Diseases Treatment

Weight loss is defined, in medical literature, as a reduction in the total body weight. This loss in body weight may be due to a loss of fluid, body fat and/or other tissues in the body.

Weight loss can be categorized as:

1. Intentional Weight Loss
2. Unintentional Weight Loss

Intentional weight loss is a decrease in body weight with a view to improving fitness and appearance. In individuals who are obese, intentional weight loss may prevent diseases such as hypertension and diabetes from settling in. For weight loss without any side effects, you must consult a physician and work in conjunction with a dietitian. They will help you develop a program which will be tailored to your body type and capabilities.

Body weight can reduce by a reduction in body fat or fluid. But when you are aiming for weight loss because of health reasons, try to reduce your body fat, and conserve the muscle and fluid. People who are otherwise healthy do not generally need to lose weight. Sometimes, demands of a profession such as athletics or modeling, may compel people to intentional lose weight. But in this case, the aim is more to achieve a certain body appearance rather than health concerns. One has to remember than people who are underweight also face significant health risks.

Unintentional weight loss may occur during or after a serious and chronic disease. In diabetes, weight loss is accompanies with thirst, fatigue, and hunger. Infections such as HIV may also contribute to weight loss. People who suffer from hormonal imbalances may show weight loss as a symptom. Temporary weight loss can be seen when people are laid up with mild illnesses such as viral fever, common cold, gastroenteritis etc. The effect of the illness on the general feeling of well being and the side effects of antibiotics sometimes decrease or suppress the appetite, leading to weight loss. This is temporary and weight generally reached pre illness levels soon.

Most of the intentional weight loss techniques prescribed by physicians revolve around adjusting the eating patterns and combining a healthy diet with ample exercise. In most overweight people, healthy intake and increased physical activity helps in weight loss. There are several other weight loss techniques which may be successful to varying degrees. Drugs and supplements to suppress appetite are becoming popular, but there is some debate about their usefulness. They may even be dangerous if taken injudiciously.

In the battle against weight, only those succeed who are looking for a lasting solution and are willing to give their best shot.

What is this Condition?

Hiatal hernia is a defect in the diaphragm that permits a portion of the stomach to pass through the diaphragm’s opening into the chest. The three types of hiatal hernia are:

• sliding hernia – both the stomach and its connection with the esophagus slip up into the chest

• paraesophageal or “rolling” hernia - a part of the big curve of the stomach rolls through the defect in the diaphragm

• mixed hernia - includes features of both of the above.

Sliding hernias are by far the most common type. The risk of developing a hiatal hernia of any type increases with age and women have a higher risk than men.

What Causes it?

Hiatal hernia is usually caused by weakened esophageal muscles due to old age or cancer, injury, certain surgical procedures or, possibly, an inherited flaw in the diaphragm. The weakened muscles allow parts of the esophagus and stomach to rise when abdominal pressure is increased. Normal pressure increases occur during bending, straining, coughing, extreme physical exertion, and when you wear tight clothing. Conditions that cause increased pressure include fluid accumulation, pregnancy, and obesity.

What are its Symptoms?

A sliding hernia may not produce any symptoms and, consequently, doesn’t require treatment. When symptoms occur, they typically reflect acid backup and include:

• heartburn from 1 to 4 hours after eating that is aggravated by reclining, belching, and abdominal pressure, and may be accompanied by regurgitation or vomiting

• high-chest pain due to backup of stomach acid, stomach distention, and spasm that is aggravated by reclining, belching, and abdominal pressure (more common after meals or at bedtime).

Symptoms that may reflect possible complications include:

• difficulty swallowing due to acid backup into the esophagus, especially after consuming very hot or cold foods, alcoholic beverages, or a large meal

• bleeding (mild or massive) caused by damage to the esophagus or stomach

• severe pain and shock resulting from a trapped hernia (a large part of the stomach is caught above the diaphragm), which may perforate the stomach and requires immediate surgery.

Paraesophageal hernia rarely causes a backflow of stomach acid and therefore usually does not produce symptoms. Often, it is discovered during a barium swallow X-ray ordered for some other reason. Symptoms, when present, are subtle displacement or stretching of the stomach that may give the person a feeling of stomach or chest fullness that mimics angina. Although it has few symptoms, this type of hernia requires surgical treatment because it has a high risk of strangulation.

How is it Diagnosed?

The doctor will use a scope to inspect the esophagus and its muscles for abnormalities and may take a specimen to rule out cancer or other growths. Lab studies and procedures provide more information. For example, chest X-ray can reveal a large hernia, and a barium study may show the hernia as a pouch at the lower end of the esophagus. Other lab tests can confirm stomach acid reflux, bleeding, anemia, or blood in stools.

How is it Treated?

Initial treatment focuses on relieving symptoms and preventing complications. The doctor will recommend changes in diet, prescribe drugs to strengthen the lower esophageal sphincter, and explain how positioning can ease discomfort. Also the person will be provided with a list of things to avoid, such as abdominal pressure (coughing, straining, bending), constrictive clothing, and smoking (stimulates gastric acid production). Other suggested treatments include using antiemetics, antacids, cough suppressants, and stool softeners, and losing any extra weight.

If these therapies fail or complications develop, surgery may be required. Most surgeons create an artificial closing mechanism at the end of the esophagus to create a barrier between the stomach and the chest.

What is this Condition?

Lung cancer usually develops within the wall or lining of the bronchial tree, the system of branching air passages within the lungs. Some people have survived for 5 years or more with diagnosed lung cancer; however, the general prognosis is poor. Although it is largely preventable, lung cancer is the most common cause of cancer death in men and is fast becoming the most common cause in women.

What Causes it?

Medical experts agree that lung cancer is caused by inhalation of carcinogenic pollutants. Pollutants in tobacco smoke cause progressive damage to lung cells.

Who is most susceptible to lung cancer? Any smoker over age 40, especially if he or she began to smoke before age 15, has smoked a whole pack or more per day for 20 years, or works with or near asbestos.

What are its Symptoms?

Because lung cancer rarely causes symptoms in its early stage, this disease is often advanced at diagnosis. Late-stage respiratory symptoms typically include “smoker’s cough,” hoarseness, wheezing, shortness of breath, coughing up blood, chest pain, fever, weakness, weight loss, appetite loss, and shoulder pain.

Lung cancer may spread to any part of the body, most commonly to the brain and spinal cord, liver, and bone. The effects of cancer spread vary greatly depending on tumor size and location.

Hormonal Effects

Lung tumors may alter the production of hormones that regulate body functions. Possible problems include:

• breast enlargement in males

• bone and joint pain from cartilage erosion due to abnormal production of growth hormone

• Cushing’s syndrome (overproduction of certain steroid hormones) and carcinoid syndrome (diarrhea, cramps, flushing, skin lesions, labored breathing)

• increased calcium levels in the blood.

How is it Diagnosed?

The person’s symptoms and physical exam findings may strongly suggest lung cancer, but firm diagnosis requires further evidence.

• Chest X-ray usually shows an advanced tumor, but it can detect a tumor up to 2 years before symptoms appear. It also indicates tumor size and location.

• Sputum cytology (the analysis of cells in the sputum), which is 75% reliable, requires a specimen coughed up from the lungs.

• Computed tomography scan (commonly called a CAT scan) of the chest may help determine the tumor’s size and whether it affects surrounding structures.

• Bronchoscopy (visual exam of the lungs using an instrument called a bronchoscope) can locate the tumor site. Specimens taken during this test provide material for cell and tissue analysis.

• Needle biopsy of the lungs can detect tumors in the outer portion of the lungs. This procedure allows firm diagnosis in 80% of people with lung cancer.

• Tissue biopsy (removal and analysis of affected tissue) can be done if the site of cancer spread is accessible.

• Thoracentesis (draining of fluid from the chest) allows chemical and cell analysis of pleural fluid.

Other tests to detect cancer spread include bone scan, bone marrow biopsy (removal of some bone marrow for analysis), and CAT scan of the brain or abdomen.

Also, the doctor will stage the tumor to determine the extent of the disease, help plan treatment, and make a prognosis.

How is it Treated?

Treatment – which consists of combinations of surgery, radiation, and chemotherapy – may improve the prognosis and prolong survival.

Surgery may be performed for certain types of lung cancer. It may include partial or total removal of the lung.

Before surgery, the person may undergo radiation therapy to help reduce the tumor’s size. Chemotherapy before radiation helps improve the person’s response to radiation. Chemotherapy may involve combinations of certain drugs.

Radiation therapy may also be performed after surgery. Generally, radiation therapy is delayed until 1 month after surgery to let the wound heal. Then, radiation is directed at the part of the chest where the tumor is most likely to spread.

Radiation treatments may be the main form of treatment when surgery is not possible. Radiation implants are another possible treatment.

In laser therapy, still largely experimental, a laser beam is directed through a bronchoscope to destroy local tumors.

What can a Person with Lung Cancer do?

If you’re receiving chemotherapy and radiation, take the following steps:

• Eat soft, nonirritating foods that are high in protein. To maintain proper nutrition, eat high-calorie snacks between meals.

• To conserve your energy, alternate activity with rest periods .

• If you’re receiving outpatient radiation therapy, avoid tight clothing, sun exposure, and harsh ointments on your chest. As instructed, perform exercises to help prevent shoulder stiffness.

What is this Condition?

Breast cancer is the most common form of cancer in women. Although it may develop any time after puberty, it most often arises after age 50. It occurs in men, but rarely.

The survival rate has improved because of earlier diagnosis and the variety of treatments now available. Bur the death rate hasn’t changed in the past 50 years. Breast cancer is the number two killer (after lung cancer) of women ages 35 to 54.

Breast cancer occurs more often in the left breast than the right, and more often in the upper outer quadrant (the upper part of the breast closest to the arm). A woman may not be able to feel a slow­growing breast tumor by touch for up to 8 years, until it has a 3/8-inch (1-centimeter) diameter.

Breast cancer may spread by way of the lymphatic system and bloodstream, through the right side of the heart to the lungs, and eventually to the other breast, chest wall, liver, bone, and brain.

What Causes it?

The cause of breast cancer isn’t known, but its high incidence in women suggests that estrogen is a cause or contributing factor. Certain predisposing factors are clear, though. Women at high risk include those who:

• have a family history of breast cancer
• have long menstrual cycles (began menstruating early or experienced menopause late)
• have never been pregnant
• were first pregnant after age 31
• have had cancer in one breast
• have had endometrial or ovarian cancer
• were exposed to low-level ionizing radiation.

Researchers have looked into many other possible predisposing factors, including estrogen therapy, drugs that lower blood pressure, a high-fat diet, obesity, and fibrocystic breasts.

Women at lower risk for breast cancer include those who:

• were pregnant before age 20
• have had more than one pregnancy
• are Indian or Asian.

What are its Symptoms?

Warning signs of possible breast cancer include:

• a lump or mass in the breast
• change in the symmetry or size of the breast
• change in the skin, such as thickening or dimpling, scaly skin around the nipple, an orange-peel-like appearance, or ulcers
• change in skin temperature (a warm, hot, or pink area)
• unusual drainage or discharge from the breast
• change in the nipple, such as itching, burning, erosion, or retraction
• pain (with an advanced tumor)
• spread of cancer to the bone, pathologic bone fractures, and increased calcium in the blood
• swelling of the arm.

How is it Diagnosed?

The most reliable way to detect breast cancer is by a monthly self­exam, with immediate evaluation of any abnormality. Other tests include mammography (an X-ray of the breast) and biopsy (removal of breast tissue).

Mammography is indicated for a woman with signs or symptoms of breast cancer. Every woman should have a baseline (initial) mammogram between ages 35 and 39. Women ages 40 to 49 should have one every 1 to 2 years; women over age 50, women who have a family history of breast cancer, or those who’ve had cancer in one breast should have a mammogram every year.

Because mammography can produce a false-negative result in as many as 30% of all tests, most doctors do a fine-needle aspiration or surgical biopsy if the woman has a suspicious mass, even if the mammogram is negative. Ultrasound, which can distinguish a fluid-filled cyst from a tumor, can be used instead of an invasive surgical biopsy.

Bone scans, a computed tomography scan (commonly called a CAT scan), measurement of a substance called alkaline phosphatase, liver function studies, and a liver biopsy can detect the spread of cancer to distant sites.

A test called a hormonal receptor assay is done to determine if the tumor is estrogen- or progesterone-dependent. This test guides decisions to use therapy that blocks the action of the estrogen hormone, which supports tumor growth.

How is it Treated?

Much controversy exists over breast cancer treatments. In choosing therapy, the woman and her doctor should consider the stage of the disease, the woman’s age and menopausal status, and the possible disfiguring effects of surgery.

A woman with breast cancer may undergo one or any combination of the following treatments:

• Surgery involves either lumpectomy or mastectomy (removal of all or part of the breast).
• Chemotherapy is used either as the main treatment or as an auxiliary to the main treatment (known as adjuvant therapy), depending on such factors as the tumor stage and estrogen receptor status. The most commonly used drugs are cyclophosphamide, fluorouracil methotrexate, doxorubicin, vincristine, paclitaxel, and prednisone.
• A treatment called peripheral stem cell therapy may be used for a woman with advanced breast cancer. In this treatment, blood is removed from a large vein. Certain cells undergo purification and are frozen and eventually reinfused.
• Primary radiation therapy before or after tumor removal is effective for small tumors in early stages that haven’t spread to distant sites. It’s also used to prevent or treat local recurrence. Also, a woman with inflammatory breast cancer may undergo radiation before surgery to make the tumor easier to remove.

What do Doctors call this Condition?

Abdominal aortic aneurysm

What is this Condition?

An aortic aneurysm of the abdomen is an abnormal bulge in the wall of the aorta, the body’s main artery. It generally occurs where this big artery branches to carry blood to the legs. Such aneurysms are four times more common in men than in women and most prevalent between ages 50 and 80.

Over half of all people with untreated abdominal aneurysms die, primarily from a rupture of the bulge, within 2 years of diagnosis. About 15% survive beyond 5 years.

What Causes it?

About 95% of aortic aneurysms of the abdomen result from arteriosclerosis (hardening of the arteries). These aneurysms develop slowly. Blood pressure within the aorta progressively weakens the vessel walls and enlarges the aneurysm.

What are its Symptoms?

Although aortic aneurysms of the abdomen usually don’t cause symptoms, most are evident (unless the person is obese) as a pulsating mass near the naval. Sometimes it’s tender.

Lower back pain that radiates to the side and groin from pressure on lumbar nerves may signifY that the aneurysm has grown and is about to rupture.

Rupture of an aneurysm may cause severe, persistent abdominal and back pain. Twenty percent of people whose aneurysms rupture die immediately. In some cases, signs of hemorrhage – such as weakness, sweating, a fast pulse, and low blood pressure – may be subtle. People with a rupture may remain in stable condition for hours before going into shock.

How is it Diagnosed?

Because an aortic aneurysm of the abdomen rarely produces symptoms, it’s often detected accidentally on an X-ray or during a routine physical exam. An ultrasound test can determine aneurysm size, shape, and location. Aortography (X-rays of the aorta after injection of a dye) shows the condition of vessels in the region of the aneurysm and the extent of the aneurysm.

How is it Treated?

Usually, aortic aneurysm of the abdomen requires surgical removal of the aneurysm and replacement of the damaged aortic section with a Dacron graft. If the aneurysm is small and produces no symptoms, surgery may be delayed; however, small aneurysms may also rupture. Regular physical exams and ultrasound checks are necessary to detect enlargement, which may forewarn of rupture. Large aneurysms or those that produce symptoms involve a significant risk of rupture and need immediate surgical repair.

An abnormal growth of spongy bone can occur at the entrance to the inner ear and immobilize the base of the stirrup, a tiny bone through which sound waves pass into the inner ear. As a result, the stirrup cannot transmit some or all of the sound waves that enter the ear. This causes conductive hearing loss in that ear. In about 80 per cent of all cases of otosclerosis, both of the ears are affected, either the two at the same time or one after the other.

What are the Symptoms?

Without treatment, otosclerosis usually leads to a slow loss of hearing, eventually ending with total deafness in both ears within 10 to 15 years. In a few cases, usually in children, the hearing loss progresses much faster. In some other cases the hearing loss stops well short of deafness. For example, someone with the disorder may be able to hear loud speech and other loud sounds.

At first, the affected person’s voice sounds normal, unlike the abnormally loud voices of people with other types of hearing loss, As the disease progresses, some sensorineural hearing loss may occur. If this happens, it may cause noises in the ear and louder speech.

A woman with otosclerosis who becomes pregnant may find that the rate of hearing loss accelerates, Usually the change is not significant enough to cause added concern.

What are the Risks?

The risks are the dangers associated with deafness and the emotional effects of the social isolation that this sometimes produces,

What should be done?

If your hearing deteriorates or you hear ringing in your ears, see your physician, who will examine your ears and probably give you some simple hearing tests, If otosclerosis is suspected, and particularly if you have a blood relative who has the disease, you will probably have to take several special hearing tests.

What is the Treatment?

The only treatment that will halt or cure otosclerosis is an operation called a stapedectomy. A stapedectomy improves hearing significantly in 90 per cent of cases. However, about two to five per cent of these operations result in total deafness in the affected ear. You and your physician should consider this risk as you decide whether you should under­go the procedure. If you have rapidly progressive otosclerosis in both ears, you will probably be advised to have the procedure done immediately to prevent quick onset of total deafness. Usually only one ear is operated on at a time, so that if the operation fails. there is a possibility of a successful operation on the other ear. If the procedure was successful, the second ear may be operated on a year after the first one.

In a stapedectomy, a surgeon folds the eardrum out of the way, removes the diseased stirrup, and replaces it with a tiny metal substitute. The patient usually feels dizzy for a short time after the operation, but can leave the hospital after one or two days. The eardrum heals naturally in one to two weeks. In another two to three weeks, the patient can usually return to normal activities.

In some cases, there is no immediate improvement in hearing after a stapedectomy because a blood clot is left in the middle ear and blocks sound conduction. The clot usually disappears in time and hearing improves.