triggers include: - Sunlight. Exposure to the sun may bring on lupus skin lesions or trigger an internal response in susceptible people. - Infections. Having an infection can initiate lupus or cause a relapse in some people. - Medications. Lupus can be triggered by certain types of blood pressure medications, anti-seizure medications and antibiotics. People who have drug-induced lupus usually get better when they stop taking the medication. Rarely, symptoms may persist even after the drug is stopped. Risk factors Factors that may increase your risk of lupus include: - Your sex. Lupus is more common in women. - Age. Although lupus affects people of all ages, it's most often diagnosed between the ages of 15 and 45. - Race. Lupus is more common in African-Americans, Hispanics and Asian-Americans. Diagnosis Diagnosing lupus is difficult because signs and symptoms vary considerably from person to person. Signs and symptoms of lupus may vary over time and overlap with those of many other disorders. No one test can diagnose lupus. The combination of blood and urine tests, signs and symptoms, and physical examination findings leads to the diagnosis. Laboratory tests Blood and urine tests may include: - Complete blood count. This test measures the number of red blood cells, white blood cells and platelets as well as the amount of hemoglobin, a protein in red blood cells. Results may indicate you have anemia, which commonly occurs in lupus. A low white blood cell or platelet count may occur in lupus as well. - Erythrocyte sedimentation rate. This blood test determines the rate at which red blood cells settle to the bottom of a tube in an hour. A faster than normal rate may indicate a systemic disease, such as lupus. The sedimentation rate isn't specific for any one disease. It may be elevated if you have lupus, an infection, another inflammatory condition or cancer. - Kidney and liver assessment. Blood tests can assess how well your kidneys and liver are functioning. Lupus can affect these organs. - Urinalysis. An examination of a sample of your urine may show an increased protein level or red blood cells in the urine, which may occur if lupus has affected your kidneys. - Antinuclear antibody (ANA) test. A positive test for the presence of these antibodies - produced by your immune system - indicates a stimulated immune system. While most people with lupus have a positive ANA test, most people with a positive ANA do not have lupus. If you test positive for ANA, your doctor may advise more-specific antibody testing. Imaging tests If your doctor suspects that lupus is affecting your lungs or heart, he or she may suggest: - Chest X-ray. An image of your chest may reveal abnormal shadows that suggest fluid or inflammation in your lungs. - Echocardiogram. This test uses sound waves to produce real-time images of your beating heart. It can check for problems with your valves and other portions of your heart. Biopsy Lupus can harm your kidneys in many different ways, and treatments can vary, depending on the type of damage that occurs. In some cases, it's necessary to test a small sample of kidney tissue to determine what the best treatment might be. The sample can be obtained with a needle or through a small incision. Skin biopsy is sometimes performed to confirm a diagnosis of lupus affecting the skin. Treatment Treatment for lupus depends on your signs and symptoms. Determining whether your signs and symptoms should be treated and what medications to use requires a careful discussion of the benefits and risks with your doctor. As your signs and symptoms flare and subside, you and your doctor may find that you'll need to change medications or dosages. The medications most commonly used to control lupus include: - Nonsteroidal anti-inflammatory drugs (NSAIDs). Over-the-counter NSAIDs, such as naproxen sodium (Aleve) and ibuprofen (Advil, Motrin IB, others), may be used to treat pain, swelling and fever associated with lupus. Stronger NSAIDs are available by prescription. Side effects of NSAIDs include stomach bleeding, kidney problems and an increased risk of heart problems. - Antimalarial drugs. Medications commonly used to treat malaria, such as hydroxychloroquine (Plaquenil), affect the immune system and can help decrease the risk of lupus flares. Side effects can include stomach upset and, very rarely, damage to the retina of the eye. Regular eye exams are recommended when taking these medications. - Corticosteroids. Prednisone and other types of corticosteroids can counter the inflammation of lupus. High doses of steroids such as methylprednisolone (A-Methapred, Medrol) are often used to control serious disease that involves the kidneys and brain. Side effects include weight gain, easy bruising, thinning bones (osteoporosis), high blood pressure, diabetes and increased risk of infection. The risk of side effects increases with higher doses and longer term therapy. - Immunosuppressants. Drugs that suppress the immune system may be helpful in serious cases of lupus. Examples include azathioprine (Imuran, Azasan), mycophenolate mofetil (CellCept) and methotrexate (Trexall). Potential side effects may include an increased risk of infection, liver damage, decreased fertility and an increased risk of cancer. - Biologics. A different type of medication, belimumab (Benlysta) administered intravenously, also reduces lupus symptoms in some people. Side effects include nausea, diarrhea and infections. Rarely, worsening of depression can occur. - Rituximab (Rituxan) can be beneficial in cases of resistant lupus. Side effects include allergic reaction to the intravenous infusion and infections. Lifestyle and home remedies Take steps to care for your body if you have lupus. Simple measures can help you prevent lupus flares and, should they occur, better cope with the signs and symptoms you experience. Try to: - See your doctor regularly. Having regular checkups instead of only seeing your doctor when your symptoms worsen may help your doctor prevent flare-ups, and can be useful in addressing routine health concerns, such as stress, diet and exercise that can be helpful in preventing lupus complications. - Be sun smart. Because ultraviolet light can trigger a flare, wear protective clothing - such as a hat, long-sleeved shirt and long pants - and use sunscreens with a sun protection factor (SPF) of at least 55 every time you go outside. - Get regular exercise. Exercise can help keep your bones strong, reduce your risk of heart attack and promote general well-being. - Don't smoke. Smoking increases your risk of cardiovascular disease and can worsen the effects of lupus on your heart and blood vessels. - Eat a healthy diet. A healthy diet emphasizes fruits, vegetables and whole grains. Sometimes you may have dietary restrictions, especially if you have high blood pressure, kidney damage or gastrointestinal problems. - Ask your doctor if you need vitamin D and calcium supplements. There is some evidence to suggest that people with lupus may benefit from supplemental vitamin D. A 1,200- to 1,500-milligram calcium supplement taken daily may help keep your bones healthy. Alternative medicine Sometimes people with lupus seek alternative or complementary medicine. However, there aren't any alternative therapies that have been shown to alter the course of lupus, although some may help ease symptoms of the disease. Discuss these treatments with your doctor before initiating them on your own. He or she can help you weigh the benefits and risks and tell you if the treatments will interfere adversely with your current lupus medications. Complementary and alternative treatments for lupus include: - Dehydroepiandrosterone (DHEA). Supplements containing this hormone may help fatigue and muscle pain. It may lead to acne in women. - Fish oil. Fish oil supplements contain omega-3 fatty acids that may be beneficial for people with lupus. Preliminary studies have found some promise, though more study is needed. Side effects of fish oil supplements can include nausea, belching and a fishy taste in the mouth. - Acupuncture. This therapy uses tiny needles inserted just under the skin. It may help ease the muscle pain associated with lupus. how do you check for lupus?

how do you check for lupus?

You may start by seeing your primary care doctor to find out if your anxiety could be related to your physical health. Your doctor can check for signs of an underlying medical condition that may need treatment. However, you may need to see a mental health specialist if you have severe anxiety. A psychiatrist is a medical doctor who specializes in diagnosing and treating mental health conditions. A psychologist and certain other mental health professionals can diagnose anxiety and provide counseling (psychotherapy). To help diagnose an anxiety disorder and rule out other conditions, your provider may: - Give you a psychological evaluation. This involves describing your thoughts, feelings and behavior to help pinpoint a diagnosis and check for related complications. Anxiety disorders often occur along with other mental health problems - such as depression or substance abuse - which can make diagnosis more challenging. - Compare your symptoms to the criteria in the DSM-5. Many doctors use the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, to diagnose an anxiety disorder.

Anxiety Overview Experiencing occasional anxiety is a normal part of life. However, people with anxiety disorders frequently have intense, excessive and persistent worry and fear about everyday situations. Often, anxiety disorders involve repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks). These feelings of anxiety and panic interfere with daily activities, are difficult to control, are out of proportion to the actual danger and can last a long time. You may avoid places or situations to prevent these feelings. Symptoms may start during childhood or the teen years and continue into adulthood. Examples of anxiety disorders include generalized anxiety disorder, social anxiety disorder (social phobia), specific phobias and separation anxiety disorder. You can have more than one anxiety disorder. Sometimes anxiety results from a medical condition that needs treatment. Whatever form of anxiety you have, treatment can help. Anxiety care at Mayo Clinic Symptoms Common anxiety signs and symptoms include: - Feeling nervous, restless or tense - Having a sense of impending danger, panic or doom - Having an increased heart rate - Breathing rapidly (hyperventilation) - Sweating - Trembling - Feeling weak or tired - Trouble concentrating or thinking about anything other than the present worry - Having trouble sleeping - Experiencing gastrointestinal (GI) problems - Having difficulty controlling worry - Having the urge to avoid things that trigger anxiety Several types of anxiety disorders exist: - Agoraphobia (ag-uh-ruh-FOE-be-uh) is a type of anxiety disorder in which you fear and often avoid places or situations that might cause you to panic and make you feel trapped, helpless or embarrassed. - Anxiety disorder due to a medical condition includes symptoms of intense anxiety or panic that are directly caused by a physical health problem. - Generalized anxiety disorder includes persistent and excessive anxiety and worry about activities or events - even ordinary, routine issues. The worry is out of proportion to the actual circumstance, is difficult to control and affects how you feel physically. It often occurs along with other anxiety disorders or depression. - Panic disorder involves repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks). You may have feelings of impending doom, shortness of breath, chest pain, or a rapid, fluttering or pounding heart (heart palpitations). These panic attacks may lead to worrying about them happening again or avoiding situations in which they've occurred. - Selective mutism is a consistent failure of children to speak in certain situations, such as school, even when they can speak in other situations, such as at home with close family members. This can interfere with school, work and social functioning. - Separation anxiety disorder is a childhood disorder characterized by anxiety that's excessive for the child's developmental level and related to separation from parents or others who have parental roles. - Social anxiety disorder (social phobia) involves high levels of anxiety, fear and avoidance of social situations due to feelings of embarrassment, self-consciousness and concern about being judged or viewed negatively by others. - Specific phobias are characterized by major anxiety when you're exposed to a specific object or situation and a desire to avoid it. Phobias provoke panic attacks in some people. - Substance-induced anxiety disorder is characterized by symptoms of intense anxiety or panic that are a direct result of abusing drugs, taking medications, being exposed to a toxic substance or withdrawal from drugs. - Other specified anxiety disorder and unspecified anxiety disorder are terms for anxiety or phobias that don't meet the exact criteria for any other anxiety disorders but are significant enough to be distressing and disruptive. When to see a doctor See your doctor if: - You feel like you're worrying too much and it's interfering with your work, relationships or other parts of your life - Your fear, worry or anxiety is upsetting to you and difficult to control - You feel depressed, have trouble with alcohol or drug use, or have other mental health concerns along with anxiety - You think your anxiety could be linked to a physical health problem - You have suicidal thoughts or behaviors - if this is the case, seek emergency treatment immediately Your worries may not go away on their own, and they may get worse over time if you don't seek help. See your doctor or a mental health provider before your anxiety gets worse. It's easier to treat if you get help early. Causes The causes of anxiety disorders aren't fully understood. Life experiences such as traumatic events appear to trigger anxiety disorders in people who are already prone to anxiety. Inherited traits also can be a factor. Medical causes For some people, anxiety may be linked to an underlying health issue. In some cases, anxiety signs and symptoms are the first indicators of a medical illness. If your doctor suspects your anxiety may have a medical cause, he or she may order tests to look for signs of a problem. Examples of medical problems that can be linked to anxiety include: - Heart disease - Diabetes - Thyroid problems, such as hyperthyroidism - Respiratory disorders, such as chronic obstructive pulmonary disease (COPD) and asthma - Drug abuse or withdrawal - Withdrawal from alcohol, anti-anxiety medications (benzodiazepines) or other medications - Chronic pain or irritable bowel syndrome - Rare tumors that produce certain "fight-or-flight" hormones Sometimes anxiety can be a side effect of certain medications. It's possible that your anxiety may be due to an underlying medical condition if: - You don't have any blood relatives (such as a parent or sibling) with an anxiety disorder - You didn't have an anxiety disorder as a child - You don't avoid certain things or situations because of anxiety - You have a sudden occurrence of anxiety that seems unrelated to life events and you didn't have a previous history of anxiety Risk factors These factors may increase your risk of developing an anxiety disorder: - Trauma. Children who endured abuse or trauma or witnessed traumatic events are at higher risk of developing an anxiety disorder at some point in life. Adults who experience a traumatic event also can develop anxiety disorders. - Stress due to an illness. Having a health condition or serious illness can cause significant worry about issues such as your treatment and your future. - Stress buildup. A big event or a buildup of smaller stressful life situations may trigger excessive anxiety - for example, a death in the family, work stress or ongoing worry about finances. - Personality. People with certain personality types are more prone to anxiety disorders than others are. - Other mental health disorders. People with other mental health disorders, such as depression, often also have an anxiety disorder. - Having blood relatives with an anxiety disorder. Anxiety disorders can run in families. - Drugs or alcohol. Drug or alcohol use or abuse or withdrawal can cause or worsen anxiety. Complications Having an anxiety disorder does more than make you worry. It can also lead to, or worsen, other mental and physical conditions, such as: - Depression (which often occurs with an anxiety disorder) or other mental health disorders - Substance abuse - Trouble sleeping (insomnia) - Digestive or bowel problems - Headaches and chronic pain - Social isolation - Problems functioning at school or work - Poor quality of life - Suicide Diagnosis You may start by seeing your primary care doctor to find out if your anxiety could be related to your physical health. Your doctor can check for signs of an underlying medical condition that may need treatment. However, you may need to see a mental health specialist if you have severe anxiety. A psychiatrist is a medical doctor who specializes in diagnosing and treating mental health conditions. A psychologist and certain other mental health professionals can diagnose anxiety and provide counseling (psychotherapy). To help diagnose an anxiety disorder and rule out other conditions, your provider may: - Give you a psychological evaluation. This involves describing your thoughts, feelings and behavior to help pinpoint a diagnosis and check for related complications. Anxiety disorders often occur along with other mental health problems - such as depression or substance abuse - which can make diagnosis more challenging. - Compare your symptoms to the criteria in the DSM-5. Many doctors use the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, to diagnose an anxiety disorder. Treatment The two main treatments for anxiety disorders are psychotherapy and medications. You may benefit most from a combination of the two. It may take some trial and error to discover which treatments work best for you. Psychotherapy Also known as talk therapy or psychological counseling, psychotherapy involves working with a therapist to reduce your anxiety symptoms. It can be an effective treatment for anxiety. Cognitive behavioral therapy (CBT) is the most effective form of psychotherapy for anxiety disorders. Generally a short-term treatment, CBT focuses on teaching you specific skills to improve your symptoms and gradually return to the activities you've avoided because of anxiety. CBT includes exposure therapy, in which you gradually encounter the object or situation that triggers your anxiety so you build confidence that you can manage the situation and anxiety symptoms. Medications Several types of medications are used to help relieve symptoms, depending on the type of anxiety disorder you have and whether you also have other mental or physical health issues. For example: - Certain antidepressants are also used to treat anxiety disorders. - An anti-anxiety medication called buspirone may be prescribed. - In limited circumstances, your doctor may prescribe a certain type of sedative called a benzodiazepine for short-term relief of anxiety symptoms. Talk with your doctor about benefits, risks and possible side effects of medications. Lifestyle and home remedies While most people with anxiety disorders need psychotherapy or medications to get anxiety under control, lifestyle changes also can make a difference. Here's what you can do: - Keep physically active. Develop a routine so that you're physically active most days of the week. Exercise is a powerful stress reducer. It may improve your mood and help you stay healthy. Start out slowly and gradually increase the amount and intensity of your activities. - Avoid alcohol and recreational drugs. These substances can cause or worsen anxiety. If you can't quit on your own, see your doctor or find a support group to help you. - Quit smoking and cut back or quit drinking caffeinated beverages. Both nicotine and caffeine can worsen anxiety. - Use stress management and relaxation techniques. Visualization techniques, meditation and yoga are examples of relaxation techniques that can ease anxiety. - Make sleep a priority. Do what you can to make sure you're getting enough sleep to feel rested. If you aren't sleeping well, see your doctor. - Eat healthy. Healthy eating - such as focusing on vegetables, fruits, whole grains and fish - may be linked to reduced anxiety, but more research is needed. Alternative medicine Several herbal remedies have been studied as a treatment for anxiety, but more research is needed to understand the risks and benefits. Herbal and dietary supplements aren't monitored by the FDA the same way medications are. You can't always be certain of what you're getting and whether it's safe. Some of these supplements can interfere with prescription medications or cause dangerous interactions. Before taking herbal remedies or dietary supplements, talk to your doctor to make sure they're safe for you and won't interact with any medications you take. how do you diagnose anxiety

how do you diagnose anxiety

To help diagnose generalized anxiety disorder, your doctor or mental health professional may: - Do a physical exam to look for signs that your anxiety might be linked to medications or an underlying medical condition - Order blood or urine tests or other tests, if a medical condition is suspected - Ask detailed questions about your symptoms and medical history - Use psychological questionnaires to help determine a diagnosis - Use the criteria listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association

Generalized anxiety disorder Overview It's normal to feel anxious from time to time, especially if your life is stressful. However, excessive, ongoing anxiety and worry that are difficult to control and interfere with day-to-day activities may be a sign of generalized anxiety disorder. It's possible to develop generalized anxiety disorder as a child or an adult. Generalized anxiety disorder has symptoms that are similar to panic disorder, obsessive-compulsive disorder and other types of anxiety, but they're all different conditions. Living with generalized anxiety disorder can be a long-term challenge. In many cases, it occurs along with other anxiety or mood disorders. In most cases, generalized anxiety disorder improves with psychotherapy or medications. Making lifestyle changes, learning coping skills and using relaxation techniques also can help. Generalized anxiety disorder care at Mayo Clinic Symptoms Generalized anxiety disorder symptoms can vary. They may include: - Persistent worrying or anxiety about a number of areas that are out of proportion to the impact of the events - Overthinking plans and solutions to all possible worst-case outcomes - Perceiving situations and events as threatening, even when they aren't - Difficulty handling uncertainty - Indecisiveness and fear of making the wrong decision - Inability to set aside or let go of a worry - Inability to relax, feeling restless, and feeling keyed up or on edge - Difficulty concentrating, or the feeling that your mind "goes blank" Physical signs and symptoms may include: - Fatigue - Trouble sleeping - Muscle tension or muscle aches - Trembling, feeling twitchy - Nervousness or being easily startled - Sweating - Nausea, diarrhea or irritable bowel syndrome - Irritability There may be times when your worries don't completely consume you, but you still feel anxious even when there's no apparent reason. For example, you may feel intense worry about your safety or that of your loved ones, or you may have a general sense that something bad is about to happen. Your anxiety, worry or physical symptoms cause you significant distress in social, work or other areas of your life. Worries can shift from one concern to another and may change with time and age. Children and teenagers may have similar worries to adults, but also may have excessive worries about: - Performance at school or sporting events - Family members' safety - Being on time (punctuality) - Earthquakes, nuclear war or other catastrophic events A child or teen with excessive worry may: - Feel overly anxious to fit in - Be a perfectionist - Redo tasks because they aren't perfect the first time - Spend excessive time doing homework - Lack confidence - Strive for approval - Require a lot of reassurance about performance - Have frequent stomachaches or other physical complaints - Avoid going to school or avoid social situations Some anxiety is normal, but see your doctor if: - You feel like you're worrying too much, and it's interfering with your work, relationships or other parts of your life - You feel depressed or irritable, have trouble with drinking or drugs, or you have other mental health concerns along with anxiety - You have suicidal thoughts or behaviors - seek emergency treatment immediately Your worries are unlikely to simply go away on their own, and they may actually get worse over time. Try to seek professional help before your anxiety becomes severe - it may be easier to treat early on. Causes As with many mental health conditions, the cause of generalized anxiety disorder likely arises from a complex interaction of biological and environmental factors, which may include: - Differences in brain chemistry and function - Genetics - Differences in the way threats are perceived - Development and personality Risk factors Women are diagnosed with generalized anxiety disorder somewhat more often than men are. The following factors may increase the risk of developing generalized anxiety disorder: - Personality. A person whose temperament is timid or negative or who avoids anything dangerous may be more prone to generalized anxiety disorder than others are. - Genetics. Generalized anxiety disorder may run in families. - Experiences. People with generalized anxiety disorder may have a history of significant life changes, traumatic or negative experiences during childhood, or a recent traumatic or negative event. Chronic medical illnesses or other mental health disorders may increase risk. Complications Having generalized anxiety disorder can be disabling. It can: - Impair your ability to perform tasks quickly and efficiently because you have trouble concentrating - Take your time and focus from other activities - Sap your energy - Increase your risk of depression Generalized anxiety disorder can also lead to or worsen other physical health conditions, such as: - Digestive or bowel problems, such as irritable bowel syndrome or ulcers - Headaches and migraines - Chronic pain and illness - Sleep problems and insomnia - Heart-health issues Generalized anxiety disorder often occurs along with other mental health problems, which can make diagnosis and treatment more challenging. Some mental health disorders that commonly occur with generalized anxiety disorder include: - Phobias - Panic disorder - Post-traumatic stress disorder (PTSD) - Obsessive-compulsive disorder (OCD) - Depression - Suicidal thoughts or suicide - Substance abuse Diagnosis To help diagnose generalized anxiety disorder, your doctor or mental health professional may: - Do a physical exam to look for signs that your anxiety might be linked to medications or an underlying medical condition - Order blood or urine tests or other tests, if a medical condition is suspected - Ask detailed questions about your symptoms and medical history - Use psychological questionnaires to help determine a diagnosis - Use the criteria listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association Treatment Treatment decisions are based on how significantly generalized anxiety disorder is affecting your ability to function in your daily life. The two main treatments for generalized anxiety disorder are psychotherapy and medications. You may benefit most from a combination of the two. It may take some trial and error to discover which treatments work best for you. Psychotherapy Also known as talk therapy or psychological counseling, psychotherapy involves working with a therapist to reduce your anxiety symptoms. Cognitive behavioral therapy is the most effective form of psychotherapy for generalized anxiety disorder. Generally a short-term treatment, cognitive behavioral therapy focuses on teaching you specific skills to directly manage your worries and help you gradually return to the activities you've avoided because of anxiety. Through this process, your symptoms improve as you build on your initial success. Medications Several types of medications are used to treat generalized anxiety disorder, including those below. Talk with your doctor about benefits, risks and possible side effects. - Antidepressants. Antidepressants, including medications in the selective serotonin reuptake inhibitor (SSRI) and serotonin and norepinephrine reuptake inhibitor (SNRI) classes, are the first line medication treatments. Examples of antidepressants used to treat generalized anxiety disorder include escitalopram (Lexapro), duloxetine (Cymbalta), venlafaxine (Effexor XR) and paroxetine (Paxil, Pexeva). Your doctor also may recommend other antidepressants. - Buspirone. An anti-anxiety medication called buspirone may be used on an ongoing basis. As with most antidepressants, it typically takes up to several weeks to become fully effective. - Benzodiazepines. In limited circumstances, your doctor may prescribe a benzodiazepine for relief of anxiety symptoms. These sedatives are generally used only for relieving acute anxiety on a short-term basis. Because they can be habit-forming, these medications aren't a good choice if you have or had problems with alcohol or drug abuse. Lifestyle and home remedies While most people with anxiety disorders need psychotherapy or medications to get anxiety under control, lifestyle changes also can make a difference. Here's what you can do: - Keep physically active. Develop a routine so that you're physically active most days of the week. Exercise is a powerful stress reducer. It may improve your mood and help you stay healthy. Start out slowly and gradually increase the amount and intensity of your activities. - Make sleep a priority. Do what you can to make sure you're getting enough sleep to feel rested. If you aren't sleeping well, see your doctor. - Use relaxation techniques. Visualization techniques, meditation and yoga are examples of relaxation techniques that can ease anxiety. - Eat healthy. Healthy eating - such as focusing on vegetables, fruits, whole grains and fish - may be linked to reduced anxiety, but more research is needed. - Avoid alcohol and recreational drugs. These substances can worsen anxiety. - Quit smoking and cut back or quit drinking coffee. Both nicotine and caffeine can worsen anxiety. Alternative medicine Several herbal remedies have been studied as treatments for anxiety. Results tend to be mixed, and in several studies people report no benefits from their use. More research is needed to fully understand the risks and benefits. Some herbal supplements, such as kava and valerian, increase the risk of serious liver damage. Other supplements, such as passionflower or theanine, may have a calming effect, but they're often combined with other products so it's hard to tell whether they help with symptoms of anxiety. Before taking any herbal remedies or supplements, talk with your doctor to make sure they're safe and won't interact with any medications you take. how do you diagnose anxiety

how do you diagnose anxiety

You may start by seeing your primary care doctor to find out if your anxiety could be related to your physical health. Your doctor can check for signs of an underlying medical condition that may need treatment. However, you may need to see a mental health specialist if you have severe anxiety. A psychiatrist is a medical doctor who specializes in diagnosing and treating mental health conditions. A psychologist and certain other mental health professionals can diagnose anxiety and provide counseling (psychotherapy). To help diagnose an anxiety disorder and rule out other conditions, your provider may: - Give you a psychological evaluation. This involves describing your thoughts, feelings and behavior to help pinpoint a diagnosis and check for related complications. Anxiety disorders often occur along with other mental health problems - such as depression or substance abuse - which can make diagnosis more challenging. - Compare your symptoms to the criteria in the DSM-5. Many doctors use the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, to diagnose an anxiety disorder.

Anxiety Overview Experiencing occasional anxiety is a normal part of life. However, people with anxiety disorders frequently have intense, excessive and persistent worry and fear about everyday situations. Often, anxiety disorders involve repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks). These feelings of anxiety and panic interfere with daily activities, are difficult to control, are out of proportion to the actual danger and can last a long time. You may avoid places or situations to prevent these feelings. Symptoms may start during childhood or the teen years and continue into adulthood. Examples of anxiety disorders include generalized anxiety disorder, social anxiety disorder (social phobia), specific phobias and separation anxiety disorder. You can have more than one anxiety disorder. Sometimes anxiety results from a medical condition that needs treatment. Whatever form of anxiety you have, treatment can help. Anxiety care at Mayo Clinic Symptoms Common anxiety signs and symptoms include: - Feeling nervous, restless or tense - Having a sense of impending danger, panic or doom - Having an increased heart rate - Breathing rapidly (hyperventilation) - Sweating - Trembling - Feeling weak or tired - Trouble concentrating or thinking about anything other than the present worry - Having trouble sleeping - Experiencing gastrointestinal (GI) problems - Having difficulty controlling worry - Having the urge to avoid things that trigger anxiety Several types of anxiety disorders exist: - Agoraphobia (ag-uh-ruh-FOE-be-uh) is a type of anxiety disorder in which you fear and often avoid places or situations that might cause you to panic and make you feel trapped, helpless or embarrassed. - Anxiety disorder due to a medical condition includes symptoms of intense anxiety or panic that are directly caused by a physical health problem. - Generalized anxiety disorder includes persistent and excessive anxiety and worry about activities or events - even ordinary, routine issues. The worry is out of proportion to the actual circumstance, is difficult to control and affects how you feel physically. It often occurs along with other anxiety disorders or depression. - Panic disorder involves repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks). You may have feelings of impending doom, shortness of breath, chest pain, or a rapid, fluttering or pounding heart (heart palpitations). These panic attacks may lead to worrying about them happening again or avoiding situations in which they've occurred. - Selective mutism is a consistent failure of children to speak in certain situations, such as school, even when they can speak in other situations, such as at home with close family members. This can interfere with school, work and social functioning. - Separation anxiety disorder is a childhood disorder characterized by anxiety that's excessive for the child's developmental level and related to separation from parents or others who have parental roles. - Social anxiety disorder (social phobia) involves high levels of anxiety, fear and avoidance of social situations due to feelings of embarrassment, self-consciousness and concern about being judged or viewed negatively by others. - Specific phobias are characterized by major anxiety when you're exposed to a specific object or situation and a desire to avoid it. Phobias provoke panic attacks in some people. - Substance-induced anxiety disorder is characterized by symptoms of intense anxiety or panic that are a direct result of abusing drugs, taking medications, being exposed to a toxic substance or withdrawal from drugs. - Other specified anxiety disorder and unspecified anxiety disorder are terms for anxiety or phobias that don't meet the exact criteria for any other anxiety disorders but are significant enough to be distressing and disruptive. When to see a doctor See your doctor if: - You feel like you're worrying too much and it's interfering with your work, relationships or other parts of your life - Your fear, worry or anxiety is upsetting to you and difficult to control - You feel depressed, have trouble with alcohol or drug use, or have other mental health concerns along with anxiety - You think your anxiety could be linked to a physical health problem - You have suicidal thoughts or behaviors - if this is the case, seek emergency treatment immediately Your worries may not go away on their own, and they may get worse over time if you don't seek help. See your doctor or a mental health provider before your anxiety gets worse. It's easier to treat if you get help early. Causes The causes of anxiety disorders aren't fully understood. Life experiences such as traumatic events appear to trigger anxiety disorders in people who are already prone to anxiety. Inherited traits also can be a factor. Medical causes For some people, anxiety may be linked to an underlying health issue. In some cases, anxiety signs and symptoms are the first indicators of a medical illness. If your doctor suspects your anxiety may have a medical cause, he or she may order tests to look for signs of a problem. Examples of medical problems that can be linked to anxiety include: - Heart disease - Diabetes - Thyroid problems, such as hyperthyroidism - Respiratory disorders, such as chronic obstructive pulmonary disease (COPD) and asthma - Drug abuse or withdrawal - Withdrawal from alcohol, anti-anxiety medications (benzodiazepines) or other medications - Chronic pain or irritable bowel syndrome - Rare tumors that produce certain "fight-or-flight" hormones Sometimes anxiety can be a side effect of certain medications. It's possible that your anxiety may be due to an underlying medical condition if: - You don't have any blood relatives (such as a parent or sibling) with an anxiety disorder - You didn't have an anxiety disorder as a child - You don't avoid certain things or situations because of anxiety - You have a sudden occurrence of anxiety that seems unrelated to life events and you didn't have a previous history of anxiety Risk factors These factors may increase your risk of developing an anxiety disorder: - Trauma. Children who endured abuse or trauma or witnessed traumatic events are at higher risk of developing an anxiety disorder at some point in life. Adults who experience a traumatic event also can develop anxiety disorders. - Stress due to an illness. Having a health condition or serious illness can cause significant worry about issues such as your treatment and your future. - Stress buildup. A big event or a buildup of smaller stressful life situations may trigger excessive anxiety - for example, a death in the family, work stress or ongoing worry about finances. - Personality. People with certain personality types are more prone to anxiety disorders than others are. - Other mental health disorders. People with other mental health disorders, such as depression, often also have an anxiety disorder. - Having blood relatives with an anxiety disorder. Anxiety disorders can run in families. - Drugs or alcohol. Drug or alcohol use or abuse or withdrawal can cause or worsen anxiety. Complications Having an anxiety disorder does more than make you worry. It can also lead to, or worsen, other mental and physical conditions, such as: - Depression (which often occurs with an anxiety disorder) or other mental health disorders - Substance abuse - Trouble sleeping (insomnia) - Digestive or bowel problems - Headaches and chronic pain - Social isolation - Problems functioning at school or work - Poor quality of life - Suicide Diagnosis You may start by seeing your primary care doctor to find out if your anxiety could be related to your physical health. Your doctor can check for signs of an underlying medical condition that may need treatment. However, you may need to see a mental health specialist if you have severe anxiety. A psychiatrist is a medical doctor who specializes in diagnosing and treating mental health conditions. A psychologist and certain other mental health professionals can diagnose anxiety and provide counseling (psychotherapy). To help diagnose an anxiety disorder and rule out other conditions, your provider may: - Give you a psychological evaluation. This involves describing your thoughts, feelings and behavior to help pinpoint a diagnosis and check for related complications. Anxiety disorders often occur along with other mental health problems - such as depression or substance abuse - which can make diagnosis more challenging. - Compare your symptoms to the criteria in the DSM-5. Many doctors use the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, to diagnose an anxiety disorder. Treatment The two main treatments for anxiety disorders are psychotherapy and medications. You may benefit most from a combination of the two. It may take some trial and error to discover which treatments work best for you. Psychotherapy Also known as talk therapy or psychological counseling, psychotherapy involves working with a therapist to reduce your anxiety symptoms. It can be an effective treatment for anxiety. Cognitive behavioral therapy (CBT) is the most effective form of psychotherapy for anxiety disorders. Generally a short-term treatment, CBT focuses on teaching you specific skills to improve your symptoms and gradually return to the activities you've avoided because of anxiety. CBT includes exposure therapy, in which you gradually encounter the object or situation that triggers your anxiety so you build confidence that you can manage the situation and anxiety symptoms. Medications Several types of medications are used to help relieve symptoms, depending on the type of anxiety disorder you have and whether you also have other mental or physical health issues. For example: - Certain antidepressants are also used to treat anxiety disorders. - An anti-anxiety medication called buspirone may be prescribed. - In limited circumstances, your doctor may prescribe a certain type of sedative called a benzodiazepine for short-term relief of anxiety symptoms. Talk with your doctor about benefits, risks and possible side effects of medications. Lifestyle and home remedies While most people with anxiety disorders need psychotherapy or medications to get anxiety under control, lifestyle changes also can make a difference. Here's what you can do: - Keep physically active. Develop a routine so that you're physically active most days of the week. Exercise is a powerful stress reducer. It may improve your mood and help you stay healthy. Start out slowly and gradually increase the amount and intensity of your activities. - Avoid alcohol and recreational drugs. These substances can cause or worsen anxiety. If you can't quit on your own, see your doctor or find a support group to help you. - Quit smoking and cut back or quit drinking caffeinated beverages. Both nicotine and caffeine can worsen anxiety. - Use stress management and relaxation techniques. Visualization techniques, meditation and yoga are examples of relaxation techniques that can ease anxiety. - Make sleep a priority. Do what you can to make sure you're getting enough sleep to feel rested. If you aren't sleeping well, see your doctor. - Eat healthy. Healthy eating - such as focusing on vegetables, fruits, whole grains and fish - may be linked to reduced anxiety, but more research is needed. Alternative medicine Several herbal remedies have been studied as a treatment for anxiety, but more research is needed to understand the risks and benefits. Herbal and dietary supplements aren't monitored by the FDA the same way medications are. You can't always be certain of what you're getting and whether it's safe. Some of these supplements can interfere with prescription medications or cause dangerous interactions. Before taking herbal remedies or dietary supplements, talk to your doctor to make sure they're safe for you and won't interact with any medications you take. how do you diagnose anxiety

how do you diagnose anxiety

There is no test that can make a diagnosis of GAD. The diagnosis is based on your answers to questions about the symptoms of GAD. Your health care provider will ask about these symptoms. You will also be asked about other aspects of your mental and physical health. A physical exam or lab tests may be done to rule out other conditions that cause similar symptoms.

Generalized anxiety disorder GAD Anxiety disorder Summary Generalized anxiety disorder (GAD) is a mental disorder in which a person is often worried or anxious about many things and finds it hard to control this anxiety. Causes The cause of GAD is unknown. Genes may play a role. Stress may also contribute to the development of GAD. GAD is a common condition. Anyone can develop this disorder, even children. GAD occurs more often in women than in men. Symptoms The main symptom is frequent worry or tension for at least 6 months, even when there is little or no clear cause. Worries seem to float from one problem to another. Problems may involve family, other relationships, work, school, money, and health. Even when aware that worries or fears are stronger than appropriate for the situation, a person with GAD still has difficulty controlling them. Other symptoms of GAD include: Problems concentrating Fatigue Irritability Problems falling or staying asleep, or sleep that is restless and unsatisfying Restlessness when awake The person may also have other physical symptoms. These can include muscle tension, upset stomach, sweating, or difficulty breathing. Exams and Tests There is no test that can make a diagnosis of GAD. The diagnosis is based on your answers to questions about the symptoms of GAD. Your health care provider will ask about these symptoms. You will also be asked about other aspects of your mental and physical health. A physical exam or lab tests may be done to rule out other conditions that cause similar symptoms. Treatment The goal of treatment is to help you feel better and function well in daily life. Talk therapy or medicine alone can be helpful. Sometimes, a combination of these may work best. TALK THERAPY Many types of talk therapy may be helpful for GAD. One common and effective talk therapy is cognitive-behavioral therapy (CBT). CBT can help you understand the relationship between your thoughts, behaviors, and symptoms. Often CBT involves a set number of visits. During CBT you can learn how to: Understand and gain control of distorted views of stressors, such as other people's behavior or life events. Recognize and replace panic-causing thoughts to help you feel more in control. Manage stress and relax when symptoms occur. Avoid thinking that minor problems will develop into terrible ones. Other types of talk therapy may also be helpful in managing symptoms of an anxiety disorder. MEDICINES Certain medicines, usually used to treat depression, may be very helpful for this disorder. They work by preventing your symptoms or making them less severe. You must take these medicines every day. DO NOT stop taking them without talking with your provider. Medicines called sedatives or hypnotics may also be prescribed. These medicines should only be taken under a doctor's direction. Your doctor will prescribe a limited amount of these drugs. They should not to be used everyday. They may be used when symptoms become very severe or when you are about to be exposed to something that always brings on your symptoms. If you are prescribed a sedative, do not drink alcohol while on this medicine. SELF-CARE Other than taking medicine and going to therapy, you can help yourself get better by: Reducing caffeine Not using street drugs or large amounts of alcohol Exercising, getting enough rest, and eating healthy foods Support Groups You can ease the stress of having GAD by joining a support group. Sharing with others who have common experiences and problems can help you not feel alone. Support groups are usually not a good substitute for talk therapy or taking medicine, but can be a helpful addition. Resources for more information include: Anxiety and Depression Association of America -- adaa.org National Institute of Mental Health -- www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml Outlook (Prognosis) How well a person does depends on how severe the condition is. In some cases, GAD is long-term and is difficult to treat. Most people, though, get better with medicine and/or talk therapy. Possible Complications Depression and substance abuse may occur with an anxiety disorder. When to Contact a Medical Professional Call your provider if you frequently worry or feel anxious, especially if it interferes with your daily activities. Review Date 3/26/2018 Updated by: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how do you diagnose anxiety

how do you diagnose anxiety

Social anxiety disorder (Exams and Tests): The health care provider will look at your history of social anxiety and will get a description of the behavior from you, your family, and friends.

Social anxiety disorder Phobia - social Anxiety disorder - social Social phobia SAD - social anxiety disorder Summary Social anxiety disorder is a persistent and irrational fear of situations that may involve scrutiny or judgment by others, such as at parties and other social events. Causes People with social anxiety disorder fear and avoid situations in which they may be judged by others. It may begin in the teens and may have to do with overprotective parents or limited social opportunities. Men and women are affected equally with this disorder. People with social phobia are at high risk for alcohol or other drug use. This is because they may come to rely on these substances to relax in social situations. Symptoms People with social anxiety become very anxious and self-conscious in everyday social situations. They have an intense, persistent, and chronic fear of being watched and judged by others, and of doing things that will embarrass them. They can worry for days or weeks before a dreaded situation. This fear may become so severe that it interferes with work, school, and other ordinary activities, and can make it hard to make and keep friends. Some of the most common fears of people with this disorder include: Attending parties and other social occasions Eating, drinking, and writing in public Meeting new people Speaking in public Using public restrooms Physical symptoms that often occur include: Blushing Difficulty talking Nausea Profuse sweating Trembling Social anxiety disorder is different from shyness. Shy people are able to participate in social functions. Social anxiety disorder affects the ability to function in work and relationships. Exams and Tests The health care provider will look at your history of social anxiety and will get a description of the behavior from you, your family, and friends. Treatment The goal of treatment is to help you function effectively. The success of the treatment usually depends on the severity of your fears. Behavioral treatment is often tried first and may have long-lasting benefits: Cognitive behavioral therapy helps you understand and change the thoughts that are causing your condition, as well as learn to recognize and replace panic-causing thoughts. Systematic desensitization or exposure therapy may be used. You are asked to relax, then imagine the situations that cause the anxiety, working from the least fearful to the most fearful. Gradual exposure to the real-life situation has also been used with success to help people overcome their fears. Social skills training may involve social contact in a group therapy situation to practice social skills. Role playing and modeling are techniques used to help you become more comfortable relating to others in a social situation. Certain medicines, usually used to treat depression, may be very helpful for this disorder. They work by preventing your symptoms or making them less severe. You must take these medicines every day. DO NOT stop taking them without talking with your provider. Medicines called sedatives (or hypnotics) may also be prescribed. These medicines should only be taken under a doctor's direction. Your doctor will prescribe a limited amount of these drugs. They should not to be used every day. They may be used when symptoms become very severe or when you are about to be exposed to something that always brings on your symptoms. If you are prescribed a sedative, do not drink alcohol while on this medicine. Lifestyle changes may help reduce how often the attacks occur. Get regular exercise, enough sleep, and regularly scheduled meals. Reduce or avoid the use of caffeine, some over-the-counter cold medicines, and other stimulants. Support Groups You can ease the stress of having social anxiety by joining a support group. Sharing with others who have common experiences and problems can help you not feel alone. Support groups are usually not a good substitute for talk therapy or taking medicine, but can be a helpful addition. Resources for more information include: Anxiety and Depression Association of America -- adaa.org National Institute of Mental Health -- www.nimh.nih.gov/health/publications/social-anxiety-disorder-more-than-just-shyness/index.shtml Outlook (Prognosis) The outcome is often good with treatment. Antidepressant medicines can also be effective. Possible Complications Alcohol or other drug use may occur with social anxiety disorder. Loneliness and social isolation may occur. When to Contact a Medical Professional Call your provider if fear is affecting your work and relationships with others. Review Date 3/26/2018 Updated by: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how do you diagnose anxiety

how do you diagnose anxiety

Separation anxiety in children (Exams and Tests): There are no tests for this condition, because it is normal. If severe separation anxiety persists past age 2, a visit with a health care provider may help determine if the child has an anxiety disorder or other condition.

Separation anxiety in children Summary Separation anxiety in children is a developmental stage in which the child is anxious when separated from the primary caregiver (usually the mother). Causes As infants grow, their emotions and reactions to the world around them seem to occur in a predictable order. Before 8 months, infants are so new to the world that they lack a sense of what is normal and safe and what may be dangerous. As a result, new settings or people seem to not frighten them. From 8 to 14 months, children often become frightened when they meet new people or visit new places. They recognize their parents as familiar and safe. When separated from their parents, they feel threatened and unsafe. Separation anxiety is a normal stage as a child grows and develops. It helped keep our ancestors alive and helps children learn how to master the world around them. It usually ends when the child is around 2 years old. At this age, toddlers begin to understand that parents may be out of sight now, but will return later. It's also normal for them to test their independence. To get over separation anxiety, children need to: Feel safe in their home. Trust people other than their parents. Trust that their parents will return. Even after children have mastered this stage, separation anxiety may return in times of stress. Most children will feel some degree of separation anxiety when in unfamiliar situations, most often when separated from their parents. When children are in situations (such as hospitals) and are under stress (such as illness or pain), they seek the safety, comfort, and protection of their parents. Since anxiety can worsen pain, staying with a child as much as possible can reduce the pain. Symptoms A child with severe separation anxiety may have any of the following: Excessive distress when separated from the primary caregiver Nightmares Reluctance to go to school or other places because of fear of separation Reluctance to go to sleep without the primary caregiver nearby Repeated physical complaints Worry about losing, or harm coming to the primary caregiver Exams and Tests There are no tests for this condition, because it is normal. If severe separation anxiety persists past age 2, a visit with a health care provider may help determine if the child has an anxiety disorder or other condition. Treatment No treatment is needed for normal separation anxiety. Parents can help their infant or toddler adjust to their absence by letting trusted caregivers babysit the child. This helps the child learn to trust and bond with other adults and understand that their parents will return. During medical procedures, a parent should go with the child if possible. When a parent can't go with the child, exposing the child to the situation beforehand may be helpful, such as visiting the doctor's office before a test. Some hospitals have child life specialists who can explain procedures and medical conditions to children of all ages. If your child is very anxious and needs extended medical care, ask your provider about such services. When it's not possible for parents to be with the child, such as for surgery, explain the experience to the child. Reassure the child that a parent is waiting, and where. For older children who have not outgrown separation anxiety, treatments may include: Anti-anxiety medicines Changes in parenting techniques Counseling for the parents and child Treatment for severe cases may include: Family education Family therapy Talk therapy Outlook (Prognosis) Young children with symptoms that improve after age 2 are normal, even if some anxiety comes back later during stress. When separation anxiety occurs in adolescence, it may signal the development of an anxiety disorder. When to Contact a Medical Professional Call your provider if your child has severe separation anxiety after age 2. Review Date 5/20/2018 Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how do you diagnose anxiety

how do you diagnose anxiety

Anxiety disorders (How are anxiety disorders diagnosed?): Your doctor or nurse will ask you questions about your symptoms and your medical history. Your doctor may also do a physical exam or other tests to rule out other health problems that could be causing your symptoms. Anxiety disorders are diagnosed when fear and dread of nonthreatening situations, events, places, or objects become excessive and are uncontrollable. Anxiety disorders are also diagnosed if the anxiety has lasted for at least six months and it interferes with social, work, family, or other aspects of daily life.

Anxiety disorders Overview Anxiety is a normal response to stress. But when it becomes hard to control and affects your day-to-day life, it can be disabling. Anxiety disorders affect nearly one in five adults in the United States.1 Women are more than twice as likely as men to get an anxiety disorder in their lifetime.2 Anxiety disorders are often treated with counseling, medicine, or a combination of both. Some women also find that yoga or meditation helps with anxiety disorders. What is anxiety? Anxiety is a feeling of worry, nervousness, or fear about an event or situation. It is a normal reaction to stress. It helps you stay alert for a challenging situation at work, study harder for an exam, or remain focused on an important speech. In general, it helps you cope. But anxiety can be disabling if it interferes with daily life, such as making you dread nonthreatening day-to-day activities like riding the bus or talking to a coworker. Anxiety can also be a sudden attack of terror when there is no threat. What are anxiety disorders? Anxiety disorders happen when excessive anxiety interferes with your everyday activities such as going to work or school or spending time with friends or family. Anxiety disorders are serious mental illnesses. They are the most common mental disorders in the United States. Anxiety disorders are more than twice as common in women as in men. What are the major types of anxiety disorder? The major types of anxiety disorder are: Some other conditions that are not considered anxiety disorders but are similar include: Who gets anxiety disorders? Anxiety disorders affect about 40 million American adults every year. Anxiety disorders also affect children and teens. About 8% of teens ages 13 to 18 have an anxiety disorder, with symptoms starting around age 6.5 Women are more than twice as likely as men to get an anxiety disorder in their lifetime.2 Also, some types of anxiety disorders affect some women more than others: What causes anxiety disorders? Researchers think anxiety disorders are caused by a combination of factors, which may include: What are the signs and symptoms of an anxiety disorder? Women with anxiety disorders experience a combination of anxious thoughts or beliefs, physical symptoms, and changes in behavior, including avoiding everyday activities they used to do. Each anxiety disorder has different symptoms. They all involve a fear and dread about things that may happen now or in the future. Physical symptoms may include: Physical symptoms of anxiety disorders often happen along with other mental or physical illnesses. This can cover up your anxiety symptoms or make them worse.2 How are anxiety disorders diagnosed? Your doctor or nurse will ask you questions about your symptoms and your medical history. Your doctor may also do a physical exam or other tests to rule out other health problems that could be causing your symptoms. Anxiety disorders are diagnosed when fear and dread of nonthreatening situations, events, places, or objects become excessive and are uncontrollable. Anxiety disorders are also diagnosed if the anxiety has lasted for at least six months and it interferes with social, work, family, or other aspects of daily life.2 How are anxiety disorders treated? Treatment for anxiety disorders depends on the type of anxiety disorder you have and your personal history of health problems, violence, or abuse. Often, treatment may include: How does counseling help treat anxiety disorders? Your doctor may refer you for a type of counseling for anxiety disorders called cognitive behavioral therapy (CBT). You can talk to a trained mental health professional about what caused your anxiety disorder and how to deal with the symptoms.2 For example, you can talk to a psychiatrist, psychologist, social worker, or counselor. CBT can help you change the thinking patterns around your fears. It may help you change the way you react to situations that may create anxiety. You may also learn ways to reduce feelings of anxiety and improve specific behaviors caused by chronic anxiety. These strategies may include relaxation therapy and problem solving. What types of medicine treat anxiety disorders? Several types of medicine treat anxiety disorders. These include: All medicines have risks. You should talk to your doctor about the benefits and risks of all medicines. Learn more about medicines to treat anxiety disorders. What if my anxiety disorder treatment is not working? Sometimes, you may need to work with your doctor to try several different treatments or combinations of treatments before you find one that works for you. If you are having trouble with side effects from medicines, talk to your doctor or nurse. Do not stop taking your medicine without talking to a doctor or nurse. Your doctor may adjust how much medicine you take and when you take it. What if my anxiety disorder comes back? Sometimes symptoms of an anxiety disorder come back after you have finished treatment. This may happen during or after a stressful event. It may also happen without any warning. Many people with anxiety disorders do get better with treatment. But, if your symptoms come back, your doctor will work with you to change or adjust your medicine or treatment plan. You can also talk to your doctor about ways to identify and prevent anxiety from coming back. This may include writing down your feelings or meeting with your counselor if you think your anxiety is uncontrollable. Can complementary or alternative medicine help manage anxiety disorders? Maybe. Some women say that complementary or alternative medicine (CAM) therapies helped lower their anxiety. CAM therapies that may help anxiety include: Learn more about CAM therapies for anxiety disorders. Will my anxiety disorder treatment affect my pregnancy? If your treatment is counseling, it will not affect your pregnancy. If you are on medicine to treat your anxiety disorder, talk to your doctor. Some medicines used to treat anxiety can affect your unborn baby. If I take medicine to treat my anxiety disorder, can I breastfeed my baby? It depends. Some medicines used to treat anxiety can pass through breastmilk. Certain antidepressants, such as some SSRIs, are safe to take during breastfeeding. Do not stop taking your medicine too quickly. Talk to your doctor to find out what medicine is best for you and your baby. Learn more about medicines and breastfeeding in our Breastfeeding section. You can also enter your medicine into the LactMed database to find out if your medicine passes through your breastmilk and any possible side effects for your nursing baby. How do anxiety disorders affect other health conditions? Anxiety disorders may affect other health problems that are common in women. These include: What is the latest research on anxiety disorders and women? Researchers are studying why women are more than twice as likely as men to develop anxiety disorders and depression. Changes in levels of the hormone estrogen throughout a woman's menstrual cycle and reproductive life (during the years a woman can have a baby) probably play a role. Researchers also recently studied the male hormone testosterone, which is found in women and men but typically in higher levels in men. They found that treatment with testosterone had similar effects as antianxiety and antidepressant medicine for the women in the study.15 Other research focuses on anxiety disorders and depression during and after pregnancy and among overweight and obese women. For more clinical trials related to anxiety disorders and women, visit ClinicalTrials.gov. Did we answer your question about anxiety disorders? For more information on anxiety disorders, call the OWH Helpline at 1-800-994-9662 or contact the following organizations: Sources how do you diagnose anxiety

how do you diagnose anxiety

Pelvic organ prolapse: Pelvic organ prolapse happens when the muscles and tissues supporting the pelvic organs (the uterus, bladder, or rectum) become weak or loose.

Pelvic organ prolapse Overview Pelvic organ prolapse happens when the muscles and tissues supporting the pelvic organs (the uterus, bladder, or rectum) become weak or loose. This allows one or more of the pelvic organs to drop or press into or out of the vagina. Many women are embarrassed to talk to their doctor about their symptoms or think that their symptoms are normal. But pelvic organ prolapse is treatable. What is pelvic organ prolapse? The pelvic muscles and tissues support the pelvic organs like a hammock. The pelvic organs include the bladder, uterus and cervix, vagina, and rectum, which is part of the bowel. A prolapse happens when the pelvis muscles and tissues can no longer support these organs because the muscles and tissues are weak or damaged. This causes one or more pelvic organs to drop or press into or out of the vagina. Pelvic organ prolapse is a type of pelvic floor disorder. The most common pelvic floor disorders are: What are the different types of pelvic organ prolapse? The different types of pelvic organ prolapse depend on the pelvic organ affected. The most common types include: Although it is rare, pelvic organ prolapse can also happen after a hysterectomy. Any part of the vaginal wall may drop, causing a bulge into or out of the vagina. Who gets pelvic organ prolapse? Pelvic floor disorders (urinary incontinence, fecal incontinence, and pelvic organ prolapse) affect one in five women in the United States.1 Pelvic organ prolapse is less common than urinary or fecal incontinence but affects almost 3% of U.S. women.1 Pelvic organ prolapse happens more often in older women and in white and Hispanic women than in younger women or women of other racial and ethnic groups.2,3 Some women develop more than one pelvic floor disorder, such as pelvic organ prolapse with urinary incontinence. What are the symptoms of pelvic organ prolapse? The pressure from prolapse can cause a bulge in the vagina that can sometimes be felt or seen. Women with pelvic organ prolapse may feel uncomfortable pressure during physical activity or sex. Other symptoms of pelvic organ prolapse include: Some women say that their symptoms are worse at certain times of the day, during physical activity, or after standing for a long time. Talk to your doctor or nurse about your symptoms. What causes pelvic organ prolapse? Pelvic organ prolapse happens when the muscles or connective tissues of the pelvis do not work as they should. The most common risk factors are: How is pelvic organ prolapse diagnosed? Your doctor will talk to you about your symptoms and do a pelvic exam. You may be asked to strain or cough during the exam so your doctor can see whether these actions cause prolapse or urine leakage. Your doctor may also do other tests to see whether you can completely empty your bladder when you go to the bathroom. How is pelvic organ prolapse treated? Treatment for pelvic organ prolapse depends on the type of prolapse you have, your symptoms, your age, other health problems, and whether you are sexually active. Your treatment may include one or more of the following: How can I prevent pelvic organ prolapse? Researchers are studying ways to prevent pelvic organ prolapse. The following steps may reduce your risk of getting a pelvic floor problem: Did we answer your question about pelvic organ prolapse? For more information about pelvic organ prolapse, call the OWH Helpline at 1-800-994-9662 or contact the following organizations: Sources how do you get a prolapse bladder

how do you get a prolapse bladder

Your pelvic floor consists of muscles, ligaments and connective tissues that support your bladder and other pelvic organs. The connections between your pelvic floor muscles and ligaments can weaken over time, as a result of trauma from childbirth or chronic straining of pelvic floor muscles. When this happens, your bladder can slip down lower than normal and bulge into your vagina (anterior prolapse). Possible causes of anterior prolapse include: - Pregnancy and vaginal childbirth - Being overweight or obese - Repeated heavy lifting - Straining with bowel movements - A chronic cough or bronchitis

Anterior prolapse (cystocele) Overview Anterior prolapse, also known as a cystocele (SIS-toe-seel), occurs when the supportive tissue between a woman's bladder and vaginal wall weakens and stretches, allowing the bladder to bulge into the vagina. Anterior prolapse is also called a prolapsed bladder. Straining the muscles that support your pelvic organs may lead to anterior prolapse. Such straining occurs during vaginal childbirth or with chronic constipation, violent coughing or heavy lifting. Anterior prolapse also tends to cause problems after menopause, when estrogen levels decrease. For a mild or moderate anterior prolapse, nonsurgical treatment is often effective. In more severe cases, surgery may be necessary to keep the vagina and other pelvic organs in their proper positions. Symptoms In mild cases of anterior prolapse, you may not notice any signs or symptoms. When signs and symptoms occur, they may include: - A feeling of fullness or pressure in your pelvis and vagina - Increased discomfort when you strain, cough, bear down or lift - A feeling that you haven't completely emptied your bladder after urinating - Repeated bladder infections - Pain or urinary leakage during sexual intercourse - In severe cases, a bulge of tissue that protrudes through your vaginal opening and may feel like sitting on an egg Signs and symptoms often are especially noticeable after standing for long periods of time and may go away when you lie down. When to see a doctor A severely prolapsed bladder can be uncomfortable. It can make emptying your bladder difficult and may lead to bladder infections. Make an appointment with your doctor if you have any signs or symptoms that bother you. Causes Your pelvic floor consists of muscles, ligaments and connective tissues that support your bladder and other pelvic organs. The connections between your pelvic floor muscles and ligaments can weaken over time, as a result of trauma from childbirth or chronic straining of pelvic floor muscles. When this happens, your bladder can slip down lower than normal and bulge into your vagina (anterior prolapse). Possible causes of anterior prolapse include: - Pregnancy and vaginal childbirth - Being overweight or obese - Repeated heavy lifting - Straining with bowel movements - A chronic cough or bronchitis Risk factors These factors may increase your risk of anterior prolapse: - Childbirth. Women who have vaginally delivered one or more children have a higher risk of anterior prolapse. - Aging. Your risk of anterior prolapse increases as you age. This is especially true after menopause, when your body's production of estrogen - which helps keep the pelvic floor strong - decreases. - Hysterectomy. Having your uterus removed may contribute to weakness in your pelvic floor support. - Genetics. Some women are born with weaker connective tissues, making them more susceptible to anterior prolapse. - Obesity. Women who are overweight or obese are at higher risk of anterior prolapse. Diagnosis Diagnosis of anterior prolapse may involve: - A pelvic exam. You may be examined while lying down and while standing up. During the exam, your doctor looks for a tissue bulge into your vagina that indicates pelvic organ prolapse. You'll likely be asked to bear down as if during a bowel movement to see how much that affects the degree of prolapse. To check the strength of your pelvic floor muscles, you'll be asked to contract them, as if you're trying to stop the stream of urine. - Filling out a questionnaire. You may fill out a form that helps your doctor assess the degree of your prolapse and how much it affects your quality of life. Information gathered also helps guide treatment decisions. - Bladder and urine tests. If you have significant prolapse, you might be tested to see how well and completely your bladder empties. Your doctor might also run a test on a urine sample to look for signs of a bladder infection, if it seems that you're retaining more urine in your bladder than is normal after urinating. Treatment Treatment depends on how severe your anterior prolapse is and whether you have any related conditions, such as a uterus that slips into the vaginal canal (uterine prolapse). Mild cases - those with few or no obvious symptoms - typically don't require treatment. You could opt for a wait-and-see approach, with occasional visits to your doctor to see if your prolapse is worsening, along with self-care measures, such as exercises that strengthen your pelvic floor muscles. If self-care measures aren't effective, anterior prolapse treatment might involve: - A supportive device (pessary). A vaginal pessary is a plastic or rubber ring inserted into your vagina to support the bladder. Your doctor or other care provider fits you for the device and shows you how to clean and reinsert it on your own. Many women use pessaries as a temporary alternative to surgery, and some use them when surgery is too risky. - Estrogen therapy. Your doctor may recommend using estrogen - usually a vaginal cream, pill or ring - especially if you've already experienced menopause. This is because estrogen, which helps keep pelvic muscles strong, decreases after menopause. When surgery is necessary If you have noticeable, uncomfortable symptoms, anterior prolapse may require surgery. - How it's done. Often, the surgery is performed vaginally and involves lifting the prolapsed bladder back into place, removing extra tissue, and tightening the muscles and ligaments of the pelvic floor. Your doctor may use a special type of tissue graft to reinforce vaginal tissues and increase support if your vaginal tissues seem very thin. - If you have a prolapsed uterus. For anterior prolapse associated with a prolapsed uterus, your doctor may recommend removing the uterus (hysterectomy) in addition to repairing the damaged pelvic floor muscles, ligaments and other tissues. If you're thinking about becoming pregnant, your doctor may recommend that you delay surgery until after you're done having children. Using a pessary may help relieve your symptoms in the meantime. The benefits of surgery can last for many years, but there's some risk of recurrence - which may mean another surgery at some point. Dealing with incontinence If your anterior prolapse is accompanied by stress incontinence - involuntary loss of urine during strenuous activity - your doctor may recommend one of a number of procedures to support the urethra (urethral suspension) and ease your incontinence symptoms. Treatment at Mayo Clinic Urologists and urogynecologists at Mayo Clinic provide expert care for female patients of all ages who suffer from problems of the pelvic floor. Mayo physicians are leaders in clinical research that enhances the capability to offer the most advanced treatments available. Many of the urologists across all Mayo Clinic campuses have advanced training and subspecialty certification in female pelvic medicine and reconstructive surgery from the American Board of Urology. Urogynecologists at Mayo Clinic also have advanced training and certification in female urology. Specialty services offered through urology and urogynecology include: - Pelvic organ prolapse with or without incontinence diagnosis and treatment - Urodynamic evaluation - Stress urinary incontinence diagnosis and treatment - Minimally invasive injection therapies - Management of mesh complications - Urge urinary incontinence diagnosis and treatment - Overactive bladder diagnosis and treatment - Botox injections of the urinary tract - Neuromodulation for the urinary tract Lifestyle and home remedies Kegel exercises strengthen your pelvic floor muscles, which support the uterus, bladder and bowel. A strengthened pelvic floor provides better support for your pelvic organs and relief from symptoms associated with anterior prolapse. To perform Kegel exercises, follow these steps: - Tighten (contract) your pelvic floor muscles - the muscles you use to stop urinating. - Hold the contraction for five seconds, then relax for five seconds. (If this is too difficult, start by holding for two seconds and relaxing for three seconds.) - Work up to holding the contraction for 10 seconds at a time. - Do three sets of 10 repetitions of the exercises each day. Ask your health care provider for feedback on whether you're using the right muscles. Kegel exercises may be most successful when they're taught by a physical therapist and reinforced with biofeedback. Biofeedback involves using monitoring devices that help ensure you're tightening the proper muscles with optimal intensity and length of time. Once you've learned the proper method, you can do Kegel exercises discreetly just about anytime, whether you're sitting at your desk or relaxing on the couch. how do you get a prolapse bladder

how do you get a prolapse bladder

Weakness of connective tissue separating the bladder and vagina may cause the bladder to bulge into the vagina.

Uterine prolapse Overview Uterine prolapse occurs when pelvic floor muscles and ligaments stretch and weaken and no longer provide enough support for the uterus. As a result, the uterus slips down into or protrudes out of the vagina. Uterine prolapse can occur in women of any age. But it often affects postmenopausal women who've had one or more vaginal deliveries. Mild uterine prolapse usually doesn't require treatment. But if uterine prolapse makes you uncomfortable or disrupts your normal life, you might benefit from treatment. Uterine prolapse care at Mayo Clinic Symptoms Mild uterine prolapse generally doesn't cause signs or symptoms. Signs and symptoms of moderate to severe uterine prolapse include: - Sensation of heaviness or pulling in your pelvis - Tissue protruding from your vagina - Urinary problems, such as urine leakage (incontinence) or urine retention - Trouble having a bowel movement - Feeling as if you're sitting on a small ball or as if something is falling out of your vagina - Sexual concerns, such as a sensation of looseness in the tone of your vaginal tissue Often, symptoms are less bothersome in the morning and worsen as the day goes on. See your doctor to discuss your options if signs and symptoms of uterine prolapse become bothersome and disrupt your normal activities. Causes Uterine prolapse results from the weakening of pelvic muscles and supportive tissues. Causes of weakened pelvic muscles and tissues include: - Pregnancy - Difficult labor and delivery or trauma during childbirth - Delivery of a large baby - Being overweight or obese - Lower estrogen level after menopause - Chronic constipation or straining with bowel movements - Chronic cough or bronchitis - Repeated heavy lifting Risk factors Factors that can increase your risk of uterine prolapse include: - One or more pregnancies and vaginal births - Giving birth to a large baby - Increasing age - Obesity - Prior pelvic surgery - Chronic constipation or frequent straining during bowel movements - Family history of weakness in connective tissue - Being Hispanic or white Complications Uterine prolapse is often associated with prolapse of other pelvic organs. You might experience: - Anterior prolapse (cystocele). Weakness of connective tissue separating the bladder and vagina may cause the bladder to bulge into the vagina. Anterior prolapse is also called prolapsed bladder. - Posterior vaginal prolapse (rectocele). Weakness of connective tissue separating the rectum and vagina may cause the rectum to bulge into the vagina. You might have difficulty having bowel movements. Severe uterine prolapse can displace part of the vaginal lining, causing it to protrude outside the body. Vaginal tissue that rubs against clothing can lead to vaginal sores (ulcers.) Rarely, the sores can become infected. Diagnosis A diagnosis of uterine prolapse generally occurs during a pelvic exam. During the pelvic exam your doctor is likely to ask you: - To bear down as if having a bowel movement. Bearing down can help your doctor assess how far the uterus has slipped into the vagina. - To tighten your pelvic muscles as if you're stopping a stream of urine. This test checks the strength of your pelvic muscles. You might fill out a questionnaire that helps your doctor assess how uterine prolapse affects your quality of life. This information helps guide treatment decisions. If you have severe incontinence, your doctor might recommend tests to measure how well your bladder functions (urodynamic testing). Treatment Treatment depends on the severity of uterine prolapse. Your doctor might recommend: - Self-care measures. If your uterine prolapse causes few or no symptoms, simple self-care measures may provide relief or help prevent worsening prolapse. Self-care measures include performing Kegel exercises to strengthen your pelvic muscles, losing weight and treating constipation. - Pessary. A vaginal pessary is a plastic or rubber ring inserted into your vagina to support the bulging tissues. A pessary must be removed regularly for cleaning. Surgery If uterine prolapse is severe, your doctor might recommend surgery. Minimally invasive (laparoscopic) or vaginal surgery might be an option. Surgery can involve: - Repair of weakened pelvic floor tissues. This surgery is generally approached through the vagina but sometimes through the abdomen. The surgeon might graft your own tissue, donor tissue or a synthetic material onto weakened pelvic floor structures to support your pelvic organs. - Removal of your uterus (hysterectomy). Hysterectomy might be recommended if uterine prolapse is severe. But hysterectomy is major surgery, and recent research suggests the surgery poses long-term health risks, including an increased risk of heart and blood vessel (cardiovascular) diseases and certain metabolic conditions. Talk with your doctor about all your treatment options to be sure you understand the risks and benefits of each so that you can choose what's best for you. Lifestyle and home remedies Depending on the severity of your uterine prolapse, self-care measures may provide relief. Try to: - Perform Kegel exercises to strengthen pelvic muscles and support the weakened fascia - Avoid constipation by eating high-fiber foods and drinking plenty of fluids - Avoid bearing down to move your bowels - Avoid heavy lifting - Control coughing - Lose weight if you're overweight or obese Kegel exercises strengthen your pelvic floor muscles. A strong pelvic floor provides better support for your pelvic organs, prevents prolapse from worsening and relieves symptoms associated with uterine prolapse. To perform Kegel exercises: - Tighten (contract) your pelvic floor muscles as though you were trying to prevent passing gas. - Hold the contraction for five seconds, and then relax for five seconds. If this is too difficult, start by holding for two seconds and relaxing for three seconds. - Work up to holding the contractions for 10 seconds at a time. - Aim for at least three sets of 10 repetitions each day. Kegel exercises may be most successful when they're taught by a physical therapist and reinforced with biofeedback. Biofeedback involves using monitoring devices that help ensure you're tightening the muscles properly for the best length of time. Once you've learned the proper method, you can do Kegel exercises discreetly just about anytime, whether you're sitting at your desk or relaxing on the couch. how do you get a prolapse bladder

how do you get a prolapse bladder

In people with myasthenia gravis, the body produces antibodies that block the muscle cells from receiving messages (neurotransmitters) from the nerve cells. The exact cause of myasthenia gravis is unknown. In some cases, it is linked to tumors of the thymus (an organ of the immune system). Myasthenia gravis can affect people at any age. It is most common in young women and older men.

Myasthenia gravis Neuromuscular disorder - myasthenia gravis Summary Myasthenia gravis is a neuromuscular disorder. Neuromuscular disorders involve the muscles and the nerves that control them. Causes Myasthenia gravis is a type of autoimmune disorder. An autoimmune disorder occurs when the immune system mistakenly attacks healthy tissue. Antibodies are proteins made by the body's immune system when it detects harmful substances. Antibodies may be produced when the immune system mistakenly considers healthy tissue to be a harmful substance, such as in the case of myasthenia gravis. In people with myasthenia gravis, the body produces antibodies that block the muscle cells from receiving messages (neurotransmitters) from the nerve cells. In some cases, myasthenia gravis is linked to tumors of the thymus (an organ of the immune system). Myasthenia gravis can affect people at any age. It is most common in young women and older men. Symptoms Myasthenia gravis causes weakness of the voluntary muscles. These are muscles that you can control. Autonomic muscles of the heart and digestive tract are usually not affected. The muscle weakness of myasthenia gravis worsens with activity and improves with rest. This muscle weakness can lead to a variety of symptoms, including: Breathing difficulty because of weakness of the chest wall muscles Chewing or swallowing difficulty, causing frequent gagging, choking, or drooling Difficulty climbing stairs, lifting objects, or rising from a seated position Difficulty talking Drooping head and eyelids Facial paralysis or weakness of the facial muscles Fatigue Hoarseness or changing voice Double vision Difficulty maintaining steady gaze Exams and Tests The health care provider will perform a physical exam. This includes a detailed nervous system (neurological) examination. This may show: Muscle weakness, with eye muscles usually affected first Normal reflexes and feeling (sensation) Tests that may be done include: Acetylcholine receptor antibodies associated with this disease CT or MRI scan of the chest to look for a tumor Nerve conduction studies to test how fast electrical signals move through a nerve EMG to test the health of the muscles and the nerves that control the muscles Pulmonary function tests to measure breathing and how well the lungs are functioning Edrophonium test to see if this medicine reverses the symptoms for a short time Treatment There is no known cure for myasthenia gravis. Treatment may allow you to have periods without any symptoms (remission). Lifestyle changes can often help you continue your daily activities. The following may be recommended: Resting throughout the day Using an eye patch if double vision is bothersome Avoiding stress and heat exposure, which can make symptoms worse Medicines that may be prescribed include: Neostigmine or pyridostigmine to improve communication between the nerves and muscles Prednisone and other drugs (such as azathioprine, cyclosporine, or mycophenolate mofetil) to suppress the immune system response if you have severe symptoms and other medicines have not worked well. Crisis situations are attacks of weakness of the breathing muscles. These attacks can occur without warning when either too much or too little medicine is taken. These attacks usually last no longer than a few weeks. You may need to be admitted to the hospital, where you may need breathing assistance with a ventilator. A procedure called plasmapheresis may also be used to help end the crisis. This procedure involves removing the clear part of the blood (plasma), which contains the antibodies. This is replaced with donated plasma that is free of antibodies, or with other fluids. Plasmapheresis may also help reduce symptoms for 4 to 6 weeks and is often used before surgery. A medicine called intravenous immunoglobulin (IVIg) may also be used Surgery to remove the thymus (thymectomy) may result in permanent remission or less need for medicines, especially when there is a tumor present. If you have eye problems, your doctor may suggest lens prisms to improve vision. Surgery may also be recommended to treat your eye muscles. Physical therapy can help maintain your muscle strength. This is especially important for the muscles that support breathing. Some medicines can worsen symptoms and should be avoided. Before taking any medicine, ask your doctor whether it is OK for you to take it. Support Groups You can ease the stress of illness by joining a myasthenia gravis support group. Sharing with others who have common experiences and problems can help you not feel alone. Outlook (Prognosis) There is no cure, but long-term remission is possible. You may have to restrict some daily activities. People who have only eye symptoms (ocular myasthenia gravis), may develop generalized myasthenia over time. A woman with myasthenia gravis can get pregnant, but careful prenatal care is important. The baby may be weak and require medications for a few weeks after birth, but usually will not develop the disorder. Possible Complications The condition may cause life-threatening breathing problems. This is called a myasthenic crisis. People with myasthenia gravis are at higher risk for other autoimmune disorders, such as thyrotoxicosis, rheumatoid arthritis, and systemic lupus erythematosus (lupus). When to Contact a Medical Professional Call your health care provider if you develop symptoms of myasthenia gravis. Go to the emergency room or call the local emergency number (such as 911) if you have breathing difficulty or swallowing problems. Review Date 5/15/2017 Updated by: Amit M. Shelat, DO, FACP, Attending Neurologist and Assistant Professor of Clinical Neurology, SUNY Stony Brook, School of Medicine, Stony Brook, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how do you get neuromuscular disorders

how do you get neuromuscular disorders

In people with myasthenia gravis, the body produces antibodies that block the muscle cells from receiving messages (neurotransmitters) from the nerve cells. The exact cause of myasthenia gravis is unknown. In some cases, it is linked to tumors of the thymus (an organ of the immune system).

Myasthenia gravis Neuromuscular disorder - myasthenia gravis Summary Myasthenia gravis is a neuromuscular disorder. Neuromuscular disorders involve the muscles and the nerves that control them. Causes Myasthenia gravis is a type of autoimmune disorder. An autoimmune disorder occurs when the immune system mistakenly attacks healthy tissue. Antibodies are proteins made by the body's immune system when it detects harmful substances. Antibodies may be produced when the immune system mistakenly considers healthy tissue to be a harmful substance, such as in the case of myasthenia gravis. In people with myasthenia gravis, the body produces antibodies that block the muscle cells from receiving messages (neurotransmitters) from the nerve cells. In some cases, myasthenia gravis is linked to tumors of the thymus (an organ of the immune system). Myasthenia gravis can affect people at any age. It is most common in young women and older men. Symptoms Myasthenia gravis causes weakness of the voluntary muscles. These are muscles that you can control. Autonomic muscles of the heart and digestive tract are usually not affected. The muscle weakness of myasthenia gravis worsens with activity and improves with rest. This muscle weakness can lead to a variety of symptoms, including: Breathing difficulty because of weakness of the chest wall muscles Chewing or swallowing difficulty, causing frequent gagging, choking, or drooling Difficulty climbing stairs, lifting objects, or rising from a seated position Difficulty talking Drooping head and eyelids Facial paralysis or weakness of the facial muscles Fatigue Hoarseness or changing voice Double vision Difficulty maintaining steady gaze Exams and Tests The health care provider will perform a physical exam. This includes a detailed nervous system (neurological) examination. This may show: Muscle weakness, with eye muscles usually affected first Normal reflexes and feeling (sensation) Tests that may be done include: Acetylcholine receptor antibodies associated with this disease CT or MRI scan of the chest to look for a tumor Nerve conduction studies to test how fast electrical signals move through a nerve EMG to test the health of the muscles and the nerves that control the muscles Pulmonary function tests to measure breathing and how well the lungs are functioning Edrophonium test to see if this medicine reverses the symptoms for a short time Treatment There is no known cure for myasthenia gravis. Treatment may allow you to have periods without any symptoms (remission). Lifestyle changes can often help you continue your daily activities. The following may be recommended: Resting throughout the day Using an eye patch if double vision is bothersome Avoiding stress and heat exposure, which can make symptoms worse Medicines that may be prescribed include: Neostigmine or pyridostigmine to improve communication between the nerves and muscles Prednisone and other drugs (such as azathioprine, cyclosporine, or mycophenolate mofetil) to suppress the immune system response if you have severe symptoms and other medicines have not worked well. Crisis situations are attacks of weakness of the breathing muscles. These attacks can occur without warning when either too much or too little medicine is taken. These attacks usually last no longer than a few weeks. You may need to be admitted to the hospital, where you may need breathing assistance with a ventilator. A procedure called plasmapheresis may also be used to help end the crisis. This procedure involves removing the clear part of the blood (plasma), which contains the antibodies. This is replaced with donated plasma that is free of antibodies, or with other fluids. Plasmapheresis may also help reduce symptoms for 4 to 6 weeks and is often used before surgery. A medicine called intravenous immunoglobulin (IVIg) may also be used Surgery to remove the thymus (thymectomy) may result in permanent remission or less need for medicines, especially when there is a tumor present. If you have eye problems, your doctor may suggest lens prisms to improve vision. Surgery may also be recommended to treat your eye muscles. Physical therapy can help maintain your muscle strength. This is especially important for the muscles that support breathing. Some medicines can worsen symptoms and should be avoided. Before taking any medicine, ask your doctor whether it is OK for you to take it. Support Groups You can ease the stress of illness by joining a myasthenia gravis support group. Sharing with others who have common experiences and problems can help you not feel alone. Outlook (Prognosis) There is no cure, but long-term remission is possible. You may have to restrict some daily activities. People who have only eye symptoms (ocular myasthenia gravis), may develop generalized myasthenia over time. A woman with myasthenia gravis can get pregnant, but careful prenatal care is important. The baby may be weak and require medications for a few weeks after birth, but usually will not develop the disorder. Possible Complications The condition may cause life-threatening breathing problems. This is called a myasthenic crisis. People with myasthenia gravis are at higher risk for other autoimmune disorders, such as thyrotoxicosis, rheumatoid arthritis, and systemic lupus erythematosus (lupus). When to Contact a Medical Professional Call your health care provider if you develop symptoms of myasthenia gravis. Go to the emergency room or call the local emergency number (such as 911) if you have breathing difficulty or swallowing problems. Review Date 5/15/2017 Updated by: Amit M. Shelat, DO, FACP, Attending Neurologist and Assistant Professor of Clinical Neurology, SUNY Stony Brook, School of Medicine, Stony Brook, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how do you get neuromuscular disorders

how do you get neuromuscular disorders

Pulmonary hypertension (PH) begins with inflammation and changes in the cells that line your pulmonary arteries. Other factors also can affect the pulmonary arteries and cause PH. For example, the condition may develop if: The walls of the arteries tighten. The walls of the arteries are stiff at birth or become stiff from an overgrowth of cells. Blood clots form in the arteries. These changes make it hard for your heart to push blood through your pulmonary arteries and into your lungs. Thus, the pressure in the arteries rises, causing PH.

Pulmonary Hypertension What Is... Pulmonary hypertension (PULL-mun-ary HI-per-TEN-shun), or PH, is increased pressure in the pulmonary arteries. These arteries carry blood from your heart to your lungs to pick up oxygen. PH causes symptoms such as shortness of breath during routine activity (for example, climbing two flights of stairs), tiredness, chest pain, and a racing heartbeat. As the condition worsens, its symptoms may limit all physical activity. Overview To understand PH, it helps to understand how your heart and lungs work. Your heart has two sides, separated by an inner wall called the septum. Each side of your heart has an upper and lower chamber. The lower right chamber of your heart, the right ventricle (VEN-trih-kul), pumps blood to your pulmonary arteries. The blood then travels to your lungs, where it picks up oxygen. The upper left chamber of your heart, the left atrium (AY-tree-um), receives the oxygen-rich blood from your lungs. The blood is then pumped into the lower left chamber of your heart, the left ventricle. From the left ventricle, the blood is pumped to the rest of your body through an artery called the aorta. For more information about the heart and lungs, go to the Diseases and Conditions Index How the Heart Works and How the Lungs Work articles. PH begins with inflammation and changes in the cells that line your pulmonary arteries. Other factors also can affect the pulmonary arteries and cause PH. For example, the condition may develop if: The walls of the arteries tighten. The walls of the arteries are stiff at birth or become stiff from an overgrowth of cells. Blood clots form in the arteries. These changes make it hard for your heart to push blood through your pulmonary arteries and into your lungs. As a result, the pressure in your arteries rises. Also, because your heart is working harder than normal, your right ventricle becomes strained and weak. Your heart may become so weak that it can't pump enough blood to your lungs. This causes heart failure. Heart failure is the most common cause of death in people who have PH. PH is divided into five groups based on its causes. In all groups, the average pressure in the pulmonary arteries is higher than 25 mmHg at rest or 30 mmHg during physical activity. The pressure in normal pulmonary arteries is 8–20 mmHg at rest. (The mmHg is millimeters of mercury—the units used to measure blood pressure.) Other diseases or conditions, such as heart and lung diseases or blood clots, usually cause PH. Some people inherit the condition (that is, their parents pass the genes for PH on to them). In some cases, the cause isn't known. Outlook PH has no cure. However, research for new treatments is ongoing. The earlier PH is treated, the easier it is to control. Treatments include medicines, procedures, and other therapies. These treatments can relieve PH symptoms and slow the progress of the disease. Lifestyle changes also can help control symptoms. Types The World Health Organization divides pulmonary hypertension (PH) into five groups. These groups are organized based on the cause of the condition. In all groups, the average pressure in the pulmonary arteries is higher than 25 mmHg at rest or 30 mmHg during physical activity. The pressure in normal pulmonary arteries is 8–20 mmHg at rest. (Note that group 1 is called pulmonary arterial hypertension (PAH) and groups 2 through 5 are called pulmonary hypertension. However, together all groups are called pulmonary hypertension.) Group 1 Pulmonary Arterial Hypertension Group 1 PAH includes: PAH that has no known cause. PAH that's inherited (passed from parents to children through genes). PAH that's caused by drugs or toxins, such as street drugs and certain diet medicines. PAH that's caused by conditions such as: - Connective tissue diseases. (Connective tissue helps support all parts of your body, including your skin, eyes, and heart.) - HIV infection. - Liver disease. - Congenital heart disease. This is heart disease that's present at birth. - Sickle cell disease. - Schistosomiasis (SKIS-toe-so-MI-ah-sis). This is an infection caused by a parasite. Schistosomiasis is one of the most common causes of PAH in many parts of the world. Connective tissue diseases. (Connective tissue helps support all parts of your body, including your skin, eyes, and heart.) HIV infection. Liver disease. Congenital heart disease. This is heart disease that's present at birth. Sickle cell disease. Schistosomiasis (SKIS-toe-so-MI-ah-sis). This is an infection caused by a parasite. Schistosomiasis is one of the most common causes of PAH in many parts of the world. PAH that's caused by conditions that affect the veins and small blood vessels of the lungs. Group 2 Pulmonary Hypertension Group 2 includes PH with left heart disease. Conditions that affect the left side of the heart, such as mitral valve disease or long-term high blood pressure, can cause left heart disease and PH. Left heart disease is likely the most common cause of PH. Group 3 Pulmonary Hypertension Group 3 includes PH associated with lung diseases, such as COPD (chronic obstructive pulmonary disease) and interstitial (IN-ter-STISH-al) lung diseases. Interstitial lung diseases cause scarring of the lung tissue. Group 3 also includes PH associated with sleep-related breathing disorders, such as sleep apnea. Group 4 Pulmonary Hypertension Group 4 includes PH caused by blood clots in the lungs or blood clotting disorders. Group 5 Pulmonary Hypertension Group 5 includes PH caused by various other diseases or conditions. Examples include: Blood disorders, such as polycythemia vera (POL-e-si-THE-me-ah VAY-rah or VE-rah) and essential thrombocythemia (THROM-bo-si-THE-me-ah). Systemic disorders, such as sarcoidosis (sar-koy-DO-sis) and vasculitis (vas-kyu-LI-tis). Systemic disorders involve many of the body's organs. Metabolic disorders, such as thyroid disease and glycogen storage disease. (In glycogen storage disease, the body's cells don't use a form of glucose (sugar) properly.) Other conditions, such as tumors that press on the pulmonary arteries and kidney disease. Other Names Group 1 pulmonary arterial hypertension (PAH) that occurs without a known cause often is called primary PAH or idiopathic (id-ee-o-PATH-ick) PAH. Group 1 PAH that occurs with a known cause often is called associated PAH. For example, PAH that occurs in a person who has scleroderma might be called "PAH occurring in association with scleroderma," or simply "scleroderma-associated PAH." Groups 2–5 pulmonary hypertension (PH) sometimes are called secondary PH. Causes Pulmonary hypertension (PH) begins with inflammation and changes in the cells that line your pulmonary arteries. Other factors also can affect the pulmonary arteries and cause PH. For example, the condition may develop if: The walls of the arteries tighten. The walls of the arteries are stiff at birth or become stiff from an overgrowth of cells. Blood clots form in the arteries. These changes make it hard for your heart to push blood through your pulmonary arteries and into your lungs. Thus, the pressure in the arteries rises, causing PH. Many factors can contribute to the process that leads to the different types of PH. Group 1 pulmonary arterial hypertension (PAH) may have no known cause, or the condition may be inherited. ("Inherited" means the condition is passed from parents to children through genes.) Some diseases and conditions also can cause group 1 PAH. Examples include HIV infection, congenital heart disease, and sickle cell disease. Also, the use of street drugs (such as cocaine) and certain diet medicines can lead to PAH. Many diseases and conditions can cause groups 2 through 5 PH (often called secondary PH), including: Mitral valve disease Lung diseases, such as COPD (chronic obstructive pulmonary disease) Sleep apnea Sarcoidosis For more information about the types of PH and the diseases, conditions, and factors that can cause them, go to "Types of Pulmonary Hypertension." Who Is at Risk The exact number of people who have pulmonary hypertension (PH) isn't known. Group 1 pulmonary arterial hypertension (PAH) without a known cause is rare. It affects women more often than men. People who have group 1 PAH tend to be overweight. PH that occurs with another disease or condition is more common. PH usually develops between the ages of 20 and 60, but it can occur at any age. People who are at increased risk for PH include: Those who have a family history of the condition. Those who have certain diseases or conditions, such as heart and lung diseases, liver disease, HIV infection, or blood clots in the pulmonary arteries. (For more information about the diseases, conditions, and factors that cause PH, go to "Types of Pulmonary Hypertension.") Those who use street drugs (such as cocaine) or certain diet medicines. Those who live at high altitudes. Signs & Symptoms Signs and symptoms of pulmonary hypertension (PH) may include: Shortness of breath during routine activity, such as climbing two flights of stairs Tiredness Chest pain A racing heartbeat Pain on the upper right side of the abdomen Decreased appetite As PH worsens, you may find it hard to do any physical activities. At this point, other signs and symptoms may include: Feeling light-headed, especially during physical activity Fainting at times Swelling in your legs and ankles A bluish color on your lips and skin Diagnosis Your doctor will diagnose pulmonary hypertension (PH) based on your medical and family histories, a physical exam, and the results from tests and procedures. PH can develop slowly. In fact, you may have it for years and not know it. This is because the condition has no early signs or symptoms. When symptoms do occur, they're often like those of other heart and lung conditions, such as asthma. This makes PH hard to diagnose. Medical and Family Histories Your doctor may ask about your signs and symptoms and how and when they began. He or she also may ask whether you have other medical conditions that can cause PH. Your doctor will want to know whether you have any family members who have or have had PH. People who have a family history of PH are at higher risk for the condition. Physical Exam During the physical exam, your doctor will listen to your heart and lungs with a stethoscope. He or she also will check your ankles and legs for swelling and your lips and skin for a bluish color. These are signs of PH. Diagnostic Tests and Procedures Your doctor may recommend tests and procedures to confirm a diagnosis of PH and to look for its underlying cause. Your doctor also will use test results to find out the severity of your PH. Tests and Procedures To Confirm a Diagnosis Echocardiography. Echocardiography (EK-o-kar-de-OG-ra-fee), or echo, uses sound waves to create a moving picture of your heart. This test can estimate the pressure in your pulmonary arteries. Echo also can show the size and thickness of your right ventricle and how well it's working. Chest x ray. A chest x ray takes pictures of the structures in your chest, such as your heart, lungs, and blood vessels. This test can show whether your pulmonary arteries and right ventricle are enlarged. The pulmonary arteries and right ventricle may get larger if the right ventricle has to work hard to pump blood through the pulmonary arteries. A chest x ray also may show signs of an underlying lung disease that's causing or contributing to PH. EKG (electrocardiogram). An EKG is a simple, painless test that records the heart's electrical activity. This test also shows whether your heart's rhythm is steady or irregular. An EKG may show whether your right ventricle is enlarged or strained. Right heart catheterization. This procedure measures the pressure in your pulmonary arteries. It also shows how well your heart is pumping blood to the rest of your body. Right heart catheterization (KATH-e-ter-ih-ZA-shun) can find any leaks between the left and right side of the heart. During this procedure, a thin, flexible tube called a catheter is put into a blood vessel in your groin (upper thigh) or neck. The tube is threaded into the right side of your heart and into the pulmonary arteries. Through the tube, your doctor can do tests and treatments on your heart. Tests To Look for the Underlying Cause of Pulmonary Hypertension PH has many causes, so many tests may need to be done to find its underlying cause. Chest CT scan. A chest computed tomography (to-MOG-ra-fee) scan, or chest CT scan, creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. These pictures can show signs of PH or a condition that may be causing PH. Chest MRI. Chest magnetic resonance imaging, or chest MRI, shows how your right ventricle is working. The test also shows blood flow in your lungs. Chest MRI also can help detect signs of PH or an underlying condition causing PH. Lung function tests. Lung function tests measure how much air you can breathe in and out, how fast you can breathe air out, and how well your lungs deliver oxygen to your blood. These tests can help detect a lung disease that may be causing PH. Polysomnogram (PSG). This test records brain activity, eye movements, heart rate, and blood pressure while you sleep. A PSG also measures the level of oxygen in your blood. A low oxygen level during sleep is common in PH, and it can make the condition worse. A PSG usually is done while you stay overnight at a sleep center. For more information about this test, go to the Diseases and Conditions Index Sleep Studies article. Lung ventilation/perfusion (VQ) scan. A lung VQ scan measures air and blood flow in your lungs. This test can help detect blood clots in your lung's blood vessels. Blood tests. Blood tests are used to rule out other diseases, such as HIV, liver disease, and autoimmune diseases (such as rheumatoid arthritis). Finding Out the Severity of Pulmonary Hypertension Exercise testing is used to find out the severity of PH. This testing consists of either a 6-minute walk test or a cardiopulmonary exercise test. A 6-minute walk test measures the distance you can quickly walk in 6 minutes. A cardiopulmonary exercise test measures how well your lungs and heart work while you exercise on a treadmill or bicycle. During exercise testing, your doctor will rate your activity level. Your level is linked to the severity of your PH. The rating system ranges from class 1 to class 4. Class 1 has no limits. You can do regular physical activities, such as walking or climbing stairs. These activities don't cause PH symptoms, such as tiredness, shortness of breath, or chest pain. Class 2 has slight or mild limits. You're comfortable while resting, but regular physical activity causes PH symptoms. Class 3 has marked or noticeable limits. You're comfortable while resting. However, walking even one or two blocks or climbing one flight of stairs can cause PH symptoms. Class 4 has severe limits. You're not able to do any physical activity without discomfort. You also may have PH symptoms while at rest. Over time, you may need more exercise tests to find out how well your treatments are working. Each time testing is done, your doctor will compare your activity level with the previous one. Treatment Pulmonary hypertension (PH) has no cure. However, treatment may help relieve symptoms and slow the progress of the disease. PH is treated with medicines, procedures, and other therapies. Treatment will depend on what type of PH you have and its severity. (For more information, go to "Types of Pulmonary Hypertension.") Group 1 Pulmonary Arterial Hypertension Group 1 pulmonary arterial hypertension (PAH) includes PH that's inherited, that has no known cause, or that's caused by certain drugs or conditions. Treatments for group 1 PAH include medicines and medical procedures. Medicines Your doctor may prescribe medicines to relax the blood vessels in your lungs and reduce excess cell growth in the blood vessels. As the blood vessels relax, more blood can flow through them. Your doctor may prescribe medicines that are taken by mouth, inhaled, or injected. Examples of medicines for group 1 PAH include: Phosphodiesterase-5 inhibitors, such as sildenafil Prostanoids, such as epoprostenol Endothelin receptor antagonists, such as bosentan and ambrisentan Calcium channel blockers, such as diltiazem Your doctor may prescribe one or more of these medicines. To find out which of these medicines works best, you'll likely have an acute vasoreactivity test. This test shows how the pressure in your pulmonary arteries reacts to certain medicines. The test is done during right heart catheterization. Medical and Surgical Procedures If you have group 1 PAH, your doctor may recommend one or more of the following procedures. Atrial septostomy (sep-TOS-toe-me). For this procedure, a thin, flexible tube called a catheter is put into a blood vessel in your leg and threaded to your heart. The tube is then put through the wall that separates your right and left atria (the upper chambers of your heart). This wall is called the septum. A tiny balloon on the tip of the tube is inflated. This creates an opening between the atria. This procedure relieves the pressure in the right atria and increases blood flow. Atrial septostomy is rarely done in the United States. Lung transplant. A lung transplant is surgery to replace a person's diseased lung with a healthy lung from a deceased donor. This procedure may be used for people who have severe lung disease that's causing PAH. Heart–lung transplant. A heart–lung transplant is surgery in which both the heart and lung are replaced with healthy organs from a deceased donor. Group 2 Pulmonary Hypertension Conditions that affect the left side of the heart, such as mitral valve disease, can cause group 2 PH. Treating the underlying condition will help treat PH. Treatments may include lifestyle changes, medicines, and surgery. Group 3 Pulmonary Hypertension Lung diseases, such as COPD (chronic obstructive pulmonary disease) and interstitial lung disease, can cause group 3 PH. Certain sleep disorders, such as sleep apnea, also can cause group 3 PH. If you have this type of PH, you may need oxygen therapy. This treatment raises the level of oxygen in your blood. You'll likely get the oxygen through soft, plastic prongs that fit into your nose. Oxygen therapy can be done at home or in a hospital. Your doctor also may recommend other treatments if you have an underlying lung disease. Group 4 Pulmonary Hypertension Blood clots in the lungs or blood clotting disorders can cause group 4 PH. If you have this type of PH, your doctor will likely prescribe blood-thinning medicines. These medicines prevent clots from forming or getting larger. Sometimes doctors use surgery to remove scarring in the pulmonary arteries due to old blood clots. Group 5 Pulmonary Hypertension Various diseases and conditions, such as thyroid disease and sarcoidosis, can cause group 5 PH. An object, such as a tumor, pressing on the pulmonary arteries also can cause group 5 PH. Group 5 PH is treated by treating its cause. All Types of Pulmonary Hypertension Several treatments may be used for all types of PH. These treatments include: Diuretics, also called water pills. These medicines help reduce fluid buildup in your body, including swelling in your ankles and feet. Blood-thinning medicines. These medicines help prevent blood clots from forming or getting larger. Digoxin. This medicine helps the heart beat stronger and pump more blood. Digoxin sometimes is used to control the heart rate if abnormal heart rhythms, such as atrial fibrillation or atrial flutter, occur. Oxygen therapy. This treatment raises the level of oxygen in your blood. Physical activity. Regular activity may help improve your ability to be active. Talk with your doctor about a physical activity plan that's safe for you. Research is ongoing for better PH treatments. These treatments offer hope for the future. Living With Pulmonary hypertension (PH) has no cure. However, you can work with your doctor to manage your symptoms and slow the progress of the disease. Ongoing Care Follow your treatment plan as your doctor advises. Call your doctor if your PH symptoms worsen or change. The earlier symptoms are addressed, the easier it is to treat them. Some symptoms, such as chest pain, may require emergency treatment. Ask your doctor when you should call him or her or seek emergency care. Also, talk with your doctor before taking any over-the-counter medicines. Some medicines can make your PH worse or interfere with the medicines you're taking for PH. Ask your doctor whether you should get a pneumonia vaccine and a yearly flu shot. You may have a complex schedule for taking medicines. Call your doctor or nurse if you're having problems with this schedule. Knowing the names of your medicines and how they work is helpful. Keep a list of your medicines with you. Don't stop or change medicines unless you talk with your doctor first. Pay careful attention to your weight. You may want to keep a daily record of your weight. You should weigh yourself at the same time each day. If you notice a rapid weight gain (2 or more pounds in 1 day or 5 or more pounds in 1 week), call your doctor. This may be a sign that your PH is worsening. Pregnancy is risky for women who have PH. Consider using birth control if there is a chance you may become pregnant. Ask your doctor which birth control methods are safe for you. Lifestyle Changes Making lifestyle changes can help you manage your symptoms. These changes will depend on the type of PH you have. Talk with your doctor about which lifestyle changes can help you. Quit Smoking If you smoke, quit. Smoking makes PH symptoms worse. Ask your doctor about programs and products that can help you quit. Also, avoid exposure to secondhand smoke. For more information about how to quit smoking, go to the Diseases and Conditions Index Smoking and Your Heart article and the National Heart, Lung, and Blood Institute's (NHLBI's) "Your Guide to a Healthy Heart." Although these resources focus on heart health, they both include general information about how to quit smoking. Follow a Healthy Diet Following a healthy diet and maintaining a healthy weight are part of a healthy lifestyle. A healthy diet includes a variety of fruits, vegetables, and whole grains. It also includes lean meats, poultry, fish, and fat-free or low-fat milk or milk products. A healthy diet also is low in saturated fat, trans fat, cholesterol, sodium (salt), and added sugar. Talk with your doctor about whether you need to limit the amount of salt and fluids in your diet. Ask him or her whether you also need to regulate foods that contain vitamin K. These foods can affect how well blood-thinning medicines work. Vitamin K is found in green leafy vegetables and some oils, such as canola and soybean oil. For more information about following a healthy diet, go to the NHLBI's Aim for a Healthy Weight Web site, "Your Guide to a Healthy Heart," and "Your Guide to Lowering Your Blood Pressure With DASH." All of these resources include general advice about healthy eating. The DASH eating plan focuses on reduced-sodium foods, which may be helpful if your doctor advises you to limit the salt in your diet. Be Physically Active Physical activity is an important part of a healthy lifestyle. Try to do physical activity, such as walking, regularly. This will keep your muscles strong and help you stay active. Ask your doctor how much activity is safe for you. Your doctor may tell you to limit or avoid certain activities, such as: Those that cause straining, such as lifting heavy objects or weights. Sitting in a hot tub or sauna or taking long baths. These activities can lower your blood pressure too much. Flying in an airplane or traveling to high-altitude areas. Your doctor may ask you to use extra oxygen during air travel. Avoid activities that cause breathing problems, dizziness, or chest pain. If you have any of these symptoms, seek care right away. Emotional Issues and Support Living with PH may cause fear, anxiety, depression, and stress. You may worry about your medical condition, treatment, finances, and other issues. Talk about how you feel with your health care team. Talking to a professional counselor also can help. If you're very depressed, your doctor may recommend medicines or other treatments that can improve your quality of life. Joining a patient support group may help you adjust to living with PH. You can see how other people who have the same symptoms have coped with them. Talk with your doctor about local support groups or check with an area medical center. Support from family and friends also can help relieve stress and anxiety. Let your loved ones know how you feel and what they can do to help you. how do you get pulmonary hypertension

how do you get pulmonary hypertension

Your heart has two upper chambers (atria) and two lower chambers (ventricles). Each time blood passes through your heart, the lower right chamber (right ventricle) pumps blood to your lungs through a large blood vessel (pulmonary artery). In your lungs, the blood releases carbon dioxide and picks up oxygen. The oxygen-rich blood then flows through blood vessels in your lungs (pulmonary arteries, capillaries and veins) to the left side of your heart. Ordinarily, the blood flows easily through the vessels in your lungs, so blood pressure is usually much lower in your lungs. With pulmonary hypertension, the rise in blood pressure is caused by changes in the cells that line your pulmonary arteries. These changes can cause the walls of the arteries to become stiff and thick, and extra tissue may form. The blood vessels may also become inflamed and tight. These changes in the pulmonary arteries can reduce or block blood flow through the blood vessels. This makes it harder for blood to flow, raising the blood pressure in the pulmonary arteries.

Pulmonary hypertension Overview Pulmonary hypertension is a type of high blood pressure that affects the arteries in your lungs and the right side of your heart. In one form of pulmonary hypertension, tiny arteries in your lungs, called pulmonary arterioles, and capillaries become narrowed, blocked or destroyed. This makes it harder for blood to flow through your lungs, and raises pressure within your lungs' arteries. As the pressure builds, your heart's lower right chamber (right ventricle) must work harder to pump blood through your lungs, eventually causing your heart muscle to weaken and fail. Some forms of pulmonary hypertension are serious conditions that become progressively worse and are sometimes fatal. Although some forms of pulmonary hypertension aren't curable, treatment can help lessen symptoms and improve your quality of life. Symptoms The signs and symptoms of pulmonary hypertension in its early stages might not be noticeable for months or even years. As the disease progresses, symptoms become worse. Pulmonary hypertension symptoms include: - Shortness of breath (dyspnea), initially while exercising and eventually while at rest - Fatigue - Dizziness or fainting spells (syncope) - Chest pressure or pain - Swelling (edema) in your ankles, legs and eventually in your abdomen (ascites) - Bluish color to your lips and skin (cyanosis) - Racing pulse or heart palpitations Causes Your heart has two upper chambers (atria) and two lower chambers (ventricles). Each time blood passes through your heart, the lower right chamber (right ventricle) pumps blood to your lungs through a large blood vessel (pulmonary artery). In your lungs, the blood releases carbon dioxide and picks up oxygen. The oxygen-rich blood then flows through blood vessels in your lungs (pulmonary arteries, capillaries and veins) to the left side of your heart. Ordinarily, the blood flows easily through the vessels in your lungs, so blood pressure is usually much lower in your lungs. With pulmonary hypertension, the rise in blood pressure is caused by changes in the cells that line your pulmonary arteries. These changes can cause the walls of the arteries to become stiff and thick, and extra tissue may form. The blood vessels may also become inflamed and tight. These changes in the pulmonary arteries can reduce or block blood flow through the blood vessels. This makes it harder for blood to flow, raising the blood pressure in the pulmonary arteries. Pulmonary hypertension is classified into five groups, depending on the cause. Group 1: Pulmonary arterial hypertension - Cause unknown, known as idiopathic pulmonary arterial hypertension - A specific gene mutation that can cause pulmonary hypertension to develop in families, also called heritable pulmonary arterial hypertension - Certain drugs - such as certain prescription diet drugs or illegal drugs such as methamphetamines - or certain toxins - Heart abnormalities present at birth (congenital heart disease) - Other conditions, such as connective tissue disorders (scleroderma, lupus, others), HIV infection or chronic liver disease (cirrhosis) Group 2: Pulmonary hypertension caused by left-sided heart disease - Left-sided valvular heart disease, such as mitral valve or aortic valve disease - Failure of the lower left heart chamber (left ventricle) Group 3: Pulmonary hypertension caused by lung disease - Chronic obstructive pulmonary disease, such as emphysema - Lung disease such as pulmonary fibrosis, a condition that causes scarring in the tissue between the lungs' air sacs (interstitium) - Sleep apnea and other sleep disorders - Long-term exposure to high altitudes in people who may be at higher risk of pulmonary hypertension Group 4: Pulmonary hypertension caused by chronic blood clots - Chronic blood clots in the lungs (pulmonary emboli) Group 5: Pulmonary hypertension associated with other conditions that have unclear reasons why the pulmonary hypertension occurs - Blood disorders - Disorders that affect several organs in the body, such as sarcoidosis - Metabolic disorders, such as glycogen storage disease - Tumors pressing against pulmonary arteries Eisenmenger syndrome and pulmonary hypertension Eisenmenger syndrome, a type of congenital heart disease, causes pulmonary hypertension. It's most commonly caused by a large hole in your heart between the two lower heart chambers (ventricles), called a ventricular septal defect. This hole in your heart causes blood to circulate abnormally in your heart. Oxygen-carrying blood (red blood) mixes with oxygen-poor blood (blue blood). The blood then returns to your lungs instead of going to the rest of your body, increasing the pressure in the pulmonary arteries and causing pulmonary hypertension. Risk factors Your risk of developing pulmonary hypertension may be greater if: - You're a young adult, as idiopathic pulmonary arterial hypertension is more common in younger adults - You're overweight - You have a family history of the disease - You have one of various conditions that can increase your risk of developing pulmonary hypertension - You use illegal drugs, such as cocaine - You take certain appetite-suppressant medications - You have an existing risk of developing pulmonary hypertension, such as a family history of the condition, and you live at a high altitude Diagnosis Pulmonary hypertension is hard to diagnose early because it's not often detected in a routine physical exam. Even when the condition is more advanced, its signs and symptoms are similar to those of other heart and lung conditions. To diagnose your condition, your doctor may review your medical and family history, discuss your signs and symptoms, and conduct a physical examination. Doctors may order several tests to diagnose pulmonary hypertension, determine the severity of your condition and find out the cause of your condition. Tests may include: - Echocardiogram. Sound waves can create moving images of the beating heart. An echocardiogram can help your doctor to check the size and functioning of the right ventricle, and the thickness of the right ventricle's wall. An echocardiogram can also show how well your heart chambers and valves are working. Doctors may also use this to measure the pressure in your pulmonary arteries. In some cases, your doctor will recommend an exercise echocardiogram to help determine how well your heart and lungs work under stress. In this test, you'll have an echocardiogram before exercising on a stationary bike or treadmill and another test immediately afterward. This could be done as an oxygen consumption test, in which you may have to wear a mask that assesses the ability of your heart and lungs to deal with oxygen and carbon dioxide. Other exercise tests may also be done. These tests can help determine the severity and cause of your condition. They may also be done at follow-up appointments to check that your treatments are working. - Chest X-ray. A chest X-ray can show images of your heart, lungs and chest. This test can show enlargement of the right ventricle of the heart or the pulmonary arteries, which can occur in pulmonary hypertension. This test can also be used to identify other conditions that may be causing pulmonary hypertension. - Electrocardiogram (ECG). This noninvasive test shows your heart's electrical patterns and can detect abnormal rhythms. Doctors may also be able to see signs of right ventricle enlargement or strain. - Right heart catheterization. After you've had an echocardiogram, if your doctor thinks you have pulmonary hypertension, you'll likely have a right heart catheterization. This test can often help confirm that you have pulmonary hypertension and determine the severity of your condition. During the procedure, a cardiologist places a thin, flexible tube (catheter) into a vein in your neck or groin. The catheter is then threaded into your right ventricle and pulmonary artery. Right heart catheterization allows your doctor to directly measure the pressure in the main pulmonary arteries and right ventricle. It's also used to see what effect different medications may have on your pulmonary hypertension. - Blood tests. Your doctor might order blood tests to check for certain substances in your blood that might show you have pulmonary hypertension or its complications. Blood tests can also test for certain conditions that may be causing your condition. Your doctor might order additional tests to check the condition of your lungs and pulmonary arteries and to determine the cause of your condition, including: - Computerized tomography (CT) scan. During a CT scan, you lie on a table inside a doughnut-shaped machine. CT scanning generates X-rays to produce cross-sectional images of your body. Doctors may inject a dye into your blood vessels that helps your arteries to be more visible on the CT pictures (CT angiography). Doctors may use this test to look at the heart's size and function and to check for blood clots in the lungs' arteries. - Magnetic resonance imaging (MRI). This test may be used to check the right ventricle's function and the blood flow in the lung's arteries. In this test, you lie on a movable table that slides into the tunnel. An MRI uses a magnetic field and pulses of radio wave energy to make pictures of the body. - Pulmonary function test. This noninvasive test measures how much air your lungs can hold, and the airflow in and out of your lungs. During the test, you'll blow into a simple instrument called a spirometer. - Polysomnogram. This test detects your brain activity, heart rate, blood pressure, oxygen levels and other factors while you sleep. It can help diagnose a sleep disorder such as obstructive sleep apnea. - Ventilation/perfusion (V/Q) scan. In this test, a tracer is injected into a vein in your arm. The tracer maps blood flow and air to your lungs. This test can be used to determine whether blood clots are causing symptoms of pulmonary hypertension. - Open-lung biopsy. Rarely, a doctor might recommend an open-lung biopsy. An open-lung biopsy is a type of surgery in which a small sample of tissue is removed from your lungs under general anesthesia to check for a possible secondary cause of pulmonary hypertension. Genetic tests If a family member has had pulmonary hypertension, your doctor might screen you for genes that are linked with pulmonary hypertension. If you test positive, your doctor might recommend that other family members be screened for the same genetic mutation. Pulmonary hypertension classifications Once you've been diagnosed with pulmonary hypertension, your doctor might classify the severity of your disease into one of several classes, including: - Class I. Although you've been diagnosed with pulmonary hypertension, you have no symptoms with normal activity. - Class II. You don't have symptoms at rest, but you experience symptoms such as fatigue, shortness of breath or chest pain with normal activity. - Class III. You're comfortable at rest, but have symptoms when you're physically active. - Class IV. You have symptoms with physical activity and while at rest. Treatment Pulmonary hypertension can't be cured, but doctors can help you manage your condition. Treatment may help improve your symptoms and slow the progress of pulmonary hypertension. It often takes some time to find the most appropriate treatment for pulmonary hypertension. The treatments are often complex and require extensive follow-up care. Your doctor might also need to change your treatment if it's no longer effective. When pulmonary hypertension is caused by another condition, your doctor will treat the underlying cause whenever possible. Medications - Blood vessel dilators (vasodilators). Vasodilators open narrowed blood vessels. One of the most commonly prescribed vasodilators for pulmonary hypertension is epoprostenol (Flolan, Veletri). The drawback to epoprostenol is that its effects last only a few minutes. This drug is continuously injected through an intravenous (IV) catheter via a small pump that you wear in a pack on your belt or shoulder. Potential side effects of epoprostenol include jaw pain, nausea, diarrhea and leg cramps, as well as pain and infection at the IV site. Another form of the drug, iloprost (Ventavis), can be inhaled six to nine times a day through a nebulizer, a machine that vaporizes your medication. Because it's inhaled, it goes directly to the lungs. Side effects associated with iloprost include chest pain - often accompanied by a headache and nausea - and breathlessness. Treprostinil (Tyvaso, Remodulin, Orenitram), another form of the drug, can be given four times a day. It can be inhaled, taken as oral medication or administered by injection. It can cause side effects such as a headache, nausea and diarrhea. - Endothelin receptor antagonists. These medications reverse the effect of endothelin, a substance in the walls of blood vessels that causes them to narrow. These drugs may improve your energy level and symptoms. However, these drugs shouldn't be taken if you're pregnant. Also, these drugs can damage your liver and you may need monthly liver monitoring. These medications include bosentan (Tracleer), macitentan (Opsumit), and ambrisentan (Letairis). - Sildenafil and tadalafil. Sildenafil (Revatio, Viagra) and tadalafil (Cialis, Adcirca) are sometimes used to treat pulmonary hypertension. These drugs work by opening the blood vessels in the lungs to allow blood to flow through more easily. Side effects can include an upset stomach, headache and vision problems. - High-dose calcium channel blockers. These drugs help relax the muscles in the walls of your blood vessels. They include medications such as amlodipine (Norvasc), diltiazem (Cardizem, Tiazac, others) and nifedipine (Procardia, others). Although calcium channel blockers can be effective, only a small number of people with pulmonary hypertension respond to them. - Soluble guanylate cyclase (SGC) stimulator. Soluble guanylate cyclase (SGC) stimulators (Adempas) interact with nitric oxide and help relax the pulmonary arteries and lower the pressure within the arteries. These medications should not be taken if you're pregnant. They can sometimes cause dizziness or nausea. - Anticoagulants. Your doctor is likely to prescribe the anticoagulant warfarin (Coumadin, Jantoven) to help prevent the formation of blood clots within the small pulmonary arteries. Because anticoagulants prevent normal blood coagulation, they increase your risk of bleeding complications. Take warfarin exactly as prescribed, because warfarin can cause severe side effects if taken incorrectly. If you're taking warfarin, your doctor will ask you to have periodic blood tests to check how well the drug is working. Many other drugs, herbal supplements and foods can interact with warfarin, so be sure your doctor knows all of the medications you're taking. - Digoxin. Digoxin (Lanoxin) can help the heart beat stronger and pump more blood. It can help control the heart rate if you experience arrhythmias. - Diuretics. Commonly known as water pills, these medications help eliminate excess fluid from your body. This reduces the amount of work your heart has to do. They may also be used to limit fluid buildup in your lungs. - Oxygen. Your doctor might suggest that you sometimes breathe pure oxygen, a treatment known as oxygen therapy, to help treat pulmonary hypertension, especially if you live at a high altitude or have sleep apnea. Some people who have pulmonary hypertension eventually require continuous oxygen therapy. Surgeries - Atrial septostomy. If medications don't control your pulmonary hypertension, this open-heart surgery might be an option. In an atrial septostomy, a surgeon will create an opening between the upper left and right chambers of your heart (atria) to relieve the pressure on the right side of your heart. Atrial septostomy can have serious complications, including heart rhythm abnormalities (arrhythmias). - Transplantation. In some cases, a lung or heart-lung transplant might be an option, especially for younger people who have idiopathic pulmonary arterial hypertension. Major risks of any type of transplantation include rejection of the transplanted organ and serious infection, and you must take immunosuppressant drugs for life to help reduce the chance of rejection. Lifestyle and home remedies Although medical treatment can't cure pulmonary hypertension, it can lessen symptoms. Lifestyle changes also can help improve your condition. Consider these tips: - Get plenty of rest. Resting can reduce the fatigue that might come from having pulmonary hypertension. - Stay as active as possible. Even the mildest forms of activity might be too exhausting for some people who have pulmonary hypertension. For others, moderate exercise such as walking might be beneficial - especially when done with oxygen. But first, talk to your doctor about specific exercise restrictions. In most cases, it's recommended that you not lift heavy weights. Your doctor can help you plan an appropriate exercise program. - Don't smoke. If you smoke, the most important thing you can do for your heart and lungs is to stop. If you can't stop smoking by yourself, ask your doctor to prescribe a treatment plan to help you quit. Also, avoid secondhand smoke if possible. - Avoid pregnancy and birth control pills. If you're a woman of childbearing age, avoid pregnancy. Pregnancy can be life-threatening for both you and your baby. Also avoid using birth control pills, which can increase your risk of blood clots. Talk to your doctor about alternative forms of birth control. If you do become pregnant, it's important to consult with your doctor as pulmonary hypertension can cause serious complications to both you and the fetus. - Avoid traveling to or living at high altitudes. High altitudes can worsen the symptoms of pulmonary hypertension. If you live at an altitude of 8,000 feet (2,438 meters) or higher, your doctor might recommend that you move to a lower altitude. - Avoid situations that can excessively lower blood pressure. These include sitting in a hot tub or sauna or taking long hot baths or showers. These activities lower your blood pressure and can cause fainting or even death. Also avoid activities that cause prolonged straining, such as lifting heavy objects or weights. - Follow a nutritious diet and stay at a healthy weight. Aim to eat a healthy diet of whole grains, a variety of fruits and vegetables, lean meats and low-fat dairy products. Avoid saturated fat, trans fat and cholesterol. It's likely your doctor will recommend limiting the amount of salt in your diet. Aim to maintain a healthy weight. - Ask your doctor about medications. Take all your medications as prescribed. Ask your doctor about any other medications before taking them, as some can interfere with your medication or worsen your condition. - See your doctor at follow-up appointments. Your doctor may recommend regular follow-up appointments. Let your doctor know if you have any questions about your condition or medications you're taking, or if you have any symptoms or side effects from your medications. If pulmonary hypertension is affecting your quality of life, ask your doctor about options that could improve your quality of life. - Get vaccines. Your doctor may recommend getting an influenza and pneumonia vaccine, as these conditions can cause serious issues for people with pulmonary hypertension. - Get support. If you're feeling stressed or worried due to your condition, get support from family or friends. Or, consider joining a support group with others who have pulmonary hypertension. how do you get pulmonary hypertension

how do you get pulmonary hypertension

Pulmonary Hypertension PH has many causes, so many tests may need to be done to find its underlying cause.

Pulmonary Hypertension What Is... Pulmonary hypertension (PULL-mun-ary HI-per-TEN-shun), or PH, is increased pressure in the pulmonary arteries. These arteries carry blood from your heart to your lungs to pick up oxygen. PH causes symptoms such as shortness of breath during routine activity (for example, climbing two flights of stairs), tiredness, chest pain, and a racing heartbeat. As the condition worsens, its symptoms may limit all physical activity. Overview To understand PH, it helps to understand how your heart and lungs work. Your heart has two sides, separated by an inner wall called the septum. Each side of your heart has an upper and lower chamber. The lower right chamber of your heart, the right ventricle (VEN-trih-kul), pumps blood to your pulmonary arteries. The blood then travels to your lungs, where it picks up oxygen. The upper left chamber of your heart, the left atrium (AY-tree-um), receives the oxygen-rich blood from your lungs. The blood is then pumped into the lower left chamber of your heart, the left ventricle. From the left ventricle, the blood is pumped to the rest of your body through an artery called the aorta. For more information about the heart and lungs, go to the Diseases and Conditions Index How the Heart Works and How the Lungs Work articles. PH begins with inflammation and changes in the cells that line your pulmonary arteries. Other factors also can affect the pulmonary arteries and cause PH. For example, the condition may develop if: The walls of the arteries tighten. The walls of the arteries are stiff at birth or become stiff from an overgrowth of cells. Blood clots form in the arteries. These changes make it hard for your heart to push blood through your pulmonary arteries and into your lungs. As a result, the pressure in your arteries rises. Also, because your heart is working harder than normal, your right ventricle becomes strained and weak. Your heart may become so weak that it can't pump enough blood to your lungs. This causes heart failure. Heart failure is the most common cause of death in people who have PH. PH is divided into five groups based on its causes. In all groups, the average pressure in the pulmonary arteries is higher than 25 mmHg at rest or 30 mmHg during physical activity. The pressure in normal pulmonary arteries is 8–20 mmHg at rest. (The mmHg is millimeters of mercury—the units used to measure blood pressure.) Other diseases or conditions, such as heart and lung diseases or blood clots, usually cause PH. Some people inherit the condition (that is, their parents pass the genes for PH on to them). In some cases, the cause isn't known. Outlook PH has no cure. However, research for new treatments is ongoing. The earlier PH is treated, the easier it is to control. Treatments include medicines, procedures, and other therapies. These treatments can relieve PH symptoms and slow the progress of the disease. Lifestyle changes also can help control symptoms. Types The World Health Organization divides pulmonary hypertension (PH) into five groups. These groups are organized based on the cause of the condition. In all groups, the average pressure in the pulmonary arteries is higher than 25 mmHg at rest or 30 mmHg during physical activity. The pressure in normal pulmonary arteries is 8–20 mmHg at rest. (Note that group 1 is called pulmonary arterial hypertension (PAH) and groups 2 through 5 are called pulmonary hypertension. However, together all groups are called pulmonary hypertension.) Group 1 Pulmonary Arterial Hypertension Group 1 PAH includes: PAH that has no known cause. PAH that's inherited (passed from parents to children through genes). PAH that's caused by drugs or toxins, such as street drugs and certain diet medicines. PAH that's caused by conditions such as: - Connective tissue diseases. (Connective tissue helps support all parts of your body, including your skin, eyes, and heart.) - HIV infection. - Liver disease. - Congenital heart disease. This is heart disease that's present at birth. - Sickle cell disease. - Schistosomiasis (SKIS-toe-so-MI-ah-sis). This is an infection caused by a parasite. Schistosomiasis is one of the most common causes of PAH in many parts of the world. Connective tissue diseases. (Connective tissue helps support all parts of your body, including your skin, eyes, and heart.) HIV infection. Liver disease. Congenital heart disease. This is heart disease that's present at birth. Sickle cell disease. Schistosomiasis (SKIS-toe-so-MI-ah-sis). This is an infection caused by a parasite. Schistosomiasis is one of the most common causes of PAH in many parts of the world. PAH that's caused by conditions that affect the veins and small blood vessels of the lungs. Group 2 Pulmonary Hypertension Group 2 includes PH with left heart disease. Conditions that affect the left side of the heart, such as mitral valve disease or long-term high blood pressure, can cause left heart disease and PH. Left heart disease is likely the most common cause of PH. Group 3 Pulmonary Hypertension Group 3 includes PH associated with lung diseases, such as COPD (chronic obstructive pulmonary disease) and interstitial (IN-ter-STISH-al) lung diseases. Interstitial lung diseases cause scarring of the lung tissue. Group 3 also includes PH associated with sleep-related breathing disorders, such as sleep apnea. Group 4 Pulmonary Hypertension Group 4 includes PH caused by blood clots in the lungs or blood clotting disorders. Group 5 Pulmonary Hypertension Group 5 includes PH caused by various other diseases or conditions. Examples include: Blood disorders, such as polycythemia vera (POL-e-si-THE-me-ah VAY-rah or VE-rah) and essential thrombocythemia (THROM-bo-si-THE-me-ah). Systemic disorders, such as sarcoidosis (sar-koy-DO-sis) and vasculitis (vas-kyu-LI-tis). Systemic disorders involve many of the body's organs. Metabolic disorders, such as thyroid disease and glycogen storage disease. (In glycogen storage disease, the body's cells don't use a form of glucose (sugar) properly.) Other conditions, such as tumors that press on the pulmonary arteries and kidney disease. Other Names Group 1 pulmonary arterial hypertension (PAH) that occurs without a known cause often is called primary PAH or idiopathic (id-ee-o-PATH-ick) PAH. Group 1 PAH that occurs with a known cause often is called associated PAH. For example, PAH that occurs in a person who has scleroderma might be called "PAH occurring in association with scleroderma," or simply "scleroderma-associated PAH." Groups 2–5 pulmonary hypertension (PH) sometimes are called secondary PH. Causes Pulmonary hypertension (PH) begins with inflammation and changes in the cells that line your pulmonary arteries. Other factors also can affect the pulmonary arteries and cause PH. For example, the condition may develop if: The walls of the arteries tighten. The walls of the arteries are stiff at birth or become stiff from an overgrowth of cells. Blood clots form in the arteries. These changes make it hard for your heart to push blood through your pulmonary arteries and into your lungs. Thus, the pressure in the arteries rises, causing PH. Many factors can contribute to the process that leads to the different types of PH. Group 1 pulmonary arterial hypertension (PAH) may have no known cause, or the condition may be inherited. ("Inherited" means the condition is passed from parents to children through genes.) Some diseases and conditions also can cause group 1 PAH. Examples include HIV infection, congenital heart disease, and sickle cell disease. Also, the use of street drugs (such as cocaine) and certain diet medicines can lead to PAH. Many diseases and conditions can cause groups 2 through 5 PH (often called secondary PH), including: Mitral valve disease Lung diseases, such as COPD (chronic obstructive pulmonary disease) Sleep apnea Sarcoidosis For more information about the types of PH and the diseases, conditions, and factors that can cause them, go to "Types of Pulmonary Hypertension." Who Is at Risk The exact number of people who have pulmonary hypertension (PH) isn't known. Group 1 pulmonary arterial hypertension (PAH) without a known cause is rare. It affects women more often than men. People who have group 1 PAH tend to be overweight. PH that occurs with another disease or condition is more common. PH usually develops between the ages of 20 and 60, but it can occur at any age. People who are at increased risk for PH include: Those who have a family history of the condition. Those who have certain diseases or conditions, such as heart and lung diseases, liver disease, HIV infection, or blood clots in the pulmonary arteries. (For more information about the diseases, conditions, and factors that cause PH, go to "Types of Pulmonary Hypertension.") Those who use street drugs (such as cocaine) or certain diet medicines. Those who live at high altitudes. Signs & Symptoms Signs and symptoms of pulmonary hypertension (PH) may include: Shortness of breath during routine activity, such as climbing two flights of stairs Tiredness Chest pain A racing heartbeat Pain on the upper right side of the abdomen Decreased appetite As PH worsens, you may find it hard to do any physical activities. At this point, other signs and symptoms may include: Feeling light-headed, especially during physical activity Fainting at times Swelling in your legs and ankles A bluish color on your lips and skin Diagnosis Your doctor will diagnose pulmonary hypertension (PH) based on your medical and family histories, a physical exam, and the results from tests and procedures. PH can develop slowly. In fact, you may have it for years and not know it. This is because the condition has no early signs or symptoms. When symptoms do occur, they're often like those of other heart and lung conditions, such as asthma. This makes PH hard to diagnose. Medical and Family Histories Your doctor may ask about your signs and symptoms and how and when they began. He or she also may ask whether you have other medical conditions that can cause PH. Your doctor will want to know whether you have any family members who have or have had PH. People who have a family history of PH are at higher risk for the condition. Physical Exam During the physical exam, your doctor will listen to your heart and lungs with a stethoscope. He or she also will check your ankles and legs for swelling and your lips and skin for a bluish color. These are signs of PH. Diagnostic Tests and Procedures Your doctor may recommend tests and procedures to confirm a diagnosis of PH and to look for its underlying cause. Your doctor also will use test results to find out the severity of your PH. Tests and Procedures To Confirm a Diagnosis Echocardiography. Echocardiography (EK-o-kar-de-OG-ra-fee), or echo, uses sound waves to create a moving picture of your heart. This test can estimate the pressure in your pulmonary arteries. Echo also can show the size and thickness of your right ventricle and how well it's working. Chest x ray. A chest x ray takes pictures of the structures in your chest, such as your heart, lungs, and blood vessels. This test can show whether your pulmonary arteries and right ventricle are enlarged. The pulmonary arteries and right ventricle may get larger if the right ventricle has to work hard to pump blood through the pulmonary arteries. A chest x ray also may show signs of an underlying lung disease that's causing or contributing to PH. EKG (electrocardiogram). An EKG is a simple, painless test that records the heart's electrical activity. This test also shows whether your heart's rhythm is steady or irregular. An EKG may show whether your right ventricle is enlarged or strained. Right heart catheterization. This procedure measures the pressure in your pulmonary arteries. It also shows how well your heart is pumping blood to the rest of your body. Right heart catheterization (KATH-e-ter-ih-ZA-shun) can find any leaks between the left and right side of the heart. During this procedure, a thin, flexible tube called a catheter is put into a blood vessel in your groin (upper thigh) or neck. The tube is threaded into the right side of your heart and into the pulmonary arteries. Through the tube, your doctor can do tests and treatments on your heart. Tests To Look for the Underlying Cause of Pulmonary Hypertension PH has many causes, so many tests may need to be done to find its underlying cause. Chest CT scan. A chest computed tomography (to-MOG-ra-fee) scan, or chest CT scan, creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. These pictures can show signs of PH or a condition that may be causing PH. Chest MRI. Chest magnetic resonance imaging, or chest MRI, shows how your right ventricle is working. The test also shows blood flow in your lungs. Chest MRI also can help detect signs of PH or an underlying condition causing PH. Lung function tests. Lung function tests measure how much air you can breathe in and out, how fast you can breathe air out, and how well your lungs deliver oxygen to your blood. These tests can help detect a lung disease that may be causing PH. Polysomnogram (PSG). This test records brain activity, eye movements, heart rate, and blood pressure while you sleep. A PSG also measures the level of oxygen in your blood. A low oxygen level during sleep is common in PH, and it can make the condition worse. A PSG usually is done while you stay overnight at a sleep center. For more information about this test, go to the Diseases and Conditions Index Sleep Studies article. Lung ventilation/perfusion (VQ) scan. A lung VQ scan measures air and blood flow in your lungs. This test can help detect blood clots in your lung's blood vessels. Blood tests. Blood tests are used to rule out other diseases, such as HIV, liver disease, and autoimmune diseases (such as rheumatoid arthritis). Finding Out the Severity of Pulmonary Hypertension Exercise testing is used to find out the severity of PH. This testing consists of either a 6-minute walk test or a cardiopulmonary exercise test. A 6-minute walk test measures the distance you can quickly walk in 6 minutes. A cardiopulmonary exercise test measures how well your lungs and heart work while you exercise on a treadmill or bicycle. During exercise testing, your doctor will rate your activity level. Your level is linked to the severity of your PH. The rating system ranges from class 1 to class 4. Class 1 has no limits. You can do regular physical activities, such as walking or climbing stairs. These activities don't cause PH symptoms, such as tiredness, shortness of breath, or chest pain. Class 2 has slight or mild limits. You're comfortable while resting, but regular physical activity causes PH symptoms. Class 3 has marked or noticeable limits. You're comfortable while resting. However, walking even one or two blocks or climbing one flight of stairs can cause PH symptoms. Class 4 has severe limits. You're not able to do any physical activity without discomfort. You also may have PH symptoms while at rest. Over time, you may need more exercise tests to find out how well your treatments are working. Each time testing is done, your doctor will compare your activity level with the previous one. Treatment Pulmonary hypertension (PH) has no cure. However, treatment may help relieve symptoms and slow the progress of the disease. PH is treated with medicines, procedures, and other therapies. Treatment will depend on what type of PH you have and its severity. (For more information, go to "Types of Pulmonary Hypertension.") Group 1 Pulmonary Arterial Hypertension Group 1 pulmonary arterial hypertension (PAH) includes PH that's inherited, that has no known cause, or that's caused by certain drugs or conditions. Treatments for group 1 PAH include medicines and medical procedures. Medicines Your doctor may prescribe medicines to relax the blood vessels in your lungs and reduce excess cell growth in the blood vessels. As the blood vessels relax, more blood can flow through them. Your doctor may prescribe medicines that are taken by mouth, inhaled, or injected. Examples of medicines for group 1 PAH include: Phosphodiesterase-5 inhibitors, such as sildenafil Prostanoids, such as epoprostenol Endothelin receptor antagonists, such as bosentan and ambrisentan Calcium channel blockers, such as diltiazem Your doctor may prescribe one or more of these medicines. To find out which of these medicines works best, you'll likely have an acute vasoreactivity test. This test shows how the pressure in your pulmonary arteries reacts to certain medicines. The test is done during right heart catheterization. Medical and Surgical Procedures If you have group 1 PAH, your doctor may recommend one or more of the following procedures. Atrial septostomy (sep-TOS-toe-me). For this procedure, a thin, flexible tube called a catheter is put into a blood vessel in your leg and threaded to your heart. The tube is then put through the wall that separates your right and left atria (the upper chambers of your heart). This wall is called the septum. A tiny balloon on the tip of the tube is inflated. This creates an opening between the atria. This procedure relieves the pressure in the right atria and increases blood flow. Atrial septostomy is rarely done in the United States. Lung transplant. A lung transplant is surgery to replace a person's diseased lung with a healthy lung from a deceased donor. This procedure may be used for people who have severe lung disease that's causing PAH. Heart–lung transplant. A heart–lung transplant is surgery in which both the heart and lung are replaced with healthy organs from a deceased donor. Group 2 Pulmonary Hypertension Conditions that affect the left side of the heart, such as mitral valve disease, can cause group 2 PH. Treating the underlying condition will help treat PH. Treatments may include lifestyle changes, medicines, and surgery. Group 3 Pulmonary Hypertension Lung diseases, such as COPD (chronic obstructive pulmonary disease) and interstitial lung disease, can cause group 3 PH. Certain sleep disorders, such as sleep apnea, also can cause group 3 PH. If you have this type of PH, you may need oxygen therapy. This treatment raises the level of oxygen in your blood. You'll likely get the oxygen through soft, plastic prongs that fit into your nose. Oxygen therapy can be done at home or in a hospital. Your doctor also may recommend other treatments if you have an underlying lung disease. Group 4 Pulmonary Hypertension Blood clots in the lungs or blood clotting disorders can cause group 4 PH. If you have this type of PH, your doctor will likely prescribe blood-thinning medicines. These medicines prevent clots from forming or getting larger. Sometimes doctors use surgery to remove scarring in the pulmonary arteries due to old blood clots. Group 5 Pulmonary Hypertension Various diseases and conditions, such as thyroid disease and sarcoidosis, can cause group 5 PH. An object, such as a tumor, pressing on the pulmonary arteries also can cause group 5 PH. Group 5 PH is treated by treating its cause. All Types of Pulmonary Hypertension Several treatments may be used for all types of PH. These treatments include: Diuretics, also called water pills. These medicines help reduce fluid buildup in your body, including swelling in your ankles and feet. Blood-thinning medicines. These medicines help prevent blood clots from forming or getting larger. Digoxin. This medicine helps the heart beat stronger and pump more blood. Digoxin sometimes is used to control the heart rate if abnormal heart rhythms, such as atrial fibrillation or atrial flutter, occur. Oxygen therapy. This treatment raises the level of oxygen in your blood. Physical activity. Regular activity may help improve your ability to be active. Talk with your doctor about a physical activity plan that's safe for you. Research is ongoing for better PH treatments. These treatments offer hope for the future. Living With Pulmonary hypertension (PH) has no cure. However, you can work with your doctor to manage your symptoms and slow the progress of the disease. Ongoing Care Follow your treatment plan as your doctor advises. Call your doctor if your PH symptoms worsen or change. The earlier symptoms are addressed, the easier it is to treat them. Some symptoms, such as chest pain, may require emergency treatment. Ask your doctor when you should call him or her or seek emergency care. Also, talk with your doctor before taking any over-the-counter medicines. Some medicines can make your PH worse or interfere with the medicines you're taking for PH. Ask your doctor whether you should get a pneumonia vaccine and a yearly flu shot. You may have a complex schedule for taking medicines. Call your doctor or nurse if you're having problems with this schedule. Knowing the names of your medicines and how they work is helpful. Keep a list of your medicines with you. Don't stop or change medicines unless you talk with your doctor first. Pay careful attention to your weight. You may want to keep a daily record of your weight. You should weigh yourself at the same time each day. If you notice a rapid weight gain (2 or more pounds in 1 day or 5 or more pounds in 1 week), call your doctor. This may be a sign that your PH is worsening. Pregnancy is risky for women who have PH. Consider using birth control if there is a chance you may become pregnant. Ask your doctor which birth control methods are safe for you. Lifestyle Changes Making lifestyle changes can help you manage your symptoms. These changes will depend on the type of PH you have. Talk with your doctor about which lifestyle changes can help you. Quit Smoking If you smoke, quit. Smoking makes PH symptoms worse. Ask your doctor about programs and products that can help you quit. Also, avoid exposure to secondhand smoke. For more information about how to quit smoking, go to the Diseases and Conditions Index Smoking and Your Heart article and the National Heart, Lung, and Blood Institute's (NHLBI's) "Your Guide to a Healthy Heart." Although these resources focus on heart health, they both include general information about how to quit smoking. Follow a Healthy Diet Following a healthy diet and maintaining a healthy weight are part of a healthy lifestyle. A healthy diet includes a variety of fruits, vegetables, and whole grains. It also includes lean meats, poultry, fish, and fat-free or low-fat milk or milk products. A healthy diet also is low in saturated fat, trans fat, cholesterol, sodium (salt), and added sugar. Talk with your doctor about whether you need to limit the amount of salt and fluids in your diet. Ask him or her whether you also need to regulate foods that contain vitamin K. These foods can affect how well blood-thinning medicines work. Vitamin K is found in green leafy vegetables and some oils, such as canola and soybean oil. For more information about following a healthy diet, go to the NHLBI's Aim for a Healthy Weight Web site, "Your Guide to a Healthy Heart," and "Your Guide to Lowering Your Blood Pressure With DASH." All of these resources include general advice about healthy eating. The DASH eating plan focuses on reduced-sodium foods, which may be helpful if your doctor advises you to limit the salt in your diet. Be Physically Active Physical activity is an important part of a healthy lifestyle. Try to do physical activity, such as walking, regularly. This will keep your muscles strong and help you stay active. Ask your doctor how much activity is safe for you. Your doctor may tell you to limit or avoid certain activities, such as: Those that cause straining, such as lifting heavy objects or weights. Sitting in a hot tub or sauna or taking long baths. These activities can lower your blood pressure too much. Flying in an airplane or traveling to high-altitude areas. Your doctor may ask you to use extra oxygen during air travel. Avoid activities that cause breathing problems, dizziness, or chest pain. If you have any of these symptoms, seek care right away. Emotional Issues and Support Living with PH may cause fear, anxiety, depression, and stress. You may worry about your medical condition, treatment, finances, and other issues. Talk about how you feel with your health care team. Talking to a professional counselor also can help. If you're very depressed, your doctor may recommend medicines or other treatments that can improve your quality of life. Joining a patient support group may help you adjust to living with PH. You can see how other people who have the same symptoms have coped with them. Talk with your doctor about local support groups or check with an area medical center. Support from family and friends also can help relieve stress and anxiety. Let your loved ones know how you feel and what they can do to help you. how do you get pulmonary hypertension

how do you get pulmonary hypertension

The right side of the heart pumps blood through the lungs, where it picks up oxygen. Blood returns to the left side of the heart, where it is pumped to the rest of the body. When the small arteries (blood vessels) of the lungs become narrowed, they cannot carry as much blood. When this happens, pressure builds up. This is called pulmonary hypertension. The heart needs to work harder to force the blood through the vessels against this pressure. Over time, this causes the right side of the heart to become larger. This condition is called right-sided heart failure, or cor pulmonale. Pulmonary hypertension may be caused by: - Autoimmune diseases that damage the lungs, such as scleroderma and rheumatoid arthritis - Birth defects of the heart - Blood clots in the lung (pulmonary embolism) - Heart failure - Heart valve disease - HIV infection - Low oxygen levels in the blood for a long time (chronic) - Lung disease, such as COPD or pulmonary fibrosis - Medicines (for example, certain diet drugs) - Obstructive sleep apnea

Pulmonary hypertension Pulmonary arterial hypertension Sporadic primary pulmonary hypertension Familial primary pulmonary hypertension Idiopathic pulmonary arterial hypertension Primary pulmonary hypertension PPH Secondary pulmonary hypertension Cor pulmonale - pulmonary hypertension Summary Pulmonary hypertension is high blood pressure in the arteries of the lungs. It makes the right side of the heart work harder than normal. Causes The right side of the heart pumps blood through the lungs, where it picks up oxygen. Blood returns to the left side of the heart, where it is pumped to the rest of the body. When the small arteries (blood vessels) of the lungs become narrowed, they cannot carry as much blood. When this happens, pressure builds up. This is called pulmonary hypertension. The heart needs to work harder to force the blood through the vessels against this pressure. Over time, this causes the right side of the heart to become larger. This condition is called right-sided heart failure, or cor pulmonale. Pulmonary hypertension may be caused by: Autoimmune diseases that damage the lungs, such as scleroderma and rheumatoid arthritis Birth defects of the heart Blood clots in the lung (pulmonary embolism) Heart failure Heart valve disease HIV infection Low oxygen levels in the blood for a long time (chronic) Lung disease, such as COPD or pulmonary fibrosis or any other severe chronic lung condition Medicines (for example, certain diet drugs) Obstructive sleep apnea In rare cases, the cause of pulmonary hypertension is unknown. In this case, the condition is called idiopathic pulmonary arterial hypertension (IPAH). Idiopathic means the cause of a disease is not known. IPAH affects more women than men. If pulmonary hypertension is caused by a known medicine or medical condition, it is called secondary pulmonary hypertension. Symptoms Shortness of breath or lightheadedness during activity is often the first symptom. Fast heart rate (palpitations) may be present. Over time, symptoms occur with lighter activity or even while at rest. Other symptoms include: Ankle and leg swelling Bluish color of the lips or skin (cyanosis) Chest pain or pressure, usually in the front of the chest Dizziness or fainting spells Fatigue Increased abdomen size Weakness People with pulmonary hypertension often have symptoms that come and go. They report good days and bad days. Exams and Tests Your health care provider will perform a physical exam and ask about your symptoms. The exam may find: Abnormal heart sounds Feeling of a pulse over the breastbone Heart murmur on the right side of the heart Larger-than-normal veins in the neck Leg swelling Liver and spleen swelling Normal breath sounds if pulmonary hypertension is idiopathic or due to congenital heart disease Abnormal breath sounds if pulmonary hypertension is from other lung disease In the early stages of the disease, the exam may be normal or almost normal. The condition may take several months to diagnose. Asthma and other diseases may cause similar symptoms and must be ruled out. Tests that may be ordered include: Blood tests Cardiac catheterization Chest x-ray CT scan of the chest Echocardiogram ECG Lung function tests Nuclear lung scan Pulmonary arteriogram 6-minute walk test Sleep study Tests to check for autoimmune problems Treatment There is no cure for pulmonary hypertension. The goal of treatment is to control symptoms and prevent more lung damage. It is important to treat medical disorders that cause pulmonary hypertension, such as obstructive sleep apnea, lung conditions, and heart valve problems. Many treatment options for pulmonary arterial hypertension are available. If you are prescribed medicines, they may be taken by mouth (oral), received through the vein (intravenous, or IV), or breathed in (inhaled). Your provider will decide which medicine is best for you. You will be closely monitored during treatment to watch for side effects and to see how well you are responding to the medicine. DO NOT stop taking your medicines without talking to your provider. Other treatments may include: Blood thinners to reduce the risk of blood clots, especially if you have IPAH Oxygen therapy at home Lung, or in some cases, heart-lung transplant, if medicines do not work Other important tips to follow: Avoid pregnancy Avoid heavy physical activities and lifting Avoid traveling to high altitudes Get a yearly flu vaccine, as well as other vaccines such as the pneumonia vaccine Stop smoking Outlook (Prognosis) How well you do depends on what caused the condition. Medicines for IPAH may help slow the disease. As the illness gets worse, you will need to make changes in your home to help you get around the house. When to Contact a Medical Professional Call your provider if: You begin to develop shortness of breath when you are active Shortness of breath gets worse You develop chest pain You develop other symptoms Review Date 2/18/2018 Updated by: Denis Hadjiliadis, MD, MHS, Paul F. Harron, Jr. Associate Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how do you get pulmonary hypertension

how do you get pulmonary hypertension

Pulmonary arterial hypertension is usually sporadic, which means it occurs in individuals with no known family history of the disorder. These non-familial cases are described as idiopathic pulmonary arterial hypertension. About 20 percent of these cases are caused by mutations in one of the genes known to be associated with the disease, but most of the time a causative gene mutation has not been identified.

Pulmonary arterial hypertension Ayerza syndrome familial primary pulmonary hypertension FPPH idiopathic pulmonary hypertension PAH PPH PPHT primary pulmonary hypertension sporadic primary pulmonary hypertension Description Pulmonary arterial hypertension is a progressive disorder characterized by abnormally high blood pressure (hypertension) in the pulmonary artery, the blood vessel that carries blood from the heart to the lungs. Pulmonary arterial hypertension is one form of a broader condition known as pulmonary hypertension. Pulmonary hypertension occurs when most of the very small arteries throughout the lungs narrow in diameter, which increases the resistance to blood flow through the lungs. To overcome the increased resistance, blood pressure increases in the pulmonary artery and in the right ventricle of the heart, which is the chamber that pumps blood into the pulmonary artery. Ultimately, the increased blood pressure can damage the right ventricle of the heart. Signs and symptoms of pulmonary arterial hypertension occur when increased blood pressure cannot fully overcome the elevated resistance. As a result, the flow of oxygenated blood from the lungs to the rest of the body is insufficient. Shortness of breath (dyspnea) during exertion and fainting spells are the most common symptoms of pulmonary arterial hypertension. People with this disorder may experience additional symptoms, particularly as the condition worsens. Other symptoms include dizziness, swelling (edema) of the ankles or legs, chest pain, and a rapid heart rate. Frequency In the United States, about 1,000 new cases of pulmonary arterial hypertension are diagnosed each year. This disorder is twice as common in females as in males. Causes Mutations in the BMPR2 gene are the most common genetic cause of pulmonary arterial hypertension. This gene plays a role in regulating the number of cells in certain tissues. Researchers suggest that a mutation in this gene promotes cell division or prevents cell death, resulting in an overgrowth of cells in small arteries throughout the lungs. As a result, these arteries narrow in diameter, which increases the resistance to blood flow. Blood pressure in the pulmonary artery and the right ventricle of the heart increases to overcome the increased resistance to blood flow. Mutations in several additional genes have also been found to cause pulmonary arterial hypertension, but they are much less common causes of the disorder than are BMPR2 gene mutations. Variations in other genes may increase the risk of developing pulmonary arterial hypertension or modify the course of the disease (usually making it more severe). Changes in as-yet-unidentified genes may also be associated with this condition. Although pulmonary arterial hypertension often occurs on its own, it can also be part of syndromes that affect many parts of the body. For example, this condition is occasionally found in people with systemic scleroderma, systemic lupus erythematosus, critical congenital heart disease, or Down syndrome. Researchers have also identified nongenetic factors that increase the risk of developing pulmonary arterial hypertension. These include certain drugs used as appetite suppressants and several illegal drugs, such as cocaine and methamphetamine. Pulmonary arterial hypertension is also a rare complication of certain infectious diseases, including HIV and schistosomiasis. Inheritance Pattern Pulmonary arterial hypertension is usually sporadic, which means it occurs in individuals with no known family history of the disorder. These non-familial cases are described as idiopathic pulmonary arterial hypertension. About 20 percent of these cases are caused by mutations in one of the genes known to be associated with the disease, but most of the time a causative gene mutation has not been identified. Inherited cases of this disorder are known as familial pulmonary arterial hypertension. When the condition is inherited, it most often has an autosomal dominant pattern of inheritance, which means one copy of an altered gene in each cell is sufficient to cause the disorder. However, many people with an altered gene never develop pulmonary arterial hypertension; this phenomenon is called reduced penetrance. Sources for This Page Austin ED, Loyd JE, Phillips JA III. Heritable Pulmonary Arterial Hypertension. 2002 Jul 18 [updated 2015 Jun 11]. In: Pagon RA, Adam MP, Ardinger HH, Wallace SE, Amemiya A, Bean LJH, Bird TD, Ledbetter N, Mefford HC, Smith RJH, Stephens K, editors. GeneReviews [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2017. Available from http://www.ncbi.nlm.nih.gov/books/NBK1485/ how do you get pulmonary hypertension

how do you get pulmonary hypertension

A blood test to check cholesterol levels - called a lipid panel or lipid profile - typically reports: - Total cholesterol - LDL cholesterol - HDL cholesterol - Triglycerides - a type of fat in the blood For the most accurate measurements, don't eat or drink anything (other than water) for nine to 12 hours before the blood sample is taken.

High cholesterol Overview Cholesterol is a waxy substance that's found in the fats (lipids) in your blood. While your body needs cholesterol to continue building healthy cells, having high cholesterol can increase your risk of heart disease. When you have high cholesterol, you may develop fatty deposits in your blood vessels. Eventually, these deposits make it difficult for enough blood to flow through your arteries. Your heart may not get as much oxygen-rich blood as it needs, which increases the risk of a heart attack. Decreased blood flow to your brain can cause a stroke. High cholesterol can be inherited, but it's often the result of unhealthy lifestyle choices, and thus preventable and treatable. A healthy diet, regular exercise and sometimes medication can go a long way toward reducing high cholesterol. Symptoms High cholesterol has no symptoms. A blood test is the only way to detect high cholesterol. When to see a doctor Ask your doctor if you should have a cholesterol test. Recommendations for the age of first screening vary. Retesting is usually performed every five years. If your test results aren't within desirable ranges, your doctor may recommend more frequent measurements. Your doctor may also suggest you have more frequent tests if you have a family history of high cholesterol, heart disease or other risk factors, such as smoking, diabetes or high blood pressure. Causes Cholesterol is carried through your blood, attached to proteins. This combination of proteins and cholesterol is called a lipoprotein. You may have heard of different types of cholesterol, based on what type of cholesterol the lipoprotein carries. They are: - Low-density lipoprotein (LDL). LDL, or "bad," cholesterol transports cholesterol particles throughout your body. LDL cholesterol builds up in the walls of your arteries, making them hard and narrow. - High-density lipoprotein (HDL). HDL, or "good," cholesterol picks up excess cholesterol and takes it back to your liver. Factors within your control - such as inactivity, obesity and an unhealthy diet - contribute to high LDL cholesterol and low HDL cholesterol. Factors beyond your control may play a role, too. For example, your genetic makeup may keep cells from removing LDL cholesterol from your blood efficiently or cause your liver to produce too much cholesterol. Risk factors Factors that may increase your risk of high cholesterol include: - Poor diet. Eating saturated fat, found in animal products, and trans fats, found in some commercially baked cookies and crackers, can raise your cholesterol level. Foods that are high in cholesterol, such as red meat and full-fat dairy products, will also increase your total cholesterol. - Obesity. Having a body mass index (BMI) of 30 or greater puts you at risk of high cholesterol. - Large waist circumference. Your risk increases if you are a man with a waist circumference of at least 40 inches (102 centimeters) or a woman with a waist circumference of at least 35 inches (89 centimeters). - Lack of exercise. Exercise helps boost your body's HDL, or "good," cholesterol while increasing the size of the particles that make up your LDL, or "bad," cholesterol, which makes it less harmful. - Smoking. Cigarette smoking damages the walls of your blood vessels, making them likely to accumulate fatty deposits. Smoking may also lower your level of HDL, or "good," cholesterol. - Diabetes. High blood sugar contributes to higher LDL cholesterol and lower HDL cholesterol. High blood sugar also damages the lining of your arteries. Complications High cholesterol can cause atherosclerosis, a dangerous accumulation of cholesterol and other deposits on the walls of your arteries. These deposits (plaques) can reduce blood flow through your arteries, which can cause complications, such as: - Chest pain. If the arteries that supply your heart with blood (coronary arteries) are affected, you may have chest pain (angina) and other symptoms of coronary artery disease. - Heart attack. If plaques tear or rupture, a blood clot may form at the plaque-rupture site - blocking the flow of blood or breaking free and plugging an artery downstream. If blood flow to part of your heart stops, you'll have a heart attack. - Stroke. Similar to a heart attack, if blood flow to part of your brain is blocked by a blood clot, a stroke occurs. Diagnosis A blood test to check cholesterol levels - called a lipid panel or lipid profile - typically reports: - Total cholesterol - LDL cholesterol - HDL cholesterol - Triglycerides - a type of fat in the blood For the most accurate measurements, don't eat or drink anything (other than water) for nine to 12 hours before the blood sample is taken. Interpreting the numbers In the United States, cholesterol levels are measured in milligrams (mg) of cholesterol per deciliter (dL) of blood. In Canada and many European countries, cholesterol levels are measured in millimoles per liter (mmol/L). To interpret your test results, use these general guidelines. Children and cholesterol testing For most children, the National Heart, Lung, and Blood Institute recommends one cholesterol screening test between the ages of 9 and 11, and another cholesterol screening test between the ages of 17 and 21. Cholesterol testing is usually avoided between the ages of 12 and 16 because false-negative results are more likely within this age group. If your child has a family history of early-onset heart disease or a personal history of obesity or diabetes, your doctor may recommend earlier or more frequent cholesterol testing. Treatment Lifestyle changes such as exercising and eating a healthy diet are the first line of defense against high cholesterol. But, if you've made these important lifestyle changes and your cholesterol levels remain high, your doctor may recommend medication. The specific choice of medication or combination of medications depends on various factors, including your individual risk factors, your age, your current health and possible side effects. Common choices include: - Statins. Statins block a substance your liver needs to make cholesterol. This causes your liver to remove cholesterol from your blood. Statins may also help your body reabsorb cholesterol from built-up deposits on your artery walls, potentially reversing coronary artery disease. Choices include atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Altoprev), pitavastatin (Livalo), pravastatin (Pravachol), rosuvastatin (Crestor) and simvastatin (Zocor). - Bile-acid-binding resins. Your liver uses cholesterol to make bile acids, a substance needed for digestion. The medications cholestyramine (Prevalite), colesevelam (Welchol) and colestipol (Colestid) lower cholesterol indirectly by binding to bile acids. This prompts your liver to use excess cholesterol to make more bile acids, which reduces the level of cholesterol in your blood. - Cholesterol absorption inhibitors. Your small intestine absorbs the cholesterol from your diet and releases it into your bloodstream. The drug ezetimibe (Zetia) helps reduce blood cholesterol by limiting the absorption of dietary cholesterol. Ezetimibe can be used in combination with a statin drug. - Injectable medications. A new class of drugs can help the liver absorb more LDL cholesterol - which lowers the amount of cholesterol circulating in your blood. Alirocumab (Praluent) and evolocumab (Repatha) may be used for people who have a genetic condition that causes very high levels of LDL or in people with a history of coronary disease who have intolerance to statins or other cholesterol medications. Medications for high triglycerides If you also have high triglycerides, your doctor may prescribe: - Fibrates. The medications fenofibrate (TriCor, Fenoglide, others) and gemfibrozil (Lopid) decrease triglycerides by reducing your liver's production of very-low-density lipoprotein (VLDL) cholesterol and by speeding up the removal of triglycerides from your blood. VLDL cholesterol contains mostly triglycerides. - Niacin. Niacin decreases triglycerides by limiting your liver's ability to produce LDL and VLDL cholesterol. But niacin doesn't provide any additional benefit than using statins alone. Niacin has also been linked to liver damage and stroke, so most doctors now recommend it only for people who can't take statins. - Omega-3 fatty acid supplements. Omega-3 fatty acid supplements can help lower your triglycerides. They are available by prescription or over-the-counter. If you choose to take over-the-counter supplements, get your doctor's OK first. Omega-3 fatty acid supplements could affect other medications you're taking. Tolerance varies Tolerance of medications varies from person to person. The common side effects are muscle pains, stomach pain, constipation, nausea and diarrhea. If you decide to take cholesterol medication, your doctor may recommend liver function tests to monitor the medication's effect on your liver. Children and cholesterol treatment Diet and exercise are the best initial treatment for children age 2 and older who have high cholesterol or who are obese. Children age 10 and older might be prescribed cholesterol-lowering drugs, such as statins, if they have extremely high cholesterol levels. Lifestyle and home remedies Lifestyle changes are essential to improve your cholesterol level. To bring your numbers down, lose excess weight, eat healthy foods and increase your physical activity. If you smoke, quit. Eat heart-healthy foods What you eat has a direct impact on your cholesterol level. - Choose healthier fats. Saturated fat and trans fat raise your total cholesterol and LDL cholesterol. The most common sources of saturated fat in the diet are red meat, processed meats and dairy products that are not fat-free. Monounsaturated fat - found in olive and canola oils - is a healthier option. Avocados, almonds, pecans and walnuts are other sources of healthy fat. - Avoid trans fats. Trans fats, which are often found in margarines and commercially baked cookies, crackers and snack cakes, are particularly bad for your cholesterol levels. Not only do trans fats increase your total LDL ("bad") cholesterol, but they also lower your HDL ("good") cholesterol. Foods listing "partially hydrogenated oils" in the ingredients contain trans fats. - Limit your dietary cholesterol. The most concentrated sources of cholesterol include organ meats, egg yolks and whole milk products. Use lean cuts of meat and skim milk instead. Limit the intake of eggs to no more than 7 a week. - Select whole grains. Various nutrients found in whole grains promote heart health. Choose whole-grain breads, whole-wheat pasta, whole-wheat flour and brown rice. Oatmeal and oat bran are other good choices. - Stock up on fruits and vegetables. Fruits and vegetables are rich in dietary fiber, which can help lower cholesterol. Snack on seasonal fruits. Experiment with vegetable-based casseroles, soups and stir-fries. - Eat heart-healthy fish. Some types of fish - such as cod, tuna and halibut - have less total fat, saturated fat and cholesterol than do meat and poultry. Salmon, mackerel and herring are rich in omega-3 fatty acids, which help promote heart health. - Drink alcohol only in moderation. Moderate use of alcohol may increase your levels of HDL cholesterol - but the benefits aren't strong enough to recommend alcohol for anyone who doesn't drink already. If you choose to drink, do so in moderation. This means no more than one drink a day for women and one to two drinks a day for men. Lose extra pounds Excess weight contributes to high cholesterol. Losing even 5 to 10 pounds can help lower total cholesterol levels. Start by taking an honest look at your eating habits and daily routine. Consider your challenges to weight loss - and ways to overcome them. Set long-term, sustainable goals. Exercise regularly Regular exercise can help improve your cholesterol levels. With your doctor's OK, work up to 30 to 60 minutes of exercise a day. Take a brisk daily walk. Ride your bike. Swim laps. To maintain your motivation, keep it fun. Find an exercise buddy or join an exercise group. And you don't need to get all 30 to 60 minutes in one exercise session. If you can squeeze in three to six 10-minute intervals of exercise, you'll still get some benefits. If you are not doing any exercise at all right now, try even 15 minutes of exercise a day several days of the week. Some exercise is much better than no exercise. Don't smoke If you smoke, stop. Cigarette smoking increases your risk of heart disease because it damages your blood vessels and speeds up the accumulation of plaque within arteries. Alternative medicine Few natural products have been proven to reduce cholesterol, but some might be helpful. With your doctor's OK, consider these cholesterol-lowering supplements and products: - Barley - Beta-sitosterol (found in oral supplements and some margarines, such as Promise Activ) - Blond psyllium (found in seed husk and products such as Metamucil) - Oat bran (found in oatmeal and whole oats) - Sitostanol (found in oral supplements and some margarines, such as Benecol) Some red yeast rice products contain monacolin K, which is chemically identical to the prescription drug lovastatin. The FDA has prohibited the sale of these products, since there's no way to determine the quantity or quality of the active ingredient. If you choose to take cholesterol-lowering supplements, remember the importance of a healthy lifestyle. If your doctor prescribes medication to reduce your cholesterol, take it as directed. Make sure your doctor knows which supplements you're taking as well. how do you test for cholesterol level in your body

how do you test for cholesterol level in your body

How to diagnose High blood cholesterol levels?: A cholesterol test is done to diagnose a lipid disorder. Some guidelines recommend having your first screening cholesterol test at age 20. Everyone should have their first screening test by age 35 in men, and age 45 in women. (Note: Different experts recommend different starting ages.)

High blood cholesterol levels Cholesterol - high Lipid disorders Hyperlipoproteinemia Hyperlipidemia Dyslipidemia Hypercholesterolemia Summary Cholesterol is a fat (also called a lipid) that your body needs to work properly. Too much bad cholesterol can increase your chance of getting heart disease, stroke, and other problems. The medical term for high blood cholesterol is lipid disorder, hyperlipidemia, or hypercholesterolemia. Causes There are many types of cholesterol. The ones talked about most are: Total cholesterol -- all the cholesterols combined High density lipoprotein (HDL) cholesterol -- often called "good" cholesterol Low density lipoprotein (LDL) cholesterol -- often called "bad" cholesterol For many people, abnormal cholesterol levels are partly due to an unhealthy lifestyle. This often includes eating a diet that is high in fat. Other lifestyle factors are: Being overweight Lack of exercise Some health conditions can also lead to abnormal cholesterol, including: Diabetes Kidney disease Polycystic ovary syndrome Pregnancy and other conditions that increase levels of female hormones Underactive thyroid gland Medicines such as certain birth control pills, diuretics (water pills), beta-blockers, and some medicines used to treat depression may also raise cholesterol levels. Several disorders that are passed down through families lead to abnormal cholesterol and triglyceride levels. They include: Familial combined hyperlipidemia Familial dysbetalipoproteinemia Familial hypercholesterolemia Familial hypertriglyceridemia Smoking does not cause higher cholesterol levels, but it can reduce your HDL (good) cholesterol. Exams and Tests A cholesterol test is done to diagnose a lipid disorder. Different experts recommend different starting ages. Recommended starting ages are between 20 to 35 for men and 20 to 45 for women. Adults with normal cholesterol levels do not need to have the test repeated for 5 years. Repeat testing sooner if changes occur in lifestyle (including weight gain and diet). Adults with a history of elevated cholesterol, diabetes, kidney problems, heart disease, and other conditions require more frequent testing. It is important to work with your health care provider to set your cholesterol goals. Newer guidelines steer doctors away from targeting specific levels of cholesterol. Instead, they recommend different medicines and doses depending on a person's history and risk factor profile. These guidelines change from time to time as more information from research studies becomes available. General targets are: LDL: 70 to 130 mg/dL (lower numbers are better) HDL: More than 50 mg/dL (high numbers are better) Total cholesterol: Less than 200 mg/dL (lower numbers are better) Triglycerides: 10 to 150 mg/dL (lower numbers are better) If your cholesterol results are abnormal, you may also have other tests such as: Blood sugar (glucose) test to look for diabetes Kidney function tests Thyroid function tests to look for an underactive thyroid gland Treatment Steps you can take to improve your cholesterol levels and to help prevent heart disease and a heart attack include: Quit smoking. This is the single biggest change you can make to reduce your risk of heart attack and stroke. Eat foods that are naturally low in fat. These include whole grains, fruits, and vegetables. Use low-fat toppings, sauces, and dressings. Avoid foods that are high in saturated fat. Exercise regularly. Lose weight if you are overweight. Your provider may want you to take medicine for your cholesterol if lifestyle changes do not work. This will depend on: Your age Whether or not you have heart disease, diabetes, or other blood flow problems Whether you smoke or are overweight Whether you have high blood pressure or diabetes You are more likely to need medicine to lower your cholesterol: If you have heart disease or diabetes If you are at risk for heart disease (even if you do not yet have any heart problems) Almost everyone else may get health benefits from LDL cholesterol that is lower than 160 to 190 mg/dL. There are several types of drugs to help lower blood cholesterol levels. The drugs work in different ways. Statins are one kind of drug that lowers cholesterol and has been proven to reduce the chance of heart disease. Outlook (Prognosis) High cholesterol levels can lead to hardening of the arteries, also called atherosclerosis. This occurs when fat, cholesterol, and other substances build up in the walls of arteries and form hard structures called plaques. Over time, these plaques can block the arteries and cause heart disease, stroke, and other symptoms or problems throughout the body. Disorders that are passed down through families often lead to higher cholesterol levels that are harder to control. Review Date 2/22/2018 Updated by: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how do you test for cholesterol level in your body

how do you test for cholesterol level in your body

Heart attack (Treatment): IMMEDIATE TREATMENT - You will be hooked up to a heart monitor, so the health care team can see how regularly your heart is beating. - You will receive oxygen so that your heart doesn't have to work as hard. - An intravenous line (IV) will be placed into one of your veins. Medicines and fluids pass through this IV. - You may get nitroglycerin and morphine to help reduce chest pain. - You may receive aspirin, unless it would not be safe for you. In that case, you will be given another medicine that prevents blood clots. EMERGENCY PROCEDURES Angioplasty is a procedure to open narrowed or blocked blood vessels that supply blood to the heart. - Angioplasty is often the first choice of treatment.

Heart attack Myocardial infarction MI Acute MI ST - elevation myocardial infarction Non-ST - elevation myocardial infarction NSTEMI CAD - heart attack Coronary artery disease - heart attack Summary Most heart attacks are caused by a blood clot that blocks one of the coronary arteries. The coronary arteries bring blood and oxygen to the heart. If the blood flow is blocked, the heart is starved of oxygen and heart cells die. The medical term for this is myocardial infarction. Causes A substance called plaque can build up in the walls of your coronary arteries. This plaque is made up of cholesterol and other cells. A heart attack may occur when: A tear in the plaque occurs. This triggers blood platelets and other substances to form a blood clot at the site that blocks most or all of the oxygen-carrying blood from flowing to a part of the heart muscle. This is the most common cause of heart attack. A slow buildup of plaque may narrow one of the coronary arteries so that it is almost blocked. In either case, there is not enough blood flow to the heart muscle and heart muscle dies. The cause of heart attack is not always known. Heart attack may occur: When you are resting or asleep After a sudden increase in physical activity When you are active outside in cold weather After sudden, severe emotional or physical stress, including an illness Many risk factors may lead to the development of plaque buildup and a heart attack. Symptoms A heart attack is a medical emergency. If you have symptoms of a heart attack, call 911 or your local emergency number right away. DO NOT try to drive yourself to the hospital. DO NOT WAIT. You are at greatest risk of sudden death in the early hours of a heart attack. Chest pain is the most common symptom of a heart attack. You may feel the pain in only one part of your body OR Pain may move from your chest to your arms, shoulder, neck, teeth, jaw, belly area, or back The pain can be severe or mild. It can feel like: A tight band around the chest Bad indigestion Something heavy sitting on your chest Squeezing or heavy pressure The pain most often lasts longer than 20 minutes. Rest and a medicine to relax the blood vessels (called nitroglycerin) may not completely relieve the pain of a heart attack. Symptoms may also go away and come back. Other symptoms of a heart attack can include: Anxiety Cough Fainting Lightheadedness, dizziness Nausea and vomiting Palpitations (feeling like your heart is beating too fast or irregularly) Shortness of breath Sweating, which may be very heavy Some people (the older adults, people with diabetes, and women) may have little or no chest pain. Or, they may have unusual symptoms such as shortness of breath, fatigue, and weakness. A "silent heart attack" is a heart attack with no symptoms. Exams and Tests A health care provider will perform a physical exam and listen to your chest using a stethoscope. The provider may hear abnormal sounds in your lungs (called crackles), a heart murmur, or other abnormal sounds. You may have a fast or uneven pulse. Your blood pressure may be normal, high, or low. You will have an electrocardiogram (ECG) to look for heart damage. Most of the time, certain changes on the ECG indicate you are having a heart attack. Sometimes these changes are not present, even though other tests indicate you have had a heart attack. This can be called non-ST elevation myocardial infarction (NSTEMI). A blood test can show if you have heart tissue damage. This test can confirm that you are having a heart attack. You will likely have this test 3 times over the first 6 to 12 hours. Coronary angiography may be done right away or when you are more stable. This test uses a special dye and x-rays to see how blood flows through your heart. It can help your doctor decide which treatments you need next. Other tests to look at your heart that may be done while you are in the hospital: Echocardiography with or with stress testing Exercise stress test Nuclear stress test Heart CT scan or heart MRI Treatment IMMEDIATE TREATMENT You will be hooked up to a heart monitor, so the health care team can see how regularly your heart is beating. You will receive oxygen so that your heart doesn't have to work as hard. An intravenous line (IV) will be placed into one of your veins. Medicines and fluids pass through this IV. You may get nitroglycerin and morphine to help reduce chest pain. You may receive aspirin, unless it would not be safe for you. In that case, you will be given another medicine that prevents blood clots. Dangerous abnormal heartbeats (arrhythmias) may be treated with medicine or electric shocks. EMERGENCY PROCEDURES Angioplasty is a procedure to open narrowed or blocked blood vessels that supply blood to the heart. Angioplasty is often the first choice of treatment. It should be done within 90 minutes after you get to the hospital, and usually no later than 12 hours after a heart attack. A stent is a small, metal mesh tube that opens up (expands) inside a coronary artery. A stent is usually placed after or during angioplasty. It helps prevent the artery from closing up again. You may be given drugs to break up the clot. This is called thrombolytic therapy. It is best if these drugs are given soon after the onset of symptoms, usually no later than 12 hours after it and ideally within 30 minutes of arriving to the hospital. Some people may also have heart bypass surgery to open narrowed or blocked blood vessels that supply blood to the heart. This procedure is also called coronary artery bypass grafting and/or open heart surgery. TREATMENT AFTER A HEART ATTACK After several days, you will be discharged from the hospital. You will likely need to take medicines, some for the rest of your life. Always talk to your provider before stopping or changing how you take any medicines. Stopping certain medicines can be deadly. While under the care of your health care team, you will learn: How to take medicines to treat your heart problem and prevent more heart attacks How to eat a heart-healthy diet How to be active and exercise safely What to do when you have chest pain How to stop smoking Strong emotions are common after a heart attack. You may feel sad You may feel anxious and worry about being careful about everything you do All of these feelings are normal. They go away for most people after 2 or 3 weeks. You may also feel tired when you leave the hospital to go home. Most people who have had a heart attack take part in a cardiac rehabilitation program. Support Groups Many people benefit from taking part in support groups for people with heart disease. Outlook (Prognosis) After a heart attack, you have a higher chance of having another heart attack. How well you do after a heart attack depends on several factors such as: The amount of damage to your heart muscle and heart valves Where that damage is located Your medical care after the heart attack If your heart can no longer pump blood out to your body as well as it used to, you may develop heart failure. Abnormal heart rhythms can occur, and they can be life threatening. Most people can slowly go back to normal activities after a heart attack. This includes sexual activity. Talk to your provider about how much activity is good for you. Review Date 6/18/2018 Updated by: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how is a heart attack treated

how is a heart attack treated

The following steps can help you not only prevent but also recover from a heart attack: - Avoid smoke. The most important thing you can do to improve your heart's health is to not smoke. Also, avoid being around secondhand smoke. - Control your blood pressure and cholesterol levels. If one or both of these is high, your doctor can prescribe changes to your diet and medications. Ask your doctor how often you need to have your blood pressure and cholesterol levels monitored. - Get regular medical checkups. Some of the major risk factors for heart attack - high blood cholesterol, high blood pressure and diabetes - cause no symptoms early on. Exercise regularly. Regular exercise helps improve heart muscle function after a heart attack and helps prevent a heart attack by helping you to control your weight, diabetes, cholesterol and blood pressure. Maintain a healthy weight. Excess weight strains your heart and can contribute to high cholesterol, high blood pressure and diabetes. - Eat a heart-healthy diet. Saturated fat, trans fats and cholesterol in your diet can narrow arteries to your heart, and too much salt can raise blood pressure. Control stress. Reduce stress in your day-to-day activities. Rethink workaholic habits and find healthy ways to minimize or deal with stressful events in your life.

Heart attack Overview A heart attack occurs when the flow of blood to the heart is blocked, most often by a build-up of fat, cholesterol and other substances, which form a plaque in the arteries that feed the heart (coronary arteries). The interrupted blood flow can damage or destroy part of the heart muscle. A heart attack, also called a myocardial infarction, can be fatal, but treatment has improved dramatically over the years. It's crucial to call 911 or emergency medical help if you think you might be having a heart attack. Symptoms Common heart attack signs and symptoms include: - Pressure, tightness, pain, or a squeezing or aching sensation in your chest or arms that may spread to your neck, jaw or back - Nausea, indigestion, heartburn or abdominal pain - Shortness of breath - Cold sweat - Fatigue - Lightheadedness or sudden dizziness Heart attack symptoms vary Not all people who have heart attacks have the same symptoms or have the same severity of symptoms. Some people have mild pain; others have more severe pain. Some people have no symptoms, while for others, the first sign may be sudden cardiac arrest. However, the more signs and symptoms you have, the greater the likelihood you're having a heart attack. Some heart attacks strike suddenly, but many people have warning signs and symptoms hours, days or weeks in advance. The earliest warning may be recurrent chest pain (angina) that's triggered by exertion and relieved by rest. Angina is caused by a temporary decrease in blood flow to the heart. A heart attack differs from a condition in which your heart suddenly stops (sudden cardiac arrest, which occurs when an electrical disturbance disrupts your heart's pumping action and causes blood to stop flowing to the rest of your body). A heart attack can cause cardiac arrest, but it's not the only cause. When to see a doctor Act immediately. Some people wait too long because they don't recognize the important signs and symptoms. Take these steps: - Call for emergency medical help. If you suspect you're having a heart attack, don't hesitate. Immediately call 911 or your local emergency number. If you don't have access to emergency medical services, have someone drive you to the nearest hospital. Drive yourself only if there are no other options. Because your condition can worsen, driving yourself puts you and others at risk. - Take nitroglycerin, if prescribed to you by a doctor. Take it as instructed while awaiting emergency help. - Take aspirin, if recommended. Taking aspirin during a heart attack could reduce heart damage by helping to keep your blood from clotting. Aspirin can interact with other medications, however, so don't take an aspirin unless your doctor or emergency medical personnel recommend it. Don't delay calling 911 to take an aspirin. Call for emergency help first. What to do if you see someone having a heart attack If you encounter someone who is unconscious, first call for emergency medical help. Then begin CPR to keep blood flowing. Push hard and fast on the person's chest in a fairly rapid rhythm - about 100 to 120 compressions a minute. It's not necessary to check the person's airway or deliver rescue breaths unless you've been trained in CPR. Causes A heart attack occurs when one or more of your coronary arteries become blocked. Over time, a coronary artery can narrow from the buildup of various substances, including cholesterol (atherosclerosis). This condition, known as coronary artery disease, causes most heart attacks. During a heart attack, one of these plaques can rupture and spill cholesterol and other substances into the bloodstream. A blood clot forms at the site of the rupture. If large enough, the clot can completely block the flow of blood through the coronary artery. Another cause of a heart attack is a spasm of a coronary artery that shuts down blood flow to part of the heart muscle. Use of tobacco and of illicit drugs, such as cocaine, can cause a life-threatening spasm. A heart attack can also occur due to a tear in the heart artery (spontaneous coronary artery dissection). Risk factors Certain factors contribute to the unwanted buildup of fatty deposits (atherosclerosis) that narrows arteries throughout your body. You can improve or eliminate many of these risk factors to reduce your chances of having a first or subsequent heart attack. Heart attack risk factors include: - Age. Men age 45 or older and women age 55 or older are more likely to have a heart attack than are younger men and women. - Tobacco. Smoking and long-term exposure to secondhand smoke increase the risk of a heart attack. - High blood pressure. Over time, high blood pressure can damage arteries that feed your heart by accelerating atherosclerosis. High blood pressure that occurs with obesity, smoking, high cholesterol or diabetes increases your risk even more. - High blood cholesterol or triglyceride levels. A high level of low-density lipoprotein (LDL) cholesterol (the "bad" cholesterol) is most likely to narrow arteries. A high level of triglycerides, a type of blood fat related to your diet, also ups your risk of heart attack. However, a high level of high-density lipoprotein (HDL) cholesterol (the "good" cholesterol) lowers your risk of heart attack. - Diabetes. Insulin, a hormone secreted by your pancreas, allows your body to use glucose, a form of sugar. Having diabetes - not producing enough insulin or not responding to insulin properly - causes your body's blood sugar levels to rise. Diabetes, especially uncontrolled, increases your risk of a heart attack. - Family history of heart attack. If your siblings, parents or grandparents have had early heart attacks (by age 55 for male relatives and by age 65 for female relatives), you may be at increased risk. - Lack of physical activity. An inactive lifestyle contributes to high blood cholesterol levels and obesity. People who get regular aerobic exercise have better cardiovascular fitness, which decreases their overall risk of heart attack. Exercise is also beneficial in lowering high blood pressure. - Obesity. Obesity is associated with high blood cholesterol levels, high triglyceride levels, high blood pressure and diabetes. Losing just 10 percent of your body weight can lower this risk, however. - Stress. You may respond to stress in ways that can increase your risk of a heart attack. - Illegal drug use. Using stimulant drugs, such as cocaine or amphetamines, can trigger a spasm of your coronary arteries that can cause a heart attack. - A history of preeclampsia. This condition causes high blood pressure during pregnancy and increases the lifetime risk of heart disease. - A history of an autoimmune condition, such as rheumatoid arthritis or lupus. Conditions such as rheumatoid arthritis, lupus and other autoimmune conditions can increase your risk of having a heart attack. Complications Complications are often related to the damage done to your heart during an attack. Damage can lead to: - Abnormal heart rhythms (arrhythmias). Electrical "short circuits" can develop, resulting in abnormal heart rhythms, some of which can be serious, even fatal. - Heart failure. An attack may damage so much heart tissue that the remaining heart muscle can't adequately pump blood out of your heart. Heart failure may be temporary, or it can be a chronic condition resulting from extensive and permanent damage to your heart. - Heart rupture. Areas of heart muscle weakened by a heart attack can rupture, leaving a hole in part of the heart. This rupture is often fatal. - Valve problems. Heart valves damaged during a heart attack may develop severe leakage problems. Diagnosis Ideally, your doctor should screen you during regular physical exams for risk factors that can lead to a heart attack. If you're in an emergency setting for symptoms of a heart attack, you'll be asked to describe your symptoms and have your blood pressure, pulse and temperature checked. You'll be hooked up to a heart monitor and will almost immediately have tests to see if you're having a heart attack. Tests will help check if your signs and symptoms, such as chest pain, indicate a heart attack or another condition. These tests include: - Electrocardiogram (ECG). This first test done to diagnose a heart attack records the electrical activity of your heart via electrodes attached to your skin. Impulses are recorded as waves displayed on a monitor or printed on paper. Because injured heart muscle doesn't conduct electrical impulses normally, the ECG may show that a heart attack has occurred or is in progress. - Blood tests. Certain heart enzymes slowly leak out into your blood if your heart has been damaged by a heart attack. Emergency room doctors will take samples of your blood to test for the presence of these enzymes. Additional tests If you've had a heart attack or one is occurring, doctors will take immediate steps to treat your condition. You may also undergo these additional tests: - Chest X-ray. An X-ray image of your chest allows your doctor to check the size of your heart and its blood vessels and to look for fluid in your lungs. - Echocardiogram. During this test, sound waves directed at your heart from a wandlike device (transducer) held on your chest bounce off your heart and are processed electronically to provide video images of your heart. An echocardiogram can help identify whether an area of your heart has been damaged by a heart attack and isn't pumping normally or at peak capacity. - Coronary catheterization (angiogram). A liquid dye is injected into the arteries of your heart through a long, thin tube (catheter) that's fed through an artery, usually in your leg or groin, to the arteries in your heart. The dye makes the arteries visible on X-ray, revealing areas of blockage. - Exercise stress test. In the days or weeks after your heart attack, you may also undergo a stress test. Stress tests measure how your heart and blood vessels respond to exertion. You may walk on a treadmill or pedal a stationary bike while attached to an ECG machine. Or you may receive a drug intravenously that stimulates your heart similar to exercise. Your doctor may also order a nuclear stress test, which is similar to an exercise stress test, but uses an injected dye and special imaging techniques to produce detailed images of your heart while you're exercising. These tests can help determine your long-term treatment. - Cardiac computerized tomography (CT) or magnetic resonance imaging (MRI). These tests can be used to diagnose heart problems, including the extent of damage from heart attacks. In a cardiac CT scan, you lie on a table inside a doughnut-shaped machine. An X-ray tube inside the machine rotates around your body and collects images of your heart and chest. In a cardiac MRI, you lie on a table inside a long tubelike machine that produces a magnetic field. The magnetic field aligns atomic particles in some of your cells. When radio waves are broadcast toward these aligned particles, they produce signals that vary according to the type of tissue they are. The signals create images of your heart. Treatment Heart attack treatment at a hospital With each passing minute after a heart attack, more heart tissue loses oxygen and deteriorates or dies. The main way to prevent heart damage is to restore blood flow quickly. Medications Medications given to treat a heart attack include: - Aspirin. The 911 operator may instruct you to take aspirin, or emergency medical personnel may give you aspirin immediately. Aspirin reduces blood clotting, thus helping maintain blood flow through a narrowed artery. - Thrombolytics. These drugs, also called clotbusters, help dissolve a blood clot that's blocking blood flow to your heart. The earlier you receive a thrombolytic drug after a heart attack, the greater the chance you'll survive and with less heart damage. - Antiplatelet agents. Emergency room doctors may give you other drugs to help prevent new clots and keep existing clots from getting larger. These include medications, such as clopidogrel (Plavix) and others, called platelet aggregation inhibitors. - Other blood-thinning medications. You'll likely be given other medications, such as heparin, to make your blood less "sticky" and less likely to form clots. Heparin is given intravenously or by an injection under your skin. - Pain relievers. You may receive a pain reliever, such as morphine, to ease your discomfort. - Nitroglycerin. This medication, used to treat chest pain (angina), can help improve blood flow to the heart by widening (dilating) the blood vessels. - Beta blockers. These medications help relax your heart muscle, slow your heartbeat and decrease blood pressure, making your heart's job easier. Beta blockers can limit the amount of heart muscle damage and prevent future heart attacks. - ACE inhibitors. These drugs lower blood pressure and reduce stress on the heart. Surgical and other procedures In addition to medications, you may undergo one of the following procedures to treat your heart attack: - Coronary angioplasty and stenting. Doctors insert a long, thin tube (catheter) that's passed through an artery, usually in your leg or groin, to a blocked artery in your heart. If you've had a heart attack, this procedure is often done immediately after a cardiac catheterization, a procedure used to locate blockages. This catheter is equipped with a special balloon that, once in position, is briefly inflated to open a blocked coronary artery. A metal mesh stent may be inserted into the artery to keep it open long term, restoring blood flow to the heart. Depending on your condition, your doctor may opt to place a stent coated with a slow-releasing medication to help keep your artery open. - Coronary artery bypass surgery. In some cases, doctors may perform emergency bypass surgery at the time of a heart attack. If possible, your doctor may suggest that you have bypass surgery after your heart has had time - about three to seven days - to recover from your heart attack. Bypass surgery involves sewing veins or arteries in place beyond a blocked or narrowed coronary artery, allowing blood flow to the heart to bypass the narrowed section. Once blood flow to your heart is restored and your condition is stable, you're likely to remain in the hospital for several days. Lifestyle and home remedies Your lifestyle affects your heart health. The following steps can help you not only prevent but also recover from a heart attack: - Avoid smoke. The most important thing you can do to improve your heart's health is to not smoke. Also, avoid being around secondhand smoke. If you need to quit, ask your doctor for help. - Control your blood pressure and cholesterol levels. If one or both of these is high, your doctor can prescribe changes to your diet and medications. Ask your doctor how often you need to have your blood pressure and cholesterol levels monitored. - Get regular medical checkups. Some of the major risk factors for heart attack - high blood cholesterol, high blood pressure and diabetes - cause no symptoms early on. Your doctor can perform tests to check for these conditions and help you manage them, if necessary. - Exercise regularly. Regular exercise helps improve heart muscle function after a heart attack and helps prevent a heart attack by helping you to control your weight, diabetes, cholesterol and blood pressure. Exercise needn't be vigorous. Walking 30 minutes a day, five days a week can improve your health. - Maintain a healthy weight. Excess weight strains your heart and can contribute to high cholesterol, high blood pressure and diabetes. - Eat a heart-healthy diet. Saturated fat, trans fats and cholesterol in your diet can narrow arteries to your heart, and too much salt can raise blood pressure. Eat a heart-healthy diet that includes lean proteins, such as fish and beans, plenty of fruits and vegetables and whole grains. - Manage diabetes. High blood sugar is damaging to your heart. Regular exercise, eating well and losing weight all help to keep blood sugar levels at more-desirable levels. Many people also need medication to manage their diabetes. - Control stress. Reduce stress in your day-to-day activities. Rethink workaholic habits and find healthy ways to minimize or deal with stressful events in your life. - If you drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women and men older than age 65, and up to two drinks a day for men age 65 and younger. how is a heart attack treated

how is a heart attack treated

Heart attack (Treatment): Heart attack treatment at a hospital With each passing minute after a heart attack, more heart tissue loses oxygen and deteriorates or dies. The main way to prevent heart damage is to restore blood flow quickly. Aspirin. The 911 operator may instruct you to take aspirin, or emergency medical personnel may give you aspirin immediately. Aspirin reduces blood clotting, thus helping maintain blood flow through a narrowed artery. Emergency room doctors may give you other drugs to help prevent new clots and keep existing clots from getting larger. Surgical and other procedures In addition to medications, you may undergo one of the following procedures to treat your heart attack: - Coronary angioplasty and stenting. Doctors insert a long, thin tube (catheter) that's passed through an artery, usually in your leg or groin, to a blocked artery in your heart. If you've had a heart attack, this procedure is often done immediately after a cardiac catheterization, a procedure used to locate blockages. This catheter is equipped with a special balloon that, once in position, is briefly inflated to open a blocked coronary artery. A metal mesh stent may be inserted into the artery to keep it open long term, restoring blood flow to the heart. In some cases, doctors may perform emergency bypass surgery at the time of a heart attack. If possible, your doctor may suggest that you have bypass surgery after your heart has had time - about three to seven days - to recover from your heart attack.

Heart attack Overview A heart attack occurs when the flow of blood to the heart is blocked, most often by a build-up of fat, cholesterol and other substances, which form a plaque in the arteries that feed the heart (coronary arteries). The interrupted blood flow can damage or destroy part of the heart muscle. A heart attack, also called a myocardial infarction, can be fatal, but treatment has improved dramatically over the years. It's crucial to call 911 or emergency medical help if you think you might be having a heart attack. Symptoms Common heart attack signs and symptoms include: - Pressure, tightness, pain, or a squeezing or aching sensation in your chest or arms that may spread to your neck, jaw or back - Nausea, indigestion, heartburn or abdominal pain - Shortness of breath - Cold sweat - Fatigue - Lightheadedness or sudden dizziness Heart attack symptoms vary Not all people who have heart attacks have the same symptoms or have the same severity of symptoms. Some people have mild pain; others have more severe pain. Some people have no symptoms, while for others, the first sign may be sudden cardiac arrest. However, the more signs and symptoms you have, the greater the likelihood you're having a heart attack. Some heart attacks strike suddenly, but many people have warning signs and symptoms hours, days or weeks in advance. The earliest warning may be recurrent chest pain (angina) that's triggered by exertion and relieved by rest. Angina is caused by a temporary decrease in blood flow to the heart. A heart attack differs from a condition in which your heart suddenly stops (sudden cardiac arrest, which occurs when an electrical disturbance disrupts your heart's pumping action and causes blood to stop flowing to the rest of your body). A heart attack can cause cardiac arrest, but it's not the only cause. When to see a doctor Act immediately. Some people wait too long because they don't recognize the important signs and symptoms. Take these steps: - Call for emergency medical help. If you suspect you're having a heart attack, don't hesitate. Immediately call 911 or your local emergency number. If you don't have access to emergency medical services, have someone drive you to the nearest hospital. Drive yourself only if there are no other options. Because your condition can worsen, driving yourself puts you and others at risk. - Take nitroglycerin, if prescribed to you by a doctor. Take it as instructed while awaiting emergency help. - Take aspirin, if recommended. Taking aspirin during a heart attack could reduce heart damage by helping to keep your blood from clotting. Aspirin can interact with other medications, however, so don't take an aspirin unless your doctor or emergency medical personnel recommend it. Don't delay calling 911 to take an aspirin. Call for emergency help first. What to do if you see someone having a heart attack If you encounter someone who is unconscious, first call for emergency medical help. Then begin CPR to keep blood flowing. Push hard and fast on the person's chest in a fairly rapid rhythm - about 100 to 120 compressions a minute. It's not necessary to check the person's airway or deliver rescue breaths unless you've been trained in CPR. Causes A heart attack occurs when one or more of your coronary arteries become blocked. Over time, a coronary artery can narrow from the buildup of various substances, including cholesterol (atherosclerosis). This condition, known as coronary artery disease, causes most heart attacks. During a heart attack, one of these plaques can rupture and spill cholesterol and other substances into the bloodstream. A blood clot forms at the site of the rupture. If large enough, the clot can completely block the flow of blood through the coronary artery. Another cause of a heart attack is a spasm of a coronary artery that shuts down blood flow to part of the heart muscle. Use of tobacco and of illicit drugs, such as cocaine, can cause a life-threatening spasm. A heart attack can also occur due to a tear in the heart artery (spontaneous coronary artery dissection). Risk factors Certain factors contribute to the unwanted buildup of fatty deposits (atherosclerosis) that narrows arteries throughout your body. You can improve or eliminate many of these risk factors to reduce your chances of having a first or subsequent heart attack. Heart attack risk factors include: - Age. Men age 45 or older and women age 55 or older are more likely to have a heart attack than are younger men and women. - Tobacco. Smoking and long-term exposure to secondhand smoke increase the risk of a heart attack. - High blood pressure. Over time, high blood pressure can damage arteries that feed your heart by accelerating atherosclerosis. High blood pressure that occurs with obesity, smoking, high cholesterol or diabetes increases your risk even more. - High blood cholesterol or triglyceride levels. A high level of low-density lipoprotein (LDL) cholesterol (the "bad" cholesterol) is most likely to narrow arteries. A high level of triglycerides, a type of blood fat related to your diet, also ups your risk of heart attack. However, a high level of high-density lipoprotein (HDL) cholesterol (the "good" cholesterol) lowers your risk of heart attack. - Diabetes. Insulin, a hormone secreted by your pancreas, allows your body to use glucose, a form of sugar. Having diabetes - not producing enough insulin or not responding to insulin properly - causes your body's blood sugar levels to rise. Diabetes, especially uncontrolled, increases your risk of a heart attack. - Family history of heart attack. If your siblings, parents or grandparents have had early heart attacks (by age 55 for male relatives and by age 65 for female relatives), you may be at increased risk. - Lack of physical activity. An inactive lifestyle contributes to high blood cholesterol levels and obesity. People who get regular aerobic exercise have better cardiovascular fitness, which decreases their overall risk of heart attack. Exercise is also beneficial in lowering high blood pressure. - Obesity. Obesity is associated with high blood cholesterol levels, high triglyceride levels, high blood pressure and diabetes. Losing just 10 percent of your body weight can lower this risk, however. - Stress. You may respond to stress in ways that can increase your risk of a heart attack. - Illegal drug use. Using stimulant drugs, such as cocaine or amphetamines, can trigger a spasm of your coronary arteries that can cause a heart attack. - A history of preeclampsia. This condition causes high blood pressure during pregnancy and increases the lifetime risk of heart disease. - A history of an autoimmune condition, such as rheumatoid arthritis or lupus. Conditions such as rheumatoid arthritis, lupus and other autoimmune conditions can increase your risk of having a heart attack. Complications Complications are often related to the damage done to your heart during an attack. Damage can lead to: - Abnormal heart rhythms (arrhythmias). Electrical "short circuits" can develop, resulting in abnormal heart rhythms, some of which can be serious, even fatal. - Heart failure. An attack may damage so much heart tissue that the remaining heart muscle can't adequately pump blood out of your heart. Heart failure may be temporary, or it can be a chronic condition resulting from extensive and permanent damage to your heart. - Heart rupture. Areas of heart muscle weakened by a heart attack can rupture, leaving a hole in part of the heart. This rupture is often fatal. - Valve problems. Heart valves damaged during a heart attack may develop severe leakage problems. Diagnosis Ideally, your doctor should screen you during regular physical exams for risk factors that can lead to a heart attack. If you're in an emergency setting for symptoms of a heart attack, you'll be asked to describe your symptoms and have your blood pressure, pulse and temperature checked. You'll be hooked up to a heart monitor and will almost immediately have tests to see if you're having a heart attack. Tests will help check if your signs and symptoms, such as chest pain, indicate a heart attack or another condition. These tests include: - Electrocardiogram (ECG). This first test done to diagnose a heart attack records the electrical activity of your heart via electrodes attached to your skin. Impulses are recorded as waves displayed on a monitor or printed on paper. Because injured heart muscle doesn't conduct electrical impulses normally, the ECG may show that a heart attack has occurred or is in progress. - Blood tests. Certain heart enzymes slowly leak out into your blood if your heart has been damaged by a heart attack. Emergency room doctors will take samples of your blood to test for the presence of these enzymes. Additional tests If you've had a heart attack or one is occurring, doctors will take immediate steps to treat your condition. You may also undergo these additional tests: - Chest X-ray. An X-ray image of your chest allows your doctor to check the size of your heart and its blood vessels and to look for fluid in your lungs. - Echocardiogram. During this test, sound waves directed at your heart from a wandlike device (transducer) held on your chest bounce off your heart and are processed electronically to provide video images of your heart. An echocardiogram can help identify whether an area of your heart has been damaged by a heart attack and isn't pumping normally or at peak capacity. - Coronary catheterization (angiogram). A liquid dye is injected into the arteries of your heart through a long, thin tube (catheter) that's fed through an artery, usually in your leg or groin, to the arteries in your heart. The dye makes the arteries visible on X-ray, revealing areas of blockage. - Exercise stress test. In the days or weeks after your heart attack, you may also undergo a stress test. Stress tests measure how your heart and blood vessels respond to exertion. You may walk on a treadmill or pedal a stationary bike while attached to an ECG machine. Or you may receive a drug intravenously that stimulates your heart similar to exercise. Your doctor may also order a nuclear stress test, which is similar to an exercise stress test, but uses an injected dye and special imaging techniques to produce detailed images of your heart while you're exercising. These tests can help determine your long-term treatment. - Cardiac computerized tomography (CT) or magnetic resonance imaging (MRI). These tests can be used to diagnose heart problems, including the extent of damage from heart attacks. In a cardiac CT scan, you lie on a table inside a doughnut-shaped machine. An X-ray tube inside the machine rotates around your body and collects images of your heart and chest. In a cardiac MRI, you lie on a table inside a long tubelike machine that produces a magnetic field. The magnetic field aligns atomic particles in some of your cells. When radio waves are broadcast toward these aligned particles, they produce signals that vary according to the type of tissue they are. The signals create images of your heart. Treatment Heart attack treatment at a hospital With each passing minute after a heart attack, more heart tissue loses oxygen and deteriorates or dies. The main way to prevent heart damage is to restore blood flow quickly. Medications Medications given to treat a heart attack include: - Aspirin. The 911 operator may instruct you to take aspirin, or emergency medical personnel may give you aspirin immediately. Aspirin reduces blood clotting, thus helping maintain blood flow through a narrowed artery. - Thrombolytics. These drugs, also called clotbusters, help dissolve a blood clot that's blocking blood flow to your heart. The earlier you receive a thrombolytic drug after a heart attack, the greater the chance you'll survive and with less heart damage. - Antiplatelet agents. Emergency room doctors may give you other drugs to help prevent new clots and keep existing clots from getting larger. These include medications, such as clopidogrel (Plavix) and others, called platelet aggregation inhibitors. - Other blood-thinning medications. You'll likely be given other medications, such as heparin, to make your blood less "sticky" and less likely to form clots. Heparin is given intravenously or by an injection under your skin. - Pain relievers. You may receive a pain reliever, such as morphine, to ease your discomfort. - Nitroglycerin. This medication, used to treat chest pain (angina), can help improve blood flow to the heart by widening (dilating) the blood vessels. - Beta blockers. These medications help relax your heart muscle, slow your heartbeat and decrease blood pressure, making your heart's job easier. Beta blockers can limit the amount of heart muscle damage and prevent future heart attacks. - ACE inhibitors. These drugs lower blood pressure and reduce stress on the heart. Surgical and other procedures In addition to medications, you may undergo one of the following procedures to treat your heart attack: - Coronary angioplasty and stenting. Doctors insert a long, thin tube (catheter) that's passed through an artery, usually in your leg or groin, to a blocked artery in your heart. If you've had a heart attack, this procedure is often done immediately after a cardiac catheterization, a procedure used to locate blockages. This catheter is equipped with a special balloon that, once in position, is briefly inflated to open a blocked coronary artery. A metal mesh stent may be inserted into the artery to keep it open long term, restoring blood flow to the heart. Depending on your condition, your doctor may opt to place a stent coated with a slow-releasing medication to help keep your artery open. - Coronary artery bypass surgery. In some cases, doctors may perform emergency bypass surgery at the time of a heart attack. If possible, your doctor may suggest that you have bypass surgery after your heart has had time - about three to seven days - to recover from your heart attack. Bypass surgery involves sewing veins or arteries in place beyond a blocked or narrowed coronary artery, allowing blood flow to the heart to bypass the narrowed section. Once blood flow to your heart is restored and your condition is stable, you're likely to remain in the hospital for several days. Lifestyle and home remedies Your lifestyle affects your heart health. The following steps can help you not only prevent but also recover from a heart attack: - Avoid smoke. The most important thing you can do to improve your heart's health is to not smoke. Also, avoid being around secondhand smoke. If you need to quit, ask your doctor for help. - Control your blood pressure and cholesterol levels. If one or both of these is high, your doctor can prescribe changes to your diet and medications. Ask your doctor how often you need to have your blood pressure and cholesterol levels monitored. - Get regular medical checkups. Some of the major risk factors for heart attack - high blood cholesterol, high blood pressure and diabetes - cause no symptoms early on. Your doctor can perform tests to check for these conditions and help you manage them, if necessary. - Exercise regularly. Regular exercise helps improve heart muscle function after a heart attack and helps prevent a heart attack by helping you to control your weight, diabetes, cholesterol and blood pressure. Exercise needn't be vigorous. Walking 30 minutes a day, five days a week can improve your health. - Maintain a healthy weight. Excess weight strains your heart and can contribute to high cholesterol, high blood pressure and diabetes. - Eat a heart-healthy diet. Saturated fat, trans fats and cholesterol in your diet can narrow arteries to your heart, and too much salt can raise blood pressure. Eat a heart-healthy diet that includes lean proteins, such as fish and beans, plenty of fruits and vegetables and whole grains. - Manage diabetes. High blood sugar is damaging to your heart. Regular exercise, eating well and losing weight all help to keep blood sugar levels at more-desirable levels. Many people also need medication to manage their diabetes. - Control stress. Reduce stress in your day-to-day activities. Rethink workaholic habits and find healthy ways to minimize or deal with stressful events in your life. - If you drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women and men older than age 65, and up to two drinks a day for men age 65 and younger. how is a heart attack treated

how is a heart attack treated

Asthma (Diagnosis): Physical exam To rule out other possible conditions - such as a respiratory infection or chronic obstructive pulmonary disease (COPD) - your doctor will do a physical exam and ask you questions about your signs and symptoms and about any other health problems. You may also be given lung (pulmonary) function tests to determine how much air moves in and out as you breathe. These tests may include: Spirometry. This test estimates the narrowing of your bronchial tubes by checking how much air you can exhale after a deep breath and how fast you can breathe out. Peak flow. A peak flow meter is a simple device that measures how hard you can breathe out. Lower than usual peak flow readings are a sign your lungs may not be working as well and that your asthma may be getting worse. A chest X-ray and high-resolution computerized tomography (CT) scan of your lungs and nose cavities (sinuses) can identify any structural abnormalities or diseases (such as infection) that can cause or aggravate breathing problems. Allergy tests can identify allergy to pets, dust, mold and pollen.

Asthma Overview Asthma is a condition in which your airways narrow and swell and produce extra mucus. This can make breathing difficult and trigger coughing, wheezing and shortness of breath. For some people, asthma is a minor nuisance. For others, it can be a major problem that interferes with daily activities and may lead to a life-threatening asthma attack. Asthma can't be cured, but its symptoms can be controlled. Because asthma often changes over time, it's important that you work with your doctor to track your signs and symptoms and adjust treatment as needed. Symptoms Asthma symptoms vary from person to person. You may have infrequent asthma attacks, have symptoms only at certain times - such as when exercising - or have symptoms all the time. Asthma signs and symptoms include: - Shortness of breath - Chest tightness or pain - Trouble sleeping caused by shortness of breath, coughing or wheezing - A whistling or wheezing sound when exhaling (wheezing is a common sign of asthma in children) - Coughing or wheezing attacks that are worsened by a respiratory virus, such as a cold or the flu Signs that your asthma is probably worsening include: - Asthma signs and symptoms that are more frequent and bothersome - Increasing difficulty breathing (measurable with a peak flow meter, a device used to check how well your lungs are working) - The need to use a quick-relief inhaler more often For some people, asthma signs and symptoms flare up in certain situations: - Exercise-induced asthma, which may be worse when the air is cold and dry - Occupational asthma, triggered by workplace irritants such as chemical fumes, gases or dust - Allergy-induced asthma, triggered by airborne substances, such as pollen, mold spores, cockroach waste or particles of skin and dried saliva shed by pets (pet dander) When to see a doctor Seek emergency treatment Severe asthma attacks can be life-threatening. Work with your doctor to determine what to do when your signs and symptoms worsen - and when you need emergency treatment. Signs of an asthma emergency include: - Rapid worsening of shortness of breath or wheezing - No improvement even after using a quick-relief inhaler, such as albuterol - Shortness of breath when you are doing minimal physical activity Contact your doctor See your doctor: - If you think you have asthma. If you have frequent coughing or wheezing that lasts more than a few days or any other signs or symptoms of asthma, see your doctor. Treating asthma early may prevent long-term lung damage and help keep the condition from worsening over time. - To monitor your asthma after diagnosis. If you know you have asthma, work with your doctor to keep it under control. Good long-term control helps you feel better from day to day and can prevent a life-threatening asthma attack. - If your asthma symptoms get worse. Contact your doctor right away if your medication doesn't seem to ease your symptoms or if you need to use your quick-relief inhaler more often. Don't try to solve the problem by taking more medication without consulting your doctor. Overusing asthma medication can cause side effects and may make your asthma worse. - To review your treatment. Asthma often changes over time. Meet with your doctor regularly to discuss your symptoms and make any needed treatment adjustments. Causes It isn't clear why some people get asthma and others don't, but it's probably due to a combination of environmental and genetic (inherited) factors. Asthma triggers Exposure to various irritants and substances that trigger allergies (allergens) can trigger signs and symptoms of asthma. Asthma triggers are different from person to person and can include: - Airborne substances, such as pollen, dust mites, mold spores, pet dander or particles of cockroach waste - Respiratory infections, such as the common cold - Physical activity (exercise-induced asthma) - Cold air - Air pollutants and irritants, such as smoke - Certain medications, including beta blockers, aspirin, ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve) - Strong emotions and stress - Sulfites and preservatives added to some types of foods and beverages, including shrimp, dried fruit, processed potatoes, beer and wine - Gastroesophageal reflux disease (GERD), a condition in which stomach acids back up into your throat Risk factors A number of factors are thought to increase your chances of developing asthma. These include: - Having a blood relative (such as a parent or sibling) with asthma - Having another allergic condition, such as atopic dermatitis or allergic rhinitis (hay fever) - Being overweight - Being a smoker - Exposure to secondhand smoke - Exposure to exhaust fumes or other types of pollution - Exposure to occupational triggers, such as chemicals used in farming, hairdressing and manufacturing Complications Asthma complications include: - Signs and symptoms that interfere with sleep, work or recreational activities - Sick days from work or school during asthma flare-ups - Permanent narrowing of the bronchial tubes (airway remodeling) that affects how well you can breathe - Emergency room visits and hospitalizations for severe asthma attacks - Side effects from long-term use of some medications used to stabilize severe asthma Proper treatment makes a big difference in preventing both short-term and long-term complications caused by asthma. Diagnosis Physical exam To rule out other possible conditions - such as a respiratory infection or chronic obstructive pulmonary disease (COPD) - your doctor will do a physical exam and ask you questions about your signs and symptoms and about any other health problems. Tests to measure lung function You may also be given lung (pulmonary) function tests to determine how much air moves in and out as you breathe. These tests may include: - Spirometry. This test estimates the narrowing of your bronchial tubes by checking how much air you can exhale after a deep breath and how fast you can breathe out. - Peak flow. A peak flow meter is a simple device that measures how hard you can breathe out. Lower than usual peak flow readings are a sign your lungs may not be working as well and that your asthma may be getting worse. Your doctor will give you instructions on how to track and deal with low peak flow readings. Lung function tests often are done before and after taking a medication called a bronchodilator (brong-koh-DIE-lay-tur), such as albuterol, to open your airways. If your lung function improves with use of a bronchodilator, it's likely you have asthma. Additional tests Other tests to diagnose asthma include: - Methacholine challenge. Methacholine is a known asthma trigger that, when inhaled, will cause mild constriction of your airways. If you react to the methacholine, you likely have asthma. This test may be used even if your initial lung function test is normal. - Nitric oxide test. This test, though not widely available, measures the amount of the gas, nitric oxide, that you have in your breath. When your airways are inflamed - a sign of asthma - you may have higher than normal nitric oxide levels. - Imaging tests. A chest X-ray and high-resolution computerized tomography (CT) scan of your lungs and nose cavities (sinuses) can identify any structural abnormalities or diseases (such as infection) that can cause or aggravate breathing problems. - Allergy testing. This can be performed by a skin test or blood test. Allergy tests can identify allergy to pets, dust, mold and pollen. If important allergy triggers are identified, this can lead to a recommendation for allergen immunotherapy. - Sputum eosinophils. This test looks for certain white blood cells (eosinophils) in the mixture of saliva and mucus (sputum) you discharge during coughing. Eosinophils are present when symptoms develop and become visible when stained with a rose-colored dye (eosin). - Provocative testing for exercise and cold-induced asthma. In these tests, your doctor measures your airway obstruction before and after you perform vigorous physical activity or take several breaths of cold air. How asthma is classified To classify your asthma severity, your doctor considers your answers to questions about symptoms (such as how often you have asthma attacks and how bad they are), along with the results of your physical exam and diagnostic tests. Determining your asthma severity helps your doctor choose the best treatment. Asthma severity often changes over time, requiring treatment adjustments. Asthma is classified into four general categories: Treatment Prevention and long-term control are key in stopping asthma attacks before they start. Treatment usually involves learning to recognize your triggers, taking steps to avoid them and tracking your breathing to make sure your daily asthma medications are keeping symptoms under control. In case of an asthma flare-up, you may need to use a quick-relief inhaler, such as albuterol. Medications The right medications for you depend on a number of things - your age, symptoms, asthma triggers and what works best to keep your asthma under control. Preventive, long-term control medications reduce the inflammation in your airways that leads to symptoms. Quick-relief inhalers (bronchodilators) quickly open swollen airways that are limiting breathing. In some cases, allergy medications are necessary. Long-term asthma control medications, generally taken daily, are the cornerstone of asthma treatment. These medications keep asthma under control on a day-to-day basis and make it less likely you'll have an asthma attack. Types of long-term control medications include: - Inhaled corticosteroids. These anti-inflammatory drugs include fluticasone (Flonase, Flovent HFA), budesonide (Pulmicort Flexhaler, Rhinocort), flunisolide (Aerospan HFA), ciclesonide (Alvesco, Omnaris, Zetonna), beclomethasone (Qnasl, Qvar), mometasone (Asmanex) and fluticasone furoate (Arnuity Ellipta). You may need to use these medications for several days to weeks before they reach their maximum benefit. Unlike oral corticosteroids, these corticosteroid medications have a relatively low risk of side effects and are generally safe for long-term use. - Leukotriene modifiers. These oral medications - including montelukast (Singulair), zafirlukast (Accolate) and zileuton (Zyflo) - help relieve asthma symptoms for up to 24 hours. In rare cases, these medications have been linked to psychological reactions, such as agitation, aggression, hallucinations, depression and suicidal thinking. Seek medical advice right away for any unusual reaction. - Long-acting beta agonists. These inhaled medications, which include salmeterol (Serevent) and formoterol (Foradil, Perforomist), open the airways. Some research shows that they may increase the risk of a severe asthma attack, so take them only in combination with an inhaled corticosteroid. And because these drugs can mask asthma deterioration, don't use them for an acute asthma attack. - Combination inhalers. These medications - such as fluticasone-salmeterol (Advair Diskus), budesonide-formoterol (Symbicort) and formoterol-mometasone (Dulera) - contain a long-acting beta agonist along with a corticosteroid. Because these combination inhalers contain long-acting beta agonists, they may increase your risk of having a severe asthma attack. - Theophylline. Theophylline (Theo-24, Elixophyllin, others) is a daily pill that helps keep the airways open (bronchodilator) by relaxing the muscles around the airways. It's not used as often now as in past years. Quick-relief (rescue) medications are used as needed for rapid, short-term symptom relief during an asthma attack - or before exercise if your doctor recommends it. Types of quick-relief medications include: - Short-acting beta agonists. These inhaled, quick-relief bronchodilators act within minutes to rapidly ease symptoms during an asthma attack. They include albuterol (ProAir HFA, Ventolin HFA, others) and levalbuterol (Xopenex). Short-acting beta agonists can be taken using a portable, hand-held inhaler or a nebulizer - a machine that converts asthma medications to a fine mist - so that they can be inhaled through a face mask or a mouthpiece. - Ipratropium (Atrovent). Like other bronchodilators, ipratropium acts quickly to immediately relax your airways, making it easier to breathe. Ipratropium is mostly used for emphysema and chronic bronchitis, but it's sometimes used to treat asthma attacks. - Oral and intravenous corticosteroids. These medications - which include prednisone and methylprednisolone - relieve airway inflammation caused by severe asthma. They can cause serious side effects when used long term, so they're used only on a short-term basis to treat severe asthma symptoms. If you have an asthma flare-up, a quick-relief inhaler can ease your symptoms right away. But if your long-term control medications are working properly, you shouldn't need to use your quick-relief inhaler very often. Keep a record of how many puffs you use each week. If you need to use your quick-relief inhaler more often than your doctor recommends, see your doctor. You probably need to adjust your long-term control medication. Allergy medications may help if your asthma is triggered or worsened by allergies. These include: - Allergy shots (immunotherapy). Over time, allergy shots gradually reduce your immune system reaction to specific allergens. You generally receive shots once a week for a few months, then once a month for a period of three to five years. - Omalizumab (Xolair). This medication, given as an injection every two to four weeks, is specifically for people who have allergies and severe asthma. It acts by altering the immune system. Bronchial thermoplasty This treatment - which isn't widely available nor right for everyone - is used for severe asthma that doesn't improve with inhaled corticosteroids or other long-term asthma medications. Generally, over the span of three outpatient visits, bronchial thermoplasty heats the insides of the airways in the lungs with an electrode, reducing the smooth muscle inside the airways. This limits the ability of the airways to tighten, making breathing easier and possibly reducing asthma attacks. Treat by severity for better control: A stepwise approach Your treatment should be flexible and based on changes in your symptoms, which should be assessed thoroughly each time you see your doctor. Then your doctor can adjust your treatment accordingly. For example, if your asthma is well-controlled, your doctor may prescribe less medicine. If your asthma isn't well-controlled or is getting worse, your doctor may increase your medication and recommend more-frequent visits. Asthma action plan Work with your doctor to create an asthma action plan that outlines in writing when to take certain medications or when to increase or decrease the dose of your medications based on your symptoms. Also include a list of your triggers and the steps you need to take to avoid them. Your doctor may also recommend tracking your asthma symptoms or using a peak flow meter on a regular basis to monitor how well your treatment is controlling your asthma. Lifestyle and home remedies Although many people with asthma rely on medications to prevent and relieve symptoms, you can do several things on your own to maintain your health and lessen the possibility of asthma attacks. Avoid your triggers Taking steps to reduce your exposure asthma triggers is a key part of asthma control, including: - Use your air conditioner. Air conditioning reduces the amount of airborne pollen from trees, grasses and weeds that finds its way indoors. Air conditioning also lowers indoor humidity and can reduce your exposure to dust mites. If you don't have air conditioning, try to keep your windows closed during pollen season. - Decontaminate your decor. Minimize dust that may worsen nighttime symptoms by replacing certain items in your bedroom. For example, encase pillows, mattresses and box springs in dustproof covers. Remove carpeting and install hardwood or linoleum flooring. Use washable curtains and blinds. - Maintain optimal humidity. If you live in a damp climate, talk to your doctor about using a dehumidifier. - Prevent mold spores. Clean damp areas in the bath, kitchen and around the house to keep mold spores from developing. Get rid of moldy leaves or damp firewood in the yard. - Reduce pet dander. If you're allergic to dander, avoid pets with fur or feathers. Having pets regularly bathed or groomed also may reduce the amount of dander in your surroundings. - Clean regularly. Clean your home at least once a week. If you're likely to stir up dust, wear a mask or have someone else do the cleaning. - Cover your nose and mouth if it's cold out. If your asthma is worsened by cold or dry air, wearing a face mask can help. Stay healthy Taking care of yourself can help keep your symptoms under control, including: - Get regular exercise. Having asthma doesn't mean you have to be less active. Treatment can prevent asthma attacks and control symptoms during activity. Regular exercise can strengthen your heart and lungs, which helps relieve asthma symptoms. If you exercise in cold temperatures, wear a face mask to warm the air you breathe. - Maintain a healthy weight. Being overweight can worsen asthma symptoms, and it puts you at higher risk of other health problems. - Control heartburn and gastroesophageal reflux disease (GERD). It's possible that the acid reflux that causes heartburn may damage lung airways and worsen asthma symptoms. If you have frequent or constant heartburn, talk to your doctor about treatment options. You may need treatment for GERD before your asthma symptoms improve. Alternative medicine Certain alternative treatments may help with asthma symptoms. However, keep in mind that these treatments are not a replacement for medical treatment - especially if you have severe asthma. Talk to your doctor before taking any herbs or supplements, as some may interact with medications you take. While some alternative remedies are used for asthma, in most cases more research is needed to see how well they work and to measure the extent of possible side effects. Alternative asthma treatments include: - Breathing exercises. These exercises may reduce the amount of medication you need to keep your asthma symptoms under control. - Herbal and natural remedies. A few herbal and natural remedies that may help improve asthma symptoms include black seed, caffeine, choline and pycnogenol. how is asthma diagnosed

how is asthma diagnosed

For adults and children over 5 years old, lung (pulmonary) function tests are used to check how well the lungs are working. Poor lung function is a sign that your asthma isn't well-controlled. In some cases, lung function tests are also used in asthma emergencies to help check the severity of an asthma attack or how well treatment is working. Lung function tests include: - Peak flow. Your doctor may take a peak flow reading when you come in for a scheduled visit or for emergency treatment during an asthma attack. This test measures how quickly you can breathe out. Spirometry. During spirometry, you take deep breaths and forcefully exhale into a hose connected to a machine called a spirometer. A common spirometry measurement is forced expiratory volume, which measures how much air you can breathe out in one second. Nitric oxide measurement. A newer diagnostic test, this exam measures the amount of nitric oxide gas you have in your breath when you exhale. High nitric oxide readings indicate inflammation of the bronchial tubes. Pulse oximetry. This test is used during a severe asthma attack. It measures the amount of oxygen in your blood.

Asthma attack Overview During an asthma attack, also called an asthma exacerbation, your airways become swollen and inflamed. The muscles around the airways contract and the airways also produce extra mucus, causing your breathing (bronchial) tubes to narrow. During an attack, you may cough, wheeze and have trouble breathing. An asthma attack may be minor, with symptoms that get better with prompt home treatment, or it may be more serious. A severe asthma attack that doesn't improve with home treatment can become a life-threatening emergency. The key to stopping an asthma attack is recognizing and treating an asthma flare-up early. Follow the treatment plan you worked out with your doctor ahead of time. Your treatment plan should include what to do when your asthma starts getting worse, and how to deal with an asthma attack in progress. Symptoms Asthma attack signs and symptoms include: - Severe shortness of breath, chest tightness or pain, and coughing or wheezing - Low peak expiratory flow (PEF) readings, if you use a peak flow meter - Symptoms that fail to respond to use of a quick-acting (rescue) inhaler Signs and symptoms of an asthma attack vary from person to person. Work with your doctor to identify your particular signs and symptoms of worsening asthma - and what to do when they occur. If your asthma symptoms keep getting worse even after you take medication as your doctor directed, you may need emergency room care. Your doctor can help you learn to recognize an asthma emergency so that you'll know when to get help. If your asthma flares up, immediately follow the treatment steps you and your doctor worked out ahead of time in your written asthma plan. If your symptoms and peak expiratory flow (PEF) readings improve, home treatment may be all that's needed. If your symptoms don't improve with home treatment, you may need to seek emergency care. When your asthma symptoms flare up, follow your written asthma plan's instructions for using your quick-acting (rescue) inhaler. PEF readings ranging from 50 to 79 percent of your personal best are a sign you need to use the quick-acting (rescue) medications prescribed by your doctor. Asthma can change over time, so you'll need periodic adjustments to your treatment plan to keep daily symptoms under control. If your asthma isn't well-controlled, it increases your risk of future asthma attacks. Lingering lung inflammation means your asthma could flare up at any time. Go to all scheduled doctor's appointments. If you have regular asthma flare-ups, low peak flow readings or other signs your asthma isn't well-controlled, make an appointment to see your doctor. Seek medical attention right away if you have signs or symptoms of a serious asthma attack, which include: - Severe breathlessness or wheezing, especially at night or in the early morning - The inability to speak more than short phrases due to shortness of breath - Having to strain your chest muscles to breathe - Low peak flow readings when you use a peak flow meter - No improvement after using a quick-acting (rescue) inhaler Causes An overly sensitive immune system makes your airways (bronchial tubes) become inflamed and swollen when you're exposed to certain triggers. Asthma triggers vary from person to person. Common asthma attack triggers include: - Pollen, pets, mold and dust mites - Upper respiratory infections - Tobacco smoke - Inhaling cold, dry air - Gastroesophageal reflux disease (GERD) - Stress For many people, asthma symptoms get worse with a respiratory infection such as a cold. Some people have asthma flare-ups caused by something in their work environment. Sometimes, asthma attacks occur with no apparent cause. Risk factors Anyone who has asthma is at risk of an asthma attack. You may be at increased risk of a serious asthma attack if: - You've had a severe asthma attack in the past - You've previously been admitted to the hospital or had to go to the emergency room for asthma - You've previously required intubation for an asthma attack - You use more than two quick-acting (rescue) inhalers a month - Your asthma attacks tend to sneak up on you before you notice symptoms have worsened - You have other chronic health conditions, such as sinusitis or nasal polyps, or cardiovascular or chronic lung disease Complications Asthma attacks can be serious. - Asthma attacks can interrupt everyday activities such as sleep, school, work and exercise, causing a significant impact on your quality of life - and can disrupt the lives of those around you. - Serious asthma attacks mean you're likely to need trips to the emergency room, which can be stressful and costly. - A very severe asthma attack can lead to respiratory arrest and death. Diagnosis For adults and children over 5 years old, lung (pulmonary) function tests are used to check how well the lungs are working. Poor lung function is a sign that your asthma isn't well-controlled. In some cases, lung function tests are also used in asthma emergencies to help check the severity of an asthma attack or how well treatment is working. Lung function tests include: - Peak flow. Your doctor may take a peak flow reading when you come in for a scheduled visit or for emergency treatment during an asthma attack. This test measures how quickly you can breathe out. You also may use a peak flow meter at home to monitor your lung function. The results of this test are known as peak expiratory flow (PEF). A peak flow test is done by blowing into a mouthpiece as hard and as fast as you can with a single breath (expiration). - Spirometry. During spirometry, you take deep breaths and forcefully exhale into a hose connected to a machine called a spirometer. A common spirometry measurement is forced expiratory volume, which measures how much air you can breathe out in one second. The results of this test are known as forced expiratory volume (FEV). Spirometry can also measure how much air your lungs can hold and the rate at which you can inhale and exhale. - Nitric oxide measurement. A newer diagnostic test, this exam measures the amount of nitric oxide gas you have in your breath when you exhale. High nitric oxide readings indicate inflammation of the bronchial tubes. Exhaled nitric oxide can be measured by having a patient exhale directly into an analyzer. Exhaled air may be captured in a nitric-oxide-impervious container for measurement later. - Pulse oximetry. This test is used during a severe asthma attack. It measures the amount of oxygen in your blood. It's measured through your fingernail and only takes seconds. Treatment If you and your doctor have worked out an asthma plan, follow its directions at the first sign of an asthma attack. This generally means taking two to six puffs of a quick-acting (rescue) inhaler to get airway-expanding medication, such as albuterol (ProAir HFA, Proventil HFA, Ventolin HFA, others), deep into your lungs. Small children and those who have trouble with inhalers can use a nebulizer. After 20 minutes, you can repeat the treatment one time if necessary. For an asthma attack with severe symptoms, such as difficulty speaking because you're so short of breath, start with the same initial step of using quick-acting medication - but instead of waiting for the drug to work, get to a doctor's office or urgent care immediately. Same-day medical care is also warranted if you continue to wheeze and feel at all breathless after initial treatment. Your doctor may recommend that you continue to use quick-acting medication every three to four hours for a day or two after the attack. You might also need to take oral corticosteroid medication for a short time. Emergency treatment If you go to the emergency room for an asthma attack in progress, you'll need medications to get your asthma under immediate control. These can include: - Short-acting beta agonists, such as albuterol (ProAir HFA, Proventil HFA, Ventolin HFA, others). These are the same medications as those in your quick-acting (rescue) inhaler. You may need to use a machine called a nebulizer, which turns the medication into a mist that can be inhaled deep into your lungs. - Oral corticosteroids. Taken in pill form, these medications help reduce lung inflammation and get your asthma symptoms under control. Corticosteroids can also be given intravenously, typically to patients who are vomiting or under respiratory failure. - Ipratropium (Atrovent). Ipratropium is sometimes used as a bronchodilator to treat a severe asthma attack, especially if albuterol is not fully effective. - Intubation, mechanical ventilation and oxygen. If your asthma attack is life-threatening, your doctor may put a breathing tube down your throat into your upper airway. Using a machine that pumps oxygen into your lungs will help you breathe while your doctor gives you medications to bring your asthma under control. After your asthma symptoms improve, your doctor may want you to stay in the emergency room for a few hours or longer to make sure you don't have another asthma attack. When your doctor feels your asthma is sufficiently under control, you'll be able to go home. Your doctor will give you instructions on what to do if you have another asthma attack. If your asthma symptoms don't improve after emergency treatment, your doctor may admit you to the hospital and give you medications every hour or every few hours. If you're having severe asthma symptoms, you may need to breathe oxygen through a mask. In some cases, a severe, persistent asthma attack requires a stay in the intensive care unit (ICU). Lifestyle and home remedies All asthma attacks require treatment with a quick-acting (rescue) inhaler such as albuterol. One of the key steps in preventing an asthma attack is to avoid your triggers. - If your asthma attacks seem to be set off by outside triggers, your doctor can help you learn how to minimize your exposure to them. Allergy tests can help identify any allergic triggers. - Washing your hands frequently can help reduce your risk of catching a cold virus. - If your asthma flares up when you exercise in the cold, it may help to cover your face with a mask or scarf until you get warmed up. how is asthma diagnosed

how is asthma diagnosed

Asthma - children (Exams and Tests): The health care provider will use a stethoscope to listen to the child's lungs. The provider may be able to hear asthma sounds. However, lung sounds are often normal when the child is not having an asthma episode. The provider will have the child breathe into a device called a peak flow meter. Peak flow meters can tell how well the child can blow air out of the lungs. - Allergy testing on the skin, or a blood test to see if your child is allergic to certain substances - Chest x-ray - Lung function tests

Asthma in children Pediatric asthma Asthma - pediatric Wheezing - asthma - children Summary Asthma is a disease that causes the airways to swell and get narrow. It leads to wheezing, shortness of breath, chest tightness, and coughing. Causes Asthma is caused by swelling (inflammation) in the airways. During an asthma attack, the muscles surrounding the airways tighten. The lining of the air passages swells. As a result, less air is able to pass through. Asthma is often seen in children. It is a leading cause of missed school days and hospital visits for children. An allergic reaction is a key part of asthma in children. Asthma and allergies often occur together. In children who have sensitive airways, asthma symptoms can be triggered by breathing in substances called allergens, or triggers. Common asthma triggers include: Animals (hair or dander) Dust, mold, and pollen Aspirin and other medicines Changes in weather (most often cold weather) Chemicals in the air or in food Tobacco smoke Exercise Strong emotions Viral infections, such as the common cold Symptoms Breathing problems are common. They can include: Shortness of breath Feeling out of breath Gasping for air Trouble breathing out (exhaling) Breathing faster than normal When the child is having a hard time breathing, the skin of the chest and neck may suck inward. Other symptoms of asthma in children include: Coughing that sometimes wakes the child up at night (it may be the only symptom). Dark bags under the eyes. Feeling tired. Irritability. Tightness in the chest. A whistling sound made when breathing (wheezing). You may notice it more when the child breathes out. Your child's asthma symptoms may vary. Symptoms may appear often or develop only when triggers are present. Some children are more likely to have asthma symptoms at night. Exams and Tests The health care provider will use a stethoscope to listen to the child's lungs. The provider may be able to hear asthma sounds. However, lung sounds are often normal when the child is not having an asthma attack. The provider will have the child breathe into a device called a peak flow meter. Peak flow meters can tell how well the child can blow air out of the lungs. If the airways are narrow due to asthma, peak flow values drop. You and your child will learn to measure peak flow at home. Your child's provider may order the following tests: Allergy testing on the skin, or a blood test to see if your child is allergic to certain substances Chest x-ray Lung function tests Treatment You and your child's providers should work together as a team to create and carry out an asthma action plan. This plan will tell you how to: Avoid asthma triggers Monitor symptoms Measure peak flow Take medicines The plan should also tell you when to call the provider. It is important to know what questions to ask your child's provider. Children with asthma need a lot of support at school. Give the school staff your asthma action plan so they know how to take care of your child's asthma. Find out how to let your child take medicine during school hours. (You may need to sign a consent form.) Having asthma does not mean your child cannot exercise. Coaches, gym teachers, and your child should know what to do if your child has asthma symptoms caused by exercise. ASTHMA MEDICINES There are two basic kinds of medicine used to treat asthma. Long-term control drugs are taken every day to prevent asthma symptoms. Your child should take these medicines even if no symptoms are present. Some children may need more than one long-term control medicine. Types of long-term control medicines include: Inhaled steroids (these are usually the first choice of treatment) Long-acting bronchodilators (these are almost always used with inhaled steroids) Leukotriene inhibitors Cromolyn sodium Quick relief or rescue asthma drugs work fast to control asthma symptoms. Children take them when they are coughing, wheezing, having trouble breathing, or having an asthma attack. Some of your child's asthma medicines can be taken using an inhaler. Children who use an inhaler should use a spacer device. This helps them get the medicine into the lungs properly. If your child uses the inhaler the wrong way, less medicine gets into the lungs. Have your provider show your child how to correctly use an inhaler. Younger children can use a nebulizer instead of an inhaler to take their medicine. A nebulizer turns asthma medicine into a mist. GETTING RID OF TRIGGERS It is important to know your child's asthma triggers. Avoiding them is the first step toward helping your child feel better. Keep pets outdoor, or at least away from the child's bedroom. No one should smoke in a house or around a child with asthma. Getting rid of tobacco smoke in the home is the single most important thing a family can do to help a child with asthma. Smoking outside the house is not enough. Family members and visitors who smoke carry the smoke inside on their clothes and hair. This can trigger asthma symptoms. DO NOT use indoor fireplaces. Keep the house clean. Keep food in containers and out of bedrooms. This helps reduce the possibility of cockroaches, which can trigger asthma attacks. Cleaning products in the home should be unscented. MONITOR YOUR CHILD'S ASTHMA Checking peak flow is one of the best ways to control asthma. It can help you keep your child's asthma from getting worse. Asthma attacks usually DO NOT happen without warning. Children under age 5 may not be able to use a peak flow meter well enough for it to be helpful. However, a child should start using the peak flow meter at a young age to get used to it. An adult should always watch for a child's asthma symptoms. Outlook (Prognosis) With proper treatment, most children with asthma can live a normal life. When asthma is not well controlled, it can lead to missed school, problems playing sports, missed work for parents, and many visits to the provider's office and emergency room. Asthma symptoms often lessen or go away completely as the child gets older. Asthma that is not well controlled can lead to lasting lung problems. In rare cases, asthma is a life-threatening disease. Families need to work closely with their providers to develop a plan to care for a child with asthma. When to Contact a Medical Professional Call your child's provider if you think your child has new symptoms of asthma. If your child has been diagnosed with asthma, call the provider: After an emergency room visit When peak flow numbers have been getting lower When symptoms get more frequent and more severe, even though your child is following the asthma action plan If your child is having trouble breathing or having an asthma attack, get medical help right away. Emergency symptoms include: Difficulty breathing Bluish color to the lips and face Severe anxiety due to shortness of breath Rapid pulse Sweating Decreased level of alertness, such as severe drowsiness or confusion A child who is having a severe asthma attack may need to stay in the hospital and get oxygen and medicines through a vein (intravenous line or IV). Review Date 5/20/2018 Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how is asthma diagnosed

how is asthma diagnosed

Asthma (Exams and Tests): The health care provider will use a stethoscope to listen to your lungs. Wheezing or other asthma-related sounds may be heard. Tests that may be ordered include: - Allergy testing -- skin or a blood test to see if a person with asthma is allergic to certain substances - Arterial blood gas (usually only done with people who are having a severe asthma attack) - Chest x-ray - Lung function tests, including peak flow measurements

Asthma Bronchial asthma Wheezing - asthma - adults Summary Asthma is a disease that causes the airways of the lungs to swell and narrow. It leads to wheezing, shortness of breath, chest tightness, and coughing. Causes Asthma is caused by swelling (inflammation) in the airways. When an asthma attack occurs, the lining of the air passages swells and the muscles surrounding the airways become tight. This reduces the amount of air that can pass through the airway. In people who have sensitive airways, asthma symptoms can be triggered by breathing in substances called allergens or triggers. Common asthma triggers include: Animals (pet hair or dander) Dust mites Certain medicines (aspirin and other NSAIDS) Changes in weather (most often cold weather) Chemicals in the air or in food Exercise Mold Pollen Respiratory infections, such as the common cold Strong emotions (stress) Tobacco smoke Substances in some workplaces can also trigger asthma symptoms, leading to occupational asthma. The most common triggers are wood dust, grain dust, animal dander, fungi, or chemicals. Many people with asthma have a personal or family history of allergies, such as hay fever (allergic rhinitis) or eczema. Others have no history of allergies. Symptoms Most people with asthma have attacks separated by symptom-free periods. Some people have long-term shortness of breath with episodes of increased shortness of breath. Either wheezing or a cough may be the main symptom. Asthma attacks can last for minutes to days. Attacks can become dangerous if airflow is severely blocked. Symptoms of asthma include: Cough with or without sputum (phlegm) production Pulling in of the skin between the ribs when breathing (intercostal retractions) Shortness of breath that gets worse with exercise or activity Wheezing Emergency symptoms that need prompt medical help include: Bluish color to the lips and face Decreased level of alertness, such as severe drowsiness or confusion, during an asthma attack Extreme difficulty breathing Rapid pulse Severe anxiety due to shortness of breath Sweating Other symptoms that may occur: Abnormal breathing pattern -- breathing out takes more than twice as long as breathing in Breathing temporarily stops Chest pain Tightness in the chest Exams and Tests The health care provider will use a stethoscope to listen to your lungs. Wheezing or other asthma-related sounds may be heard. Tests that may be ordered include: Allergy testing -- skin or a blood test to see if a person with asthma is allergic to certain substances Arterial blood gas (usually only done with people who are having a severe asthma attack) Chest x-ray Lung function tests, including peak flow measurements Treatment The goals of treatment are: Control airway swelling Stay away from substances that trigger your symptoms Help you to be able to do normal activities without asthma symptoms You and your doctor should work as a team to manage your asthma. Follow your doctor's instructions on taking medicines, eliminating asthma triggers, and monitoring symptoms. MEDICINES FOR ASTHMA There are two kinds of medicines for treating asthma: Control medicines to help prevent attacks Quick-relief (rescue) medicines for use during attacks LONG-TERM MEDICINES These are also called maintenance or control medicines. They are used to prevent symptoms in people with moderate to severe asthma. You must take them every day for them to work. Take them even when you feel OK. Some long-term medicines are breathed in (inhaled), such as steroids and long-acting beta-agonists. Others are taken by mouth (orally). Your doctor will prescribe the right medicine for you. QUICK-RELIEF MEDICINES These are also called rescue medicines. They are taken: For coughing, wheezing, trouble breathing, or an asthma attack Just before exercising to help prevent asthma symptoms caused by exercise Tell your doctor if you are using quick-relief medicines twice a week or more. If so, your asthma may not be under control and your doctor may need to change your dose of daily control drugs. Quick-relief medicines include: Short-acting inhaled bronchodilators Oral corticosteroids for when you have an asthma attack that is not going away A severe asthma attack requires a checkup by a doctor. You may also need a hospital stay. There, you will likely be given oxygen, breathing assistance, and medicines given through a vein (IV). ASTHMA CARE AT HOME Know the asthma symptoms to watch for. Know how to take your peak flow reading and what it means. Know which triggers make your asthma worse and what to do when this happens. Know how to care for your asthma when you exercise. Asthma action plans are written documents for managing asthma. An asthma action plan should include: Instructions for taking asthma medicines when your condition is stable A list of asthma triggers and how to avoid them How to recognize when your asthma is getting worse, and when to call your provider A peak flow meter is a simple device to measure how quickly you can move air out of your lungs. It can help you see if an attack is coming, sometimes even before symptoms appear. Peak flow measurements help let you know when you need to take medicine or other action. Peak flow values of 50% to 80% of your best results are a sign of a moderate asthma attack. Numbers below 50% are a sign of a severe attack. Outlook (Prognosis) There is no cure for asthma, although symptoms sometimes improve over time. With proper self-management and medical treatment, most people with asthma can lead a normal life. Possible Complications The complications of asthma can be severe, and may include: Death Decreased ability to exercise and take part in other activities Lack of sleep due to nighttime symptoms Permanent changes in the function of the lungs Persistent cough Trouble breathing that requires breathing assistance (ventilator) When to Contact a Medical Professional Call for an appointment with your provider if asthma symptoms develop. Call your provider or go to the emergency room if: An asthma attack requires more medicine than recommended Symptoms get worse or do not improve with treatment You have shortness of breath while talking Your peak flow measurement is 50% to 80% of your personal best Go to the emergency room if these symptoms occur: Drowsiness or confusion Severe shortness of breath at rest A peak flow measurement of less than 50% of your personal best Severe chest pain Bluish color to the lips and face Extreme difficulty breathing Rapid pulse Severe anxiety due to shortness of breath Prevention You can reduce asthma symptoms by avoiding triggers and substances that irritate the airways. Cover bedding with allergy-proof casings to reduce exposure to dust mites. Remove carpets from bedrooms and vacuum regularly. Use only unscented detergents and cleaning materials in the home. Keep humidity levels low and fix leaks to reduce the growth of organisms such as mold. Keep the house clean and keep food in containers and out of bedrooms. This helps reduce the possibility of cockroaches. Body parts and droppings from cockroaches can trigger asthma attacks in some people. If someone is allergic to an animal that cannot be removed from the home, the animal should be kept out of the bedroom. Place filtering material over the heating outlets to trap animal dander. Change the filter in furnaces and air conditioners often. Eliminate tobacco smoke from the home. This is the single most important thing a family can do to help someone with asthma. Smoking outside the house is not enough. Family members and visitors who smoke outside carry smoke residue inside on their clothes and hair. This can trigger asthma symptoms. If you smoke, now is a good time to quit. Avoid air pollution, industrial dust, and irritating fumes as much as possible. Review Date 2/19/2018 Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how is asthma diagnosed

how is asthma diagnosed

Your primary care doctor will diagnose asthma based on your medical and family histories, a physical exam, and test results. Your doctor also will figure out the severity of your asthma?that is, whether it's intermittent, mild, moderate, or severe. The level of severity will determine what treatment you'll start on. Your doctor may ask about your family history of asthma and allergies. He or she also may ask whether you have asthma symptoms and when and how often they occur. Let your doctor know whether your symptoms seem to happen only during certain times of the year or in certain places, or if they get worse at night. Your doctor also may want to know what factors seem to trigger your symptoms or worsen them. Your doctor will listen to your breathing and look for signs of asthma or allergies.

Asthma What Is... Español Asthma (AZ-ma) is a chronic (long-term) lung disease that inflames and narrows the airways. Asthma causes recurring periods of wheezing (a whistling sound when you breathe), chest tightness, shortness of breath, and coughing. The coughing often occurs at night or early in the morning. Asthma affects people of all ages, but it most often starts during childhood. In the United States, more than 25 million people are known to have asthma. About 7 million of these people are children. Overview To understand asthma, it helps to know how the airways work. The airways are tubes that carry air into and out of your lungs. People who have asthma have inflamed airways. The inflammation makes the airways swollen and very sensitive. The airways tend to react strongly to certain inhaled substances. When the airways react, the muscles around them tighten. This narrows the airways, causing less air to flow into the lungs. The swelling also can worsen, making the airways even narrower. Cells in the airways might make more mucus than usual. Mucus is a sticky, thick liquid that can further narrow the airways. This chain reaction can result in asthma symptoms. Symptoms can happen each time the airways are inflamed. Asthma Sometimes asthma symptoms are mild and go away on their own or after minimal treatment with asthma medicine. Other times, symptoms continue to get worse. When symptoms get more intense and/or more symptoms occur, you're having an asthma attack. Asthma attacks also are called flareups or exacerbations (eg-zas-er-BA-shuns). Treating symptoms when you first notice them is important. This will help prevent the symptoms from worsening and causing a severe asthma attack. Severe asthma attacks may require emergency care, and they can be fatal. Outlook Asthma has no cure. Even when you feel fine, you still have the disease and it can flare up at any time. However, with today's knowledge and treatments, most people who have asthma are able to manage the disease. They have few, if any, symptoms. They can live normal, active lives and sleep through the night without interruption from asthma. If you have asthma, you can take an active role in managing the disease. For successful, thorough, and ongoing treatment, build strong partnerships with your doctor and other health care providers. Causes The exact cause of asthma isn't known. Researchers think some genetic and environmental factors interact to cause asthma, most often early in life. These factors include: An inherited tendency to develop allergies, called atopy (AT-o-pe) Parents who have asthma Certain respiratory infections during childhood Contact with some airborne allergens or exposure to some viral infections in infancy or in early childhood when the immune system is developing If asthma or atopy runs in your family, exposure to irritants (for example, tobacco smoke) may make your airways more reactive to substances in the air. Some factors may be more likely to cause asthma in some people than in others. Researchers continue to explore what causes asthma. The "Hygiene Hypothesis" One theory researchers have for what causes asthma is the "hygiene hypothesis." They believe that our Western lifestyle—with its emphasis on hygiene and sanitation—has resulted in changes in our living conditions and an overall decline in infections in early childhood. Many young children no longer have the same types of environmental exposures and infections as children did in the past. This affects the way that young children's immune systems develop during very early childhood, and it may increase their risk for atopy and asthma. This is especially true for children who have close family members with one or both of these conditions. Who Is at Risk Asthma affects people of all ages, but it most often starts during childhood. In the United States, more than 22 million people are known to have asthma. Nearly 6 million of these people are children. Young children who often wheeze and have respiratory infections—as well as certain other risk factors—are at highest risk of developing asthma that continues beyond 6 years of age. The other risk factors include having allergies, eczema (an allergic skin condition), or parents who have asthma. Among children, more boys have asthma than girls. But among adults, more women have the disease than men. It's not clear whether or how sex and sex hormones play a role in causing asthma. Most, but not all, people who have asthma have allergies. Some people develop asthma because of contact with certain chemical irritants or industrial dusts in the workplace. This type of asthma is called occupational asthma. Signs & Symptoms Common signs and symptoms of asthma include: Coughing. Coughing from asthma often is worse at night or early in the morning, making it hard to sleep. Wheezing. Wheezing is a whistling or squeaky sound that occurs when you breathe. Chest tightness. This may feel like something is squeezing or sitting on your chest. Shortness of breath. Some people who have asthma say they can't catch their breath or they feel out of breath. You may feel like you can't get air out of your lungs. Not all people who have asthma have these symptoms. Likewise, having these symptoms doesn't always mean that you have asthma. The best way to diagnose asthma for certain is to use a lung function test, a medical history (including type and frequency of symptoms), and a physical exam. The types of asthma symptoms you have, how often they occur, and how severe they are may vary over time. Sometimes your symptoms may just annoy you. Other times, they may be troublesome enough to limit your daily routine. Severe symptoms can be fatal. It's important to treat symptoms when you first notice them so they don't become severe. With proper treatment, most people who have asthma can expect to have few, if any, symptoms either during the day or at night. What Causes Asthma Symptoms To Occur? Many things can trigger or worsen asthma symptoms. Your doctor will help you find out which things (sometimes called triggers) may cause your asthma to flare up if you come in contact with them. Triggers may include: Allergens from dust, animal fur, cockroaches, mold, and pollens from trees, grasses, and flowers Irritants such as cigarette smoke, air pollution, chemicals or dust in the workplace, compounds in home décor products, and sprays (such as hairspray) Medicines such as aspirin or other nonsteroidal anti-inflammatory drugs and nonselective beta-blockers Sulfites in foods and drinks Viral upper respiratory infections, such as colds Physical activity, including exercise Other health conditions can make asthma harder to manage. Examples of these conditions include a runny nose, sinus infections, reflux disease, psychological stress, and sleep apnea. These conditions need treatment as part of an overall asthma care plan. Asthma is different for each person. Some of the triggers listed above may not affect you. Other triggers that do affect you may not be on the list. Talk with your doctor about the things that seem to make your asthma worse. Diagnosis Your primary care doctor will diagnose asthma based on your medical and family histories, a physical exam, and test results. Your doctor also will figure out the severity of your asthma—that is, whether it's intermittent, mild, moderate, or severe. The level of severity will determine what treatment you'll start on. You may need to see an asthma specialist if: You need special tests to help diagnose asthma You've had a life-threatening asthma attack You need more than one kind of medicine or higher doses of medicine to control your asthma, or if you have overall problems getting your asthma well controlled You're thinking about getting allergy treatments Medical and Family Histories Your doctor may ask about your family history of asthma and allergies. He or she also may ask whether you have asthma symptoms and when and how often they occur. Let your doctor know whether your symptoms seem to happen only during certain times of the year or in certain places, or if they get worse at night. Your doctor also may want to know what factors seem to trigger your symptoms or worsen them. For more information about possible asthma triggers, go to "What Are the Signs and Symptoms of Asthma?" Your doctor may ask you about related health conditions that can interfere with asthma management. These conditions include a runny nose, sinus infections, reflux disease, psychological stress, and sleep apnea. Physical Exam Your doctor will listen to your breathing and look for signs of asthma or allergies. These signs include wheezing, a runny nose or swollen nasal passages, and allergic skin conditions (such as eczema). Keep in mind that you can still have asthma even if you don't have these signs on the day that your doctor examines you. Diagnostic Tests Lung Function Test Your doctor will use a test called spirometry (spi-ROM-eh-tre) to check how your lungs are working. This test measures how much air you can breathe in and out. It also measures how fast you can blow air out. Your doctor also may give you medicine and then test you again to see whether the results have improved. If the starting results are lower than normal and improve with the medicine, and if your medical history shows a pattern of asthma symptoms, your diagnosis will likely be asthma. Other Tests Your doctor may recommend other tests if he or she needs more information to make a diagnosis. Other tests may include: Allergy testing to find out which allergens affect you, if any. A test to measure how sensitive your airways are. This is called a bronchoprovocation (brong-KO-prav-eh-KA-shun) test. Using spirometry, this test repeatedly measures your lung function during physical activity or after you receive increasing doses of cold air or a special chemical to breathe in. A test to show whether you have another condition with the same symptoms as asthma, such as reflux disease, vocal cord dysfunction, or sleep apnea. A chest x ray or an EKG (electrocardiogram). These tests will help find out whether a foreign object or other disease may be causing your symptoms. Diagnosing Asthma in Young Children Most children who have asthma develop their first symptoms before 5 years of age. However, asthma in young children (aged 0 to 5 years) can be hard to diagnose. Sometimes it's hard to tell whether a child has asthma or another childhood condition. This is because the symptoms of asthma also occur with other conditions. Also, many young children who wheeze when they get colds or respiratory infections don't go on to have asthma after they're 6 years old. A child may wheeze because he or she has small airways that become even narrower during colds or respiratory infections. The airways grow as the child grows older, so wheezing no longer occurs when the child gets colds. A young child who has frequent wheezing with colds or respiratory infections is more likely to have asthma if: One or both parents have asthma The child has signs of allergies, including the allergic skin condition eczema The child has allergic reactions to pollens or other airborne allergens The child wheezes even when he or she doesn't have a cold or other infection The most certain way to diagnose asthma is with a lung function test, a medical history, and a physical exam. However, it's hard to do lung function tests in children younger than 5 years. Thus, doctors must rely on children's medical histories, signs and symptoms, and physical exams to make a diagnosis. Doctors also may use a 4–6 week trial of asthma medicines to see how well a child responds. Treatments Asthma is a long-term disease that has no cure. The goal of asthma treatment is to control the disease. Good asthma control will: Prevent chronic and troublesome symptoms, such as coughing and shortness of breath Reduce your need for quick-relief medicines (see below) Help you maintain good lung function Let you maintain your normal activity level and sleep through the night Prevent asthma attacks that could result in an emergency room visit or hospital stay To control asthma, partner with your doctor to manage your asthma or your child's asthma. Children aged 10 or older—and younger children who are able—should take an active role in their asthma care. Taking an active role to control your asthma involves: Working with your doctor to treat other conditions that can interfere with asthma management. Avoiding things that worsen your asthma (asthma triggers). However, one trigger you should not avoid is physical activity. Physical activity is an important part of a healthy lifestyle. Talk with your doctor about medicines that can help you stay active. Working with your doctor and other health care providers to create and follow an asthma action plan. An asthma action plan gives guidance on taking your medicines properly, avoiding asthma triggers (except physical activity), tracking your level of asthma control, responding to worsening symptoms, and seeking emergency care when needed. Asthma is treated with two types of medicines: long-term control and quick-relief medicines. Long-term control medicines help reduce airway inflammation and prevent asthma symptoms. Quick-relief, or "rescue," medicines relieve asthma symptoms that may flare up. Your initial treatment will depend on the severity of your asthma. Followup asthma treatment will depend on how well your asthma action plan is controlling your symptoms and preventing asthma attacks. Your level of asthma control can vary over time and with changes in your home, school, or work environments. These changes can alter how often you're exposed to the factors that can worsen your asthma. Your doctor may need to increase your medicine if your asthma doesn't stay under control. On the other hand, if your asthma is well controlled for several months, your doctor may decrease your medicine. These adjustments to your medicine will help you maintain the best control possible with the least amount of medicine necessary. Asthma treatment for certain groups of people—such as children, pregnant women, or those for whom exercise brings on asthma symptoms—will be adjusted to meet their special needs. Follow an Asthma Action Plan You can work with your doctor to create a personal asthma action plan. The plan will describe your daily treatments, such as which medicines to take and when to take them. The plan also will explain when to call your doctor or go to the emergency room. If your child has asthma, all of the people who care for him or her should know about the child's asthma action plan. This includes babysitters and workers at daycare centers, schools, and camps. These caretakers can help your child follow his or her action plan. Go to the National Heart, Lung, and Blood Institute's (NHLBI's) "Asthma Action Plan" for a sample plan. Avoid Things That Can Worsen Your Asthma Many common things (called asthma triggers) can set off or worsen your asthma symptoms. Once you know what these things are, you can take steps to control many of them. (For more information about asthma triggers, go to "What Are the Signs and Symptoms of Asthma?") For example, exposure to pollens or air pollution might make your asthma worse. If so, try to limit time outdoors when the levels of these substances in the outdoor air are high. If animal fur triggers your asthma symptoms, keep pets with fur out of your home or bedroom. One possible asthma trigger you shouldn’t avoid is physical activity. Physical activity is an important part of a healthy lifestyle. Talk with your doctor about medicines that can help you stay active. The NHLBI offers many useful tips for controlling asthma triggers. For more information, go to page 2 of NHLBI's "Asthma Action Plan." If your asthma symptoms are clearly related to allergens, and you can't avoid exposure to those allergens, your doctor may advise you to get allergy shots. You may need to see a specialist if you're thinking about getting allergy shots. These shots can lessen or prevent your asthma symptoms, but they can't cure your asthma. Several health conditions can make asthma harder to manage. These conditions include runny nose, sinus infections, reflux disease, psychological stress, and sleep apnea. Your doctor will treat these conditions as well. Medicines Your doctor will consider many things when deciding which asthma medicines are best for you. He or she will check to see how well a medicine works for you. Then, he or she will adjust the dose or medicine as needed. Asthma medicines can be taken in pill form, but most are taken using a device called an inhaler. An inhaler allows the medicine to go directly to your lungs. Not all inhalers are used the same way. Ask your doctor or another health care provider to show you the right way to use your inhaler. Review the way you use your inhaler at every medical visit. Long-Term Control Medicines Most people who have asthma need to take long-term control medicines daily to help prevent symptoms. The most effective long-term medicines reduce airway inflammation, which helps prevent symptoms from starting. These medicines don't give you quick relief from symptoms. Inhaled corticosteroids. Inhaled corticosteroids are the preferred medicine for long-term control of asthma. They're the most effective option for long-term relief of the inflammation and swelling that makes your airways sensitive to certain inhaled substances. Reducing inflammation helps prevent the chain reaction that causes asthma symptoms. Most people who take these medicines daily find they greatly reduce the severity of symptoms and how often they occur. Inhaled corticosteroids generally are safe when taken as prescribed. These medicines are different from the illegal anabolic steroids taken by some athletes. Inhaled corticosteroids aren't habit-forming, even if you take them every day for many years. Like many other medicines, though, inhaled corticosteroids can have side effects. Most doctors agree that the benefits of taking inhaled corticosteroids and preventing asthma attacks far outweigh the risk of side effects. One common side effect from inhaled corticosteroids is a mouth infection called thrush. You might be able to use a spacer or holding chamber on your inhaler to avoid thrush. These devices attach to your inhaler. They help prevent the medicine from landing in your mouth or on the back of your throat. Check with your doctor to see whether a spacer or holding chamber should be used with the inhaler you have. Also, work with your health care team if you have any questions about how to use a spacer or holding chamber. Rinsing your mouth out with water after taking inhaled corticosteroids also can lower your risk for thrush. If you have severe asthma, you may have to take corticosteroid pills or liquid for short periods to get your asthma under control. If taken for long periods, these medicines raise your risk for cataracts and osteoporosis (OS-te-o-po-RO-sis). A cataract is the clouding of the lens in your eye. Osteoporosis is a disorder that makes your bones weak and more likely to break. Your doctor may have you add another long-term asthma control medicine so he or she can lower your dose of corticosteroids. Or, your doctor may suggest you take calcium and vitamin D pills to protect your bones. Other long-term control medicines. Other long-term control medicines include: Cromolyn. This medicine is taken using a device called a nebulizer. As you breathe in, the nebulizer sends a fine mist of medicine to your lungs. Cromolyn helps prevent airway inflammation. Omalizumab (anti-IgE). This medicine is given as a shot (injection) one or two times a month. It helps prevent your body from reacting to asthma triggers, such as pollen and dust mites. Anti-IgE might be used if other asthma medicines have not worked well. A rare, but possibly life-threatening allergic reaction called anaphylaxis might occur when the Omalizumab injection is given. If you take this medication, work with your doctor to make sure you understand the signs and symptoms of anaphylaxis and what actions you should take. Inhaled long-acting beta2-agonists. These medicines open the airways. They might be added to inhaled corticosteroids to improve asthma control. Inhaled long-acting beta2-agonists should never be used on their own for long-term asthma control. They must used with inhaled corticosteroids. Leukotriene modifiers. These medicines are taken by mouth. They help block the chain reaction that increases inflammation in your airways. Theophylline. This medicine is taken by mouth. Theophylline helps open the airways. If your doctor prescribes a long-term control medicine, take it every day to control your asthma. Your asthma symptoms will likely return or get worse if you stop taking your medicine. Long-term control medicines can have side effects. Talk with your doctor about these side effects and ways to reduce or avoid them. With some medicines, like theophylline, your doctor will check the level of medicine in your blood. This helps ensure that you’re getting enough medicine to relieve your asthma symptoms, but not so much that it causes dangerous side effects. Quick-Relief Medicines All people who have asthma need quick-relief medicines to help relieve asthma symptoms that may flare up. Inhaled short-acting beta2-agonists are the first choice for quick relief. These medicines act quickly to relax tight muscles around your airways when you're having a flareup. This allows the airways to open up so air can flow through them. You should take your quick-relief medicine when you first notice asthma symptoms. If you use this medicine more than 2 days a week, talk with your doctor about your asthma control. You may need to make changes to your asthma action plan. Carry your quick-relief inhaler with you at all times in case you need it. If your child has asthma, make sure that anyone caring for him or her has the child's quick-relief medicines, including staff at the child's school. They should understand when and how to use these medicines and when to seek medical care for your child. You shouldn't use quick-relief medicines in place of prescribed long-term control medicines. Quick-relief medicines don't reduce inflammation. Track Your Asthma To track your asthma, keep records of your symptoms, check your peak flow number using a peak flow meter, and get regular asthma checkups. Record Your Symptoms You can record your asthma symptoms in a diary to see how well your treatments are controlling your asthma. Asthma is well controlled if: You have symptoms no more than 2 days a week, and these symptoms don't wake you from sleep more than 1 or 2 nights a month. You can do all your normal activities. You take quick-relief medicines no more than 2 days a week. You have no more than one asthma attack a year that requires you to take corticosteroids by mouth. Your peak flow doesn't drop below 80 percent of your personal best number. If your asthma isn't well controlled, contact your doctor. He or she may need to change your asthma action plan. Use a Peak Flow Meter This small, hand-held device shows how well air moves out of your lungs. You blow into the device and it gives you a score, or peak flow number. Your score shows how well your lungs are working at the time of the test. Your doctor will tell you how and when to use your peak flow meter. He or she also will teach you how to take your medicines based on your score. Your doctor and other health care providers may ask you to use your peak flow meter each morning and keep a record of your results. You may find it very useful to record peak flow scores for a couple of weeks before each medical visit and take the results with you. When you're first diagnosed with asthma, it's important to find your "personal best" peak flow number. To do this, you record your score each day for a 2- to 3-week period when your asthma is well-controlled. The highest number you get during that time is your personal best. You can compare this number to future numbers to make sure your asthma is controlled. Your peak flow meter can help warn you of an asthma attack, even before you notice symptoms. If your score shows that your breathing is getting worse, you should take your quick-relief medicines the way your asthma action plan directs. Then you can use the peak flow meter to check how well the medicine worked. Get Asthma Checkups When you first begin treatment, you'll see your doctor about every 2 to 6 weeks. Once your asthma is controlled, your doctor may want to see you from once a month to twice a year. During these checkups, your doctor may ask whether you've had an asthma attack since the last visit or any changes in symptoms or peak flow measurements. He or she also may ask about your daily activities. This information will help your doctor assess your level of asthma control. Your doctor also may ask whether you have any problems or concerns with taking your medicines or following your asthma action plan. Based on your answers to these questions, your doctor may change the dose of your medicine or give you a new medicine. If your control is very good, you might be able to take less medicine. The goal is to use the least amount of medicine needed to control your asthma. Emergency Care Most people who have asthma, including many children, can safely manage their symptoms by following their asthma action plans. However, you might need medical attention at times. Call your doctor for advice if: Your medicines don't relieve an asthma attack. Your peak flow is less than half of your personal best peak flow number. Call 9–1–1 for emergency care if: You have trouble walking and talking because you're out of breath. You have blue lips or fingernails. At the hospital, you'll be closely watched and given oxygen and more medicines, as well as medicines at higher doses than you take at home. Such treatment can save your life. Asthma Treatment for Special Groups The treatments described above generally apply to all people who have asthma. However, some aspects of treatment differ for people in certain age groups and those who have special needs. Children It's hard to diagnose asthma in children younger than 5 years. Thus, it's hard to know whether young children who wheeze or have other asthma symptoms will benefit from long-term control medicines. (Quick-relief medicines tend to relieve wheezing in young children whether they have asthma or not.) Doctors will treat infants and young children who have asthma symptoms with long-term control medicines if, after assessing a child, they feel that the symptoms are persistent and likely to continue after 6 years of age. (For more information, go to "How Is Asthma Diagnosed?") Inhaled corticosteroids are the preferred treatment for young children. Montelukast and cromolyn are other options. Treatment might be given for a trial period of 1 month to 6 weeks. Treatment usually is stopped if benefits aren't seen during that time and the doctor and parents are confident the medicine was used properly. Inhaled corticosteroids can possibly slow the growth of children of all ages. Slowed growth usually is apparent in the first several months of treatment, is generally small, and doesn't get worse over time. Poorly controlled asthma also may reduce a child's growth rate. Many experts think the benefits of inhaled corticosteroids for children who need them to control their asthma far outweigh the risk of slowed growth. Older Adults Doctors may need to adjust asthma treatment for older adults who take certain other medicines, such as beta blockers, aspirin and other pain relievers, and anti-inflammatory medicines. These medicines can prevent asthma medicines from working well and may worsen asthma symptoms. Be sure to tell your doctor about all of the medicines you take, including over-the-counter medicines. Older adults may develop weak bones from using inhaled corticosteroids, especially at high doses. Talk with your doctor about taking calcium and vitamin D pills, as well as other ways to help keep your bones strong. Pregnant Women Pregnant women who have asthma need to control the disease to ensure a good supply of oxygen to their babies. Poor asthma control increases the risk of preeclampsia, a condition in which a pregnant woman develops high blood pressure and protein in the urine. Poor asthma control also increases the risk that a baby will be born early and have a low birth weight. Studies show that it's safer to take asthma medicines while pregnant than to risk having an asthma attack. Talk with your doctor if you have asthma and are pregnant or planning a pregnancy. Your level of asthma control may get better or it may get worse while you're pregnant. Your health care team will check your asthma control often and adjust your treatment as needed. People Whose Asthma Symptoms Occur With Physical Activity Physical activity is an important part of a healthy lifestyle. Adults need physical activity to maintain good health. Children need it for growth and development. In some people, however, physical activity can trigger asthma symptoms. If this happens to you or your child, talk with your doctor about the best ways to control asthma so you can stay active. The following medicines may help prevent asthma symptoms caused by physical activity: Short-acting beta2-agonists (quick-relief medicine) taken shortly before physical activity can last 2 to 3 hours and prevent exercise-related symptoms in most people who take them. Long-acting beta2-agonists can be protective for up to 12 hours. However, with daily use, they'll no longer give up to 12 hours of protection. Also, frequent use of these medicines for physical activity might be a sign that asthma is poorly controlled. Leukotriene modifiers. These pills are taken several hours before physical activity. They can help relieve asthma symptoms brought on by physical activity. Long-term control medicines. Frequent or severe symptoms due to physical activity may suggest poorly controlled asthma and the need to either start or increase long-term control medicines that reduce inflammation. This will help prevent exercise-related symptoms. Easing into physical activity with a warmup period may be helpful. You also may want to wear a mask or scarf over your mouth when exercising in cold weather. If you use your asthma medicines as your doctor directs, you should be able to take part in any physical activity or sport you choose. People Having Surgery Asthma may add to the risk of having problems during and after surgery. For instance, having a tube put into your throat may cause an asthma attack. Tell your surgeon about your asthma when you first talk with him or her. The surgeon can take steps to lower your risk, such as giving you asthma medicines before or during surgery. Prevention You can’t prevent asthma. However, you can take steps to control the disease and prevent its symptoms. For example: Learn about your asthma and ways to control it. Follow your written asthma action plan. (For a sample plan, go to the National Heart, Lung, and Blood Institute's "Asthma Action Plan.") Use medicines as your doctor prescribes. Identify and try to avoid things that make your asthma worse (asthma triggers). However, one trigger you should not avoid is physical activity. Physical activity is an important part of a healthy lifestyle. Talk with your doctor about medicines that can help you stay active. Keep track of your asthma symptoms and level of control. Get regular checkups for your asthma. For more details about how to prevent asthma symptoms and attacks, go to "How Is Asthma Treated and Controlled?" Living With If you have asthma, you’ll need long-term care. Successful asthma treatment requires that you take an active role in your care and follow your asthma action plan. Learn How To Manage Your Asthma Partner with your doctor to develop an asthma action plan. This plan will help you know when and how to take your medicines. The plan also will help you identify your asthma triggers and manage your disease if asthma symptoms worsen. Children aged 10 or older—and younger children who can handle it—should be involved in creating and following their asthma action plans. For a sample plan, go to the National Heart, Lung, and Blood Institute's "Asthma Action Plan." Most people who have asthma can successfully manage their symptoms by following their asthma action plans and having regular checkups. However, knowing when to seek emergency medical care is important. Learn how to use your medicines correctly. If you take inhaled medicines, you should practice using your inhaler at your doctor's office. If you take long-term control medicines, take them daily as your doctor prescribes. Record your asthma symptoms as a way to track how well your asthma is controlled. Also, your doctor may advise you to use a peak flow meter to measure and record how well your lungs are working. Your doctor may ask you to keep records of your symptoms or peak flow results daily for a couple of weeks before an office visit. You'll bring these records with you to the visit. (For more information about using a peak flow meter, go to "How Is Asthma Treated and Controlled?") These steps will help you keep track of how well you're controlling your asthma over time. This will help you spot problems early and prevent or relieve asthma attacks. Recording your symptoms and peak flow results to share with your doctor also will help him or her decide whether to adjust your treatment. Ongoing Care Have regular asthma checkups with your doctor so he or she can assess your level of asthma control and adjust your treatment as needed. Remember, the main goal of asthma treatment is to achieve the best control of your asthma using the least amount of medicine. This may require frequent adjustments to your treatments. If you find it hard to follow your asthma action plan or the plan isn't working well, let your health care team know right away. They will work with you to adjust your plan to better suit your needs. Get treatment for any other conditions that can interfere with your asthma management. Watch for Signs That Your Asthma Is Getting Worse Your asthma might be getting worse if: Your symptoms start to occur more often, are more severe, or bother you at night and cause you to lose sleep. You're limiting your normal activities and missing school or work because of your asthma. Your peak flow number is low compared to your personal best or varies a lot from day to day. Your asthma medicines don't seem to work well anymore. You have to use your quick-relief inhaler more often. If you're using quick-relief medicine more than 2 days a week, your asthma isn't well controlled. You have to go to the emergency room or doctor because of an asthma attack. If you have any of these signs, see your doctor. He or she might need to change your medicines or take other steps to control your asthma. Partner with your health care team and take an active role in your care. This can help you better control your asthma so it doesn't interfere with your activities and disrupt your life. how is asthma diagnosed

how is asthma diagnosed

An exam during pregnancy may show an unusually large uterus and extra amniotic fluid. There may be an unusually small placenta when the baby is born. A physical exam of the infant may show unusual fingerprint patterns. X-rays may show a short breast bone. Chromosome studies will show trisomy 18. The chromosome abnormality may be present in every cell or present in only a certain percentage of the cells (called mosaicism). Studies may also show part of the chromosome in some cells. Rarely, part of the chromosome 18 becomes attached to another chromosome. This is called translocation. Other signs include: - Hole, split, or cleft in the iris of the eye (coloboma) - Separation between the left and right side of the abdominal muscle (diastasis recti) - Umbilical hernia or inguinal hernia There are often signs of congenital heart disease, such as: - Atrial septal defect (ASD) - Patent ductus arteriosus (PDA) - Ventricular septal defect (VSD) Tests may also show kidney problems, including: - Horseshoe kidney - Hydronephrosis - Polycystic kidney

Trisomy 18 Edwards syndrome Summary Trisomy 18 is a genetic disorder in which a person has a third copy of material from chromosome 18, instead of the usual 2 copies. Causes Trisomy 18 occurs in 1 in 6,000 live births. It is 3 times more common in girls than boys. The syndrome occurs when there is extra material from chromosome 18. The extra material affects normal development. Symptoms Symptoms may include: Clenched hands Crossed legs Feet with a rounded bottom (rocker-bottom feet) Low birth weight Low-set ears Mental delay Poorly developed fingernails Small head (microcephaly) Small jaw (micrognathia) Undescended testicle Unusual shaped chest (pectus carinatum) Exams and Tests An exam during pregnancy may show an unusually large uterus and extra amniotic fluid. There may be an unusually small placenta when the baby is born. A physical exam of the infant may show unusual fingerprint patterns. X-rays may show a short breast bone. Chromosome studies will show trisomy 18. The chromosome abnormality may be present in every cell or present in only a certain percentage of the cells (called mosaicism). Studies may also show part of the chromosome in some cells. Rarely, part of the chromosome 18 becomes attached to another chromosome. This is called translocation. Other signs include: Hole, split, or cleft in the iris of the eye (coloboma) Separation between the left and right side of the abdominal muscle (diastasis recti) Umbilical hernia or inguinal hernia There are often signs of congenital heart disease, such as: Atrial septal defect (ASD) Patent ductus arteriosus (PDA) Ventricular septal defect (VSD) Tests may also show kidney problems, including: Horseshoe kidney Hydronephrosis Polycystic kidney Treatment There are no specific treatments for trisomy 18. Which treatments are used depend on the person's individual condition. Support Groups Support groups include: Support Organization for Trisomy 18, 13 and Related Disorders (SOFT): trisomy.org Trisomy 18 Foundation: www.trisomy18.org Hope for Trisomy 13 and 18: www.hopefortrisomy13and18.org Outlook (Prognosis) Half of infants with this condition do not survive beyond the first week of life. Nine out of ten children will die by 1 year of age. Some children have survived to the teenage years, but with serious medical and developmental problems. Possible Complications Complications depend on the specific defects and symptoms. When to Contact a Medical Professional Genetic counseling can help families understand the condition, the risks of inheriting it, and how to care for the person. Prevention Tests can be done during pregnancy to find out if the child has this syndrome. Genetic counseling is recommended for parents who have a child with this syndrome and who want to have more children. Review Date 8/6/2017 Updated by: Anna C. Edens Hurst, MD, MS, Assistant Professor in Medical Genetics, The University of Alabama at Birmingham, Birmingham, AL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how is edward's syndrome diagnosed

how is edward's syndrome diagnosed

Trisomy 18 (Prevention): Tests can be done during pregnancy to find out if the child has this syndrome. Genetic testing is recommended for parents who have a child with this syndrome and who want to have more children.

Trisomy 18 Edwards syndrome Summary Trisomy 18 is a genetic disorder in which a person has a third copy of material from chromosome 18, instead of the usual 2 copies. Causes Trisomy 18 occurs in 1 in 6,000 live births. It is 3 times more common in girls than boys. The syndrome occurs when there is extra material from chromosome 18. The extra material affects normal development. Symptoms Symptoms may include: Clenched hands Crossed legs Feet with a rounded bottom (rocker-bottom feet) Low birth weight Low-set ears Mental delay Poorly developed fingernails Small head (microcephaly) Small jaw (micrognathia) Undescended testicle Unusual shaped chest (pectus carinatum) Exams and Tests An exam during pregnancy may show an unusually large uterus and extra amniotic fluid. There may be an unusually small placenta when the baby is born. A physical exam of the infant may show unusual fingerprint patterns. X-rays may show a short breast bone. Chromosome studies will show trisomy 18. The chromosome abnormality may be present in every cell or present in only a certain percentage of the cells (called mosaicism). Studies may also show part of the chromosome in some cells. Rarely, part of the chromosome 18 becomes attached to another chromosome. This is called translocation. Other signs include: Hole, split, or cleft in the iris of the eye (coloboma) Separation between the left and right side of the abdominal muscle (diastasis recti) Umbilical hernia or inguinal hernia There are often signs of congenital heart disease, such as: Atrial septal defect (ASD) Patent ductus arteriosus (PDA) Ventricular septal defect (VSD) Tests may also show kidney problems, including: Horseshoe kidney Hydronephrosis Polycystic kidney Treatment There are no specific treatments for trisomy 18. Which treatments are used depend on the person's individual condition. Support Groups Support groups include: Support Organization for Trisomy 18, 13 and Related Disorders (SOFT): trisomy.org Trisomy 18 Foundation: www.trisomy18.org Hope for Trisomy 13 and 18: www.hopefortrisomy13and18.org Outlook (Prognosis) Half of infants with this condition do not survive beyond the first week of life. Nine out of ten children will die by 1 year of age. Some children have survived to the teenage years, but with serious medical and developmental problems. Possible Complications Complications depend on the specific defects and symptoms. When to Contact a Medical Professional Genetic counseling can help families understand the condition, the risks of inheriting it, and how to care for the person. Prevention Tests can be done during pregnancy to find out if the child has this syndrome. Genetic counseling is recommended for parents who have a child with this syndrome and who want to have more children. Review Date 8/6/2017 Updated by: Anna C. Edens Hurst, MD, MS, Assistant Professor in Medical Genetics, The University of Alabama at Birmingham, Birmingham, AL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how is edward's syndrome diagnosed

how is edward's syndrome diagnosed

Trisomy 18 (Exams and Tests): An exam during pregnancy may show an unusually large uterus and extra amniotic fluid. There may be an unusually small placenta when the baby is born. A physical exam of the infant may show unusual fingerprint patterns. X-rays may show a short breast bone. Chromosome studies will show trisomy 18. The chromosome abnormality may be present in every cell or present in only a certain percentage of the cells (called mosaicism). Other signs include: - Hole, split, or cleft in the iris of the eye (coloboma) - Separation between the left and right side of the abdominal muscle (diastasis recti) - Umbilical hernia or inguinal hernia There are often signs of congenital heart disease, such as: - Atrial septal defect (ASD) - Patent ductus arteriosus (PDA) - Ventricular septal defect (VSD) Tests may also show kidney problems, including: - Horseshoe kidney - Hydronephrosis - Polycystic kidney

Trisomy 18 Edwards syndrome Summary Trisomy 18 is a genetic disorder in which a person has a third copy of material from chromosome 18, instead of the usual 2 copies. Causes Trisomy 18 occurs in 1 in 6,000 live births. It is 3 times more common in girls than boys. The syndrome occurs when there is extra material from chromosome 18. The extra material affects normal development. Symptoms Symptoms may include: Clenched hands Crossed legs Feet with a rounded bottom (rocker-bottom feet) Low birth weight Low-set ears Mental delay Poorly developed fingernails Small head (microcephaly) Small jaw (micrognathia) Undescended testicle Unusual shaped chest (pectus carinatum) Exams and Tests An exam during pregnancy may show an unusually large uterus and extra amniotic fluid. There may be an unusually small placenta when the baby is born. A physical exam of the infant may show unusual fingerprint patterns. X-rays may show a short breast bone. Chromosome studies will show trisomy 18. The chromosome abnormality may be present in every cell or present in only a certain percentage of the cells (called mosaicism). Studies may also show part of the chromosome in some cells. Rarely, part of the chromosome 18 becomes attached to another chromosome. This is called translocation. Other signs include: Hole, split, or cleft in the iris of the eye (coloboma) Separation between the left and right side of the abdominal muscle (diastasis recti) Umbilical hernia or inguinal hernia There are often signs of congenital heart disease, such as: Atrial septal defect (ASD) Patent ductus arteriosus (PDA) Ventricular septal defect (VSD) Tests may also show kidney problems, including: Horseshoe kidney Hydronephrosis Polycystic kidney Treatment There are no specific treatments for trisomy 18. Which treatments are used depend on the person's individual condition. Support Groups Support groups include: Support Organization for Trisomy 18, 13 and Related Disorders (SOFT): trisomy.org Trisomy 18 Foundation: www.trisomy18.org Hope for Trisomy 13 and 18: www.hopefortrisomy13and18.org Outlook (Prognosis) Half of infants with this condition do not survive beyond the first week of life. Nine out of ten children will die by 1 year of age. Some children have survived to the teenage years, but with serious medical and developmental problems. Possible Complications Complications depend on the specific defects and symptoms. When to Contact a Medical Professional Genetic counseling can help families understand the condition, the risks of inheriting it, and how to care for the person. Prevention Tests can be done during pregnancy to find out if the child has this syndrome. Genetic counseling is recommended for parents who have a child with this syndrome and who want to have more children. Review Date 8/6/2017 Updated by: Anna C. Edens Hurst, MD, MS, Assistant Professor in Medical Genetics, The University of Alabama at Birmingham, Birmingham, AL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how is edward's syndrome diagnosed

how is edward's syndrome diagnosed

There is no test that can make a diagnosis of GAD. The diagnosis is based on your answers to questions about the symptoms of GAD. Your health care provider will ask about these symptoms. You will also be asked about other aspects of your mental and physical health. A physical exam or lab tests may be done to rule out other conditions that cause similar symptoms.

Generalized anxiety disorder GAD Anxiety disorder Summary Generalized anxiety disorder (GAD) is a mental disorder in which a person is often worried or anxious about many things and finds it hard to control this anxiety. Causes The cause of GAD is unknown. Genes may play a role. Stress may also contribute to the development of GAD. GAD is a common condition. Anyone can develop this disorder, even children. GAD occurs more often in women than in men. Symptoms The main symptom is frequent worry or tension for at least 6 months, even when there is little or no clear cause. Worries seem to float from one problem to another. Problems may involve family, other relationships, work, school, money, and health. Even when aware that worries or fears are stronger than appropriate for the situation, a person with GAD still has difficulty controlling them. Other symptoms of GAD include: Problems concentrating Fatigue Irritability Problems falling or staying asleep, or sleep that is restless and unsatisfying Restlessness when awake The person may also have other physical symptoms. These can include muscle tension, upset stomach, sweating, or difficulty breathing. Exams and Tests There is no test that can make a diagnosis of GAD. The diagnosis is based on your answers to questions about the symptoms of GAD. Your health care provider will ask about these symptoms. You will also be asked about other aspects of your mental and physical health. A physical exam or lab tests may be done to rule out other conditions that cause similar symptoms. Treatment The goal of treatment is to help you feel better and function well in daily life. Talk therapy or medicine alone can be helpful. Sometimes, a combination of these may work best. TALK THERAPY Many types of talk therapy may be helpful for GAD. One common and effective talk therapy is cognitive-behavioral therapy (CBT). CBT can help you understand the relationship between your thoughts, behaviors, and symptoms. Often CBT involves a set number of visits. During CBT you can learn how to: Understand and gain control of distorted views of stressors, such as other people's behavior or life events. Recognize and replace panic-causing thoughts to help you feel more in control. Manage stress and relax when symptoms occur. Avoid thinking that minor problems will develop into terrible ones. Other types of talk therapy may also be helpful in managing symptoms of an anxiety disorder. MEDICINES Certain medicines, usually used to treat depression, may be very helpful for this disorder. They work by preventing your symptoms or making them less severe. You must take these medicines every day. DO NOT stop taking them without talking with your provider. Medicines called sedatives or hypnotics may also be prescribed. These medicines should only be taken under a doctor's direction. Your doctor will prescribe a limited amount of these drugs. They should not to be used everyday. They may be used when symptoms become very severe or when you are about to be exposed to something that always brings on your symptoms. If you are prescribed a sedative, do not drink alcohol while on this medicine. SELF-CARE Other than taking medicine and going to therapy, you can help yourself get better by: Reducing caffeine Not using street drugs or large amounts of alcohol Exercising, getting enough rest, and eating healthy foods Support Groups You can ease the stress of having GAD by joining a support group. Sharing with others who have common experiences and problems can help you not feel alone. Support groups are usually not a good substitute for talk therapy or taking medicine, but can be a helpful addition. Resources for more information include: Anxiety and Depression Association of America -- adaa.org National Institute of Mental Health -- www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml Outlook (Prognosis) How well a person does depends on how severe the condition is. In some cases, GAD is long-term and is difficult to treat. Most people, though, get better with medicine and/or talk therapy. Possible Complications Depression and substance abuse may occur with an anxiety disorder. When to Contact a Medical Professional Call your provider if you frequently worry or feel anxious, especially if it interferes with your daily activities. Review Date 3/26/2018 Updated by: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how is generalized anxiety disorder diagnosed

how is generalized anxiety disorder diagnosed

To help diagnose generalized anxiety disorder, your doctor or mental health professional may: - Do a physical exam to look for signs that your anxiety might be linked to medications or an underlying medical condition - Order blood or urine tests or other tests, if a medical condition is suspected - Ask detailed questions about your symptoms and medical history - Use psychological questionnaires to help determine a diagnosis - Use the criteria listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association

Generalized anxiety disorder Overview It's normal to feel anxious from time to time, especially if your life is stressful. However, excessive, ongoing anxiety and worry that are difficult to control and interfere with day-to-day activities may be a sign of generalized anxiety disorder. It's possible to develop generalized anxiety disorder as a child or an adult. Generalized anxiety disorder has symptoms that are similar to panic disorder, obsessive-compulsive disorder and other types of anxiety, but they're all different conditions. Living with generalized anxiety disorder can be a long-term challenge. In many cases, it occurs along with other anxiety or mood disorders. In most cases, generalized anxiety disorder improves with psychotherapy or medications. Making lifestyle changes, learning coping skills and using relaxation techniques also can help. Generalized anxiety disorder care at Mayo Clinic Symptoms Generalized anxiety disorder symptoms can vary. They may include: - Persistent worrying or anxiety about a number of areas that are out of proportion to the impact of the events - Overthinking plans and solutions to all possible worst-case outcomes - Perceiving situations and events as threatening, even when they aren't - Difficulty handling uncertainty - Indecisiveness and fear of making the wrong decision - Inability to set aside or let go of a worry - Inability to relax, feeling restless, and feeling keyed up or on edge - Difficulty concentrating, or the feeling that your mind "goes blank" Physical signs and symptoms may include: - Fatigue - Trouble sleeping - Muscle tension or muscle aches - Trembling, feeling twitchy - Nervousness or being easily startled - Sweating - Nausea, diarrhea or irritable bowel syndrome - Irritability There may be times when your worries don't completely consume you, but you still feel anxious even when there's no apparent reason. For example, you may feel intense worry about your safety or that of your loved ones, or you may have a general sense that something bad is about to happen. Your anxiety, worry or physical symptoms cause you significant distress in social, work or other areas of your life. Worries can shift from one concern to another and may change with time and age. Children and teenagers may have similar worries to adults, but also may have excessive worries about: - Performance at school or sporting events - Family members' safety - Being on time (punctuality) - Earthquakes, nuclear war or other catastrophic events A child or teen with excessive worry may: - Feel overly anxious to fit in - Be a perfectionist - Redo tasks because they aren't perfect the first time - Spend excessive time doing homework - Lack confidence - Strive for approval - Require a lot of reassurance about performance - Have frequent stomachaches or other physical complaints - Avoid going to school or avoid social situations Some anxiety is normal, but see your doctor if: - You feel like you're worrying too much, and it's interfering with your work, relationships or other parts of your life - You feel depressed or irritable, have trouble with drinking or drugs, or you have other mental health concerns along with anxiety - You have suicidal thoughts or behaviors - seek emergency treatment immediately Your worries are unlikely to simply go away on their own, and they may actually get worse over time. Try to seek professional help before your anxiety becomes severe - it may be easier to treat early on. Causes As with many mental health conditions, the cause of generalized anxiety disorder likely arises from a complex interaction of biological and environmental factors, which may include: - Differences in brain chemistry and function - Genetics - Differences in the way threats are perceived - Development and personality Risk factors Women are diagnosed with generalized anxiety disorder somewhat more often than men are. The following factors may increase the risk of developing generalized anxiety disorder: - Personality. A person whose temperament is timid or negative or who avoids anything dangerous may be more prone to generalized anxiety disorder than others are. - Genetics. Generalized anxiety disorder may run in families. - Experiences. People with generalized anxiety disorder may have a history of significant life changes, traumatic or negative experiences during childhood, or a recent traumatic or negative event. Chronic medical illnesses or other mental health disorders may increase risk. Complications Having generalized anxiety disorder can be disabling. It can: - Impair your ability to perform tasks quickly and efficiently because you have trouble concentrating - Take your time and focus from other activities - Sap your energy - Increase your risk of depression Generalized anxiety disorder can also lead to or worsen other physical health conditions, such as: - Digestive or bowel problems, such as irritable bowel syndrome or ulcers - Headaches and migraines - Chronic pain and illness - Sleep problems and insomnia - Heart-health issues Generalized anxiety disorder often occurs along with other mental health problems, which can make diagnosis and treatment more challenging. Some mental health disorders that commonly occur with generalized anxiety disorder include: - Phobias - Panic disorder - Post-traumatic stress disorder (PTSD) - Obsessive-compulsive disorder (OCD) - Depression - Suicidal thoughts or suicide - Substance abuse Diagnosis To help diagnose generalized anxiety disorder, your doctor or mental health professional may: - Do a physical exam to look for signs that your anxiety might be linked to medications or an underlying medical condition - Order blood or urine tests or other tests, if a medical condition is suspected - Ask detailed questions about your symptoms and medical history - Use psychological questionnaires to help determine a diagnosis - Use the criteria listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association Treatment Treatment decisions are based on how significantly generalized anxiety disorder is affecting your ability to function in your daily life. The two main treatments for generalized anxiety disorder are psychotherapy and medications. You may benefit most from a combination of the two. It may take some trial and error to discover which treatments work best for you. Psychotherapy Also known as talk therapy or psychological counseling, psychotherapy involves working with a therapist to reduce your anxiety symptoms. Cognitive behavioral therapy is the most effective form of psychotherapy for generalized anxiety disorder. Generally a short-term treatment, cognitive behavioral therapy focuses on teaching you specific skills to directly manage your worries and help you gradually return to the activities you've avoided because of anxiety. Through this process, your symptoms improve as you build on your initial success. Medications Several types of medications are used to treat generalized anxiety disorder, including those below. Talk with your doctor about benefits, risks and possible side effects. - Antidepressants. Antidepressants, including medications in the selective serotonin reuptake inhibitor (SSRI) and serotonin and norepinephrine reuptake inhibitor (SNRI) classes, are the first line medication treatments. Examples of antidepressants used to treat generalized anxiety disorder include escitalopram (Lexapro), duloxetine (Cymbalta), venlafaxine (Effexor XR) and paroxetine (Paxil, Pexeva). Your doctor also may recommend other antidepressants. - Buspirone. An anti-anxiety medication called buspirone may be used on an ongoing basis. As with most antidepressants, it typically takes up to several weeks to become fully effective. - Benzodiazepines. In limited circumstances, your doctor may prescribe a benzodiazepine for relief of anxiety symptoms. These sedatives are generally used only for relieving acute anxiety on a short-term basis. Because they can be habit-forming, these medications aren't a good choice if you have or had problems with alcohol or drug abuse. Lifestyle and home remedies While most people with anxiety disorders need psychotherapy or medications to get anxiety under control, lifestyle changes also can make a difference. Here's what you can do: - Keep physically active. Develop a routine so that you're physically active most days of the week. Exercise is a powerful stress reducer. It may improve your mood and help you stay healthy. Start out slowly and gradually increase the amount and intensity of your activities. - Make sleep a priority. Do what you can to make sure you're getting enough sleep to feel rested. If you aren't sleeping well, see your doctor. - Use relaxation techniques. Visualization techniques, meditation and yoga are examples of relaxation techniques that can ease anxiety. - Eat healthy. Healthy eating - such as focusing on vegetables, fruits, whole grains and fish - may be linked to reduced anxiety, but more research is needed. - Avoid alcohol and recreational drugs. These substances can worsen anxiety. - Quit smoking and cut back or quit drinking coffee. Both nicotine and caffeine can worsen anxiety. Alternative medicine Several herbal remedies have been studied as treatments for anxiety. Results tend to be mixed, and in several studies people report no benefits from their use. More research is needed to fully understand the risks and benefits. Some herbal supplements, such as kava and valerian, increase the risk of serious liver damage. Other supplements, such as passionflower or theanine, may have a calming effect, but they're often combined with other products so it's hard to tell whether they help with symptoms of anxiety. Before taking any herbal remedies or supplements, talk with your doctor to make sure they're safe and won't interact with any medications you take. how is generalized anxiety disorder diagnosed

how is generalized anxiety disorder diagnosed

You also need to get tested if you have any symptoms of gonorrhea. Testing is very important, because women with untreated gonorrhea can develop serious health problems. If you are tested for gonorrhea, you also need to get tested for other STIs, including chlamydia, syphilis, and HIV.

Gonorrhea Overview Gonorrhea is a sexually transmitted infection (STI). It is usually spread by having vaginal, oral, or anal sex. In 2014, gonorrhea affected more than 162,000 women in the United States.1 Antibiotics can treat gonorrhea. If left untreated, it can cause serious health problems, including problems getting pregnant. What is gonorrhea? Gonorrhea is an STI that is caused by the bacteria Neisseria gonorrhoeae. It is an especially serious problem for women because it can damage the female reproductive organs. Who gets gonorrhea? In 2014, gonorrhea affected more than 162,000 women in the United States.1 Gonorrhea most often affects women ages 15 to 24. But, gonorrhea is becoming more common in older women too.1 How do you get gonorrhea? Gonorrhea is spread through: What are the signs and symptoms of gonorrhea? Most women with gonorrhea do not have any signs or symptoms. If you do get symptoms, they are often mild and can be mistaken for a bladder or vaginal infection. Signs or symptoms of gonorrhea depend on where you are first infected by the gonorrhea bacteria. Signs and symptoms in the genital area can include: Signs and symptoms in other parts of the body include: Gonorrhea can cause serious health problems, even if you do not have any signs or symptoms. Do I need to get tested for gonorrhea? You also need to get tested if you have any symptoms of gonorrhea. Testing is very important, because women with untreated gonorrhea can develop serious health problems. If you are tested for gonorrhea, you also need to get tested for other STIs, including chlamydia, syphilis, and HIV. How is gonorrhea diagnosed? There are two ways that a doctor or nurse tests for gonorrhea: A Pap test is not used to detect gonorrhea. How is gonorrhea treated? Your doctor or nurse will give you antibiotics to treat gonorrhea. The antibiotics are usually a pill you swallow. Although antibiotics can cure gonorrhea, they cannot fix any permanent damage done to your body. For this reason, it is important to get tested and to take the antibiotics as soon as possible. For the antibiotics to work, you must finish all of the antibiotics that your doctor gives you, even if the symptoms go away. Do not share your antibiotics for gonorrhea with anyone. If symptoms do not go away after treatment, see your doctor or nurse. It is possible to get gonorrhea again if you have sex with someone who has gonorrhea. Tell your recent sex partner(s) so they can be tested and treated. What can happen if gonorrhea is not treated? Gonorrhea that is not treated can cause serious health problems in women:3 What should I do if I have gonorrhea? Gonorrhea is easy to treat. But you need to get tested and treated as soon as possible. If you have gonorrhea: How does gonorrhea affect pregnancy? For pregnant women, untreated gonorrhea raises the risk of: Babies born to infected mothers are at risk for: Treatment of gonorrhea as soon as it is found in pregnant women will lower the risk of these problems for both mother and baby. Your baby will get antibiotics if you have gonorrhea or if your baby has a gonorrheal eye infection. How can I prevent gonorrhea? The best way to prevent gonorrhea or any STI is to not have vaginal, oral, or anal sex. If you do have sex, lower your risk of getting an STI with the following steps: The steps work best when used together. No single step can protect you from every single type of STI. Can women who have sex with women get gonorrhea? Yes. It is possible to get gonorrhea, or any other STI, if you are a woman who has sex only with women. Talk to your partner about her sexual history before having sex, and ask your doctor about getting tested if you have signs or symptoms of gonorrhea. Did we answer your question about gonorrhea? For more information about gonorrhea, call the OWH Helpline at 1-800-994-9662 or contact the following organizations: Sources how is gonorrhea diagnosed

how is gonorrhea diagnosed

To determine whether the gonorrhea bacterium is present in your body, your doctor will analyze a sample of cells. Samples can be collected by: - Urine test. This may help identify bacteria in your urethra. - Swab of affected area. A swab of your throat, urethra, vagina or rectum may collect bacteria that can be identified in a laboratory. For women, home test kits are available for gonorrhea. Home test kits include vaginal swabs for self-testing that are sent to a specified lab for testing. If you prefer, you can choose to be notified by email or text message when your results are ready. You may then view your results online or receive them by calling a toll-free hotline.

Gonorrhea Overview Gonorrhea is an infection caused by a sexually transmitted bacterium that can infect both males and females. Gonorrhea most often affects the urethra, rectum or throat. In females, gonorrhea can also infect the cervix. Gonorrhea is most commonly spread during sex. But babies can be infected during childbirth if their mothers are infected. In babies, gonorrhea most commonly affects the eyes. Gonorrhea is a common infection that, in many cases, causes no symptoms. You may not even know that you're infected. Abstaining from sex, using a condom if you do have sex and being in a mutually monogamous relationship are the best ways to prevent sexually transmitted infections. Symptoms In many cases, gonorrhea infection causes no symptoms. When symptoms do appear, gonorrhea infection can affect multiple sites in your body, but it commonly appears in the genital tract. Gonorrhea affecting the genital tract Signs and symptoms of gonorrhea infection in men include: - Painful urination - Pus-like discharge from the tip of the penis - Pain or swelling in one testicle Signs and symptoms of gonorrhea infection in women include: - Increased vaginal discharge - Painful urination - Vaginal bleeding between periods, such as after vaginal intercourse - Painful intercourse - Abdominal or pelvic pain Gonorrhea at other sites in the body Gonorrhea can also affect these parts of the body: - Rectum. Signs and symptoms include anal itching, pus-like discharge from the rectum, spots of bright red blood on toilet tissue and having to strain during bowel movements. - Eyes. Gonorrhea that affects your eyes may cause eye pain, sensitivity to light, and pus-like discharge from one or both eyes. - Throat. Signs and symptoms of a throat infection may include a sore throat and swollen lymph nodes in the neck. - Joints. If one or more joints become infected by bacteria (septic arthritis), the affected joints may be warm, red, swollen and extremely painful, especially when you move an affected joint. When to see your doctor Make an appointment with your doctor if you notice any troubling signs or symptoms, such as a burning sensation when you urinate or a pus-like discharge from your penis, vagina or rectum. Also make an appointment with your doctor if your partner has been diagnosed with gonorrhea. You may not experience signs or symptoms that prompt you to seek medical attention. But without treatment, you can reinfect your partner even after he or she has been treated for gonorrhea. Causes Gonorrhea is caused by the bacterium Neisseria gonorrhoeae. The gonorrhea bacteria are most often passed from one person to another during sexual contact, including oral, anal or vaginal intercourse. Risk factors Factors that may increase your risk of gonorrhea infection include: - Younger age - A new sex partner - A sex partner who has concurrent partners - Multiple sex partners - Previous gonorrhea diagnosis - Having other sexually transmitted infections Complications Untreated gonorrhea can lead to significant complications, such as: - Infertility in women. Untreated gonorrhea can spread into the uterus and fallopian tubes, causing pelvic inflammatory disease (PID), which may result in scarring of the tubes, greater risk of pregnancy complications and infertility. PID is a serious infection that requires immediate treatment. - Infertility in men. Men with untreated gonorrhea can experience epididymitis - inflammation of a small, coiled tube in the rear portion of the testicles where the sperm ducts are located (epididymis). Epididymitis is treatable, but if left untreated, it may lead to infertility. - Infection that spreads to the joints and other areas of your body. The bacterium that causes gonorrhea can spread through the bloodstream and infect other parts of your body, including your joints. Fever, rash, skin sores, joint pain, swelling and stiffness are possible results. - Increased risk of HIV/AIDS. Having gonorrhea makes you more susceptible to infection with human immunodeficiency virus (HIV), the virus that leads to AIDS. People who have both gonorrhea and HIV are able to pass both diseases more readily to their partners. - Complications in babies. Babies who contract gonorrhea from their mothers during birth can develop blindness, sores on the scalp and infections. Diagnosis To determine whether the gonorrhea bacterium is present in your body, your doctor will analyze a sample of cells. Samples can be collected by: - Urine test. This may help identify bacteria in your urethra. - Swab of affected area. A swab of your throat, urethra, vagina or rectum may collect bacteria that can be identified in a laboratory. For women, home test kits are available for gonorrhea. Home test kits include vaginal swabs for self-testing that are sent to a specified lab for testing. If you prefer, you can choose to be notified by email or text message when your results are ready. You may then view your results online or receive them by calling a toll-free hotline. Testing for other sexually transmitted infections Your doctor may recommend tests for other sexually transmitted infections. Gonorrhea increases your risk of these infections, particularly chlamydia, which often accompanies gonorrhea. Testing for HIV also is recommended for anyone diagnosed with a sexually transmitted infection. Depending on your risk factors, tests for additional sexually transmitted infections could be beneficial as well. Treatment Gonorrhea treatment in adults Adults with gonorrhea are treated with antibiotics. Due to emerging strains of drug-resistant Neisseria gonorrhoeae, the Centers for Disease Control and Prevention recommends that uncomplicated gonorrhea be treated only with the antibiotic ceftriaxone - given as an injection - in combination with either azithromycin (Zithromax, Zmax) or doxycycline (Monodox, Vibramycin, others) - two antibiotics that are taken orally. Some research indicates that oral gemifloxacin (Factive) or injectable gentamicin, combined with oral azithromycin, is highly successful in treating gonorrhea. This treatment may be helpful in treating people who are allergic to cephalosporin antibiotics, such as ceftriaxone. Gonorrhea treatment for partners Your partner also should undergo testing and treatment for gonorrhea, even if he or she has no signs or symptoms. Your partner receives the same treatment you do. Even if you've been treated for gonorrhea, you can be reinfected if your partner isn't treated. Gonorrhea treatment for babies Babies born to mothers with gonorrhea receive a medication in their eyes soon after birth to prevent infection. If an eye infection develops, babies can be treated with antibiotics. how is gonorrhea diagnosed

how is gonorrhea diagnosed

Gonorrhea can be quickly detected by looking at a sample of discharge or tissue under the microscope. This is called a gram stain. This method is fast, but it is not the most certain. Gonorrhea is most accurately detected with DNA tests.

Gonorrhea Clap The drip Summary Gonorrhea is a common sexually transmitted infection (STI). Causes Gonorrhea is caused by the bacteria <em>Neisseria gonorrhoeae</em>. Any type of sex can spread gonorrhea. You can get it through contact with the mouth, throat, eyes, urethra, vagina, penis, or anus. Gonorrhea is the second most commonly reported communicable disease. Approximately 330,000 cases occur in the US each year. The bacteria grow in warm, moist areas of the body. This can include the tube that carries urine out of the body (urethra). In women, the bacteria may be found in the reproductive tract (which includes the fallopian tubes, uterus, and cervix). The bacteria can also grow in the eyes. Health care providers are required by law to tell the State Board of Health about all cases of gonorrhea. The goal of this law is make sure the person gets proper follow-up care and treatment. Sexual partners also need to be found and tested. You are more likely to develop this infection if: You have multiple sex partners. You have a partner with a past history of any STI. You do not use a condom during sex. You abuse alcohol or illegal substances. Symptoms Symptoms of gonorrhea most often appear 2 to 5 days after infection. However, it may take up to a month for symptoms to appear in men. Some people do not have symptoms. They may not know that they have caught the infection, so do not seek treatment. This increases the risk of complications and the chances of passing the infection on to another person. Symptoms in men include: Burning and pain while urinating Need to urinate urgently or more often Discharge from the penis (white, yellow, or green in color) Red or swollen opening of penis (urethra) Tender or swollen testicles Sore throat (gonococcal pharyngitis) Symptoms in women can be very mild. They can be mistaken for another type of infection. They include: Burning and pain while urinating Sore throat Painful sexual intercourse Severe pain in lower abdomen (if the infection spreads to the fallopian tubes and uterus area) Fever (if the infection spreads to the fallopian tubes and uterus area) Abnormal uterine bleeding Bleeding after sex Abnormal vaginal discharge with greenish, yellow or foul smelling discharge If the infection spreads to the bloodstream, symptoms include: Fever Rash Arthritis-like symptoms Exams and Tests Gonorrhea can be quickly detected by looking at a sample of discharge or tissue under the microscope. This is called a gram stain. This method is fast, but it is not the most certain. Gonorrhea is most accurately detected with DNA tests. DNA tests are useful for screening. The ligase chain reaction (LCR) test is one of the tests. DNA tests are quicker than cultures. These tests can be performed on urine samples, which are easier to collect than samples from the genital area. Prior to DNA tests, cultures (cells that grow in a lab dish) were used to provide proof of gonorrhea, but are less commonly used now. Samples for a culture are most often taken from the cervix, vagina, urethra, anus, or throat. Rarely, samples are taken from joint fluid or blood. Cultures can often provide an early diagnosis within 24 hours. A confirmed diagnosis is available within 72 hours. If you have gonorrhea, you should ask to be tested for other sexually transmitted infections, including chlamydia, syphilis, and HIV herpes and hepatitis. Treatment A number of different antibiotics may be used for treating this type of infection. You may receive one large dose of oral antibiotics or take a smaller dose for seven days. You may be given an antibiotic injection or shot, and then perhaps be sent home with antibiotic pills. More severe cases of PID (pelvic inflammatory disease) may require you to stay in the hospital. Antibiotics are given intravenously. Never treat yourself without being seen by your doctor first. Your health care provider will determine the best treatment. About half of the women with gonorrhea are also infected with chlamydia. Chlamydia is treated at the same time as a gonorrhea infection. You will need a follow-up visit 7 days after if your symptoms include joint pain, skin rash, or more severe pelvic or abdomen pain. Tests will be done to make sure the infection is gone. Sexual partners must be tested and treated to prevent passing the infection back and forth. You and your partner must finish all of the antibiotics. Use condoms until you both have finished taking your antibiotics. All sexual contacts of the person with gonorrhea should be contacted and tested. This helps prevent further spread of the infection. In some places you may be able to take information and medicines to your sexual partner yourself. In other places, the health department will contact your partner. Outlook (Prognosis) A gonorrhea infection that has not spread can almost always be cured with antibiotics. Gonorrhea that has spread is a more serious infection. Most of the time, it gets better with treatment. Possible Complications Complications in women may include: Infections that spread to the fallopian tubes can cause scarring. This can cause problems getting pregnant at a later time. It can also lead to chronic pelvic pain, PID, infertility, and ectopic pregnancy. Pregnant women with severe gonorrhea may pass the disease to their baby while in the womb or during delivery. It can also cause complications in pregnancy such as infection and preterm delivery. Abscess in the womb (uterus) and abdomen. Complications in men may include: Scarring or narrowing of the urethra (tube that carries urine out of the body) Abscess (collection of pus around the urethra) Complications in both men and women may include: Joint infections Heart valve infection Infection around the brain (meningitis) When to Contact a Medical Professional Call your health care provider right away if you have symptoms of gonorrhea. Most state-sponsored clinics will diagnose and treat STIs without charge. Prevention Avoiding sexual contact is the only sure way to prevent gonorrhea. If you and your partner do not have sex with any other people, this can greatly reduce your chance also. Safe sex means taking steps before and during sex that can prevent you from getting an infection, or from giving one to your partner. Safe sex practices include screening for STIs in all sexual partners, using condoms consistently, having fewer sexual contacts. Ask your provider if you should receive the hepatitis B vaccine-link and the HPV vaccine-link. You may also want to consider the HPV vaccine. Review Date 5/10/2017 Updated by: Anita Sit, MD, Department of OB/GYN, Santa Clara Valley Medical Center, San Jose, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how is gonorrhea diagnosed

how is gonorrhea diagnosed

To determine whether the gonorrhea bacterium is present in your body, your doctor will analyze a sample of cells. Samples can be collected by: - Urine test. This may help identify bacteria in your urethra. - Swab of affected area. A swab of your throat, urethra, vagina or rectum may collect bacteria that can be identified in a laboratory. For women, home test kits are available for gonorrhea. Home test kits include vaginal swabs for self-testing that are sent to a specified lab for testing.

Gonorrhea Overview Gonorrhea is an infection caused by a sexually transmitted bacterium that can infect both males and females. Gonorrhea most often affects the urethra, rectum or throat. In females, gonorrhea can also infect the cervix. Gonorrhea is most commonly spread during sex. But babies can be infected during childbirth if their mothers are infected. In babies, gonorrhea most commonly affects the eyes. Gonorrhea is a common infection that, in many cases, causes no symptoms. You may not even know that you're infected. Abstaining from sex, using a condom if you do have sex and being in a mutually monogamous relationship are the best ways to prevent sexually transmitted infections. Symptoms In many cases, gonorrhea infection causes no symptoms. When symptoms do appear, gonorrhea infection can affect multiple sites in your body, but it commonly appears in the genital tract. Gonorrhea affecting the genital tract Signs and symptoms of gonorrhea infection in men include: - Painful urination - Pus-like discharge from the tip of the penis - Pain or swelling in one testicle Signs and symptoms of gonorrhea infection in women include: - Increased vaginal discharge - Painful urination - Vaginal bleeding between periods, such as after vaginal intercourse - Painful intercourse - Abdominal or pelvic pain Gonorrhea at other sites in the body Gonorrhea can also affect these parts of the body: - Rectum. Signs and symptoms include anal itching, pus-like discharge from the rectum, spots of bright red blood on toilet tissue and having to strain during bowel movements. - Eyes. Gonorrhea that affects your eyes may cause eye pain, sensitivity to light, and pus-like discharge from one or both eyes. - Throat. Signs and symptoms of a throat infection may include a sore throat and swollen lymph nodes in the neck. - Joints. If one or more joints become infected by bacteria (septic arthritis), the affected joints may be warm, red, swollen and extremely painful, especially when you move an affected joint. When to see your doctor Make an appointment with your doctor if you notice any troubling signs or symptoms, such as a burning sensation when you urinate or a pus-like discharge from your penis, vagina or rectum. Also make an appointment with your doctor if your partner has been diagnosed with gonorrhea. You may not experience signs or symptoms that prompt you to seek medical attention. But without treatment, you can reinfect your partner even after he or she has been treated for gonorrhea. Causes Gonorrhea is caused by the bacterium Neisseria gonorrhoeae. The gonorrhea bacteria are most often passed from one person to another during sexual contact, including oral, anal or vaginal intercourse. Risk factors Factors that may increase your risk of gonorrhea infection include: - Younger age - A new sex partner - A sex partner who has concurrent partners - Multiple sex partners - Previous gonorrhea diagnosis - Having other sexually transmitted infections Complications Untreated gonorrhea can lead to significant complications, such as: - Infertility in women. Untreated gonorrhea can spread into the uterus and fallopian tubes, causing pelvic inflammatory disease (PID), which may result in scarring of the tubes, greater risk of pregnancy complications and infertility. PID is a serious infection that requires immediate treatment. - Infertility in men. Men with untreated gonorrhea can experience epididymitis - inflammation of a small, coiled tube in the rear portion of the testicles where the sperm ducts are located (epididymis). Epididymitis is treatable, but if left untreated, it may lead to infertility. - Infection that spreads to the joints and other areas of your body. The bacterium that causes gonorrhea can spread through the bloodstream and infect other parts of your body, including your joints. Fever, rash, skin sores, joint pain, swelling and stiffness are possible results. - Increased risk of HIV/AIDS. Having gonorrhea makes you more susceptible to infection with human immunodeficiency virus (HIV), the virus that leads to AIDS. People who have both gonorrhea and HIV are able to pass both diseases more readily to their partners. - Complications in babies. Babies who contract gonorrhea from their mothers during birth can develop blindness, sores on the scalp and infections. Diagnosis To determine whether the gonorrhea bacterium is present in your body, your doctor will analyze a sample of cells. Samples can be collected by: - Urine test. This may help identify bacteria in your urethra. - Swab of affected area. A swab of your throat, urethra, vagina or rectum may collect bacteria that can be identified in a laboratory. For women, home test kits are available for gonorrhea. Home test kits include vaginal swabs for self-testing that are sent to a specified lab for testing. If you prefer, you can choose to be notified by email or text message when your results are ready. You may then view your results online or receive them by calling a toll-free hotline. Testing for other sexually transmitted infections Your doctor may recommend tests for other sexually transmitted infections. Gonorrhea increases your risk of these infections, particularly chlamydia, which often accompanies gonorrhea. Testing for HIV also is recommended for anyone diagnosed with a sexually transmitted infection. Depending on your risk factors, tests for additional sexually transmitted infections could be beneficial as well. Treatment Gonorrhea treatment in adults Adults with gonorrhea are treated with antibiotics. Due to emerging strains of drug-resistant Neisseria gonorrhoeae, the Centers for Disease Control and Prevention recommends that uncomplicated gonorrhea be treated only with the antibiotic ceftriaxone - given as an injection - in combination with either azithromycin (Zithromax, Zmax) or doxycycline (Monodox, Vibramycin, others) - two antibiotics that are taken orally. Some research indicates that oral gemifloxacin (Factive) or injectable gentamicin, combined with oral azithromycin, is highly successful in treating gonorrhea. This treatment may be helpful in treating people who are allergic to cephalosporin antibiotics, such as ceftriaxone. Gonorrhea treatment for partners Your partner also should undergo testing and treatment for gonorrhea, even if he or she has no signs or symptoms. Your partner receives the same treatment you do. Even if you've been treated for gonorrhea, you can be reinfected if your partner isn't treated. Gonorrhea treatment for babies Babies born to mothers with gonorrhea receive a medication in their eyes soon after birth to prevent infection. If an eye infection develops, babies can be treated with antibiotics. how is gonorrhea diagnosed

how is gonorrhea diagnosed

Gonorrhea can cause serious health problems, even if you do not have any signs or symptoms. You also need to get tested if you have any symptoms of gonorrhea. Testing is very important, because women with untreated gonorrhea can develop serious health problems. If you are tested for gonorrhea, you also need to get tested for other STIs, including chlamydia, syphilis, and HIV.

Gonorrhea Overview Gonorrhea is a sexually transmitted infection (STI). It is usually spread by having vaginal, oral, or anal sex. In 2014, gonorrhea affected more than 162,000 women in the United States.1 Antibiotics can treat gonorrhea. If left untreated, it can cause serious health problems, including problems getting pregnant. What is gonorrhea? Gonorrhea is an STI that is caused by the bacteria Neisseria gonorrhoeae. It is an especially serious problem for women because it can damage the female reproductive organs. Who gets gonorrhea? In 2014, gonorrhea affected more than 162,000 women in the United States.1 Gonorrhea most often affects women ages 15 to 24. But, gonorrhea is becoming more common in older women too.1 How do you get gonorrhea? Gonorrhea is spread through: What are the signs and symptoms of gonorrhea? Most women with gonorrhea do not have any signs or symptoms. If you do get symptoms, they are often mild and can be mistaken for a bladder or vaginal infection. Signs or symptoms of gonorrhea depend on where you are first infected by the gonorrhea bacteria. Signs and symptoms in the genital area can include: Signs and symptoms in other parts of the body include: Gonorrhea can cause serious health problems, even if you do not have any signs or symptoms. Do I need to get tested for gonorrhea? You also need to get tested if you have any symptoms of gonorrhea. Testing is very important, because women with untreated gonorrhea can develop serious health problems. If you are tested for gonorrhea, you also need to get tested for other STIs, including chlamydia, syphilis, and HIV. How is gonorrhea diagnosed? There are two ways that a doctor or nurse tests for gonorrhea: A Pap test is not used to detect gonorrhea. How is gonorrhea treated? Your doctor or nurse will give you antibiotics to treat gonorrhea. The antibiotics are usually a pill you swallow. Although antibiotics can cure gonorrhea, they cannot fix any permanent damage done to your body. For this reason, it is important to get tested and to take the antibiotics as soon as possible. For the antibiotics to work, you must finish all of the antibiotics that your doctor gives you, even if the symptoms go away. Do not share your antibiotics for gonorrhea with anyone. If symptoms do not go away after treatment, see your doctor or nurse. It is possible to get gonorrhea again if you have sex with someone who has gonorrhea. Tell your recent sex partner(s) so they can be tested and treated. What can happen if gonorrhea is not treated? Gonorrhea that is not treated can cause serious health problems in women:3 What should I do if I have gonorrhea? Gonorrhea is easy to treat. But you need to get tested and treated as soon as possible. If you have gonorrhea: How does gonorrhea affect pregnancy? For pregnant women, untreated gonorrhea raises the risk of: Babies born to infected mothers are at risk for: Treatment of gonorrhea as soon as it is found in pregnant women will lower the risk of these problems for both mother and baby. Your baby will get antibiotics if you have gonorrhea or if your baby has a gonorrheal eye infection. How can I prevent gonorrhea? The best way to prevent gonorrhea or any STI is to not have vaginal, oral, or anal sex. If you do have sex, lower your risk of getting an STI with the following steps: The steps work best when used together. No single step can protect you from every single type of STI. Can women who have sex with women get gonorrhea? Yes. It is possible to get gonorrhea, or any other STI, if you are a woman who has sex only with women. Talk to your partner about her sexual history before having sex, and ask your doctor about getting tested if you have signs or symptoms of gonorrhea. Did we answer your question about gonorrhea? For more information about gonorrhea, call the OWH Helpline at 1-800-994-9662 or contact the following organizations: Sources how is gonorrhea diagnosed

how is gonorrhea diagnosed

The main treatment for hemophilia is called replacement therapy. Concentrates of clotting factor VIII (for hemophilia A) or clotting factor IX (for hemophilia B) are slowly dripped or injected into a vein. These infusions help replace the clotting factor that's missing or low. Clotting factor concentrates can be made from human blood. The blood is treated to prevent the spread of diseases, such as hepatitis. With the current methods of screening and treating donated blood, the risk of getting an infectious disease from human clotting factors is very small. To further reduce the risk, you or your child can take clotting factor concentrates that aren't made from human blood. These are called recombinant clotting factors. Clotting factors are easy to store, mix, and use at home?it only takes about 15 minutes to receive the factor. You may have replacement therapy on a regular basis to prevent bleeding. This is called preventive or prophylactic (PRO-fih-lac-tik) therapy. Or, you may only need replacement therapy to stop bleeding when it occurs. This use of the treatment, on an as-needed basis, is called demand therapy. Demand therapy is less intensive and expensive than preventive therapy. However, there's a risk that bleeding will cause damage before you receive the demand therapy.

Hemophilia What Is... Español Hemophilia (heem-o-FILL-ee-ah) is a rare bleeding disorder in which the blood doesn't clot normally. If you have hemophilia, you may bleed for a longer time than others after an injury. You also may bleed inside your body (internally), especially in your knees, ankles, and elbows. This bleeding can damage your organs and tissues and may be life threatening. Overview Hemophilia usually is inherited. "Inherited” means that the disorder is passed from parents to children through genes. People born with hemophilia have little or no clotting factor. Clotting factor is a protein needed for normal blood clotting. There are several types of clotting factors. These proteins work with platelets (PLATE-lets) to help the blood clot. Platelets are small blood cell fragments that form in the bone marrow—a sponge-like tissue in the bones. Platelets play a major role in blood clotting. When blood vessels are injured, clotting factors help platelets stick together to plug cuts and breaks on the vessels and stop bleeding. The two main types of hemophilia are A and B. If you have hemophilia A, you're missing or have low levels of clotting factor VIII (8). About 8 out of 10 people who have hemophilia have type A. If you have hemophilia B, you're missing or have low levels of clotting factor IX (9). Rarely, hemophilia can be acquired. "Acquired” means you aren't born with the disorder, but you develop it during your lifetime. This can happen if your body forms antibodies (proteins) that attack the clotting factors in your bloodstream. The antibodies can prevent the clotting factors from working. This article focuses on inherited hemophilia. Outlook Hemophilia can be mild, moderate, or severe, depending on how much clotting factor is in your blood. About 7 out of 10 people who have hemophilia A have the severe form of the disorder. People who don't have hemophilia have a factor VIII activity of 100 percent. People who have severe hemophilia A have a factor VIII activity of less than 1 percent. Hemophilia usually occurs in males (with rare exceptions). About 1 in 5,000 males are born with hemophilia each year. Other Names Hemophilia A Classic hemophilia Factor VIII deficiency Hemophilia B Christmas disease Factor IX deficiency Causes A defect in one of the genes that determines how the body makes blood clotting factor VIII or IX causes hemophilia. These genes are located on the X chromosomes (KRO-muh-somz). Chromosomes come in pairs. Females have two X chromosomes, while males have one X and one Y chromosome. Only the X chromosome carries the genes related to clotting factors. A male who has a hemophilia gene on his X chromosome will have hemophilia. When a female has a hemophilia gene on only one of her X chromosomes, she is a "hemophilia carrier” and can pass the gene to her children. Sometimes carriers have low levels of clotting factor and have symptoms of hemophilia, including bleeding. Clotting factors are proteins in the blood that work together with platelets to stop or control bleeding. Very rarely, a girl may be born with a very low clotting factor level and have a greater risk for bleeding, similar to boys who have hemophilia and very low levels of clotting factor. There are several hereditary and genetic causes of this much rarer form of hemophilia in females. Some males who have the disorder are born to mothers who aren't carriers. In these cases, a mutation (random change) occurs in the gene as it is passed to the child. Below are two examples of how the hemophilia gene is inherited. Inheritance Pattern for Hemophilia—Example 1 Each daughter has a 50 percent chance of inheriting the hemophilia gene from her mother and being a carrier. Each son has a 50 percent chance of inheriting the hemophilia gene from his mother and having hemophilia. Inheritance Pattern for Hemophilia—Example 2 Each daughter will inherit the hemophilia gene from her father and be a carrier. None of the sons will inherit the hemophilia gene from their father; thus, none will have hemophilia. Signs & Symptoms The major signs and symptoms of hemophilia are excessive bleeding and easy bruising. Excessive Bleeding The extent of bleeding depends on how severe the hemophilia is. Children who have mild hemophilia may not have signs unless they have excessive bleeding from a dental procedure, an accident, or surgery. Males who have severe hemophilia may bleed heavily after circumcision. Bleeding can occur on the body's surface (external bleeding) or inside the body (internal bleeding). Signs of external bleeding may include: Bleeding in the mouth from a cut or bite or from cutting or losing a tooth Nosebleeds for no obvious reason Heavy bleeding from a minor cut Bleeding from a cut that resumes after stopping for a short time Signs of internal bleeding may include: Blood in the urine (from bleeding in the kidneys or bladder) Blood in the stool (from bleeding in the intestines or stomach) Large bruises (from bleeding into the large muscles of the body) Bleeding in the Joints Bleeding in the knees, elbows, or other joints is another common form of internal bleeding in people who have hemophilia. This bleeding can occur without obvious injury. At first, the bleeding causes tightness in the joint with no real pain or any visible signs of bleeding. The joint then becomes swollen, hot to touch, and painful to bend. Swelling continues as bleeding continues. Eventually, movement in the joint is temporarily lost. Pain can be severe. Joint bleeding that isn't treated quickly can damage the joint. Bleeding in the Brain Internal bleeding in the brain is a very serious complication of hemophilia. It can happen after a simple bump on the head or a more serious injury. The signs and symptoms of bleeding in the brain include: Long-lasting, painful headaches or neck pain or stiffness Repeated vomiting Sleepiness or changes in behavior Sudden weakness or clumsiness of the arms or legs or problems walking Double vision Convulsions or seizures Diagnosis If you or your child appears to have a bleeding problem, your doctor will ask about your personal and family medical histories. This will reveal whether you or your family members, including women and girls, have bleeding problems. However, some people who have hemophilia have no recent family history of the disease. You or your child also will likely have a physical exam and blood tests to diagnose hemophilia. Blood tests are used to find out: How long it takes for your blood to clot Whether your blood has low levels of any clotting factors Whether any clotting factors are completely missing from your blood The test results will show whether you have hemophilia, what type of hemophilia you have, and how severe it is. Hemophilia A and B are classified as mild, moderate, or severe, depending on the amount of clotting factor VIII or IX in the blood. The severity of symptoms can overlap between the categories. For example, some people who have mild hemophilia may have bleeding problems almost as often or as severe as some people who have moderate hemophilia. Severe hemophilia can cause serious bleeding problems in babies. Thus, children who have severe hemophilia usually are diagnosed during the first year of life. People who have milder forms of hemophilia may not be diagnosed until they're adults. The bleeding problems of hemophilia A and hemophilia B are the same. Only special blood tests can tell which type of the disorder you or your child has. Knowing which type is important because the treatments are different. Pregnant women who are known hemophilia carriers can have the disorder diagnosed in their unborn babies as early as 12 weeks into their pregnancies. Women who are hemophilia carriers also can have "preimplantation diagnosis" to have children who don't have hemophilia. For this process, women have their eggs removed and fertilized by sperm in a laboratory. The embryos are then tested for hemophilia. Only embryos without the disorder are implanted in the womb. Treatments Treatment With Replacement Therapy The main treatment for hemophilia is called replacement therapy. Concentrates of clotting factor VIII (for hemophilia A) or clotting factor IX (for hemophilia B) are slowly dripped or injected into a vein. These infusions help replace the clotting factor that's missing or low. Clotting factor concentrates can be made from human blood. The blood is treated to prevent the spread of diseases, such as hepatitis. With the current methods of screening and treating donated blood, the risk of getting an infectious disease from human clotting factors is very small. To further reduce the risk, you or your child can take clotting factor concentrates that aren't made from human blood. These are called recombinant clotting factors. Clotting factors are easy to store, mix, and use at home—it only takes about 15 minutes to receive the factor. You may have replacement therapy on a regular basis to prevent bleeding. This is called preventive or prophylactic (PRO-fih-lac-tik) therapy. Or, you may only need replacement therapy to stop bleeding when it occurs. This use of the treatment, on an as-needed basis, is called demand therapy. Demand therapy is less intensive and expensive than preventive therapy. However, there's a risk that bleeding will cause damage before you receive the demand therapy. Complications of Replacement Therapy Complications of replacement therapy include: Developing antibodies (proteins) that attack the clotting factor Developing viral infections from human clotting factors Damage to joints, muscles, or other parts of the body resulting from delays in treatment Antibodies to the clotting factor. Antibodies can destroy the clotting factor before it has a chance to work. This is a very serious problem. It prevents the main treatment for hemophilia (replacement therapy) from working. These antibodies, also called inhibitors, develop in about 20–30 percent of people who have severe hemophilia A. Inhibitors develop in 2–5 percent of people who have hemophilia B. When antibodies develop, doctors may use larger doses of clotting factor or try different clotting factor sources. Sometimes the antibodies go away. Researchers are studying new ways to deal with antibodies to clotting factors. Viruses from human clotting factors. Clotting factors made from human blood can carry the viruses that cause HIV/AIDS and hepatitis. However, the risk of getting an infectious disease from human clotting factors is very small due to: Careful screening of blood donors Testing of donated blood products Treating donated blood products with a detergent and heat to destroy viruses Vaccinating people who have hemophilia for hepatitis A and B Damage to joints, muscles, and other parts of the body. Delays in treatment can cause damage such as: Bleeding into a joint. If this happens many times, it can lead to changes in the shape of the joint and impair the joint's function. Swelling of the membrane around a joint. Pain, swelling, and redness of a joint. Pressure on a joint from swelling, which can destroy the joint. Home Treatment With Replacement Therapy You can do both preventive (ongoing) and demand (as-needed) replacement therapy at home. Many people learn to do the infusions at home for their child or for themselves. Home treatment has several advantages: You or your child can get quicker treatment when bleeding happens. Early treatment lowers the risk of complications. Fewer visits to the doctor or emergency room are needed. Home treatment costs less than treatment in a medical care setting. Home treatment helps children accept treatment and take responsibility for their own health. Discuss options for home treatment with your doctor or your child's doctor. A doctor or other health care provider can teach you the steps and safety procedures for home treatment. Hemophilia treatment centers are another good resource for learning about home treatment (discussed in "Living With Hemophilia”). Doctors can surgically implant vein access devices to make it easier for you to access a vein for treatment with replacement therapy. These devices can be helpful if treatment occurs often. However, infections can be a problem with these devices. Your doctor can help you decide whether this type of device is right for you or your child. Other Types of Treatment Desmopressin Desmopressin (DDAVP) is a man-made hormone used to treat people who have mild hemophilia A. DDAVP isn't used to treat hemophilia B or severe hemophilia A. DDAVP stimulates the release of stored factor VIII and von Willebrand factor; it also increases the level of these proteins in your blood. Von Willebrand factor carries and binds factor VIII, which can then stay in the bloodstream longer. DDAVP usually is given by injection or as nasal spray. Because the effect of this medicine wears off if it's used often, the medicine is given only in certain situations. For example, you may take this medicine prior to dental work or before playing certain sports to prevent or reduce bleeding. Antifibrinolytic Medicines Antifibrinolytic medicines (including tranexamic acid and epsilon aminocaproic acid) may be used with replacement therapy. They're usually given as a pill, and they help keep blood clots from breaking down. These medicines most often are used before dental work or to treat bleeding from the mouth or nose or mild intestinal bleeding. Gene Therapy Researchers are trying to find ways to correct the faulty genes that cause hemophilia. Gene therapy hasn't yet developed to the point that it's an accepted treatment for hemophilia. However, researchers continue to test gene therapy in clinical trials. For more information, go to the "Clinical Trials" section of this article. Treatment of a Specific Bleeding Site Pain medicines, steroids, and physical therapy may be used to reduce pain and swelling in an affected joint. Talk with your doctor or pharmacist about which medicines are safe for you to take. Which Treatment Is Best for You? The type of treatment you or your child receives depends on several things, including how severe the hemophilia is, the activities you'll be doing, and the dental or medical procedures you'll be having. Mild hemophilia—Replacement therapy usually isn't needed for mild hemophilia. Sometimes, though, DDAVP is given to raise the body's level of factor VIII. Moderate hemophilia—You may need replacement therapy only when bleeding occurs or to prevent bleeding that could occur when doing certain activities. Your doctor also may recommend DDAVP prior to having a procedure or doing an activity that increases the risk of bleeding. Severe hemophilia—You usually need replacement therapy to prevent bleeding that could damage your joints, muscles, or other parts of your body. Typically, replacement therapy is given at home two or three times a week. This preventive therapy usually is started in patients at a young age and may need to continue for life. For both types of hemophilia, getting quick treatment for bleeding is important. Quick treatment can limit damage to your body. If you or your child has hemophilia, learn to recognize signs of bleeding. Other family members also should learn to watch for signs of bleeding in a child who has hemophilia. Children sometimes ignore signs of bleeding because they want to avoid the discomfort of treatment. Living With If you or your child has hemophilia, you can take steps to prevent bleeding problems. Thanks to improvements in treatment, a child who has hemophilia today is likely to live a normal lifespan. Hemophilia Treatment Centers The Federal Government funds a nationwide network of hemophilia treatment centers (HTCs). These centers are an important resource for people who have hemophilia and their families. The medical experts at HTCs provide treatment, education, and support. They can teach you or your family members how to do home treatments. Center staff also can provide your doctor with information. People who get care at HTCs are less likely than those who get care elsewhere to have bleeding complications and hospitalizations. They're also more likely to have a better quality of life. This may be due to the centers' emphasis on bleeding prevention and the education and support provided to patients and their caregivers. More than 100 federally funded HTCs are located throughout the United States. Many HTCs are located at major university medical and research centers. The hemophilia teams at these centers include: Nurse coordinators Pediatricians (doctors who treat children) and adult and pediatric hematologists (doctors who specialize in blood disorders) Social workers (who can help with financial issues, transportation, mental health, and other issues) Physical therapists and orthopedists (doctors who specialize in disorders of the bones and joints) Dentists To find an HTC located near you, go to the directory of HTCs on the Centers for Disease Control and Prevention's Web site. Many people who have hemophilia go to HTCs for annual checkups, even if it means traveling some distance to do so. At an HTC, you or your child may be able to take part in clinical research and benefit from the latest hemophilia research findings. The HTC team also will work with your local health care providers to help meet your needs or your child's needs. Ongoing Care If you have hemophilia, you can take steps to avoid complications. For example: Follow your treatment plan exactly as your doctor prescribes. Have regular checkups and vaccinations as recommended. Tell all of your health care providers—such as your doctor, dentist, and pharmacist—that you have hemophilia. You also may want to tell people like your employee health nurse, gym trainer, and sports coach about your condition. Have regular dental care. Dentists at the HTCs are experts in providing dental care for people who have hemophilia. If you see another dentist, tell him or her that you have hemophilia. The dentist can provide medicine that will reduce bleeding during dental work. Know the signs and symptoms of bleeding in joints and other parts of the body. Know when to call your doctor or go to the emergency room. For example, you'll need care if you have: - Heavy bleeding that can't be stopped or a wound that continues to ooze blood. - Any signs or symptoms of bleeding in the brain. Such bleeding is life threatening and requires emergency care. - Limited motion, pain, or swelling of any joint. Heavy bleeding that can't be stopped or a wound that continues to ooze blood. Any signs or symptoms of bleeding in the brain. Such bleeding is life threatening and requires emergency care. Limited motion, pain, or swelling of any joint. It's a good idea to keep a record of all previous treatments. Be sure to take this information with you to medical appointments and to the hospital or emergency room. If Your Child Is Diagnosed With Hemophilia You may have emotional, financial, social, or other strains as you adjust to having a child who has hemophilia. Learn all you can about the disorder and get the support you need. Talk with doctors and other health care providers about treatment, prevention of bleeding, and what to do during an emergency. The care teams at HTCs can provide your child with treatment and help educate and support you. The social worker on the team can help with emotional issues, financial and transportation problems, and other concerns. Seek the many resources available through the Web, books, and other materials, including those provided by national and local hemophilia organizations. Look into support groups that offer a variety of activities for children who have hemophilia and for family members. Some groups offer summer camps for children who have hemophilia. Ask your doctor, nurse coordinator, or social worker about these groups and camps. Challenges will occur as your child grows and becomes more active. In addition to treatment and regular health and dental care, your child needs information about hemophilia that he or she can understand. Children who have hemophilia also need ongoing support, and they need to be reassured that the condition isn't their fault. Young children who have hemophilia need extra protection from things in the home and elsewhere that could cause injuries and bleeding: Protect toddlers with kneepads, elbow pads, and protective helmets. All children should wear safety helmets when riding tricycles or bicycles. Be sure to use the safety belts and straps in highchairs, car seats, and strollers to protect your child from falls. Remove furniture with sharp corners or pad them while your child is a toddler. Keep out of reach or locked away small and sharp objects and other items that could cause bleeding or harm. Check play equipment and outdoor play areas for possible hazards. You also should learn how to examine your child for and recognize signs of bleeding. Learn to prepare for bleeding episodes when they occur. Keep a cold pack in the freezer ready to use as directed or to take along with you to treat bumps and bruises. Popsicles work fine when there is minor bleeding in the mouth. You also might want to keep a bag ready to go with items you'll need if you must take your child to the emergency room or elsewhere. Be sure that anyone who is responsible for your child knows that he or she has hemophilia. Talk with your child's babysitters, daycare providers, teachers, other school staff, and coaches or leaders of afterschool activities about when to contact you or to call 9–1–1 for emergency care. Your child should wear a medical ID bracelet or necklace. If your child is injured, the ID will alert anyone caring for your child about his or her hemophilia. Physical Activity and Hemophilia Physical activity helps keep muscles flexible, strengthens joints, and helps maintain a healthy weight. Children and adults who have hemophilia should be physically active, but they may have limits on what they can do safely. People who have mild hemophilia can take part in many activities. Those who have severe hemophilia should avoid contact sports and other activities that are likely to lead to injuries that could cause bleeding. Examples of these activities include football, hockey, and wrestling. Physical therapists at HTCs can develop exercise programs tailored to your needs and teach you how to exercise safely. Talk with your doctor or physical therapist about recommended types of physical activity and sports. In general, some safe physical activities are swimming, biking (wearing a helmet), walking, and golf. To prevent bleeding, you also may be able to take clotting factors prior to exercise or a sporting event. Medicine Precautions Some medicines increase the risk of bleeding, such as: Aspirin and other medicines that contain salicylates (sa-LIH-sil-ates) Ibuprofen, naproxen, and some other nonsteroidal anti-inflammatory medicines Talk with your doctor or pharmacist about which medicines are safe for you to take. Treatment at Home and When Traveling Home treatment with replacement therapy has many benefits. It lets you treat bleeding early, before complications are likely to develop. Home treatment also can prevent frequent trips to the doctor's office or hospital. This can give you more independence and control over your hemophilia. However, if you're treating yourself or your child with clotting factors at home, you should take some steps for safety: Follow instructions for storage, preparation, and use of clotting factors and treatment materials. Keep a record of all medical treatment. Know the signs and symptoms of bleeding, infection, or an allergic reaction, and know the correct way to respond. Have someone with you when you treat yourself. Know when to call the doctor or 9–1–1. When you're traveling, be sure to take enough treatment supplies along. You also should carry a letter from your doctor describing your hemophilia and treatment. It's a good idea to find out in advance where to go for care when out of town. Cost Issues Clotting factors are very costly. Many health insurance companies will only pay for clotting factors on a case-by-case basis. It's important to know: What your insurance covers Whether your insurance has a limit on the dollar amount it will cover and what that amount is Whether restrictions or waiting periods apply As children grow, it's important to learn about available options for insurance. Look into what kinds of health insurance are offered when seeking a job. how is hemophilia treated

how is hemophilia treated

Hemophilia A (Treatment): People with inherited hemophilia A require life-long care, preferably through a specialized hemophilia treatment center. Although there is no cure for hemophilia A, current treatments usually work well. Treatment primarily consists of replacing the missing clotting factor VIII ( replacement therapy) and preventing complications that are associated with the disorder. The type and frequency of treatment often depends on the severity of the disorder in each person. People with mild or moderate hemophilia A may be treated with replacement therapy as needed (for example, when a specific bleeding episode occurs). This is called episodic therapy. Some people with mild hemophilia A may be treated with desmopressin (DDAVP). Desmopressin raises the levels of factor VIII in the blood and may be taken intravenously or through a nasal spray. Drugs known as antifibrinolytics, which slow the breakdown of clotting factors in the blood, can also be used to treat those with a mild form of the disorder. Some people with severe hemophilia A may receive periodic factor VIII infusions to prevent bleeding episodes and associated complications such as joint damage.

Hemophilia A Hemophilia, classic HEM A Classic hemophilia Hemophilia, classic HEM A Classic hemophilia Factor 8 deficiency Factor VIII deficiency Classical hemophilia Haemophilia A Hemophilia A, congenital See More Summary Hemophilia A is an inherited bleeding disorder in which the blood does not clot normally. [1] [2] [3] People with hemophilia A will bleed more than normal after an injury, surgery, or dental procedure. This disorder can be severe, moderate, or mild. In severe cases, heavy bleeding occurs after minor injury or even when there is no injury (spontaneous bleeding). Bleeding into the joints, muscles, brain, or organs can cause pain and other serious complications. In milder forms, there is no spontaneous bleeding, and the disorder might only be diagnosed after a surgery or serious injury. Hemophilia A is caused by having low levels of a protein called factor VIII. Factor VIII is needed to form blood clots. The disorder is inherited in an X-linked recessive manner and is caused by changes ( mutations ) in the F8 gene. [1] [2] The diagnosis of hemophilia A is made through clinical symptoms and specific laboratory tests to measure the amount of clotting factors in the blood. The main treatment is replacement therapy, during which clotting factor VIII is dripped or injected slowly into a vein. [2] [3] Hemophilia A mainly affects males. With treatment, most people with this disorder do well. Some people with severe hemophilia A may have a shortened lifespan due to the presence of other health conditions and rare complications of the disorder. [3] Symptoms The symptoms of hemophilia A and the age symptoms appear vary depending on the amount of factor VIII a person's body makes. Infants with the severe form may bleed abnormally from their mouth and develop 'goose eggs' on their heads (collections of blood under the scalp). Other symptoms of the severe form include bleeding without any known cause (spontaneous bleeding) into the muscles, joints, and organs . Children with the moderate form may bruise easily and bleed too much after minor injuries, dental work, or surgery. People with the mild form of hemophilia A may not be diagnosed until they bleed more than normal after a major injury or surgery. With the mild form, there are no episodes of spontaneous bleeds. [1] [2] This table lists symptoms that people with this disease may have. For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. This information comes from a database called the Human Phenotype Ontology (HPO) . The HPO collects information on symptoms that have been described in medical resources. The HPO is updated regularly. Use the HPO ID to access more in-depth information about a symptom. Showing of Medical Terms Other Names Learn More: HPO ID 80%-99% of people have these symptoms Arthralgia Joint pain 0002829 Bleeding with minor or no trauma Easy bleeding 0011889 Joint swelling 0001386 Reduced factor VIII activity 0003125 30%-79% of people have these symptoms Oral cavity bleeding Bleeding from mouth 0030140 Spontaneous hematomas 0007420 Thromboembolism 0001907 5%-29% of people have these symptoms Abnormality of the elbow Abnormality of the elbows 0009811 Gastrointestinal hemorrhage Gastrointestinal bleeding 0002239 Intramuscular hematoma 0012233 Intraventricular hemorrhage 0030746 Joint hemorrhage Bleeding within a joint Hemarthrosis 0005261 1%-4% of people have these symptoms Splenic rupture Ruptured spleen 0012223 Percent of people who have these symptoms is not available through HPO Bruising susceptibility Bruise easily Easy bruisability Easy bruising 0000978 Osteoarthritis Degenerative joint disease 0002758 Persistent bleeding after trauma Excessive bleeding after minor trauma Frequent bleeding with trauma Prolonged bleeding after minor trauma 0001934 Prolonged partial thromboplastin time 0003645 X-linked recessive inheritance 0001419 Showing of Cause Hemophilia A is caused by genetic changes ( mutations ) in the F8 gene. This gene is responsible for making the Factor VIII protein , an important protein that helps start the formation of blood clots. Mutations in the F8 gene lead to reduced or absent levels of Factor VIII in the blood, making it hard for the body to form blood clots. [1] [2] Inheritance The F8 gene is located on the X- chromosome . Therefore, hemophilia A is inherited in an X-linked recessive pattern. [1] [2] In males (who have only one X chromosome ), one mutated copy of the F8 gene in each cell is enough to cause hemophilia A. In females (who have two X chromosomes), a mutation needs to occur in both copies of the F8 gene to cause the disorder. Because it is unlikely that females will have two mutated copies of this gene, hemophilia A, like other X-linked recessive disorders, affects males much more frequently than females. Females who have a mutation in one copy of the F8 gene are called carriers . Most carriers have no signs or symptoms, however about 10% of female carriers of hemophilia A will experience some abnormal bleeding. [2] A female who carries one F8 gene mutation has a 50% or 1 in 2 chance of having a son with hemophilia A. A male with hemophilia A cannot pass on the disorder to his sons, but all of his daughters will be carriers for hemophilia A. [1] When a male child is the first person in a family with hemophilia A, further testing may be needed to determine if the child inherited the disorder from his mother, or if the mutation occurred by chance for the first time in the child. [2] Diagnosis The diagnosis of hemophilia A is made through the clinical symptoms and confirmed by laboratory testing. Blood tests are done to measure the time it takes the blood to clot and the amount of clotting factors found in the blood. [4] Genetic testing can also help determine the exact change in the F8 gene and can be helpful for identifying other family members at risk for hemophilia A. [2] Testing Resources The Genetic Testing Registry (GTR) provides information about the genetic tests for this condition. The intended audience for the GTR is health care providers and researchers. Patients and consumers with specific questions about a genetic test should contact a health care provider or a genetics professional. Treatment People with inherited hemophilia A require life-long care, preferably through a specialized hemophilia treatment center. [2] [4] These centers are located around the United States and can be found through the Centers for Disease Control and Prevention. The National Hemophilia Foundation has links to management and treatment guidelines. There is no cure for hemophilia A, but current treatments can prevent many of the symptoms of hemophilia A [4]. Treatment may include medications and replacing the missing clotting factor (replacement therapy). This type of replacement therapy is done by slowing injecting or dripping concentrated factor VIII into a vein (intravenous infusion). The type and frequency of treatment often depends on the severity of the disorder in each person. [2] [5] People with mild or moderate hemophilia A may be treated with replacement therapy as needed (for example, when a bleeding episode occurs). This is called 'on-demand' therapy. Some people with mild hemophilia A may be treated with desmopressin (DDAVP). [2] [4] Desmopressin raises the levels of factor VIII in the blood and may be given directly into a vein or through a nasal spray. Drugs known as antifibrinolytics, which slow the breakdown of clotting factors in the blood, can also be used to treat a mild form of the disorder. [4] Some people with severe hemophilia A may receive regular factor VIII replacement therapy to prevent bleeding episodes and other complications such as joint damage. This is referred to as prophylactic or preventative therapy. These factor VIII infusions may be done as often as necessary depending on the severity. [2] [4] The immune system of some people with the severe form of hemophilia A may start to make antibodies (inhibitors) that prevent the replacement factor VIII from working. [4] [5] Treatment for these people includes larger doses of replacement factor VIII and/or medications that may help block the inhibitors. [5] Infusions of replacement Factor VIII can be given at home. This is especially important for people with severe disease because the infusion works the best within one hour of a bleeding episode. In general, prompt treatment is important because it reduces pain and damage to the joints, muscles, or other affected tissues or organs . [4] FDA-Approved Treatments The medication(s) listed below have been approved by the Food and Drug Administration (FDA) as orphan products for treatment of this condition. Learn more orphan products. National Library of Medicine Drug Information Portal National Library of Medicine Drug Information Portal National Library of Medicine Drug Information Portal National Library of Medicine Drug Information Portal National Library of Medicine Drug Information Portal National Library of Medicine Drug Information Portal Medline Plus Health Information Prognosis Hemophilia A can be mild, moderate, or severe, depending on how much clotting factor VIII is in a person's blood. About 50-60% of people with hemophilia A have the severe form of the disorder. [4] With education and treatment, people with hemophilia A can live healthy and active lives. Life expectancy may depend on the response to treatment and the presence of other health conditions. Life-threatening complications of hemophilia A include bleeding within the skull (intracranial hemorrhage) and bleeding into the soft tissue around important organs . Chronic, debilitating joint disease may also develop. [4] Statistics About 1/5000 -1/6000 people in the US are born with hemophilia A. This disorder affects males more than females, and occurs equally in all races and ethnic groups. [4] [5] Find a Specialist If you need medical advice, you can look for doctors or other healthcare professionals who have experience with this disease. You may find these specialists through advocacy organizations, clinical trials, or articles published in medical journals. You may also want to contact a university or tertiary medical center in your area, because these centers tend to see more complex cases and have the latest technology and treatments. If you can't find a specialist in your local area, try contacting national or international specialists. They may be able to refer you to someone they know through conferences or research efforts. Some specialists may be willing to consult with you or your local doctors over the phone or by email if you can't travel to them for care. You can find more tips in our guide, How to Find a Disease Specialist. We also encourage you to explore the rest of this page to find resources that can help you find specialists. Healthcare Resources To find a medical professional who specializes in genetics, you can ask your doctor for a referral or you can search for one yourself. Online directories are provided by the American College of Medical Genetics and the National Society of Genetic Counselors. If you need additional help, contact a GARD Information Specialist. You can also learn more about genetic consultations from Genetics Home Reference. Related Diseases Related diseases are conditions that have similar signs and symptoms. A health care provider may consider these conditions in the table below when making a diagnosis. Please note that the table may not include all the possible conditions related to this disease. Conditions with similar signs and symptoms from Orphanet The differential diagnosis should include von Willebrand disease (see this term) and other coagulation anomalies leading to prolonged blood coagulation times. Visit the Orphanet disease page for more information. how is hemophilia treated

how is hemophilia treated

Hemophilia A (Treatment): Treatment includes replacing the missing clotting factor. You will receive factor VIII concentrates. How much you get depends on: - Severity of bleeding - Site of bleeding - Your weight and height Mild hemophilia may be treated with desmopressin (DDAVP). This medicine helps the body release factor VIII that is stored within the lining of blood vessels. To prevent a bleeding crisis, people with hemophilia and their families can be taught to give factor VIII concentrates at home at the first signs of bleeding. People with severe forms of the disease may need regular preventive treatment. DDAVP or factor VIII concentrate may also be needed before having dental extractions or surgery. You should get the hepatitis B vaccine. People with hemophilia are more likely to get hepatitis B because they may receive blood products.

Hemophilia A Factor VIII deficiency Classic hemophilia Bleeding disorder - hemophilia A Summary Hemophilia A is a hereditary bleeding disorder caused by a lack of blood clotting factor VIII. Without enough factor VIII, the blood cannot clot properly to control bleeding. Causes When you bleed, a series of reactions take place in the body that helps blood clots form. This process is called the coagulation cascade. It involves special proteins called coagulation, or clotting, factors. You may have a higher chance of excess bleeding if one or more of these factors are missing or are not functioning like they should. Factor VIII (eight) is one such coagulation factor. Hemophilia A is the result of the body not making enough factor VIII. Hemophilia A is caused by an inherited X-linked recessive trait, with the defective gene located on the X chromosome. Females have two copies of the X chromosome. So if the factor VIII gene on one chromosome does not work, the gene on the other chromosome can do the job of making enough factor VIII. Males have only one X chromosome. If the factor VIII gene is missing on a boy's X chromosome, he will have hemophilia A. For this reason, most people with hemophilia A are male. If a woman has a defective factor VIII gene, she is considered a carrier. This means the defective gene can be passed down to her children. Boys born to such women have a 50% chance of having hemophilia A. Their daughters have a 50% chance of being a carrier. All female children of men with hemophilia carry the defective gene. Risk factors for hemophilia A include: Family history of bleeding Being male Symptoms Severity of symptoms vary. Prolonged bleeding is the main symptom. It is often first seen when an infant is circumcised. Other bleeding problems usually show up when the infant starts crawling and walking. Mild cases may go unnoticed until later in life. Symptoms may first occur after surgery or injury. Internal bleeding may occur anywhere. Symptoms can include: Bleeding into joints with associated pain and swelling Blood in the urine or stool Bruising Gastrointestinal tract and urinary tract bleeding Nosebleeds Prolonged bleeding from cuts, tooth extraction, and surgery Bleeding that starts without cause Exams and Tests If you are the first person in the family to have a suspected bleeding disorder, your health care provider will order a series of tests called a coagulation study. Once the specific defect has been identified, other people in your family will need tests to diagnose the disorder. Tests to diagnose hemophilia A include: Prothrombin time Bleeding time Fibrinogen level Partial thromboplastin time (PTT) Serum factor VIII activity Treatment Treatment includes replacing the missing clotting factor. You will receive factor VIII concentrates. How much you get depends on: Severity of bleeding Site of bleeding Your weight and height Mild hemophilia may be treated with desmopressin (DDAVP). This medicine helps the body release factor VIII that is stored within the lining of blood vessels. To prevent a bleeding crisis, people with hemophilia and their families can be taught to give factor VIII concentrates at home at the first signs of bleeding. People with severe forms of the disease may need regular preventive treatment. DDAVP or factor VIII concentrate may also be needed before having dental extractions or surgery. You should get the hepatitis B vaccine. People with hemophilia are more likely to get hepatitis B because they may receive blood products. Some people with hemophilia A develop antibodies to factor VIII. These antibodies are called inhibitors. The inhibitors attack factor VIII so that it no longer works. In such cases, a man-made clotting factor called VIIa can be given. Support Groups You can ease the stress of illness by joining a hemophilia support group. Sharing with others who have common experiences and problems can help you not feel alone. Outlook (Prognosis) With treatment, most people with hemophilia A are able to lead a fairly normal life. If you have hemophilia A, you should have regular checkups with a hematologist. Possible Complications Complications may include: Long-term joint problems, which may require a joint replacement Bleeding in the brain (intracerebral hemorrhage) Blood clots due to treatment When to Contact a Medical Professional Call your provider if: Symptoms of a bleeding disorder develops A family member has been diagnosed with hemophilia A You have hemophilia A and you plan to have children; genetic counseling is available Prevention Genetic counseling may be recommended. Testing can identify women and girls who carry the hemophilia gene. Identify women and girls who carry the hemophilia gene. Testing can be done during pregnancy on a baby in the mother's womb. Review Date 1/19/2018 Updated by: Richard LoCicero, MD, private practice specializing in hematology and medical oncology, Longstreet Cancer Center, Gainesville, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how is hemophilia treated

how is hemophilia treated

Hemophilia (Treatment): The most common treatment is to replace the missing clotting factor in the blood through a vein (intravenous infusions). Special care during surgery needs to be taken if you have this bleeding disorder. So, be sure to tell your surgeon that you have this disorder. It is also very important to share information about your disorder with blood relatives as they may also be affected.

Hemophilia Hemophilia A Classic hemophilia Factor VIII deficiency Hemophilia B Christmas disease Factor IX deficiency Bleeding disorder - hemophilia Summary Hemophilia refers to a group of bleeding disorders in which blood clotting takes a long time. There are two forms of hemophilia: Hemophilia A (classic hemophilia, or factor VIII deficiency) Hemophilia B (Christmas disease, or factor IX deficiency) Causes When you bleed, a series of reactions take place in the body that helps blood clots form. This process is called the coagulation cascade. It involves special proteins called coagulation, or clotting factors. You may have a higher chance of excess bleeding if one or more of these factors are missing or aren't functioning like they should. Hemophilia is caused by the lack of clotting factor VIII or IX in the blood. In most cases, hemophilia is passed down through families (inherited). Most of the time, it is passed to male children. Symptoms The main symptom of hemophilia is bleeding. Mild cases may not be detected until later in life, after excessive bleeding following surgery or an injury. In the worst cases, bleeding occurs for no reason. Internal bleeding may occur anywhere and bleeding into joints is common. Exams and Tests Most often, hemophilia is diagnosed after a person has an abnormal bleeding episode. It can also be diagnosed by a blood test done to detect the problem, if other family members have the condition. Treatment The most common treatment is to replace the missing clotting factor in the blood through a vein (intravenous infusions). Special care during surgery needs to be taken if you have this bleeding disorder. So, be sure to tell your surgeon that you have this disorder. It is also very important to share information about your disorder with blood relatives as they may also be affected. Support Groups Joining a support group where members share common issues can relieve the stress of a long-term (chronic) disease. Outlook (Prognosis) Most people with hemophilia are able to do normal activities. But some people have bleeding into the joints, which may limit their activity. A small number of people with hemophilia may die of severe bleeding. Review Date 2/1/2017 Updated by: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how is hemophilia treated

how is hemophilia treated

A diagnosis of Klinefelter syndrome is often suspected based on the presence of characteristic signs and symptoms. Additional testing can then be ordered to confirm the diagnosis. This generally includes a chromosomal analysis (called a karyotype ). [3] [5] It is also possible to diagnosis Klinefelter syndrome before birth through chorionic villous sampling or amniocentesis.

Klinefelter syndrome Klinefelter's syndrome XXY syndrome 47,XXY syndrome Summary Klinefelter syndrome (KS) is a condition that occurs in males when they have an extra X chromosome . Some males with KS have no obvious signs or symptoms while others may have varying degrees of cognitive, social, behavioral, and learning difficulties. Adults with Klinefelter syndrome may also have primary hypogonadism (decreased testosterone production), small and/or undescendent testes (cryptorchidism), enlarged breast tissue ( gynecomastia ), tall stature, and/or inability to have biological children (infertility), as well as an abnormal opening of the penis (hypospadias), and an small penis (micropenis). KS is not inherited , but usually occurs as a random event during the formation of reproductive cells (eggs and sperm) that results in the presence of one extra copy of the X chromosome in each cell (47,XXY). KS treatment is based on the signs and symptoms present in each person. [1] [2] [3] Life expectancy is usually normal and many people with KS have normal life. There is a very small risk of developing breast cancer and other conditions such as a chronic inflammatory disease called systemic lupus erythematosus. [3] In some cases, there is more than one X chromosome in each cell (for example, 48,XXXY or 49,XXXXY). These conditions, which are often called "variants of Klinefelter" syndrome usually have more serious problems ( intellectual disability , skeletal problems, and poor coordination) than classic Klinefelter syndrome (47,XXY). [3] Symptoms The signs and symptoms of Klinefelter syndrome (KS) vary among affected people. Some men with KS have no symptoms of the condition or are only mildy affected. In these cases, they may not even know that they are affected by KS. When present, symptoms may include: [1] [2] [3] Small, firm testicles Delayed or incomplete puberty with lack of secondary sexual characteristics resulting in sparse facial, body, or sexual hair a high-pitched voice and body fat distribution resulting in a rounder, lower half of the body, with more fat deposited in the hips, buttocks and thigh instead of around the chest and abdomen Breast growth ( gynecomastia ) Reduced facial and body hair Infertility Tall stature Abnormal body proportions (long legs, short trunk, shoulder equal to hip size) Learning disablity Speech delay Crypthochirdism Opening (meatus) of the urethra (the tube that carries urine and sperm through the penis to the outside) on the underside of the penis (hypospadias) instead of the tip of the head of the penis Social, psychologic and behavioral problems Whether or not a male with KS has visible symptoms depends on many factors, including how much testosterone his body makes, if he is mosaic (with both XY and XXY cells ), and his age when the condition is diagnosed and treated. [1] Some people have a slightly increased risk of developing breast cancer , a rare extragonadal germ cell tumor, lung disease, varicose veins and osteoporosis as well as some autoimmune disorders such as systemic lupus erythematosus, rheumatoid arthritis and Sjogren's syndrome. [2] [4] Some people with features of Klinefelter syndrome have more than one extra X chromosome in each cell (such as 48,XXXY or 49,XXXXY). In these cases, known as "variants of Klinefelter syndrome", the signs and symptoms can be more severe and may include: [1] [2] [4] Intellectual disability Distinctive facial features Skeletal abnormalities Poor coordination Severe speech difficulties Behavioral problems Heart defects Teeth problems. Cause Klinefelter syndrome usually occurs as a random event during the formation of reproductive cells (eggs and sperm). An error in cell division called nondisjunction results in a reproductive cell with an abnormal number of chromosomes . For example, an egg or sperm cell may gain one or more extra copies of the X chromosome as a result of nondisjunction. If one of these atypical reproductive cells contributes to the genetic makeup of a child, the child will have one or more extra X chromosomes in each of the body's cells. [2] Most often, Klinefelter syndrome is caused by a single extra copy of the X chromosome, resulting in a total of 47 chromosomes per cell. Males normally have one X chromosome and one Y chromosome in each cell (46, XY), while females have two X chromosomes (46, XX). People with Klinefelter syndrome usually have two X chromosomes and one Y chromosome (47, XXY). Some people with Klinefelter syndrome have the extra X chromosome in only some of their cells; these people are said to have mosaic Klinefelter syndrome. [2] It is estimated that about half of the time, the cell division error occurs during development of the sperm, while the remainder are due to errors in egg development. Women who have pregnancies after age 35 have a slightly increased chance of having offspring with this syndrome. [5] The features of Klinefelter syndrome are due to the extra copies of genes on the extra X chromosome, which can alter male sexual development. [3] Some people with features of Klinefelter syndrome have conditions known as "variants of Klinefelter syndrome" where there is more than one extra sex chromosome in each cell ( 48,XXXY, 48,XXYY and 49,XXXXY). [5] Inheritance Klinefelter syndrome is not inherited , but usually occurs as a random event during the formation of reproductive cells (eggs and sperm). An error in cell division called nondisjunction can result in reproductive cells with an abnormal number of chromosomes . For example, an egg or sperm cell may gain one or more extra copies of the X chromosome as a result of nondisjunction. If one of these reproductive cells contributes to the genetic makeup of a child, the child will have one or several extra X chromosomes in each of the body's cells. [2] Diagnosis A diagnosis of Klinefelter syndrome is often suspected based on the presence of characteristic signs and symptoms. Additional testing can then be ordered to confirm the diagnosis. This generally includes a chromosomal analysis (called a karyotype ). [3] [6] It is also possible to diagnosis Klinefelter syndrome before birth through chorionic villous sampling or amniocentesis . [6] Treatment Because symptoms of Klinefelter syndrome (KS) can sometimes be very mild, many people are never diagnosed or treated. When a diagnosis is made, treatment is based on the signs and symptoms present in each person, especially the problems related to hypogonadism , gynecomastia , and psychosocial problems. Treatment may include: [1] [3] [4] Testosterone replacement: About half of people with SK have low testosterone levels, which may be raised by taking supplemental testosterone. Having a more normal testosterone level can help affected people develop bigger muscles, a deeper voice, and facial and body hair, and may also increase sexual desire, enlarge the testes , improve mood, self-image, and behavior; it may also protect against osteoporosis and decrease the risks of autoimmune disease and breast cancer . Breast removal or reduction surgery. Educational interventions: As children, many people with Klinefelter syndrome qualify for special services to help them in school. Teachers can also help by using certain methods in the classroom, such as breaking bigger tasks into small steps. Several forms of therapy such as physical, speech, occupational, behavioral, mental health, and family therapy can often help reduce or eliminate some of the symptoms of Klinefelter syndrome such as poor muscle tone; speech and language problems; or low self-confidence. Prognosis Babies with the 47, XXY form of Klinefelter differ little from healthy children. The results of one study on non- mosaic XXY infants younger than 2 years indicated that most XXY babies had normal external genitalia and facial features with height and weight in the normal range. Genetic testing had been performed due to a delay in walking and/or speech. Early diagnosis of Klinefelter syndrome is shown to be important to monitor potential developmental problems. [4] Boys with the 47, XXY karyotype may struggle through adolescence with academics, various frustrations, and, in a few instances, serious emotional or behavioral difficulties. However, most move toward full independence from their families as they enter adulthood. Some have completed graduate education and have a normal level of functioning. Lifespan is not affected by Klinefelter syndrome. [4] Statistics It is estimated that 1 in every 500 to 1,000 newborn males has an extra X chromosome, making Klinefelter syndrome one of the most common chromosomal disorders seen among newborns. Variants of Klinefelter syndrome (such as 48,XXXY, 49,XXXXY) are much rarer, occurring in 1 in 50,000 to 1 in 85,000 or fewer newborns. [1] [7] It is suspected that Klinefelter syndrome is underdiagnosed because mild cases may not be identified. In addition, the features of this condition vary and can overlap significantly with those of other conditions. [7] how is klineflyers syndrome screened

how is klineflyers syndrome screened

Most cases of CCHD are sporadic, which means they occur in people with no history of the disorder in their family. However, close relatives (such as siblings) of people with CCHD may have an increased risk of being born with a heart defect compared with people in the general population.

Critical congenital heart disease CCHD critical congenital heart defects Description Critical congenital heart disease (CCHD) is a term that refers to a group of serious heart defects that are present from birth. These abnormalities result from problems with the formation of one or more parts of the heart during the early stages of embryonic development. CCHD prevents the heart from pumping blood effectively or reduces the amount of oxygen in the blood. As a result, organs and tissues throughout the body do not receive enough oxygen, which can lead to organ damage and life-threatening complications. Individuals with CCHD usually require surgery soon after birth. Although babies with CCHD may appear healthy for the first few hours or days of life, signs and symptoms soon become apparent. These can include an abnormal heart sound during a heartbeat (heart murmur), rapid breathing (tachypnea), low blood pressure (hypotension), low levels of oxygen in the blood (hypoxemia), and a blue or purple tint to the skin caused by a shortage of oxygen (cyanosis). If untreated, CCHD can lead to shock, coma, and death. However, most people with CCHD now survive past infancy due to improvements in early detection, diagnosis, and treatment. Some people with treated CCHD have few related health problems later in life. However, long-term effects of CCHD can include delayed development and reduced stamina during exercise. Adults with these heart defects have an increased risk of abnormal heart rhythms, heart failure, sudden cardiac arrest, stroke, and premature death. Each of the heart defects associated with CCHD affects the flow of blood into, out of, or through the heart. Some of the heart defects involve structures within the heart itself, such as the two lower chambers of the heart (the ventricles) or the valves that control blood flow through the heart. Others affect the structure of the large blood vessels leading into and out of the heart (including the aorta and pulmonary artery). Still others involve a combination of these structural abnormalities. People with CCHD have one or more specific heart defects. The heart defects classified as CCHD include coarctation of the aorta, double-outlet right ventricle, D-transposition of the great arteries, Ebstein anomaly, hypoplastic left heart syndrome, interrupted aortic arch, pulmonary atresia with intact septum, single ventricle, total anomalous pulmonary venous connection, tetralogy of Fallot, tricuspid atresia, and truncus arteriosus. Frequency Heart defects are the most common type of birth defect, accounting for more than 30 percent of all infant deaths due to birth defects. CCHD represents some of the most serious types of heart defects. About 7,200 newborns, or 18 per 10,000, in the United States are diagnosed with CCHD each year. Causes In most cases, the cause of CCHD is unknown. A variety of genetic and environmental factors likely contribute to this complex condition. Changes in single genes have been associated with CCHD. Studies suggest that these genes are involved in normal heart development before birth. Most of the identified mutations reduce the amount or function of the protein that is produced from a specific gene, which likely impairs the normal formation of structures in the heart. Studies have also suggested that having more or fewer copies of particular genes compared with other people, a phenomenon known as copy number variation, may play a role in CCHD. However, it is unclear whether genes affected by copy number variation are involved in heart development and how having missing or extra copies of those genes could lead to heart defects. Researchers believe that single-gene mutations and copy number variation account for a relatively small percentage of all CCHD. CCHD is usually isolated, which means it occurs alone (without signs and symptoms affecting other parts of the body). However, the heart defects associated with CCHD can also occur as part of genetic syndromes that have additional features. Some of these genetic conditions, such as Down syndrome, Turner syndrome, and 22q11.2 deletion syndrome, result from changes in the number or structure of particular chromosomes. Other conditions, including Noonan syndrome and Alagille syndrome, result from mutations in single genes. Environmental factors may also contribute to the development of CCHD. Potential risk factors that have been studied include exposure to certain chemicals or drugs before birth, viral infections (such as rubella and influenza) that occur during pregnancy, and other maternal illnesses including diabetes and phenylketonuria. Although researchers are examining risk factors that may be associated with this complex condition, many of these factors remain unknown. Inheritance Pattern Most cases of CCHD are sporadic, which means they occur in people with no history of the disorder in their family. However, close relatives (such as siblings) of people with CCHD may have an increased risk of being born with a heart defect compared with people in the general population. Sources for This Page Fahed AC, Gelb BD, Seidman JG, Seidman CE. Genetics of congenital heart disease: the glass half empty. Circ Res. 2013 Feb 15;112(4):707-20. doi: 10.1161/CIRCRESAHA.112.300853. Review. Erratum in: Circ Res. 2013 Jun 7;112(12):e182. how is congenital heart disease passed down

how is congenital heart disease passed down

Congenital heart disease can describe a number of different problems affecting the heart. heart defects may be part of genetic and chromosomal syndromes. Some of these syndromes may be passed down through families. Examples include: - DiGeorge syndrome - Down syndrome - Marfan syndrome - Noonan syndrome - Trisomy 13 - Turner syndrome Often, no cause for the heart disease can be found.

Congenital heart disease Summary Congenital heart disease (CHD) is a problem with the heart's structure and function that is present at birth. Causes CHD can describe a number of different problems affecting the heart. It is the most common type of birth defect. CHD causes more deaths in the first year of life than any other birth defects. CHD is often divided into two types: cyanotic (blue skin color caused by a lack of oxygen) and non-cyanotic. The following lists cover the most common CHDs: Cyanotic: Ebstein's anomaly Hypoplastic left heart Pulmonary atresia Tetralogy of Fallot Total anomalous pulmonary venous return Transposition of the great vessels Tricuspid atresia Truncus arteriosus Non-cyanotic: Aortic stenosis Bicuspid aortic valve Atrial septal defect (ASD) Atrioventricular canal (endocardial cushion defect) Coarctation of the aorta Patent ductus arteriosus (PDA) Pulmonic stenosis Ventricular septal defect (VSD) These problems may occur alone or together. Most children with CHD do not have other types of birth defects. However, heart defects may be part of genetic and chromosomal syndromes. Some of these syndromes may be passed down through families. Examples include: DiGeorge syndrome Down syndrome Marfan syndrome Noonan syndrome Edwards syndrome Trisomy 13 Turner syndrome Often, no cause for the heart disease can be found. CHDs continue to be investigated and researched. Drugs such as retinoic acid for acne, chemicals, alcohol, and infections (such as rubella) during pregnancy can contribute to some congenital heart problems. Poorly controlled blood sugar in women who have diabetes during pregnancy has also been linked to a high rate of congenital heart defects. Symptoms Symptoms depend on the condition. Although CHD is present at birth, the symptoms may not appear right away. Defects such as coarctation of the aorta may not cause problems for years. Other problems, such as a small VSD, ASD, or PDA may never cause any problems. Exams and Tests Most congenital heart defects are found during a pregnancy ultrasound. When a defect is found, a pediatric heart doctor, surgeon, and other specialists can be there when the baby is delivered. Having medical care ready at the delivery can mean the difference between life and death for some babies. Which tests are done on the baby depend on the defect and the symptoms. Treatment Which treatment is used, and how well the baby responds to it, depends on the condition. Many defects need to be followed carefully. Some will heal over time, while others will need to be treated. Some CHDs can be treated with medicine alone. Others need to be treated with one or more heart procedures or surgeries. Prevention Women who are pregnant should get good prenatal care: Avoid alcohol and illegal drugs during pregnancy. Tell your health care provider that you are pregnant before taking any new medicines. Have a blood test early in your pregnancy to see if you are immune to rubella. If you are not immune, avoid any possible exposure to rubella and get vaccinated right after delivery. Pregnant women who have diabetes should try to get good control over their blood sugar level. Certain genes may play a role in CHD. Many family members may be affected. Talk to your provider about genetic counseling and screening if you have a family history of CHD. Review Date 12/8/2017 Updated by: Steven Kang, MD, Director, Cardiac Electrophysiology, Alta Bates Summit Medical Center, Stanford Healthcare, Oakland, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how is congenital heart disease passed down

how is congenital heart disease passed down

critical congenital heart disease (Genetic Changes): In most cases, the cause of CCHD is unknown. A variety of genetic and environmental factors likely contribute to this complex condition. Changes in single genes have been associated with CCHD. Studies suggest that these genes are involved in normal heart development before birth. Most of the identified mutations reduce the amount or function of the protein that is produced from a specific gene, which likely impairs the normal formation of structures in the heart. Studies have also suggested that having more or fewer copies of particular genes compared with other people, a phenomenon known as copy number variation, may play a role in CCHD. Potential risk factors that have been studied include exposure to certain chemicals or drugs before birth, viral infections (such as rubella and influenza) that occur during pregnancy, and other maternal illnesses including diabetes and phenylketonuria. Although researchers are examining risk factors that may be associated with this complex condition, many of these factors remain unknown.

Critical congenital heart disease CCHD critical congenital heart defects Description Critical congenital heart disease (CCHD) is a term that refers to a group of serious heart defects that are present from birth. These abnormalities result from problems with the formation of one or more parts of the heart during the early stages of embryonic development. CCHD prevents the heart from pumping blood effectively or reduces the amount of oxygen in the blood. As a result, organs and tissues throughout the body do not receive enough oxygen, which can lead to organ damage and life-threatening complications. Individuals with CCHD usually require surgery soon after birth. Although babies with CCHD may appear healthy for the first few hours or days of life, signs and symptoms soon become apparent. These can include an abnormal heart sound during a heartbeat (heart murmur), rapid breathing (tachypnea), low blood pressure (hypotension), low levels of oxygen in the blood (hypoxemia), and a blue or purple tint to the skin caused by a shortage of oxygen (cyanosis). If untreated, CCHD can lead to shock, coma, and death. However, most people with CCHD now survive past infancy due to improvements in early detection, diagnosis, and treatment. Some people with treated CCHD have few related health problems later in life. However, long-term effects of CCHD can include delayed development and reduced stamina during exercise. Adults with these heart defects have an increased risk of abnormal heart rhythms, heart failure, sudden cardiac arrest, stroke, and premature death. Each of the heart defects associated with CCHD affects the flow of blood into, out of, or through the heart. Some of the heart defects involve structures within the heart itself, such as the two lower chambers of the heart (the ventricles) or the valves that control blood flow through the heart. Others affect the structure of the large blood vessels leading into and out of the heart (including the aorta and pulmonary artery). Still others involve a combination of these structural abnormalities. People with CCHD have one or more specific heart defects. The heart defects classified as CCHD include coarctation of the aorta, double-outlet right ventricle, D-transposition of the great arteries, Ebstein anomaly, hypoplastic left heart syndrome, interrupted aortic arch, pulmonary atresia with intact septum, single ventricle, total anomalous pulmonary venous connection, tetralogy of Fallot, tricuspid atresia, and truncus arteriosus. Frequency Heart defects are the most common type of birth defect, accounting for more than 30 percent of all infant deaths due to birth defects. CCHD represents some of the most serious types of heart defects. About 7,200 newborns, or 18 per 10,000, in the United States are diagnosed with CCHD each year. Causes In most cases, the cause of CCHD is unknown. A variety of genetic and environmental factors likely contribute to this complex condition. Changes in single genes have been associated with CCHD. Studies suggest that these genes are involved in normal heart development before birth. Most of the identified mutations reduce the amount or function of the protein that is produced from a specific gene, which likely impairs the normal formation of structures in the heart. Studies have also suggested that having more or fewer copies of particular genes compared with other people, a phenomenon known as copy number variation, may play a role in CCHD. However, it is unclear whether genes affected by copy number variation are involved in heart development and how having missing or extra copies of those genes could lead to heart defects. Researchers believe that single-gene mutations and copy number variation account for a relatively small percentage of all CCHD. CCHD is usually isolated, which means it occurs alone (without signs and symptoms affecting other parts of the body). However, the heart defects associated with CCHD can also occur as part of genetic syndromes that have additional features. Some of these genetic conditions, such as Down syndrome, Turner syndrome, and 22q11.2 deletion syndrome, result from changes in the number or structure of particular chromosomes. Other conditions, including Noonan syndrome and Alagille syndrome, result from mutations in single genes. Environmental factors may also contribute to the development of CCHD. Potential risk factors that have been studied include exposure to certain chemicals or drugs before birth, viral infections (such as rubella and influenza) that occur during pregnancy, and other maternal illnesses including diabetes and phenylketonuria. Although researchers are examining risk factors that may be associated with this complex condition, many of these factors remain unknown. Inheritance Pattern Most cases of CCHD are sporadic, which means they occur in people with no history of the disorder in their family. However, close relatives (such as siblings) of people with CCHD may have an increased risk of being born with a heart defect compared with people in the general population. Sources for This Page Fahed AC, Gelb BD, Seidman JG, Seidman CE. Genetics of congenital heart disease: the glass half empty. Circ Res. 2013 Feb 15;112(4):707-20. doi: 10.1161/CIRCRESAHA.112.300853. Review. Erratum in: Circ Res. 2013 Jun 7;112(12):e182. how is congenital heart disease passed down

how is congenital heart disease passed down

There may be an unusually small placenta when the baby is born. A physical exam of the infant may show unusual fingerprint patterns. X-rays may show a short breast bone. Chromosome studies will show trisomy 18.

Trisomy 18 Edwards syndrome Summary Trisomy 18 is a genetic disorder in which a person has a third copy of material from chromosome 18, instead of the usual 2 copies. Causes Trisomy 18 occurs in 1 in 6,000 live births. It is 3 times more common in girls than boys. The syndrome occurs when there is extra material from chromosome 18. The extra material affects normal development. Symptoms Symptoms may include: Clenched hands Crossed legs Feet with a rounded bottom (rocker-bottom feet) Low birth weight Low-set ears Mental delay Poorly developed fingernails Small head (microcephaly) Small jaw (micrognathia) Undescended testicle Unusual shaped chest (pectus carinatum) Exams and Tests An exam during pregnancy may show an unusually large uterus and extra amniotic fluid. There may be an unusually small placenta when the baby is born. A physical exam of the infant may show unusual fingerprint patterns. X-rays may show a short breast bone. Chromosome studies will show trisomy 18. The chromosome abnormality may be present in every cell or present in only a certain percentage of the cells (called mosaicism). Studies may also show part of the chromosome in some cells. Rarely, part of the chromosome 18 becomes attached to another chromosome. This is called translocation. Other signs include: Hole, split, or cleft in the iris of the eye (coloboma) Separation between the left and right side of the abdominal muscle (diastasis recti) Umbilical hernia or inguinal hernia There are often signs of congenital heart disease, such as: Atrial septal defect (ASD) Patent ductus arteriosus (PDA) Ventricular septal defect (VSD) Tests may also show kidney problems, including: Horseshoe kidney Hydronephrosis Polycystic kidney Treatment There are no specific treatments for trisomy 18. Which treatments are used depend on the person's individual condition. Support Groups Support groups include: Support Organization for Trisomy 18, 13 and Related Disorders (SOFT): trisomy.org Trisomy 18 Foundation: www.trisomy18.org Hope for Trisomy 13 and 18: www.hopefortrisomy13and18.org Outlook (Prognosis) Half of infants with this condition do not survive beyond the first week of life. Nine out of ten children will die by 1 year of age. Some children have survived to the teenage years, but with serious medical and developmental problems. Possible Complications Complications depend on the specific defects and symptoms. When to Contact a Medical Professional Genetic counseling can help families understand the condition, the risks of inheriting it, and how to care for the person. Prevention Tests can be done during pregnancy to find out if the child has this syndrome. Genetic counseling is recommended for parents who have a child with this syndrome and who want to have more children. Review Date 8/6/2017 Updated by: Anna C. Edens Hurst, MD, MS, Assistant Professor in Medical Genetics, The University of Alabama at Birmingham, Birmingham, AL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how is edward's syndrome diagnosed

how is edward's syndrome diagnosed

Trisomy 18 (Exams and Tests): An exam during pregnancy may show an unusually large uterus and extra amniotic fluid. There may be an unusually small placenta when the baby is born. A physical exam of the infant may show unusual fingerprint patterns. X-rays may show a short breast bone. Chromosome studies will show trisomy 18. The chromosome abnormality may be present in every cell or present in only a certain percentage of the cells (called mosaicism). Studies may also show part of the chromosome in some cells. Rarely, part of the chromosome 18 becomes attached to another chromosome. Other signs include: - Hole, split, or cleft in the iris of the eye (coloboma) - Separation between the left and right side of the abdominal muscle (diastasis recti) - Umbilical hernia or inguinal hernia There are often signs of congenital heart disease

Trisomy 18 Edwards syndrome Summary Trisomy 18 is a genetic disorder in which a person has a third copy of material from chromosome 18, instead of the usual 2 copies. Causes Trisomy 18 occurs in 1 in 6,000 live births. It is 3 times more common in girls than boys. The syndrome occurs when there is extra material from chromosome 18. The extra material affects normal development. Symptoms Symptoms may include: Clenched hands Crossed legs Feet with a rounded bottom (rocker-bottom feet) Low birth weight Low-set ears Mental delay Poorly developed fingernails Small head (microcephaly) Small jaw (micrognathia) Undescended testicle Unusual shaped chest (pectus carinatum) Exams and Tests An exam during pregnancy may show an unusually large uterus and extra amniotic fluid. There may be an unusually small placenta when the baby is born. A physical exam of the infant may show unusual fingerprint patterns. X-rays may show a short breast bone. Chromosome studies will show trisomy 18. The chromosome abnormality may be present in every cell or present in only a certain percentage of the cells (called mosaicism). Studies may also show part of the chromosome in some cells. Rarely, part of the chromosome 18 becomes attached to another chromosome. This is called translocation. Other signs include: Hole, split, or cleft in the iris of the eye (coloboma) Separation between the left and right side of the abdominal muscle (diastasis recti) Umbilical hernia or inguinal hernia There are often signs of congenital heart disease, such as: Atrial septal defect (ASD) Patent ductus arteriosus (PDA) Ventricular septal defect (VSD) Tests may also show kidney problems, including: Horseshoe kidney Hydronephrosis Polycystic kidney Treatment There are no specific treatments for trisomy 18. Which treatments are used depend on the person's individual condition. Support Groups Support groups include: Support Organization for Trisomy 18, 13 and Related Disorders (SOFT): trisomy.org Trisomy 18 Foundation: www.trisomy18.org Hope for Trisomy 13 and 18: www.hopefortrisomy13and18.org Outlook (Prognosis) Half of infants with this condition do not survive beyond the first week of life. Nine out of ten children will die by 1 year of age. Some children have survived to the teenage years, but with serious medical and developmental problems. Possible Complications Complications depend on the specific defects and symptoms. When to Contact a Medical Professional Genetic counseling can help families understand the condition, the risks of inheriting it, and how to care for the person. Prevention Tests can be done during pregnancy to find out if the child has this syndrome. Genetic counseling is recommended for parents who have a child with this syndrome and who want to have more children. Review Date 8/6/2017 Updated by: Anna C. Edens Hurst, MD, MS, Assistant Professor in Medical Genetics, The University of Alabama at Birmingham, Birmingham, AL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how is edward's syndrome diagnosed

how is edward's syndrome diagnosed

Many studies have shown that an epidural is a safe way to manage pain during childbirth. While rare, there are some risks. Your blood pressure may drop for a short while. This might cause the baby's heart rate to slow down. - To avoid this, you will receive fluids through an intravenous (IV) line to help keep your blood pressure stable. An epidural block may change or alter labor and delivery. - If you are very numb from the block, you may have a harder time bearing down to push your baby through the birth canal. - Contractions may lessen or slow down for a little while, but labor will still move along as it should. Other rare side effects are: - You may get a headache after your epidural but this is rare. - Medicine could enter your spinal fluid. For a short while, it could make you feel dizzy, or you might have a hard time breathing. You could also have a seizure. This is also rare.

Epidural block - pregnancy Delivery - epidural Labor - epidural Summary An epidural block is a numbing medicine given by injection (shot) in the back. It numbs or causes a loss of feeling in the lower half your body. This lessens the pain of contractions during childbirth. An epidural block may also be used to reduce pain during surgery on the lower extremities. This article focuses on epidural blocks during childbirth. How is the Epidural Given? The block or shot is given into an area over your lower back or spine. You may be asked to lie on your side, or you may sit up. Either way, you will be asked to pull your stomach inward and hunch your back outward. Your health care provider will wash the area of your back and inject a little medicine to numb the spot where the epidural needle is placed: The provider inserts a needle into your lower back. The needle is placed into a small space outside your spinal cord. A small soft tube (catheter) is placed into your back, next to your spine. The needle is removed. The numbing medicine is given through the tube for as long as it is needed. In most cases, you will receive a low dose because it is safer for you and baby. Once the medicine takes effect (10 to 20 minutes), you should feel better. You may still feel some back or rectal pressure during contractions. You may shiver after an epidural, but this is common. Many women shiver during labor even without an epidural. Is an Epidural Safe? Many studies have shown that an epidural is a safe way to manage pain during childbirth. While rare, there are some risks. Your blood pressure may drop for a short while. This might cause the baby's heart rate to slow down. To avoid this, you will receive fluids through an intravenous (IV) line to help keep your blood pressure stable. If your blood pressure shows a drop, you may need to lie on your side to keep the blood moving throughout your body. Your provider may also give you medicine to raise your blood pressure. An epidural block may change or alter labor and delivery. If you are very numb from the block, you may have a harder time bearing down to push your baby through the birth canal. Contractions may lessen or slow down for a little while, but labor will still move along as it should. In some cases, it may even go faster. If your labor slows down, your doctor can give you medicine to speed up your contractions. It is best to wait until you are in active labor to have the epidural placed. Other rare side effects are: You may get a headache after your epidural but this is rare. Medicine could enter your spinal fluid. For a short while, it could make you feel dizzy, or you might have a hard time breathing. You could also have a seizure. This is also rare. What Types of Epidurals are There? There are 2 types: "Walking" epidural block. This type of epidural will lessen your pain, but you will still be able to move your legs. Most women are not really able to walk around, but they can move their legs. Combined spinal epidural block. This combines both a spinal and epidural block. It provides pain relief much faster. The combined block is used when women are in very active labor and want relief right away. Review Date 4/19/2018 Updated by: John D. Jacobson, MD, Professor of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda Center for Fertility, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how is epidural harmful

how is epidural harmful

Spinal and epidural anesthesia are generally safe. Ask your doctor about these possible complications: - Allergic reaction to the anesthesia used - Bleeding around the spinal column (hematoma) - Difficulty urinating - Drop in blood pressure - Infection in your spine (meningitis or abscess) - Nerve damage - Seizures (this is rare) - Severe headache Tell your health care provider: - If you are or could be pregnant - What medicines you are taking, including medicines, supplements, or herbs you bought without a prescription During the days before the procedure: - Tell your doctor about any allergies or health conditions you have, what medicines you are taking, and what anesthesia or sedation you have had before.

Spinal and epidural anesthesia Intraspinal anesthesia Subarachnoid anesthesia Epidural Peridural anesthesia Summary Spinal and epidural anesthesia are medicines that numb parts of your body to block pain. They are given through shots in or around the spine. Description The doctor who gives you epidural or spinal anesthesia is called an anesthesiologist. First, the area of your back where the needle is inserted is cleaned with a special solution. The area may also be numbed with a local anesthetic. You'll likely receive fluids through an intravenous line (IV) in a vein. You may receive medicine through the IV to help you relax or sleep lightly. For an epidural: The doctor injects medicine just outside of the sac of fluid around your spinal cord. This is called the epidural space. The medicine numbs, or blocks feeling in a certain part of your body so that you cannot feel pain. The medicine begins to take effect in about 10 to 20 minutes. It works well for longer procedures. Women often have an epidural during childbirth. A small tube (catheter) is often left in place. You can receive more medicine through the catheter to help control your pain during or after your procedure. For a spinal: The doctor injects medicine into the fluid in your spinal cord. This is usually done only once, so you will not need to have a catheter placed. The medicine begins to take effect right away. It works well for shorter and simpler procedures. Your pulse, blood pressure and oxygen level in your blood are checked during the procedure. After the procedure, you will have a bandage where the needle was inserted. Why the Procedure is Performed Spinal and epidural anesthesia have fewer side effects and risks than general anesthesia (asleep and pain-free). People usually recover their senses much faster. Sometimes, they have to wait for the anesthetic to wear off so they can walk. Spinal anesthesia is often used for genital, urinary tract, or lower body procedures. Epidural anesthesia is often used during labor and delivery, and surgery in the pelvis and legs. Epidural and spinal anesthesia are often used when: The procedure or labor is too painful without any pain medicine. The procedure is in the belly, legs, or feet. Your body can remain in a comfortable position during your procedure. You want fewer systemic side effects and a shorter recovery than you would have from general anesthesia. Risks Spinal and epidural anesthesia are generally safe. Ask your doctor about these possible complications: Allergic reaction to the anesthesia used Bleeding around the spinal column (hematoma) Difficulty urinating Drop in blood pressure Infection in your spine (meningitis or abscess) Nerve damage Seizures (this is rare) Severe headache Before the Procedure Tell your health care provider: If you are or could be pregnant What medicines you are taking, including medicines, supplements, or herbs you bought without a prescription During the days before the procedure: Tell your doctor about any allergies or health conditions you have, what medicines you are taking, and what anesthesia or sedation you have had before. If your procedure is planned, you may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), warfarin (Coumadin), and any other blood thinners. Ask your doctor which medicines you should still take on the day of your procedure. Arrange for a responsible adult to drive you to and from the hospital or clinic. If you smoke, try to stop. Ask your provider for help quitting. On the day of the procedure: Follow instructions on when to stop eating and drinking. Do not drink alcohol the night before and the day of your procedure. Take the medicines your doctor told you to take with a small sip of water. Follow instructions on when to arrive at the hospital. Be sure to arrive on time. After the Procedure After an epidural, the catheter in your back is removed. You lie in bed until you have feeling in your legs and can walk. You may feel sick to your stomach and be dizzy. You may be tired. After spinal anesthesia, you lie flat in bed for a few hours. This is to keep you from getting a headache. You may feel sick to your stomach and be dizzy. You may be tired. Outlook (Prognosis) Most people feel no pain during spinal and epidural anesthesia and recover fully. Review Date 5/1/2017 Updated by: Jennifer Sobol, DO, urologist with the Michigan Institute of Urology, West Bloomfield, MI. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how is epidural harmful

how is epidural harmful

Many studies have shown that an epidural is a safe way to manage pain during childbirth. While rare, there are some risks. Your blood pressure may drop for a short while. This might cause the baby's heart rate to slow down. - To avoid this, you will receive fluids through an intravenous (IV) line to help keep your blood pressure stable. - If your blood pressure shows a drop, you may need to lie on your side to keep the blood moving throughout your body. - Your provider may also give you medicine to raise your blood pressure. An epidural block may change or alter labor and delivery. - If you are very numb from the block, you may have a harder time bearing down to push your baby through the birth canal. - Contractions may lessen or slow down for a little while, but labor will still move along as it should. In some cases, it may even go faster. If your labor slows down, your doctor can give you medicine to speed up your contractions. It is best to wait until you are in active labor to have the epidural placed. Other rare side effects are: - You may get a headache after your epidural but this is rare. - Medicine could enter your spinal fluid. For a short while, it could make you feel dizzy, or you might have a hard time breathing. You could also have a seizure. This is also rare.

Epidural block - pregnancy Delivery - epidural Labor - epidural Summary An epidural block is a numbing medicine given by injection (shot) in the back. It numbs or causes a loss of feeling in the lower half your body. This lessens the pain of contractions during childbirth. An epidural block may also be used to reduce pain during surgery on the lower extremities. This article focuses on epidural blocks during childbirth. How is the Epidural Given? The block or shot is given into an area over your lower back or spine. You may be asked to lie on your side, or you may sit up. Either way, you will be asked to pull your stomach inward and hunch your back outward. Your health care provider will wash the area of your back and inject a little medicine to numb the spot where the epidural needle is placed: The provider inserts a needle into your lower back. The needle is placed into a small space outside your spinal cord. A small soft tube (catheter) is placed into your back, next to your spine. The needle is removed. The numbing medicine is given through the tube for as long as it is needed. In most cases, you will receive a low dose because it is safer for you and baby. Once the medicine takes effect (10 to 20 minutes), you should feel better. You may still feel some back or rectal pressure during contractions. You may shiver after an epidural, but this is common. Many women shiver during labor even without an epidural. Is an Epidural Safe? Many studies have shown that an epidural is a safe way to manage pain during childbirth. While rare, there are some risks. Your blood pressure may drop for a short while. This might cause the baby's heart rate to slow down. To avoid this, you will receive fluids through an intravenous (IV) line to help keep your blood pressure stable. If your blood pressure shows a drop, you may need to lie on your side to keep the blood moving throughout your body. Your provider may also give you medicine to raise your blood pressure. An epidural block may change or alter labor and delivery. If you are very numb from the block, you may have a harder time bearing down to push your baby through the birth canal. Contractions may lessen or slow down for a little while, but labor will still move along as it should. In some cases, it may even go faster. If your labor slows down, your doctor can give you medicine to speed up your contractions. It is best to wait until you are in active labor to have the epidural placed. Other rare side effects are: You may get a headache after your epidural but this is rare. Medicine could enter your spinal fluid. For a short while, it could make you feel dizzy, or you might have a hard time breathing. You could also have a seizure. This is also rare. What Types of Epidurals are There? There are 2 types: "Walking" epidural block. This type of epidural will lessen your pain, but you will still be able to move your legs. Most women are not really able to walk around, but they can move their legs. Combined spinal epidural block. This combines both a spinal and epidural block. It provides pain relief much faster. The combined block is used when women are in very active labor and want relief right away. Review Date 4/19/2018 Updated by: John D. Jacobson, MD, Professor of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda Center for Fertility, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how is epidural harmful

how is epidural harmful

People who are concerned they may be having seizures or other neurological signs or symptoms should be evaluated by a neurologist. The diagnosis of autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE) is made on clinical grounds. The key to diagnosis is a detailed history from the affected person, as well as witnesses. Sometimes video- EEG monitoring is necessary.

Autosomal dominant nocturnal frontal lobe epilepsy ADNFLE Epilepsy, nocturnal frontal lobe, 1 ENFL1 Summary Autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE) is an uncommon, inherited form of epilepsy. People with ADNFLE have seizures that usually occur at night during sleep. Some people with ADNFLE also have seizures during the day. These seizures can last from a few seconds to a few minutes, and can vary from causing simple arousal from sleep, to dramatic muscle spasms and movements. The onset of ADNFLE ranges from infancy to adulthood, but most cases begin in childhood. Episodes tend to become milder and less frequent with age. [1] [2] It is diagnosed based on symptoms and the results of tests such as an EEG . ADNFLE is inherited in an autosomal dominant manner and may be caused by a mutation in any of several genes . In most cases however, the genetic cause is not found. Seizures can usually be controlled with anti-seizure medications. [2] Symptoms The main symptom in people with autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE) is seizures that generally occur at night. Seizures may begin anywhere from early childhood to adulthood, but most often begin in childhood. [3] [4] Seizures may last from a few seconds to a few minutes. [1] The frequency of seizures varies from several per year to several per night. [3] Seizures may become less frequent or more mild as a person gets older. [1] Some people with ADNFLE occasionally have seizures while they are awake. [4] When a person with ADNFLE is having a seizure, they may experience a variety of movement-related symptoms ranging from mild to severe. Examples include: [1] [3] [4] Short bursts of random, repetitive movements of the limbs, trunk, or head, lasting 2 to 4 seconds. Brief, sudden arousal (waking), sometimes with repetitive movements, making sounds, crying, or feelings of fear. Major attacks lasting 20 to 30 seconds, characterized by extreme stiffening of muscles, or movements such as pelvic thrusting, pedaling, twisting and writhing, or fast, forceful motions of the limbs. Recurring episodes of exertion during the night may lead to sleepiness during the day. [4] Most people with ADNFLE have normal intellect (thinking abilities), but in some cases, intellect is reduced. Some people with ADNFLE also have psychiatric disorders or behavior problems, but it is unclear if these are directly related to ADNFLE. [1] [3] This table lists symptoms that people with this disease may have. For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. This information comes from a database called the Human Phenotype Ontology (HPO) . The HPO collects information on symptoms that have been described in medical resources. The HPO is updated regularly. Use the HPO ID to access more in-depth information about a symptom. Showing of Medical Terms Other Names Learn More: HPO ID 5%-29% of people have these symptoms Intellectual disability Mental deficiency Mental retardation Mental retardation, nonspecific Mental-retardation 0001249 Percent of people who have these symptoms is not available through HPO Autosomal dominant inheritance 0000006 Childhood onset Symptoms begin in childhood 0011463 Focal-onset seizure 0007359 Incomplete penetrance 0003829 Showing of Diagnosis A diagnosis of autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE) is made based on signs and symptoms. In addition to the doctor taking a detailed medical and family history from the person with symptoms, obtaining information from others who see episodes occur is very helpful. In some cases, video- EEG monitoring during sleep is needed. The features that suggest a diagnosis of ADNFLE include: Clusters of seizures that occur mainly during sleep. A normal neurologic exam and normal findings on brain imaging tests. A normal EEG recorded during a seizure (ictal EEG), or one that is obscured by movement of the cables or electrodes. An EEG recorded between seizures (interictal EEG) that shows few or no instances of patterns seen in people with epilepsy. The presence of the same disorder in other family members, with evidence of autosomal dominant If ADNFLE is suspected, genetic testing may be ordered. However, genetic testing can confirm the diagnosis in only 20% of people with a family history of ADNFLE, and in fewer than 5% of people with no family history. [2] Testing Resources The Genetic Testing Registry (GTR) provides information about the genetic tests for this condition. The intended audience for the GTR is health care providers and researchers. Patients and consumers with specific questions about a genetic test should contact a health care provider or a genetics professional. Find a Specialist If you need medical advice, you can look for doctors or other healthcare professionals who have experience with this disease. You may find these specialists through advocacy organizations, clinical trials, or articles published in medical journals. You may also want to contact a university or tertiary medical center in your area, because these centers tend to see more complex cases and have the latest technology and treatments. If you can't find a specialist in your local area, try contacting national or international specialists. They may be able to refer you to someone they know through conferences or research efforts. Some specialists may be willing to consult with you or your local doctors over the phone or by email if you can't travel to them for care. You can find more tips in our guide, How to Find a Disease Specialist. We also encourage you to explore the rest of this page to find resources that can help you find specialists. Healthcare Resources To find a medical professional who specializes in genetics, you can ask your doctor for a referral or you can search for one yourself. Online directories are provided by the American College of Medical Genetics and the National Society of Genetic Counselors. If you need additional help, contact a GARD Information Specialist. You can also learn more about genetic consultations from Genetics Home Reference. Related Diseases Related diseases are conditions that have similar signs and symptoms. A health care provider may consider these conditions in the table below when making a diagnosis. Please note that the table may not include all the possible conditions related to this disease. Conditions with similar signs and symptoms from Orphanet Differential diagnoses include sporadic NFLE, paroxysmal dyskinesia, familial focal epilepsy with variable foci (see these terms), restless legs syndrome, periodic limb movement disorders (PLMS), REM sleep behavior disorders (RBD), nocturnal panic attacks, non-REM parasomnias, obstructive sleep apnea syndrome, and arousal disorders. Visit the Orphanet disease page for more information. how is epilepsy diagnosed

how is epilepsy diagnosed

Only when a person has had two or more seizures is he or she considered to have epilepsy. A measurement of electrical activity in the brain and brain scans such as magnetic resonance imaging or computed tomography are common diagnostic tests for epilepsy

Epilepsy What is Epilepsy? The epilepsies are a spectrum of brain disorders ranging from severe, life-threatening and disabling, to ones that are much more benign. In epilepsy, the normal pattern of neuronal activity becomes disturbed, causing strange sensations, emotions, and behavior or sometimes convulsions, muscle spasms, and loss of consciousness. The epilepsies have many possible causes and there are several types of seizures. Anything that disturbs the normal pattern of neuron activity—from illness to brain damage to abnormal brain development—can lead to seizures. Epilepsy may develop because of an abnormality in brain wiring, an imbalance of nerve signaling chemicals called neurotransmitters, changes in important features of brain cells called channels, or some combination of these and other factors. Having a single seizure as the result of a high fever (called febrile seizure) or head injury does not necessarily mean that a person has epilepsy. Only when a person has had two or more seizures is he or she considered to have epilepsy. A measurement of electrical activity in the brain and brain scans such as magnetic resonance imaging or computed tomography are common diagnostic tests for epilepsy. Is there any treatment? Once epilepsy is diagnosed, it is important to begin treatment as soon as possible. For about 70 percent of those diagnosed with epilepsy, seizures can be controlled with modern medicines and surgical techniques. Some drugs are more effective for specific types of seizures. An individual with seizures, particularly those that are not easily controlled, may want to see a neurologist specifically trained to treat epilepsy. In some children, special diets may help to control seizures when medications are either not effective or cause serious side effects. What is the prognosis? While epilepsy cannot be cured, for some people the seizures can be controlled with medication, diet, devices, and/or surgery. Most seizures do not cause brain damage, but ongoing uncontrolled seizures may cause brain damage. It is not uncommon for people with epilepsy, especially children, to develop behavioral and emotional problems in conjunction with seizures. Issues may also arise as a result of the stigma attached to having epilepsy, which can led to embarrassment and frustration or bullying, teasing, or avoidance in school and other social settings. For many people with epilepsy, the risk of seizures restricts their independence (some states refuse drivers licenses to people with epilepsy) and recreational activities. Epilepsy can be a life-threatening condition. Some people with epilepsy are at special risk for abnormally prolonged seizures or sudden unexplained death in epilepsy. What research is being done? Scientists are studying the underlying causes of the epilepsies in children, adults, and the elderly, as well as seizures that occur following brain trauma, stroke, and brain tumors. Ongoing research is focused on developing new model systems that can be used to more quickly screen potential new treatments for the epilepsies. The identification of genes or other genetic information that may influence or cause the epilepsies may allow doctors to prevent the disorders or to predict which treatments will be most beneficial to individuals with specific types of epilepsy. Scientists also continue to study how neurotransmitters interact with brain cells to control nerve firing and how non-neuronal cells in the brain contribute to seizures. Researchers funded by the National Institutes of Health have developed a flexible brain implant that could one day be used to treat seizures. Scientists are continually improving MRI and other brain scans that may assist in diagnosing the epilepsies and identify the source, or focus, of the seizures in the brain. Other areas of study include prevention of seizures and the role of inflammation in epilepsy. Patients may enter trials of experimental drugs and surgical interventions. More about epilepsy research how is epilepsy diagnosed

how is epilepsy diagnosed

To diagnose your condition, your doctor will review your symptoms and medical history. Your doctor may order several tests to diagnose epilepsy and determine the cause of seizures. Your evaluation may include: - A neurological exam. Your doctor may test your behavior, motor abilities, mental function and other areas to diagnose your condition and determine the type of epilepsy you may have. - Blood tests. Your doctor may take a blood sample to check for signs of infections, genetic conditions or other conditions that may be associated with seizures. Your doctor may also suggest tests to detect brain abnormalities, such as: - Electroencephalogram (EEG). This is the most common test used to diagnose epilepsy. Computerized tomography (CT) scan. A CT scan uses X-rays to obtain cross-sectional images of your brain. CT scans can reveal abnormalities in your brain that might be causing your seizures, such as tumors, bleeding and cysts. - Magnetic resonance imaging (MRI). An MRI uses powerful magnets and radio waves to create a detailed view of your brain. Accurate diagnosis of your seizure type and where seizures begin gives you the best chance for finding an effective treatment.

Epilepsy Overview Epilepsy is a central nervous system (neurological) disorder in which brain activity becomes abnormal, causing seizures or periods of unusual behavior, sensations, and sometimes loss of awareness. Anyone can develop epilepsy. Epilepsy affects both males and females of all races, ethnic backgrounds and ages. Seizure symptoms can vary widely. Some people with epilepsy simply stare blankly for a few seconds during a seizure, while others repeatedly twitch their arms or legs. Having a single seizure doesn't mean you have epilepsy. At least two unprovoked seizures are generally required for an epilepsy diagnosis. Treatment with medications or sometimes surgery can control seizures for the majority of people with epilepsy. Some people require lifelong treatment to control seizures, but for others, the seizures eventually go away. Some children with epilepsy may outgrow the condition with age. Epilepsy care at Mayo Clinic Symptoms Because epilepsy is caused by abnormal activity in the brain, seizures can affect any process your brain coordinates. Seizure signs and symptoms may include: - Temporary confusion - A staring spell - Uncontrollable jerking movements of the arms and legs - Loss of consciousness or awareness - Psychic symptoms such as fear, anxiety or deja vu Symptoms vary depending on the type of seizure. In most cases, a person with epilepsy will tend to have the same type of seizure each time, so the symptoms will be similar from episode to episode. Doctors generally classify seizures as either focal or generalized, based on how the abnormal brain activity begins. Focal seizures When seizures appear to result from abnormal activity in just one area of your brain, they're called focal (partial) seizures. These seizures fall into two categories: - Focal seizures without loss of consciousness. Once called simple partial seizures, these seizures don't cause a loss of consciousness. They may alter emotions or change the way things look, smell, feel, taste or sound. They may also result in involuntary jerking of a body part, such as an arm or leg, and spontaneous sensory symptoms such as tingling, dizziness and flashing lights. - Focal seizures with impaired awareness. Once called complex partial seizures, these seizures involve a change or loss of consciousness or awareness. During a complex partial seizure, you may stare into space and not respond normally to your environment or perform repetitive movements, such as hand rubbing, chewing, swallowing or walking in circles. Symptoms of focal seizures may be confused with other neurological disorders, such as migraine, narcolepsy or mental illness. A thorough examination and testing are needed to distinguish epilepsy from other disorders. Generalized seizures Seizures that appear to involve all areas of the brain are called generalized seizures. Six types of generalized seizures exist. - Absence seizures. Absence seizures, previously known as petit mal seizures, often occur in children and are characterized by staring into space or subtle body movements such as eye blinking or lip smacking. These seizures may occur in clusters and cause a brief loss of awareness. - Tonic seizures. Tonic seizures cause stiffening of your muscles. These seizures usually affect muscles in your back, arms and legs and may cause you to fall to the ground. - Atonic seizures. Atonic seizures, also known as drop seizures, cause a loss of muscle control, which may cause you to suddenly collapse or fall down. - Clonic seizures. Clonic seizures are associated with repeated or rhythmic, jerking muscle movements. These seizures usually affect the neck, face and arms. - Myoclonic seizures. Myoclonic seizures usually appear as sudden brief jerks or twitches of your arms and legs. - Tonic-clonic seizures. Tonic-clonic seizures, previously known as grand mal seizures, are the most dramatic type of epileptic seizure and can cause an abrupt loss of consciousness, body stiffening and shaking, and sometimes loss of bladder control or biting your tongue. When to see a doctor Seek immediate medical help if any of the following occurs: - The seizure lasts more than five minutes. - Breathing or consciousness doesn't return after the seizure stops. - A second seizure follows immediately. - You have a high fever. - You're experiencing heat exhaustion. - You're pregnant. - You have diabetes. - You've injured yourself during the seizure. If you experience a seizure for the first time, seek medical advice. Causes Epilepsy has no identifiable cause in about half the people with the condition. In the other half, the condition may be traced to various factors, including: - Genetic influence. Some types of epilepsy, which are categorized by the type of seizure you experience or the part of the brain that is affected, run in families. In these cases, it's likely that there's a genetic influence. Researchers have linked some types of epilepsy to specific genes, but for most people, genes are only part of the cause of epilepsy. Certain genes may make a person more sensitive to environmental conditions that trigger seizures. - Head trauma. Head trauma as a result of a car accident or other traumatic injury can cause epilepsy. - Brain conditions. Brain conditions that cause damage to the brain, such as brain tumors or strokes, can cause epilepsy. Stroke is a leading cause of epilepsy in adults older than age 35. - Infectious diseases. Infectious diseases, such as meningitis, AIDS and viral encephalitis, can cause epilepsy. - Prenatal injury. Before birth, babies are sensitive to brain damage that could be caused by several factors, such as an infection in the mother, poor nutrition or oxygen deficiencies. This brain damage can result in epilepsy or cerebral palsy. - Developmental disorders. Epilepsy can sometimes be associated with developmental disorders, such as autism and neurofibromatosis. Risk factors Certain factors may increase your risk of epilepsy: - Age. The onset of epilepsy is most common in children and older adults, but the condition can occur at any age. - Family history. If you have a family history of epilepsy, you may be at an increased risk of developing a seizure disorder. - Head injuries. Head injuries are responsible for some cases of epilepsy. You can reduce your risk by wearing a seat belt while riding in a car and by wearing a helmet while bicycling, skiing, riding a motorcycle or engaging in other activities with a high risk of head injury. - Stroke and other vascular diseases. Stroke and other blood vessel (vascular) diseases can lead to brain damage that may trigger epilepsy. You can take a number of steps to reduce your risk of these diseases, including limiting your intake of alcohol and avoiding cigarettes, eating a healthy diet, and exercising regularly. - Dementia. Dementia can increase the risk of epilepsy in older adults. - Brain infections. Infections such as meningitis, which causes inflammation in your brain or spinal cord, can increase your risk. - Seizures in childhood. High fevers in childhood can sometimes be associated with seizures. Children who have seizures due to high fevers generally won't develop epilepsy. The risk of epilepsy increases if a child has a long seizure, another nervous system condition or a family history of epilepsy. Diagnosis To diagnose your condition, your doctor will review your symptoms and medical history. Your doctor may order several tests to diagnose epilepsy and determine the cause of seizures. Your evaluation may include: - A neurological exam. Your doctor may test your behavior, motor abilities, mental function and other areas to diagnose your condition and determine the type of epilepsy you may have. - Blood tests. Your doctor may take a blood sample to check for signs of infections, genetic conditions or other conditions that may be associated with seizures. Your doctor may also suggest tests to detect brain abnormalities, such as: - Electroencephalogram (EEG). This is the most common test used to diagnose epilepsy. In this test, doctors attach electrodes to your scalp with a paste-like substance. The electrodes record the electrical activity of your brain. If you have epilepsy, it's common to have changes in your normal pattern of brain waves, even when you're not having a seizure. Your doctor may monitor you on video while conducting an EEG while you're awake or asleep, to record any seizures you experience. Recording the seizures may help the doctor determine what kind of seizures you're having or rule out other conditions. Your doctor may give you instructions to do something that will cause seizures, such as getting little sleep prior to the test. - High-density EEG. In a variation of an EEG test, your doctor may recommend high-density EEG, which spaces electrodes more closely than conventional EEG - about a half a centimeter apart. High-density EEG may help your doctor more precisely determine which areas of your brain are affected by seizures. - Computerized tomography (CT) scan. A CT scan uses X-rays to obtain cross-sectional images of your brain. CT scans can reveal abnormalities in your brain that might be causing your seizures, such as tumors, bleeding and cysts. - Magnetic resonance imaging (MRI). An MRI uses powerful magnets and radio waves to create a detailed view of your brain. Your doctor may be able to detect lesions or abnormalities in your brain that could be causing your seizures. - Functional MRI (fMRI). A functional MRI measures the changes in blood flow that occur when specific parts of your brain are working. Doctors may use an fMRI before surgery to identify the exact locations of critical functions, such as speech and movement, so that surgeons can avoid injuring those places while operating. - Positron emission tomography (PET). PET scans use a small amount of low-dose radioactive material that's injected into a vein to help visualize active areas of the brain and detect abnormalities. - Single-photon emission computerized tomography (SPECT). This type of test is used primarily if you've had an MRI and EEG that didn't pinpoint the location in your brain where the seizures are originating. A SPECT test uses a small amount of low-dose radioactive material that's injected into a vein to create a detailed, 3-D map of the blood flow activity in your brain during seizures. Doctors also may conduct a form of a SPECT test called subtraction ictal SPECT coregistered to MRI (SISCOM), which may provide even more-detailed results. - Neuropsychological tests. In these tests, doctors assess your thinking, memory and speech skills. The test results help doctors determine which areas of your brain are affected. Along with your test results, your doctor may use a combination of analysis techniques to help pinpoint where in the brain seizures start: - Statistical parametric mapping (SPM). SPM is a method of comparing areas of the brain that have increased metabolism during seizures to normal brains, which can give doctors an idea of where seizures begin. - Curry analysis. Curry analysis is a technique that takes EEG data and projects it onto an MRI of the brain to show doctors where seizures are occurring. - Magnetoencephalography (MEG). MEG measures the magnetic fields produced by brain activity to identify potential areas of seizure onset. Accurate diagnosis of your seizure type and where seizures begin gives you the best chance for finding an effective treatment. Treatment Doctors generally begin by treating epilepsy with medication. If medications don't treat the condition, doctors may propose surgery or another type of treatment. Medication Most people with epilepsy can become seizure-free by taking one anti-seizure medication, which is also called anti-epileptic medication. Others may be able to decrease the frequency and intensity of their seizures by taking a combination of medications. Many children with epilepsy who aren't experiencing epilepsy symptoms can eventually discontinue medications and live a seizure-free life. Many adults can discontinue medications after two or more years without seizures. Your doctor will advise you about the appropriate time to stop taking medications. Finding the right medication and dosage can be complex. Your doctor will consider your condition, frequency of seizures, your age and other factors when choosing which medication to prescribe. Your doctor will also review any other medications you may be taking, to ensure the anti-epileptic medications won't interact with them. Your doctor likely will first prescribe a single medication at a relatively low dosage and may increase the dosage gradually until your seizures are well-controlled. Anti-seizure medications may have some side effects. Mild side effects include: - Fatigue - Dizziness - Weight gain - Loss of bone density - Skin rashes - Loss of coordination - Speech problems - Memory and thinking problems More-severe but rare side effects include: - Depression - Suicidal thoughts and behaviors - Severe rash - Inflammation of certain organs, such as your liver To achieve the best seizure control possible with medication, follow these steps: - Take medications exactly as prescribed. - Always call your doctor before switching to a generic version of your medication or taking other prescription medications, over-the-counter drugs or herbal remedies. - Never stop taking your medication without talking to your doctor. - Notify your doctor immediately if you notice new or increased feelings of depression, suicidal thoughts, or unusual changes in your mood or behaviors. - Tell your doctor if you have migraines. Doctors may prescribe one of the anti-epileptic medications that can prevent your migraines and treat epilepsy. At least half the people newly diagnosed with epilepsy will become seizure-free with their first medication. If anti-epileptic medications don't provide satisfactory results, your doctor may suggest surgery or other therapies. You'll have regular follow-up appointments with your doctor to evaluate your condition and medications. Surgery When medications fail to provide adequate control over seizures, surgery may be an option. With epilepsy surgery, a surgeon removes the area of your brain that's causing seizures. Doctors usually perform surgery when tests show that: - Your seizures originate in a small, well-defined area of your brain - The area in your brain to be operated on doesn't interfere with vital functions such as speech, language, motor function, vision or hearing Although many people continue to need some medication to help prevent seizures after successful surgery, you may be able to take fewer drugs and reduce your dosages. In a small number of cases, surgery for epilepsy can cause complications such as permanently altering your thinking (cognitive) abilities. Talk to your surgeon about his or her experience, success rates, and complication rates with the procedure you're considering. Therapies Apart from medications and surgery, these potential therapies offer an alternative for treating epilepsy: - Vagus nerve stimulation. In vagus nerve stimulation, doctors implant a device called a vagus nerve stimulator underneath the skin of your chest, similar to a heart pacemaker. Wires from the stimulator are connected to the vagus nerve in your neck. The battery-powered device sends bursts of electrical energy through the vagus nerve and to your brain. It's not clear how this inhibits seizures, but the device can usually reduce seizures by 20 to 40 percent. Most people still need to take anti-epileptic medication, although some people may be able to lower their medication dose. You may experience side effects from vagus nerve stimulation, such as throat pain, hoarse voice, shortness of breath or coughing. - Ketogenic diet. Some children with epilepsy have been able to reduce their seizures by following a strict diet that's high in fats and low in carbohydrates. In this diet, called a ketogenic diet, the body breaks down fats instead of carbohydrates for energy. After a few years, some children may be able to stop the ketogenic diet - under close supervision of their doctors - and remain seizure-free. Consult a doctor if you or your child is considering a ketogenic diet. It's important to make sure that your child doesn't become malnourished when following the diet. Side effects of a ketogenic diet may include dehydration, constipation, slowed growth because of nutritional deficiencies and a buildup of uric acid in the blood, which can cause kidney stones. These side effects are uncommon if the diet is properly and medically supervised. Following a ketogenic diet can be a challenge. Low-glycemic index and modified Atkins diets offer less restrictive alternatives that may still provide some benefit for seizure control. Potential future treatments Researchers are studying many potential new treatments for epilepsy, including: - Deep brain stimulation. In deep brain stimulation, surgeons implant electrodes into a specific part of your brain, typically your thalamus. The electrodes are connected to a generator implanted in your chest or the skull that sends electrical pulses to your brain and may reduce your seizures. - Responsive neurostimulation. Implantable, pacemaker-like devices that help prevent seizures are also under investigation. These responsive stimulation or closed loop devices analyze brain activity patterns to detect seizures before they happen and deliver an electrical charge or drug to stop the seizure. - Continuous stimulation of the seizure onset zone (subthreshold stimulation). Subthreshold stimulation - continuous stimulation to an area of your brain below a level that's physically noticeable - appears to improve seizure outcomes and quality of life for some people with seizures. This treatment approach may work in people who have seizures that start in an area of the brain that can't be removed because it would affect speech and motor functions (eloquent area). Or it might benefit people whose seizure characteristics mean their chances of successful treatment with responsive neurostimulation are low. - Minimally invasive surgery. New minimally invasive surgical techniques, such as MRI-guided laser ablation, show promise at reducing seizures with fewer risks than traditional open brain surgery for epilepsy. - Stereotactic laser ablation or radiosurgery. For some types of epilepsy, stereotactic laser ablation or stereotactic radiosurgery may provide effective treatment for people in which an open procedure may be too risky. In these procedures, doctors direct radiation at the specific area in the brain causing seizures, to destroy that tissue in an effort to better control the seizures. - External nerve stimulation device. Similar to vagus nerve stimulation, this device would stimulate specific nerves to reduce frequency of seizures. But unlike vagus nerve stimulation, this device would be worn externally so that no surgery to implant the device is needed. Lifestyle and home remedies Understanding your condition can help you take better control of it: - Take your medication correctly. Don't adjust your dosage before talking to your doctor. If you feel your medication should be changed, discuss it with your doctor. - Get enough sleep. Lack of sleep can trigger seizures. Be sure to get adequate rest every night. - Wear a medical alert bracelet. This will help emergency personnel know how to treat you correctly. - Exercise. Exercising may help keep you physically healthy and reduce depression. Make sure to drink enough water, and rest if you get tired during exercise. In addition, make healthy life choices, such as managing stress, limiting alcoholic beverages and avoiding cigarettes. how is epilepsy diagnosed

how is epilepsy diagnosed

To diagnose your condition, your doctor will review your symptoms and medical history. Your doctor may order several tests to diagnose epilepsy and determine the cause of seizures. Your evaluation may include: - A neurological exam. Your doctor may test your behavior, motor abilities, mental function and other areas to diagnose your condition and determine the type of epilepsy you may have. - Blood tests. Your doctor may take a blood sample to check for signs of infections, genetic conditions or other conditions that may be associated with seizures. Your doctor may also suggest tests to detect brain abnormalities, such as: - Electroencephalogram (EEG). This is the most common test used to diagnose epilepsy. Computerized tomography (CT) scan. A CT scan uses X-rays to obtain cross-sectional images of your brain. CT scans can reveal abnormalities in your brain that might be causing your seizures, such as tumors, bleeding and cysts. - Magnetic resonance imaging (MRI). An MRI uses powerful magnets and radio waves to create a detailed view of your brain. Accurate diagnosis of your seizure type and where seizures begin gives you the best chance for finding an effective treatment.

Epilepsy Overview Epilepsy is a central nervous system (neurological) disorder in which brain activity becomes abnormal, causing seizures or periods of unusual behavior, sensations, and sometimes loss of awareness. Anyone can develop epilepsy. Epilepsy affects both males and females of all races, ethnic backgrounds and ages. Seizure symptoms can vary widely. Some people with epilepsy simply stare blankly for a few seconds during a seizure, while others repeatedly twitch their arms or legs. Having a single seizure doesn't mean you have epilepsy. At least two unprovoked seizures are generally required for an epilepsy diagnosis. Treatment with medications or sometimes surgery can control seizures for the majority of people with epilepsy. Some people require lifelong treatment to control seizures, but for others, the seizures eventually go away. Some children with epilepsy may outgrow the condition with age. Epilepsy care at Mayo Clinic Symptoms Because epilepsy is caused by abnormal activity in the brain, seizures can affect any process your brain coordinates. Seizure signs and symptoms may include: - Temporary confusion - A staring spell - Uncontrollable jerking movements of the arms and legs - Loss of consciousness or awareness - Psychic symptoms such as fear, anxiety or deja vu Symptoms vary depending on the type of seizure. In most cases, a person with epilepsy will tend to have the same type of seizure each time, so the symptoms will be similar from episode to episode. Doctors generally classify seizures as either focal or generalized, based on how the abnormal brain activity begins. Focal seizures When seizures appear to result from abnormal activity in just one area of your brain, they're called focal (partial) seizures. These seizures fall into two categories: - Focal seizures without loss of consciousness. Once called simple partial seizures, these seizures don't cause a loss of consciousness. They may alter emotions or change the way things look, smell, feel, taste or sound. They may also result in involuntary jerking of a body part, such as an arm or leg, and spontaneous sensory symptoms such as tingling, dizziness and flashing lights. - Focal seizures with impaired awareness. Once called complex partial seizures, these seizures involve a change or loss of consciousness or awareness. During a complex partial seizure, you may stare into space and not respond normally to your environment or perform repetitive movements, such as hand rubbing, chewing, swallowing or walking in circles. Symptoms of focal seizures may be confused with other neurological disorders, such as migraine, narcolepsy or mental illness. A thorough examination and testing are needed to distinguish epilepsy from other disorders. Generalized seizures Seizures that appear to involve all areas of the brain are called generalized seizures. Six types of generalized seizures exist. - Absence seizures. Absence seizures, previously known as petit mal seizures, often occur in children and are characterized by staring into space or subtle body movements such as eye blinking or lip smacking. These seizures may occur in clusters and cause a brief loss of awareness. - Tonic seizures. Tonic seizures cause stiffening of your muscles. These seizures usually affect muscles in your back, arms and legs and may cause you to fall to the ground. - Atonic seizures. Atonic seizures, also known as drop seizures, cause a loss of muscle control, which may cause you to suddenly collapse or fall down. - Clonic seizures. Clonic seizures are associated with repeated or rhythmic, jerking muscle movements. These seizures usually affect the neck, face and arms. - Myoclonic seizures. Myoclonic seizures usually appear as sudden brief jerks or twitches of your arms and legs. - Tonic-clonic seizures. Tonic-clonic seizures, previously known as grand mal seizures, are the most dramatic type of epileptic seizure and can cause an abrupt loss of consciousness, body stiffening and shaking, and sometimes loss of bladder control or biting your tongue. When to see a doctor Seek immediate medical help if any of the following occurs: - The seizure lasts more than five minutes. - Breathing or consciousness doesn't return after the seizure stops. - A second seizure follows immediately. - You have a high fever. - You're experiencing heat exhaustion. - You're pregnant. - You have diabetes. - You've injured yourself during the seizure. If you experience a seizure for the first time, seek medical advice. Causes Epilepsy has no identifiable cause in about half the people with the condition. In the other half, the condition may be traced to various factors, including: - Genetic influence. Some types of epilepsy, which are categorized by the type of seizure you experience or the part of the brain that is affected, run in families. In these cases, it's likely that there's a genetic influence. Researchers have linked some types of epilepsy to specific genes, but for most people, genes are only part of the cause of epilepsy. Certain genes may make a person more sensitive to environmental conditions that trigger seizures. - Head trauma. Head trauma as a result of a car accident or other traumatic injury can cause epilepsy. - Brain conditions. Brain conditions that cause damage to the brain, such as brain tumors or strokes, can cause epilepsy. Stroke is a leading cause of epilepsy in adults older than age 35. - Infectious diseases. Infectious diseases, such as meningitis, AIDS and viral encephalitis, can cause epilepsy. - Prenatal injury. Before birth, babies are sensitive to brain damage that could be caused by several factors, such as an infection in the mother, poor nutrition or oxygen deficiencies. This brain damage can result in epilepsy or cerebral palsy. - Developmental disorders. Epilepsy can sometimes be associated with developmental disorders, such as autism and neurofibromatosis. Risk factors Certain factors may increase your risk of epilepsy: - Age. The onset of epilepsy is most common in children and older adults, but the condition can occur at any age. - Family history. If you have a family history of epilepsy, you may be at an increased risk of developing a seizure disorder. - Head injuries. Head injuries are responsible for some cases of epilepsy. You can reduce your risk by wearing a seat belt while riding in a car and by wearing a helmet while bicycling, skiing, riding a motorcycle or engaging in other activities with a high risk of head injury. - Stroke and other vascular diseases. Stroke and other blood vessel (vascular) diseases can lead to brain damage that may trigger epilepsy. You can take a number of steps to reduce your risk of these diseases, including limiting your intake of alcohol and avoiding cigarettes, eating a healthy diet, and exercising regularly. - Dementia. Dementia can increase the risk of epilepsy in older adults. - Brain infections. Infections such as meningitis, which causes inflammation in your brain or spinal cord, can increase your risk. - Seizures in childhood. High fevers in childhood can sometimes be associated with seizures. Children who have seizures due to high fevers generally won't develop epilepsy. The risk of epilepsy increases if a child has a long seizure, another nervous system condition or a family history of epilepsy. Diagnosis To diagnose your condition, your doctor will review your symptoms and medical history. Your doctor may order several tests to diagnose epilepsy and determine the cause of seizures. Your evaluation may include: - A neurological exam. Your doctor may test your behavior, motor abilities, mental function and other areas to diagnose your condition and determine the type of epilepsy you may have. - Blood tests. Your doctor may take a blood sample to check for signs of infections, genetic conditions or other conditions that may be associated with seizures. Your doctor may also suggest tests to detect brain abnormalities, such as: - Electroencephalogram (EEG). This is the most common test used to diagnose epilepsy. In this test, doctors attach electrodes to your scalp with a paste-like substance. The electrodes record the electrical activity of your brain. If you have epilepsy, it's common to have changes in your normal pattern of brain waves, even when you're not having a seizure. Your doctor may monitor you on video while conducting an EEG while you're awake or asleep, to record any seizures you experience. Recording the seizures may help the doctor determine what kind of seizures you're having or rule out other conditions. Your doctor may give you instructions to do something that will cause seizures, such as getting little sleep prior to the test. - High-density EEG. In a variation of an EEG test, your doctor may recommend high-density EEG, which spaces electrodes more closely than conventional EEG - about a half a centimeter apart. High-density EEG may help your doctor more precisely determine which areas of your brain are affected by seizures. - Computerized tomography (CT) scan. A CT scan uses X-rays to obtain cross-sectional images of your brain. CT scans can reveal abnormalities in your brain that might be causing your seizures, such as tumors, bleeding and cysts. - Magnetic resonance imaging (MRI). An MRI uses powerful magnets and radio waves to create a detailed view of your brain. Your doctor may be able to detect lesions or abnormalities in your brain that could be causing your seizures. - Functional MRI (fMRI). A functional MRI measures the changes in blood flow that occur when specific parts of your brain are working. Doctors may use an fMRI before surgery to identify the exact locations of critical functions, such as speech and movement, so that surgeons can avoid injuring those places while operating. - Positron emission tomography (PET). PET scans use a small amount of low-dose radioactive material that's injected into a vein to help visualize active areas of the brain and detect abnormalities. - Single-photon emission computerized tomography (SPECT). This type of test is used primarily if you've had an MRI and EEG that didn't pinpoint the location in your brain where the seizures are originating. A SPECT test uses a small amount of low-dose radioactive material that's injected into a vein to create a detailed, 3-D map of the blood flow activity in your brain during seizures. Doctors also may conduct a form of a SPECT test called subtraction ictal SPECT coregistered to MRI (SISCOM), which may provide even more-detailed results. - Neuropsychological tests. In these tests, doctors assess your thinking, memory and speech skills. The test results help doctors determine which areas of your brain are affected. Along with your test results, your doctor may use a combination of analysis techniques to help pinpoint where in the brain seizures start: - Statistical parametric mapping (SPM). SPM is a method of comparing areas of the brain that have increased metabolism during seizures to normal brains, which can give doctors an idea of where seizures begin. - Curry analysis. Curry analysis is a technique that takes EEG data and projects it onto an MRI of the brain to show doctors where seizures are occurring. - Magnetoencephalography (MEG). MEG measures the magnetic fields produced by brain activity to identify potential areas of seizure onset. Accurate diagnosis of your seizure type and where seizures begin gives you the best chance for finding an effective treatment. Treatment Doctors generally begin by treating epilepsy with medication. If medications don't treat the condition, doctors may propose surgery or another type of treatment. Medication Most people with epilepsy can become seizure-free by taking one anti-seizure medication, which is also called anti-epileptic medication. Others may be able to decrease the frequency and intensity of their seizures by taking a combination of medications. Many children with epilepsy who aren't experiencing epilepsy symptoms can eventually discontinue medications and live a seizure-free life. Many adults can discontinue medications after two or more years without seizures. Your doctor will advise you about the appropriate time to stop taking medications. Finding the right medication and dosage can be complex. Your doctor will consider your condition, frequency of seizures, your age and other factors when choosing which medication to prescribe. Your doctor will also review any other medications you may be taking, to ensure the anti-epileptic medications won't interact with them. Your doctor likely will first prescribe a single medication at a relatively low dosage and may increase the dosage gradually until your seizures are well-controlled. Anti-seizure medications may have some side effects. Mild side effects include: - Fatigue - Dizziness - Weight gain - Loss of bone density - Skin rashes - Loss of coordination - Speech problems - Memory and thinking problems More-severe but rare side effects include: - Depression - Suicidal thoughts and behaviors - Severe rash - Inflammation of certain organs, such as your liver To achieve the best seizure control possible with medication, follow these steps: - Take medications exactly as prescribed. - Always call your doctor before switching to a generic version of your medication or taking other prescription medications, over-the-counter drugs or herbal remedies. - Never stop taking your medication without talking to your doctor. - Notify your doctor immediately if you notice new or increased feelings of depression, suicidal thoughts, or unusual changes in your mood or behaviors. - Tell your doctor if you have migraines. Doctors may prescribe one of the anti-epileptic medications that can prevent your migraines and treat epilepsy. At least half the people newly diagnosed with epilepsy will become seizure-free with their first medication. If anti-epileptic medications don't provide satisfactory results, your doctor may suggest surgery or other therapies. You'll have regular follow-up appointments with your doctor to evaluate your condition and medications. Surgery When medications fail to provide adequate control over seizures, surgery may be an option. With epilepsy surgery, a surgeon removes the area of your brain that's causing seizures. Doctors usually perform surgery when tests show that: - Your seizures originate in a small, well-defined area of your brain - The area in your brain to be operated on doesn't interfere with vital functions such as speech, language, motor function, vision or hearing Although many people continue to need some medication to help prevent seizures after successful surgery, you may be able to take fewer drugs and reduce your dosages. In a small number of cases, surgery for epilepsy can cause complications such as permanently altering your thinking (cognitive) abilities. Talk to your surgeon about his or her experience, success rates, and complication rates with the procedure you're considering. Therapies Apart from medications and surgery, these potential therapies offer an alternative for treating epilepsy: - Vagus nerve stimulation. In vagus nerve stimulation, doctors implant a device called a vagus nerve stimulator underneath the skin of your chest, similar to a heart pacemaker. Wires from the stimulator are connected to the vagus nerve in your neck. The battery-powered device sends bursts of electrical energy through the vagus nerve and to your brain. It's not clear how this inhibits seizures, but the device can usually reduce seizures by 20 to 40 percent. Most people still need to take anti-epileptic medication, although some people may be able to lower their medication dose. You may experience side effects from vagus nerve stimulation, such as throat pain, hoarse voice, shortness of breath or coughing. - Ketogenic diet. Some children with epilepsy have been able to reduce their seizures by following a strict diet that's high in fats and low in carbohydrates. In this diet, called a ketogenic diet, the body breaks down fats instead of carbohydrates for energy. After a few years, some children may be able to stop the ketogenic diet - under close supervision of their doctors - and remain seizure-free. Consult a doctor if you or your child is considering a ketogenic diet. It's important to make sure that your child doesn't become malnourished when following the diet. Side effects of a ketogenic diet may include dehydration, constipation, slowed growth because of nutritional deficiencies and a buildup of uric acid in the blood, which can cause kidney stones. These side effects are uncommon if the diet is properly and medically supervised. Following a ketogenic diet can be a challenge. Low-glycemic index and modified Atkins diets offer less restrictive alternatives that may still provide some benefit for seizure control. Potential future treatments Researchers are studying many potential new treatments for epilepsy, including: - Deep brain stimulation. In deep brain stimulation, surgeons implant electrodes into a specific part of your brain, typically your thalamus. The electrodes are connected to a generator implanted in your chest or the skull that sends electrical pulses to your brain and may reduce your seizures. - Responsive neurostimulation. Implantable, pacemaker-like devices that help prevent seizures are also under investigation. These responsive stimulation or closed loop devices analyze brain activity patterns to detect seizures before they happen and deliver an electrical charge or drug to stop the seizure. - Continuous stimulation of the seizure onset zone (subthreshold stimulation). Subthreshold stimulation - continuous stimulation to an area of your brain below a level that's physically noticeable - appears to improve seizure outcomes and quality of life for some people with seizures. This treatment approach may work in people who have seizures that start in an area of the brain that can't be removed because it would affect speech and motor functions (eloquent area). Or it might benefit people whose seizure characteristics mean their chances of successful treatment with responsive neurostimulation are low. - Minimally invasive surgery. New minimally invasive surgical techniques, such as MRI-guided laser ablation, show promise at reducing seizures with fewer risks than traditional open brain surgery for epilepsy. - Stereotactic laser ablation or radiosurgery. For some types of epilepsy, stereotactic laser ablation or stereotactic radiosurgery may provide effective treatment for people in which an open procedure may be too risky. In these procedures, doctors direct radiation at the specific area in the brain causing seizures, to destroy that tissue in an effort to better control the seizures. - External nerve stimulation device. Similar to vagus nerve stimulation, this device would stimulate specific nerves to reduce frequency of seizures. But unlike vagus nerve stimulation, this device would be worn externally so that no surgery to implant the device is needed. Lifestyle and home remedies Understanding your condition can help you take better control of it: - Take your medication correctly. Don't adjust your dosage before talking to your doctor. If you feel your medication should be changed, discuss it with your doctor. - Get enough sleep. Lack of sleep can trigger seizures. Be sure to get adequate rest every night. - Wear a medical alert bracelet. This will help emergency personnel know how to treat you correctly. - Exercise. Exercising may help keep you physically healthy and reduce depression. Make sure to drink enough water, and rest if you get tired during exercise. In addition, make healthy life choices, such as managing stress, limiting alcoholic beverages and avoiding cigarettes. how is epilepsy diagnosed

how is epilepsy diagnosed

Epilepsy - children (Exams and Tests): The provider will: - Ask about your child's medical and family history in detail - Ask about the seizure episode - Do a physical exam of your child, including a detailed look at the brain and nervous system The provider will order an EEG (electroencephalogram) to check the electrical activity in the brain. This test often shows any abnormal electrical activity in the brain. In some cases, the test shows the area in the brain where the seizures start. To diagnose epilepsy or plan for epilepsy surgery, your child may need to: - Wear an EEG recorder for few days during day-to-day activities - Stay in the hospital where brain activity can be watched on video cameras (video EEG) The provider also may order other tests, including: - Blood chemistry - Blood sugar - Complete blood count (CBC) - Kidney function tests - Liver function tests - Lumbar puncture (spinal tap) - Tests for infectious diseases Head CT or MRI scan are often done to find the cause and location of the problem in the brain.

Epilepsy in children Seizure disorder - children Convulsion - childhood epilepsy Medically refractory childhood epilepsy Anticonvulsant - childhood epilepsy Antiepileptic drug - childhood epilepsy AED - childhood epilepsy Summary Epilepsy is a brain disorder in which a person has repeated seizures over time. A seizure is a sudden change in the electrical and chemical activity in the brain. A single seizure that does not happen again is NOT epilepsy. Causes Epilepsy may be due to a medical condition or injury that affects the brain. Or the cause may be unknown. Common causes of epilepsy include: Traumatic brain injury Damage or scarring after infections of the brain Birth defects that involve the brain Brain injury that occurs during or near birth Metabolic disorders present at birth (such as phenylketonuria) Benign brain tumor, often very small Abnormal blood vessels in the brain Stroke Other illnesses that damage or destroy brain tissue Epileptic seizures usually start between ages 5 and 20. But they can happen at any age. There may be a family history of seizures or epilepsy. A febrile seizure is a convulsion in a child triggered by a fever. Most of the time, a febrile seizure is not a sign that the child has epilepsy. Symptoms Symptoms vary from child to child. Some children may simply stare. Others may shake violently and lose alertness. The movements or symptoms of a seizure may depend on the part of the brain that is affected. Your child's health care provider can tell you more about the specific type of seizure your child may have: Absence (petit mal) seizure: Staring spells Generalized tonic-clonic (grand mal) seizure: Involves the entire body, including aura, rigid muscles, and loss of alertness Partial (focal) seizure: Can involve any of the symptoms described above, depending on where in the brain the seizure starts Most of the time, the seizure is similar to the one before it. Some children have a strange sensation before a seizure. Sensations may be tingling, smelling an odor that is not actually there, feeling fear or anxiety for no reason or having a sense of deja vu (feeling that something has happened before). This is called an aura. Exams and Tests The provider will: Ask about your child's medical and family history in detail Ask about the seizure episode Do a physical exam of your child, including a detailed look at the brain and nervous system The provider will order an EEG (electroencephalogram) to check the electrical activity in the brain. This test often shows any abnormal electrical activity in the brain. In some cases, the test shows the area in the brain where the seizures start. The brain may appear normal after a seizure or between seizures. To diagnose epilepsy or plan for epilepsy surgery, your child may need to: Wear an EEG recorder for few days during day-to-day activities Stay in the hospital where brain activity can be watched on video cameras (video EEG) The provider also may order other tests, including: Blood chemistry Blood sugar Complete blood count (CBC) Kidney function tests Liver function tests Lumbar puncture (spinal tap) Tests for infectious diseases Head CT or MRI scan are often done to find the cause and location of the problem in the brain. Much less often, PET scan of the brain is needed to help plan surgery. Treatment Treatment for epilepsy includes: Medicines Lifestyle changes Surgery If your child's epilepsy is due to a tumor, abnormal blood vessels, or bleeding in the brain, surgery may be needed. Medicines to prevent seizures are called anticonvulsants or antiepileptic drugs. These may reduce the number of future seizures. These medicines are taken by mouth. The type of medicine prescribed depends on the type of seizure your child has. The dosage may need to be changed from time to time. The provider may order regular blood tests to check for side effects. Always make sure your child takes the medicine on time and as directed. Missing a dose can cause your child to have a seizure. Do NOT stop or change medicines on your own. Talk to the provider first. Many epilepsy drugs may affect your child's bone health. Talk to your child's provider about whether your child needs vitamins and other supplements. Epilepsy that is not well controlled after trying a number of antiseizure drugs is called "medically refractory epilepsy." In this case, the doctor may recommend surgery to: Remove the abnormal brain cells causing the seizures. Place a vagal nerve stimulator (VNS). This device is similar to a heart pacemaker. It can help reduce the number of seizures. Some children are placed on a special diet to help prevent seizures. The most popular one is the ketogenic diet. A diet low in carbohydrates, such as the Atkins diet, also may be helpful. Be sure to discuss these options with your child's provider before trying them. Epilepsy is often a lifelong or chronic illness. Important management issues include: Taking medicines Staying safe, such as never swimming alone, fall-proofing your home and so on Managing stress and sleep Avoiding alcohol and drug abuse Keeping up in school Managing other illnesses Managing these lifestyle or medical issues at home can be a challenge. Be sure to talk with your child's provider if you have concerns. Support Groups The stress of being a caretaker of a child with epilepsy can often be helped by joining a support group. In these groups, members share common experiences and problems. Outlook (Prognosis) Most children with epilepsy live a normal life. Certain types of childhood epilepsy go away or improve with age, usually in the late teens or 20s. If your child does not have seizures for a few years, the provider may stop medicines. For many children, epilepsy is a lifelong condition. In these cases, the medicines need to be continued. Children who have developmental disorders in addition to epilepsy may face challenges throughout their life. Knowing more about the condition will help you take better care of your child's epilepsy. Possible Complications Complications may include: Difficulty learning Breathing in food or saliva into the lungs during a seizure, which can cause aspiration pneumonia Irregular heartbeat Injury from falls, bumps, or self-caused bites during a seizure Permanent brain damage (stroke or other damage) Side effects of medicines When to Contact a Medical Professional Call your local emergency number (such as 911) if: This is the first time your child has a seizure A seizure occurs in a child who is not wearing a medical ID bracelet (which has instructions explaining what to do) If your child has had seizures before, call 911 for any of these emergency situations: The seizure is longer than the child normally has or the child has an unusual number of seizures The child has repeated seizures over a few minutes The child has repeated seizures in which consciousness or normal behavior is not regained between them (status epilepticus) The child gets injured during the seizure The child has difficulty breathing Call the provider if your child has new symptoms: Nausea or vomiting Rash Side effects of medicines, such as drowsiness, restlessness, or confusion Tremors or abnormal movements, or problems with coordination Contact the provider even if your child is normal after the seizure has stopped. Prevention There is no known way to prevent epilepsy. Proper diet and sleep may decrease the chances of seizures in children with epilepsy. Reduce the risk of head injury during risky activities. This can decrease the likelihood of a brain injury that leads to seizures and epilepsy. Review Date 4/30/2018 Updated by: Amit M. Shelat, DO, FACP, Attending Neurologist and Assistant Professor of Clinical Neurology, SUNY Stony Brook, School of Medicine, Stony Brook, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how is epilepsy diagnosed

how is epilepsy diagnosed

Epilepsy - overview (Exams and Tests): The doctor will perform a physical exam. This will include a detailed look at the brain and nervous system. An EEG (electroencephalogram) will be done to check the electrical activity in the brain. People with epilepsy often have abnormal electrical activity seen on this test. In some cases, the test shows the area in the brain where the seizures start. To diagnose epilepsy or plan for epilepsy surgery, you may need to: - Wear an EEG recorder for days or weeks as you go about your everyday life. - Stay in a special hospital where brain activity can be recorded while video cameras capture what happens to you during the seizure. This is called video EEG. Tests that may be done include: - Blood chemistry - Blood sugar - Complete blood count (CBC) - Kidney function tests - Liver function tests - Lumbar puncture (spinal tap) - Tests for infectious diseases Head CT or MRI scan is often done to find the cause and location of the problem in the brain.

Epilepsy - overview Seizure disorder Epileptic - epilepsy Summary Epilepsy is a brain disorder in which a person has repeated seizures over time. Seizures are episodes of uncontrolled and abnormal firing of brain cells that may cause changes in attention or behavior. Causes Epilepsy occurs when changes in the brain cause it to be too excitable or irritable. As a result, the brain sends out abnormal signals. This leads to repeated, unpredictable seizures. (A single seizure that does not happen again is not epilepsy.) Epilepsy may be due to a medical condition or injury that affects the brain. Or, the cause may be unknown (idiopathic). Common causes of epilepsy include: Stroke or transient ischemic attack (TIA) Dementia, such as Alzheimer disease Traumatic brain injury Infections, including brain abscess, meningitis, encephalitis, and HIV/AIDS Brain problems that are present at birth (congenital brain defect) Brain injury that occurs during or near birth Metabolism disorders present at birth (such as phenylketonuria) Brain tumor Abnormal blood vessels in the brain Other illness that damages or destroys brain tissue Seizure disorders that run in families (hereditary epilepsy) Epileptic seizures usually begin between ages 5 and 20. There is also a higher chance of seizures in adults older than 60. But epileptic seizures can happen at any age. There may be a family history of seizures or epilepsy. Symptoms Symptoms vary from person to person. Some people may have simple staring spells. Others have violent shaking and loss of alertness. The type of seizure depends on the part of the brain that is affected. Most of the time, the seizure is similar to the one before it. Some people with epilepsy have a strange sensation before each seizure. Sensations may be tingling, smelling an odor that is not actually there, or emotional changes. This is called an aura. Your doctor can tell you more about the specific type of seizure you may have: Absence (petit mal) seizure (staring spells) Generalized tonic-clonic (grand mal) seizure (involves the entire body, including aura, rigid muscles, and loss of alertness) Partial (focal) seizure (can involve any of the symptoms described above, depending on where in the brain the seizure starts) Exams and Tests The doctor will perform a physical exam. This will include a detailed look at the brain and nervous system. An EEG (electroencephalogram) will be done to check the electrical activity in the brain. People with epilepsy often have abnormal electrical activity seen on this test. In some cases, the test shows the area in the brain where the seizures start. The brain may appear normal after a seizure or between seizures. To diagnose epilepsy or plan for epilepsy surgery, you may need to: Wear an EEG recorder for days or weeks as you go about your everyday life. Stay in a special hospital where brain activity can be recorded while video cameras capture what happens to you during the seizure. This is called video EEG. Tests that may be done include: Blood chemistry Blood sugar Complete blood count (CBC) Kidney function tests Liver function tests Lumbar puncture (spinal tap) Tests for infectious diseases Head CT or MRI scan is often done to find the cause and location of the problem in the brain. Treatment Treatment for epilepsy includes taking medicines, lifestyle changes, and sometimes surgery. If epilepsy is due to a tumor, abnormal blood vessels, or bleeding in the brain, surgery to treat these disorders may make the seizures stop. Medicines to prevent seizures, called anticonvulsants (or antiepileptic drugs), may reduce the number of future seizures: These drugs are taken by mouth. Which type you are prescribed depends on the type of seizures you have. Your dosage may need to be changed from time to time. You may need regular blood tests to check for side effects. Always take your medicine on time and as directed. Missing a dose can cause you to have a seizure. DO NOT stop taking or change medicines on your own. Talk to your doctor first. Many epilepsy medicines cause birth defects. Women who plan to become pregnant should tell their doctor in advance in order to adjust medicines. Many epilepsy drugs may affect the health of your bones. Talk to your doctor about whether you need vitamins and other supplements. Epilepsy that does not get better after 2 or 3 anti-seizure drugs have been tried is called "medically refractory epilepsy." In this case, the doctor may recommend surgery to: Remove the abnormal brain cells causing the seizures. Place a vagal nerve stimulator (VNS). This device is similar to a heart pacemaker. It can help reduce the number of seizures. Some children are placed on a special diet to help prevent seizures. The most popular one is the ketogenic diet. A diet low in carbohydrates, such as the Atkins diet, may also be helpful in some adults. Be sure to discuss these options with your doctor before trying them. Lifestyle or medical changes can increase the risk for a seizure in adults and children with epilepsy. Talk with your doctor about: New prescribed drugs, vitamins, or supplements Emotional stress Illness, especially infection Lack of sleep Pregnancy Skipping doses of epilepsy medicines Use of alcohol or other recreational drugs Other considerations: People with epilepsy should wear medical alert jewelry so that prompt treatment can be obtained if a seizure occurs. People with poorly controlled epilepsy should not drive. Check your state's law about which people with a history of seizures are allowed to drive. DO NOT use machinery or do activities that can cause loss of awareness, such as climbing to high places, biking, and swimming alone. Support Groups The stress of having epilepsy or being a caretaker of someone with epilepsy can often be helped by joining a support group. In these groups, members share common experiences and problems. Outlook (Prognosis) Some people with epilepsy may be able to reduce or even stop their anti-seizure medicines after having no seizures for several years. Certain types of childhood epilepsy go away or improve with age, usually in the late teens or 20s. For many people, epilepsy is a lifelong condition. In these cases, anti-seizure drugs need to be continued. There is a very low risk for sudden death with epilepsy. Possible Complications Complications may include: Difficulty learning Breathing in food or saliva into the lungs during a seizure, which can cause aspiration pneumonia Injury from falls, bumps, self-inflicted bites, driving or operating machinery during a seizure Permanent brain damage (stroke or other damage) Side effects of medicines When to Contact a Medical Professional Call your local emergency number (such as 911) if: This is the first time a person has a seizure A seizure occurs in someone who is not wearing a medical ID bracelet (which has instructions explaining what to do) In the case of someone who has had seizures before, call 911 for any of these emergency situations: This is a longer seizure than the person normally has, or an unusual number of seizures for the person Repeated seizures over a few minutes Repeated seizures in which consciousness or normal behavior is not regained between them (status epilepticus) Call your doctor if any new symptoms occur: Loss of hair Nausea or vomiting Rash Side effects of medicines, such as drowsiness, restlessness, confusion, sedation Tremors or abnormal movements, or problems with coordination Prevention There is no known way to prevent epilepsy. Proper diet and sleep, and staying away from alcohol and illegal drugs may decrease the likelihood of triggering seizures in people with epilepsy. Reduce the risk for head injury by wearing a helmet during risky activities. This can lessen the likelihood of a brain injury that leads to seizures and epilepsy. Review Date 2/27/2018 Updated by: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School at Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how is epilepsy diagnosed

how is epilepsy diagnosed

Prescription ibuprofen comes as a tablet to take by mouth. It is usually taken three or four times a day for arthritis or every 4 to 6 hours as needed for pain. Nonprescription ibuprofen comes as a tablet, chewable tablet, suspension (liquid), and drops (concentrated liquid). Adults and children older than 12 years of age may usually take nonprescription ibuprofen every 4 to 6 hours as needed for pain or fever. Children and infants may usually be given nonprescription ibuprofen every 6 to 8 hours as needed for pain or fever, but should not be given more than 4 doses in 24 hours.

Ibuprofen IMPORTANT WARNING: People who take nonsteroidal anti-inflammatory drugs (NSAIDs) (other than aspirin) such as ibuprofen may have a higher risk of having a heart attack or a stroke than people who do not take these medications. These events may happen without warning and may cause death. This risk may be higher for people who take NSAIDs for a long time. Do not take an NSAID such as ibuprofen if you have recently had a heart attack, unless directed to do so by your doctor. Tell your doctor if you or anyone in your family has or has ever had heart disease, a heart attack, or a stroke; if you smoke; and if you have or have ever had high cholesterol, high blood pressure, or diabetes. Get emergency medical help right away if you experience any of the following symptoms: chest pain, shortness of breath, weakness in one part or side of the body, or slurred speech. If you will be undergoing a coronary artery bypass graft (CABG; a type of heart surgery), you should not take ibuprofen right before or right after the surgery. NSAIDs such as ibuprofen may cause ulcers, bleeding, or holes in the stomach or intestine. These problems may develop at any time during treatment, may happen without warning symptoms, and may cause death. The risk may be higher for people who take NSAIDs for a long time, are older in age, have poor health, or who drink three or more alcoholic drinks per day while taking ibuprofen. Tell your doctor if you take any of the following medications: anticoagulants ('blood thinners') such as warfarin (Coumadin, Jantoven); aspirin; other NSAIDs such as ketoprofen and naproxen (Aleve, Naprosyn); oral steroids such as dexamethasone, methylprednisolone (Medrol), and prednisone (Rayos); selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa), fluoxetine (Prozac, Sarafem, Selfemra, in Symbyax), fluvoxamine (Luvox), paroxetine (Brisdelle, Paxil, Pexeva), and sertraline (Zoloft); or serotonin norepinephrine reuptake inhibitors (SNRIs) such as desvenlafaxine (Khedezla, Pristiq), duloxetine (Cymbalta), and venlafaxine (Effexor XR). Also tell your doctor if you have or have ever had ulcers, bleeding in your stomach or intestines, or other bleeding disorders. If you experience any of the following symptoms, stop taking ibuprofen and call your doctor: stomach pain, heartburn, vomit that is bloody or looks like coffee grounds, blood in the stool, or black and tarry stools. Keep all appointments with your doctor and the laboratory. Your doctor will monitor your symptoms carefully and will probably order certain tests to check your body's response to ibuprofen. Be sure to tell your doctor how you are feeling so that your doctor can prescribe the right amount of medication to treat your condition with the lowest risk of serious side effects. Your doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with prescription ibuprofen and each time you refill your prescription. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) or the manufacturer's website to obtain the Medication Guide. Why is this medication prescribed? Prescription ibuprofen is used to relieve pain, tenderness, swelling, and stiffness caused by osteoarthritis (arthritis caused by a breakdown of the lining of the joints) and rheumatoid arthritis (arthritis caused by swelling of the lining of the joints). It is also used to relieve mild to moderate pain, including menstrual pain (pain that happens before or during a menstrual period). Nonprescription ibuprofen is used to reduce fever and to relieve minor aches and pain from headaches, muscle aches, arthritis, menstrual periods, the common cold, toothaches, and backaches. Ibuprofen is in a class of medications called NSAIDs. It works by stopping the body's production of a substance that causes pain, fever, and inflammation. How should this medicine be used? Prescription ibuprofen comes as a tablet to take by mouth. It is usually taken three or four times a day for arthritis or every 4 to 6 hours as needed for pain. Nonprescription ibuprofen comes as a tablet, chewable tablet, suspension (liquid), and drops (concentrated liquid). Adults and children older than 12 years of age may usually take nonprescription ibuprofen every 4 to 6 hours as needed for pain or fever. Children and infants may usually be given nonprescription ibuprofen every 6 to 8 hours as needed for pain or fever, but should not be given more than 4 doses in 24 hours. Ibuprofen may be taken with food or milk to prevent stomach upset. If you are taking ibuprofen on a regular basis, you should take it at the same time(s) every day. Follow the directions on the package or prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take ibuprofen exactly as directed. Do not take more or less of it or take it more often than directed by the package label or prescribed by your doctor. Ibuprofen comes alone and in combination with other medications. Some of these combination products are available by prescription only, and some of these combination products are available without a prescription and are used to treat cough and cold symptoms and other conditions. If your doctor has prescribed a medication that contains ibuprofen, you should be careful not to take any nonprescription medications that also contain ibuprofen. If you are selecting a product to treat cough or cold symptoms, ask your doctor or pharmacist for advice on which product is best for you. Check nonprescription product labels carefully before using two or more products at the same time. These products may contain the same active ingredient(s) and taking them together could cause you to receive an overdose. This is especially important if you will be giving cough and cold medications to a child. Nonprescription cough and cold combination products, including products that contain ibuprofen, can cause serious side effects or death in young children. Do not give these products to children younger than 4 years of age. If you give these products to children 4 to 11 years of age, use caution and follow the package directions carefully. If you are giving ibuprofen or a combination product that contains ibuprofen to a child, read the package label carefully to be sure that it is the right product for a child of that age. Do not give ibuprofen products that are made for adults to children. Before you give an ibuprofen product to a child, check the package label to find out how much medication the child should receive. Give the dose that matches the child's age on the chart. Ask the child's doctor if you don't know how much medication to give the child. Shake the suspension and drops well before each use to mix the medication evenly. Use the measuring cup provided to measure each dose of the suspension, and use the dosing device provided to measure each dose of the drops. The chewable tablets may cause a burning feeling in the mouth or throat. Take the chewable tablets with food or water. Stop taking nonprescription ibuprofen and call your doctor if your symptoms get worse, you develop new or unexpected symptoms, the part of your body that was painful becomes red or swollen, your pain lasts for more than 10 days, or your fever lasts more than 3 days. Stop giving nonprescription ibuprofen to your child and call your child's doctor if your child does not start to feel better during the first 24 hours of treatment. Also stop giving nonprescription ibuprofen to your child and call your child's doctor if your child develops new symptoms, including redness or swelling on the painful part of his body, or if your child's pain or fever get worse or lasts longer than 3 days. Do not give nonprescription ibuprofen to a child who has a sore throat that is severe or does not go away, or that comes along with fever, headache, nausea, or vomiting. Call the child's doctor right away, because these symptoms may be signs of a more serious condition. Other uses for this medicine Ibuprofen is also sometimes used to treat ankylosing spondylitis (arthritis that mainly affects the spine), gouty arthritis (joint pain caused by a build-up of certain substances in the joints), and psoriatic arthritis (arthritis that occurs with a long-lasting skin disease that causes scaling and swelling). Talk to your doctor about the risks of using this drug for your condition. This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information. What special precautions should I follow? <h3>Before taking ibuprofen,</h3> /h3> tell your doctor and pharmacist if you are allergic to ibuprofen, aspirin or other NSAIDs such as ketoprofen and naproxen (Aleve, Naprosyn), any other medications, or any of the inactive ingredients in the type of ibuprofen you plan to take. Ask your pharmacist or check the label on the package for a list of the inactive ingredients. tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention the medications listed in the IMPORTANT WARNING section and any of the following: angiotensin-converting enzyme (ACE) inhibitors such as benazepril (Lotensin, in Lotrel), captopril, enalapril (Vasotec, in Vaseretic), fosinopril, lisinopril (in Zestoretic), moexipril (Univasc), perindopril (Aceon, in Prestalia), quinapril (Accupril, in Quinaretic), ramipril (Altace), and trandolapril (Mavik, in Tarka); angiotensin receptor blockers such as candesartan (Atacand, in Atacand HCT), eprosartan (Teveten), irbesartan (Avapro, in Avalide), losartan (Cozaar, in Hyzaar), olmesartan (Benicar, in Azor, in Benicar HCT, in Tribenzor), telmisartan (Micardis, in Micardis HCT, in Twynsta), and valsartan (in Exforge HCT); beta blockers such as atenolol (Tenormin, in Tenoretic), labetalol (Trandate), metoprolol (Lopressor, Toprol XL, in Dutoprol), nadolol (Corgard, in Corzide), and propranolol (Hemangeol, Inderal, Innopran); diuretics ('water pills'); lithium (Lithobid); and methotrexate (Otrexup, Rasuvo, Trexall). Your doctor may need to change the doses of your medications or monitor you more carefully for side effects. do not take nonprescription ibuprofen with any other medication for pain unless your doctor tells you that you should. tell your doctor if you have or have ever had any of the conditions mentioned in the IMPORTANT WARNING section or asthma, especially if you also have frequent stuffed or runny nose or nasal polyps (swelling of the inside of the nose); heart failure; swelling of the hands, arms, feet, ankles, or lower legs; lupus (a condition in which the body attacks many of its own tissues and organs, often including the skin, joints, blood, and kidneys); or liver or kidney disease. If you are giving ibuprofen to a child, tell the child's doctor if the child has not been drinking fluids or has lost a large amount of fluid from repeated vomiting or diarrhea. tell your doctor if you are pregnant, especially if you are in the last few months of your pregnancy; you plan to become pregnant; or you are breast-feeding. If you become pregnant while taking ibuprofen, call your doctor. if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking ibuprofen. if you have phenylketonuria (PKU, an inborn disease in which mental retardation develops if a specific diet is not followed), read the package label carefully before taking nonprescription ibuprofen. Some types of nonprescription ibuprofen may be sweetened with aspartame, a source of phenylalanine. What special dietary instructions should I follow? Unless your doctor tells you otherwise, continue your normal diet. What should I do if I forget a dose? If you are taking ibuprofen on a regular basis, take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one. What side effects can this medication cause? <h3>Ibuprofen may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: </h3> /h3> constipation diarrhea gas or bloating dizziness nervousness ringing in the ears <h3>Some side effects can be serious. If you experience any of the following symptoms, or those mentioned in the IMPORTANT WARNING section, call your doctor immediately. Do not take any more ibuprofen until you speak to your doctor. </h3> /h3> unexplained weight gain shortness of breath or difficulty breathing swelling of the abdomen, feet, ankles, or lower legs fever blisters rash itching hives swelling of the eyes, face, throat, arms, or hands difficulty breathing or swallowing hoarseness excessive tiredness pain in the upper right part of the stomach nausea loss of appetite yellowing of the skin or eyes flu-like symptoms pale skin fast heartbeat cloudy, discolored, or bloody urine back pain difficult or painful urination blurred vision, changes in color vision, or other vision problems red or painful eyes stiff neck headache confusion aggression Ibuprofen may cause other side effects. Call your doctor if you have any unusual problems while taking this medication. If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088). What should I know about storage and disposal of this medication? Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program. It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location - one that is up and away and out of their sight and reach. http://www.upandaway.org In case of emergency/overdose In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911. <h3>Symptoms of overdosage may include: </h3> /h3> dizziness fast eye movements that you cannot control slow breathing or short periods of time without breathing blue color around the lips, mouth, and nose What other information should I know? If you are taking prescription ibuprofen, do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies. Brand names Addaprin Advil Cedaprin I-Prin Midol Motrin Motrin IB NeoProfen Profen IB Proprinal Ultraprin Brand names of combination products Advil PM (containing Diphenhydramine, Ibuprofen) Combunox (containing Ibuprofen, Oxycodone) Duexis (containing Famotidine, Ibuprofen) Ibudone (containing Hydrocodone, Ibuprofen) Reprexain (containing Hydrocodone, Ibuprofen) Vicoprofen (containing Hydrocodone, Ibuprofen) how much ibuprofen is too much

how much ibuprofen is too much

Prescription ibuprofen comes as a tablet to take by mouth. It is usually taken three or four times a day for arthritis or every 4 to 6 hours as needed for pain. Nonprescription ibuprofen comes as a tablet, chewable tablet, suspension (liquid), and drops (concentrated liquid). Adults and children older than 12 years of age may usually take nonprescription ibuprofen every 4 to 6 hours as needed for pain or fever. Children and infants may usually be given nonprescription ibuprofen every 6 to 8 hours as needed for pain or fever, but should not be given more than 4 doses in 24 hours.

Ibuprofen IMPORTANT WARNING: People who take nonsteroidal anti-inflammatory drugs (NSAIDs) (other than aspirin) such as ibuprofen may have a higher risk of having a heart attack or a stroke than people who do not take these medications. These events may happen without warning and may cause death. This risk may be higher for people who take NSAIDs for a long time. Do not take an NSAID such as ibuprofen if you have recently had a heart attack, unless directed to do so by your doctor. Tell your doctor if you or anyone in your family has or has ever had heart disease, a heart attack, or a stroke; if you smoke; and if you have or have ever had high cholesterol, high blood pressure, or diabetes. Get emergency medical help right away if you experience any of the following symptoms: chest pain, shortness of breath, weakness in one part or side of the body, or slurred speech. If you will be undergoing a coronary artery bypass graft (CABG; a type of heart surgery), you should not take ibuprofen right before or right after the surgery. NSAIDs such as ibuprofen may cause ulcers, bleeding, or holes in the stomach or intestine. These problems may develop at any time during treatment, may happen without warning symptoms, and may cause death. The risk may be higher for people who take NSAIDs for a long time, are older in age, have poor health, or who drink three or more alcoholic drinks per day while taking ibuprofen. Tell your doctor if you take any of the following medications: anticoagulants ('blood thinners') such as warfarin (Coumadin, Jantoven); aspirin; other NSAIDs such as ketoprofen and naproxen (Aleve, Naprosyn); oral steroids such as dexamethasone, methylprednisolone (Medrol), and prednisone (Rayos); selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa), fluoxetine (Prozac, Sarafem, Selfemra, in Symbyax), fluvoxamine (Luvox), paroxetine (Brisdelle, Paxil, Pexeva), and sertraline (Zoloft); or serotonin norepinephrine reuptake inhibitors (SNRIs) such as desvenlafaxine (Khedezla, Pristiq), duloxetine (Cymbalta), and venlafaxine (Effexor XR). Also tell your doctor if you have or have ever had ulcers, bleeding in your stomach or intestines, or other bleeding disorders. If you experience any of the following symptoms, stop taking ibuprofen and call your doctor: stomach pain, heartburn, vomit that is bloody or looks like coffee grounds, blood in the stool, or black and tarry stools. Keep all appointments with your doctor and the laboratory. Your doctor will monitor your symptoms carefully and will probably order certain tests to check your body's response to ibuprofen. Be sure to tell your doctor how you are feeling so that your doctor can prescribe the right amount of medication to treat your condition with the lowest risk of serious side effects. Your doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with prescription ibuprofen and each time you refill your prescription. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) or the manufacturer's website to obtain the Medication Guide. Why is this medication prescribed? Prescription ibuprofen is used to relieve pain, tenderness, swelling, and stiffness caused by osteoarthritis (arthritis caused by a breakdown of the lining of the joints) and rheumatoid arthritis (arthritis caused by swelling of the lining of the joints). It is also used to relieve mild to moderate pain, including menstrual pain (pain that happens before or during a menstrual period). Nonprescription ibuprofen is used to reduce fever and to relieve minor aches and pain from headaches, muscle aches, arthritis, menstrual periods, the common cold, toothaches, and backaches. Ibuprofen is in a class of medications called NSAIDs. It works by stopping the body's production of a substance that causes pain, fever, and inflammation. How should this medicine be used? Prescription ibuprofen comes as a tablet to take by mouth. It is usually taken three or four times a day for arthritis or every 4 to 6 hours as needed for pain. Nonprescription ibuprofen comes as a tablet, chewable tablet, suspension (liquid), and drops (concentrated liquid). Adults and children older than 12 years of age may usually take nonprescription ibuprofen every 4 to 6 hours as needed for pain or fever. Children and infants may usually be given nonprescription ibuprofen every 6 to 8 hours as needed for pain or fever, but should not be given more than 4 doses in 24 hours. Ibuprofen may be taken with food or milk to prevent stomach upset. If you are taking ibuprofen on a regular basis, you should take it at the same time(s) every day. Follow the directions on the package or prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take ibuprofen exactly as directed. Do not take more or less of it or take it more often than directed by the package label or prescribed by your doctor. Ibuprofen comes alone and in combination with other medications. Some of these combination products are available by prescription only, and some of these combination products are available without a prescription and are used to treat cough and cold symptoms and other conditions. If your doctor has prescribed a medication that contains ibuprofen, you should be careful not to take any nonprescription medications that also contain ibuprofen. If you are selecting a product to treat cough or cold symptoms, ask your doctor or pharmacist for advice on which product is best for you. Check nonprescription product labels carefully before using two or more products at the same time. These products may contain the same active ingredient(s) and taking them together could cause you to receive an overdose. This is especially important if you will be giving cough and cold medications to a child. Nonprescription cough and cold combination products, including products that contain ibuprofen, can cause serious side effects or death in young children. Do not give these products to children younger than 4 years of age. If you give these products to children 4 to 11 years of age, use caution and follow the package directions carefully. If you are giving ibuprofen or a combination product that contains ibuprofen to a child, read the package label carefully to be sure that it is the right product for a child of that age. Do not give ibuprofen products that are made for adults to children. Before you give an ibuprofen product to a child, check the package label to find out how much medication the child should receive. Give the dose that matches the child's age on the chart. Ask the child's doctor if you don't know how much medication to give the child. Shake the suspension and drops well before each use to mix the medication evenly. Use the measuring cup provided to measure each dose of the suspension, and use the dosing device provided to measure each dose of the drops. The chewable tablets may cause a burning feeling in the mouth or throat. Take the chewable tablets with food or water. Stop taking nonprescription ibuprofen and call your doctor if your symptoms get worse, you develop new or unexpected symptoms, the part of your body that was painful becomes red or swollen, your pain lasts for more than 10 days, or your fever lasts more than 3 days. Stop giving nonprescription ibuprofen to your child and call your child's doctor if your child does not start to feel better during the first 24 hours of treatment. Also stop giving nonprescription ibuprofen to your child and call your child's doctor if your child develops new symptoms, including redness or swelling on the painful part of his body, or if your child's pain or fever get worse or lasts longer than 3 days. Do not give nonprescription ibuprofen to a child who has a sore throat that is severe or does not go away, or that comes along with fever, headache, nausea, or vomiting. Call the child's doctor right away, because these symptoms may be signs of a more serious condition. Other uses for this medicine Ibuprofen is also sometimes used to treat ankylosing spondylitis (arthritis that mainly affects the spine), gouty arthritis (joint pain caused by a build-up of certain substances in the joints), and psoriatic arthritis (arthritis that occurs with a long-lasting skin disease that causes scaling and swelling). Talk to your doctor about the risks of using this drug for your condition. This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information. What special precautions should I follow? <h3>Before taking ibuprofen,</h3> /h3> tell your doctor and pharmacist if you are allergic to ibuprofen, aspirin or other NSAIDs such as ketoprofen and naproxen (Aleve, Naprosyn), any other medications, or any of the inactive ingredients in the type of ibuprofen you plan to take. Ask your pharmacist or check the label on the package for a list of the inactive ingredients. tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention the medications listed in the IMPORTANT WARNING section and any of the following: angiotensin-converting enzyme (ACE) inhibitors such as benazepril (Lotensin, in Lotrel), captopril, enalapril (Vasotec, in Vaseretic), fosinopril, lisinopril (in Zestoretic), moexipril (Univasc), perindopril (Aceon, in Prestalia), quinapril (Accupril, in Quinaretic), ramipril (Altace), and trandolapril (Mavik, in Tarka); angiotensin receptor blockers such as candesartan (Atacand, in Atacand HCT), eprosartan (Teveten), irbesartan (Avapro, in Avalide), losartan (Cozaar, in Hyzaar), olmesartan (Benicar, in Azor, in Benicar HCT, in Tribenzor), telmisartan (Micardis, in Micardis HCT, in Twynsta), and valsartan (in Exforge HCT); beta blockers such as atenolol (Tenormin, in Tenoretic), labetalol (Trandate), metoprolol (Lopressor, Toprol XL, in Dutoprol), nadolol (Corgard, in Corzide), and propranolol (Hemangeol, Inderal, Innopran); diuretics ('water pills'); lithium (Lithobid); and methotrexate (Otrexup, Rasuvo, Trexall). Your doctor may need to change the doses of your medications or monitor you more carefully for side effects. do not take nonprescription ibuprofen with any other medication for pain unless your doctor tells you that you should. tell your doctor if you have or have ever had any of the conditions mentioned in the IMPORTANT WARNING section or asthma, especially if you also have frequent stuffed or runny nose or nasal polyps (swelling of the inside of the nose); heart failure; swelling of the hands, arms, feet, ankles, or lower legs; lupus (a condition in which the body attacks many of its own tissues and organs, often including the skin, joints, blood, and kidneys); or liver or kidney disease. If you are giving ibuprofen to a child, tell the child's doctor if the child has not been drinking fluids or has lost a large amount of fluid from repeated vomiting or diarrhea. tell your doctor if you are pregnant, especially if you are in the last few months of your pregnancy; you plan to become pregnant; or you are breast-feeding. If you become pregnant while taking ibuprofen, call your doctor. if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking ibuprofen. if you have phenylketonuria (PKU, an inborn disease in which mental retardation develops if a specific diet is not followed), read the package label carefully before taking nonprescription ibuprofen. Some types of nonprescription ibuprofen may be sweetened with aspartame, a source of phenylalanine. What special dietary instructions should I follow? Unless your doctor tells you otherwise, continue your normal diet. What should I do if I forget a dose? If you are taking ibuprofen on a regular basis, take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one. What side effects can this medication cause? <h3>Ibuprofen may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: </h3> /h3> constipation diarrhea gas or bloating dizziness nervousness ringing in the ears <h3>Some side effects can be serious. If you experience any of the following symptoms, or those mentioned in the IMPORTANT WARNING section, call your doctor immediately. Do not take any more ibuprofen until you speak to your doctor. </h3> /h3> unexplained weight gain shortness of breath or difficulty breathing swelling of the abdomen, feet, ankles, or lower legs fever blisters rash itching hives swelling of the eyes, face, throat, arms, or hands difficulty breathing or swallowing hoarseness excessive tiredness pain in the upper right part of the stomach nausea loss of appetite yellowing of the skin or eyes flu-like symptoms pale skin fast heartbeat cloudy, discolored, or bloody urine back pain difficult or painful urination blurred vision, changes in color vision, or other vision problems red or painful eyes stiff neck headache confusion aggression Ibuprofen may cause other side effects. Call your doctor if you have any unusual problems while taking this medication. If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088). What should I know about storage and disposal of this medication? Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program. It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location - one that is up and away and out of their sight and reach. http://www.upandaway.org In case of emergency/overdose In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911. <h3>Symptoms of overdosage may include: </h3> /h3> dizziness fast eye movements that you cannot control slow breathing or short periods of time without breathing blue color around the lips, mouth, and nose What other information should I know? If you are taking prescription ibuprofen, do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies. Brand names Addaprin Advil Cedaprin I-Prin Midol Motrin Motrin IB NeoProfen Profen IB Proprinal Ultraprin Brand names of combination products Advil PM (containing Diphenhydramine, Ibuprofen) Combunox (containing Ibuprofen, Oxycodone) Duexis (containing Famotidine, Ibuprofen) Ibudone (containing Hydrocodone, Ibuprofen) Reprexain (containing Hydrocodone, Ibuprofen) Vicoprofen (containing Hydrocodone, Ibuprofen) how much ibuprofen is too much

how much ibuprofen is too much

Ibuprofen dosing for children: Taking ibuprofen can help children feel better when they have colds or minor injuries. As with all drugs, it is important to give children the correct dose. Ibuprofen is safe when taken as directed. But taking too much of this medicine can be harmful. To give the correct dose, you need to know your child's weight. You also need to know how much ibuprofen is in a tablet, teaspoon (tsp), 1.25 milliliters (mL), or 5 mL of the product you are using. You can read the label to find out. If you are not sure how much to give your child, call your health care provider. DO NOT give ibuprofen to children under 6 months of age, unless directed by your provider.

Ibuprofen dosing for children Motrin Advil Summary Taking ibuprofen can help children feel better when they have colds or minor injuries. As with all drugs, it is important to give children the correct dose. Ibuprofen is safe when taken as directed. But taking too much of this medicine can be harmful. How Ibuprofen can Help Your Child Ibuprofen is a type of nonsteroidal anti-inflammatory drug (NSAID). It can help: Reduce aches, pain, sore throat, or fever in children with a cold or the flu Relieve headaches or toothaches Reduce pain and swelling from an injury or broken bone Proper Dosing Ibuprofen can be taken as liquid or chewable tablets. To give the correct dose, you need to know your child's weight. You also need to know how much ibuprofen is in a tablet, teaspoon (tsp), 1.25 milliliters (mL), or 5 mL of the product you are using. You can read the label to find out. For chewable tablets, the label will tell you how many milligrams (mg) are found in each tablet, for example 50 mg per tablet. For liquids, the label will tell you how many mg are found in 1 tsp, in 1.25 mL, or in 5mL. For example, the label may read 100 mg/1 tsp, 50 mg/1.25 mL, or 100 mg/5 mL. For syrups, you need some type of dosing syringe. It may come with the medicine, or you can ask your pharmacist. Make sure to clean it out after every usage. <strong>If your child weighs 12 to 17 pounds (lbs) or 5.4 to 7.7 kilograms (kg):</strong> For infant drops that say 50mg/1.25 mL on the label, give a 1.25 mL dose. For liquid that says 100 mg/1 teaspoon (tsp) on the label, give a 1/2 tsp dose. For liquid that says 100 mg/5 mL on the label, give a 2.5 mL dose. <strong>If your child weighs 18 to 23 lbs or 8 to 10 kg:</strong> For infant drops that say 50mg/1.25 mL on the label, give a 1.875 mL dose. For liquid that says 100 mg/1 tsp on the label, give a 3/4 tsp dose. For liquid that says 100 mg/5 mL on the label, give a 4 mL dose. <strong>If your child weighs 24 to 35 lbs or 10.5 to 15.5 kg:</strong> For infant drops that say 50mg/1.25 mL on the label, give a 2.5 mL dose. For liquid that says 100 mg/1 tsp on the label, give a 1 tsp dose. For liquid that says 100 mg/5 mL on the label, give a 5 mL dose. For chewable tablets that say 50 mg tablets on the label, give 2 tablets. <strong>If your child weighs 36 to 47 lbs or 16 to 21 kg:</strong> For infant drops that say 50mg/1.25 mL on the label, give a 3.75 mL dose. For liquid that says 100 mg/1 tsp on the label, give a 11/2 tsp dose. For liquid that says 100 mg/5 mL on the label, give a 7.5 mL dose. For chewable tablets that say 50 mg tablets on the label, give 3 tablets. <strong>If your child weighs 48 to 59 lbs or 21.5 to 26.5 kg:</strong> For infant drops that say 50mg/1.25 mL on the label, give a 5 mL dose. For liquid that says 100 mg/1 tsp on the label, give a 2 tsp dose. For liquid that says 100 mg/5 mL on the label, give a 10 mL dose. For chewable tablets that say 50 mg tablets on the label, give 4 tablets. For junior-strength tablets that say 100 mg tablets on the label, give 2 tablets. <strong>If your child weighs 60 to 71 lbs or 27 to 32 kg:</strong> For liquid that says 100 mg/1 tsp on the label, give a 21/2 tsp dose. For liquid that says 100 mg/5 mL on the label, give a 12.5 mL dose. For chewable tablets that say 50 mg tablets on the label, give 5 tablets. For junior-strength tablets that say 100 mg tablets on the label, give 21/2 tablets. <strong>If your child weighs 72 to 95 lbs or 32.5 to 43 kg:</strong> For liquid that says 100 mg/1 tsp on the label, give a 3 tsp dose. For liquid that says 100 mg/5 mL on the label, give a 15 mL dose. For chewable tablets that say 50 mg tablets on the label, give 6 tablets. For junior-strength tablets that say 100 mg tablets on the label, give 3 tablets. <strong>If your child weighs 96 lbs or 43.5 kg or more:</strong> For liquid that says 100 mg/1 tsp on the label, give a 4 tsp dose. For liquid that says 100 mg/5 mL on the label, give a 20 mL dose. For chewable tablets that say 50 mg tablets on the label, give 8 tablets. For junior-strength tablets that say 100 mg tablets on the label, give 4 tablets. Try giving your child the medicine with food to avoid stomach upset. If you are not sure how much to give your child, call your health care provider. DO NOT give ibuprofen to children under 6 months of age, unless directed by your provider. You should also check with your provider before giving ibuprofen to children under 2 years old or less than 12 pounds or 5.5 kilograms. Giving Medicine to Children Make sure you don't give your child more than one medicine with ibuprofen. For example, ibuprofen can be found in many allergy and cold remedies. Read the label before giving any medicine to children. You should not give medicine with more than one active ingredient to children under age 6. There are important child medicine safety tips to follow. Carefully read all of the instructions on the label before giving your child medicine. Make sure you know the strength of the medicine in the bottle you purchased. Use the syringe, dropper, or dosing cup that comes with your child's liquid medicine. You can also get one at your local pharmacy. Make sure you are using the right unit of measurement when filling medicine. You may have the option of milliliters (mL) or teaspoon (tsp) dosing. If you are not sure what medicine to give your child, call your provider. Children with certain medical conditions or taking certain medicines should not take ibuprofen. Check with your provider. If Your Child Takes too Much Be sure to post the number for the poison control center by your home phone. If you think your child has taken too much medicine, call the poison control center at 1-800-222-1222. It is open 24 hours a day. Signs of poisoning include nausea, vomiting, fatigue, and abdominal pain. Go to the nearest emergency room. Your child may need: Activated charcoal. Charcoal stops the body from absorbing the medicine. It has to be given within an hour. It does not work for every medicine. To be admitted to the hospital to be monitored. Blood tests to see what the medicine is doing. To have his or her heart rate, breathing rate, and blood pressure monitored. When to Call the Doctor Call your provider if: You are not sure what dose of medicine to give your infant or child. You are having trouble getting your child to take medicine. Your child's symptoms do not go away when you would expect. Your child is an infant and has signs of illness, such as fever. Review Date 12/9/2016 Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how much ibuprofen is too much

how much ibuprofen is too much

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911. Keep all appointments with your doctor. Do not let anyone else take your medication. Oxazepam is a controlled substance. Prescriptions may be refilled only a limited number of times; ask your pharmacist if you have any questions.

Oxazepam IMPORTANT WARNING: Oxazepam may increase the risk of serious or life-threatening breathing problems, sedation, or coma if used along with certain medications. Tell your doctor if you are taking or plan to take certain opiate medications for cough such as codeine (in Triacin-C, in Tuzistra XR) or hydrocodone (in Anexsia, in Norco, in Zyfrel) or for pain such as codeine (in Fiorinal), fentanyl (Actiq, Duragesic, Subsys, others), hydromorphone (Dilaudid, Exalgo), meperidine (Demerol), methadone (Dolophine, Methadose), morphine (Astramorph, Duramorph PF, Kadian), oxycodone (in Oxycet, in Percocet, in Roxicet, others), and tramadol (Conzip, Ultram, in Ultracet). Your doctor may need to change the dosages of your medications and will monitor you carefully. If you take oxazepam with any of these medications and you develop any of the following symptoms, call your doctor immediately or seek emergency medical care immediately: unusual dizziness, lightheadedness, extreme sleepiness, slowed or difficult breathing, or unresponsiveness. Be sure that your caregiver or family members know which symptoms may be serious so they can call the doctor or emergency medical care if you are unable to seek treatment on your own. Drinking alcohol or using street drugs during your treatment with oxazepam also increases the risk that you will experience these serious, life-threatening side effects. Do not drink alcohol or use street drugs during your treatment. Why is this medication prescribed? Oxazepam is used to relieve anxiety, including anxiety caused by alcohol withdrawal (symptoms that may develop in people who stop drinking alcohol after drinking large amounts for a long time). Oxazepam is in a class of medications called benzodiazepines. It works by slowing activity in the brain to allow for relaxation. How should this medicine be used? Oxazepam comes as a capsule to take by mouth. It is usually taken three or four times a day and may be taken with or without food. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take oxazepam exactly as directed. Oxazepam can be habit-forming. Do not take a larger dose, take it more often, or take it for a longer time than prescribed by your doctor. Oxazepam may not work as well if it is taken for a long time. Oxazepam may help control your symptoms but will not cure your condition. Continue to take oxazepam even if you feel well. Do not skip doses even if you feel that you do not need them. Do not stop taking this medication without talking to your doctor. If you suddenly stop taking oxazepam, you may experience withdrawal symptoms (anxiousness, sleeplessness, and irritability). Your doctor will probably decrease your dose gradually. Other uses for this medicine Oxazepam is also used to treat irritable bowel syndrome. Talk to your doctor about the possible risks of using this medication for your condition. This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information. What special precautions should I follow? <h3>Before taking oxazepam,</h3> /h3> tell your doctor and pharmacist if you are allergic to oxazepam, any other medications, or any of the ingredients in oxazepam capsules. Ask your doctor or pharmacist for more information. tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: antihistamines; digoxin (Lanoxin); levodopa (in Ritary, in Sinemet, in Stalevo); medication for depression, seizures, Parkinson's disease, asthma, colds, or allergies; muscle relaxants; oral contraceptives; phenytoin (Dilantin, Phenytek); probenecid (Probalan, in Col-Probenecid); rifampin (Rifadin, Rimactane, in Rifamate, in Rifater); sedatives; sleeping pills; theophylline (Elixophyllin, Theo 24, Theochron); or tranquilizers. Your doctor may need to change the doses of your medications or monitor you carefully for side effects. tell your doctor if you have or have ever had glaucoma or seizures, or lung, heart, or liver disease. tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking oxazepam, call your doctor immediately. talk to your doctor about the risks and benefits of taking oxazepam if you are 65 years of age or older. Older adults should take lower doses of oxazepam because higher doses may not be more effective and are more likely to cause serious side effects. if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking oxazepam. you should know that this medication may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you. tell your doctor if you use tobacco products. Cigarette smoking may decrease the effectiveness of this medication. What special dietary instructions should I follow? Unless your doctor tells you otherwise, continue your normal diet. What should I do if I forget a dose? Take the missed dose as soon as you remember it. However, if it is almost time for your next dose skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one. What side effects can this medication cause? <h3>Oxazepam may cause side effects. Call your doctor if any of the symptoms are severe or do not go away: </h3> /h3> drowsiness dizziness tiredness weakness dry mouth diarrhea upset stomach changes in appetite restlessness or excitement constipation difficulty urinating frequent urination blurred vision changes in sex drive or ability <h3>Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately: </h3> /h3> shuffling walk persistent, fine tremor or inability to sit still fever difficulty breathing or swallowing severe skin rash yellowing of the skin or eyes irregular heartbeat Oxazepam may cause other side effects. Call your doctor if you experience any unusual problems during your treatment with oxazepam. If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088). What should I know about storage and disposal of this medication? Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program. It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location - one that is up and away and out of their sight and reach. http://www.upandaway.org In case of emergency/overdose In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911. What other information should I know? Keep all appointments with your doctor. Do not let anyone else take your medication. Oxazepam is a controlled substance. Prescriptions may be refilled only a limited number of times; ask your pharmacist if you have any questions. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies. Brand names Serax how much oxazepam could cause an overdose?

how much oxazepam could cause an overdose?

Oxazepam is a medicine used to treat anxiety and symptoms of alcohol withdrawal. Oxazepam overdose occurs when someone accidentally or intentionally takes too much of this medicine. If you or someone you are with overdoses, call your local emergency number (such as 911), or your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.

Oxazepam overdose Benzodiazepine overdose Serax overdose Adumbran overdose Serenid Forte overdose Zapex overdose Novoxapam overdose Oxpam overdose Summary Oxazepam is a medicine used to treat anxiety and symptoms of alcohol withdrawal. It belongs to the class of medicines known as benzodiazepines. Oxazepam overdose occurs when someone accidentally or intentionally takes too much of this medicine. Benzodiazepines are the most common prescription drugs used in suicide attempts. This is for information only and not for use in the treatment or management of an actual overdose. DO NOT use it to treat or manage an actual overdose. If you or someone you are with overdoses, call your local emergency number (such as 911), or your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. Poisonous Ingredient Oxazepam Where Found Oxazepam is sold under the following brand names: Adumbran Novoxapam Oxpam Serax Serenid Forte Zapex This list may not be all-inclusive. Symptoms Symptoms of oxazepam overdose include: Blurred or double vision, rapid side-to-side movement of eyes Confusion, slurred speech Dizziness Drowsiness, tiredness, fainting Nausea Rash Slowed breathing Decreased alertness, or even coma Weakness, uncoordinated movement, staggering gait Before Calling Emergency The following information is helpful for emergency assistance: Person's age, weight, and condition Name of the product (ingredients and strengths, if known) Time it was swallowed Amount swallowed If the medicine was prescribed for the person DO NOT delay calling for help if this information is not immediately available. Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This hotline number will let you talk to experts in poisoning. They will give you further instructions. This is a free and confidential service. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week. What to Expect at the Emergency Room The health care provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated as appropriate. The person may receive: Activated charcoal Airway support, including oxygen, breathing tube through the mouth (intubation), and breathing machine (ventilator) Blood and urine test Chest x-ray ECG (electrocardiogram), or heart tracing Fluids through a vein (intravenous or IV) Laxative Medicines to treat symptoms, including flumazenil, an antidote to reverse the effect of the poison Outlook (Prognosis) Recovery usually occurs with proper treatment. People who are in a prolonged coma or who have respiratory complications may have permanent disability. Review Date 1/31/2017 Updated by: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how much oxazepam could cause an overdose?

how much oxazepam could cause an overdose?

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Oxazepam IMPORTANT WARNING: Oxazepam may increase the risk of serious or life-threatening breathing problems, sedation, or coma if used along with certain medications. Tell your doctor if you are taking or plan to take certain opiate medications for cough such as codeine (in Triacin-C, in Tuzistra XR) or hydrocodone (in Anexsia, in Norco, in Zyfrel) or for pain such as codeine (in Fiorinal), fentanyl (Actiq, Duragesic, Subsys, others), hydromorphone (Dilaudid, Exalgo), meperidine (Demerol), methadone (Dolophine, Methadose), morphine (Astramorph, Duramorph PF, Kadian), oxycodone (in Oxycet, in Percocet, in Roxicet, others), and tramadol (Conzip, Ultram, in Ultracet). Your doctor may need to change the dosages of your medications and will monitor you carefully. If you take oxazepam with any of these medications and you develop any of the following symptoms, call your doctor immediately or seek emergency medical care immediately: unusual dizziness, lightheadedness, extreme sleepiness, slowed or difficult breathing, or unresponsiveness. Be sure that your caregiver or family members know which symptoms may be serious so they can call the doctor or emergency medical care if you are unable to seek treatment on your own. Drinking alcohol or using street drugs during your treatment with oxazepam also increases the risk that you will experience these serious, life-threatening side effects. Do not drink alcohol or use street drugs during your treatment. Why is this medication prescribed? Oxazepam is used to relieve anxiety, including anxiety caused by alcohol withdrawal (symptoms that may develop in people who stop drinking alcohol after drinking large amounts for a long time). Oxazepam is in a class of medications called benzodiazepines. It works by slowing activity in the brain to allow for relaxation. How should this medicine be used? Oxazepam comes as a capsule to take by mouth. It is usually taken three or four times a day and may be taken with or without food. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take oxazepam exactly as directed. Oxazepam can be habit-forming. Do not take a larger dose, take it more often, or take it for a longer time than prescribed by your doctor. Oxazepam may not work as well if it is taken for a long time. Oxazepam may help control your symptoms but will not cure your condition. Continue to take oxazepam even if you feel well. Do not skip doses even if you feel that you do not need them. Do not stop taking this medication without talking to your doctor. If you suddenly stop taking oxazepam, you may experience withdrawal symptoms (anxiousness, sleeplessness, and irritability). Your doctor will probably decrease your dose gradually. Other uses for this medicine Oxazepam is also used to treat irritable bowel syndrome. Talk to your doctor about the possible risks of using this medication for your condition. This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information. What special precautions should I follow? <h3>Before taking oxazepam,</h3> /h3> tell your doctor and pharmacist if you are allergic to oxazepam, any other medications, or any of the ingredients in oxazepam capsules. Ask your doctor or pharmacist for more information. tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: antihistamines; digoxin (Lanoxin); levodopa (in Ritary, in Sinemet, in Stalevo); medication for depression, seizures, Parkinson's disease, asthma, colds, or allergies; muscle relaxants; oral contraceptives; phenytoin (Dilantin, Phenytek); probenecid (Probalan, in Col-Probenecid); rifampin (Rifadin, Rimactane, in Rifamate, in Rifater); sedatives; sleeping pills; theophylline (Elixophyllin, Theo 24, Theochron); or tranquilizers. Your doctor may need to change the doses of your medications or monitor you carefully for side effects. tell your doctor if you have or have ever had glaucoma or seizures, or lung, heart, or liver disease. tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking oxazepam, call your doctor immediately. talk to your doctor about the risks and benefits of taking oxazepam if you are 65 years of age or older. Older adults should take lower doses of oxazepam because higher doses may not be more effective and are more likely to cause serious side effects. if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking oxazepam. you should know that this medication may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you. tell your doctor if you use tobacco products. Cigarette smoking may decrease the effectiveness of this medication. What special dietary instructions should I follow? Unless your doctor tells you otherwise, continue your normal diet. What should I do if I forget a dose? Take the missed dose as soon as you remember it. However, if it is almost time for your next dose skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one. What side effects can this medication cause? <h3>Oxazepam may cause side effects. Call your doctor if any of the symptoms are severe or do not go away: </h3> /h3> drowsiness dizziness tiredness weakness dry mouth diarrhea upset stomach changes in appetite restlessness or excitement constipation difficulty urinating frequent urination blurred vision changes in sex drive or ability <h3>Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately: </h3> /h3> shuffling walk persistent, fine tremor or inability to sit still fever difficulty breathing or swallowing severe skin rash yellowing of the skin or eyes irregular heartbeat Oxazepam may cause other side effects. Call your doctor if you experience any unusual problems during your treatment with oxazepam. If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088). What should I know about storage and disposal of this medication? Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program. It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location - one that is up and away and out of their sight and reach. http://www.upandaway.org In case of emergency/overdose In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911. What other information should I know? Keep all appointments with your doctor. Do not let anyone else take your medication. Oxazepam is a controlled substance. Prescriptions may be refilled only a limited number of times; ask your pharmacist if you have any questions. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies. Brand names Serax how much oxazepam could cause an overdose?

how much oxazepam could cause an overdose?

The nicotine in tobacco can be addictive like alcohol, cocaine, and morphine. Nicotine use can have many different effects on the body. It can: - Decrease the appetite; fear of weight gain makes some people unwilling to stop smoking - Boost mood, give people a sense of well-being, and possibly even relieve minor depression - Increase activity in the intestines - Create more saliva and phlegm - Increase the heart rate by around 10 to 20 beats per minute - Increase blood pressure by 5 to 10 mm Hg - Possibly cause sweating, nausea, and diarrhea - Stimulate memory and alertness; people who use tobacco often depend on it to help them accomplish certain tasks and perform well Symptoms of nicotine withdrawal appear within 2 to 3 hours after you last use tobacco. Common symptoms include: - Intense craving for nicotine - Anxiety - Depression - Drowsiness or trouble sleeping - Bad dreams and nightmares - Feeling tense, restless, or frustrated - Headaches - Increased appetite and weight gain - Problems concentrating

Nicotine and tobacco Withdrawal from nicotine Smoking - nicotine addiction and withdrawal Smokeless tobacco - nicotine addiction Cigar smoking Pipe smoking Smokeless snuff Tobacco use Chewing tobacco Nicotine addiction and tobacco Summary The nicotine in tobacco can be addictive like alcohol, cocaine, and morphine. Causes Tobacco is a plant grown for its leaves, which are smoked, chewed, or sniffed. Tobacco contains a chemical called nicotine. Nicotine is an addictive substance. Millions of people in the United States have been able to quit smoking. Although the number of cigarette smokers in the United States has dropped in recent years, the number of smokeless tobacco users has steadily increased. Smokeless tobacco products are either placed in the mouth, cheek, or lip and sucked or chewed on, or placed in the nasal passage. The nicotine in these products is absorbed at the same rate as smoking tobacco, and addiction is still very strong. Both smoking and smokeless tobacco use carry many health risks. Symptoms Nicotine use can have many different effects on the body. It can: Decrease the appetite -- Fear of weight gain makes some people unwilling to stop smoking. Boost mood, give people a sense of well-being, and possibly even relieve minor depression. Increase activity in the intestines. Create more saliva and phlegm. Increase the heart rate by around 10 to 20 beats per minute. Increase blood pressure by 5 to 10 mm Hg. Possibly cause sweating, nausea, and diarrhea. Stimulate memory and alertness -- People who use tobacco often depend on it to help them accomplish certain tasks and perform well. Symptoms of nicotine withdrawal appear within 2 to 3 hours after you last use tobacco. People who smoked the longest or smoked a greater number of cigarettes each day are more likely to have withdrawal symptoms. For those who are quitting, symptoms peak about 2 to 3 days later. Common symptoms include: Intense craving for nicotine Anxiety Depression Drowsiness or trouble sleeping Bad dreams and nightmares Feeling tense, restless, or frustrated Headaches Increased appetite and weight gain Problems concentrating You may notice some or all of these symptoms when switching from regular to low-nicotine cigarettes or reducing the number of cigarettes you smoke. Treatment It is hard to stop smoking or using smokeless tobacco, but anyone can do it. There are many ways to quit smoking. There are also resources to help you quit. Family members, friends, and co-workers may be supportive. Quitting tobacco is hard if you are trying to do it alone. To be successful, you must really want to quit. Most people who have quit smoking were unsuccessful at least once in the past. Try not to view past attempts as failures. See them as learning experiences. Most smokers find it hard to break all the habits they have created around smoking. A smoking cessation program may improve your chance for success. These programs are offered by hospitals, health departments, community centers, work sites, and national organizations. Nicotine replacement therapy may also be helpful. It involves the use of products that provide low doses of nicotine, but none of the toxins found in smoke. Nicotine replacement comes in the form of: Gum Inhalers Throat lozenges Nasal spray Skin patches You can buy many types of nicotine replacement without a prescription. Your health care provider can also prescribe other types of medicines to help you quit. Varenicline (Chantix) and bupropion (Zyban, Wellbutrin) are prescription medications that affect the nicotine receptors in the brain. The goal of these therapies is to relieve cravings for nicotine and ease your withdrawal symptoms. Health experts warn that e-cigarettes are not a replacement therapy for cigarette smoking. It is not known exactly how much nicotine is in e-cigarette cartridges, because information on labels is often wrong. Support Groups Your provider can refer you to stop smoking programs. These are offered by hospitals, health departments, community centers, work sites, and national organizations. Outlook (Prognosis) People who are trying to quit smoking often become discouraged when they do not succeed at first. Research shows that the more times you try, the more likely you are to succeed. If you start smoking again after you have tried to quit, do not give up. Look at what worked or did not work, think of new ways to quit smoking, and try again. Possible Complications There are many more reasons to quit using tobacco. Knowing the serious health risks from tobacco may help motivate you to quit. Tobacco and related chemicals can increase your risk of serious health problems such as cancer, lung disease, and heart attack. When to Contact a Medical Professional See your provider if you wish to stop smoking, or have already done so and are having withdrawal symptoms. Your provider can help recommend treatments. Review Date 2/12/2018 Updated by: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how nicotine effects the brain

how nicotine effects the brain

Nicotine produces physical and mood-altering effects in your brain that are temporarily pleasing. These effects make you want to use tobacco and lead to dependence. At the same time, stopping tobacco use causes withdrawal symptoms, including irritability and anxiety. Nicotine is very addictive when delivered by inhaling tobacco smoke into the lungs, which quickly releases nicotine into the blood allowing it to get into the brain within seconds of taking a puff. In the brain nicotine increases the release of brain chemicals called neurotransmitters, which help regulate mood and behavior. Dopamine, one of these neurotransmitters, is released in the "reward center" of the brain and causes improved mood and feelings of pleasure. Experiencing these effects from nicotine is what makes tobacco so addictive. Nicotine dependence involves behavioral (routines, habits, feelings) as well as physical factors.

Nicotine dependence Overview Nicotine dependence -- also called tobacco dependence -- is an addiction to tobacco products caused by the drug nicotine. Nicotine dependence means you can't stop using the substance, even though it's causing you harm. Nicotine produces physical and mood-altering effects in your brain that are temporarily pleasing. These effects make you want to use tobacco and lead to dependence. At the same time, stopping tobacco use causes withdrawal symptoms, including irritability and anxiety. While it's the nicotine in tobacco that causes nicotine dependence, the toxic effects of tobacco result from other substances in tobacco. Smokers have much higher rates of heart disease, stroke and cancer than nonsmokers do. Regardless of how long you've smoked, stopping smoking can improve your health. Many effective treatments for nicotine dependence are available to help you manage withdrawal and stop smoking for good. Ask your doctor for help. Symptoms For some people, using any amount of tobacco can quickly lead to nicotine dependence. Signs that you may be addicted include: - You can't stop smoking. You've made one or more serious, but unsuccessful, attempts to stop. - You experience withdrawal symptoms when you try to stop. Your attempts at stopping have caused physical and mood-related symptoms, such as strong cravings, anxiety, irritability, restlessness, difficulty concentrating, depressed mood, frustration, anger, increased hunger, insomnia, constipation or diarrhea. - You keep smoking despite health problems. Even though you've developed health problems with your lungs or your heart, you haven't been able to stop. - You give up social or recreational activities in order to smoke. You may stop going to smoke-free restaurants or stop socializing with certain family members or friends because you can't smoke in these locations or situations. You're not alone if you've tried to stop smoking but haven't been able to stop for good. Most smokers make many attempts to stop smoking before they achieve stable, long-term abstinence from smoking. You're more likely to stop for good if you follow a treatment plan that addresses both the physical and the behavioral aspects of nicotine dependence. Using medications and working with a counselor specially trained to help people stop smoking (a tobacco treatment specialist) will significantly boost your chances of success. Ask your doctor, counselor or therapist to help you develop a treatment plan that works for you or to advise you on where to get help to stop smoking. Causes Nicotine is the chemical in tobacco that keeps you smoking. Nicotine is very addictive when delivered by inhaling tobacco smoke into the lungs, which quickly releases nicotine into the blood allowing it to get into the brain within seconds of taking a puff. In the brain nicotine increases the release of brain chemicals called neurotransmitters, which help regulate mood and behavior. Dopamine, one of these neurotransmitters, is released in the "reward center" of the brain and causes improved mood and feelings of pleasure. Experiencing these effects from nicotine is what makes tobacco so addictive. Nicotine dependence involves behavioral (routines, habits, feelings) as well as physical factors. These behavioral associations with smoking may act as triggers - situations or feelings that activate a craving for tobacco, even if you have not smoked for some time. Behaviors and cues that you may associate with smoking include: - Certain times of the day, such as first thing in the morning, with morning coffee or during breaks at work - After a meal - Drinking alcohol - Certain places or friends - Talking on the phone - Stressful situations or when you're feeling down - Sight or smell of a burning cigarette - Driving your car To overcome your dependence on tobacco, you need to become aware of your triggers and develop a plan to deal with the behaviors and routines that you associate with smoking. Risk factors Anyone who smokes or uses other forms of tobacco is at risk of becoming dependent. Factors that influence who will use tobacco include: - Genetics. The likelihood that you will start smoking and keep smoking may be partly inherited - genetic factors may influence how receptors on the surface of your brain's nerve cells respond to high doses of nicotine delivered by cigarettes. - Home and peer influence. Children who grow up with parents who smoke are more likely to become smokers. Children with friends who smoke also are more likely to try cigarettes. Evidence suggests that smoking shown in movies and on the Internet can encourage young people to smoke. - Age. Most people begin smoking during childhood or the teen years. The younger you are when you begin smoking, the greater the chance that you'll become a heavy smoker as an adult. - Depression or other mental illness. Many studies show an association between depression and smoking. People who have depression, schizophrenia, post-traumatic stress disorder (PTSD) or other forms of mental illness are more likely to be smokers. - Substance use. People who abuse alcohol and illegal drugs are more likely to be smokers. Complications Tobacco smoke contains more than 60 known cancer-causing chemicals and thousands of other harmful substances. Even "all natural" or herbal cigarettes have chemicals that are harmful to your health. Smoking harms almost every organ of your body and impairs your body's immune system. About half of all regular smokers will die of a disease caused by tobacco. Women smokers are now at equal risk to men smokers of dying from lung cancer, COPD and cardiovascular disease caused by using tobacco. The negative health effects include: - Lung cancer and other lung diseases. Smoking causes nearly 9 out of 10 lung cancer cases. In addition, smoking causes other lung diseases, such as emphysema and chronic bronchitis. Smoking also makes asthma worse. - Other cancers. Smoking is a major cause of cancers of the esophagus, larynx, throat (pharynx) and mouth and is related to cancers of the bladder, pancreas, kidney and cervix, and some leukemias. Overall, smoking causes 30 percent of all cancer deaths. - Heart and circulatory system problems. Smoking increases your risk of dying of heart and blood vessel (cardiovascular) disease, including heart attack and stroke. Even smoking just one to four cigarettes daily increases your risk of heart disease. If you have heart or blood vessel disease, such as heart failure, smoking worsens your condition. However, stopping smoking reduces your risk of having a heart attack by 50 percent in the first year. - Diabetes. Smoking increases insulin resistance, which can set the stage for the development of type 2 diabetes. If you have diabetes, smoking can speed the progress of complications, such as kidney disease and eye problems. - Eye problems. Smoking can increase your risk of serious eye problems such as cataracts and loss of eyesight from macular degeneration. - Infertility and impotence. Smoking increases the risk of reduced fertility in women and the risk of impotence in men. - Pregnancy and newborn complications. Mothers who smoke while pregnant face a higher risk of miscarriage, preterm delivery, lower birth weight and sudden infant death syndrome (SIDS) in their newborns. - Cold, flu and other illnesses. Smokers are more prone to respiratory infections, such as colds, flu and bronchitis. - Weakened senses. Smoking deadens your senses of taste and smell, so food isn't as appetizing. - Teeth and gum disease. Smoking is associated with an increased risk of developing inflammation of the gum (gingivitis) and a serious gum infection that can destroy the support system for teeth (periodontitis). - Physical appearance. The chemicals in tobacco smoke can change the structure of your skin, causing premature aging and wrinkles. Smoking also yellows your teeth, fingers and fingernails. - Risks to your family. Nonsmoking spouses and partners of smokers have a higher risk of lung cancer and heart disease compared with people who don't live with a smoker. If you smoke, your children will be more prone to SIDS, worsening asthma, ear infections and colds. Diagnosis Your doctor may ask you questions or have you complete a questionnaire to get a sense of how dependent you are on nicotine. The more cigarettes you smoke each day and the sooner you smoke after awakening, the more dependent you are. Knowing your degree of dependence will help your doctor determine the best treatment plan for you. Treatment Like most smokers, you've probably made at least one serious attempt to stop. But it's rare to stop smoking on your first attempt - especially if you try to do it without help. You're much more likely to stop if you use medications and counseling, which have both been proved effective, especially in combination. Medications Many treatments, including nicotine replacement therapy and non-nicotine medications, have been approved as safe and effective in treating nicotine dependence. Using more than one medication may help you get better results. For example, combining a longer acting medication with a short-acting nicotine replacement product may be beneficial. Talk to your health care provider about the right treatment for you. If you're pregnant or breast-feeding, you smoke fewer than 10 cigarettes a day, or you're under age 18, talk to your doctor before taking any over-the-counter nicotine replacement products. Nicotine replacement therapy Nicotine replacement therapy gives you nicotine without tobacco and the harmful chemicals in tobacco smoke. Nicotine replacement products help relieve withdrawal symptoms and cravings. The best time to start using nicotine replacement medication is on the date you've set to stop smoking. Some smokers start earlier in order to reduce smoking on their way to stopping altogether. The following nicotine replacement products are available over-the-counter: - Nicotine patch (NicoDerm CQ, Habitrol, others). The patch delivers nicotine through your skin and into your bloodstream. You wear a new patch each day. You typically use the patch for eight weeks or longer. If you haven't been able to stop smoking completely after two weeks of wearing the patch, ask your doctor about adjusting the dose or adding another nicotine replacement product. Common side effects include skin irritation, insomnia and vivid dreams. - Nicotine gum (Nicorette, others). This gum delivers nicotine to your blood through the lining of your mouth. Nicotine gum is often recommended to curb cravings. Chew the gum for a few times until you feel a mild tingling or peppery taste, then park the gum between your cheek and gumline for several minutes. This chewing and parking allows nicotine to be gradually absorbed in your bloodstream. Mouth irritation is a common side effect. Other side effects are often a result of overly vigorous chewing that releases nicotine too quickly. These include heartburn, nausea and hiccups. - Nicotine lozenge (Commit, Nicorette mini lozenge, others). This lozenge dissolves in your mouth and, like nicotine gum, delivers nicotine through the lining of your mouth. Place the lozenge in your mouth between your gumline and cheek or under your tongue and allow it to dissolve. You'll start with one lozenge every one to two hours and gradually increase the time between lozenges. Avoid drinking anything right before, while using or right after the lozenge. Side effects include mouth irritation as well as nicotine-related effects such as heartburn, nausea and hiccups. These nicotine replacement products are available by prescription: - Nicotine nasal spray (Nicotrol NS). The nicotine in this product, sprayed directly into each nostril, is absorbed through your nasal membranes into your blood vessels. The nasal spray delivers nicotine a bit quicker than gum, lozenges or the patch, but not as rapidly as smoking a cigarette. It's usually prescribed for three-month periods for up to six months. Nasal and throat irritation, runny nose, sneezing and coughing are common side effects. - Nicotine inhaler (Nicotrol). This device is shaped something like a cigarette holder. You puff on it, and it delivers nicotine vapor into your mouth. You absorb the nicotine through the lining in your mouth, where it then enters your bloodstream. Common side effects are mouth and throat irritation and occasional coughing. Non-nicotine medications Medications that don't contain nicotine and are available by prescription include: - Bupropion (Zyban). The antidepressant drug bupropion increases levels of dopamine and norepinephrine, brain chemicals that are also boosted by nicotine. Typically your doctor will advise you to start bupropion one week before you stop smoking. Bupropion has the advantage of helping to minimize weight gain after you quit smoking. Common side effects include insomnia, agitation, headache and dry mouth. If you have a history of seizures or serious head trauma, such as a skull fracture, you shouldn't take this drug. - Varenicline (Chantix). This medication acts on the brain's nicotine receptors, decreasing withdrawal symptoms and reducing the feelings of pleasure you get from smoking. Typically your doctor will advise you to start varenicline one week before you stop smoking. Common side effects include nausea, headache, insomnia and vivid dreams. Rarely, varenicline has been associated with serious psychiatric symptoms, such as depressed mood and suicidal thoughts. - Nortriptyline (Pamelor). This medication may be prescribed if other medications haven't helped. This tricyclic antidepressant acts by increasing the levels of the brain neurotransmitter norepinephrine. Common side effects may include dry mouth, drowsiness, dizziness and constipation. Counseling, support groups and other programs Combining medications with behavioral counseling provides the best chance for establishing long-term smoking abstinence. Medications help you cope by reducing withdrawal symptoms including tobacco craving, while behavioral treatments help you develop the skills you need to avoid tobacco over the long run. The more time you spend with a counselor, the better your treatment results will be. Several types of counseling and support can help with stopping smoking: - Telephone counseling. No matter where you live, you can take advantage of phone counseling to help you give up tobacco. Every state in the U.S. has a telephone quit line, and some have more than one. To find the options in your state, call 800-QUIT-NOW (800-784-8669). - Individual or group counseling program. Your doctor may recommend local support groups or a treatment program where counseling is provided by a tobacco treatment specialist. Counseling helps you learn techniques for preparing to stop smoking and provides support for you during the process. Many hospitals, health care plans, health care providers and employers offer treatment programs or have tobacco treatment specialists who are certified to provide treatment for nicotine dependence. Nicotine Anonymous groups are available in many locations to provide support for smokers trying to quit. Some medical centers provide residential treatment programs - the most intensive treatment available. - Internet-based programs. Several websites offer support and strategies for people who want to stop smoking. BecomeAnEX is free and provides information and techniques as well as blogs, community forums, ask the expert and many other features. Text messaging services, including personalized reminders about a quit-smoking plan, also may prove helpful. Methods to avoid It's not a good idea to substitute another type of tobacco use for cigarette smoking. Tobacco in any form is not safe. Even products that deliver nicotine without tobacco are risky. Stick with proven stop-smoking aids and steer clear of the following products: - Dissolvable tobacco products. Tobacco pouches, lozenges, strips or other products contain small amounts of tobacco and nicotine you hold or dissolve in your mouth. There is no evidence they will help you stop smoking and little is known about their health effects. - E-cigarettes. Electronic cigarettes, or e-cigarettes, are battery-powered devices that heat liquid containing nicotine into a vapor to be inhaled. Because these products are new, there isn't much data about possible safety risks. Studies of e-cigarettes for smoking cessation have shown mixed results. For these reasons, e-cigarettes aren't recommended for people trying to quit smoking. - Flavored cigarettes. Clove cigarettes (kreteks) and flavored cigarettes (bidis) carry the same health risks as smoking regular cigarettes and can cause additional health problems. Although they're banned in the United States, flavored cigarettes are available in other countries. - Hookahs (narghiles). These are water pipes that burn tobacco, and the smoke is inhaled through a hose. They are not safer than cigarettes. The water does not filter out toxins in the smoke, and the water and pipe have a risk of transmitting infections. - Nicotine lollipops and balms. Products containing nicotine salicylate are not approved by the Food and Drug Administration, and they pose a risk for accidental use by children. - Pipes and cigars. These products have similar, though less frequent, health risks as cigarettes, and they are not a safe alternative. - Smokeless tobacco and snuff (snus). These products contain nicotine in amounts similar to cigarettes and increase your risk of mouth and throat cancer, tooth and gum diseases, and other health problems. Lifestyle and home remedies It's important to have a plan for managing nicotine withdrawal symptoms. Withdrawal symptoms are usually the most intense during the first week after you stop smoking. They may continue for several weeks, with declining intensity. Although most nicotine withdrawal symptoms pass within a month, you may occasionally experience a strong urge or craving to smoke months after stopping. Triggers or cues that were associated with your smoking can provoke these urges or cravings. Here's what you can do to help manage nicotine withdrawal symptoms: - Exercise regularly. Regular physical activity has been found to reduce withdrawal symptoms and help people stop smoking. Exercise also helps avoid potential weight gain often associated with stopping. - Wait out cravings. Cravings or urges usually last less than five minutes. Wash the dishes, go for a walk or have a healthy snack, such as carrots, an apple or sunflower seeds, which will keep your mouth busy. Do something that keeps your hands busy, and before you know it, the urge will have passed. This is why you want to get rid of tobacco supplies when you decide to quit. You don't want to have any on hand when a craving hits. - Identify rationalizations. If you find yourself thinking, "I'll just smoke one to get through this tough time" or "Just one won't hurt," recognize it as a message that can derail your plan. Review your reasons for quitting, and replace that thought with something positive to support your stopping. - Talk to a support person. If you're feeling anxious or depressed or need encouragement, a support person can help you get through a difficult craving. - Avoid high-risk situations. Know your triggers, and stay away from people, places and situations that tempt you to smoke. - Eat regular, healthy meals. Include plenty of fruits and vegetables, and drink more water. Alternative medicine Many products claim to be smoking-cessation aids. Many also claim to be "natural." Just remember that "natural" doesn't necessarily mean "safe." Talk with your doctor before trying any alternative medicine treatments. - Acupuncture. Acupuncture involves stimulating points on the body, typically with thin, solid, metallic needles. Several studies have been conducted on the effects of acupuncture or acupressure for smoking cessation, but there's no definitive evidence that it works. - Herbs and supplements. A few studies have been conducted on the dietary supplements SAMe, silver acetate and St. John's wort for the treatment of tobacco dependence, but there is no current evidence that any natural product improves smoking cessation rates. - Hypnosis. Although no evidence supports the use of hypnosis - also called hypnotherapy - in smoking cessation, some people find it helpful. If you choose to pursue hypnosis, talk to your doctor about finding a reputable therapist. - Meditation. Although no evidence supports the effectiveness of meditation in smoking cessation, some people find it helpful to reduce symptoms of anxiety. how nicotine effects the brain

how nicotine effects the brain

Cervical dysplasia refers to abnormal changes in the cells on the surface of the cervix. For women of any age who have a slightly abnormal Pap test result Treatment depends on the degree of dysplasia. Mild dysplasia (LSIL or CIN I) may go away without treatment. You may only need careful follow-up by your provider with repeat Pap smears every 6 to 12 months. If the changes do not go away or get worse, treatment is needed.

Cervical dysplasia Cervical intraepithelial neoplasia - dysplasia CIN - dysplasia Precancerous changes of the cervix - dysplasia Cervical cancer - dysplasia Squamous intraepithelial lesion - dysplasia LSIL - dysplasia HSIL - dysplasia Low-grade dysplasia High-grade dysplasia Carcinoma in situ - dysplasia CIS - dysplasia ASCUS - dysplasia Atypical glandular cells - dysplasia AGUS - dysplasia Atypical squamous cells - dysplasia Pap smear - dysplasia HPV - dysplasia Human papilloma virus - dysplasia Cervix - dysplasia Colposcopy - dysplasia Summary Cervical dysplasia refers to abnormal changes in the cells on the surface of the cervix. The cervix is the lower part of the uterus (womb) that opens at the top of the vagina. The changes are not cancer. But they are considered to be precancerous. This means they can lead to cancer of the cervix if not treated. Causes Cervical dysplasia can develop at any age. However, follow up and treatment will depend on your age. Cervical dysplasia is caused by the human papillomavirus (HPV). HPV is a common virus that is spread through sexual contact. There are many types of HPV. Some types lead to cervical dysplasia or cancer. Other types of HPV can cause genital warts. The following may increase your risk for cervical dysplasia: Having sex before age 18 Having a baby at very young age Having had multiple sexual partners Having other illnesses, such as tuberculosis or HIV Using medicines that suppress your immune system Smoking Symptoms Most of the time, there are no symptoms. Exams and Tests Your health care provider will perform a pelvic exam to check cervical dysplasia. The initial test is usually a Pap smear and a test for the presence of HPV. Cervical dysplasia that is seen on a Pap smear is called squamous intraepithelial lesion (SIL). On the Pap smear report, these changes will be described as: Low-grade (LSIL) High-grade (HSIL) Possibly cancerous (malignant) Atypical glandular cells (AGC) Atypical squamous cells (ASC) You will need more tests if a Pap smear shows abnormal cells or cervical dysplasia. If the changes were mild, follow-up Pap smears may be all that is needed. The provider may perform a biopsy to confirm the condition. This may be done with the use of colposcopy. Any areas of concern will be biopsied. The biopsies are very small and most women feel only a small cramp. Dysplasia that is seen on a biopsy of the cervix is called cervical intraepithelial neoplasia (CIN). It is grouped into 3 categories: CIN I -- mild dysplasia CIN II -- moderate to marked dysplasia CIN III -- severe dysplasia to carcinoma in situ Some strains of HPV are known to cause cervical cancer. An HPV DNA test can identify the high-risk types of HPV linked to this cancer. This test may be done: As a screening test for women over age 30 For women of any age who have a slightly abnormal Pap test result Treatment Treatment depends on the degree of dysplasia. Mild dysplasia (LSIL or CIN I) may go away without treatment. You may only need careful follow-up by your provider with repeat Pap smears every 6 to 12 months. If the changes do not go away or get worse, treatment is needed. Treatment for moderate-to-severe dysplasia or mild dysplasia that does not go away may include: Cryosurgery to freeze abnormal cells Laser therapy, which uses light to burn away abnormal tissue LEEP (loop electrosurgical excision procedure), which uses electricity to remove abnormal tissue Surgery to remove the abnormal tissue (cone biopsy) Hysterectomy (in rare cases) If you have had dysplasia, you will need to have repeat exams every 12 months or as suggested by your provider. Make sure to get the HPV vaccine when it is offered to you. This vaccine prevents many cervical cancers. Outlook (Prognosis) Early diagnosis and prompt treatment cures most cases of cervical dysplasia. However, the condition may return. Without treatment, severe cervical dysplasia may change into cervical cancer. When to Contact a Medical Professional Call your provider if your age is 21 or older and you have never had a pelvic exam and Pap smear. Prevention Ask your provider about the HPV vaccine. Girls who receive this vaccine before they become sexually active reduce their chance of getting cervical cancer. You can reduce your risk of developing cervical dysplasia by taking the following steps: Get vaccinated for HPV between ages 9 to 26. Do not smoke. Smoking increases your risk of developing more severe dysplasia and cancer. Do not have sex until you are 18 or older. Practice safe sex. Use a condom. Practice monogamy. This means you have only one sexual partner at a time. Review Date 1/14/2018 Updated by: John D. Jacobson, MD, Professor of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda Center for Fertility, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how often do you need a pap smear

how often do you need a pap smear

Screening should start at age 21. After the first test: - You should have a Pap test every 3 years to check for cervical cancer. - If you are over age 30 and you also have HPV testing done, and both the Pap test and HPV test are normal, you can be tested every 5 years (HPV is the human papillomavirus, the virus that causes genital warts and cervical cancer). - Most women can stop having Pap tests after age 65 to 70 as long as they have had 3 negative tests within the past 10 years.

Pap test Papanicolaou test Pap smear Cervical cancer screening - Pap test Cervical intraepithelial neoplasia - Pap CIN - Pap Precancerous changes of the cervix - Pap Cervical cancer - Pap Squamous intraepithelial lesion - Pap LSIL - Pap HSIL - Pap Low-grade Pap High-grade Pap Carcinoma in situ - Pap CIS - Pap ASCUS - Pap Atypical glandular cells - Pap AGUS - Pap Atypical squamous cells - Pap HPV - Pap Human papilloma virus - Pap cervix - Pap Colposcopy - Pap Summary The Pap test checks for cervical cancer. Cells scraped from the opening of the cervix are examined under a microscope. The cervix is the lower part of the uterus (womb) that opens at the top of the vagina. This test is sometimes called a Pap smear. How the Test is Performed You lie on a table and place your feet in stirrups. The health care provider gently places an instrument called a speculum into the vagina to open it slightly. This allows the provider to see inside the vagina and cervix. Cells are gently scraped from the cervix area. The sample of cells is sent to a lab for examination. How to Prepare for the Test Tell your provider about all the medicines you are taking. Some birth control pills that contain estrogen or progestin may affect test results. Also tell your provider if you: Have had an abnormal Pap test Might be pregnant DO NOT do the following for 24 hours before the test: Douche (douching should never be done) Have intercourse Use tampons Avoid scheduling your Pap test while you have your period (are menstruating). Blood may make the Pap test results less accurate. If you are having unexpected bleeding, do not cancel your exam. Your provider will determine if the Pap test can still be done. Empty your bladder just before the test. How the Test will Feel A Pap test causes little to no discomfort for most women. It can cause some discomfort, similar to menstrual cramps. You may also feel some pressure during the exam. You may bleed a little bit after the test. Why the Test is Performed The Pap test is a screening test for cervical cancer. Most cervical cancers can be detected early if a woman has routine Pap tests. Screening should start at age 21. After the first test: You should have a Pap test every 3 years to check for cervical cancer. If you are over age 30 and you also have HPV testing done, and both the Pap test and HPV test are normal, you can be tested every 5 years (HPV is the human papillomavirus, the virus that causes genital warts and cervical cancer). Most women can stop having Pap tests after age 65 to 70 as long as they have had 3 negative tests within the past 10 years. You may not need to have a Pap test if you have had a total hysterectomy (uterus and cervix removed) and have not had an abnormal Pap test, cervical cancer, or other pelvic cancer. Discuss this with your provider. Normal Results A normal result means there are no abnormal cells present. The Pap test is not 100% accurate. Cervical cancer may be missed in a small number of cases. Most of the time, cervical cancer develops very slowly, and follow-up Pap tests should find any changes in time for treatment. What Abnormal Results Mean Abnormal results are grouped as follows: ASCUS or AGUS: This result means there are atypical cells, but it is uncertain or unclear what these changes mean. The changes may be due to HPV. They may also mean there are changes that may lead to cancer. These cells could be precancerous and they could be coming from the outside of the cervix or inside the uterus. LOW-GRADE DYSPLASIA (LSIL) OR HIGH-GRADE DYSPLASIA (HSIL): This means changes that may lead to cancer are present. The risk of progression to cervical cancer is greater with HSIL. CARCINOMA IN SITU (CIS): This result most often means the abnormal changes are likely to lead to cervical cancer if not treated ATYPICAL SQUAMOUS CELLS (ASC): Abnormal changes have been found and may be HSIL ATYPICAL GLANDULAR CELLS (AGC): Cell changes that may lead to cancer are seen in the upper part of the cervical canal or inside the uterus. When a Pap test shows abnormal changes, further testing or follow-up is needed. The next step depends on the results of the Pap test, your previous history of Pap tests, and risk factors you may have for cervical cancer. For minor cell changes, providers will recommend another Pap test or repeat HPV testing in 6 to 12 months. Follow-up testing or treatment may include: Colposcopy-directed biopsy -- Colposcopy is a procedure in which the cervix is magnified with a binocular like tool called a colposcope. Small biopsies are often obtained during this procedure to determine the extent of the problem. An HPV test to check for the presence of the HPV virus types most likely to cause cancer. Cervix cryosurgery. Cone biopsy. Review Date 7/17/2017 Updated by: Cynthia D. White, MD, Fellow American College of Obstetricians and Gynecologists, Group Health Cooperative, Bellevue, WA. Internal review and update 11/06/2018 by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how often do you need a pap smear

how often do you need a pap smear

Cervical cancer usually develops slowly. It starts as precancerous changes called dysplasia. Dysplasia can be detected by a medical test called a Pap smear. Dysplasia is fully treatable. That is why it is important for women to get regular Pap smears, so that precancerous cells can be removed before they can become cancer. Pap smear screening should start at age 21. After the first test: - Women ages 21 through 29 should have a Pap smear every 3 years. - Women ages 30 through 65 should be screened with either a Pap smear every 3 years or a Pap smear and HPV test every 5 years. - If you or your sexual partner has other new partners, you should have a Pap smear every 3 years. - Women ages 65 through 70 can stop having Pap smears as long as they have had 3 normal tests within the past 10 years. - Women who have been treated for precancer (cervical dysplasia) should continue to have Pap smears for 20 years after treatment or until age 65, whichever is longer. Talk with your provider about how often you should have a Pap smear.

Cervical cancer - screening and prevention Cancer cervix - screening HPV - cervical cancer screening Dysplasia - cervical cancer screening Cervical cancer - HPV vaccine Summary Cervical cancer is a cancer that starts in the cervix. The cervix is the lower part of the uterus (womb) that opens at the top of the vagina. There is a lot you can do to decrease your chance of having cervical cancer. Also, your health care provider can do tests to find early changes that may lead to cancer, or to find cervical cancer in the early stages. Lifestyle and Safer Sex Habits Almost all cervical cancers are caused by HPV (human papilloma virus). HPV is a common virus that spreads through sexual contact. Certain types of HPV are more likely to lead to cervical cancer. These are called high-risk types of HPV. Other types of HPV cause genital warts. HPV can be passed from person to person even when there are no visible warts or other symptoms. Vaccines to Prevent Cervical Cancer A vaccine is available to protect against the HPV types that cause most cervical cancer in women. The vaccine is: Recommended for girls and women ages 9 through 26. Given as 2 shots in girls ages 9 through 14, and as 3 shots in teens older than 14 years. Best for girls to get by age 11 or before becoming sexually active. However, girls and younger women who are already sexually active can still be protected by the vaccine if they've never been infected. These safer sex practices can also help reduce your risk of getting HPV and cervical cancer: Always use condoms. But be aware that condoms cannot fully protect you. This is because the virus or warts can also be on the nearby skin. Have only one sexual partner, whom you know is infection-free. Limit the number of sexual partners you have over time. DO NOT get involved with partners who take part in high-risk sexual activities. DO NOT smoke. Cigarette smoking increases the risk of getting cervical cancer. Pap Smears Cervical cancer often develops slowly. It starts as precancerous changes called dysplasia. Dysplasia can be detected by a medical test called a Pap smear. Dysplasia is fully treatable. That is why it is important for women to get regular Pap smears, so that precancerous cells can be removed before they can become cancer. Pap smear screening should start at age 21. After the first test: Women ages 21 through 29 should have a Pap smear every 3 years. HPV testing is not recommended for this age group. Women ages 30 through 65 should be screened with either a Pap smear every 3 years or the HPV test every 5 years. If you or your sexual partner has other new partners, you should have a Pap smear every 3 years. Women ages 65 through 70 can stop having Pap smears as long as they have had 3 normal tests within the past 10 years. Women who have been treated for precancer (cervical dysplasia) should continue to have Pap smears for 20 years after treatment or until age 65, whichever is longer. Talk with your provider about how often you should have a Pap smear or HPV test. Review Date 9/28/2017 Updated by: John D. Jacobson, MD, Professor of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda Center for Fertility, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how often do you need a pap smear

how often do you need a pap smear

Using tobacco over a long time can increase your risk of many health problems. Heart and blood vessel problems: - Blood clots and weakness in the walls of blood vessels in the brain, which can lead to stroke - Blood clots in the legs, which may travel to the lungs - Coronary artery disease, including angina and heart attacks - Temporarily increased blood pressure after smoking - Poor blood supply to the legs - Problems with erections because of decreased blood flow into the penis Other health risks or problems: - Cancer (more likely in the lung, mouth, larynx, nose and sinuses, throat, esophagus, stomach, bladder, kidney, pancreas, cervix, colon, and rectum) - Poor wound healing after surgery - Lung problems, such as COPD or asthma that is harder to control - Problems during pregnancy, such as babies born at a low birth weight, early labor, losing your baby, and cleft lip - Decreased ability to taste and smell - Harm to sperm, which may lead to infertility - Loss of sight due to an increased risk of macular degeneration - Tooth and gum diseases - Wrinkling of the skin

Risks of tobacco Secondhand smoke - risks Cigarette smoking - risks Smoking and smokeless tobacco - risks Nicotine - risks Summary Tobacco is a plant. Its leaves are smoked, chewed, or sniffed for a variety of effects. Tobacco contains the chemical nicotine, which is an addictive substance. Tobacco smoke contains more than 7,000 chemicals, at least 70 of which are known to cause cancer. Tobacco that is not burned is called smokeless tobacco. Including nicotine, there are at least 30 chemicals in smokeless tobacco that are known to cause cancer. HEALTH RISKS OF SMOKING OR USING SMOKELESS TOBACCO Knowing the serious health risks of using tobacco may help motivate you to quit. Using tobacco over a long time can increase your risk of many health problems. Heart and blood vessel problems: Blood clots and weakness in the walls of blood vessels in the brain, which can lead to stroke Blood clots in the legs, which may travel to the lungs Coronary artery disease, including angina and heart attack Temporarily increased blood pressure after smoking Poor blood supply to the legs Problems with erections because of decreased blood flow into the penis Other health risks or problems: Cancer (more likely in the lung, mouth, larynx, nose and sinuses, throat, esophagus, stomach, bladder, kidney, pancreas, cervix, colon, and rectum) Poor wound healing after surgery Lung problems, such as COPD, or asthma that is harder to control Problems during pregnancy, such as babies born at a low birth weight, early labor, losing your baby, and cleft lip Decreased ability to taste and smell Harm to sperm, which may lead to infertility Loss of sight due to an increased risk of macular degeneration Tooth and gum diseases Wrinkling of the skin Smokers who switch to smokeless tobacco instead of quitting tobacco still have health risks: Increased risk of cancer of the mouth, tongue, esophagus, and pancreas Gum problems, tooth wear, and cavities Worsening high blood pressure and angina HEALTH RISKS OF SECONDHAND SMOKE Those who are often around the smoke of others (secondhand smoke) have a higher risk of: Heart attack and heart disease Lung cancer Sudden and severe reactions, including of the eye, nose, throat, and lower respiratory tract Infants and children who are often exposed to secondhand smoke are at risk of: Asthma flares (children with asthma who live with a smoker are much more likely to visit the emergency room) Infections of the mouth, throat, sinuses, ears, and lungs Lung damage (poor lung function) Sudden infant death syndrome (SIDS) Like any addiction, quitting tobacco is difficult, especially if you are doing it alone. Seek support from family members, friends, and coworkers. Talk to your health care provider about nicotine replacement therapy and smoking cessation medicines. Join a smoking cessation program and you will have a much better chance of success. Such programs are offered by hospitals, health departments, community centers, and work sites. Review Date 2/12/2018 Updated by: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how smoking tobacco affects the brain

how smoking tobacco affects the brain

Tar, nicotine, and other chemicals from smoking can increase your risk of many health problems. These include heart and blood vessel problems, such as: - Blood clots and aneurysms in the brain, which can lead to strokes. - Coronary artery disease, including chest pain (angina) and heart attacks - High blood pressure - Poor blood supply to the legs - Problems with erections Smoking also increases your risk for different types of cancer, including cancer of the: - Lungs - Mouth - Larynx - Esophagus - Bladder - Kidneys - Pancreas - Cervix Smoking also leads to lung problems, such as emphysema and chronic bronchitis, and makes asthma harder to control. Some smokers switch to smokeless tobacco instead of quitting tobacco completely.

Smoking and surgery Surgery - quitting smoking Surgery - quitting tobacco Wound healing - smoking Summary Quitting smoking and other tobacco products before surgery can improve your recovery and outcome after surgery. Most people who successfully quit smoking have tried and failed many times. DO NOT give up. Learning from your past tries can help you succeed. There Are Many Reasons to Quit Smoking Tar, nicotine, and other chemicals from smoking can increase your risk of many health problems. These include heart and blood vessel problems, such as: Blood clots and aneurysms in the brain, which can lead to strokes Coronary artery disease, including chest pain (angina) and heart attacks High blood pressure Poor blood supply to the legs Problems with erections Smoking also increases your risk for different types of cancer, including cancer of the: Lungs Mouth Larynx Esophagus Bladder Kidneys Pancreas Cervix Smoking also leads to lung problems, such as emphysema and chronic bronchitis, and makes asthma harder to control. Some smokers switch to smokeless tobacco instead of quitting tobacco completely. But using smokeless tobacco still carries health risks, such as: Developing mouth or nasal cancer Gum problems, tooth wear, and cavities Worsening high blood pressure and chest pain How Smoking Affects Surgery Smokers who have surgery have a higher chance than nonsmokers of blood clots forming in their legs. These clots may travel to and damage the lungs. Smoking decreases the amount of oxygen that reaches the cells in your surgical wound. As a result, your wound may heal more slowly and is more likely to become infected. All smokers carry an increased risk for heart and lung problems. Even when your surgery goes smoothly, smoking causes your body, heart, and lungs to work harder than if you did not smoke. Making the Decision to Quit Most doctors will tell you to stop using cigarettes and tobacco at least 4 weeks before your surgery. Stretching the time between quitting smoking and your surgery out to at least 10 weeks can decrease your risk of problems even more. Like any addiction, quitting tobacco is difficult. There are many ways to quit smoking and many resources to help you, such as: Family members, friends, and coworkers may be supportive or encouraging. Talk to your doctor about medicines, such as nicotine replacement and prescription medicines. If you join smoking cessation programs, you have a much better chance of success. Such programs are offered by hospitals, health departments, community centers, and work sites. Using nicotine gum around the time of surgery is not encouraged. The nicotine will still interfere with the healing of your surgical wound and have the same effect on your general health as using cigarettes and tobacco. Review Date 9/17/2016 Updated by: Debra G. Wechter, MD, FACS, general surgery practice specializing in breast cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. how smoking tobacco affects the brain

how smoking tobacco affects the brain

Nicotine use can have many different effects on the body. It can: - Decrease the appetite; fear of weight gain makes some people unwilling to stop smoking - Boost mood, give people a sense of well-being, and possibly even relieve minor depression - Increase activity in the intestines - Create more saliva and phlegm - Increase the heart rate by around 10 to 20 beats per minute - Increase blood pressure by 5 to 10 mm Hg - Possibly cause sweating, nausea, and diarrhea - Stimulate memory and alertness; people who use tobacco often depend on it to help them accomplish certain tasks and perform well Symptoms of nicotine withdrawal appear within 2 to 3 hours after you last use tobacco.

Nicotine and tobacco Withdrawal from nicotine Smoking - nicotine addiction and withdrawal Smokeless tobacco - nicotine addiction Cigar smoking Pipe smoking Smokeless snuff Tobacco use Chewing tobacco Nicotine addiction and tobacco Summary The nicotine in tobacco can be addictive like alcohol, cocaine, and morphine. Causes Tobacco is a plant grown for its leaves, which are smoked, chewed, or sniffed. Tobacco contains a chemical called nicotine. Nicotine is an addictive substance. Millions of people in the United States have been able to quit smoking. Although the number of cigarette smokers in the United States has dropped in recent years, the number of smokeless tobacco users has steadily increased. Smokeless tobacco products are either placed in the mouth, cheek, or lip and sucked or chewed on, or placed in the nasal passage. The nicotine in these products is absorbed at the same rate as smoking tobacco, and addiction is still very strong. Both smoking and smokeless tobacco use carry many health risks. Symptoms Nicotine use can have many different effects on the body. It can: Decrease the appetite -- Fear of weight gain makes some people unwilling to stop smoking. Boost mood, give people a sense of well-being, and possibly even relieve minor depression. Increase activity in the intestines. Create more saliva and phlegm. Increase the heart rate by around 10 to 20 beats per minute. Increase blood pressure by 5 to 10 mm Hg. Possibly cause sweating, nausea, and diarrhea. Stimulate memory and alertness -- People who use tobacco often depend on it to help them accomplish certain tasks and perform well. Symptoms of nicotine withdrawal appear within 2 to 3 hours after you last use tobacco. People who smoked the longest or smoked a greater number of cigarettes each day are more likely to have withdrawal symptoms. For those who are quitting, symptoms peak about 2 to 3 days later. Common symptoms include: Intense craving for nicotine Anxiety Depression Drowsiness or trouble sleeping Bad dreams and nightmares Feeling tense, restless, or frustrated Headaches Increased appetite and weight gain Problems concentrating You may notice some or all of these symptoms when switching from regular to low-nicotine cigarettes or reducing the number of cigarettes you smoke. Treatment It is hard to stop smoking or using smokeless tobacco, but anyone can do it. There are many ways to quit smoking. There are also resources to help you quit. Family members, friends, and co-workers may be supportive. Quitting tobacco is hard if you are trying to do it alone. To be successful, you must really want to quit. Most people who have quit smoking were unsuccessful at least once in the past. Try not to view past attempts as failures. See them as learning experiences. Most smokers find it hard to break all the habits they have created around smoking. A smoking cessation program may improve your chance for success. These programs are offered by hospitals, health departments, community centers, work sites, and national organizations. Nicotine replacement therapy may also be helpful. It involves the use of products that provide low doses of nicotine, but none of the toxins found in smoke. Nicotine replacement comes in the form of: Gum Inhalers Throat lozenges Nasal spray Skin patches You can buy many types of nicotine replacement without a prescription. Your health care provider can also prescribe other types of medicines to help you quit. Varenicline (Chantix) and bupropion (Zyban, Wellbutrin) are prescription medications that affect the nicotine receptors in the brain. The goal of these therapies is to relieve cravings for nicotine and ease your withdrawal symptoms. Health experts warn that e-cigarettes are not a replacement therapy for cigarette smoking. It is not known exactly how much nicotine is in e-cigarette cartridges, because information on labels is often wrong. Support Groups Your provider can refer you to stop smoking programs. These are offered by hospitals, health departments, community centers, work sites, and national organizations. Outlook (Prognosis) People who are trying to quit smoking often become discouraged when they do not succeed at first. Research shows that the more times you try, the more likely you are to succeed. If you start smoking again after you have tried to quit, do not give up. Look at what worked or did not work, think of new ways to quit smoking, and try again. Possible Complications There are many more reasons to quit using tobacco. Knowing the serious health risks from tobacco may help motivate you to quit. Tobacco and related chemicals can increase your risk of serious health problems such as cancer, lung disease, and heart attack. When to Contact a Medical Professional See your provider if you wish to stop smoking, or have already done so and are having withdrawal symptoms. Your provider can help recommend treatments. Review Date 2/12/2018 Updated by: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how smoking tobacco affects the brain

how smoking tobacco affects the brain

Tar, nicotine, and other chemicals from smoking can increase your risk of many health problems. These include heart and blood vessel problems, such as: - Blood clots and aneurysms in the brain, which can lead to strokes - Coronary artery disease, including chest pain (angina) and heart attacks - High blood pressure - Poor blood supply to the legs - Problems with erections Smoking also increases your risk for different types of cancer, including cancer of the: - Lungs - Mouth - Larynx - Esophagus - Bladder - Kidneys - Pancreas - Cervix Smoking also leads to lung problems, such as emphysema and chronic bronchitis, and makes asthma harder to control.

Smoking and surgery Surgery - quitting smoking Surgery - quitting tobacco Wound healing - smoking Summary Quitting smoking and other tobacco products before surgery can improve your recovery and outcome after surgery. Most people who successfully quit smoking have tried and failed many times. DO NOT give up. Learning from your past tries can help you succeed. There Are Many Reasons to Quit Smoking Tar, nicotine, and other chemicals from smoking can increase your risk of many health problems. These include heart and blood vessel problems, such as: Blood clots and aneurysms in the brain, which can lead to strokes Coronary artery disease, including chest pain (angina) and heart attacks High blood pressure Poor blood supply to the legs Problems with erections Smoking also increases your risk for different types of cancer, including cancer of the: Lungs Mouth Larynx Esophagus Bladder Kidneys Pancreas Cervix Smoking also leads to lung problems, such as emphysema and chronic bronchitis, and makes asthma harder to control. Some smokers switch to smokeless tobacco instead of quitting tobacco completely. But using smokeless tobacco still carries health risks, such as: Developing mouth or nasal cancer Gum problems, tooth wear, and cavities Worsening high blood pressure and chest pain How Smoking Affects Surgery Smokers who have surgery have a higher chance than nonsmokers of blood clots forming in their legs. These clots may travel to and damage the lungs. Smoking decreases the amount of oxygen that reaches the cells in your surgical wound. As a result, your wound may heal more slowly and is more likely to become infected. All smokers carry an increased risk for heart and lung problems. Even when your surgery goes smoothly, smoking causes your body, heart, and lungs to work harder than if you did not smoke. Making the Decision to Quit Most doctors will tell you to stop using cigarettes and tobacco at least 4 weeks before your surgery. Stretching the time between quitting smoking and your surgery out to at least 10 weeks can decrease your risk of problems even more. Like any addiction, quitting tobacco is difficult. There are many ways to quit smoking and many resources to help you, such as: Family members, friends, and coworkers may be supportive or encouraging. Talk to your doctor about medicines, such as nicotine replacement and prescription medicines. If you join smoking cessation programs, you have a much better chance of success. Such programs are offered by hospitals, health departments, community centers, and work sites. Using nicotine gum around the time of surgery is not encouraged. The nicotine will still interfere with the healing of your surgical wound and have the same effect on your general health as using cigarettes and tobacco. Review Date 9/17/2016 Updated by: Debra G. Wechter, MD, FACS, general surgery practice specializing in breast cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. how smoking tobacco affects the rest of the body

how smoking tobacco affects the rest of the body

Both smoking and smokeless tobacco use carry many health risks.

Nicotine and tobacco Withdrawal from nicotine Smoking - nicotine addiction and withdrawal Smokeless tobacco - nicotine addiction Cigar smoking Pipe smoking Smokeless snuff Tobacco use Chewing tobacco Nicotine addiction and tobacco Summary The nicotine in tobacco can be addictive like alcohol, cocaine, and morphine. Causes Tobacco is a plant grown for its leaves, which are smoked, chewed, or sniffed. Tobacco contains a chemical called nicotine. Nicotine is an addictive substance. Millions of people in the United States have been able to quit smoking. Although the number of cigarette smokers in the United States has dropped in recent years, the number of smokeless tobacco users has steadily increased. Smokeless tobacco products are either placed in the mouth, cheek, or lip and sucked or chewed on, or placed in the nasal passage. The nicotine in these products is absorbed at the same rate as smoking tobacco, and addiction is still very strong. Both smoking and smokeless tobacco use carry many health risks. Symptoms Nicotine use can have many different effects on the body. It can: Decrease the appetite -- Fear of weight gain makes some people unwilling to stop smoking. Boost mood, give people a sense of well-being, and possibly even relieve minor depression. Increase activity in the intestines. Create more saliva and phlegm. Increase the heart rate by around 10 to 20 beats per minute. Increase blood pressure by 5 to 10 mm Hg. Possibly cause sweating, nausea, and diarrhea. Stimulate memory and alertness -- People who use tobacco often depend on it to help them accomplish certain tasks and perform well. Symptoms of nicotine withdrawal appear within 2 to 3 hours after you last use tobacco. People who smoked the longest or smoked a greater number of cigarettes each day are more likely to have withdrawal symptoms. For those who are quitting, symptoms peak about 2 to 3 days later. Common symptoms include: Intense craving for nicotine Anxiety Depression Drowsiness or trouble sleeping Bad dreams and nightmares Feeling tense, restless, or frustrated Headaches Increased appetite and weight gain Problems concentrating You may notice some or all of these symptoms when switching from regular to low-nicotine cigarettes or reducing the number of cigarettes you smoke. Treatment It is hard to stop smoking or using smokeless tobacco, but anyone can do it. There are many ways to quit smoking. There are also resources to help you quit. Family members, friends, and co-workers may be supportive. Quitting tobacco is hard if you are trying to do it alone. To be successful, you must really want to quit. Most people who have quit smoking were unsuccessful at least once in the past. Try not to view past attempts as failures. See them as learning experiences. Most smokers find it hard to break all the habits they have created around smoking. A smoking cessation program may improve your chance for success. These programs are offered by hospitals, health departments, community centers, work sites, and national organizations. Nicotine replacement therapy may also be helpful. It involves the use of products that provide low doses of nicotine, but none of the toxins found in smoke. Nicotine replacement comes in the form of: Gum Inhalers Throat lozenges Nasal spray Skin patches You can buy many types of nicotine replacement without a prescription. Your health care provider can also prescribe other types of medicines to help you quit. Varenicline (Chantix) and bupropion (Zyban, Wellbutrin) are prescription medications that affect the nicotine receptors in the brain. The goal of these therapies is to relieve cravings for nicotine and ease your withdrawal symptoms. Health experts warn that e-cigarettes are not a replacement therapy for cigarette smoking. It is not known exactly how much nicotine is in e-cigarette cartridges, because information on labels is often wrong. Support Groups Your provider can refer you to stop smoking programs. These are offered by hospitals, health departments, community centers, work sites, and national organizations. Outlook (Prognosis) People who are trying to quit smoking often become discouraged when they do not succeed at first. Research shows that the more times you try, the more likely you are to succeed. If you start smoking again after you have tried to quit, do not give up. Look at what worked or did not work, think of new ways to quit smoking, and try again. Possible Complications There are many more reasons to quit using tobacco. Knowing the serious health risks from tobacco may help motivate you to quit. Tobacco and related chemicals can increase your risk of serious health problems such as cancer, lung disease, and heart attack. When to Contact a Medical Professional See your provider if you wish to stop smoking, or have already done so and are having withdrawal symptoms. Your provider can help recommend treatments. Review Date 2/12/2018 Updated by: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how smoking tobacco affects the rest of the body

how smoking tobacco affects the rest of the body

Long-term use of tobacco can increase your risk of many serious health problems. THE BENEFITS OF QUITTING Some health benefits begin almost immediately. Every week, month, and year without tobacco further improves your health. - Within 20 minutes of quitting: Your blood pressure and pulse rate drop to normal and the temperature of your hands and feet increases to normal. - Within 8 hours of quitting: Your blood carbon monoxide levels drop and your blood oxygen levels increase to normal levels. - Within 24 hours of quitting: Your risk of a sudden heart attack goes down. - Within 48 hours of quitting: Your nerve endings begin to regrow. Your senses of smell and taste begin to return to normal. - Within 2 weeks to 3 months of quitting: Your circulation improves. Walking becomes easier. Your lungs work better. Wounds heal more quickly. - Within 1 to 9 months of quitting: You have more energy. Smoking-related symptoms, such as coughing, nasal congestion, fatigue, and shortness of breath improve. You will have fewer illnesses, colds, and asthma attacks. You will gradually no longer be short of breath with everyday activities. - Within 1 year of quitting: Your risk of coronary heart disease is half that of someone still using tobacco. - Within 5 years of quitting: Your risk of mouth, throat, esophagus, and bladder cancers are reduced by half. - Within 10 years of quitting: Your risk of dying from lung cancer is about one half that of a person who still smokes.

Benefits of quitting tobacco Secondhand smoke Cigarette smoking - quitting Tobacco cessation Smoking and smokeless tobacco - quitting Why you should quit smoking Summary If you smoke, you should quit. But quitting can be hard. Most people who have quit smoking have tried at least once, without success, in the past. View any past attempts to quit as a learning experience, not a failure. There are many reasons to quit using tobacco. Long-term use of tobacco can increase your risk of many serious health problems. THE BENEFITS OF QUITTING You may enjoy the following when you quit smoking. Your breath, clothes, and hair will smell better. Your sense of smell will return. Food will taste better. Your fingers and fingernails will slowly appear less yellow. Your stained teeth may slowly become whiter. Your children will be healthier and will be less likely to start smoking. It will be easier and cheaper to find an apartment or hotel room. You may have an easier time getting a job. Friends may be more willing to be in your car or home. It may be easier to find a date. Many people do not smoke and do not like to be around people who smoke. You will save money. If you smoke a pack a day, you spend about $2,000 a year on cigarettes. HEALTH BENEFITS Some health benefits begin almost immediately. Every week, month, and year without tobacco further improves your health. Within 20 minutes of quitting: Your blood pressure and pulse rate drop to normal and the temperature of your hands and feet increases to normal. Within 8 hours of quitting: Your blood carbon monoxide levels drop and your blood oxygen levels increase to normal levels. Within 24 hours of quitting: Your risk of a sudden heart attack goes down. Within 48 hours of quitting: Your nerve endings begin to regrow. Your senses of smell and taste begin to return to normal. Within 2 weeks to 3 months of quitting: Your circulation improves. Walking becomes easier. Your lungs work better. Wounds heal more quickly. Within 1 to 9 months of quitting: You have more energy. Smoking-related symptoms, such as coughing, nasal congestion, fatigue, and shortness of breath improve. You will have fewer illnesses, colds, and asthma attacks. You will gradually no longer be short of breath with everyday activities. Within 1 year of quitting: Your risk of coronary heart disease is half that of someone still using tobacco. Within 5 years of quitting: Your risk of mouth, throat, esophagus, and bladder cancers are reduced by half. Within 10 years of quitting: Your risk of dying from lung cancer is about one half that of a person who still smokes. Other health benefits of quitting smoking include: Lower chance of blood clots in the legs, which may travel to the lungs Lower risk of erectile dysfunction Fewer problems during pregnancy, such as babies born at low birth weight, premature labor, miscarriage, and cleft lip Lower risk of infertility due to damaged sperm Healthier teeth, gums, and skin Infants and children who you live with will have: Asthma that is easier to control Fewer visits to the emergency room Fewer colds, ear infections, and pneumonia Reduced risk of sudden infant death syndrome (SIDS) MAKING THE DECISION Like any addiction, quitting tobacco is difficult, especially if you do it alone. There are a lot of ways to quit smoking and many resources to help you. Talk to your health care provider about nicotine replacement therapy and smoking cessation medicines. If you join smoking cessation programs, you have a much better chance of success. Such programs are offered by hospitals, health departments, community centers, and work sites. Review Date 11/20/2017 Updated by: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how smoking tobacco affects the rest of the body

how smoking tobacco affects the rest of the body

Smoking harms nearly every organ of the body. Cigarette smoking causes 87 percent of lung cancer deaths. It is also responsible for many other cancers and health problems. These include lung disease, heart and blood vessel disease, stroke and cataracts. Women who smoke have a greater chance of certain pregnancy problems or having a baby die from sudden infant death syndrome (SIDS).

Smoking Cigar smoking Cigarette smoking Pipe smoking Tobacco smoking Summary There's no way around it. Smoking is bad for your health. Smoking harms nearly every organ of the body. Cigarette smoking causes 87 percent of lung cancer deaths. It is also responsible for many other cancers and health problems. These include lung disease, heart and blood vessel disease, stroke and cataracts. Women who smoke have a greater chance of certain pregnancy problems or having a baby die from sudden infant death syndrome (SIDS). Your smoke is also bad for other people - they breathe in your smoke secondhand and can get many of the same problems as smokers do. E-cigarettes often look like cigarettes, but they work differently. They are battery-operated smoking devices. Not much is known about the health risks of using them. Quitting smoking can reduce your risk of health problems. The earlier you quit, the greater the benefit. NIH: National Cancer Institute how smoking tobacco affects the rest of the body

how smoking tobacco affects the rest of the body

Social anxiety disorder (Treatment): The goal of treatment is to help you function effectively. The success of the treatment usually depends on the severity of your fears. Behavioral treatment is often tried first and may have long-lasting benefits: - Cognitive behavioral therapy helps you understand and change the thoughts that are causing your condition, as well as learn to recognize and replace panic-causing thoughts. - Systematic desensitization or exposure therapy may be used. You are asked to relax, then imagine the situations that cause the anxiety, working from the least fearful to the most fearful. Gradual exposure to the real-life situation has also been used with success to help people overcome their fears. - Social skills training may involve social contact in a group therapy situation to practice social skills. Role playing and modeling are techniques used to help you become more comfortable relating to others in a social situation. Certain medicines, usually used to treat depression, may be very helpful for this disorder. They work by preventing your symptoms or making them less severe. Lifestyle changes may help reduce how often the attacks occur. - Get regular exercise, enough sleep, and regularly scheduled meals. - Reduce or avoid the use of caffeine, some over-the-counter cold medicines, and other stimulants.

Social anxiety disorder Phobia - social Anxiety disorder - social Social phobia SAD - social anxiety disorder Summary Social anxiety disorder is a persistent and irrational fear of situations that may involve scrutiny or judgment by others, such as at parties and other social events. Causes People with social anxiety disorder fear and avoid situations in which they may be judged by others. It may begin in the teens and may have to do with overprotective parents or limited social opportunities. Men and women are affected equally with this disorder. People with social phobia are at high risk for alcohol or other drug use. This is because they may come to rely on these substances to relax in social situations. Symptoms People with social anxiety become very anxious and self-conscious in everyday social situations. They have an intense, persistent, and chronic fear of being watched and judged by others, and of doing things that will embarrass them. They can worry for days or weeks before a dreaded situation. This fear may become so severe that it interferes with work, school, and other ordinary activities, and can make it hard to make and keep friends. Some of the most common fears of people with this disorder include: Attending parties and other social occasions Eating, drinking, and writing in public Meeting new people Speaking in public Using public restrooms Physical symptoms that often occur include: Blushing Difficulty talking Nausea Profuse sweating Trembling Social anxiety disorder is different from shyness. Shy people are able to participate in social functions. Social anxiety disorder affects the ability to function in work and relationships. Exams and Tests The health care provider will look at your history of social anxiety and will get a description of the behavior from you, your family, and friends. Treatment The goal of treatment is to help you function effectively. The success of the treatment usually depends on the severity of your fears. Behavioral treatment is often tried first and may have long-lasting benefits: Cognitive behavioral therapy helps you understand and change the thoughts that are causing your condition, as well as learn to recognize and replace panic-causing thoughts. Systematic desensitization or exposure therapy may be used. You are asked to relax, then imagine the situations that cause the anxiety, working from the least fearful to the most fearful. Gradual exposure to the real-life situation has also been used with success to help people overcome their fears. Social skills training may involve social contact in a group therapy situation to practice social skills. Role playing and modeling are techniques used to help you become more comfortable relating to others in a social situation. Certain medicines, usually used to treat depression, may be very helpful for this disorder. They work by preventing your symptoms or making them less severe. You must take these medicines every day. DO NOT stop taking them without talking with your provider. Medicines called sedatives (or hypnotics) may also be prescribed. These medicines should only be taken under a doctor's direction. Your doctor will prescribe a limited amount of these drugs. They should not to be used every day. They may be used when symptoms become very severe or when you are about to be exposed to something that always brings on your symptoms. If you are prescribed a sedative, do not drink alcohol while on this medicine. Lifestyle changes may help reduce how often the attacks occur. Get regular exercise, enough sleep, and regularly scheduled meals. Reduce or avoid the use of caffeine, some over-the-counter cold medicines, and other stimulants. Support Groups You can ease the stress of having social anxiety by joining a support group. Sharing with others who have common experiences and problems can help you not feel alone. Support groups are usually not a good substitute for talk therapy or taking medicine, but can be a helpful addition. Resources for more information include: Anxiety and Depression Association of America -- adaa.org National Institute of Mental Health -- www.nimh.nih.gov/health/publications/social-anxiety-disorder-more-than-just-shyness/index.shtml Outlook (Prognosis) The outcome is often good with treatment. Antidepressant medicines can also be effective. Possible Complications Alcohol or other drug use may occur with social anxiety disorder. Loneliness and social isolation may occur. When to Contact a Medical Professional Call your provider if fear is affecting your work and relationships with others. Review Date 3/26/2018 Updated by: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how to deal with anxiety

how to deal with anxiety

Generalized anxiety disorder - self-care (Therapy): Talk therapy takes place with a trained therapist and in a safe place. It helps you learn ways of managing and reducing your anxiety. Some forms of talk therapy can help you understand what causes your anxiety. This allows you to gain better control over it. Many types of talk therapy may be helpful for GAD. One common and effective talk therapy is cognitive-behavioral therapy (CBT). CBT can help you understand the relationship between your thoughts, your behaviors, and your symptoms. Often CBT involves a set number of visits. During CBT you can learn how to: - Understand and gain control of distorted views of stressors, such as other people's behavior or life events. - Recognize and replace panic-causing thoughts to help you feel more in control. - Manage stress and relax when symptoms occur. - Avoid thinking that minor problems will develop into terrible ones. Your provider can discuss talk therapy options with you.

Generalized anxiety disorder - self-care GAD - self-care Anxiety - self-care Anxiety disorder - self-care Summary Generalized anxiety disorder (GAD) is a mental condition in which you're frequently worried or anxious about many things. Even when there is no clear cause, you're still not able to control your anxiety. The right treatment can often improve GAD. You and your health care provider should make a treatment plan that could include talk therapy (psychotherapy), taking medicine, or both. Taking Medicine Your provider may prescribe one or more medicines, including: An antidepressant, which can help with anxiety and depression. This kind of medicine may take weeks to start working. It is a safe medium- to long-term treatment for GAD. A benzodiazepine, which acts faster than an antidepressant to control anxiety. But it can become less effective over time. Your provider may prescribe a benzodiazepine to help your anxiety while you wait for the antidepressant to work. Also, benzodiazepines may become habit forming over time. When taking medicine for GAD: Keep your provider informed about your symptoms. If a medicine isn't controlling symptoms, its dosage may need to be changed, or you may need to try a new medicine instead. DO NOT change the dosage or stop taking the medicine without talking to your provider. Take medicine at set times. For example, take it every day at breakfast. Check with your provider about the best time to take your medicine. Ask your provider about side effects and what to do if they occur. Therapy Talk therapy takes place with a trained therapist and in a safe place. It helps you learn ways of managing and reducing your anxiety. Some forms of talk therapy can help you understand what causes your anxiety. This allows you to gain better control over it. Many types of talk therapy may be helpful for GAD. One common and effective talk therapy is cognitive-behavioral therapy (CBT). CBT can help you understand the relationship between your thoughts, your behaviors, and your symptoms. Often CBT involves a set number of visits. During CBT you can learn how to: Understand and gain control of distorted views of stressors, such as other people's behavior or life events. Recognize and replace panic-causing thoughts to help you feel more in control. Manage stress and relax when symptoms occur. Avoid thinking that minor problems will develop into terrible ones. Your provider can discuss talk therapy options with you. Then you can decide together if it is right for you. Other Ways to Manage Your Anxiety Taking medicine and going to talk therapy can get you started on the road to feeling better. It can also help you take care of your body and relationships. To help improve your condition: Get enough sleep. Eat healthy foods. Keep a regular daily schedule. Get out of the house every day. Exercise every day. Even a little bit of exercise, such as a 15-minute walk, can help. Stay away from alcohol and street drugs. Talk with family or friends when you feel nervous or frightened. Find out about different types of group activities you can join. When to Call the Doctor Call your provider if you: Find it hard to control your anxiety Do not sleep well Feel sad or feel like you want to hurt yourself Have physical symptoms from your anxiety Review Date 5/12/2017 Updated by: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how to deal with anxiety

how to deal with anxiety

Separation anxiety in children (Treatment): No treatment is needed for normal separation anxiety. Parents can help their infant or toddler adjust to their absence by letting trusted caregivers babysit the child. This helps the child learn to trust and bond with other adults and understand that their parents will return. For older children who have not outgrown separation anxiety, treatments may include: - Anti-anxiety medicines - Changes in parenting techniques - Counseling for the parents and child Treatment for severe cases may include: - Family education - Family therapy - Talk therapy

Separation anxiety in children Summary Separation anxiety in children is a developmental stage in which the child is anxious when separated from the primary caregiver (usually the mother). Causes As infants grow, their emotions and reactions to the world around them seem to occur in a predictable order. Before 8 months, infants are so new to the world that they lack a sense of what is normal and safe and what may be dangerous. As a result, new settings or people seem to not frighten them. From 8 to 14 months, children often become frightened when they meet new people or visit new places. They recognize their parents as familiar and safe. When separated from their parents, they feel threatened and unsafe. Separation anxiety is a normal stage as a child grows and develops. It helped keep our ancestors alive and helps children learn how to master the world around them. It usually ends when the child is around 2 years old. At this age, toddlers begin to understand that parents may be out of sight now, but will return later. It's also normal for them to test their independence. To get over separation anxiety, children need to: Feel safe in their home. Trust people other than their parents. Trust that their parents will return. Even after children have mastered this stage, separation anxiety may return in times of stress. Most children will feel some degree of separation anxiety when in unfamiliar situations, most often when separated from their parents. When children are in situations (such as hospitals) and are under stress (such as illness or pain), they seek the safety, comfort, and protection of their parents. Since anxiety can worsen pain, staying with a child as much as possible can reduce the pain. Symptoms A child with severe separation anxiety may have any of the following: Excessive distress when separated from the primary caregiver Nightmares Reluctance to go to school or other places because of fear of separation Reluctance to go to sleep without the primary caregiver nearby Repeated physical complaints Worry about losing, or harm coming to the primary caregiver Exams and Tests There are no tests for this condition, because it is normal. If severe separation anxiety persists past age 2, a visit with a health care provider may help determine if the child has an anxiety disorder or other condition. Treatment No treatment is needed for normal separation anxiety. Parents can help their infant or toddler adjust to their absence by letting trusted caregivers babysit the child. This helps the child learn to trust and bond with other adults and understand that their parents will return. During medical procedures, a parent should go with the child if possible. When a parent can't go with the child, exposing the child to the situation beforehand may be helpful, such as visiting the doctor's office before a test. Some hospitals have child life specialists who can explain procedures and medical conditions to children of all ages. If your child is very anxious and needs extended medical care, ask your provider about such services. When it's not possible for parents to be with the child, such as for surgery, explain the experience to the child. Reassure the child that a parent is waiting, and where. For older children who have not outgrown separation anxiety, treatments may include: Anti-anxiety medicines Changes in parenting techniques Counseling for the parents and child Treatment for severe cases may include: Family education Family therapy Talk therapy Outlook (Prognosis) Young children with symptoms that improve after age 2 are normal, even if some anxiety comes back later during stress. When separation anxiety occurs in adolescence, it may signal the development of an anxiety disorder. When to Contact a Medical Professional Call your provider if your child has severe separation anxiety after age 2. Review Date 5/20/2018 Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how to deal with anxiety

how to deal with anxiety

Losing weight after pregnancy (Eat to Lose Weight): These healthy eating tips will help you lose weight safely. - DO NOT skip meals. With a new baby, many new moms forget to eat. If you do not eat, you will have less energy, and it will not help you lose weight. - Eat 5 to 6 small meals a day with healthy snacks in between (rather than 3 larger meals). - Eat breakfast. Even if you do not normally eat in the mornings, get into the habit of having breakfast. Choose nonfat or low-fat dairy products. - When you reach for a snack try to include foods with fiber and protein to help keep you full (such as raw bell pepper or carrot with bean dip, apple slices with peanut butter, or a slice of whole-wheat toast with hard-boiled egg). Drink at least 12 cups of fluid a day. Choose broiled or baked rather than fried foods. - Limit sweets, sugar, saturated fat and trans fats. Make your goals about your new body realistic.

Losing weight after pregnancy Summary You should plan to return to your pre-pregnancy weight by 6 to 12 months after delivery. Most women lose half of their baby weight by 6 weeks after childbirth (postpartum). The rest most often comes off over the next several months. A healthy diet with daily exercise will help you shed the pounds. Breastfeeding can also help with postpartum weight loss. Take Your Time Your body needs time to recover from childbirth. If you lose weight too soon after childbirth, it can take longer for you to recover. Give yourself until your 6-week checkup before trying to slim down. If you are breastfeeding, wait until your baby is at least 2 months old and your milk supply has normalized before drastically cutting calories. Aim for a weight loss of about a pound and a half a week. You can do this by eating healthy foods and adding in exercise once you are cleared by your health care provider for regular physical activity. Women who are exclusively breastfeeding need about 500 more calories per day than they did before pregnancy. Get these calories from healthy choices such as fruits, vegetables, whole grains, low-fat dairy, and lean protein. DO NOT drop below the minimum number of calories you need. Breastfeeding If you are breastfeeding, you will want to lose weight slowly. Weight loss that happens too fast can make you produce less milk. Losing about a pound and a half (670 grams) a week should not affect your milk supply or your health. Breastfeeding makes your body burn calories which helps you lose weight. If you are patient, you may be surprised at how much weight you lose naturally while breastfeeding. Eat to Lose Weight These healthy eating tips will help you lose weight safely. DO NOT skip meals. With a new baby, many new moms forget to eat. If you do not eat, you will have less energy, and it will not help you lose weight. Eat 5 to 6 small meals a day with healthy snacks in between (rather than 3 larger meals). Eat breakfast. Even if you do not normally eat in the mornings, get into the habit of having breakfast. It will give you energy to start your day and stop you from feeling tired later. Slow down. When you take your time eating, you will notice that it is easier to tell that you are full. It is tempting to multitask, but if you focus on your meal you will be less likely to overeat. Choose nonfat or low-fat dairy products. When you reach for a snack try to include foods with fiber and protein to help keep you full (such as raw bell pepper or carrot with bean dip, apple slices with peanut butter, or a slice of whole-wheat toast with hard-boiled egg). Drink at least 12 cups of fluid a day. Keep a water bottle near the spot where you usually feed the baby, that way you'll remember to drink when they do. Limit drinks like sodas, juices, and other fluids with added sugar and calories. They can add up and keep you from losing weight. Choose broiled or baked rather than fried foods. Limit sweets, sugar, saturated fat and trans fats. Do Not Crash and Burn DO NOT go on a crash diet (not eating enough) or a fad diet (popular diets that limit certain types of foods and nutrients). They will probably make you drop pounds at first, but those first few pounds you lose are fluid and will come back. Other pounds you lose on a crash diet may be muscle instead of fat. You will gain back any fat you lose on a crash diet once you return to normal eating. Be Realistic You may not be able to return to your exact pre-pregnancy shape. For many women, pregnancy causes lasting changes in the body. You may have a softer belly, wider hips, and a larger waistline. Make your goals about your new body realistic. Exercise A healthy diet combined with regular exercise is the best way to shed the pounds. Exercise will help you lose fat instead of muscle. Once you are ready to start losing weight, eat a little less and move a little more each day. It may be tempting to push yourself into a hard routine for fast weight loss. But rapid weight loss is not healthy and is hard on your body. DO NOT overdo it. Just a quick walk around the block with your baby in the stroller is a great way to start adding exercise to your daily routine. Review Date 2/27/2017 Updated by: Emily Wax, RD, The Brooklyn Hospital Center, Brooklyn, NY. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how to loose weight

how to loose weight

Diet for rapid weight loss: Rapid weight loss diet is usually for people who have health problems because of obesity. Rapid weight loss diet is a type of diet in which you lose more than 2 pounds (1 kilogram, kg) a week over several weeks. To lose weight this quickly you eat very few calories. These diets are most often for obese people who need to lose weight quickly because of a health problem. People on these diets should be followed closely by a health care provider. Rapid weight loss is not safe for most people to do on their own. These diets are only to be used for a short time and are not recommended for more than several weeks. Some fad diets also severely limit calories to achieve rapid weight loss. In many cases, these diets are not safe.

Diet for rapid weight loss Very low-calorie diet VLCD Low-calorie diet LCD Very low energy diet Weight loss - rapid weight loss Overweight - rapid weight loss Obesity - rapid weight loss Diet - rapid weight loss Summary Rapid weight loss diet is a type of diet in which you lose more than 2 pounds (1 kilogram, kg) a week over several weeks. To lose weight this quickly you eat very few calories. How It Works These diets are most often chosen by obese people who want to lose weight quickly. These diets are rarely recommended by health care providers. People on these diets should be followed closely by a provider. Rapid weight loss is not safe for most people to do on their own. These diets are only to be used for a short time and are not recommended for more than several weeks. The types of rapid weight loss diets are described below. People who lose weight very quickly are much more likely to regain the weight over time than people who lose weight slowly through less drastic diet changes and physical activity. Very Low-Calorie Diet (VLCD) On a VLCD, you may have as few as 800 calories a day and may lose up to 3 to 5 pounds (1.5 to 2 kg) week. Most VLCDs use meal replacements, such as formulas, soups, shakes, and bars instead of regular meals. This helps ensure that you get all of the nutrients you need each day. A VLCD is only recommended for adults who are obese and need to lose weight for health reasons. These diets are often used before weight-loss surgery. You should only use a VLCD with the help of your provider. Most experts DO NOT recommend using a VLCD for more than 12 weeks. Low-Calorie Diet (LCD) These diets usually allow about 1,000 to 1,200 calories a day for women and 1,200 to 1,600 calories a day for men. An LCD is a better choice than a VLCD for most people who want to lose weight quickly. But you should still be supervised by a provider. You will not lose weight as fast with an LCD, but you can lose just as much weight with a VLCD. An LCD may use a mix of meal replacements and regular food. This makes it easier to follow than a VLCD. Fad Diets Some fad diets also severely limit calories to achieve rapid weight loss. In many cases, these diets are not safe. Once you stop the diet, you are at risk for regaining the weight if you return to your old eating habits. For most people, it is safest to choose a diet in which you lose a 1/2 pound to 1 pound (225 grams to 500 grams) a week. The Role of Exercise Rapid weight loss is more about cutting calories than exercising. Talk with your provider about what type of exercise you should do while you are on this type of diet. Your provider may suggest waiting until you are on a more long-term diet to start exercising. Health Benefits Rapid weight loss diet is usually for people who have health problems because of obesity. For these people, losing a lot of weight quickly can help improve: Diabetes High cholesterol High blood pressure Possible Health Concerns You should only follow one of these diets with the help of your provider. Losing more than 1 or 2 pounds (0.5 to 1 kg) a week is not safe for most people. It can cause you to lose muscle, water, and bone density. Rapid weight loss can also cause some side effects including: Gallstones Gout Fatigue Constipation Diarrhea Nausea People who lose weight quickly are also more likely to gain back the weight quickly. This can lead to other health problems. In general, a rapid weight loss diet is not safe for children. It may also not be safe for teens, pregnant women or older adults unless a provider recommends it. If you have a health condition, it is a good idea to talk with your provider before starting this or any diet plan to lose weight. Review Date 5/17/2018 Updated by: Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology & Nutrition, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how to loose weight

how to loose weight

The best way to lose weight is to use more calories than you take in. You can do this by following a healthy eating plan and being more active. Before you start a weight-loss program, talk to your doctor.

Overweight, obesity, and weight loss Overview Over 60 percent of U.S. adult women are overweight, according to 2007 estimates from the National Center for Health Statistics of the Center for Disease Control and Prevention. Just over one-third of overweight adult women are obese. How do I know if I'm overweight or obese? Find out your body mass index (BMI). BMI is a measure of body fat based on height and weight. People with a BMI of 25 to 29.9 are considered overweight. People with a BMI of 30 or more are considered obese. You can find out your BMI by using this calculator or the chart. What causes someone to become overweight or obese? You can become overweight or obese when you eat more calories (KAL-oh-rees) than you use. A calorie is a unit of energy in the food you eat. Your body needs this energy to function and to be active. But if you take in more energy than your body uses, you will gain weight. Many factors can play a role in becoming overweight or obese. These factors include: Overweight and obesity problems keep getting worse in the United States. Some cultural reasons for this include: What are the health effects of being overweight or obese? Being overweight or obese can increase your risk of: But excess body weight isn't the only health risk. The places where you store your body fat also affect your health. Women with a "pear" shape tend to store fat in their hips and buttocks. Women with an "apple" shape store fat around their waists. If your waist is more than 35 inches, you may have a higher risk of weight-related health problems. What is the best way for me to lose weight? The best way to lose weight is to use more calories than you take in. You can do this by following a healthy eating plan and being more active. Before you start a weight-loss program, talk to your doctor. Safe weight-loss programs that work well: How can I make healthier food choices? The U.S. Department of Health and Human Services (HHS) and Department of Agriculture (USDA) offer tips for healthy eating in Dietary Guidelines for All Americans. How can physical activity help? The new 2008 Physical Activity Guidelines for Americans state that an active lifestyle can lower your risk of early death from a variety of causes. There is strong evidence that regular physical activity can also lower your risk of: Regular activity can help prevent unhealthy weight gain and also help with weight loss, when combined with lower calorie intake. If you are overweight or obese, losing weight can lower your risk for many diseases. Being overweight or obese increases your risk of heart disease, high blood pressure, stroke, type 2 diabetes, breathing problems, osteoarthritis, gallbladder disease, sleep apnea (breathing problems while sleeping), and some cancers. Regular physical activity can also improve your cardiorespiratory (heart, lungs, and blood vessels) and muscular fitness. For older adults, activity can improve mental function. Physical activity may also help: Health benefits are gained by doing the following each week: This physical activity should be in addition to your routine activities of daily living, such as cleaning or spending a few minutes walking from the parking lot to your office. If you want to lose a substantial (more than 5 percent of body weight) amount of weight, you need a high amount of physical activity unless you also lower calorie intake. This is also the case if you are trying to keep the weight off. Many people need to do more than 300 minutes of moderate-intensity activity a week to meet weight-control goals. During moderate-intensity activities you should notice an increase in your heart rate, but you should still be able to talk comfortably. An example of a moderate-intensity activity is walking on a level surface at a brisk pace (about 3 to 4 miles per hour). Other examples include ballroom dancing, leisurely bicycling, moderate housework, and waiting tables. If your heart rate increases a lot and you are breathing so hard that it is difficult to carry on a conversation, you are probably doing vigorous-intensity activity. Examples of vigorous-intensity activities include jogging, bicycling fast or uphill, singles tennis, and pushing a hand mower. How you can increase your physical activity What medicines are approved for long-term treatment of obesity? The Food and Drug Administration has approved two medicines for long-term treatment of obesity: These medicines are for people who: If you take these medicines, you will need to follow a healthy eating and physical activity plan at the same time. Before taking these medicines, talk with your doctor about the benefits and the side effects. What surgical options are used to treat obesity? Weight loss surgeries - also called bariatric (bair-ee-AT-rik) surgeries - can help treat obesity. You should only consider surgical treatment for weight loss if you: Common types of weight loss surgeries are: If you are thinking about weight-loss surgery, talk with your doctor about changes you will need to make after the surgery. You will need to: You should also talk to your doctor about risks and side effects of weight loss surgery. Side effects may include: Is liposuction a treatment for obesity? Liposuction (LY-poh-suhk-shuhn) is not a treatment for obesity. In this procedure, a surgeon removes fat from under the skin. Liposuction can be used to reshape parts of your body. But this surgery does not promise lasting weight loss. I'm concerned about my children's eating and physical activity levels. How can I help improve their habits? The things children learn when they are young are hard to change as they get older. This is true for their eating and physical activity habits. Many children have a poor diet and are not very active. They may eat foods high in calories and fat and not eat enough fruits and vegetables. They also may watch TV, play video games, or use the computer instead of being active. Kids who are overweight have a greater chance of becoming obese adults. Overweight children may develop weight-related health problems like high blood pressure and diabetes at a young age. You can find out if your child is overweight or obese by using this Body Mass Index calculator for children and teens. You can help your child build healthy eating and activity habits. We know children do what they see - not always what they are told. Set a good example for your children. Your kids will learn to eat right and be active by watching you. Setting a good example can mean a lifetime of good habits for you and your kids. Did we answer your question about overweight, obesity, and weight loss? For more information about overweight, obesity, and weight loss, call womenshealth.gov at 1-800-994-9662 (TDD: 888-220-5446) or contact the following organizations: how to loose weight

how to loose weight

Health care providers generally agree that people who are considered to be obese (have a BMI of 30 or greater) may improve their health by losing weight.If you are overweight (BMI between 25 and 29.9), experts recommend that you avoid gaining any extra weight. If you are overweight and have other risk factors, losing weight may reduce these risks.

Understanding Adult Overweight & Obesity Definition and Facts The terms “overweight” and “obesity” refer to body weight that is greater than what is considered normal or healthy for a certain height. Reaching and staying at a healthy weight can be a long-term challenge for people who are overweight or have obesity. What are overweight and obesity? The terms "overweight" and "obesity" refer to body weight that is greater than what is considered normal or healthy for a certain height. Overweight is generally due to extra body fat. However, overweight may also be due to extra muscle, bone, or water. People who have obesity usually have too much body fat.Your body mass index (BMI) is one way to tell if you are at a healthy weight, overweight, or have obesity. The BMI is a measure based on your weight in relation to your height. The greater your BMI, the greater your risk of health problems from overweight and obesity.Reaching and staying at a healthy weight may be a long-term challenge if you are overweight or have obesity. Maintaining a healthy weight-or at least not gaining more weight if you are already overweight-can help lower your chance of developing certain health problems. How common is overweight and obesity? According to a national U.S. survey1,2,3more than 1 in 3 adults were considered to be overweight more than 1 in 3 adults were considered to have obesity more than 2 in 3 adults were considered to be overweight or have obesityFor more statistics on overweight and obesity in the United States, see NIDDK's Overweight & Obesity Statistics. Who is more likely to be overweight? Men are more likely than women to be overweight.3 Who is more likely to have obesity? According to a national U.S. survey, some groups are more likely to have obesity.2Among black adults, 48 out of 100 were considered to have obesity. Among Hispanic adults, 42 out of 100 were considered to have obesity. Among white adults, 36 out of 100 were considered to have obesity.Women are more likely than men to have obesity.2Many factors play a role in who is more likely to have obesity, and these factors may affect people differently. Why do people gain weight? Many factors may cause weight gain and affect how much weight your body stores. When you take in more calories from food or beverages than you use up from physical activity and through daily living, such as sitting or sleeping, your body stores the extra calories. Over time, if you continue to consume more calories than you burn off, you will likely gain weight. Excessive weight gain may lead to overweight or obesity. Who should lose weight? Medical experts recommend that people who have obesity should lose weight.Most people who are overweight and have one or more factors that raise their chance for heart disease should lose weight. These factors includediabetes prediabetes high blood pressure dyslipidemia-high levels of LDL cholesterol, low levels of HDL cholesterol, or high levels of triglycerides a large waist size-for men, greater than 40 inches; for women, greater than 35 inches Definition & Facts Factors Affecting Weight and Health Many factors can affect your weight, leading to overweight, obesity, or extreme obesity. Some of these factors may make it hard for you to lose weight or not regain weight you have lost. Being overweight or having obesity may lead to certain health problems. What factors affect weight and health? Many factors can affect your weight and lead to overweight or obesity. Some of these factors may make it hard for you to lose weight or avoid regaining weight that you've lost.Overweight and obesity tend to run in families, suggesting that genes may play a role. Your chances of being overweight are greater if one or both of your parents are overweight or have obesity. Your genes may affect the amount of fat you store in your body and where on your body you carry the extra fat.Some racial and ethnic minority groups are more likely to have obesity. Obesity rates in American adults are highest in African Americans, followed by Hispanics/Latinos, then Caucasians. This is true for men and women.4 While Asian American men and women have the lowest rates of obesity,4 they can still be at risk of diseases associated with obesity if they carry a lot of unhealthy fat in their abdomen-even when their body mass index (BMI) is lower.5Many people gain weight as they age. Adults who have a normal BMI often start to gain weight in young adulthood and continue to gain weight until they are ages 60 to 65. In addition, children who have obesity are more likely to have obesity as adults.In the United States, obesity is more common in black or Hispanic women than in black or Hispanic men.4 A person's sex may also affect where the body stores fat. Women tend to build up fat in their hips and buttocks. Men usually build up fat in their abdomen or belly. Extra fat, particularly if it is around the abdomen, may put people at risk of health problems even if they have a normal weight.Your eating and physical activity habits may raise your chances of becoming overweight and having obesity if youeat and drink a lot of foods and beverages that are high in calories, sugar, and fat drink a lot of beverages that are high in added sugars spend a lot of time sitting or lying down and have limited physical activityWhere you live, work, play, and worship may affect your eating and physical activity habits, and access to healthy foods and places to be active.For example, living in an area that has a high number of grocery stores can increase your access to better quality, lower calorie foods. Living in a neighborhood with a lot of green spaces and areas for safe physical activity may encourage you to be more physically active.Where you work and worship may also make it easier for you to eat unhealthy, high-calorie foods. Vending machines, cafeterias, or special events at your workplace or place of worship may not offer healthy, lower calorie options. Whenever possible, choose the healthier options and limit your treats to a small sliver of pie or cake.Family eating and lifestyle habits may affect your weight and health. Some families may consume foods and beverages that are high in fat, salt, and added sugars or eat large amounts of unhealthy foods at family gatherings. Some families may also spend a lot of inactive time watching TV, using a computer, or using a mobile device instead of being active.Your social, ethnic, or religious group culture may also affect your weight and health because of shared eating and lifestyle habits. Some cultures may consume foods and beverages that are high in fat, salt, and added sugars. Some common food preparation methods, such as frying, may lead to high-calorie intake. Regularly consuming foods high in calories, fat, and sugar may lead to weight gain overtime.People who don't get enough sleep may eat more calories and snack more.6 Experts recommend that adults ages 18 to 64 get 7 to 9 hours of sleep a day, and that adults ages 65 and older get 7 to 8 hours of sleep a day.7Other factors that can lead to weight gain includecertain medical conditions certain medicines binge eating disorder stress What makes it hard for some people to lose weight? Many factors can make it hard to lose weight, includingyour genes what and how much you eat not getting regular physical activity or being inactive taking certain medicines having certain medical conditions Difficulty in managing stress Factors Affecting Weight & Health Am I at a Healthy Weight? Knowing your body mass index (BMI) and waist size help tell if you are at a normal or healthy weight; are overweight; have obesity; or have extreme obesity. Your body shape may make you more likely to have certain health problems. How can I tell if I am at a healthy weight? Knowing your body mass index (BMI), waist size, and waist-to-hip ratio can help you tell if you're at a healthy weight.The BMI is the tool most commonly used to estimate and screen for overweight and obesity in adults. BMI is a measure based on your weight in relation to your height. You can easily calculate your BMI.Your BMI can tell if you are at a normal or healthy weight, are overweight, or have obesity. The greater your BMI, the greater your risk of health problems such as type 2 diabetes and heart disease.Normal or healthy weight. A person with a BMI of 18.5 to 24.9 is in the normal or healthy range. Overweight. A person with a BMI of 25 to 29.9 is considered overweight. Obesity. A person with a BMI of 30 to 39.9 is considered to have obesity. Extreme obesity. A person with a BMI of 40 or greater is considered to have extreme obesity.Because BMI doesn't measure actual body fat, a person who is very muscular, like a bodybuilder, may have a high BMI without having a lot of body fat. Also, some groups who tend to have a lower BMI, such as Asian men and women or older adults, may still have high amounts of body fat even if they are not overweight.Another important measure is your waist size. Having too much fat around your waist may raise your chances of health problems even more than having fat in other parts of your body. Women with a waist size of more than 35 inches and men with a waist size of more than 40 inches may be more likely to develop diseases related to obesity. Does my body shape matter? Doctors are concerned not only with how much body fat you have, but where the fat is located on your body. Women tend to build up fat in their hips and buttocks, giving them a "pear" shape. Men usually build up fat in their abdomen, giving them more of an "apple" shape. Of course, some men are pear-shaped, and some women are apple-shaped.Extra fat, especially in the abdomen, may put people at risk for certain health problems, even if they have a normal weight. People who are apple-shaped may be more likely to develop type 2 diabetes, heart disease, or certain types of cancer than people of the same weight who are pear-shaped. Am I at a Healthy Weight? You should seek a doctor's help if you are gaining weight quickly, have a large waist size, or a BMI of 30 or greater. You should also seek a doctor's help if you are overweight or have obesity and havea family history of certain diseases, such as type 2 diabetes or heart disease health problems such as type 2 diabetes, heart disease, or metabolic syndrome Health Risks Overweight and obesity may increase your risk for certain health problems and may be linked to certain emotional and social problems. What are some health risks of overweight and obesity? Type 2 diabetes is a disease that occurs when your blood glucose, also called blood sugar, is too high. About 8 out of 10 people with type 2 diabetes are overweight or have obesity.8 Over time, high blood glucose leads to problems such as heart disease, stroke, kidney disease, eye problems, nerve damage, and other health problems.If you are at risk for type 2 diabetes, losing 5 to 7 percent of your body weight and getting regular physical activity may prevent or delay the onset of type 2 diabetes.High blood pressure, also called hypertension, is a condition in which blood flows through your blood vessels with a force greater than normal. High blood pressure can strain your heart, damage blood vessels, and raise your risk of heart attack, stroke, kidney disease, and death.Heart disease is a term used to describe several problems that may affect your heart. If you have heart disease, you may have a heart attack, heart failure, sudden cardiac death, angina, or an abnormal heart rhythm. High blood pressure, abnormal levels of blood fats, and high blood glucose levels may raise your risk for heart disease. Blood fats, also called blood lipids, include HDL cholesterol, LDL cholesterol, and triglycerides.Losing 5 to 10 percent of your weight may lower your risk factors for developing heart disease. If you weigh 200 pounds, this means losing as little as 10 pounds. Weight loss may improve blood pressure, cholesterol levels, and blood flow.Stroke is a condition in which the blood supply to your brain is suddenly cut off, caused by a blockage or the bursting of a blood vessel in your brain or neck. A stroke can damage brain tissue and make you unable to speak or move parts of your body. High blood pressure is the leading cause of strokes.Sleep apnea is a common disorder in which you do not breathe regularly while sleeping. You may stop breathing altogether for short periods of time. Untreated sleep apnea may raise your risk of other health problems, such as type 2 diabetes and heart disease.Metabolic syndrome is a group of conditions that put you at risk for heart disease, diabetes, and stroke. These conditions arehigh blood pressure high blood glucose levels high triglyceride levels in your blood low levels of HDL cholesterol (the "good" cholesterol) in your blood too much fat around your waistFatty liver diseases are conditions in which fat builds up in your liver. Fatty liver diseases include nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH). Fatty liver diseases may lead to severe liver damage, cirrhosis, or even liver failure.Osteoarthritis is a common, long-lasting health problem that causes pain, swelling, and reduced motion in your joints. Being overweight or having obesity may raise your risk of getting osteoarthritis by putting extra pressure on your joints and cartilage.Overweight and obesity may raise your risk of getting gallbladder diseases, such as gallstones and cholecystitis. Imbalances in substances that make up bile cause gallstones. Gallstones may form if bile contains too much cholesterol.Cancer is a collection of related diseases. In all types of cancer, some of the body's cells begin to divide without stopping and spread into surrounding tissues. Overweight and obesity may raise your risk of developing certain types of cancer.Kidney disease means that your kidneys are damaged and can't filter blood like they should. Obesity raises the risk of diabetes and high blood pressure, the most common causes of kidney disease. Even if you don't have diabetes or high blood pressure, obesity itself may promote kidney disease and quicken its progress.Overweight and obesity raise the risk of health problems that may occur during pregnancy. Pregnant women who are overweight or obese may have a greater chance ofdeveloping gestational diabetes having preeclampsia-high blood pressure during pregnancy, which can cause severe health problems for mother and baby if left untreated needing a cesarean section, or C-section and, as a result, taking longer to recover after giving birth What emotional and social problems are linked to overweight and obesity? Overweight and obesity are associated with mental health problems such as depression. People who deal with overweight and obesity may also be the subject of weight bias and stigma from others, including health care providers. This can lead to feelings of rejection, shame, or guilt-further worsening mental health problems. Health Risks Eating and Physical Activity Changing your eating habits is central to losing and maintaining your weight. To lose weight, you have to eat fewer calories and use more calories than you take in. Sticking with an eating plan may be more important than the type of eating plan you follow. What options might help you lose weight? Changing your eating habits is central to losing and maintaining your weight. To lose weight, you have to eat fewer calories and use more calories than you take in. This can be challenging for many people to do for an extended period of time. Emerging research shows that sticking with an eating plan may be more important to losing and maintaining weight than the type of eating plan you follow.All your food and beverage choices count. Eating healthy is a journey shaped by many factors, including your age, weight, metabolism, food preferences, access to food, culture, and traditions; whether you are a man or woman; and the personal decisions you make over time. A healthy eating plan includesa variety of vegetables, fruits, and whole grains, such as brown rice, oats, and whole-wheat bread fat-free or low-fat dairy products such as milk, yogurt, and cheese and similar products such as soy beverages a variety of protein foods, including seafood, lean meats and poultry, eggs, legumes (beans and peas), nuts, seeds, and soy products oils, such as olive and canola oils and those found in nuts, olives, and avocadosA healthy eating plan also includesconsuming fewer foods and beverages that have refined carbohydrates, added sugars, and salt (sodium) controlling portion sizes limiting foods with saturated fats and trans fats, like those found in desserts and fried foodsTo learn more about a healthy eating plan and the amounts of food and beverages that are right for you, visit ChooseMyPlate.gov.The Physical Activity Guidelines for Americans define regular physical activity as at least 150 minutes a week of moderate-intensity aerobic activity, such as brisk walking. A moderate-intensity aerobic activity makes your heart beat faster and makes you breathe harder but does not overwork or overheat you. This type of physical activity is safe for most people.People with physical disabilities also can do certain activities, such as wheelchair aerobics or basketball. Talk with your doctor about the types of physical activity that might work well with your abilities.If you have a health condition such as heart disease, high blood pressure, or diabetes, talk with your doctor before you start regular physical activity. Your doctor can review with you the types and amounts of physical activity that might suit your lifestyle, interests, and skills.Read Tips to Help You Get Active. What should I do to stay at a healthy weight? Recent research has found there are many reasons why it is difficult to keep weight off after losing weight. In addition to metabolism slowing during weight loss, your body needs fewer calories at your new, lower weight. Hormonal and other factors also tend to promote weight regain. People who have kept weight off long-term report needing to keep careful track of their food intake and to do high levels of physical activity. Some people who have reached a healthy weight may find it hard to keep the weight off.Weigh yourself regularly. Keep a record of your weight to help make sure you are maintaining your weight loss and not regaining weight.Continue to make healthy food choices, and make following your healthy eating plan a lifelong habit. Find healthy food options that you prefer and enjoy, as you are more likely to stick with your eating plan.Regular physical activity may help you keep from regaining weight you've lost. Aim for 200 to 300 minutes of moderate-intensity physical activity a week to prevent regaining weight.9 Make regular physical activity a lifelong habit.If you were overweight or had obesity and lost weight, your doctor may advise you to take part in a program to help you maintain your weight loss. The program may help you stick to your healthy eating and regular physical activity plan, and track your progress. Eating & Physical Activity Treatment Common treatments for losing weight include healthy eating, being physically active, and making other changes to your usual habits. If you have extreme obesity and related health problems, your doctor may consider other treatments, such as bariatric surgery. Healthy eating plan and regular physical activity Following a healthy eating plan with fewer calories is often the first step in trying to treat overweight and obesity.People who are overweight or have obesity should also start regular physical activity when they begin their healthy eating plan. Being active may help you use calories. Regular physical activity may help you stay at a healthy weight.Learn more about healthy eating and physical activity to lose or maintain weight. Changing your habits Changing your eating and physical activity habits and lifestyle is difficult, but with a plan, effort, regular support, and patience, you may be able to lose weight and improve your health. The following tips may help you think about ways to lose weight, engage in regular physical activity, and improve health over the long-term.Be prepared for setbacks-they are normal. After a setback, like overeating at a family or workplace gathering, try to regroup and focus on getting back to your healthy eating plan as soon as you can. Try to eat only when you're sitting at your dining room or kitchen table. At work, avoid areas where treats may be available. Track your progress using online food or physical activity trackers, such as the Body Weight Planner, that can help you keep track of the foods you eat, your physical activity, and your weight. These tools may help you stick with it and stay motivated. Set goals. Having specific goals can help you stay on track. Rather than "be more active," set a goal to walk 15 to 30 minutes before work or at lunch on Monday and Friday. If you miss a walk on Monday, pick it up again Tuesday. Seek support. Ask for help or encouragement from your family, friends, or health care professionals. You can get support in person, through email or texting, or by talking on the phone. You can also join a support group. Specially trained health professionals can help you change your lifestyle. Weight-management programs Some people benefit from a formal weight-management program. In a weight-management program, trained weight-management specialists will design a broad plan just for you and help you carry out your plan. Plans include a lower-calorie diet, increased physical activity, and ways to help you change your habits and stick with them. You may work with the specialists on-site (that is, face-to-face) in individual or group sessions. The specialists may contact you regularly by telephone or internet to help support your plan. Devices such as smartphones, pedometers, and accelerometers may help you track how well you are sticking with your plan.Some people may also benefit from online weight-management programs or commercial weight-loss programs. Weight-loss medicines When healthy eating and physical activity habits are not enough, your doctor may prescribe medicines to treat overweight and obesity.You should try to stick with your healthy eating plan and continue getting regular physical activity while taking weight-loss medicines.You may see ads for herbal remedies and dietary supplements that claim to help you lose weight. But many of these claims are not true. Some of these supplements can even have serious side effects. Talk with your doctor before taking any over-the-counter herbal remedies or dietary supplements for the purpose of trying to lose weight. Weight-loss devices Your doctor may consider weight-loss devices if you haven't been able to lose weight or keep from gaining back any weight you lost with other treatments. Because weight-loss devices have only recently been approved, researchers do not have long-term data on their safety and effectiveness. Weight-loss devices includeElectrical stimulation system. The electrical stimulation system uses a device a surgeon places in your abdomen with laparoscopic surgery. The device blocks nerve activity between your stomach and brain. Gastric balloon system. For the gastric balloon system, a doctor places one or two balloons in your stomach through a tube that goes in your mouth. Once the balloons are in your stomach, the surgeon fills them with salt water so they take up more space in your stomach and help you feel fuller. Gastric emptying system. A gastric emptying system uses a pump to drain part of the food from your stomach after a meal. The device includes a tube that goes from the inside of your stomach to the outside of your abdomen. About 20 to 30 minutes after eating, you use the pump to drain the food from your stomach through the tube into the toilet. Bariatric surgery Bariatric surgery includes several types of operations that help you lose weight by making changes to your digestive system. Bariatric surgery may be an option if you have extreme obesity and haven't been able to lose enough weight to improve your health or keep from gaining back the weight you lost with other treatments. Bariatric surgery also may be an option at lower levels of obesity if you have serious health problems, such as type 2 diabetes or sleep apnea, related to obesity. Bariatric surgery can improve many of the medical conditions linked to obesity, especially type 2 diabetes. Special diets Your doctor may recommend a lower-calorie diet such as 1,200 to 1,500 calories a day for women and 1,500 to 1,800 calories a day for men. The calorie level depends on your body weight and physical activity level. A lower calorie diet with a variety of healthy foods will give you the nutrients you need to stay healthy.Intermittent fasting is another way of reducing food intake that is gaining attention as a strategy for weight loss and health benefits. Alternate-day fasting is one type of intermittent fasting that consists of a "fast day" (eating no calories to one-fourth of caloric needs) alternating with a "fed day," or a day of unrestricted eating. Researchers have conducted only a few studies of intermittent fasting as a strategy for weight loss. They have no long-term data on the safety and effectiveness of intermittent fasting for long-term weight maintenance. Treatment how to loose weight

how to loose weight

Losing weight after pregnancy (Eat to Lose Weight): These healthy eating tips will help you lose weight safely. - DO NOT skip meals. With a new baby, many new moms forget to eat. If you do not eat, you will have less energy, and it will not help you lose weight. - Eat 5 to 6 small meals a day with healthy snacks in between (rather than 3 larger meals). - Eat breakfast. Even if you do not normally eat in the mornings, get into the habit of having breakfast. Choose nonfat or low-fat dairy products. - When you reach for a snack try to include foods with fiber and protein to help keep you full (such as raw bell pepper or carrot with bean dip, apple slices with peanut butter, or a slice of whole-wheat toast with hard-boiled egg). Drink at least 12 cups of fluid a day. Choose broiled or baked rather than fried foods. - Limit sweets, sugar, saturated fat and trans fats.

Losing weight after pregnancy Summary You should plan to return to your pre-pregnancy weight by 6 to 12 months after delivery. Most women lose half of their baby weight by 6 weeks after childbirth (postpartum). The rest most often comes off over the next several months. A healthy diet with daily exercise will help you shed the pounds. Breastfeeding can also help with postpartum weight loss. Take Your Time Your body needs time to recover from childbirth. If you lose weight too soon after childbirth, it can take longer for you to recover. Give yourself until your 6-week checkup before trying to slim down. If you are breastfeeding, wait until your baby is at least 2 months old and your milk supply has normalized before drastically cutting calories. Aim for a weight loss of about a pound and a half a week. You can do this by eating healthy foods and adding in exercise once you are cleared by your health care provider for regular physical activity. Women who are exclusively breastfeeding need about 500 more calories per day than they did before pregnancy. Get these calories from healthy choices such as fruits, vegetables, whole grains, low-fat dairy, and lean protein. DO NOT drop below the minimum number of calories you need. Breastfeeding If you are breastfeeding, you will want to lose weight slowly. Weight loss that happens too fast can make you produce less milk. Losing about a pound and a half (670 grams) a week should not affect your milk supply or your health. Breastfeeding makes your body burn calories which helps you lose weight. If you are patient, you may be surprised at how much weight you lose naturally while breastfeeding. Eat to Lose Weight These healthy eating tips will help you lose weight safely. DO NOT skip meals. With a new baby, many new moms forget to eat. If you do not eat, you will have less energy, and it will not help you lose weight. Eat 5 to 6 small meals a day with healthy snacks in between (rather than 3 larger meals). Eat breakfast. Even if you do not normally eat in the mornings, get into the habit of having breakfast. It will give you energy to start your day and stop you from feeling tired later. Slow down. When you take your time eating, you will notice that it is easier to tell that you are full. It is tempting to multitask, but if you focus on your meal you will be less likely to overeat. Choose nonfat or low-fat dairy products. When you reach for a snack try to include foods with fiber and protein to help keep you full (such as raw bell pepper or carrot with bean dip, apple slices with peanut butter, or a slice of whole-wheat toast with hard-boiled egg). Drink at least 12 cups of fluid a day. Keep a water bottle near the spot where you usually feed the baby, that way you'll remember to drink when they do. Limit drinks like sodas, juices, and other fluids with added sugar and calories. They can add up and keep you from losing weight. Choose broiled or baked rather than fried foods. Limit sweets, sugar, saturated fat and trans fats. Do Not Crash and Burn DO NOT go on a crash diet (not eating enough) or a fad diet (popular diets that limit certain types of foods and nutrients). They will probably make you drop pounds at first, but those first few pounds you lose are fluid and will come back. Other pounds you lose on a crash diet may be muscle instead of fat. You will gain back any fat you lose on a crash diet once you return to normal eating. Be Realistic You may not be able to return to your exact pre-pregnancy shape. For many women, pregnancy causes lasting changes in the body. You may have a softer belly, wider hips, and a larger waistline. Make your goals about your new body realistic. Exercise A healthy diet combined with regular exercise is the best way to shed the pounds. Exercise will help you lose fat instead of muscle. Once you are ready to start losing weight, eat a little less and move a little more each day. It may be tempting to push yourself into a hard routine for fast weight loss. But rapid weight loss is not healthy and is hard on your body. DO NOT overdo it. Just a quick walk around the block with your baby in the stroller is a great way to start adding exercise to your daily routine. Review Date 2/27/2017 Updated by: Emily Wax, RD, The Brooklyn Hospital Center, Brooklyn, NY. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how to loose weight

how to loose weight

Very Low-calorie Diets (Should I use a VLCD to lose weight?) Most people who need to lose weight should not use a VLCD. For many of them, a low-calorie diet (LCD) may work better (see The Low-calorie Diet (LCD)).VLCDs may be used to promote rapid weight loss among adults who have obesity. Health care providers must review risks and benefits on a case-by-case basis. In general, VLCDs are not appropriate for children. In a few cases, they may be used with some adolescents who are being treated for obesity.Not much is known about the use of VLCDs to promote weight loss among older adults. Some people over age 50 may have medical issues that may not make them good candidates for this type of diet.

Very Low-calorie Diets How is obesity treated? Obesity is treated using one or more of these strategies:a diet low in calories increased physical activity behavior therapy prescription medications weight-loss surgery What is a VLCD? A VLCD is a special diet that provides up to 800 calories per day. VLCDs use commercial formulas, usually liquid shakes, soups, or bars, which replace all your regular meals. These formulas are not the same as the meal replacements you can find at grocerystores or pharmacies, which are meant to replace one or two meals a day.Depending on a number of factors, healthy adults need different amounts of calories to meet their daily energy needs. A standard amount is about 2,000 calories. VLCDs provide far fewer calories than most people need to maintain a healthy weight. This type of diet is used to promote quick weight loss, often as a way to jump-start an obesity treatment program.VLCD formulas are designed to provide all of the nutrients you need while helping you lose weight quickly. However, this type of diet should only be used for a short time—usually about 12 weeks.The Low-calorie Diet (LCD)An LCD limits calories, but not as much as a VLCD. A typical LCD may provide1,000–1,200 calories/day for a woman 1,200–1,600 calories/day for a manThe number of calories may be adjusted based on your age, weight, and how active you are. An LCD usually consists of regular foods, but could also include meal replacements. As a result, you may find this type of diet much easier to follow than a VLCD. In the long term, LCDs have been found to lead to the same amount of weight loss as VLCDs. Should I use a VLCD to lose weight? Most people who need to lose weight should not use a VLCD. For many of them, a low-calorie diet (LCD) may work better (see The Low-calorie Diet (LCD)).VLCDs may be used to promote rapid weight loss among adults who have obesity. Health care providers must review risks and benefits on a case-by-case basis.In general, VLCDs are not appropriate for children. In a few cases, they may be used with some adolescents who are being treated for obesity.Not much is known about the use of VLCDs to promote weight loss among older adults. Some people over age 50 may have medical issues that may not make them good candidates for this type of diet. What are the health benefits of a VLCD? A VLCD may allow you to lose about 3 to 5 pounds per week. This may lead to an average total weight loss of 44 pounds over 12 weeks. Such a weight loss can rapidly improve medical conditions linked to obesity, including diabetes, high blood pressure, and high cholesterol.The rapid weight loss experienced by most people on a VLCD can be very motivating. Patients who participate in a VLCD program that also includes lifestyle changes may lose about 15 to 25 percent of their initial weight during the first 3 to 6 months. They may maintain a 5 percent weight loss after 4 years if they adopt a healthy eating plan and physical activity habits. What are the health risks of a VLCD? Doctors must monitor all VLCD patients regularly—ideally every 2 weeks in the initial period of rapid weight loss—to be sure patients are not experiencing serious side effects.Many patients on a VLCD for 4 to 16 weeks report minor side effects such as fatigue, constipation, nausea, or diarrhea. These conditions usually improve within a few weeks and rarely prevent patients from completing the program.The most common serious side effect is gallstones. Gallstones, which often develop in people who are obese, especially women, may be even more commonly developed during rapid weight loss. Some medicines can prevent gallstones from forming during rapid weight loss. Your health care provider can determine if these medicines are appropriate for you. For more information, see the WIN fact sheet on dieting and gallstones, listed under Additional Links. Will I regain the weight? Although the long-term results of VLCDs vary widely, weight regain is common. To prevent weight regain, the VLCD should always be combined with other ways to lose weight and with an active follow-up program.For most people who have obesity, the condition is long term and requires a lifetime of attention even after formal methods to treat the obesity end. You may need to commit to permanent changes of healthier eating, regular physical activity, and an improved outlook about food. Very Low-calorie Diets The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and conditions.What are clinical trials, and are they right for you?Clinical trials are part of clinical research and at the heart of all medical advances. Clinical trials look at new ways to prevent, detect, or treat disease. Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses. Find out if clinical trials are right for you.What clinical trials are open?Clinical trials that are currently open and are recruiting can be viewed at www.ClinicalTrials.gov. how to loose weight

how to loose weight

Calories used in exercise > calories eaten = weight loss. This means that to lose weight, the number of calories you burn by exercising needs to be greater than the number of calories from the foods you eat and drink. Even if you work out a lot, if you eat more calories than you burn, you will gain weight. Another way to look at this is that a woman ages 30 to 50 years who does not exercise needs about 1,800 calories a day to maintain her normal weight. A man ages 30 to 50 years who does not exercise needs about 2,200 calories to maintain his normal weight. Even if you don't change the amount of calories in your diet, but you do add activity to your daily life, you'll lose weight or gain less weight.

Exercise and activity for weight loss Weight loss - activity Weight loss - exercise Obesity - activity Summary An active lifestyle and exercise routine, along with eating healthy foods, is the best way to lose weight. The Weight-loss Formula Calories used in exercise > calories eaten = weight loss. This means that to lose weight, the number of calories you burn by exercising needs to be greater than the number of calories from the foods you eat and drink. Even if you work out a lot, if you eat more calories than you burn, you will gain weight. Another way to look at this is that a woman ages 30 to 50 years old who does not exercise needs about 1,800 calories a day to maintain her normal weight. A man ages 30 to 50 years old who does not exercise needs about 2,200 calories to maintain his normal weight. For every hour of exercise they do, they would burn: 240 to 300 calories doing light activity such as cleaning house or playing baseball or golf. 370 to 460 calories doing activity such as a brisk walk (3.5 mph), gardening, biking (5.5 mph), or dancing. 580 to 730 calories doing activity such as jogging at a pace of 9 minutes per mile, playing football, or swimming laps. 740 to 920 calories doing activity such as running at a pace of 7 minutes per mile, playing racquetball, and skiing. Even if you don't change the amount of calories in your diet, but you do add activity to your daily life, you'll lose weight or gain less weight. Benefits of Weight Loss An exercise weight-loss program that works needs to be fun and keep you motivated. It helps to have a specific goal. Your goal might be managing a health condition, reducing stress, improving your stamina, or being able to buy clothes in a smaller size. Your exercise program may also be a way for you to be with other people. Exercise classes or exercising with a buddy are both good social outlets. You may have a hard time starting an exercise routine, but once you do, you will begin to notice other benefits. Improved sleep and self-esteem might be a couple of them. Other benefits you may not notice include increased bone and muscle strength and a lower risk for heart disease and type 2 diabetes. Getting Started You do not need to join a gym to get exercise. If you have not exercised or been active in a long time, be sure to start off slowly to prevent injuries. Taking a brisk 10-minute walk twice a week is a good start. You can also try joining a dance, yoga, or karate class. You could also join a baseball or bowling team, or even a mall-walking group. The social aspects of these groups can be rewarding and motivating. The most important thing is that you do exercises that you enjoy. Build Physical Activity into Your Regular Routine Simple lifestyle changes can make a big difference over time. At work, try taking the stairs instead of the elevator, walking down the hall to talk with a co-worker instead of sending an e-mail, or adding a 10- to 20-minute walk during lunch. When you are running errands, try parking at the far end of the parking lot or down the street. Even better, try walking to the store. At home, try taking on common chores such as vacuuming, washing a car, gardening, raking leaves, or shoveling snow. If you ride the bus, get off the bus one stop before your usual stop and walk the rest of the way. Reduce Your Screen Time Sedentary behaviors are things you do while you are sitting still. Decreasing your sedentary behaviors can help you lose weight. For most people, the best way to decrease sedentary behavior is to reduce the time they spend watching TV and using a computer and other electronic devices. All of these activities are called "screen time." Some ways to decrease the harm of too much screen time are: Choose 1 or 2 TV programs to watch and turn off the TV when they are over. Don't keep the TV on all the time for background noise -- you might end up sitting down and watching it. Turn on the radio instead. You can be up doing things around the house and still listen to the radio. Don't eat while you are watching TV. Before you turn on the TV, take your dog for a walk. If you are going to miss your favorite show, record it. Find activities to replace TV watching. Read a book, play a board game with family or friends, or take an evening class. Work out on an exercise mat while you watch TV. You will burn calories. Ride a stationary bike or use a treadmill while you watch TV. If you like playing video games, try games that require you to move your whole body, not just your thumbs. How Much Exercise do you Need? Aim to exercise about 2.5 hours a week. Do moderate-intensity aerobic and muscle-strengthening activities. Depending on your schedule, you could exercise 30 minutes 5 days a week or 45 to 60 minutes 3 days a week. You do not have to do your total daily exercise all at once. If your goal is to exercise for 30 minutes, you can break that up into shorter time periods that add up to 30 minutes. As you become more fit, you can challenge yourself by increasing the intensity of your exercise by going from light activity to moderate activity. You can also increase the amount of time you exercise. Review Date 7/12/2018 Updated by: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how to loose weight

how to loose weight

Prostate cancer - treatment (Hormonal Therapy): Testosterone is the main male hormone. Prostate tumors need testosterone to grow. Hormonal therapy is treatment that decreases the effect of testosterone on prostate cancer. Hormone therapy is mainly used for cancer that has spread beyond the prostate. The treatment can help relieve symptoms and prevent further growth and spread of cancer. But it does not cure the cancer. The main type of hormone therapy is called a luteinizing hormone-releasing hormones (LH-RH) agonist: - The medicine blocks the testicles from making testosterone. The drugs must be given by injection, usually every 3 to 6 months. - Possible side effects include nausea and vomiting, hot flashes, anemia, fatigue, thinning bones (osteoporosis), reduced sexual desire, decreased muscle mass, weight gain, and impotence.

Prostate cancer treatment Summary Treatment for your prostate cancer is chosen after a thorough evaluation. Your health care provider will discuss the benefits and risks of each treatment. Sometimes your provider may recommend one treatment for you because of your type of cancer and risk factors. Other times, there may be two or more treatments that could be good for you. Factors you and your provider must think about include: Your age and other medical problems you may have Side effects that occur with each type of treatment How much the prostate cancer has spread Your Gleason score, which tells how likely it is that cancer has already spread Your prostate-specific antigen (PSA) test result Ask your provider to explain these things following about your treatment choices: Which choices offer the best chance of curing your cancer or controlling its spread? How likely is it that you will have different side effects, and how they will affect your life? Radical Prostatectomy (Prostate Removal) Radical prostatectomy is a surgery to remove the prostate and some of the surrounding tissue. It is an option when the cancer has not spread beyond the prostate gland. Healthy men who will likely live 10 or more years after being diagnosed with prostate cancer often have this procedure. Be aware that it is not always possible to know for certain, before surgery, if the cancer has spread beyond the prostate gland. Possible problems after surgery include difficulty controlling urine and erection problems. Also, some men need further treatments after this surgery. Radiation Therapy Radiation therapy works best for treating prostate cancer that has not spread outside of the prostate. It may also be used after surgery if there is a risk that cancer cells are still present. Radiation is sometimes used for pain relief when cancer has spread to the bone. External beam radiation therapy uses high-powered x-rays pointed at the prostate gland: Before treatment, the radiation therapist uses a special pen to mark the part of the body that is to be treated. Radiation is delivered to the prostate gland using a machine similar to a regular x-ray machine. The treatment itself is usually painless. Treatment is done in a radiation oncology center that is usually connected to a hospital. Treatment is usually done 5 days a week for 6 to 8 weeks. Side effects may include: Appetite loss Diarrhea Erection problems Fatigue Rectal burning or injury Skin reactions Urinary incontinence, the feeling of needing to urinate urgently, or blood in the urine There are reports of secondary cancers arising from the radiation as well. Proton therapy is another kind of radiation therapy used to treat prostate cancer. Proton beams target the tumor precisely, so there is less damage to the surrounding tissue. This therapy is not widely accepted or used. Prostate Brachytherapy Brachytherapy is often used for small prostate cancers that are found early and are slow-growing. Brachytherapy may be combined with external beam radiation therapy for more advanced cancers. Brachytherapy involves placing radioactive seeds inside the prostate gland. A surgeon inserts small needles through the skin beneath your scrotum to inject the seeds. The seeds are so small that you do not feel them. The seeds are left in place permanently. Side effects may include: Pain, swelling, or bruising in the penis or scrotum Red-brown urine or semen Impotence Incontinence Urinary retention Diarrhea Hormonal Therapy Testosterone is the main male hormone. Prostate tumors need testosterone to grow. Hormonal therapy is treatment that decreases the effect of testosterone on prostate cancer. Hormone therapy is mainly used for cancer that has spread beyond the prostate. The treatment can help relieve symptoms and prevent further growth and spread of cancer. But it does not cure the cancer. The main type of hormone therapy is called a luteinizing hormone-releasing hormones (LH-RH) agonist: The medicine blocks the testicles from making testosterone. The drugs must be given by injection, usually every 3 to 6 months. Possible side effects include nausea and vomiting, hot flashes, anemia, fatigue, thinning bones (osteoporosis), reduced sexual desire, decreased muscle mass, weight gain, and impotence. The other type of hormone medicine is called an androgen-blocking drug: It is often given along with LH-RH drugs to block the effect of testosterone produced by the adrenal glands, which make a small amount of testosterone. Possible side effects include erection problems, reduced sexual desire, liver problems, diarrhea, and enlarged breasts. Much of the body's testosterone is made by the testes. As a result, surgery to remove the testes (called orchiectomy) can also be used as a hormonal treatment. Chemotherapy Chemotherapy and immunotherapy (medicine that helps the body's immune system fight the cancer) may be used to treat prostate cancer that no longer responds to hormone treatment. Usually a single drug or a combination of drugs is recommended. Cryotherapy Cryotherapy uses very cold temperatures to freeze and kill prostate cancer cells. The goal of cryosurgery is to destroy the entire prostate gland and possibly surrounding tissue. Cryosurgery is generally not used as a first treatment for prostate cancer. Review Date 10/10/2017 Updated by: Jennifer Sobol, DO, Urologist with the Michigan Institute of Urology, West Bloomfield, MI. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how to manage prostate cancer

how to manage prostate cancer

Treatment for your prostate cancer is chosen after a thorough evaluation. Your doctor will discuss the benefits and risks of each treatment. Sometimes your doctor may recommend 1 treatment for you because of your type of cancer and risk factors. Other times, there may be 2 or more treatments that could be good for you. Factors you and your doctor must think about include: - Your age and other medical problems you may have - Side effects that occur with each type of treatment - How much the prostate cancer has spread - Your Gleason score, which tells how likely it is that cancer has already spread - Your prostate-specific antigen (PSA) test result Ask your doctor to explain these things following about your treatment choices: - Which choices offer the best chance of curing your cancer or controlling its spread? - How likely is it that you will have different side effects, and how they will affect your life?

Prostate cancer treatment Summary Treatment for your prostate cancer is chosen after a thorough evaluation. Your health care provider will discuss the benefits and risks of each treatment. Sometimes your provider may recommend one treatment for you because of your type of cancer and risk factors. Other times, there may be two or more treatments that could be good for you. Factors you and your provider must think about include: Your age and other medical problems you may have Side effects that occur with each type of treatment How much the prostate cancer has spread Your Gleason score, which tells how likely it is that cancer has already spread Your prostate-specific antigen (PSA) test result Ask your provider to explain these things following about your treatment choices: Which choices offer the best chance of curing your cancer or controlling its spread? How likely is it that you will have different side effects, and how they will affect your life? Radical Prostatectomy (Prostate Removal) Radical prostatectomy is a surgery to remove the prostate and some of the surrounding tissue. It is an option when the cancer has not spread beyond the prostate gland. Healthy men who will likely live 10 or more years after being diagnosed with prostate cancer often have this procedure. Be aware that it is not always possible to know for certain, before surgery, if the cancer has spread beyond the prostate gland. Possible problems after surgery include difficulty controlling urine and erection problems. Also, some men need further treatments after this surgery. Radiation Therapy Radiation therapy works best for treating prostate cancer that has not spread outside of the prostate. It may also be used after surgery if there is a risk that cancer cells are still present. Radiation is sometimes used for pain relief when cancer has spread to the bone. External beam radiation therapy uses high-powered x-rays pointed at the prostate gland: Before treatment, the radiation therapist uses a special pen to mark the part of the body that is to be treated. Radiation is delivered to the prostate gland using a machine similar to a regular x-ray machine. The treatment itself is usually painless. Treatment is done in a radiation oncology center that is usually connected to a hospital. Treatment is usually done 5 days a week for 6 to 8 weeks. Side effects may include: Appetite loss Diarrhea Erection problems Fatigue Rectal burning or injury Skin reactions Urinary incontinence, the feeling of needing to urinate urgently, or blood in the urine There are reports of secondary cancers arising from the radiation as well. Proton therapy is another kind of radiation therapy used to treat prostate cancer. Proton beams target the tumor precisely, so there is less damage to the surrounding tissue. This therapy is not widely accepted or used. Prostate Brachytherapy Brachytherapy is often used for small prostate cancers that are found early and are slow-growing. Brachytherapy may be combined with external beam radiation therapy for more advanced cancers. Brachytherapy involves placing radioactive seeds inside the prostate gland. A surgeon inserts small needles through the skin beneath your scrotum to inject the seeds. The seeds are so small that you do not feel them. The seeds are left in place permanently. Side effects may include: Pain, swelling, or bruising in the penis or scrotum Red-brown urine or semen Impotence Incontinence Urinary retention Diarrhea Hormonal Therapy Testosterone is the main male hormone. Prostate tumors need testosterone to grow. Hormonal therapy is treatment that decreases the effect of testosterone on prostate cancer. Hormone therapy is mainly used for cancer that has spread beyond the prostate. The treatment can help relieve symptoms and prevent further growth and spread of cancer. But it does not cure the cancer. The main type of hormone therapy is called a luteinizing hormone-releasing hormones (LH-RH) agonist: The medicine blocks the testicles from making testosterone. The drugs must be given by injection, usually every 3 to 6 months. Possible side effects include nausea and vomiting, hot flashes, anemia, fatigue, thinning bones (osteoporosis), reduced sexual desire, decreased muscle mass, weight gain, and impotence. The other type of hormone medicine is called an androgen-blocking drug: It is often given along with LH-RH drugs to block the effect of testosterone produced by the adrenal glands, which make a small amount of testosterone. Possible side effects include erection problems, reduced sexual desire, liver problems, diarrhea, and enlarged breasts. Much of the body's testosterone is made by the testes. As a result, surgery to remove the testes (called orchiectomy) can also be used as a hormonal treatment. Chemotherapy Chemotherapy and immunotherapy (medicine that helps the body's immune system fight the cancer) may be used to treat prostate cancer that no longer responds to hormone treatment. Usually a single drug or a combination of drugs is recommended. Cryotherapy Cryotherapy uses very cold temperatures to freeze and kill prostate cancer cells. The goal of cryosurgery is to destroy the entire prostate gland and possibly surrounding tissue. Cryosurgery is generally not used as a first treatment for prostate cancer. Review Date 10/10/2017 Updated by: Jennifer Sobol, DO, Urologist with the Michigan Institute of Urology, West Bloomfield, MI. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. how to manage prostate cancer

how to manage prostate cancer

There are different types of treatment for patients with prostate cancer. - Seven types of standard treatment are used: - Watchful waiting or active surveillance - Surgery - Radiation therapy and radiopharmaceutical therapy - Hormone therapy - Chemotherapy - Biologic therapy - Bisphosphonate therapy - There are treatments for bone pain caused by bone metastases or hormone therapy. - New types of treatment are being tested in clinical trials. - Cryosurgery - High-intensity-focused ultrasound therapy - Proton beam radiation therapy - Patients may want to think about taking part in a clinical trial. - Patients can enter clinical trials before, during, or after starting their cancer treatment.

Prostate Cancer Overview The prostate gland makes fluid that forms part of semen. The prostate lies just below the bladder in front of the rectum. It surrounds the urethra (the tube that carries urine and semen through the penis and out of the body). Prostate cancer is the most common cancer in men in the United States, after skin cancer. It is the second leading cause of death from cancer in men. Prostate cancer occurs more often in African-American men than in white men. African-American men with prostate cancer are more likely to die from the disease than white men with prostate cancer. Almost all prostate cancers are adenocarcinomas (cancers that begin in cells that make and release mucus and other fluids). Prostate cancer often has no early symptoms. Advanced prostate cancer can cause men to urinate more often or have a weaker flow of urine, but these symptoms can also be caused by benign prostate conditions. Prostate cancer usually grows very slowly. Most men with prostate cancer are older than 65 years and do not die from the disease. Finding and treating prostate cancer before symptoms occur may not improve health or help you live longer. Talk to your doctor about your risk of prostate cancer and whether you need screening tests. General Information About Prostate Cancer Key Points - Prostate cancer is a disease in which malignant (cancer) cells form in the tissues of the prostate. - Signs of prostate cancer include a weak flow of urine or frequent urination. - Tests that examine the prostate and blood are used to detect (find) and diagnose prostate cancer. - Certain factors affect prognosis (chance of recovery) and treatment options. Prostate cancer is a disease in which malignant (cancer) cells form in the tissues of the prostate. The prostate is a gland in the male reproductive system. It lies just below the bladder (the organ that collects and empties urine) and in front of the rectum (the lower part of the intestine). It is about the size of a walnut and surrounds part of the urethra (the tube that empties urine from the bladder). The prostate gland makes fluid that is part of the semen. Enlarge Anatomy of the male reproductive and urinary systems, showing the prostate, testicles, bladder, and other organs. Prostate cancer is most common in older men. In the U.S., about 1 out of 5 men will be diagnosed with prostate cancer. Signs of prostate cancer include a weak flow of urine or frequent urination. These and other signs and symptoms may be caused by prostate cancer or by other conditions. Check with your doctor if you have any of the following: - Weak or interrupted ("stop-and-go") flow of urine. - Sudden urge to urinate. - Frequent urination (especially at night). - Trouble starting the flow of urine. - Trouble emptying the bladder completely. - Pain or burning while urinating. - Blood in the urine or semen. - A pain in the back, hips, or pelvis that doesn't go away. - Shortness of breath, feeling very tired, fast heartbeat, dizziness, or pale skin caused by anemia. Other conditions may cause the same symptoms. As men age, the prostate may get bigger and block the urethra or bladder. This may cause trouble urinating or sexual problems. The condition is called benign prostatic hyperplasia (BPH), and although it is not cancer, surgery may be needed. The symptoms of benign prostatic hyperplasia or of other problems in the prostate may be like symptoms of prostate cancer. Enlarge Normal prostate and benign prostatic hyperplasia (BPH). A normal prostate does not block the flow of urine from the bladder. An enlarged prostate presses on the bladder and urethra and blocks the flow of urine. Tests that examine the prostate and blood are used to detect (find) and diagnose prostate cancer. The following tests and procedures may be used: - Physical exam and history : An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient's health habits and past illnesses and treatments will also be taken. - Digital rectal exam (DRE): An exam of the rectum. The doctor or nurse inserts a lubricated, gloved finger into the rectum and feels the prostate through the rectal wall for lumps or abnormal areas. Enlarge Digital rectal exam (DRE). The doctor inserts a gloved, lubricated finger into the rectum and feels the prostate to check for anything abnormal. - Prostate-specific antigen (PSA) test : A test that measures the level of PSA in the blood. PSA is a substance made by the prostate that may be found in an increased amount in the blood of men who have prostate cancer. PSA levels may also be high in men who have an infection or inflammation of the prostate or BPH (an enlarged, but noncancerous, prostate). - Transrectal ultrasound : A procedure in which a probe that is about the size of a finger is inserted into the rectum to check the prostate. The probe is used to bounce high-energy sound waves (ultrasound) off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. Transrectal ultrasound may be used during a biopsy procedure. Enlarge Transrectal ultrasound. An ultrasound probe is inserted into the rectum to check the prostate. The probe bounces sound waves off body tissues to make echoes that form a sonogram (computer picture) of the prostate. - Transrectal magnetic resonance imaging (MRI): A procedure that uses a strong magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. A probe that gives off radio waves is inserted into the rectum near the prostate. This helps the MRI machine make clearer pictures of the prostate and nearby tissue. A transrectal MRI is done to find out if the cancer has spread outside the prostate into nearby tissues. This procedure is also called nuclear magnetic resonance imaging (NMRI). - Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist. The pathologist will check the tissue sample to see if there are cancer cells and find out the Gleason score. The Gleason score ranges from 2-10 and describes how likely it is that a tumor will spread. The lower the number, the less likely the tumor is to spread. A transrectal biopsy is used to diagnose prostate cancer. A transrectal biopsy is the removal of tissue from the prostate by inserting a thin needle through the rectum and into the prostate. This procedure is usually done using transrectal ultrasound to help guide where samples of tissue are taken from. A pathologist views the tissue under a microscope to look for cancer cells. Enlarge Transrectal biopsy. An ultrasound probe is inserted into the rectum to show where the tumor is. Then a needle is inserted through the rectum into the prostate to remove tissue from the prostate. Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery) and treatment options depend on the following: - The stage of the cancer (level of PSA, Gleason score, grade of the tumor, how much of the prostate is affected by the cancer, and whether the cancer has spread to other places in the body). - The patient's age. - Whether the cancer has just been diagnosed or has recurred (come back). Treatment options also may depend on the following: - Whether the patient has other health problems. - The expected side effects of treatment. - Past treatment for prostate cancer. - The wishes of the patient. Most men diagnosed with prostate cancer do not die of it. Stages of Prostate Cancer Key Points - After prostate cancer has been diagnosed, tests are done to find out if cancer cells have spread within the prostate or to other parts of the body. - There are three ways that cancer spreads in the body. - Cancer may spread from where it began to other parts of the body. - The following stages are used for prostate cancer: - Stage I - Stage II - Stage III - Stage IV After prostate cancer has been diagnosed, tests are done to find out if cancer cells have spread within the prostate or to other parts of the body. The process used to find out if cancer has spread within the prostate or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The results of the tests used to diagnose prostate cancer are often also used to stage the disease. (See the General Information section.) In prostate cancer, staging tests may not be done unless the patient has symptoms or signs that the cancer has spread, such as bone pain, a high PSA level, or a high Gleason score. The following tests and procedures also may be used in the staging process: - Bone scan : A procedure to check if there are rapidly dividing cells, such as cancer cells, in the bone. A very small amount of radioactive material is injected into a vein and travels through the bloodstream. The radioactive material collects in the bones with cancer and is detected by a scanner. Enlarge Bone scan. A small amount of radioactive material is injected into the patient's bloodstream and collects in abnormal cells in the bones. As the patient lies on a table that slides under the scanner, the radioactive material is detected and images are made on a computer screen or film. - MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI). - CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography. - Pelvic lymphadenectomy : A surgical procedure to remove the lymph nodes in the pelvis. A pathologist views the tissue under a microscope to look for cancer cells. - Seminal vesicle biopsy : The removal of fluid from the seminal vesicles (glands that make semen) using a needle. A pathologist views the fluid under a microscope to look for cancer cells. - ProstaScint scan : A procedure to check for cancer that has spread from the prostate to other parts of the body, such as the lymph nodes. A very small amount of radioactive material is injected into a vein and travels through the bloodstream. The radioactive material attaches to prostate cancer cells and is detected by a scanner. The radioactive material shows up as a bright spot on the picture in areas where there are a lot of prostate cancer cells. The stage of the cancer is based on the results of the staging and diagnostic tests, including the prostate-specific antigen (PSA) test and the Gleason score. The tissue samples removed during the biopsy are used to find out the Gleason score. The Gleason score ranges from 2-10 and describes how different the cancer cells look from normal cells and how likely it is that the tumor will spread. The lower the number, the less likely the tumor is to spread. There are three ways that cancer spreads in the body. Cancer can spread through tissue, the lymph system, and the blood: - Tissue. The cancer spreads from where it began by growing into nearby areas. - Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body. - Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body. Cancer may spread from where it began to other parts of the body. When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began (the primary tumor) and travel through the lymph system or blood. - Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor (metastatic tumor) in another part of the body. - Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body. The metastatic tumor is the same type of cancer as the primary tumor. For example, if prostate cancer spreads to the bone, the cancer cells in the bone are actually prostate cancer cells. The disease is metastatic prostate cancer, not bone cancer. Denosumab, a monoclonal antibody, may be used to prevent bone metastases. The following stages are used for prostate cancer: Enlarge As prostate cancer progresses from Stage I to Stage IV, the cancer cells grow within the prostate, through the outer layer of the prostate into nearby tissue, and then to lymph nodes or other parts of the body. Stage I In stage I, cancer is found in the prostate only. The cancer: - is found by needle biopsy (done for a high PSA level) or in a small amount of tissue during surgery for other reasons (such as benign prostatic hyperplasia). The PSA level is lower than 10 and the Gleason score is 6 or lower; or - is found in one-half or less of one lobe of the prostate. The PSA level is lower than 10 and the Gleason score is 6 or lower; or - cannot be felt during a digital rectal exam and cannot be seen in imaging tests. Cancer is found in one-half or less of one lobe of the prostate. The PSA level and the Gleason score are not known. Stage II In stage II, cancer is more advanced than in stage I, but has not spread outside the prostate. Stage II is divided into stages IIA and IIB. In stage IIA, cancer: - is found by needle biopsy (done for a high PSA level) or in a small amount of tissue during surgery for other reasons (such as benign prostatic hyperplasia). The PSA level is lower than 20 and the Gleason score is 7; or - is found by needle biopsy (done for a high PSA level) or in a small amount of tissue during surgery for other reasons (such as benign prostatic hyperplasia). The PSA level is at least 10 but lower than 20 and the Gleason score is 6 or lower; or - is found in one-half or less of one lobe of the prostate. The PSA level is at least 10 but lower than 20 and the Gleason score is 6 or lower; or - is found in one-half or less of one lobe of the prostate. The PSA level is lower than 20 and the Gleason score is 7; or - is found in more than one-half of one lobe of the prostate. In stage IIB, cancer: - is found in opposite sides of the prostate. The PSA can be any level and the Gleason score can range from 2 to 10; or - cannot be felt during a digital rectal exam and cannot be seen in imaging tests. The PSA level is 20 or higher and the Gleason score can range from 2 to 10; or - cannot be felt during a digital rectal exam and cannot be seen in imaging tests. The PSA can be any level and the Gleason score is 8 or higher. Stage III In stage III, cancer has spread beyond the outer layer of the prostate and may have spread to the seminal vesicles. The PSA can be any level and the Gleason score can range from 2 to 10. Stage IV In stage IV, the PSA can be any level and the Gleason score can range from 2 to 10. Also, cancer: - has spread beyond the seminal vesicles to nearby tissue or organs, such as the rectum, bladder, or pelvic wall; or - may have spread to the seminal vesicles or to nearby tissue or organs, such as the rectum, bladder, or pelvic wall. Cancer has spread to nearby lymph nodes; or - has spread to distant parts of the body, which may include lymph nodes or bones. Prostate cancer often spreads to the bones. Stage I In stage I, cancer is found in the prostate only. The cancer: - is found by needle biopsy (done for a high PSA level) or in a small amount of tissue during surgery for other reasons (such as benign prostatic hyperplasia). The PSA level is lower than 10 and the Gleason score is 6 or lower; or - is found in one-half or less of one lobe of the prostate. The PSA level is lower than 10 and the Gleason score is 6 or lower; or - cannot be felt during a digital rectal exam and cannot be seen in imaging tests. Cancer is found in one-half or less of one lobe of the prostate. The PSA level and the Gleason score are not known. Stage II In stage II, cancer is more advanced than in stage I, but has not spread outside the prostate. Stage II is divided into stages IIA and IIB. In stage IIA, cancer: - is found by needle biopsy (done for a high PSA level) or in a small amount of tissue during surgery for other reasons (such as benign prostatic hyperplasia). The PSA level is lower than 20 and the Gleason score is 7; or - is found by needle biopsy (done for a high PSA level) or in a small amount of tissue during surgery for other reasons (such as benign prostatic hyperplasia). The PSA level is at least 10 but lower than 20 and the Gleason score is 6 or lower; or - is found in one-half or less of one lobe of the prostate. The PSA level is at least 10 but lower than 20 and the Gleason score is 6 or lower; or - is found in one-half or less of one lobe of the prostate. The PSA level is lower than 20 and the Gleason score is 7; or - is found in more than one-half of one lobe of the prostate. In stage IIB, cancer: - is found in opposite sides of the prostate. The PSA can be any level and the Gleason score can range from 2 to 10; or - cannot be felt during a digital rectal exam and cannot be seen in imaging tests. The PSA level is 20 or higher and the Gleason score can range from 2 to 10; or - cannot be felt during a digital rectal exam and cannot be seen in imaging tests. The PSA can be any level and the Gleason score is 8 or higher. Stage III In stage III, cancer has spread beyond the outer layer of the prostate and may have spread to the seminal vesicles. The PSA can be any level and the Gleason score can range from 2 to 10. Stage IV In stage IV, the PSA can be any level and the Gleason score can range from 2 to 10. Also, cancer: - has spread beyond the seminal vesicles to nearby tissue or organs, such as the rectum, bladder, or pelvic wall; or - may have spread to the seminal vesicles or to nearby tissue or organs, such as the rectum, bladder, or pelvic wall. Cancer has spread to nearby lymph nodes; or - has spread to distant parts of the body, which may include lymph nodes or bones. Prostate cancer often spreads to the bones. Recurrent Prostate Cancer Treatment Option Overview Key Points - There are different types of treatment for patients with prostate cancer. - Seven types of standard treatment are used: - Watchful waiting or active surveillance - Surgery - Radiation therapy and radiopharmaceutical therapy - Hormone therapy - Chemotherapy - Biologic therapy - Bisphosphonate therapy - There are treatments for bone pain caused by bone metastases or hormone therapy. - New types of treatment are being tested in clinical trials. - Cryosurgery - High-intensity-focused ultrasound therapy - Proton beam radiation therapy - Patients may want to think about taking part in a clinical trial. - Patients can enter clinical trials before, during, or after starting their cancer treatment. - Follow-up tests may be needed. There are different types of treatment for patients with prostate cancer. Different types of treatment are available for patients with prostate cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment. Seven types of standard treatment are used: Watchful waiting or active surveillance Watchful waiting and active surveillance are treatments used for older men who do not have signs or symptoms or have other medical conditions and for men whose prostate cancer is found during a screening test. Watchful waiting is closely monitoring a patient's condition without giving any treatment until signs or symptoms appear or change. Treatment is given to relieve symptoms and improve quality of life. Active surveillance is closely following a patient's condition without giving any treatment unless there are changes in test results. It is used to find early signs that the condition is getting worse. In active surveillance, patients are given certain exams and tests, including digital rectal exam, PSA test, transrectal ultrasound, and transrectal needle biopsy, to check if the cancer is growing. When the cancer begins to grow, treatment is given to cure the cancer. Other terms that are used to describe not giving treatment to cure prostate cancer right after diagnosis are observation, watch and wait, and expectant management. Surgery Patients in good health whose tumor is in the prostate gland only may be treated with surgery to remove the tumor. The following types of surgery are used: - Radical prostatectomy: A surgical procedure to remove the prostate, surrounding tissue, and seminal vesicles. There are two types of radical prostatectomy: - Retropubic prostatectomy: A surgical procedure to remove the prostate through an incision (cut) in the abdominal wall. Removal of nearby lymph nodes may be done at the same time. - Perineal prostatectomy: A surgical procedure to remove the prostate through an incision (cut) made in the perineum (area between the scrotum and anus). Nearby lymph nodes may also be removed through a separate incision in the abdomen. Enlarge Two types of radical prostatectomy. In a retropubic prostatectomy, the prostate is removed through an incision in the wall of the abdomen. In a perineal prostatectomy, the prostate is removed through an incision in the area between the scrotum and the anus. - Pelvic lymphadenectomy: A surgical procedure to remove the lymph nodes in the pelvis. A pathologist views the tissue under a microscope to look for cancer cells. If the lymph nodes contain cancer, the doctor will not remove the prostate and may recommend other treatment. - Transurethral resection of the prostate (TURP): A surgical procedure to remove tissue from the prostate using a resectoscope (a thin, lighted tube with a cutting tool) inserted through the urethra. This procedure is done to treat benign prostatic hypertrophy and it is sometimes done to relieve symptoms caused by a tumor before other cancer treatment is given. TURP may also be done in men whose tumor is in the prostate only and who cannot have a radical prostatectomy. Enlarge Transurethral resection of the prostate (TURP). Tissue is removed from the prostate using a resectoscope (a thin, lighted tube with a cutting tool at the end) inserted through the urethra. Prostate tissue that is blocking the urethra is cut away and removed through the resectoscope. In some cases, nerve-sparing surgery can be done. This type of surgery may save the nerves that control erection. However, men with large tumors or tumors that are very close to the nerves may not be able to have this surgery. Possible problems after prostate cancer surgery include the following: - Impotence. - Leakage of urine from the bladder or stool from the rectum. - Shortening of the penis (1 to 2 centimeters). The exact reason for this is not known. - Inguinal hernia (bulging of fat or part of the small intestine through weak muscles into the groin). Inguinal hernia may occur more often in men treated with radical prostatectomy than in men who have some other types of prostate surgery, radiation therapy, or prostate biopsy alone. It is most likely to occur within the first 2 years after radical prostatectomy. Radiation therapy and radiopharmaceutical therapy Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are different types of radiation therapy: - External radiation therapy uses a machine outside the body to send radiation toward the cancer. Conformal radiation is a type of external radiation therapy that uses a computer to make a 3-dimensional (3-D) picture of the tumor and shapes the radiation beams to fit the tumor. This allows a high dose of radiation to reach the tumor and causes less damage to nearby healthy tissue. Hypofractionated radiation therapy may be given because it has a more convenient treatment schedule. Hypofractionated radiation therapy is radiation treatment in which a larger than usual total dose of radiation is given once a day over a shorter period of time (fewer days) compared to standard radiation therapy. Hypofractionated radiation therapy may have worse side effects than standard radiation therapy, depending on the schedules used. - Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. In early-stage prostate cancer, the radioactive seeds are placed in the prostate using needles that are inserted through the skin between the scrotum and rectum. The placement of the radioactive seeds in the prostate is guided by images from transrectal ultrasound or computed tomography (CT). The needles are removed after the radioactive seeds are placed in the prostate. - Radiopharmaceutical therapy uses a radioactive substance to treat cancer. Radiopharmaceutical therapy includes the following: - Alpha emitter radiation therapy uses a radioactive substance to treat prostate cancer that has spread to the bone. A radioactive substance called radium-223 is injected into a vein and travels through the bloodstream. The radium-223 collects in areas of bone with cancer and kills the cancer cells. The way the radiation therapy is given depends on the type and stage of the cancer being treated. External radiation therapy, internal radiation therapy, and radiopharmaceutical therapy are used to treat prostate cancer. Men treated with radiation therapy for prostate cancer have an increased risk of having bladder and/or gastrointestinal cancer. Radiation therapy can cause impotence and urinary problems that may get worse with age. Hormone therapy Hormone therapy is a cancer treatment that removes hormones or blocks their action and stops cancer cells from growing. Hormones are substances made by glands in the body and circulated in the bloodstream. In prostate cancer, male sex hormones can cause prostate cancer to grow. Drugs, surgery, or other hormones are used to reduce the amount of male hormones or block them from working. Hormone therapy for prostate cancer may include the following: - Abiraterone acetate can prevent prostate cancer cells from making androgens. It is used in men with advanced prostate cancer that has not gotten better with other hormone therapy. - Orchiectomy is a surgical procedure to remove one or both testicles, the main source of male hormones, such as testosterone, to decrease the amount of hormone being made. - Estrogens (hormones that promote female sex characteristics) can prevent the testicles from making testosterone. However, estrogens are seldom used today in the treatment of prostate cancer because of the risk of serious side effects. - Luteinizing hormone-releasing hormone agonists can stop the testicles from making testosterone. Examples are leuprolide, goserelin, and buserelin. - Antiandrogens can block the action of androgens (hormones that promote male sex characteristics), such as testosterone. Examples are flutamide, bicalutamide, enzalutamide, and nilutamide. - Drugs that can prevent the adrenal glands from making androgens include ketoconazole and aminoglutethimide. Hot flashes, impaired sexual function, loss of desire for sex, and weakened bones may occur in men treated with hormone therapy. Other side effects include diarrhea, nausea, and itching. See Drugs Approved for Prostate Cancer for more information. Chemotherapy Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated. See Drugs Approved for Prostate Cancer for more information. Biologic therapy Biologic therapy is a treatment that uses the patient's immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer. Sipuleucel-T is a type of biologic therapy used to treat prostate cancer that has metastasized (spread to other parts of the body). See Drugs Approved for Prostate Cancer for more information. Bisphosphonate therapy Bisphosphonate drugs, such as clodronate or zoledronate, reduce bone disease when cancer has spread to the bone. Men who are treated with antiandrogen therapy or orchiectomy are at an increased risk of bone loss. In these men, bisphosphonate drugs lessen the risk of bone fracture (breaks). The use of bisphosphonate drugs to prevent or slow the growth of bone metastases is being studied in clinical trials. Watchful waiting or active surveillance Watchful waiting and active surveillance are treatments used for older men who do not have signs or symptoms or have other medical conditions and for men whose prostate cancer is found during a screening test. Watchful waiting is closely monitoring a patient's condition without giving any treatment until signs or symptoms appear or change. Treatment is given to relieve symptoms and improve quality of life. Active surveillance is closely following a patient's condition without giving any treatment unless there are changes in test results. It is used to find early signs that the condition is getting worse. In active surveillance, patients are given certain exams and tests, including digital rectal exam, PSA test, transrectal ultrasound, and transrectal needle biopsy, to check if the cancer is growing. When the cancer begins to grow, treatment is given to cure the cancer. Other terms that are used to describe not giving treatment to cure prostate cancer right after diagnosis are observation, watch and wait, and expectant management. Surgery Patients in good health whose tumor is in the prostate gland only may be treated with surgery to remove the tumor. The following types of surgery are used: - Radical prostatectomy: A surgical procedure to remove the prostate, surrounding tissue, and seminal vesicles. There are two types of radical prostatectomy: - Retropubic prostatectomy: A surgical procedure to remove the prostate through an incision (cut) in the abdominal wall. Removal of nearby lymph nodes may be done at the same time. - Perineal prostatectomy: A surgical procedure to remove the prostate through an incision (cut) made in the perineum (area between the scrotum and anus). Nearby lymph nodes may also be removed through a separate incision in the abdomen. Enlarge Two types of radical prostatectomy. In a retropubic prostatectomy, the prostate is removed through an incision in the wall of the abdomen. In a perineal prostatectomy, the prostate is removed through an incision in the area between the scrotum and the anus. - Pelvic lymphadenectomy: A surgical procedure to remove the lymph nodes in the pelvis. A pathologist views the tissue under a microscope to look for cancer cells. If the lymph nodes contain cancer, the doctor will not remove the prostate and may recommend other treatment. - Transurethral resection of the prostate (TURP): A surgical procedure to remove tissue from the prostate using a resectoscope (a thin, lighted tube with a cutting tool) inserted through the urethra. This procedure is done to treat benign prostatic hypertrophy and it is sometimes done to relieve symptoms caused by a tumor before other cancer treatment is given. TURP may also be done in men whose tumor is in the prostate only and who cannot have a radical prostatectomy. Enlarge Transurethral resection of the prostate (TURP). Tissue is removed from the prostate using a resectoscope (a thin, lighted tube with a cutting tool at the end) inserted through the urethra. Prostate tissue that is blocking the urethra is cut away and removed through the resectoscope. In some cases, nerve-sparing surgery can be done. This type of surgery may save the nerves that control erection. However, men with large tumors or tumors that are very close to the nerves may not be able to have this surgery. Possible problems after prostate cancer surgery include the following: - Impotence. - Leakage of urine from the bladder or stool from the rectum. - Shortening of the penis (1 to 2 centimeters). The exact reason for this is not known. - Inguinal hernia (bulging of fat or part of the small intestine through weak muscles into the groin). Inguinal hernia may occur more often in men treated with radical prostatectomy than in men who have some other types of prostate surgery, radiation therapy, or prostate biopsy alone. It is most likely to occur within the first 2 years after radical prostatectomy. Radiation therapy and radiopharmaceutical therapy Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are different types of radiation therapy: - External radiation therapy uses a machine outside the body to send radiation toward the cancer. Conformal radiation is a type of external radiation therapy that uses a computer to make a 3-dimensional (3-D) picture of the tumor and shapes the radiation beams to fit the tumor. This allows a high dose of radiation to reach the tumor and causes less damage to nearby healthy tissue. Hypofractionated radiation therapy may be given because it has a more convenient treatment schedule. Hypofractionated radiation therapy is radiation treatment in which a larger than usual total dose of radiation is given once a day over a shorter period of time (fewer days) compared to standard radiation therapy. Hypofractionated radiation therapy may have worse side effects than standard radiation therapy, depending on the schedules used. - Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. In early-stage prostate cancer, the radioactive seeds are placed in the prostate using needles that are inserted through the skin between the scrotum and rectum. The placement of the radioactive seeds in the prostate is guided by images from transrectal ultrasound or computed tomography (CT). The needles are removed after the radioactive seeds are placed in the prostate. - Radiopharmaceutical therapy uses a radioactive substance to treat cancer. Radiopharmaceutical therapy includes the following: - Alpha emitter radiation therapy uses a radioactive substance to treat prostate cancer that has spread to the bone. A radioactive substance called radium-223 is injected into a vein and travels through the bloodstream. The radium-223 collects in areas of bone with cancer and kills the cancer cells. The way the radiation therapy is given depends on the type and stage of the cancer being treated. External radiation therapy, internal radiation therapy, and radiopharmaceutical therapy are used to treat prostate cancer. Men treated with radiation therapy for prostate cancer have an increased risk of having bladder and/or gastrointestinal cancer. Radiation therapy can cause impotence and urinary problems that may get worse with age. Hormone therapy Hormone therapy is a cancer treatment that removes hormones or blocks their action and stops cancer cells from growing. Hormones are substances made by glands in the body and circulated in the bloodstream. In prostate cancer, male sex hormones can cause prostate cancer to grow. Drugs, surgery, or other hormones are used to reduce the amount of male hormones or block them from working. Hormone therapy for prostate cancer may include the following: - Abiraterone acetate can prevent prostate cancer cells from making androgens. It is used in men with advanced prostate cancer that has not gotten better with other hormone therapy. - Orchiectomy is a surgical procedure to remove one or both testicles, the main source of male hormones, such as testosterone, to decrease the amount of hormone being made. - Estrogens (hormones that promote female sex characteristics) can prevent the testicles from making testosterone. However, estrogens are seldom used today in the treatment of prostate cancer because of the risk of serious side effects. - Luteinizing hormone-releasing hormone agonists can stop the testicles from making testosterone. Examples are leuprolide, goserelin, and buserelin. - Antiandrogens can block the action of androgens (hormones that promote male sex characteristics), such as testosterone. Examples are flutamide, bicalutamide, enzalutamide, and nilutamide. - Drugs that can prevent the adrenal glands from making androgens include ketoconazole and aminoglutethimide. Hot flashes, impaired sexual function, loss of desire for sex, and weakened bones may occur in men treated with hormone therapy. Other side effects include diarrhea, nausea, and itching. See Drugs Approved for Prostate Cancer for more information. Chemotherapy Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated. See Drugs Approved for Prostate Cancer for more information. Biologic therapy Biologic therapy is a treatment that uses the patient's immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer. Sipuleucel-T is a type of biologic therapy used to treat prostate cancer that has metastasized (spread to other parts of the body). See Drugs Approved for Prostate Cancer for more information. Bisphosphonate therapy Bisphosphonate drugs, such as clodronate or zoledronate, reduce bone disease when cancer has spread to the bone. Men who are treated with antiandrogen therapy or orchiectomy are at an increased risk of bone loss. In these men, bisphosphonate drugs lessen the risk of bone fracture (breaks). The use of bisphosphonate drugs to prevent or slow the growth of bone metastases is being studied in clinical trials. There are treatments for bone pain caused by bone metastases or hormone therapy. Prostate cancer that has spread to the bone and certain types of hormone therapy can weaken bones and lead to bone pain. Treatments for bone pain include the following: - Pain medicine. - External radiation therapy. - Strontium-89 (a radioisotope). - Targeted therapy with a monoclonal antibody, such as denosumab. - Bisphosphonate therapy. - Corticosteroids. See the PDQ summary on Pain for more information. New types of treatment are being tested in clinical trials. This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI website. Cryosurgery Cryosurgery is a treatment that uses an instrument to freeze and destroy prostate cancer cells. Ultrasound is used to find the area that will be treated. This type of treatment is also called cryotherapy. Cryosurgery can cause impotence and leakage of urine from the bladder or stool from the rectum. High-intensity-focused ultrasound therapy High-intensity-focused ultrasound therapy is a treatment that uses ultrasound (high-energy sound waves) to destroy cancer cells. To treat prostate cancer, an endorectal probe is used to make the sound waves. Proton beam radiation therapy Proton beam radiation therapy is a type of high-energy, external radiation therapy that targets tumors with streams of protons (small, positively charged particles). This type of radiation therapy is being studied in the treatment of prostate cancer. Cryosurgery Cryosurgery is a treatment that uses an instrument to freeze and destroy prostate cancer cells. Ultrasound is used to find the area that will be treated. This type of treatment is also called cryotherapy. Cryosurgery can cause impotence and leakage of urine from the bladder or stool from the rectum. High-intensity-focused ultrasound therapy High-intensity-focused ultrasound therapy is a treatment that uses ultrasound (high-energy sound waves) to destroy cancer cells. To treat prostate cancer, an endorectal probe is used to make the sound waves. Proton beam radiation therapy Proton beam radiation therapy is a type of high-energy, external radiation therapy that targets tumors with streams of protons (small, positively charged particles). This type of radiation therapy is being studied in the treatment of prostate cancer. Patients may want to think about taking part in a clinical trial. For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment. Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment. Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward. Patients can enter clinical trials before, during, or after starting their cancer treatment. Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment. Clinical trials are taking place in many parts of the country. Information about clinical trials supported by NCI can be found on NCI's clinical trials search webpage. Clinical trials supported by other organizations can be found on the ClinicalTrials.gov website. Follow-up tests may be needed. Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups. Treatment Options by Stage Stage I Prostate Cancer Standard treatment of stage I prostate cancer may include the following: - Watchful waiting. - Active surveillance. If the cancer begins to grow, hormone therapy may be given. - Radical prostatectomy, usually with pelvic lymphadenectomy. Radiation therapy may be given after surgery. - External radiation therapy. Hormone therapy may be given after radiation therapy. - Internal radiation therapy with radioactive seeds. - A clinical trial of high-intensity-focused ultrasound therapy. - A clinical trial of cryosurgery. Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available. Stage II Prostate Cancer Standard treatment of stage II prostate cancer may include the following: - Watchful waiting. - Active surveillance. If the cancer begins to grow, hormone therapy may be given. - Radical prostatectomy, usually with pelvic lymphadenectomy. Radiation therapy may be given after surgery. - External radiation therapy. Hormone therapy may be given after radiation therapy. - Internal radiation therapy with radioactive seeds. - A clinical trial of cryosurgery. - A clinical trial of high-intensity-focused ultrasound therapy. - A clinical trial of proton beam radiation therapy. - Clinical trials of new types of treatment, such as hormone therapy followed by radical prostatectomy. Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available. Stage III Prostate Cancer Standard treatment of stage III prostate cancer may include the following: - External radiation therapy. Hormone therapy may be given after radiation therapy. - Hormone therapy. Radiation therapy may be given after hormone therapy. - Radical prostatectomy. Radiation therapy may be given after surgery. - Watchful waiting. - Active surveillance. If the cancer begins to grow, hormone therapy may be given. Treatment to control cancer that is in the prostate and lessen urinary symptoms may include the following: - External radiation therapy. - Internal radiation therapy with radioactive seeds. - Hormone therapy. - Transurethral resection of the prostate (TURP). - A clinical trial of new types of radiation therapy. - A clinical trial of cryosurgery. Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available. Stage IV Prostate Cancer Standard treatment of stage IV prostate cancer may include the following: - Hormone therapy. - Hormone therapy combined with chemotherapy. - Bisphosphonate therapy. - External radiation therapy. Hormone therapy may be given after radiation therapy. - Alpha emitter radiation therapy. - Watchful waiting. - Active surveillance. If the cancer begins to grow, hormone therapy may be given. - A clinical trial of radical prostatectomy with orchiectomy. Treatment to control cancer that is in the prostate and lessen urinary symptoms may include the following: - Transurethral resection of the prostate (TURP). - Radiation therapy. Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available. Treatment Options for Recurrent Prostate Cancer how to manage prostate cancer

how to manage prostate cancer

Treatments for atherosclerosis may include heart-healthy lifestyle changes, medicines, and medical procedures or surgery. The goals of treatment include: Lowering the risk of blood clots forming Preventing atherosclerosis-related diseases Reducing risk factors in an effort to slow or stop the buildup of plaque Relieving symptoms Widening or bypassing plaque-clogged arteries

Atherosclerosis What Is... Español Atherosclerosis is a disease in which plaque builds up inside your arteries. Arteries are blood vessels that carry oxygen-rich blood to your heart and other parts of your body. Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood. Over time, plaque hardens and narrows your arteries. This limits the flow of oxygen-rich blood to your organs and other parts of your body. Atherosclerosis can lead to serious problems, including heart attack, stroke, or even death. Atherosclerosis Atherosclerosis-Related Diseases Atherosclerosis can affect any artery in the body, including arteries in the heart, brain, arms, legs, pelvis, and kidneys. As a result, different diseases may develop based on which arteries are affected. Coronary Heart Disease Coronary heart disease (CHD), also called coronary artery disease, occurs when plaque builds up in the coronary arteries. These arteries supply oxygen-rich blood to your heart. Plaque narrows the coronary arteries and reduces blood flow to your heart muscle. Plaque buildup also makes it more likely that blood clots will form in your arteries. Blood clots can partially or completely block blood flow. If blood flow to your heart muscle is reduced or blocked, you may have angina (chest pain or discomfort) or a heart attack. Plaque also can form in the heart's smallest arteries. This disease is called coronary microvascular disease (MVD). In coronary MVD, plaque doesn't cause blockages in the arteries as it does in CHD. Carotid Artery Disease Carotid (ka-ROT-id) artery disease occurs if plaque builds up in the arteries on each side of your neck (the carotid arteries). These arteries supply oxygen-rich blood to your brain. If blood flow to your brain is reduced or blocked, you may have a stroke. Peripheral Artery Disease Peripheral artery disease (P.A.D.) occurs if plaque builds up in the major arteries that supply oxygen-rich blood to your legs, arms, and pelvis. If blood flow to these parts of your body is reduced or blocked, you may have numbness, pain, and, sometimes, dangerous infections. Chronic Kidney Disease Chronic kidney disease can occur if plaque builds up in the renal arteries. These arteries supply oxygen-rich blood to your kidneys. Over time, chronic kidney disease causes a slow loss of kidney function. The main function of the kidneys is to remove waste and extra water from the body. Overview The cause of atherosclerosis isn't known. However, certain traits, conditions, or habits may raise your risk for the disease. These conditions are known as risk factors. You can control some risk factors, such as lack of physical activity, smoking, and an unhealthy diet. Others you can't control, such as age and a family history of heart disease. Some people who have atherosclerosis have no signs or symptoms. They may not be diagnosed until after a heart attack or stroke. The main treatment for atherosclerosis is lifestyle changes. You also may need medicines and medical procedures. These treatments, along with ongoing medical care, can help you live a healthier life. Outlook Improved treatments have reduced the number of deaths from atherosclerosis-related diseases. These treatments also have improved the quality of life for people who have these diseases. However, atherosclerosis remains a common health problem. You may be able to prevent or delay atherosclerosis and the diseases it can cause. Making lifestyle changes and getting ongoing care can help you avoid the problems of atherosclerosis and live a long, healthy life. OTHER NAMES Arteriosclerosis Hardening of the arteries CAUSES The exact cause of atherosclerosis isn't known. However, studies show that atherosclerosis is a slow, complex disease that may start in childhood. It develops faster as you age. Atherosclerosis may start when certain factors damage the inner layers of the arteries. These factors include: Smoking High amounts of certain fats and cholesterol in the blood High blood pressure High amounts of sugar in the blood due to insulin resistance or diabetes Plaque may begin to build up where the arteries are damaged. Over time, plaque hardens and narrows the arteries. Eventually, an area of plaque can rupture (break open). When this happens, blood cell fragments called platelets (PLATE-lets) stick to the site of the injury. They may clump together to form blood clots. Clots narrow the arteries even more, limiting the flow of oxygen-rich blood to your body. Depending on which arteries are affected, blood clots can worsen angina (chest pain) or cause a heart attack or stroke. Researchers continue to look for the causes of atherosclerosis. They hope to find answers to questions such as: Why and how do the arteries become damaged? How does plaque develop and change over time? Why does plaque rupture and lead to blood clots? WHO IS AT RISK The exact cause of atherosclerosis isn't known. However, certain traits, conditions, or habits may raise your risk for the disease. These conditions are known as risk factors. The more risk factors you have, the more likely it is that you'll develop atherosclerosis. You can control most risk factors and help prevent or delay atherosclerosis. Other risk factors can't be controlled. Major Risk Factors Unhealthy blood cholesterol levels. This includes high LDL cholesterol (sometimes called "bad" cholesterol) and low HDL cholesterol (sometimes called "good" cholesterol). High blood pressure. Blood pressure is considered high if it stays at or above 140/90 mmHg over time. If you have diabetes or chronic kidney disease, high blood pressure is defined as 130/80 mmHg or higher. (The mmHg is millimeters of mercury—the units used to measure blood pressure.) Smoking. Smoking can damage and tighten blood vessels, raise cholesterol levels, and raise blood pressure. Smoking also doesn't allow enough oxygen to reach the body's tissues. Insulin resistance. This condition occurs if the body can't use its insulin properly. Insulin is a hormone that helps move blood sugar into cells where it's used as an energy source. Insulin resistance may lead to diabetes. Diabetes. With this disease, the body's blood sugar level is too high because the body doesn't make enough insulin or doesn't use its insulin properly. Overweight or obesity. The terms "overweight" and "obesity" refer to body weight that's greater than what is considered healthy for a certain height. Lack of physical activity. A lack of physical activity can worsen other risk factors for atherosclerosis, such as unhealthy blood cholesterol levels, high blood pressure, diabetes, and overweight and obesity. Unhealthy diet. An unhealthy diet can raise your risk for atherosclerosis. Foods that are high in saturated and trans fats, cholesterol, sodium (salt), and sugar can worsen other atherosclerosis risk factors. Older age. As you get older, your risk for atherosclerosis increases. Genetic or lifestyle factors cause plaque to build up in your arteries as you age. By the time you're middle-aged or older, enough plaque has built up to cause signs or symptoms. In men, the risk increases after age 45. In women, the risk increases after age 55. Family history of early heart disease. Your risk for atherosclerosis increases if your father or a brother was diagnosed with heart disease before 55 years of age, or if your mother or a sister was diagnosed with heart disease before 65 years of age. Although age and a family history of early heart disease are risk factors, it doesn't mean that you'll develop atherosclerosis if you have one or both. Controlling other risk factors often can lessen genetic influences and prevent atherosclerosis, even in older adults. Studies show that an increasing number of children and youth are at risk for atherosclerosis. This is due to a number of causes, including rising childhood obesity rates. Emerging Risk Factors Scientists continue to study other possible risk factors for atherosclerosis. High levels of a protein called C-reactive protein (CRP) in the blood may raise the risk for atherosclerosis and heart attack. High levels of CRP are a sign of inflammation in the body. Inflammation is the body's response to injury or infection. Damage to the arteries' inner walls seems to trigger inflammation and help plaque grow. People who have low CRP levels may develop atherosclerosis at a slower rate than people who have high CRP levels. Research is under way to find out whether reducing inflammation and lowering CRP levels also can reduce the risk for atherosclerosis. High levels of triglycerides (tri-GLIH-seh-rides) in the blood also may raise the risk for atherosclerosis, especially in women. Triglycerides are a type of fat. Studies are under way to find out whether genetics may play a role in atherosclerosis risk. Other Factors That Affect Atherosclerosis Other factors also may raise your risk for atherosclerosis, such as: Sleep apnea. Sleep apnea is a disorder that causes one or more pauses in breathing or shallow breaths while you sleep. Untreated sleep apnea can raise your risk for high blood pressure, diabetes, and even a heart attack or stroke. Stress. Research shows that the most commonly reported "trigger" for a heart attack is an emotionally upsetting event, especially one involving anger. Alcohol. Heavy drinking can damage the heart muscle and worsen other risk factors for atherosclerosis. Men should have no more than two drinks containing alcohol a day. Women should have no more than one drink containing alcohol a day. SIGNS & SYMPTOMS Atherosclerosis usually doesn't cause signs and symptoms until it severely narrows or totally blocks an artery. Many people don't know they have the disease until they have a medical emergency, such as a heart attack or stroke. Some people may have signs and symptoms of the disease. Signs and symptoms will depend on which arteries are affected. Coronary Arteries The coronary arteries supply oxygen-rich blood to your heart. If plaque narrows or blocks these arteries (a disease called coronary heart disease, or CHD), a common symptom is angina. Angina is chest pain or discomfort that occurs when your heart muscle doesn't get enough oxygen-rich blood. Angina may feel like pressure or squeezing in your chest. You also may feel it in your shoulders, arms, neck, jaw, or back. Angina pain may even feel like indigestion. The pain tends to get worse with activity and go away with rest. Emotional stress also can trigger the pain. Other symptoms of CHD are shortness of breath and arrhythmias (ah-RITH-me-ahs). Arrhythmias are problems with the rate or rhythm of the heartbeat. Plaque also can form in the heart's smallest arteries. This disease is called coronary microvascular disease (MVD). Symptoms of coronary MVD include angina, shortness of breath, sleep problems, fatigue (tiredness), and lack of energy. Carotid Arteries The carotid arteries supply oxygen-rich blood to your brain. If plaque narrows or blocks these arteries (a disease called carotid artery disease), you may have symptoms of a stroke. These symptoms may include: Sudden weakness Paralysis (an inability to move) or numbness of the face, arms, or legs, especially on one side of the body Confusion Trouble speaking or understanding speech Trouble seeing in one or both eyes Problems breathing Dizziness, trouble walking, loss of balance or coordination, and unexplained falls Loss of consciousness Sudden and severe headache Peripheral Arteries Plaque also can build up in the major arteries that supply oxygen-rich blood to the legs, arms, and pelvis (a disease called peripheral artery disease). If these major arteries are narrowed or blocked, you may have numbness, pain, and, sometimes, dangerous infections. Renal Arteries The renal arteries supply oxygen-rich blood to your kidneys. If plaque builds up in these arteries, you may develop chronic kidney disease. Over time, chronic kidney disease causes a slow loss of kidney function. Early kidney disease often has no signs or symptoms. As the disease gets worse it can cause tiredness, changes in how you urinate (more often or less often), loss of appetite, nausea (feeling sick to the stomach), swelling in the hands or feet, itchiness or numbness, and trouble concentrating. DIAGNOSIS Your doctor will diagnose atherosclerosis based on your medical and family histories, a physical exam, and test results. Specialists Involved If you have atherosclerosis, a primary care doctor, such as an internist or family practitioner, may handle your care. Your doctor may recommend other health care specialists if you need expert care, such as: A cardiologist. This is a doctor who specializes in diagnosing and treating heart diseases and conditions. You may go to a cardiologist if you have peripheral artery disease (P.A.D.) or coronary microvascular disease (MVD). A vascular specialist. This is a doctor who specializes in diagnosing and treating blood vessel problems. You may go to a vascular specialist if you have P.A.D. A neurologist. This is a doctor who specializes in diagnosing and treating nervous system disorders. You may see a neurologist if you've had a stroke due to carotid artery disease. A nephrologist. This is a doctor who specializes in diagnosing and treating kidney diseases and conditions. You may go to a nephrologist if you have chronic kidney disease. Physical Exam During the physical exam, your doctor may listen to your arteries for an abnormal whooshing sound called a bruit (broo-E). Your doctor can hear a bruit when placing a stethoscope over an affected artery. A bruit may indicate poor blood flow due to plaque buildup. Your doctor also may check to see whether any of your pulses (for example, in the leg or foot) are weak or absent. A weak or absent pulse can be a sign of a blocked artery. Diagnostic Tests Your doctor may recommend one or more tests to diagnose atherosclerosis. These tests also can help your doctor learn the extent of your disease and plan the best treatment. Blood Tests Blood tests check the levels of certain fats, cholesterol, sugar, and proteins in your blood. Abnormal levels may be a sign that you're at risk for atherosclerosis. EKG (Electrocardiogram) An EKG is a simple, painless test that detects and records the heart's electrical activity. The test shows how fast the heart is beating and its rhythm (steady or irregular). An EKG also records the strength and timing of electrical signals as they pass through the heart. An EKG can show signs of heart damage caused by CHD. The test also can show signs of a previous or current heart attack. Chest X Ray A chest x ray takes pictures of the organs and structures inside your chest, such as your heart, lungs, and blood vessels. A chest x ray can reveal signs of heart failure. Ankle/Brachial Index This test compares the blood pressure in your ankle with the blood pressure in your arm to see how well your blood is flowing. This test can help diagnose P.A.D. Echocardiography Echocardiography (echo) uses sound waves to create a moving picture of your heart. The test provides information about the size and shape of your heart and how well your heart chambers and valves are working. Echo also can identify areas of poor blood flow to the heart, areas of heart muscle that aren't contracting normally, and previous injury to the heart muscle caused by poor blood flow. Computed Tomography Scan A computed tomography (CT) scan creates computer-generated pictures of the heart, brain, or other areas of the body. The test can show hardening and narrowing of large arteries. A cardiac CT scan also can show whether calcium has built up in the walls of the coronary (heart) arteries. This may be an early sign of CHD. Stress Testing During stress testing, you exercise to make your heart work hard and beat fast while heart tests are done. If you can't exercise, you may be given medicine to make your heart work hard and beat fast. When your heart is working hard, it needs more blood and oxygen. Plaque-narrowed arteries can't supply enough oxygen-rich blood to meet your heart's needs. A stress test can show possible signs and symptoms of CHD, such as: Abnormal changes in your heart rate or blood pressure Shortness of breath or chest pain Abnormal changes in your heart rhythm or your heart's electrical activity As part of some stress tests, pictures are taken of your heart while you exercise and while you rest. These imaging stress tests can show how well blood is flowing in various parts of your heart. They also can show how well your heart pumps blood when it beats. Angiography Angiography (an-jee-OG-ra-fee) is a test that uses dye and special x rays to show the inside of your arteries. This test can show whether plaque is blocking your arteries and how severe the blockage is. A thin, flexible tube called a catheter is put into a blood vessel in your arm, groin (upper thigh), or neck. Dye that can be seen on an x-ray picture is injected through the catheter into the arteries. By looking at the x-ray picture, your doctor can see the flow of blood through your arteries. Other Tests Other tests are being studied to see whether they can give a better view of plaque buildup in the arteries. Examples of these tests include magnetic resonance imaging (MRI) and positron emission tomography (PET). TREATMENTS Treatments for atherosclerosis may include heart-healthy lifestyle changes, medicines, and medical procedures or surgery. The goals of treatment include: Lowering the risk of blood clots forming Preventing atherosclerosis-related diseases Reducing risk factors in an effort to slow or stop the buildup of plaque Relieving symptoms Widening or bypassing plaque-clogged arteries Heart-Healthy Lifestyle Changes Your doctor may recommend heart-healthy lifestyle changes if you have atherosclerosis. Heart-healthy lifestyle changes include heart-healthy eating, maintaining a healthy weight, managing stress, physical activity and quitting smoking. Heart-Healthy Eating Your doctor may recommend heart-healthy eating, which should include: Fat-free or low-fat dairy products, such as skim milk Fish high in omega-3 fatty acids, such as salmon, tuna, and trout, about twice a week Fruits, such as apples, bananas, oranges, pears, and prunes Legumes, such as kidney beans, lentils, chickpeas, black-eyed peas, and lima beans Vegetables, such as broccoli, cabbage, and carrots Whole grains, such as oatmeal, brown rice, and corn tortillas When following a heart-healthy diet, you should avoid eating: A lot of red meat Palm and coconut oils Sugary foods and beverages Two nutrients in your diet make blood cholesterol levels rise: Saturated fat—found mostly in foods that come from animals Trans fat (trans fatty acids)—found in foods made with hydrogenated oils and fats, such as stick margarine; baked goods, such as cookies, cakes, and pies; crackers; frostings; and coffee creamers. Some trans fats also occur naturally in animal fats and meats. Saturated fat raises your blood cholesterol more than anything else in your diet. When you follow a heart-healthy eating plan, only 5 percent to 6 percent of your daily calories should come from saturated fat. Food labels list the amounts of saturated fat. To help you stay on track, here are some examples: 1,200 calories a day 8 grams of saturated fat a day 1,500 calories a day 10 grams of saturated fat a day 1,800 calories a day 12 grams of saturated fat a day 2,000 calories a day 13 grams of saturated fat a day 2,500 calories a day 17 grams of saturated fat a day Not all fats are bad. Monounsaturated and polyunsaturated fats actually help lower blood cholesterol levels. Some sources of monounsaturated and polyunsaturated fats are: Avocados Corn, sunflower, and soybean oils Nuts and seeds, such as walnuts Olive, canola, peanut, safflower, and sesame oils Peanut butter Salmon and trout Tofu Sodium You should try to limit the amount of sodium that you eat. This means choosing and preparing foods that are lower in salt and sodium. Try to use low-sodium and “no added salt” foods and seasonings at the table or while cooking. Food labels tell you what you need to know about choosing foods that are lower in sodium. Try to eat no more than 2,300 milligrams of sodium a day. If you have high blood pressure, you may need to restrict your sodium intake even more. Dietary Approaches to Stop Hypertension Your doctor may recommend the Dietary Approaches to Stop Hypertension (DASH) eating plan if you have high blood pressure. The DASH eating plan focuses on fruits, vegetables, whole grains, and other foods that are heart healthy and low in fat, cholesterol, and sodium and salt. The DASH eating plan is a good heart-healthy eating plan, even for those who don’t have high blood pressure. Read more about DASH. Alcohol Try to limit alcohol intake. Too much alcohol will raise your blood pressure and triglyceride levels, a type of fat found in the blood. Alcohol also adds extra calories, which may cause weight gain. Men should have no more than two drinks containing alcohol a day. Women should have no more than one drink containing alcohol a day. One drink is: 12 ounces of beer 5 ounces of wine 1½ ounces of liquor Maintaining a Healthy Weight Maintaining a healthy weight is important for overall health and can lower your risk for coronary heart disease. Aim for a Healthy Weight by following a heart-healthy eating plan and keeping physically active. Knowing your body mass index (BMI) helps you find out if you’re a healthy weight in relation to your height and gives an estimate of your total body fat. To figure out your BMI, check out the National Heart, Lung, and Blood Institute’s online BMI calculator or talk to your doctor. A BMI: Below 18.5 is a sign that you are underweight. Between 18.5 and 24.9 is in the normal range. Between 25.0 and 29.9 is considered overweight. A BMI of 30.0 or higher is considered obese. A general goal to aim for is a BMI of less than 25. Your doctor or health care provider can help you set an appropriate BMI goal. Measuring waist circumference helps screen for possible health risks. If most of your fat is around your waist rather than at your hips, you’re at a higher risk for heart disease and type 2 diabetes. This risk may be high with a waist size that is greater than 35 inches for women or greater than 40 inches for men. To learn how to measure your waist, visit Assessing Your Weight and Health Risk. For more information about losing weight or maintaining your weight, visit Aim for a Healthy Weight. If you’re overweight or obese, try to lose weight. A loss of just 3 percent to 5 percent of your current weight can lower your triglycerides, blood glucose, and the risk of developing type 2 diabetes. Greater amounts of weight loss can improve blood pressure readings, lower LDL cholesterol, and increase HDL cholesterol. Managing Stress Learning how to manage stress, relax, and cope with problems can improve your emotional and physical health. Consider healthy stress-reducing activities, such as: A stress management program Meditation Physical activity Relaxation therapy Talking things out with friends or family Physical Activity Regular physical activity can lower many atherosclerosis risk factors, including LDL or “bad” cholesterol, high blood pressure, and excess weight. Physical activity also can lower your risk for diabetes and raise your HDL or “good” cholesterol, which helps prevent atherosclerosis. Everyone should try to participate in moderate-intensity aerobic exercise at least 2 hours and 30 minutes per week or vigorous aerobic exercise for 1 hour and 15 minutes per week. Aerobic exercise, such as brisk walking, is any exercise in which your heart beats faster and you use more oxygen than usual. The more active you are, the more you will benefit. Participate in aerobic exercise for at least 10 minutes at a time spread throughout the week. Talk with your doctor before you start a new exercise plan. Ask your doctor how much and what kinds of physical activity are safe for you. Read more about physical activity at: Physical Activity and Your Heart U.S. Department of Health and Human Services, 2008 Physical Activity Guidelines for Americans Quitting Smoking If you smoke or use tobacco, quit. Smoking can damage and tighten blood vessels and raise your risk for atherosclerosis. Talk with your doctor about programs and products that can help you quit. Also, try to avoid secondhand smoke. If you have trouble quitting smoking on your own, consider joining a support group. Many hospitals, workplaces, and community groups offer classes to help people quit smoking. For more information about how to quit smoking, visit Smoking and Your Heart. Medicines Sometimes lifestyle changes alone aren’t enough to control your cholesterol levels. For example, you also may need statin medications to control or lower your cholesterol. By lowering your blood cholesterol level, you can decrease your chance of having a heart attack or stroke. Doctors usually prescribe statins for people who have: Coronary heart disease, peripheral artery disease, or had a prior stroke Diabetes High LDL cholesterol levels Doctors may discuss beginning statin treatment with people who have an elevated risk for developing heart disease or having a stroke. Your doctor also may prescribe other medications to: Lower your blood pressure Lower your blood sugar levels Prevent blood clots, which can lead to heart attack and stroke Prevent inflammation Take all medicines regularly, as your doctor prescribes. Don’t change the amount of your medicine or skip a dose unless your doctor tells you to. You should still follow a heart healthy lifestyle, even if you take medicines to treat your atherosclerosis. Medical Procedures and Surgery If you have severe atherosclerosis, your doctor may recommend a medical procedure or surgery. Percutaneous coronary intervention (PCI), also known as coronary angioplasty, is a procedure that’s used to open blocked or narrowed coronary (heart) arteries. PCI can improve blood flow to the heart and relieve chest pain. Sometimes a small mesh tube called a stent is placed in the artery to keep it open after the procedure. Coronary artery bypass grafting (CABG) is a type of surgery. In CABG, arteries or veins from other areas in your body are used to bypass or go around your narrowed coronary arteries. CABG can improve blood flow to your heart, relieve chest pain, and possibly prevent a heart attack. Bypass grafting also can be used for leg arteries. For this surgery, a healthy blood vessel is used to bypass a narrowed or blocked artery in one of the legs. The healthy blood vessel redirects blood around the blocked artery, improving blood flow to the leg. Carotid endarterectomy is a type of surgery to remove plaque buildup from the carotid arteries in the neck. This procedure restores blood flow to the brain, which can help prevent a stroke. PREVENTION Taking action to control your risk factors can help prevent or delay atherosclerosis and its related diseases. Your risk for atherosclerosis increases with the number of risk factors you have. One step you can take is to adopt a healthy lifestyle, which can include: Heart-Healthy Eating. Adopt heart-healthy eating habits, which include eating different fruits and vegetables (including beans and peas), whole grains, lean meats, poultry without skin, seafood, and fat-free or low-fat milk and dairy products. A heart-healthy diet is low in sodium, added sugar, solid fats, and refined grains. Following a heart-healthy diet is an important part of a healthy lifestyle. Physical Activity. Be as physically active as you can. Physical activity can improve your fitness level and your health. Ask your doctor what types and amounts of activity are safe for you. Read more about Physical Activity and Your Heart. Quit Smoking. If you smoke, quit. Smoking can damage and tighten blood vessels and raise your risk for atherosclerosis. Talk with your doctor about programs and products that can help you quit. Also, try to avoid secondhand smoke. Read more about Smoking and Your Heart. Weight Control. If you’re overweight or obese, work with your doctor to create a reasonable weight-loss plan. Controlling your weight helps you control risk factors for atherosclerosis. Other steps that can prevent or delay atherosclerosis include knowing your family history of atherosclerosis. If you or someone in your family has an atherosclerosis-related disease, be sure to tell your doctor. If lifestyle changes aren’t enough, your doctor may prescribe medicines to control your atherosclerosis risk factors. Take all of your medicines as your doctor advises. LIVING WITH Improved treatments have reduced the number of deaths from atherosclerosis-related diseases. These treatments also have improved the quality of life for people who have these diseases. Adopting a healthy lifestyle may help you prevent or delay atherosclerosis and the problems it can cause. This, along with ongoing medical care, can help you avoid the problems of atherosclerosis and live a long, healthy life. Researchers continue to look for ways to improve the health of people who have atherosclerosis or may develop it. Ongoing Care If you have atherosclerosis, work closely with your doctor and other health care providers to avoid serious problems, such as heart attack and stroke. Follow your treatment plan and take all of your medicines as your doctor prescribes. Your doctor will let you know how often you should schedule office visits or blood tests. Be sure to let your doctor know if you have new or worsening symptoms. Emotional Issues and Support Having an atherosclerosis-related disease may cause fear, anxiety, depression, and stress. Talk about how you feel with your doctor. Talking to a professional counselor also can help. If you're very depressed, your doctor may recommend medicines or other treatments that can improve your quality of life. Community resources are available to help you learn more about atherosclerosis. Contact your local public health departments, hospitals, and local chapters of national health organizations to learn more about available resources in your area. Talk about your lifestyle changes with your family and friends—whoever can provide support or needs to understand why you're changing your habits. Family and friends may be able to help you make lifestyle changes. For example, they can help you plan healthier meals. Because atherosclerosis tends to run in families, your lifestyle changes may help many of your family members too. how to prevent atherosclerosis

how to prevent atherosclerosis