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Gastroenteritis

What is gastroenteritis?

Gastroenteritis is an inflammation of the lining of the stomach and intestines. The main symptoms include vomiting and diarrhea. It is usually not serious in healthy people, but it can sometimes lead to dehydration or cause severe symptoms.

What causes gastroenteritis?

There can be many different causes of gastroenteritis:

  • Viruses
  • Bacteria
  • Parasites
  • Chemicals
  • Reactions to certain medicines and food

Viral gastroenteritis is the most common type. It can be caused by many different viruses, including noroviruses and rotaviruses. Some people call viral gastroenteritis the "stomach flu." But this name is not medically correct. It is not caused by flu viruses. The flu is a respiratory infection that affects your nose, throat and lungs.

When gastroenteritis is caused by consuming foods or drinks contaminated with viruses, bacteria, parasites, or chemicals, this is called food poisoning.

The viruses, bacteria, and parasites that cause gastroenteritis can also spread from person to person. You could be infected when you touch something that has the germs on it and then touch your eyes, mouth, or nose.

What are the symptoms of gastroenteritis?

The symptoms of gastroenteritis include:

  • Diarrhea
  • Pain or cramping in your abdomen (belly)
  • Nausea
  • Vomiting
  • Sometimes fever

Gastroenteritis is usually not serious. But it can sometimes cause lead to dehydration or cause severe symptoms. Certain people are at higher risk for these problems. They include:

  • Pregnant women
  • Older adults
  • People with weakened immune systems or other serious health conditions
  • Infants
  • Babies who were born prematurely or have other health conditions

If you or a family member are at higher risk and have symptoms of gastroenteritis, contact a health care provider right away. Even if you are not at high risk, it is possible to become dehydrated or have more serious symptoms. There are some warning signs to watch for. It's important to contact a provider right away if you or your child have any of them:

  • For adults, they include:
    • Change in mental state, such as irritability or lack of energy
    • Diarrhea lasting more than 2 days
    • High fever
    • Vomiting often
    • Six or more loose stools in a day
    • Severe pain in the abdomen (belly) or rectum
    • Stools that are black and tarry or contain blood or pus
    • Symptoms of dehydration, such as thirst, dry mouth, headache, dark-colored urine, and urinating less than normal
  • For infants and children, they include:
    • Change in the child's mental state, such as irritability or lack of energy
    • Diarrhea lasting more than a day
    • Any fever in infants
    • High fever in older children
    • Frequent loose stools
    • Vomiting often
    • Severe pain in the abdomen (belly) or rectum
    • Signs or symptoms of dehydration, such as thirst, dry mouth, urinating less than usual or no wet diapers for 3 hours or more, and no tears when crying
    • Stools that are black and tarry or contain blood or pus
How is gastroenteritis diagnosed?

To find out if you have gastroenteritis, your provider:

  • Will do a physical exam
  • Will ask about your symptoms
  • May do tests of your stool
What are the treatments for gastroenteritis?

Usually, people with gastroenteritis get better on their own, with rest and plenty of fluids and electrolytes. Your provider may suggest that you take a probiotic. Studies suggest that some probiotics may help shorten a case of diarrhea.

People with more severe symptoms may need medicines to control nausea or vomiting. Providers may also give other medicines for certain types of gastroenteritis, such as antibiotics for some bacterial types and antiparasitic medicines for some parasitic types.

Can gastroenteritis be prevented?

Gastroenteritis cannot always be prevented. But proper hand washing, cleaning surfaces that may be infected with germs, and safe food preparation may help prevent some of the infections that can cause gastroenteritis. There are vaccines for infants to protect against rotavirus infections.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Gastrointestinal Bleeding

Your digestive or gastrointestinal (GI) tract includes the esophagus, stomach, small intestine, large intestine or colon, rectum, and anus. Bleeding can come from any of these areas. The amount of bleeding can be so small that only a lab test can find it.

Signs of bleeding in the digestive tract depend on where it is and how much bleeding there is.

Signs of bleeding in the upper digestive tract include:

  • Bright red blood in vomit
  • Vomit that looks like coffee grounds
  • Black or tarry stool
  • Dark blood mixed with stool

Signs of bleeding in the lower digestive tract include:

  • Black or tarry stool
  • Dark blood mixed with stool
  • Stool mixed or coated with bright red blood

GI bleeding is not a disease, but a symptom of a disease. There are many possible causes of GI bleeding, including hemorrhoids, peptic ulcers, tears or inflammation in the esophagus, diverticulosis and diverticulitis, ulcerative colitis and Crohn's disease, colonic polyps, or cancer in the colon, stomach or esophagus.

The test used most often to look for the cause of GI bleeding is called endoscopy. It uses a flexible instrument inserted through the mouth or rectum to view the inside of the GI tract. A type of endoscopy called colonoscopy looks at the large intestine.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

GERD

What is GERD?

Sometimes, after eating a large meal or lying down too soon after eating, you might feel acid coming up into your throat. This is called gastroesophageal reflux (GER). It happens when the muscle at the end of your esophagus (the tube that carries food from your mouth to your stomach) doesn't close properly. Stomach contents can then move back up and irritate the esophagus.

Having reflux occasionally is common. But if you have symptoms two or more times a week or if they cause damage to the lining of your esophagus, you may have gastroesophageal reflux disease (GERD). GERD is a chronic (long-lasting) condition that can cause discomfort and, over time, lead to other health problems.

Anyone can have GERD, including infants and children.

What causes GERD?

GERD can happen when the muscle at the bottom of your esophagus becomes weak or relaxes at the wrong time. You are more likely to have GERD if you:

  • Are overweight or have obesity
  • Are pregnant
  • Smoke or are around secondhand smoke
  • Have a hiatal hernia (when part of the stomach pushes up into the chest)

Certain foods, drinks, or medicines can also make GERD worse.

What are common symptoms of GERD?

The most common symptom of GERD is heartburn. This is a burning feeling in your chest or throat. You can also have GERD without having heartburn. Other symptoms may include:

  • Tasting acid or food in the back of your mouth
  • A dry cough or hoarse voice
  • Asthma-like symptoms
  • Trouble swallowing

Get medical help right away if you have chest pain with shortness of breath, or pain in your jaw or arm. These can be signs of a heart problem.

How is GERD diagnosed?

Your health care provider will ask about your symptoms and medical history. They may recommend tests such as:

  • Upper GI endoscopy to look at the esophagus and stomach lining with a tiny camera.
  • Biopsy to check a small tissue sample.
  • X-Ray to take pictures of the upper digestive system.
  • Esophageal pH test to measure how often acid backs up the esophagus and how long the acid stays there.
  • Esophageal manometry to check how well your esophagus moves food when you swallow.
  • Transnasal esophagoscopy to look for damage to the esophagus by using a small tube with a camera.
How is GERD treated?

Most people can manage GERD with lifestyle changes and medicine. In rare cases, surgery is needed.

Lifestyle changes can include:

  • Eating smaller meals and avoiding lying down for at least 2-3 hours after eating
  • Avoiding foods that trigger symptoms, such as spicy foods, chocolate, caffeine, or fatty foods
  • Losing weight if needed
  • Raising the head of your bed
  • Quitting smoking

Medicines can include:

  • Over-the-counter medicines, such as antacids
  • Prescription medicines

If not treated, GERD can cause problems like inflammation of the esophagus, scarring, or changes in the tissue lining (Barrett's esophagus). It can also worsen asthma or cause chronic (long-term) cough or hoarseness.

Can GERD be prevented?

You may be able to improve symptoms of GERD by:

  • Avoiding alcohol and trigger foods
  • Eating smaller meals
  • Not eating close to bedtime
  • Wearing loose-fitting clothes
  • Sleeping on your left side or raising the head of your bed
  • Maintaining a healthy weight

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Glaucoma

What is glaucoma?

Glaucoma is a group of diseases that can damage the optic nerve of one, or both, of your eyes. This can result in vision loss. There are different types of glaucoma, but the most common type is open-angle glaucoma. Other less common types include angle-closure glaucoma, and congenital glaucoma.

You may not have any symptoms of glaucoma. Regular eye exams by an eye care provider can check for glaucoma and other eye problems to help protect your vision. Treatments that lower eye pressure help slow the disease. Without treatment, glaucoma can eventually lead to blindness.

What causes glaucoma?

Medical experts aren't sure what causes glaucoma, but the most common types usually happen when the fluid pressure inside your eye slowly rises, damaging the optic nerve. Other types of glaucoma may be caused by medical conditions, or a baby may be born with it.

Not everyone with high eye pressure develops glaucoma. Some people may even get glaucoma with normal eye pressure. The amount of pressure your optic nerve can handle is different for each person. Getting regular dilated eye exams helps your provider figure out what level of eye pressure is normal for you.

What are the symptoms of glaucoma?

Often there are no symptoms of glaucoma at first. Or symptoms may start so slowly that you may not notice them. Without treatment, you slowly lose your peripheral (side) vision. It may seem like you're looking through a tunnel. Over time, your straight-ahead vision may decrease until no vision remains.

If you have sudden symptoms of intense eye pain, blurry vision, red eyes, or an upset stomach (nausea), you need to go to your eye care provider or an emergency room right away. These could be symptoms of angle-closure glaucoma. This less common type of glaucoma causes fluid to build up quickly in your eye.

How is glaucoma diagnosed?

A comprehensive eye exam can tell if you have glaucoma. This would include:

  • A dilated eye exam. This involves getting eye drops that dilate (widen) your pupils. This allows more light to enter your eye. Your eye care provider examines your eyes using a special magnifying lens. This provides a clear view of important tissues at the back of your eye to check for glaucoma or other eye problems. For a few hours after the exam your vision may be blurry and sensitive to light, so you will need someone to take you home.
  • Visual field testing. This check of your peripheral (side) vision allows your eye care provider to find out how well you can see objects off to the side of your vision without moving your eyes.
  • Tonometry. This measures the pressure inside your eye.

If you're at higher risk for glaucoma, you should get comprehensive eye exams every one to two years. You're at higher risk if you:

  • Are Black or African American and over age 40
  • Are over age 60, especially if you're Hispanic or Latino
  • Have a family history of glaucoma

You're also at higher risk if you have high blood pressure or diabetes and should get a dilated eye exam at least once a year. Talk with your provider about your risk and how often you should get your eyes checked.

What are the treatments for glaucoma?

Early treatment can help protect your eyes against vision loss. There is no cure, but glaucoma can usually be controlled. Without treatment it can eventually cause blindness. Treatments can include:

  • Prescription eye drops are the most common treatment to lower the pressure in your eye and prevent damage to your optic nerve.
  • Other treatments may include oral medicines, laser treatment, and/or surgery.

A combination of these treatments may be used to lower eye pressure and help drain the fluid out of your eye.

Can glaucoma be prevented?

There is no way to prevent glaucoma. Eye exams can help find glaucoma or other eye problems before they can affect your vision. If you have glaucoma, be sure to continue with treatment to prevent your vision from getting worse.

NIH: National Eye Institute

HDL: The "Good" Cholesterol

What is cholesterol?

Cholesterol is a waxy, fat-like substance that's found in all the cells in your body. Your liver makes cholesterol, and it is also in some foods, such as meat and dairy products. Your body needs some cholesterol to work properly. But having too much cholesterol in your blood raises your risk of coronary artery disease.

What are HDL and LDL?

HDL and LDL are two types of lipoproteins.They are a combination of fat (lipid) and protein. The lipids need to be attached to the proteins so they can move through the blood. HDL and LDL have different purposes:

  • HDL stands for high-density lipoproteins. It is sometimes called the "good" cholesterol because it carries cholesterol from other parts of your body back to your liver. Your liver then removes the cholesterol from your body.
  • LDL stands for low-density lipoproteins. It is sometimes called the "bad" cholesterol because a high LDL level leads to a buildup of cholesterol in your arteries.
How do I know what my HDL level is?

A blood test can measure your cholesterol levels, including HDL. When and how often you should get this test depends on your age, risk factors, and family history. The general recommendations are:

For people who are age 19 or younger::

  • The first test should be between ages 9 to 11
  • Children should have the test again every 5 years
  • Some children may have this test starting at age 2 if there is a family history of high blood cholesterol, heart attack, or stroke

For people who are age 20 or older::

  • Younger adults should have the test every 5 years
  • Men ages 45 to 65 and women ages 55 to 65 should have it every 1 to 2 years
What should my HDL level be?

With HDL cholesterol, higher numbers are better, because a high HDL level can lower your risk for coronary artery disease and stroke. How high your HDL should be depends on your age and sex:

GroupHealthy HDL LevelAge 19 or youngerMore than 45mg/dlMen age 20 or olderMore than 40mg/dlWomen age 20 or olderMore than 50mg/dlHow can I raise my HDL level?

If your HDL level is too low, lifestyle changes may help. These changes may also help prevent other diseases, and make you feel better overall:

  • Eat a healthy diet. To raise your HDL level, you need to eat good fats instead of bad fats. This means limiting saturated fats, which include full-fat milk and cheese, high-fat meats like sausage and bacon, and foods made with butter, lard, and shortening. You should also avoid trans fats, which may be in some margarines, fried foods, and processed foods like baked goods. Instead, eat unsaturated fats, which are found in avocado, vegetable oils like olive oil, and nuts. Limit carbohydrates, especially sugar. Also try to eat more foods naturally high in fiber, such as oatmeal and beans.
  • Stay at a healthy weight. You can boost your HDL level by losing weight, especially if you have lots of fat around your waist.
  • Exercise. Getting regular exercise can raise your HDL level, as well as lower your LDL. You should try to do 30 minutes of moderate to vigorous aerobic exercise on most, if not all, days.
  • Avoid cigarettes.Smoking and exposure to secondhand smoke can lower your HDL level. If you are a smoker, ask your health care provider for help in finding the best way for you to quit. You should also try to avoid secondhand smoke.
  • Limit alcohol. Moderate alcohol may lower your HDL level, although more studies are needed to confirm that. What we do know is that too much alcohol can make you gain weight, and that lowers your HDL level.

Some cholesterol medicines, including certain statins, can raise your HDL level, in addition to lowering your LDL level. Health care providers don't usually prescribe medicines only to raise HDL. But if you have a low HDL and high LDL level, you might need medicine.

What else can affect my HDL level?

Taking certain medicines can lower HDL levels in some people. They include:

  • Beta blockers, a type of blood pressure medicine
  • Anabolic steroids, including testosterone, a male hormone
  • Progestins, which are female hormones that are in some birth control pills and hormone replacement therapy
  • Benzodiazepines, sedatives that are often used for anxiety and insomnia

If you are taking one of these and you have a very low HDL level, ask your provider if you should continue to take them.

Diabetes can also lower your HDL level, so that gives you another reason to manage your diabetes.

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